Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

Phase II Trial of Oxaliplatin and Capecitabine After Progression to First-Line Chemotherapy in Androgen-Independent Prostate Cancer Patients

[EN] Introduction: Docetaxel plus prednisone is the current standard of care in first-line chemotherapy for metastatic hormone-refractory prostate cancer. However, there is no agent proven as effective after progression to standard docetaxel-based therapy. Platins and capecitabine have shown activity in this setting. Patients and Methods: A total of 14 patients were included in this prospective, single-center trial. All patients had progressed to first-line docetaxel-based treatment. Patients received oxaliplatin 100 mg/sqm on D1 and capecitabine 1000 mg/sqm/bid on days 1 to 14 every 21 days. Results: Median number of cycles was 3. No unexpected toxicity was observed. Only grade 3 toxicity reported was grade 3 anemia. Of the 14 patients, 3 presented grade 2 neuropathy which was spontaneously resolved. Prostate-specific antigenresponse rate was 57%, with a median time to progression of 14.5 weeks, and overall survival of 24 weeks. Conclusions: In the second-line setting, after receiving docetaxel-based chemotherapy, the combination of oxaliplatin and capecitabine offers promising activity with an excellent safety profile.Gasent Blesa, JM.; Giner Marco, V.; Giner-Bosch, V.; Cerezuela Fuentes, P.; Alberola Candel, V. (2011). Phase II Trial of Oxaliplatin and Capecitabine After Progression to First-Line Chemotherapy in Androgen-Independent Prostate Cancer Patients. American Journal of Clinical Oncology. 34(2):1-5. https://doi.org/10.1097/COC.0b013e3181d6b453S1534

A phase III randomized study comparing two different dose-intensity regimens as neoadjuvant chemotherapy followed by thoracic irradiation in patients with advanced locoregional non-small cell lung cancer

39th ASCO, Chicago, USA 31/05-03/06/2003info:eu-repo/semantics/publishe

Resectability after two different dose-intensity chemotherapy regimens: analysis of a randomised trial in initialy unresectable stage III non small cell lung cancer

39th ASCO, Chicago, USA 31/05-03/06/2003for the European Lung Cancer Working Partyinfo:eu-repo/semantics/publishe

ADRB2 Gly16Arg polymorphism, asthma control and lung function decline.

Arg/Arg homozygous for the Gly16Arg polymorphism in ADRB2 have a reduced response to short acting β2-agonists but no effect has been associated with long-acting β2-agonists (LABA). We selected 604 subjects from the European Community Respiratory Health Study with current asthma to evaluate if asthma control and lung function decline were associated with Gly16Arg polymorphism and test if LABA or inhaled corticosteroids (ICS) use modified these effects. There was an increased risk of non-controlled asthma OR=1.33 (1.01-1.75, p=0.046) for each Arg allele. Among nonusers of ICS, the risk of non-controlled asthma among Arg/Arg vs. Gly/Gly subjects was OR=2.73 (1.28-5.82, p=0.009). No increased risk of non-controlled asthma associated to the Arg allele was observed among ICS and/or LABA users. For each Arg allele a decrease of 7.7 mL·year(-1) (SE 2.5) in FEV1 decline was found (p-trend=0.003), irrespective of ICS or LABA use. Arg/Arg subjects vs. Gly/Gly subjects had an increased risk of bronchial hyperresponsiveness with an OR of 2.51 (1.12-5.63, p=0.025) if they did not use ICS. The Arg allele was associated with poorer asthma control, a steeper lung function decline and bronchial hyperresponsiveness. Absence of genotypic effects on asthma control among ICS users may be due to reversed ADRB2 desensitization

ADRB2 Gly16Arg polymorphism, asthma control and lung function decline

Arg/Arg homozygous for the Gly16Arg polymorphism in ADRB2 have a reduced response to short acting \u3b22-agonists but no effect has been associated with long-acting \u3b22-agonists (LABA). We selected 604 subjects from the European Community Respiratory Health Study with current asthma to evaluate if asthma control and lung function decline were associated with Gly16Arg polymorphism and test if LABA or inhaled corticosteroids (ICS) use modified these effects. There was an increased risk of non-controlled asthma OR=1.33 (1.01-1.75, p=0.046) for each Arg allele. Among nonusers of ICS, the risk of non-controlled asthma among Arg/Arg vs. Gly/Gly subjects was OR=2.73 (1.28-5.82, p=0.009). No increased risk of non-controlled asthma associated to the Arg allele was observed among ICS and/or LABA users. For each Arg allele a decrease of 7.7\u2005mL\ub7year(-1) (SE 2.5) in FEV1 decline was found (p-trend=0.003), irrespective of ICS or LABA use. Arg/Arg subjects vs. Gly/Gly subjects had an increased risk of bronchial hyperresponsiveness with an OR of 2.51 (1.12-5.63, p=0.025) if they did not use ICS. The Arg allele was associated with poorer asthma control, a steeper lung function decline and bronchial hyperresponsiveness. Absence of genotypic effects on asthma control among ICS users may be due to reversed ADRB2 desensitization

ADRB2 Gly16Arg polymorphism, asthma control and lung function decline

Arg/Arg homozygotes for the Gly16Arg polymorphism in the beta(2)-adrenoreceptor gene (ADRB2) have a reduced response to short-acting beta(2)-agonists but no effect has been associated with long-acting beta(2)-agonists (LABAs). We selected 604 subjects with current asthma from the European Community Respiratory Health Study to evaluate whether asthma control and lung function decline were associated with Gly16Arg polymorphism, and to test whether LABA or inhaled corticosteroid (ICS) use modified these effects. There was an increased risk of noncontrolled asthma (OR 1.33, 95% CI 1.01-1.75; p=0.046) for each Arg allele. Among nonusers of ICS, the odds ratio of noncontrolled asthma among Arg/Arg versus Gly/Gly subjects was 2.73 (95% CI 1.28-5.82; p=0.009). No increased risk of noncontrolled asthma associated with the Arg allele was observed among ICS and/or LABA users. For each Arg allele, a mean+/-SE decrease in decline in forced expiratory volume in 1 s of 7.7+/-2.5 mL.yr(-1) was found (p-value for trend 0.003), irrespective of ICS or LABA use. Arg/Arg subjects had an increased risk of bronchial hyperresponsiveness (BHR) versus Gly/Gly subjects, with an odds ratio of 2.51 (95% CI 1.12-5.63; p=0.025) if they did not use ICS. The Arg allele was associated with poorer asthma control, a steeper lung function decline and BHR. Absence of genotypic effects on asthma control among ICS users may be due to reversed beta(2)-adrenoreceptor desensitisation

ADRB2 Gly16Arg polymorphism, asthma control and lung function decline.

Arg/Arg homozygous for the Gly16Arg polymorphism in ADRB2 have a reduced response to short acting β2-agonists but no effect has been associated with long-acting β2-agonists (LABA). We selected 604 subjects from the European Community Respiratory Health Study with current asthma to evaluate if asthma control and lung function decline were associated with Gly16Arg polymorphism and test if LABA or inhaled corticosteroids (ICS) use modified these effects. There was an increased risk of non-controlled asthma OR=1.33 (1.01-1.75, p=0.046) for each Arg allele. Among nonusers of ICS, the risk of non-controlled asthma among Arg/Arg vs. Gly/Gly subjects was OR=2.73 (1.28-5.82, p=0.009). No increased risk of non-controlled asthma associated to the Arg allele was observed among ICS and/or LABA users. For each Arg allele a decrease of 7.7 mL·year(-1) (SE 2.5) in FEV1 decline was found (p-trend=0.003), irrespective of ICS or LABA use. Arg/Arg subjects vs. Gly/Gly subjects had an increased risk of bronchial hyperresponsiveness with an OR of 2.51 (1.12-5.63, p=0.025) if they did not use ICS. The Arg allele was associated with poorer asthma control, a steeper lung function decline and bronchial hyperresponsiveness. Absence of genotypic effects on asthma control among ICS users may be due to reversed ADRB2 desensitization