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Szeged, Hungary

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Szeged, Hungary

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Robert M.,The French Public Health Agency | Juilliere Y.,University of Lorraine | Gabet A.,The French Public Health Agency | Kownator S.,Cardiology Center | Olie V.,The French Public Health Agency
International Journal of Cardiology | Year: 2017

Background Abdominal aortic aneurysms (AAA) are serious disease with a high fatality rate but recent epidemiologic data showed a decrease of AAA mortality. Our objective was to estimate, in France, the hospitalization, inhospital mortality and mortality rates due to AAA and to analyze their trends over time. Methods Hospitalization data were extracted from the hospital discharge summaries in the national database between 2002 and 2013. The analysis covered all patients hospitalized for AAA as a principal diagnosis. During the same period, all death certificates mentioning AAA as an initial cause of death were included in the study. Crude and standardized rates were calculated according to age and sex. Poisson regression was used to analyze the average annual percent change. Results In 2013, there were 8853 patients hospitalized for AAA in France (7986 unruptured and 867 ruptured). Between 2002 and 2013, the rate of patients hospitalized for unruptured AAA decreased slightly in men (− 5.0%) but increased in women (+ 5.2%). By contrast, the rate of patients hospitalized for ruptured AAA has decreased by > 20% in men and women. The proportion of endovascular treatment of unruptured AAA rose from < 10% in 2005 to 35% in women and 40% in men in 2013. In 2013, 939 deaths from AAA were recorded. Mortality for this disease declined significantly from 2002 to 2013 in men and women. Conclusion The unfavorable epidemiological trends in women and important evolution of the management of AAA call for an epidemiological surveillance of this disease. © 2017 Elsevier B.V.


News Article | May 8, 2017
Site: www.prnewswire.co.uk

Browse 138 tables and 76 figures, 25 Company profiles spread across 189 pages available at The global vascular stents market is projected to reach USD 17.68 billion by 2021 from USD 12.21 billion in 2016, at a CAGR of 7.7% from 2016 to 2021. Major factors contributing to the growth of the global vascular stents market include technological advancements, increasing number of angioplasty procedures, rising burden of vascular diseases, increasing demand for minimally invasive procedures, and rising geriatric population. However, the presence of alternative treatments for cardiovascular diseases, stringent regulations for product approvals, and numerous cases of product failure and recalls are the major factors that are expected to restrain the growth of this market during the forecast period of 2016 to 2021. Various companies are focusing on R&D activities to improve their vascular stent offerings. Companies like Abbott Laboratories and Boston Scientific are focusing on the development of biodegradable stents to offer effective products that overcome the complications caused by thrombosis [resulting from long-term device implantation]. For instance, in May 2014, Boston Scientific (U.S.) launched the Promus PREMIER Everolimus-eluting Platinum Chromium Coronary Stent System in Japan. Currently, the vascular stents market is witnessing a new phase of technology development with the launch of fully dissolving stents. In July 2016, Abbott Laboratories (U.S.) received the U.S. FDA approval to commercially launch its Absorb bioresorbable heart stent. Absorb is the fully dissolving stent approved for the treatment of CAD. Furthermore, a number of bioabsorbable stents for treating PAD are in clinical trials. Some of these products include 480 Biomedical's Stanza bioresorbable self-expanding scaffold [which is currently under SPIRIT trial and will be used to treat PAD for superficial femoral artery (SFA)] and the Esprit bioresorbable vascular scaffold (BVS) from Abbott Vascular [will be used in the treatment of PAD for SFA and iliac lesions]. On the basis of product, the vascular stent market is segmented into coronary stents, peripheral stents, and EVAR stent grafts. Peripheral stents are further segmented into carotid stents, renal artery stents, femoral stents, iliac stents, and other peripheral stents. EVAR stent grafts are further segmented into abdominal aortic aneurysm and thoracic aortic aneurysm. The coronary stents segment accounted for the largest share of the vascular stent market in 2016. The large share of this segment can primarily be attributed to the rising incidence of coronary artery disease and technological advancements in coronary stents. On the basis of type, the market is segmented into bare-metal stents, drug-eluting stents, and bio absorbable stents. The drug-eluting stents segment accounted for the largest share in 2016 primarily due to the advantages these stents offer over bare-metal stents, including lower risk of restenosis and other related complications. On the basis of mode of delivery, the vascular stent market is segmented into balloon-expandable stents and self-expanding stents. The balloon-expandable stents segment is estimated to register the highest growth during the forecast period due to the growing regulatory approvals for balloon-expandable stents and the increasing number of research activities focusing on improving the balloon-expandable stent technology. On the basis of material, the market is segmented into metallic stents (cobalt chromium, platinum chromium, nickel titanium, and stainless steel) and other stents. The other stents segment is projected to grow at the highest CAGR during the forecast period. The high growth in this segment is attributed to the growing utilization of polymers and copolymers for the development of bio absorbable stents. On the basis of end user, the market is segmented into hospitals & cardiac centers and ambulatory surgical centers. The hospitals & cardiac centers segment dominated this market in 2016 as the majority of patients opt to undergo angioplasty procedures in hospitals, owing to which the demand for vascular stents is higher in this end-user segment. The Asian market is estimated to register the highest growth during the forecast period. The high-growth in this regional segment can be attributed to the presence of a large population base, growing prevalence of vascular diseases, rising adoption of advanced technologies, and low manufacturing costs for medical devices in emerging Asian countries. Order a copy of Vascular Stent Market by Type (BMS, BVS, Drug Eluting), Product (Coronary, Peripheral, Carotid, Femoral, Aortic Aneurysm), Material [Metal (Stainless Steel, PtCr, Nitinol), Polymer], End User (Hospital, Cardiology Center, ASC)- Global Forecast to 2021 Research Report at Explore more reports on Medical Devices market Research at ReportsnReports.com is an online market research reports library of 500,000+ in-depth studies of over 5000 micro markets. Not limited to any one industry, ReportsnReports.com offers research studies on agriculture, energy and power, chemicals, environment, medical devices, healthcare, food and beverages, water, advanced materials and much more.


News Article | May 8, 2017
Site: www.prnewswire.com

Browse 138 tables and 76 figures, 25 Company profiles spread across 189 pages available at The global vascular stents market is projected to reach USD 17.68 billion by 2021 from USD 12.21 billion in 2016, at a CAGR of 7.7% from 2016 to 2021. Major factors contributing to the growth of the global vascular stents market include technological advancements, increasing number of angioplasty procedures, rising burden of vascular diseases, increasing demand for minimally invasive procedures, and rising geriatric population. However, the presence of alternative treatments for cardiovascular diseases, stringent regulations for product approvals, and numerous cases of product failure and recalls are the major factors that are expected to restrain the growth of this market during the forecast period of 2016 to 2021. Various companies are focusing on R&D activities to improve their vascular stent offerings. Companies like Abbott Laboratories and Boston Scientific are focusing on the development of biodegradable stents to offer effective products that overcome the complications caused by thrombosis [resulting from long-term device implantation]. For instance, in May 2014, Boston Scientific (U.S.) launched the Promus PREMIER Everolimus-eluting Platinum Chromium Coronary Stent System in Japan. Currently, the vascular stents market is witnessing a new phase of technology development with the launch of fully dissolving stents. In July 2016, Abbott Laboratories (U.S.) received the U.S. FDA approval to commercially launch its Absorb bioresorbable heart stent. Absorb is the fully dissolving stent approved for the treatment of CAD. Furthermore, a number of bioabsorbable stents for treating PAD are in clinical trials. Some of these products include 480 Biomedical's Stanza bioresorbable self-expanding scaffold [which is currently under SPIRIT trial and will be used to treat PAD for superficial femoral artery (SFA)] and the Esprit bioresorbable vascular scaffold (BVS) from Abbott Vascular [will be used in the treatment of PAD for SFA and iliac lesions]. On the basis of product, the vascular stent market is segmented into coronary stents, peripheral stents, and EVAR stent grafts. Peripheral stents are further segmented into carotid stents, renal artery stents, femoral stents, iliac stents, and other peripheral stents. EVAR stent grafts are further segmented into abdominal aortic aneurysm and thoracic aortic aneurysm. The coronary stents segment accounted for the largest share of the vascular stent market in 2016. The large share of this segment can primarily be attributed to the rising incidence of coronary artery disease and technological advancements in coronary stents. On the basis of type, the market is segmented into bare-metal stents, drug-eluting stents, and bio absorbable stents. The drug-eluting stents segment accounted for the largest share in 2016 primarily due to the advantages these stents offer over bare-metal stents, including lower risk of restenosis and other related complications. On the basis of mode of delivery, the vascular stent market is segmented into balloon-expandable stents and self-expanding stents. The balloon-expandable stents segment is estimated to register the highest growth during the forecast period due to the growing regulatory approvals for balloon-expandable stents and the increasing number of research activities focusing on improving the balloon-expandable stent technology. On the basis of material, the market is segmented into metallic stents (cobalt chromium, platinum chromium, nickel titanium, and stainless steel) and other stents. The other stents segment is projected to grow at the highest CAGR during the forecast period. The high growth in this segment is attributed to the growing utilization of polymers and copolymers for the development of bio absorbable stents. On the basis of end user, the market is segmented into hospitals & cardiac centers and ambulatory surgical centers. The hospitals & cardiac centers segment dominated this market in 2016 as the majority of patients opt to undergo angioplasty procedures in hospitals, owing to which the demand for vascular stents is higher in this end-user segment. The Asian market is estimated to register the highest growth during the forecast period. The high-growth in this regional segment can be attributed to the presence of a large population base, growing prevalence of vascular diseases, rising adoption of advanced technologies, and low manufacturing costs for medical devices in emerging Asian countries. Order a copy of Vascular Stent Market by Type (BMS, BVS, Drug Eluting), Product (Coronary, Peripheral, Carotid, Femoral, Aortic Aneurysm), Material [Metal (Stainless Steel, PtCr, Nitinol), Polymer], End User (Hospital, Cardiology Center, ASC)- Global Forecast to 2021 Research Report at Explore more reports on Medical Devices market Research at ReportsnReports.com is an online market research reports library of 500,000+ in-depth studies of over 5000 micro markets. Not limited to any one industry, ReportsnReports.com offers research studies on agriculture, energy and power, chemicals, environment, medical devices, healthcare, food and beverages, water, advanced materials and much more.


Jaguszewski M.,University of Zürich | Radovanovic D.,University of Zürich | Nallamothu B.K.,University of Michigan | Luscher T.F.,University of Zürich | And 6 more authors.
EuroIntervention | Year: 2013

Aims: We examined what type of STEMI patients are more likely to undergo multivessel PCI (MPCI) in a "real-world" setting and whether MPCI leads to worse or better outcomes compared with single-vessel PCI (SPCI) after stratifying patients by risk. Methods and results: Among STEMI patients enrolled in the Swiss AMIS Plus registry between 2005 and 2012 (n=12,000), 4,941 were identified with multivessel disease. We then stratified patients based on MPCI use and their risk. High-risk patients were identified a priori as those with: 1) left main (LM) involvement (lesions, n=263); 2) out-of-hospital cardiac arrest; or 3) Killip class III/IV. Logistic regression models examined for predictors of MPCI use and the association between MPCI and in-hospital mortality. Three thousand eight hundred and thirty-three (77.6%) patients underwent SPCI and 1,108 (22.4%) underwent MPCI. Rates of MPCI were greater among high-risk patients for each of the three categories: 8.6% vs. 5.9% for out-of-hospital cardiac arrest (p<0.01); 12.3% vs. 6.2% for Killip III/IV (p<0.001); and 14.5% vs. 2.7% for LM involvement (p<0.001). Overall, in-hospital mortality after MPCI was higher when compared with SPCI (7.3% vs. 4.4%; p<0.001). However, this result was not present when patients were stratified by risk: in-hospital mortality for MPCI vs. SPCI was 2.0% vs. 2.0% (p=1.00) in low-risk patients and 22.2% vs. 21.7% (p=1.00) in high-risk patients. Conclusions: High-risk patients are more likely to undergo MPCI. Furthermore, MPCI does not appear to be associated with higher mortality after stratifying patients based on their risk. © Europa Digital & Publishing 2013.


Radovanovic D.,University of Zürich | Seifert B.,University of Zürich | Eberli F.R.,Stadtspital Triemli | Rickli H.,Kantonsspital St. Gallen | And 3 more authors.
Heart | Year: 2014

Objective This study aimed to assess the impact of individual comorbid conditions as well as the weight assignment, predictive properties and discriminating power of the Charlson Comorbidity Index (CCI) on outcome in patients with acute coronary syndrome (ACS). Methods A prospective multicentre observational study (AMIS Plus Registry) from 69 Swiss hospitals with 29 620 ACS patients enrolled from 2002 to 2012. The main outcome measures were in-hospital and 1-year follow-up mortality. Results Of the patients, 27% were female (age 72.1 ±12.6 years) and 73% were male (64.2±12.9 years). 46.8% had comorbidities and they were less likely to receive guideline-recommended drug therapy and reperfusion. Heart failure (adjusted OR 1.88; 95% CI 1.57 to 2.25), metastatic tumours (OR 2.25; 95% CI 1.60 to 3.19), renal diseases (OR 1.84; 95% CI 1.60 to 2.11) and diabetes (OR 1.35; 95% CI 1.19 to 1.54) were strong predictors of in-hospital mortality. In this population, CCI weighted the history of prior myocardial infarction higher (1 instead of -0.4, 95% CI -1.2 to 0.3 points) but heart failure (1 instead of 3.7, 95% CI 2.6 to 4.7) and renal disease (2 instead of 3.5, 95% CI 2.7 to 4.4) lower than the benchmark, where all comorbidities, age and gender were used as predictors. However, the model with CCI and age has an identical discrimination to this benchmark (areas under the receiver operating characteristic curves were both 0.76). Conclusions Comorbidities greatly influenced clinical presentation, therapies received and the outcome of patients admitted with ACS. Heart failure, diabetes, renal disease or metastatic tumours had a major impact on mortality. CCI seems to be an appropriate prognostic indicator for in-hospital and 1-year outcomes in ACS patients. ClinicalTrials.gov Identifier NCT01305785.


Erne P.,AMIS Plus | Erne P.,University of Zürich | Bertel O.,Cardiology Center | Urban P.,La Tour Hospital | And 3 more authors.
European Journal of Internal Medicine | Year: 2015

Abstract Background There are few studies on patients suffering acute myocardial infarction (AMI) when already in hospital for other reasons; therefore, this study aimed to compare patients with in-hospital-onset AMI admitted for either medical or surgical reasons versus patients with outpatient-onset AMI. Methods Patients enrolled in the AMIS Plus registry from 2002 to 2014 were analyzed. The main endpoint was in-hospital mortality. Results Among 35,394 AMI patients, 356 (1%) had inpatient-onset AMI following hospital admission due to other pathologies (surgical 175, non-surgical 181). These patients were older (74 vs. 66 years; P < 0.001), more often female (35% vs. 27%; P < 0.001), had less frequently ST-elevation myocardial infarction (35.5% vs. 55.5%; P < 0.001), but higher risk profiles: hypertension (83% vs. 62%; P < 0.001), diabetes (28% vs. 20%; P = 0.001), known coronary artery disease (54% vs. 35%; P < 0.001), and more comorbidities (Charlson Comorbidity Index above 1 in 51% vs. 22%; P < 0.001) than those with outpatient-onset AMI. Percutaneous coronary intervention was less frequently applied (OR 0.45; 95% CI 0.36-0.57), and they were less likely to be treated with aspirin (OR 0.43; 95% CI 0.37-0.59), P2Y12 blockers (OR 0.42; 0.34-0.52) or statins (OR 0.51; 95% CI 0.41-0.63). Crude mortality was higher (14.3% vs. 5.5%; P < 0.001) and inpatient-onset AMI was an independent predictor of in-hospital mortality (OR 2.35; 95% CI 1.63-3.39; P < 0.001). Conclusions Patients with in-hospital-onset AMI were at greater risk of death than those with outpatient-onset AMI. More work is needed to improve the identification of hospitalized patients at risk of AMI in order to provide the appropriate management. © 2015 European Federation of Internal Medicine.


Alho I.,Cardiology Center | Alho I.,Institute Medicina Molecular | Costa L.,Institute Medicina Molecular | Costa L.,Hospital Of Santa Maria | And 2 more authors.
PLoS ONE | Year: 2013

Low molecular weight protein tyrosine phosphatase (LMW-PTP) has been associated with cell proliferation control through dephosphorylation and inactivation of growth factor receptors such as PDGF-R and EphA2, and with cellular adhesion and migration through p190RhoGap and RhoA. We aim to clarify the role of two main LMW-PTP isoforms in breast cancer tumorigenesis. We used a siRNA-mediated loss-of-function in MDA-MB-435 breast cancer cell line to study the role of the two main LMW-PTP isoforms, fast and slow, in breast cancer tumorigenesis and migration. Our results show that the siRNAs directed against total LMW-PTP and LMW-PTP slow isoform enhanced cell motility in an invasive breast cancer cell line, MDA-MB-435, with no changes in the proliferation and invasive potential of cells. The total LMW-PTP knockdown caused a more pronounced increase of cell migration. Suppression of total LMW-PTP decreased RhoA activation and suppression of the LMW-PTP slow isoform caused a small but significant increase in RhoA activation. We propose that the increase or decrease in RhoA activation induces changes in stress fibers formation and consequently alter the adhesive and migratory potential of cells. These findings suggest that the two main isoforms of LMW-PTP may act differentially, with the fast isoform having a more prominent role in tumor cell migration. In addition, our results highlight functional specificity among LMW-PTP isoforms, suggesting hitherto unknown roles for these proteins in breast cancer biology. Novel therapeutic approaches targeting LMW-PTP, considering the expression of these two isoforms and not LMW-PTP as a whole, should be investigated. © 2013 Alho et al.


Alho I.,Cardiology Center | Alho I.,Institute Medicina Molecular | Costa L.,Institute Medicina Molecular | Costa L.,Hospital Of Santa Maria | And 2 more authors.
Tumor Biology | Year: 2013

Protein tyrosine phosphorylation is a crucial cellular event that is involved in the most important processes of cellular metabolism. Low-molecular-weight protein tyrosine phosphatase (LMW-PTP) is a tyrosine phosphatase that presents two active distinct isoforms and is regulated through cysteine oxidation and tyrosine phosphorylation. This enzyme has been linked to tumorigenesis, but its role is considered controversial: it may be considered oncogenic or anti-oncogenic depending on its interaction with different substrates. Furthermore, recent studies have demonstrated that LMW-PTP is involved in epithelial cell migration, a characteristic of tumor cells. This fact strengthens the importance of this enzyme in the oncogenic process and opens new avenues for future research. The study of LMW-PTP and its pathways may enhance therapeutic strategies that target tyrosine phosphorylation and its substrates. In this review, we try to clarify the importance of this protein in carcinogenesis through the analysis of LMW-PTP interaction with different substrates. © 2013 International Society of Oncology and BioMarkers (ISOBM).


Erne P.,University of Zürich | Erne P.,Cardiovasc Schweiz AG | Radovanovic D.,University of Zürich | Schoenenberger A.W.,University of Bern | And 4 more authors.
Journal of Hypertension | Year: 2015

Objective: The role of hypertension and its impact on outcome in patients with acute coronary syndrome (ACS) is still debated. This study aimed to compare the outcomes of hypertensive and nonhypertensive ACS patients. Methods: Using data of ACS patients enrolled in the Acute Myocardial Infarction in Switzerland Plus Registry from 1997 to 2013, characteristics at presentation and outcomes in hospital and after 1 year were analyzed. Hypertension was defined as previously diagnosed and treated by a physician. The primary endpoint was mortality. Data were analyzed using multiple logistic regressions. Results: Among 41 771 ACS patients, 16 855 (40.4%) were without and 24 916 (59.6%) with preexisting hypertension. Patients with preexisting hypertension had a more favorable in-hospital outcome [odds ratio (OR) inhospital mortality 0.82, 95% confidence interval (CI) 0.73-0.93; P=0.022]. The independent predictors of inhospital mortality for patients with preexisting hypertension were age, Killip class greater than 2, Charlson Comorbidity Index greater than 1, no pretreatment with statins and lower admission systemic blood pressure. Preexisting hypertension was not an independent predictor of 1-year mortality in the subgroup of patients (n=7801) followed: OR 1.07, 95% CI 0.78-1.47; P=0.68. Independent predictors of mortality 1 year after discharge for the 4796 patients with preexisting hypertension were age, male sex and comorbidities. Angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists and statins prescribed at discharge improved the outcomes. Conclusion: Outcome of ACS patients with preexisting hypertension was associated with an improved in-hospital prognosis after adjustment for their higher baseline risk. However, this effect was not long-lasting and does not necessarily mean a causal relationship exists. Short-term and long-term management of patients with hypertension admitted with ACS could be further improved. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.


PubMed | Hospital Of Santa Cruz, Azienda Ospedaliera Ordine Mauriziano, Interventional Cardiology, Policlinico S. Marco and 11 more.
Type: Comparative Study | Journal: JACC. Cardiovascular interventions | Year: 2016

This study sought to investigate the ischemic and bleeding outcomes of patients fulfilling high bleeding risk (HBR) criteria who were randomized to zotarolimus-eluting Endeavor Sprint stent (E-ZES) or bare-metal stent (BMS) implantation followed by an abbreviated dual antiplatelet therapy (DAPT) duration for stable or unstable coronary artery disease.DES instead of BMS use remains controversial in HBR patients, in whom long-term DAPT poses safety concerns.The ZEUS (Zotarolimus-Eluting Endeavor Sprint Stent in Uncertain DES Candidates) is a multinational, randomized single-blinded trial that randomized among others, in a stratified manner, 828 patients fulfilling pre-defined clinical or biochemical HBR criteria-including advanced age, indication to oral anticoagulants or other pro-hemorrhagic medications, history of bleeding and known anemia-to receive E-ZES or BMS followed by a protocol-mandated 30-day DAPT regimen. The primary endpoint of the study was the 12-month major adverse cardiovascular event rate, consisting of death, myocardial infarction, or target vessel revascularization.Compared with patients without, those with 1 or more HBR criteria had worse outcomes, owing to higher ischemic and bleeding risks. Among HBR patients, major adverse cardiovascular events occurred in 22.6% of the E-ZES and 29% of the BMS patients (hazard ratio: 0.75; 95% confidence interval: 0.57 to 0.98; p = 0.033), driven by lower myocardial infarction (3.5% vs. 10.4%; p < 0.001) and target vessel revascularization (5.9% vs. 11.4%; p = 0.005) rates in the E-ZES arm. The composite of definite or probable stent thrombosis was significantly reduced in E-ZES recipients, whereas bleeding events did not differ between stent groups.Among HBR patients with stable or unstable coronary artery disease, E-ZES implantation provides superior efficacy and safety as compared with conventional BMS. (Zotarolimus-Eluting Endeavor Sprint Stent in Uncertain DES Candidates [ZEUS]; NCT01385319).

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