Browsing by Author "Maggioni, A"
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- Ablation Strategies for Different Types of Atrial Fibrillation in Europe: Results of the ESC-EORP EHRA Atrial Fibrillation Ablation Long-Term RegistryPublication . Schmidt, B; Brugada, J; Arbelo, E; Laroche, C; Bayramova, S; Bertini, M; Letsas, K; Pison, L; Romanov, A; Scherr, D; Tilz, R; Maggioni, A; Adragao, P; Lund, J; Haman, L; Oliveira, MM; Dagres, NAims: The ESC EORP EHRA Atrial Fibrillation (AF) Ablation Long-Term registry was designed to assess management and outcomes of AF catheter ablation procedures in Europe. To investigate the current ablation approaches and their outcomes for patients with paroxymal AF (PAF) and non-PAF in Europe. Methods and results: Data from index ablations were collected in 27 European countries at 104 centres in a prospective fashion. Pre-procedural, procedural, and 1-year follow-up data were captured on a web-based electronic case record form. Data on the ablation procedure were available for 3446 patients. Of these, 2513 patients and 933 patients underwent pulmonary vein isolation (PVI) or PVI plus (PVIplus) additional ablation, respectively. The ablation strategy was limited to PVI in 81% and 56% of patients in the PAF and non-PAF group, respectively (P < 0.001). In the non-PAF group, left atrial linear ablation and ablation of complex fragmented atrial electrograms were more commonly performed. Arrhythmias recurrence after PVI was 29% and 39% in the PAF and non-PAF group, respectively (P < 0.001) and 42% after PVIplus in both groups. Atrial fibrillation related hospital admissions were more common in the PVIplus group (20% vs. 14%). A very low procedural complication rate was observed. No relevant differences were observed with regard to repeat ablation (PVI 9% and PVIplus 11%). Conclusion: In patients with PAF and non-PAF, the ablation strategies of PVI and PVIplus led to similar arrhythmia-free survival rates after 1 year. A considerable hospital readmission rate was noted.
- Adherence to the “Atrial Fibrillation Better Care” (ABC) Pathway in Patients with Atrial Fibrillation and Cancer: a Report From the ESC-EHRA EURObservational Research Programme in Atrial Fibrillation (EORP-AF) General Long-Term RegistryPublication . Vitolo, M; Proietti, M; Malavasi, V; Bonini, N; Romiti, G; Imberti, J; Fauchier, L; Marin, F; Nabauer, M; Potpara, T; Dan, GA; Kalarus, Z; Maggioni, A; Lane, D; Lip, G; Boriani, G; Boriani Chair, G; Lip, G; Tavazzi, L; Maggioni, A; Dan, G; Potpara, T; Nabauer, M; Marin, F; Kalarus, Z; Fauchier, L; Goda, A; Mairesse, G; Shalganov, T; Antoniades, L; Taborsky, M; Riahi, S; Muda, P; Bolao, I; Piot, O; Nabauer, M; Etsadashvili, K; Simantirakis, E; Haim, M; Azhari, A; Najafian, J; Santini, M; Mirrakhimov, E; Kulzida, K; Erglis, A; Poposka, L; Burg, M; Crijns, H; Erküner, Ö; Atar, D; Lenarczyk, R; Oliveira, M; Shah, D; Serdechnaya, E; Dan, G; Potpara, T; Diker, E; Lip, G; Lane, DBackground: Implementation of the Atrial fibrillation Better Care (ABC) pathway is recommended by guidelines on atrial fibrillation (AF), but the impact of adherence to ABC pathway in patients with cancer is unknown. Objectives: To investigate the adherence to ABC pathway and its impact on adverse outcomes in AF patients with cancer. Methods: Patients enrolled in the EORP-AF General Long-Term Registry were analyzed according to (i) No Cancer; and (ii) Prior or active cancer and stratified in relation to adherence to the ABC pathway. The composite Net Clinical Outcome (NCO) of all-cause death, major adverse cardiovascular events and major bleeding was the primary endpoint. Results: Among 6550 patients (median age 69 years, females 40.1%), 6005 (91.7%) had no cancer, while 545 (8.3%) had a diagnosis of active or prior cancer at baseline, with the proportions of full adherence to ABC pathway of 30.6% and 25.7%, respectively. Adherence to the ABC pathway was associated with a significantly lower occurrence of the primary outcome vs. non-adherence, both in 'no cancer' and 'cancer' patients [adjusted Hazard Ratio (aHR) 0.78, 95% confidence interval (CI): 0.66-0.92 and aHR 0.59, 95% CI 0.37-0.96, respectively]. Adherence to a higher number of ABC criteria was associated with a lower risk of the primary outcome, being lowest when 3 ABC criteria were fulfilled (no cancer: aHR 0.54, 95%CI: 0.36-0.81; with cancer: aHR 0.32, 95% CI 0.13-0.78). Conclusion: In AF patients with cancer enrolled in the EORP-AF General Long-Term Registry, adherence to ABC pathway was sub-optimal. Full adherence to ABC-pathway was associated with a lower risk of adverse events.
- Lifestyle and Impact on Cardiovascular Risk Factor Control in Coronary Patients Across 27 Countries: Results From the European Society of Cardiology ESC-EORP EUROASPIRE V RegistryPublication . Kotseva, K; De Backer, G; De Bacquer, D; Rydén, L; Hoes, A; Grobbee, D; Maggioni, A; Marques-Vidal, P; Jennings, C; Abreu, A; Aguiar, C; Badariene, J; Bruthans, J; Castro Conde, A; Cifkova, R; Crowley, J; Davletov, K; Deckers, J; De Smedt, D; De Sutter, J; Dilic, M; Dolzhenko, M; Dzerve, V; Erglis, A; Fras, Z; Gaita, D; Gotcheva, N; Heuschmann, P; Hasan-Ali, H; Jankowski, P; Lalic, N; Lehto, S; Lovic, D; Mancas, S; Mellbin, L; Milicic, D; Mirrakhimov, E; Oganov, R; Pogosova, N; Reiner, Z; Stöerk, S; Tokgözoğlu, L; Tsioufis, C; Vulic, D; Wood, DAims: The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design: A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods: Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results: A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion: A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.