• Je něco špatně v tomto záznamu ?

Arrhythmia monitoring and outcome after myocardial infarction (BIO|GUARD-MI): a randomized trial

C. Jøns, PE. Bloch Thomsen, S. Riahi, T. Smilde, U. Bach, PK. Jacobsen, M. Táborský, J. Faluközy, M. Wiemer, PD. Christensen, A. Kónyi, D. Schelfaut, A. Bulava, M. Grabowski, B. Merkely, D. Nuyens, R. Mahajan, P. Nagel, R. Tilz, J. Malczynski, C....

. 2024 ; 11 (-) : 1300074. [pub] 20240513

Status neindexováno Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc24012798

OBJECTIVES: Cardiac arrhythmias predict poor outcome after myocardial infarction (MI). We studied if arrhythmia monitoring with an insertable cardiac monitor (ICM) can improve treatment and outcome. DESIGN: BIO|GUARD-MI was a randomized, international open-label study with blinded outcome assessment. SETTING: Tertiary care facilities monitored the arrhythmias, while the follow-up remained with primary care physicians. PARTICIPANTS: Patients after ST-elevation (STEMI) or non-ST-elevation MI with an ejection fraction >35% and a CHA2DS2-VASc score ≥4 (men) or ≥5 (women). INTERVENTIONS: Patients were randomly assigned to receive or not receive an ICM in addition to standard post-MI treatment. Device-detected arrhythmias triggered immediate guideline recommended therapy changes via remote monitoring. MAIN OUTCOME MEASURES: MACE, defined as a composite of cardiovascular death or acute unscheduled hospitalization for cardiovascular causes. RESULTS: 790 patients (mean age 71 years, 72% male, 51% non-STEMI) of planned 1,400 pts were enrolled and followed for a median of 31.6 months. At 2 years, 39.4% of the device group and 6.7% of the control group had their therapy adapted for an arrhythmia [hazard ratio (HR) = 5.9, P < 0.0001]. Most frequent arrhythmias were atrial fibrillation, pauses and bradycardia. The use of an ICM did not improve outcome in the entire cohort (HR = 0.84, 95%-CI: 0.65-1.10; P = 0.21). In secondary analysis, a statistically significant interaction of the type of infarction suggests a benefit in the pre-specified non-STEMI subgroup. Risk factor analysis indicates that this may be connected to the higher incidence of MACE in patients with non-STEMI. CONCLUSIONS: The burden of asymptomatic but actionable arrhythmias is large in post-infarction patients. However, arrhythmia monitoring with an ICM did not improve outcome in the entire cohort. Post-hoc analysis suggests that it may be beneficial in non-STEMI patients or other high-risk subgroups. CLINICAL TRIAL REGISTRATION: [https://www.clinicaltrials.gov/ct2/show/NCT02341534], NCT02341534.

1st Department of Cardiology Medical University of Warsaw Warsaw Poland

Biotronik SE and Co KG Berlin Germany

Cardiovascular Centre Onze Lieve Vrouw Clinic Aalst Aalst Belgium

Department of Cardiology Aalborg University Hospital Aalborg Denmark

Department of Cardiology České Budějovice Hospital and Faculty of Health and Social Sciences University of South Bohemia České Budějovice Czech Republic

Department of Cardiology Charité Universitätsmedizin Berlin Berlin Germany

Department of Cardiology Fakultní Nemocnice Olomouc Olomouc Czech Republic

Department of Cardiology Johannes Wesling Universitätsklinik Minden Germany

Department of Cardiology Kepler University Hospital Linz Linz Austria

Department of Cardiology Klinikum Coburg Coburg Germany

Department of Cardiology Lyell McEwin Hospital and Adelaide Medical School The University of Adelaide Adelaide SA Australia

Department of Cardiology Rigshospitalet University of Copenhagen Copenhagen Denmark

Department of Cardiology Scheperziekenhuis Treant Zorggroep Emmen Netherlands

Department of Cardiology St Louis Heart and Vascular Bridgeton MO United States

Department of Cardiology Universitätsklinikum Schleswig Holstein Campus Lübeck Lübeck Germany

Department of Cardiology Viborg Regional Hospital Viborg Denmark

Department of Cardiology Vivantes Humboldt Klinikum and Klinikum Spandau Berlin Germany

Department of Cardiology Vivantes Humboldt Klinikum Berlin Germany

Heart and Vascular Centre Semmelweis University Budapest Hungary

Heart Institute The University of Pécs Pécs Hungary

Herning Hospital Herning Denmark

National Hospital of Cardiology Balatonfüred Hungary

Ziekenhuis Oost Limburg Genk Belgium

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc24012798
003      
CZ-PrNML
005      
20240726151345.0
007      
ta
008      
240723e20240513sz f 000 0|eng||
009      
AR
024    7_
$a 10.3389/fcvm.2024.1300074 $2 doi
035    __
$a (PubMed)38807948
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a sz
100    1_
$a Jøns, Christian $u Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
245    10
$a Arrhythmia monitoring and outcome after myocardial infarction (BIO|GUARD-MI): a randomized trial / $c C. Jøns, PE. Bloch Thomsen, S. Riahi, T. Smilde, U. Bach, PK. Jacobsen, M. Táborský, J. Faluközy, M. Wiemer, PD. Christensen, A. Kónyi, D. Schelfaut, A. Bulava, M. Grabowski, B. Merkely, D. Nuyens, R. Mahajan, P. Nagel, R. Tilz, J. Malczynski, C. Steinwender, J. Brachmann, H. Serota, J. Schrader, S. Behrens, P. Søgaard
520    9_
$a OBJECTIVES: Cardiac arrhythmias predict poor outcome after myocardial infarction (MI). We studied if arrhythmia monitoring with an insertable cardiac monitor (ICM) can improve treatment and outcome. DESIGN: BIO|GUARD-MI was a randomized, international open-label study with blinded outcome assessment. SETTING: Tertiary care facilities monitored the arrhythmias, while the follow-up remained with primary care physicians. PARTICIPANTS: Patients after ST-elevation (STEMI) or non-ST-elevation MI with an ejection fraction >35% and a CHA2DS2-VASc score ≥4 (men) or ≥5 (women). INTERVENTIONS: Patients were randomly assigned to receive or not receive an ICM in addition to standard post-MI treatment. Device-detected arrhythmias triggered immediate guideline recommended therapy changes via remote monitoring. MAIN OUTCOME MEASURES: MACE, defined as a composite of cardiovascular death or acute unscheduled hospitalization for cardiovascular causes. RESULTS: 790 patients (mean age 71 years, 72% male, 51% non-STEMI) of planned 1,400 pts were enrolled and followed for a median of 31.6 months. At 2 years, 39.4% of the device group and 6.7% of the control group had their therapy adapted for an arrhythmia [hazard ratio (HR) = 5.9, P < 0.0001]. Most frequent arrhythmias were atrial fibrillation, pauses and bradycardia. The use of an ICM did not improve outcome in the entire cohort (HR = 0.84, 95%-CI: 0.65-1.10; P = 0.21). In secondary analysis, a statistically significant interaction of the type of infarction suggests a benefit in the pre-specified non-STEMI subgroup. Risk factor analysis indicates that this may be connected to the higher incidence of MACE in patients with non-STEMI. CONCLUSIONS: The burden of asymptomatic but actionable arrhythmias is large in post-infarction patients. However, arrhythmia monitoring with an ICM did not improve outcome in the entire cohort. Post-hoc analysis suggests that it may be beneficial in non-STEMI patients or other high-risk subgroups. CLINICAL TRIAL REGISTRATION: [https://www.clinicaltrials.gov/ct2/show/NCT02341534], NCT02341534.
590    __
$a NEINDEXOVÁNO
655    _2
$a časopisecké články $7 D016428
700    1_
$a Bloch Thomsen, Poul Erik $u Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
700    1_
$a Riahi, Sam $u Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
700    1_
$a Smilde, Tom $u Department of Cardiology, Scheperziekenhuis, Treant Zorggroep, Emmen, Netherlands
700    1_
$a Bach, Ulrich $u Department of Cardiology, Vivantes Humboldt-Klinikum, Berlin, Germany
700    1_
$a Jacobsen, Peter Karl $u Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
700    1_
$a Táborský, Miloš $u Department of Cardiology, Fakultní Nemocnice Olomouc, Olomouc, Czech Republic
700    1_
$a Faluközy, Jozsef $u National Hospital of Cardiology, Balatonfüred, Hungary
700    1_
$a Wiemer, Marcus $u Department of Cardiology, Johannes Wesling Universitätsklinik, Minden, Germany
700    1_
$a Christensen, Per Dahl $u Department of Cardiology, Viborg Regional Hospital, Viborg, Denmark
700    1_
$a Kónyi, Attila $u Heart Institute, The University of Pécs, Pécs, Hungary
700    1_
$a Schelfaut, Dan $u Cardiovascular Centre, Onze Lieve Vrouw Clinic Aalst, Aalst, Belgium
700    1_
$a Bulava, Alan $u Department of Cardiology, České Budějovice Hospital and Faculty of Health and Social Sciences, University of South Bohemia, České Budějovice, Czech Republic
700    1_
$a Grabowski, Marcin $u First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
700    1_
$a Merkely, Béla $u Heart and Vascular Centre, Semmelweis University, Budapest, Hungary
700    1_
$a Nuyens, Dieter $u Ziekenhuis Oost-Limburg, Genk, Belgium
700    1_
$a Mahajan, Rajiv $u Department of Cardiology, Lyell McEwin Hospital, and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
700    1_
$a Nagel, Patrick $u Department of Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany
700    1_
$a Tilz, Roland $u Department of Cardiology, Universitätsklinikum Schleswig-Holstein - Campus Lübeck, Lübeck, Germany
700    1_
$a Malczynski, Jerzy $u Herning Hospital, Herning, Denmark
700    1_
$a Steinwender, Clemens $u Department of Cardiology, Kepler University Hospital Linz, Linz, Austria
700    1_
$a Brachmann, Johannes $u Department of Cardiology, Klinikum Coburg, Coburg, Germany
700    1_
$a Serota, Harvey $u Department of Cardiology, St. Louis Heart and Vascular, Bridgeton, MO, United States
700    1_
$a Schrader, Jürgen $u Biotronik SE & Co. KG, Berlin, Germany
700    1_
$a Behrens, Steffen $u Department of Cardiology, Vivantes Humboldt-Klinikum and Klinikum Spandau, Berlin, Germany
700    1_
$a Søgaard, Peter $u Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
773    0_
$w MED00198704 $t Frontiers in cardiovascular medicine $x 2297-055X $g Roč. 11 (20240513), s. 1300074
856    41
$u https://pubmed.ncbi.nlm.nih.gov/38807948 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20240723 $b ABA008
991    __
$a 20240726151338 $b ABA008
999    __
$a ok $b bmc $g 2125477 $s 1224661
BAS    __
$a 3
BAS    __
$a PreBMC-PubMed-not-MEDLINE
BMC    __
$a 2024 $b 11 $c - $d 1300074 $e 20240513 $i 2297-055X $m Frontiers in cardiovascular medicine $n Front Cardiovasc Med $x MED00198704
LZP    __
$a Pubmed-20240723

Najít záznam

Citační ukazatele

Možnosti archivace