Article
Cardiac & Cardiovascular Systems
Rafael Hitter, Amir Orlev, Itshak Amsalem, Nir Levi, Talya Wolak, Rivka Farkash, Naama Bogot, Michael Glikson, Arik Wolak
Summary: This study found that a high CACS is more strongly associated with severe CAD in patients with ACP compared to those with SCP. These findings suggest that CACS could impact the management of patients during the scan.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Jia Zhou, Chunjie Li, Hong Zhang, Chang Liu, Junjie Yang, Jia Zhao, Yonghong Hou, Yahang Tan, Hao Wang, Yaoshuang Li, Cun Xie, Minghui Wang, Chengjian Wang, Enyuan Zhang, Shuo Wang, Pengyu Zhao, Dongkai Shan, Shuo Liang, Yufan Gao, Yong Huo, Hongliang Cong, Zhigang Guo, Yundai Chen
Summary: This study retrospectively assessed the association between the appropriateness of post-CCTA management according to CAD-RADS 2.0 and clinical outcomes. The results showed that appropriate management was associated with a lower risk of major adverse cardiovascular events and a more prudent use of invasive coronary angiography.
Article
Radiology, Nuclear Medicine & Medical Imaging
Mahmoud Mohamed, Maria Bosserdt, Viktoria Wieske, Benjamin Dubourg, Hatem Alkadhi, Mario J. Garcia, Sebastian Leschka, Elke Zimmermann, Abbas A. Shabestari, Bjarne L. Norgaard, Matthijs F. L. Meijs, Kristian A. Ovrehus, Axel C. P. Diederichsen, Juhani Knuuti, Bjrn A. Halvorsen, Vladymir Mendoza-Rodriguez, Yung-Liang Wan, Nuno Bettencourt, Eugenio Martuscelli, Ronny R. Buechel, Hans Mickley, Kai Sun, Simone Muraglia, Philipp A. Kaufmann, Bernhard A. Herzog, Jean-Claude Tardif, Georg M. Schuetz, Michael Laule, David E. Newby, Stephan Achenbach, Matthew Budoff, Robert Haase, Federico Biavati, Aldo Vasquez Mezquita, Peter Schlattmann, Marc Dewey
Summary: Combining coronary computed tomography angiography (CCTA) with coronary artery calcium (CAC) score can significantly improve the diagnosis of coronary artery disease (CAD). The addition of CAC score is particularly beneficial when CCTA alone is inconclusive.
EUROPEAN RADIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Gowtham R. Grandhi, Reed Mszar, Miguel Cainzos-Achirica, Tanuja Rajan, Muhammad A. Latif, Marcio S. Bittencourt, Leslee J. Shaw, Juan C. Batlle, Ron Blankstein, Michael J. Blaha, Ricardo C. Cury, Khurram Nasir
Summary: This study evaluated the effectiveness of coronary artery calcium (CAC) as an initial diagnostic tool to rule out obstructive coronary artery disease (CAD) in patients with acute chest pain (CP) who were at low to intermediate risk for acute coronary syndrome (ACS).
JACC-CARDIOVASCULAR IMAGING
(2022)
Article
Medicine, General & Internal
Klaus F. Kofoed, Maria Bosserdt, Pal Maurovich-Horvat, Nina Rieckmann, Theodora Benedek, Patrick Donnelly, Jose Rodriguez Palomares, Andrejs Erglis, Cyril Stechovsky, Gintare Sakalyte, Filip Adic, Matthias Gutberlet, Jonathan D. Dodd, Ignacio Diez, Gershan Davis, Elke Zimmermann, Cezary Kepka, Radosav Vidakovic, Marco Francone, Malgorzata Ilnicka-Suckiel, Fabian Plank, Juhani Knuuti, Rita Faria, Stephen Schroeder, Colin Berry, Luca Saba, Balazs Ruzsics, Christine Kubiak, Kristian Schultz Hansen, Jacqueline Mueller-Nordhorn, Bela Merkely, Tem S. Jorgensen, Imre Benedek, Clare Orr, Filipa Xavier Valente, Ligita Zvaigzne, Vojtech Suchanek, Laura Zajanckauskiene, Milenko Cankovic, Michael Woinke, Stephen Keane, Inigo Lecumberri, Erica Thwaite, Michael Laule, Mariusz Kruk, Aleksandar N. Neskovic, Massimo Mancone, Donata Kusmierz, Gudrun Feuchtner, Mikko Pietila, Vasco Gama Ribeiro, Tanja Drosch, Christian Delles, Bruno Loi, Michael Fisher, Balint Szilveszter, Per E. Sigvardsen, Mihaela Ratiu, Stephanie Kelly, Bruno Garcia del Blanco, Ainhoa Rubio, Zsofia D. Drobni, Charlotte Kragelund, Ioana Rodean, Susan Regan, Hug Cuellar Calabria, Melinda Boussoussou, Thomas Engstrom, Roxana Hodas, Adriane E. Napp, Robert Haase, Sarah Feger, Mahmoud M. A. Mohamed, Lina M. Serna-Higuita, Konrad Neumann, Henryk Dreger, Matthias Rief, Viktoria Wieske, Melanie Estrella, Peter Martus, Marc Dewey
Summary: This study compared the effectiveness of computed tomography (CT) and invasive coronary angiography (ICA) in the management of stable chest pain in men and women. The results showed that for patients with an intermediate pretest probability of coronary artery disease, an initial CT scan was associated with fewer major complications in women and a lower frequency of a composite endpoint in men.
BMJ-BRITISH MEDICAL JOURNAL
(2022)
Article
Medicine, General & Internal
June-sung Kim, Youn-jung Kim, Yo Sep Shin, Shin Ahn, Won Young Kim
Summary: This retrospective observational cohort study aimed to develop a prediction model for rapidly determining the occurrence of significant stenosis in coronary computed tomography angiography (CCTA) among chest pain patients without troponin elevation and ST-segment changes. A new prediction model was developed with independent associated factors for significant stenosis, and a score of >= 5 was chosen as cut-off values with 86.6% sensitivity and 56.4% specificity.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Praveen Thokala, Steve Goodacre, Katherine Oatey, Rachel O'Brien, David E. Newby, Alasdair Gray
Summary: This study aimed to estimate the cost-effectiveness of early CT coronary angiography (CTCA) for intermediate risk patients with suspected acute coronary syndrome (ACS), compared with standard care. The results showed that within the trial, there were no significant differences in costs or QALYs between early CTCA and standard care. Long-term economic analysis suggested higher long-term costs with CTCA and uncertain effect on long-term QALYs, making routine use of CTCA for suspected ACS unlikely to be a cost-effective use of NHS resources.
Article
Radiology, Nuclear Medicine & Medical Imaging
Toshimitsu Tsugu, Kaoru Tanaka, Dries Belsack, Yuji Nagatomo, Mayuko Tsugu, Jean-Francois Argacha, Bernard Cosyns, Nico Buls, Michel De Maeseneer, Johan De Mey
Summary: In non-obstructive coronary artery disease, the decline of CT-derived fractional flow reserve (FFRCT) depends not only on vessel length but also on the lumen volume. A new marker, the ratio of lumen volume to vessel length (V/L ratio), was found to be the strongest predictor of distal FFRCT.
EUROPEAN RADIOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Kristian Taekker Madsen, Karsten Tange Veien, Pia Larsen, Majed Husain, Lone Deibjerg, Anders Junker, Martin Weber Kusk, Kristian Korsgaard Thomsen, Allan Rohold, Lisette Okkels Jensen, Niels Peter Ronnow Sand
Summary: This study aimed to evaluate the association between CCTA-derived FFRCT and recurrent chest pain in patients with SAP. The results showed that an abnormal FFRCT test result was associated with an increased risk of recurrent chest pain, independent of coronary calcification and stenosis. Additionally, a negative association between per-patient minimal d-FFRCT and recurrent chest pain was demonstrated, highlighting the importance of FFRCT testing in predicting long-term outcomes for patients with SAP.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING
(2022)
Review
Cardiac & Cardiovascular Systems
Rex A. Burch, Taha A. Siddiqui, Leila C. Tou, Kiera B. Turner, Muhammad Umair
Summary: This review evaluates the long-term cost-effectiveness of coronary computed tomography angiography (CCTA) compared to other diagnostic modalities and defines the cost and effective diagnostic utilization of computed tomography-fractional flow reserve (CT-FFR). The analysis suggests that CCTA is a cost-effective strategy for low-risk acute chest pain patients and low-to-intermediate risk stable chest pain outpatients. CT-FFR is superior to CCTA in identifying clinically significant stenosis in intermediate-to-high risk patients. CCTA provides a cost-effective diagnostic strategy for low-to-intermediate risk patients, while CT-FFR should be utilized in intermediate-to-high risk patients with stenosis of uncertain clinical significance.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2023)
Article
Cardiac & Cardiovascular Systems
Gianluca Pontone, Alexia Rossi, Alessia Gimelli, Danilo Neglia
Summary: In patients with chest pain, guidelines recommend using coronary computed tomography angiography and single-photon emission tomography/positron emission tomography as diagnostic tests. However, there is no clear recommendation on which test to use as a first-line option. The choice should be based on individualized risk assessment, patient characteristics, local expertise/availability, and patient preferences.
Article
Medicine, General & Internal
Sivabaskari Pasupathy, Sarena La, Rosanna Tavella, Christopher Zeitz, Matthew Worthley, Ajay Sinhal, Margaret Arstall, John F. Beltrame
Summary: This study compares the chest pain characteristics between MINOCA and MICAD patients and finds no significant differences in terms of pain location, quality, associated symptoms, or duration. This suggests that the chest pain experienced by MINOCA patients is similar to that of MICAD patients, indicating an ischemic nature.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Robin Fabian Gohmann, Patrick Seitz, Konrad Pawelka, Nicolas Majunke, Adrian Schug, Linda Heiser, Katharina Renatus, Steffen Desch, Philipp Lauten, David Holzhey, Thilo Noack, Johannes Wilde, Philipp Kiefer, Christian Krieghoff, Christian Luecke, Sebastian Ebel, Sebastian Gottschling, Michael A. Borger, Holger Thiele, Christoph Panknin, Mohamed Abdel-Wahab, Matthias Horn, Matthias Gutberlet
Summary: ML-based CT-FFR can be used to correctly categorize cCTA studies without obstructive CAD, especially for less experienced readers. Image quality and coronary artery calcium score have no correlation with recategorization.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Ji Won Lee, Jin Young Kim, Kyunghwa Han, Dong Jin Im, Kye Ho Lee, Tae Hoon Kim, Chul Hwan Park, Jin Hur
Summary: The study assessed the prognostic value of CAD-RADS in CCTA for MACEs in patients with acute chest pain presenting to the emergency department. Results showed an association between CAD-RADS categories and high-risk plaques with MACEs, and CAD-RADS score improved risk stratification more than using clinical risk factors alone.
Article
Cardiac & Cardiovascular Systems
Wenbo Wang, Lan Lan, Huijuan Hu
Summary: Braid-like coronary artery is a rare condition characterized by multiple tortuous channels that converge into a normal lumen. We presented a case of a 27-year-old male patient with braid-like appearance in the right coronary artery. After multidisciplinary discussion, it was speculated to be a woven coronary artery (WCA). We conducted a literature review about woven coronary arteries.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Andrea C. Lo, Lyndon P. James, Anca Prica, Adam Raymakers, Stuart Peacock, Melody Qu, Alex Louie, Kerry J. Savage, Laurie H. Sehn, David Hodgson, Joanna C. Yang, Hans T. T. Eich, Andrew Wirth, M. G. Myriam Hunink
Summary: The study demonstrated that staging PET/CT in early-stage FL patients can reduce costs and improve QALYs, making it the dominant strategy.
JOURNAL OF NUCLEAR MEDICINE
(2022)
Article
Endocrinology & Metabolism
Bart S. Ferket, M. G. Myriam Hunink, Umesh Masharani, Wendy Max, Joseph Yeboah, Gregory L. Burke, Kirsten E. Fleischmann
Summary: The study assesses the lifetime cardiovascular disease risk in individuals with diabetes using coronary artery calcium score and compares it with that of individuals without diabetes. The results show that diabetes increases the lifetime CVD risk, and the CAC score can better delineate the risk and help make decisions for preventive interventions in patients with diabetes.
Article
Genetics & Heredity
Kathryn A. Phillips, Julia R. Trosman, Michael P. Douglas, Bruce D. Gelb, Bart S. Ferket, Lucia A. Hindorff, Anne M. Slavotinek, Jonathan S. Berg, Heidi Russell, Beth Devine, Veronica Greve, Hadley Stevens Smith
Summary: This study examined coverage considerations for genome sequencing (GS) and exome sequencing (ES) by payers. The findings suggest that payers see advantages to GS and are open to expanding its coverage, but they require more evidence to support their decision-making. The study also identified several steps to facilitate the coverage of GS, such as establishing evidence of its benefits in specific clinical scenarios and developing quality standards.
GENETICS IN MEDICINE
(2022)
Article
Clinical Neurology
Tim Yannick Cras, Myriam M. G. Hunink, Ruben Dammers, Adriaan C. G. M. van Es, Victor Volovici, James F. Burke, Femke C. C. Kremers, Diederik W. J. Dippel, Bob Roozenbeek
Summary: This study aimed to determine the optimal MRI surveillance strategies for the growth of UIAs using cost-effectiveness analysis and develop a clinical tool for personalizing UIA surveillance. The results showed that the optimal surveillance strategy varied in different countries, and it is feasible to personalize the surveillance strategy considering factors such as age and aneurysm characteristics.
Article
Economics
Stijntje W. Dijk, Eline M. Krijkamp, Natalia Kunst, Cary P. Gross, John B. Wong, M. G. Myriam Hunink
Summary: This study used a cohort state-transition model to evaluate the effectiveness and cost-effectiveness of different therapies for COVID-19 patients. The results showed that only a few therapies were cost-effective and should be immediately approved for use. Additionally, the value of information analysis revealed the importance of collecting additional evidence in informing policy and decision-making.
Article
Health Care Sciences & Services
Fernando Alarid-Escudero, Eline Krijkamp, Eva A. Enns, Alan Yang, M. G. Myriam Hunink, Petros Pechlivanoglou, Hawre Jalal
Summary: This article introduces the application of decision models in medical decision making, focusing on the time-independent cohort state-transition model (cSTM) and its implementation using R language. The article provides a detailed explanation of the model's application and calculation methods, along with open-source code in R.
MEDICAL DECISION MAKING
(2023)
Article
Cardiac & Cardiovascular Systems
S. P. Sharma, A. Hirsch, M. G. M. Hunink, M. J. M. Cramer, F. A. A. Mohamed Hoesein, C. A. Geluk, G. Kramer, J. W. C. Gratama, R. L. Braam, P. M. van der Zee, W. Yassi, S. L. Wolters, C. Guerlek, G. Pundziute, R. Vliegenthart, R. P. J. Budde
Summary: This study aims to evaluate the impact of adding FFRct analysis in the diagnostic pathway of patients with coronary stenosis on CCTA on the rate of unnecessary invasive coronary angiography, cost-effectiveness, quality of life and clinical outcome.
NETHERLANDS HEART JOURNAL
(2023)
Article
Medicine, Research & Experimental
S. W. Dijk, O. F. M. Steijlen, L. W. Kranenburg, E. V. Rouwet, A. I. Luik, A. E. Bierbooms, T. A. Kouwenhoven-Pasmooij, D. Rizopoulos, S. A. Swanson, W. J. G. Hoogendijk, M. G. M. Hunink
Summary: This study aims to assess whether offering mindfulness-based resilience training to university students in healthcare professions reduces their perceived chronic stress. The study has a hybrid design combining a longitudinal observational cohort with a nested randomized controlled trial (RCT) and takes participants' preferences into account.
CONTEMPORARY CLINICAL TRIALS
(2022)
Article
Critical Care Medicine
Crispijn L. van den Brand, Kelly A. Foks, Hester F. Lingsma, Joukje van der Naalt, Bram Jacobs, Eline de Jong, Hugo F. den Boogert, Ozcan Sir, Peter Patka, Suzanne Polinder, Menno Gaakeer, Charlotte E. Schutte, Kim E. Jie, Huib F. Visee, Myriam G. M. Hunink, Eef Reijners, Meriam Braaksma, Guus G. Schoonman, Ewout W. Steyerberg, Diederik W. J. Dippel, Korne Jellema
Summary: The objective of this study was to update the CHIP decision rule for detecting (intra)cranial findings in adult patients with minor head injury. The updated model showed similar performance to the original model in detecting traumatic (intra)cranial findings and had a higher sensitivity for (potential) neurosurgical lesions or death as a result of traumatic brain injury. The updated CHIP decision rule is a good alternative for patients with minor head injury.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2022)
Article
Health Care Sciences & Services
Fernando Alarid-Escudero, Eline Krijkamp, Eva A. Enns, Alan Yang, M. G. Myriam Hunink, Petros Pechlivanoglou, Hawre Jalal
Summary: This tutorial illustrates adding two types of time dependence in cSTMs and uses a cost-effectiveness analysis as an example. These time-dependent cSTMs are used for cost-effectiveness and probabilistic sensitivity analyses and provide various epidemiological outcomes.
MEDICAL DECISION MAKING
(2023)
Article
Endocrinology & Metabolism
Lisa Caulley, Eline Krijkamp, Mary-Anne Doyle, Kednapa Thavorn, Fahad Alkherayf, Nick Sahlollbey, Selina X. Dong, Jason Quinn, Stephanie Johnson-Obaseki, David Schramm, Shaun J. Kilty, Myriam G. M. Hunink
Summary: This study compared the cost-effectiveness of preoperative octreotide therapy followed by surgery versus direct surgery for patients with growth-hormone secreting pituitary adenomas. The results showed that direct surgery had lower costs and greater health effects compared to the preoperative octreotide strategy.
Review
Endocrinology & Metabolism
Lisa Caulley, Jonathan Whelan, Michel Khoury, Dorsa Mavedatnia, Nick Sahlollbey, Lisa Amrani, Anas Eid, Mary-Anne Doyle, Janine Malcolm, Fahad Alkherayf, Tim Ramsay, David Moher, Stephanie Johnson-Obaseki, David Schramm, Myriam G. M. Hunink, Shaun J. Kilty
Summary: This comprehensive review quantified the recurrence rates of commonly observed pituitary adenomas after transsphenoidal surgery with curative intent. The findings suggest that surveillance within 1 year may have low yield. Further studies can investigate cost-effectiveness of surveillance schedules and impact on patients' quality of life to optimize follow-up.
Review
Endocrinology & Metabolism
Jose M. Rodriguez-Valadez, Malak Tahsin, Kirsten E. E. Fleischmann, Umesh Masharani, Joseph Yeboah, Meyeon Park, Lihua Li, Ellerie Weber, Yan Li, Asem Berkalieva, Wendy Max, M. G. Myriam Hunink, Bart S. S. Ferket
Summary: This study investigated whether patients with varying risks differ in cardiovascular and renal benefits from GLP-1RA and SGLT2i. The results showed that the relative effects of novel diabetes drugs are preserved across baseline cardiovascular risk, while the absolute benefits increase at higher risks, especially for heart failure. This suggests a need for baseline risk assessment tools to identify variation in absolute treatment benefits and improve decision-making.
Review
Psychology, Applied
Chia-Ping Lu, Stijntje W. Dijk, Aradhana Pandit, Leonieke Kranenburg, Annemarie I. Luik, M. G. Myriam Hunink
Summary: Students in health professions face high levels of stress due to demanding academic schedules, heavy workloads, disrupted work-life balance, and sleep deprivation. Addressing stress during their education can prevent negative consequences for their mental health and the well-being of their future patients.
APPLIED PSYCHOLOGY-HEALTH AND WELL BEING
(2023)
Article
Medicine, Research & Experimental
Stijntje W. Dijk, Thomas Kroencke, Claudia Wollny, Joerg Barkhausen, Olav Jansen, Moritz C. Halfmann, Dimitris Rizopoulos, M. G. Myriam Hunink
Summary: This study aims to evaluate the impact of implementing a CDSS with active decision support on the appropriate use of imaging tests and ordering behavior. The study utilizes a multi-center cluster-randomized trial with a before-after-revert design.
CONTEMPORARY CLINICAL TRIALS
(2023)