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Article ; Online: In Non-STEMI, Go for the Culprit.

Fefer, Paul

2021 Volume 159, Issue 4, Page(s) 1319–1320

MeSH term(s)	Coronary Angiography ; Humans ; Myocardial Infarction
Language	English
Publishing date	2021-04-06
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2020.11.030
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Article ; Online: Percutaneous Recanalization of Coronary Chronic Total Occlusions: The Case for Centralized Care.

Fefer, Paul

Revista espanola de cardiologia (English ed.)

2018 Volume 72, Issue 5, Page(s) 365–366

MeSH term(s)	Angioplasty, Balloon, Coronary/methods ; Angioplasty, Balloon, Coronary/mortality ; Centralized Hospital Services/organization & administration ; Chronic Disease ; Coronary Angiography/methods ; Coronary Occlusion/diagnostic imaging ; Coronary Occlusion/mortality ; Coronary Occlusion/therapy ; Female ; Humans ; Israel ; Male ; Percutaneous Coronary Intervention/methods ; Percutaneous Coronary Intervention/statistics & numerical data ; Prognosis ; Registries ; Risk Assessment ; Severity of Illness Index ; Survival Analysis ; Treatment Outcome
Language	Spanish
Publishing date	2018-11-01
Publishing country	Spain
Document type	Editorial ; Review
ISSN	1885-5857
ISSN (online)	1885-5857
DOI	10.1016/j.rec.2018.10.001
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Article: Monitoring Outcomes of Novel Interventions: The Case for Comprehensive Data Collection.

Fefer, Paul / Guetta, Victor

The Israel Medical Association journal : IMAJ

2019 Volume 21, Issue 5, Page(s) 353

MeSH term(s)	Data Collection ; Humans ; Patient Outcome Assessment
Language	English
Publishing date	2019-05-15
Publishing country	Israel
Document type	Editorial ; Comment
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Article: The Impact of Novel Anti-Diabetic Medications on CV Outcomes: A New Therapeutic Horizon for Diabetic and Non-Diabetic Cardiac Patients.

Mazin, Israel / Chernomordik, Fernando / Fefer, Paul / Matetzky, Shlomi / Beigel, Roy

Journal of clinical medicine

2022 Volume 11, Issue 7

Abstract: It is estimated that in the past two decades the number of patients diagnosed with diabetes mellites (DM) has doubled. Despite significant progress in the treatment of cardiovascular disease (CVD), including novel anti-platelet agents, effective lipid- ... ...

Abstract	It is estimated that in the past two decades the number of patients diagnosed with diabetes mellites (DM) has doubled. Despite significant progress in the treatment of cardiovascular disease (CVD), including novel anti-platelet agents, effective lipid-lowering medications, and advanced revascularization techniques, patients with DM still are least twice as likely to die of cardiovascular causes compared with their non-diabetic counterparts, and current guidelines define patients with DM at the highest risk for atherosclerotic cardiovascular disease and major adverse cardiovascular events (MACE). Over the last few years, there has been a breakthrough in anti-diabetic therapeutics, as two novel anti-diabetic classes have demonstrated cardiovascular benefit with consistently reduced MACE, and for some agents, also improvement in heart failure status as well as reduced cardiovascular and all-cause mortality. These include the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists. The benefits of these medications are thought to be derived not only from their anti-diabetic effect but also from additional mechanisms. The purpose of this review is to provide the everyday clinician a detailed review of the various agents within each class with regard to their specific characteristics and the effects on MACE and cardiovascular outcomes.
Language	English
Publishing date	2022-03-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11071904
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Article ; Online: The Impact of Novel Anti-Diabetic Medications on CV Outcomes

Israel Mazin / Fernando Chernomordik / Paul Fefer / Shlomi Matetzky / Roy Beigel

Journal of Clinical Medicine, Vol 11, Iss 1904, p

A New Therapeutic Horizon for Diabetic and Non-Diabetic Cardiac Patients

2022 Volume 1904

Abstract	It is estimated that in the past two decades the number of patients diagnosed with diabetes mellites (DM) has doubled. Despite significant progress in the treatment of cardiovascular disease (CVD), including novel anti-platelet agents, effective lipid-lowering medications, and advanced revascularization techniques, patients with DM still are least twice as likely to die of cardiovascular causes compared with their non-diabetic counterparts, and current guidelines define patients with DM at the highest risk for atherosclerotic cardiovascular disease and major adverse cardiovascular events (MACE). Over the last few years, there has been a breakthrough in anti-diabetic therapeutics, as two novel anti-diabetic classes have demonstrated cardiovascular benefit with consistently reduced MACE, and for some agents, also improvement in heart failure status as well as reduced cardiovascular and all-cause mortality. These include the sodium-glucose cotransporter-2 inhibitors and the glucagon-like peptide-1 receptor agonists. The benefits of these medications are thought to be derived not only from their anti-diabetic effect but also from additional mechanisms. The purpose of this review is to provide the everyday clinician a detailed review of the various agents within each class with regard to their specific characteristics and the effects on MACE and cardiovascular outcomes.
Keywords	GLP1-RA ; SGLT-2i ; cardiovascular ; heart failure ; diabetes mellitus ; Medicine ; R
Subject code	616
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Echocardiography vs hemodynamic assessment of diastolic dysfunction.

Shaham, Lital / Fisher, Lior / Segev, Amit / Falach, Batla / Maor, Elad / Barbash, Israel M / Hai, Ilan / Vaturi, Ori / Kuperstein, Rafi / Guetta, Victor / Fefer, Paul

The Journal of invasive cardiology

2024 Volume 36, Issue 1

Abstract: Objectives: Ostial CTOs can be challenging to revascularize. We aim to describe the outcomes of ostial chronic total occlusion (CTO) percutaneous coronary intervention (PCI).: Methods: We examined the clinical and angiographic characteristics and ... ...

Abstract	Objectives: Ostial CTOs can be challenging to revascularize. We aim to describe the outcomes of ostial chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Methods: We examined the clinical and angiographic characteristics and procedural outcomes of 8788 CTO PCIs performed at 35 US and non-US centers between 2012 and 2022. In-hospital major adverse cardiac events (MACE) included death, myocardial infarction, urgent repeat target-vessel revascularization, tamponade requiring pericardiocentesis or surgery, and stroke. Results: Ostial CTOs constituted 12% of all CTOs. Patients with ostial CTOs had higher J-CTO score (2.9 ± 1.2 vs 2.3 ± 1.3; P less than .01). Ostial CTO PCI had lower technical (82% vs. 86%; P less than .01) and procedural (81% vs. 85%; P less than .01) success rates compared with non-ostial CTO PCI. Ostial location was not independently associated with technical success (OR 1.03, CI 95% 0.83-1.29 P =.73). Ostial CTO PCI had a trend towards higher incidence of MACE (2.6% vs. 1.8%; P =.06), driven by higher incidence of in-hospital death (0.9% vs 0.3% P less than.01) and stroke (0.5% vs 0.1% P less than .01). Ostial lesions required more often use of the retrograde approach (30% vs 9%; P less than .01). Ostial CTO PCI required longer procedure time (149 [103,204] vs 110 [72,160] min; P less than .01) and higher air kerma radiation dose (2.3 [1.3, 3.6] vs 2.0 [1.1, 3.5] Gray; P less than .01). Conclusions: Ostial CTOs are associated with higher lesion complexity and lower technical and procedural success rates. CTO PCI of ostial lesions is associated with frequent need for retrograde crossing, higher incidence of death and stroke, longer procedure time and higher radiation dose.
MeSH term(s)	Humans ; Hospital Mortality ; Percutaneous Coronary Intervention/adverse effects ; Echocardiography ; Stroke/diagnosis ; Stroke/epidemiology ; Stroke/etiology ; Hemodynamics
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	1154372-3
ISSN	1557-2501 ; 1042-3931
ISSN (online)	1557-2501
ISSN	1042-3931
DOI	10.25270/jic/23.00106
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Zs.A 3701: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Echocardiographic Ventricular Septal Motion Abnormalities Are Associated With Pre-Capillary Pulmonary Hypertension in Patients With Preserved Left Ventricular Function.

Balmor, Gingy Ronen / Segel, Michael J / Fefer, Paul / Maor, Elad / Ben-Zekrey, Sagit / Segev, Amit

Heart, lung & circulation

2021 Volume 31, Issue 1, Page(s) 119–127

Abstract: Background: Ventricular septal motion abnormalities (VSMA) are common echocardiographic finding in patients with pulmonary hypertension (PHTN). This study sought to evaluate the relationship between echocardiographic findings and the classification of ... ...

Abstract	Background: Ventricular septal motion abnormalities (VSMA) are common echocardiographic finding in patients with pulmonary hypertension (PHTN). This study sought to evaluate the relationship between echocardiographic findings and the classification of PHTN. Methods: This study retrospectively studied 146 consecutive patients referred for right heart catheterisation for clinically suspected PHTN. VSMA were defined as any echocardiographic description of leftward abnormal septal motion or position. Results: VSMA were present in 42 patients (29%). Patients with VSMA were younger and more likely to have prior pulmonary embolism. They also had less obstructive sleep apnoea, hypertension and dyslipidaemia. By echocardiography, patients with VSMA had lower left ventricular mass, left atrial size and lateral wall E/e' ratio. At cardiac catheterisation, PHTN was confirmed in all (100%) patients with VSMA (compared with 75% in patients without VSMA); 98% with VSMA had elevated pulmonary vascular resistance (compared with 55% without VSMA; p<0.005 for all). VSMA were found to have 91% sensitivity and 51% specificity for the diagnosis of pre-capillary PHTN. On multivariate analysis, VSMA were found to be strong independent predictors for the diagnosis of pre-capillary PHTN (HR, 9.15; 95% CI, 3.0-28.2; p<0.001). Left atrial enlargement was also a strong negative predictor for pre-capillary PHTN (HR, 0.14; 95% CI, 0.05-0.36; p<0.001). Conclusion: Ventricular septal motion abnormalities were strongly associated with pre-capillary PHTN in patients with suspected PHTN. The findings suggest that patients with VSMA should be further evaluated by right heart catheterisation.
MeSH term(s)	Echocardiography ; Humans ; Hypertension, Pulmonary/diagnostic imaging ; Retrospective Studies ; Vascular Resistance ; Ventricular Function, Left
Language	English
Publishing date	2021-06-01
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2020980-0
ISSN	1444-2892 ; 1443-9506
ISSN (online)	1444-2892
ISSN	1443-9506
DOI	10.1016/j.hlc.2021.04.015
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Article: Clinical Outcome and Safety of Transcaval Access for Transcatheter Aortic Valve Replacement as Compared to Other Alternative Approaches.

Barbash, Israel M / Segev, Amit / Berkovitch, Anat / Fefer, Paul / Maor, Elad / Elian, Dan / Regev, Ehud / Guetta, Victor

Frontiers in cardiovascular medicine

2021 Volume 8, Page(s) 731639

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2021-09-22
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2781496-8
ISSN	2297-055X
ISSN	2297-055X
DOI	10.3389/fcvm.2021.731639
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Article ; Online: Evaluation of coronary disease among patients undergoing transcatheter aortic valve implantation: propensity score matching analysis.

Berkovitch, Anat / Finkelstein, Ariel / Barbash, Israel M / Fefer, Paul / Maor, Elad / Banai, Shmuel / Brodov, Yafim / Goitein, Orly / Aviram, Galit / Halkin, Amir / Guetta, Victor / Steinvil, Arie / Segev, Amit

Clinical research in cardiology : official journal of the German Cardiac Society

2023 Volume 113, Issue 1, Page(s) 11–17

Abstract: Background: Chronic coronary syndrome (CCS) is common among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Current guidelines recommend performance of percutaneous coronary intervention (PCI) of ... ...

Abstract	Background: Chronic coronary syndrome (CCS) is common among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Current guidelines recommend performance of percutaneous coronary intervention (PCI) of any > 70% proximal coronary lesions prior to TAVI. Aims: To evaluate the outcomes of two diagnostic approaches for CCS clearance pre-TAVI and to determine the reduction in the need of invasive angiography (IA). Methods: We investigated 2219 patients undergoing TAVI for severe aortic stenosis at two large centers with different pre-procedural strategies for CCS assessment: pre-TAVI computed tomography angiography (CTA) with selective invasive angiography according to CTA results or mandatory IA. We preformed propensity score matching analysis using a 1:1 ratio. The final study cohort included 870 matched patients. Peri-procedural complications were documented according to the VARC-2 criteria. Mortality rates were prospectively documented. Results: Mean age of the study population was 82 ± 7, of whom 55% were female. Patients in the IA group had significantly higher rates of pre-TAVI PCI compared to the CTA group (39% vs. 22%, p < 0.001). Following TAVI, peri-procedural myocardial infarction (MI) rates were similar between the two groups (0.3% vs. 0.7%, p value = 0.41), but spontaneous MI were significantly lower among the IA group (0% vs. 1.3%, p value = 0.03). Kaplan-Meier's survival analysis found that the cumulative probability of 1-year morality was similar between the two groups (p value log rank = 0.65). Cox regression analysis did not find association between CCS clearance strategy and outcome. Conclusions: In elderly patients, CTA-driven approach for CCS evaluation pre-TAVI is a valid strategy with similar outcome as compared to invasive approach. CTA strategy significantly reduces invasive procedures rates without compromising patient's outcome.
MeSH term(s)	Humans ; Female ; Aged ; Male ; Transcatheter Aortic Valve Replacement/methods ; Percutaneous Coronary Intervention/adverse effects ; Aortic Valve Stenosis/surgery ; Propensity Score ; Heart Valve Prosthesis Implantation/methods ; Treatment Outcome ; Coronary Artery Disease/surgery ; Myocardial Infarction/complications ; Aortic Valve/surgery ; Retrospective Studies
Language	English
Publishing date	2023-03-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2213295-8
ISSN	1861-0692 ; 1861-0684
ISSN (online)	1861-0692
ISSN	1861-0684
DOI	10.1007/s00392-023-02175-7
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Article ; Online: Comparison of MANTA versus Perclose Prostyle large-bore vascular closure devices during transcatheter aortic valve implantation.

Barbash, Israel M / Wasserstrum, Yishay / Erlebach, Magdalena / Guetta, Victor / Ziegelmüller, Johannes / Segev, Amit / Fefer, Paul / Maor, Elad / Lange, Rüdiger / Ruge, Hendrik

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

2023 Volume 103, Issue 1, Page(s) 160–168

Abstract: Background: New vascular closure devices (VCD) are being introduced for achieving hemostasis after transcatheter aortic valve implantation (TAVI). However, no safety or efficacy data have been published compared to other contemporary VCD.: Aim: To ... ...

Abstract	Background: New vascular closure devices (VCD) are being introduced for achieving hemostasis after transcatheter aortic valve implantation (TAVI). However, no safety or efficacy data have been published compared to other contemporary VCD. Aim: To compare the safety and efficacy of suture-based Perclose Prostyle as compared to plug-based MANTA device. Methods: A total of 408 consecutive TAVI patients from two high volume TAVI centers were included in the present study. Patients were grouped according to VCD: Prostyle versus MANTA. Propensity score matching (PSM) and multivariable analysis were utilized to compare clinical endpoints between the two groups. The primary endpoint was any vascular complication (VC) according to VARC-3 criteria. Results: After PSM, a total of 264 patients were analyzed, of them 132 in each group. Overall baseline characteristics of the two groups were comparable. Primary end-point was similar between MANTA as compared to Prostyle (16.7% vs. 15.3% respectively, p = 0.888). The main driver for VC among MANTA group were minor vascular complications (15.2%). Conversely, minor and major VC contributed equally to the primary endpoint among Prostyle group (7.6%) (p = 0.013). No outcome predictors were identified in multivariate analysis. Conclusions: VCD for transfemoral TAVI using the new-generation Prostyle device or the MANTA device achieved comparable VARC-3 VC rates.
MeSH term(s)	Humans ; Vascular Closure Devices ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome ; Femoral Artery/diagnostic imaging ; Femoral Artery/surgery ; Catheterization, Peripheral/adverse effects ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Aortic Valve/diagnostic imaging ; Aortic Valve/surgery ; Hemostatic Techniques/adverse effects
Language	English
Publishing date	2023-12-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	1459995-8
ISSN	1522-726X ; 1522-1946
ISSN (online)	1522-726X
ISSN	1522-1946
DOI	10.1002/ccd.30921
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