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Article ; Online: Reply to letter to the editors: The long-term prognosis of patients with takotsubo syndrome.

Pogran, Edita / Huber, Kurt

2022 Volume 134, Issue 17-18, Page(s) 677–678

MeSH term(s)	Humans ; Myocardial Infarction ; Prognosis ; Takotsubo Cardiomyopathy/diagnosis
Language	English
Publishing date	2022-08-26
Publishing country	Austria
Document type	Letter
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-022-02085-0
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Article: Antiplatelet Therapy and Anticoagulation before, during, and after Acute Coronary Syndrome.

Kaufmann, Christoph C / Muthspiel, Marie / Lunzer, Laura / Pogran, Edita / Zweiker, David / Burger, Achim Leo / Wojta, Johann / Huber, Kurt

Journal of clinical medicine

2024 Volume 13, Issue 8

Abstract: Acute coronary syndrome (ACS) remains a major challenge in clinical practice, requiring rapid and effective antithrombotic treatment to mitigate adverse ischemic events while minimizing the risk of bleeding. In recent years, results from several clinical ...

Abstract	Acute coronary syndrome (ACS) remains a major challenge in clinical practice, requiring rapid and effective antithrombotic treatment to mitigate adverse ischemic events while minimizing the risk of bleeding. In recent years, results from several clinical trials addressing this issue through various approaches have substantially improved the treatment landscape for patients presenting with ACS. The emergence of new, potent P2Y
Language	English
Publishing date	2024-04-17
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13082313
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Article: New Treatment Targets and Innovative Lipid-Lowering Therapies in Very-High-Risk Patients with Cardiovascular Disease.

Burger, Achim Leo / Pogran, Edita / Muthspiel, Marie / Kaufmann, Christoph Clemens / Jäger, Bernhard / Huber, Kurt

Biomedicines

2022 Volume 10, Issue 5

Abstract: The effective and fast reduction of circulating low-density lipoprotein cholesterol (LDL-C) is a cornerstone for secondary prevention of atherosclerotic disease progression. Despite the substantial lipid-lowering effects of the established treatment ... ...

Abstract	The effective and fast reduction of circulating low-density lipoprotein cholesterol (LDL-C) is a cornerstone for secondary prevention of atherosclerotic disease progression. Despite the substantial lipid-lowering effects of the established treatment option with statins and ezetimibe, a significant proportion of very-high-risk patients with cardiovascular disease do not reach the recommended treatment goal of <55 mg/dL (<1.4 mmol/L). Novel lipid-lowering agents, including the proprotein convertase subtilisin/kexin type 9 (PCSK9) antibodies alirocumab and evolocumab, the small interfering ribonucleotide acid (si-RNA) inclisiran, as well as the recently approved bempedoic acid, now complete the current arsenal of LDL-C lowering agents. These innovative therapies have demonstrated promising results in clinical studies. Besides a strong reduction of LDL-C by use of highly effective agents, there is still discussion as to whether a very rapid achievement of the treatment goal should be a new strategic approach in lipid-lowering therapy. In this review, we summarize evidence for the lipid-modifying properties of these novel agents and their safety profiles, and discuss their potential pleiotropic effects beyond LDL-C reduction (if any) as well as their effects on clinical endpoints as cardiovascular mortality. In addition to a treatment strategy of “the lower, the better”, we also discuss the concept of “the earlier, the better”, which may also add to the early clinical benefit of large LDL-C reduction after an acute ischemic event.
Language	English
Publishing date	2022-04-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines10050970
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Article: Lipid-Lowering Therapy after Acute Coronary Syndrome.

Pogran, Edita / Burger, Achim Leo / Zweiker, David / Kaufmann, Christoph Clemens / Muthspiel, Marie / Rega-Kaun, Gersina / Wenkstetten-Holub, Alfa / Wojta, Johann / Drexel, Heinz / Huber, Kurt

Journal of clinical medicine

2024 Volume 13, Issue 7

Abstract: Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets remains a significant challenge in clinical practice. This review assesses the barriers to reaching LDL-C goals and explores the potential solutions to these issues. When ...

Abstract	Achieving guideline-recommended low-density lipoprotein cholesterol (LDL-C) targets remains a significant challenge in clinical practice. This review assesses the barriers to reaching LDL-C goals and explores the potential solutions to these issues. When aiming for the recommended LDL-C goal, strategies like "lower is better" and "strike early and strong" should be used. The evidence supports the safety and efficacy of intensive lipid-lowering therapy post-acute coronary syndrome (ACS), leading to improved long-term cardiovascular health and atherosclerotic plaque stabilization. Despite the availability of effective lipid-lowering therapies, such as high-intensity statins, ezetimibe, the combination of both, bempedoic acid, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, a substantial proportion of patients do not meet their LDL-C targets. Contributing factors include systemic healthcare barriers, healthcare provider inertia, patient non-adherence, and statin intolerance. Statin intolerance, often rather statin reluctance, is a notable obstacle due to perceived or expected side effects, which can lead to discontinuation of therapy. In conclusion, while there are obstacles to achieving optimal LDL-C levels post-ACS, these can be overcome with a combination of patient-centric approaches, clinical vigilance, and the judicious use of available therapies. The safety and necessity of reaching lower LDL-C goals to improve outcomes in patients post-ACS are well-supported by current evidence.
Language	English
Publishing date	2024-04-01
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13072043
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Article ; Online: The LIPL study: Postprandial lipid profile, inflammation, and platelet activity in patients with chronic coronary syndrome.

Pogran, Edita / Haller, Paul M / Wegberger, Claudia / Tscharre, Maximilian / Vujasin, Irena / Kaufmann, Christoph C / Dick, Petra / Jäger, Bernhard / Wojta, Johann / Huber, Kurt

Atherosclerosis plus

2023 Volume 54, Page(s) 14–21

Abstract: Background and aims: It is suggested that the changes in atherosclerosis happen mainly under the influence of non-fasting lipids. To date, the studies in the postprandial state were primarily performed on healthy subjects. This exploratory, cross- ... ...

Abstract	Background and aims: It is suggested that the changes in atherosclerosis happen mainly under the influence of non-fasting lipids. To date, the studies in the postprandial state were primarily performed on healthy subjects. This exploratory, cross-sectional study investigates the change in lipid profile, inflammation, and platelet activation in patients with different cardiovascular risk profiles in the postprandial state. Methods: The studied population consists of 66 patients with different cardiovascular risks: patients with a history of the chronic coronary syndrome (CCS) and diabetes mellitus type 2 (DM2) (n = 20), CCS without DM2 (n = 25), and a healthy control group (n = 21). Lipid variables and markers of platelet function and inflammation were assessed during the fasting state and three and 5 h after a standardized fat meal using a standardized oral fat tolerance test (OFTT), a milkshake with 90 g of fat. Results: Patients with CCS and DM2 were significantly older and had the highest BMI. All patients with CCS were on acetylsalicylic acid, and 95% of CCS patients were on high-dose statins. The absolute leukocyte and neutrophile count increased significantly in the control group during the OFTT in comparison to CCS subjects. There was a significant decrease of HDL and increase of triglycerides during the OFTT, however with no difference between groups. There was no difference in the change of platelet activity between all groups. Conclusion: This study showed that OFTT leads to an increased postprandial inflammation response in healthy group compared to CCS ± DM2 while there was no change in lipid profile and platelet activity.
Language	English
Publishing date	2023-09-21
Publishing country	Netherlands
Document type	Journal Article
ISSN	2667-0895
ISSN (online)	2667-0895
DOI	10.1016/j.athplu.2023.09.002
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Article ; Online: Low-density lipoprotein cholesterol reduction with immediate combination therapy of statin and ezetimibe compared to statin monotherapy after percutaneous coronary intervention.

Burger, Achim Leo / Beran, Nora / Pogran, Edita / Kaufmann, Christoph C / Zweiker, David / Muthspiel, Marie / Panzer, Benjamin / Jäger, Bernhard / Rohla, Miklos / Huber, Kurt

Wiener klinische Wochenschrift

2023 Volume 135, Issue 23-24, Page(s) 674–679

Abstract: Background: Current guidelines recommend a stepwise initiation of lipid-lowering therapy after percutaneous coronary interventions (PCI) in treatment-naïve individuals. Patients might benefit from an earlier and stronger low-density lipoprotein- ... ...

Abstract	Background: Current guidelines recommend a stepwise initiation of lipid-lowering therapy after percutaneous coronary interventions (PCI) in treatment-naïve individuals. Patients might benefit from an earlier and stronger low-density lipoprotein-cholesterol (LDL-C) reduction through upfront combination therapies. Methods: This retrospective study included patients without previous lipid-lowering therapy undergoing acute or elective PCI with stent implantation between January 2016 and December 2019. Patients initiated on statin monotherapy vs. a combination of statin and ezetimibe were compared. The primary endpoint was an LDL‑C reduction into the target range of < 55 mg/dL at 3 months. The secondary endpoint was the occurrence of major cardiovascular events (MACE). Results: A total of 204 lipid-lowering therapy naive patients were included, of whom 157 (77.0%) received statin monotherapy and 47 (23.0%) combination therapy. Median LDL‑C levels were higher in patients initiated on combination therapy vs. monotherapy (140 mg/dL, interquartile range, IQR, 123-167 mg/dL vs. 102 mg/dL, IQR 80-136 mg/dL, p < 0.001). The LDL‑C reduction was greater in patients treated with combination therapy vs. statin monotherapy (-73 mg/dL, -52.1% vs. -43 mg/dL, -42.2%, p < 0.001). While the primary endpoint was similar between groups (44.7% vs. 36.1%, p = 0.275), combination therapy significantly increased the proportion of patients achieving the treatment target in the presence of an admission LDL-C > 120 mg/dL (46.2% vs. 26.2%, p = 0.031). The rates of MACE were similar between the two groups (10.6% vs. 17.8%, p = 0.237) at a median follow-up of 2.2 years, IQR 1.46-3.10 years. Conclusion: Immediate initiation of high-intensity statin and ezetimibe treatment might be considered as the default strategy in treatment-naïve patients with high admission LDL‑C undergoing PCI.
MeSH term(s)	Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Ezetimibe ; Cholesterol, LDL ; Percutaneous Coronary Intervention ; Retrospective Studies ; Drug Therapy, Combination ; Treatment Outcome
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Ezetimibe (EOR26LQQ24) ; Cholesterol, LDL
Language	English
Publishing date	2023-10-24
Publishing country	Austria
Document type	Journal Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-023-02296-z
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Article ; Online: Direct cardiovascular complications and indirect collateral damage during the COVID-19 pandemic : A review.

Burger, Achim Leo / Kaufmann, Christoph C / Jäger, Bernhard / Pogran, Edita / Ahmed, Amro / Wojta, Johann / Farhan, Serdar / Huber, Kurt

Wiener klinische Wochenschrift

2021 Volume 133, Issue 23-24, Page(s) 1289–1297

Abstract: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), puts a heavy strain on healthcare systems around the globe with high numbers of infected patients. Pre-existing cardiovascular ... ...

Abstract	The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), puts a heavy strain on healthcare systems around the globe with high numbers of infected patients. Pre-existing cardiovascular disease is a major risk factor for a severe clinical course of COVID-19 and is associated with adverse outcome. COVID-19 may directly exacerbate underlying heart disease and is frequently aggravated by cardiovascular complications, including arterial and venous thromboembolic events, malignant arrhythmia and myocardial injury. In addition to these direct cardiac manifestations of COVID-19, patients with cardiovascular disease face further indirect consequences of the pandemic, as the respective resources in the healthcare systems need to be redirected to cope with the high numbers of infected patients. Consecutively, a substantial decrease in cardiac procedures was reported during the pandemic with lower numbers of coronary angiographies and device implantations worldwide. As a consequence an increased number of out-of-hospital cardiac arrests, late-comers with subacute myocardial infarction and of patients presenting in cardiogenic shock or preshock were observed. Maintenance of high-quality cardiac care by avoiding a reduction of cardiac services is of utmost importance, especially in times of a pandemic.
MeSH term(s)	Arrhythmias, Cardiac ; COVID-19 ; Cardiovascular Diseases/epidemiology ; Humans ; Myocardial Infarction ; Pandemics ; SARS-CoV-2
Language	English
Publishing date	2021-10-20
Publishing country	Austria
Document type	Journal Article ; Review
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-021-01956-2
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Article ; Online: Psychocardiological assessment in the acute phase of the takotsubo syndrome : Somatic and depressive disorders, resilience and illness perception.

Weihs, Valerie / Pogran, Edita / Kunschitz, Evelyn / Weihs, Wolfgang / Prinz, Erika / Eichenberg, Christiane / Fiegl, Jutta / Friedrich, Oliver / Huber, Kurt

Wiener klinische Wochenschrift

2021 Volume 134, Issue 7-8, Page(s) 269–275

Abstract: Objective: To analyze the psychocardiological profile and the clinical characteristics in the acute phase of takotsubo syndrome (TTS).: Methods: Prospective multicenter cohort study of TTS patients evaluating the clinical characteristics as well as ... ...

Abstract	Objective: To analyze the psychocardiological profile and the clinical characteristics in the acute phase of takotsubo syndrome (TTS). Methods: Prospective multicenter cohort study of TTS patients evaluating the clinical characteristics as well as the prevalence of somatic, depressive, panic, stress and anxiety disorders. Assessment of illness perception and resilience in the acute phase of the syndrome. Results: All 27 evaluated TTS patients were female with a mean age of 68 years (±11.4 years). The apical type of TTS was found in 60% of patients, followed by the combined type of TTS in 30% of patients. Main clinical symptom leading to hospital admission was chest pain in nearly 80% of patients. An ST-segment elevation mimicking acute myocardial infarction was found in 44% of patients and T wave inversion in 26% of patients. An endogenous (emotional) stress event was found in 17 patients (63.0%), an exogenous (physical) stress event in 5 patients (18.5%) and a combined stress event in 2 patients (7.4%). In 11.1% of patients (n = 3) no stress event could be found. Moderate to high levels of illness threatening were found in 48% of patients and low to moderate resilience scores were found in 40% of patients. Somatic disorders were found in half of the patients (56%) followed by depressive disorders in 26% of patients. Conclusion: Moderate to low resilience scores and moderate to high levels of illness threatening can be seen in the acute phase of TTS, reflecting the severity of the experience as an adverse life event. Patients suffering from TTS present in the acute phase with a high prevalence of somatic disorders and relatively high prevalence of depressive disorders.
MeSH term(s)	Aged ; Cohort Studies ; Depressive Disorder/diagnosis ; Depressive Disorder/epidemiology ; Female ; Humans ; Male ; Perception ; Prospective Studies ; Takotsubo Cardiomyopathy/diagnosis ; Takotsubo Cardiomyopathy/epidemiology
Language	English
Publishing date	2021-10-20
Publishing country	Austria
Document type	Journal Article ; Multicenter Study
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-021-01957-1
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Article: Psychocardiological assessment in the acute phase of the takotsubo syndrome. Somatic and depressive disorders, resilience and illness perception

Weihs, Valerie / Pogran, Edita / Kunschitz, Evelyn / Weihs, Wolfgang / Prinz, Erika / Eichenberg, Christiane / Fiegl, Jutta / Friedrich, Oliver / Huber, Kurt

Wiener Klinische Wochenschrift

2022 Volume 134, Issue 7-8, Page(s) 269–275

Abstract: Objective: To analyze the psychocardiological profile and the clinical characteristics in the acute phase of takotsubo syndrome (TTS). Methods: Prospective multicenter cohort study of TTS patients evaluating the clinical characteristics as well as the ... ...

Title translation	Psychokardiologische Beurteilung in der akuten Phase des Takotsubo-Syndroms. Somatische und depressive Störungen, Resilienz und Krankheitswahrnehmung
Abstract	Objective: To analyze the psychocardiological profile and the clinical characteristics in the acute phase of takotsubo syndrome (TTS). Methods: Prospective multicenter cohort study of TTS patients evaluating the clinical characteristics as well as the prevalence of somatic, depressive, panic, stress and anxiety disorders. Assessment of illness perception and resilience in the acute phase of the syndrome. Results: All 27 evaluated TTS patients were female with a mean age of 68 years (+/- 11.4 years). The apical type of TTS was found in 60% of patients, followed by the combined type of TTS in 30% of patients. Main clinical symptom leading to hospital admission was chest pain in nearly 80% of patients. An ST-segment elevation mimicking acute myocardial infarction was found in 44% of patients and T wave inversion in 26% of patients. An endogenous (emotional) stress event was found in 17 patients (63.0%), an exogenous (physical) stress event in 5 patients (18.5%) and a combined stress event in 2 patients (7.4%). In 11.1% of patients (n = 3) no stress event could be found. Moderate to high levels of illness threatening were found in 48% of patients and low to moderate resilience scores were found in 40% of patients. Somatic disorders were found in half of the patients (56%) followed by depressive disorders in 26% of patients. Conclusion: Moderate to low resilience scores and moderate to high levels of illness threatening can be seen in the acute phase of TTS, reflecting the severity of the experience as an adverse life event. Patients suffering from TTS present in the acute phase with a high prevalence of somatic disorders and relatively high prevalence of depressive disorders.
Keywords	Bewältigungsverhalten ; Coping Behavior ; Heart Disorders ; Herzkrankheiten ; Illness Behavior ; Krankenverhalten ; Major Depression ; Resilience (Psychological) ; Resilienz ; Risikofaktoren ; Risk Factors ; Somatoform Disorders ; Somatoforme Störungen ; Stress ; Symptome ; Symptoms
Language	English
Document type	Article
ZDB-ID	200462-8
ISSN	1613-7671 ; 0043-5325 ; 0300-5178
ISSN (online)	1613-7671
ISSN	0043-5325 ; 0300-5178
DOI	10.1007/s00508-021-01957-1
Database	PSYNDEX

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Article: Association of Interleukin-32 and Interleukin-34 with Cardiovascular Disease and Short-Term Mortality in COVID-19.

Kaufmann, Christoph C / Ahmed, Amro / Muthspiel, Marie / Rostocki, Isabella / Pogran, Edita / Zweiker, David / Burger, Achim Leo / Jäger, Bernhard / Aicher, Gabriele / Spiel, Alexander O / Vafai-Tabrizi, Florian / Gschwantler, Michael / Fasching, Peter / Wojta, Johann / Huber, Kurt

Journal of clinical medicine

2023 Volume 12, Issue 3

Abstract: Background: Excess cardiovascular (CV) morbidity and mortality has been observed in patients with COVID-19. Both interleukin-32 (IL-32) and interleukin-34 (IL-34) have been hypothesized to contribute to CV involvement in COVID-19.: Methods: This ... ...

Abstract	Background: Excess cardiovascular (CV) morbidity and mortality has been observed in patients with COVID-19. Both interleukin-32 (IL-32) and interleukin-34 (IL-34) have been hypothesized to contribute to CV involvement in COVID-19. Methods: This prospective, observational study of patients with laboratory-confirmed COVID-19 infection was conducted from 6 June to 22 December 2020 in a tertiary care hospital in Vienna, Austria. IL-32 and IL-34 levels on admission were collected and tested for their association with CV disease and short-term mortality in patients with COVID-19. CV disease was defined by the presence of coronary artery disease, heart failure, stroke or atrial fibrillation and patients were stratified by CV disease burden. Results: A total of 245 eligible patients with COVID-19 were included, of whom 37 (15.1%) reached the primary endpoint of 28-day mortality. Of the total sample, 161 had no CV disease (65.7%), 69 had one or two CV diseases (28.2%) and 15 patients had ≥three CV diseases (6.1%). Median levels of IL-32 and IL-34 at admission were comparable across the three groups of CV disease burden. IL-32 and IL-34 failed to predict mortality upon both univariable and multivariable Cox regression analysis. The two CV disease groups, however, had a significantly higher risk of mortality within 28 days (one or two CV diseases: crude HR 4.085 (95% CI, 1.913-8.725), Conclusion: In our study population of hospitalized patients with COVID-19, IL-32 and IL-34 did not show any associations with CV disease or 28-day mortality in the context of COVID-19. Patients with multiple CV diseases, however, had a significantly increased risk of short-term mortality.
Language	English
Publishing date	2023-01-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12030975
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