Supplementary Table 9, column 'Edoxaban', row 'eGFR category', '95 mL/min' (page 15). The cell should be coloured green instead of yellow. It should also read "60 mg"instead of "60 mg (use with caution in 'supranormal' renal function)."In the above-indicated cell, a footnote has also been added to state: "Edoxaban should be used in patients with high creatinine clearance only after a careful evaluation of the individual thromboembolic and bleeding risk."Supplementary Table 9, column 'Edoxaban', row 'Dose reduction in selected patients' (page 16). The cell should read "Edoxaban 60 mg reduced to 30 mg once daily if any of the following: creatinine clearance 15-50 mL/min, body weight <60 kg, concomitant use of dronedarone, erythromycin, ciclosporine or ketokonazole"instead of "Edoxaban 60 mg reduced to 30 mg once daily, and edoxaban 30 mg reduced to 15mg once daily, if any of the following: creatinine clearance of 30-50 mL/min, body weight <60 kg, concomitant us of verapamil or quinidine or dronedarone."

/pdf/2020-esc-guidelines-for-the-diagnosis-and-management-of-3p9h99nhm3.pdf

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

2020 ESC Guidelines for the management of adult congenital heart disease

Introduction: Prospective data on long term outcome after ventricular septal defect (VSD) closure do not exist.

Objectives: To evaluate survival and clinical outcome in a prospectively followed patient cohort up to 40 years after surgical VSD closure.

Methods: A cohort of 174 consecutive patients who had surgical VSD repair at young age between 1968-1980, is investigated every 10 years. The study protocol comprised echocardiography, ergometry, Holter monitoring, NT-proBNP, and SF-36 questionnaire.

Results: Survival status was obtained in 90% of 174 patients, and 84% of the eligible survivors participated in the in-hospital examination after median follow-up of 36 (range 30-40) years. A simple concomitant cardiac lesion (non-isolated VSD) was present in 32%. Postoperative mortality within 30 days was 10%, and late mortality at 40 years was 14%. Eight patients died in the last decade: 3 cardiac (arrhythmia n=2, heart failure n=1), 3 non-cardiac, and 2 unknown causes. Cumulative event incidence at 40 years was 38%, including interventions in 13%, symptomatic arrhythmias in 11%, and pacemaker/ICD in 7%. Most events occurred in non-isolated VSD patients (Fig. 1). LV systolic function was impaired in 21%, but remained stable over the last decade. Prevalence of RV systolic dysfunction increased from 1% to 16% (p=0.001). Mean workload decreased from 91% to 87% of expected (p=0.01). NT-proBNP (median 11.6 [IQR 7.0-19.8] pmol/L) was elevated in 38%. Postoperative complete atrioventricular block and non-isolated VSD were predictive for late events (HR 3.9 [95%CI 1.2-13.0]; HR 3.5 [95%CI 1.7-7.2]). Regarding the SF-36, patients scored their health status significantly better than the reference population.

Conclusions: Survival up to 40 years after successful surgical VSD closure is slightly lower than in the general Dutch population. Although many patients are discharged from routine follow-up, morbidity is substantial, especially in patients with non-isolated VSD.

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Abstract 13663: The Unnatural History of the Ventricular Septal Defect: Outcome up to 40 Years after Surgical Closure

Introduction and objectives Patients with type 2 diabetes (T2D) and stable coronary artery disease (CAD) previously revascularized with percutaneous coronary intervention (PCI) are at high risk of recurrent ischemic events. We aimed to provide real-world insights into the clinical characteristics and management of this clinical population, excluding patients with a history of myocardial infarction (MI) or stroke, using Natural Language Processing (NLP) technology. Methods This is a multicenter, retrospective study based on the secondary use of 2014–2018 real-world data captured in the Electronic Health Records (EHRs) of 1,579 patients (0.72% of the T2D population analyzed; n = 217,632 patients) from 12 representative hospitals in Spain. To access the unstructured clinical information in EHRs, we used the EHRead® technology, based on NLP and machine learning. Major adverse cardiovascular events (MACE) were considered: MI, ischemic stroke, urgent coronary revascularization, and hospitalization due to unstable angina. The association between MACE rates and the variables included in this study was evaluated following univariate and multivariate approaches. Results Most patients were male (72.13%), with a mean age of 70.5±10 years. Regarding T2D, most patients were non-insulin-dependent T2D (61.75%) with high prevalence of comorbidities. The median (Q1-Q3) duration of follow-up was 1.2 (0.3–4.5) years. Overall, 35.66% of patients suffered from at least one MACE during follow up. Using a Cox Proportional Hazards regression model analysis, several independent factors were associated with MACE during follow up: CAD duration (p < 0.001), COPD/Asthma (p = 0.021), heart valve disease (p = 0.031), multivessel disease (p = 0.005), insulin treatment (p < 0.001), statins treatment (p < 0.001), and clopidogrel treatment (p = 0.039). Conclusions Our results showed high rates of MACE in a large real-world series of PCI-revascularized patients with T2D and CAD with no history of MI or stroke. These data represent a potential opportunity to improve the clinical management of these patients.

Assessment of medical management in Coronary Type 2 Diabetic patients with previous percutaneous coronary intervention in Spain: A retrospective analysis of electronic health records using Natural Language Processing

ArticleCopyright : Kutty et al; licensee BioMed Central Ltd.2015 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver

/pdf/abnormal-right-atrial-performance-in-surgically-repaired-4lf95emyzp.pdf

Abnormal right atrial performance in surgically repaired Tetralogy of Fallot: the German Competence Network for Congenital Heart Defects investigators

Guía ESC 2020 para el tratamiento de las cardiopatías congénitas del adulto

Guía ESC 2019 sobre diabetes, prediabetes y enfermedades cardiovasculares, en colaboración con la European Association for the Study of Diabetes (EASD)

Anna Sonia Petronio

Papers

Guía ESC 2020 para el tratamiento de las cardiopatías congénitas del adulto

Guía ESC 2019 sobre diabetes, prediabetes y enfermedades cardiovasculares, en colaboración con la European Association for the Study of Diabetes (EASD)