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See detailPrognostic impact of electrocardiographic signs in patients with Type 2 diabetes and cardiovascular disease: results from the PROactive study
Pfister, R.; Cairns, R.; Erdmann, E. et al

in Diabetic Medicine : A Journal of the British Diabetic Association (2011), 28

Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating patientswith Type 2 diabetes and cardiovascular disease, the independent prognostic relevance of ... [more ▼]

Aims Although a resting electrocardiograph is broadly applied in clinical practice for evaluating patientswith Type 2 diabetes and cardiovascular disease, the independent prognostic relevance of electrocardiographic signs has not thoroughly been examined. Methods Baseline 12-lead electrocardiographs available in 5231 of the 5238 participants of the PROactive trial were analysed for heart rate, heart rate corrected QT-interval, presence of atrial fibrillation ⁄ flutter, left axis deviation, right and left bundle branch block. The association of electrocardiographic signs with total mortality, the principal secondary composite endpoint (death, myocardial infarction and stroke) and serious adverse heart failure events was examined by Cox-regression analysis. Results Two hundred and twenty-three (4.3%) patients showed atrial fibrillation ⁄ flutter, 213 (4.1%) patients had right bundle branch block, 111 (2.1%) patients had left bundle branch block and 706 (13.5%) patients had left axis deviation. Mean cQT-interval was 418 ms ( 25 ms) and mean heart ratewas 72 ⁄min ( 14 ⁄ min). Inmultivariate adjusted analyses, heart rate and cQT-interval were significantly associated with mortality, the composite secondary endpoint and heart failure, whereas right and left bundle branch blockswere significantly associated with heart failure only. Left axis deviationwas associated with heart failure and atrial fibrillation ⁄ flutter was associated with mortality and heart failure in univariate but not multivariate analyses. Conclusion Easily assessable electrocardiographic signs such as heart rate, cQT-interval and bundle branch blocks were predictive for adverse outcome independently of multiple risk factor adjustment and should be considered in clinical care. [less ▲]

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See detailPrognostic importance of exercise brain natriuretic peptide in asymptomatic degenerative mitral regurgitation
Magne, Julien ULg; Mahjoub, H.; Pibarot, P. et al

in European Journal of Heart Failure (2012), 14(11), 1293-1302

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See detailPrognostic Importance of Exercise Brain Natriuretic Peptide in Asymptomatic Degenerative Mitral Regurgitation.
Magne, Julien ULg; Mahjoub, H; Pibarot, P et al

Conference (2012)

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See detailPrognostic importance of exercise-induced changes in mitral regurgitation in patients with chronic ischemic left ventricular dysfunction
Lancellotti, Patrizio ULg; Troisfontaines, P.; Toussaint, A. C. et al

in Circulation (2003), 108(14), 1713-1717

Background-In the post-myocardial infarction phase, mortality risk is related to the severity of mitral regurgitation (MR). Ischemic MR is a dynamic condition that can be studied during exercise. Whether ... [more ▼]

Background-In the post-myocardial infarction phase, mortality risk is related to the severity of mitral regurgitation (MR). Ischemic MR is a dynamic condition that can be studied during exercise. Whether the assessment of exercise-induced changes in the degree of MR provides prognostic information is unknown. Methods and Results-Ninety-eight consecutive patients with chronic ischemic left ventricular dysfunction and at least mild MR who prospectively underwent quantitative measurement of the regurgitant volume and the effective regurgitant orifice (ERO) of MR at rest and during semisupine exercise test were followed up for 19+/-8 months. The 16 patients who underwent surgery were censored at the time of operation. Of the 82 patients who were medically treated, 9 (11%) died. No clinical data demonstrated a distinction between survivors and nonsurvivors. By multivariate Cox regression analysis, independent predictors of cardiac death were an increase in ERO by greater than or equal to13 mm(2) (P=0.0045) during exercise, an ERO >20 mm(2) at rest (P=0.01), and a shorter mitral deceleration time (P=0.044). Half of the patients with exercise-induced significant increases in MR who died had moderate MR at rest. In contrast, none of the 14 patients with a decrease in MR at exercise displayed cardiac death. Conclusions-In patients with ischemic MR and left ventricular dysfunction, quantitative assessment of exercise-induced changes in the degree of MR provides independent prognostic information. Significant exercise-induced increases in MR unmask patients at high risk of poor outcome. [less ▲]

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See detailPrognostic importance of quantitative exercise Doppler echocardiography in asymptomatic valvular aortic stenosis
Lancellotti, Patrizio ULg; Lebois, Florence ULg; Simon, Marc et al

in Circulation (2005), 112(9 Suppl.), 377-382

BACKGROUND: In patients with asymptomatic valvular aortic stenosis, exercise testing may help to stratify the clinical risk. However, data are limited, and the role of quantitative exercise Doppler ... [more ▼]

BACKGROUND: In patients with asymptomatic valvular aortic stenosis, exercise testing may help to stratify the clinical risk. However, data are limited, and the role of quantitative exercise Doppler echocardiography has never been investigated. METHODS AND RESULTS: Sixty-nine consecutive patients with severe asymptomatic aortic stenosis (aortic valve area <1 cm2) who prospectively underwent quantitative Doppler echocardiographic measurements at rest and during semisupine exercise test were followed up for 15+/-7 months. Of these, 26 had an abnormal response to exercise [occurrence of > or =1 of the following findings: angina, dyspnea, > or =2 mm ST segment depression, or fall or small (<20 mm Hg) rise in systolic blood pressure during the test] and 18 presented cardiac events during follow-up (symptoms in 2 patients, acute pulmonary edema in 2, aortic valve replacement in 12, and cardiac death in 2). In univariate analysis, patients who had cardiac events exhibited a higher increase in both peak (29+/-16 versus 22+/-14 mm Hg; P=0.019) and mean (23+/-8 versus 12+/-7 mm Hg; P=0.000003) transvalvular pressure gradients, whereas the left ventricular ejection fraction reached at peak stress was lower. These patients experienced more frequently symptoms during exercise (14 of 18 versus 12 of 51; P=0.0008). By multivariate Cox regression analysis, independent predictors of cardiac events were as follows: an increase in mean transaortic pressure gradient by > or =18 mm Hg during exercise (P=0.0015), an abnormal exercise test (P=0.0026), and an aortic valve area <0.75 cm2 (P=0.0031). Exercise Doppler echocardiographic findings provided incremental prognostic value over resting echocardiographic and exercise electrocardiographic parameters. CONCLUSIONS: Quantitative Doppler exercise echocardiography could be useful to identify a high-risk subset of patients with asymptomatic valvular aortic stenosis and help for clinical decision making. [less ▲]

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See detailPrognostic markers in malignant diseases
Chapelle, Jean-Paul ULg; Duvivier, J.; Gielen, J.

Conference (1995, July)

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See detailPrognostic markers in malignant diseases
Chapelle, Jean-Paul ULg; Duvivier, J.; Gielen, Jacques

in Scandinavian Journal of Clinical and Laboratory Investigation. Supplementum (1995), 55

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See detailPrognostic significance of a low peak serum creatine kinase level in acute myocardial infarction
Pierard, Luc ULg; Dubois, Christophe ULg; Albert, Adelin ULg et al

in American Journal of Cardiology (1989), 63(12), 792-6

To assess the prognostic significance of a low peak creatine kinase (CK) level, 723 consecutive patients admitted with acute myocardial infarction (AMI) within 16 hours after onset of symptoms were ... [more ▼]

To assess the prognostic significance of a low peak creatine kinase (CK) level, 723 consecutive patients admitted with acute myocardial infarction (AMI) within 16 hours after onset of symptoms were studied. Thrombolytic therapy was not attempted during the study. Patients were dichotomized according to their peak CK levels, determined from a cluster analysis of peak CK distribution among the population of patients who died within 3 years after hospital discharge. The 139 patients with low peak CK (less than or equal to 650 IU/liter) (group 1) were compared to the 584 patients with high peak CK (greater than 650 IU/liter) (group 2). Patients in group 1 were older and had a higher incidence of previous AMI, angina pectoris before AMI and non-Q-wave AMI. Despite a lower incidence of in-hospital complications and a nonsignificantly lower hospital mortality rate (4 vs 9%) the group 1 three-year posthospital mortality rate was higher (26 vs 17%; p less than 0.02), especially in the subgroup of patients with a Q-wave infarct (mortality 31% in group 1 vs 16% in group 2; p less than 0.001). Among the 491 patients who had a first Q-wave AMI, 55 had a peak CK less than or equal to 650 IU/liter. Compared to the 436 patients with a higher peak CK, these 55 patients had a higher incidence of early postinfarction angina (31 vs 14%; p less than 0.01), a similar hospital mortality (4 vs 7%) but a higher 3-year posthospital mortality (23 vs 12%; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) [less ▲]

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See detailPrognostic significance of aberrant promoter hypermethylation of CpG islands in patients with diffuse large B-cell lymphomas
Amara, Khaled; Trimeche, Mounir; Ziadi, Sonia et al

in Annals of Oncology (2008), 19(10), 1774-1786

Background: Diffuse large B-cell lymphoma (DLBCL) exhibits heterogeneous clinical features and a marked variable response to treatment. Patients and methods: We investigated the prognostic significance of ... [more ▼]

Background: Diffuse large B-cell lymphoma (DLBCL) exhibits heterogeneous clinical features and a marked variable response to treatment. Patients and methods: We investigated the prognostic significance of the methylation status of DAPK, GSTP1, P14, P15, P16, P33, RB1, SHP1, CDH1, APC, BLU, VHL, TIMP3, and RASSF1A genes in 46 DLBCL specimens from Tunisian patients. Methylation status of each gene was correlated with clinicopathological parameters including the International Prognostic Index (IPI), the germinal center immunophenotype, and response to treatment and survival. Overall survival (OS) and disease-free survival (DFS) rates were calculated by the Kaplan–Meier method and differences were compared with the log-rank test. Results: Hypermethylation of SHP1 was associated with elevated lactate dehydrogenase level (P = 0.031). P16 and VHL were frequently hypermethylated in patients with high IPI scores (P = 0.006 and 0.004) and a performance status of two or more (P = 0.007 and 0.047). In addition, hypermethylation of P16 was significantly associated with advanced clinical stages and B symptoms (P = 0.041 and 0.012). Interestingly, hypermethylation of DAPK was significantly correlated with resistance to treatment (P = 0.023). With regard to survival rates, promoter hypermethylation of DAPK, P16, and VHL were significantly associated with shortened OS (P = 0.003, 0.001, and 0.017, respectively) and DFS (P = 0.006, 0.003, and 0.046, respectively). In multivariate analysis, hypermethylation of DAPK remains an independent prognostic factor in predicting shortened OS (P = 0.001) and DFS (P = 0.024), as well as the IPI and the germinal center status. Conclusions: This study demonstrates that DLBCLs with hypermethylated P16, VHL, DAPK, and SHP1 commonly show a biologically aggressive phenotype and worse prognosis. Interestingly, hypermethylation of DAPK was found to be an independent prognostic factor that may be used in conjunction with the conventional prognostic factors such as the IPI and the germinal center status. [less ▲]

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See detailPrognostic Significance of bcl-2 Protein Expression in Aggressive Non-Hodkin's Lymphoma
Hermine, Olivier; Haioun, Corinne; Lepage, Eric et al

in Blood (1996)

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See detailPrognostic significance of electrocardiographic findings in angina at rest. Therapeutic implications.
Demoulin, J. C.; Bertholet, M.; Chevigne, M. et al

in British heart journal (1981), 46(3), 320-4

Ninety-five patients with angina at rest were observed in the coronary care unit. Eighty-one per cent presented concomitantly or had previously presented some other manifestations of coronary artery ... [more ▼]

Ninety-five patients with angina at rest were observed in the coronary care unit. Eighty-one per cent presented concomitantly or had previously presented some other manifestations of coronary artery disease. These patients were divided into two subgroups. In subgroup 1 (40 patients), episodes of non-exertional angina were associated with a pattern of hyperacute subepicardial injury and, frequently, with ventricular arrhythmias. In subgroup 2 (55 patients), the episodes of angina at rest were attended by horizontal ST depression, isolated T wave inversion, or trivial ST-T changes. Coronary angiographic findings were similar in both subgroups. Symptoms regressed in only 9% of patients in subgroup 1 while they were receiving beta-receptor antagonists, whereas amiodarone alone or amiodarone with nifedipine was successful in 58%. Of these patients, 25% developed a myocardial infarction shortly after admission. In subgroup 2 patients, beta-blockers were successful in 61%. Amiodarone isolated or associated with nifedipine was successful in 55% of the patients in whom it was tried. Only 5% of patients in this subgroup developed a myocardial infarction during their hospital stay. It is concluded that: (1) observation of the electrocardiogram during spontaneous angina in patients with known atherosclerotic coronary heart disease may be of prognostic significance and may influence therapeutic decision. (2) Amiodarone by virtue of its anginal and antiarrhythmic properties may be particularly useful in the treatment of non-exertional angina. [less ▲]

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See detailPrognostic significance of increased baseline plasma troponin I levels in PTCA patients
Chapelle, Jean-Paul ULg; Legrand, Victor ULg; Gielen, Jacques

in Clinical Chemistry (2000), 46(suppl), 82

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See detailThe prognostic significance of serum alpha 1-acid glycoprotein changes in acute myocardial infarction.
Chapelle, Jean-Paul ULg; Albert, Adelin ULg; Smeets, J. P. et al

in Clinica Chimica Acta (1981), 115(2), 199-209

Serum alpha 1-acid glycoprotein and haptoglobin concentrations were evaluated in 151 patients with acute myocardial infarction (MI) during the first ten days of hospitalization. Maximum glycoprotein ... [more ▼]

Serum alpha 1-acid glycoprotein and haptoglobin concentrations were evaluated in 151 patients with acute myocardial infarction (MI) during the first ten days of hospitalization. Maximum glycoprotein concentrations were found to be related to myoglobin and enzyme peak levels. Glycoprotein levels recorded upon patients' admission did not vary for acute phase survivors and early deaths (15 patients), but the latter demonstrated significantly higher alpha 1-acid glycoprotein levels (p less than 0.05) on day 1. The maximum glycoprotein concentrations were, however, reached too long after the onset of acute MI to be of interest for short-term prognosis. Comparison of the evolution of the two glycoproteins investigated in late deaths (10 patients) and in 6-month survivors indicated increased alpha 1-acid glycoprotein levels in non-survivors, with a maximum discrimination occurring on day 8 (p less than 0.001). Haptoglobin was not significantly different in the two groups and even demonstrated lower concentrations from day 4 to day 10 in non-survivors. The decrease of haptoglobin levels in patients with hepatic dysfunction could explain the divergent results given by the serum concentrations of the two glycoproteins to predict mortality. We show in this study that alpha 1-acid glycoprotein measured at the end of hospitalization can give relevant prognostic information for the 6-month period following acute MI. [less ▲]

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See detailPROGNOSTIC VALUE OF AMPS METHOD IN ALS PATIENTS
WANG, François-Charles ULg; GERARD, Pascale ULg; BOUQUIAUX, Olivier ULg et al

in Amyotrophic Lateral Sclerosis & Other Motor Neuron Disorders (2005)

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See detailPrognostic Value of Aortic Stiffness and Calcification for Cardiovascular Events and Mortality in Dialysis Patients: Outcome of the Calcification Outcome in Renal Disease (CORD) Study
Verbeke, Francis; Van Biesen, Wim; Honkanen, Eero et al

in Clinical Journal of the American Society of Nephrology (2011), 6

Background and objectives: Radiographic calcification and arterial stiffness each individually are predictive of outcome in dialysis patients. However, it is unknown whether combined assessment of these ... [more ▼]

Background and objectives: Radiographic calcification and arterial stiffness each individually are predictive of outcome in dialysis patients. However, it is unknown whether combined assessment of these intermediate endpoints also provides additional predictive value: Design, setting, participants & measurements: Scoring of abdominal aortic calcification (AAC) using plain lateral abdominal x-ray and measurement of carotid-femoral pulse wave velocity (PWV) were performed in a cohort of 1084 prevalent dialysis patients recruited from 47 European dialysis centers. Results: During a follow-up of 2 years, 234 deaths and 91 nonfatal cardiovascular (CV) events occured. Compared with the lowest tertile of AAC, the risk of an event was increased by a factor 3.7 in patients wih a score of 5 to 15 (middle tertile), and by a factor 8.6 in patients with scores of 16 to 24. Additionally, each 1-m/s increase in PWV was associated with a 15% higer risk. At higher AAC (scores >= 5), the effect of PWV was attenuated because of a negative PWV X AAC interaction (hazard ratio [HR]:0.895 and 0.865 for middle and upper AAC tertiles). After accounting for age, diabetes, and serum albumin, AAC and PWV remained independent predictors of outcome. Conclusions: AAC and central arterial stiffness are independent predictors of mortality and nonfatal CV events in dialysis patients. The risk associated with an increased PWV is less pronounced at higher levels of calcification. Assessment of AAC and PWV is feasible in a clinical setting and both may be used or an accurate CV risk estimation in this heterogeneous population. [less ▲]

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See detailPrognostic Value of Bone Sialoprotein Expression in Clinically Localized Human Prostate Cancer
Waltregny, David ULg; Bellahcene, Akeila ULg; Van Riet, Ivan et al

in Journal of the National Cancer Institute (1998), 90(13), 1000-8

BACKGROUND: Bone sialoprotein (BSP), a bone matrix protein, was recently found to be expressed ectopically in breast cancer and to have a statistically significant association with poor prognosis and the ... [more ▼]

BACKGROUND: Bone sialoprotein (BSP), a bone matrix protein, was recently found to be expressed ectopically in breast cancer and to have a statistically significant association with poor prognosis and the development of bone metastases in that disease. These data prompted us to investigate whether BSP might also be expressed in human prostate cancer, which often metastasizes to bone, and be predictive for progression risk. METHODS: Tissue sections from 180 patients who had undergone a radical prostatectomy for localized prostate cancer were analyzed immunohistochemically for BSP expression. Biochemical progression was defined as an increasing serum prostate-specific antigen level of 0.5 ng/mL or more. Statistical analysis was used to assess associations between pathologic findings and level of BSP expression, and a Cox proportional hazards model was used to determine which clinical and histologic parameters, including stage, Gleason score, and BSP expression (immunostaining intensity and extent), were independently associated with biochemical progression. All P values were two-sided. RESULTS: Most of the prostate cancer lesions examined (78.9%) expressed detectable levels of BSP, compared with no or low expression in the adjacent normal glandular tissue. A statistically significant association was found between BSP expression and biochemical progression in both univariate and multivariate analyses. After a follow-up interval of 3 years, the biochemical relapse rate was 36.7% (95% confidence interval [CI] = 23.4%-47.7%) in patients whose tumors expressed high levels of BSP compared with 12.1% (95% CI = 2.3%-20.8%) in patients whose tumors expressed no or a low detectable level of the protein (logrank test, P = .0014). BSP expression status could identify those patients at higher risk of biochemical progression (logrank test, P<.05) among patients with moderately differentiated tumors or with pathologically confined tumors. CONCLUSIONS: To our knowledge, this study is the first to demonstrate BSP expression in human prostate cancer and to highlight the protein's statistically significant prognostic value in patients with clinically confined prostate adenocarcinomas. [less ▲]

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