11 research outputs found
High adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study
No full textFranz Goss,1 Johannes Brachmann,2 Christian W Hamm,3 Winfried Haerer,4 Nicolaus Reifart,5 Benny Levenson6 1Herzzentrum Alter Hof, München, Germany; 2Klinikum Coburg GmbH, II. Medizinische Klinik, Coburg, Germany; 3Kerckhoff Klinik GmbH, Kardiologie, Bad Nauheim, Germany; 4Herzklinik Ulm, Ulm, Germany; 5Kardiologische Praxis Prof. Reifart & Partner, Bad Soden, Germany; 6Kardiologische Gemeinschaftspraxis und Herzkatheterlabor Berlin-Charlottenburg, Berlin, Germany Abstract: We aimed to assess patient acceptance and effectiveness of a 12-month structured management program in patients after an acute coronary syndrome (ACS) event who were treated in a special setting of office-based cardiologists. The program comprised patient documentation with a specific tool (Bundesverband Niedergelassener Kardiologen [German Federation of Office-Based Cardiologists] cardiac pass with visit scheduling) shared by the hospital physician and the office-based cardiologist, the definition of individual treatment targets, and the systematic information of patients in order to optimize adherence to therapy. Participating centers (36 hospitals, 60 office-based cardiologists) included a total of 1,003 patients with ACS (ST-segment elevation myocardial infarction [STEMI] 44.3%, non-ST-segment elevation myocardial infarction [NSTEMI] 39.5%, unstable angina pectoris [UA] 15.2%, and unspecified 1.0%). During follow-up, treatment rates with cardiac medication remained high in all groups, with dual antiplatelet therapy in 91.0% at 3 months, 90.0% at 6 months, and 82.8% at 12 months, respectively. Twelve months after the inclusion, a total of 798 patients (79.6%) still participated in the program. Eighteen patients (1.8%) had died after discharge from hospital (6 in the STEMI, 12 in the NSTEMI group), while for 58 the status was unknown (5.8%). Based on a conservative approach that considered patients with unknown status as dead, 1-year mortality was 7.6%. Recurrent cardiac events were noted in14.9% at 1 year, with an about equal distribution across STEMI and NSTEMI patients. In conclusion, patients’ acceptance of the ProAcor program as determined by adherence rates over time was high. Treatment rates of recommended medications used for patients with coronary heart disease were excellent. The 1-year mortality rate was comparatively low. Keywords: myocardial infarction, patient management, patient education, feedback, ­patient-oriented outcomes, therapy adherence, compliance, mortality, quality of lif
Angioplasty of chronic total coronary occlusions — results of a controlled randomized trial
No full textHigh adherence to therapy and low cardiac mortality and morbidity in patients after acute coronary syndrome systematically managed by office-based cardiologists in Germany: 1-year outcomes of the ProAcor Study
No full text1074-160 16-slice computed tomography for coronary angiography: Can we do it at higher heart rates?
No full textAuthor Correction: Discovery of a radiation component from the Vela pulsar reaching 20 teraelectronvolts
No full textIn the version of the article initially published, R. Zanin, M. Kerr, S. Johnston, R. M. Shannon and D. A. Smith mistakenly appeared in the main author list but are now instead listed as members of The H.E.S.S. Collaboration et al. in the HTML and PDF versions of the article
Survey of clinical practice pattern in Germany’s certified chest pain units
No full textBackground!#!We aimed to analyze the 2020 standard of care in certified German chest pain units (CPU) with a special focus on non-ST-segment elevation acute coronary syndrome (NSTE-ACS) through a voluntary survey obtained from all certified units, using a prespecified questionnaire.!##!Methods!#!The assessment included the collection of information on diagnostic protocols, risk assessment, management and treatment strategies in suspected NSTE-ACS, the timing of invasive therapy in non-ST-segment elevation myocardial infarction (NSTEMI), and the choice of antiplatelet therapy.!##!Results!#!The response rate was 75%. Among all CPUs, 77% are currently using the European Society of Cardiology (ESC) 0/3‑h high-sensitive troponin protocol, and only 20% use the ESC 0/1‑h high-sensitive troponin protocol as a default strategy. Conventional ergometry is still the commonly performed stress test with a utilization rate of 47%. Among NSTEMI patients, coronary angiography is planned within 24 h in 96% of all CPUs, irrespective of the day of the week. Prasugrel is the P2Y12 inhibitor of choice in ST-segment elevation myocardial infarction (STEMI), but despite the impact of the ISAR-REACT 5 trial on selection of antiplatelet therapy, ticagrelor is still favored over prasugrel in NSTE-ACS. If triple therapy is used in NSTE-ACS with atrial fibrillation, it is maintained up to 4 weeks in 51% of these patients.!##!Conclusion!#!This survey provides evidence that Germany's certified CPUs ensure a high level of guideline adherence and quality of care. The survey also identified areas in need of improvement such as the high utilization rate of stress electrocardiogram (ECG)
4. Bericht des Bundesverbandes Niedergelassener Kardiologen zur Qualitätssicherung in der diagnostischen und therapeutischen Invasivkardiologie 1999–2002
No full textIntravenous Recombinant Tissue Plasminogen Activator (rt-PA) and Urokinase in Acute Myocardial Infarction: Results of the German Activator Urokinase Study (GAUS)
No full textAbstractThe effects of recombinant tissue plasminogen activator (rt-PA) and urokinase on patency and early reocclusion of infarct-related coronary arteries were investigated in a single blind, randomized multicenter trial in 246 patients with acute myocardial infarction of < 6 h duration. Both 70 mg of single chain rt-PA with an initial bolus of 10 mg and 3 million units of urokinase with an initial bolus of 1.5 million units were given intravenously over 90 min. The first angiographic study at the end of the infusion revealed a patent infarct-related artery (Thrombolysis in Myocardial Infarction trial [TIMI] grade 2 or 3) in 69.4% of 121 patients given rt-PA versus 65.8% of 117 patients given urokinase (p = NS). Among patients treated within 3 h from symptom onset a patent infarct-related artery was found in 63.9% of 72 patients given rt-PA versus 70% of 70 patients given urokinase (p = NS).There were five cardiac deaths in each group and one fatal intracranial hemorrhage in the rt-PA group. The in-hospital reinfarction rate was 8.9% versus 13.2% for patients treated with rt-PA and urokinase, respectively. There was no difference in left ventricular function at baseline and follow-up catheterization studies. Both drugs were well tolerated and there was no significant difference in cardiovascular or bleeding complications between the two groups.It is concluded that rt-PA and urokinase in the dosages used provide similar efficacy and safety in the treatment of acute myocardial infarction. Reocclusion during the first 24 h may be less frequent after urokinase treatment
Broadband multi-wavelength properties of M87 during the 2018 EHT campaign including a very high energy flaring episode
No full textAlgaba, Juan-Carlos et al.-- Full list of authors: Algaba, J. C.; Baloković, M.; Chandra, S.; Cheong, W. -Y.; Cui, Y. -Z.; D'Ammando, F.; Falcone, A. D.; Ford, N. M.; Giroletti, M.; Goddi, C.; Gurwell, M. A.; Hada, K.; Haggard, D.; Jorstad, S.; Kaur, A.; Kawashima, T.; Kerby, S.; Kim, J. -Y.; Kino, M.; Kravchenko, E. V.; Lee, S. -S.; Lu, R. -S.; Markoff, S.; Michail, J.; Neilsen, J.; Nowak, M. A.; Principe, G.; Ramakrishnan, V.; Ripperda, B.; Sasada, M.; Savchenko, S. S.; Sheridan, C.; Akiyama, K.; Alberdi, A.; Alef, W.; Anantua, R.; Asada, K.; Azulay, R.; Bach, U.; Baczko, A. -K.; Ball, D.; Bandyopadhyay, B.; Barrett, J.; Bauböck, M.; Benson, B. A.; Bintley, D.; lackburn, L.; Blundell, R.; Bouman, K. L.; Bower, G. C.; Boyce, H.; Bremer, M.; Brissenden, R.; Britzen, S.; Broderick, A. E.; Broguiere, D.; Bronzwaer, T.; Bustamante, S.; Carlstrom, J. E.; Chael, A.; Chan, C. -k.; Chang, D. O.; Chatterjee, K.; Chatterjee, S.; Chen, M. -T.; Chen, Y.; Cheng, X.; Cho, I.; Christian, P.; Conroy, N. S.; Conway, J. E.; Crawford, T. M.; Crew, G. B.; Cruz-Osorio, A.; Dahale, R.; Davelaar, J.; De Laurentis, M.; Deane, R.; Dempsey, J.; Desvignes, G.; Dexter, J.; Dhruv, V.; Dihingia, I. K.; Doeleman, S. S.; Dzib, S. A.; Eatough, R. P.; Emami, R.; Falcke, H.; Farah, J.; Fish, V. L.; Fomalont, E.; Ford, H. A.; Foschi, M.; Fraga-Encinas, R.; Freeman, W. T.; Friberg, P.; Fromm, C. M.; Fuentes, A.; Galison, P.; Gammie, C. F.; García, R.; Gentaz, O.; Georgiev, B.; Gold, R.; Gómez-Ruiz, A. I.; Gómez, J. L.; Gu, M.; Hesper, R.; Heumann, D.; Ho, L. C.; Ho, P.; Honma, M.; Huang, C. -W. L.; Huang, L.; Hughes, D. H.; Ikeda, S.; Impellizzeri, C. M. V.; Inoue, M.; Issaoun, S.; James, D. J.; Jannuzi, B. T.; Janssen, M.; Jeter, B.; Jiang, W.; Jiménez-Rosales, A.; Johnson, M. D.; Jones, A. C.; Joshi, A. V.; Jung, T.; Karuppusamy, R.; Keating, G. K.; Kettenis, M.; Kim, D. -J.; Kim, J.; Kim, J.; Koay, J. Y.; Kocherlakota, P.; Kofuji, Y.; Koch, P. M.; Koyama, S.; Kramer, C.; Kramer, J. A.; Kramer, M.; Krichbaum, T. P.; Kuo, C. -Y.; La Bella, N.; Levis, A.; Li, Z.; Lico, R.; Lindahl, G.; Lindqvist, M.; Lisakov, M.; Liu, J.; Liu, K.; Liuzzo, E.; Lo, W. -P.; Lobanov, A. P.; Loinard, L.; Lonsdale, C. J.; Lowitz, A. E.; MacDonald, N. R.; Mao, J.; Marchili, N.; Marrone, D. P.; Marscher, A. P.; Martí-Vidal, I.; Matsushita, S.; Matthews, L. D.; Medeiros, L.; Menten, K. M.; Mizuno, I.; Mizuno, Y.; Montgomery, J.; Moran, J. M.; Moriyama, K.; Moscibrodzka, M.; Mulaudzi, W.; Müller, C.; Müller, H.; Mus, A.; Musoke, G.; Myserlis, I.; Nagai, H.; Nagar, N. M.; Nair, D. G.; Nakamura, M.; Narayanan, G.; Natarajan, I.; Nathanail, A.; Navarro Fuentes, S.; Ni, C.; Oh, J.; Okino, H.; Olivares, H.; Oyama, T.; Özel, F.; Palumbo, D. C. M.; Filippos Paraschos, G.; Park, J.; Parsons, H.; Patel, N.; Pen, U. -L.; Pesce, D. W.; Piétu, V.; PopStefanija, A.; Porth, O.; Prather, B.; Psaltis, D.; Pu, H. -Y.; Rao, R.; Rawlings, M. G.; Raymond, A. W.; Rezzolla, L.; Ricarte, A.; Roelofs, F.; Romero-Cañizales, C.; Ros, E.; Roshanineshat, A.; Rottmann, H.; Roy, A. L.; Ruiz, I.; Ruszczyk, C.; Rygl, K. L. J.; Sánchez, S.; Sánchez-Argüelles, D.; Sánchez-Portal, M.; Satapathy, K.; Savolainen, T.; Schloerb, F. P.; Schonfeld, J.; Schuster, K. -F.; Shao, L.; Shen, Z.; Small, D.; Sohn, B. W.; SooHoo, J.; Sosapanta Salas, L. D.; Souccar, K.; Stanway, J. S.; Sun, H.; Tazaki, F.; Tetarenko, A. J.; Tiede, P.; Tilanus, R. P. J.; Titus, M.; Toma, K.; Torne, P.; Toscano, T.; Traianou, E.; Trent, T.; Trippe, S.; Turk, M.; van Bemmel, I.; van Langevelde, H. J.; van Rossum, D. R.; Vos, J.; Wagner, J.; Ward-Thompson, D.; Wardle, J.; Washington, J. E.; Weintroub, J.; Wharton, R.; Wielgus, M.; Wiik, K.; Witzel, G.; Wondrak, M. F.; Wong, G. N.; Wu, Q.; Yadlapalli, N.; Yamaguchi, P.; Yfantis, A.; Yoon, D.; Young, A.; Younsi, Z.; Yu, W.; Yuan, F.; Yuan, Y. -F.; Zensus, J. A.; Zhang, S.; Zhao, G. -Y.; Zhao, S. -S.; Bellazzini, R.; Berenji, B.; Bissaldi, E.; Blandford, R. D.; Bonino, R.; Bruel, P.; Cameron, R. A.; Caraveo, P. A.; Cavazzuti, E.; Cheung, C. C.; Ciprini, S.; Cristarella Orestano, P.; Cutini, S.; Di Lalla, N.; Dinesh, A.; Di Venere, L.; Domínguez, A.; Fegan, S. J.; Franckowiak, A.; Fukazawa, Y.; Fusco, P.; Gargano, F.; Gasbarra, C.; Germani, S.; Giliberti, M.; Grenier, I. A.; Hays, E.; Horan, D.; Kuss, M.; Larsson, S.; Liodakis, I.; Longo, F.; Loparco, F.; Lovellette, M. N.; Maldera, S.; Mazziotta, M. N.; Mereu, I.; Michelson, P. F.; Mirabal, N.; Mizuno, T.; Monzani, M. E.; Morselli, A.; Negro, M.; Omodei, N.; Orlando, E.; Persic, M.; Rainò, S.; Rani, B.; Reimer, A.; Reimer, O.; Sánchez-Conde, M.; Saz Parkinson, P. M.; Sgrò, C.; Siskind, E. J.; Spinelli, P.; Suson, D. J.; Tajima, H.; Torres, D. F.; Zaharijas, G.; Aharonian, F.; Ait Benkhali, F.; Aschersleben, J.; Ashkar, H.; Backes, M.; Barbosa Martins, V.; Batzofin, R.; Becherini, Y.; Berge, D.; Böttcher, M.; Boisson, C.; Bolmont, J.; de Bony de Lavergne, M.; Borowska, J.; Bouyahiaoui, M.; Bradascio, F.; Brose, R.; Brown, A.; Bruno, B.; Bulik, T.; Burger-Scheidlin, C.; Casanova, S.; Cecil, R.; Celic, J.; Cerruti, M.; Chand, T.; Chen, A.; Chibueze, J.; Chibueze, O.; Cotter, G.; Damascene Mbarubucyeye, J.; Devin, J.; Djuvsland, J.; Dmytriiev, A.; Einecke, S.; Ernenwein, J. -P.; Feijen, K.; Fontaine, G.; Funk, S.; Gabici, S.; Glawion, D.; Glicenstein, J. F.; Goswami, P.; Grolleron, G.; Haerer, L.; Heß, B.; Holch, T. L.; Holler, M.; Horns, D.; Huang, Zhiqiu; Jamrozy, M.; Jankowsky, F.; Jung-Richardt, I.; Kasai, E.; Katarzyński, K.; Khatoon, R.; Khélifi, B.; Kluźniak, W.; Komin, Nu.; Kosack, K.; Kundu, A.; Lang, R. G.; Le Stum, S.; Leitl, F.; Lemière, A.; Lemoine-Goumard, M.; Lenain, J. -P.; Leuschner, F.; Luashvili, A.; Mackey, J.; Malyshev, D.; Martí-Devesa, G.; Marx, R.; Meyer, M.; Mitchell, A.; Moderski, R.; Moghadam, M. O.; Mohrmann, L.; Montanari, A.; Moulin, E.; de Naurois, M.; Niemiec, J.; O'Brien, P.; Ohm, S.; de Ona Wilhelmi, E.; Ostrowski, M.; Panny, S.; Panter, M.; Pensec, U.; Pita, S.; Pühlhofer, G.; Quirrenbach, A.; Ravikularaman, S.; Reimer, A.; Reimer, O.; Reville, B.; Reis, I.; Ren, H.; Rieger, F.; Roellinghoff, G.; Rudak, B.; Ruiz-Velasco, E.; Sabri, K.; Sahakian, V.; Salzmann, H.; Santangelo, A.; Sasaki, M.; Schäfer, J.; Schüssler, F.; Schutte, H. M.; Shapopi, J. N. S.; Sharma, A.; Sol, H.; Spencer, S.; Stawarz, Ł.; Steppa, C.; Streil, K.; Suzuki, H.; Takahashi, T.; Tanaka, T.; Taylor, A. M.; Terrier, R.; Tluczykont, M.; Tsirou, M.; van Eldik, C.; Vecchi, M.; Wach, T.; Wagner, S. J.; Wierzcholska, A.; Zacharias, M.; Zdziarski, A. A.; Zech, A.; Żywucka, N.; Abe, S.; Abhir, J.; Abhishek, A.; Acciari, V. A.; Aguasca-Cabot, A.; Agudo, I.; Aniello, T.; Ansoldi, S.; Antonelli, L. A.; Arbet Engels, A.; Arcaro, C.; Artero, M.; Asano, K.; Babić, A.; Barres de Almeida, U.; Barrio, J. A.; Batković, I.; Bautista, A.; Baxter, J.; Becerra González, J.; Bednarek, W.; Bernardini, E.; Bernete, J.; Berti, A.; Besenrieder, J.; Bigongiari, C.; Biland, A.; Blanch, O.; Bonnoli, G.; Bošnjak, Ž.; Bronzini, E.; Burelli, I.; Busetto, G.; Campoy-Ordaz, A.; Carosi, A.; Carosi, R.; Carretero-Castrillo, M.; Castro-Tirado, A. J.; Cerasole, D.; Ceribella, G.; Chai, Y.; Cifuentes, A.; Colombo, E.; Contreras, J. L.; Cortina, J.; Covino, S.; D'Amico, G.; D'Elia, V.; Da Vela, P.; Dazzi, F.; De Angelis, A.; De Lotto, B.; de Menezes, R.; Delfino, M.; Delgado, J.; Delgado Mendez, C.; Di Pierro, F.; Di Tria, R.; Di Venere, L.; Dominis Prester, D.; Donini, A.; Dorner, D.; Doro, M.; Elsaesser, D.; Escudero, J.; Fariña, L.; Fattorini, A.; Foffano, L.; Font, L.; Fröse, S.; Fukami, S.; Fukazawa, Y.; García López, R. J.; Garczarczyk, M.; Gasparyan, S.; Gaug, M.; Giesbrecht Paiva, J. G.; Giglietto, N.; Giordano, F.; Gliwny, P.; Godinović, N.; Gradetzke, T.; Grau, R.; Green, D.; Green, J. G.; Günther, P.; Hadasch, D.; Hahn, A.; Hassan, T.; Heckmann, L.; Herrera Llorente, J.; Hrupec, D.; Imazawa, R.; Ishio, K.; Jiménez Martínez, I.; Jormanainen, J.; Kayanoki, T.; Kerszberg, D.; Kluge, G. W.; Kobayashi, Y.; Kouch, P. M.; Kubo, H.; Kushida, J.; Láinez, M.; Lamastra, A.; Leone, F.; Lindfors, E.; Lombardi, S.; López-Coto, R.; López-Moya, M.; López-Oramas, A.; Loporchio, S.; Lorini, A.; Lyard, E.; Machado de Oliveira Fraga, B.; Majumdar, P.; Makariev, M.; Maneva, G.; Manganaro, M.; Mangano, S.; Mannheim, K.; Mariotti, M.; Martínez, M.; Martínez-Chicharro, M.; Mas-Aguilar, A.; Mazin, D.; Menchiari, S.; Mender, S.; Miceli, D.; Miener, T.; Miranda, J. M.; Mirzoyan, R.; Molero González, M.; Molina, E.; Mondal, H. A.; Moralejo, A.; Morcuende, D.; Nakamori, T.; Nanci, C.; Neustroev, V.; Nickel, L.; Nievas Rosillo, M.; Nigro, C.; Nikolić, L.; Nilsson, K.; Nishijima, K.; Njoh Ekoume, T.; Noda, K.; Nozaki, S.; Ohtani, Y.; Okumura, A.; Otero-Santos, J.; Paiano, S.; Paneque, D.; Paoletti, R.; Paredes, J. M.; Peresano, M.; Persic, M.; Pihet, M.; Pirola, G.; Podobnik, F.; Prada Moroni, P. G.; Prandini, E.; Priyadarshi, C.; Ribó, M.; Rico, J.; Righi, C.; Sahakyan, N.; Saito, T.; Saturni, F. G.; Schmidt, K.; Schmuckermaier, F.; Schubert, J. L.; Schweizer, T.; Sciaccaluga, A.; Silvestri, G.; Sitarek, J.; Sliusar, V.; Sobczynska, D.; Spolon, A.; Stamerra, A.; Strišković, J.; Strom, D.; Strzys, M.; Suda, Y.; Suutarinen, S.; Tajima, H.; Takahashi, M.; Takeishi, R.; Tavecchio, F.; Temnikov, P.; Terauchi, K.; Terzić, T.; Teshima, M.; Truzzi, S.; Tutone, A.; Ubach, S.; van Scherpenberg, J.; Vazquez Acosta, M.; Ventura, S.; Verna, G.; Viale, I.; Vigorito, C. F.; Vitale, V.; Vovk, I.; Walter, R.; Will, M.; Wunderlich, C.; Yamamoto, T.; Acharyya, A.; Adams, C. B.; Bangale, P.; Bartkoske, J. T.; Benbow, W.; Christiansen, J. L.; Duerr, A.; Errando, M.; Feng, Q.; Foote, J.; Fortson, L.; Furniss, A.; Hanlon, W.; Hervet, O.; Hinrichs, C. E.; Holder, J.; Humensky, T. B.; Jin, W.; Johnson, M. N.; Kaaret, P.; Kertzman, M.; Kieda, D.; Kleiner, T. K.; Korzoun, N.; Krennrich, F.; Kumar, S.; Lang, M. J.; Lundy, M.; Maier, G.; McGrath, C. E.; Millard, M. J.; Mooney, C. L.; Moriarty, P.; Mukherjee, R.; Ning, W.; O'Brien, S.; Ong, R. A.; Pohl, M.; Pueschel, E.; Quinn, J.; Ragan, K.; Reynolds, P. T.; Ribeiro, D.; Roache, E.; Ryan, J. L.; Sadeh, I.; Saha, L.; Santander, M.; Sembroski, G. H.; Shang, R.; Splettstoesser, M.; Talluri, A. K.; Tucci, J. V.; Valverde, J.; Vassiliev, V. V.; Williams, D. A.; Wong, S. L.; Chen, Z.; Cui, L.; Hirota, T.; Li, B.; Li, G.; Liu, Q.; Liu, X.; Liu, Z.; Ma, J.; Niinuma, K.; Ro, H.; Sakai, N.; Sawada-Satoh, S.; Wajima, K.; Wang, J.; Wang, N.; Xia, B.; Yan, H.; Yonekura, Y.; Zhang, H.; Zhao, R.; Zhong, W.Context. The nearby elliptical galaxy M87 contains one of only two supermassive black holes whose emission surrounding the event horizon has been imaged by the Event Horizon Telescope (EHT). In 2018, more than two dozen multi-wavelength (MWL) facilities (from radio to γ-ray energies) took part in the second M87 EHT campaign.Aims. The goal of this extensive MWL campaign was to better understand the physics of the accreting black hole M87*, the relationship between the inflow and inner jets, and the high-energy particle acceleration. Understanding the complex astrophysics is also a necessary first step towards performing further tests of general relativity.Methods. The MWL campaign took place in April 2018, overlapping with the EHT M87* observations. We present a new, contemporaneous spectral energy distribution (SED) ranging from radio to very high-energy (VHE) γ-rays as well as details of the individual observations and light curves. We also conducted phenomenological modelling to investigate the basic source properties.Results. We present the first VHE γ-ray flare from M87 detected since 2010. The flux above 350 GeV more than doubled within a period of ≈36 hours. We find that the X-ray flux is enhanced by about a factor of two compared to 2017, while the radio and millimetre core fluxes are consistent between 2017 and 2018. We detect evidence for a monotonically increasing jet position angle that corresponds to variations in the bright spot of the EHT image.Conclusions. Our results show the value of continued MWL monitoring together with precision imaging for addressing the origins of high-energy particle acceleration. While we cannot currently pinpoint the precise location where such acceleration takes place, the new VHE γ-ray flare already presents a challenge to simple one-zone leptonic emission model approaches, and it emphasises the need for combined image and spectral modelling. © The Authors 2024The Event Horizon Telescope Collaboration thanks the following organisations and programs: the Academia Sinica;
the Academy of Finland (projects 274477, 284495, 312496,
315721); the Agencia Nacional de Investigación y Desarrollo
(ANID), Chile via NCN19_058 (TITANs), Fondecyt 1221421
and BASAL FB210003; the Alexander von Humboldt Stiftung;
an Alfred P. Sloan Research Fellowship; Allegro, the European
ALMA Regional Centre node in the Netherlands, the NL astronomy research network NOVA and the astronomy institutes of
the University of Amsterdam, Leiden University, and Radboud
University; the ALMA North America Development Fund; the
Astrophysics and High Energy Physics programme by MCIN
(with funding from European Union NextGenerationEU, PRTRC17I1); the Black Hole Initiative, that is funded by grants from
the John Templeton Foundation (60477, 61497, 62286) and the
Gordon and Betty Moore Foundation (Grant GBMF-8273) -
although the opinions expressed in this work are those of the
author and do not necessarily reflect the views of these Foundations; the Brinson Foundation; “la Caixa” Foundation (ID
100010434) through fellowship codes LCF/BQ/DI22/11940027
and LCF/BQ/DI22/11940030; Chandra DD7-18089X and
TM6-17006X; the China Scholarship Council; the China
Postdoctoral Science Foundation fellowships (2020M671266,
2022M712084); Consejo Nacional de Humanidades, Ciencia
y Tecnología (CONAHCYT, Mexico, projects U0004-246083,
U0004-259839, F0003-272050, M0037-279006, F0003-
281692, 104497, 275201, 263356); the Colfuturo Scholarship;
the Consejería de Economía, Conocimiento, Empresas y
Universidad of the Junta de Andalucía (grant P18-FR-1769),
the Consejo Superior de Investigaciones Científicas (grant
2019AEP112); the Delaney Family via the Delaney Family
John A. Wheeler Chair at Perimeter Institute; Dirección General
de Asuntos del Personal Académico-Universidad Nacional
Autónoma de México (DGAPA-UNAM, projects IN112820
and IN108324); the Dutch Organization for Scientific Research
(NWO) for the VICI award (grant 639.043.513), the grant
OCENW.KLEIN.113, and the Dutch Black Hole Consortium
(with project No. NWA 1292.19.202) of the research programme
the National Science Agenda; the Dutch National Supercomputers, Cartesius and Snellius (NWO grant 2021.013); the EACOA
Fellowship awarded by the East Asia Core Observatories
Association, which consists of the Academia Sinica Institute
of Astronomy and Astrophysics, the National Astronomical
Observatory of Japan, Center for Astronomical Mega-Science,
Chinese Academy of Sciences, and the Korea Astronomy and
Space Science Institute; the European Research Council (ERC)
Synergy Grant “BlackHoleCam: Imaging the Event Horizon of
Black Holes" (grant 610058); the European Union Horizon 2020
research and innovation programme under grant agreements
RadioNet (No. 730562) and M2FINDERS (No. 101018682);
the European Research Council for advanced grant ‘JETSET:
Launching, propagation and emission of relativistic jets from
binary mergers and across mass scales’ (grant No. 884631); the
Horizon ERC Grants 2021 programme under grant agreement
No. 101040021; the FAPESP (Fundação de Amparo á Pesquisa
do Estado de São Paulo) under grant 2021/01183-8; the Fondo
CAS-ANID folio CAS220010; the Generalitat Valenciana
(grants APOSTD/2018/177 and ASFAE/2022/018) and GenT
Program (project CIDEGENT/2018/021); the Gordon and Betty
Moore Foundation (GBMF-3561, GBMF-5278, GBMF-10423);
the Institute for Advanced Study; the Istituto Nazionale di
Fisica Nucleare (INFN) sezione di Napoli, iniziative specifiche
TEONGRAV; the International Max Planck Research School
for Astronomy and Astrophysics at the Universities of Bonn
and Cologne; DFG research grant “Jet physics on horizon scales
and beyond” (grant No. 443220636); Joint Columbia/Flatiron
Postdoctoral Fellowship (research at the Flatiron Institute is
supported by the Simons Foundation); the Japan Ministry of
Education, Culture, Sports, Science and Technology (MEXT;
grant JPMXP1020200109); the Japan Society for the Promotion
of Science (JSPS) Grant-in-Aid for JSPS Research Fellowship
(JP17J08829); the Joint Institute for Computational Fundamental Science, Japan; the Key Research Program of Frontier
Sciences, Chinese Academy of Sciences (CAS, grants QYZDJSSW-SLH057, QYZDJSSW-SYS008, ZDBS-LY-SLH011);
the Leverhulme Trust Early Career Research Fellowship; the
Max-Planck-Gesellschaft (MPG); the Max Planck Partner
Group of the MPG and the CAS; the MEXT/JSPS KAKENHI
(grants 18KK0090, JP21H01137, JP18H03721, JP18K13594,
18K03709, JP19K14761, 18H01245, 25120007, 19H01943,
21H01137, 21H04488, 22H00157, 23K03453); the MICINN
Research Project PID2019-108995GB-C22; the MIT International Science and Technology Initiatives (MISTI) Funds;
the Ministry of Science and Technology (MOST) of Taiwan
(103-2119-M-001-010-MY2, 105-2112-M-001-025-MY3, 105-
2119-M-001-042, 106-2112-M-001-011, 106-2119-M-001-013,
106-2119-M-001-027, 106-2923-M-001-005, 107-2119-
M-001-017, 107-2119-M-001-020, 107-2119-M-001-041,
107-2119-M-110-005, 107-2923-M-001-009, 108-2112-M001-048, 108-2112-M-001-051, 108-2923-M-001-002, 109-
2112-M-001-025, 109-2124-M-001-005, 109-2923-M-001-001,
110-2112-M-001-033, 110-2124-M-001-007, 110-2923-M-001-
001, and 112-2112-M-003-010-MY3); the National Science and
Technology Council (NSTC) of Taiwan (111-2124-M-001-005,
112-2124-M-001-014); the Ministry of Education (MoE) of
Taiwan Yushan Young Scholar Program; the Physics Division, National Center for Theoretical Sciences of Taiwan; the
National Aeronautics and Space Administration (NASA, Fermi
Guest Investigator grant 80NSSC23K1508, NASA Astrophysics
Theory Program grant 80NSSC20K0527, NASA NuSTAR
award 80NSSC20K0645); NASA Hubble Fellowship grants
HST-HF2-51431.001-A, HST-HF2-51482.001-A awarded by
the Space Telescope Science Institute, which is operated by
the Association of Universities for Research in Astronomy,
Inc., for NASA, under contract NAS5-26555; the National
Institute of Natural Sciences (NINS) of Japan; the National
Key Research and Development Program of China (grant
2016YFA0400704, 2017YFA0402703, 2016YFA0400702); the
National Science and Technology Council (NSTC, grants NSTC
111-2112-M-001 -041, NSTC 111-2124-M-001-005, NSTC
112-2124-M-001-014); the US National Science Foundation
(NSF, grants AST-0096454, AST-0352953, AST-0521233,
AST-0705062, AST-0905844, AST-0922984, AST-1126433,
OIA-1126433, AST-1140030, DGE-1144085, AST-1207704,
AST-1207730, AST-1207752, MRI-1228509, OPP-1248097,
AST-1310896, AST-1440254, AST-1555365, AST-1614868,
AST-1615796, AST-1715061, AST-1716327, AST-1726637,
OISE-1743747, AST-1743747, AST-1816420, AST-1935980,
AST-1952099, AST-2034306, AST-2205908, AST-2307887);
NSF Astronomy and Astrophysics Postdoctoral Fellowship
(AST-1903847); the Natural Science Foundation of China
(grants 11650110427, 10625314, 11721303, 11725312,
11873028, 11933007, 11991052, 11991053, 12192220,
12192223, 12273022, 12325302); the Natural Sciences and
Engineering Research Council of Canada (NSERC, including
a Discovery Grant and the NSERC Alexander Graham Bell
Canada Graduate Scholarships-Doctoral Program); the National
Research Foundation of Korea (the Global PhD Fellowship
Grant: grants NRF-2015H1A2A1033752, the Korea Research
Fellowship Program: NRF-2015H1D3A1066561, Brain Pool
Program: 2019H1D3A1A01102564, Basic Research Support Grant 2019R1F1A1059721, 2021R1A6A3A01086420,
2022R1C1C1005255, 2022R1F1A1075115); Netherlands
Research School for Astronomy (NOVA) Virtual Institute of
Accretion (VIA) postdoctoral fellowships; NOIRLab, which
is managed by the Association of Universities for Research
in Astronomy (AURA) under a cooperative agreement with
the National Science Foundation; Onsala Space Observatory
(OSO) national infrastructure, for the provisioning of its
facilities/observational support (OSO receives funding through
the Swedish Research Council under grant 2017-00648);
the Perimeter Institute for Theoretical Physics (research at
Perimeter Institute is supported by the Government of Canada
through the Department of Innovation, Science and Economic
Development and by the Province of Ontario through the
Ministry of Research, Innovation and Science); the Princeton
Gravity Initiative; the Spanish Ministerio de Ciencia e Innovación (grants PGC2018-098915-B-C21, AYA2016-80889-P,
PID2019-108995GB-C21, PID2020-117404GB-C21); the
University of Pretoria for financial aid in the provision of
the new Cluster Server nodes and SuperMicro (USA) for a
SEEDING GRANT approved toward these nodes in 2020; the
Shanghai Municipality orientation program of basic research for
international scientists (grant no. 22JC1410600); the Shanghai
Pilot Program for Basic Research, Chinese Academy of Science,
Shanghai Branch (JCYJ-SHFY-2021-013); the State Agency
for Research of the Spanish MCIU through the “Center of
Excellence Severo Ochoa” award for the Instituto de Astrofísica
de Andalucía (SEV-2017- 0709); the Spanish Ministry for
Science and Innovation grant CEX2021-001131-S funded by
MCIN/AEI/10.13039/501100011033; the Spinoza Prize SPI
78-409; the South African Research Chairs Initiative, through
the South African Radio Astronomy Observatory (SARAO,
grant ID 77948), which
The Changing Landscape for Stroke Prevention in AF: Findings From the GLORIA-AF Registry Phase 2
No full textBackground GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non–vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients’ baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score ≥2; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701
