@article{MTMT:34784180,
	title = {A vérzéses rizikó csökkentése pitvarfibrillációban},
	url = {https://m2.mtmt.hu/api/publication/34784180},
	author = {Komócsi, András},
	doi = {10.33616/lam.34.0131},
	journal-iso = {LEGE ART MED},
	journal = {LEGE ARTIS MEDICINAE},
	volume = {34},
	unique-id = {34784180},
	issn = {0866-4811},
	abstract = {Háttér – A pitvarfibrilláció (AF) a leggyakoribb tartós szívritmuszavar, amely thromboemboliás eseményekhez vezethet, beleértve az agyi érkatasztrófát és a perifériás embolisatiót is. Az AF kezelése, a ritmuszavar direkt kezelési módjai mellett, az antikoaguláns terápián és a thromboemboliás események megelőzésén alapszik. Célkitűzés – Az összefoglalás célja a vérzésveszély befolyásolható tényezőinek vizsgálata az AF kezelésében, különös tekintettel a megfelelő antikoaguláns választására, a betegjellemzőkhöz igazított alkalmazásra, a társbetegségek kezelésére és a vérzésrizikó csökkentésére irányuló stratégiákra. Módszerek – Az elemzés a különböző antikoagulánsok (VKA, DOAC) hatékonyságát és biztonságosságát hasonlítja össze, továbbá kiterjed a betegjellemzők, mint a vesefunkció és a társbetegségek, figyelembevételére az antikoaguláns kezelés során. Eredmények – Az eredmények szerint a vérzésveszély csökkenthető az antikoaguláns megfelelő választásával, és azok betegspecifikus alkalmazásával. Különösen a társbetegségek figyelembevétele kulcsfontosságú a biztonságos és hatékony kezelés szempontjából. A VKA szerek stabil INR-értékek fenntartását igénylik, míg a DOAC-ok kevesebb súlyos vérzéses eseményhez vezetnek. Tervezett és sürgősségi beavatkozások esetében a vérzésrizikót csökkentő stratégiák alkalmazása szintén fontos. A betegjellemzők, mint a vesefunkció és a társbetegségek figyelembevétele, valamint a megfelelő antikoaguláns választása és annak alkalmazása, elengedhetetlen a hatékony és biztonságos antikoaguláns terápia alkalmazásához.},
	year = {2024},
	eissn = {2063-4161},
	pages = {131-138}
}

@article{MTMT:34757147,
	title = {Prognosis Impact and Prediction of Trans-radial Access Failure in Patients with STEMI, a Nationwide Observational Study},
	url = {https://m2.mtmt.hu/api/publication/34757147},
	author = {Tornyos, Dániel and Lukács, Réka Aliz and Jánosi, András and Komócsi, András},
	doi = {10.1016/j.amjcard.2024.03.016},
	journal-iso = {AM J CARDIOL},
	journal = {AMERICAN JOURNAL OF CARDIOLOGY},
	unique-id = {34757147},
	issn = {0002-9149},
	abstract = {Trans-radial access (TRA) is the primary arterial approach for percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). However, occasionally, a crossover to trans-femoral access is necessary due to unsuccessful TRA. The impact of failed TRA on the prognosis in STEMI patients and the utility of predictive models for TRA failure remains uncertain. Data from the Hungarian Myocardial Infarction Registry (January 2014 - December 2020) were analyzed. Primary endpoints were 1-year mortality and major adverse cardiovascular events (MACE). Propensity score (PS) matching was employed to create a balanced cohort for comparing successful and failed TRA. The impact of unsuccessful TRA on prognosis was evaluated using Cox regression analysis. Machine learning techniques were applied to predict TRA failure. The performance and the clinical applicability of the novel and prior prediction models were comprehensively evaluated. Out of 76,625 registered patients, 34,293 (69.8 ± 13.4 years, male/female: 21,893/12,400) underwent TRA (33,573) or failed TRA (720) PCI for STEMI. After PS-matching, in the unsuccessful TRA group, the risk of mortality (34.3% vs 22.5%, HR: 1.6, 95% CI: [1.3 - 2.0], p < 0.001) and MACE (37.4% vs 26.8%, HR: 1.5, 95% CI: [1.3 - 1.8], p < 0.001) were significantly higher. Door-to-balloon time did not differ significantly (p = 0.835). In predictive analysis, regularized discriminant analysis emerged as the most promising model, surpassing prior prediction models (AUC: 0.66, sensitivity: 0.32, specificity: 0.86). Nevertheless, GRACE 2.0 score demonstrated a remarkable performance (AUC: 0.65, sensitivity: 0.51, specificity: 0.73). This study underscores the pivotal role of successful TRA in enhancing outcomes in STEMI cases, advocating for its prioritization. The inability to conclude interventions via this approach is linked to a poorer prognosis, even in risk-adjusted analyses. Our findings indicate that prediction models utilizing clinical parameters do not outperform the established GRACE 2.0 algorithm, questioning their utility. In conclusion, the results emphasize the significance of TRA success and the continued relevance of the GRACE score in clinical decision-making to optimize patient outcomes.},
	keywords = {MORTALITY; prediction models; STEMI; Coronary intervention; Access site; Trans-radial; failed trans-radial},
	year = {2024},
	eissn = {1879-1913}
}

@article{MTMT:34684523,
	title = {Comparing Endovascular Approaches in Lower Extremity Artery Disease : Insights from a Network Meta-Analysis},
	url = {https://m2.mtmt.hu/api/publication/34684523},
	author = {Lukács, Réka Aliz and Weisshaar, Lisa Ingrid and Tornyos, Dániel and Komócsi, András},
	doi = {10.3390/jcm13041024},
	journal-iso = {J CLIN MED},
	journal = {JOURNAL OF CLINICAL MEDICINE},
	volume = {13},
	unique-id = {34684523},
	abstract = {Endovascular therapy offers an alternative for treating femoropopliteal (FP) and infrapopliteal (IP) lesions related to occlusive lower extremity artery disease. Despite numerous trials, the effectiveness of restenosis prevention using local drug delivery devices remains a topic of debate.An updated systematic review and network meta-analysis was conducted. Our overall aim was to summarize the most recent clinical evidence regarding endovascular approaches for FP and IP atherosclerotic lesions.We conducted a search for randomized trials in the MEDLINE database, and extracted data related to clinical endpoints. Our primary focus was on the rate of major adverse events (MAEs), including mortality, amputation, and target lesion revascularization (TLR). A multiple treatment network meta-analysis supplemented with component network analyses was performed to examine the impact of combined treatment.Our search yielded 33 randomized controlled trials encompassing 5766 patients. This included 19 studies focused on femoropopliteal and 14 on IP lesions, accounting for 3565 and 2201 patients, respectively. Drug-coated balloons (DCBs) and drug-eluting stents (DESs) displayed a reduced MAE risk in comparison to plain old balloon angioplasty (POBA)-RR for DCB: 0.64 (95% CI: 0.52-0.77) and for DES: 0.71 (95% CI: 0.51-0.99). The bare-metal stent (BMS) group manifested the most substantial MAE risk, being 59% higher relative to the DCB cohort (BMS vs. DCB RR: 1.59; 95% CI: 1.03-2.47). For FP lesions, DES was the standout performer, curtailing MAE risk by 55% relative to POBA. Within IP lesions, DES mitigated the MAE risk by 25% versus POBA. DCB did not exhibit any notable MAE reduction when pitted against POBA.In FP arteries, both DESs and DCBs yielded significantly diminished MAEs, thus outpacing other techniques. Regarding IP arteries, only DESs resulted in significantly fewer MAEs. In alignment with contemporary research, our findings revealed no signs of elevated mortality in patients undergoing treatment with drug-eluting apparatuses.},
	keywords = {Peripheral artery disease; endovascular intervention; network meta-analysis; femoropopliteal; chronic limb ischemia; Infrapopliteal},
	year = {2024},
	eissn = {2077-0383}
}

@article{MTMT:34495566,
	title = {Cardioprotective strategies against myocardial ischemia–reperfusion injury},
	url = {https://m2.mtmt.hu/api/publication/34495566},
	author = {El Alaoui El Abdallaoui, Oumaima and Komócsi, András and Szokodi, István},
	journal-iso = {SPORT- ÉS EGÉSZSÉGTUD FÜZ},
	journal = {SPORT- ÉS EGÉSZSÉGTUDOMÁNYI FÜZETEK},
	unique-id = {34495566},
	issn = {2560-0680},
	year = {2024},
	eissn = {2560-1210},
	orcid-numbers = {El Alaoui El Abdallaoui, Oumaima/0000-0003-1564-4506}
}

@article{MTMT:34395283,
	title = {Angiography-based coronary microvascular assessment with and without intracoronary pressure measurements: a systematic review},
	url = {https://m2.mtmt.hu/api/publication/34395283},
	author = {Kest, Michael and Ágoston, András and Szabó, Gábor Tamás and Kiss, Attila and Üveges, Áron and Czuriga, Dániel and Komócsi, András and Hizoh, István and Kőszegi, Zsolt},
	doi = {10.1007/s00392-023-02338-6},
	journal-iso = {CLIN RES CARDIOL},
	journal = {CLINICAL RESEARCH IN CARDIOLOGY},
	volume = {In press},
	unique-id = {34395283},
	issn = {1861-0684},
	year = {2023},
	eissn = {1861-0692},
	pages = {In press},
	orcid-numbers = {Czuriga, Dániel/0000-0002-6972-0781; Hizoh, István/0000-0001-5141-2070}
}

@article{MTMT:34104380,
	title = {A jobb pitvar méretét és funkcióját tükröző echokardiográfiás paraméterek alkalmasak a prognózis becslésére pulmonális artériás hipertóniás betegeknél = Echocardiographic markers of right atrial size and function are suitable tools to estimate the prognosis in pulmonary hypertension},
	url = {https://m2.mtmt.hu/api/publication/34104380},
	author = {Vértes, Vivien and Faludi, Réka and Komócsi, András},
	journal-iso = {CARDIOL HUNG},
	journal = {CARDIOLOGIA HUNGARICA},
	volume = {52},
	unique-id = {34104380},
	issn = {0133-5596},
	year = {2023},
	eissn = {1588-0230},
	pages = {308-308}
}

@article{MTMT:34023528,
	title = {Zero fluoroscopy catheter ablation for atrial fibrillation: a systematic review and meta-analysis},
	url = {https://m2.mtmt.hu/api/publication/34023528},
	author = {Debreceni, Dorottya and Janosi, Kristof and Bocz, Botond and Turcsan, Marton and Lukács, Réka Aliz and Simor, Tamás and Antolič, Bor and Vámos, Máté and Komócsi, András and Kupó, Péter},
	doi = {10.3389/fcvm.2023.1178783},
	journal-iso = {FRONT CARDIOVASC MED},
	journal = {FRONTIERS IN CARDIOVASCULAR MEDICINE},
	volume = {10},
	unique-id = {34023528},
	issn = {2297-055X},
	year = {2023},
	eissn = {2297-055X},
	orcid-numbers = {Kupó, Péter/0000-0002-9422-4245}
}

@article{MTMT:33937639,
	title = {Individualized or Uniform De-Escalation Strategies for Antiplatelet Therapy in Acute Coronary Syndrome : A Review of Clinical Trials with Platelet Function Testing and Genetic Testing-Based Protocols},
	url = {https://m2.mtmt.hu/api/publication/33937639},
	author = {El Alaoui El Abdallaoui, Oumaima and Tornyos, Dániel and Lukács, Réka Aliz and Szabó, Dóra and Komócsi, András},
	doi = {10.3390/ijms24109071},
	journal-iso = {INT J MOL SCI},
	journal = {INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES},
	volume = {24},
	unique-id = {33937639},
	issn = {1661-6596},
	abstract = {This comprehensive literature review assessed the effectiveness of precision medicine approaches in individualizing P2Y12 de-escalation strategies, such as platelet function testing guidance, genetic testing guidance, and uniform de-escalation, for acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). Analyzing six trials with a total of 13,729 patients, the cumulative analyses demonstrated a significant reduction in major adverse cardiac events (MACE), net adverse clinical events (NACE), and major and minor bleeding events with P2Y12 de-escalation. Specifically, the analysis found a 24% reduction of MACE and a 22% reduction of adverse event risk (relative risk (RR) 0.76, 95% confidence interval (CI): 0.71-0.82, and RR: 0.78, 95% CI 0.67-0.92, respectively). Reductions in bleeding events were highest with uniform unguided de-escalation, followed by guided de-escalations, while ischemic event rates were similarly lower across all three strategies. Although the review highlights the potential of individualized P2Y12 de-escalation strategies to offer a safer alternative to the long-term potent P2Y12 inhibitor-based dual antiplatelet therapy, it also indicates that laboratory-guided precision medicine approaches may not yet offer the expected benefits, necessitating further research to optimize individualized strategies and evaluate the potential of precision medicine approaches in this context.},
	keywords = {ANTIPLATELET THERAPY; Genetic Testing; acute coronary syndrome; Platelet function testing; individualized therapy; De-escalation},
	year = {2023},
	eissn = {1422-0067},
	orcid-numbers = {El Alaoui El Abdallaoui, Oumaima/0000-0003-1564-4506}
}

@article{MTMT:33742459,
	title = {Impact of body mass on P2Y12-inhibitor de-escalation in acute coronary syndromes-a substudy of the TROPICAL-ACS trial},
	url = {https://m2.mtmt.hu/api/publication/33742459},
	author = {Komócsi, András and Merkely, Béla Péter and Hadamitzky, Martin and Massberg, Steffen and Rizas, Konstantinos D and Hein-Rothweiler, Ralph and Gross, Lisa and Trenk, Dietmar and Sibbing, Dirk and Aradi, Dániel},
	doi = {10.1093/ehjcvp/pvad027},
	journal-iso = {EUR HEART J-CARD PHA},
	journal = {EUROPEAN HEART JOURNAL - CARDIOVASCULAR PHARMACOTHERAPY},
	volume = {9},
	unique-id = {33742459},
	issn = {2055-6837},
	abstract = {Clinical guidelines recommend de-escalation antiplatelet strategies to reduce bleeding risk in acute coronary syndrome (ACS) patients, albeit with a weak recommendation. This sub-study of the TROPICAL-ACS trial aimed to determine the impact of body mass on the efficacy of platelet-function testing-guided de-escalation regimen in ACS patients after PCI.Patients were randomized to prasugrel (control group) or a platelet-function testing-guided regimen with clopidogrel or prasugrel defined after one-week clopidogrel. The primary endpoint was the net clinical benefit (cardiovascular death, myocardial infarction, stroke, or BARC 2-5 bleeding) for 12 months. Overweight was defined as a body mass index (BMI) >25 kg/m2.Patients without overweight showed a significant net clinical benefit from the de-escalation strategy while in overweight cases de-escalation was comparable to prasugrel treatment (HR: 0.52; 95% CI: 0.31-0.88; p = 0.013, and HR: 0.95; 95%CI: 0.69-1.31, p = 0.717, p-non-inferiority = 0.03, respectively, p-interaction = 0.053). The benefit of de-escalation in terms of the risk of bleeding or of the ischemic events did not reach statistical significance. Bleeding events with de-escalation were less frequent in non-overweight patients but comparable in overweight patients (HR: 0.55; 95% CI: 0.30-1.03; p = 0.057, and HR: 0.95; 95% CI: 0.64-1.41, respectively p-interaction = 0.147). Non-overweight patients had lower ischemic event rates with de-escalation, while overweight cases had slightly less. (HR: 0.47; 95%CI: 0.18-1.25, p = 0.128, and HR: 0.89; 95% CI: 0.53-1.50, respectively p-interaction = 0.261).The strategy of guided DAPT de-escalation was associated with a significant net clinical benefit in non-overweight patients, while the two strategies were equivalent in overweight patients.},
	keywords = {ANTIPLATELET THERAPY; prasugrel; acute coronary syndromes; Platelet function testing},
	year = {2023},
	eissn = {2055-6845},
	pages = {608-616},
	orcid-numbers = {Merkely, Béla Péter/0000-0001-6514-0723}
}

@article{MTMT:33692491,
	title = {A pitvarfibrilláció diagnosztikájának, antikoaguláns-kezelésének és a betegadherencia fenntartásának modern gyakorlata},
	url = {https://m2.mtmt.hu/api/publication/33692491},
	author = {Lukács, Réka Aliz and Tornyos, Dániel and Tóth, Judit and Komócsi, András},
	doi = {10.33616/lam.33.0019},
	journal-iso = {LEGE ART MED},
	journal = {LEGE ARTIS MEDICINAE},
	volume = {33},
	unique-id = {33692491},
	issn = {0866-4811},
	abstract = {A pitvarfibrilláció (PF) a leggyakoribb tartós szívritmuszavar, azonban az esetek egyharmadában a beteg tünetmentes marad. A nem diagnosztizált és alulkezelt pitvarfibrilláció hozzájárul az ischaemiás stroke
		kialakulásához, ezért a PF szûrése magában hordozza a korai ritmuskezelés, a stroke és a halálozás megelôzésének lehetôségét. Ennek kapcsán az utóbbi évtizedben jelentôs elôrelépések tanúi voltunk a mindennapi használatban lévô digitális eszközök fejlôdése terén. Ezek új lehetôségeket nyújthatnak a szívritmuszavar idôben történô felismerésében. A korai diagnosztikát és az ideális gyógyszeres kezelés beállítását követôen a megfelelô terápia elengedhetetlen része a betegadherencia fenntartása. A páciens bevonása a döntési folyamatba és az antikoaguláció lehetôségeinek vele való megbeszélése („közös döntéshozatal”) kulcsfontosságú a beteg szükségleteinek megfelelô felméréséhez és az adherencia növeléséhez. Cikkünk célja, hogy naprakész gyakorlati útmutatást nyújtson a digitális eszközök szívritmuszavar esetén történô megfelelô alkalmazásához, valamint összefoglaló áttekintést adjon a mindennapi gyakorlatban használt antikoagulánsokkal kapcsolatos adherencia növelésének kihívásairól.},
	keywords = {atrial fibrillation; adherence; anticoagulant therapy; digital devices},
	year = {2023},
	eissn = {2063-4161},
	pages = {19-25}
}