Publications by authors named "Christian Oliver Fallesen"

6 Publications

  • Page 1 of 1

Coronary Artery Healing Process after Bioresorbable Scaffold in Patients with Non-ST-Segment Elevation Myocardial Infarction: Rationale, Design, and Methodology of the HONEST Study.

Cardiology 2021 Feb 1:1-11. Epub 2021 Feb 1.

Department of Cardiology, Odense University Hospital, Odense, Denmark.

Background: Bioresorbable scaffolds (BRSs) is a relatively new approach in treating coronary artery stenosis. The initial results of the first commercially available scaffolds consisting of a backbone of poly-L-lactide raised safety concerns related to delayed resorption and healing. The magnesium alloy-based scaffold degrades via bio-corrosion within months, whereas it often takes several years for polymer scaffolds to degrade. The aim of the study was to assess the healing stage by optical coherence tomography (OCT) after 6 months in patients with non-ST-segment elevation myocardial infarct (NSTEMI) randomized to OCT or angiography-guided percutaneous coronary intervention with implantation of a magnesium sirolimus-eluting Magmaris scaffold (Magmaris; Biotronik, Bülach, Switzerland).

Methods: We analyzed the healing process by comparing OCT at baseline and after 6 months. Five stages of healing were defined with stage 1 being the least healed and stage 5 demonstrating complete resorption and healing with no visible scaffold/remnant. The primary end point is a calculated healing score that is based on 5 subtypes of healing stage: (1) malapposed, (2) uncovered with no detection of smooth surface tissue on top of struts or remnants, (3) covered protruding, (4) covered embedded, and (5) complete healing with a smooth neointimal surface and no sign of struts or visible remnants assessed by OCT 6 months after the index procedure.

Results: The impact of OCT-guided compared to angiography-guided scaffold implantation will be illuminated.

Conclusion: The present study will provide new information on midterm healing properties of the magnesium BRS in patients with NSTEMI.
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http://dx.doi.org/10.1159/000512417DOI Listing
February 2021

Influence of plaque characteristics on early vascular healing in patients with ST-elevation myocardial infarction.

Cardiovasc Revasc Med 2020 Sep 24. Epub 2020 Sep 24.

Department of Cardiology, Odense University Hospital, Odense, Denmark.

Objectives: To compare the early vascular healing of ruptured plaques (RP) and non-ruptured plaques (NRP) one month after primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI), using optical coherence tomography (OCT).

Background: Vascular healing and strut coverage are important factors in reducing the risk of stent thrombosis after PCI. Influence of underlying lesion characteristics and differences in healing response between RP and NRP are unknown.

Methods: Twenty-six STEMI-patients underwent PCI and implantation of a polymer-free drug-coated Biofreedom stent (BF-BES). OCT was performed pre-PCI, post-PCI and at 1-month follow-up. The patients were divided into two groups: RP = 15 and NRP = 11. OCT analyses of culprit lesion, post stent implantation at baseline and follow-up were performed to determine the difference in vascular healing based on presence of uncovered and/or malapposed stent struts and intraluminal filling defects.

Results: The stent coverage did not differ significantly between the two groups at 1-month follow-up with percentage of uncovered struts: RP 26.5% [IQR 15.0-49.0] and NRP 28.1% [IQR 15.5-38.8] for NRP (p = 0.78). At 1-month, RP showed an increased percentage of late acquired malapposed struts (1.4% [IQR 0.8-2.4] vs. 0.0% [IQR 0.0-1.4], p = 0.03) and a larger total malapposition area (1.3 mm [IQR 0.4-2.5] vs. 0.0 mm [IQR 0.0-0.9], p = 0.01), compared to NRP.

Conclusion: Three out of four struts were covered within one month after stenting. The vascular healing was comparable in RP and NRP on stent coverage. However, RP had more and larger late acquired malapposition areas.
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http://dx.doi.org/10.1016/j.carrev.2020.09.033DOI Listing
September 2020

One-year rehospitalisation after percutaneous coronary intervention: a retrospective analysis.

EuroIntervention 2018 Oct;14(8):926-934

Department of Cardiology, Odense University Hospital, Odense, Denmark.

Aims: The aim of the study was to evaluate the incidence and causes of rehospitalisation within one year after percutaneous coronary intervention (PCI) in a country where the National Health Service provides universal tax-supported healthcare, guaranteeing residents free hospital access.

Methods And Results: Between January 2010 and September 2014, 17,111 patients were treated with PCI in two University Hospitals in Western Denmark. Patients who were readmitted within one year after PCI were identified. The overall one-year readmission rate was 50.4%. The cause was angina/myocardial infarction (MI) in 4,282 patients (49.7%), and other reasons in 4,334 (50.3%). Predictors of angina/MI-related readmissions were female gender (odds ratio [OR] 1.15, 95% confidence interval [CI]: 1.07-1.25), diabetes (OR 1.14, 95% CI: 1.04-1.26), age (per 10-year increase) (OR 0.86, 95% CI: 0.83-0.88), and indication for index PCI (stable angina pectoris as reference): ST-segment elevation myocardial infarction (OR 1.34, 95% CI: 1.23-1.47) and non-ST-segment elevation myocardial infarction (OR 1.18, 95% CI: 1.08-1.29). Predictors for other readmissions were female gender (OR 1.09, 95% CI: 1.01-1.18), diabetes (OR 1.29, 95% CI: 1.18-1.42), age (OR 1.30, 95% CI: 1.26-1.34) and Charlson comorbidity index ≥3 (OR 3.03, 95% CI: 2.71-3.27).

Conclusions: In an unselected patient cohort treated with PCI, half of the patients were rehospitalised within one year, highlighting the impact of comorbidity in patients with ischaemic heart disease.
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http://dx.doi.org/10.4244/EIJ-D-17-00800DOI Listing
October 2018

[Platypnoea-orthodeoxia: a rare cause of severe dyspnoea].

Ugeskr Laeger 2013 Nov;175(47A)

Hjertemedicinsk Afdeling B, Odense Universitetshospital, Søndre Boulevard 29, 5000 Odense.

Platypnoea-orthodeoxia is a relatively unknown syndrome characterized by dyspnoea and arterial desaturation during the transition from a lying to an uprighth position by right to left shunting of blood without increased blood pressure in the right atrium. The condition is assumed to be underdiagnosed because of challenging diagnostics. This case describes a woman who, despite extensive investigation, remained undiagnosed for years. The diagnosis should be kept in mind when treating unexplained desaturation.
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November 2013

[Fulminant perimyocarditis following tonsillitis].

Ugeskr Laeger 2013 Apr;175(16):1117-8

Medicinsk Afdeling, Sygehus Sønderjylland, Haderslev, Denmark.

Fulminant perimyocarditis is a rare and potentially fatal condition that may mimick myocardial infarction. The long-term prognosis is favourable, once the patient has survived the index admission, and recurrence is extremely rare. This case describes a 35-year-old man, who experienced recurrence twice within six months. Due to the risk of a potentially fatal outcome, patients should be followed closely with clinical controls of infection parameters and echocardiography.
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April 2013