Publications by authors named "J G Meeder"

50 Publications

URGENT 1.5: diagnostic accuracy of the modified HEART score, with fingerstick point-of-care troponin testing, in ruling out acute coronary syndrome.

Neth Heart J 2021 Nov 24. Epub 2021 Nov 24.

Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands.

Background: The HEART score is a validated risk stratification tool for chest pain patients presenting to the emergency department and was recently investigated for implementation in a pre-hospital setting. Fingerstick (capillary blood) point-of-care (POC) troponin testing enables quick measurements outside the hospital and seems easier to implement than the current venous blood sampling techniques. This study investigates the diagnostic accuracy of the modified HEART score, integrating fingerstick POC troponin testing, in ruling out acute coronary syndrome (ACS).

Methods: The data of 96 patients with chest pain, included in a study investigating a novel POC troponin device under development at the cardiac emergency department, were analysed retrospectively. Based on the patients' admission data and capillary POC high-sensitivity troponin I (hs-cTnI) results, the modified HEART score was determined. The outcome measure, for evaluating the diagnostic accuracy of the modified HEART score, was the occurrence of ACS.

Results: Of the total study population, 33 patients (34%) were diagnosed with ACS. Seventeen patients (18%) were classified as low risk (0-3 points) and one patient (6%) in this group was diagnosed with ACS. The sensitivity and negative predictive value of the modified HEART score was 97.0 and 97.6%, respectively.

Conclusion: The modified HEART score, integrating capillary POC hs-cTnI results, is a promising tool for ruling out ACS in patients with chest pain presenting to the cardiac emergency department. These results encourage prospective investigation into the integration of fingerstick POC troponin testing in the modified HEART score in a pre-hospital setting.
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http://dx.doi.org/10.1007/s12471-021-01646-8DOI Listing
November 2021

Outpatient Management of Patients With Angina With No Obstructive Coronary Arteries: How to Come to a Proper Diagnosis and Therapy.

Front Cardiovasc Med 2021 2;8:716319. Epub 2021 Nov 2.

Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands.

Two-thirds of women and one-third of men who undergo a clinically indicated coronary angiography for stable angina, have no obstructive coronary artery disease (CAD). Coronary vascular dysfunction is a highly prevalent underlying cause of angina in these so called "Angina with No Obstructive Coronary Arteries (ANOCA)" patients, foremost in middle aged women. Coronary vascular dysfunction encompasses various endotypes, namely epicardial and microvascular coronary spasms, impaired vasodilatation, and increased microvascular resistance. ANOCA patients, especially those with underlying coronary vascular dysfunction, have an adverse cardiovascular prognosis, poor physical functioning, and a reduced quality of life. Since standard ischemia detection tests and coronary angiograms are not designed to diagnose coronary vascular dysfunction, this ischemic heart disease is often overlooked and hence undertreated. But adequate diagnosis is vital, so that treatment can be started to reduce symptoms, reduce healthcare costs and improve quality of life and cardiovascular prognosis. The purpose of this review is to give a contemporary overview of ANOCA with focus on coronary vascular dysfunction. We will provide a possible work-up of patients suspected of coronary vascular dysfunction in the outpatient clinical setting, based on the latest scientific insights and international consensus documents. We will discuss the value of ischemia detection testing, and non-invasive and invasive methods to diagnose coronary vascular dysfunction. Furthermore, we will go into pharmacological and non-pharmacological therapeutic options including anti-anginal regimens and lifestyle interventions.
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http://dx.doi.org/10.3389/fcvm.2021.716319DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8592903PMC
November 2021

Contemporary management of patients with atrial fibrillation in the Netherlands and Belgium: a report from the EORP-AF long-term general registry.

Neth Heart J 2021 Nov 15;29(11):584-594. Epub 2021 Sep 15.

Arlon and Clinique Ste Thérèse, Department of Cardiology, Cliniques du Sud-Luxembourg, Bastogne, Belgium.

Background: Contemporary data regarding the characteristics, treatment and outcomes of patients with atrial fibrillation (AF) are needed. We aimed to assess these data and guideline adherence in the EURObservational Research Programme on Atrial Fibrillation (EORP-AF) long-term general registry.

Methods: We analysed 967 patients from the EORP-AF long-term general registry included in the Netherlands and Belgium from 2013 to 2016. Baseline and 1‑year follow-up data were gathered.

Results: At baseline, 887 patients (92%) received anticoagulant treatment. In 88 (10%) of these patients, no indication for chronic anticoagulant treatment was present. A rhythm intervention was performed or planned in 52 of these patients, meaning that the remaining 36 (41%) were anticoagulated without indication. Forty patients were not anticoagulated, even though they had an indication for chronic anticoagulation. Additionally, 63 of the 371 patients (17%) treated with a non-vitamin K antagonist oral anticoagulant (NOAC) were incorrectly dosed. In total, 50 patients (5%) were overtreated and 89 patients (9%) were undertreated. However, the occurrence of major adverse cardiac and cerebrovascular events (MACCE) was still low with 4.2% (37 patients).

Conclusions: Overtreatment and undertreatment with anticoagulants are still observable in 14% of this contemporary, West-European AF population. Still, MACCE occurred in only 4% of the patients after 1 year of follow-up.
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http://dx.doi.org/10.1007/s12471-021-01634-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556427PMC
November 2021

Problems on the labour market for young Dutch cardiologists.

Neth Heart J 2021 Sep 23;29(9):423-426. Epub 2021 Aug 23.

Department of Cardiology, VieCuri Medical Centre, Venlo, The Netherlands.

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http://dx.doi.org/10.1007/s12471-021-01626-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397813PMC
September 2021

Efficient Redox-Neutral Photocatalytic Formate to Carbon Monoxide Conversion Enabled by Long-Range Hot Electron Transfer from Mn-Doped Quantum Dots.

J Am Chem Soc 2021 07 30;143(27):10292-10300. Epub 2021 Jun 30.

Department of Chemistry, Texas A&M University, College Station, Texas 77843, United States.

Energetic hot electrons generated in Mn-doped quantum dots (QDs) via exciton-to-hot-electron upconversion possess long-range transfer capability. The long-range hot electron transfer allowed for superior efficiency in various photocatalytic reduction reactions compared to conventional QDs, which solely rely on the transfer of band edge electrons. Here we show that the synergistic action of the interfacial hole transfer to the initial reactant and subsequent long-range hot electron transfer to an intermediate species enables highly efficient photocatalytic reactions, thereby extending the benefits of Mn-doped QDs beyond reduction reactions. The photocatalytic conversion of formate (HCOO) to carbon monoxide (CO), which is an important route to obtain a key component of syngas from an abundant source, is an exemplary redox-neutral reaction that exhibits a drastic enhancement of catalytic efficiency by Mn-doped QDs. Mn-doped QDs increased the formate to CO conversion rate by 2 orders of magnitude compared to conventional QDs with high selectivity. Spectroscopic study of charge transfer processes and the computational study of reaction intermediates revealed the critical role of long-range hot electron transfer to an intermediate species lacking binding affinity to the QD surface for efficient CO production. Specifically, we find that the formate radical (HCOO), formed after the initial hole transfer from the QD to HCOO, undergoes isomerization to the (HOCO) radical that subsequently is reduced to yield CO and OH. Long-range hot electron transfer is particularly effective for reducing the nonbinding (HOCO) radical, resulting in the large enhancement of CO production by overcoming the limitation of interfacial electron transfer.
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http://dx.doi.org/10.1021/jacs.1c03844DOI Listing
July 2021
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