TY  - JOUR
A1  - Montellano, Felipe A.
A1  - Kluter, Elisabeth J.
A1  - Rücker, Viktoria
A1  - Ungethüm, Kathrin
A1  - Mackenrodt, Daniel
A1  - Wiedmann, Silke
A1  - Dege, Tassilo
A1  - Quilitzsch, Anika
A1  - Morbach, Caroline
A1  - Frantz, Stefan
A1  - Störk, Stefan
A1  - Haeusler, Karl Georg
A1  - Kleinschnitz, Christoph
A1  - Heuschmann, Peter U.
T1  - Cardiac dysfunction and high-sensitive C-reactive protein are associated with troponin T elevation in ischemic stroke: insights from the SICFAIL study
JF  - BMC Neurology
N2  - Background
Troponin elevation is common in ischemic stroke (IS) patients. The pathomechanisms involved are incompletely understood and comprise coronary and non-coronary causes, e.g. autonomic dysfunction. We investigated determinants of troponin elevation in acute IS patients including markers of autonomic dysfunction, assessed by heart rate variability (HRV) time domain variables.
Methods
Data were collected within the Stroke Induced Cardiac FAILure (SICFAIL) cohort study. IS patients admitted to the Department of Neurology, Würzburg University Hospital, underwent baseline investigation including cardiac history, physical examination, echocardiography, and blood sampling. Four HRV time domain variables were calculated in patients undergoing electrocardiographic Holter monitoring. Multivariable logistic regression with corresponding odds ratios (OR) and 95% confidence intervals (CI) was used to investigate the determinants of high-sensitive troponin T (hs-TnT) levels ≥14 ng/L.
Results
We report results from 543 IS patients recruited between 01/2014–02/2017. Of those, 203 (37%) had hs-TnT ≥14 ng/L, which was independently associated with older age (OR per year 1.05; 95% CI 1.02–1.08), male sex (OR 2.65; 95% CI 1.54–4.58), decreasing estimated glomerular filtration rate (OR per 10 mL/min/1.73 m2 0.71; 95% CI 0.61–0.84), systolic dysfunction (OR 2.79; 95% CI 1.22–6.37), diastolic dysfunction (OR 2.29; 95% CI 1.29–4.02), atrial fibrillation (OR 2.30; 95% CI 1.25–4.23), and increasing levels of C-reactive protein (OR 1.48 per log unit; 95% CI 1.22–1.79). We did not identify an independent association of troponin elevation with the investigated HRV variables.
Conclusion
Cardiac dysfunction and elevated C-reactive protein, but not a reduced HRV as surrogate of autonomic dysfunction, were associated with increased hs-TnT levels in IS patients independent of established cardiovascular risk factors.
KW  - echocardiography
KW  - ischemic stroke
KW  - troponin
KW  - heart failure
KW  - biomarkers
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300119
VL  - 22
IS  - 1
ER  - 
TY  - JOUR
A1  - Grünwald, Viktor
A1  - Pink, Daniel
A1  - Egerer, Gerlinde
A1  - Schalk, Enrico
A1  - Augustin, Marinela
A1  - Deinzer, Christoph K. W.
A1  - Kob, Viola
A1  - Reichert, Dietmar
A1  - Kebenko, Maxim
A1  - Brandl, Stephan
A1  - Hahn, Dennis
A1  - Lindner, Lars H.
A1  - Hoiczyk, Mathias
A1  - Ringsdorf, Uta
A1  - Hanker, Lars C.
A1  - Hempel, Dirk
A1  - De Rivas, Beatriz
A1  - Wismann, Tobias
A1  - Ivanyi, Philipp
T1  - Trabectedin for patients with advanced soft tissue sarcoma: a non-interventional, prospective, multicenter, phase IV trial
JF  - Cancers
N2  - This non-interventional, prospective phase IV trial evaluated trabectedin in patients with soft tissue sarcoma (STS) in real-life clinical practice across Germany. The primary endpoints were progression-free survival (PFS) rates at 3 and 6 months, as defined by investigators. Overall, 128 patients from 19 German sites were evaluated for efficacy and 130 for safety. Median age was 58.5 years (range: 23–84) and leiomyosarcoma was the most frequent histotype (n = 45; 35.2%). Trabectedin was mostly used as second/third-line treatment (n = 91; 71.1%). Median PFS was 5.2 months (95% CI: 3.3–6.7), with 60.7% and 44.5% of patients free from progression at 3 and 6 months, respectively. Median overall survival was 15.2 months (95% CI: 9.6–21.4). One patient achieved a complete and 14 patients a partial response, conferring an objective response rate of 11.7%. Decreases in white blood cells (27.0% of patients), platelets (16.2%) and neutrophils (13.1%) and increased alanine aminotransferase (10.8%) were the most common trabectedin-related grade 3/4 adverse drug reactions. Two deaths due to pneumonia and sepsis were considered trabectedin-related. Trabectedin confers clinically meaningful activity in patients with multiple STS histotypes, comparable to that previously observed in clinical trials and other non-interventional studies, and with a manageable safety profile.
KW  - trabectedin
KW  - STS
KW  - sarcoma
KW  - non-interventional
KW  - prospective
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-290898
SN  - 2072-6694
VL  - 14
IS  - 21
ER  - 
TY  - JOUR
A1  - Lüke, Florian
A1  - Haller, Florian
A1  - Utpatel, Kirsten
A1  - Krebs, Markus
A1  - Meidenbauer, Norbert
A1  - Scheiter, Alexander
A1  - Spoerl, Silvia
A1  - Heudobler, Daniel
A1  - Sparrer, Daniela
A1  - Kaiser, Ulrich
A1  - Keil, Felix
A1  - Schubart, Christoph
A1  - Tögel, Lars
A1  - Einhell, Sabine
A1  - Dietmaier, Wolfgang
A1  - Huss, Ralf
A1  - Dintner, Sebastian
A1  - Sommer, Sebastian
A1  - Jordan, Frank
A1  - Goebeler, Maria-Elisabeth
A1  - Metz, Michaela
A1  - Haake, Diana
A1  - Scheytt, Mithun
A1  - Gerhard-Hartmann, Elena
A1  - Maurus, Katja
A1  - Brändlein, Stephanie
A1  - Rosenwald, Andreas
A1  - Hartmann, Arndt
A1  - Märkl, Bruno
A1  - Einsele, Hermann
A1  - Mackensen, Andreas
A1  - Herr, Wolfgang
A1  - Kunzmann, Volker
A1  - Bargou, Ralf
A1  - Beckmann, Matthias W.
A1  - Pukrop, Tobias
A1  - Trepel, Martin
A1  - Evert, Matthias
A1  - Claus, Rainer
A1  - Kerscher, Alexander
T1  - Identification of disparities in personalized cancer care — a joint approach of the German WERA consortium
JF  - Cancers
N2  - (1) Background: molecular tumor boards (MTBs) are crucial instruments for discussing and allocating targeted therapies to suitable cancer patients based on genetic findings. Currently, limited evidence is available regarding the regional impact and the outreach component of MTBs; (2) Methods: we analyzed MTB patient data from four neighboring Bavarian tertiary care oncology centers in Würzburg, Erlangen, Regensburg, and Augsburg, together constituting the WERA Alliance. Absolute patient numbers and regional distribution across the WERA-wide catchment area were weighted with local population densities; (3) Results: the highest MTB patient numbers were found close to the four cancer centers. However, peaks in absolute patient numbers were also detected in more distant and rural areas. Moreover, weighting absolute numbers with local population density allowed for identifying so-called white spots—regions within our catchment that were relatively underrepresented in WERA MTBs; (4) Conclusions: investigating patient data from four neighboring cancer centers, we comprehensively assessed the regional impact of our MTBs. The results confirmed the success of existing collaborative structures with our regional partners. Additionally, our results help identifying potential white spots in providing precision oncology and help establishing a joint WERA-wide outreach strategy.
KW  - precision oncology
KW  - MTB
KW  - patient access
KW  - cancer care
KW  - outreach
KW  - real world data
KW  - outcomes research
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-290311
SN  - 2072-6694
VL  - 14
IS  - 20
ER  -