Top

Published in:

01-06-2018 | Original Article

Geriatric nutritional risk index as a prognostic factor in patients with diffuse large B cell lymphoma

Authors: Yusuke Kanemasa, Tatsu Shimoyama, Yuki Sasaki, Tsunekazu Hishima, Yasushi Omuro

Published in: Annals of Hematology | Issue 6/2018

Abstract

The geriatric nutritional risk index (GNRI) is a simple and well-established nutritional assessment tool that is a significant prognostic factor for various cancers. However, the role of the GNRI in predicting clinical outcomes of diffuse large B cell lymphoma (DLBCL) patients has not been investigated. To address this issue, we retrospectively analyzed a total of 476 patients with newly diagnosed de novo DLBCL. We defined the best cutoff value of the GNRI as 96.8 using a receiver operating characteristic curve. Patients with a GNRI < 96.8 had significantly lower overall survival (OS) and progression-free survival (PFS) than those with a GNRI ≥ 96.8 (5-year OS, 61.2 vs. 84.4%, P < 0.001; 5-year PFS, 53.7 vs. 75.8%, P < 0.001). Multivariate analysis showed that performance status, Ann Arbor stage, serum lactate dehydrogenase, and GNRI were independent prognostic factors for OS. Among patients with high-intermediate and high-risk by National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI), the 5-year OS was significantly lower in patients with a GNRI < 96.8 than in those with a GNRI ≥ 96.8 (high-intermediate risk, 59.5 vs. 75.2%, P = 0.006; high risk, 37.4 vs. 64.9%, P = 0.033). In the present study, we demonstrated that the GNRI was an independent prognostic factor in DLBCL patients. The GNRI could identify a population of poor-risk patients among those with high-intermediate and high-risk by NCCN-IPI.

Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW (2008) World Health Organization classification of tumours of haematopoietic and lymphoid tissues, 4th edn. France IARC Press, Lyon, pp 233–237

Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P, Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C (2002) CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 346(4):235–242. https://doi.org/10.1056/NEJMoa011795 CrossRefPubMed

Habermann TM, Weller EA, Morrison VA, Gascoyne RD, Cassileth PA, Cohn JB, Dakhil SR, Woda B, Fisher RI, Peterson BA, Horning SJ (2006) Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma. J Clin Oncol Off J Am Soc Clin Oncol 24(19):3121–3127. https://doi.org/10.1200/jco.2005.05.1003 CrossRef

Pfreundschuh M, Kuhnt E, Trumper L, Osterborg A, Trneny M, Shepherd L, Gill DS, Walewski J, Pettengell R, Jaeger U, Zinzani PL, Shpilberg O, Kvaloy S, de Nully Brown P, Stahel R, Milpied N, Lopez-Guillermo A, Poeschel V, Grass S, Loeffler M, Murawski N (2011) CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group. Lancet Oncol 12(11):1013–1022. https://doi.org/10.1016/s1470-2045(11)70235-2 CrossRefPubMed

Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E, Reiser M, Nickenig C, Clemens M, Peter N, Bokemeyer C, Eimermacher H, Ho A, Hoffmann M, Mertelsmann R, Trumper L, Balleisen L, Liersch R, Metzner B, Hartmann F, Glass B, Poeschel V, Schmitz N, Ruebe C, Feller AC, Loeffler M (2008) Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol 9(2):105–116. https://doi.org/10.1016/s1470-2045(08)70002-0 CrossRefPubMed

Cortelazzo S, Tarella C, Gianni AM, Ladetto M, Barbui AM, Rossi A, Gritti G, Corradini P, Di Nicola M, Patti C, Mule A, Zanni M, Zoli V, Billio A, Piccin A, Negri G, Castellino C, Di Raimondo F, Ferreri AJ, Benedetti F, La Nasa G, Gini G, Trentin L, Frezzato M, Flenghi L, Falorio S, Chilosi M, Bruna R, Tabanelli V, Pileri S, Masciulli A, Delaini F, Boschini C, Rambaldi A (2016) Randomized trial comparing R-CHOP versus high-dose sequential chemotherapy in high-risk patients with diffuse large B-cell lymphomas. J Clin Oncol 34(33):4015–4022. https://doi.org/10.1200/jco.2016.67.2980 CrossRefPubMed

Friedberg JW (2011) Relapsed/refractory diffuse large B-cell lymphoma. Hematol Am Soc Hematol Educ Program 2011(1):498–505. https://doi.org/10.1182/asheducation-2011.1.498

The International Non-Hodgkin's Lymphoma Prognostic Factors Project (1993) A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med 329(14):987–994. https://doi.org/10.1056/nejm199309303291402 CrossRef

Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, Klasa R, Savage KJ, Shenkier T, Sutherland J, Gascoyne RD, Connors JM (2007) The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 109(5):1857–1861. https://doi.org/10.1182/blood-2006-08-038257 CrossRefPubMed

10.

Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A, Vanderplas A, Zelenetz AD, Abel GA, Rodriguez MA, Nademanee A, Kaminski MS, Czuczman MS, Millenson M, Niland J, Gascoyne RD, Connors JM, Friedberg JW, Winter JN (2014) An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood 123(6):837–842. https://doi.org/10.1182/blood-2013-09-524108 CrossRefPubMedPubMedCentral

11.

Hao X, Wei Y, Wei X, Zhou L, Wei Q, Zhang Y, Huang W, Feng R (2017) Glasgow prognostic score is superior to other inflammation-based scores in predicting survival of diffuse large B-cell lymphoma. Oncotarget 8(44):76740–76748. https://doi.org/10.18632/oncotarget.20832 CrossRefPubMedPubMedCentral

12.

Kim Y, Kim SJ, Hwang D, Jang J, Hyun SY, Kim YR, Kim JS, Min YH, Cheong JW (2014) The modified Glasgow Prognostic Scores as a predictor in diffuse large B cell lymphoma treated with R-CHOP regimen. Yonsei Med J 55(6):1568–1575. https://doi.org/10.3349/ymj.2014.55.6.1568 CrossRefPubMedPubMedCentral

13.

Li X, Zhang Y, Zhao W, Liu Z, Shen Y, Li J, Shen Z (2015) The Glasgow Prognostic Score as a significant predictor of diffuse large B cell lymphoma treated with R-CHOP in China. Ann Hematol 94(1):57–63. https://doi.org/10.1007/s00277-014-2167-0 CrossRefPubMed

14.

Perisa V, Zibar L, Knezovic A, Perisa I, Sincic-Petricevic J, Aurer I (2017) Prognostic nutritional index as a predictor of prognosis in patients with diffuse large B cell lymphoma. Wien Klin Wochenschr 129(11–12):411–419. https://doi.org/10.1007/s00508-016-1077-7 CrossRefPubMed

15.

Zhou Q, Wei Y, Huang F, Wei X, Wei Q, Hao X, Zhang Y, Feng R (2016) Low prognostic nutritional index predicts poor outcome in diffuse large B-cell lymphoma treated with R-CHOP. Int J Hematol 104(4):485–490. https://doi.org/10.1007/s12185-016-2052-9 CrossRefPubMed

16.

Park S, Han B, Cho JW, Woo SY, Kim S, Kim SJ, Kim WS (2014) Effect of nutritional status on survival outcome of diffuse large B-cell lymphoma patients treated with rituximab-CHOP. Nutr Cancer 66(2):225–233. https://doi.org/10.1080/01635581.2014.867065 CrossRefPubMed

17.

Buzby GP, Knox LS, Crosby LO, Eisenberg JM, Haakenson CM, McNeal GE, Page CP, Peterson OL, Reinhardt GF, Williford WO (1988) Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. Am J Clin Nutr 47(2 Suppl):366–381. https://doi.org/10.1093/ajcn/47.2.366 CrossRefPubMed

18.

Buzby GP, Williford WO, Peterson OL, Crosby LO, Page CP, Reinhardt GF, Mullen JL (1988) A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr 47(2 Suppl):357–365. https://doi.org/10.1093/ajcn/47.2.357 CrossRefPubMed

19.

Naber TH, de Bree A, Schermer TR, Bakkeren J, Bar B, de Wild G, Katan MB (1997) Specificity of indexes of malnutrition when applied to apparently healthy people: the effect of age. Am J Clin Nutr 65(6):1721–1725. https://doi.org/10.1093/ajcn/65.6.1721 CrossRefPubMed

20.

Bouillanne O, Morineau G, Dupont C, Coulombel I, Vincent JP, Nicolis I, Benazeth S, Cynober L, Aussel C (2005) Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients. Am J Clin Nutr 82(4):777–783CrossRefPubMed

21.

Bo Y, Wang K, Liu Y, You J, Cui H, Zhu Y, Lu Q, Yuan L (2016) The geriatric nutritional risk index predicts survival in elderly esophageal squamous cell carcinoma patients with radiotherapy. PLoS One 11(5):e0155903. https://doi.org/10.1371/journal.pone.0155903 CrossRefPubMedPubMedCentral

22.

Gu W, Zhang G, Sun L, Ma Q, Cheng Y, Zhang H, Shi G, Zhu Y, Ye D (2015) Nutritional screening is strongly associated with overall survival in patients treated with targeted agents for metastatic renal cell carcinoma. J Cachexia Sarcopenia Muscle 6(3):222–230. https://doi.org/10.1002/jcsm.12025 CrossRefPubMedPubMedCentral

23.

Miyake H, Tei H, Fujisawa M (2017) Geriatric nutrition risk index is an important predictor of cancer-specific survival, but not recurrence-free survival, in patients undergoing surgical resection for non-metastatic renal cell carcinoma. Curr Urol 10(1):26–31. https://doi.org/10.1159/000447147 CrossRefPubMedPubMedCentral

24.

Shoji F, Matsubara T, Kozuma Y, Haratake N, Akamine T, Takamori S, Katsura M, Toyokawa G, Okamoto T, Maehara Y (2017) Preoperative geriatric nutritional risk index: a predictive and prognostic factor in patients with pathological stage I non-small cell lung cancer. Surg Oncol 26(4):483–488. https://doi.org/10.1016/j.suronc.2017.09.006 CrossRefPubMed

25.

Shoji F, Miura N, Matsubara T, Akamine T, Kozuma Y, Haratake N, Takamori S, Katsura M, Takada K, Toyokawa G, Takenaka T, Yamazaki K, Okamoto T, Takeo S, Maehara Y (2017) Prognostic significance of immune-nutritional parameters for surgically resected elderly lung cancer patients: a multicentre retrospective study. Interact Cardiovasc Thorac Surg. https://doi.org/10.1093/icvts/ivx337

26.

Mori M, Niitsu N, Takagi T, Tomiyama J, Matsue T, Nakagawa Y, Okamoto R (2001) Reduced-dose chop therapy for elderly patients with non-Hodgkin’s lymphoma. Leuk Lymphoma 41(3–4):359–366. https://doi.org/10.3109/10428190109057991 CrossRefPubMed

27.

Shah B, Sucher K, Hollenbeck CB (2006) Comparison of ideal body weight equations and published height-weight tables with body mass index tables for healthy adults in the United States. Nutr Clin Pract 21(3):312–319. https://doi.org/10.1177/0115426506021003312 CrossRefPubMed

28.

Yamada K, Furuya R, Takita T, Maruyama Y, Yamaguchi Y, Ohkawa S, Kumagai H (2008) Simplified nutritional screening tools for patients on maintenance hemodialysis. Am J Clin Nutr 87(1):106–113CrossRefPubMed

29.

Kanda Y (2013) Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant 48(3):452–458. https://doi.org/10.1038/bmt.2012.244 CrossRefPubMed

30.

Bozzetti F, Mariani L, Lo Vullo S, Amerio ML, Biffi R, Caccialanza G, Capuano G, Correja I, Cozzaglio L, Di Leo A, Di Cosmo L, Finocchiaro C, Gavazzi C, Giannoni A, Magnanini P, Mantovani G, Pellegrini M, Rovera L, Sandri G, Tinivella M, Vigevani E (2012) The nutritional risk in oncology: a study of 1,453 cancer outpatients. Support Care Cancer 20(8):1919–1928. https://doi.org/10.1007/s00520-012-1387-x CrossRefPubMedPubMedCentral

31.

Hebuterne X, Lemarie E, Michallet M, de Montreuil CB, Schneider SM, Goldwasser F (2014) Prevalence of malnutrition and current use of nutrition support in patients with cancer. JPEN J Parenter Enteral Nutr 38(2):196–204. https://doi.org/10.1177/0148607113502674 CrossRefPubMed

32.

Carson KR, Bartlett NL, McDonald JR, Luo S, Zeringue A, Liu J, Fu Q, Chang SH, Colditz GA (2012) Increased body mass index is associated with improved survival in United States veterans with diffuse large B-cell lymphoma. J Clin Oncol Off J Am Soc Clin Oncol 30(26):3217–3222. https://doi.org/10.1200/jco.2011.39.2100 CrossRef

33.

Jones JA, Fayad LE, Elting LS, Rodriguez MA (2010) Body mass index and outcomes in patients receiving chemotherapy for intermediate-grade B-cell non-Hodgkin lymphoma. Leuk Lymphoma 51(9):1649–1657. https://doi.org/10.3109/10428194.2010.494315 CrossRefPubMed

34.

Li T, Liu ZG, Liang PQ, Wang HT (2016) Can body mass index predict the outcome of diffuse large B-cell lymphoma? A single-center retrospective study in China. Leuk Lymphoma 58(7):1–6. https://doi.org/10.1080/10428194.2016.1257793

35.

Weiss L, Melchardt T, Habringer S, Boekstegers A, Hufnagl C, Neureiter D, Hopfinger G, Greil R, Egle A (2014) Increased body mass index is associated with improved overall survival in diffuse large B-cell lymphoma. Ann Oncol 25(1):171–176. https://doi.org/10.1093/annonc/mdt481 CrossRefPubMed

36.

Boyle T, Connors JM, Gascoyne RD, Berry BR, Sehn LH, Bashash M, Spinelli JJ (2017) Physical activity, obesity and survival in diffuse large B-cell and follicular lymphoma cases. Br J Haematol 178(3):442–447. https://doi.org/10.1111/bjh.14702 CrossRefPubMed

37.

Hong F, Habermann TM, Gordon LI, Hochster H, Gascoyne RD, Morrison VA, Fisher RI, Bartlett NL, Stiff PJ, Cheson BD, Crump M, Horning SJ, Kahl BS (2014) The role of body mass index in survival outcome for lymphoma patients: US intergroup experience. Ann Oncol 25(3):669–674. https://doi.org/10.1093/annonc/mdt594 CrossRefPubMedPubMedCentral

38.

Hwang HS, Yoon DH, Suh C, Huh J (2015) Body mass index as a prognostic factor in Asian patients treated with chemoimmunotherapy for diffuse large B cell lymphoma, not otherwise specified. Ann Hematol 94(10):1655–1665. https://doi.org/10.1007/s00277-015-2438-4 CrossRefPubMed

39.

Kanemasa Y, Shimoyama T, Sasaki Y, Tamura M, Sawada T, Omuro Y, Hishima T, Maeda Y (2017) Analysis of the prognostic value of BMI and the difference in its impact according to age and sex in DLBCL patients. Hematol Oncol. https://doi.org/10.1002/hon.2426

40.

Camus V, Lanic H, Kraut J, Modzelewski R, Clatot F, Picquenot JM, Contentin N, Lenain P, Groza L, Lemasle E, Fronville C, Cardinael N, Fontoura ML, Chamseddine A, Brehar O, Stamatoullas A, Lepretre S, Tilly H, Jardin F (2014) Prognostic impact of fat tissue loss and cachexia assessed by computed tomography scan in elderly patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Eur J Haematol 93(1):9–18. https://doi.org/10.1111/ejh.12285 CrossRefPubMed

41.

Lanic H, Kraut-Tauzia J, Modzelewski R, Clatot F, Mareschal S, Picquenot JM, Stamatoullas A, Lepretre S, Tilly H, Jardin F (2014) Sarcopenia is an independent prognostic factor in elderly patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Leuk Lymphoma 55(4):817–823. https://doi.org/10.3109/10428194.2013.816421 CrossRefPubMed

42.

de van der Schueren M, Elia M, Gramlich L, Johnson MP, Lim SL, Philipson T, Jaferi A, Prado CM (2014) Clinical and economic outcomes of nutrition interventions across the continuum of care. Ann N Y Acad Sci 1321(1):20–40. https://doi.org/10.1111/nyas.12498 CrossRef

43.

Bairey O, Shacham-Abulafia A, Shpilberg O, Gurion R (2016) Serum albumin level at diagnosis of diffuse large B-cell lymphoma: an important simple prognostic factor. Hematol Oncol 34(4):184–192. https://doi.org/10.1002/hon.2233 CrossRefPubMed

44.

Dalia S, Chavez J, Little B, Bello C, Fisher K, Lee JH, Chervenick P, Sokol L, Sotomayor E, Shah B (2014) Serum albumin retains independent prognostic significance in diffuse large B-cell lymphoma in the post-rituximab era. Ann Hematol 93(8):1305–1312. https://doi.org/10.1007/s00277-014-2031-2 CrossRefPubMed

45.

Ngo L, Hee SW, Lim LC, Tao M, Quek R, Yap SP, Loong EL, Sng I, Hwan-Cheong TL, Ang MK, Ngeow J, Tham CK, Tan MH, Lim ST (2008) Prognostic factors in patients with diffuse large B cell lymphoma: before and after the introduction of rituximab. Leuk Lymphoma 49(3):462–469. https://doi.org/10.1080/10428190701809156 CrossRefPubMed

46.

Marian M, August DA (2014) Prevalence of malnutrition and current use of nutrition support in cancer patient study. JPEN J Parenter Enteral Nutr 38(2):163–165. https://doi.org/10.1177/0148607113506940 CrossRefPubMed

47.

Forrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ (2003) Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer 89(6):1028–1030. https://doi.org/10.1038/sj.bjc.6601242 CrossRefPubMedPubMedCentral

48.

Ignacio de Ulibarri J, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A, Rodriguez F, Fernandez G (2005) CONUT: a tool for controlling nutritional status. First validation in a hospital population. Nutr Hosp 20(1):38–45PubMed

49.

McMillan DC, Crozier JE, Canna K, Angerson WJ, McArdle CS (2007) Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Color Dis 22(8):881–886. https://doi.org/10.1007/s00384-006-0259-6 CrossRef

50.

Onodera T, Goseki N, Kosaki G (1984) Prognostic nutritional index in gastrointestinal surgery of malnourished cancer patients. Nihon Geka Gakkai zasshi 85(9):1001–1005PubMed

51.

Iseki Y, Shibutani M, Maeda K, Nagahara H, Ohtani H, Sugano K, Ikeya T, Muguruma K, Tanaka H, Toyokawa T, Sakurai K, Hirakawa K (2015) Impact of the preoperative Controlling Nutritional Status (CONUT) score on the survival after curative surgery for colorectal cancer. PLoS One 10(7):e0132488. https://doi.org/10.1371/journal.pone.0132488 CrossRefPubMedPubMedCentral

52.

Toyokawa T, Kubo N, Tamura T, Sakurai K, Amano R, Tanaka H, Muguruma K, Yashiro M, Hirakawa K, Ohira M (2016) The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer 16(1):722. https://doi.org/10.1186/s12885-016-2696-0 CrossRefPubMedPubMedCentral

53.

Thieblemont C, Coiffier B (2007) Lymphoma in older patients. J Clin Oncol Off J Am Soc Clin Oncol 25(14):1916–1923. https://doi.org/10.1200/jco.2006.10.5957 CrossRef

54.

Klapper W, Kreuz M, Kohler CW, Burkhardt B, Szczepanowski M, Salaverria I, Hummel M, Loeffler M, Pellissery S, Woessmann W, Schwanen C, Trumper L, Wessendorf S, Spang R, Hasenclever D, Siebert R (2012) Patient age at diagnosis is associated with the molecular characteristics of diffuse large B-cell lymphoma. Blood 119(8):1882–1887. https://doi.org/10.1182/blood-2011-10-388470 CrossRefPubMed

55.

Duran Alert P, Mila Villarroel R, Formiga F, Virgili Casas N, Vilarasau Farre C (2012) Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI). Nutr Hosp 27(2):590–598. https://doi.org/10.1590/s0212-16112012000200036 PubMed

56.

Kinugasa Y, Kato M, Sugihara S, Hirai M, Yamada K, Yanagihara K, Yamamoto K (2013) Geriatric nutritional risk index predicts functional dependency and mortality in patients with heart failure with preserved ejection fraction. Circ J 77(3):705–711CrossRefPubMed

57.

Matsumura T, Mitani Y, Oki Y, Fujimoto Y, Ohira M, Kaneko H, Kawashima T, Nishio M, Ishikawa A (2015) Comparison of Geriatric Nutritional Risk Index scores on physical performance among elderly patients with chronic obstructive pulmonary disease. Heart Lung 44(6):534–538. https://doi.org/10.1016/j.hrtlng.2015.08.004 CrossRefPubMed

Title: Geriatric nutritional risk index as a prognostic factor in patients with diffuse large B cell lymphoma
Authors: Yusuke Kanemasa
Tatsu Shimoyama
Yuki Sasaki
Tsunekazu Hishima
Yasushi Omuro
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 6/2018
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-018-3273-1

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2018

Enlarged spleen is associated with low neutrophil and platelet engraftment rates and poor survival after allogeneic stem cell transplantation in patients with acute myeloid leukemia and myelodysplastic syndrome

Variants in FIX propeptide associated with vitamin K antagonist hypersensitivity: functional analysis and additional data confirming the common founder mutations

Genome-wide genotype-based risk model for survival in core binding factor acute myeloid leukemia patients

Extramedullary involvement of the stomach presenting as multiple white elevations in the initial diagnosis of chronic myeloid leukemia treated with dasatinib

Adult T cell leukemia/lymphoma with different pathological features in each tumor site

High proportion of TAFRO syndrome in Thai adult Castleman’s disease patients: a 10-year experience

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage