Top

Published in:

01-02-2019 | Original Article

Platelet number and graft function predict intensive care survival in allogeneic stem cell transplantation patients

Authors: Amin T. Turki, Wolfgang Lamm, Christoph Schmitt, Evren Bayraktar, Ferras Alashkar, Martin Metzenmacher, Philipp Wohlfarth, Dietrich W. Beelen, Tobias Liebregts

Published in: Annals of Hematology | Issue 2/2019

Abstract

Despite significant advances in the treatment of complications requiring intensive care unit (ICU) admission, ICU mortality remains high for patients after allogeneic stem cell transplantation. We evaluated the role of thrombocytopenia and poor graft function in allogeneic stem cell recipients receiving ICU treatments along with established prognostic ICU markers in order to identify patients at risk for severe complications. At ICU admission, clinical and laboratory data of 108 allogeneic stem cell transplanted ICU patients were collected and retrospectively analyzed. Platelet counts (≤ 50,000/μl, p < 0.0005), hemoglobin levels (≤ 8.5 mg/dl, p = 0.019), and leukocyte count (≤ 1500/μl, p = 0.025) along with sepsis (p = 0.002) and acute myeloid leukemia (p < 0.0005) correlated significantly with survival. Multivariate analysis confirmed thrombocytopenia (hazard ratio (HR) 2.79 (1.58–4.92, 95% confidence interval (CI)) and anemia (HR 1.82, 1.06–3.11, 95% CI) as independent mortality risk factors. Predominant ICU diagnoses were acute respiratory failure (75%), acute kidney injury (47%), and septic shock (30%). Acute graft versus host disease was diagnosed in 42% of patients, and 47% required vasopressors. Low platelet (≤ 50,000/μl) and poor graft function are independent prognostic factors for impaired survival in critically ill stem cell transplanted patients. The underlying pathophysiology of poor graft function is not fully understood and currently under investigation. High-risk patients may be identified and ICU treatments stratified according to allogeneic stem cell patients’ individual risk profiles. In contrast to previous studies involving medical or surgical ICU patients, the fraction of thrombocytopenic patients was larger and low platelets were a better differentiating factor in multivariate analysis than any other parameter.

Available only for authorised users

Champlin RE, Schmitz N, Horowitz MM, Chapuis B, Chopra R, Cornelissen JJ, Gale RP, Goldman JM, Loberiza FR Jr, Hertenstein B, Klein JP, Montserrat E, Zhang MJ, Ringden O, Tomany SC, Rowlings PA, Van Hoef ME, Gratwohl A (2000) Blood stem cells compared with bone marrow as a source of hematopoietic cells for allogeneic transplantation. IBMTR histocompatibility and stem cell sources working committee and the European Group for Blood and Marrow Transplantation (EBMT). Blood 95(12):3702–3709PubMed

Stasia A, Ghiso A, Galaverna F, Raiola AM, Gualandi F, Luchetti S, Pozzi S, Varaldo R, Lamparelli T, Bregante S, Van Lint MT, di Grazia C, Bacigalupo A (2014) CD34 selected cells for the treatment of poor graft function after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 20(9):1440–1443. https://doi.org/10.1016/j.bbmt.2014.05.016 CrossRefPubMed

Torrecilla C, Cortes JL, Chamorro C, Rubio JJ, Galdos P, Dominguez de Villota E (1988) Prognostic assessment of the acute complications of bone marrow transplantation requiring intensive therapy. Intensive Care Med 14(4):393–398CrossRef

Paz HL, Crilley P, Weinar M, Brodsky I (1993) Outcome of patients requiring medical ICU admission following bone marrow transplantation. Chest 104(2):527–531CrossRef

Staudinger T, Stoiser B, Mullner M, Locker GJ, Laczika K, Knapp S, Burgmann H, Wilfing A, Kofler J, Thalhammer F, Frass M (2000) Outcome and prognostic factors in critically ill cancer patients admitted to the intensive care unit. Crit Care Med 28(5):1322–1328CrossRef

Azoulay E, Soares M, Darmon M, Benoit D, Pastores S, Afessa B (2011) Intensive care of the cancer patient: recent achievements and remaining challenges. Ann Intensive Care 1(1):5. https://doi.org/10.1186/2110-5820-1-5 CrossRefPubMedPubMedCentral

Vogelzang NJ, Benowitz SI, Adams S, Aghajanian C, Chang SM, Dreyer ZE, Janne PA, Ko AH, Masters GA, Odenike O, Patel JD, Roth BJ, Samlowski WE, Seidman AD, Tap WD, Temel JS, Von Roenn JH, Kris MG (2012) Clinical cancer advances 2011: annual report on Progress against Cancer from the American Society of Clinical Oncology. J Clin Oncol Off J Am Soc Clin Oncol 30(1):88–109. https://doi.org/10.1200/JCO.2011.40.1919 CrossRef

Lindgaard SC, Nielsen J, Lindmark A, Sengelov H (2016) Prognosis of allogeneic haematopoietic stem cell recipients admitted to the intensive care unit: a retrospective, single-centre study. Acta Haematol 135(2):72–78. https://doi.org/10.1159/000440937 CrossRefPubMed

Legrand M, Max A, Peigne V, Mariotte E, Canet E, Debrumetz A, Lemiale V, Seguin A, Darmon M, Schlemmer B, Azoulay E (2012) Survival in neutropenic patients with severe sepsis or septic shock. Crit Care Med 40(1):43–49. https://doi.org/10.1097/CCM.0b013e31822b50c2 CrossRef

10.

Zuber B, Tran TC, Aegerter P, Grimaldi D, Charpentier J, Guidet B, Mira JP, Pene F, Network CU-R (2012) Impact of case volume on survival of septic shock in patients with malignancies. Crit Care Med 40(1):55–62. https://doi.org/10.1097/CCM.0b013e31822d74ba CrossRef

11.

Azoulay E, Alberti C, Bornstain C, Leleu G, Moreau D, Recher C, Chevret S, Le Gall JR, Brochard L, Schlemmer B (2001) Improved survival in cancer patients requiring mechanical ventilatory support: impact of noninvasive mechanical ventilatory support. Crit Care Med 29(3):519–525CrossRef

12.

Baughman RP, Lower EE, Flessa HC, Tollerud DJ (1993) Thrombocytopenia in the intensive care unit. Chest 104(4):1243–1247CrossRef

13.

Stephan F, Hollande J, Richard O, Cheffi A, Maier-Redelsperger M, Flahault A (1999) Thrombocytopenia in a surgical ICU. Chest 115(5):1363–1370CrossRef

14.

Vanderschueren S, De Weerdt A, Malbrain M, Vankersschaever D, Frans E, Wilmer A, Bobbaers H (2000) Thrombocytopenia and prognosis in intensive care. Crit Care Med 28(6):1871–1876CrossRef

15.

Boyacı N, Aygencel G, Turkoglu M, Yegin ZA, Acar K, Sucak GT (2014) The intensive care management process in patients with hematopoietic stem cell transplantation and factors affecting their prognosis. Hematology 19(6):338–345. https://doi.org/10.1179/1607845413Y.0000000130 CrossRefPubMed

16.

van Vliet M, van der Burgt MP, van der Velden WJ, van der Hoeven JG, de Haan AF, Donnelly JP, Pickkers P, Blijlevens NM (2014) Trends in the outcomes of Dutch haematological patients receiving intensive care support. Neth J Med 72(2):107–112PubMed

17.

Afessa B, Tefferi A, Dunn WF, Litzow MR, Peters SG (2003) Intensive care unit support and acute physiology and chronic health evaluation III performance in hematopoietic stem cell transplant recipients. Crit Care Med 31(6):1715–1721. https://doi.org/10.1097/01.ccm.0000065761.51367.2d CrossRefPubMed

18.

Neumann F, Lobitz O, Fenk R, Bruns I, Köstering M, Steiner S, Hennersdorf M, Kelm M, Strauer BE, Germing U, Hinke A, Haas R, Kobbe G (2008) The sepsis-related organ failure assessment (SOFA) score is predictive for survival of patients admitted to the intensive care unit following allogeneic blood stem cell transplantation. Ann Hematol 87(4):299–304. https://doi.org/10.1007/s00277-008-0440-9 CrossRefPubMed

19.

Gilli K, Remberger M, Hjelmqvist H, Ringden O, Mattsson J (2010) Sequential organ failure assessment predicts the outcome of SCT recipients admitted to intensive care unit. Bone Marrow Transplant 45(4):682–688. https://doi.org/10.1038/bmt.2009.220 CrossRefPubMed

20.

Bayraktar UD, Shpall EJ, Liu P, Ciurea SO, Rondon G, de Lima M, Cardenas-Turanzas M, Price KJ, Champlin RE, Nates JL (2013) Hematopoietic cell transplantation-specific comorbidity index predicts inpatient mortality and survival in patients who received allogeneic transplantation admitted to the intensive care unit. J Clin Oncol Off J Am Soc Clin Oncol 31(33):4207–4214. https://doi.org/10.1200/jco.2013.50.5867 CrossRef

21.

Benz R, Schanz U, Maggiorini M, Seebach JD, Stussi G (2014) Risk factors for ICU admission and ICU survival after allogeneic hematopoietic SCT. Bone Marrow Transplant 49(1):62–65. https://doi.org/10.1038/bmt.2013.141 CrossRefPubMed

22.

Olsson R, Remberger M, Schaffer M, Berggren DM, Svahn BM, Mattsson J, Ringden O (2013) Graft failure in the modern era of allogeneic hematopoietic SCT. Bone Marrow Transplant 48(4):537–543. https://doi.org/10.1038/bmt.2012.239 CrossRefPubMed

23.

Ghobadi A, Fiala MA, Ramsingh G, Gao F, Abboud CN, Stockerl-Goldstein K, Uy GL, Grossman BJ, Westervelt P, DiPersio JF (2017) Fresh or cryopreserved CD34(+)-selected mobilized peripheral blood stem and progenitor cells for the treatment of poor graft function after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 23(7):1072–1077. https://doi.org/10.1016/j.bbmt.2017.03.019 CrossRefPubMedPubMedCentral

24.

Klyuchnikov E, El-Cheikh J, Sputtek A, Lioznov M, Calmels B, Furst S, Chabannon C, Crocchiolo R, Lemarie C, Faucher C, Bacher U, Alchalby H, Stubig T, Wolschke C, Ayuk F, Reckhaus ML, Blaise D, Kroger N (2014) CD34(+)-selected stem cell boost without further conditioning for poor graft function after allogeneic stem cell transplantation in patients with hematological malignancies. Biol Blood Marrow Transplant 20(3):382–386. https://doi.org/10.1016/j.bbmt.2013.11.034 CrossRefPubMed

25.

Kim DH, Sohn SK, Baek JH, Kim JG, Lee NY, Won DI, Suh JS, Lee KB (2006) Clinical significance of platelet count at day +60 after allogeneic peripheral blood stem cell transplantation. J Korean Med Sci 21(1):46–51. https://doi.org/10.3346/jkms.2006.21.1.46 CrossRefPubMedPubMedCentral

26.

Kim DH, Sohn SK, Jeon SB, Baek JH, Kim JG, Lee NY, Suh JS, Lee KB, Shin IH (2006) Prognostic significance of platelet recovery pattern after allogeneic HLA-identical sibling transplantation and its association with severe acute GVHD. Bone Marrow Transplant 37(1):101–108. https://doi.org/10.1038/sj.bmt.1705203 CrossRefPubMed

27.

Dominietto A, Raiola Anna M, Van Lint Maria T, Lamparelli T, Gualandi F, Berisso G, Bregante S, Frassoni F, Casarino L, Verdiani S, Bacigalupo A (2001) Factors influencing haematological recovery after allogeneic haemopoietic stem cell transplants: graft-versus-host disease, donor type, cytomegalovirus infections and cell dose. Br J Haematol 112(1):219–227. https://doi.org/10.1046/j.1365-2141.2001.02468.x CrossRefPubMed

28.

Mokart D, Darmon M, Resche-Rigon M, Lemiale V, Pene F, Mayaux J, Rabbat A, Kouatchet A, Vincent F, Nyunga M, Bruneel F, Lebert C, Perez P, Renault A, Hamidfar R, Jourdain M, Meert AP, Benoit D, Chevret S, Azoulay E (2015) Prognosis of neutropenic patients admitted to the intensive care unit. Intensive Care Med 41(2):296–303. https://doi.org/10.1007/s00134-014-3615-y CrossRefPubMed

29.

Agarwal S, O'Donoghue S, Gowardman J, Kennedy G, Bandeshe H, Boots R (2012) Intensive care unit experience of haemopoietic stem cell transplant patients. Intern Med J 42(7):748–754. https://doi.org/10.1111/j.1445-5994.2011.02533.x CrossRefPubMed

30.

Bayraktar UD, Milton DR, Shpall EJ, Rondon G, Price KJ, Champlin RE, Nates JL (2017) Prognostic index for critically ill allogeneic transplantation patients. Biol Blood Marrow Transplant 23(6):991–996. https://doi.org/10.1016/j.bbmt.2017.03.003 CrossRefPubMed

31.

Azoulay E, Thiery G, Chevret S, Moreau D, Darmon M, Bergeron A, Yang K, Meignin V, Ciroldi M, Le Gall JR, Tazi A, Schlemmer B (2004) The prognosis of acute respiratory failure in critically ill cancer patients. Medicine 83(6):360–370CrossRef

32.

Harris AC, Young R, Devine S, Hogan WJ, Ayuk F, Bunworasate U, Chanswangphuwana C, Efebera YA, Holler E, Litzow M, Ordemann R, Qayed M, Renteria AS, Reshef R, Wölfl M, Chen Y-B, Goldstein S, Jagasia M, Locatelli F, Mielke S, Porter D, Schechter T, Shekhovtsova Z, Ferrara JLM, Levine JE (2016) International, multicenter standardization of acute graft-versus-host disease clinical data collection: a report from the Mount Sinai acute GVHD international consortium. Biol Blood Marrow Transplant 22(1):4–10. https://doi.org/10.1016/j.bbmt.2015.09.001 CrossRefPubMed

33.

Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA, Lerner KG, Thomas ED (1974) Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation 18(4):295–304CrossRef

34.

Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW, Palmer J, Weisdorf D, Treister NS, Cheng G-S, Kerr H, Stratton P, Duarte RF, McDonald GB, Inamoto Y, Vigorito A, Arai S, Datiles MB, Jacobsohn D, Heller T, Kitko CL, Mitchell SA, Martin PJ, Shulman H, Wu RS, Cutler CS, Vogelsang GB, Lee SJ, Pavletic SZ, Flowers MED (2015) National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. the 2014 diagnosis and staging working group report. Biol Blood Marrow Transplant 21(3):389–401.e381. https://doi.org/10.1016/j.bbmt.2014.12.001 CrossRef

35.

Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, Martin P, Chien J, Przepiorka D, Couriel D, Cowen EW, Dinndorf P, Farrell A, Hartzman R, Henslee-Downey J, Jacobsohn D, McDonald G, Mittleman B, Rizzo JD, Robinson M, Schubert M, Schultz K, Shulman H, Turner M, Vogelsang G, Flowers ME (2005) National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. diagnosis and staging working group report. Biol Blood Marrow Transplant 11(12):945–956. https://doi.org/10.1016/j.bbmt.2005.09.004 CrossRef

36.

Larocca A, Piaggio G, Podesta M, Pitto A, Bruno B, Di Grazia C, Gualandi F, Occhini D, Raiola AM, Dominietto A, Bregante S, Lamparelli T, Tedone E, Oneto R, Frassoni F, Van Lint MT, Pogliani E, Bacigalupo A (2006) Boost of CD34+−selected peripheral blood cells without further conditioning in patients with poor graft function following allogeneic stem cell transplantation. Haematologica 91(7):935–940PubMed

37.

Le Gall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS II) based on a European/north American multicenter study. JAMA 270(24):2957–2963CrossRef

38.

Schellongowski P, Benesch M, Lang T, Traunmuller F, Zauner C, Laczika K, Locker GJ, Frass M, Staudinger T (2004) Comparison of three severity scores for critically ill cancer patients. Intensive Care Med 30(3):430–436. https://doi.org/10.1007/s00134-003-2043-1 CrossRefPubMed

39.

Knaus WA, Zimmerman JE, Wagner DP, Draper EA, Lawrence DE (1981) APACHE-acute physiology and chronic health evaluation: a physiologically based classification system. Crit Care Med 9(8):591–597CrossRef

40.

Vincent JL, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-Related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on Sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med 22(7):707–710CrossRef

41.

Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, Liu KD, Mehta RL, Pannu N, Van Biesen W, Vanholder R (2013) Acute kidney injury: an increasing global concern. Lancet 382(9887):170–179. https://doi.org/10.1016/S0140-6736(13)60647-9 CrossRefPubMed

42.

Scala R, Heunks L (2018) Highlights in acute respiratory failure. Eur Respir Rev 27(147)

43.

Pène F, Aubron C, Azoulay E, Blot F, Thiéry G, Raynard B, Schlemmer B, Nitenberg G, Buzyn A, Arnaud P, Socié G, Mira J-P (2006) Outcome of critically ill allogeneic hematopoietic stem-cell transplantation recipients: a reappraisal of indications for organ failure supports. J Clin Oncol 24(4):643–649. https://doi.org/10.1200/jco.2005.03.9073 CrossRefPubMed

44.

Claushuis TA, van Vught LA, Scicluna BP, Wiewel MA, Klein Klouwenberg PM, Hoogendijk AJ, Ong DS, Cremer OL, Horn J, Franitza M, Toliat MR, Nurnberg P, Zwinderman AH, Bonten MJ, Schultz MJ, van der Poll T, Molecular D, Risk Stratification of Sepsis C (2016) Thrombocytopenia is associated with a dysregulated host response in critically ill sepsis patients. Blood 127(24):3062–3072. https://doi.org/10.1182/blood-2015-11-680744 CrossRefPubMed

45.

Depuydt P, Kerre T, Noens L, Nollet J, Offner F, Decruyenaere J, Benoit D (2011) Outcome in critically ill patients with allogeneic BM or peripheral haematopoietic SCT: a single-Centre experience. Bone Marrow Transplant 46(9):1186–1191. https://doi.org/10.1038/bmt.2010.255 CrossRefPubMed

46.

Platon L, Amigues L, Ceballos P, Fegueux N, Daubin D, Besnard N, Larcher R, Landreau L, Agostini C, Machado S, Jonquet O, Klouche K (2016) A reappraisal of ICU and long-term outcome of allogeneic hematopoietic stem cell transplantation patients and reassessment of prognosis factors: results of a 5-year cohort study (2009-2013). Bone Marrow Transplant 51(2):256–261. https://doi.org/10.1038/bmt.2015.269 CrossRefPubMed

47.

Christou G, Kekre N, Petrcich W, Tokessy M, Neurath D, Giulivi A, Saidenberg E, McDiarmid S, Atkins H, Bence-Bruckler I, Bredeson C, Huebsch L, Sabloff M, Sheppard D, Tay J, Tinmouth A, Allan DS (2015) Impact of platelet transfusion on toxicity and mortality after hematopoietic progenitor cell transplantation. Transfusion 55(2):253–258. https://doi.org/10.1111/trf.12817 CrossRefPubMed

48.

Nevo S, Fuller AK, Zahurak ML, Hartley E, Borinsky ME, Vogelsang GB (2007) Profound thrombocytopenia and survival of hematopoietic stem cell transplant patients without clinically significant bleeding, using prophylactic platelet transfusion triggers of 10 x 10(9) or 20 x 10(9) per L. Transfusion 47(9):1700–1709. https://doi.org/10.1111/j.1537-2995.2007.01345.x CrossRefPubMed

49.

Clark SR, Ma AC, Tavener SA, McDonald B, Goodarzi Z, Kelly MM, Patel KD, Chakrabarti S, McAvoy E, Sinclair GD, Keys EM, Allen-Vercoe E, DeVinney R, Doig CJ, Green FHY, Kubes P (2007) Platelet TLR4 activates neutrophil extracellular traps to ensnare bacteria in septic blood. Nat Med 13:463–469. https://doi.org/10.1038/nm1565 https://www.nature.com/articles/nm1565#supplementary-information CrossRefPubMed

50.

Hara T, Shimizu K, Ogawa F, Yanaba K, Iwata Y, Muroi E, Takenaka M, Komura K, Hasegawa M, Fujimoto M, Sato S (2010) Platelets control leukocyte recruitment in a murine model of cutaneous Arthus reaction. Am J Pathol 176(1):259–269. https://doi.org/10.2353/ajpath.2010.081117 CrossRefPubMedPubMedCentral

51.

Xiang B, Zhang G, Guo L, Li X-A, Morris AJ, Daugherty A, Whiteheart SW, Smyth SS, Li Z (2013) Platelets protect from septic shock by inhibiting macrophage-dependent inflammation via the cyclooxygenase 1 signalling pathway. Nat Commun 4:2657. https://doi.org/10.1038/ncomms3657 https://www.nature.com/articles/ncomms3657#supplementary-information CrossRefPubMedPubMedCentral

52.

Zhang X, Fu H, Xu L, Liu D, Wang J, Liu K, Huang X (2011) Prolonged thrombocytopenia following allogeneic hematopoietic stem cell transplantation and its association with a reduction in ploidy and an Immaturation of megakaryocytes. Biol Blood Marrow Transplant 17(2):274–280. https://doi.org/10.1016/j.bbmt.2010.09.007 CrossRefPubMed

53.

Song Y, Shi M-M, Zhang Y-Y, Mo X-D, Wang Y, Zhang X-H, Xu L-P, Huang X-J, Kong Y (2017) Abnormalities of the bone marrow immune microenvironment in patients with prolonged isolated thrombocytopenia after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 23(6):906–912. https://doi.org/10.1016/j.bbmt.2017.02.021 CrossRefPubMed

54.

Kong Y, Chang Y-J, Wang Y-Z, Chen Y-H, Han W, Wang Y, Sun Y-Q, Yan C-H, Wang F-R, Liu Y-R, Xu L-P, Liu D-H, Huang X-J (2013) Association of an Impaired Bone Marrow Microenvironment with secondary poor graft function after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 19(10):1465–1473. https://doi.org/10.1016/j.bbmt.2013.07.014 CrossRefPubMed

Title: Platelet number and graft function predict intensive care survival in allogeneic stem cell transplantation patients
Authors: Amin T. Turki
Wolfgang Lamm
Christoph Schmitt
Evren Bayraktar
Ferras Alashkar
Martin Metzenmacher
Philipp Wohlfarth
Dietrich W. Beelen
Tobias Liebregts
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 2/2019
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-018-3538-8

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

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2019

Radotinib-induced eruptive melanocytic nevi in patient with chronic myeloid leukemia: a case report and literature review

Treating early-stage myelofibrosis

Clinical impact of prognostic nutritional index in diffuse large B cell lymphoma

Safety and efficacy of bosutinib in fourth-line therapy of chronic myeloid leukemia patients

Systematic review and meta-analysis of the effect of iron chelation therapy on overall survival and disease progression in patients with lower-risk myelodysplastic syndromes

Frequency of venous thrombotic events in patients with myelodysplastic syndrome and 5q deletion syndrome during lenalidomide therapy

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

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage