Erik Stroes
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Articles by Erik Stroes
Metabolic Modulation in Hypertrophic Cardiomyopathy: A Systematic Review of Clinical and Observational Evidence
Average (ratings) Abstract Background: Hypertrophic cardiomyopathy (HCM) is characterised by left ventricular hypertrophy, microvascular dysfunction and chronic energetic inefficiency. Current therapies relieve symptoms or left ventricular outflow tract obstruction but do not directly target these metabolic abnormalities.
Safety and Usability of a Novel, Robotic Assistance System for Echocardiographic Examination
Average (ratings) Abstract Background: Transthoracic echocardiography (TTE) is essential for modern cardiac diagnostics, yet it is difficult to access in remote areas. Remotely operated robotic-assisted ultrasound may enable access to services in rural and remote locations, while also improving ergonomics for the sonographer. This study evaluated the safety, usability and patient satisfaction of a novel robotic ultrasound assistance tool (RUAT).
Post-COVID Cardiac Symptoms in the Absence of Epicardial Stenoses: Potential Association with Persistent Coronary Microvascular Dysfunction
Average (ratings) Keywords Post-acute sequelae of COVID-19, coronary vasomotor disorders, coronary microvascular dysfunction, chest pain, COVID-19 cardiac sequelae, long COVID, Received: 06 July 2026 Accepted: 31 July 2026 Published online: 02 November 2026 Disclosure: PO has received grants from Berthold Leibinger Foundation; consulting fees from Medtronic and Pohl Boskamp; honoraria from Edwards, Bayer and Shockwave; is an unpaid treasurer for the COVADIS group; and is on the European...
Transthyretin Amyloid Cardiomyopathy: Contemporary Pharmacological Management
Average (ratings) Abstract Transthyretin amyloid cardiomyopathy (ATTR-CM) is a progressive infiltrative cardiomyopathy increasingly recognised as a cause of heart failure. Advances in the understanding of its pathophysiology have enabled the development of targeted therapies, making ATTR-CM a paradigm of precision medicine in cardiology.
Letter to the Editor Regarding “Lifetime Management in Transcatheter Aortic Valve Implantation”
Average (ratings) Keywords Transcatheter aortic valve implantation, lifetime management, commissural alignment, Received: 23 August 2026 Accepted: 27 August 2026 Published online: 30 October 2026 Disclosure: The author has no conflicts of interest to declare. Correspondence: Aysha Hashmi, Medical College (MBBS) Department, Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, University Avenue, Block D, New Muslim Town, Lahore, 54660, Pakistan.
Risk–Benefit Profile of Oral Antiplatelet Strategies After Percutaneous Coronary Intervention with a Drug-eluting Stent: A Contemporary Network Meta-analysis of Major Bleeding and Stent Thrombosis Outcomes
Average (ratings) Abstract Background: Optimal antiplatelet therapy after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) requires balancing thrombotic protection and bleeding risk, but the comparative effectiveness of current strategies remains uncertain. Aims: To evaluate the risk–benefit profile of oral antiplatelet strategies after PCI with DES, focusing on major bleeding and stent thrombosis.
Foreword: Sleep-disordered Breathing in Heart Failure
Average (ratings) Keywords Sleep apnoea heart failure guidelines, sleep apnoea, sleep-disordered breathing, Cheyne-Stokes respiration, positive airway pressure therapy, phrenic nerve stimulation, Received: 02 March 2026 Accepted: 09 March 2026 Published online: 29 October 2026 Disclosure: AC has received consulting fees from AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, GSK, Novartis, Novo Nordisk, Servier, Vifor, Actimed, Cardiac Dimensions, Corvia, ESN Cleer, Faraday,...
Spotlight on EAS: Precision Lipid Management
Overview The burden of hypertriglyceridaemia (HTG) spans a broad and diverse patient population, from rare genetic disorders such as familial chylomicronemia syndrome (FCS) to mixed hyperlipidaemia and familial dyslipidaemias. Current treatment strategies, including statins and fibrates, remain limited in their ability to adequately control triglyceride levels in many patients, highlighting the need for education around emerging therapeutic classes.
ApoC-III inhibition: from regulatory approval to equitable implementation
Apolipoprotein C-III (apoC-III) inhibition represents a major therapeutic advance in the management of severe hypertriglyceridaemia and pancreatitis. The potential role of apoC-III inhibition in preventing atherosclerotic cardiovascular disease will depend on rigorous outcomes data, appropriate patient selection and equitable implementation across healthcare systems.
New Horizons in Dyslipidaemia 2026
Overview Watch the on-demand version of New Horizons in Dyslipidaemia (NHD) 2026, a virtual educational event designed for healthcare professionals involved in the management of cardiovascular risk and other lipid-related conditions. The programme is led by course directors Dr Peter Libby (Brigham and Women’s Hospital, Boston, US), Prof Kausik Ray (Imperial College London, London, UK) and Prof Erik Stroes (Academic Medical Centre, Amsterdam, NL).
Frailty Meets Cardio-oncology: A New Frontier in Personalised Cancer Care
Average (ratings) Abstract In recent years, novel cancer therapies have significantly improved patient survival, but they have also introduced clinical challenges, particularly regarding treatment-related cardiovascular toxicity. Frailty is a clinical syndrome characterised by reduced physiological reserve, and is associated with poorer clinical outcomes and an elevated risk of cardiovascular disease.
The Role of Glucagon-like Peptide-1 in the Pathophysiology of Heart Failure: A Special Focus
Average (ratings) Keywords Glucagon-like peptide-1 receptor agonists, heart failure with preserved ejection fraction, cardiometabolic syndrome, Received: 01 December 2025 Accepted: 13 December 2025 Published online: 06 February 2026 Disclosure: AR is on the Cardiac Failure Review editorial board; this did not influence acceptance. AZ has no conflicts of interest to declare. Correspondence: Anton Zatsarinnyy, City Cardiology Center, Tole Bi Street 93, Almaty 050000, Kazakhstan.
Non-invasive Coronary Functional Tests in Patients with Angina and Non-obstructive Coronary Artery Disease
Average (ratings) Abstract Background: Invasive coronary functional tests (I-CFTs) can identify the mechanism(s) of angina in patients with non-obstructed coronary arteries (ANOCA). In this study, we assessed whether non-invasive coronary functional tests (NI-CFTs) can also produce reliable results when assessing these mechanisms.
Revascularisation in Cancer Patients: A Comprehensive Review
Average (ratings) Abstract The emerging field of cardio-oncology has grown considerably over the past two decades. While the issue of myocardial cardiotoxicity has received the most attention, it is now recognised that cardio-oncology encompasses the full spectrum of cardiovascular disease, which includes invasive therapy as part of management. Historically, these were seldom considered in cancer patients, due to their perceived poor prognosis and high risk of complications.
Ethical and Regulatory Frameworks for Artificial Intelligence in Clinical Research: A European Perspective on the Artificial Intelligence Act for Ethics Committees and Researchers
Average (ratings) Abstract The rapid integration of artificial intelligence (AI) into clinical research is transforming the landscape of biomedical innovation, influencing numerous phases of research, with critical ethical and legal implications.
The Art and Science of Congestion Diagnosis and Management in Heart Failure
Average (ratings) Keywords Congestion, heart failure, intravascular, extravascular, biomarkers, pathophysiology, devices, Received: 19 November 2025 Accepted: 26 November 2025 Published online: 23 December 2025 Disclosure: JAB is on the Cardiac Failure Review editorial board; this did not influence acceptance. DM has no conflicts of interest to declare.
Targeting Obesity to Combat Heart Failure
Average (ratings) Abstract Obesity is a growing global health challenge and a significant contributor to the rising prevalence of heart failure (HF), affecting both HF with preserved and reduced ejection fraction. While obesity increases HF incidence through haemodynamic stress, neurohormonal activation, metabolic dysfunction and systemic inflammation, the so-called ‘obesity paradox’ complicates our understanding of prognosis in established HF.
Phrenic Nerve Stimulation for Central Sleep Apnoea: When and Why?
Average (ratings) Abstract Central sleep apnoea (CSA) is a sleep-disordered breathing condition characterised by diminished or absent respiratory effort during sleep due to instability in the respiratory control system. While various treatments exist, ranging from positive airway pressure therapy to pharmacological interventions, many patients’ symptoms remain refractory to standard therapies.
Reverse Remodelling, Myocardial Recovery and Remission in Heart Failure with Reduced Ejection Fraction: Clinical Implications and Management Strategies
Average (ratings) Abstract Cardiac reverse remodelling (RR) is a complex process involving structural and functional recovery of the myocardium, with significant implications for the prognosis of patients with heart failure (HF). This review summarises current concepts, underlying mechanisms, therapeutic strategies, and clinical implications of RR, while distinguishing it from myocardial recovery and remission.
Expert Opinion on Targeted Lipid Control for Very-high-risk Indian Patients: Bridging the Gap in Real-world Practice
Average (ratings) Abstract Despite robust clinical guidelines and the availability of potent lipid-lowering therapies (LLTs), many very-high-risk dyslipidaemia patients fail to achieve target LDL cholesterol (LDL-C) levels, primarily due to poor adherence and delayed treatment intensification. Two virtual meetings were convened involving a panel of senior cardiologists. Insights were synthesised into an expert framework, developed through polling and collective inputs from expert.
Ventricular–Arterial Coupling in Heart Failure with Preserved Ejection Fraction: A Bibliometric Review and Clinical Implications
Heart failure (HF) affects approximately 55 million people worldwide by 2021 – more than doubling since 1990.1 Its rising prevalence, high mortality, and frequent hospitalisations demand better prevention and therapy.
Impact of Hypopnoea Classifications on the Assessment of Sleep Disordered Breathing in Heart Failure
Average (ratings) Abstract Sleep-related breathing disorders (SRBD), particularly central sleep apnoea and obstructive sleep apnoea, are highly prevalent among individuals with heart failure (HF). Accurate classification of SRBD is critical for accurate diagnosis and to improve management by limiting treatment failures.
Positive Airway Pressure Therapies for Heart Failure: What Do the Trials Tell Us?
Average (ratings) Abstract Sleep-disordered breathing (SDB) represents a modifiable treatment target in patients with heart failure (HF). Despite the evolution of positive airway pressure (PAP) therapy over the past several decades, randomised controlled trials have not demonstrated a consistent benefit in reducing mortality or hospital admissions related to HF. As a result, the use of PAP therapy has been primarily limited to symptom control of SDB.
Refine Your Ideas for Better Outcomes
Average (ratings) Keywords ICD, heart failure, guidelines, Received: 17 October 2025 Accepted: 20 November 2025 Published online: 26 November 2025 Disclosure: GD is on the European Cardiology Review editorial board; this did not influence acceptance. Correspondence: Gheorghe-Andrei Dan, Carol Davila University, Academy of Romanian Scientists, Dionisie Lupu St, No. 37, Sector 2, Bucharest, Romania.
The Role of Frailty in Cardio-oncology and its Challenges
Cardiovascular disease (CVD) and cancer are among the leading causes of mortality, particularly in older populations.1 Cardio-oncology is a dynamic and interdisciplinary field that brings together a diverse team of specialists, including oncologists, cardiologists, and other dedicated healthcare providers, to identify and address cardiovascular complications that can arise as a result of cancer and its treatments, particularly for patients exposed to potentially cardiotoxic therapies.2–4...
Home Sleep Apnoea Testing: Advances, Challenges and Considerations in Heart Failure
Average (ratings) Abstract Sleep-disordered breathing (SDB), including obstructive and central sleep apnoea, is highly prevalent in heart failure (HF) and contributes to adverse outcomes. In-lab polysomnography is the diagnostic gold standard, but is limited by cost and accessibility. Home sleep apnoea testing (HSAT) offers an accessible alternative, but its accuracy in HF populations remains under evaluation.
Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia : A Randomized Clinical Trial
Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With Heterozygous Familial Hypercholesterolemia: A Randomized Clinical Trial Supplement 1. Supplement 2. Statistical analysis plan Supplement 3. eTable 1. Investigator and IRB/IEC Lists eTable 2. Reasons for screen failure and exclusion from randomization eTable 3. Laboratory reference values eFigure.
The Coronary Microcirculation Re-explored: Pathophysiological Insights and Clinical Implications
The human heart is a highly demanding organ because of its substantial need for oxygen and nutrients. It relies on a specialised and intricate network of blood vessels known as the coronary circulation to meet these demands. The coronary microvessels are those elements of this circulation that are less than 500 µm in diameter and are critical in transporting vital elements necessary for myocardial metabolism.
AHA 25: CRISPR-Cas9 Gene Editing Therapy Targeting ANGPTL3
Video Published: Likes: 0 Average (ratings) AHA 2025 - Phase 1 results show the CRISPR-Cas9 gene editing therapy is a safe treatment option targeting ANGPTL3 in patients with lipid disorders. Prof Stephen Nicholls (Monash Victorian Heart Institute, Clayton, AU) joins us to share results from a first-in-human phase 1 trial investigating a one-time infusion of CTX310, a CRISPR-Cas9 gene editing therapy, at different doses targeting angiopoietin-like protein 3 (ANGPTL3).
Decoding Immune Influence: A Mendelian Randomisation Study on Dilated Cardiomyopathy
Average (ratings) Abstract Background: Dilated cardiomyopathy (DCM) is a significant contributor to heart failure, originating from complex interactions between genetic and environmental factors. Although the immune system has been implicated in various cardiovascular diseases, its precise role in DCM pathogenesis remains ambiguous. This study uses Mendelian randomisation (MR) to explore the causal relationship between diverse immune cell traits and DCM risk.
Patient Perspective: How Patient Values Set a Historic Benchmark for the ESC/EACTS Guidelines 2025 for the Management of Valvular Heart Disease
Approximately 60 years ago, Dr David Sackett started the movement for evidence-based medicine (EBM). EBM uses all the available scientific proof to come to a decision on the best possible treatment for patients.1 Guidelines improve economic efficiency in healthcare, quality of care and patient outcomes. Their importance cannot be underrated.
New Approaches for Targeting PCSK9: Small-Interfering Ribonucleic Acid and Genome Editing
References 1. Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, Olaetxea JR, Alloza I, Vandenbroeck K, Benito-Vicente A, Martín C . Pathophysiology of atherosclerosis.Int J Mol Sci. 2022; 23:3346. doi: 10.3390/ijms23063346CrossrefMedlineGoogle Scholar 2. Domanski MJ, Tian X, Wu CO, Reis JP, Dey AK, Gu Y, Zhao L, Bae S, Liu K, Hasan AA, . Time course of LDL cholesterol exposure and cardiovascular disease event risk.J Am Coll Cardiol. 2020; 76:1507–1516.
Plasma Lipoprotein Lipase Is Associated with Risk for Future Major Adverse Cardiovascular Events in Patients Following Carotid Endarterectomy
Carotid plaque intraplaque haemorrhage (IPH) is associated with future cardiovascular events. It was hypothesised that plasma proteins associated with carotid plaque IPH are also likely to be associated with major adverse cardiovascular events (MACE) after carotid endarterectomy (CEA). In pre-operative blood samples from patients undergoing CEA within the Athero-Express biobank, proteins involved in cardiovascular disease were measured using three OLINK proteomics immunoassays.
Electronic health records to facilitate continuous detection of familial hypercholesterolemia
Highlights • Familial hypercholesterolemia (FH) results in high risk of coronary heart disease. • FH is underdiagnosed, possibly due to lack of recognition by physicians. • An automated algorithm in electronic health records (EHR) may facilitate detection of FH. • Correction for lipid lowering therapy and patient characteristics are taken into account. • This continuous EHR-based algorithm can facilitate FH detection.
Lipoprotein(a) and Its Potential Association with Thrombosis and Inflammation in COVID-19: a Testable Hypothesis
Abstract Purpose of Review The COVID-19 pandemic has infected over > 11 million as of today people worldwide and is associated with significant cardiovascular manifestations, particularly in subjects with preexisting comorbidities and cardiovascular risk factors. Recently, a predisposition for arterial and venous thromboses has been reported in COVID-19 infection.
Guidelines, Clinical Evidence, and Real-Life Practice: How to Find Your Way in Managing Hypercholesterolaemia
Generally, the following LDL cholesterol reductions can be achieved with therapy: ezetimibe: -20%; moderate-intensity statin: -40%; high-intensity statin: -50%; PCSK9 inhibitor: -60%; high-intensity statin plus ezetimibe: -60%; moderate intensity statin plus PCSK9 inhibitor: -76%; high-intensity statin plus PCSK9 inhibitor: -80%; moderate-intensity statin plus ezetimibe plus PCSK9 inhibitor: -81%; and high-intensity statin plus ezetimibe plus PCSK9 inhibitor: -84%.
Nonstatin Therapies in Patients With Muscle-Related Statin Intolerance
Importance Muscle-related statin intolerance is reported by 5% to 20% of patients. Objective To identify patients with muscle symptoms confirmed by statin rechallenge and compare lipid-lowering efficacy for 2 nonstatin therapies, ezetimibe and evolocumab.
Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management | European Heart Journal
Abstract Statin-associated muscle symptoms (SAMS) are one of the principal reasons for statin non-adherence and/or discontinuation, contributing to adverse cardiovascular outcomes. This European Atherosclerosis Society (EAS) Consensus Panel overviews current understanding of the pathophysiology of statin-associated myopathy, and provides guidance for diagnosis and management of SAMS.
Efficacy and Safety of Alirocumab 150 mg Every 4 Weeks in Patients With Hypercholesterolemia Not on Statin Therapy: The ODYSSEY CHOICE II Study
Background The PCSK9 antibody alirocumab (75 mg every 2 weeks; Q2W) as monotherapy reduced low‐density lipoprotein‐cholesterol (LDL‐C) levels by 47%. Because the option of a monthly dosing regimen is convenient, ODYSSEY CHOICE II evaluated alirocumab 150 mg Q4W in patients with inadequately controlled hypercholesterolemia and not on statin (majority with statin‐associated muscle symptoms), receiving treatment with fenofibrate, ezetimibe, or diet alone.
Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance: The GAUSS-3 Randomized Clinical Trial
Importance Muscle-related statin intolerance is reported by 5% to 20% of patients. Objective To identify patients with muscle symptoms confirmed by statin rechallenge and compare lipid-lowering efficacy for 2 nonstatin therapies, ezetimibe and evolocumab.
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