Christoph Saely

• Professor
• Vorarlberg Institute for Vascular Investigation (VIVIT)

Introduction and Objective: Subjective feelings of patients regarding the likelihood of undesired disease outcomes can influence their behavior and medication adherence. We investigated the individual risk perception for cardiovascular (CV) death within 10 years in patients with coronary artery disease (CAD) confirmed at coronary angiography. Metho...

Introduction and Objective: Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a marker of cardiovascular risk in several high risk populations. However, its power to predict MACE and cardiovascular death in patients with established coronary artery disease (CAD) and non-alcoholic fatty liver disease (NAFLD) is unclear. Methods:...

Introduction and Objective: The rise of Big Data necessitates artificial intelligence-driven analyses to extract valuable insights, particularly for risk prediction in high-risk patient populations. This observational study applied machine learning (ML) algorithms to predict 5-year overall mortality in heart failure patients with type 2 diabetes me...

Introduction and Objective: Health literacy reflects the ability to make appropriate health decisions and affects health outcomes. It therefore is an important parameter in patient care. Health literacy in patients undergoing coronary angiography is unclear and is addressed in the present study. Methods: We enrolled 697 consecutive patients undergo...

Introduction and Objective: A low LDL-C/Apo B ratio reflects small LDL particle size which like type 2 diabetes (T2DM) is associated with insulin resistance and reflects an unfavorable lipid profile. The LDL-C/Apo B ratio has been shown to be predictive of cardiovascular events in patients with atherosclerotic disease and of cardiovascular and over...

Introduction and Objective: Artificial Intelligence (AI) and Machine Learning (ML) have the potential to improve risk prediction by identifying complex patterns in clinical and laboratory data, surpassing traditional approaches. ML has already shown success in detecting metabolic diseases, including Type 2 Diabetes Mellitus (T2DM). However, the abi...

Introduction and Objective: This study aims to investigate the single and joint effects of T2DM and albuminuria on major cardiovascular events (MACE) in patients with established cardiovascular disease (CVD). Methods: We prospectively investigated 854 patients with CVD (743 with coronary artery disease and 111 with peripheral artery disease) over 9...

Introduction and Objective: We aimed to assess long-term trends in glucose-lowering therapy (GLT) among patients with type 2 diabetes (T2DM) with proven coronary artery disease (CAD). Methods: We investigated T2DM patients (n=590) referred to elective coronary angiography and diagnosed with CAD in one of three observational cohort studies (OS): OS1...

Introduction and Objective: The power of cardiovascular risk prediction is biased by comorbidities (e.g. metabolic syndrome, MetS), medical treatment, and age, which impact cholesterol levels. When applying LDL-C, the true risk of such confounded patients is often underestimated. However, it is unclear whether this likewise applies to other lipid m...

Introduction and Objective: The triglyceride-glucose index (TyG) is a validated biomarker of insulin resistance. Its power to predict major cardiovascular events (MACE) in patients with established cardiovascular disease is unclear and is addressed in the present study. Methods: We enrolled 1790 consecutive patients, 1481 with angiographically prov...

Introduction and Objective: Satisfaction with medical information plays a critical role in appropriate medication use and is fundamental to pharmacotherapy. This study addresses the lack of data on this important issue in the clinically important population of patients with type 2 diabetes (T2DM) undergoing coronary angiography. Methods: We consecu...

Introduction and Objective: Coronary angiography is the gold standard for diagnosing coronary artery stenoses, but is invasive and confers potential risks. This study aimed to develop a Machine Learning (ML) model to predict significant stenoses while minimizing false negatives, ensuring accurate risk stratification and better patient selection. Me...

Introduction and Objective: The waist circumference-to-body-mass-ratio (W/BMI-Ratio) has attracted interest as a predictor of cardiovascular risk. Its power to predict cardiovascular events in patients with established coronary artery disease (CAD) is not known and is addressed in the present study. Methods: We prospectively recorded cardiovascular...

Introduction and Objective: The visceral adiposity Index (VAI) is a reliable biomarker of insulin resistance and is associated with the metabolic syndrome as well as with type 2 diabetes (T2DM). Its power to predict the development of T2DM in patients with established coronary artery disease (CAD) is unclear and is addressed in the presence study....

The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerotic disease, those with angiographically documented minor co...

Background Both chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) confer a high risk of cardiovascular disease and mortality. These entities frequently coincide. The separate and joint impact of CKD and T2DM on the risk of major cardiovascular events (MACE) and survival is unclear. Methods In this prospective cohort study, patients...

Aim Over recent years, therapy options and strategies for type 2 diabetes mellitus (T2DM) have developed substantially. This study investigated glucose‐lowering treatment in patients with high cardiovascular risk over three decades. Materials and Methods A total of 2158 patients undergoing elective coronary angiography at a tertiary care hospital...

The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI. Its power to predict cardiovascular events in patients with coronary artery disease (CAD) is unclear and is addressed in the present study. We prospectively recorded cardiovascular events in a cohort of 938 pat...

Cystatin C is an established biomarker for renal function, and, given the close association of chronic kidney disease and cardiovascular disease might indicate new-onset or deteriorating cardiovascular disease. However, evidence for cystatin C as a predictor of cardiovascular events is limited and controversial. We therefore aimed at investigating...

The power of cardiovascular risk prediction is biased by comorbidities (including T2DM), medical treatment, and age, which impact cholesterol levels. Consequently, when applying LDL-C, the true cardiovascular risk of such confounded patients is often underestimated. However, it is not clear whether this constraint for risk prediction may likewise a...

A high ApoB/LDL-C ratio reflects small LDL particle size which like type 2 diabetes (T2DM) is associated with insulin resistance. Whether the ApoB/LDL-C ratio and the presence of T2DM are mutually independent predictors of cardiovascular events is unclear and is addressed in the present study. We enrolled a large high-risk cohort of 1200 patients w...

Health literacy reflects the ability to make appropriate health decisions and affects health outcomes. It therefore is an important parameter in patient care and for health care providers. Health literacy in patients undergoing coronary angiography, the standard procedure for the definite evaluation of coronary artery disease (CAD) is unclear and i...

Type 2 Diabetes (T2DM) and pre-existing coronary artery disease (CAD) are strong and independent risk factors for cardiovascular events, and data from large cohort studies suggest that the cardiovascular risk conferred by T2DM in the absence of CAD is equivalent to that conferred by CAD in the absence of T2DM. However, because the presence of CAD i...

The triglyceride-glucose index (TyG) is a validated biomarker of insulin resistance. Its power to predict major cardiovascular events (MACE) in patients with established cardiovascular disease is unclear and is addressed in the present study. We enrolled 1790 consecutive patients, 1481 with angiographically proven CAD and 309 with sonographically p...

Lipid-lowering therapy (LLT) is key to reducing the burden of macrovascular diabetes complications. Here, we aim to assess long-term trends in LLT and LDL-C levels among patients with type 2 diabetes (T2DM) with angiographically proven coronary artery disease (CAD). We investigated T2DM patients (n=590), who were referred to elective coronary angio...

A high ApoB/LDL-C ratio reflects small LDL particle size which like type 2 diabetes (T2DM) is associated with insulin resistance. Whether the ApoB/LDL-C ratio and the presence of T2DM are mutually independent predictors of cardiovascular events is unclear and is addressed in the present study. We enrolled a large high-risk cohort of 1200 patients w...

Remnant cholesterol has attracted interest as a marker of cardiovascular event risk. The power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with non-alcoholic fatty liver disease (NAFLD) is unclear and is addressed in the present study. We enrolled a high-risk cohort of 913 patients with coronary artery disease (...

The Visceral Adiposity Index (VAI) is calculated based on waist circumference, BMI, triglyceride and HDL-cholesterol levels and is a validated measure of visceral adiposity. In the general population, the VAI has been shown to be an independent risk factor for premature mortality. Its power to predict cardiovascular events in patients with coronary...

Chronic medical conditions such as type 2 diabetes (T2DM) or coronary artery disease (CAD) and their treatment have a crucial impact on patients’ daily life. The EQ-5D-5L questionnaire is a validated and widely used tool to measure the health-related quality of life (HRQL). We investigated and compared the HRQL in patients with or without T2DM and...

Cystatin C is an established biomarker for renal function, and, given the close association of chronic kidney disease and cardiovascular disease might indicate new-onset or deteriorating cardiovascular disease. However, evidence for cystatin C as a predictor of cardiovascular events is limited and controversial. We therefore aimed at investigating...

BACKGROUND Despite the currently prevailing, milder Omicron variant of COVID-19, older adults remain at elevated risk of hospital admission, critical illness, and death. Loss of efficacy of the immune system, including reduced strength, quality, and durability of antibody responses, may render generalized recommendations on booster vaccinations ina...

Objectives: Despite the currently prevailing, milder Omicron variant, coronary artery disease (CAD) patients constitute a major risk group in COVID-19, exhibiting 2.6 times the mortality risk of non-CAD patients and representing over 22% of non-survivors. No data are currently available on the efficacy of antibody levels in CAD patients, nor on the...

Chronic medical conditions such as type 2 diabetes (T2DM) or coronary artery disease (CAD) and their treatment have a crucial impact on patients’ daily life. The EQ-5D-5L questionnaire is a validated and widely used tool to measure the health-related quality of life (HRQL). We investigated and compared the HRQL in patients with or without T2DM and...

The Triglyceride-Glucose-Index (TyG-Index) is a predictor of cardiovascular event risk and is associated with the metabolic syndrome as well as with type 2 diabetes (T2DM). Whether this parameter also predicts incident diabetes in subjects who do not yet have diabetes is less clear; this issue is adressed in the present study. We prospectively reco...

The A Body Shape index (ABSI) is a validated measure of visceral adiposity that is calculated based on waist circumference, height and BMI. Its power to predict cardiovascular events in patients with coronary artery disease (CAD) is unclear and is addressed in the present study. We prospectively recorded cardiovascular events in a cohort of 938 pat...

The triglyceride-glucose index (TyG) is a validated biomarker of insulin resistance. Its power to predict major cardiovascular events (MACE) in patients with established cardiovascular disease is unclear and is addressed in the present study. We enrolled 1790 consecutive patients, 1481 with angiographically proven CAD and 309 with sonographically p...

Satisfaction with information regarding pharmaceutic therapy is important because it may strongly affect the appropriate use of drug therapy including medication adherence. Data on this parameter in the clinically important population of patients with type 2 diabetes (T2DM) undergoing coronary angiography is scarce and is therefore addressed in the...

The Visceral Adiposity Index (VAI) is calculated based on waist circumference, BMI, triglyceride and HDL-cholesterol levels and is a validated measure of visceral adiposity. In the general population, the VAI has been shown to be an independent risk factor for premature mortality. Its power to predict cardiovascular events in patients with coronary...

The utilization of multiple medications and the increasing complexity of medication regimens associated with chronic diseases such as type 2 diabetes (T2DM) necessitate the implementation of a medication documentation (MD). A complete medication plan serves to enhance medication safety and promotes adherence. The availability of MD in the clinicall...

The impact of diabetes on major cardiovascular events (MACE) in relation to the extent of pre-existing atherosclerotic disease remains unclear. In this study we compare the impact of T2DM on MACE in patients with two different states of atherosclerosis: minor coronary atherosclerosis (minAS) and peripheral artery disease, one of the most severe man...

High remnant cholesterol is associated with the metabolic syndrome and with type 2 diabetes (T2DM) and has attracted much interest as a cardiovascular risk factor. However, its distribution in T2DM patients with established cardiovascular disease is not clear. This issue is addressed in the present study. We obtained remnant cholesterol in a large...

Elevated pro-B type natriuretic peptide (pro-BNP) has been found to be a marker of cardiovascular risk in several risk populations. However, its power to predict MACE and cardiovascular death in patients with the combination of established cardiovascular disease (CVD) and non-alcoholic fatty liver disease (NAFLD) is unclear. We therefore enrolled 6...

Cystatin C is an established biomarker for renal function, and, given the close association of chronic kidney disease and cardiovascular disease might indicate new-onset or deteriorating cardiovascular disease. However, evidence for cystatin C as a predictor of cardiovascular events is limited and controversial. We therefore aimed at investigating...

Remnant cholesterol has attracted interest as a marker of cardiovascular event risk. The power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with differing fasting glucose state is unclear and is addressed in the present study. We prospectively recorded MACE including cardiovascular death, non-fatal myocardial inf...

Lipid-lowering therapy (LLT) is key to reducing the burden of macrovascular diabetes complications. Here, we aim to assess long-term trends in LLT and LDL-C levels among patients with type 2 diabetes (T2DM) with angiographically proven coronary artery disease (CAD). We investigated T2DM patients (n=590), who were referred to elective coronary angio...

Health literacy reflects the ability to make appropriate health decisions and affects health outcomes. It therefore is an important parameter in patient care and for health care providers. Health literacy in patients undergoing coronary angiography, the standard procedure for the definite evaluation of coronary artery disease (CAD) is unclear and i...

Waist circumference reflects central fat accumulation and is an important additive information to BMI. The Waist Circumference-to-Body-Mass-Ratio (W/BMI-Ratio) has been suggested to provide additional information on cardiovascular event risk. Its power to predict cardiovascular events in patients with established cardiovascular disease is unclear a...

Pulse pressure, i.e. the difference between systolic and diastolic blood pressure is a measure of arterial stiffness, which is a strong predictor of cardiovascular risk. The power of pulse pressure to predict cardiovascular events in patients with differing glycemic state is unclear and is addressed in the present study. We prospectively recorded c...

Type 2 Diabetes (T2DM) and pre-existing coronary artery disease (CAD) are strong and independent risk factors for cardiovascular events, and data from large cohort studies suggest that the cardiovascular risk conferred by T2DM in the absence of CAD is equivalent to that conferred by CAD in the absence of T2DM. However, because the presence of CAD i...

The power of cardiovascular risk prediction is biased by comorbidities (including T2DM), medical treatment, and age, which impact cholesterol levels. Consequently, when applying LDL-C, the true cardiovascular risk of such confounded patients is often underestimated. However, it is not clear whether this constraint for risk prediction may likewise a...

This study aims to investigate the single and joint effects of T2DM and CKD on cardiovascular events in patients with coronary artery disease (CAD). We prospectively investigated 1044 patients with CAD over 8.5±5.0 years. Cardiovascular events occurred more frequently in T2DM patients (n=347) than in nondiabetic subjects (60.1% vs 50.6%, p=0.004) a...

Remnant cholesterol has attracted interest as a marker of cardiovascular event risk. The power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with non-alcoholic fatty liver disease (NAFLD) is unclear and is addressed in the present study. We enrolled a high-risk cohort of 913 patients with coronary artery disease (...

A high ApoB/LDL-C ratio reflects small LDL particle size which like type 2 diabetes (T2DM) is associated with insulin resistance. Whether the ApoB/LDL-C ratio and the presence of T2DM are mutually independent predictors of cardiovascular events is unclear and is addressed in the present study. We enrolled a large high-risk cohort of 1200 patients w...

A complete medication plan (MPlan) increases medication safety and adherence and is crucial in care transitions. Countries that implemented a standardized MPlan reported benefits on patients’ understanding and handling of their medication. Austria lacks such a standardization, with no available data on the issue. Objective: This study aimed to inve...

Metabolomics, with its wealth of data, offers a valuable avenue for enhancing predictions and decision-making in diabetes. This observational study aimed to leverage machine learning (ML) algorithms to predict the 4-year risk of developing type 2 diabetes mellitus (T2DM) using targeted quantitative metabolomics data. A cohort of 279 cardiovascular...

Background and aim: Guidelines on dyslipidemia and lipid-lowering therapy (LLT) over the years recommend lower low-density lipoprotein cholesterol (LDL-C) goals by more intense therapy. Nevertheless, LDL‑C has increased in the general population. Real-world trends of LLT medication as well as of LDL‑C levels in cardiovascular high-risk patients ar...

Background The impact of diabetes on incident cardiovascular disease in relation to the extent of atherosclerotic disease remains unclear. We aimed to investigate major adverse cardiovascular events (MACE) in patients with or without type 2 diabetes (T2DM) presenting with two extremes of atherosclerotic disease, those with angiographically document...

Blood pressure (BP) varies over a lifetime. This cardiovascular observation study (OS) compared the predictive value of earlier- and later-in-life blood pressure (BP) in 1,497 cardiovascular disease patients utilizing readings taken during a health survey (HS) and 15 years later from the same subjects at the baseline of this OS. Prediction of the c...

Background and Aims LDL-cholesterol (LDL-C) is the best documented cardiovascular risk predictor and at the same time serves as a target for lipid-lowering therapy. However, the power of LDL-C to predict risk is biased by advanced age, comorbidities, and medical treatment, all known to impact cholesterol levels. Consequently, such biased patient co...

Remnant cholesterol has attracted interest as a marker of cardiovascular event risk. The purpose of this study was to assess the power of remnant cholesterol to predict major cardiovascular events (MACE) in patients with non-alcoholic fatty liver disease (NAFLD). We enrolled a high-risk cohort of 1420 consecutive patients with established cardiovas...

Introduction: Ceramides recently have attracted interest as a marker of cardiovascular event risk. Hypothesis: We hypothesize that they play a role in the development of type 2 diabetes (T2DM). Methods: We analyzed the ceramide ratio Cer d18:18/Cer d 18:24:0 (CerRatio) in 894 consecutive Caucasian patients who were referred to angiography for the e...

Introduction: Blood pressure (BP) is a predictor of cardiovascular risk but it changes during lifetime. Hypothesis: We hypothesize that there are differences in the value of systolic and diastolic blood pressure (BP) at different stages of life for predicting cardiovascular mortality risk, an issue which was addressed in this observation study (OS)...

Patients with type 2 diabetes (T2D) constitute one of the most vulnerable subgroups in COVID-19. Despite high vaccination rates, a correlate of protection to advise vaccination strategies for novel SARS-CoV-2 variants of concern and lower mortality in this high-risk group is still missing. It is further unclear what antibody levels provide protecti...

(1) Background: Ceramides are a new kind of lipid biomarker and have already been demonstrated to be valuable risk predictors in coronary patients. Patients with peripheral artery disease (PAD) are a population with a worse prognosis and higher mortality risk compared to coronary artery disease (CAD) patients. However, the value of ceramides for ri...

The immune system is affected by psychosocial stimuli and plays a major role in the development of various diseases. Psychoneuroimmunology (PNI)-based interventions may positively influence the disease course; however, the impact of PNI research findings on clinical practice differs depending on the medical specialties involved. A comprehensive ove...

Background: Recent studies suggest that both lipid levels and anti-severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) antibody levels are associated with outcome in coronavirus disease 2019 (COVID-19). While both parameters have separately been implicated in the neutralization and clearance of pathogens during severe infections, it is cu...

Background: Ceramides are a new kind of lipid biomarkers and have already been demonstrated to be valuable risk predictors in coronary patients. Patients with peripheral artery disease (PAD) are a population with worse prognosis and higher mortality risk compared to coronary artery disease (CAD) patients. However, the value of ceramides for risk pr...

Low-density-lipoprotein cholesterol (LDL-C) target achievement is a cornerstone in the prevention of cardiovascular events in patients with atherosclerotic disease. Whether the presence of type 2 diabetes (T2DM) affects LDL-C target achievement in PAD and CAD patients is unclear and is addressed in the present study. We enrolled a large high-risk c...

Diabetic patients constitute one of the most vulnerable subgroups in COVID-19. Despite high vaccination rates, a correlate of protection to advise vaccination strategies for novel SARS-CoV2 variants of concern and lower mortality in this high-risk group is still missing. It is further unclear what antibody levels provide protection and whether pre-...

Despite the atherosclerotic cardiovascular disease (ASCVD) risk reduction achieved by low-density lipoprotein-cholesterol (LDL-C) lowering therapy, residual ASCVD risk still exists. Previous epidemiological studies have suggested high plasma triglycerides (TG) levels as a risk factor or risk marker for ASCVD independent of LDL-C levels. In this rev...

Statins are the primary pharmacological intervention to reduce LDL cholesterol; they significantly reduce inflammatory markers. Ezetimibe also reduces LDL cholesterol and reduces cardiovascular events when given on top of statin therapy. Whether ezetimibe, like statins, reduces markers of inflammation is less clear. We, therefore, conducted a syste...

Zusammenfassung Die Zusammenhänge zwischen Diabetes mellitus, koronarer Herzkrankheit und Herzinsuffizienz sind wechselseitig. Bei Erstmanifestation einer koronaren Herzkrankheit sollte aktiv auf Diabetes mellitus gescreent werden, während bei an Diabetes mellitus erkrankten Patient:innen die kardiovaskuläre Risikostratifizierung immer in Zusammens...

Zusammenfassung Es besteht eine hohe Prävalenz an Diabetes mellitus Typ 2 bei über 70-Jährigen in industrialisierten Ländern. Dieser Artikel enthält Empfehlungen für Diagnose, Prävention und Therapieziele in der Behandlung älterer Menschen mit Diabetes anhand der aktuellen Evidenzlage.

Zusammenfassung Hyper- und Dyslipidämie tragen zur kardiovaskulären Morbidität und Mortalität diabetischer Patienten bei. Überzeugende Daten zeigen, dass eine medikamentöse Therapie mit Statinen, Ezetimibe und PCSK9 Hemmern das kardiovaskuläre Risiko von Patienten mit Diabetes senken kann. Der vorliegende Artikel stellt die Behandlungsvorschläge de...

Acute thrombotic complications as a key feature of accelerated atherothrombotic disease typically precipitate cardiovascular events and therefore strongly contribute to cardiovascular morbidity and mortality in patients with diabetes. Inhibition of platelet aggregation can reduce the risk for acute atherothrombosis. The present article represents t...

Zusammenfassung Die Hyperglykämie ist wesentlich an der Entstehung der Spätkomplikationen bei an Diabetes mellitus Typ 2 erkrankten Patienten/Patientinnen beteiligt. Während Lebensstilmaßnahmen die Eckpfeiler jeder Diabetestherapie bleiben, benötigen im Verlauf die meisten Patienten/Patientinnen mit Typ 2 Diabetes eine medikamentöse Therapie. Bei d...

Zusammenfassung Hypertonie ist eine sehr häufige Komorbidität bei Patient:innen mit Diabetes mellitus, die – wenn unzureichend behandelt – signifikant zur erhöhten Mortalität und zum Auftreten von mikrovaskulären und makrovaskulären Komplikationen beiträgt. Eine Individualisierung der Blutdruckzielwerte in Abhängigkeit vom Patient:innenalter und vo...