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Roule V, Agueznai M, Sabatier R, Blanchart K, Lemaître A, Ardouin P, Collet JP, Milliez P, Montalescot G, Beygui F. Safety and efficacy of IIb/IIIa inhibitors in combination with highly active oral antiplatelet regimens in acute coronary syndromes: A meta-analysis of pivotal trials. Platelets 2016; 28:174-181. [PMID: 27657930 DOI: 10.1080/09537104.2016.1218453] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The risk and benefit of GP-IIb/IIIa Inhibition (GPI) in combination with recent antiplatelet regimens in acute coronary syndromes (ACS) remain unassessed. The advent of fast-acting highly active oral P2Y12 inhibitors questions the additional value and risk of their association with GPI. We studied the effect of GPI in combination with prasugrel and ticagrelor, compared to clopidogrel on major bleeding in pivotal randomized controlled trials in the setting of ACS, using a meta-analytic approach. A similar analysis, further including the comparison of a double versus standard dose clopidogrel regimen, was performed for the risk of the primary efficacy endpoint. The combination of GPI and recent P2Y12 inhibitors was associated with a similar risk of bleeding as compared with GPI and the standard clopidogrel regimen (RR 0.92 [0.74; 1.13]). The benefit of recent regimens, including double dose clopidogrel, in reducing the primary ischemic endpoint (RR 0.86 [0.78; 0.94]) persisted in those treated with GPI. Although GPI use was associated with a consistent increase in the risk of bleeding in both recent (RR 1.27 [1.05-1.55]) and standard regimens (RR 2.01 [1.64-2.47]), the relative magnitude of such an increase was lower in association with prasugrel or ticagrelor as compared with clopidogrel. The risk of bleeding using a combination of GPI and oral antiplatelet regimens is mainly related to the use of GPI and not the oral antiplatelet regimen. Considering the absence of increased risk of bleeding and the persistence of the benefit of recent P2Y12 regimens in combination with GPI as compared with the standard clopidogrel regimen, the use of such a combination within the guidelines is supported by our findings.
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Boudin L, Gonçalves A, Sabatier R, Moretta J, Sfumato P, Asseeva P, Livon D, Bertucci F, Extra JM, Tarpin C, Houvenaeghel G, Lambaudie E, Tallet A, Resbeut M, Sobol H, Charafe-Jauffret E, Calmels B, Lemarie C, Boher JM, Viens P, Eisinger F, Chabannon C. Highly favorable outcome in BRCA-mutated metastatic breast cancer patients receiving high-dose chemotherapy and autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 2016; 51:1082-6. [PMID: 27042835 DOI: 10.1038/bmt.2016.82] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 02/20/2016] [Accepted: 02/24/2016] [Indexed: 01/04/2023]
Abstract
Breast cancer carrying BRCA mutation may be highly sensitive to DNA-damaging agents. We hypothesized a better outcome for BRCA-mutated (BRCA(mut)) metastatic breast cancer (MBC) patients receiving high-dose chemotherapy and autologous hematopoietic stem cell transplantation (HDC AHSCT) versus unaffected BRCA (BRCA wild type; (BRCA(wt))) or patients without documented BRCA mutation (BRCA untested (BRCA(ut))). All female patients treated for MBC with AHSCT at Institut Paoli-Calmettes between 2003 and 2012 were included. BRCA(mut) and BRCA(wt) patients were identified from our institutional genetic database. Overall survival (OS) was the primary end point. A total of 235 patients were included. In all, 15 patients were BRCA(mut), 62 BRCA(wt) and 149 BRCA(ut). In multivariate analyses, the BRCA(mut) status was an independent prognostic factor for OS (hazard ratio (HR): 3.08, 95% confidence interval (CI): 1.10-8.64, P=0.0326) and PFS (HR: 2.52, 95% CI :1.29-4.91, P=0.0069). In this large series of MBC receiving HDC AHSCT, we report a highly favorable survival outcome in the subset of patients with documented germline BRCA mutations.
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Gonçalves A, Bertucci F, Chaffanet M, Guille A, Garnier S, Adelaide J, Carbuccia N, Brunelle S, Piana G, Cabaud O, Thomassin-Piana J, Paciencia-Gros M, Chereau-Ewald E, Lambaudie E, Sabatier R, Tarpin C, Provansal M, Jalaguier-Coudray A, Extra JM, Sarran A, Pakradouni J, Viens P, Lopez M, Ginestier C, Charafe-Jauffret E, Birnbaum D. Abstract P4-13-23: Next-generation sequencing (NGS), array comparative genomic hybridization (aCGH) and patient-derived tumor xenograft (PDX) for precision medicine in advanced breast cancer: A single-center prospective study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Genomic-based approaches in advanced breast cancer (ABC) were recently demonstrated as feasible in the clinical practice, but only a limited number of patients were actually treated with targeted therapies matching genomic alterations, with low antitumor activity. We conducted a pilot study to evaluate whether precision medicine using NGS and aCGH could be implemented prospectively at a single center in ABC patients. In addition, we examined whether PDX could be derived from ABC and thus could help inform therapeutic decision.
Methods
ABC patients accessible to tumor biopsy were prospectively enrolled at the Institut Paoli-Calmettes in the BC-BIO study (ClinicalTrials.gov, NCT01521676). Tumor tissue from locally recurrent or metastatic disease was immediately frozen after dedicated biopsy. Genomic profiling included high-resolution 4x180K aCGH (Agilent Technologies, Massy, France) and DNA sequencing, using a library of 365 cancer candidate genes (HaloPlex target enrichment kit, Agilent technologies, Santa Clara, CA, USA) and MiSeq analyzer (Illumina, San Diego, CA, USA) with 2x150-bp, paired-end at about 300x coverage. In a subset of patients, fresh tumor was implanted orthotopically in humanized cleared fat pads of NSG mice for establishing xenotransplants.
Results
A total of 34 ABC patients were included, with the following characteristics: median age 54 years (35-77); molecular subtypes: 11 triple-negative (32%), 12 luminal non-HER2 (35%), 4 luminal HER2 (12%), 3 HER2 non-luminal (9%), and 4 unknown (12%); 33 with previous chemotherapy (97%); 22 with previous endocrine treatment (35%); 7 with previous anti-HER2 (21%). Tumor biopsies were obtained from liver (15), skin (6), peritoneum (4), breast (3), node (3), lung (1), pleura (1), and ascitis (1), with a median tumor cellularity of 70% (range 10-90%). aCGH and NGS were available from 34 and 33 patients, respectively. An actionable target was found in 28 patients (82%), corresponding to 66 targets, including 37 mutations (8 in PIK3CA, 7 TP53, 4 ESR1, 2 AKT1, 2 BRCA2, 2 HER2), 22 amplifications (7 for CCND1, 2 CCNE1, 2 FGFR1, 2 IGF1R) and 7 homozygous deletions (3 for PTEN, 2 CDKN2A/B,1 BRCA2, 1 STK11). A targeted therapeutic proposal was possible, either in a clinical trial (N=18, 52%) or using already registered drugs (N=17, 50%). Ten patients actually received a targeted treatment, 1 of them experienced objective response and 1 showed stable disease for more than 6 months. Of 26 patients subjected to mouse implantation, 10 had successful xenografting (6 triple-negative, 2 HER2, 1 luminal non-HER2, 1 subtype non-attributed), with a median time to reach 10 mm of 148 days. These PDX will be used as models to understand the patient's therapeutic response.
Conclusion
Precision medicine using high-throughput DNA sequencing and aCGH can be implemented at a single center in the context of clinical practice and may allow direct therapeutic proposal in 1/3 of patients, but antitumor activity was minimal. PDX may be obtained in a significant fraction of patients, especially in triple-negative and HER2 subtypes, and could phenotypically complement genomic data.
Citation Format: Gonçalves A, Bertucci F, Chaffanet M, Guille A, Garnier S, Adelaide J, Carbuccia N, Brunelle S, Piana G, Cabaud O, Thomassin-Piana J, Paciencia-Gros M, Chereau-Ewald E, Lambaudie E, Sabatier R, Tarpin C, Provansal M, Jalaguier-Coudray A, Extra J-M, Sarran A, Pakradouni J, Viens P, Lopez M, Ginestier C, Charafe-Jauffret E, Birnbaum D. Next-generation sequencing (NGS), array comparative genomic hybridization (aCGH) and patient-derived tumor xenograft (PDX) for precision medicine in advanced breast cancer: A single-center prospective study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-23.
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Roule V, Ailem S, Legallois D, Dahdouh Z, Lognoné T, Bergot E, Grollier G, Milliez P, Sabatier R, Beygui F. Antecubital vs Femoral Venous Access for Right Heart Catheterization: Benefits of a Flashback. Can J Cardiol 2015; 31:1497.e1-6. [DOI: 10.1016/j.cjca.2015.04.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/02/2015] [Accepted: 04/27/2015] [Indexed: 10/23/2022] Open
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Rahal S, Boher JM, Extra JM, Tarpin C, Charafe-Jauffret E, Lambaudie E, Sabatier R, Thomassin-Piana J, Tallet A, Resbeut M, Houvenaeghel G, Laborde L, Bertucci F, Viens P, Gonçalves A. Immunohistochemical subtypes predict the clinical outcome in high-risk node-negative breast cancer patients treated with adjuvant FEC regimen: results of a single-center retrospective study. BMC Cancer 2015; 15:697. [PMID: 26466893 PMCID: PMC4607139 DOI: 10.1186/s12885-015-1746-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 10/09/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Anthracycline-based adjuvant chemotherapy improves survival in patients with high-risk node-negative breast cancer (BC). In this setting, prognostic factors predicting for treatment failure might help selecting among the different available cytotoxic combinations. METHODS Between 1998 and 2008, 757 consecutive patients with node-negative BC treated in our institution with adjuvant FEC (5FU, epirubicin, cyclophosphamide) chemotherapy were identified. Data collection included demographic, clinico-pathological characteristics and treatment information. Molecular subtypes were derived from estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) status and Scarff-Bloom-Richardson (SBR) grade. Disease-free survival (DFS), distant disease-free survival (DDFS) and overall survival (OS) were estimated using the Kaplan-Meier Method, and prognostic factors were examined by multivariate Cox analysis. RESULTS After a median follow-up of 70 months, the 5-year DFS, DDFS and OS were 90.6 % (95 % confidence interval (CI): 88.2-93.1), 92.8 % (95 % CI: 90.7-95) and 95.1 % (95 % CI, 93.3-96.9), respectively. In the multivariate analysis including classical clinico-pathological parameters, only grade 3 maintained a significant and independent adverse prognostic impact. In an alternative multivariate model where ER, PR and grade were replaced by molecular subtypes, only luminal B/HER2-negative and triple-negative subtypes were associated with reduced DFS and DDFS. CONCLUSIONS Node-negative BC patients receiving adjuvant FEC regimen have a favorable outcome. Luminal B/HER2-negative and triple-negative subtypes identify patients with a higher risk of treatment failure, which might warrant more aggressive systemic treatment.
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Roule V, Lemaitre A, Sabatier R, Lognoné T, Dahdouh Z, Berger L, Milliez P, Grollier G, Montalescot G, Beygui F. Transradial versus transfemoral approach for percutaneous coronary intervention in cardiogenic shock: A radial-first centre experience and meta-analysis of published studies. Arch Cardiovasc Dis 2015; 108:563-75. [PMID: 26365478 DOI: 10.1016/j.acvd.2015.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 04/22/2015] [Accepted: 06/01/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND The transradial approach for percutaneous coronary intervention (PCI) is associated with a better outcome in myocardial infarction (MI), but patients with cardiogenic shock (CS) were excluded from most trials. AIMS To compare outcomes of PCI for MI-related CS via the transradial versus transfemoral approach. METHODS A prospective cohort of 101 consecutive patients admitted for PCI for MI-related CS were treated via the transradial (n=74) or transfemoral (n=27) approach. Cox proportional hazards models adjusted for prespecified variables and a propensity score for approach were used to compare mortality, death/MI/stroke and bleeding between the two groups. A complementary meta-analysis of six studies was also performed. RESULTS Patients in the transradial group were younger (P=0.039), more often male (P=0.002) and had lower GRACE and CRUSADE scores (P=0.003 and 0.001, respectively) and rates of cardiac arrest before PCI (P=0.009) and mechanical ventilation (P=0.006). Rates of PCI success were similar. At a mean follow-up of 756 days, death occurred in 40 (54.1%) patients in the transradial group versus 22 (81.5%) in the transfemoral group (adjusted hazard ratio [HR]: 0.49, 95% confidence interval [CI] 0.28-0.84; P=0.012). The transradial approach was associated with reduced rates of death/MI/stroke (adjusted HR: 0.53, 95%CI: 0.31-0.91; P=0.02) and major bleeding (adjusted HR: 0.34, 95%CI: 0.13-0.87; P=0.02). The meta-analysis confirmed the benefit of transradial access in terms of mortality (relative risk [RR]: 0.63, 95%CI: 0.58-0.68) and major bleeding (RR: 0.43, 95%CI: 0.32-0.59). CONCLUSION The transradial approach in the setting of PCI for ischaemic CS is associated with a dramatic reduction in mortality, ischaemic and bleeding events, and should be preferred to the transfemoral approach in radial expert centres.
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Sabatier R. Towards biodiversity-based livestock systems: review of evidence and options for improvement. ACTA ACUST UNITED AC 2015. [DOI: 10.1079/pavsnnr201510020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Abstract
A major challenge for livestock farming systems (LFSs) is to reconcile production with the management of natural resources, especially biodiversity and ecosystem services. Based on a review of research conducted on grassland- and rangeland-based LFSs, this paper addresses this challenge by analysing biodiversity as a product of and a key resource for LFSs. Although most studies reveal antagonisms between biodiversity and production, our findings show that it is possible to move towards synergies. The literature review sheds light on five points: (i) moving beyond an antagonistic view of biodiversity and production by considering biodiversity as a resource requires new criteria for biodiversity categorization from a taxonomic view to a functional one; (ii) functional biodiversity (both domestic and wild) considered as a resource provides beneficial properties (e.g. stability and resilience) to LFSs; (iii) links between production and biodiversity cannot be simply summarized as having a negative impact of production intensity as management practices have various impacts on the different components of biodiversity; (iv) impact assessment studies linking management of LFSs and biodiversity reveal complex multi-level interactions between grassland or rangeland management and biodiversity; (v) a large range of management options are available to move towards biodiversity-based LFSs. We conclude that future research should address the challenge of collective management of wild biodiversity at higher levels of organization (landscapes, territories, etc.) and that such collective management would greatly benefit from the experience of domestic biodiversity.
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Campone M, Isambert N, Sabatier R, Castanie H, Zanetta S, Sudey I, Cantero F, Pauly J, Leroux E, Malasse S, Goncalves A. 586 Phase I study of pan-histone deacetylase inhibitor abexinostat in combination with cisplatin in patients with advanced solid tumors. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70712-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sabatier R, Van Campo M. L'analyse en composantes principales de variables instrumentales appliquée à l'estimation des paléoclimats de la Grèce, il y a 18 000 ans. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/01811789.1984.10826650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dahdouh Z, Roule V, Lognoné T, Sabatier R, Grollier G. Aortic arch rupture: an uncommon but fatal complication during transcatheter aortic valve implantation. JACC Cardiovasc Interv 2013; 6:416-7. [PMID: 23597608 DOI: 10.1016/j.jcin.2012.08.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 08/24/2012] [Accepted: 08/31/2012] [Indexed: 12/18/2022]
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Dahdouh Z, Roule V, Lognone T, Sabatier R, Massetti M, Grollier G. Atrial septostomy in cardiogenic shock related to H1N1 infection. ACTA ACUST UNITED AC 2013; 15:7-9. [PMID: 23425007 DOI: 10.3109/17482941.2012.760740] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The circulatory assistance, mainly the extra-corporeal membrane oxygenation (ECMO) restores hemodynamics and serves to limit the myocardial work, in order to avoid left ventricular dilation, high end-diastolic pressures, increased wall stress, subendocardial ischemia and consequently worsening pulmonary congestion and edema. In patients with large myocardial damage, sometimes an additional unloading of the left ventricle is warranted. We report a case of percutaneous blade and balloon atrial septostomy (BAS) as an add-on to the circulatory assistance to unload the left heart in a cardiogenic shock related to H1N1 infection.
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Beygui F, Labombarda F, Sabatier R, Lognone T, Sylvain J, Collet JP, Montalescot G, Milliez P. A meta-analysis of randomized trials comparing percutaneous closure of patent foramen ovale to medical therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Beygui F, Agueznai M, Roule V, Sabatier R, Lognone T, Bellemain-Appaix A, Collet JP, Montalescot G, Milliez P. Association of 2B3A inhibition with new antiplatelet regimens in the setting of acute coronary syndromes: a meta-analysis of randomized controlled trials. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dahdouh Z, Roule V, Lognoné T, Sabatier R, Grollier G. Iatrogenic bidirectional dissection during transcatheter aortic valve implantation: a fatal complication. J Cardiovasc Med (Hagerstown) 2013; 15:266-7. [PMID: 23846680 DOI: 10.2459/jcm.0b013e3283641bd4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Iatrogenic aortic or coronary dissections are well known complications in the field of interventional cardiology. They are the most dreadful situations, often with terrible consequences. We present herein a case of bidirectional dissection to the right coronary artery and to the ascending aorta during a transcatheter aortic valve implantation procedure.
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Audemard A, Boutemy J, Guilpain P, Sabatier R, Silva NM, Bienvenu B. Coronary vasculitis associated with T-cell prolymphocytic leukemia. Joint Bone Spine 2013; 81:93-4. [PMID: 23731632 DOI: 10.1016/j.jbspin.2013.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/16/2013] [Indexed: 11/30/2022]
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Dahdouh Z, Roule V, Lognoné T, Sabatier R, Massetti M, Grollier G. Transcatheter aortic valve implantation: how old is too old? J Am Geriatr Soc 2012; 60:1772-4. [PMID: 22985148 DOI: 10.1111/j.1532-5415.2012.04134.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Cuttone F, Saplacan V, Sabatier R, Buklas D. Angioplasty balloon catheter entrapment. Asian Cardiovasc Thorac Ann 2012; 20:491. [PMID: 22879568 DOI: 10.1177/0218492311427458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dahdouh Z, Roule V, Lognoné T, Sabatier R, Bignon M, Malcor G, Lemaitre A, Blanchart K, Wain-Hobson J, Saplacan V, Cutone F, Buklas D, Ivascau C, Massetti M, Grollier G. Iatrogenic bidirectional dissection of the right coronary artery and the ascending aorta: the worst nightmare for an interventional cardiologist. Korean Circ J 2012; 42:504-6. [PMID: 22870087 PMCID: PMC3409402 DOI: 10.4070/kcj.2012.42.7.504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Revised: 01/11/2012] [Accepted: 01/11/2012] [Indexed: 11/21/2022] Open
Abstract
Although rare, iatrogenic aortocoronary dissection is one of the complications most dreaded by the interventional cardiologist. If not managed promptly, it can have redoubted and serious consequences. Herein, we present the case of a 70 year-old woman who was treated by stenting of the second segment of the right coronary artery (RCA) for recurrent angina but, unfortunately, the procedure was complicated by anterograde dissection of the RCA with a simultaneous retrograde propagation to the proximal part of the ascending aorta. Successful stenting of the entry point was able to recuperate the RCA and to limit the retrograde propagation to the ascending aorta, but there was an extension of the dissection to the aortic valve leaflets resulting in a massive aortic insufficiency. Therefore, an isolated surgical aortic valve replacement was performed.
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Dahdouh Z, Roule V, Sabatier R, Lognoné T, Labombarda F, Pellissier A, Belin A, Ivascau C, Buklas D, Massetti M, Grollier G. Extra-corporeal life support, transradial thrombus aspiration and stenting, percutaneous blade and balloon atrioseptostomy, all as a bridge to heart transplantation to save one life. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2012; 13:241-5. [DOI: 10.1016/j.carrev.2012.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 02/09/2012] [Accepted: 02/27/2012] [Indexed: 11/16/2022]
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Dahdouh ZS, Roule V, Sabatier R, Grollier G. An alternative approach in tortuous coronary artery and distal stenosis during transradial percutaneous coronary intervention: deep engagement by a 5-Fr guiding catheter. Turk Kardiyol Dern Ars 2012; 40:159-61. [PMID: 22710587 DOI: 10.5543/tkda.2012.01766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Transradial approach for percutaneous interventions has emerged as an alternative to transfemoral access which is known to be more associated with vascular local complications. However, lack of guiding-catheter support via the radial access is one of the problems encountering the operators. Many solutions have been proposed to overcome this problem. We report on a 62-year-old man with tight stenosis of the distal part of the right coronary artery. He underwent coronary angiography and then percutaneous angioplasty via the right radial artery. During the procedure, attempts to advance a stent beyond a tortuosity at the level of the second segment failed due to lack of support of the 6-Fr Judkins right 4 guiding catheter, even with the buddy wire technique. Then, switching to a 5-Fr Judkins right 4 guiding catheter allowed safe deep engagement and resulted in successful advancement and deployment of the stent.
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Wain-Hobson J, Roule V, Dahdouh Z, Sabatier R, Lognoné T, Grollier G. Spontaneous coronary artery dissection: one entity with several therapeutic options. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2012; 13:203.e1-4. [PMID: 22475868 DOI: 10.1016/j.carrev.2012.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Revised: 01/21/2012] [Accepted: 02/03/2012] [Indexed: 10/28/2022]
Abstract
Spontaneous coronary artery dissection is an unusual and a rare cause of acute coronary syndrome and sudden death with multiple predisposing factors. Prompt recognition is crucial for appropriate patient management, but specific guidelines for optimal treatment are lacking. We report four cases of women with spontaneous coronary artery dissection revealed by ST-segment elevation, three in women during postpartum and one case associated with a Marfan syndrome. Our cases span the different therapeutic options from medical treatment, stenting, to coronary artery bypass graft surgery.
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Biannic C, Coutance G, Calus J, Belin A, Loiselet P, Michel L, Pradère G, Delmas P, Grollier G, Sabatier R. Suivi éducatif à domicile dans l’insuffisance cardiaque par télémédecine. Étude multicentrique bas normande randomisée. Résultats préliminaires. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.eurtel.2012.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sabatier R, Eymard JC, Walz J, Deville JL, Narbonne H, Boher JM, Salem N, Marcy M, Brunelle S, Viens P, Bladou F, Gravis G. Could thyroid dysfunction influence outcome in sunitinib-treated metastatic renal cell carcinoma? Ann Oncol 2012; 23:714-721. [PMID: 21653681 DOI: 10.1093/annonc/mdr275] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Sunitinib is a standard of care for metastatic renal cell carcinoma (mRCC). Hypothyroidism is frequently observed under sunitinib therapy. This study was conducted to prospectively determine the correlation between thyroid function and progression-free survival (PFS) in this population. PATIENTS AND METHODS One hundred and eleven mRCC patients treated with sunitinib were evaluated for serum thyroid-stimulating hormone (TSH) and T4 levels before treatment and every 6 weeks during treatment. Survival was analysed according to a landmark method with a cut-off of 6 months, excluding early progressive or early-censored patients. RESULTS Out of the 102 patients with normal baseline thyroid function, 53% developed thyroid dysfunction, including 95% hypothyroidisms out of which 90.9% received L-thyroxine replacement. Median time to TSH alteration was 5.4 months. Median PFS was 11.7 months for the entire population. Median PFS was not different between the groups with abnormal or normal thyroid function after 6 months of treatment (18.9 and 15.9 months, respectively, log-rank P = 0.94, hazard ratio = 1.02, 95% confidence interval = 0.54-1.93). There was no difference even after adjustment for Memorial Sloan-Kettering Cancer Centre classification and therapy line. CONCLUSIONS Abnormal thyroid function with hormonal substitution did not increase survival in our population, independent of initial prognosis and previous treatments. Larger comparative studies are deserved to validate these conclusions.
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Dahdouh Z, Roule V, Bignon M, Malcor G, Sabatier R, Lognoné T, Grollier G. 066 Left main coronary stenting in a non surgical octogenarian population: A possible approach. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2012. [DOI: 10.1016/s1878-6480(12)70462-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Roule V, Dahdouh Z, Lemaitre A, Sabatier R, Lognoné T, Bignon M, Malcor G, Grollier G. Coronary-Pulmonary Fistulas Involving All Three Major Coronary Arteries Co-Existing With Myocardial Infarction. Korean Circ J 2012; 42:292-3. [PMID: 22563346 PMCID: PMC3341430 DOI: 10.4070/kcj.2012.42.4.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2011] [Revised: 09/13/2011] [Accepted: 09/27/2011] [Indexed: 11/11/2022] Open
Abstract
We report the case of a man who presented with acute anterior myocardial infarction and in whom the coronary angiogram showed tight stenosis of the left anterior descending coronary artery and the right coronary artery associated with substantial coronary-pulmonary fistulas involving all three major coronary arteries. We discuss the possible links between coronary artery fistulas and myocardial infarction.
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