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Schiele F, Lemesle G, Angoulvant D, Krempf M, Kownator S, Cheggour S, Belle L, Ferrières J, Bauters C, Bergerot C, Beygui F, Boccara F, Bonnefoy E, Bruckert E, Cayla G, Collet JP, Coste P, Descotes-Genon V, Ducrocq G, Elbaz M, Farnier M, Ferrari E, Guedj D, Levai L, Mansourati J, Mansencal N, Meneveau N, Meune C, Morel O, Ohlmann P, Paillard F, Piot C, Puymirat E, Rioufol G, Roubille F, Sabouret P, Teiger E. Proposal for a standardized discharge letter after hospital stay for acute myocardial infarction. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2020; 9:788-801. [DOI: 10.1177/2048872619844444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
In patients admitted for acute myocardial infarction, the communication and transition from specialists to primary care physicians is often delayed, and the information imparted to subsequent healthcare providers (HCPs) may be sub-optimal. A French group of cardiologists, lipidologists and diabetologists decided to establish a consensus to optimize the discharge letter after hospitalization for acute myocardial infarction. The aim is to improve both the timeframe and the quality of the content transmitted to subsequent HCPs, including information regarding baseline assessment, procedures during hospitalization, residual risk, discharge treatments, therapeutic targets and follow-up recommendations in compliance with European Society of Cardiology guidelines. A consensus was obtained regarding a template discharge letter, to be released within two days after patient’s discharge, and containing the description of the patient’s history, risk factors, acute management, risk assessment, discharge treatments and follow-up pathway. Specifically for post acute MI patients, tailored details are necessary regarding the antithrombotic regimen, lipid-lowering and anti-diabetic treatments, including therapeutic targets. Lastly, the follow-up pathway needs to be precisely mentioned in the discharge letter. Additional information such as technical descriptions, imaging, and quality indicators may be provided separately. A template for a standardized discharge letter based on 8 major headings could be useful for implementation in routine practice and help to improve the quality and timing of information transmission between HCPs after acute MI.
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Affiliation(s)
- Francois Schiele
- Department of Cardiology, University Hospital Besancon, and EA3920, University of Franche-Comté, Besancon, France
| | - Gilles Lemesle
- USIC et Centre Hémodynamique, Institut Cœur Poumon, Centre Hospitalier Universitaire de Lille, France
- Faculté de Médecine de l’Université de Lille, France
- INSERM UMR 1011, Institut Pasteur de Lille, France
- FACT (French Alliance for Cardiovascular Trials), Paris, France
| | - Denis Angoulvant
- Service de cardiologie, faculté de médecine, université François-Rabelais, CHU Trousseau, Tours
| | - Michel Krempf
- CHU de Nantes-Hôpital Nord Laennec, Saint Herblain, France
| | | | | | - Loic Belle
- Service de Cardiologie, Centre Hospitalier Annecy-Genevois, Metz-Tessy, France
| | - Jean Ferrières
- Service de Cardiologie B, CHU Rangueil, Toulouse, France
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Lemesle G, Tricot O, Meurice T, Lallemant R, Delomez M, Equine O, Lamblin N, Bauters C. Incident Myocardial Infarction and Very Late Stent Thrombosis in Outpatients With Stable Coronary Artery Disease. J Am Coll Cardiol 2017; 69:2149-2156. [DOI: 10.1016/j.jacc.2017.02.050] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 10/19/2022]
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Batty JA, Dunford JR, Mehran R, Kunadian V. Triple Antiplatelet Therapy and Combinations with Oral Anticoagulants After PCI. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jonathan A. Batty
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
- The Royal Victoria Infirmary; Newcastle upon Tyne NHS Foundation Trust; Newcastle upon Tyne UK
| | - Joseph R. Dunford
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
| | - Roxana Mehran
- Department of Cardiology; Mount Sinai Medical Center; New York NY USA
| | - Vijay Kunadian
- Institute of Cellular Medicine; Newcastle University; Newcastle upon Tyne UK
- Freeman Hospital; Newcastle upon Tyne Hospital NHS Foundation Trust; Newcastle upon Tyne UK
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Lemesle G, Schurtz G, Meurice T, Tricot O, Lemaire N, Caudmont S, Philias A, Ketelers R, Lamblin N, Bauters C. Clopidogrel Use as Single Antiplatelet Therapy in Outpatients with Stable Coronary Artery Disease: Prevalence, Correlates and Association with Prognosis (from the CORONOR Study). Cardiology 2016; 134:11-8. [DOI: 10.1159/000442706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/23/2015] [Indexed: 11/19/2022]
Abstract
Background: Clopidogrel use as single antiplatelet therapy (SAPT) has never been evaluated in stable coronary artery disease (CAD) outpatients either as compared to placebo or aspirin. Methods: We therefore studied 2,823 outpatients included in a prospective registry. The patients were divided into 2 groups according to their antiplatelet therapy regimen: patients treated with clopidogrel were compared with those treated with aspirin alone. Results: The mean time since CAD diagnosis was 7.9 years. Altogether, 776 (27.5%) patients received clopidogrel as SAPT. Factors independently associated with clopidogrel use were prior aortic or peripheral intervention, drug-eluting stent implantation, stroke, carotid endarterectomy and time since CAD diagnosis. Clopidogrel tended to be used in higher-risk patients: composite of cardiovascular death, myocardial infarction or stroke at 5.8 versus 4.2% (p = 0.056). However, after propensity score matching, similar event rates were observed between the groups: 5.9% when treated with clopidogrel versus 4.4% with aspirin (p = 0.207). The rate of bleeding was also similar between the groups. Conclusions: Our study shows that a significant proportion of stable CAD patients are treated with clopidogrel as SAPT in modern practice. Several correlates of such an attitude were identified. Our results suggest that this strategy is not beneficial as compared to aspirin alone in terms of ischaemic or bleeding events.
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Schurtz G, Manchuelle A, Lemesle G. Stent length as a potential indicator to select patients who may benefit from long-term dual antiplatelet therapy. Interv Cardiol 2015. [DOI: 10.2217/ica.15.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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