1
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Cherbi M, Maury P, Schneider F, Bonnefoy-Cudraz E, Roubille F, Puymirat E, Bonello L, Leurent G, Levy B, Lamblin N, Bourenne J, Quentin C, Delabranche X, Combaret N, Marchandot B, Lattuca B, Leborgne L, Fillippi E, Gerbaud E, Delmas C. 1-year outcomes in cardiogenic shock triggered by ventricular tachycardia: An analysis of the FRENSHOCK nationwide multicenter prospective registry. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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2
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Pezel T, Dillinger JG, Trimaille A, Delmas C, Piliero N, Bouleti C, Pommier T, El Ouahidi A, Andrieu S, Lattuca B, Rossanaly Vasram R, Noirclerc N, Schurtz G, Roubille F, Fauvel C, Bochaton T, Aboyans V, Puymirat E, Vicaut E, Henry P. Prevalence of illicit drugs use and association with in-hospital major adverse events in patients hospitalised for acute cardiac events: The ADDICT-ICCU Trial. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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3
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Gall E, Pezel T, Lattuca B, Puymirat E, Hauguel-Moreau M, Gretzinger A, Trimaille A, Léquipar A, Fauvel C, Charbonnel C, Zakine C, Bedossa M, Aboyans V, Deney A, Schurtz G, Bouleti C, Rossanaly Vasram R, Bochaton T, Dillinger JG, Henry P. Description of intensive cardiac care units (ICCU) in France in 2021: Insight from ADDICT-ICCU registry. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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4
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Pezel T, Dillinger JG, Trimaille A, Delmas C, Piliero N, Bouleti C, Pommier T, El Ouahidi A, Andrieu S, Lattuca B, Rossanaly Vasram R, Fard D, Noirclerc N, Vicaut E, Henry P. Prevalence of illicit drugs use and association with in-hospital major adverse events in patients hospitalised for acute cardiac events: the ADDICT-ICCU Trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prevalence and short-term cardiovascular consequences of illicit drug use in patients admitted to the intensive cardiac care unit (ICCU) for acute cardiovascular events are not well established.
Purpose
The Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study was designed to assess prospectively the prevalence of illicit drugs use, and their association with the occurrence of in-hospital major adverse events (MAEs) in consecutive patients admitted to ICCUs for acute cardiovascular events.
Methods
From 7 to 22 April 2021, screening for illicit drug was performed by systematic urinary testing in a prospective study including all consecutive patients admitted to ICCU in 39 centres throughout France. The primary outcome was the prevalence of the illicit drugs detected. The secondary clinical outcome was in-hospital Major Adverse cardiac Events (MAEs) defined by death, resuscitated cardiac arrest or cardiogenic shock.
Results
Among 1,499 consecutive patients screened (age 63.3±14.9 years, 69.6% male), 161 (10.7%) had a positive test for illicit drugs (cannabis: 9.1%, opioids: 2.1%, cocaine: 1.7%, amphetamines: 0.7%, 3,4-methylenedioxymethamphetamine: 0.6%). Patients who used illicit drugs were young (33.0% at age <40 vs. 5.9% at age ≥60 years), and more frequently male (11.9% vs. 8.1%, p<0.001). Self-reported current use was 56.5% in patients with a positive test. After a median duration of hospitalisation of five days, there were 61 in-hospital MAEs (4.1%).
The detection of illicit drugs was associated with a higher rate of MAEs after adjustment for known predictors of severity (OR=8.84; 95% CI: 4.68–16.7, p<0.001) or after using a propensity score adjustment (OR=5.81; 95% CI: 4.14–8.14, p<0.001). After adjustment for age and sex, detection of cannabis or cocaine was significantly associated with MAEs (OR=3.53; 95% CI: 1.25–9.95, p<0.001; OR=5.12; 95% CI: 1.48–17.2, p=0.004 respectively). Multiple drug detection (28% of positive patients) was associated with a higher incidence of MAEs than single drug detection.
Conclusions
The prevalence of illicit drugs use in patients hospitalised in the ICCUs for acute cardiovascular events was 10.7% and was under-reported. Illicit drugs detection was independently associated with a higher occurrence of in-hospital MAEs.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Fondation Coeur et Recherche
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Affiliation(s)
- T Pezel
- Hospital Lariboisiere, Cardiology , Paris , France
| | | | - A Trimaille
- University Hospital of Strasbourg , Strasbourg , France
| | - C Delmas
- Toulouse Rangueil University Hospital (CHU) , Toulouse , France
| | - N Piliero
- University Hospital of Grenoble , Grenoble , France
| | - C Bouleti
- University of Poitiers , Poitiers , France
| | - T Pommier
- University Hospital of Dijon , Dijon , France
| | | | | | - B Lattuca
- University Hospital of Nimes , Nimes , France
| | | | - D Fard
- Henri-Mondor University Hospital , Créteil , France
| | - N Noirclerc
- Centre Hospitalier Annecy Genevois , Annecy , France
| | - E Vicaut
- Hôpital Fernand Widal, AP-HP, Unité de Recherche Clinique et Statistiques , Paris , France
| | - P Henry
- Hospital Lariboisiere, Cardiology , Paris , France
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5
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Ricci J, Aguilhon S, Occean B, Soullier C, Solecki K, Robert C, Huet F, Cornillet L, Schmutz L, Chevallier T, Akodad M, Leclercq F, Cayla G, Lattuca B, Roubille F. Impact of daily bedside echocardiographic assessment on readmissions in acute heart failure: The JECICA randomized trial. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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6
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Lattuca B, Prunet E, Huet F, Akodad M, Manna F, Macia J, Schmutz L, Gandet T, Cayla G, Leclercq F. Post TAVR coronary revascularization guided by stress cardiac imaging and impact on cardiovascular events. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The prognostic impact of systematic revascularization of asymptomatic coronary artery stenosis before transcatheter aortic valve replacement (TAVR) is still debated
Purpose
The main objectives of this study were to evaluate the feasibility and the safety of a functional evaluation of coronary artery disease (CAD) followed by a selective ischemia-guided percutaneous coronary intervention (PCI) after TAVR.
Methods
This prospective, bi-centric, one-arm, open-label trial included patients with severe aortic stenosis (AS) eligible for TAVR and with significant CAD defined as one or more coronary stenosis ≥70%. Patients with left main stenosis ≥50%, proximal left anterior descending artery (LAD) stenosis ≥90% or > class 2 Canadian cardiovascular society angina pectoris were excluded. Coronary revascularization was not performed before TAVR and myocardial ischemia was evaluated by stress cardiac imaging one month after the procedure using Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging or Stress Echocardiography using dobutamine infusion. The primary endpoint was the composite of all cause of death, stroke, major bleeding (Bleeding Academic Research Consortium (BARC) ≥3), major vascular complication (Valve Academic Research Consortium 2 criteria), myocardial infarction (MI) and hospitalization for cardiac causes at 6 months following TAVR.
Results
Between June 2016 and March 2019, 71 patients were included with a complete follow-up in 66 patients. The mean age was 84±5.2 years and the mean Euroscore was 13±8.6. Stress cardiac imaging could be achieved in 70% (n=46) of the patients and the main causes to not perform it were patient refusal or secondary impaired medical condition. Significant myocardial ischemia was observed in only 3 patients (4.5%), of whom 2 patients had successful PCI. The primary endpoint occurred at 6 months in 15 patients (23%) including death in 6 patients (9%), stroke in 3 patients (5%) and major bleedings in 3 patients (5%). Acute MI was observed in only 2 patients (3%) that had not-LAD proximal and severe coronary stenosis (≥90%). Hospital readmission (n=27, 41%) was mostly related to non-cardiac causes (n=18, 27%).
Conclusions
In patients scheduled to TAVR and with significant coronary disease, a strategy of selective ischemia-guided coronary revascularization after TAVR appears safe with a low rate of myocardial infarction and myocardial ischemia requiring revascularization during follow-up. However, the poor adherence of elderly patients to stress test could suggest to perform PCI of proximal and severe coronary lesions. Large-scale and randomized trials are warranted to validate this strategy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- B Lattuca
- University Hospital of Nimes, Cardiology department, Nimes, France
| | - E Prunet
- University Hospital of Nimes, Cardiology department, Nimes, France
| | - F Huet
- Hospital Regional University of Montpellier, Montpellier, France
| | - M Akodad
- Hospital Regional University of Montpellier, Montpellier, France
| | - F Manna
- Department of Epidemiology, Medical statistics and Public Health, Montpellier University Hospital, Montpellier, France
| | - J.C Macia
- Hospital Regional University of Montpellier, Montpellier, France
| | - L Schmutz
- University Hospital of Nimes, Cardiology department, Nimes, France
| | - T Gandet
- Department of cardiac and thoracic surgery, Montpellier University Hospital,, Montpellier, France
| | - G Cayla
- University Hospital of Nimes, Cardiology department, Nimes, France
| | - F Leclercq
- Hospital Regional University of Montpellier, Montpellier, France
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7
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Silvain J, Kerneis M, Zeitouni M, Lattuca B, Mertens E, Procopi N, Suc G, Salloum T, Frisdal E, Le Goff W, Collet J, Vicaut E, Lesnik P, Montalescot G, Guerrin M. Interleukin-1Beta and risk of premature death and MACE in patients with myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Inhibition of the interleukin-1β (IL-1β) innate immunity pathway is associated with anti-inflammatory effects and a reduced risk of recurrent cardiovascular events in stable patients with previous myocardial infarction (MI) and elevated high sensitivity C-reactive protein (hs-CRP). However, the prognosis value of IL-1β level in acute myocardial infarction patients has never been evaluated. We aim to assess the association between IL-1β level with all-cause mortality in patients with acute ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention and the interplay between IL-1β and hs-CRP concentrations on the risk of premature death.
Methods
IL-1β concentration was measured among 1398 STEMI patients enrolled in a prospective cohort study. Crude and hazard ratios for all-cause and cardiovascular mortality were analyzed at 90-days and one-year using a multivariate-cox proportional regression analysis. Major cardiovascular events (MACE) were also analyzed.
Results
In a STEMI population, IL-1β concentration measured at admission was independently associated with all-cause mortality at 90 days (adjusted hazard ratio [adjHR], 1.43 per 1SD increase; 95% CI, 1.12 to 1.83; p<0.005). The relation was nonlinear, and we identified a threshold of IL-1β >10 pg/mL that was markedly associated with higher mortality rates at 90 days (adjHR: 2.80; 95% CI: 1.63–4.80, p=0.0002) and one-year (adjHR: 1.75; 95% CI: 1.09–2.78, p=0.019), regardless of the hs-CRP concentration. The relationship was even stronger when considering cardiovascular mortality and MACE at 90 days (adjHR: 2.31; 95% CI: 1.30–4.10, p=0.004 and 2.17; 95% CI: 1.24–3.80, p=0.006) and at one year (adjHR: 2.26; 95% CI: 1.31–3.87, p=0.03 and 2.25; 95% CI: 1.33–3.79, p=0.004).
Conclusion
IL-1β measured at admission in acute MI patients is associated with the risk of mortality and recurrent major cardiovascular events, regardless of the CRP level. A threshold of 10 pg/mL identifies patients at higher risk of events.
Survival
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | | | - G Suc
- Sorbonne University, Paris, France
| | | | - E Frisdal
- INSERM UMRS1166, ICAN, Paris, France
| | - W Le Goff
- INSERM UMRS1166, ICAN, Paris, France
| | | | - E Vicaut
- Sorbonne University, Paris, France
| | - P Lesnik
- INSERM UMRS1166, ICAN, Paris, France
| | | | - M Guerrin
- INSERM UMRS1166, ICAN, Paris, France
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8
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Lattuca B, Odorico X, Occean B, Cornillet L, Schmutz L, Ledermann B, Fabbro-Peray P, Leclercq F, Cayla G. Long-term efficacy and safety of newer generation ultrathin strut drug-eluting stents: a systematic review and meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent trials have demonstrated that short-term efficacy and safety of ultrathin strut drug-eluting stents (DES) were non-inferior to contemporary stents but long-term benefit remains uncertain.
Purpose
The main objective of this meta-analysis was to evaluate efficacy and safety of ultrathin strut DES with an extended follow-up in comparison to 2nd and 3rd generations DES.
Methods
A double-blind review of randomized controlled trials (RCT) comparing ultrathin strut DES to contemporary DES was performed from MEDLINE and CENTRAL databases and from cardiological congresses. The primary efficacy endpoint was target vessel failure (TLF) defined as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization (TLR) and the primary safety endpoint was occurrence of stent thrombosis (ST). Short (1 year) and long term (≥2 years) effects were estimated separately. This analysis was pre-specified in PROSPERO (CRD42019142206).
Results
The meta-analysis included 13 RCT including 19,490 patients. In short term, we found TLF decrease with ultrathin strut DES (RR 0.85, CI [0.75–0.97], p=0.01), driven by lower TV-MI (RR 0.83, CI [0.66–1.03], p=0.1) and TLR (RR 0.77, CI [0.58–1.01], p=0.1) rates, and a non-significant downward trend in ST (RR 0.85 CI [0.64–1.14]).
In long term, from the 5 trials with extended follow-up, there was no significant difference between ultrathin strut DES and thicker strut stents in rate of TLF at the longest available follow-up (RR 0.90, CI [0.76–1.06], p=0.2), despite a numerically reduction of TV-MI (RR 0.81, CI [0.61–1.08], p=0.05) and TLR (RR 0.85, CI [0.69–1.04], p=0.1) in favor of ultrathin strut stents. However, we observed a persistent numerically reduction in ST (RR 0.79, CI [0.61–1.02], p=0.01).
Conclusion
Ultrathin strut DES was associated with a lower target lesion failure rate at one year but not beyond 2-years follow-up. Nevertheless, the safety of the ultrathin strut stents was sustained over time with a numerically reduction of ST.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- B Lattuca
- University Hospital of Nimes, Cardiology, Nimes, France
| | - X Odorico
- Perpignan Hospital Centre, Cardiology, Perpignan, France
| | - B.V Occean
- University Hospital of Nimes, Cardiology, Nimes, France
| | - L Cornillet
- University Hospital of Nimes, Cardiology, Nimes, France
| | - L Schmutz
- University Hospital of Nimes, Cardiology, Nimes, France
| | - B Ledermann
- University Hospital of Nimes, Cardiology, Nimes, France
| | | | - F Leclercq
- University Hospital Arnaud de Villeneuve, Cardiology, Montpellier, France
| | - G Cayla
- University Hospital of Nimes, Cardiology, Nimes, France
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9
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Guedeney P, Mesnier J, Sorrentino S, Abcha F, Zeitouni M, Lattuca B, Silvain J, De Rosa S, Indolfi C, Collet J, Kerneis M, Montalescot G. Early aspirin discontinuation following acute coronary syndrome or percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The respective ischemic and bleeding risks of early aspirin discontinuation following an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) remains uncertain.
Objectives
To evaluate the safety and efficacy of early aspirin discontinuation in ACS or PCI patients treated with P2Y12 inhibitors with or without anticoagulants.
Methods
We performed a review of randomized controlled trials (RCTs) comparing a P2Y12 inhibitor-based single antiplatelet strategy following early aspirin discontinuation to a strategy of sustained dual antiplatelet therapy (DAPT) in ACS or PCI patients requiring or not anticoagulation for another indication. The primary safety endpoint was major bleeding while non-major bleeding and all bleeding were secondary safety endpoints. The primary efficacy endpoint was all-cause mortality while secondary efficacy endpoints included major adverse cardiovascular and cerebrovascular events (MACCE), myocardial infarction (MI), definite stent thrombosis (ST) or any stroke. We estimated risk ratios (RR) and 95% confidence intervals (CI) using random effect models. The study is registered in PROSPERO (CRD42019139576).
Results
We included 9 RCTs comprising 40,621 patients.Compared to prolonged DAPT, major bleeding (2.2% vs. 2.8%; RR 0.68; 95% CI: 0.54 to 0.87; p=0.002; I2: 63%), non-major bleeding (5.0% vs. 6.1%; RR: 0.66; 95% CI: 0.47 to 0.94; p=0.02; I2:87%) and all bleeding (7.4% vs. 9.9%; RR: 0.65; 95% CI: 0.53 to 0.79; p<0.0001; I2: 88%) were significantly reduced with early aspirin discontinuation (Figure 1), without significant difference for all-cause death (p=0.60), MACCE (p=0.60), MI (p=0.77), definite ST (p=0.63), and any stroke (p=0.59). Results were consistent in patients with or without anticoagulation, without significant interaction for any outcomes but MI (p=0.04).
Conclusions
In patients on DAPT after an ACS or a PCI, early aspirin discontinuation prevents bleeding events with no effect on the ischemic risk or mortality.
Figure 1. Central illustration
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | - J Mesnier
- Hospital Pitie-Salpetriere, Paris, France
| | - S Sorrentino
- Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - F Abcha
- Hospital Pitie-Salpetriere, Paris, France
| | - M Zeitouni
- Hospital Pitie-Salpetriere, Paris, France
| | - B Lattuca
- Hospital Pitie-Salpetriere, Paris, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Paris, France
| | - S De Rosa
- Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - C Indolfi
- Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - J.P Collet
- Hospital Pitie-Salpetriere, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Paris, France
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10
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Lattuca B, Meilhac A, Akodad M, Robert C, Vandenberghe D, Manna F, Nagot N, Chettouh M, Gandet T, Macia J, Delseny D, Schmutz L, Albat B, Cayla G, Leclercq F. Eight-year clinical outcome and valve durability after trans-catheter aortic-valve implantation. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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11
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Lattuca B, Bouziri N, Kerneis M, Portal J, Zhou J, Hauguel-Moreau M, Mameri A, Zeitouni M, Guedeney P, Hammoudi N, Isnard R, Pousset F, Collet J, Vicaut E, Montalescot G, Silvain J. Antithrombotic therapy and cardiovascular events in patients with left ventricular thrombus. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Cayla G, Schmutz L, Soullier C, Ricci JE, Robert C, Cambon-Viala M, Goger AL, Lattuca B. [Which patient for TAVI in 2019?]. Ann Cardiol Angeiol (Paris) 2019; 68:405-409. [PMID: 31668846 DOI: 10.1016/j.ancard.2019.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
The therapeutic management of aortic stenosis has been drastically changed by the advent of percutaneous valve replacement (TAVI). Since the first implantation, the indications have progressively been extended from the inoperable patient to the patient at low surgical risk. The main objective of this review is to describe the currently recommended main indications of TAVI depending on an individualized assessment of each patient's risk, technical characteristics and anatomical valvular criteria.
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Affiliation(s)
- G Cayla
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France.
| | - L Schmutz
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - C Soullier
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - J E Ricci
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - C Robert
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - M Cambon-Viala
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - A L Goger
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
| | - B Lattuca
- Service de cardiologie, université de Montpellier, CHU de Nîmes, 30029 Nîmes, France
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13
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Lattuca B, Bouziri N, Portal JJ, Zhou J, Zeitouni M, Kerneis M, Guedeney P, Legrand L, Hammoudi N, Isnard R, Pousset F, Collet JP, Vicaut E, Montalescot G, Silvain J. P6454Antithrombotic therapy and cardiovascular events in patients with left ventricular thrombus. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left Ventricular Thrombus (LVT) is associated with a high risk of thromboembolic complications such as stroke. Contemporary data are lacking on the management, prognosis and treatment of LVT, particularly with the emergence of the non-vitamin K antagonist anticoagulants (NOACs).
Purpose
To study the time and predictive factors associated with thrombus regression on treatment and its association with survival, embolic and bleeding complications.
Methods
From January 2011 to January 2018, a computerized case sensitive search of LVT was performed on 90 065 consecutive echocardiogram reports. All patients with a confirmed LVT were included in this analysis after imaging review by two independent experts. Repeated echocardiographic data, treatment management and clinical outcomes were collected during follow-up. Major adverse cardiac events (MACE), defined as the composite of death, ischemic stroke or transient ischemic attack (TIA), myocardial infarction (MI) or embolic peripheral artery occlusion were analyzed as well as major bleeding events (BARC ≥3) and the predictive factors and impact of LVT regression.
Results
We identified 174 patients with a suspected LVT of whom 159 had confirmed LVT on two different cardiac imaging exams. Ischemic cardiomyopathy was the main cause of LVT (n=125, 78.6%) including 56 (35.2%) patients with an acute ST segment elevation MI. The mean left ventricular ejection fraction was 31.9±12.5% with predominant (98.1%) apical location of the LVT.
Anticoagulation therapy was achieved with vitamin K antagonists, NOACs and parenteral heparins in 48.7%, 22.8% and 27.8% of patients, respectively. Concomitant antiplatelet therapy was prescribed in 67.9% of patients. Total LVT regression was reached in two third of patients (62.3%, n=99) within a median time of 103 [32–392] days. Independent predictors of total LVT regression were an ischemic cardiomyopathy (HR: 0.36 [0.19–0.70], p=0.002), a larger baseline thrombus area (HR=0.66 [0.45–0.96], p<0.031) and a prolonged anticoagulation therapy over 3 months (HR=0.11 [0.05–0.22], p<0.0001).
During a median follow-up of 632 [187–1126] days, MACE occurred in 59 (37.1%) patients with a 18.9% rate of mortality and 13.2% of major bleeding. Patients with a total LVT regression had a non-significant lower rate of MACE as compared with patients without total LVT regression (35.4% vs. 40.0%; HR=0.71 [0.42–1.21]; p=0.20), and a significant lower rate of mortality (15.2% vs. 25.0%; HR=0.48 [0.23–0.98]; p=0.039).
Occurence of mortality (A) and MACE (B)
Conclusions
The prognosis of LVT remains severe with a high risk of major cardiovascular event and mortality. Total LVT regression, mostly reached in 3 months, can be obtained with both vitamin K antagonists and NOACs and is associated with a better prognosis.
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Affiliation(s)
- B Lattuca
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - N Bouziri
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - J J Portal
- ACTION Study Group, Unité de Recherche Clinique, Lariboisière Hospital (APHP), Paris, France
| | - J Zhou
- Information system department, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - M Zeitouni
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - M Kerneis
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - P Guedeney
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - L Legrand
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - N Hammoudi
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - R Isnard
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - F Pousset
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - J P Collet
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - E Vicaut
- ACTION Study Group, Unité de Recherche Clinique, Lariboisière Hospital (APHP), Paris, France
| | - G Montalescot
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
| | - J Silvain
- Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France
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14
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Robert P, Leclercq F, Lattuca B, Albat B, Maupas E, Robert G, Akodad M, Macia JC, Dubar A, Targosz F, Gandet T, Cayla G. P1843Transcatheter aortic valve implantation in patients with uninterrupted vitamin k antagonist. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Bridging of vitamin K antagonist (VKA) with heparin is usually not promoted during interventional or surgical procedures related to increased risk of bleeding and thrombotic events but this strategy has not been evaluated during TAVI.
Purpose
The aim of this study was to evaluate the rate of major bleeding and vascular complications after TAVI performed in patients with uninterrupted VKA.
Methods
From January 2016 to October 2017, consecutive patients who underwent TAVI with uninterrupted VKA (INR between 1.5 and 3.5) were prospectively included in a monocentric registry. TAVI were performed according to current guidelines and a 50UI/kg bolus of heparin was injected at the beginning of the procedure for all patients. Vascular and bleeding complications were assessed using the Valve Academic Research Consortium 2 (VARC2) and the Bleeding Academic Research Consortium (BARC) definitions at 30 day follow-up.
Results
A total of 88 patients were included with a median age of 84 years [81.8–87], 42% being female, the median STS score was 5.1 [4.1–7.5], the median CHADS2-VASc was 5.5 [5–6] and 60.2% had a chronic kidney failure. Median INR at time of implantation was at 2.1 [1.8–2.6]. VKA were used for atrial fibrillation (89.8%), mechanic mitral prosthesis (5.7%) or venous thromboembolic disease (4.5%). Trans femoral access was used in 88.6% of the patients. Major bleeding (BARC ≥3b) occurred in 5 patients (5,7%) and major vascular complications occurred in 7 patients (8%). Peripheral arterial disease (RR = 10.95; 95% CI: 1.63 to 73.75; p=0.014) and carotid access (RR=8.56; 95% CI: 1.19 to 61.51; p=0.033) were significantly associated with major bleeding. INR >2.5 was significantly associated with vascular complications (RR=7.14; 95% CI: 1.29 to 39.63; p=0.025). In multivariate analysis, Body mass index (OR=1.26; 95% CI: 1.02 to 1.57; p=0.032) and INR >2.5 (OR=18.91; 95% CI: 1.62 to 221.26; p=0.010) were independent factor significantly associated with vascular complications or major bleeding. Mortality rate at 30 days follow-up was 2.3%, there was no myocardial infarction and stroke rate was 4.5%.
Figure 1. Study flowchart
Conclusion
TAVI with uninterrupted VKA treatment seems to be feasible and safe with low risk of bleeding and vascular complications in this first single centre experience. Particular caution is advocated in low BMI patients and to keep INR<2.5.
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Affiliation(s)
- P Robert
- University Hospital Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - F Leclercq
- University Hospital Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - B Lattuca
- University Hospital of Nimes, Nimes, France
| | - B Albat
- University Hospital Arnaud de Villeneuve, Cardiac Surgery, Montpellier, France
| | - E Maupas
- Franciscaines clinic, Nimes, France
| | - G Robert
- Saint-Pierre Clinic, Perpignan, France
| | - M Akodad
- University Hospital Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - J C Macia
- University Hospital Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - A Dubar
- Millénaire Clinic, Montpellier, France
| | - F Targosz
- University Hospital Arnaud de Villeneuve, Cardiology Department, Montpellier, France
| | - T Gandet
- University Hospital Arnaud de Villeneuve, Cardiac Surgery, Montpellier, France
| | - G Cayla
- University Hospital of Nimes, Nimes, France
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15
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Lattuca B, Meilhac A, Robert C, Vandenbergh D, Manna F, Nagot N, Chettouh M, Akodad M, Gandet T, Macia JC, Delseny D, Schmutz L, Albat B, Cayla G, Leclercq F. P1793Eight-year clinical outcome and valve durability after transcatheter aortic valve implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
With the growing indications of transcatheter aortic valve implantation (TAVI) worldwide and among lower risk patients, valve durability has become a crucial issue.
Purpose
To assess mid and long-term evolution of different generations of percutaneous balloon-expandable prostheses, predictive factors of valve deterioration and its correlation with long-term mortality.
Methods
All consecutive patients undergoing TAVI for severe aortic stenosis with balloon-expandable prosthesis between 2009 and 2014 and with a minimum follow-up of one-year were included in this monocentric prospective study. All echocardiograms were reviewed by two independent experts. Clinical events were defined according to the Valve Academic Research Consortium criteria. Valve deterioration was defined according to the 2017 EAPCI-ESC-EACTS international consensus statement at the longest follow-up.
Results
A total of 160 patients were included with a median follow-up of 3.4 years [1.5–4.9] and a maximum of 8 years. Patients were mostly implanted with the first generation Sapien XT valve (n=138, 86.2%). Median age was 85 [79–86] years, with 42.5% of women and a median logistic Euro-SCORE of 14.2% [10.6–23.2]. Immediately after TAVI, mean aortic gradient decreased dramatically from 51±12mmHg to 9±2.6mmHg (p<0.0001) and remained overall stable with a mean gradient of 12±1mmHg at 8 years. Valve deterioration occurred in 5.6% (n=9) of patients, of which 3.7% (n=6) with severe deterioration. Moderate or severe peri-prosthetic aortic regurgitation was observed in 2.5% (n=4) of patients. The eight-year survival rate was 12.9%. During follow-up, hospitalization for acute heart failure was required for 23.7% (n=38) of patients, a myocardial infarction or a stroke occurred respectively among 1.9% (n=3) and 5% (n=8) of patients. After multivariate analysis, size or generation of valves were not independent predictive factors of valve deterioration.
Evolution of mean aortic gradient
Conclusions
After a maximal 8-year follow-up, valve deterioration after balloon-expandable TAVI is very low. In this high-risk population, TAVI seems to be a safe and durable alternative to surgery in severe aortic stenosis regardless of prosthesis generation.
Acknowledgement/Funding
Edwards Lifesciences
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Affiliation(s)
- B Lattuca
- University Hospital of Nimes, Nimes, France
| | - A Meilhac
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - C Robert
- University Hospital of Nimes, Nimes, France
| | - D Vandenbergh
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - F Manna
- University Hospital of Montpellier, Montpellier, France
| | - N Nagot
- University Hospital of Montpellier, Montpellier, France
| | - M Chettouh
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - M Akodad
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - T Gandet
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - J C Macia
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - D Delseny
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - L Schmutz
- University Hospital of Nimes, Nimes, France
| | - B Albat
- University Hospital Arnaud de Villeneuve, Montpellier, France
| | - G Cayla
- University Hospital of Nimes, Nimes, France
| | - F Leclercq
- University Hospital Arnaud de Villeneuve, Montpellier, France
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16
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Lattuca B, Boccara F, Cohen A. Un risque thrombotique persistant malgré les traitements de référence. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/s1878-6480(19)30444-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Lattuca B, Cayla G, Silvain J, Cuisset T, Leclercq F, Manzo-Silberman S, Saint-Étienne C, Delarche N, El Mahmoud R, Carrie D, Souteyrand G, Diallo A, Collet J, Vicaut E, Montalescot G. Impact and predictive factors of bleeding complications in elderly patients admitted for an acute coronary syndrome: Insights from the ANTARCTIC trial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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18
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Lattuca B, Cayla G, Cuisset T, Silvain J, Bellemain-Appaix A, Beygui F, Sabouret P, Varenne O, Boueri Z, Motreff P, Bonnet J, Diallo A, Collet J, Vicaut E, Montalescot G. Platelet function testing predicts bleeding complications in elderly patients admitted for an acute coronary syndrome: insights from the ANTARCTIC trial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Zeitouni M, Collet JP, Hulot JS, Silvain J, Kerneis M, Lattuca B, Barthelemy O, Lavie-Badie Y, Esteve JB, Payot L, Brugier D, Galier S, Diallo A, Vicaut E, Montalescot G. P4207The natural history of premature coronary artery disease over 20 years: the AFIJI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Zeitouni
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J S Hulot
- Hospital Pitie-Salpetriere, Institut de cardiologie, Paris, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - B Lattuca
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - O Barthelemy
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - Y Lavie-Badie
- Toulouse Rangueil University Hospital (CHU), Cardiac Imaging Center, Toulouse, France
| | - J B Esteve
- Protestant Infirmary of Lyon, Cardiology, Caluire et Cuire, France
| | - L Payot
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - D Brugier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - S Galier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - A Diallo
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
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20
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Lattuca B, Cayla G, Cuisset T, Silvain J, Bellemain-Appaix A, Beygui F, Varenne O, Sabouret P, Boueri Z, Motreff P, Bonnet JL, Diallo A, Collet JP, Vicaut E, Montalescot G. 5916Platelet function testing predicts bleeding complications in elderly patients admitted for an acute coronary syndrome: insights from the ANTARCTIC trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Lattuca
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - G Cayla
- University Hospital of Nimes, Cardiology, Nimes, France
| | - T Cuisset
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | | | - F Beygui
- Hospital Cote de Nacre, Cardiology, Caen, France
| | - O Varenne
- Hospital Cochin, Cardiology, Paris, France
| | - P Sabouret
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - Z Boueri
- Hospital of Bastia, Cardiology, Bastia, France
| | - P Motreff
- University Hospital Gabriel Montpied, Cardiology, Clermont-Ferrand, France
| | - J L Bonnet
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - A Diallo
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
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21
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Lattuca B, Silvain J, Zeitouni M, Guerin M, Kerneis M, Guedeney P, Collet JP, Lesnik P, Montalescot G. P2708Impact of heterozygous familial hypercholesterolemia on mortality in ST-segment elevation myocardial infarction patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- B Lattuca
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - M Zeitouni
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - M Guerin
- ICAN - Institute of CardioMetabolism and Nutrition, Pitie Salpêtrière Hospital, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - P Guedeney
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - P Lesnik
- ICAN - Institute of CardioMetabolism and Nutrition, Pitie Salpêtrière Hospital, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
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22
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Lattuca B, Cayla G, Silvain J, Cuisset T, Leclercq F, Manzo-Silberman S, Saint-Etienne C, Delarche N, El Mahmoud R, Carrie D, Souteyrand G, Diallo A, Collet JP, Vicaut E, Montalescot G. P2245Impact and predictive factors of bleeding complications in elderly patients admitted for an acute coronary syndrome: insights from the ANTARCTIC trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Lattuca
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - G Cayla
- University Hospital of Nimes, Cardiology, Nimes, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - T Cuisset
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - F Leclercq
- Hospital Regional University of Montpellier, Montpellier, France
| | | | | | - N Delarche
- Hospital Center of Pau, Cardiology, Pau, France
| | - R El Mahmoud
- University Hospital Ambroise Pare, Cardiology, Boulogne-Billancourt, France
| | - D Carrie
- University Hospital of Toulouse, Cardiology, Toulouse, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Cardiology, Clermont-Ferrand, France
| | - A Diallo
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
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23
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Lattuca B, Yan Y, Kerneis M, Cuisset T, Silvain J, Range G, Elhadad S, Pouillot C, Leclercq F, Manzo-Silberman S, Bellemain-Appaix A, Vicaut E, Cayla G, Collet JP, Montalescot G. P1722Platelet function monitoring for the prediction of clinical outcomes: a pooled analysis of the randomized ARCTIC and ANTARCTIC trials. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Lattuca
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - Y Yan
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - T Cuisset
- Hospital La Timone of Marseille, Cardiology, Marseille, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - G Range
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
| | - S Elhadad
- Hospital of Lagny Marne la Vallée, Cardiology, Jossigny, France
| | - C Pouillot
- Clinic Sainte Clotilde, Cardiology, Saint Denis de la Réunion, France
| | - F Leclercq
- University Hospital Arnaud de Villeneuve, Cardiology, Montpellier, France
| | | | | | - E Vicaut
- Hospital Lariboisiere, Epidemiology and Clinical Research Unit, Paris, France
| | - G Cayla
- University Hospital of Nimes, Cardiology, Nimes, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Institute of Cardiology, Paris, France
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24
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Collet JP, Zeitouni M, Hulot JS, Silvain J, Barthelemy O, Kerneis M, Lattuca B, Lavie-Badie Y, Payot L, Esteve JB, Brugier D, Galier S, Diallo A, Vicaut E, Montalescot G. P6233Intima-Media thickness to better risk-stratify patients with premature coronary artery disease: an analysis from the AFUI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J P Collet
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - M Zeitouni
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J S Hulot
- Hospital Pitie-Salpetriere, Institut de cardiologie, Paris, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - O Barthelemy
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - B Lattuca
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - Y Lavie-Badie
- Toulouse Rangueil University Hospital (CHU), Cardiac Imaging Center, Toulouse, France
| | - L Payot
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - J B Esteve
- Protestant Infirmary of Lyon, Cardiology, Caluire et Cuire, France
| | - D Brugier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - S Galier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - A Diallo
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
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25
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Cayla G, Cuisset T, Lattuca B, Silvain J, Leclercq F, Manzo Silberman S, Pouillot C, Carrie D, Beygui F, Vicaut E, Range G, Henry P, Van Belle E, Collet JP, Montalescot G. 5914De-escalation versus escalation of antiplatelet therapy in elderly ACS patients: insight from the ANTARCTIC trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Cayla
- CHU Nimes, ACTION Study Group, Cardiology, Nimes, France
| | - T Cuisset
- AP-HM - Hospital La Timone, Marseille, France
| | - B Lattuca
- University Hospital of Nimes, Cardiology, Nimes, France
| | - J Silvain
- AP-HP Hospital Pitie-Salpetriere ACTION Study Group, Cardiology, Paris, France
| | - F Leclercq
- University Hospital Arnaud de Villeneuve, Cardiology, Montpellier, France
| | | | - C Pouillot
- Clinique Sainte Clotilde, Cardiology, Sainte Clotilde, France
| | - D Carrie
- University Hospital of Toulouse, Cardiology, Toulouse, France
| | - F Beygui
- University Hospital of Caen, Cardiology, Caen, France
| | - E Vicaut
- Hospital Lariboisiere, Recherche Clinique, Paris, France
| | - G Range
- Hospital Louis Pasteur of Chartres, Cardiology, Chartres, France
| | - P Henry
- Hospital Lariboisiere, Cardiology, Paris, France
| | - E Van Belle
- Hospital Regional University of Lille - Cardiological Hospital, Lille, France
| | - J P Collet
- AP-HP Hospital Pitie-Salpetriere ACTION Study Group, Cardiology, Paris, France
| | - G Montalescot
- AP-HP Hospital Pitie-Salpetriere ACTION Study Group, Cardiology, Paris, France
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Zeitouni M, Collet JP, Silvain J, Hulot JS, Kerneis M, Lavie-Badie Y, Barthelemy O, Payot L, Esteve JB, Lattuca B, Galier S, Brugier D, Diallo A, Vicaut E, Montalescot G. P5400Professional status and long-term prognosis of premature coronary artery disease: the AFIJI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Zeitouni
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J Silvain
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - J S Hulot
- Hospital Pitie-Salpetriere, Institut de cardiologie, Paris, France
| | - M Kerneis
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - Y Lavie-Badie
- Toulouse Rangueil University Hospital (CHU), Cardiac Imaging Center, Toulouse, France
| | - O Barthelemy
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - L Payot
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - J B Esteve
- Protestant Infirmary of Lyon, Cardiology, Caluire et Cuire, France
| | - B Lattuca
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - S Galier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - D Brugier
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
| | - A Diallo
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - E Vicaut
- Hospital Lariboisiere, Unité de Recherche Clinique, Paris, France
| | - G Montalescot
- Hospital Pitie-Salpetriere, Sorbonne Université Paris 6 (UPMC), ACTION Study Group, INSERM UMRS_1166, Institut de Cardiologie, Paris, France
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Vandenberghe D, Lattuca B, Roubille F, Cayla G, Pasquie J, Amedro P, Macia J, Nagot N, Nogue E, Bredy C, Sorbets E, Cade S, Cransac F, Verges M, Solecki K, Hedon C, Lavastre K, Leclercq F. Evaluation of a pre-consultation questionnaire on patient knowledge concerning oral anticoagulant therapy: The EDUCONSULT randomized trial. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Huet F, Vernhet-Kovacsik H, Dupuy A, Lattuca B, Leclercq F, Cristol J, Roubille F. A second peak highlighted by daily hs-T-Troponin and high CRP dosage conspire to microvascular occlusion on MRI after reperfused myocardial infarction. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lattuca B, Kerneis M, Lesnik P, Guerin M, Legoff W, Leroy T, Barthelemy O, Helft G, Lefeuvre C, Brugier D, Collet J, Montalescot G, Silvain J. A prospective cardiometabolism ApPRoach of mechanisms of coronary plaque rupture to apprehend patients at risk of recurrent events — The APPROACH registry. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Morra S, Bughin F, Solecki K, Aboubadra M, Lattuca B, Gouzi F, Macia JC, Cung TT, Cade S, Cransac F, Davy JM, Dauvilliers Y, Corrado D, Roubille F. Prevalence of obstructive sleep apnoea in acute coronary syndrome: Routine screening in intensive coronary care units. Ann Cardiol Angeiol (Paris) 2017. [PMID: 28647057 DOI: 10.1016/j.ancard.2017.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Increased evidence has shown that, despite the maximum care afforded to patients admitted with acute coronary syndromes (ACS), a residual risk of mortality remains, in which obstructive sleep apnoea (OSA) appears to be a largely undiagnosed factor, particularly in the intensive cardiac care unit (ICCU). The purpose of this study is to determine whether the systematic screening for sleep-disordered breathing (SDB) is feasible and may be recommended. The aims of our study are to determine: (1) The estimated prevalence of OSA in patients admitted to the ICCU for ACS determined by a validated, user-friendly portable screening device; (2) The feasibility of the screening in this context; (3) To assess any negative impact of OSA on the severity of ACS. PATIENTS AND METHODS This is an observational study of 101 patients admitted to the ICCU for ACS showing no clinical evidence of heart failure (HF). In the 24-72hours following admission, they underwent an overnight sleep study using a 3-channel portable screening device with automatic analysis. RESULTS Sixty-two out of the 101 patients proved positive to the screening test, and its feasibility was acceptable. OSA patients tended to have greater peak levels of hs-cTnT (3685±3576ng/L versus 2830±3333ng/L, P=0.08) than the non-OSA group. Compared with the non-OSA group, OSA patients presented more severe ACS, with a greater average GRACE score at admission of 112.2±26.3 (versus 98.4±19.2, P<0.001). In the OSA group, we found a statistically significant inverse correlation between the apnoea-hypopnea index (AHI) and the left ventricular ejection fraction (LVEF) in the linear regression analysis (r=-0.26; P=0.037). CONCLUSIONS A systematic screening of patients in the ICCU is acceptable. OSA is frequently found in the acute phase of ischaemic heart disease and its presence is associated with more severe ACS and a poorer left ventricle systolic function.
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Affiliation(s)
- S Morra
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France; Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Via Giustiniani 2, 35121 Padova, Italy.
| | - F Bughin
- Inserm U1046, CNRS UMR 9214, Physio, University of Montpellier, 34295 Montpellier cedex 5, France
| | - K Solecki
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - M Aboubadra
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - B Lattuca
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - F Gouzi
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - J-C Macia
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - T-T Cung
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - S Cade
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - F Cransac
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - J-M Davy
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - Y Dauvilliers
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France
| | - D Corrado
- Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Via Giustiniani 2, 35121 Padova, Italy
| | - F Roubille
- Cardiology Department, Arnaud-de-Villeneuve Hospital, Medical University of Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France; Inserm U1046, CNRS UMR 9214, PhyMedExp, University of Montpellier, 34295 Montpellier cedex 5, France.
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Akodad M, Hammer F, Aguilhon S, Cristol J, Leclercq F, Macia J, Gervasoni R, Lattuca B, Dupuy A, Roubille F. Systemic inflammation after transradial coronary angiogram: statistically (but not clinically) significant? Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lattuca B, Schmutz L, Ledermann B, Cornillet L, Messner-Pellenc P, Leclercq F, Cayla G. [What is the place of bioresorbable vascular scaffolds in setting of ST-segment elevation myocardial infarction?]. Ann Cardiol Angeiol (Paris) 2015; 64:499-504. [PMID: 26482633 DOI: 10.1016/j.ancard.2015.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 50-year-old woman was admitted for an inferior ST-segment elevation myocardial infarction; immediate coronary angiogram revealed a subocclusive stenosis of the right coronary artery. After optimal antithrombotic treatment, the type of stent could be discussed. The latest generation of drug-eluting stents showed excellent efficacy and safety in the long-term but has limitations such as potential chronic inflammation of the arterial wall and no recovery of vasoactive function. Bioresorbable vascular scaffolds, with complete resorption within several months, may reduce these limitations. Implantation of bioresorbable scaffold in the context of myocardial infarction may be interesting. However, very few studies are currently available in this setting. Preliminary results and perspectives are presented in this review.
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Affiliation(s)
- B Lattuca
- Département de cardiologie, CHU Arnaud-de-Villeneuve, 37, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex, France
| | - L Schmutz
- Unité de cardiologie interventionnelle, CHU Caremeau, place du Pr-Debré, 30029 Nîmes cedex, France
| | - B Ledermann
- Unité de cardiologie interventionnelle, CHU Caremeau, place du Pr-Debré, 30029 Nîmes cedex, France
| | - L Cornillet
- Unité de cardiologie interventionnelle, CHU Caremeau, place du Pr-Debré, 30029 Nîmes cedex, France
| | - P Messner-Pellenc
- Unité de cardiologie interventionnelle, CHU Caremeau, place du Pr-Debré, 30029 Nîmes cedex, France
| | - F Leclercq
- Département de cardiologie, CHU Arnaud-de-Villeneuve, 37, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex, France
| | - G Cayla
- Unité de cardiologie interventionnelle, CHU Caremeau, place du Pr-Debré, 30029 Nîmes cedex, France.
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