1
|
Siniawski D, Masson G, Masson W, Barbagelata L, Destaville J, Lynch S, Vitagliano L, Parodi JB, Berton F, Indavere A, Epstein T, Huerin M. Residual cardiovascular risk, use of standard care treatments, and achievement of treatment goals in patients with cardiovascular disease. Int J Cardiol Cardiovasc Risk Prev 2023; 18:200198. [PMID: 37521245 PMCID: PMC10374461 DOI: 10.1016/j.ijcrp.2023.200198] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/24/2023] [Accepted: 07/13/2023] [Indexed: 08/01/2023]
Abstract
Background Residual risk management in patients with previous cardiovascular disease (CVD) is a relevant issue. Objectives: 1) to assess the residual risk of patients with CVD using the new scores developed to predict recurrent CVD events (SMART score/SMART-REACH model); 2) to determine the use of therapies with cardiovascular benefit and the achievement of therapeutic goals in patients with very high residual risk. Methods A multicenter, descriptive, cross-sectional study was performed. Individuals over 18 years of age with CVD were included consecutively. The 10-year risk of recurrent events was estimated using the SMART score and the SMART-REACH model. A value ≥ 30% was considered "very high risk". Results In total, 296 patients (mean age 68.2 ± 9.4 years, 75.7% men) were included. Globally, 32.43% and 64.53% of the population was classified as very high risk by the SMART score and the SMART-REACH model, respectively. Among patients classified as very high risk by the SMART score, 45.7% and 33.3% were treated with high-intensity statins and reached the goal of LDL-C <55 mg/dL, respectively. The results were similar when evaluating very high patients according to the SMART-REACH model (high-intensity statins: 59.7%; LDL-C <55 mg/dL: 43.9%). Few very high-risk patients with diabetes were receiving glucose-lowering drugs with demonstrated cardiovascular benefit. Conclusion In this secondary prevention population, the residual risk was considerable. Underutilization of standard care treatments and failure to achieve therapeutic goals were evident even in subjects with very high residual risk.
Collapse
Affiliation(s)
- Daniel Siniawski
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Gerardo Masson
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
- Servicio de Cardiología, Instituto Cardiovascular San Isidro - Sanatorio Las Lomas, San Isidro, Buenos Aires, Argentina
| | - Walter Masson
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Leandro Barbagelata
- Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Josefina Destaville
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| | - Santiago Lynch
- Servicio de Cardiología, Instituto Cardiovascular San Isidro - Sanatorio Las Lomas, San Isidro, Buenos Aires, Argentina
| | - Laura Vitagliano
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
- Servicio de Cardiología, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina
| | - Josefina Belén Parodi
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| | - Felipe Berton
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| | - Agustin Indavere
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| | - Teo Epstein
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| | - Melina Huerin
- Consejo de Epidemiología y Prevención Cardiovascular, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
- Servicio de Cardiología, Instituto Cardiovascular Lezica, San Isidro, Buenos Aires, Argentina
| |
Collapse
|
2
|
Celeste-Carrero M, Constantin I, Masson G, Benger J, Cintora F, Makhoul S, Baratta S, Bagnati R, Asch FM. Looking for a definition of aortic dilatation in overweight and obese individuals: body surface area-indexed values versus height-indexed diameters. Arch Cardiol Mex 2023; 93:139-148. [PMID: 37037226 PMCID: PMC10161800 DOI: 10.24875/acm.22000017] [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] [Received: 01/19/2022] [Accepted: 06/20/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Patient's body size is a significant determinant of aortic dimensions. Overweight and obesity underestimate aortic dilatation when indexing diameters by body surface area (BSA). We compared the indexation of aortic dimensions by height and BSA in subjects with and without overweight to determine the upper normal limit (UNL). METHODS The MATEAR study was a prospective, observational, and multicenter study (53 echocardiography laboratories in Argentina). We included 879 healthy adult individuals (mean age: 39.7 ± 11.4 years, 399 men) without hypertension, bicuspid aortic valve, aortic aneurysm, or genetic aortopathies. Echocardiograms were acquired and proximal aorta measured at the sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) levels (EACVI/ASE guidelines). We compared absolute and indexed aortic diameters by height and BSA between groups (men with body mass index [BMI] < 25 and BMI ≥ 25, women with BMI < 25 and BMI ≥ 25). RESULTS Indexing of aortic diameters by BSA showed significantly lower values in overweight and obese subjects compared to normal weight in their respective gender (for women: SV 1.75 cm/m2 in BMI < 25 vs. 1.52 cm/m2 in BMI between 25 and 29.9 vs. 1.41 cm/m2 in BMI ≥ 30; at the STJ: 1.53 cm/m2 vs. 1.37 cm/m2 vs. 1.25 cm/m2; and at the AA: 1.63 cm/m2 vs. 1.50 cm/m2 vs. 1.37 cm/m2; all p < 0.0001 and for men, all p < 0.0001). These differences disappeared when indexing by height in both gender groups (all p = NS). CONCLUSION While indexing aortic diameters by BSA in obese and overweight subjects underestimate aortic dilation, the use of aortic height index (AHI) yields a similar UNL for individuals with normal weight, overweight, and obesity. Therefore, AHI could be used regardless of their weight.
Collapse
Affiliation(s)
- María Celeste-Carrero
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Iván Constantin
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Gerardo Masson
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Juan Benger
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Federico Cintora
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Silvia Makhoul
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Sergio Baratta
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Rodrigo Bagnati
- Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| | - Federico M. Asch
- Advisory, Research Group, Council of Echocardiography and Vascular Doppler Oscar Orías, Sociedad Argentina de Cardiología, Buenos Aires, Argentina
| |
Collapse
|
3
|
Lobo LM, Masson W, Masson G, Molinero G, Lavalle Cobo A, Huerin M, Delgado J, Benincasa F, Losada P. Statins and influenza mortality: systematic review and meta-analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2239] [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
Due to their anti-inflammatory properties, it has been suggested that the use of statins could influence the evolution of influenza virus infection.
Objective
To evaluate the effect of statin therapy on mortality from influenza.
Material and methods
A meta-analysis that included studies evaluating the use of statins in patients with influenza and reporting data on mortality, after searching the PubMed/MEDLINE, Embase, and Cochrane Controlled Trials databases, was performed. A random effects model was applied. The risk of bias was analyzed and a sensitivity analysis was performed.
Results
Eight studies (10 independent cohorts), which included a total of 2,390,730 patients, were identified and eligible for analysis. A total of 1,146,995 subjects analyzed received statins, while 1,243,735 subjects were part of the control group. Statin therapy was associated with lower mortality (OR: 0.66; 95% CI: 0.51–0.85). The sensitivity analysis showed that the results were robust.
Conclusions
Our data suggest that, in a population with influenza, the use of statins was associated with a significant reduction in mortality. These results must be confirmed in future clinical trials.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- L M Lobo
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - W Masson
- Italian Hospital , Caba , Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - A Lavalle Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology , Caba , Argentina
| | - J Delgado
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - F Benincasa
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| | - P Losada
- Campo de Mayo Military Hospital , Buenos Aires , Argentina
| |
Collapse
|
4
|
Masson G, Huart J, Viva T, Weekers L, Bonvoisin C, Bouquegneau A, Seidel L, Pottel H, Lancellotti P, Jouret F. Remodelage cardiaque après la fermeture de la fistule artérioveineuse chez le patient greffé rénal. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.278] [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: 10/14/2022]
|
5
|
Masson W, Lobo M, Lavalle-Cobo A, Masson G, Molinero G, Huerín M. Estatinas y mortalidad por influenza: revisión sistemática y meta-análisis. Rev Chilena Infectol 2022; 39:321-329. [DOI: 10.4067/s0716-10182022000200321] [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] [Received: 12/22/2020] [Accepted: 05/19/2022] [Indexed: 11/17/2022] Open
|
6
|
Masson W, Barbagelata L, Lavalle-Cobo A, Lobo M, Masson G, Nogueira JP, Vergès B. Low-doses aspirin in the primary prevention of cardiovascular disease in patients with diabetes: Meta-analysis stratified by baseline cardiovascular risk. Diabetes Metab Syndr 2022; 16:102391. [PMID: 35030453 DOI: 10.1016/j.dsx.2022.102391] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/30/2021] [Accepted: 01/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIM The aim of this meta-analysis was to analyze the risks and benefits of low-dose aspirin in patients with T2D without cardiovascular conditions according to the baseline cardiovascular risk. METHODS We performed a meta-analysis including randomized clinical trials that evaluated the use of low-dose aspirin (75-100 mg/day) versus placebo/usual care in patients with T2D. Studies were classified as low, moderate and high risk based on the number of events in the placebo/control arms or by cardiovascular risk score when reported. The incidence of MACE, cardiovascular mortality and bleeding were evaluated. RESULTS Ten eligible trials (34069 patients) were considered eligible for the analyses. According to the stratified analysis, low-dose aspirin use was associated with reduced risk for MACE in the moderate/high-risk group (OR: 0.88; 95% CI, 0.80-0.97; I2 = 0%) but not in the low-risk group (OR: 0.89; 95% CI, 0.77-1.01; I2 = 0%). Likewise, low-dose aspirin use was associated with more bleeding in the low-risk group, showing a non-significant trend in the moderate/high-risk group. There was no reduction in cardiovascular mortality in either group. Beyond the different findings in each stratum, the differences between the subgroups were not statistically significant. CONCLUSION This study showed that low-dose aspirin in patients with T2D reduces MACE and increases bleeding. Based on the within-subgroups results, the baseline cardiovascular risk does not modify the effect of aspirin therapy. However, few studies were included and the comparison between subgroups showed a trend in favor to the highest risk group, these results should be confirmed in future studies.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - Leandro Barbagelata
- Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Augusto Lavalle-Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Sanatorio Finochietto, Av. Córdoba, 2678, Buenos Aires, Argentina
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Hospital Militar Campo de Mayo, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Instituto Cardiovascular San Isidro-Sanatorio Las Lomas, Von Wernicke, 3031, San Isidro, Argentina
| | - Juan P Nogueira
- Centro de Investigación en Endocrinología, Nutrición y Metabolismo (CIENM), Facultad de Ciencias de la Salud, Universidad Nacional de Formosa, Argentina
| | - Bruno Vergès
- Service Endocrinologie, Diabétologie, et Maladies Métaboliques, Centre Hospitalier Universitaire (CHU), Institut National de la Santé et de la Recherche Médicale (INSERM) Lipides, Nutrition, Cancer (LNC)-Unité Mixte de Recherche (UMR) 1231, University of Burgundy, 21000, Dijon, France
| |
Collapse
|
7
|
Lavalle-Cobo A, Masson W, Lobo M, Masson G, Molinero G. Glucagon-like Peptide-1 Receptor Agonists and Cardioprotective Benefit in Patients with Type 2 Diabetes Without Baseline Metformin: A Systematic Review and Update Meta-analysis. High Blood Press Cardiovasc Prev 2021; 28:605-612. [PMID: 34705249 DOI: 10.1007/s40292-021-00479-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Sodium Glucose Co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1RAs) were associated with a reduction in cardiovascular disease events in cardiovascular outcomes trials (CVOTs) in type 2 diabetes. Most of the patients included in these trials received metformin as background therapy. AIM To evaluate the effect of glucagon-like peptide 1 receptor agonists on major cardiovascular events (MACE) and mortality in metformin-naïve patients with type 2 diabetes. METHODS A systematic review and meta-analysis of randomized controlled clinical trials of GLP-1RAs on type 2 diabetes population was performed, after searching the PubMed/MEDLINE, Embase, Scielo, Google Scholar and Cochrane Controlled Trials databases. The primary endpoint was MACE. The secondary endpoints were cardiovascular death and all-cause mortality. A meta-analysis of time-to-event outcomes was performed. This meta-analysis was registered in PROSPERO (CRD42021260040) RESULTS: Seven trials, including 11510 patients, were identified and considered eligible for the analyses. GLP-1RAs were associated with a significant reduction in MACE incidence (HR: 0.86, 95% confidence interval: 0.79-0.94; I2: 0%). The secondary endpoints analysis showed a non-significant reduction in all-cause mortality (HR: 0.86, 95% confidence interval: 0.73-1.00 I2: 0%) and cardiovascular mortality (HR: 0.81, 95% confidence interval: 0.63-1.05; I2: 0%). CONCLUSIONS In this meta-analysis, GLP-1RAs reduced the incidence of MACE in patients with type 2 diabetes without metformin at baseline, without significant reduction in all-cause mortality and cardiovascular mortality. These results support the fact that when a GLP-1RAs is administered, the benefit on cardiovascular outcomes is independent of the use of metformin.
Collapse
Affiliation(s)
- Augusto Lavalle-Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina. .,Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, Buenos Aires, Argentina. .,, 926 7B, Ayacucho, Argentina.
| | - Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina.,Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, Buenos Aires, Argentina.,Cardiology Department, Hospital Italiano de Buenos Aires. Tte. Gral, Juan Domingo Perón 4190, Buenos Aires, Argentina
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina.,Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, Buenos Aires, Argentina.,Cardiology Department, Hospital Italiano de Buenos Aires. Tte. Gral, Juan Domingo Perón 4190, Buenos Aires, Argentina.,Cardiology Department, Hospital Militar Campo de Mayo. Tte. Gral. Ricchieri S/N, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina.,Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, Buenos Aires, Argentina.,Cardiology Department, Hospital Italiano de Buenos Aires. Tte. Gral, Juan Domingo Perón 4190, Buenos Aires, Argentina.,Cardiology Department, Hospital Militar Campo de Mayo. Tte. Gral. Ricchieri S/N, Buenos Aires, Argentina.,Cardiology Department, Instituto Cardiovascular San Isidro-Sanatorio Las Lomas, Von Wernicke 3031, San Isidro, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina
| |
Collapse
|
8
|
Masson G, Jouret F. Impact de la fermeture de fistule artérioveineuse chez le greffé rénal sur la pression artérielle et les biomarqueurs cardiaques. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.132] [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: 10/20/2022]
|
9
|
Abstract
Introducción La utilidad de la aspirina en la prevención primaria es todavía objeto de controversia. Los avances médicos y la variabilidad del riesgo cardiovascular podrían explicar la heterogeneidad de los estudios publicados, y las poblaciones de alto riesgo tendrían mayor beneficio. Objetivo Analizar los efectos de la aspirina en pacientes sin antecedentes cardiovasculares y evaluar los resultados de acuerdo con el riesgo cardiovascular de las poblaciones. Métodos Se incluyeron estudios que evaluaron el uso de la aspirina en comparación con placebo en la prevención primaria. Se analizó la combinación de muerte cardiovascular, infarto agudo de miocardio (IAM) y accidente cerebrovascular (ACV) isquémico. El punto final de seguridad fue la combinación de ACV hemorrágico y sangrado mayor. Se clasificaron los estudios en riesgo bajo y moderado/ alto, de acuerdo con el número de episodios en la rama de placebo. Resultados Se evaluaron 13 estudios (n = 164,225), ocho de riesgo cardiovascular bajo (n = 118,455) y cinco de moderado/alto (n = 45,770). Se observó una reducción del punto final combinado en el grupo de aspirina (OR 0.90; IC 95%, 0.85-0.94), sin diferencias en mortalidad cardiovascular (OR 0.94; IC 95%, 0.86-1.04). No se identificaron diferencias entre los subgrupos de riesgo. Se reconocieron mayores complicaciones hemorrágicas en el grupo de aspirina (OR 1.45; IC 95%, 1.32-1.60), sin diferencias entre los subgrupos de riesgo. Conclusión La aspirina se relacionó con una leve disminución de IAM y ACV isquémico en términos absolutos, sin diferencias en la mortalidad cardiovascular. Esto, junto con el aumento de las complicaciones hemorrágicas, se traduce en una ausencia de beneficio clínico neto. El riesgo cardiovascular basal de la población no modificó los resultados. Background The usefulness of aspirin in primary prevention continues to be the subject of debate. Medical advances and the variability of cardiovascular risk could explain the heterogeneity of the published studies. High risk populations would have greater benefit. Objective Analyzing the effects of aspirin in patients without cardiovascular disease and evaluating the results according to the cardiovascular risk of the populations. Methods Studies evaluating aspirin versus placebo in primary prevention were included. The primary endpoint was the combined cardiovascular death, acute myocardial infarction (AMI) and ischemic stroke. The final safety point was the combination of hemorrhagic stroke and major bleeding. The studies were classified into low and moderate/high risk, according to the number of events in the placebo arm. Results Thirteen studies were evaluated (n = 164,225), eight of low cardiovascular risk (n = 118,455) and five of moderate/high risk (n = 45,770). There was a reduction of the combined endpoint in the aspirin group (odds ratio [OR] 0.90; 95% confidence interval [CI], 0.85-0.94), without differences in cardiovascular mortality (OR 0.94; 95% CI, 0.86-1.04). No differences were observed when comparing the risk subgroups. Greater hemorrhagic complications were observed in the aspirin group (OR 1.45; 95% CI, 1.32-1.60), without differences between the risk subgroups. Conclusion Aspirin was associated with a slight decrease in AMI and ischemic stroke in absolute terms, with no differences in cardiovascular mortality. This accompanied by the increase in hemorrhagic complications, results in an absence of net clinical benefit. The baseline cardiovascular risk of the population did not affect the results.
Collapse
Affiliation(s)
- Gerardo Masson
- Servicio de Cardiología, Instituto Cardiovascular San Isidro. Buenos Aires, Argentina.,Consejo de Prevención y Epidemiología, Sociedad Argentina de Cardiología. Buenos Aires, Argentina
| | - Martín Lobo
- Consejo de Prevención y Epidemiología, Sociedad Argentina de Cardiología. Buenos Aires, Argentina
| | - Walter Masson
- Consejo de Prevención y Epidemiología, Sociedad Argentina de Cardiología. Buenos Aires, Argentina
| | - Graciela Molinero
- Consejo de Prevención y Epidemiología, Sociedad Argentina de Cardiología. Buenos Aires, Argentina
| |
Collapse
|
10
|
Masson W, Lobo M, Masson G, Molinero G, Casciato P. Statin use in patients with elevated serum hepatic transaminases at baseline: A meta-analysis. Nutr Metab Cardiovasc Dis 2021; 31:1357-1364. [PMID: 33715945 DOI: 10.1016/j.numecd.2021.01.026] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/01/2020] [Accepted: 01/28/2021] [Indexed: 12/19/2022]
Abstract
AIMS Clinical trials showed that statin therapy decreased cardiovascular events without significantly raising the level of transaminases. However, the information in subjects with altered liver test at baseline is more limited. The objectives of this meta-analysis were to analyze the liver safety and cardiovascular benefit when using a statin-based lipid-lowering treatment compared to a less intensive treatment or placebo, in subjects with abnormal liver tests at baseline. DATA SYNTHESIS We performed a meta-analysis including randomized trials of statin-based lipid-lowering therapy versus less intensive lipid-lowering therapy or placebo, reporting worsening hepatic test (>3 ULN) and cardiovascular events in patients with abnormal liver tests at baseline. The random-effects model was performed. This meta-analysis was performed according to PRISMA guidelines. Five eligible trials, including 2548 patients were identified and considered eligible for the analyses. A more intensive statin-based lipid-lowering therapy were associated with a similar occurrence of serious alteration of liver tests (OR: 0.90, 95% confidence interval: 0.21-3.99; I2: 64%) compared to less intensive or placebo treatments. Likewise, more intensive lipid-lowering strategies were associated with a significant reduction in major cardiovascular events (OR: 0.34, 95% confidence interval: 0.17-0.70; I2: 66%). CONCLUSIONS In this study, a more intensive statin-based lipid-lowering treatment, compared with less intensive treatment or placebo, showed a similar incidence of worsening transaminases levels in patients with abnormal liver tests at baseline. Also, a reduction in cardiovascular events was observed when a more intensive lipid-lowering therapy was used.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, Buenos Aires, Argentina.
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Hospital Militar Campo de Mayo, Tte. Gral. Ricchieri S/N, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina; Cardiology Department, Instituto Cardiovascular San Isidro - Sanatorio Las Lomas, Von Wernicke 3031, San Isidro, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires, Argentina
| | - Paola Casciato
- Hepatology Unit, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, Buenos Aires, Argentina
| |
Collapse
|
11
|
Masson W, Lobo M, Siniawski D, Masson G, Lavalle-Cobo A, Molinero G. LDL-C Levels Below 55 mg/dl and Risk of Hemorrhagic Stroke: A Meta-Analysis. J Stroke Cerebrovasc Dis 2021; 30:105655. [PMID: 33571878 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105655] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Received: 12/08/2020] [Revised: 01/17/2021] [Accepted: 01/30/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the effect of very low levels of LDL-C (< 55 mg/dl) achieved with lipid-lowering therapy on hemorrhagic stroke incidence. METHODS We performed a meta-analysis including randomized trials that achieved LDL-C levels under 55 mg/dl in more intensive lipid-lowering arms, regardless of the lipid-lowering drug used. A fixed-effects model was used. This meta-analysis was performed according to PRISMA guidelines. RESULTS Eight eligible trials including 122.802 patients, were identified and considered eligible for the analyses. A total of 62.526 subjects were allocated to receive more intensive lipid-lowering therapy while 60.276 subjects were allocated to the respective control arms. There were no differences in the incidence of hemorrhagic stroke between the group that received a more intensive lipid-lowering therapy (achieved LDL-C level <55 mg/dl), and the group that received a less intense scheme (OR, 1.05; 95%CI, 0.85-1.31). The statistical heterogeneity was low (I2 = 2%). The sensitivity analysis showed that the results were robust. CONCLUSIONS The use of more intensive lipid-lowering therapy that achieved an LDL-C level lower than 55 mg/dl in patients with high cardiovascular risk, is not associated with an increased risk of hemorrhagic stroke. Considering the cardiovascular benefit and safety observed with the achievement of very low LDL-C values, the challenging lipid goals recommended by the new guidelines seem consistent.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department. Hospital Italiano de Buenos Aires. Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina.
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department. Hospital Militar Campo de Mayo. Tte. Gral. Ricchieri S/N (B1659AMA), Buenos Aires, Argentina
| | - Daniel Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department. Hospital Italiano de Buenos Aires. Tte. Gral. Juan Domingo Perón 4190 (C1199ABB), Buenos Aires, Argentina.
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department. Sanatorio Las Lomas. Diego Carman 555 (B1642AKG), San Isidro, Buenos Aires, Argentina
| | - Augusto Lavalle-Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department. Sanatorio Finochietto. Av. Córdoba 2678 (C1187AAN), Buenos Aires, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina
| |
Collapse
|
12
|
Lobo L, Molinero G, Masson W, Siniawski D, Masson G, Huerin M, Nogueira J, Benincasa F, Losada P, Suarez F. Non-statin lipid-lowering therapy in coronary atherosclerosis regression: a meta-analysis and meta-regression. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2981] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Several studies have investigated the association between non-statin lipid-lowering therapy and regression of atherosclerosis. However, the studies were mostly small and their results were not always robust.
Objectives
(1) to define if a dual lipid-lowering therapy (statin ± non-statin drugs) is associated with coronary atherosclerosis regression, estimated by intravascular ultrasound (IVUS); (2) to assess the association between dual lipid-lowering-induced changes in LDL-C and non-HDL-C levels and atherosclerosis regression.
Methods
We performed a meta-analysis including trials of non-statin lipid-lowering therapy, reporting C-LDL, non-HDL-C and total atheroma volume (TAV) with a minimum of 6 months of follow-up. The primary endpoint was defined as the change in TAV measured from baseline to follow-up, comparing groups of subjects on statins alone versus combination of statin and non-statin drugs. The random-effects model and meta-regression were performed.
Results
Eight eligible trials of non-statin lipid-lowering drugs (1759 patients) were included. Overall, the dual lipid-lowering therapy was associated with a significant reduction in TAV [−3.5 mm3 (95% CI: −4.5 to −2.6)]; I2=11%]. In the analysis stratified according to the lipid-lowering drug class (ezetimibe or PCSK9 inhibitors), the findings were similar. In a meta-regression, a 10% decrease in LDL-C or non-HDL-C levels, was associated, respectively, with 0.92 mm3 and 1.05 mm3 regressions in TAV.
Conclusion
Our data suggest the addition of ezetimibe or PCSK9 inhibitors to statin therapy results in significantly increased regression of TAV. When the LDL-C and non-HDL-C levels reached were lower, the observed effect was also greater.
Forest Plot by Drugs Group
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- L.M Lobo
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - W Masson
- Italian Hospital, Caba, Argentina
| | - D Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | | | - F Benincasa
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - P Losada
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - F Suarez
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| |
Collapse
|
13
|
Carrero M, Constantin I, Masson G, Mezzadra M, Ruano M, Diaz Babio G, Pessio C, De Stefano L, Lopez Rosetti M, San Miguel J, Espinosa E, Stutzbach P. Bicuspid aortic valve: prompt identification of high-risk groups in a heterogeneous disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1981] [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: 11/14/2022] Open
Abstract
Abstract
Background
Bicuspid aortic valve (BAV) is a congenital heart disease that can be associated with aortic and/or valve complications. Although most BAV are predisposed to progressive calcification, little is known on variables related to significant valvular dysfunction. BAV is a heterogeneous disease, therefore it is important to identify high-risk groups for a closer follow- up and timely intervention.
Objective
Identify the main determinants of primary cardiovascular events (aortic valve replacement, aortic surgery and death) in a cohort of adults with BAV.
Methods
We included 325 consecutive patients with non-syndromatic BAV (2010–2019) referred to our hospital (3rd level). Clinical information was prospectively collected. All patients underwent serial echocardiograms and Cardiac CT was available in 125 patients (38%). We performed univariate and multivariate analyses and Kaplan-Meyer survival analysis with log-rank test. A p-value <0.05 was considered significant.
Results
325 patients (44.4±15.3 years, 73% men), right–left coronary cusp fusion (RL) in 79%,and presence of raphe in 77%. 100 patients (31.2%) had significant aortic valve dysfunction and 103 (31.7%) had aortic dialatation (>40mm) at the onset of the follow-up. Twenty-nine patients required cardiac surgery (8.9%, mainly symptomatic severe aortic stenosis with aortic valve replacement)and 3 died (1%) during a follow-up of 6.3±1.2 years. Patients with at least 2 of the following determinants at baseline: aortic valve prolapse, aortic valve calcification >1, age >50 years and/or aorta >45mm had higher risk of major cardiovascular events during follow-up (Chi2 for log rank test=27,229 p=0,000005).
Conclusions
In this study population of young adults with BAV we observed a high incidence of events related to the BAV. Age>50 years, aortic valve calcification, aortic valve prolapse and aortic dilatation were independently associated with primary cardiac events. Despite significant BAV heterogeneity, the identification of risk factors may help to stratify the risk of valvular dysfunction, aortic dilatation and major cardiovascular events.
BAV: Risk factors for cardiac surgery
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- M.C Carrero
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - I Constantin
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - G Masson
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - M Mezzadra
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - M Ruano
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - G Diaz Babio
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - C Pessio
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - L De Stefano
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - M Lopez Rosetti
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - J San Miguel
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - E Espinosa
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - P Stutzbach
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| |
Collapse
|
14
|
Lobo L, Masson G, Molinero G, Masson G, Lavalle Cobo A, Losada P, Benincasa F, Suarez F, Huerin M. Role of colchicine in stroke prevention: an updated meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2822] [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
Colchicine is a microtubule inhibitor with anti-inflammatory proprieties. As the body and quality of evidence regarding the efficacy of colchicine for cardiovascular prevention is controversial, the aims of this study was to evaluate the effect of colchicine therapy on vascular events.
Methods
A meta-analysis was performed of randomized controlled clinical trials of colchicine on high cardiovascular risk populations, reporting data from stroke, myocardial infarction, cardiovascular mortality and all-cause mortality, after searching the PubMed/MEDLINE, Embase and Cochrane Controlled Trials databases. A random-effects meta-analysis model was then applied.
Results
Nine eligible trials of colchicine therapy, involving a total of 6630 patients, were considered eligible for analysis (3359 subjects were allocated to receive colchicine while 3271 subjects were allocated to the respective control arms). The stroke incidence was lower in the colchicine group compared with placebo arm (OR, 0.33; 95% CI, 0.15–0.70; six studies evaluated). We did not find a significant reduction in the incidence of myocardial infarction, cardiovascular mortality or all-cause mortality.
Conclusion
Our data suggest that in a population with high cardiovascular risk, the use of colchicine results in significantly reduction on stroke risk. Colchicine is an accessible drug that could be successfully utilized for the prevention of atherosclerotic cerebrovascular disease. The tolerability and benefits should be confirmed in ongoing clinical trials.
Forest Plot Primary endpoint
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- L.M Lobo
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - G Masson
- Italian Hospital, Caba, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - A Lavalle Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| | - P Losada
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - F Benincasa
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - F Suarez
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - M Huerin
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Caba, Argentina
| |
Collapse
|
15
|
Masson W, Lobo M, Lavalle-Cobo A, Masson G, Molinero G. Effect of bempedoic acid on new onset or worsening diabetes: A meta-analysis. Diabetes Res Clin Pract 2020; 168:108369. [PMID: 32827596 DOI: 10.1016/j.diabres.2020.108369] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/22/2020] [Accepted: 08/10/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Bempedoic acid is a new agent that reduces low-density lipoprotein cholesterol. Since inhibits cholesterol synthesis through a different mechanism than statins, the adverse effects related to it may also be different. Therefore, the objective of the present meta-analysis was to evaluate the effect of bempedoic acid on new onset or worsening diabetes. METHODS We performed a meta-analysis including randomized trials of bempedoic acid therapy, reporting new onset or worsening diabetes with a minimum of 4 weeks of follow-up. The fixed-effects model was performed. This meta-analysis was performed according to PRISMA guidelines. RESULTS Five eligible trials of bempedoic acid, including 3629 patients, were identified and considered eligible for the analyses. A total of 2419 subjects were allocated to receive bempedoic acid while 1210 subjects were allocated to the respective control arms. Bempedoic acid therapy is associated with a significant reduction in new onset or worsening diabetes [Odds Ratio: 0.66, 95% confidence interval: 0.48-0.90; I2: 0%]. CONCLUSION This data suggests that the use of bempedoic acid significantly reduces the new onset or worsening diabetes risk. This finding should be confirmed with future studies.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB Buenos Aires, Argentina.
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department, Hospital Militar Campo de Mayo, Tte. Gral. Ricchieri S/N, B1659AMA Buenos Aires, Argentina
| | - Augusto Lavalle-Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, C1187AAN Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina; Cardiology Department, Instituto Cardiovascular San Isidro - Sanatorio Las Lomas, Von Wernicke 3031, B1642AKG San Isidro, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD Buenos Aires, Argentina
| |
Collapse
|
16
|
Masson W, Lavalle-Cobo A, Lobo M, Masson G, Molinero G. Novel antidiabetic drugs and risk of cardiovascular events in patients without baseline metformin use: a meta-analysis. Eur J Prev Cardiol 2020; 28:69-75. [PMID: 33606884 DOI: 10.1093/eurjpc/zwaa074] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Abstract
AIMS To evaluate the effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RAs) on major cardiovascular events (MACE) in metformin-naïve patients with type 2 diabetes (T2D). METHODS AND RESULTS A meta-analysis was performed of randomized controlled clinical trials of GLP-1RAs and SGLT-2 inhibitors on T2D populations, after searching the PubMed/MEDLINE, Embase, and Cochrane Controlled Trials databases. The primary endpoint was MACE. The secondary endpoint, explored in the subgroup of SGLT-2 inhibitors studies, was cardiovascular death or hospitalization for heart failure. A random-effects meta-analysis model was applied. Six eligible trials (three studies of SGLT-2 inhibitors and three trials of GLP-1RAs), including 13 049 patients, were identified and considered eligible for the analyses. The new antidiabetic drugs were associated with a significant reduction in MACE [odds ratio (OR): 0.80, 95% confidence interval: 0.70-0.93; I2: 53%]. The subgroup analysis showed the following findings: GLP-1RAs group, OR: 0.77 (95% confidence interval 0.67-0.88); SGLT-2 inhibitors, OR: 0.85 (95% confidence interval 0.63-1.15). SGLT-2 inhibitors were associated with a significant reduction in hospitalization for heart failure or cardiovascular mortality incidence (OR: 0.67, 95% confidence interval: 0.47-0.95; I2: 78%). CONCLUSION In this meta-analysis, new antidiabetic drugs reduced the incidence of MACE in metformin-naïve T2D patients. The beneficial effect was especially observed in the GLP-1RAs subgroup. The use of SGLT-2 inhibitors was associated with a reduction in cardiovascular death or hospitalization for heart failure. These results support the fact that metformin would not be indispensable to obtain positive cardiovascular effects when new antidiabetic drugs are administered.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires C1115AAD, Argentina.,Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB Buenos Aires, Argentina
| | - Augusto Lavalle-Cobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires C1115AAD, Argentina.,Cardiology Department, Sanatorio Finochietto, Av. Córdoba 2678, Buenos Aires C1187AAN, Argentina
| | - Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires C1115AAD, Argentina.,Cardiology Department, Hospital Militar Campo de Mayo, Tte. Gral. Ricchieri S/N, Buenos Aires B1661GXB, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires C1115AAD, Argentina.,Cardiology Department, Instituto Cardiovascular San Isidro-Sanatorio Las Lomas, Von Wernicke 3031, San Isidro B1642GKA, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, Buenos Aires C1115AAD, Argentina
| |
Collapse
|
17
|
Masson W, Lobo M, Siniawski D, Molinero G, Masson G, Huerín M, Nogueira JP. Role of non-statin lipid-lowering therapy in coronary atherosclerosis regression: a meta-analysis and meta-regression. Lipids Health Dis 2020; 19:111. [PMID: 32460779 PMCID: PMC7254726 DOI: 10.1186/s12944-020-01297-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Several studies have investigated the association between non-statin lipid-lowering therapy and regression of atherosclerosis. However, these studies were mostly small and their results were not always robust. The objectives were: (1) to define if a dual lipid-lowering therapy (statin + non-statin drugs) is associated with coronary atherosclerosis regression, estimated by intravascular ultrasound (IVUS); (2) to assess the association between dual lipid-lowering-induced changes in low density lipoprotein cholesterol (LDL-C) and non-high-density-lipoprotein cholesterol (non-HDL-C) levels and atherosclerosis regression. METHODS A meta-analysis including trials of non-statin lipid-lowering therapy, reporting LDL-C, non-HDL-C and total atheroma volume (TAV) with a minimum of 6 months of follow-up was performed. The primary endpoint was defined as the change in TAV measured from baseline to follow-up, comparing groups of subjects on statins alone versus combination of statin and non-statin drugs. The random-effects model and meta-regression were performed. RESULTS Eight eligible trials of non-statin lipid-lowering drugs (1759 patients) were included. Overall, the dual lipid-lowering therapy was associated with a significant reduction in TAV [- 4.0 mm3 (CI 95% -5.4 to - 2.6)]; I2 = 0%]. The findings were similar in the stratified analysis according to the lipid-lowering drug class (ezetimibe or PCSK9 inhibitors). In the meta-regression, a 10% decrease in LDL-C or non-HDL-C levels, was associated, respectively, with 1.0 mm3 and 1.1 mm3 regressions in TAV. CONCLUSION These data suggests the addition of ezetimibe or PCSK9 inhibitors to statin therapy results in a significant regression of TAV. Reduction of coronary atherosclerosis observed with non-statin lipid-lowering therapy is associated to the degree of LDL-C and non-HDL-C lowering. Therefore, it seems reasonable to achieve lipid goals according to cardiovascular risk and regardless of the lipid-lowering strategy used (statin monotherapy or dual treatment).
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina.,Argentine Society of Lipids, Ambrosio Olmos 820, X5000JGQ, Córdoba, Argentina
| | - Martin Lobo
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Daniel Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina.,Argentine Society of Lipids, Ambrosio Olmos 820, X5000JGQ, Córdoba, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Melina Huerín
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Juan Patricio Nogueira
- Argentine Society of Lipids, Ambrosio Olmos 820, X5000JGQ, Córdoba, Argentina. .,, Av. Dr. Luis Gutniski 3200, 3600, Formosa, Argentina.
| |
Collapse
|
18
|
Carrero MC, De Stefano L, Constantin I, Masson G, Mezzadra M, Diaz Babio G, Ruano M, Veron F, Vera Janavel G, Stutzbach P. P811 More than aortic measurements: evaluation with TTE and angioCT in bicuspid aortic valve yields useful information about valvular compromise. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.464] [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: 11/14/2022] Open
Abstract
Abstract
Background
2D transthoracic echocardiogram (TTE) is the technique of choice in the diagnosis of bicuspid aortic valve (BAV). Computed tomography (CT) is widely used in BAV to measure aortic diameters. However, in some cases CT or magnetic resonance (MRI) can add important information to TTE regarding valvular degeneration and morphotype.
We designed the present prospective study to determine the agreement between TTE and gated CT in the assessment of aortic valve morphology, fibrosis, calcification and measurements of thoracic aorta. We also aimed to analyze the utility of CT in the evaluation of BAV patients, in addition to aortic measurements.
Methods
We included 30 consecutive patients with BAV (mean age 45 ± 15.7 years ; 73.3% men) who underwent both TTE and ECG-gated cardiac and aortic CT for valvular and aortic assessment in a follow-up protocol with a time interval between TTE and CT of 4 ± 2.6 months.
We performed measurements of thoracic aorta at 6 levels (annulus, Valsalva sinus: VS, sinotubular junction, ascendent, arch and isthmus) with both techniques following guideline recommendations blinded to the results of the other technique.
Several measurements of VS were performed in short-axis view (double-oblique method) (maximal diameter perpendicular to the valve opening, sinus to sinus, raphe to sinus, commissure to commissure) at systole and diastole with CT.
Valve phenotype, presence of raphe, calcification scoring, aortic valve prolapse and fibrosis were also determined with both techniques and maximum aortic diameters were compared. An indexed aortic diameter > 21 mm/m2 was considered as aortic dilation and assimetryc root was defined when differences between CT measurements were ≥5mm.
Results
In 7 patients (23.3%) aortic diameter differences at Sinus by TTE and CT were ≥3mm. Concerning ascending aorta measurements, there was better agreement and only 2 cases (6.6%) showed differences ≥ 3mm.
In 2 patients with severe calcification valve morphology was identified only with CT. There was good agreement between TTE and CT in calcium quantification in patients with valvular calcium score over 2000 AU (n = 5) and in those without calcification. However, TTE failed in identification of valvular fibrosis in 5 patients.
10 patients (30%) had aortic dilatation with CT and 7 according to TTE measurements. The 3 patients that were not identified as dilated in TTE had dilatation at the distal tubular portion.
CT led to identification of coronary anomalies in 5 patients (16.7%), most of them anomalous high origin above the sinotubular junction.
Conclusions
Although TTE is the gold-standard in the diagnosis and follow-up of patients with BAV, CT was useful to confirm aortic measurements and to identify valvular fibrosis, assimetry, coronary anomalies and dilatation at the tubular portion. CT can add important information to TTE regarding valvular morphotype and aortic measurements, although radiation and cost should be evaluated.
Abstract P811 Figure. Calcification agreement TTE and CT
Collapse
Affiliation(s)
- M C Carrero
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - L De Stefano
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - I Constantin
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - G Masson
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - M Mezzadra
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - G Diaz Babio
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - M Ruano
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - F Veron
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - G Vera Janavel
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| | - P Stutzbach
- Cardiovascular Institute of San Isidro (ICSI), Buenos Aires, Argentina
| |
Collapse
|
19
|
Lobo LM, Masson G, Molinero G, Masson W, Giorgi MA, Siniawski D. P667Aspirin in primary prevention. Risks and benefits. Up date 2019. A meta-analysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0273] [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
The usefulness of aspirin in patients without a cardiovascular history continues to be a subject of controversy.
Objectives
1. Perform an updated meta-analysis on the use of aspirin in primary cardiovascular prevention. 2. Analyze the results by risk.
Methods
This meta-analysis was performed according to the PRISMA guidelines. The primary endpoint was cardiovascular death, AMI, and ischemic stroke. The measures of effect size are expressed as odds ratios. The level of statistical significance was established at 0.05.
Characteristics of the studies Trials Year N Follow-up Risk RTPDABMD 1988 5,139 5.5 Middle PHS 1989 22,071 5 Low HOT 1998 18,790 3.8 Middle TPT 1998 5,085 6.7 Middle PPP 2001 44,95 3.6 Low WHS 2005 39,876 10.1 Low JPAD 2008 2,539 4.4 Low POPADAD 2008 1276 6.7 High AAA 2010 3,350 8.2 Low JPPP 2014 14,464 5 Low ASCEND 2018 15,480 7.4 Middle ARRIVE 2018 12,546 5 Low ASPREE 2018 19,114 4.7 Low RTPDABMD, Randomised trial of prophylactic daily aspirin in British male doctors; PHS, Physicians' Health Study; HOT, Hypertension Optimal Treatment; TPT, Thrombosis Prevention Trial; PPP, Primary Prevention Project; WHS, Women's Health Study; JPAD, Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes; POPADAD, Prevention of Progression of Arterial Disease and Diabetes; AAA, Aspirin for Asymptomatic Atherosclerosis; JPPP, Japanese Primary Prevention Project; ASCEND, A Study of Cardiovascular Events in Diabetes; ARRIVE, Aspirin to Reduce Risk of Initial Vascular Events; ASPREE, Aspirin in Reducing Events in the Elderly.
Figure 1
Results
Thirteen works were considered for the analysis (Table 1). A total of 164,225 patients were included, 82,900 in the aspirin arm and 81,325 in the control group. A reduction of the primary endpoint was observed in the AAS group (OR 0.90, 95% CI 0.85–0.94). No differences by risk group (Figure 1). Risk of severe bleeding was significantly higher in patients treated with ASA (OR 1.45, 95% CI 1.34–1.56), this difference was maintained by risk (Figure 1).
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- L M Lobo
- Campo de Mayo Military Hospital, Buenos Aires, Argentina
| | - G Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - G Molinero
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - W Masson
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - M A Giorgi
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| | - D Siniawski
- Council of Epidemiology and Cardiovascular Prevention, Argentine Society of Cardiology, CABA, Argentina
| |
Collapse
|
20
|
Vranken L, Masson G, Pottel H, Cavalier E, Delanaye P. Impact of the creatinine-based EQ. on the chronic kidney disease classification in a large laboratory database. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1025] [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]
|
21
|
Masson L, Masson G, Beisel JN, Gutowsky LFG, Fox MG. Consistent life history shifts along invasion routes? An examination of round goby populations invading on two continents. DIVERS DISTRIB 2018. [DOI: 10.1111/ddi.12726] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- L. Masson
- Environmental and Life Sciences Graduate Program; Trent University; Peterborough ON Canada
| | - G. Masson
- Laboratoire Interdisciplinaire des Environnements Continentaux (LIEC); UMR 7360 CNRS Université de Lorraine; UFR Sci. F.A.; Metz France
| | - J. N. Beisel
- Ecole Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES); Strasbourg France
- CNRS, ENGEES, LIVE UMR 7362; Université de Strasbourg; Strasbourg France
| | - L. F. G. Gutowsky
- Ontario Ministry of Natural Resources and Forestry; Peterborough ON Canada
| | - M. G. Fox
- School of the Environment and Department of Biology; Trent University; Peterborough ON Canada
| |
Collapse
|
22
|
Leblanc D, Conté M, Masson G, Richard F, Jeanneteau A, Bouhours G, Chrétien J, Rony L, Rineau E, Lasocki S. SmartPilot® view-guided anaesthesia improves postoperative outcomes in hip fracture surgery: a randomized blinded controlled study. Br J Anaesth 2017; 119:1022-1029. [DOI: 10.1093/bja/aex317] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
23
|
Abstract
We report an analysis of gait during human treadmill walking when visual information from the self-displacement velocity was modulated. Removing or sinusoidally modulating the frequency edge information in the optical flow did not induce significant changes in the walking velocity as analyzed using Fast Fourier Transform or in the spatiotemporal gait parameters. While low-frequency fluctuations in displacement speed increased, there was no significant change in locomotor cycle stability. When a constant frequency edge was provided, i.e., when a backward optical flow was added, stride length decreased as compared to the no-optical-flow condition and instantaneous fluctuations in stride amplitude increased. Temporal gait parameters did not change. These partial effects might be better explained by modifications in trunk balance. In humans, modulation of velocity information on self-motion cannot induce unintentional modulation of walking velocity and did not enhance fluctuations in the locomotor pattern. These results argue against the proprioceptive role of sagittal visual-motion information in control of stability of rhythmic leg movement, at least when other proprioceptive feedback sources are available.
Collapse
Affiliation(s)
- G Masson
- Université d'Aix-Marseille II, France
| | | |
Collapse
|
24
|
Masson W, Epstein T, Huerín M, Lobo LM, Molinero G, Angel A, Masson G, Millán D, De Francesca S, Vitagliano L, Cafferata A, Losada P. Cardiovascular Risk Stratification in Patients with Metabolic Syndrome Without Diabetes or Cardiovascular Disease: Usefulness of Metabolic Syndrome Severity Score. High Blood Press Cardiovasc Prev 2017; 24:297-303. [PMID: 28502055 DOI: 10.1007/s40292-017-0209-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 04/18/2017] [Accepted: 05/05/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION The estimated cardiovascular risk determined by the different risk scores, could be heterogeneous in patients with metabolic syndrome without diabetes or vascular disease. This risk stratification could be improved by detecting subclinical carotid atheromatosis. AIMS To estimate the cardiovascular risk measured by different scores in patients with metabolic syndrome and analyze its association with the presence of carotid plaque. METHODS Non-diabetic patients with metabolic syndrome (Adult Treatment Panel III definition) without cardiovascular disease were enrolled. The Framingham score, the Reynolds score, the new score proposed by the 2013 ACC/AHA Guidelines and the Metabolic Syndrome Severity Calculator were calculated. Prevalence of carotid plaque was determined by ultrasound examination. A Receiver Operating Characteristic analysis was performed. RESULTS A total of 238 patients were enrolled. Most patients were stratified as "low risk" by Framingham score (64%) and Reynolds score (70.1%). Using the 2013 ACC/AHA score, 45.3% of the population had a risk ≥7.5%. A significant correlation was found between classic scores but the agreement (concordance) was moderate. The correlation between classical scores and the Metabolic Syndrome Severity Calculator was poor. Overall, the prevalence of carotid plaque was 28.2%. The continuous metabolic syndrome score used in our study showed a good predictive power to detect carotid plaque (area under the curve 0.752). CONCLUSION In this population, the calculated cardiovascular risk was heterogenic. The prevalence of carotid plaque was high. The Metabolic Syndrome Severity Calculator showed a good predictive power to detect carotid plaque.
Collapse
Affiliation(s)
- Walter Masson
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina.
| | - Teo Epstein
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Melina Huerín
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Lorenzo Martín Lobo
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Graciela Molinero
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Adriana Angel
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Gerardo Masson
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Diana Millán
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Salvador De Francesca
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Laura Vitagliano
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Alberto Cafferata
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| | - Pablo Losada
- Council of Epidemiology and Cardiovascular Prevention "Dr. Mario Ciruzzi", Argentine Society of Cardiology, Azcuenaga 980, C1115AAD, Buenos Aires, Argentina
| |
Collapse
|
25
|
Masson G, Bégin MA, Lopez Poncelas M, Pelletier SK, Lessard JL, Laroche J, Berrigan F, Langelier E, Smeesters C, Rancourt D. Contribution of limb momentum to power transfer in athletic wheelchair pushing. J Biomech 2016; 49:2577-2583. [PMID: 27264619 DOI: 10.1016/j.jbiomech.2016.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/05/2015] [Revised: 03/30/2016] [Accepted: 05/06/2016] [Indexed: 11/27/2022]
Abstract
Pushing capacity is a key parameter in athletic racing wheelchair performance. This study estimated the potential contribution of upper limb momentum to pushing. The question is relevant since it may affect the training strategy adopted by an athlete. A muscle-free Lagrangian dynamic model of the upper limb segments was developed and theoretical predictions of power transfer to the wheelchair were computed during the push phase. Results show that limb momentum capacity for pushing can be in the order of 40J per push cycle at 10m/s, but it varies with the specific pushing range chosen by the athlete. Although use of momentum could certainly help an athlete improve performance, quantifying the actual contribution of limb momentum to pushing is not trivial. A preliminary experimental investigation on an ergometer, along with a simplified model of the upper limb, suggests that momentum is not the sole contributor to power transfer to a wheelchair. Muscles substantially contribute to pushing, even at high speeds. Moreover, an optimal pushing range is challenging to find since it most likely differs if an athlete chooses a limb momentum pushing strategy versus a muscular exertion pushing strategy, or both at the same time. The study emphasizes the importance of controlling pushing range, although one should optimize it while also taking the dynamics of the recovery period into account.
Collapse
Affiliation(s)
- G Masson
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - M-A Bégin
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - M Lopez Poncelas
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - S-K Pelletier
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - J-L Lessard
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - J Laroche
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - F Berrigan
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - E Langelier
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - C Smeesters
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1
| | - D Rancourt
- Groupe de recherche en performance et sécurité humaine de l'Université de Sherbrooke, Université de Sherbrooke, Département de génie mécanique, 2500 Boul. de l'Université, Sherbrooke, PQ, Canada J1K 2R1.
| |
Collapse
|
26
|
Franck G, Sausen G, Mawson T, Salinas M, Masson G, Cole A, Beltrami-Moreira M, Chatzizisis Y, Tesmenitsky Y, Swartz E, Sukhova G, Swirski F, Nahrendorf M, Aikawa E, Croce K, Libby P. Flow perturbation mediates neutrophil recruitment and potentiates endothelial injury via TLR2 in mice. A novel in vivo approach for probing the pathophysiology of superficial erosion. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
27
|
Valente E, Masson G, Maul A, Fox MG, Meyer A, Pihan JC. Seasonal gonadal development and age-related maturity patterns of introduced pumpkinseed (Lepomis gibbosus Linnaeus, 1758) in a heated thermal reservoir and an adjacent river reach. J Therm Biol 2016; 58:60-71. [PMID: 27157335 DOI: 10.1016/j.jtherbio.2016.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/03/2015] [Revised: 12/23/2015] [Accepted: 03/08/2016] [Indexed: 10/22/2022]
Abstract
Testis and ovarian maturation status, maturity profile and gonado-somatic index (GSI) were assessed in pumpkinseed (Lepomis gibbosus) collected from Mirgenbach, a cooling-water reservoir associated with a nuclear power plant, and from the River Moselle 7km downstream of the reservoir's thermal outflow. Histological investigation indicated that in both sexes, gonadal development of pumpkinseed in the heated reservoir was more advanced than in the cooler Moselle River throughout the breeding season. The histological maturity profile of reservoir males ranked by the advancement of sperm cells was highly correlated with its GSI (rs=0.73, P<0.001). GSI of females in the reservoir increased with the stage at maturity, but GSI was not significantly correlated with total length, age or growth rate of the individual. All sampled individuals of both sexes were mature at age 1 in the heated reservoir, whereas 48% of age 1 males and 57% of age 1 females were not mature in the river. GSI patterns suggest that males in the reservoir adopted one of two reproductive strategies (nesters or cuckolders), whereas no small males with large enough testes to be considered cuckolders were apparent in the river. The warm thermal regime of Mirgenbach Reservoir led to precocial maturity, early season reproduction, and the greater prevalence of apparent cuckolder males than would normally occur in this climatic zone.
Collapse
Affiliation(s)
- E Valente
- Laboratoire Interdisciplinaire des Environnements Continentaux (UMR 7360), Université de Lorraine, France
| | - G Masson
- Laboratoire Interdisciplinaire des Environnements Continentaux (UMR 7360), Université de Lorraine, France
| | - A Maul
- Laboratoire Interdisciplinaire des Environnements Continentaux (UMR 7360), Université de Lorraine, France.
| | - M G Fox
- Environmental and Resource Studies Program and Department of Biology, Trent University, Canada
| | - A Meyer
- Laboratoire Interdisciplinaire des Environnements Continentaux (UMR 7360), Université de Lorraine, France
| | - J C Pihan
- UFR Sciences Fondamentales et Appliquées, Université de Lorraine, France
| |
Collapse
|
28
|
Thorgeirsson TE, Steinberg S, Reginsson GW, Bjornsdottir G, Rafnar T, Jonsdottir I, Helgadottir A, Gretarsdottir S, Helgadottir H, Jonsson S, Matthiasson SE, Gislason T, Tyrfingsson T, Gudbjartsson T, Isaksson HJ, Hardardottir H, Sigvaldason A, Kiemeney LA, Haugen A, Zienolddiny S, Wolf HJ, Franklin WA, Panadero A, Mayordomo JI, Hall IP, Rönmark E, Lundbäck B, Dirksen A, Ashraf H, Pedersen JH, Masson G, Sulem P, Thorsteinsdottir U, Gudbjartsson DF, Stefansson K. A rare missense mutation in CHRNA4 associates with smoking behavior and its consequences. Mol Psychiatry 2016; 21:594-600. [PMID: 26952864 PMCID: PMC5414061 DOI: 10.1038/mp.2016.13] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 12/17/2015] [Accepted: 01/04/2016] [Indexed: 11/22/2022]
Abstract
Using Icelandic whole-genome sequence data and an imputation approach we searched for rare sequence variants in CHRNA4 and tested them for association with nicotine dependence. We show that carriers of a rare missense variant (allele frequency=0.24%) within CHRNA4, encoding an R336C substitution, have greater risk of nicotine addiction than non-carriers as assessed by the Fagerstrom Test for Nicotine Dependence (P=1.2 × 10(-4)). The variant also confers risk of several serious smoking-related diseases previously shown to be associated with the D398N substitution in CHRNA5. We observed odds ratios (ORs) of 1.7-2.3 for lung cancer (LC; P=4.0 × 10(-4)), chronic obstructive pulmonary disease (COPD; P=9.3 × 10(-4)), peripheral artery disease (PAD; P=0.090) and abdominal aortic aneurysms (AAAs; P=0.12), and the variant associates strongly with the early-onset forms of LC (OR=4.49, P=2.2 × 10(-4)), COPD (OR=3.22, P=2.9 × 10(-4)), PAD (OR=3.47, P=9.2 × 10(-3)) and AAA (OR=6.44, P=6.3 × 10(-3)). Joint analysis of the four smoking-related diseases reveals significant association (P=6.8 × 10(-5)), particularly for early-onset cases (P=2.1 × 10(-7)). Our results are in agreement with functional studies showing that the human α4β2 isoform of the channel containing R336C has less sensitivity for its agonists than the wild-type form following nicotine incubation.
Collapse
Affiliation(s)
- T E Thorgeirsson
- deCODE genetics/Amgen, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
| | | | | | | | - T Rafnar
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - I Jonsdottir
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | | | | | - S Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | | | - T Gislason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - T Tyrfingsson
- SAA National Center of Addiction Medicine, Reykjavik, Iceland
| | - T Gudbjartsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland,Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland
| | - H J Isaksson
- Department of Pathology, Landspitali University Hospital, Reykjavik, Iceland
| | - H Hardardottir
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - A Sigvaldason
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - L A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Haugen
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - S Zienolddiny
- Department for the Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - H J Wolf
- Community & Behavioral Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | - W A Franklin
- Department of Pathology, University of Colorado Denver, Aurora, CO, USA
| | - A Panadero
- Division of Medical Oncology, Hospital Ciudad de Coria, Coria, Spain
| | - J I Mayordomo
- Division of Medical Oncology, University of Colorado School of Medicine, Denver, CO, USA
| | - I P Hall
- Division of Respiratory Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - E Rönmark
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - B Lundbäck
- The OLIN studies, Department of Medicine, Sunderby Central Hospital of Norrbotten, Luleå, Sweden,Krefting Research Centre, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Dirksen
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark
| | - H Ashraf
- Department of Respiratory Medicine, Gentofte Hospital, Copenhagen University, Hellerup, Denmark,Centre for Diagnostic Imaging—Thoracic Section, Akershus University Hospital, Loerenskog, Norway
| | - J H Pedersen
- Department of Thoracic Surgery RT, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - G Masson
- deCODE genetics/Amgen, Reykjavik, Iceland
| | - P Sulem
- deCODE genetics/Amgen, Reykjavik, Iceland
| | | | | | - K Stefansson
- deCODE genetics/Amgen, Reykjavik, Iceland,Faculty of Medicine, University of Iceland, Reykjavik, Iceland,deCODE genetics/Amgen, Sturlugata 8, Reykjavik IS-101, Iceland. E-mail: or
| |
Collapse
|
29
|
Williams R, Masson G, Vadas O, Burke J, Perisic O. Structural Mechanisms of PI3K and PTEN Regulation. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.493.2] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - G. Masson
- ‐ MRC Laboratory of MolecularBiologyUnited States
| | - O. Vadas
- ‐ MRC Laboratory of MolecularBiologyUnited States
| | - J. Burke
- ‐ MRC Laboratory of MolecularBiologyUnited States
| | - O. Perisic
- ‐ MRC Laboratory of MolecularBiologyUnited States
| |
Collapse
|
30
|
Porcellato L, Masson G, O'Mahony F, Jenkinson S, Vanner T, Cheshire K, Perkins E. ‘It's something you have to put up with’-service users’ experiences ofin uterotransfer: a qualitative study. BJOG 2015; 122:1825-32. [DOI: 10.1111/1471-0528.13235] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- L Porcellato
- Centre for Public Health; Faculty of Education, Health and Community; Liverpool John Moores University; Liverpool UK
| | - G Masson
- Maternity Centre; Royal Stoke University Hospital; Stoke on Trent UK
| | - F O'Mahony
- Maternity Centre; Royal Stoke University Hospital; Stoke on Trent UK
| | - S Jenkinson
- Royal Wolverhampton Hospitals NHS Trust; New Cross Hospital; Wolverhampton UK
| | - T Vanner
- Royal Wolverhampton Hospitals NHS Trust; New Cross Hospital; Wolverhampton UK
| | - K Cheshire
- Royal Wolverhampton Hospitals NHS Trust; New Cross Hospital; Wolverhampton UK
| | - E Perkins
- Maternity Centre; Royal Stoke University Hospital; Stoke on Trent UK
| |
Collapse
|
31
|
Montagnini A, Masson G, Madelain L. Contrast-dependent motion processing : insight from ocular tracking dynamics. J Vis 2014. [DOI: 10.1167/14.10.490] [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: 11/24/2022] Open
|
32
|
Oddsson A, Kristinsson SY, Helgason H, Gudbjartsson DF, Masson G, Sigurdsson A, Jonasdottir A, Jonasdottir A, Steingrimsdottir H, Vidarsson B, Reykdal S, Eyjolfsson GI, Olafsson I, Onundarson PT, Runarsson G, Sigurdardottir O, Kong A, Rafnar T, Sulem P, Thorsteinsdottir U, Stefansson K. The germline sequence variant rs2736100_C in TERT associates with myeloproliferative neoplasms. Leukemia 2014; 28:1371-4. [PMID: 24476768 PMCID: PMC4051217 DOI: 10.1038/leu.2014.48] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A Oddsson
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - S Y Kristinsson
- 1] Faculty of Medicine, University of Iceland, Reykjavik, Iceland [2] Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - H Helgason
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | - G Masson
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | | | | | | | - H Steingrimsdottir
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - B Vidarsson
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - S Reykdal
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | | | - I Olafsson
- Department of Clinical Biochemistry, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - P T Onundarson
- 1] Faculty of Medicine, University of Iceland, Reykjavik, Iceland [2] Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - G Runarsson
- Department of Hematology, Landspitali, National University Hospital of Iceland, Reykjavik, Iceland
| | - O Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, Akureyri, Iceland
| | - A Kong
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - T Rafnar
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - P Sulem
- deCODE Genetics/Amgen Inc., Reykjavik, Iceland
| | - U Thorsteinsdottir
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - K Stefansson
- 1] deCODE Genetics/Amgen Inc., Reykjavik, Iceland [2] Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| |
Collapse
|
33
|
Meso A, Simoncini C, Perrinet L, Masson G. How and why do image frequency properties influence perceived speed? J Vis 2013. [DOI: 10.1167/13.9.354] [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: 11/24/2022] Open
|
34
|
Spotorno S, Montagnini A, Madelein L, Masson G. Adaptivity of fixational saccadic eye movements in a visual detection task. J Vis 2013. [DOI: 10.1167/13.9.1343] [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: 11/24/2022] Open
|
35
|
Madelain L, Montagnini A, Masson G. Transient contrast-induced perceived-velocity perturbations and smooth pursuit: tracking the footstep illusion. J Vis 2013. [DOI: 10.1167/13.9.384] [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: 11/24/2022] Open
|
36
|
Porcellato L, Masson G, O'Mahony F, Jenkinson S, Vanner T. W346 THE EXPERIENCE OF IN UTERO TRANSFER PERSPECTIVES FROM UK WOMEN AND THEIR FAMILIES. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)62069-4] [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: 12/01/2022]
|
37
|
Meso AI, Rankin J, Kornprobst P, Faugeras O, Masson G. Perceptual transition dynamics of a multi-stable visual motion stimulus I: experiments. J Vis 2012. [DOI: 10.1167/12.9.748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
38
|
Chavane F, Reynaud A, Montardy Q, Masson G. Cortical origin of contextual modulations in motion integration: linking V1 population response to the behavioral ocular following response. J Vis 2012. [DOI: 10.1167/12.9.758] [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: 11/24/2022] Open
|
39
|
Bogadhi A, Montagnini A, Masson G. Interaction between retinal and extra retinal signals in dynamic motion integration for smooth pursuit. J Vis 2011. [DOI: 10.1167/11.11.533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
40
|
Reynaud A, Masson G, Chavane F. Cortical origin of contrast response function contextual modulation in V1 population activity measured with voltage-sensitive dye imaging. J Vis 2010. [DOI: 10.1167/9.8.749] [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: 11/24/2022] Open
|
41
|
Montagnini A, Souto D, Masson G. Anticipatory eye-movements under uncertainty: a window onto the internal representation of a visuomotor prior. J Vis 2010. [DOI: 10.1167/10.7.554] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
42
|
Bogadhi A, Montagnini A, Mamassian P, Perrinet L, Masson G. A recurrent Bayesian model of dynamic motion integration for smooth pursuit. J Vis 2010. [DOI: 10.1167/10.7.545] [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: 11/24/2022] Open
|
43
|
Masson G, Fleuriet J, Montagnini A, Mamassian P. Predicting and computing 2D target motion for smooth-pursuit eye movements in macaque monkeys. J Vis 2010. [DOI: 10.1167/8.6.384] [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: 11/24/2022] Open
|
44
|
Chavane F, Reynaud A, Masson G. The role of cortico-cortical interactions during motion integration: a voltage-sensitive dye imaging study in V1 and V2 of the awake monkey. J Vis 2010. [DOI: 10.1167/8.6.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
45
|
Mehta C, Masson G, Iqbal Z, O'Mahony F, Khalid R. Prevalence of excessive alcohol consumption in pregnancy. Public Health 2009; 123:630-1. [DOI: 10.1016/j.puhe.2009.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2009] [Revised: 04/06/2009] [Accepted: 07/15/2009] [Indexed: 10/20/2022]
|
46
|
Banas D, Masson G, Leglize L, Usseglio-Polatera P, Boyd CE. Assessment of sediment concentration and nutrient loads in effluents drained from extensively managed fishponds in France. Environ Pollut 2008; 152:679-85. [PMID: 17714841 DOI: 10.1016/j.envpol.2007.06.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Revised: 05/09/2007] [Accepted: 06/27/2007] [Indexed: 05/16/2023]
Abstract
Expansion of aquaculture has increased concern over its environmental impact. The composition of effluents from intensive aquaculture is well documented, but few data on extensive aquaculture are available. During 12 draining operations, 523 water samples were collected downstream from six extensively-managed fishponds in northeastern France. Study ponds had surface areas of 2-620 ha and were managed for production of Cyprinids and Percids. Concentrations of total suspended solids, total phosphorus, and Kjeldahl nitrogen in effluents from the ponds were greatest during the final stage of draining. Loads of phosphorus were higher than those reported for effluents of more intensive aquaculture ponds in the USA, but the source of the potential pollutants was catchments and sediment rather than feeds and fertilizer. It will be necessary to reduce the water drawdown rate during the fishing stage and possibly implement other best management practices to prevent the TSS concentration from exceeding 1 g/L.
Collapse
Affiliation(s)
- D Banas
- Université Paris-Sud, UMR 8079, Bât. 362, F-91405 Orsay Cedex, France.
| | | | | | | | | |
Collapse
|
47
|
Goldstein AM, Stacey SN, Olafsson JH, Jonsson GF, Helgason A, Sulem P, Sigurgeirsson B, Benediktsdottir KR, Thorisdottir K, Ragnarsson R, Kjartansson J, Kostic J, Masson G, Kristjansson K, Gulcher JR, Kong A, Thorsteinsdottir U, Rafnar T, Tucker MA, Stefansson K. CDKN2A mutations and melanoma risk in the Icelandic population. J Med Genet 2008; 45:284-9. [PMID: 18178632 DOI: 10.1136/jmg.2007.055376] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Germline CDKN2A mutations have been observed in 20-40% of high risk, melanoma prone families; however, little is known about their prevalence in population based series of melanoma cases and controls. METHODS We resequenced the CDKN2A gene, including the p14ARF variant and promoter regions, in approximately 703 registry ascertained melanoma cases and 691 population based controls from Iceland, a country in which the incidence of melanoma has increased rapidly. RESULTS We identified a novel germline variant, G89D, that was strongly associated with increased melanoma risk and appeared to be an Icelandic founder mutation. The G89D variant was present in about 2% of Icelandic invasive cutaneous malignant melanoma cases. Relatives of affected G89D carriers were at significantly increased risk of melanoma, head and neck cancers, and pancreatic carcinoma compared to relatives of other melanoma patients. Nineteen other germline variants were identified, but none conferred an unequivocal risk of melanoma. CONCLUSIONS This population based study of Icelandic melanoma cases and controls showed a frequency of disease related CDKN2A mutant alleles ranging from 0.7% to 1.0%, thus expanding our knowledge about the frequency of CDKN2A mutations in different populations. In contrast to North America and Australia where a broad spectrum of mutations was observed at a similar frequency, in Iceland, functional CDKN2A mutations consist of only one or two different variants. Additional genetic and/or environmental factors are likely critical for explaining the high incidence rates for melanoma in Iceland. This study adds to the geographic regions for which population based estimates of CDKN2A mutation frequencies are available.
Collapse
Affiliation(s)
- A M Goldstein
- Genetic Epidemiology Branch, Division of Cancer Epidemiologyand Genetics/NCI/NIH/DHHS, Executive Plaza South, Room 7004, 6120 Executive Blvd MSC 7236, Bethesda, MD 20892-7236, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
de Tayrac R, Panel L, Masson G, Mares P. [Episiotomy and prevention of perineal and pelvic floor injuries]. J Gynecol Obstet Biol Reprod (Paris) 2006; 35:1S24-1S31. [PMID: 16495824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVES The objective of this review was to assess the efficacy of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse. MATERIAL AND METHODS A systematic review on Medline database was performed between 1980 and 2005. One hundred seventy seven articles were selected. Trial quality was assessed on the following parameters: design (prospective, randomized, meta-analysis), sample size (>50) and relevant results. Finally, 43 articles were analysed. RESULTS The routine use of episiotomy did not prevent severe perineal tears. It decreased the risk of moderate anterior perineal lacerations. The risk of severe perineal tears during episiotomy increased in the following circumstances: primiparity, Asian women, perineal length<or=3cm, forceps or vacuum-assisted deliveries and macrosomia. Relevant studies were consistent in demonstrating no benefit for routine episiotomy to prevent urinary or faecal incontinence or pelvic floor relaxation, even if there is a lack of data concerning long-term effects on pelvic floor support. CONCLUSION The routine use of episiotomy to prevent severe perineal tears, urinary incontinence, faecal incontinence and genital prolapse should be abandoned.
Collapse
Affiliation(s)
- R de Tayrac
- Service de Gynécologie-Obstétrique, Hôpital Carémeau, place du Professeur-Robert-Debré, 30900 Nîmes Cedex 9.
| | | | | | | |
Collapse
|
49
|
David S, Durif-Bruckert C, Durif-Varembont JP, Lemery D, Masson G, Scharnitzky P, Claris O, Mamelle N. Perinatal care regionalization and acceptability by professionals in France. Rev Epidemiol Sante Publique 2005; 53:361-72. [PMID: 16353511 DOI: 10.1016/s0398-7620(05)84618-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND For twenty years, most of industrial countries developed recommendations on regionalization of perinatal care. Perinatal regionalization is particularly aimed at improving morbidity and mortality outcomes of low birth weight newborns by transferring pregnant women to the maternity units having a medical or neonatal environment suited to the risks incurred by mothers or babies. Perinatal regionalization cannot be effective without being well accepted by the majority of professionals. The objectives of this study were then to identify professionals'expectations and objections to perinatal regionalisation and to compare them from a professional group to another one. METHODS Professionals of 3 French perinatal networks were under consideration: the Rhône, the Auvergne and the Gard-Lozère networks. The study included two stages: 1) a psychosociological qualitative study, based on professionals'interviews, aimed at identifying main concerns of professionals and developing a questionnaire; then 2) an epidemiological quantitative study, using this questionnaire within French networks. In the questionnaire, 8 dimensions explored the professionals'views: constraints related to regulation aspects and to the setting up of maternity units care levels, risk of loss of professionals' competence and prestige, consequences on medical practices, on inter-professional relationship, on work organization and financial aspects, and related to the new role of 'private practice'professionals, legal consequences. RESULTS The response rate of the epidemiological study was 80%. The results permitted to construct 8 dimension scores describing the reasons of poor acceptability of regionalization. After taking into account the age, the sex, the network and the juridical status of the institution, the study revealed a significant poorer acceptability of regionalization by most of medical specialty groups (anesthetists, obstetricians, midwives and "private practice" professionals) compared with neonatologists, or by "private" professionals (professionals working in private clinics and "private practice" professionals) compared with professionals working in university or community hospitals. The study described also network setting up conditions related to its functioning. CONCLUSION By identifying clearly professionals 'objections and expectations, this study should facilitate improvement in the organization of studied perinatal networks.
Collapse
Affiliation(s)
- S David
- Service de Biostatistiques des Hospices Civils de Lyon, 162, avenue Lacassagne, 69003 Lyon.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Contal M, Masson G, Boyer C, Cazevielle C, Mares P. [Neonatal consequences of maternal smoking during pregnancy]. J Gynecol Obstet Biol Reprod (Paris) 2005; 34 Spec No 1:3S215-22. [PMID: 15980791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
In utero tobacco consumption is a serious public health problem in France; it is very frequent and the long term consequences are not only numerous but also misinterpreted by our population. 25 to 29% of women arrive at the end of their pregnancy without stopping smoking and 50% of non smoking mothers live in an environment polluted by tobacco during pregnancy. The authors would like to stress the gravity of this situation. At the maternity hospital in Nîmes, 358 women who gave birth at term and after a normal pregnancy were enrolled in a survey and monitored with thiocyanate for their tobacco consumption. Birth weight, height, and cranial perimeter of the infants were noted at birth. Results confirmed earlier work on this subject: the three variables studied were consistently weakened by the mother's addiction to tobacco. The authors recall previous medical literature on the pathophysiology and other consequences on the brain: such as I.Q. behavior, sudden infant death syndrome, vascular alterations with possible long-term complications, as well as pulmonary alterations on which there has recently been much research. The question is raised as to why this problem is so neglected in our society and what could be done to change this state of affairs.
Collapse
Affiliation(s)
- M Contal
- Ligue Contre le Cancer du Gard, 8, rue Suger, BP 145, 30011 Nîmes Cedex 4
| | | | | | | | | |
Collapse
|