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Jee YH, Thibord F, Dominguez A, Sept C, Boulier K, Venkateswaran V, Ding Y, Cherlin T, Verma SS, Faro VL, Bartz TM, Boland A, Brody JA, Deleuze JF, Emmerich J, Germain M, Johnson AD, Kooperberg C, Morange PE, Pankratz N, Psaty BM, Reiner AP, Smadja DM, Sitlani CM, Suchon P, Tang W, Trégouët DA, Zöllner S, Pasaniuc B, Damrauer SM, Sanna S, Snieder H, Kabrhel C, Smith NL, Kraft P. Multi-ancestry polygenic risk scores for venous thromboembolism. medRxiv 2024:2024.01.09.24300914. [PMID: 38260294 PMCID: PMC10802635 DOI: 10.1101/2024.01.09.24300914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality, with large disparities in incidence rates between Black and White Americans. Polygenic risk scores (PRSs) limited to variants discovered in genome-wide association studies in European-ancestry samples can identify European-ancestry individuals at high risk of VTE. However, there is limited evidence on whether high-dimensional PRS constructed using more sophisticated methods and more diverse training data can enhance the predictive ability and their utility across diverse populations. We developed PRSs for VTE using summary statistics from the International Network against Venous Thrombosis (INVENT) consortium GWAS meta-analyses of European- (71,771 cases and 1,059,740 controls) and African-ancestry samples (7,482 cases and 129,975 controls). We used LDpred2 and PRSCSx to construct ancestry-specific and multi-ancestry PRSs and evaluated their performance in an independent European- (6,261 cases and 88,238 controls) and African-ancestry sample (1,385 cases and 12,569 controls). Multi-ancestry PRSs with weights tuned in European- and African-ancestry samples, respectively, outperformed ancestry-specific PRSs in European- (PRSCSXEUR: AUC=0.61 (0.60, 0.61), PRSCSX_combinedEUR: AUC=0.61 (0.60, 0.62)) and African-ancestry test samples (PRSCSXAFR: AUC=0.58 (0.57, 0.6), PRSCSX_combined AFR: AUC=0.59 (0.57, 0.60)). The highest fifth percentile of the best-performing PRS was associated with 1.9-fold and 1.68-fold increased risk for VTE among European- and African-ancestry subjects, respectively, relative to those in the middle stratum. These findings suggest that the multi-ancestry PRS may be used to identify individuals at highest risk for VTE and provide guidance for the most effective treatment strategy across diverse populations.
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Affiliation(s)
- Yon Ho Jee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, MA, USA
| | - Florian Thibord
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, MD, USA
- The Framingham Heart Study, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702 USA
| | - Alicia Dominguez
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Corriene Sept
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Kristin Boulier
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, CA, USA
| | - Vidhya Venkateswaran
- Department of Oral Biology, University of California Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - Yi Ding
- Bioinformatics Interdepartmental Program, University of California Los Angeles, Los Angeles, CA, USA
| | - Tess Cherlin
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Shefali Setia Verma
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Valeria Lo Faro
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
- Laboratory of Excellence in Medical Genomics, GENMED, Evry, France
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
| | - Jean-Francois Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
- Laboratory of Excellence in Medical Genomics, GENMED, Evry, France
- Centre d’Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Joseph Emmerich
- Department of Vascular Medicine, Paris Saint-Joseph Hospital Group, University of Paris, Paris, France
- UMR1153, INSERM CRESS, Paris, France
| | - Marine Germain
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Andrew D. Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, MD, USA
- The Framingham Heart Study, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702 USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinbson Cancer Center, Seattle WA 98109
| | - Pierre-Emmanuel Morange
- Aix-Marseille University, INSERM, INRAE, Centre de Recherche en CardioVasculaire et Nutrition, Laboratory of Haematology, CRB Assistance Publique – Hôpitaux de Marseille, HemoVasc, Marseille, France
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, 55455, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
- Department of Epidemiology, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
- Department of Health Systems and Population Health, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
| | - Alexander P. Reiner
- Division of Public Health Sciences, Fred Hutchinbson Cancer Center, Seattle WA 98109
- Department of Epidemiology, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
| | - David M. Smadja
- Innovative Therapies in Hemostasis, Université de Paris, INSERM, F-75006 Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), F-75015 Paris, France
| | - Colleen M. Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
| | - Pierre Suchon
- Aix-Marseille University, INSERM, INRAE, Centre de Recherche en CardioVasculaire et Nutrition, Laboratory of Haematology, CRB Assistance Publique – Hôpitaux de Marseille, HemoVasc, Marseille, France
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, 55454, USA
| | - David-Alexandre Trégouët
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Sebastian Zöllner
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Bogdan Pasaniuc
- Department of Oral Biology, University of California Los Angeles School of Dentistry, Los Angeles, CA, USA
| | - Scott M. Damrauer
- Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Surgery, Department of Genetics, and Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA
- Department of Surgery, Corporal Michael Crescenz VA Medical Center, Philadelphia PA
| | - Serena Sanna
- University of Groningen, UMCG, Department of Genetics, Groningen, the Netherlands
- Institute for Genetics and Biomedical Research, National Research Council, Monserrato, Italy
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Christopher Kabrhel
- Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicholas L. Smith
- Department of Health Systems and Population Health, University of Washington, 4333 Brooklyn Ave, Seattle, WA 98195
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle WA 98101, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle WA 98108, USA
| | - Peter Kraft
- Transdivisional Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, MD, USA
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Iglesias MJ, Sanchez-Rivera L, Ibrahim-Kosta M, Naudin C, Munsch G, Goumidi L, Farm M, Smith PM, Thibord F, Kral-Pointner JB, Hong MG, Suchon P, Germain M, Schrottmaier W, Dusart P, Boland A, Kotol D, Edfors F, Koprulu M, Pietzner M, Langenberg C, Damrauer SM, Johnson AD, Klarin DM, Smith NL, Smadja DM, Holmström M, Magnusson M, Silveira A, Uhlén M, Renné T, Martinez-Perez A, Emmerich J, Deleuze JF, Antovic J, Soria Fernandez JM, Assinger A, Schwenk JM, Souto Andres JC, Morange PE, Butler LM, Trégouët DA, Odeberg J. Author Correction: Elevated plasma complement factor H related 5 protein is associated with venous thromboembolism. Nat Commun 2023; 14:7752. [PMID: 38012230 PMCID: PMC10682365 DOI: 10.1038/s41467-023-43764-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Affiliation(s)
- Maria Jesus Iglesias
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Division of Internal Medicine, University Hospital of North Norway (UNN), PB100, 9038, Tromsø, Norway
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Laura Sanchez-Rivera
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Manal Ibrahim-Kosta
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Clément Naudin
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Gaëlle Munsch
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France
| | - Louisa Goumidi
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Maria Farm
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Philip M Smith
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
- Theme of Emergency and Reparative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Florian Thibord
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Framingham, MA, USA
- The Framingham Heart Study, Boston University, Framingham, MA, USA
| | - Julia Barbara Kral-Pointner
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Mun-Gwan Hong
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Pierre Suchon
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Marine Germain
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France
- Laboratory of Excellence GENMED (Medical Genomics), Bordeaux, France
| | - Waltraud Schrottmaier
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Philip Dusart
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057, Evry, France
- Laboratory of Excellence GENMED (Medical Genomics), Evry, France
| | - David Kotol
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Fredrik Edfors
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Mine Koprulu
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Scott M Damrauer
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
- Department of Surgery and Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew D Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Framingham, MA, USA
- The Framingham Heart Study, Boston University, Framingham, MA, USA
| | - Derek M Klarin
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Vascular Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, USA
| | - David M Smadja
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, 20 rue Leblanc, Paris, 75015, France
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, 4 avenue de l'Observatoire, Paris, 75270, France
| | - Margareta Holmström
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - Maria Magnusson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Angela Silveira
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Mathias Uhlén
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Thomas Renné
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Centre Hamburg-Eppendorf, D-20246, Hamburg, Germany
- Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center, D-55131, Mainz, Germany
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, D02 YN77, Ireland
| | - Angel Martinez-Perez
- Genomics of Complex Diseases Group, Research Institute Hospital de la Santa Creu i Sant Pau. IIB Sant Pau, Barcelona, Spain
| | - Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, INSERM 1153-CRESS, University of Paris Cité, 185 rue Raymond Losserand, Paris, 75674, France
| | - Jean-Francois Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057, Evry, France
- Laboratory of Excellence GENMED (Medical Genomics), Evry, France
- Centre D'Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Jovan Antovic
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Jose Manuel Soria Fernandez
- Genomics of Complex Diseases Group, Research Institute Hospital de la Santa Creu i Sant Pau. IIB Sant Pau, Barcelona, Spain
| | - Alice Assinger
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Jochen M Schwenk
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Joan Carles Souto Andres
- Unitat d'Hemostàsia i Trombosi, Hospital de la Santa Creu i Sant Pau and IIB-Sant Pau, Barcelona, Spain
| | - Pierre-Emmanuel Morange
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Lynn Marie Butler
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - David-Alexandre Trégouët
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France.
- Laboratory of Excellence GENMED (Medical Genomics), Bordeaux, France.
| | - Jacob Odeberg
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden.
- Division of Internal Medicine, University Hospital of North Norway (UNN), PB100, 9038, Tromsø, Norway.
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway.
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
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3
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Belgodère L, Emmerich J, Albin N, Bacon T, Daynes P, Vignot S, Vial T, Renaud G, Le Saulnier C, Maillard-Couvreur C, Cachet M, Veyries ML, Youdarene R, Oualikene-Gonin W, Ratignier-Carbonneil C, Maison P. Prevention and management of health products shortages by the French national agency (ANSM), 10 years of experience. Front Public Health 2023; 11:1293110. [PMID: 38045969 PMCID: PMC10690943 DOI: 10.3389/fpubh.2023.1293110] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Shortages of drugs and medical devices have tended to increase in France and worldwide, with consequences for patients and healthcare professionals. Preventing shortages of health products has become a priority for regulatory authorities, including the French National Agency for Medicines and Health Products Safety (ANSM). To highlight perspectives for a better prevention, we described and analyzed the management of shortages in the availability of health products in France over the last 10 years. The supply chain was mapped to identify the main causes of shortages and stakeholders involved in managing shortages throughout the supply chain. National and European initiatives and regulatory measures were reviewed. A retrospective nationwide data analysis from the French reporting system of health product shortage reports was conducted over 10 years for drugs (2013-2022) and over an 18-month period for medical devices, from 1st March 2022 to 31st August 2023. An increase in drug shortage reports was observed, rising from 404 in 2013 to 3,761 in 2022 for drugs, with a relatively constant distribution of affected therapeutic classes. In 2022, the main reported causes of drug shortage risk were insufficient production capacity (27.1%), increased sales volume (21.5%), or lack of supply (13.6%). Over half of the reports on medical devices (55.4%) were objectified as indispensable, and their causes were mainly due to a lack of supply (48.2%), discontinuation of marketing (14.9%), increased sales volume (13.2%), and regulatory reasons (9.6%). ANSM and French authorities have engaged a public health policy for prevention and management of health product shortages including financial penalties, minimum safety stocks for Major Therapeutic Interest drugs, and a shortage management plan. Based on 10 years of experience, four priority measures have been identified to anticipate the risk of heath products shortages based: the importance of a national coordination from raw materials to local market, the implementation of new prevention and management actions in the supply chain, strengthening European cooperation and regulation including the establishment of a list of critical drugs, and promoting transparency and information.
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Affiliation(s)
- Laëtitia Belgodère
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | - Joseph Emmerich
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- Hôpital Saint Joseph Paris (Médecine Vasculaire), INSERM 1153 CRESS, Université de Paris Cité, Paris, France
| | - Nicolas Albin
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- Groupe Hospitalier Mutualiste de Grenoble, Institut Daniel Hollard, Grenoble, France
| | - Trystan Bacon
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- General Practitioner, Montmerle-sur-Saône, France
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Lyon, France
- Groupe de travail "Thérapeutique", Collège de la médecine générale, Paris, France
| | - Pascale Daynes
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- Union Francophone des Patients Partenaires, Faculté de Médecine, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche, France
| | - Stéphane Vignot
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- Institut Godinot, Reims, France
| | - Thierry Vial
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- Hospices Civils de Lyon, Lyon, France
| | - Guillaume Renaud
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | - Carole Le Saulnier
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | | | - Mélanie Cachet
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | - Marie-Laure Veyries
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | - Rym Youdarene
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | - Wahiba Oualikene-Gonin
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
| | | | - Patrick Maison
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (ANSM), Saint Denis, France
- EA 7379, Epiderme, Faculté de Santé, Université Paris-Est Créteil, Créteil, France
- CHI Créteil, Créteil, France
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4
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Ward J, Le NQ, Suryakant S, Brody JA, Amouyel P, Boland A, Bown R, Cullen B, Debette S, Deleuze JF, Emmerich J, Graham N, Germain M, Anderson JJ, Pell JP, Lyall DM, Lyall LM, Smith DJ, Wiggins KL, Soria JM, Souto JC, Morange PE, Smith NL, Trégouët DA, Sabater-Lleal M, Strawbridge RJ. Polygenic risk of major depressive disorder as a risk factor for venous thromboembolism. Blood Adv 2023; 7:5341-5350. [PMID: 37399490 PMCID: PMC10506044 DOI: 10.1182/bloodadvances.2023010562] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/17/2023] [Accepted: 06/16/2023] [Indexed: 07/05/2023] Open
Abstract
Major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia (SCZ) are associated with an increased risk of cardiovascular diseases, including venous thromboembolism (VTE). The reasons for this are complex and include obesity, smoking, and use of hormones and psychotropic medications. Genetic studies have increasingly provided evidence of the shared genetic risk of psychiatric and cardiometabolic illnesses. This study aimed to determine whether a genetic predisposition to MDD, BD, or SCZ is associated with an increased risk of VTE. Genetic correlations using the largest genome-wide genetic meta-analyses summary statistics for MDD, BD, and SCZ (Psychiatric Genetics Consortium) and a recent genome-wide genetic meta-analysis of VTE (INVENT Consortium) demonstrated a positive association between VTE and MDD but not BD or SCZ. The same summary statistics were used to construct polygenic risk scores for MDD, BD, and SCZ in UK Biobank participants of self-reported White British ancestry. These were assessed for impact on self-reported VTE risk (10 786 cases, 285 124 controls), using logistic regression, in sex-specific and sex-combined analyses. We identified significant positive associations between polygenic risk for MDD and the risk of VTE in men, women, and sex-combined analyses, independent of the known risk factors. Secondary analyses demonstrated that this association was not driven by those with lifetime experience of mental illness. Meta-analyses of individual data from 6 additional independent cohorts replicated the sex-combined association. This report provides evidence for shared biological mechanisms leading to MDD and VTE and suggests that, in the absence of genetic data, a family history of MDD might be considered when assessing the risk of VTE.
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Affiliation(s)
- Joey Ward
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Ngoc-Quynh Le
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Suryakant Suryakant
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Philippe Amouyel
- University of Lille, INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
- Laboratory of Excellence in Medical Genomics, GENMED, Evry, France
| | - Rosemary Bown
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stéphanie Debette
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine, Evry, France
- Laboratory of Excellence in Medical Genomics, GENMED, Evry, France
- Centre d’Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Joseph Emmerich
- Department of Vascular Medicine, Paris Saint-Joseph Hospital Group, University of Paris, Paris, France
- UMR1153, INSERM CRESS, Paris, France
| | - Nicholas Graham
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Marine Germain
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Jana J. Anderson
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jill P. Pell
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Donald M. Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Laura M. Lyall
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Laboratory of Excellence in Medical Genomics, GENMED, Evry, France
| | - Daniel J. Smith
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - José Manuel Soria
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Juan Carlos Souto
- Unitat d’Hemostàsia i Trombosi, Institut d’Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pierre-Emmanuel Morange
- Aix-Marseille University, INSERM, INRAE, Centre de Recherche en CardioVasculaire et Nutrition, Laboratory of Haematology, CRB Assistance Publique – Hôpitaux de Marseille, HemoVasc, Marseille, France
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA
- Department of Veterans Affairs Office of Research and Development, Seattle Epidemiologic Research and Information Center, Seattle, WA
| | - David-Alexandre Trégouët
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France
| | - Maria Sabater-Lleal
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau, Barcelona, Spain
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
| | - Rona J. Strawbridge
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Cardiovascular Medicine Unit, Department of Medicine Solna, Karolinska Institute, Stockholm, Sweden
- Health Data Research UK, Glasgow, United Kingdom
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5
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Lebreton O, Fels A, Compagnon A, Lazareth I, Ghaffari P, Chatellier G, Emmerich J, Michon-Pasturel U, Priollet P, Yannoutsos A. Amputation-free survival in the long-term follow-up and gender-related characteristics in patients revascularized for critical limb ischemia. J Med Vasc 2023; 48:105-115. [PMID: 37914455 DOI: 10.1016/j.jdmv.2023.10.002] [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] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 10/01/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Patients with Critical Limb Ischemia (CLI) present a high risk of cardiovascular events and death. Revascularization is the cornerstone of therapy to relieve ischemic pain and prevent limb loss. Literature data suggest that women tend to present with worse outcomes after revascularization. The aim of the present study is to determine amputation-free survival in a long-term follow-up in women and men following endovascular revascularization procedure for CLI. METHODS From November 2013 to December 2020, 357 consecutive patients were retrospectively included. Clinical and biological parameters were recorded at baseline before endovascular revascularization. During follow-up until February 2023, overall survival and amputation-free survival (freedom from major amputation) were analysed using the Kaplan-Meier method. Univariate and multivariate analyses were performed to study the parameters associated with amputation-free survival. A P<0.05 was considered as statistically significant. RESULTS A total of 357 consecutive patients were included, 189 men and 168 women with CLI, with a mean age of 78.6±12 years. Treated hypertension (79%), diabetes mellitus (48%), coronary artery disease (39%) and protein malnutrition (61%) were the most prevalent comorbidities. Women were older than men with a mean age of 82.4±11.4 years (versus 75.4±11 years in men) and presented more frequently with protein malnutrition (70% of women). Prevalence of diabetes, tobacco use and history of coronary heart disease were significantly higher in men. During the 10-year follow-up period, 241 patients had died (68%) and 38 (11%) underwent major amputation, of whom 22 patients were still alive on February 2023. Median survival was 35.5 months [IQR: 29.5; 43] in the overall population, 38.5 [32; 50.4] months in women and 33.5 months [24.7; 43.5] in men. No gender-related differences were noted according to peri-procedural complications, survival probability and amputation-free survival. In multivariate analysis for amputation-free survival, age, previous coronary heart disease, C-reactive protein level, left ventricular ejection fraction (LVEF)<60% and albumin level<35g/L were correlated with poor outcome. In particular, protein malnutrition, as a treatable risk factor, appears significantly correlated with poor outcome in both men and women (HR=2.50 [1.16;5.38], P=0.0196 in men; HR=1.77 [1.00;3.13], P=0.049 in women). CONCLUSION The present results highlight that mortality in patients after endovascular revascularization remains high with a mortality rate of 28% at 1 year, 40% at 2 years and 51% at 3 years. Women represented a distinct population, almost 10-year older than their male counterparts, with more prevalent protein malnutrition. However, no gender-related difference was noted according to amputation-free survival on the long-term follow-up. Associated risk factors are mainly age, a history of coronary heart disease, pre-procedural inflammatory syndrome and protein malnutrition. Correction of malnutrition could have the potential to improve functional and general long-term prognosis in patients with CLI together with optimal medical and interventional management.
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Affiliation(s)
- O Lebreton
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - A Fels
- Clinical Research Center, groupe hospitalier Paris St-Joseph, Paris, France
| | - A Compagnon
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - I Lazareth
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - P Ghaffari
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - G Chatellier
- Clinical Research Center, groupe hospitalier Paris St-Joseph, Paris, France
| | - J Emmerich
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France; Université Paris Cité, Inserm CRESS UMR 1153, Paris, France
| | - U Michon-Pasturel
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - P Priollet
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - A Yannoutsos
- Vascular Medicine Department, groupe hospitalier Paris St-Joseph, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France; Université Paris Cité, Inserm CRESS UMR 1153, Paris, France.
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6
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Iglesias MJ, Sanchez-Rivera L, Ibrahim-Kosta M, Naudin C, Munsch G, Goumidi L, Farm M, Smith PM, Thibord F, Kral-Pointner JB, Hong MG, Suchon P, Germain M, Schrottmaier W, Dusart P, Boland A, Kotol D, Edfors F, Koprulu M, Pietzner M, Langenberg C, Damrauer SM, Johnson AD, Klarin DM, Smith NL, Smadja DM, Holmström M, Magnusson M, Silveira A, Uhlén M, Renné T, Martinez-Perez A, Emmerich J, Deleuze JF, Antovic J, Soria Fernandez JM, Assinger A, Schwenk JM, Souto Andres JC, Morange PE, Butler LM, Trégouët DA, Odeberg J. Elevated plasma complement factor H related 5 protein is associated with venous thromboembolism. Nat Commun 2023; 14:3280. [PMID: 37286573 PMCID: PMC10247781 DOI: 10.1038/s41467-023-38383-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
Venous thromboembolism (VTE) is a common, multi-causal disease with potentially serious short- and long-term complications. In clinical practice, there is a need for improved plasma biomarker-based tools for VTE diagnosis and risk prediction. Here we show, using proteomics profiling to screen plasma from patients with suspected acute VTE, and several case-control studies for VTE, how Complement Factor H Related 5 protein (CFHR5), a regulator of the alternative pathway of complement activation, is a VTE-associated plasma biomarker. In plasma, higher CFHR5 levels are associated with increased thrombin generation potential and recombinant CFHR5 enhanced platelet activation in vitro. GWAS analysis of ~52,000 participants identifies six loci associated with CFHR5 plasma levels, but Mendelian randomization do not demonstrate causality between CFHR5 and VTE. Our results indicate an important role for the regulation of the alternative pathway of complement activation in VTE and that CFHR5 represents a potential diagnostic and/or risk predictive plasma biomarker.
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Affiliation(s)
- Maria Jesus Iglesias
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Division of Internal Medicine, University Hospital of North Norway (UNN), PB100, 9038, Tromsø, Norway
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Laura Sanchez-Rivera
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Manal Ibrahim-Kosta
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Clément Naudin
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Gaëlle Munsch
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France
| | - Louisa Goumidi
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Maria Farm
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Philip M Smith
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
- Theme of Emergency and Reparative Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Florian Thibord
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Framingham, MA, USA
- The Framingham Heart Study, Boston University, Framingham, MA, USA
| | - Julia Barbara Kral-Pointner
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Mun-Gwan Hong
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Pierre Suchon
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Marine Germain
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France
- Laboratory of Excellence GENMED (Medical Genomics), Bordeaux, France
| | - Waltraud Schrottmaier
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Philip Dusart
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057, Evry, France
- Laboratory of Excellence GENMED (Medical Genomics), Evry, France
| | - David Kotol
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Fredrik Edfors
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Mine Koprulu
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Maik Pietzner
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Claudia Langenberg
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
- Computational Medicine, Berlin Institute of Health at Charité-Universitätsmedizin Berlin, 10117, Berlin, Germany
- Precision Healthcare University Research Institute, Queen Mary University of London, London, UK
| | - Scott M Damrauer
- Corporal Michael Crescenz VA Medical Center, Philadelphia, PA, USA
- Department of Surgery and Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew D Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, Framingham, MA, USA
- The Framingham Heart Study, Boston University, Framingham, MA, USA
| | - Derek M Klarin
- VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Vascular Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, USA
| | - David M Smadja
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, 20 rue Leblanc, Paris, 75015, France
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, 4 avenue de l'Observatoire, Paris, 75270, France
| | - Margareta Holmström
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - Maria Magnusson
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 77, Stockholm, Sweden
| | - Angela Silveira
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | - Mathias Uhlén
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Thomas Renné
- Institute for Clinical Chemistry and Laboratory Medicine, University Medical Centre Hamburg-Eppendorf, D-20246, Hamburg, Germany
- Center for Thrombosis and Hemostasis (CTH), Johannes Gutenberg University Medical Center, D-, 55131, Mainz, Germany
- Irish Centre for Vascular Biology, School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin 2, D02 YN77, Ireland
| | - Angel Martinez-Perez
- Genomics of Complex Diseases Group, Research Institute Hospital de la Santa Creu i Sant Pau. IIB Sant Pau, Barcelona, Spain
| | - Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, INSERM 1153-CRESS, University of Paris Cité, 185 rue Raymond Losserand, Paris, 75674, France
| | - Jean-Francois Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057, Evry, France
- Laboratory of Excellence GENMED (Medical Genomics), Evry, France
- Centre D'Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Jovan Antovic
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Jose Manuel Soria Fernandez
- Genomics of Complex Diseases Group, Research Institute Hospital de la Santa Creu i Sant Pau. IIB Sant Pau, Barcelona, Spain
| | - Alice Assinger
- Center for Physiology and Pharmacology, Institute of Vascular Biology and Thrombosis Research, Medical University of Vienna, Vienna, Austria
| | - Jochen M Schwenk
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
| | - Joan Carles Souto Andres
- Unitat d'Hemostàsia i Trombosi. Hospital de la Santa Creu i Sant Pau and IIB-Sant Pau, Barcelona, Spain
| | - Pierre-Emmanuel Morange
- Aix-Marseille Univ, INSERM, INRAE, C2VN, Laboratory of Haematology, CRB Assistance Publique-Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
| | - Lynn Marie Butler
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - David-Alexandre Trégouët
- University of Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, ELEANOR, Bordeaux, France.
- Laboratory of Excellence GENMED (Medical Genomics), Bordeaux, France.
| | - Jacob Odeberg
- Science for Life Laboratory, Department of Protein Science, CBH, KTH Royal Institute of Technology, SE-171 21, Stockholm, Sweden.
- Division of Internal Medicine, University Hospital of North Norway (UNN), PB100, 9038, Tromsø, Norway.
- Translational Vascular Research, Department of Clinical Medicine, UiT The Arctic University of Norway, 9019, Tromsø, Norway.
- Department of Medicine Solna, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
- Coagulation Unit, Department of Haematology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
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7
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Munsch G, Proust C, Labrouche-Colomer S, Aïssi D, Boland A, Morange PE, Roche A, de Chaisemartin L, Harroche A, Olaso R, Deleuze JF, James C, Emmerich J, Smadja DM, Jacqmin-Gadda H, Trégouët DA. Genome-wide association study of a semicontinuous trait: illustration of the impact of the modeling strategy through the study of Neutrophil Extracellular Traps levels. NAR Genom Bioinform 2023; 5:lqad062. [PMID: 37388819 PMCID: PMC10304785 DOI: 10.1093/nargab/lqad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/10/2023] [Accepted: 06/07/2023] [Indexed: 07/01/2023] Open
Abstract
Over the last years, there has been a considerable expansion of genome-wide association studies (GWAS) for discovering biological pathways underlying pathological conditions or disease biomarkers. These GWAS are often limited to binary or quantitative traits analyzed through linear or logistic models, respectively. In some situations, the distribution of the outcome may require more complex modeling, such as when the outcome exhibits a semicontinuous distribution characterized by an excess of zero values followed by a non-negative and right-skewed distribution. We here investigate three different modeling for semicontinuous data: Tobit, Negative Binomial and Compound Poisson-Gamma. Using both simulated data and a real GWAS on Neutrophil Extracellular Traps (NETs), an emerging biomarker in immuno-thrombosis, we demonstrate that Compound Poisson-Gamma was the most robust model with respect to low allele frequencies and outliers. This model further identified the MIR155HG locus as significantly (P = 1.4 × 10-8) associated with NETs plasma levels in a sample of 657 participants, a locus recently highlighted to be involved in NETs formation in mice. This work highlights the importance of the modeling strategy for GWAS of a semicontinuous outcome and suggests Compound Poisson-Gamma as an elegant but neglected alternative to Negative Binomial for modeling semicontinuous outcome in the context of genomic investigations.
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Affiliation(s)
| | - Carole Proust
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Sylvie Labrouche-Colomer
- UMR1034, Inserm, Biology of Cardiovascular Diseases, University of Bordeaux, Pessac, France
- Laboratoire d’Hématologie, CHU de Bordeaux, Pessac, France
| | - Dylan Aïssi
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France
| | - Anne Boland
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057 Evry, France
| | - Pierre-Emmanuel Morange
- Cardiovascular and Nutrition Research Center (C2VN), INSERM, INRAE, Aix-Marseille University, Marseille, France
| | - Anne Roche
- Service pneumologie hôpital Bicêtre, France
| | - Luc de Chaisemartin
- Service Auto-immunité, Hypersensibilité et Biothérapies, Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris, France
- Université Paris-Saclay, INSERM, Inflammation, Microbiome, Immunosurveillance, Orsay, France
| | - Annie Harroche
- Service d’Hématologie Clinique Centre de Traitement de l’Hémophilie Hôpital Necker Enfants Malades, France
| | - Robert Olaso
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057 Evry, France
- Centre d’Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Jean-François Deleuze
- Université Paris-Saclay, CEA, Centre National de Recherche en Génomique Humaine (CNRGH), 91057 Evry, France
- Centre d’Etude du Polymorphisme Humain, Fondation Jean Dausset, Paris, France
| | - Chloé James
- UMR1034, Inserm, Biology of Cardiovascular Diseases, University of Bordeaux, Pessac, France
- Laboratoire d’Hématologie, CHU de Bordeaux, Pessac, France
| | - Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, University of Paris, UMR1153, INSERM, CRESS, 185 rue Raymond Losserand, Cité, 75674, France
| | - David M Smadja
- Innovative Therapies in Hemostasis, Université de Paris, INSERM, F-75006 Paris, France
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), Assistance Publique Hôpitaux de Paris, Centre-Université de Paris (APHP-CUP), F-75015 Paris, France
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8
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Emmerich J. Factor XI-inhibitors the search of the holy graal. J Med Vasc 2023; 48:51-52. [PMID: 37422326 DOI: 10.1016/j.jdmv.2023.04.003] [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] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Joseph Emmerich
- Inserm UMR-1153 CRESS, Vascular Medicine, Paris Cité University, Saint-Joseph Hospital, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
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9
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Cleofort V, Attal R, Sayegh J, Yannoutsos A, Lazareth I, Emmerich J, Priollet P. Evaluation of the ankle brachial index and toe brachial index for peripheral arterial disease diagnosis in patients over 70 years with lower limb ulcers. J Med Vasc 2023; 48:11-17. [PMID: 37120264 DOI: 10.1016/j.jdmv.2023.01.002] [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] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Indexed: 05/01/2023]
Abstract
OBJECTIVE The aim of our study was to evaluate the diagnostic performance of the ankle brachial index using pulsed Doppler, and the toe brachial index using laser Doppler, in comparison with the arterial Doppler ultrasound of the lower limbs as a reference test, in a population of non-diabetic subjects over 70 years old with lower limb ulcers and without chronic renal failure. METHODS We included 50 patients, 100 lower limbs from the vascular medicine department of the Paris Saint-Joseph hospital from December 2019 to May 2021. RESULTS We found a sensitivity of 54.5% for the ankle brachial index and a specificity of 67.6%. Regarding the toe brachial index, the sensitivity was 80.3% and the specificity 44.1%. We could explain the low sensitivity of the ankle brachial index in our population by the mediacalcosis of elderly subjects, avoidable with the measurement of the toe blood pressure index, which had a better sensitivity. CONCLUSION In a population of subjects over 70 years of age with a lower limb ulcer, without diabetes and without chronic renal failure, it would seem judicious to use the ankle brachial index in association with the toe brachial index for the diagnosis of peripheral arterial disease, followed by an arterial Doppler ultrasound of the lower limbs in order to evaluate the lesion profile of patients with a result of less than 0.7 of toe brachial index.
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Affiliation(s)
- V Cleofort
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
| | - R Attal
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - J Sayegh
- Service de cardiologie pédiatrique, avenue de la Côte de Nacre, 14033 Caen cedex 9, France
| | - A Yannoutsos
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - I Lazareth
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - J Emmerich
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
| | - P Priollet
- Service de médecine vasculaire, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France
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10
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Khider L, Templé M, Bally C, Spaeth A, Darnige L, Sanchez O, Planquette B, Mortelette H, Messas E, Smadja DM, Emmerich J, Mirault T, Kosmider O, Gendron N. Systematic search for the UBA1 mutation in men after a first episode of venous thromboembolism: A monocentric study. J Thromb Haemost 2022; 20:2697-2699. [PMID: 36002395 PMCID: PMC9826241 DOI: 10.1111/jth.15858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Lina Khider
- Vascular Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Marie Templé
- Hematology Department, Cochin HospitalAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Cécile Bally
- Hematology Department, Necker – Enfants Malades HospitalAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Agathe Spaeth
- Hematology Department, Cochin HospitalAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Luc Darnige
- Hematology Department, Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Innovative Therapies in Haemostasis, INSERMUniversité Paris CitéParisFrance
- Biosurgical Research Lab (Carpentier Foundation), Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Olivier Sanchez
- Innovative Therapies in Haemostasis, INSERMUniversité Paris CitéParisFrance
- Biosurgical Research Lab (Carpentier Foundation), Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Respiratory Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- F‐CRIN INNOVTESaint‐ÉtienneFrance
| | - Benjamin Planquette
- Innovative Therapies in Haemostasis, INSERMUniversité Paris CitéParisFrance
- Biosurgical Research Lab (Carpentier Foundation), Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Respiratory Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- F‐CRIN INNOVTESaint‐ÉtienneFrance
| | - Hélène Mortelette
- Vascular Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Emmanuel Messas
- Vascular Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - David M. Smadja
- Hematology Department, Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Innovative Therapies in Haemostasis, INSERMUniversité Paris CitéParisFrance
- Biosurgical Research Lab (Carpentier Foundation), Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- F‐CRIN INNOVTESaint‐ÉtienneFrance
| | - Joseph Emmerich
- Vascular Medicine DepartmentGroupe Hospitalier Paris Saint‐JosephParisFrance
- INSERM CRESS UMR 1153Université Paris CitéParisFrance
- Institut Cochin, CNRS UMR8104, INSERM U1016Université Paris CitéParisFrance
| | - Tristan Mirault
- Vascular Medicine DepartmentAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
| | - Olivier Kosmider
- Hematology Department, Cochin HospitalAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Institut Cochin, CNRS UMR8104, INSERM U1016Université Paris CitéParisFrance
| | - Nicolas Gendron
- Hematology Department, Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
- Innovative Therapies in Haemostasis, INSERMUniversité Paris CitéParisFrance
- Biosurgical Research Lab (Carpentier Foundation), Hôpital européen Georges PompidouAssistance Publique Hôpitaux de Paris‐Centre Université Paris Cité (APHP‐CUP)ParisFrance
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Thibord F, Klarin D, Brody JA, Chen MH, Levin MG, Chasman DI, Goode EL, Hveem K, Teder-Laving M, Martinez-Perez A, Aïssi D, Daian-Bacq D, Ito K, Natarajan P, Lutsey PL, Nadkarni GN, de Vries PS, Cuellar-Partida G, Wolford BN, Pattee JW, Kooperberg C, Braekkan SK, Li-Gao R, Saut N, Sept C, Germain M, Judy RL, Wiggins KL, Ko D, O’Donnell CJ, Taylor KD, Giulianini F, De Andrade M, Nøst TH, Boland A, Empana JP, Koyama S, Gilliland T, Do R, Huffman JE, Wang X, Zhou W, Soria JM, Souto JC, Pankratz N, Haessler J, Hindberg K, Rosendaal FR, Turman C, Olaso R, Kember RL, Bartz TM, Lynch JA, Heckbert SR, Armasu SM, Brumpton B, Smadja DM, Jouven X, Komuro I, Clapham KR, Loos RJ, Willer CJ, Sabater-Lleal M, Pankow JS, Reiner AP, Morelli VM, Ridker PM, van Hylckama Vlieg A, Deleuze JF, Kraft P, Rader DJ, Lee KM, Psaty BM, Skogholt AH, Emmerich J, Suchon P, Rich SS, Vy HMT, Tang W, Jackson RD, Hansen JB, Morange PE, Kabrhel C, Trégouët DA, Damrauer SM, Johnson AD, Smith NL. Cross-Ancestry Investigation of Venous Thromboembolism Genomic Predictors. Circulation 2022; 146:1225-1242. [PMID: 36154123 PMCID: PMC10152894 DOI: 10.1161/circulationaha.122.059675] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/09/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a life-threatening vascular event with environmental and genetic determinants. Recent VTE genome-wide association studies (GWAS) meta-analyses involved nearly 30 000 VTE cases and identified up to 40 genetic loci associated with VTE risk, including loci not previously suspected to play a role in hemostasis. The aim of our research was to expand discovery of new genetic loci associated with VTE by using cross-ancestry genomic resources. METHODS We present new cross-ancestry meta-analyzed GWAS results involving up to 81 669 VTE cases from 30 studies, with replication of novel loci in independent populations and loci characterization through in silico genomic interrogations. RESULTS In our genetic discovery effort that included 55 330 participants with VTE (47 822 European, 6320 African, and 1188 Hispanic ancestry), we identified 48 novel associations, of which 34 were replicated after correction for multiple testing. In our combined discovery-replication analysis (81 669 VTE participants) and ancestry-stratified meta-analyses (European, African, and Hispanic), we identified another 44 novel associations, which are new candidate VTE-associated loci requiring replication. In total, across all GWAS meta-analyses, we identified 135 independent genomic loci significantly associated with VTE risk. A genetic risk score of the significantly associated loci in Europeans identified a 6-fold increase in risk for those in the top 1% of scores compared with those with average scores. We also identified 31 novel transcript associations in transcriptome-wide association studies and 8 novel candidate genes with protein quantitative-trait locus Mendelian randomization analyses. In silico interrogations of hemostasis and hematology traits and a large phenome-wide association analysis of the 135 GWAS loci provided insights to biological pathways contributing to VTE, with some loci contributing to VTE through well-characterized coagulation pathways and others providing new data on the role of hematology traits, particularly platelet function. Many of the replicated loci are outside of known or currently hypothesized pathways to thrombosis. CONCLUSIONS Our cross-ancestry GWAS meta-analyses identified new loci associated with VTE. These findings highlight new pathways to thrombosis and provide novel molecules that may be useful in the development of improved antithrombosis treatments.
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Affiliation(s)
- Florian Thibord
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Derek Klarin
- Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA, 94305, USA
- VA Palo Alto Healthcare System, Palo Alto, CA, 94550, USA
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Ming-Huei Chen
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Michael G. Levin
- Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA, 19104, USA
| | - Daniel I. Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Ellen L. Goode
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Kristian Hveem
- HUNT Research Center, Department of Public Health and Nursing, Norwegian University of Science and Technology, Forskningsvegen 2, Levanger, 7600, Norway
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Maris Teder-Laving
- Institute of Genomics, University of Tartu, Riia 23b, Tartu, Tartu, 51010, Estonia
| | - Angel Martinez-Perez
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
| | - Dylan Aïssi
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
| | - Delphine Daian-Bacq
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Kaoru Ito
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehirocho, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Girish N. Nadkarni
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Paul S. de Vries
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX, 77030, USA
| | | | - Brooke N. Wolford
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Jack W. Pattee
- Division of Biostatistics, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
- Center for Innovative Design & Analysis and Department of Biostatistics & Informatics, Colorado School of Public Health, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Sigrid K. Braekkan
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Ruifang Li-Gao
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Noemie Saut
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
| | - Corriene Sept
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Marine Germain
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Renae L. Judy
- Surgery, University of Pennsylvania, 3401 Walnut Street, Philadelphia, PA, 19104, USA
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Darae Ko
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- Section of Cardiovascular Medicine, Boston University School of Medicine, 85 East Newton Street, Boston, MA, 02118, USA
| | - Christopher J. O’Donnell
- Cardiology Section, Department of Medicine, VA Boston Healthcare System, Boston, MA, 02132, USA
- Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation, 1124 W Carson St., Torrance, CA, 90502, USA
| | - Franco Giulianini
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
| | - Mariza De Andrade
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Therese H. Nøst
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Jean-Philippe Empana
- Integrative Epidemiology of cardiovascular diseases, Université Paris Cité, Paris Cardiovascular Research Center (PARCC), 56 rue Leblanc, Paris, 75015, France
- Department of Cardiology, APHP, Hopital Européen Georges Pompidou, 20 rue Leblanc, Paris, 75015, France
| | - Satoshi Koyama
- Laboratory for Cardiovascular Genomics and Informatics, RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehirocho, Tsurumi-ku, Yokohama, Kanagawa, 230-0045, Japan
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
| | - Thomas Gilliland
- Cardiovascular Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA, 02446, USA
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
| | - Ron Do
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
- BioMe Phenomics Center, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Jennifer E. Huffman
- MAVERIC, VA Boston Heathcare System, 2 Avenue de Lafayette, Boston, MA, 02111, USA
| | - Xin Wang
- 23andMe, Inc., 223 N Mathilda Ave, Sunnyvale, CA, 94086, USA
| | - Wei Zhou
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - Jose Manuel Soria
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
| | - Juan Carlos Souto
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
- Unit of Thrombosis and Hemostasis, Hospital de la Santa Creu i Sant Pau, St Quinti 89, Barcelona, 8041, Spain
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Jeffery Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
| | - Kristian Hindberg
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
| | - Frits R. Rosendaal
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Constance Turman
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Rachel L. Kember
- Psychiatry, University of Pennsylvania, 3401 Walnut Street, Philadelphia, PA, 19104, USA
| | - Traci M. Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Julie A. Lynch
- VA Informatics & Computing Infrastructure, VA Salt Lake City Healthcare System, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
- Epidemiology, University of Utah, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Sebastian M. Armasu
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Ben Brumpton
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - David M. Smadja
- Hematology Department and Biosurgical Research Lab (Carpentier Foundation), European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, 20 rue Leblanc, Paris, 75015, France
- Innovative Therapies in Haemostasis, INSERM, Université de Paris, 4 avenue de l’Observatoire, Paris, 75270, France
| | - Xavier Jouven
- Integrative Epidemiology of cardiovascular diseases, Université Paris Descartes, Sorbonne Paris Cité, 56 rue Leblanc, Paris, 75015, France
- Paris Cardiovascular Research Center, Inserm U970, Université Paris Descartes, Sorbonne Paris Cité, 20 rue Leblanc, Paris, 75015, France
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Tokyo, 113-8655, Japan
| | - Katharine R. Clapham
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard & MIT, 75 Ames St, Cambridge, MA, 02142, USA
- Department of Medicine, Harvard Medical School, Shattuck St, Boston, MA, 02115, USA
- Division of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
| | - Ruth J.F. Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
| | - Cristen J. Willer
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Maria Sabater-Lleal
- Genomics of Complex Disease Unit, Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), St Quinti 77-79, Barcelona, 8041, Spain
- Cardiovascular Medicine Unit, Department of Medicine, Karolinska Institutet, Center for Molecular Medicine, Stockholm, 17176, Sweden
| | - James S. Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Alexander P. Reiner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Vania M. Morelli
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Paul M. Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave, Boston, MA, 02215, USA
- Harvard Medical School, Boston, MA, 02115, USA
| | - Astrid van Hylckama Vlieg
- Clinical Epidemiology, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, CEA, Université Paris-Saclay, 2 Rue Gaston Crémieux, Evry, 91057, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
- Centre D’Etude du Polymorphisme Humain, Fondation Jean Dausset, 27 rue Juliette Dodu, Paris, 75010, France
| | - Peter Kraft
- Department of Epidemiology, Harvard TH Chan Harvard School of Public Health, 655 Huntington Ave., Building II, Boston, MA, 02115, USA
| | - Daniel J. Rader
- Departments of Medicine and Genetics and Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | | | | | | | | | | | - Kyung Min Lee
- VA Informatics & Computing Infrastructure, VA Salt Lake City Healthcare System, 500 Foothills Drive, Salt Lake City, UT, 84148, USA
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Department of Health Systems and Population Heath, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
| | - Anne Heidi Skogholt
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, Håkon Jarls gate 11, Trondheim, 7030, Norway
| | - Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, University of Paris, 185 rue Raymond Losserand, Paris, 75674, France
- UMR1153, INSERM CRESS, 185 rue Raymond Losserand, Paris, 75674, France
| | - Pierre Suchon
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
- C2VN, INSERM, INRAE, Aix-Marseille University, 27, bd Jean Moulin, Marseille, 13385, France
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, 3242 West Complex, Charlottesville, VA, 22908-0717, USA
| | - Ha My T. Vy
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY, 10029, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1 Gu stave L. Levy Pl, New York, NY, 10029, USA
| | - Weihong Tang
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN, 55454, USA
| | - Rebecca D. Jackson
- College of Medicine, Ohio State University, 376 W. 10th Ave, Columbus, OH, 43210, USA
| | - John-Bjarne Hansen
- Thrombosis Research Center (TREC), UiT - The Arctic University of Norway, Universitetsvegen 57, Tromsø, 9037, Norway
- Division of internal medicine, University Hospital of North Norway, Tromsø, 9038, Norway
| | - Pierre-Emmanuel Morange
- Hematology Laboratory, La Timone University Hospital of Marseille, 264 Rue Saint-Pierre, Marseille, 13385, France
- C2VN, INSERM, INRAE, Aix-Marseille University, 27, bd Jean Moulin, Marseille, 13385, France
| | - Christopher Kabrhel
- Emergency Medicine, Massachusetts General Hospital, Zero Emerson Place, Suite 3B, Boston, MA, 02114, USA
- Emergency Medicine, Harvard Medical School, Zero Emerson Place, Suite 3B, Boston, MA, 02114, USA
| | - David-Alexandre Trégouët
- Bordeaux Population Health Research Center, University of Bordeaux, 146 rue Léo Saignat, Bordeaux, 33076, France
- UMR1219, INSERM, 146 rue Léo Saignat, Bordeaux, 33076, France
- Laboratory of Excellence on Medical Genomics, GenMed, France
| | - Scott M. Damrauer
- Corporal Michael J. Crescenz Philadelphia VA Medical Center, 3900 Woodland Ave, Philadelphia, PA, 19104, USA
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Andrew D. Johnson
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
- The Framingham Heart Study, Boston University and NHLBI, 73 Mt. Wayte Ave, Suite #2, Framingham, MA, 01702, USA
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA, 98101, USA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, 98101, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, 98108, USA
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Compagnon A, Lazareth I, Fels A, Chatellier G, Emmerich J, Michon-Pasturel U, Priollet P, Yannoutsos A. Peri-procedural complications following endovascular revascularization for critical limb ischemia. J Med Vasc 2022; 47:175-185. [PMID: 36344028 DOI: 10.1016/j.jdmv.2022.10.007] [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] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Revascularization procedures are considered the cornerstone of therapy in patients with critical limb ischemia (CLI) and multiple procedures are often required to attain limb salvage. The aim of the present study is to determine the prevalence of peri-procedural complications after endovascular procedure, and to determine the clinical and biological characteristics of patients associated to the risk of peri-procedural complications. METHODS From November 2013 to May 2021, 324 consecutive patients were retrospectively included, of whom 99 underwent more than one revascularization procedure for contralateral CLI or clinical recurrence of CLI. A total of 532 revascularizations were performed. Clinical and biological parameters were recorded at baseline before endovascular revascularization. The occurrence of a peri-procedural complication (local complications, fatal and non-fatal major bleeding or cardiovascular events) was recorded up to 30days after revascularization. Univariate and multivariate analyses were performed to study the parameters associated with per-procedural complications. A P<0.05 was considered as statistically significant. RESULTS A total of 324 consecutive patients were included, 177 men and 147 women with CLI, with a mean age of 77.6±11.9years. Most of these patients had cardiovascular comorbidities (41% with a history of coronary heart disease, 78% treated hypertensive patients, 49% diabetic patients). Peri-procedural mortality occurred in 13 patients (4%) and 9 patients (2.8%) experienced major amputation at one-month following revascularization. Among the 532 revascularization procedures, 99 major bleeding events (22.8% of the cohort population) and 31 cardiovascular events (8.6% of the cohort population), were recorded in the peri-procedural period. Cardiovascular events were associated with peri-procedural mortality. Complications at the puncture site occurred during 38 of the 532 procedures (10.2% of the cohort population). Compared with patients undergoing a single revascularization procedure, patients with multiple procedures presented a higher risk of major bleeding events (48.5% vs. 11.6%, P<0.0001) and access site complications (20.2% vs. 5.78%, P<0.0001). In multivariate analysis, pulse pressure <60mmHg and hemoglobin level <10g/dl were correlated with the occurrence of major bleeding events; left ventricular ejection fraction<60% and the absence of statin treatment were correlated with the occurrence of cardiovascular complications; a high chronological rank of revascularization was correlated with the occurrence of local complication. Finally, age and gender were not associated with the occurrence of peri-procedural complication. CONCLUSION The present results highlight that multiple revascularization procedures for limb salvage are required in almost one third of the population with critical limb ischemia and were associated with the risk of major bleeding events and access site complications. The most frequent complications of peripheral vascular interventions were major bleeding events. Adverse cardiovascular events were related with peri-procedural mortality. Anemia, blood pressure, left ventricular ejection fraction and statin treatment are important parameters to consider for peri-procedural outcomes, independently of age, gender and the chronological rank of revascularization procedure.
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Affiliation(s)
- A Compagnon
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France; Department of Clinical Research, GH Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France
| | - I Lazareth
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France
| | - A Fels
- Department of Clinical Research, GH Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France
| | - G Chatellier
- Department of Clinical Research, GH Paris Saint-Joseph, 185, rue Raymond Losserand, 75014 Paris, France
| | - J Emmerich
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France; Inserm UMR 1153-CRESS, Université Paris Cité, Paris, France
| | - U Michon-Pasturel
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France
| | - P Priollet
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France
| | - A Yannoutsos
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Resident Sorbonne Université, Paris, France; Inserm UMR 1153-CRESS, Université Paris Cité, Paris, France.
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Emmerich J. Is aortic thrombosis an intruder in the COVID pandemic? JMV-Journal de Médecine Vasculaire 2022; 47:167-168. [PMID: 36344026 PMCID: PMC9595397 DOI: 10.1016/j.jdmv.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Indexed: 11/06/2022]
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14
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Vignals C, Lanternier F, Garcia-Hermoso D, Emmerich J, Bronnimann D. P306 Scedosporium spp. and Lomentospora prolificans, fungal agents with unexpected vascular tropism. Med Mycol 2022. [PMCID: PMC9509952 DOI: 10.1093/mmy/myac072.p306] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Invasive scedosporiosis and lomentosporiosis are deadly fungal infections due to Scedosporium spp. and Lomentospora prolificans. The Scedosporiosis/lomentosporiosis Observational Study (S.O.S.) highlighted for the first time a frequent vascular involvement in these infections including aortitis and peripheral arteritis (PA). We here describe the clinical, microbiological, radiological and anatomopathological characteristics of these vascular infections. Methods We retrospectively reviewed cases of arteritis (with the exception of central nervous system arteritis) from the S.O.S. cohort and from the literature. Results Seven cases of vascular infections were identified from the S.O.S. cohort representing 24% (7/29) of the disseminated scedosporiosis/lomentosporiosis. Four cases had both aortitis and PA, 2 patients were diagnosed with PA and one patient with aortitis. A total of 9 aortitis and 4 PA cases were identified from the literature. All 20 cases were proven scedosporiosis/lomentosporiosis. The main species was S. apiospermum [60% of cases (12/20)] followed by L. prolificans [35% of cases (7/20)]. One infection was caused by both species. An underlying immunosuppression was present in 70% of the cases (14/20, with 10 cases of solid organ transplantation and 3 cases of hematologic malignancies). The main risk factor in immunocompetent patients was a previous cutaneous trauma (4/6). Interestingly, vascular involvement was identified at diagnosis of the scedosporiosis/lomentosporiosis in only half of the cases. Aortitis was mainly abdominal (8/13). Various PA localizations were reported with frequent iliac or femoral involvement (4/10). Arteritis was the only localization in only 10% (2/20) of the scedosporiosis/lomentosporiosis, other sites involved being mainly osteoarticular (10/20), and pulmonary (9/20) followed by central nervous system (5/20), cutaneous localizations (4/20), and endocarditis (4/20). Of note, three-quarters of the cases were disseminated. Aneurysmal lesion was the most frequent imaging aspect (8/11 of aortitis and 6/10 of PA) which was complicated by a rupture in half of the aortitis (4/8) and only one PA (1/6). Vascular wall thickening (2/11 of aortitis and 1/10 of PA) and perivascular abscess (1/11 and 1/10, respectively) were more rarely described. Hypermetabolism was constant on PET-CT scan when performed (6/6). When available (11/20), pathological analysis showed an invasion of the artery wall by fungal hyphae (10/11), particularly in the media and the adventice. A total of 3-months of mortality related to infection was 44% (8/18), rising to 71% (5/7) in case of fungemia. Conclusion The vascular tropism of Scedosporium spp. and L. prolificans underlies the necessity of vascular imaging in the management of these infections, especially in case of dissemination seeking in particular aneurysmal lesions of the abdominal aorta and iliofemoral arteries.
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Affiliation(s)
- Carole Vignals
- Centre Hospitalier Universitaire de Bordeaux , Bordeaux , France
| | - Fanny Lanternier
- Université de Paris, Hôpital Necker-enfants malades , Assistance Publique des hôpitaux de Paris, Paris , France
- Institut Pasteur, Centre National de Référence Mycoses invasives et Antifongiques , Paris , France
| | - Dea Garcia-Hermoso
- Institut Pasteur, Centre National de Référence Mycoses invasives et Antifongiques , Paris , France
| | - Joseph Emmerich
- Université de Paris, Hôpital Saint-Joseph , Inserm CRESS UMR 1153, Paris , France
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15
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Audemard-Verger A, Le Gouge A, Pestre V, Courjon J, Langlois V, Vareil MO, Devaux M, Bienvenu B, Leroy V, Goulabchand R, Colombain L, Bigot A, Guimard T, Douadi Y, Urbanski G, Faucher JF, Maulin L, Lioger B, Talarmin JP, Groh M, Emmerich J, Deriaz S, Ferreira-Maldent N, Cook AR, Lengellé C, Bourgoin H, Mekinian A, Aouba A, Maillot F, Caille A. Efficacy and safety of anakinra in adults presenting deteriorating respiratory symptoms from COVID-19: A randomized controlled trial. PLoS One 2022; 17:e0269065. [PMID: 35925914 PMCID: PMC9351999 DOI: 10.1371/journal.pone.0269065] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 05/12/2022] [Indexed: 01/08/2023] Open
Abstract
Objective We aimed to investigate whether anakinra, an interleukin-1receptor inhibitor, could improve outcome in moderate COVID-19 patients. Methods In this controlled, open-label trial, we enrolled adults with COVID-19 requiring oxygen. We randomly assigned patients to receive intravenous anakinra plus optimized standard of care (oSOC) vs. oSOC alone. The primary outcome was treatment success at day 14 defined as patient alive and not requiring mechanical ventilation or extracorporeal membrane oxygenation. Results Between 27th April and 6th October 2020, we enrolled 71 patients (240 patients planned to been enrolled): 37 were assigned to the anakinra group and 34 to oSOC group. The study ended prematurely by recommendation of the data and safety monitoring board due to safety concerns. On day 14, the proportion of treatment success was significantly lower in the anakinra group 70% (n = 26) vs. 91% (n = 31) in the oSOC group: risk difference—21 percentage points (95% CI, -39 to -2), odds ratio 0.23 (95% CI, 0.06 to 0.91), p = 0.027. After a 28-day follow-up, 9 patients in the anakinra group and 3 in the oSOC group had died. Overall survival at day 28 was 75% (95% CI, 62% to 91%) in the anakinra group versus 91% (95% CI, 82% to 100%) (p = 0.06) in the oSOC group. Serious adverse events occurred in 19 (51%) patients in the anakinra group and 18 (53%) in the oSOC group (p = 0·89). Conclusion This trial did not show efficacy of anakinra in patients with COVID-19. Furthermore, contrary to our hypothesis, we found that anakinra was inferior to oSOC in patients with moderate COVID-19 pneumonia.
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Affiliation(s)
- Alexandra Audemard-Verger
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
- University of Tours, Tours, France
- * E-mail:
| | | | - Vincent Pestre
- Department of Internal Medicine and Infectious Diseases, CH Avignon, Avignon, France
| | - Johan Courjon
- Department of Infectious Diseases, Université Côte d’Azur, CHU Nice, Nice, France
| | | | | | - Mathilde Devaux
- Department of Internal Medicine, CH de Poissy, Poissy, France
| | - Boris Bienvenu
- Department of Internal Medicine, Hôpital Saint Joseph, Marseille, France
| | - Vincent Leroy
- Department of Infectious Diseases, Clinique Tessier, Valenciennes, France
| | - Radjiv Goulabchand
- Internal Medicine Department & Department of Infectious and Tropical Diseases, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | - Léa Colombain
- Department of Infectious Diseases, CH de Perpignan, Perpignan, France
| | - Adrien Bigot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | - Thomas Guimard
- Department of Infectious Diseases, CH la Roche sur Yon, La Roche sur Yon, France
| | - Youcef Douadi
- Department of Infectious Diseases, CH Saint Quentin, Saint Quentin, France
| | - Geoffrey Urbanski
- Department of Internal Medicine and Clinical Immunology, CHU Angers, Angers France
| | | | - Laurence Maulin
- Department of Infectious Diseases, CH Aix en Provence, Aix en Provence, France
| | | | | | - Matthieu Groh
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | - Joseph Emmerich
- Department of Vascular Medicine, GH Saint Joseph and Université de Paris, INSERM CRESS 1153, Paris, France
| | - Sophie Deriaz
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | - Ann-Rose Cook
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
| | | | | | - Arsène Mekinian
- Department of Internal Medicine, Hôpital Saint Antoine, Sorbonne Université, Paris, France
| | - Achille Aouba
- Department of Internal Medicine, CHU de Caen, Caen, France
| | - François Maillot
- Department of Internal Medicine and Clinical Immunology, CHRU Tours, Tours, France
- University of Tours, Tours, France
| | - Agnès Caille
- University of Tours, Tours, France
- INSERM CIC1415, CHRU Tours, Tours, France
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16
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Hermine O, Mariette X, Porcher R, Djossou F, Nguyen Y, Arlet JB, Savale L, Diehl JL, Georgin-Lavialle S, Cadranel J, Pialoux G, Lacombe K, Mekinian A, Gros H, Lescure X, Ghosn J, Coupez E, Grapin K, Rapp C, Michel M, Lecapitaine AL, Michot JM, Costedoat-Chalumeau N, Nguyen LBL, Semerano L, Raffi F, Aguillar C, Rouzaud C, Gottenberg JE, Hansmann Y, Bienvenu B, London J, Fantchou FS, Ackermann F, Gros A, Morel A, Gambier N, Sène D, Mégarbane B, Azoulay E, Bureau S, Dougados M, Emmerich J, Fartoukh M, Guidet B, Humbert M, Mahevas M, Pène F, Schlemmer F, Pourcher-Martinez V, Tibi A, Baron G, Perrodeau E, Baron S, Steg G, Yazdapanah Y, Simon T, Resche-Rigon M, Tharaux PL, Ravaud P. Tocilizumab plus dexamethasone versus dexamethasone in patients with moderate-to-severe COVID-19 pneumonia: A randomised clinical trial from the CORIMUNO-19 study group. EClinicalMedicine 2022; 46:101362. [PMID: 35350097 PMCID: PMC8949640 DOI: 10.1016/j.eclinm.2022.101362] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 02/07/2022] [Accepted: 03/08/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In moderate-to-severe COVID-19 pneumonia, dexamethasone (DEX) and tocilizumab (TCZ) reduce the occurrence of death and ventilatory support. We investigated the efficacy and safety of DEX+TCZ in an open randomized clinical trial. METHODS From July 24, 2020, through May 18, 2021, patients with moderate-to-severe COVID-19 pneumonia requiring oxygen (>3 L/min) were randomly assigned to receive DEX (10 mg/d 5 days tapering up to 10 days) alone or combined with TCZ (8 mg/kg IV) at day 1, possibly repeated with a fixed dose of 400 mg i.v. at day 3. The primary outcome was time from randomization to mechanical ventilation support or death up to day 14, analysed on an intent-to-treat basis using a Bayesian approach. ClinicalTrials.gov number, NCT04476979. FINDINGS A total of 453 patients were randomized, 3 withdrew consent, 450 were analysed, of whom 226 and 224 patients were assigned to receive DEX or TCZ+DEX, respectively. At day 14, mechanical ventilation or death occurred in 32/226 (14%) and 27/224 (12%) in the DEX and TCZ+DEX arms, respectively (hazard ratio [HR] 0·85, 90% credible interval [CrI] 0·55 to 1·31). At day 14, the World health Organization (WHO) clinical progression scale (CPS) was significantly improved in the TCZ+DEX arm (OR 0·69, 95% CrI, 0·49 to 0.97). At day 28, the cumulative incidence of oxygen supply independency was 82% in the TCZ+DEX arms and 72% in the DEX arm (HR 1·36, 95% CI 1·11 to 1·67). On day 90, 24 deaths (11%) were observed in the DEX arm and 18 (8%) in the TCZ+DEX arm (HR 0·77, 95% CI 0·42-1·41). Serious adverse events were observed in 25% and 21% in DEX and TCZ+DEX arms, respectively. INTERPRETATION Mechanical ventilation need and mortality were not improved with TCZ+DEX compared with DEX alone. The safety of both treatments was similar. However, given the wide confidence intervals for the estimate of effect, definitive interpretation cannot be drawn. FUNDING Programme Hospitalier de Recherche Clinique [PHRC COVID-19-20-0151, PHRC COVID-19-20-0029], Fondation de l'Assistance Publique - Hôpitaux de Paris (Alliance Tous Unis Contre le Virus) and from Fédération pour la Recherche Médicale" (FRM). Tocilizumab was provided by Roche.
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Affiliation(s)
- Olivier Hermine
- Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France
- Laboratory of physiopathology and treatment of Hematological malignancies, Institut imagine, INSERM U1153, Université de Paris, Paris, France
- Corresponding author at: Département d'hématologie, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, 149 rue de Sèvres, Paris 75015, France.
| | - Xavier Mariette
- Département de Rhumatologie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Université Paris Saclay, Le Kremlin Bicêtre, France
| | - Raphael Porcher
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Felix Djossou
- Service de maladies infectieuses et tropicales (UMIT), TBIP, Univ. de Guyane, Cayenne 97300, French Guiana
- Univ. de Lille, CNRS, Inserm, Institut Pasteur de Lille, U1019-UMR9017-CIIL Centre d'Infection et d'Immunité de Lille, Lille 59000, France
| | - Yann Nguyen
- Département de Médecine interne, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jean-Benoît Arlet
- Département de Médecine interne, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Laurent Savale
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Jean Luc Diehl
- Département de Réanimation, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Sophie Georgin-Lavialle
- Département de Médecine Interne, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Jacques Cadranel
- Département de Pneumologie, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Gilles Pialoux
- Département de Maladies Infectieuses, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Karine Lacombe
- Département de Maladies Infectieuses, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Arsène Mekinian
- Département de Médecine Interne, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Hélène Gros
- Service de Médecine Interne et Maladies Infectieuses, CHI Robert Ballanger, Aulnay sous Bois 93600, France
| | - Xavier Lescure
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Jade Ghosn
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, and INSERM UMRS 1137 IAME, Université de Paris, Paris France
| | - Elisabeth Coupez
- Département de Réanimation, Hôpital Gabriel Montpied, CHU de Clermont Ferrand Université de Clermont Ferrand, France
| | - Kevin Grapin
- Département de Pneumologie, Hôpital Gabriel Montpied, CHU de Clermont Ferrand, Université de Clermont Ferrand, France
| | - Christophe Rapp
- Service de Médecine Interne, Hôpital Américain, Neuilly, France
| | - Marc Michel
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | | | - Jean Marie Michot
- Service d'hématologie, Institut Gustave Roussy, Université Paris Saclay, Villejuif, France
| | - Nathalie Costedoat-Chalumeau
- Département de Médecine Interne, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Liem Binh Luong Nguyen
- CIC Cochin Pasteur, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Luca Semerano
- Service de Rhumatologie, Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Université de Paris Nord Sorbonne, Bobigny, France
| | - François Raffi
- Department of Infectious Diseases, Hotel-Dieu Hospital and INSERM CIC 1413, Nantes University Hospital, Nantes, France
| | - Claire Aguillar
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Claire Rouzaud
- Département de maladies Infectieuses, Hôpital Necker, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
- Département de maladies Infectieuses, Hôpital Saint Joseph, University of Paris, Paris France
| | - Jacques Eric Gottenberg
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Yves Hansmann
- Service de maladies infectieuses, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Boris Bienvenu
- Département de médecine Interne, Hôpital Saint Joseph, Marseille, France
| | - Jonathan London
- Service de Médecine interne, Hôpital des Diaconesse-Croix saint Simon, Paris, France
| | - Franklin Samou Fantchou
- Service de Maladies Infectieuses, Centre hospitalier du centre Hospitalier de l'ouest Guyanais, Saint Laurent du Maroni, France
| | | | - Antoine Gros
- Service de Réanimation Médico-chirurgicale, Hôpital André Mignot, Versailles, France
| | - Alexandre Morel
- Service d'Hématologie, Hôpital Privé d'Antony, Antony, France
| | - Nicolas Gambier
- Service de Maladies Infectieuses, Centre Hospitalier Saint Denis, Hôpital Delafontaine, Saint Denis, France
| | - Damien Sène
- Service de Médecine Interne, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Bruno Mégarbane
- Réanimation Médicale et Toxicologique, Hôpital de Lariboisière, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM UMRS-1144, Paris France
| | - Elie Azoulay
- Département de Réanimation, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Serge Bureau
- Direction de la recherche clinique, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Maxime Dougados
- Département de Rhumatologie, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Joseph Emmerich
- Département de médecine vasculaire, Hôpital Saint Joseph, Université de Paris, Paris France
| | - Muriel Fartoukh
- Département de Réanimation, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Bertrand Guidet
- Département de Réanimation, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Marc Humbert
- Université Paris–Saclay, INSERM UMR_S999, Assistance Publique Hôpitaux de Paris, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Mathieu Mahevas
- Département de Médecine interne, Hôpital Henri Mondor, Assistance Publique Hôpitaux de Paris, Université de Paris Est Créteil, Créteil France
| | - Frédéric Pène
- Service de Médecine Intensive et Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris. Centre, Université de Paris, Paris France
| | - Frédéric Schlemmer
- Université de Paris Est Créteil, Assistance Publique-Hôpitaux de Paris, Unité de Pneumologie - Service de Médecine Intensive et Réanimation, Hôpitaux Universitaires Henri Mondor, Créteil France
| | - Valérie Pourcher-Martinez
- Département de Maladies Infectieuses, Hôpital de la Pitié Salpétrière, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Annick Tibi
- Agence Générale des Equipements et Produits de Santé, Assistance Publique des hôpitaux de Paris, Paris, France
| | - Gabriel Baron
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Elodie Perrodeau
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
| | - Stéphanie Baron
- Département de physiologie et explorations fonctionelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Gabriel Steg
- Département de cardiologie, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Yazdan Yazdapanah
- Département de Maladies infectieuses, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Tabassome Simon
- Service de pharmacologie clinique, centre de recherche clinique de Paris Est, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris, Université de Paris Sorbonne, Paris France
| | - Matthieu Resche-Rigon
- Service de biostatistique et information médicale, INSERM U153, Hôpital Saint Louis, Assistance Publique Hôpitaux de Paris, Université de Paris, Paris France
| | - Pierre-Louis Tharaux
- INSERM U970 Paris Cardiovascular Centre (PARCC), Université de Paris, Paris, France
| | - Philippe Ravaud
- Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS-UMR1153), Inserm / Université Paris, Centre d'épidémiologie clinique, Hôpital Hôtel-Dieu, France
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17
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Gabet A, Grave C, Tuppin P, Olié V, Emmerich J. One Year Prevalence of Venous Thromboembolism in Hospitalized COVID-19 Patients in France: Patients' Characteristics, Time Trends, and Outcomes. Thromb Haemost 2022; 122:1532-1541. [PMID: 35288889 DOI: 10.1055/s-0042-1743475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Patients hospitalized with coronavirus disease-2019 (COVID-19) are at high risk of deep venous thrombosis (DVT) and pulmonary embolism (PE). OBJECTIVES The aims were to provide time trends in the 2020 nation-wide prevalence of venous thromboembolism (VTE) in patients hospitalized with a COVID-19 diagnosis in France, and to describe in-hospital and up to 30-day postdischarge death. METHODS All patients hospitalized in France with a COVID-19 diagnosis in 2020 were selected. Crude and age-adjusted prevalence of VTE and PE was computed by 4-week intervals and for the overall study period using Poisson regression. Time trends in in-hospital and 30-day postdischarge case-fatality rates were evaluated by comparing each 4-week intervals to weeks 10 to 14 corresponding to the first part of the first lockdown using logistic regression models. RESULTS Among the 287,638 patients hospitalized with a COVID-19 diagnosis in 2020 in France, 14,985 (5.2%) had a concomitant VTE, with 10,453 (3.6%) having PE and 4,532 (1.6%) having DVT. In patients admitted to intensive care units, the crude prevalence of VTE and PE reached 16.1 and 11.0% respectively during the first lockdown. After adjustment, the prevalence of VTE and PE decreased during the year 2020 but a rebound was observed during the second lockdown. In-hospital case-fatality rates among hospitalized COVID-19 patients with PE globally decreased between the first and the second epidemic waves. CONCLUSION Our study showed a decrease in the incidence of symptomatic VTE and PE in hospitalized COVID-19 patients, and a decreased time trend of outcomes during the second wave compared with the first one.
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Affiliation(s)
- Amélie Gabet
- Cardiovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice (94), France
| | - Clémence Grave
- Cardiovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice (94), France
| | - Philippe Tuppin
- Department of Studies Strategy and Statistics, Caisse Nationale d'Assurance Maladie, Paris, France
| | - Valérie Olié
- Cardiovascular Division, Department of Non-Communicable Diseases, Santé Publique France, Saint-Maurice (94), France
| | - Joseph Emmerich
- Department of Vascular Medicine, Groupe Hospitalier Paris Saint-Joseph, Université de Paris, INSERM CRESS 1153, Paris, France
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18
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Planquette B, Khider L, Le Berre A, Soudet S, Pernod G, Le Mao R, Besutti M, Gendron N, Yannoutsos A, Smadja DM, Goudot G, Al Kahf S, Mohammedi N, Al Hamoud A, Philippe A, Fournier L, Rance B, Diehl JL, Mirault T, Messas E, Emmerich J, Chocron R, Couturaud F, Ferreti G, Sevestre-Pietri MA, Meneveau N, Chatellier G, Sanchez O. Adjusting D-dimer to lung disease extent to exclude Pulmonary Embolism in COVID-19 patients (Co-LEAD). Thromb Haemost 2022; 122:1888-1898. [PMID: 35144305 PMCID: PMC9626028 DOI: 10.1055/a-1768-4371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective
D-dimer measurement is a safe tool to exclude pulmonary embolism (PE), but its specificity decreases in coronavirus disease 2019 (COVID-19) patients. Our aim was to derive a new algorithm with a specific D-dimer threshold for COVID-19 patients.
Methods
We conducted a French multicenter, retrospective cohort study among 774 COVID-19 patients with suspected PE. D-dimer threshold adjusted to extent of lung damage found on computed tomography (CT) was derived in a patient set (
n
= 337), and its safety assessed in an independent validation set (
n
= 337).
Results
According to receiver operating characteristic curves, in the derivation set, D-dimer safely excluded PE, with one false negative, when using a 900 ng/mL threshold when lung damage extent was <50% and 1,700 ng/mL when lung damage extent was ≥50%. In the derivation set, the algorithm sensitivity was 98.2% (95% confidence interval [CI]: 94.7–100.0) and its specificity 28.4% (95% CI: 24.1–32.3). The negative likelihood ratio (NLR) was 0.06 (95% CI: 0.01–0.44) and the area under the curve (AUC) was 0.63 (95% CI: 0.60–0.67). In the validation set, sensitivity and specificity were 96.7% (95% CI: 88.7–99.6) and 39.2% (95% CI: 32.2–46.1), respectively. The NLR was 0.08 (95% CI; 0.02–0.33), and the AUC did not differ from that of the derivation set (0.68, 95% CI: 0.64–0.72,
p
= 0.097). Using the Co-LEAD algorithm, 76 among 250 (30.4%) COVID-19 patients with suspected PE could have been managed without CT pulmonary angiography (CTPA) and 88 patients would have required two CTs.
Conclusion
The Co-LEAD algorithm could safely exclude PE, and could reduce the use of CTPA in COVID-19 patients. Further prospective studies need to validate this strategy.
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Affiliation(s)
- Benjamin Planquette
- Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France, Université de Paris Faculté de Santé, Paris, France.,Department of Respiratory Medicine, France; Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France., HEGP, Paris, France
| | - Lina Khider
- Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France, INSERM, Paris, France.,Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France, Université de Paris, Paris, France.,Vascular medicine department, Georges Pompidou european hospital, Université de Paris, Paris, France
| | - Alice Le Berre
- 3- Department of Radiology, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France., GHPSJ, Paris, France
| | - Simon Soudet
- Vascular Medicine, CHU Amiens-Picardie, Amiens, France
| | - Gilles Pernod
- CNRS / TIMC-IMAG UMR 5525 / Themas, Grenoble-Alpes University, France.,Vascular Medicine, University Hospital Grenoble-Alpes, Grenoble, France
| | - Raphael Le Mao
- médecine interne, medecine vasculaire et Pneumologie, Brest University hopsital, Brest, France.,EA 3878, CIC INSERM 1412, Université de Bretagne Occidentale, Brest, France
| | - Matthieu Besutti
- 7- Department of Cardiology, University Hospital, Besançon, EA3920, University of Franche Comté, Besançon, France., CHU Besancon, Besancon, France
| | - Nicolas Gendron
- Hematology, Université Paris decartes, Paris, France.,Hematology, AP-HP, European Hospital Georges Pompidou, France
| | - Alexandra Yannoutsos
- Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France., GHPSJ, Paris, France
| | - David M Smadja
- Hematology, Hopital Europeen Georges Pompidou, Paris, France.,Hematology, Université Paris Descartes, Paris, France
| | - Guillaume Goudot
- Vascular medicine department and Biosurgical research lab (Carpentier Foundation), Georges Pompidou european hospital, Université de Paris, Paris, France
| | - Salma Al Kahf
- Department of Respiratory Medicine, France; Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France., HEGP, Paris, France
| | - Nassim Mohammedi
- Department of Vascular Medicine, Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France, HEGP, Paris, France
| | - Antoine Al Hamoud
- Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Respiratory Medicine, France; Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France., HEGP, Paris, France
| | - Aurélien Philippe
- Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Haematology, Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France., HEGP, Paris, France
| | - Laure Fournier
- Department of Radiology, Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France., HEGP, Paris, France
| | - Bastien Rance
- Université de Paris, France; Department of Medical Informatics, Assistance Publique Hôpitaux de Paris.Centre-Université de Paris (APHP-CUP), F-75015 Paris, France, Université de Paris Faculté de Santé, Paris, France
| | - Jean-Luc Diehl
- Réanimation médicale - HEGP, Assistance Publique - Hopitaux de Paris, Paris, France
| | - Tristan Mirault
- Vascular medicine department, Georges Pompidou european hospital, Université de Paris, Paris, France
| | - Emmanuel Messas
- Vascular medicine department, Georges Pompidou european hospital, Université de Paris, Paris, France
| | - Joseph Emmerich
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France, Université de Paris Faculté de Santé, Paris, France
| | - Richard Chocron
- Emergency department, Georges Pompidou european hospital, Université de Paris, Paris, France
| | - Francis Couturaud
- Department of internal medicine and chest diseases, Brest University Hospital Centre, Brest, France
| | - Gilbert Ferreti
- Department of Radiology, CHU Grenoble-Alpes, CHU Grenoble Alpes, Grenoble, France
| | - Marie-Antoinette Sevestre-Pietri
- 4- Université Picardie Jules Verne EA7516 CHIMERE and Service de médecine vasculaire, CHU Amiens-Picardie, Amiens, France, Université de Picardie Jules Verne, Amiens, France
| | | | | | - Olivier Sanchez
- Université Paris Descartes, Sorbonne Paris Cité, and INSERM UMR S 1140, Paris, FRANCE, Paris, France
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19
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Fernex de Mongex A, Lefebvre M, Zemouri A, Ghaffari P, Di Primio M, Rajzbaum G, Emmerich J, Yannoutsos A, Priollet P. Infected pseudoaneurysm of dorsalis pedis artery. J Med Vasc 2022; 47:43-46. [PMID: 35393093 DOI: 10.1016/j.jdmv.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Indexed: 06/14/2023]
Affiliation(s)
- A Fernex de Mongex
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
| | - M Lefebvre
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - A Zemouri
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - P Ghaffari
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - M Di Primio
- Interventional Radiology Department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - G Rajzbaum
- Medical Center, Rheumatology, 20, rue Parmentier, 92200 Neuilly-sur-Seine, France
| | - J Emmerich
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université Paris, Inserm UMR 1153-CRESS, Paris, France
| | - A Yannoutsos
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université Paris, Inserm UMR 1153-CRESS, Paris, France
| | - P Priollet
- Vascular Medicine Department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
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20
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Gaisset R, Lin F, Borry O, Quemeneur C, Lazareth I, Emmerich J, Priollet P, Yannoutsos A. Incident cardiovascular events and early mortality in patients with revascularized critical limb ischemia. J Med Vasc 2022; 47:19-26. [PMID: 35393087 DOI: 10.1016/j.jdmv.2022.02.001] [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] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Patients with critical limb ischemia (CLI) present a high risk of cardiovascular events and death. This study aimed to investigate the incidence of major adverse cardiovascular events (MACE) and one-year mortality in patients undergoing percutaneous revascularization procedure for CLI. METHODS This investigation is a retrospective analysis of an ongoing cohort study in patients with CLI undergoing endovascular revascularization, hospitalized in the vascular medicine department from November 2013 to December 2018. Major cardiovascular events were collected during the first year after revascularization procedure and were defined as heart failure, acute coronary syndrome, ischemic stroke and sudden death. Mortality and major limb amputations, defined as above-the-ankle amputation, were determined during the one-year follow-up period. Multivariate logistic regression analyses were performed to identify factors independently associated with the occurrence of MACE and one-year mortality after revascularization procedure. A P≤0.05 was considered as statistically significant. RESULTS The study included 285 consecutive patients, 157 men (55%) and 128 women (45%), with a mean age of 77.8±12 years. Treated hypertension was present in 222 (78%) patients; diabetes was present in 137 (48%) patients; 112 (39%) patients had known coronary heart disease and 20 (7%) patients were dialysis dependent. During the one-year follow-up after revascularization procedure, 75 (26.3%) patients presented an incident cardiovascular event, of whom 19 (6.7%) patients in the perioperative period. Cumulative mortality rate was 26.7% (76 patients) mostly from cardiovascular causes. Twenty-five patients (8.8%) experienced major amputation. In multivariate analysis, the occurrence of MACE was associated with an increased mortality risk (HR 6.96 (2.99-16.94), P<0.001). Other variables associated with an increased mortality were living in a nursing home and malnutrition. Decompensated heart failure and coronary heart disease were both associated with incident MACE in multivariate analysis, independently of confounders. CONCLUSION In the present study population, incident MACE were prevalent in the year following endovascular revascularization procedure in patients with CLI and were associated with an increased risk of mortality. Coronary heart disease and decompensated heart failure are important contributors for the occurrence of MACE. In this elderly patient population with CLI, these results should be taken into account during the multidisciplinary team meeting before consideration of revascularization procedure.
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Affiliation(s)
- R Gaisset
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Clinical Investigation Center, Hôpital Européen George-Pompidou, AP-HP, Paris, France
| | - F Lin
- Medical Information department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - O Borry
- Internal medicine department, Hôpital Louis-Mourier, AP-HP, Colombes, France
| | - C Quemeneur
- Department of Anaesthesiology and critical care, GRC 29, DMU DREAM, Sorbonne University, Pitié-Salpêtrière Hospital, AP-HP, Paris, France; Department of Anaesthesiology, Clinique Drouot Sport, 21, rue Rémusat, 75016 Paris, France
| | - I Lazareth
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Clinical Investigation Center, Hôpital Européen George-Pompidou, AP-HP, Paris, France
| | - J Emmerich
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Clinical Investigation Center, Hôpital Européen George-Pompidou, AP-HP, Paris, France; Inserm UMR 1153-CRESS, Université Paris, Paris, France
| | - P Priollet
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Clinical Investigation Center, Hôpital Européen George-Pompidou, AP-HP, Paris, France
| | - A Yannoutsos
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Clinical Investigation Center, Hôpital Européen George-Pompidou, AP-HP, Paris, France; Inserm UMR 1153-CRESS, Université Paris, Paris, France.
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21
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Mariette X, Hermine O, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P, Bureau S, Dougados M, Tibi A, Azoulay E, Cadranel J, Emmerich J, Fartoukh M, Guidet B, Humbert M, Lacombe K, Mahevas M, Pene F, Pourchet-Martinez V, Schlemmer F, Yazdanpanah Y, Baron G, Perrodeau E, Vanhoye D, Kedzia C, Demerville L, Gysembergh-Houal A, Bourgoin A, Dalibey S, Raked N, Mameri L, Alary S, Hamiria S, Bariz T, Semri H, Hai DM, Benafla M, Belloul M, Vauboin P, Flamand S, Pacheco C, Walter-Petrich A, Stan E, Benarab S, Nyanou C, Montlahuc C, Biard L, Charreteur R, Dupré C, Cardet K, Lehmann B, Baghli K, Madelaine C, D'Ortenzio E, Puéchal O, Semaille C, Savale L, Harrois A, Figueiredo S, Duranteau J, Anguel N, Pavot A, Monnet X, Richard C, Teboul JL, Durand P, Tissieres P, Jevnikar M, Montani D, Bulifon S, Jaïs X, Sitbon O, Pavy S, Noel N, Lambotte O, Escaut L, Jauréguiberry S, Baudry E, Verny C, Noaillon M, Lefèvre E, Zaidan M, Le Tiec CLT, Verstuyft C, Roques AM, Grimaldi L, Molinari D, Leprun G, Fourreau A, Cylly L, Virlouvet M, Meftali R, Fabre S, Licois M, Mamoune A, Boudali Y, Georgin-Lavialle S, Senet P, Pialoux G, Soria A, Parrot A, François H, Rozensztajn N, Blin E, Choinier P, Camuset J, Rech JS, Canellas A, Rolland-Debord C, Lemarié N, Belaube N, Nadal M, Siguier M, Petit-Hoang C, Chas J, Drouet E, Lemoine M, Phibel A, Aunay L, Bertrand E, Ravato S, Vayssettes M, Adda A, Wilpotte C, Thibaut P, Fillon J, Debrix I, Fellahi S, Bastard JP, Lefèvre G, Fallet V, Gottenberg JE, Hansmann Y, Andres E, Bayer S, Becker G, Blanc F, Brin S, Castelain V, Chatelus E, Chatron E, Collange O, Danion F, De Blay F, Demonsant E, Diemunsch P, Diemunsch S, Felten R, Goichot B, Greigert V, Guffroy A, Heger B, Hutt A, Kaeuffer C, Kassegne L, Korganow AS, Le Borgne P, Lefebvre N, Martin T, Mertes PM, Metzger C, Meyer N, Nisand G, Noll E, Oberlin M, Ohlmann-Caillard S, Poindron V, Pottecher J, Ruch Y, Sublon C, Tayebi H, Weill F, Mekinian A, Abisror N, Jachiet V, Chopin D, Fain O, Garnier M, Krause le Garrec J, Morgand M, Pacanowski J, Urbina T, McAvoy C, Pereira M, Aratus G, Berard L, Simon T, Daguenel-Nguyen A, Antignac M, Leplay C, Arlet JB, Diehl JL, Bellenfant F, Blanchard A, Buffet A, Cholley B, Fayol A, Flamarion E, Godier A, Gorget T, Hamada SR, Hauw-Berlemont C, Hulot JS, Lebeaux D, Livrozet M, Michon A, Neuschwander A, Penet MA, Planquette B, Ranque B, Sanchez O, Volle G, Briois S, Cornic M, Elisee V, Jesuthasan D, Djadi-Prat J, Jouany P, Junquera R, Henriques M, Kebir A, Lehir I, Meunier J, Patin F, Paquet V, Tréhan A, Vigna V, Sabatier B, Bergerot D, Jouve C, Knosp C, Lenoir O, Mahtal N, Resmini L, Lescure FX, Ghosn J, BACHELARD A, BIRONNE T, BORIE R, BOUNHIOL A, BOUSSARD C, CHAUFFiER J, CHALAL S, CHALAL L, CHANSOMBAT M, CRESPIN P, CRESTANI B, DACONCEICAO O, DECONINCK L, DIEUDE P, DOSSIER A, DUBERT M, DUCROCQ G, FUENTES A, GERVAIS A, GILBERT M, ISERNIA V, ISMAEL S, JOLY V, JULIA Z, LARIVEN S, LE GAC S, LE PLUART D, LOUNI F, NDIAYE A, PAPO T, PARISEY M, PHUNG B, POURBAIX A, RACHLINE A, RIOUX C, SAUTEREAU A, STEG G, TARHINI H, VALAYER S, VALLOIS D, VERMES P, VOLPE T, Nguyen Y, Honsel V, Weiss E, Codorniu A, Zarrouk V, De Lastours V, Uzzan M, Olivier O, Rossi G, Gamany N, Rahli R, Louis Z, Boutboul D, Galicier L, Amara Y, Archer G, Benattia A, Bergeron A, Bondeelle L, De Castro N, Clément M, Darmont M, Denis B, Dupin C, Feredj E, Feyeux D, Joseph A, Lengliné E, Le Guen P, Liégeon G, Lorillon G, Mabrouki A, Mariotte E, Martin de Frémont G, Mirouse A, Molina JM, Peffault de Latour R, Oksenhendler E, Saussereau J, Tazi A, Tudesq JJ, Zafrani L, Brindele I, Bugnet E, Celli Lebras K, Chabert J, Djaghout L, Fauvaux C, Jegu AL, Kozaliewicz E, Meunier M, Tremorin MT, Davoine C, Madeleine I, Caillat-Zucman S, Delaugerre C, Morin F, SENE D, BURLACU R, CHOUSTERMAN B, MEGARBANE B, RICHETTE P, RIVELINE JP, FRAZIER A, VICAUT E, BERTON L, HADJAM T, VASQUEZ-IBARRA MA, JOURDAINE C, JACOB A, SMATI J, RENAUD S, MANIVET P, PERNIN C, SUAREZ L, Semerano L, ABAD S, Benainous R, Bloch Queyrat C, Bonnet N, Brahmi S, Cailhol J, Cohen Y, Comparon C, Cordel H, Dhote R, Dournon N, Duchemann B, Ebstein N, Giroux-Leprieur B, Goupil de Bouille J, Jacolot A, Nunes H, Oziel J, Rathouin V, Rigal M, Roulot D, Tantet C, Uzunhan Y, COSTEDOAT-CHALUMEAU N, Ait Hamou Z, Benghanem S, BLANCHE P, CANOUI E, CARLIER N, CHAIGNE B, CONTEJEAN A, DUNOGUE B, DUPLAND P, DUREL - MAURISSE A, GAUZIT R, JAUBERT P, Joumaa H, Jozwiak M, KERNEIS S, LACHATRE M, Lafoeste H, LEGENDRE P, LUONG NGUYEN LB, MAREY J, MORBIEU C, MOUTHON L, NGUYEN L, Palmieri LJ, REGENT A, SZWEBEL TA, TERRIER B, GUERIN C, ZERBIT J, CHEREF K, CHITOUR K, CISSE MS, CLARKE A, CLAVERE G, DUSANTER I, GAUDEFROY C, JALLOULI M, KOLTA S, LE BOURLOUT C, MARIN N, MENAGE N, MOORES A, PEIGNEY I, PIERRON C, SALEH-MGHIR S, VALLET M, MICHEL M, MELICA G, LELIEVRE JD, FOIS E, LIM P, MATIGNON M, GUILLAUD C, THIEMELE A, SCHMITZ D, BOUHRIS M, BELAZOUZ S, LANGUILLE L, MEKONTSO-DESSAPS A, SADAOUI T, Mayaux J, Cacoub P, Corvol JC, Louapre C, Sambin S, Mariani LL, Karachi C, Tubach F, Estellat C, Gimeno L, Martin K, Bah A, Keo V, Ouamri S, Messaoudi Y, Yelles N, Faye P, Cavelot S, Larcheveque C, Annonay L, Benhida J, Zahrate-Ghoul A, Hammal S, Belilita R, Lecronier M, Beurton A, Haudebourg L, Deleris R, Le Marec J, Virolle S, Nemlaghi S, Bureau C, Mora P, De Sarcus M, Clovet O, Duceau B, Grisot PH, Pari MH, Arzoine J, Clarac U, Faure M, Delemazure J, Decavele M, Morawiec E, Demoule A, Dres M, Vautier M, Allenbach Y, Benveniste O, Leroux G, Rigolet A, Guillaume-Jugnot P, Domont F, Desbois AC, Comarmond C, Champtiaux N, Toquet S, Ghembaza A, Vieira M, Maalouf G, Boleto G, Ferfar Y, Charbonnier F, AGUILAR C, ALBY-LAURENT F, ALYANAKIAN MA, BAKOUBOULA P, BROISSAND C, BURGER C, CAMPOS-VEGA C, CHAVAROT N, CHOUPEAUX L, FOURNIER B, GRANVILLE S, ISSORAT E, ROUZAUD C, VIMPERE D, Geri G, Derridj N, Sguiouar N, Meddah H, Djadel M, Chambrin-Lauvray H, Duclos-Vallée JC, Saliba F, Sacleux SC, Koumis I, Michot JM, Stoclin A, Colomba E, Pommeret F, Willekens C, Sakkal M, Da Silva R, Dejean V, Mekid Y, Ben-Mabrouk I, Pradon C, Drouard L, Camara-Clayette V, Morel A, Garcia G, Mohebbi A, Berbour F, Dehais M, Pouliquen AL, Klasen A, Soyez-Herkert L, London J, Keroumi Y, Guillot E, Grailles G, El Amine Y, Defrancq F, Fodil H, Bouras C, Dautel D, Gambier N, Dieye T, Razurel A, Bienvenu B, Lancon V, Lecomte L, Beziriganyan K, Asselate B, Allanic L, Kiouris E, Legros MH, Lemagner C, Martel P, Provitolo V, Ackermann F, Le Marchand M, Clan Hew Wai A, Fremont D, Coupez E, Adda M, Duée F, Bernard L, Gros A, Henry E, Courtin C, Pattyn A, Guinot PG, Bardou M, Maurer A, Jambon J, Cransac A, Pernot C, Mourvillier B, Servettaz A, Deslée G, Wynckel A, Benoit P, Marquis E, Roux D, Gernez C, Yelnik C, Poissy J, Nizard M, Denies F, Gros H, Mourad JJ, Sacco E, Renet S. Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial. The Lancet Rheumatology 2022; 4:e24-e32. [PMID: 34812424 PMCID: PMC8598187 DOI: 10.1016/s2665-9913(21)00315-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia. Methods We did a multicentric, open-label, Bayesian randomised, adaptive, phase 2/3 clinical trial, nested within the CORIMUNO-19 cohort, to test a superiority hypothesis. Patients 18 years or older hospitalised with COVID-19 in six French centres, requiring at least 3L/min of oxygen but without ventilation assistance and a WHO Clinical Progression Scale [CPS] score of 5 were enrolled. Patients were randomly assigned (1:1) via a web-based system, according to a randomisation list stratified on centre and with blocks randomly selected among 2 and 4, to receive usual care plus 400 mg of sarilumab intravenously on day 1 and on day 3 if clinically indicated (sarilumab group) or usual care alone (usual care group). Primary outcomes were the proportion of patients with WHO-CPS scores greater than 5 on the 10-point scale on day 4 and survival without invasive or non-invasive ventilation at day 14. This completed trial is closed to new participants and is registered with ClinicalTrials.gov, NCT04324073. Findings 165 patients were recruited from March 27 to April 6, 2020, and 148 patients were randomised (68 patients to the sarilumab group and 80 to the usual care group) and followed up for 90 days. Median age was 61·7 years [IQR 53·0–71·1] in the sarilumab group and 62·8 years [56·0–71·7] in the usual care group. In the sarilumab group 49 (72%) of 68 were men and in the usual care group 59 (78%) of 76 were men. Four patients in the usual care group withdrew consent and were not analysed. 18 (26%) of 68 patients in the sarilumab group had a WHO-CPS score greater than 5 at day 4 versus 20 (26%) of 76 in the usual care group (median posterior absolute risk difference 0·2%; 90% credible interval [CrI] −11·7 to 12·2), with a posterior probability of absolute risk difference greater than 0 of 48·9%. At day 14, 25 (37%) patients in the sarilumab and 26 (34%) patients in the usual care group needed ventilation or died, (median posterior hazard ratio [HR] 1·10; 90% CrI 0·69–1·74) with a posterior probability HR greater than 1 of 37·4%. Serious adverse events occurred in 27 (40%) patients in the sarilumab group and 28 (37%) patients in the usual care group (p=0·73). Interpretation Sarilumab treatment did not improve early outcomes in patients with moderate-to-severe COVID-19 pneumonia. Further studies are warranted to evaluate the effect of sarilumab on long-term survival. Funding Assistance publique—Hôpitaux de Paris
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22
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Gabet A, Grave C, Tuppin P, Emmerich J, Olié V. Changes in the epidemiology of patients hospitalized in France with deep venous thrombosis and pulmonary embolism during the COVID-19 pandemic. Thromb Res 2021; 207:67-74. [PMID: 34562677 PMCID: PMC9753774 DOI: 10.1016/j.thromres.2021.09.009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/07/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The onset of the COVID-19 pandemic and the first national lockdown implemented might have disrupted the epidemiology of deep venous thrombosis (DVT) and pulmonary embolism (PE). This study aimed to analyze time trends in patients hospitalized for DVT and PE in France and related in-patient and 90-day post-admission mortality rates. MATERIALS AND METHODS All patients hospitalized in France for DVT or PE between January and September (weeks 1-40) for each year from 2017 to 2020, were selected. Weekly incidence rate ratios (IRR) were computed to compare the rates of patients hospitalized in 2020 with those hospitalized in 2017-2019. RESULTS Compared with the 2017-2019 study period, the rates of patients hospitalized with a primary diagnosis (PD) of DVT or PE in 2020 were significantly (50 and 40%, respectively) lower during weeks 12-13. The rate of patients hospitalized with an associated diagnosis (AD) of PE during weeks 12-19 of 2020 was twice as high as in the same period in 2017-2019. The prevalence of COVID-19 in patients hospitalized with a PD of DVT and PE, and in those hospitalized with an AD of DVT and PE reached respectively 4.0, 9.6, 17.2 and 44.6 during the country's first lockdown. Inpatients case-fatality rates in patients hospitalized with an AD of PE increased significantly during weeks 12-13. CONCLUSIONS Epidemiology of VT and PE was seriously impacted by the COVID-19 pandemic in 2020 in France, with a significant decrease in the rate of patients hospitalized for PE and a threefold increase in the related in-patient mortality rate. This highlight the need to inform the general population about the symptoms of PE and about the need to immediately seek medical care, particularly those infected with SARS-CoV-2.
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Affiliation(s)
- Amélie Gabet
- Santé Publique France, Saint-Maurice 94, France.
| | | | | | - Joseph Emmerich
- Department of Vascular Medicine, Hôpital Saint-Joseph, Université de Paris, INSERM CRESS 1153, Paris, France
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23
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Yannoutsos A, Lin F, Gaisset R, Jaillette C, Lazareth I, Emmerich J, Priollet P. Characteristics and outcomes of octogenarians with revascularized critical limb ischemia: Impact of altered cardiac function for early mortality. J Med Vasc 2021; 46:224-231. [PMID: 34862016 DOI: 10.1016/j.jdmv.2021.10.003] [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] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Patients with critical limb ischemia (CLI) present with advanced age and end-stage organ damage, in particular heart failure. The aim of the present study is to describe clinical and biological characteristics in octogenarian patients with CLI compared to their younger counterparts and to determine the peri-procedural risk and early mortality after endovascular procedure. METHODS From November 2013 to May 2019, 315 consecutive patients were retrospectively included. Clinical and biological parameters were recorded at baseline before endovascular revascularization. The main outcome was total 1-year mortality. RESULTS The study included 170 octogenarians and 145 non-octogenarians. The mean age of octogenarian patients was 86.9±4.8 years, almost 20 years higher than that registered in non-octagenarians patients (67.4±8.6 years). Octogenarian patients were mostly women (59.4%), presented with lower body mass index (23.8±4.4kg/m2), lower serum albumin level (31.5±5.4g/L) and lower creatinine clearance (66.1±24.5mL/mn) than younger counterparts. They were more likely to be institutionalized in a nursing home (27.1%). In the peri-procedural period, major bleeding occurred in 40 patients (12.7%), without statistical significance between the two age groups. Peri-procedural mortality occurred in 12 patients (3.8%), of whom 10 patients (83%) were octogenarians. Cumulative mortality rate was 25.4% (80 patients) during the one-year follow-up period: 58 octogenarians died (34.1%) compared to 22 non-octogenarian patients (15.2%), P<0.001. Cardiovascular events were highly prevalent, accounting for 40% of overall mortality. Twenty-five patients (8%) experienced major amputation, without significant difference between the two age groups. In octogenarian population, institutionalized status (P=0.004) and BNP level (P=0.001) were positively correlated with mortality whereas systolic blood pressure (P<0.001), left ventricular ejection fraction (P=0.003), serum albumin (P=0.020), C-Reactive protein (P=0.020) and renin-angiotensin system inhibitors at hospital discharge were negatively correlated with mortality. In multivariate analysis for mortality, only BNP level≥500pg/mL (HR 3.27; 95% CI 1.04-10.97; P=0.04), was correlated with mortality, independently of other confounders. CONCLUSION In the present study population, octogenarians represent a rather distinct CLI population, 20 years of age older as compared to non-octogenarians, with prevalent malnutrition and institutionalized status. The present results underline a substantial one-year mortality rate of 34.1% in this elderly population following revascularization procedure with a 6% peri-procedural mortality. Decompensated heart failure is an important contributor for mortality.
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Affiliation(s)
- A Yannoutsos
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, université Paris Descartes, Paris, France.
| | - F Lin
- Medical information department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - R Gaisset
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - C Jaillette
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - I Lazareth
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - J Emmerich
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, université Paris Descartes, Paris, France
| | - P Priollet
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
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24
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Giauffret E, Milongo V, Sebbane S, Foudi F, Garçon P, Kamtchueng P, Emmerich J, Priollet P, Yannoutsos A. Late limb ischemia diagnosis in a child. J Med Vasc 2021; 46:241-245. [PMID: 34862018 DOI: 10.1016/j.jdmv.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Affiliation(s)
- E Giauffret
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - V Milongo
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - S Sebbane
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - F Foudi
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - P Garçon
- Cardiology department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - P Kamtchueng
- Interventional cardiology department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - J Emmerich
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, Paris Descartes University, Paris, France
| | - P Priollet
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - A Yannoutsos
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, Paris Descartes University, Paris, France.
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25
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Mazzolai L, Ageno W, Alatri A, Bauersachs R, Becattini C, Brodmann M, Emmerich J, Konstantinides S, Meyer G, Middeldorp S, Monreal M, Righini M, Aboyans V. Second consensus document on diagnosis and management of acute deep vein thrombosis: updated document elaborated by the ESC Working Group on aorta and peripheral vascular diseases and the ESC Working Group on pulmonary circulation and right ventricular function. Eur J Prev Cardiol 2021; 29:1248-1263. [PMID: 34254133 DOI: 10.1093/eurjpc/zwab088] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [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: 10/19/2020] [Revised: 02/25/2021] [Accepted: 05/07/2021] [Indexed: 12/14/2022]
Abstract
This consensus document is proposed to clinicians to provide the whole spectrum of deep vein thrombosis management as an update to the 2017 consensus document. New data guiding clinicians in indicating extended anticoagulation, management of patients with cancer, and prevention and management of post-thrombotic syndrome are presented. More data on benefit and safety of non-vitamin K antagonists oral anticoagulants are highlighted, along with the arrival of new antidotes for severe bleeding management.
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Affiliation(s)
- Lucia Mazzolai
- Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Chemin de Mont-Paisible 18, CH-1011 Lausanne, Switzerland
| | - Walter Ageno
- Department of Medicine and Surgery, University of Insubria, Via Ravasi 2, 21100 Varese, Italy
| | - Adriano Alatri
- Division of Angiology, Heart and Vessel Department, Lausanne University Hospital, Chemin de Mont-Paisible 18, CH-1011 Lausanne, Switzerland
| | - Rupert Bauersachs
- Department of Vascular Medicine, Klinikum Darmstadt GmbH, Grafenstraße 9, 64283 Darmstadt, Germany.,Departement of Vascular Medicine, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Cecilia Becattini
- Departement of Internal and Cardiovascular Medicine-Stroke Unit, University of Perugia, Perugia, Italy
| | - Marianne Brodmann
- Département of Internal Medicine, Division of Angiology, Medical University Graz, Graz, Austria
| | - Joseph Emmerich
- Department of Vascular Medicine, Groupe Hospitalier Paris Saint-Joseph and University of Paris, Paris, France
| | - Stavros Konstantinides
- Departement of Vascular Medicine, Center for Thrombosis and Hemostasis, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.,Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Saskia Middeldorp
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, Spain
| | - Marc Righini
- Division of Angiology and Hemostasis, Department of Internal Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Victor Aboyans
- Department of Cardiology, Dupuytren University Hospital and Inserm 1094, Tropical Neuroepidemiology, School of Medicine, 2 avenue martin Luther-King 87042 Limoges, France
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26
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Zemouri A, Lin F, Billuart O, Sacco E, Emmerich J, Priollet P, Yannoutsos A. Prevalence and management of antivitamin K overdose in a hospital setting. J Med Vasc 2021; 46:175-181. [PMID: 34238512 DOI: 10.1016/j.jdmv.2021.05.008] [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] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Vitamin K antagonist (VKA) related adverse events are the first cause for iatrogenic events in France, particularly due to the narrow therapeutic margin. The risk of bleeding increases significantly when the INR level is ≥5. The main objective of this study was to assess the prevalence of VKA overdose in a hospital setting (at D2 of hospital entry) and to evaluate physicians' adherence to clinical practice guidelines for the management of VKA overdose according to French National Authority for Health recommendations. METHODS This single-center retrospective observational study consisted in querying the computerized database of a Parisian hospital on 21275INR determinations (3995 patients, 6813 hospital stays) performed between 2013 and 2018. RESULTS An INR level ≥5 was noted during 350 (6%) of the hospital stays, in 331 patients (of whom 57% were women). The mean age of the patient population with an INR≥5 was 81.1 years. Infection, heart failure and renal failure were the most frequent acute medical conditions for hospital admission. Twenty-three patients (7%) had a bleeding complication, 11 of which were major bleeding complications. Older age was associated with the severity of bleeding complications. Fifteen in-hospital deaths (4%) were reported, not related to bleeding events. The management of VKA overdose did not comply with the recommendations in 43% of cases, in particular for the highest INRs (50% of noncompliance for an INR>6.4). Non-compliance with recommendations for VKA overdose was related to: the delay until the INR was checked (44% of cases); the indication for prescribing vitamin K (34% of cases); the dose or route of administration of vitamin K therapy (19% of cases); and the interruption or not of VKA therapy (12% of cases). CONCLUSION The management of VKA overdose in a hospital setting remains non-compliant with the recommendations in almost half of the cases, mainly due to the delayed INR control and inappropriate management of vitamin K therapy. Computerized alert system would be helpful for personalized patient management and improved pharmacovigilance to prevent iatrogenic VKA events.
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Affiliation(s)
- A Zemouri
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - F Lin
- Medical Information Department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - O Billuart
- Medical Information Department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - E Sacco
- Clinical Research Center, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - J Emmerich
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, Paris, France
| | - P Priollet
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Yannoutsos
- Vascular medicine department, Groupe Hospitalier Paris Saint-Joseph, Paris, France; Inserm UMR 1153-CRESS, Paris, France.
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27
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Legrand F, Fernex de Mongex A, Delrue M, Ghaffari P, Jaillette C, Yannoutsos A, Emmerich J, Priollet P. Foot ischemia related to essential thrombocytemia and atherosclerosis. J Med Vasc 2021; 46:123-128. [PMID: 33990286 DOI: 10.1016/j.jdmv.2021.03.009] [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] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
We report two cases of foot ischemia combining microvascular thrombosis related to essential thrombocytemia (ET) and a proximal ulcerating atherosclerotic plaque. This suggests that myeloproliferative neoplasms could also trigger distal embolism from an unstable atherosclerotic plaque by creating a prothrombotic status. These distal ischemic events were the first ET manifestation and therefore lead to myeloproliferative neoplasm diagnosis. In ET, thrombosis event can occur with a normal platelet count. Furthermore, hemogram should be regularly controlled among JAK2 muted patients considering the frequent evolution from isolated JAK2 mutation to ET.
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Affiliation(s)
- F Legrand
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France.
| | | | - M Delrue
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France; Université de Paris, EA 3518, Saint-Louis Hospital, Paris, France
| | - P Ghaffari
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France
| | - C Jaillette
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France
| | - A Yannoutsos
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France; Université de Paris, INSERM CRESS UMR 1153, 75005 Paris, France
| | - J Emmerich
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France; Université de Paris, INSERM CRESS UMR 1153, 75005 Paris, France
| | - P Priollet
- Vascular medicine department, GH Paris Saint-Joseph, Paris, France
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28
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Emmerich J. From CASS to ischemia: Almost 40 years of blindness in stable coronary artery disease. J Med Vasc 2021; 46:105-107. [PMID: 33990283 DOI: 10.1016/j.jdmv.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Joseph Emmerich
- Department of vascular medicine, Paris Saint-Joseph Hospital Group, University of Paris, INSERM CRESS UMR 1153, 185 rue Raymond Losserand, 75674 Paris Cedex 14, France.
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29
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Vignot S, Daynes P, Bacon T, Vial T, Montagne O, Albin N, Emmerich J, Ratignier-Carbonneil C, Martin D, Maison P. Collaboration Between Health-Care Professionals, Patients, and National Competent Authorities Is Crucial for Prevention of Health Risks Linked to the Inappropriate Use of Drugs: A Position Paper of the ANSM (Agence Nationale de Sécurité du Médicament et des Produits de Santé). Front Pharmacol 2021; 12:635841. [PMID: 33995037 PMCID: PMC8113868 DOI: 10.3389/fphar.2021.635841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Stéphane Vignot
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,Institut Godinot, Reims, France
| | - Pascale Daynes
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,Union Francophone des Patients Partenaires, Faculté de Médecine, Bâtiment Jean Roget, La Tronche, France
| | - Trystan Bacon
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,General Practitioner, Angers, France
| | - Thierry Vial
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,Hospices Civils de Lyon, Lyon, France
| | - Olivier Montagne
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,General Practitioner, Collège de la médecine générale, Paris, France
| | - Nicolas Albin
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,Institut Daniel Hollard, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France
| | - Joseph Emmerich
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,Université de Paris, Hôpital Saint Joseph Paris (Médecine Vasculaire), Paris, France
| | | | - Dominique Martin
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris
| | - Patrick Maison
- Collège, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Saint Denis, Grand Paris.,EA 7379 EpiDermE, Paris-Est-Créteil, Créteil, France
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30
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Lanéelle D, Dadon M, Quere I, Zuily S, Emmerich J, Sevestre MA, Mahé G. Discontinuation of vascular therapeutics during the COVID-19 pandemic first wave in France. JMV-Journal de Médecine Vasculaire 2021; 46:90-92. [PMID: 33752851 PMCID: PMC7816936 DOI: 10.1016/j.jdmv.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/07/2021] [Indexed: 11/30/2022]
Affiliation(s)
- D Lanéelle
- Department of Vascular Medicine, Inserm UMR 1075, CHU Caen Normandie, Caen, France
| | - M Dadon
- Vascular Explorations Center, 7, rue Chalgrin, 75116 Paris, France
| | - I Quere
- Department of Vascular medicine, CHU Saint-Éloi, University of Montpellier, Inserm CIC1001, InnoVTE, Montpellier, France
| | - S Zuily
- University of Lorraine, Inserm UMR 1116, CHRU de Nancy, Vascular Medicine Division, Nancy, France
| | - J Emmerich
- University of Paris, Vascular Medicine, Groupe Hospitalier Paris Saint-Joseph, INSERM CRESS UMR 1153, Paris, France
| | - M-A Sevestre
- Department of Vascular Medicine, EA Chimère 7516, CHU Amiens Picardie, 80054 Amiens cedex 1, France
| | - G Mahé
- Department of Vascular Medicine, CHU Rennes, 35033 Rennes cedex 9, France; Université de Rennes 1, INSERM CIC 1414, 35033 Rennes cedex 9, France.
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31
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Bintein F, Yannoutsos A, Chatellier G, Fontaine M, Damotte D, Paterlini-Bréchot P, Meyer G, Duchatelle V, Marini V, Schwering KL, Labrousse C, Beaussier H, Zins M, Salmeron S, Lajonchère JP, Priollet P, Emmerich J, Trédaniel J. Patients with atherosclerotic peripheral arterial disease have a high risk of lung cancer: Systematic review and meta-analysis of literature. J Med Vasc 2021; 46:53-65. [PMID: 33752847 DOI: 10.1016/j.jdmv.2020.12.005] [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] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Lung cancer and atherosclerosis share common risk factors. Literature data suggest that the prevalence of lung malignancy in patients with peripheral arterial disease (PAD) is higher than in the general population. Our goal was to determine, through a systematic literature review, the prevalence of lung cancer in patients with PAD. METHODS We consulted available publications in the Cochrane library, MEDLINE, PUBMED, EMBASE, and ClinicalTrials.gov. We included all articles, written in English or French, published between 1990 and 2020 reporting the prevalence of lung cancer in patients with PAD (atherosclerotic aortic aneurysm or peripheral occlusive diseases). Patients with coronary artery disease, cardiac valvulopathy or carotid stenosis were not included. We did not include case reports. We performed a critical analysis of each article. Data were collected from two independent readers. A fixed effect model meta-analysis allowed to estimate a summary prevalence rate. RESULTS We identified 303 articles, and selected 19 articles according to selection criteria. A total of 16849 patients were included (mean age 68.3 years, 75.1% of males). Aortic aneurysms were found in 29% of patients and atherosclerotic occlusive disease in 66% of patients. Lung cancer was identified in 538 patients, representing a prevalence of 3%. DISCUSSION Lung cancer is found in 3% of patients with atherosclerotic PAD. This prevalence is higher than that found in lung cancer screening programs performed in the general population of smokers and former smokers. These patients should be screened for lung cancer. Their selection may dramatically increase the benefit of lung cancer screening.
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Affiliation(s)
- F Bintein
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France.
| | - A Yannoutsos
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France; Inserm UMR 1153 Center of Research in Epidemiology and Statistics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - G Chatellier
- Hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | | | - D Damotte
- Hôpital Cochin, AP-HP, 75014 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Unité Inserm U1138, centre de recherche des Cordeliers, Paris, France
| | | | - G Meyer
- Hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - V Duchatelle
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - V Marini
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | | | - C Labrousse
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - H Beaussier
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - M Zins
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - S Salmeron
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - J-P Lajonchère
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - P Priollet
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France
| | - J Emmerich
- Groupe hospitalier Paris Saint-Joseph, 75014 Paris, France; Inserm UMR 1153 Center of Research in Epidemiology and Statistics, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - J Trédaniel
- Hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Unité Inserm UMR-S 1124, toxicologie, pharmacologie et signalisation cellulaire, Paris, France
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Emmerich J, Girard P, Sanchez O, Mismetti P. In memory of Professor Guy Meyer, 1957-2020. Thromb Res 2021; 200:A1-A2. [PMID: 33726929 DOI: 10.1016/j.thromres.2021.02.001] [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: 11/30/2022]
Affiliation(s)
- Joseph Emmerich
- Université de Paris, Dept of Vascular Medicine, Groupe Hospitalier Paris Saint-Joseph, INSERM UMR 1153 CRESS, Paris, France
| | - Philippe Girard
- Institut Mutualiste Montsouris, Paris, France; F-CRIN INNOVTE, Saint Etienne, France
| | - Olivier Sanchez
- Université de Paris, Service de Pneumologie et Soins Intensifs, Hôpital Européen Georges Pompidou, AP-HP, INSERM UMR-S 1140, Paris, France; F-CRIN INNOVTE, Saint Etienne, France
| | - Patrick Mismetti
- Unité de Recherche Clinique, Innovation, Pharmacologie, F-CRIN INNOVTE Network, Service de Médecine Vasculaire et Thérapeutique, CHU Saint-Etienne, Hôpital Nord, F-40255 Saint-Etienne, France; SAINBIOSE U1059, Université Jean Monnet, Univ. Lyon, INSERM, F-42023 Saint-Etienne, France
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Emmerich J, Girard P, Sanchez O, Mismetti P. In memory of Professor Guy Meyer, 1957–2020. J Thromb Haemost 2021. [DOI: 10.1111/jth.15234] [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: 12/01/2022]
Affiliation(s)
- Joseph Emmerich
- Groupe Hospitalier Paris Saint‐Joseph INSERM UMR 1153 CRESS Department of Vascular Medicine Université de Paris Paris France
| | - Philippe Girard
- Institut Mutualiste Montsouris Paris France
- F‐CRIN INNOVTE Saint Etienne France
| | - Olivier Sanchez
- F‐CRIN INNOVTE Saint Etienne France
- Service de Pneumologie et Soins Intensifs INSERM UMR‐S 1140 Hôpital Européen Georges Pompidou AP‐HP Université de Paris Paris France
| | - Patrick Mismetti
- Unité de Recherche Clinique, Innovation, Pharmacologie Service de Médecine Vasculaire et Thérapeutique CHU Saint‐Etienne Hôpital Nord F‐CRIN INNOVTE Network Saint‐Etienne France
- SAINBIOSE U1059 INSERM Université Jean MonnetUniv. Lyon Saint‐Etienne France
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Le Berre A, Boeken T, Caramella C, Afonso D, Nhy C, Saccenti L, Tardivel AM, Gerber S, Frison Roche A, Emmerich J, Marini V, Zins M, Toledano S. Dual-energy CT angiography reveals high prevalence of perfusion defects unrelated to pulmonary embolism in COVID-19 lesions. Insights Imaging 2021; 12:24. [PMID: 33595746 PMCID: PMC7887542 DOI: 10.1186/s13244-021-00972-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/26/2020] [Accepted: 01/25/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Lung perfusion defects (PDs) have been described in COVID-19 using dual-energy computed tomography pulmonary angiography (DE-CTPA). We assessed the prevalence and characteristics of PDs in COVID-19 patients with suspected pulmonary embolism (PE) and negative CTPA. METHODS This retrospective study included COVID-19 and non-COVID-19 pneumonia groups of patients with DE-CTPA negative for PE. Two radiologists rated the presence of PD within the lung opacities and analyzed the type of lung opacities and PD pattern (i.e. homogeneous or heterogeneous). The clinical, biological, radiological characteristics including time from first symptoms and admission to DE-CTPA, oxygen requirements, CRP, D-dimer levels, duration of hospital admission and death were compared within the COVID-19 group between patients with (PD +) or without PD (PD-). RESULTS 67 COVID-19 and 79 non-COVID-19 patients were included. PDs were more frequent in the COVID-19 than in the non-COVID-19 group (59.7% and 26.6% respectively, p < 0.001). Patterns of PDs were different, with COVID-19 patients exhibiting heterogenous PDs (38/40, 95%) whereas non-COVID-19 patients showed mostly homogeneous perfusion defects (7/21 heterogeneous PDs, 33%), p < 0.001. In COVID-19 patients, most consolidations (9/10, 90%) exhibited PDs while less than a third of consolidations (19/67, 28%) had PDs in non-COVID-19 patients. D-dimer, oxygen levels and outcome were similar between COVID-19 PD + and PD- patients; however, time between admission and DE-CTPA was longer in PD + patients (median [IQR], 1 [0-7] and 0 [0-2]; p = 0.045). CONCLUSION Unlike in bacterial pneumonia, heterogeneous PDs within lung opacities are a frequent feature of COVID-19 pneumonia in PE-suspected patients.
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Affiliation(s)
- Alice Le Berre
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France.
| | - Tom Boeken
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Caroline Caramella
- Department of Radiology, Hôpital Marie Lannelongue, 133 Avenue de la Résistance, 92350, Le Plessis-Robinson, France
| | - Daniel Afonso
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Caroline Nhy
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Laetitia Saccenti
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Anne-Marie Tardivel
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Sophie Gerber
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Adrien Frison Roche
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Joseph Emmerich
- Department of Vascular Medicine, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Valeria Marini
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Marc Zins
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
| | - Sarah Toledano
- Department of Radiology, Fondation Hôpital Saint Joseph, 185 rue Raymond Losserand, 75014, Paris, France
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Affiliation(s)
- J Emmerich
- Inserm CRESS UMR 1153, Department of Vascular Medicine, Paris Saint-Joseph Hospital Group, University of Paris, Paris, France.
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Emmerich J, Girard P, Sanchez O, Mismetti P. In Memory of Professor Guy Meyer, 1957–2020. Res Pract Thromb Haemost 2021. [PMCID: PMC7938614 DOI: 10.1002/rth2.12487] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Joseph Emmerich
- Department of Vascular Medicine Université de ParisGroupe Hospitalier Paris Saint‐JosephINSERM UMR 1153 CRESS Paris France
| | - Philippe Girard
- Institut Mutualiste Montsouris Paris France
- F‐CRIN INNOVTE Saint Etienne France
| | - Olivier Sanchez
- F‐CRIN INNOVTE Saint Etienne France
- Université de ParisService de Pneumologie et Soins IntensifsHôpital Européen Georges PompidouAP‐HPINSERM UMR‐S 1140 Paris
| | - Patrick Mismetti
- F‐CRIN INNOVTE Saint Etienne France
- Unité de Recherche CliniqueInnovationPharmacologieF‐CRIN INNOVTE NetworkService de Médecine Vasculaire et ThérapeutiqueCHU Saint‐EtienneHôpital NordF‐40255 Saint‐Etienne France
- SAINBIOSE U1059Université Jean MonnetUniv. LyonINSERMF‐42023 Saint‐Etienne France
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Planquette B, Le Berre A, Khider L, Yannoutsos A, Gendron N, de Torcy M, Mohamedi N, Jouveshomme S, Smadja DM, Lazareth I, Goudot G, Fournier L, Bruel C, Diehl JL, Mourad JJ, Meyer G, Priollet P, Messas E, Sanchez O, Beaussier H, Mirault T, Zins M, Chatelier G, Emmerich J. Prevalence and characteristics of pulmonary embolism in 1042 COVID-19 patients with respiratory symptoms: A nested case-control study. Thromb Res 2021; 197:94-99. [PMID: 33190025 PMCID: PMC7648521 DOI: 10.1016/j.thromres.2020.11.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/12/2020] [Accepted: 11/03/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) has been associated with cardiovascular complications and coagulation disorders. Previous studies reported pulmonary embolism (PE) in severe COVID-19 patients. Aim of the study was to estimate the prevalence of symptomatic PE in COVID-19 patients and to identify the clinical, radiological or biological characteristics associated with PE. PATIENTS/METHODS We conducted a retrospective nested case-control study in 2 French hospitals. Controls were matched in a 1:2 ratio on the basis of age, sex and center. PE patients with COVID-19 were compared to patients in whom PE was ruled out (CTPA controls) and in whom PE has not been investigated (CT controls). RESULTS PE was suspected in 269 patients among 1042 COVID-19 patients, and confirmed in 59 patients (5.6%). Half of PE was diagnosed at COVID-19 diagnosis. PE patients did not differ from CT and CTPA controls for thrombosis risk factors. PE patients more often required invasive ventilation compared to CTPA controls (odds ratio (OR) 2.79; 95% confidence interval (CI) 1.33-5.84) and to CT controls (OR 8.07; 95% CI 2.70-23.82). PE patients exhibited more extensive parenchymal lesions (>50%) than CT controls (OR 3.90; 95% CI 1.54-9.94). D-dimer levels were 5.1 (95% CI 1.90-13.76) times higher in PE patients than CTPA controls. CONCLUSIONS Our results suggest a PE prevalence in COVID-19 patients close to 5% in the whole population and to 20% of the clinically suspected population. PE seems to be associated with more extensive lung damage and to require more frequently invasive ventilation.
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Affiliation(s)
- Benjamin Planquette
- Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France.
| | - Alice Le Berre
- Department of Radiology, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France
| | - Lina Khider
- Université de Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France
| | - Alexandra Yannoutsos
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France
| | - Nicolas Gendron
- Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Haematology, France
| | - Marie de Torcy
- Department of Respiratory Medicine, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France
| | - Nassim Mohamedi
- Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Vascular Medicine, France
| | - Stéphane Jouveshomme
- Department of Respiratory Medicine, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France
| | - David M Smadja
- Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Haematology, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - Isabelle Lazareth
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France
| | - Guillaume Goudot
- Université de Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France
| | - Laure Fournier
- Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Radiology, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France
| | - Cédric Bruel
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Intensive Care Unit, France
| | - Jean Luc Diehl
- Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Intensive Care Unit, France
| | - Jean-Jacques Mourad
- Université de Paris, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Internal Medicine, France
| | - Guy Meyer
- Université de Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France; INSERM CIC 14-18, F-75015 Paris, France
| | - Pascal Priollet
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France
| | - Emmanuel Messas
- Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Physics for Medicine Paris, INSERM U1273, ESPCI Paris, CNRS FRE 2031, F-75011 Paris, France; Department of Vascular Medicine, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France
| | - Olivier Sanchez
- Université de Paris, France; Innovative Therapies in Haemostasis, INSERM, F-75006 Paris, France; Biosurgical research lab (Carpentier Foundation), F-75015 Paris, France; Department of Respiratory Medicine, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; F-CRIN INNOVTE, Saint-Étienne, France
| | - Hélène Beaussier
- Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Clinical Investigation, France
| | - Tristan Mirault
- Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; Department of Vascular Medicine, France; Paris research cardiovascular center PARCC INSERM UMR-S 970, F-75015 Paris, France
| | - Marc Zins
- Department of Radiology, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France
| | - Gilles Chatelier
- Université de Paris, France; Assistance publique hôpitaux de Paris AH-HP, Hôpital européen Georges-Pompidou, F-75015 Paris, France; INSERM CIC 14-18, F-75015 Paris, France; Department of statistics, bioinformatics and public health, France
| | - Joseph Emmerich
- Université de Paris, France; Groupe Hospitalier Paris Saint-Joseph, F-75014 Paris, France; Department of Vascular Medicine, France; INSERM CRESS UMR 1153, F-75005 Paris, France
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Bintein F, Yannoustsos A, Chatellier G, Fontaine M, Damotte D, Paterlini-Bréchot P, Meyer G, Duchatelle V, Marini V, Schwering KL, Labrousse C, Beaussier H, Zins M, Salmeron S, Lajonchère JP, Priollet P, Emmerich J, Trédaniel J. Prevalence of lung cancer in patients with atherosclerotic peripheral arterial disease:meta-analysis of literature data. Lung Cancer 2020. [DOI: 10.1183/13993003.congress-2020.1612] [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: 11/05/2022]
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Valensi P, Henry P, Boccara F, Cosson E, Prevost G, Emmerich J, Ernande L, Marcadet D, Mousseaux E, Rouzet F, Sultan A, Ferrières J, Vergès B, Van Belle E. Risk stratification and screening for coronary artery disease in asymptomatic patients with diabetes mellitus: Position paper of the French Society of Cardiology and the French-speaking Society of Diabetology. Diabetes Metab 2020; 47:101185. [PMID: 32846201 DOI: 10.1016/j.diabet.2020.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/09/2023]
Affiliation(s)
- Paul Valensi
- Unit of Endocrinology Diabetology Nutrition, AP-HP, Jean Verdier hospital, CINFO, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bondy, France
| | - Patrick Henry
- Department of Cardiology, Inserm U942, Lariboisiere Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, Paris, France.
| | - Franck Boccara
- AP-HP, Hôpitaux de l'Est Parisien, Hôpital Saint-Antoine, Department of Cardiology, Sorbonne Université-Inserm UMR S_938, Centre de Recherche Saint-Antoine, Paris, France
| | - Emmanuel Cosson
- AP-HP, Avicenne Hospital, Paris 13 University, Sorbonne Paris Cité, Department of Endocrinology-Diabetology-Nutrition, CRNH-IdF, CINFO, Bobigny, France; Paris 13 University, Sorbonne Paris Cité, UMR U557 Inserm/U11125 INRAE/CNAM/Université Paris13, Unité de Recherche Epidémiologique Nutritionnelle, Bobigny, France
| | - Gaetan Prevost
- Department of Endocrinology, Diabetes and Metabolic Diseases, Normandie Univ, UNIROUEN, Rouen University Hospital, Centre d'Investigation Clinique (CIC-CRB)-Inserm 1404, Rouen University Hospital, 76000 Rouen, France
| | - Joseph Emmerich
- Service de Médecine Vasculaire, Groupe Hospitalier Paris Saint-Joseph, Université de Paris, Inserm UMR1153-CRESS, 75674 Paris cedex 14, France
| | - Laura Ernande
- Service des explorations fonctionnelles, Hôpital Henri Mondor, AP-HP et Inserm U955, Université Paris-Est Créteil, France
| | - Dany Marcadet
- Centre Coeur et Santé Bernoulli - Cardiologie du sport et Réadaptation Cardiaque, 3, rue Bernoulli, 75008 Paris, France
| | - Elie Mousseaux
- Radiology Department, Hôpital Européen Georges Pompidou & Inserm U 970; Assistance Publique - Hôpitaux de Paris, University of Paris, French Society of Cardiovascular Imaging (SFICV), Paris, France
| | - François Rouzet
- Nuclear Medicine Department, Bichat Hospital, AP-HP Paris - Université de Paris, Laboratory for Vascular Translational Science, Inserm, UMR 1148, 75018 Paris, France
| | - Ariane Sultan
- Physiologie et Médecine Expérimentale du Coeur et des Muscles (PHYMEDEX), U1046 Inserm, UMR9214 CNRS, Université de Montpellier, 34295 Montpellier; Département Endocrinologie, Nutrition, Diabète, Equipe Nutrition, Diabète, CHRU Montpellier, 34090 Montpellier, France
| | - Jean Ferrières
- Department of Cardiology and UMR Inserm 1027, Toulouse Rangueil University Hospital, Toulouse University School of Medicine, Toulouse, France
| | - Bruno Vergès
- Service Endocrinologie-Diabétologie, CHU Dijon - Inserm LNC-UMR 1231, Dijon, France
| | - Eric Van Belle
- Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, Institut Coeur Poumon, Centre Hospitalier Universitaire de Lille, Lille, France; Inserm, U1011, Institut Pasteur de Lille, EGID, Lille, France; Department of Medicine, Université de Lille, Lille, France
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Khider L, Soudet S, Laneelle D, Boge G, Bura-Rivière A, Constans J, Dadon M, Desmurs-Clavel H, Diard A, Elias A, Emmerich J, Galanaud JP, Giordana P, Gracia S, Hamade A, Jurus C, Le Hello C, Long A, Michon-Pasturel U, Mirault T, Miserey G, Perez-Martin A, Pernod G, Quere I, Sprynger M, Stephan D, Wahl D, Zuily S, Mahe G, Sevestre MA. Proposal of the French Society of Vascular Medicine for the prevention, diagnosis and treatment of venous thromboembolic disease in outpatients with COVID-19. J Med Vasc 2020; 45:210-213. [PMID: 32571561 PMCID: PMC7183940 DOI: 10.1016/j.jdmv.2020.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 01/08/2023]
Affiliation(s)
- L Khider
- Vascular Medicine department, Georges-Pompidou European Hospital, Paris University, AP-HP, 75015 Paris, France
| | - S Soudet
- Vascular Medicine department, University Hospital Amiens Picardie, 80000 Amiens, France
| | - D Laneelle
- Vascular Medicine department, University Hospital of Caen-Normandie, 14000 Caen, France
| | - G Boge
- Vascular Medicine unit, Department of Internal Medicine, Montpellier University Hospital, 34000 Montpellier cedex 5, France
| | - A Bura-Rivière
- Vascular Medicine department, CHU of Rangueil, 31059 Toulouse cedex 9, France
| | - J Constans
- Vascular Medicine department, Saint-André Hospital, 33075 Bordeaux cedex, France
| | - M Dadon
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France
| | - H Desmurs-Clavel
- Internal Medicine department, Hospital Edouard-Herriot, 69003 Lyon, France
| | - A Diard
- Vascular Medicine office, 33550 Langoiran, France
| | - A Elias
- Vascular Medicine department, Sainte-Musse Hospital Center, 83100 Toulon, France
| | - J Emmerich
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France; Paris Descartes University, Paris, France
| | - J-P Galanaud
- Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, M4N 3M5 Toronto, ON, Canada
| | - P Giordana
- Vascular Medicine office, 06000 Nice, France
| | - S Gracia
- Vascular Medicine office, 17138 Puilboreau, France
| | - A Hamade
- Vascular Medicine unit, Emile-Muller Hospital, 68070 Mulhouse cedex 01, France
| | - C Jurus
- Vascular Medicine department, Tonkin Clinic, 69100 Villeurbanne, France
| | - C Le Hello
- Vascular Medicine department, University Hospital of Saint-Étienne, 42000 Saint-Étienne, France
| | - A Long
- Vascular Medicine department, Edouard-Herriot Hospital, 69003 Lyon, France
| | - U Michon-Pasturel
- Vascular Medicine department, Paris Saint-Joseph Hospital Group, 75014 Paris, France; Paris Descartes University, Paris, France
| | - T Mirault
- Vascular Medicine department, Georges-Pompidou European Hospital, Paris University, AP-HP, 75015 Paris, France
| | - G Miserey
- Vascular Medicine office, 78120 Rambouillet, France
| | - A Perez-Martin
- Vascular Medicine department, University hospital of Nîmes, 30000 Nîmes, France
| | - G Pernod
- Vascular Medicine department, Grenoble-Alpes University Hospital, 38000 Grenoble, France
| | - I Quere
- Vascular Medicine unit, Department of Internal Medicine, Montpellier University Hospital, 34000 Montpellier cedex 5, France
| | - M Sprynger
- Department of Cardiology, University Hospital of Liège, 4000 Liège, Belgium
| | - D Stephan
- Hypertension and Vascular Medicine department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - D Wahl
- Vascular Medicine Division and Regional Competence Centre for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy, 54000 Nancy, France
| | - S Zuily
- Vascular Medicine departement, University hospital of Rennes, 35000 Rennes, France
| | - G Mahe
- Vascular Medicine departement, University hospital of Rennes, 35000 Rennes, France
| | - M A Sevestre
- Vascular Medicine department, University Hospital Amiens Picardie, 80000 Amiens, France.
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Le Berre A, Marteau V, Emmerich J, Zins M. Concomitant acute aortic thrombosis and pulmonary embolism complicating COVID-19 pneumonia. Diagn Interv Imaging 2020; 101:321-322. [PMID: 32334995 PMCID: PMC7161476 DOI: 10.1016/j.diii.2020.04.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/11/2022]
Affiliation(s)
- A Le Berre
- Department of Radiology, Fondation Hôpital Saint-Joseph, 75014 Paris, France.
| | - V Marteau
- Department of Radiology, Fondation Hôpital Saint-Joseph, 75014 Paris, France
| | - J Emmerich
- Department of Vascular Medicine, Fondation Hôpital Saint-Joseph, 75014 Paris, France
| | - M Zins
- Department of Radiology, Fondation Hôpital Saint-Joseph, 75014 Paris, France
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Henry-Bonniot G, Côté B, Yannoutsos A, Emmerich J. Consistency of thrombophilia testing in a reference center according to the current guidelines. J Med Vasc 2020; 45:125-129. [PMID: 32402426 DOI: 10.1016/j.jdmv.2020.03.007] [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] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 03/08/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The clinical relevance of hereditary thrombophilia (HT) testing in venous thromboembolic disease (VTE) is limited to specific guidelines. The present study aimed to evaluate the consistency of HT prescriptions in clinical practice according to the current French guidelines. METHODS This study was conducted from April 2017 to February 2018 in a specialized haemostasis centre and included 58 consecutive patients referred by their clinicians for thrombophilia screening (56 patients following a personal VTE event and 2 asymptomatic relatives of a first-degree patient who had had VTE). One experienced clinician met every patient and assessed a pre-test prediction for the presence or absence of HT based on the clinical characteristics of VTE which was compared to the HT biological results. RESULTS Among the 58 patients referred to our specialized haemostasis centre, 60% were outside the scope of recommendations for thrombophilia screening. Eight patients were diagnosed with HT. Six out of 8 (75%) patients with diagnosed HT had a history of unprovoked VTE event. Familial history with VTE was a poor predictor for positive HT testing among relatives. The positive and negative predictive values of the clinical prediction were respectively of 19% and 89%. CONCLUSION The present results underline that screening for HT remains too largely prescribed. Pre-test physician's feeling for the presence of HT was neither sensitive nor specific. Increasing physicians' awareness on this issue and current recommendations should limit prescriptions of HT tests while providing the best possible care for patients with VTE.
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Affiliation(s)
- G Henry-Bonniot
- Hôtel-Dieu hospital, diagnostic and therapeutic center, AP-HP, 1, place du Parvis-Notre-Dame, 75004 Paris, France.
| | - B Côté
- Enfant-Jésus hospital, Laval University, CHU, Québec Canada
| | - A Yannoutsos
- Vascular medicine department, Paris Saint-Joseph hospital group, Paris University, 185, rue Raymond-Losserand 75014 Paris France
| | - J Emmerich
- Vascular medicine department, Paris Saint-Joseph hospital group, Paris University, 185, rue Raymond-Losserand 75014 Paris France
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43
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Boursier-Bossy V, Zuber M, Emmerich J. Ischemic stroke and non-valvular atrial fibrillation: When to introduce anticoagulant therapy? J Med Vasc 2020; 45:72-80. [PMID: 32265018 DOI: 10.1016/j.jdmv.2020.01.153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 12/19/2019] [Indexed: 06/11/2023]
Abstract
About 20 to 30% of ischemic strokes are related to non-valvular atrial fibrillation. This type of situation is particularly at risk for both recurrence of the ischemic event and the hemorrhagic transformation of this stroke. The timing of the introduction or going back to the anticoagulant therapy in these patients remains a difficult issue, with a complex benefit-risk balance that needs to be assessed. Randomized controlled studies are lacking and current recommendations do not allow for clear decision making. The administration of a curative anticoagulant within 72 hours after the event is not recommended in the absence of demonstrated efficacy in preventing recurrence at this stage and because of the risk of intracerebral hemorrhage. This attitude can nevertheless be qualified by a transient accident or ischemic accident of very small size, and in the absence of any other risk factor for intra- or extra-cerebral hemorrhage. From the 4th day, after an appropriate case by case evaluation, the introduction of anticoagulant would be possible within a time which will remain at the appreciation of the medical teams. If the patient's risk of an intracerebral hemorrhage or general bleeding is transiently increased, it will be preferable to wait at least 2 weeks after the stroke. If this risk persists in the long term, the decision of the administration or not of an anticoagulant will have to be made with a multidisciplinary consultation. Vitamin K antagonists or direct oral anticoagulants may be prescribed as first-line therapy for the prevention of recurrence of ischemic stroke in a non-valvular atrial fibrillation patient. The choice will be based on the clinical and biological data of each patient. Direct oral anticoagulants have not shown superiority in the prevention of ischemic recurrence but open up new prospects for earlier treatment if their lesser risk of bleeding is confirmed after further studies.
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Affiliation(s)
- V Boursier-Bossy
- Department of Neurology and Neurovascular, Paris Saint-Joseph Hospital Group, 185, rue Raymond-Losserand, 75014 Paris, France.
| | - M Zuber
- Department of Neurology and Neurovascular, Paris Saint-Joseph Hospital Group, 185, rue Raymond-Losserand, 75014 Paris, France; Paris Descartes University, Paris, France
| | - J Emmerich
- Department of Vascular Medicine, Paris Saint-Joseph Hospital Group, 185, rue Raymond-Losserand, 75014 Paris, France; Paris Descartes University, Paris, France
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44
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Di Primio M, Angelopoulos G, Lazareth I, Priollet P, Zins M, Emmerich J, Yannoutsos A. Innovative endovascular approach for limb salvage in critical limb ischemia. J Med Vasc 2020; 45:23-27. [PMID: 32057322 DOI: 10.1016/j.jdmv.2019.09.005] [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] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/24/2019] [Indexed: 11/18/2022]
Abstract
In the absence of feasible revascularization, nearly one third of patients with critical limb ischemia experienced major amputation at 6 months. In patients with an independent living status, this decision is difficult to support without exhausting all chances to attain limb salvage and preserve functional autonomy. The present report describes a new procedure of revascularization by performing a full endovascular extra-anatomic femoropopliteal bypass for the treatment of limb-threatening ischemia. The patient presented with extensive tissue loss and a short-term risk of major amputation. She had experienced previous failure of conventional surgical and endovascular revascularization procedures and ligation of proximal femoral artery precluded any further revascularization attempt. Limb salvage was achieved with this endovascular revascularization procedure with complete wound closure. The patient still presents an independent living status and preserved functional autonomy without wound recurrence after a follow-up of more than 5 years.
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Affiliation(s)
- M Di Primio
- Interventional radiology department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
| | - G Angelopoulos
- Interventional radiology department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - I Lazareth
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université de Paris (Paris Descartes), Paris, France
| | - P Priollet
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université de Paris (Paris Descartes), Paris, France
| | - M Zins
- Interventional radiology department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - J Emmerich
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université de Paris (Paris Descartes), Paris, France; INSERM UMR 1153-CRESS, Paris, France
| | - A Yannoutsos
- Vascular medicine department, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; Université de Paris (Paris Descartes), Paris, France; INSERM UMR 1153-CRESS, Paris, France
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45
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Rafii H, Frère C, Benzidia I, Crichi B, Andre T, Assenat E, Bournet B, Carpentier A, Connault J, Doucet L, Durant C, Emmerich J, Gris JC, Hij A, Le Hello C, Madelaine I, Messas E, Ndour A, Villiers S, Marjanovic Z, Ait Abdallah N, Yannoutsos A, Farge D. Management of cancer-related thrombosis in the era of direct oral anticoagulants: A comprehensive review of the 2019 ITAC-CME clinical practice guidelines. On behalf of the Groupe Francophone Thrombose et Cancer (GFTC). J Med Vasc 2020; 45:28-40. [PMID: 32057323 DOI: 10.1016/j.jdmv.2019.12.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Venous thromboembolism (VTE) is a common disease complication in cancer patients and the second cause of death after cancer progression. VTE management and prophylaxis are critical in cancer patients, but effective therapy can be challenging because these patients are at higher risk of VTE recurrence and bleeding under anticoagulant treatment. Numerous published studies report inconsistent implementation of existing evidence-based clinical practice guidelines (CPG), including underutilization of thromboprophylaxis, and wide variability in clinical practice patterns across different countries and various practitioners. This review aims to summarize the 2019 ITAC-CME evidence-based CPGs for treatment and prophylaxis of cancer-related VTE, which include recommendations on the use of direct oral anticoagulants specifically in cancer patients. The guidelines underscore the gravity of developing VTE in cancer and recommend the best approaches for treating and preventing cancer-associated VTE, while minimizing unnecessary or over-treatment. Greater adherence to the 2019 ITAC guidelines could substantially decrease the burden of VTE and improve survival of cancer patients.
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Affiliation(s)
- H Rafii
- Eurocord, Équipe 3 EA3518, hôpital Saint-Louis, Université de Paris, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Frère
- Inserm UMRS_1166, Department of Haematology, hôpital Pitié-Salpêtrière, Université de Paris, Sorbonne Paris-Cité, AP-HP, Paris, France
| | - I Benzidia
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - B Crichi
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - T Andre
- Hôpital Saint-Antoine, AP-HP, Paris, France
| | - E Assenat
- Montpellier school of Medicine, Saint-Eloi University Hospital, Montpellier, France
| | - B Bournet
- Hôpital Rangueil, CHU de Toulouse, Toulouse, France
| | | | | | - L Doucet
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | | | | | - A Hij
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | - C Le Hello
- CHU Saint-Étienne, Saint-Étienne, France
| | | | - E Messas
- Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
| | - A Ndour
- Hôpital Saint-Louis, AP-HP, Paris, France
| | - S Villiers
- Hôpital Saint-Louis, AP-HP, Paris, France
| | | | - N Ait Abdallah
- Autoimmune and vascular disease unit, hôpital Saint-Louis, Internal Medicine (UF04), Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, EA3518, AP-HP, Sorbonne Paris-Cité, Paris, France
| | | | - D Farge
- Internal Medicine (UF04), Équipe 3 EA 3518, Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Center of reference for rare systemic autoimmune diseases (FAI2R), Université de Paris, AP-HP, Sorbonne Paris-Cité, Paris, France; Department of Medicine, McGill University, Montreal, QC, Canada
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46
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El Bèze N, Blacher J, Martin A, Emmerich J. Aortic atherosclerosis complicated by retroperitoneal fibrosis treated only by optimal cardiovascular risk factors management. J Med Vasc 2020; 45:41-43. [PMID: 32057325 DOI: 10.1016/j.jdmv.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/29/2019] [Indexed: 06/10/2023]
Affiliation(s)
- N El Bèze
- Unité Hypertension Artérielle, Prévention et Thérapeutique Cardiovasculaires, Hôtel-Dieu, AP-HP et Université Paris-Descartes, 1 Parvis Notre-Dame - Pl. Jean-Paul II, 75004 Paris, France.
| | - J Blacher
- Unité Hypertension Artérielle, Prévention et Thérapeutique Cardiovasculaires, Hôtel-Dieu, AP-HP et Université Paris-Descartes, 1 Parvis Notre-Dame - Pl. Jean-Paul II, 75004 Paris, France
| | - A Martin
- Université de Médecine Johns Hopkins, 3400N. Charles Street, Baltimore, MD 21218, USA
| | - J Emmerich
- Service de Médecine Vasculaire, Groupe Hospitalier Paris Saint-Joseph et Université Paris-Descartes, 185, rue Raymond-Losserand, 75014 Paris, France
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47
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Yannoutsos A, Fontaine M, Galloula A, Damotte D, Chatellier G, Paterlini-Bréchot P, Meyer G, Pastre J, Duchatelle V, Marini V, Schwering KL, Lazareth I, Ghaffari P, Stansal A, Sanson H, Labrousse C, Beaussier H, Nasr NB, Zins M, Salmeron S, Messas E, Lajonchère JP, Emmerich J, Priollet P, Trédaniel J. Peripheral arterial disease and systematic detection of circulating tumor cells: rationale and design of the DETECTOR prospective cohort study. BMC Cardiovasc Disord 2019; 19:212. [PMID: 31519196 PMCID: PMC6743149 DOI: 10.1186/s12872-019-1193-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/11/2019] [Accepted: 09/06/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Smoking is a strong risk factor for cancer and atherosclerosis. Cancer mortality, especially from lung cancer, overtakes cardiovascular (CV) death rate in patients with peripheral arterial disease (PAD). Only a few patients with lung cancer after PAD management may benefit from surgical excision. Circulating tumor cells (CTC) associated with low-dose chest CT (LDCT) may improve early cancer detection. This study focuses on a screening strategy that can address not only lung cancer but all tobacco-related cancers in this high-risk population. METHODS DETECTOR Project is a prospective cohort study in two French University hospitals. Participants are smokers or former smokers (≥30 pack-years, quitted ≤15 years), aged ≥55 to 80 years, with atherosclerotic PAD or abdominal aortic aneurysm. After the first screening round combining LDCT and CTC search on a blood sample, two other screening rounds will be performed at one-year interval. Incidental lung nodule volume, volume doubling time and presence of CTC will be taken into consideration for adapted diagnostic management. In case of negative LDCT and presence of CTC, a contrast enhanced whole-body PET/CT will be performed for extra-pulmonary malignancy screening. Psychological impact of this screening strategy will be evaluated in population study using a qualitative methodology. Assuming 10% prevalence of smoking-associated cancer in the studied population, a total of at least 300 participants will be enrolled. DISCUSSION Epidemiological data underline an increase incidence in cancer and related death in the follow-up of patients with PAD, compared with the general population, particularly for tobacco-related cancers. The clinical benefit of a special workup for neoplasms in patients with PAD and a history of cigarette smoking has never been investigated. By considering CTCs detection in this very high-risk selected PAD population for tobacco-induced cancer, we expect to detect earlier pulmonary and extra-pulmonary malignancies, at a potentially curable stage. TRIAL REGISTRATION The study was registered in the French National Agency for Medicines and Health Products Safety (No N° EUDRACT_ID RCB: 2016-A00657-44) and was approved by the ethics Committee for Persons Protection (IRB number 1072 and n° initial agreement 2016-08-02; ClinicalTrials.gov identifier NCT02849041).
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Affiliation(s)
- Alexandra Yannoutsos
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Unité INSERM UMR 1153-CRESS, Paris, France
| | | | - Alexandre Galloula
- Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France
| | - Diane Damotte
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France.,Unité INSERM U1138, Centre de Recherche des Cordeliers, Paris, France
| | - Gilles Chatellier
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France
| | | | - Guy Meyer
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France
| | - Jean Pastre
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France
| | - Véronique Duchatelle
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Valéria Marini
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | | | - Isabelle Lazareth
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Parinaz Ghaffari
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Audrey Stansal
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Hélène Sanson
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Cécile Labrousse
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Hélène Beaussier
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Nesrine Ben Nasr
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Marc Zins
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Sergio Salmeron
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Emmanuel Messas
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, 75014, Paris, France
| | | | - Joseph Emmerich
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Unité INSERM UMR 1153-CRESS, Paris, France
| | - Pascal Priollet
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France
| | - Jean Trédaniel
- Groupe Hospitalier Paris Saint Joseph, 185 rue Raymond Losserand, 75 014, Paris, France. .,Université Paris Descartes, Sorbonne Paris Cité, Paris, France. .,Unité INSERM UMR-S 1124, Toxicologie, pharmacologie et signalisation cellulaire, Paris, France.
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48
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Verma D, Kumar R, Pereira RS, Karantanou C, Zanetti C, Minciacchi VR, Fulzele K, Kunz K, Hoelper S, Zia-Chahabi S, Jabagi MJ, Emmerich J, Dray-Spira R, Kuhlee F, Hackmann K, Schroeck E, Wenzel P, Müller S, Filmann N, Fontenay M, Pajevic PD, Krause DS. Vitamin K antagonism impairs the bone marrow microenvironment and hematopoiesis. Blood 2019; 134:227-238. [PMID: 31003999 PMCID: PMC7022447 DOI: 10.1182/blood.2018874214] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 04/04/2019] [Indexed: 12/28/2022] Open
Abstract
Vitamin K antagonists (VKAs) have been used in 1% of the world's population for prophylaxis or treatment of thromboembolic events for 64 years. Impairment of osteoblast function and osteoporosis has been described in patients receiving VKAs. Given the involvement of cells of the bone marrow microenvironment (BMM), such as mesenchymal stem cells (MSCs) and macrophages, as well as other factors such as the extracellular matrix for the maintenance of normal hematopoietic stem cells (HSCs), we investigated a possible effect of VKAs on hematopoiesis via the BMM. Using various transplantation and in vitro assays, we show here that VKAs alter parameters of bone physiology and reduce functional HSCs 8-fold. We implicate impairment of the functional, secreted, vitamin K-dependent, γ-carboxylated form of periostin by macrophages and, to a lesser extent, MSCs of the BMM and integrin β3-AKT signaling in HSCs as at least partly causative of this effect, with VKAs not being directly toxic to HSCs. In patients, VKA use associates with modestly reduced leukocyte and monocyte counts, albeit within the normal reference range. VKAs decrease human HSC engraftment in immunosuppressed mice. Following published examples that alteration of the BMM can lead to hematological malignancies in mice, we describe, without providing a causal link, that the odds of VKA use are higher in patients with vs without a diagnosis of myelodysplastic syndrome (MDS). These results demonstrate that VKA treatment impairs HSC function via impairment of the BMM and the periostin/integrin β3 axis, possibly associating with increased MDS risk.
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Affiliation(s)
- Divij Verma
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Rahul Kumar
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Raquel S Pereira
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Christina Karantanou
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Costanza Zanetti
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | - Valentina R Minciacchi
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
| | | | - Kathrin Kunz
- Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Soraya Hoelper
- Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Sara Zia-Chahabi
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre-Cochin, Laboratory of Hematology, Institut Cochin, Université Paris Descartes, Paris, France
| | - Marie-Joëlle Jabagi
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis Cedex, France
| | - Joseph Emmerich
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis Cedex, France
- Vascular Medicine and Cardiology, University Paris Descartes and Hotel Dieu Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Rosemary Dray-Spira
- Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis Cedex, France
| | - Franziska Kuhlee
- Institut für Klinische Genetik, Medizinische Fakultät Carl Gustav Carus, Dresden, Germany
| | - Karl Hackmann
- Institut für Klinische Genetik, Medizinische Fakultät Carl Gustav Carus, Dresden, Germany
| | - Evelin Schroeck
- Institut für Klinische Genetik, Medizinische Fakultät Carl Gustav Carus, Dresden, Germany
| | - Philip Wenzel
- University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Stefan Müller
- Institute of Biochemistry II, Goethe University, Frankfurt am Main, Germany
| | - Natalie Filmann
- Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt, Germany
| | - Michaela Fontenay
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Centre-Cochin, Laboratory of Hematology, Institut Cochin, Université Paris Descartes, Paris, France
| | | | - Daniela S Krause
- Georg-Speyer-Haus, Institute for Tumor Biology and Experimental Therapy, Frankfurt am Main, Germany
- German Cancer Consortium, Heidelberg, Germany
- German Cancer Research Center, Heidelberg, Germany; and
- Faculty of Medicine, Johann Wolfgang Goethe University, Frankfurt, Germany
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49
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Emmerich J, Blachier V, Fanon L, Mairesse S, Cordier C, Alsac JM. Treatment of popliteal venous aneurysms by femoral vein ligation. J Vasc Surg Cases Innov Tech 2019; 5:228-231. [PMID: 31297472 PMCID: PMC6598725 DOI: 10.1016/j.jvscit.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 07/04/2018] [Accepted: 11/13/2018] [Indexed: 11/05/2022]
Abstract
Popliteal venous aneurysms are highly associated with local venous thrombosis and pulmonary embolism. We propose a simple and new surgical therapy for popliteal venous aneurysm by ligation of the femoral vein. We describe the case of a woman with recurrent pulmonary embolism. Venous ultrasound examination showed a venous aneurysm of the right popliteal fossa. We proposed a ligature-section of the femoral vein just below the confluence of the great saphenous vein. After >6 years of follow-up, the patient is asymptomatic, with a completely normal life and only a small amount of edema of the right leg.
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Affiliation(s)
- Joseph Emmerich
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Vincent Blachier
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Laurie Fanon
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Sandrine Mairesse
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Clémence Cordier
- Department of Vascular Medicine and Cardiology, University Paris-Descartes, AP-HP, INSERM UMR 1153, Hôtel Dieu, Paris, France
| | - Jean-Marc Alsac
- Department of Vascular Surgery, University Paris-Descartes, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
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50
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Emmerich J, Yannoutsos A. [Reflections on unresolved questions on venous thromboembolic disease]. J Med Vasc 2019; 44:1-2. [PMID: 30770080 DOI: 10.1016/j.jdmv.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- J Emmerich
- Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, université Paris-Descartes, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
| | - A Yannoutsos
- Service de médecine vasculaire, groupe hospitalier Paris Saint-Joseph, université Paris-Descartes, 185, rue Raymond-Losserand, 75674 Paris cedex 14, France.
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