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Houchi C, Marcil MJ, Nadarajah K, Mageau GA, Khairy P, Marin MF, Cossette M, Dubé MP, Chaix MA, Mongeon FP, Dore A, Mondésert B, Ibrahim R, Brouillette J. The relationship between perceived parenting practices and anxiety in adults with congenital heart disease. Can J Cardiol 2024:S0828-282X(24)00343-X. [PMID: 38705272 DOI: 10.1016/j.cjca.2024.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/31/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND Patients with congenital heart disease (CHD) and their parents face challenges throughout their lives that can lead to anxiety lasting into adulthood. We aim to assess the association between perceived parenting practices and anxiety beyond pediatric medical-surgical histories in adults with CHD. METHODS A cross-sectional study of adults with CHD was conducted at the Montreal Heart Institute (MHI). Perception of parental practices during childhood was retrospectively assessed using validated self-report questionnaires, while anxiety in adulthood was assessed with the Hospital Anxiety and Depression Scale (HADS). Sociodemographic and medical information were collected from a questionnaire and medical records. Hierarchical multiple linear regression was conducted. RESULTS Of the 223 participants, 59% were female, and the mean age was 46 ± 14 years. Perceived parenting practices explained more variance (11%) in the anxiety score than pediatric medical-surgical history (2%). In our final model, anxiety was significantly associated with age, parental history of anxiety, and positive parenting practices, but not with overprotection. CONCLUSIONS Parenting practices are associated with anxiety in adults with CHD beyond pediatric medical-surgical history and sociodemographic. Positive parenting practices may be protective against anxiety in adulthood. Longitudinal studies are needed to determine causality.
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Affiliation(s)
- Cylia Houchi
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Joëlle Marcil
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | | | - Geneviève A Mageau
- Department of Psychology, Faculty of Arts and Science, Université de Montréal, Montréal, Québec, Canada
| | - Paul Khairy
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Marie-France Marin
- Department of Psychology, Faculty of Social Sciences and Humanities, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Centre, a division of the Montreal Heart Institute, Montréal, Québec, Canada
| | - Marie-Pierre Dubé
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Marie-A Chaix
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - François-Pierre Mongeon
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Annie Dore
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Blandine Mondésert
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Reda Ibrahim
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - Judith Brouillette
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
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Ferron M, Merlet N, Mihalache-Avram T, Mecteau M, Brand G, Gillis MA, Shi Y, Nozza A, Cossette M, Guertin MC, Rhéaume E, Tardif JC. Adcy9 Gene Inactivation Improves Cardiac Function After Myocardial Infarction in Mice. Can J Cardiol 2023; 39:952-962. [PMID: 37054880 DOI: 10.1016/j.cjca.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Polymorphisms in the adenylate cyclase 9 (ADCY9) gene influence the benefits of the cholesteryl ester transfer protein (CETP) modulator dalcetrapib on cardiovascular events after acute coronary syndrome. We hypothesized that Adcy9 inactivation could improve cardiac function and remodelling following myocardial infarction (MI) in absence of CETP activity. METHODS Wild-type (WT) and Adcy9-inactivated (Adcy9Gt/Gt) male mice, transgenic or not for human CETP (tgCETP+/-), were subjected to MI by permanent left anterior descending coronary artery ligation and studied for 4 weeks. Left ventricular (LV) function was assessed by echocardiography at baseline, 1, and 4 weeks after MI. At sacrifice, blood, spleen and bone marrow cells were collected for flow cytometry analysis, and hearts were harvested for histologic analyses. RESULTS All mice developed LV hypertrophy, dilation, and systolic dysfunction, but Adcy9Gt/Gt mice exhibited reduced pathologic LV remodelling and better LV function compared with WT mice. There were no differences between tgCETP+/- and Adcy9Gt/Gt tgCETP+/- mice, which both exhibited intermediate responses. Histologic analyses showed smaller cardiomyocyte size, reduced infarct size, and preserved myocardial capillary density in the infarct border zone in Adcy9Gt/Gt vs WT mice. Count of bone marrow T cells and B cells were significantly increased in Adcy9Gt/Gt mice compared with the other genotypes. CONCLUSIONS Adcy9 inactivation reduced infarct size, pathologic remodelling, and cardiac dysfunction. These changes were accompanied by preserved myocardial capillary density and increased adaptive immune response. Most of the benefits of Adcy9 inactivation were only observed in the absence of CETP.
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Affiliation(s)
| | | | | | | | | | | | - Yanfen Shi
- Montréal Heart Institute, Montréal, Québec, Canada
| | - Anna Nozza
- Montréal Health Innovations Coordinating Centre (MHICC), Montréal, Québec, Canada
| | - Mariève Cossette
- Montréal Health Innovations Coordinating Centre (MHICC), Montréal, Québec, Canada
| | - Marie-Claude Guertin
- Montréal Health Innovations Coordinating Centre (MHICC), Montréal, Québec, Canada
| | - Eric Rhéaume
- Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Jean-Claude Tardif
- Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada.
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Noly PE, Moriguchi J, Shah KB, Anyanwu AC, Mahr C, Skipper E, Cossette M, Lamarche Y, Carrier M. A bridge-to-bridge approach to heart transplantation using extracorporeal membrane oxygenation and total artificial heart. J Thorac Cardiovasc Surg 2023; 165:1138-1148.e1. [PMID: 34627602 DOI: 10.1016/j.jtcvs.2021.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/29/2021] [Accepted: 09/07/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study aims to describe the outcomes after heart transplantation using a bridge-to-bridge strategy with a sequence of extracorporeal membrane oxygenation (ECMO) support followed by temporary total artificial heart implantation (TAH-t). METHODS A retrospective, multicenter analysis of 54 patients who underwent TAH-t implantation following an ECMO for cardiogenic shock was performed (ECMO-TAH-t group). A control group of 163 patients who underwent TAH-t implantation as a direct bridge to transplantation (TAH-t group) was used to assess this strategy's impact on outcomes. RESULTS Fifty-four patients, averaging 47 ± 13 year old, underwent implantation of a TAH-t after 5.3 ± 3.4 days of ECMO perfusion for cardiogenic shock. In the ECMO-TAH-t group, 20 patients (20/54%; 37%) died after TAH-t implantation and 57 patients (57/163%; 35%) died in the TAH-t group (Gray test; P = .49). The top 3 causes of death of patients on TAH-t support were multisystem organ failure (40%), sepsis (20%), and neurologic events (20%). Overall, 32 patients (32/54%; 59%) underwent heart transplantation in the ECMO-TAH-t group compared with 106 patients (106/163%, 65%) in the TAH-t group (P = .44). No significant difference in survival was observed at 6 months, 1 year, and 3 years after heart transplant (ECMO-TAH-t group: 94%, 87%, and 80% vs 87%, 83%, and 76% in the TAH-t group, respectively). Deterioration of liver function (bilirubin, aspartate transaminase, and alanine aminotransferase levels on TAH-t) was associated with increased mortality before heart transplant in both groups. CONCLUSIONS Sequential bridging from ECMO to TAH-t followed by heart transplantation is a viable option for a group of highly selected patients.
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Affiliation(s)
- Pierre-Emmanuel Noly
- Department of Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada.
| | - Jaime Moriguchi
- Department of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, Calif
| | - Keyur B Shah
- Division of Cardiology, The Pauley Heart Center, Virginia Commonwealth University, Richmond, Va
| | - Anelechi C Anyanwu
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Claudius Mahr
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, Wash
| | - Eric Skipper
- Department of Thoracic and Cardiovascular Surgery, Carolinas Medical Center, Charlotte, NC
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center (MHICC), Montreal, Canada
| | - Yoan Lamarche
- Department of Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Michel Carrier
- Department of Cardiac Surgery, Montreal Heart Institute, Montreal, Quebec, Canada
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Bénard F, Harsini S, Wilson D, Zukotynski K, Abikhzer G, Turcotte E, Cossette M, Metser U, Romsa J, Martin M, Mar C, Saad F, Soucy JP, Eigl BJ, Black P, Krauze A, Burrell S, Nichol A, Tardif JC. Intra-individual comparison of 18F-sodium fluoride PET-CT and 99mTc bone scintigraphy with SPECT in patients with prostate cancer or breast cancer at high risk for skeletal metastases (MITNEC-A1): a multicentre, phase 3 trial. Lancet Oncol 2022; 23:1499-1507. [PMID: 36343655 DOI: 10.1016/s1470-2045(22)00642-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/03/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Detection of skeletal metastases in patients with prostate cancer or breast cancer remains a major clinical challenge. We aimed to compare the diagnostic performance of 99mTc-methylene diphosphonate (99mTc-MDP) single-photon emission CT (SPECT) and 18F-sodium fluoride (18F-NaF) PET-CT for the detection of osseous metastases in patients with high-risk prostate or breast cancer. METHODS MITNEC-A1 was a prospective, multicentre, single-cohort, phase 3 trial conducted in ten hospitals across Canada. Patients aged 18 years or older with breast or prostate cancer with a WHO performance status of 0-2 and with high risk or clinical suspicion for bone metastasis, but without previously documented bone involvement, were eligible. 18F-NaF PET-CT and 99mTc-MDP SPECT were done within 14 days of each other for each participant. Two independent reviewers interpreted each modality without knowledge of other imaging findings. The primary endpoint was the overall accuracy of 99mTc-MDP SPECT and 18F-NaF PET-CT scans for the detection of bone metastases in the per-protocol population. A combination of histopathological, clinical, and imaging follow-up for up to 24 months was used as the reference standard to assess the imaging results. Safety was assessed in all enrolled participants. This study is registered with ClinicalTrials.gov, NCT01930812, and is complete. FINDINGS Between July 11, 2014, and March 3, 2017, 290 patients were screened, 288 of whom were enrolled (64 participants with breast cancer and 224 with prostate cancer). 261 participants underwent both 18F-NaF PET-CT and 99mTc-MDP SPECT and completed the required follow-up for statistical analysis. Median follow-up was 735 days (IQR 727-750). Based on the reference methods used, 109 (42%) of 261 patients had bone metastases. In the patient-based analysis, 18F-NaF PET-CT was more accurate than 99mTc-MDP SPECT (84·3% [95% CI 79·9-88·7] vs 77·4% [72·3-82·5], difference 6·9% [95% CI 1·3-12·5]; p=0·016). No adverse events were reported for the 288 patients recruited. INTERPRETATION 18F-NaF has the potential to displace 99mTc-MDP as the bone imaging radiopharmaceutical of choice in patients with high-risk prostate or breast cancer. FUNDING Canadian Institutes of Health Research.
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Affiliation(s)
- François Bénard
- BC Cancer Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
| | - Sara Harsini
- BC Cancer Research Institute, Vancouver, BC, Canada
| | - Don Wilson
- BC Cancer Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | | | | | - Eric Turcotte
- Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mariève Cossette
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Ur Metser
- University Health Network, Toronto, ON, Canada
| | - Jonathan Romsa
- Division of Nuclear Medicine, London Health Sciences Centre, London, ON, Canada; St Joseph's Health Care, London, ON, Canada; Western University, London, ON, Canada
| | - Montgomery Martin
- BC Cancer Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Colin Mar
- BC Cancer Research Institute, Vancouver, BC, Canada; Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Fred Saad
- Division of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Jean-Paul Soucy
- Department of Radiology, McGill University, Montreal, QC, Canada
| | | | - Peter Black
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Andra Krauze
- BC Cancer Research Institute, Vancouver, BC, Canada
| | - Steven Burrell
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada
| | - Alan Nichol
- BC Cancer Research Institute, Vancouver, BC, Canada
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Vadeboncoeur A, Marcil MJ, Cyr S, Gupta M, Cournoyer A, Minichiello A, Larose D, Sirois-Leclerc J, Tardif JC, Morin J, Masson V, Cossette M, Brouillette J. Trajectory of patients consulting the emergency department for high blood pressure values. CAN J EMERG MED 2022; 24:515-519. [PMID: 35503402 PMCID: PMC9345802 DOI: 10.1007/s43678-022-00307-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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Emergency department (ED) visits for high blood pressure are increasing in frequency. We aimed to map those patients' trajectory, from referral sources to the type of care received at the ED to anticipated actions for future high blood pressure concerns, and to better understand their reasons for consulting the ED for high blood pressure values. METHODS Between 2018 and 2020, patients who presented to the Montreal Heart Institute's ED for elevated blood pressure were recruited in a prospective observational study including a post hoc structured telephone interview and medical chart review. Five possible referral sources were predetermined. We provided proportions and 95% confidence intervals. RESULTS A total of 100 patients were recruited (female: 59%, mean age: 69 ± 12). A majority (93%, 95% CI 88-98%) possessed a home blood pressure device, among which 46% (95% CI 36-56%) remembered receiving advice for its use. The main referral sources for high blood pressure to the ED were self-reference (53%, 95% CI 43-63%), advice of a lay person (19%, 95% CI 11-27%) or a nurse (13%, 95% CI 6-20%). Mainly, patients reported being concerned by concomitant symptoms or experiencing acute medical consequences (44%, 95% CI 34-54%), having followed the recommendation of a third party (33%, 95% CI 24-42%), or having concerns about their medication (6%, 95% CI 1-11%). Two weeks following their ED visits, consulting ED remained the main choice for future concerns about high blood pressure for 27% of participants. When specifically asked if they would return to the ED for elevated blood pressure, 73% (95% CI 64-83%) said yes. CONCLUSIONS Most patients who consulted the ED for elevated blood pressure values were self-referred. More can be done to promote blood pressure education, effective use of personal blood pressure devices, and recommendations for patients and health professionals when confronted with high blood pressure results.
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Affiliation(s)
- Alain Vadeboncoeur
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Marie-Joelle Marcil
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Samuel Cyr
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada.,Faculty of Pharmacy, Université de Montréal, Montréal, QC, Canada
| | - Mona Gupta
- Centre de recherche, Centre Hospitalier de L'Université de Montréal, Montréal, QC, Canada
| | - Alexis Cournoyer
- Centre de recherche, Hôpital du Sacré-Cœur de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Anthony Minichiello
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Dominic Larose
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Julie Sirois-Leclerc
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Jean-Claude Tardif
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Josée Morin
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada
| | - Violaine Masson
- Centre de recherche, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, QC, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center, Montréal, QC, Canada
| | - Judith Brouillette
- Research Centre, Montréal Heart Institute, Université de Montréal, 5000 Belanger Street, Montréal, QC, H1T 1C8, Canada. .,Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
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Tardif JC, Cossette M, Guertin MC, Bouabdallaoui N, Dubé MP, Boivin G. Predictive risk factors for hospitalization and response to colchicine in patients with COVID-19. Int J Infect Dis 2022; 116:387-390. [PMID: 35038601 PMCID: PMC8758567 DOI: 10.1016/j.ijid.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/10/2022] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE A predictive model for hospitalization due to COVID-19 or death was developed in the placebo group (N=2084) from a large clinical trial of colchicine in COVID-19 patients (N = 4159). RESULTS The seven variables retained in the predictive model were age, sex, body-mass index, history of respiratory disease, use of diabetes drugs, use of anticoagulants and use of oral steroids at the time of randomization. An optimal threshold value identified from the predictive model was used to classify high-risk patients (those with a predicted probability above the optimal threshold) and low-risk patients (those with a predicted probability below the optimal threshold). The number needed to treat to prevent one hospitalization or death with colchicine treatment decreased from 71 in the whole study population (N = 4159) to 29 in the high-risk subgroup (N=1692). CONCLUSION This model could serve to identify high-risk subjects who will particularly benefit from early colchicine therapy.
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Affiliation(s)
- Jean-Claude Tardif
- Montreal Heart Institute and Université de Montréal, Montreal, QC, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center (MHICC), Montreal, QC, Canada
| | | | | | - Marie-Pierre Dubé
- Montreal Heart Institute and Université de Montréal, Montreal, QC, Canada
| | - Guy Boivin
- Research Center in Infectious Diseases, CHU de Québec and Université Laval, Quebec City, QC, Canada..
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Tardif JC, Bouabdallaoui N, L'Allier PL, Gaudet D, Shah B, Pillinger MH, Lopez-Sendon J, da Luz P, Verret L, Audet S, Dupuis J, Denault A, Pelletier M, Tessier PA, Samson S, Fortin D, Tardif JD, Busseuil D, Goulet E, Lacoste C, Dubois A, Joshi AY, Waters DD, Hsue P, Lepor NE, Lesage F, Sainturet N, Roy-Clavel E, Bassevitch Z, Orfanos A, Stamatescu G, Grégoire JC, Busque L, Lavallée C, Hétu PO, Paquette JS, Deftereos SG, Levesque S, Cossette M, Nozza A, Chabot-Blanchet M, Dubé MP, Guertin MC, Boivin G. Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial. Lancet Respir Med 2021. [PMID: 34051877 DOI: 10.1101/2021.01.26.21250494] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence suggests a role for excessive inflammation in COVID-19 complications. Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis, and coronary disease. We aimed to investigate the effect of colchicine on the composite of COVID-19-related death or hospital admission. METHODS The present study is a phase 3, randomised, double-blind, adaptive, placebo-controlled, multicentre trial. The study was done in Brazil, Canada, Greece, South Africa, Spain, and the USA, and was led by the Montreal Heart Institute. Patients with COVID-19 diagnosed by PCR testing or clinical criteria who were not being treated in hospital were eligible if they were at least 40 years old and had at least one high-risk characteristic. The randomisation list was computer-generated by an unmasked biostatistician, and masked randomisation was centralised and done electronically through an automated interactive web-response system. The allocation sequence was unstratified and used a 1:1 ratio with a blocking schema and block sizes of six. Patients were randomly assigned to receive orally administered colchicine (0·5 mg twice per day for 3 days and then once per day for 27 days thereafter) or matching placebo. The primary efficacy endpoint was the composite of death or hospital admission for COVID-19. Vital status at the end of the study was available for 97·9% of patients. The analyses were done according to the intention-to-treat principle. The COLCORONA trial is registered with ClinicalTrials.gov (NCT04322682) and is now closed to new participants. FINDINGS Trial enrolment began in March 23, 2020, and was completed in Dec 22, 2020. A total of 4488 patients (53·9% women; median age 54·0 years, IQR 47·0-61·0) were enrolled and 2235 patients were randomly assigned to colchicine and 2253 to placebo. The primary endpoint occurred in 104 (4·7%) of 2235 patients in the colchicine group and 131 (5·8%) of 2253 patients in the placebo group (odds ratio [OR] 0·79, 95·1% CI 0·61-1·03; p=0·081). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 96 (4·6%) of 2075 patients in the colchicine group and 126 (6·0%) of 2084 patients in the placebo group (OR 0·75, 0·57-0·99; p=0·042). Serious adverse events were reported in 108 (4·9%) of 2195 patients in the colchicine group and 139 (6·3%) of 2217 patients in the placebo group (p=0·051); pneumonia occurred in 63 (2·9%) of 2195 patients in the colchicine group and 92 (4·1%) of 2217 patients in the placebo group (p=0·021). Diarrhoea was reported in 300 (13·7%) of 2195 patients in the colchicine group and 161 (7·3%) of 2217 patients in the placebo group (p<0·0001). INTERPRETATION In community-treated patients including those without a mandatory diagnostic test, the effect of colchicine on COVID-19-related clinical events was not statistically significant. Among patients with PCR-confirmed COVID-19, colchicine led to a lower rate of the composite of death or hospital admission than placebo. Given the absence of orally administered therapies to prevent COVID-19 complications in community-treated patients and the benefit of colchicine in patients with PCR-proven COVID-19, this safe and inexpensive anti-inflammatory agent could be considered for use in those at risk of complications. Notwithstanding these considerations, replication in other studies of PCR-positive community-treated patients is recommended. FUNDING The Government of Quebec, the Bill & Melinda Gates Foundation, the National Heart, Lung, and Blood Institute of the US National Institutes of Health, the Montreal Heart Institute Foundation, the NYU Grossman School of Medicine, the Rudin Family Foundation, and philanthropist Sophie Desmarais.
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Affiliation(s)
| | | | | | - Daniel Gaudet
- Ecogene-21, Université de Montréal, Montreal, QC, Canada; Department of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Binita Shah
- New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Protasio da Luz
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Lucie Verret
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Sylvia Audet
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Jocelyn Dupuis
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - André Denault
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Martin Pelletier
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
| | - Philippe A Tessier
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
| | - Sarah Samson
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Denis Fortin
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | - David Busseuil
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Elisabeth Goulet
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Chantal Lacoste
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Anick Dubois
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | | | | | - Norman E Lepor
- Cedars-Sinai Heart Institute, Geffen School of Medicine-UCLA, Los Angeles, CA, USA
| | - Frédéric Lesage
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Nicolas Sainturet
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Eve Roy-Clavel
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Zohar Bassevitch
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Andreas Orfanos
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | | | - Jean C Grégoire
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Lambert Busque
- Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada
| | - Christian Lavallée
- Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, QC, Canada
| | | | | | - Spyridon G Deftereos
- Second Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sylvie Levesque
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Mariève Cossette
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | - Anna Nozza
- Montréal Health Innovations Coordinating Center, Montreal, QC, Canada
| | | | - Marie-Pierre Dubé
- Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | | | - Guy Boivin
- Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC, Canada
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8
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Dubé MP, Lemaçon A, Barhdadi A, Lemieux Perreault LP, Oussaïd E, Asselin G, Provost S, Sun M, Sandoval J, Legault MA, Mongrain I, Dubois A, Valois D, Dedelis E, Lousky J, Choi J, Goulet E, Savard C, Chicoine LM, Cossette M, Chabot-Blanchet M, Guertin MC, de Denus S, Bouabdallaoui N, Marchand R, Bassevitch Z, Nozza A, Gaudet D, L'Allier PL, Hussin J, Boivin G, Busseuil D, Tardif JC. Genetics of symptom remission in outpatients with COVID-19. Sci Rep 2021; 11:10847. [PMID: 34035401 PMCID: PMC8149390 DOI: 10.1038/s41598-021-90365-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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] [Received: 03/02/2021] [Accepted: 05/11/2021] [Indexed: 01/09/2023] Open
Abstract
We conducted a genome-wide association study of time to remission of COVID-19 symptoms in 1723 outpatients with at least one risk factor for disease severity from the COLCORONA clinical trial. We found a significant association at 5p13.3 (rs1173773; P = 4.94 × 10-8) near the natriuretic peptide receptor 3 gene (NPR3). By day 15 of the study, 44%, 54% and 59% of participants with 0, 1, or 2 copies of the effect allele respectively, had symptom remission. In 851 participants not treated with colchicine (placebo), there was a significant association at 9q33.1 (rs62575331; P = 2.95 × 10-8) in interaction with colchicine (P = 1.19 × 10-5) without impact on risk of hospitalisations, highlighting a possibly shared mechanistic pathway. By day 15 of the study, 46%, 62% and 64% of those with 0, 1, or 2 copies of the effect allele respectively, had symptom remission. The findings need to be replicated and could contribute to the biological understanding of COVID-19 symptom remission.
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Affiliation(s)
- Marie-Pierre Dubé
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada. .,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada. .,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada.
| | - Audrey Lemaçon
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Amina Barhdadi
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Louis-Philippe Lemieux Perreault
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Essaïd Oussaïd
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Géraldine Asselin
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Sylvie Provost
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Maxine Sun
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Johanna Sandoval
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Marc-André Legault
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Ian Mongrain
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Anick Dubois
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Diane Valois
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Emma Dedelis
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Jennifer Lousky
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Julie Choi
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada
| | - Elisabeth Goulet
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada
| | - Christiane Savard
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada
| | - Lea-Mei Chicoine
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada
| | - Mariève Cossette
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Montreal Health Innovations Coordinating Centre, Montreal, Canada
| | - Malorie Chabot-Blanchet
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Montreal Health Innovations Coordinating Centre, Montreal, Canada
| | - Marie-Claude Guertin
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Montreal Health Innovations Coordinating Centre, Montreal, Canada
| | - Simon de Denus
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre, Montreal, Canada.,Faculty of Pharmacy, Université de Montréal, Montreal, Canada
| | | | - Richard Marchand
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada
| | - Zohar Bassevitch
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Montreal Health Innovations Coordinating Centre, Montreal, Canada
| | - Anna Nozza
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Montreal Health Innovations Coordinating Centre, Montreal, Canada
| | - Daniel Gaudet
- Ecogene-21 and Department of Medicine, Université de Montréal, Chicoutimi, Canada
| | | | - Julie Hussin
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Guy Boivin
- Centre Hospitalier de l'Université Laval, Quebec City, Canada
| | - David Busseuil
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, 5000 Belanger Street, Montreal, H1T 1C8, Canada. .,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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9
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Nachar W, Merlet N, Maafi F, Mihalache-Avram T, Mecteau M, Gélinas D, Shi Y, Brodeur M, Alem S, Blondeau L, Cossette M, Guertin MC, Rhainds D, Busseuil D, Rhéaume E, Tardif JC. ApoA-I mimetic does not improve left ventricular diastolic dysfunction in rabbits without aortic valve stenosis. Int J Cardiol 2021; 331:199-205. [PMID: 33421451 DOI: 10.1016/j.ijcard.2020.12.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND We previously demonstrated that high-density lipoprotein (HDL) infusions may improve left ventricular diastolic dysfunction (LVDD) in an aortic valve stenosis (AVS) model. Whether the benefit was direct or mediated by the observed reduction in AVS severity is not clear. Here, we aimed to test the direct effect of an ApoA-I mimetic on LVDD in the absence of AVS. METHODS Rabbits were exposed to three different protocols to develop LVDD. First, rabbits were exposed to 0.5% cholesterol-rich diet for an average of 17 weeks. Second, rabbits were subjected to surgical ascending aortic constriction (AAC), to mimic the effect of fixed reduced aortic valve area, and studied after 10 weeks. The third model combined both cholesterol-enriched diet (for 12 weeks) and surgical AAC. The control group consisted of age-matched rabbits under normal diet. After development of LVDD, rabbits were randomized to receive infusions of saline or apoA-I mimetic (25 mg/kg) 3 times per week for 4 weeks. Detailed cardiac structure and function measurements were assessed at baseline and weekly during treatment period. Histological and molecular analyses were performed on LV samples. RESULTS In the three models, echocardiographic results showed development of LVDD over time, with preserved LV systolic and aortic valve functions versus controls. ApoA-I mimetic infusions did not significantly improve echocardiographic parameters nor molecular markers of cardiac inflammation, oxidative stress and fibrosis. CONCLUSION ApoA-I mimetic therapy did not directly improve LVDD. These results indicate that previously observed changes of LVDD were caused by AVS improvement induced by this treatment.
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Affiliation(s)
- Walid Nachar
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | - Nolwenn Merlet
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Foued Maafi
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | | | - Mélanie Mecteau
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Danielle Gélinas
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Yanfen Shi
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Mathieu Brodeur
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Sonia Alem
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Lucie Blondeau
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - Marie-Claude Guertin
- Montreal Health Innovations Coordinating Centre (MHICC), 4100 Molson Street, Montreal H1Y 3N1, Canada
| | - David Rhainds
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - David Busseuil
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada
| | - Eric Rhéaume
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada
| | - Jean-Claude Tardif
- Montreal Heart Institute, 5000 Belanger Street, Montreal H1T 1C8, Canada; Department of medicine, Université de Montréal, 2900 Edouard-Montpetit boulevard, Montreal H3T 1J4, Canada.
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10
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Carrier M, Moriguchi J, Shah K, Anyanwau A, Mahr C, Skipper E, Cossette M, Noly P. Outcomes after Heart Transplantation and Total Artificial Heart Implantation: A Multicenter Study. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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11
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Noly P, Moriguchi J, Shah K, Anyanwau A, Mahr C, Skipper E, Cossette M, Lamarche Y, Carrier M. A Bridged Approach to Heart Transplantation Using ECMO and Total Artificial Heart Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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12
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Dubé MP, Legault MA, Lemaçon A, Lemieux Perreault LP, Fouodjio R, Waters DD, Kouz S, Pinto FJ, Maggioni AP, Diaz R, Berry C, Koenig W, Lopez-Sendon J, Gamra H, Kiwan GS, Asselin G, Provost S, Barhdadi A, Sun M, Cossette M, Blondeau L, Mongrain I, Dubois A, Rhainds D, Bouabdallaoui N, Samuel M, de Denus S, L'Allier PL, Guertin MC, Roubille F, Tardif JC. Pharmacogenomics of the Efficacy and Safety of Colchicine in COLCOT. Circ Genom Precis Med 2021; 14:e003183. [PMID: 33560138 PMCID: PMC8284376 DOI: 10.1161/circgen.120.003183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Supplemental Digital Content is available in the text. Background: The randomized, placebo-controlled COLCOT (Colchicine Cardiovascular Outcomes Trial) has shown the benefits of colchicine 0.5 mg daily to lower the rate of ischemic cardiovascular events in patients with a recent myocardial infarction. Here, we conducted a post hoc pharmacogenomic study of COLCOT with the aim to identify genetic predictors of the efficacy and safety of treatment with colchicine. Methods: There were 1522 participants of European ancestry from the COLCOT trial available for the pharmacogenomic study of COLCOT trial. The pharmacogenomic study’s primary cardiovascular end point was defined as for the main trial, as time to first occurrence of cardiovascular death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization. The safety end point was time to the first report of gastrointestinal events. Patients’ DNA was genotyped using the Illumina Global Screening array followed by imputation. We performed a genome-wide association study in colchicine-treated patients. Results: None of the genetic variants passed the genome-wide association study significance threshold for the primary cardiovascular end point conducted in 702 patients in the colchicine arm who were compliant to medication. The genome-wide association study for gastrointestinal events was conducted in all 767 patients in the colchicine arm and found 2 significant association signals, one with lead variant rs6916345 (hazard ratio, 1.89 [95% CI, 1.52–2.35], P=7.41×10−9) in a locus which colocalizes with Crohn disease, and one with lead variant rs74795203 (hazard ratio, 2.51 [95% CI, 1.82–3.47]; P=2.70×10−8), an intronic variant in gene SEPHS1. The interaction terms between the genetic variants and treatment with colchicine versus placebo were significant. Conclusions: We found 2 genomic regions associated with gastrointestinal events in patients treated with colchicine. Those findings will benefit from replication to confirm that some patients may have genetic predispositions to lower tolerability of treatment with colchicine.
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Affiliation(s)
- Marie-Pierre Dubé
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
| | - Marc-André Legault
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada.,Departments of Biochemistry and Molecular Medicine, Faculty of Medicine (M.-A.L.), Université de Montréal, Canada
| | - Audrey Lemaçon
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
| | - Louis-Philippe Lemieux Perreault
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - René Fouodjio
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | | | - Simon Kouz
- Centre Hospitalier Régional de Lanaudière, Joliette, Canada (S.K.)
| | - Fausto J Pinto
- Santa Maria University Hospital (CHULN), CAML, CCUL, Faculdade de Medicina da Universidade de Lisboa, Portugal (F.J.P.)
| | - Aldo P Maggioni
- Maria Cecilia Hospital, GVM Care and Research, Italy (A.P.M.)
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica, Rosario, Argentina (R.D.)
| | - Colin Berry
- University of Glasgow, NHS Glasgow Clinical Research Facility, United Kingsom (C.B.)
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany (W.K.).,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany (W.K.).,Institute of Epidemiology and Medical Biometry, University of Ulm, Germany (W.K.)
| | | | - Habib Gamra
- Fattouma Bourguiba University Hospital, Monastir, Tunisia (H.G.)
| | | | - Géraldine Asselin
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - Sylvie Provost
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - Amina Barhdadi
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - Maxine Sun
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
| | - Mariève Cossette
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Montreal Health Innovation Coordinating Centre, Canada (M.C., L.B., M.-C.G.)
| | - Lucie Blondeau
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Montreal Health Innovation Coordinating Centre, Canada (M.C., L.B., M.-C.G.)
| | - Ian Mongrain
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - Anick Dubois
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada
| | - David Rhainds
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada
| | - Nadia Bouabdallaoui
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
| | - Michelle Samuel
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
| | - Simon de Denus
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Université de Montréal Beaulieu-Saucier Pharmacogenomics Centre (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., I.M., A.D., S.d.D.), Université de Montréal, Canada.,Université de Montréal, Faculty of Pharmacy, Canada (S.d.D.)
| | - Philippe L L'Allier
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada
| | - Marie-Claude Guertin
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Montreal Health Innovation Coordinating Centre, Canada (M.C., L.B., M.-C.G.)
| | - François Roubille
- PhyMedExp (Physiologie et Médecine Expérimentale du Coeur et des Muscles), Université de Montpellier, INSERM, Centre National de la Recherche Scientifique, Cardiology Department, CHU de Montpellier, France (F.R.)
| | - Jean-Claude Tardif
- Montreal Heart Institute (M.-P.D., M.-A.L., A.L., L.-P.L.P., R.F., G.A., S.P., A.B., M.S., M.C., L.B., I.M., A.D., D.R., N.B., M.S., S.d.D., P.L.L., M.-C.G., J.-C.T.), Université de Montréal, Canada.,Department of Medicine (M.-P.D., A.L., M.S., N.B., M.S., J.-C.T.), Université de Montréal, Canada
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13
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Hébert M, Amr G, Cossette M, Cartier R. Reassessment of kidney function equations in predicting long-term survival in cardiac surgery. J Card Surg 2020; 35:2550-2558. [PMID: 32840928 DOI: 10.1111/jocs.14834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND/OBJECTIVES Chronic kidney disease (CKD) is a risk factor for long-term survival in cardiac surgery. The Cockcroft-Gault, Modification of Diet in Renal Disease (MDRD) study, CKD Epidemiology Collaboration (CKD-EPI), revised Lund-Malmö (LM), and full age spectrum equations are used to estimate glomerular filtration rates (eGFR), but each have advantages and disadvantages. Our objective was to determine which equation better predicts long-term survival. METHODS Data on 1492 consecutive patients who underwent isolated off-pump coronary artery bypass surgery between September 1996 and December 2008 were prospectively collected. Preoperative and postoperative eGFR were calculated using the five equations and compared using Cox regression analyses and time-dependent receiver operating characteristic (ROC) curves at 10 years. RESULTS In a Cox regression model after correction for significant predictors of long-term mortality, adjusted hazard ratios (HR) for one standard deviation increase in preoperative eGFR were 0.661 (P < .0001), 0.844 (P = .0166), 0.787 (P = .0002), 0.746 (P < .0001), and 0.717 (P < .0001) for the CG, MDRD, CKD-EPI, LM, and FAS equations, respectively. The areas under the time-dependent ROC curve at 10 years also showed that the CG formula has a better predictive value. Postoperative eGFR at discharge were also significant predictors of long-term mortality (HR = 0.603, P < .0001; HR = 0.725, P < .0001; HR = 0.688, P < .0001; HR = 0.673, P < .0001; HR = 0.632, P < .0001 for the CG, MDRD, CKD-EPI, LM, and FAS equations, respectively). CONCLUSIONS The CG formula was shown to better predict survival in cardiac surgery, though the FAS equation has a comparable prognostic value. Additionally, postoperative eGFR at discharge also predicted long-term survival.
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Affiliation(s)
- Mélanie Hébert
- Division of Cardiac Surgery, Montreal Heart Institute, Montreal, Canada
| | - Gilles Amr
- Division of Cardiac Surgery, Montreal Heart Institute, Montreal, Canada
| | - Mariève Cossette
- Division of Biostatistics, Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, Canada
| | - Raymond Cartier
- Division of Cardiac Surgery, Montreal Heart Institute, Montreal, Canada
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14
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Trachsel LD, David LP, Gayda M, Henri C, Hayami D, Thorin-Trescases N, Thorin É, Blain MA, Cossette M, Lalongé J, Juneau M, Nigam A. The impact of high-intensity interval training on ventricular remodeling in patients with a recent acute myocardial infarction-A randomized training intervention pilot study. Clin Cardiol 2019; 42:1222-1231. [PMID: 31599994 PMCID: PMC6906981 DOI: 10.1002/clc.23277] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 05/13/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High‐intensity interval training (HIIT) is a time‐efficient method to improve V˙O2peak in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI). Methods Nineteen post‐AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N‐terminal pro B‐type natriuretic peptide levels and G protein‐coupled receptor kinase 2 expression) were performed before and after a 12‐week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and V˙O2 at the first ventilatory threshold (V˙O2 VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed. Results V˙O2peak and OUES improved solely in the HIIT group (P < .05 for group/time, respectively). There was a significant training effect for the improvement of peak work load in both groups (P < .05). O2 pulse and V˙O2 at VT1 both improved only in the HIIT group (P < .05 for time, no interaction). HIIT improved radial strain and pulsed‐wave tissue Doppler imaging derived e′ (P < .05 for time, no interaction). Cardiac biomarkers did not change in either group. Conclusions In post‐AMI patients, HIIT lead to significant improvements in prognostic CPET parameters compared to usual care. HIIT was associated with favorable ventricular remodeling regarding certain echocardiographic parameters of LV function.
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Affiliation(s)
- Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Douglas Hayami
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Éric Thorin
- Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mélissa-Anne Blain
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
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15
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Gebhard C, Rhainds D, He G, Rodés-Cabau J, Lavi S, Spence JD, Title L, Kouz S, L'Allier PL, Grégoire J, Ibrahim R, Cossette M, Guertin MC, Beanlands R, Rhéaume E, Tardif JC. Elevated level of lecithin:cholesterol acyltransferase (LCAT) is associated with reduced coronary atheroma burden. Atherosclerosis 2018; 276:131-139. [DOI: 10.1016/j.atherosclerosis.2018.07.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 07/10/2018] [Accepted: 07/18/2018] [Indexed: 01/08/2023]
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16
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Harel F, Levac X, Nguyen QT, Létourneau M, Marcil S, Finnerty V, Cossette M, Fournier A, Dupuis J. Molecular imaging of the human pulmonary vascular endothelium using an adrenomedullin receptor ligand. Mol Imaging 2015; 14:7290201500003. [PMID: 25812438 DOI: 10.2310/7290.2015.00003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This phase I study (NCT01539889) evaluated the safety, efficacy, and dosing of PulmoBind for molecular imaging of pulmonary circulation. PulmoBind is a ligand of the adrenomedullin receptor abundantly distributed in lung capillaries. Labeled with 99mTc, it allows single-photon emission computed tomographic (SPECT) imaging of lung perfusion. In preclinical studies, PulmoBind scans enabled detection of lung perfusion defects and quantification of microcirculatory occlusion caused by pulmonary hypertension. Healthy humans (N = 20) were included into escalating groups of 5 mCi (n = 5), 10 mCi (n = 5), or 15 mCi (n = 10) 99mTc-PulmoBind. SPECT imaging was serially performed, and 99mTc-PulmoBind dosimetric analysis was accomplished. The radiochemical purity of 99mTc-PulmoBind was greater than 95%. There were no safety concerns at the three dosages studied. Imaging revealed predominant and prolonged lung uptake with a mean peak extraction of 58% ± 7%. PulmoBind was well tolerated, with no clinically significant adverse event related to the study drug. The highest dose of 15 mCi provided a favorable dosimetric profile and excellent imaging. The postural lung perfusion gradient was detectable. 99mTc-PulmoBind is safe and provides good quality lung perfusion imaging. The safety/efficacy of this agent can be tested in disorders of pulmonary circulation such as pulmonary arterial hypertension.
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17
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Cossette M, Hess U. Service with style and smile. How and why employees are performing emotional labour? European Review of Applied Psychology 2015. [DOI: 10.1016/j.erap.2015.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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White M, Myers J, Guertin M, Cossette M, Ducharme A, Harel F, O'Meara E, Gravel G, Thibault B. 694 Characterization and functional implications of heart rate increase at the onset of exercise testing and heart rate recovery in patients with advanced heart failure. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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19
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Lavoie V, Kernaleguen AE, Charron G, Farhat N, Cossette M, Mamarbachi AM, Allen BG, Rhéaume E, Tardif JC. Functional effects of adiponectin on endothelial progenitor cells. Obesity (Silver Spring) 2011; 19:722-8. [PMID: 20814418 DOI: 10.1038/oby.2010.187] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Adiponectin is an adipokine whose plasma levels are inversely correlated to metabolic syndrome components. Adiponectin protects against atherosclerosis and decreases risks in myocardial infarction. Endothelial progenitor cells (EPCs) are a heterogeneous population of circulating cells involved in vascular repair and neovascularization. EPCs number is reduced in patients with cardiovascular disease. We hypothesize that the positive effects of adiponectin against atherosclerosis are explained in part by its interactions with EPCs. Cells were obtained from healthy volunteers' blood by mononuclear cell isolation and plating on collagen-coated dishes. Three sub-populations of EPCs were identified and characterized using flow cytometry. EPCs' expression of adiponectin receptors, AdipoR1, and AdipoR2 was evaluated by quantitative PCR. The effects of recombinant adiponectin on EPCs' susceptibility to apoptosis were assessed. Finally, expression of neutrophil elastase by EPCs and activity of this enzyme on adiponectin processing were assessed. Quantitative PCR analysis of EPCs mRNAs showed that AdipoR1 mRNA is expressed at higher levels than AdipoR2. Expression of AdipoR1 protein was confirmed by western blot. Adiponectin significantly increased survival of two sub-populations of EPCs in conditions of serum deprivation. Such effect could not be demonstrated in the third EPCs sub-population. We also demonstrated that EPCs, particularly one sub-population, express neutrophil elastase. Neutrophil elastase activity was confirmed in EPCs' conditioned media. Adiponectin protects some EPCs sub-populations against apoptosis and therefore could modulate EPCs ability to induce repair of vascular damage. Neutrophil elastase activity of EPCs could locally modulate adiponectin activity by its involvement in the generation of the globular form of adiponectin.
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Affiliation(s)
- Véronique Lavoie
- Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada
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20
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Abdel-Baki A, Lesage A, Nicole L, Cossette M, Salvat E, Lalonde P. Schizophrenia, an illness with bad outcome: myth or reality? Can J Psychiatry 2011; 56:92-101. [PMID: 21333036 DOI: 10.1177/070674371105600204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Different myths about schizophrenia endorsed by clinicians maintain the pessimism about outcome thus reducing chances of improvement. There are no recent North American studies on the long-term outcome of first-episode schizophrenia to clarify if these beliefs are myths or reality. Our study describes the long-term outcome (10 to 16 years) of a first-episode schizophrenia incidence cohort (n = 142) in a Canadian urban centre between 1983 and 1999. METHOD Clinical and social functioning at different time points were assessed retrospectively from medical files of a catchment area hospital in Montreal. Service use and deaths were noted from provincial databases of physician billings, hospitalization, and vital statistics. RESULTS Hospitalization days decreased considerably after the first year, with a small minority still needing it episodically after 4 years. Marital and occupational status were generally stable over time, but autonomy in living arrangements worsened. Thirty-three percent of subjects quit the Catchment Area Specialized Psychiatric Services. This group showed better social functioning while they were followed, were hospitalized less afterwards, and had fewer suicides, therefore indicating a better outcome for them. At the end of our study, 15% of the patients still alive were well enough to function without seeking medical help and 25% were not taking antipsychotic medication. Better outcome was predicted by older age at admission, being married, higher premorbid autonomy in living arrangements, and female sex. CONCLUSION A significant proportion of first-episode schizophrenia patients achieve moderate long-term outcome, and the stability of global functioning is more frequent than deterioration, as shown in most industrialized countries.
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Affiliation(s)
- Amal Abdel-Baki
- Centre hospitalier de l'Université de Montreal-Hôpital Notre-Dame, Montreal, Quebec.
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21
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Lebon JS, Couture P, Rochon AG, Laliberté É, Harvey J, Aubé N, Cossette M, Bouchard D, Jeanmart H, Pellerin M. The Endovascular Coronary Sinus Catheter in Minimally Invasive Mitral and Tricuspid Valve Surgery: A Case Series. J Cardiothorac Vasc Anesth 2010; 24:746-51. [DOI: 10.1053/j.jvca.2010.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Indexed: 11/11/2022]
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22
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Tardif JC, L'allier PL, Ibrahim R, Grégoire JC, Nozza A, Cossette M, Kouz S, Lavoie MA, Paquin J, Brotz TM, Taub R, Pressacco J. Treatment with 5-lipoxygenase inhibitor VIA-2291 (Atreleuton) in patients with recent acute coronary syndrome. Circ Cardiovasc Imaging 2010; 3:298-307. [PMID: 20190281 DOI: 10.1161/circimaging.110.937169] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Production of leukotrienes by 5-lipoxygenase (5-LO) has been linked to unstable atherosclerotic plaques and cardiovascular events. VIA-2291 is a potent 5-LO inhibitor. METHODS AND RESULTS In a double-blinded study, 191 patients were randomly assigned 3 weeks after an acute coronary syndrome to receive 25, 50, or 100 mg VIA-2291 or placebo daily for 12 weeks. The primary study end point, whole blood stimulated leukotriene LTB4 at trough drug level, was reduced in all VIA-2291 groups (P<0.0001) in a dose-dependent fashion, with approximately 80% inhibition in >90% of patients in the 100-mg group. A significant reduction of urine leukotriene LTE4 was obtained in all dose groups. No serious adverse events were considered related to study drug. A subset of 93 patients who had undergone a 64-slice coronary CT examination at baseline continued on study medication for a total of 24 weeks and underwent a repeat scan. Five of these patients withdrew or were noncompliant and 28 had nonevaluable scans. Among the 60 remaining patients, new coronary plaques were observed in 5 of 18 (27.8%) placebo-treated patients and in 2 of 42 (4.8%) VIA-2291-treated patients (P=0.01). A reduction in noncalcified plaque volume at 24 weeks versus placebo was observed in VIA-2291-treated groups in the 34 of these 60 patients in whom this end point was analyzable (P<0.01). CONCLUSIONS VIA-2291 reduces leukotriene production at 12 weeks after an acute coronary syndrome. Preliminary data from the CT substudy suggest that such a reduction in leukotriene production may influence atherosclerosis; however, this requires confirmation in a larger study. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00358826.
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Affiliation(s)
- Jean-Claude Tardif
- Department of Medicine, Radiology, Montreal Heart Institute and Université de Montréal, Montreal, Canada
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23
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Rodés-Cabau J, Tardif JC, Cossette M, Bertrand OF, Ibrahim R, Larose E, Grégoire J, L'Allier PL, Guertin MC. Acute effects of statin therapy on coronary atherosclerosis following an acute coronary syndrome. Am J Cardiol 2009; 104:750-7. [PMID: 19733706 DOI: 10.1016/j.amjcard.2009.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 05/05/2009] [Accepted: 05/05/2009] [Indexed: 01/19/2023]
Abstract
No data exist on the acute effects of statin therapy on human coronary atherosclerotic plaques. The objective of our study was to evaluate the early (<2 months) effects of newly initiated statin therapy on coronary atherosclerosis as evaluated by intravascular ultrasonography. The study population consisted of 74 patients (mean age 58 +/- 8 years) who had been included in the ERASE trial (evaluating the effects of reconstituted high-density lipoprotein infusions). All patients underwent serial intravascular ultrasonographic (IVUS) evaluation at baseline (3 +/- 2 days after an acute coronary syndrome [ACS]) and after 6 +/- 1 weeks of follow-up. Statin therapy was initiated after ACS in 36 patients who received < or =1 dose of statins before baseline IVUS examination (newly initiated statin therapy group), and 38 patients were already on a stable statin dose before the ACS (long-term statin therapy group). Atorvastatin at a dose of 40 mg/day was the most common regimen in the 2 groups. Percent changes in atheroma volume (prespecified primary efficacy parameter) were -4.71 +/- 0.96% in the newly initiated statin therapy group (p <0.0001) and -0.54 +/- 0.89% in the long-term statin therapy group (p = 0.546; p = 0.002 for comparison between groups). Median nominal changes in atheroma volume were -9.10 mm(3) (interquartile range -12.56 to -3.73, p <0.0001 vs baseline) and 1.21 mm(3) (interquartile range -6.41 to 3.76, p = 0.429 vs baseline) in the newly initiated and long-term statin therapy groups, respectively (p = 0.003 for comparison between groups). Greater decreases in total cholesterol (r = 0.25, p = 0.035), ratio of total to high-density lipoprotein cholesterol (r = 0.28, p = 0.018), and high-sensitivity C-reactive protein (r = 0.31, p = 0.046, for patients with high-sensitivity C-reactive protein measurements within 7 days after IVUS examination) were associated with larger percent changes in atheroma volume. In conclusion, newly initiated statin therapy is associated with rapid regression of coronary atherosclerosis within 2 months. This effect was in part associated with decreases in atherogenic lipid and inflammatory parameters. These results provide insight into the rapid clinical benefits of statin therapy after an ACS.
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Carrier M, Cossette M, Pellerin M, Hébert Y, Bouchard D, Cartier R, Demers P, Jeanmart H, Pagé P, Perrault LP. Statin treatment equalizes long-term survival between patients with single and bilateral internal thoracic artery grafts. Ann Thorac Surg 2009; 88:789-95; discussion 795. [PMID: 19699899 DOI: 10.1016/j.athoracsur.2009.04.097] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 04/21/2009] [Accepted: 04/24/2009] [Indexed: 11/16/2022]
Abstract
BACKGROUND The use of 2 internal thoracic artery (ITA) grafts increases survival 10 years after coronary artery bypass grafting (CABG) compared with single ITA grafting. Statin treatment was also shown to decrease development and progression of saphenous vein graft atherosclerosis. This study examined the effect of statin treatment on long-term survival after CABG. METHODS Operative, survival, and pharmacologic data of 6655 patients who underwent CABG with ITAs between 1995 and 2007 in our institution were obtained. RESULTS Patients with bilateral ITA grafts had an average 10-year-survival rate of 83% +/- 2% compared with 67% +/-1% in patients with single ITA grafts (p = 0.0001). Statin treatment caused a significant decrease in the long-term risk of death among patients who underwent single ITA grafting (hazard ratio [HR], 0.735, p = 0.0001). However, statin treatment had no effect on the risk of long-term death among patients who underwent bilateral ITA grafting (HR, 1.053; p = 0.7806). CONCLUSIONS Statin treatment initiated early after grafting improved long-term survival in patients with a single ITA graft but not in those with bilateral ITA grafts. Survival of statin-treated patients with single ITA grafts was similar to bilateral ITA patients.
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Affiliation(s)
- Michel Carrier
- Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.
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25
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Le VV, Racine N, Pelletier GB, Carrier M, Cossette M, White M. Impact of ezetimibe on cholesterol subfractions in dyslipidemic cardiac transplant recipients receiving statin therapy. Clin Transplant 2009; 23:249-55. [PMID: 19402219 DOI: 10.1111/j.1399-0012.2008.00920.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ezetimibe decreases cholesterol in cardiac transplant recipients intolerant to statins therapy. The effects of ezetimibe in addition to statins therapy and its relationship with the magnitude of dyslipidemia and statins utilization have not been studied in cardiac transplant recipients. METHODS The design of this investigation was a retrospective case control study. Twenty-two patients receiving the combination of therapy of statins plus ezetimibe were compared with 43 patients treated with statins only. The endpoints were assessed after three months of follow-up. RESULTS The addition of ezetimibe decreased low density lipoprotein-cholesterol by 25% compared with a 4% increase in patients receiving statins only. The impact of ezetimibe was similar regardless of the magnitude of dyslipidemia or statins dosage. Ezetimibe increase high density lipoprotein (HDL)-cholesterol only in patients with baseline HDL-cholesterol above 1.3 mM/L (p < 0.05). There was an asymptomatic, but significant increase in creatinine kinase level [+31.4 +/- 8.1 (ezetimibe) vs. + 1.5 +/- 5.0 mM/L (placebo); p = 0.005]. CONCLUSION Ezetimibe therapy provides a significant reduction in most cholesterol subfractions regardless of the magnitude of dyslipidemia and statins dosage.
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Affiliation(s)
- Vy-Van Le
- Research Center, Montreal Heart Institute andUniversité de Montré al, Montreal, QC, Canada
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26
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Skrobik Y, Cossette M, Kavanagh BP. Reply to the comment by Drs. Girard et al. Intensive Care Med 2007. [DOI: 10.1007/s00134-007-0685-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ouimet S, Riker R, Bergeron N, Cossette M, Kavanagh BP, Skrobik Y. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007. [DOI: 10.1007/s00134-007-0731-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ouimet S, Riker R, Bergeron N, Bergeon N, Cossette M, Kavanagh B, Skrobik Y. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med 2007; 33:1007-13. [PMID: 17404704 DOI: 10.1007/s00134-007-0618-y] [Citation(s) in RCA: 213] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Accepted: 03/05/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE ICU delirium is common and adverse. The Intensive Care Delirium Screening Checklist (ICDSC) score ranges from 0 to 8, with a score of 4 or higher indicating clinical delirium. We investigated whether lower (subsyndromal) values affect outcome. PATIENTS 600 patients were evaluated with the ICDSC every 8[Symbol: see text]h. MEASUREMENTS AND RESULTS Of 558 assessed patients 537 noncomatose patients were divided into three groups: no delirium (score = 0; n = 169, 31.5%), subsyndromal delirium (score = 1-3; n = 179, 33.3%), and clinical delirium (score >or=4; n = 189, 35.2%). ICU mortality rates were 2.4%, 10.6%, and 15.9% in these three groups, respectively. Post-ICU mortality was significantly greater in the clinical delirium vs. no delirium groups (hazard ratio = 1.67) after adjusting for age, APACHE II score, and medication-induced coma. Relative ICU length of stay was: no delirium < subsyndromal delirium < clinical delirium and hospital LOS: no delirium < subsyndromal delirium approximately clinical delirium. Patients with no delirium were more likely to be discharged home and less likely to need convalescence or long-term care than those with subsyndromal delirium or clinical delirium. ICDSC score increments higher than 4/8 were not associated with a change in mortality or LOS. CONCLUSIONS Clinical delirium is common, important and adverse in the critically ill. A graded diagnostic scale permits detection of a category of subsyndromal delirium which occurs in many ICU patients, and which is associated with adverse outcome.
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Affiliation(s)
- Sébastien Ouimet
- Maisonneuve-Rosemont Hospital and Université de Montréal, Intensive Care Unit, 5415 Boulevard del'Assomption, H1T 2M4, Montreal, QC, Canada
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Serri K, Bouchard D, Demers P, Coutu M, Pellerin M, Carrier M, Perrault LP, Cartier R, Pagé P, Cossette M, Basmadjian AJ. Is a good perioperative echocardiographic result predictive of durability in ischemic mitral valve repair? J Thorac Cardiovasc Surg 2006; 131:565-573.e2. [PMID: 16515906 DOI: 10.1016/j.jtcvs.2005.09.037] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2005] [Revised: 10/10/2005] [Accepted: 10/20/2005] [Indexed: 01/20/2023]
Abstract
BACKGROUND Chronic ischemic mitral regurgitation is associated with poor long-term survival. Despite the increasing popularity of valve repair, its durability and long-term outcome for ischemic mitral regurgitation have recently been questioned. METHODS Seventy-eight patients underwent repair for ischemic mitral regurgitation between 1996 and 2002 at our institution. Of these patients, 73 had complete clinical and echocardiographic follow-up. Preoperative, intraoperative, and postoperative clinical data were obtained, and the results of echocardiograms were reviewed to assess the rate of recurrence of regurgitation after repair and to identify predictive factors. RESULTS The mean preoperative mitral regurgitation grade, New York Heart Association class, and left ventricular ejection fraction were 2.72, 2.65, and 39.4%, respectively. Mortality was 12.3% at 30 days and 30.1% at a mean follow-up of 39 +/- 25 months. Immediate postoperative echocardiography showed absent or mild mitral regurgitation in 89.4% of patients and showed moderate mitral regurgitation in 10.6%. Freedom from reoperation was 93.2%. Recurrent moderate mitral regurgitation (2+) was present in 36.7% of patients, and severe mitral regurgitation (3+ to 4+) was present in 20.0% at mean follow-up of 28.1 +/- 22.5 months. Only age (P = .0130) and less marked preoperative posterior tethering (P = .0362) were predictive of recurrent mitral regurgitation. Patients with a preoperative New York Heart Association class greater than II and recurrent mitral regurgitation greater than 2+ had decreased survival (P = .0152 and P = .0450, respectively). CONCLUSIONS Significant recurrent mitral regurgitation occurs following repair for ischemic mitral regurgitation, despite good early results. This finding raises questions about the need for improved repair techniques, better patient selection, or eventual mitral valve replacement in selected patients.
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Affiliation(s)
- K Serri
- Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
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Parent A, Cossette M. Extrastriatal dopamine and Parkinson's disease. Adv Neurol 2002; 86:45-54. [PMID: 11554008] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Parent
- Laboratoire de Neurobiologie, Hôpital Robert-Giffard, Beauport, Québec G1J 2G3, Canada
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Abstract
This paper summarises the results of some of our recent tyrosine hydroxylase (TH) immunohistochemical studies of the dopaminergic innervation of the human basal ganglia. It also reports new findings on the presence of TH-immunoreactive (ir) neurons in the striatum. Our data show the existence of nigrostriatal TH-ir axons that provide collaterals arborizing in the globus pallidus and subthalamic nucleus. These thin and varicose collaterals emerge from thick and smooth axons that course along the main output pathways of the basal ganglia, including the ansa lenticularis, the lenticular fasciculus and Wilson's pencils. We postulate that this extrastriatal innervation, which allows nigral dopaminergic neurons to directly affect the pallidum and subthalamic nucleus, plays a critical role in the functional organisation of human basal ganglia. The TH-ir fibres that reach the striatum arborize according to a highly heterogeneous pattern. At rostral striatal levels, numerous small TH-poor zones embedded in a TH-rich matrix correspond to calbindin-poor striosomes and calbindin-rich extrastriosomal matrix, respectively. At caudal striatal levels, in contrast, striosomes display a TH immunostaining that is more intense than that of the matrix. A significant number of small, oval, aspiny TH-ir neurons scattered throughout the rostrocaudal extent of the caudate nucleus and putamen, together with a few larger, multipolar, spiny TH-ir neurons lying principally within the ventral portion of the putamen, were disclosed in human. This potential source of intrinsic striatal dopamine might play an important role in the functional organisation of the human striatum, particularly in case of Parkinson's disease.
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Affiliation(s)
- L Prensa
- Laboratoire de Neurobiologie, Centre de recherche Université Laval Robert-Giffard, 2601, de la Canardière, Local F-6500, Quebec, Beauport, Canada G1J 2G3
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Abstract
The subventricular zone (SVZ) is an embryonic remnant that persists and remains mitotically active throughout adulthood. The rodent SVZ harbors neuronal precursors, principally in its anterior part, and generates neuroblasts that migrate tangentially into the olfactory bulb, thus forming the so-called rostral migratory stream. This study aimed at characterizing the SVZ in the human brain. Antibodies raised against the widely used SVZ molecular markers nestin, glial fibrillary acidic protein, beta-tubulin-III and polysialylated neural cell adhesion molecule, have allowed us to characterize in detail a zone similar to the rodent SVZ in humans. Virtually all portions of the lateral ventricle, as well as the ventral (hypothalamic) sector of the third ventricle, displayed immunoreactivity for most of the molecular markers. The midline region of the septum (septal recess) and the ventral portion of the SVZ displayed a particularly intense immunostaining for all SVZ markers. These two regions may represent zones of adult neurogenesis that are unique to primates. Furthermore, the anti-apoptotic protein Bcl-2 was found to be actively synthesized and co-expressed with all the other markers throughout the entire SVZ. This study reveals that a well-developed SVZ exists in the adult human brain and suggests that Bcl-2 might play an important role in the functional organization of such a system.
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Affiliation(s)
- P J Bernier
- Laboratoire de Neurobiologie, Centre de Recherche Université Laval Robert-Giffard, 2601 Chemin de la Canardière, Local F-6500, Beauport, Canada
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Abstract
A tyrosine-hydroxylase immunohistochemical analysis of the brains of normal human individuals has revealed nigrostriatal axons providing collaterals that arborize in the pallidum and subthalamic nucleus. These thin and varicose collaterals emerge from thick and smooth axons that course backward along the main output pathways of the basal ganglia, including the ansa lenticularis, the lenticular fasciculus and Wilson's pencils. Many of these fibers run within pallidal medullary laminae before reaching the putamen, whereas others climb along the reticular thalamic nucleus to reach the caudate nucleus. This extrastriatal innervation, which allows nigral dopaminergic neurons to directly affect the pallidum and subthalamic nucleus, may play a crucial role in the functional organization of human basal ganglia, in both health and disease.
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Affiliation(s)
- M Cossette
- Centre de recherche Université Laval Robert-Giffard, Beauport, Québec, Canada
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Mello P, Cossette M. The ordinary things of life: aides do what no one else can. Caring 1995; 14:68-9. [PMID: 10154900] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- P Mello
- Missouri Home Care, Rolla, USA
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Abstract
OBJECTIVE Anthropometric measures were performed to determine differences in estimated fat mass, lean body mass, and body weight among three groups of men infected with human immunodeficiency virus (HIV). DESIGN This study was cross-sectional. SETTING Local centers of community services and support groups for persons infected with HIV in the province of Quebec, Canada. SUBJECTS Thirty-seven HIV-positive men were recruited; 11 were asymptomatic (T helper cells [CD4+ count] > 400 cells/mm3), 8 were symptomatic (CD4+ < 400 cells/mm3), and 17 were clinically stable but met the criteria of the Centers for Disease Control and Prevention for acquired immunodeficiency syndrome (AIDS). MAIN OUTCOME MEASURES Self-reported usual weight, actual weight, body mass index, midarm circumference, and triceps and subscapular skinfolds were recorded. From those we derived the percentage of body fat, the midarm muscle, and fat areas. Daily energy and protein intakes were determined from a 7-day food record. Clinical signs and symptoms were assessed by a structured questionnaire. STATISTICAL ANALYSES PERFORMED For statistical comparisons, analysis of variance was used, with P < .05 being significant. RESULTS We found a trend toward a decrease in body weight and in the fat mass indicators as the disease progressed. Lower energy intakes were observed among symptomatic and AIDS groups. The number of nutrition-related clinical signs and symptoms experienced by each individual correlated with the magnitude of weight loss (P < .0004, r = -.69). APPLICATIONS The findings suggest that anthropometric measures can be used in routine clinical practice to assess changes in body weight and in estimated fat mass among men infected with HIV. Symptoms and energy intakes should be assessed to identify subjects at high risk of greater weight loss.
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Affiliation(s)
- C Parisien
- Department of Nutrition, University of Montreal, Quebec, Canada
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Landry D, Lafontaine M, Cossette M, Barthélémy H, Chartrand C, Montplaisir S, Pelletier M. Human thymic dendritic cells. Characterization, isolation and functional assays. Immunology 1988; 65:135-42. [PMID: 2972601 PMCID: PMC1385032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The phenotypic analysis of human thymic dentritic cells (DC) in culture and in purified suspensions has been studied with light and electron microscopic (EM) immunolabelling techniques. Using a series of monoclonal antibodies (mAb) and a protein A-gold technique, we demonstrated that DR- and T6-positive cultured DC strongly bind the 9.3F10 mAb, an anti-DR-related antibody produced against human blood DC, and weakly express the T4 antigen, a membrane marker shared by Langerhan's cells (LC). On the other hand, thymic-cultured DC are negative for the other T-cell and monocyte-macrophage antigens. These results support the hypothesis that human thymic DC may be related to blood DC and epidermal LC. Moreover DC, unlike thymic macrophages, do not phagocytose latex particles, opsonized sheep red blood cells (SRBC) or Candida albicans. An efficient two-step technique of isolation, using a Percoll density gradient followed by an indirect panning technique, yields a purified (70-80%) thymic DC population, OKIa1-, 9.3F10- and OKT6-positive and esterase-negative. Immunolabelling and electron microscopy confirm that these isolated DC present similar phenotypic and ultrastructural features to human thymic DC in situ and in culture. Purified DC, used as stimulator cells in mixed leucocyte reaction (MLR), induce stronger proliferative responses than peripheral blood monocytes used as a control; blocking assays with OKIa1 mAb plus complement greatly reduced this stimulatory potency. These functional assays demonstrate that we obtained a purified typical DC population that can be used in immunological functional studies to elucidate the specific role of DC in human thymus.
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Cossette M. HMOs and home care: defining the partnership. Caring 1987; 6:8-11. [PMID: 10283323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Cossette M. Missouri home care: home health care in a rural area. Caring 1986; 5:63-8. [PMID: 10276106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Cossette M, Lemonde J, Massey DG. [Alkalinity and coagulation produced by chrysotile asbestos]. Union Med Can 1971; 100:759-64. [PMID: 5555428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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