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Ducasse E, Sapoval M, Brunet J, Commeau P, Goueffic Y, Sabatier J, Steinmetz E, Lermusiaux P, Rosset E, Caradu C. Outcomes and Comparative Analysis of the Initial Results of Standard Balloon Angioplasty Versus Drug-Coated Balloons Alone Versus in Association With Laser-Excimer Atherectomy in the Treatment of Femoropopliteal Artery In-Stent Restenosis (INTACT). J Endovasc Ther 2024:15266028241248333. [PMID: 38659343 DOI: 10.1177/15266028241248333] [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: 04/26/2024]
Abstract
BACKGROUND Despite improved patency with newer-generation nitinol stents, one-half of patients will require secondary interventions for in-stent restenosis (ISR). The best treatment strategy remains unclear. This study aimed to compare drug-coated balloons (DCBs) used alone or in association with excimer laser atherectomy (ELA) to simple percutaneous transluminal angioplasty (PTA) in the treatment of femoropopliteal-ISR. METHODS The INTACT trial is a multicenter, prospective, triple-arm randomized trial conducted across 14 centers from December 2015 to November 2019. Patients Rutherford Class 2-5 with ISR≥70% were followed-up for 18 months. The primary efficacy endpoint was recurrent ISR>70% by duplex ultrasound analysis. The primary safety endpoint was major adverse events (MAEs) defined as death, major amputation, or target lesion revascularization (TLR). RESULTS Around 134 subjects were randomized to PTA alone (n=41), PTA+DCB (n=43) or PTA+ELA+DCB (n=50). Procedural success was similar (p=.74), as was clinical success (p=.17). The number of recurrent ISR>70% decreased after PTA+ELA+DCB (30.0%; p=.04) and PTA+DCB (30.2%; p=.05) compared to PTA alone (51.2%). Primary patency was higher after PTA+ELA+DCB (log-rank p=.04) and PTA+DCB (log-rank p=.02) compared to PTA alone at 12 months (78.7% and 70.4% vs 61.5%) and 18 months (61.6% and 67.7% vs 37.3%). Freedom from MAEs was lower after PTA+DCB (27.9%) compared to PTA alone (53.7%; p=.02) but did not differ with PTA+ELA+DCB (40.0%). It was primarily driven by TLR; 2 major amputations occurred after PTA+ELA+DCB (4.0%; p=.18). CONCLUSION This independent study demonstrated a decrease in recurrent ISR>70% and increase in primary patency up to 18 months after PTA+ELA+DCB and PTA+DCB compared to PTA alone in the treatment of FP-ISR. It did not show an increase in MAEs but could have lacked power. CLINICAL IMPACT This multicenter, prospective, triple-arm randomized, controlled trial focuses on the results of adjunctive therapies, such as excimer laser atherectomy (ELA) and/or drug-coated balloons (DCBs) in the treatment of in-stent restenosis (ISR) in femoropopliteal lesions in 134 patients. It has the originality of being an independent study funded by a grant from the French Ministry of Health. This study confirms a significant decrease in recurrent ISR >70% and increase in primary patency up to 18 months after the use of ELA+DCB and DCBs compared to simple percutaneous transluminal angioplasty in the treatment of femoropopliteal ISR without an increase in major adverse events.
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Affiliation(s)
- Eric Ducasse
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Marc Sapoval
- Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | - Yann Goueffic
- Department of Vascular and Endovascular Surgery, Groupe Hospitalier Paris Saint Joseph, Paris, France
| | | | - Eric Steinmetz
- Centre Hospitalier Universitaire de Dijon, Dijon, France
| | | | - Eugenio Rosset
- Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Caroline Caradu
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
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Auffret V, Boulmier D, Didier R, Leurent G, Bedossa M, Tomasi J, Cayla G, Benamer H, Beurtheret S, Verhoye JP, Commeau P, Lefèvre T, Iung B, Eltchaninoff H, Collet JP, Dumonteil N, Du Chayla F, Gouysse M, Gilard M, Le Breton H. Clinical effects of permanent pacemaker implantation after transcatheter aortic valve implantation: Insights from the nationwide FRANCE-TAVI registry. Arch Cardiovasc Dis 2024; 117:213-223. [PMID: 38388290 DOI: 10.1016/j.acvd.2023.12.011] [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: 09/27/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND The influence of permanent pacemaker implantation upon outcomes after transcatheter aortic valve implantation (TAVI) remains controversial. AIMS To evaluate the impact of permanent pacemaker implantation after TAVI on short- and long-term mortality, and on the risk of hospitalization for heart failure. METHODS Data from the large FRANCE-TAVI registry, linked to the French national health single-payer claims database, were analysed to compare 30-day and long-term mortality rates and hospitalization for heart failure rates among patients with versus without permanent pacemaker implantation after TAVI. Multivariable regressions were performed to adjust for confounders. RESULTS A total of 36,549 patients (mean age 82.6years; 51.6% female) who underwent TAVI from 2013 to 2019 were included in the present analysis. Among them, 6999 (19.1%) received permanent pacemaker implantation during the index hospitalization, whereas 232 (0.6%) underwent permanent pacemaker implantation between hospital discharge and 30days after TAVI, at a median of 11 (interquartile range: 7-18) days. In-hospital permanent pacemaker implantation was not associated with an increased risk of death between discharge and 30days (adjusted odds ratio: 0.91, 95% confidence interval: 0.64-1.29). At 5years, the incidence of all-cause death was higher among patients with versus without permanent pacemaker implantation within 30days of the procedure (adjusted hazard ratio: 1.13, 95% confidence interval: 1.07-1.19). Permanent pacemaker implantation within 30days of TAVI was also associated with a higher 5-year rate of hospitalization for heart failure (adjusted subhazard ratio: 1.17, 95% confidence interval: 1.11-1.23). CONCLUSIONS Permanent pacemaker implantation after TAVI is associated with an increased risk of long-term hospitalization for heart failure and all-cause mortality. Further research to mitigate the risk of postprocedural permanent pacemaker implantation is needed as TAVI indications expand to lower-risk patients.
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Affiliation(s)
- Vincent Auffret
- Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France.
| | - Dominique Boulmier
- Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
| | - Romain Didier
- Department of Cardiology, Brest University Hospital, Inserm UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Western Brittany University, 29200 Brest, France
| | - Guillaume Leurent
- Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
| | - Marc Bedossa
- Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
| | - Jacques Tomasi
- Service de Chirurgie Thoracique et Cardiovasculaire, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
| | - Guillaume Cayla
- Service de Cardiologie, CHU de Nîmes, Université de Montpellier, 30900 Nîmes, France
| | - Hakim Benamer
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques-Cartier, Ramsay Santé, 91300 Massy, France
| | | | - Jean-Philippe Verhoye
- Service de Chirurgie Thoracique et Cardiovasculaire, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
| | - Philippe Commeau
- Service de Cardiologie Interventionnelle, Polyclinique Les Fleurs, Groupe ELSAN, 83190 Ollioules, France
| | - Thierry Lefèvre
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques-Cartier, Ramsay Santé, 91300 Massy, France
| | - Bernard Iung
- Cardiology Department, Bichat Hospital, AP-HP, Inserm U1148, Université Paris-Cité, 75018 Paris, France
| | - Hélène Eltchaninoff
- Department of Cardiology, CHU de Rouen, UNIROUEN, U1096, Normandie Université, 76000 Rouen, France
| | - Jean-Philippe Collet
- Institut de Cardiologie, Pitié-Salpêtrière University Hospital, AP-HP, ACTION Study Group, Inserm UMRS_1166 and 1146, Sorbonne Université, 75013 Paris, France
| | | | | | | | - Martine Gilard
- Department of Cardiology, Brest University Hospital, Inserm UMR 1304 (GETBO), Western Brittany Thrombosis Study Group, Western Brittany University, 29200 Brest, France
| | - Hervé Le Breton
- Service de Cardiologie, CHU de Rennes, Inserm LTSI U1099, Université de Rennes 1, 35000 Rennes, France
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Rangé G, Motreff P, Benamer H, Commeau P, Cayla G, Chassaing S, Laure C, Monsegu J, Van Belle E, Py A, Amabile N, Beygui F, Honton B, Lhermusier T, Boiffard E, Boueri Z, Lhoest N, Deharo P, Adjedj J, Pouillot C, Pereira B, Koning R, Collet JP. The France PCI registry: Design, methodology and key findings. Arch Cardiovasc Dis 2023; 116:489-497. [PMID: 37783602 DOI: 10.1016/j.acvd.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Obstructive coronary artery disease is the main cause of death worldwide. By tracking events and gaining feedback on patient management, the most relevant information is provided to public health services to further improve prognosis. AIMS To create an inclusive and accurate registry of all percutaneous coronary intervention (PCI) procedures performed in France, to assess and improve the quality of care and create research incentives. Also, to describe the methodology of this French national registry of interventional cardiology, and present early key findings. METHODS The France PCI registry is a multicentre observational registry that includes consecutive patients undergoing coronary angiography and/or PCI. The registry was set up to provide online data analysis and structured reports of PCI activity, including process of care measures and assessment of risk-adjusted outcomes in all French PCI centres that are willing to participate. More than 150 baseline data items, describing demographic status, PCI indications and techniques, and in-hospital and 1-year outcomes, are captured into local reporting software by medical doctors and local research technicians, with subsequent encryption and internet transfer to central data servers. Annual activity reports and scoring tools available on the France PCI website enable users to benchmark and improve clinical practices. External validation and consistency assessments are performed, with feedback of data completeness to centres. RESULTS Between 01 January 2014 and 31 December 2022, participating centres increased from six to 47, and collected 364,770 invasive coronary angiograms and 176,030 PCIs, including 54,049 non-ST-segment elevation myocardial infarction cases and 31,631 ST-segment elevation myocardial infarction cases. Fifteen studies stemming from the France PCI registry have already been published. CONCLUSIONS This fully electronic, daily updated, high-quality, low-cost, national registry is sustainable, and is now expanding. Merging with medicoeconomic databases and nested randomized scientific studies are ongoing steps to expand its scientific potential.
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Affiliation(s)
- Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Chartres, France.
| | - Pascal Motreff
- Cardiology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, 02200 Soissons, France
| | - Philippe Commeau
- Cardiology Department, Polyclinique Les Fleurs, Groupe ELSAN, 83190 Ollioules, France
| | - Guillaume Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, 30029 Nîmes, France
| | - Stephan Chassaing
- Cardiology Department, Nouvelle Clinique Tourangelle, 37540 Saint-Cyr-sur-Loire, France
| | - Christophe Laure
- Cardiology Department, Les Hôpitaux de Chartres, 28630 Chartres, France
| | - Jacques Monsegu
- Department of Interventional Cardiology, Institut Cardio-Vasculaire, Groupe Hospitalier Mutualiste, 38028 Grenoble, France
| | - Eric Van Belle
- Department of Cardiology, Institut Coeur-Poumon-CHU Lille and INSERM U1011, 59000 Lille, France
| | - Antoine Py
- Department of Cardiology, Clinique Victor Pauchet, 80094 Amiens, France
| | - Nicolas Amabile
- Cardiology Department, Institut Mutualiste Montsouris, 75014 Paris, France
| | - Farzin Beygui
- Cardiology Department, CHU de Caen, 14000 Caen, France
| | - Benjamin Honton
- Department of Interventional Cardiology, Clinique Pasteur, 31076 Toulouse, France
| | - Thomas Lhermusier
- Department of Cardiology, Toulouse University Hospital, 31000 Toulouse, France
| | - Emmanuel Boiffard
- Department of Cardiology, Centre Hospitalier Départemental de Vendée, 85000 La Roche-sur-Yon, France
| | - Ziad Boueri
- Department of Cardiology, Centre Hospitalier de Bastia, 20600 Bastia, France
| | - Nicolas Lhoest
- Department of Cardiology, Clinique Rhéna, 67000 Strasbourg, France
| | - Pierre Deharo
- Department of Cardiology, CHU Timone, Aix Marseille Université, INSERM, INRA, C2VN, 13005 Marseille, France
| | - Julien Adjedj
- Department of Cardiology, Arnault Tzanck Institute, 06700 Saint-Laurent-du-Var, France
| | - Christophe Pouillot
- Department of Cardiology, Clinique Sainte Clotilde, 97400 Saint-Denis, Reunion
| | - Bruno Pereira
- Cardiology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - René Koning
- Cardiology Department, Clinique Saint-Hilaire, 76000 Rouen, France
| | - Jean-Philippe Collet
- Sorbonne Université, Action Study Group (action-groupe.org), Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Duband B, Souteyrand G, Clerc JM, Chassaing S, Fichaux O, Marcollet P, Deballon R, Roussel L, Pereira B, Collet JP, Commeau P, Cayla G, Koning R, Motreff P, Benamer H, Rangé G. Prevalence, Management and Outcomes of Percutaneous Coronary Intervention for Coronary In-Stent Restenosis: Insights From the France PCI Registry. Cardiovasc Revasc Med 2023; 52:39-46. [PMID: 36813696 DOI: 10.1016/j.carrev.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Despite the evolution of stent technology, there is a non-negligible risk of in-stent restenosis (ISR) after Percutaneous coronary intervention (PCI). Large-scale registry data on the prevalence and clinical management of ISR is lacking. METHODS The aim was to describe the epidemiology and management of patients with ≥1 ISR lesions treated with PCI (ISR PCI). Data on characteristics, management and clinical outcomes were analyzed for patients undergoing ISR PCI in the France-PCI all-comers registry. RESULTS Between January 2014 and December 2018, 31,892 lesions were treated in 22,592 patients, 7.3 % of whom underwent ISR PCI. Patients undergoing ISR PCI were older (68.5 vs 67.8; p < 0.001), and more likely to have diabetes (32.7 % vs 25.4 %, p < 0.001), chronic coronary syndrome or multivessel disease. ISR PCI concerned drug eluting stents (DES) ISR in 48.8 % of cases. Patients with ISR lesions were more frequently treated with DES than drug eluting balloon or balloon angioplasty (74.2 %, 11.6 % and 12.9 %, respectively). Intravascular imaging was rarely used. At 1 year, patients with ISR had higher target lesion revascularization rates (4.3 % vs. 1.6 %; HR 2.24 [1.64-3.06]; p < 0.001). CONCLUSIONS In a large all-comers registry, ISR PCI was not infrequent and associated with worse prognosis than non-ISR PCI. Further studies and technical improvements are warranted to improve the outcomes of ISR PCI.
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Affiliation(s)
- Benjamin Duband
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.
| | - Géraud Souteyrand
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean Michel Clerc
- Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France
| | | | - Olivier Fichaux
- Cardiology Department, Centre Hospitalo-Régional d'Orléans, Orléans, France
| | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier Jacques Cœur, Bourges, France
| | | | - Laurent Roussel
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
| | - Bruno Pereira
- Biostatistics Unit, Direction de la Recherche Clinique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Philippe Commeau
- Cardiology Department, Polyclinique Les Fleurs, Groupe ELSAN, Ollioules, France
| | - Guillaume Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, Rouen, France
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, Soissons, France
| | - Gregoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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Dürig M, Arroyo D, Bedossa M, Commeau P, Fournier S, Müller O, Barragan P, Le Breton H, Puricel S, Cook S. Clinical outcomes after unprotected left main coronary artery occlusion: A retrospective multicentre cohort analysis. Catheter Cardiovasc Interv 2023; 101:679-686. [PMID: 36786485 DOI: 10.1002/ccd.30585] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 01/05/2023] [Accepted: 01/23/2023] [Indexed: 02/15/2023]
Abstract
AIMS Unprotected left main coronary artery (ULMCA) occlusion is a rare and disastrous condition with scarce data on presentation and outcomes. Herein, we report data on patients presenting with acute coronary syndrome due to ULMCA occlusion at four different institutions. METHODS This is an international multicentre observational study. Baseline characteristics were retro- and prospectively collected. Clinical follow-up was prospective. The primary outcome was in-hospital death. Patients surviving the index hospitalization were compared with nonsurvivors to find predictors of survival. RESULTS The study population consisted of 55 patients. Eight patients (15%) died in the cath lab, and 23 (42%) died in hospital. Three (6%) deaths were noncardiac and due to major bleeding. Thirty-two (58%) patients survived the index hospitalization and were discharged. These patients were followed for a median of 17.5 months during which three cardiac deaths occurred. Repeat revascularization was performed in 25% (n = 8). Overall mortality at maximum follow-up was 47% (n = 26). The only significant predictor for hospital survival was left ventricular ejection fraction (odds ratio [OR]: 1.10 (per 1 point increase); 95% confidence interval [CI]: 1.02-1.19; p = 0.02). CONCLUSION ULMCA occlusion carries a high short-term mortality. Patients who survive index hospitalization have similar mortality rates as compared with other st elevation myocardial infarction patients.
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Affiliation(s)
- Marco Dürig
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Diego Arroyo
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Marc Bedossa
- Department of Cardiology and Vascular Diseases, University of Rennes, Rennes, France
| | - Philippe Commeau
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Olivier Müller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Paul Barragan
- Department of Cardiology, Polyclinique les Fleurs, Ollioules, France
| | - Hervé Le Breton
- Department of Cardiology and Vascular Diseases, University of Rennes, Rennes, France
| | - Serban Puricel
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
| | - Stéphane Cook
- Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
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Deharo P, Leroux L, Theron A, Ferrara J, Vaillier A, Jaussaud N, Porto A, Morera P, Gariboldi V, Iung B, Lefevre T, Commeau P, Gouysse M, du Chayla F, Glatt N, Cayla G, Le Breton H, Benamer H, Beurtheret S, Verhoye JP, Eltchaninoff H, Gilard M, Collet JP, Dumonteil N, Collart F, Modine T, Cuisset T. Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch Following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry. J Clin Med 2022; 11:jcm11206117. [PMID: 36294438 PMCID: PMC9604905 DOI: 10.3390/jcm11206117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.
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Affiliation(s)
- Pierre Deharo
- Département de Cardiologie, CHU Timone, 13385 Marseille, France
- INSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
| | - Lionel Leroux
- Département de Cardiologie, CHU Bordeaux, 33075 Bordeaux, France
| | - Alexis Theron
- Département de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Jérome Ferrara
- Département de Cardiologie, CHU Timone, 13385 Marseille, France
| | | | - Nicolas Jaussaud
- Département de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Alizée Porto
- Département de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Pierre Morera
- Département de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Vlad Gariboldi
- INSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
- Département de Chirurgie Cardiaque, CHU Timone, 13005 Marseille, France
| | - Bernard Iung
- AP-HP, Cardiology Department, Bichat Hospital, Université Paris Cité, INSERM 1148, 46 rue Henri Huchard, 75018 Paris, France
| | - Thierry Lefevre
- Hopital Privé Jacques Cartier, 6 Av. Noyer Lambert, 91300 Massy, France
| | - Philippe Commeau
- Cardiologie Interventionnelle, Polyclinique Les Fleurs, Groupe ELSAN, 83190 Ollioules, France
| | | | | | | | | | - Herve Le Breton
- Service de Cardiologie, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, 35033 Rennes, France
| | - Hakim Benamer
- Hopital Privé Jacques Cartier, 6 Av. Noyer Lambert, 91300 Massy, France
| | | | | | - Helene Eltchaninoff
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, 76000 Rouen, France
| | - Martine Gilard
- Department of Cardiology, CHRU Brest, 29200 Brest, France
| | - Jean Philippe Collet
- Department of Cardiology, Sorbonne Université, INSERM UMRS_1166, Pitié Salpêtrière (AP-HP), 75000 Paris, France
| | - Nicolas Dumonteil
- Groupe CardioVasculaire Interventionnel, Clinique Pasteur, 31300 Toulouse, France
| | - Frederic Collart
- INSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
- Département de Cardiologie, CHU Bordeaux, 33075 Bordeaux, France
| | - Thomas Modine
- Département de Cardiologie, CHU Bordeaux, 33075 Bordeaux, France
| | - Thomas Cuisset
- Département de Cardiologie, CHU Timone, 13385 Marseille, France
- INSERM, Inra, C2VN, Aix Marseille La Timone University, 13005 Marseille, France
- Faculté de Médecine, Aix-Marseille Université, 13005 Marseille, France
- Correspondence: ; Tel.: +33-4-91-38-59-74; Fax: +33-4-91-38-59-74
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Duband B, Motreff P, Marcollet P, Gamet A, Decomis MP, Bar O, Saint Etienne C, Hakim R, Canville A, Viallard L, BeyguI F, Lesault PF, Bonnet P, Durand E, Boiffard E, Collet JP, Benamer H, Commeau P, Cayla G, Pereira B, Koning R, Rangé G. Early survival after acute myocardial infarction with ST-segment elevation: What could be improved? Insights from France PCI French registry. Medicine (Baltimore) 2022; 101:e30190. [PMID: 36107504 PMCID: PMC9439734 DOI: 10.1097/md.0000000000030190] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Early mortality post-ST-segment elevation myocardial infarction (STEMI) in France remains high. The multicentre France Percutaneous Coronary Intervention Registry includes every patient undergoing coronary angiography in France. We analyzed the prevalence and impact of unmodifiable and modifiable risk factors on 30-day survival in patients experiencing STEMI. Patients admitted for STEMI between 01/2014 and 12/2016 were included in the analysis. Patients with nonobstructive coronary artery disease, with cardiogenic shock or cardiac arrest without STEMI, were excluded. Prehospital, clinical and procedural data were collected prospectively by the cardiologist in the cath lab using medical reporting software. Information on outcomes, including mortality, was obtained by a dedicated research technician by phone calls or from medical records. Marginal Cox proportional hazards regression was used to test the predictive value for survival at 30 days in a multivariable analysis. Included were 2590 patients (74% men) aged 63 ± 14 years. During the first month, 174 patients (6.7%) died. After adjustment, unmodifiable variables significantly associated with reduced 30-day survival were: age > 80 years (prevalence 15%; hazard ratio [HR] 2.7; 95% confidence interval [CI] 1.5-4.7), chronic kidney disease (2%; HR 5.3; 95% CI 2.6-11.1), diabetes mellitus (14%; HR 1.6; 95% CI 1.0-2.5), anterior or circumferential electrical localization (39%; HR 2.0; 95% CI 1.4-2.9), and Killip class 2, 3, or 4 (7%; HR 3.4; 95% CI 1.9-5.9; 2%; HR 10.1; 95% CI 5.3-19.4; 4%; HR 18; 95% CI 10.8-29.8, respectively). Among modifiable variables, total ischemic time > 3 hours (68%; HR 1.8; 95% CI 1.1-3.0), lack of appropriate premedication (18%; HR 2.2; 95% CI 1.5-3.3), and post-PCI TIMI < 3 (6%; HR 4.9; 95% CI 3.2-7.6) were significantly associated with reduced 30-day survival. Most predictors of 30-day survival post-STEMI are unmodifiable, but outcomes might be improved by optimizing modifiable factors, most importantly ischemic time and appropriate premedication.
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Affiliation(s)
- Benjamin Duband
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
- *Correspondence: Benjamin Duband, Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, 58, Rue Montalembert, 63000 Clermont-Ferrand, France (e-mail: )
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier Jacques Cœur, Bourges, France
| | - Alexandre Gamet
- Cardiology Department, Centre Hospitalier Régional d’Orléans, Orléans, France
| | | | - Olivier Bar
- Cardiology Department, Centre Hospitalier Universitaire de Tours, Tours, France
| | | | - Radwan Hakim
- Cardiology Department, Les hôpitaux de Chartres, Chartres, France
| | | | - Louis Viallard
- Cardiology Department, Centre Hospitalier Henri Mondor, Aurillac, France
| | - Farzin BeyguI
- Cardiology Department, Centre Hospitalier Universitaire de Caen, Caen, France
| | | | - Philippe Bonnet
- Cardiology Department, Centre Hospitalier Le Havre, Le Havre, France
| | - Eric Durand
- Cardiology Department, Rouen University Hospital, FHU REMOD-VHF, 76000 Rouen, France; Normandie Université, UNIROUEN, INSERM U1096, 76000 Rouen, France
| | - Emmanuel Boiffard
- Cardiology Department, Centre Hospitalier Départemental Vendée, La Roche-sur-Yon, France
| | | | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, Soissons, France
| | | | - Guillaume Cayla
- Cardiology Department, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Bruno Pereira
- Biostatistics Unit, Direction de la Recherche Clinique, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, Rouen, France
| | - Gregoire Rangé
- Cardiology Department, Les hôpitaux de Chartres, Chartres, France
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Honton B, Lipiecki J, Monségu J, Leroy F, Benamer H, Commeau P, Motreff P, Cayla G, Banos JL, Bouchou G, Laperche C, Farah B, Rangé G, Lefèvre T, Amabile N. Mid-term outcome of de novo lesions vs. in stent restenosis treated by intravascular lithotripsy procedures: Insights from the French Shock Initiative. Int J Cardiol 2022; 365:106-111. [PMID: 35870637 DOI: 10.1016/j.ijcard.2022.07.023] [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: 02/17/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Intravascular lithotripsy (IVL) is a promising new technology for disrupting de-novo calcified coronary lesions (DNL) before percutaneous coronary intervention (PCI). We assessed 12-month outcomes of IVL in patients undergoing PCI for DNL or intra stent restenosis (ISR) lesions related to device underexpansion. METHODS Prospective analysis of patients in the multicentre all-comers French Shock Initiative IVL registry. The primary safety endpoints in this analysis were in-hospital and 12-month major adverse cardiovascular events (MACE: cardiac death, myocardial infarction or target vessel revascularization). The primary effectiveness endpoint was procedural success, defined as <30% residual stenosis without severe angiographic complications. Event rates were analysed for the cohort and for DNL and ISR procedures separately. RESULTS A total of 220 lesions were treated (76.7% DNL and 23.3% ISR) in 202 patients. Procedural success was achieved in 95.5% of patients (DNL group: 96.5%; ISR group: 92.0%). In-hospital MACE occurred in 6.4% of cases, mainly driven by periprocedural infarctions. The rate of MACE-free survival at 1 year was 86.6% in the overall cohort. Rates of target vessel (TVR) and lesion (TLR) revascularisation were 6.4% and 2.5%, respectively. The 1-year MACE rate was 91.5% in DNL group and 83.8% in ISR group. CONCLUSIONS In this large all-comers IVL cohort, rates of in-hospital and 1-year MACE were moderate. The safety and efficiency of IVL was comparable in DNL and ISR lesions. A comparative study of the impact of IVL on outcomes appears warranted.
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Affiliation(s)
- Benjamin Honton
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France.
| | - Janusz Lipiecki
- Department of Interventional Cardiology, Pole Santé République, Clermont-Ferrand, France
| | - Jacques Monségu
- Department of Interventional Cardiology, Institut Cardio Vasculaire, Groupe Hospitalier Mutualiste, Grenoble, France
| | - Fabrice Leroy
- Department of Interventional Cardiology, Clinique La Louviere, Lille, France
| | - Hakim Benamer
- Department of Interventional Cardiology, Hôpital La Roseraie, Aubervilliers, France
| | - Philippe Commeau
- Department of Interventional Cardiology, Polyclinique Les Fleurs, Ollioules, France
| | - Pascal Motreff
- Department of Interventional Cardiology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Guillaume Cayla
- Department of Interventional Cardiology, Nimes University Hospital, University of Montpellier-Nimes, France
| | - Jean Luc Banos
- Department of Interventional Cardiology, Centre cardiologique du Pays Basque, Bayonne, France
| | - Gael Bouchou
- Department of Interventional Cardiology, Saint Etienne University Hospital, Saint Etienne, France
| | - Clémence Laperche
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France
| | - Bruno Farah
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France
| | - Grégoire Rangé
- Department of Interventional Cardiology, Centre Hospitalier, Chartres, France
| | - Thierry Lefèvre
- Department of Interventional Cardiology, Institut Cardio-Vasculaire Paris Sud, Ramsay Générale de Santé, Massy, France
| | - Nicolas Amabile
- Department of Interventional Cardiology, Institut Mutualiste Montsouris, Paris, France
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Didier R, Le Breton H, Eltchaninoff H, Cayla G, Commeau P, Collet JP, Cuisset T, Dumonteil N, Verhoye JP, Beurtheret S, Lefèvre T, Iung B, Gilard M. Erratum to "Evolution of TAVI patients and techniques over the past decade: The French TAVI registries" [Arch. Cardiovasc. Dis. 115 (4) (2022) 206-13]. Arch Cardiovasc Dis 2022; 115:408-409. [PMID: 35718719 DOI: 10.1016/j.acvd.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | | | | | | | | | | | - Thomas Cuisset
- University Hospital of Marseille, 13000 La Timone, France
| | | | | | | | | | - Bernard Iung
- Bichat Hospital, AP-HP, Université de Paris, 75000 Paris, France
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Didier R, Breton HL, Eltchaninoff H, Cayla G, Commeau P, Collet JP, Cuisset T, Dumonteil N, Verhoye JP, Beurtheret S, Lefèvre T, Iung B, Gilard M. Evolution of TAVI patients and techniques over the past decade: The French TAVI registries. Arch Cardiovasc Dis 2022; 115:206-213. [DOI: 10.1016/j.acvd.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
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Steiner S, Honton B, Langhoff R, Chiesa R, Kahlberg A, Thieme M, Zeller T, Garot P, Commeau P, Cremonesi A, Marone EM, Sauguet A, Scheinert D. 2-Year Results With a Sirolimus-Eluting Self-Expanding Stent for Femoropopliteal Lesions: The First-in-Human ILLUMINA Study. JACC Cardiovasc Interv 2022; 15:618-626. [PMID: 35219622 DOI: 10.1016/j.jcin.2021.12.034] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of the study was to assess 24-month efficacy and safety of a novel drug-eluting stent (DES) for femoropopliteal interventions with an innovative stent design and abluminal reservoir technology releasing the amphilimus formulation (sirolimus plus fatty acid) for efficient drug transfer and optimized release kinetics. BACKGROUND DES releasing paclitaxel exhibited good patency rates after femoropopliteal interventions. No benefit has been reported when sirolimus or everolimus were used for antiproliferative stent coating. METHODS Within a multicenter, first-in-man, single-arm study, 100 patients with symptomatic femoropopliteal disease (Rutherford category 2-4, mean lesion length 5.8 ± 3.9 cm, 35.0% total occlusions) were treated with the NiTiDES stent (Alvimedica). Two-year follow-up included assessment of primary patency (defined as absence of clinically driven target lesion revascularization or binary restenosis with a peak systolic velocity ratio >2.4 by duplex ultrasound), safety, functional, and clinical outcomes. RESULTS At 24 months, Kaplan-Meier estimates of primary patency and freedom from clinically driven target lesion revascularization were 83.4% (95% CI: 73.9%-89.6%) and 93.1% (95% CI: 85.3%-96.9%), respectively. Over the study period, 3 deaths were reported with no major limb amputation. Functional and clinical benefits were sustained, as 82.1% of patients fell into Rutherford category 0 or 1 at 24 months, which was associated with preserved improvements in all walking disability questionnaire scores. CONCLUSIONS The 2-year results of the ILLUMINA (Innovative siroLimus seLf expanding drUg-eluting stent for the treatMent of perIpheral disease: evaluation of safety aNd efficAcy) study demonstrate a sustained treatment benefit with a novel sirolimus-eluting stent that also compares favorably to other femoropopliteal intervention trials. Head-to-head comparisons of NiTiDES with a paclitaxel-based DES are warranted. (The ILLUMINA Study [ILLUMINA]; NCT03510676).
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Affiliation(s)
- Sabine Steiner
- Division of Angiology, Department of Internal Medicine, Neurology and Dermatology, University Hospital Leipzig, Leipzig, Germany; Helmholtz Institute for Metabolic, Obesity and Vascular Research, Helmholtz Zentrum München at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | | | - Ralf Langhoff
- Department of Angiology, Center for Internal Medicine I, Campus Clinic Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany
| | - Roberto Chiesa
- Department of Vascular Surgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Kahlberg
- Department of Vascular Surgery, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy
| | | | - Thomas Zeller
- Department of Angiology, Universitäts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Philippe Garot
- Institut Cardio-vasculaire Paris Sud, Hôpital Privé Claude Galien, Ramsay-Générale de santé, Quincy-sous-Sénart, France
| | | | - Alberto Cremonesi
- Cardiovascular Department, Humanitas Gavazzeni Hospital, Bergamo, Italy
| | - Enrico Maria Marone
- Vascular Surgery, Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Department of Vascular Surgery, Policlinico di Monza Group, Monza and Ivrea, Ollioules, Italy
| | | | - Dierk Scheinert
- Division of Angiology, Department of Internal Medicine, Neurology and Dermatology, University Hospital Leipzig, Leipzig, Germany.
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12
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Beygui F, Roule V, Ivanes F, Dechery T, Bizeau O, Roussel L, Dequenne P, Arnould MA, Combaret N, Collet JP, Commeau P, Cayla G, Montalescot G, Benamer H, Motreff P, Angoulvant D, Marcollet P, Chassaing S, Blanchart K, Koning R, Rangé G. Indirect Transfer to Catheterization Laboratory for ST Elevation Myocardial Infarction Is Associated With Mortality Independent of System Delays: Insights From the France-PCI Registry. Front Cardiovasc Med 2022; 9:793067. [PMID: 35360033 PMCID: PMC8962625 DOI: 10.3389/fcvm.2022.793067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFirst medical contact (FMC)-to-balloon time is associated with outcome of ST-elevation myocardial infarction (STEMI). We assessed the impact on mortality and the determinants of indirect vs. direct transfer to the cardiac catheterization laboratory (CCL).MethodsWe analyzed data from 2,206 STEMI patients consecutively included in a prospective multiregional percutaneous coronary intervention (PCI) registry. The primary endpoint was 1-year mortality. The impact of indirect admission to CCL on mortality was assessed using Cox models adjusted on FMC-to-balloon time and covariables unequally distributed between groups. A multivariable logistic regression model assessed determinants of indirect transfer.ResultsA total of 359 (16.3%) and 1847 (83.7%) were indirectly and directly admitted for PCI. Indirect admission was associated with higher risk features, different FMCs and suboptimal pre-PCI antithrombotic therapy.At 1-year follow-up, 51 (14.6%) and 137 (7.7%) were dead in the indirect and direct admission groups, respectively (adjusted-HR 1.73; 95% CI 1.22–2.45). The association of indirect admission with mortality was independent of pre-FMC and FMC characteristics. Older age, paramedics- and private physician-FMCs were independent determinants of indirect admission (adjusted-HRs 1.02 per year, 95% CI 1.003–1.03; 5.94, 95% CI 5.94 3.89–9.01; 3.41; 95% CI 1.86–6.2, respectively).ConclusionsOur study showed that, indirect admission to PCI for STEMI is associated with 1-year mortality independent of FMC to balloon time and should be considered as an indicator of quality of care. Indirect admission is associated with higher-risk features and suboptimal antithrombotic therapy. Older age, paramedics-FMC and self-presentation to a private physician were independently associated with indirect admission. Our study, supports population education especially targeting elderly, more adequately dispatched FMC and improved pre-CCL management.
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Affiliation(s)
- Farzin Beygui
- Cardiology Department, CHU de Caen, Caen, France
- *Correspondence: Farzin Beygui
| | | | | | - Thierry Dechery
- Cardiology Department, Center Hospitalier de Bourges, Bourges, France
| | | | - Laurent Roussel
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
| | | | - Marc-Antoine Arnould
- Cardiology Department, Nouvelle clinique Tourangelle, Saint-Cyr-sur-Loire, France
| | - Nicolas Combaret
- Cardiology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Philippe Commeau
- Cardiology Department, Polyclinique les fleurs, Ollioules, France
| | | | - Gilles Montalescot
- Cardiology Department, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie, Aubervilliers, France
| | - Pascal Motreff
- Cardiology Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Pierre Marcollet
- Cardiology Department, Center Hospitalier de Bourges, Bourges, France
| | - Stephan Chassaing
- Cardiology Department, Nouvelle clinique Tourangelle, Saint-Cyr-sur-Loire, France
| | | | - René Koning
- Cardiology Department, Clinique Saint Hilaire, Saint Hilaire, France
| | - Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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13
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Beygui F, Ivanes F, Roule V, Dechery T, Roussel L, Dequenne P, Arnould MA, Combaret N, Collet JP, Commeau P, Cayla G, Montalescot G, Benamer H, Motreff P, Angoulvant D, Marcollet P, Chassaing S, Blanchart K, Koning R, Range G. INDIRECT TRANSFER TO CATHETERIZATION LABORATORY FOR ST ELEVATION MYOCARDIAL INFARCTION IS ASSOCIATED WITH MORTALITY INDEPENDENT OF SYSTEM DELAYS: INSIGHTS FROM THE FRANCE-PCI REGISTRY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02088-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Bouisset F, Deney A, Ferrières J, Panagides V, Becker M, Riviere N, Yvorel C, Commeau P, Adjedj J, Benamer H, Bonnet G, Cayla G. Mechanical complications in ST-elevation myocardial infarction: The impact of pre-hospital delay. Int J Cardiol 2021; 345:14-19. [PMID: 34699868 DOI: 10.1016/j.ijcard.2021.10.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/26/2021] [Accepted: 10/15/2021] [Indexed: 02/02/2023]
Abstract
AIMS Mechanical complications (MC) (i.e., free wall rupture (FWR), papillary muscle rupture (PMR) and ventricular septal rupture (VSR)) are rare complications of ST- elevation acute myocardial infarction (STEMI). Incidence of MC according to pre-hospital delay remains unknown. We aimed to determine the rates of MC according to pre-hospital delay. METHODS Analysis was conducted on the MODIF registry data. Patients were allocated to four groups according to pre-hospital delay: 0 to 12 h, 12 to 24 h, 24 to 36 h and 36 to 48 h. RESULTS 6185 patients with complete data were analyzed. Mean age was 64.1 years old and 75.7% of patients were males. Eighty-three patients (1.34%) presented with MC: 44 (0.71%) experienced a FWR, 17 (0.27%) a PMR, and 22 (0.36%) a VSR. Global rates of MC were 0.82%, 1.43%, 1.24% and 5.07% in the four groups of pre-hospital delays - 0 to 12 h, 12 to 24 h, 24 to 36 h and 36 to 48 h - respectively (p < 0.001). In-hospital mortality rates were high: 44.2%, 47.1% and 54.6% for FWR, PMR and VSR, respectively. In multivariate analysis, factors independently related to the occurrence of MC were older age, female sex, simultaneous COVID-19 infection, absence of dyslipidemia, initial TIMI flow 0 or 1 in the culprit artery, 36 to 48 h-pre-hospital delay and absence of revascularization by percutaneous coronary intervention (PCI) with stent implantation. CONCLUSION The probability of MC in STEMI increases with pre-hospital delay. Mechanical complications of STEMI remain associated with a very poor prognosis.
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Affiliation(s)
- Frederic Bouisset
- Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, Toulouse, France; Department of Epidemiology INSERM UMR 1027, Toulouse, France.
| | - Antoine Deney
- Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, Toulouse, France
| | - Jean Ferrières
- Centre Hospitalier Universitaire de Toulouse, Hôpital Rangueil, Toulouse, France; Department of Epidemiology INSERM UMR 1027, Toulouse, France
| | - Vassili Panagides
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France
| | - Mathieu Becker
- CHR Metz -Thionville, Metz Hopital de Mercy, Metz, France
| | - Nicolas Riviere
- University of Bordeaux, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | | | | | - Julien Adjedj
- Institute Arnaud Tzanck, Saint Laurent du Var, France
| | - Hakim Benamer
- Institut Jacques Cartier, Ramsay Générale de Santé, ICPS, Massy, France
| | - Guillaume Bonnet
- University of Bordeaux, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Guillaume Cayla
- Cardiology Department, Nimes University Hospital, Montpellier University, Nimes, France
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15
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Rangé G, Hakim R, Etienne CS, Deballon R, Dechery T, Souteyrand G, Bar O, Albert F, Canville A, Gamet A, Beygui F, Viallard L, Bonnet P, Durand E, Lesault PF, Boiffard E, Koning R, Benamer H, Commeau P, Cayla G, Motreff P. [stent thrombosis : A won battle ? (data from the France PCI registry)]. Ann Cardiol Angeiol (Paris) 2021; 70:388-394. [PMID: 34686307 DOI: 10.1016/j.ancard.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/02/2021] [Indexed: 10/20/2022]
Abstract
GOAL The aim of the study is to assess the incidence, risk factors and prognosis of definite stent thrombosis (ST) at 1 year in the France PCI multicenter prospective registry. PATIENTS AND METHODS Only patients who underwent coronary angioplasty with at least one stent implantation between 1st January 2014 and 31 December 2019 were included. The population was separated into 2 groups: the "ST" group with stent thrombosis and the "control" group without stent thrombosis. RESULTS 35,435 patients were included. 256 patients (0.72%) presented a ST at 1 year. The rate of ST decreased significantly in acute coronary syndrome (1.5% in 2014 vs. 0.73% in 2019; p = 0.05) but not in chronic coronary syndrome (0.46% in 2014 vs 0.40%; p = 0.98). The risk factors are young age (65.8 years vs 68.2; p = 0.002), clinical context (35.27% vs 16.68%; p = 0.0001), diabetes (35.2 % vs 26.4%; p = 0.002), renal failure (11.7% vs 8%; p = 0.009) and history of coronary angioplasty (28.63% vs 21.86%; p = 0.009) and peripheral arterial disease (14.5% vs 10.1%; p = 0.021), LV dysfunction (37% vs 27.5%; p = 0.003), mean length (39.6 mm vs 31, 7mm; p <0.0001) and the mean number of stents per procedure (1.9 vs 1.6; p <0.0001), a TIMI flow ≤1 pre procedure (21.5% vs 12.4%; p <0.0001) and an intrastent restenosis (11% vs 6%; p <0.0001). The 1-year mortality of the ST group was significantly higher than that of the control group (19.14% vs 5.82%; p <0.0001). CONCLUSION Since 2014, the incidence of ST at 1 year has been decreasing but remains stuck at a floor level of 0.54% in 2019. The battle for ST seems to have been partly won and its risk factors well identified, but its mortality is still high.
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Affiliation(s)
- G Rangé
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray.
| | - R Hakim
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray
| | - C Saint Etienne
- Service de cardiologie, Centre Hospitalo-Universitaire de Tours, 37170 Chambray les Tours, France
| | - R Deballon
- Service de cardiologie, Pôle santé Oréliance, 45770 Saran, France
| | - T Dechery
- Service de cardiologie, Centre Hospitalier Jacques-Cœur, 18020 Bourges, France
| | - G Souteyrand
- Service de cardiologie, Centre Hospitalo-Universitaire Gabriel-Montpied, 63000 Clermont Ferrand, France
| | - O Bar
- Service de cardiologie, Nouvelle Clinique Tours Plus, 37541 Saint Cyr sur Loire, France
| | - F Albert
- Hôpitaux de Chartres, Service de Cardiologie, 4 rue Claude Bernard 28630 Le Coudray
| | - A Canville
- Service de cardiologie, Clinique Saint-Hilaire, 76000 Rouen, France
| | - A Gamet
- Service de cardiologie, Centre Hospitalier Régional d'Orléans, 45100 Orléans, France
| | - F Beygui
- Service de cardiologie, Centre Hospitalo-Universitaire de Caen, 14033 Caen, France
| | - L Viallard
- Service de cardiologie, Centre Hospitalier Henri-Mondor, 15000 Aurillac, France
| | - P Bonnet
- Service de cardiologie, Groupe Hospitalier du Havre, 76290 Montivilliers, France
| | - E Durand
- Service de cardiologie, Centre Hospitalo-Universitaire de Rouen, 76038 Rouen, France
| | - P-F Lesault
- Service de cardiologie, Hôpital Privé de l'Estuaire, 76600 Le Havre, France
| | - E Boiffard
- Service de cardiologie, Centre Hospitalier Départemental de Vendée, 85000 La Roche-Sur-Yon, France
| | - R Koning
- Service de cardiologie, Clinique Saint-Hilaire, 76000 Rouen, France
| | - H Benamer
- Service de cardiologie, ICVGVM La Roseraie, 93300 Aubervilliers, France
| | - P Commeau
- Service de cardiologie, Polyclinique des Fleurs, 83190 Ollioules, France
| | - G Cayla
- Service de cardiologie, CHU Nîmes, Université Montpellier, Nîmes, France
| | - P Motreff
- Service de cardiologie, Centre Hospitalo-Universitaire Gabriel-Montpied, 63000 Clermont Ferrand, France
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16
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Didier R, Lhermusier T, Auffret V, Eltchaninoff H, Le Breton H, Cayla G, Commeau P, Collet JP, Cuisset T, Dumonteil N, Verhoye JP, Beurtheret S, Lefèvre T, Teiger E, Carrié D, Himbert D, Albat B, Cribier A, Sudre A, Blanchard D, Bar O, Rioufol G, Collet F, Houel R, Labrousse L, Meneveau N, Ghostine S, Manigold T, Guyon P, Delepine S, Favereau X, Souteyrand G, Ohlmann P, Doisy V, Beygui F, Gommeaux A, Claudel JP, Bourlon F, Bertrand B, Iung B, Gilard M. TAVR Patients Requiring Anticoagulation: Direct Oral Anticoagulant or Vitamin K Antagonist? JACC Cardiovasc Interv 2021; 14:1704-1713. [PMID: 34274294 DOI: 10.1016/j.jcin.2021.05.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Using French transcatheter aortic valve replacement (TAVR) registries linked with the nationwide administrative databases, the study compared the rates of long-term mortality, bleeding, and ischemic events after TAVR in patients requiring oral anticoagulation with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs). BACKGROUND The choice of optimal drug for anticoagulation after TAVR remains debated. METHODS Data from the France-TAVI and FRANCE-2 registries were linked to the French national health single-payer claims database, from 2010 to 2017. Propensity score matching was used to reduce treatment-selection bias. Two primary endpoints were death from any cause (efficacy) and major bleeding (safety). RESULTS A total of 24,581 patients who underwent TAVR were included and 8,962 (36.4%) were treated with OAC. Among anticoagulated patients, 2,180 (24.3%) were on DOACs. After propensity matching, at 3 years, mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.12-1.67; P < 0.005) and major bleeding including hemorrhagic stroke (HR: 1.64; 95% CI: 1.17-2.29; P < 0.005) were lower in patients on DOACs compared with those on VKAs. The rates of ischemic stroke (HR: 1.32; 95% CI: 0.81-2.15; P = 0.27) and acute coronary syndrome (HR: 1.17; 95% CI: 0.68-1.99; P = 0.57) did not differ among groups. CONCLUSIONS In these large multicenter French TAVR registries with an exhaustive clinical follow-up, the long-term mortality and major bleeding were lower with DOACs than VKAs at discharge. The present study supports preferential use of DOACs rather than VKAs in patients requiring oral anticoagulation therapy after TAVR.
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Affiliation(s)
- Romain Didier
- Department of Cardiology, Brest University Hospital, Brest, France
| | | | | | | | | | | | | | - Jean Philippe Collet
- Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | - Emmanuel Teiger
- University Hospital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Dominique Himbert
- Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Bernard Albat
- University Hospital of Montpellier, Montpellier, France
| | | | | | - Didier Blanchard
- University Hospital Paris Ouest, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | - Remi Houel
- Saint Joseph Hospital, Marseille, France
| | | | | | - Said Ghostine
- Hospital Marie Lannelongue, Le Plessis-Robinson, France
| | - Thibaut Manigold
- University of Nantes, Department of Cardiologie, Saint-Herblain, France
| | | | | | - Xavier Favereau
- Private Hospital of Parly II, Le Chesnay-Rocquencourt, France
| | | | | | | | | | | | | | | | - Bernard Bertrand
- Department of Cardiology, Grenoble Alpes University Hospital, Grenoble, France
| | - Bernard Iung
- Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - Martine Gilard
- Department of Cardiology, Brest University Hospital, Brest, France.
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17
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Lafont A, Sinnaeve PR, Cuisset T, Cook S, Sideris G, Kedev S, Carrie D, Hovasse T, Garot P, El Mahmoud R, Spaulding C, Helft G, Diaz Fernandez JF, Brugaletta S, Pinar-Bermudez E, Ferre JM, Commeau P, Teiger E, Bogaerts K, Sabate M, Morice MC, Varenne O. Two-year outcomes after percutaneous coronary intervention with drug-eluting stents or bare-metal stents in elderly patients with coronary artery disease. Catheter Cardiovasc Interv 2021; 97:E607-E613. [PMID: 32761890 DOI: 10.1002/ccd.29159] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/09/2020] [Accepted: 07/09/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Report the results at 2 years of the patients included in the SENIOR trial. BACKGROUND Patients above 75 years of age represent a fast-growing population in the cathlab. In the SENIOR trial, patients treated by percutaneous coronary intervention (PCI) with drug eluting stent (DES) and a short duration of P2Y12 inhibitor (1 and 6 months for stable and unstable coronary syndromes, respectively) compared with bare metal stents (BMS) was associated with a 29% reduction in the rate of all-cause mortality, myocardial infarction (MI), stroke, and ischaemia-driven target lesion revascularization (ID-TLR) at 1 year. The results at 2 years are reported here. METHODS AND RESULTS We randomly assigned 1,200 patients (596[50%] to the DES group and 604[50%] to the BMS group). At 2 years, the composite endpoint of all-cause mortality, MI, stroke and ID-TLR had occurred in 116 (20%) patients in the DES group and 131 (22%) patients in the BMS group (RR 0.90 [95%CI 0.72-1.13], p = .37). IDTLR occurred in 14 (2%) patients in the DES group and 41 (7%) patients in the BMS group (RR 0.35 [95%CI 0.16-0.60], p = .0002). Major bleedings (BARC 3-5) occurred in 27(5%) patients in both groups (RR 1.00, [95%CI 0.58-1.75], p = .99). Stent thrombosis rates were low and similar between DES and BMS (0.8 vs 1.3%, (RR 0.52 [95%CI 0.01-1.95], p = .27). CONCLUSION Among elderly PCI patients, a strategy combining a DES together with a short duration of DAPT is associated with a reduction in revascularization up to 2 years compared with BMS with very few late events and without any increased in bleeding complications or stent thrombosis.
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Affiliation(s)
- Alexandre Lafont
- Cardiology Department Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and, Université de Paris, Paris, France
| | - Peter R Sinnaeve
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Thomas Cuisset
- Cardiology Department, Centre Hospitalier Universitaire Timone, Marseille, France
| | - Stéphane Cook
- Cardiology Department, University and Hospital Fribourg, Fribourg, Switzerland
| | - Giorgios Sideris
- Cardiology Department Service de Cardiologie-Institut national de la santé et de la recherche médicale U942, Hôpital Lariboisiere, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Sasko Kedev
- Cardiology Department, University St Cyril and Methodius, Skopje, Macedonia
| | - Didier Carrie
- Service de Cardiologie, Centre hospitalier universitaire Toulouse Rangueil, Université Paul Sabatier, Toulouse, France
| | - Thomas Hovasse
- Institut Cardiovasculaire Paris-Sud, Ramsay Générale de Santé, Massy, France
| | - Philippe Garot
- Institut Cardiovasculaire Paris-Sud, Ramsay Générale de Santé, Massy, France
| | - Rami El Mahmoud
- Hôpital Ambroise Paré Assistance Publique-Hôpitaux de Paris, Université Versailles-Saint Quentin en Yvelines, Versailles, France
| | - Christian Spaulding
- Service de Cardiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris and Sudden Death Expert Center, Institut national de la santé et de la recherche médicale U990, Paris, France
| | - Gérard Helft
- Institut de Cardiologie, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie et Institut hospitalo-universitaire, Institute of Cardiometabolism and Nutrition, Hôpital Pitié-Salpétrière, Paris, France
| | | | - Salvatore Brugaletta
- Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Josepa Mauri Ferre
- Cardiology department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Philippe Commeau
- Département de Cardiologie Interventionnelle, Polyclinique Les Fleurs, France
| | - Emmanuel Teiger
- Service de Cardiologie, Hôpital Henri Mondor Assistance Publique-Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France
| | - Kris Bogaerts
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium, and Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), University Hasselt, Hasselt, Belgium
| | - Manel Sabate
- Interventional Cardiology Unit, Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Olivier Varenne
- Cardiology Department Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and, Université de Paris, Paris, France
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Puymirat E, Nakache A, Saint Etienne C, Marcollet P, Fichaux O, Decomis MP, Chassaing S, Commeau P, Danchin N, Cayla G, Montalescot G, Benamer H, Koning R, Motreff P, Rangé G. Is coronary multivessel disease in acute myocardial infarction patients still associated with worse clinical outcomes at 1-year? Clin Cardiol 2021; 44:429-437. [PMID: 33586188 PMCID: PMC7943894 DOI: 10.1002/clc.23567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/30/2020] [Accepted: 01/07/2021] [Indexed: 11/23/2022] Open
Abstract
Background ST‐elevation myocardial infarction (STEMI) patients with multivessel disease (MVD) are associated with a worse prognosis. However, few comparisons are available according to coronary status in the era of modern reperfusion and optimized secondary prevention. Hypothesis We hypothesized that the difference in prognosis according to number of vessel disease in STEMI patients has reduced. Methods All consecutive STEMI patients undergoing primary percutaneous coronary intervention (PCI) within 24 h of symptoms onset between January 1, 2014 and June 30, 2016 enrolled in the CRAC (Club Régional des Angioplasticiens de la région Centre) France PCI registry were analyzed. Baseline characteristics, management, and outcomes at 1‐year were analyzed according to coronary status (one‐, two‐, and three‐VD). Results A total of 1886 patients (mean age 62.2 ± 14.0 year; 74% of male) were included. Patients with MVD (two or three‐VD) represented 53.7%. They were older with higher cardiovascular risk factor profile. At 1 year, the rate of major adverse cardiovascular events (MACE, defined as all‐cause death, stroke or re‐MI) was 10%, 12%, and 12% in one‐, two, and three‐VD respectively (p = .28). In multivariable adjusted Cox proportional hazard regression model, two‐ and three‐VD were not associated with higher rate of MACE compared to patients with single VD (HR, 1.09; 95%CI 0.76–1.56 for two‐VD; HR, 0.74; 95%CI 0.48–1.14 for three‐VD). Conclusions MVD still represents an important proportion of STEMI patients but their prognoses were not associated with worse clinical outcomes at 1‐year compared with one‐VD patients in a modern reperfusion area and secondary medication prevention.
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Affiliation(s)
- Etienne Puymirat
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | - Ariel Nakache
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | | | - Pierre Marcollet
- Cardiology Department, Centre Hospitalier de Bourges, Bourges, France
| | - Olivier Fichaux
- Cardiology Department, Centre Hospitalo-régional d'Orléans, Orléans, France
| | | | | | - Philippe Commeau
- Cardiology Department, Polyclinique les Fleurs, Ollioules, France
| | - Nicolas Danchin
- Department of Cardiology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, Paris, France
| | - Guillaume Cayla
- Cardiology Department, CHU Nîmes, Université Montpellier, Nîmes, France
| | - Gilles Montalescot
- Cardiology Department, Groupe hospitalier Pitié-Salpêtrière, Paris, France
| | - Hakim Benamer
- Cardiology Department, Clinique de la Roseraie; ICPS Massy Ramsay group, Paris 13, France
| | - Rene Koning
- Cardiology Department, Clinique Saint-Hilaire, Rouen, France
| | - Pascal Motreff
- Cardiology Department, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont Ferrand, France
| | - Grégoire Rangé
- Cardiology Department, Les Hôpitaux de Chartres, Chartres, France
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19
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Bonnet G, Panagides V, Palermo V, Gautier A, Pommier T, Weizman O, Noirclerc N, Adjedj J, Commeau P, Benamer H, Cayla G. Myocardial infarction rates overview during COVID-19 pandemic In France: Results of the MODIF registry. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC8719936 DOI: 10.1016/j.acvdsp.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background The emergence of Coronavirus disease 2019 (COVID-19) has evolved into a global pandemic. Systems of care have been reorganized worldwide in an effort to preserve hospital bed capacity. In France, from March 17 to May 11 2020, government imposed a complete lockdown on the whole population. Only urgent cardiac procedures have been ensured such as ST-elevation myocardial infarction (STEMI) revascularization. Some previously published studies suggest a reduction of admission for STEMI in many countries. Nevertheless, strong evidences and data across different French regions that have been affected variously by the outbreak are still lacking. Purpose We aimed to describe the incidence rates and characteristics of patients presenting with STEMI in order to evaluate the impact of the COVID-19 outbreak on STEMI care in France covering the lockdown period compared to same period one year ago. Methods We performed a retrospective multicenter registry across 60 French interventional cardiology centers including all consecutive STEMI patients referred for urgent revascularization in the heart catheterization laboratory between two periods: March 1st to May 31th 2020 compared with March 1st to May 31th 2019. Comprehensive data, including clinical, biological, COVID status and angiographic variables including time taken for care were recorded at admission. The primary outcome was a composite of invasive mechanical ventilation support or in-hospital death. The secondary outcome was the occurrence of myocardial infarction related complications during hospitalization. Enrollement is not complete at the time of the abstract submission. Conclusion This data collection between two periods with and without COVID19 will gave insights for a complete descriptive cartography of STEMI patients among different French regions which have been variously impacted by the outbreak.
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20
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Rangé G, Hakim R, Beygui F, Angoulvant D, Marcollet P, Godin M, Deballon R, Bonnet P, Fichaux O, Barbey C, Viallard L, Lesault PF, Durand E, Boiffard E, Dutheil G, Collet JP, Benamer H, Commeau P, Montalescot G, Koning R, Motreff P. Incidence, delays, and outcomes of STEMI during COVID-19 outbreak: Analysis from the France PCI registry. J Am Coll Emerg Physicians Open 2020; 1:1168-1176. [PMID: 33363285 PMCID: PMC7753646 DOI: 10.1002/emp2.12325] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/29/2022] Open
Abstract
Objectives The aim of this study was to assess the impact of the coronavirus disease 2019 (COVID‐19) outbreak on incidence, delays, and outcomes of ST‐elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) in France. Methods We analyzed all patients undergoing PPCI <24 hours STEMI included in the prospective France PCI registry. The 2 groups were compared on mean monthly number of patients, delays in the pathway care, and in‐hospital major adverse cardiac events (MACE: death, stent thrombosis, myocardial infarction, unplanned coronary revascularization, stroke, and major bleeding). Results From January 15, 2019 to April 14, 2020, 2064 STEMI patients undergoing PPCI were included: 1942 in the prelockdown group and 122 in the lockdown group. Only 2 cases in the lockdown group were positive for COVID‐19. A significant drop (12%) in mean number of STEMI/month was observed in the lockdown group compared with prelockdown (139 vs 122, P < 0.04). A significant increase in “symptom onset to first medical contact” delay was found for patients who presented directly to the emergency department (ED) (238 minutes vs 450 minutes; P = 0.04). There were higher rates of in‐hospital MACE (7.7% vs 12.3%; P = 0.06) and mortality (4.9% vs 8.2%; P = 0.11) in the lockdown group but the differences were not significant. Conclusion According to the multicenter France PCI registry, the COVID‐19 outbreak in France was associated with a significant decline in STEMI undergoing PPCI and longer transfer time for patients who presented directly to the ED. Mortality rates doubled, but the difference was not statistically significant.
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Affiliation(s)
- Grégoire Rangé
- Cardiology department Les hôpitaux de Chartres Chartres France
| | - Radwan Hakim
- Cardiology department Les hôpitaux de Chartres Chartres France
| | - Farzin Beygui
- Cardiology Department Centre Hospitalier Universitaire de Caen Caen France
| | - Denis Angoulvant
- Cardiology Department Centre Hospitalier Universitaire de Tours Tours France
| | - Pierre Marcollet
- Cardiology Department Centre Hospitalier Jacques Coeur Bourges France
| | - Matthieu Godin
- Cardiology Department Clinique Saint-Hilaire Rouen France
| | | | - Philippe Bonnet
- Cardiology Department Centre Hospitalier Le Havre Le Havre France
| | - Olivier Fichaux
- Cardiology Department Centre Hospitalier Régional d'Orléans Orléans France
| | - Christophe Barbey
- Cardiology Department Nouvelle Clinique Tourengelle, Saint-Cyr-sur-Loire France
| | - Louis Viallard
- Cardiology Department Centre Hospitalier Henri Mondor Aurillac France
| | | | - Eric Durand
- Cardiology Department UNIROUEN INSERM U1096 Rouen University Hospital Department of Cardiology Normandie Univ FHU REMOD-VHF Rouen F76000 France
| | - Emmanuel Boiffard
- Cardiology Department Centre Hospitalier Départemental Vendée La Roche-sur-Yon France
| | - Gerard Dutheil
- Cardiology Department Clinique Bergouignan Evreux France
| | | | - Hakim Benamer
- Cardiology Department Clinique de la Roseraie Soissons France
| | | | | | - Rene Koning
- Cardiology Department Clinique Saint-Hilaire Rouen France
| | - Pascal Motreff
- Cardiology Department Centre Hospitalier Universitaire de Clermont-Ferrand Clermont-Ferrand France
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21
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Hernández-Enríquez M, Belle L, Madiot H, Pansieri M, Souteyrand G, de Poli F, Piot C, Boueri Z, Gerbaud E, Boiffard E, Benamer H, Lattuca B, Commeau P, Gervasoni R, Rangé G, Lhoest N, Marliere S, Abdellaoui M, Delarche N, Zemour G, Armengaud J, Carre M, Levesque S, Boudou N. Use and outcomes of the PK Papyrus covered stent in France: SOS PK Papyrus Registry. Catheter Cardiovasc Interv 2020; 98:874-881. [PMID: 33085150 DOI: 10.1002/ccd.29328] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/17/2020] [Accepted: 10/02/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To evaluate the rate of procedural success and long-term outcomes of the PK Papyrus (PKP) covered stent (CS). BACKGROUND CS are essential in the treatment of coronary artery perforation (CAP). They have also been used to treat coronary artery aneurysms. Limited evidence is available on clinical outcomes with the PKP. METHODS This was a multicenter, observational, retrospective, and prospective study. Consecutive patients undergoing intentional PKP implantation in 22 centers in France were included. The primary endpoint was the rate of procedural success. Secondary endpoints included rates of death, myocardial infarction (MI), target lesion revascularization (TLR), in-stent restenosis (ISR), and stent thrombosis (ST). RESULTS Data from 130 patients were analyzed (mean age 72.5 ± 10.5 years; 71% men). The main indication for PKP was CAP, in 84 patients (65%). Delivery success was achieved in 95% and procedural success in 91%. During the in-hospital stay, 15 patients died (12%) and 7 (5%) presented with ST. Data from 127 patients were available at 19.2 ± 12.8 month follow-up. Thirty-three patients died (26%), 15 (12%) had an MI and 21 (17%) presented with TLR. TLR was due to ISR in 12 patients (9%), 10 had definite ST (8%) and 1 patient for stent under-expansion. CONCLUSIONS The principal indication for PKP was CAP. PKP had high rates of delivery and procedural success. At long-term follow-up, there was a high rate of TLR, mainly due to ISR and ST. These results are consistent with previously reported data in these clinical settings.
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Affiliation(s)
- Marco Hernández-Enríquez
- Cardiology Department, Hospital Universitari General de Catalunya, Barcelona, Spain.,Cardiology Department, Rangueil University Hospital, Toulouse, France
| | - Loic Belle
- Cardiology Department, Hospital of Annecy, Annecy, France
| | - Hende Madiot
- Cardiology Department, Hospital of Annecy, Annecy, France
| | | | - Geraud Souteyrand
- Cardiology Department, University Hospital of Clermont Ferrand, Clermont-Ferrand, France
| | - Fabiel de Poli
- Cardiology Department, Hospital of Haguenau, Haguenau, France
| | - Christophe Piot
- Cardiology Department, Private Hospital of Millenaire, Montpellier, France
| | - Ziad Boueri
- Cardiology Department, Hospital of Bastia, Bastia, France
| | - Edouard Gerbaud
- Cardiology Department, University Hospital of Bordeaux, Burdeaux, France
| | - Emmanuel Boiffard
- Cardiology Department, Hospital of La Roche sur Yon, La Roche sur Yon, France
| | - Hakim Benamer
- Cardiology Department, ICPS Massy groupe Ramsay générale de santé, Aubervilliers, France
| | - Benoit Lattuca
- Cardiology Department, University Hospital of Nîmes, Nîmes, France
| | - Philippe Commeau
- Cardiology Department, Private Hospital of Clinique des Fleurs, Ollioule, France
| | - Richard Gervasoni
- Cardiology Department, University Hospital of Montpellier, Montpellier, France
| | - Gregoire Rangé
- Cardiology Department, Hospital of Chartres, Chartres, France
| | - Nicolas Lhoest
- Cardiology Department, Private Hospital of L'Orangerie, Strasbourg, France
| | - Stéphanie Marliere
- Cardiology Department, University Hospital of Grenoble, Grenoble, France
| | - Mohamed Abdellaoui
- Cardiology Department, "Groupement Hospitalier Mutualiste" of Grenoble, Grenoble, France
| | | | - Gilles Zemour
- Cardiology Department, Hospital of Cannes, Cannes, France
| | | | - Max Carre
- Cardiology Department, Hospital of Auxerre, Auxerre, France
| | - Sebastien Levesque
- Cardiology Department, University Hospital of Poitiers, Poitiers, France
| | - Nicolas Boudou
- Cardiology Department, Rangueil University Hospital, Toulouse, France
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22
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Postaire B, Sauguet A, Desgranges P, Feugier P, Rosset E, Ducasse E, Kaladji A, Salomon du Mont L, Pernès JM, Commeau P, Lermusiaux P, Guyomarc’h B, Hoffmann C, Maurel B, Leclere B, Gouëffic Y. Mortality and active stents for femoro-popliteal lesions. Ann Vasc Surg 2020. [DOI: 10.1016/j.avsg.2020.08.050] [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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23
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Didier R, Gouysse M, Eltchaninoff H, Le Breton H, Commeau P, Cayla G, Glatt N, Glatt B, Gabbas M, Tuppin P, Liepchitz L, Boussac M, Iung B, Gilard M. Successful linkage of French large-scale national registry populations to national reimbursement data: Improved data completeness and minimized loss to follow-up. Arch Cardiovasc Dis 2020; 113:534-541. [DOI: 10.1016/j.acvd.2020.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/11/2020] [Accepted: 04/08/2020] [Indexed: 10/23/2022]
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Gouëffic Y, Sauguet A, Desgranges P, Feugier P, Rosset E, Ducasse E, Kaladji A, Salomon du Mont L, Pernès JM, Commeau P, Lermusiaux P, Leclere B, Guyomarc’h B, Hoffmann CT, Maurel B. A Polymer-Free Paclitaxel-Eluting Stent Versus a Bare-Metal Stent for De Novo Femoropopliteal Lesions. JACC Cardiovasc Interv 2020; 13:447-457. [DOI: 10.1016/j.jcin.2019.12.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/25/2019] [Accepted: 12/03/2019] [Indexed: 11/26/2022]
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Van Belle E, Vincent F, Labreuche J, Auffret V, Debry N, Lefèvre T, Eltchaninoff H, Manigold T, Gilard M, Verhoye JP, Himbert D, Koning R, Collet JP, Leprince P, Teiger E, Duhamel A, Cosenza A, Schurtz G, Porouchani S, Lattuca B, Robin E, Coisne A, Modine T, Richardson M, Joly P, Rioufol G, Ghostine S, Bar O, Amabile N, Champagnac D, Ohlmann P, Meneveau N, Lhermusier T, Leroux L, Leclercq F, Gandet T, Pinaud F, Cuisset T, Motreff P, Souteyrand G, Iung B, Folliguet T, Commeau P, Cayla G, Bayet G, Darremont O, Spaulding C, Le Breton H, Delhaye C. Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valve Replacement. Circulation 2020; 141:243-259. [DOI: 10.1161/circulationaha.119.043785] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [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: 12/13/2022]
Abstract
Background:
No randomized study powered to compare balloon expandable (BE) with self expanding (SE) transcatheter heart valves (THVs) on individual end points after transcatheter aortic valve replacement has been conducted to date.
Methods:
From January 2013 to December 2015, the FRANCE-TAVI nationwide registry (Registry of Aortic Valve Bioprostheses Established by Catheter) included 12 141 patients undergoing BE-THV (Edwards, n=8038) or SE-THV (Medtronic, n=4103) for treatment of native aortic stenosis. Long term mortality status was available in all patients (median 20 months; interquartile range, 14 to 30). Patients treated with BE-THV (n=3910) were successfully matched 1:1 with 3910 patients treated with SE-THV by using propensity score (25 clinical, anatomical, and procedural variables) and by date of the procedure (within 3 months). The first coprimary outcome was ≥ moderate occurrence of paravalvular regurgitation or in-hospital mortality, or both. The second coprimary outcome was 2-year all-cause mortality.
Results:
In propensity–matched analyses, the incidence of the first coprimary outcome was higher with SE-THV (19.8%) compared with BE-THV (11.9%; relative risk, 1.68 [95% CI, 1.46–1.91];
P
<0.0001). Each component of the outcome was also higher in patients receiving SE-THV: ≥ moderate paravalvular regurgitation (15.5% versus 8.3%; relative risk, 1.90 [95% CI, 1.63–2.22];
P
<0.0001) and in hospital mortality (5.6% versus 4.2%; relative risk, 1.34 [95% CI, 1.07–1.66];
P
=0.01). During follow up, all cause mortality occurred in 899 patients treated with SE-THV (2-year mortality, 29.8%) and in 801 patients treated with BE-THV (2-year mortality, 26.6%; hazard ratio, 1.17 [95% CI, 1.06–1.29];
P
=0.003). Similar results were found using inverse probability of treatment weighting using propensity score analysis.
Conclusion:
The present study suggests that use of SE-THV was associated with a higher risk of paravalvular regurgitation and higher in-hospital and 2-year mortality compared with use of BE-THV. These data strongly support the need for a randomized trial sufficiently powered to compare the latest generation of SE-THV and BE-THV.
Clinical Trial Registration:
https://www.clinicaltrials.gov
. Unique identifier: NCT01777828.
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Affiliation(s)
- Eric Van Belle
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Flavien Vincent
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Julien Labreuche
- Department of Biostatistics, EA 2694-Santé Publique: épidémiologie et Qualité des Soins (J.L., A.D.)
| | - Vincent Auffret
- CHU de Lille, Université de Lille, France. CHU Pontchaillou, Service de Cardiologie et Maladies Vasculaires, CIC-IT 804, Université de Rennes 1, Laboratoire de Traitement du Signal et de l’Image, Inserm U1099, Rennes, France (V.A., J.P.-V., H.L.B.)
| | - Nicolas Debry
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Thierry Lefèvre
- Institut Cardiovasculaire Paris-Sud, Hôpital Privé Jacques-Cartier, Massy, France (T. Lefèvre)
| | - Helene Eltchaninoff
- CHU Rouen–Charles-Nicolle, Service de Cardiologie, Inserm U644, Rouen, France (H.E.)
| | - Thibaut Manigold
- CHU Guillaume et René Laennec, Institut du Thorax, Service de Cardiologie, Nantes, France (T. Manigold)
| | - Martine Gilard
- CHU La Cavale Blanche, Département de Cardiologie, Optimisation des Régulations Physiologiques, UFR Sciences et Techniques, Brest, France (M.G.)
| | - Jean-Phillipe Verhoye
- CHU de Lille, Université de Lille, France. CHU Pontchaillou, Service de Cardiologie et Maladies Vasculaires, CIC-IT 804, Université de Rennes 1, Laboratoire de Traitement du Signal et de l’Image, Inserm U1099, Rennes, France (V.A., J.P.-V., H.L.B.)
| | - Dominique Himbert
- AP–HP, Hôpital Bichat, Département de Cardiologie, Université Paris-Diderot, France (D.H., B.I.)
| | - Rene Koning
- Clinique Saint-Hilaire, Service de Cardiologie, Rouen, France (R.K.)
| | - Jean-Phillipe Collet
- AP–HP, CHU La Pitié-Salpêtrière, Service de Cardiologie, Paris, France (J.-P.C., P.L.)
| | - Pascal Leprince
- AP–HP, CHU La Pitié-Salpêtrière, Service de Cardiologie, Paris, France (J.-P.C., P.L.)
| | - Emmanuel Teiger
- Hôpital Henri-Mondor Assistance Publique Hôpitaux de Paris, Département de Cardiologie, Créteil, France (E.T.)
| | - Alain Duhamel
- Department of Biostatistics, EA 2694-Santé Publique: épidémiologie et Qualité des Soins (J.L., A.D.)
| | - Alessandro Cosenza
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Guillaume Schurtz
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Sina Porouchani
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Benoit Lattuca
- CHU Nîmes, Cardiologie, Université Montpellier, Nimes, France (B.L., G.C.)
| | - Emmanuel Robin
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Augustin Coisne
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Thomas Modine
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Marjorie Richardson
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
| | - Patrick Joly
- Hopital Saint-Joseph, Fédération de Cardiologie, Marseille, France (P.J.)
| | - Gilles Rioufol
- CHU Louis Pradel, Division de Cardiologie, Centre d’Investigation Clinique de Lyon (CIC), Bron, France (G.R.)
| | - Said Ghostine
- Centre Marie Lannelongue, Département de Cardiologie, Le Plessis Robinson, France (S.G.)
| | - Olivier Bar
- Clinique Saint Gatien, Service de Cardiologie, Tours, France (O.B.)
| | - Nicolas Amabile
- Institut Mutualiste Montsouris, Département de Cardiologie, Paris, France (N.A.)
| | - Didier Champagnac
- Clinique du Tonkin, Service de Cardiologie, Villeurbanne, France (D.C.)
| | - Patrick Ohlmann
- CHU de Strasbourg, Nouvel Hôpital Civil, Département de Cardiologie, Université de Strasbourg, France (P.O.)
| | - Nicolas Meneveau
- CHU Besançon, Cardiologie, Hopital Jean Minjoz, Besançon, France (N.M.)
| | - Thibaut Lhermusier
- CHU de Toulouse, Département de Cardiologie, Inserm U1048, Université de Toulouse 3, France (T. Lhermusier)
| | - Lionel Leroux
- Hôpital Cardiologique du Haut-Lévêque, Département de Cardiologie Interventionnelle, Université de Bordeaux, Pessac, France (L.L.)
| | - Florence Leclercq
- CHU Arnaud de Villeneuve, Service de Cardiologie, Montpellier, France (F.L., T.G.)
| | - Thomas Gandet
- CHU Arnaud de Villeneuve, Service de Cardiologie, Montpellier, France (F.L., T.G.)
| | - Frédéric Pinaud
- CHU d’Angers, Service de Chirurgie Cardiaque, CNRS UMR 6214, INSERM 1083, Université d’Angers, France (F.P.)
| | - Thomas Cuisset
- CHU La Timone Assistance Publique Hôpitaux de Marseille, Département de Cardiologie, Inserm UMR1062, INRA UMR 1260, Université d’Aix-Marseille, France (T.C.)
| | - Pascal Motreff
- CHU Gabriel Montpied, Département de Cardiologie, ISIT, CaVITI, CNRS (UMR-6284), Université d’Auvergne, Clermont-Ferrand, France (P.M., G. Souteyrand)
| | - Géraud Souteyrand
- CHU Gabriel Montpied, Département de Cardiologie, ISIT, CaVITI, CNRS (UMR-6284), Université d’Auvergne, Clermont-Ferrand, France (P.M., G. Souteyrand)
| | - Bernard Iung
- AP–HP, Hôpital Bichat, Département de Cardiologie, Université Paris-Diderot, France (D.H., B.I.)
| | - Thierry Folliguet
- CHU de Nancy, Service de Chirurgie Cardiovasculaire, Vandoeuvre-lès-Nancy, France (T.F.)
| | | | - Guillaume Cayla
- CHU Nîmes, Cardiologie, Université Montpellier, Nimes, France (B.L., G.C.)
| | - Gilles Bayet
- Hôpital Privé Clairval, Service de Cardiologie, Marseille, France (G.B.)
| | - Olivier Darremont
- Clinique Saint Augustin, Service de Cardiologie, Bordeaux, France (O.D.)
| | | | - Hervé Le Breton
- CHU de Lille, Université de Lille, France. CHU Pontchaillou, Service de Cardiologie et Maladies Vasculaires, CIC-IT 804, Université de Rennes 1, Laboratoire de Traitement du Signal et de l’Image, Inserm U1099, Rennes, France (V.A., J.P.-V., H.L.B.)
| | - Cédric Delhaye
- Département de Cardiologie, Institut Coeur Poumon, Inserm U1011, Institut Pasteur de Lille, EGID (E.V.B., F.V., N.D., A. Cosenza, G. Schurtz, S.P., E.R., A. Coisne, T. Modine, M.R., C.D.)
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Beurtheret S, Karam N, Resseguier N, Houel R, Modine T, Folliguet T, Chamandi C, Com O, Gelisse R, Bille J, Joly P, Barra N, Tavildari A, Commeau P, Armero S, Pankert M, Pansieri M, Siame S, Koning R, Laskar M, Le Dolley Y, Maudiere A, Villette B, Khanoyan P, Seitz J, Blanchard D, Spaulding C, Lefevre T, Van Belle E, Gilard M, Eltchaninoff H, Iung B, Verhoye JP, Abi-Akar R, Achouh P, Cuisset T, Leprince P, Marijon E, Le Breton H, Lafont A. Femoral Versus Nonfemoral Peripheral Access for Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2019; 74:2728-2739. [DOI: 10.1016/j.jacc.2019.09.054] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/12/2019] [Accepted: 09/15/2019] [Indexed: 11/15/2022]
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Belle L, Enríquez MH, Madiot H, Souteyrand G, Piot C, Boueri Z, Gerbaud E, Boiffard E, Lattuca B, Commeau P, Gervasoni R, Range G, Delarche N, Zemour G, Levesque S, Boudou N. TCT-251 SOS PK Papyrus, an Observational Study of Patients With Covered PK Papyrus Stent. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Steiner S, Sauguet A, Langhoff R, Kahlberg A, Thieme M, Zeller T, Garot P, Commeau P, Cremonesi A, Marone EM, Scheinert D. First-in-Human Experience With Sirolimus-Eluting Self-Expanding Stent for Femoropopliteal Lesions. J Am Coll Cardiol 2019; 74:2216-2218. [DOI: 10.1016/j.jacc.2019.08.1019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 11/26/2022]
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Goueffic Y, Sauguet A, Desgranges P, Feugier P, Rosset E, Ducasse E, Cardon A, Salomon du Mont L, Pernes JM, Commeau P, Lermusiaux P, Leclere B, Guyomarch B, Hoffmann C, Maurel B. TCT-62 A Polymer-Free Paclitaxel-Eluting Stent (Zilver PTX) Versus a Bare-Metal Stent (Misago) for De Novo Femoropopliteal Lesions (BATTLE): A Randomized Trial. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ciobotaru V, Combes N, Iriart X, Marijon E, Hascoet S, Nguyen A, Ternacle J, Defaye P, Jacon P, Lepillier A, Thambo JB, Teiger E, Cheneau E, Commeau P, Elbaz M. P2436Preliminary data from “LAA-Print French registry”: a large national multi-centric prospective registry evaluating a new preoperative approach based on 3Dprinted simulation in LAAC procedures. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/15/2022] Open
Abstract
Abstract
Left atrial appendage closure (LAAC) is an alternative to OAC in patients with contra indication to OAC and AF. But LAAC may be at risk, especially in frail patients.
There are no imaging criteria to asses individual procedural risk.
Furthermore, procedural factors (double curve catheter alignment) are hard to predict
3D-printing simulation has capability to integrate all anatomical and procedural parameters and has demonstrated improvements in LAAC device sizing in a pilot study
Aim
To demonstrate efficiency of 3D-printing simulation to predict LAAC procedural risk (failure, long procedure time, pericardial effusion or others serious adverse events (SAES) or inappropriate implantations)
Methods
Open study: Prospective and Consecutive.
Recruiting 150 patients in 16 centres (of 300 patients expected).
Start: Jan 18th, 2018.
Study Completion: Nov 1st, 2019.
ClinicalTrials ID: NCT03330210.
1. Cardiac CT prior to LAAC.
2. Industrial manufacture, laser sintering, of 3D-printed models including the whole LA cavity including interatrial thin septum and vena cava (using material TPU with adequat elasticity: shore 50).
3. LAAC Simulation based on 3Dprinted models using specific sheaths and prosthesis.
Prior to LAAC procedure each operator asses a risk score for procedural failure (low/moderate/high) based on real 3D printed LAAC simulation taking into account: trans-septal puncture site/sheath alignment with LAA ostium/device deployment and stability.
4. LAAC procedure TEE guided.
5. CT or TEE control M3 or M6.
Procedural outcomes according to risk Sc Low risk (N=63) Moderate risk (N=50) High risk (N=37) p<0.05 vs High risk Failure 1 (1.6%) 1 (2%) 10 (27%) * Recaptures ≥2 4 (6%) 5 (10%) 12 (32%) * Prosthesis ≥2 2 (3%) 1 (2%) 9 (24%) * Inappropriate implantation 0 6 (12%) 7 (19%) * SAES 2 (3%) 6 (12%) 12 (32%) * Pericardial effusion (pericardiocentesis) 2 (3%) 1 (2%) 4 (11%) * Haemorrhage (≥2 points) 0 2 (4%) 5 (13%) * Coronary syndrome 0 0 4 (11%) * Time (intra left atrium) min 21±10 29±16 50±25 * *p<0.05 vs High risk group according to prospective risk score.
LAAC simulation on 3D printed model
Conclusion
3D printing simulation accurately stratifies the risk of procedure according to LA anatomy. 3D printing may guide the procedure through verification of the transseptal puncture site and/or using a specific catheter shape and device. In case of high risk, a careful assessment of risk/benefice ratio is mandatory
Acknowledgement/Funding
AG2RFondation and Boston Scientific
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Affiliation(s)
- V Ciobotaru
- Hopital Prive Les Franciscaines, Nimes, France
| | - N Combes
- Clinic Pasteur, Toulouse, France
| | - X Iriart
- Hospital Haut Leveque, Cardiology, Bordeaux-Pessac, France
| | - E Marijon
- Hôpital Européen Georges Pompidou- Université Paris Descartes, Cardiology, Paris, France
| | - S Hascoet
- Surgical Centre Marie Lannelongue, Cardiology, Le Plessis Robinson, France
| | - A Nguyen
- University Hospital Henri Mondor, Cardiology, Creteil, France
| | - J Ternacle
- University Hospital Henri Mondor, Cardiology, Creteil, France
| | - P Defaye
- University Hospital of Grenoble, Cardiology, Grenoble, France
| | - P Jacon
- University Hospital of Grenoble, Cardiology, Grenoble, France
| | - A Lepillier
- Centre Cardiologique du Nord, Cardiology, Saint Denis, France
| | - J B Thambo
- Hospital Haut Leveque, Cardiology, Bordeaux-Pessac, France
| | - E Teiger
- University Hospital Henri Mondor, Cardiology, Creteil, France
| | - E Cheneau
- Hopital Prive Clairval, Cardiology, Marseille, France
| | - P Commeau
- Polyclinique Les Fleurs, Cardiology, Ollioules, France
| | - M Elbaz
- Toulouse Rangueil University Hospital (CHU), Cardiology, Toulouse, France
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Beurtheret S, Karam N, Resseguier N, Com O, Gelisse R, Barra N, Tavildari A, Commeau P, Armero S, Pankert M, Siame S, Laskar M, Khanoyan P, Seitz J, Gilard M, Verhoye J, Eltchaninoff H, Leprince P, Le Breton H, Houel R. Outcomes of transcatheter aortic valve replacement according to femoral or non-femoral peripheral vascular access site: A propensity-matched comparison from the French TAVI Registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.155] [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: 11/28/2022]
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Benamer H, Auffret V, Cayla G, Chevalier B, Dupouy P, Eltchaninoff H, Gilard M, Guerin P, Iung B, Koning R, Monsegu J, Lantelme P, Le Breton H, Lefèvre T, Verhoye JP, Commeau P, Motreff P. Position paper of French Interventional Group (GACI) for TAVI in France in 2018. Ann Cardiol Angeiol (Paris) 2018; 67:455-465. [PMID: 30376969 DOI: 10.1016/j.ancard.2018.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Aortic stenosis is a frequent disease in the elderly. Its prevalence is 0.4% with a sharp increase after the age of 65, and its outcome is very poor when the patient becomes symptomatic. The interventional procedure known as TAVI (trans-catheter aortic valve implantation), which was developed in France and carried out for the first time in Rouen by Prof. Alain Cribier and his team in 2002, has proven to be a valid alternative to surgical aortic valve replacement. At first, this technique was shown to be efficient in patients with contra-indications to surgical treatment or deemed to be at high surgical risk. Given the very promising outcomes achieved as a result of close heart team collaboration, appropriate patient selection, simplified procedures and reduced complication rates, transfemoral (TF) TAVI is now preferred in symptomatic intermediate risk patients>75 years old according to the latest ESC guidelines. In 2017, in France, TAVI is currently performed in 50 centers with on-site cardiac surgery. The 2016 TAVI outcomes recorded in the French national TAVI registry (France TAVI) are very encouraging and show that for 7133 patients treated (age 83.4±7 years, logistic Euroscore 14%), 87% of whom via the TF approach, cross-over to surgery was very low (0.5%) with a 3.0% in-hospital mortality rate. The substantial increase in TAVI indications and the improvement of its outcomes may in the near future call for a reconsideration of the number of high volume centers authorized to carry out this technique.
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Affiliation(s)
- H Benamer
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France.
| | - V Auffret
- Inserm U1099, service de cardiologie et maladies vasculaires, CIC-IT 804, laboratoire de traitement du signal et de l'image, université de Rennes 1, CHU Pontchaillou, 35000 Rennes, France
| | - G Cayla
- Service de cardiologie, université de Montpellier, CHU Nîmes, 34000 Nîmes, France
| | - B Chevalier
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France
| | - P Dupouy
- Hôpital privé d'Anthony, 25, rue De La Providence, 92160 Antony, France
| | - H Eltchaninoff
- Inserm U1096, department of cardiology, FHU REMOD-VHF, Rouen university hospital, Normandie Univ, Unirouen, 76000 Rouen, France
| | - M Gilard
- CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France
| | - P Guerin
- CHU hôpital G R Laennec, boulevard Jacques Monod, 44800 St Herblain, France
| | - B Iung
- Hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France
| | - R Koning
- Clinique Saint Hilaire, 2, place Saint Hilaire, 76000 Rouen, France
| | - J Monsegu
- Groupe hospitalier mutualiste de Grenoble, 8, rue du Dr Calmette, 38000 Grenoble cedex 1, France
| | - P Lantelme
- Hôpital Croix Rousse, 103, Gr De La Croix Rousse à Lyon, 34000 Lyon, France
| | - H Le Breton
- Inserm U1099, service de cardiologie et maladies vasculaires, CIC-IT 804, laboratoire de traitement du signal et de l'image, université de Rennes 1, CHU Pontchaillou, 35000 Rennes, France
| | - T Lefèvre
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France
| | - J-P Verhoye
- Service de chirurgie cardiaque, université de Rennes, CHU Pontchaillou, 35000 Rennes, France
| | - P Commeau
- Polyclinique Les Fleurs Quartier Quiez, 83190 Ollioules, France
| | - P Motreff
- Department of cardiology, Gabriel Montpied hospital, Clermont-Ferrand university hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France
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Gouëffic Y, Sauguet A, Desgranges P, Feugier P, Rosset E, Ducasse E, Cardon A, Rinckenbach S, Pernes JM, Commeau P, Guyomarch B, Bressolette L. Prospective Randomized Multicentric Study Comparing Active Stents and Bare Stents for the Treatment of Symptomatic Femoro-popliteal Lesions of Intermediate Length: Intermediate Six Month Results of BATTLE. Ann Vasc Surg 2018. [DOI: 10.1016/j.avsg.2018.08.014] [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: 11/28/2022]
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Varenne O, Stephane Cook, Sideris G, Kedev S, Carrie D, Hovasse T, Garot P, Helft G, Brugaletta S, Bermudez EP, Mauri J, Commeau P, Teiger E, Bogaerts K, Sabate M, Morice MC, Sinnaeve P. TCT-868 Drug-eluting stents and short duration of DAPT in elderly patients with coronary artery disease. Results of the SENIOR randomized clinical trial at 2 years. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.2119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Helleu B, Auffret V, Bedossa M, Gilard M, Letocart V, Chassaing S, Angoulvant D, Commeau P, Range G, Prunier F, Sabatier R, Filippi E, Delaunay R, Boulmier D, Le Breton H, Leurent G. Current indications for the intra-aortic balloon pump: The CP-GARO registry. Arch Cardiovasc Dis 2018; 111:739-748. [PMID: 29908713 DOI: 10.1016/j.acvd.2018.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/22/2017] [Revised: 02/08/2018] [Accepted: 03/21/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intra-aortic balloon pumps (IABPs) have been used routinely since the 1970s. Recently, large randomized trials failed to show that IABP therapy has meaningful benefit, and international recommendations downgraded its place, particularly in cardiogenic shock. AIMS The aim of this registry was to describe the contemporary use of IABP therapy, in light of these new data. METHODS This prospective multicentre registry included 172 patients implanted with an IABP in 19 French cardiac centres in 2015. Baseline characteristics, aetiologies leading to IABP use, and IABP-related and disease-related complications were assessed. In-hospital and 1-year mortality rates were studied. RESULTS A total of 172 patients were included (mean age 65.5±12.0 years; 118 men [68.6%]). The reasons for IABP implantation were mainly haemodynamic (n=107; 62.2%), followed by bridge to revascularization (n=34; 19.8%) and four other "rare" aetiologies (n=29 patients; 16.8%). In-hospital and 1-year mortality rates were 40.7% and 45.8%, respectively. Fourteen patients (8.1%) experienced ischaemic or haemorrhagic complications, which were directly related to the IABP in seven patients (4.1%). CONCLUSIONS Despite current international guidelines regarding the place of IABPs in ischaemic cardiogenic shock without mechanical complications, this aetiology remains the leading cause for its utilization in the contemporary era.
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Affiliation(s)
- Benoit Helleu
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Vincent Auffret
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Marc Bedossa
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France
| | - Martine Gilard
- EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France
| | - Vincent Letocart
- L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Stephan Chassaing
- Service de cardiologie interventionnelle et d'imagerie cardiaque, clinique Saint-Gatien, 37000 Tours, France
| | - Denis Angoulvant
- EA 4245 and Loire Valley Cardiovascular Collaboration, Service de Cardiologie, CHRU de Tours et Université de Tours, 37000 Tours, France
| | - Philippe Commeau
- Service de cardiologie, polyclinique les Fleurs, 83190 Ollioules, France
| | - Grégoire Range
- Service de cardiologie, Les hôpitaux de Chartres, 28000 Chartres, France
| | - Fabrice Prunier
- Institut Mitovasc, UMR CNRS 6015 - INSERM U1083, Service de cardiologie, CHU d'Angers, Université d'Angers, 49100 Angers, France
| | - Remi Sabatier
- Cardiology Department, University Hospital of Caen, 14033 Caen, France
| | - Emmanuelle Filippi
- Service de cardiologie, centre hospitalier de Vannes, 56000 Vannes, France
| | - Régis Delaunay
- Service de cardiologie, centre hospitalier de Saint-Brieuc, 22000 Saint-Brieuc, France
| | - Dominique Boulmier
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Hervé Le Breton
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France
| | - Guillaume Leurent
- Université Rennes, Department of cardiology, CHU Rennes, Inserm, LTSI-UMR 1099, 35000 Rennes, France; EA4324, département de cardiologie, optimisation des régulations physiologiques (ORPhy), UFR sciences et techniques, CHU de Brest, 29200 Brest, France; L'institut du Thorax, CHU Nantes, service de cardiologie, 44093 Nantes, France.
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Teiger E, Thambo JB, Defaye P, Hermida JS, Abbey S, Klug D, Juliard JM, Pasquie JL, Rioufol G, Lepillier A, Elbaz M, Horvilleur J, Brenot P, Pierre B, Le Corvoisier P, Amabile N, Andronache M, Anselme F, Armero S, Aubry P, Audureau E, Babuty D, Bakouboula B, Bars C, Baruteau AE, Bille J, Bonnet JL, Brigadeau F, Brochet E, Bun SS, Cailla G, Cesari O, Champagnac D, Chevalier P, Combes N, Comet B, Commeau P, Dearo JC, Dompnier A, Farah B, Garot P, Gras D, Giraudeau C, Granier M, Guerin P, Iriart X, Jalal Z, Jesel-Morel L, Jeu A, Kamtchueng P, Lellouche N, Meneveau N, Nighoghossian N, Otmani A, Pelliere R, Pillière R, Pons M, Popovic B, Pujadas P, Rossi R, Roux A, Saludas Y, Spaulding C, Statiev V, Ternacle J, Traulle S, Winum PF. Percutaneous Left Atrial Appendage Closure Is a Reasonable Option for Patients With Atrial Fibrillation at High Risk for Cerebrovascular Events. Circ Cardiovasc Interv 2018. [DOI: 10.1161/circinterventions.117.005841] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 12/20/2022]
Abstract
Background—
Percutaneous left atrial appendage (LAA) closure is an emerging option for patients with atrial fibrillation at high risk for cerebrovascular events. The multicenter FLAAC registry (French Nationwide Observational LAA Closure Registry) was established to assess LAA closure outcomes in everyday practice.
Methods and Results—
Four hundred thirty-six patients referred from April 2013 to September 2015 to 33 French interventional cardiology centers for percutaneous LAA closure were included prospectively in the FLAAC registry. Mean age was 75.4±0.4 years. The stroke risk was high (mean CHA
2
DS
2
–VASc score, 4.5±0.1) and most patients had experienced clinically significant bleeding (HAS-BLED score, 3.1±0.05). The device used was Amplatzer LAA occluder in 58% and the Watchman device in 42% of the patients. The procedural success rate was 98.4%. Median postprocedure follow-up was 12.0 (11.8–12.0) months and a single patient was lost to follow-up. During the periprocedural and subsequent follow-up period, procedure-related severe adverse events occurred in 21 (4.9%) and 10 (2.3%) patients, respectively. One-year cumulative incidences of ischemic stroke and cerebral hemorrhage were 2.9% (1.6–5.0) and 1.5% (0.7–3.2), respectively. Overall, 1-year mortality was 9.3% (6.9–12.5) with 7 of the 39 deaths related or possibly related to the device or procedure.
Conclusions—
This nationwide prospective registry shows that, in the French population, LAA closure is mainly used in patients with high comorbidity rates and a poor prognosis. LAA closure in such patients seems reasonable to decrease the stroke rate. The overall health status of these patients should be taken into account during the preprocedural evaluation process.
Clinical Trial Registration—
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02252861.
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Affiliation(s)
- Emmanuel Teiger
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Benoit Thambo
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Pascal Defaye
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Sylvain Hermida
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Sélim Abbey
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Didier Klug
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Michel Juliard
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jean-Luc Pasquie
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Gilles Rioufol
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Antoine Lepillier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Meyer Elbaz
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Jerome Horvilleur
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Brenot
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Bertrand Pierre
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
| | - Philippe Le Corvoisier
- From the Interventional Cardiology Unit (E.T.) and Inserm, CIC 1430, U955 team 3 (P.L.C.), Henri Mondor Hospital, Creteil, France; Department of Pediatric and Congenital Cardiology, University Hospital of Bordeaux, Pessac, France (J.-B.T.); Department of Rhythmology, University Hospital of Grenoble-Alpes, France (P.D.); Department of Cardiac Arrhythmia, Picardie University Hospital, Amiens, France (J.-S.H.); Interventional Cardiology Unit, Hopital Prive du Confluent, Nantes, France (S.A.)
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Van Belle E, Gil R, Klauss V, Balghith M, Meuwissen M, Clerc J, Witzenbichler B, Cercek M, Vlachojannis M, Lang I, Commeau P, Vincent F, Testa L, Wasek W, Debry N, Kische S, Gabrielli G, Sardella G. Impact of Routine Invasive Physiology at Time of Angiography in Patients With Multivessel Coronary Artery Disease on Reclassification of Revascularization Strategy. JACC Cardiovasc Interv 2018; 11:354-365. [DOI: 10.1016/j.jcin.2017.11.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/15/2017] [Accepted: 11/21/2017] [Indexed: 01/10/2023]
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Varenne O, Cook S, Sideris G, Kedev S, Cuisset T, Carrié D, Hovasse T, Garot P, El Mahmoud R, Spaulding C, Helft G, Diaz Fernandez JF, Brugaletta S, Pinar-Bermudez E, Mauri Ferre J, Commeau P, Teiger E, Bogaerts K, Sabate M, Morice MC, Sinnaeve PR. Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial. Lancet 2018; 391:41-50. [PMID: 29102362 DOI: 10.1016/s0140-6736(17)32713-7] [Citation(s) in RCA: 261] [Impact Index Per Article: 43.5] [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: 09/27/2017] [Revised: 10/11/2017] [Accepted: 10/12/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI). Exclusion criteria were indication for myocardial revascularisation by coronary artery bypass grafting; inability to tolerate, obtain, or comply with DAPT; requirement for additional surgery; non-cardiac comorbidities with a life expectancy of less than 1 year; previous haemorrhagic stroke; allergy to aspirin or P2Y12 inhibitors; contraindication to P2Y12 inhibitors; and silent ischaemia of less than 10% of the left myocardium with a fractional flow reserve of 0·80 or higher. After the intended duration of DAPT was recorded (1 month for patients with stable presentation and 6 months for those with unstable presentation), patients were randomly allocated (1:1) by a central computer system (blocking used with randomly selected block sizes [two, four, eight, or 16]; stratified by site and antiplatelet agent) to either a DES or similar BMS in a single-blind fashion (ie, patients were masked), but those assessing outcomes were masked. The primary outcome was to compare major adverse cardiac and cerebrovascular events (ie, a composite of all-cause mortality, myocardial infarction, stroke, or ischaemia-driven target lesion revascularisation) between groups at 1 year in the intention-to-treat population, assessed at 30 days, 180 days, and 1 year. This trial is registered with ClinicalTrials.gov, number NCT02099617. FINDINGS Between May 21, 2014, and April 16, 2016, we randomly assigned 1200 patients (596 [50%] to the DES group and 604 [50%] to the BMS group). The primary endpoint occurred in 68 (12%) patients in the DES group and 98 (16%) in the BMS group (relative risk [RR] 0·71 [95% CI 0·52-0·94]; p=0·02). Bleeding complications (26 [5%] in the DES group vs 29 [5%] in the BMS group; RR 0·90 [0·51-1·54]; p=0·68) and stent thrombosis (three [1%] vs eight [1%]; RR 0·38 [0·00-1·48]; p=0·13) at 1 year were infrequent in both groups. INTERPRETATION Among elderly patients who have PCI, a DES and a short duration of DAPT are better than BMS and a similar duration of DAPT with respect to the occurrence of all-cause mortality, myocardial infarction, stroke, and ischaemia-driven target lesion revascularisation. A strategy of combination of a DES to reduce the risk of subsequent repeat revascularisations with a short BMS-like DAPT regimen to reduce the risk of bleeding event is an attractive option for elderly patients who have PCI. FUNDING Boston Scientific.
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Affiliation(s)
- Olivier Varenne
- Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France; Cardiology Department, Université Paris Descartes, Sorbonne Paris-Cité, Paris, France.
| | - Stéphane Cook
- Cardiology Department, University and Hospital Fribourg, Fribourg, Switzerland
| | - Georgios Sideris
- Service de Cardiologie-Institut national de la santé et de la recherche médicale U942, Hôpital Lariboisiere, Assistance Publique - Hôpitaux de Paris, Université Paris Diderot, Paris, France
| | - Sasko Kedev
- Cardiology Department, University St Cyril and Methodius, Skopje, Macedonia
| | - Thomas Cuisset
- Département de Cardiologie, Centre hospitalier universitaire Timone, Marseille, France
| | - Didier Carrié
- Service de Cardiologie, Centre hospitalier universitaire Toulouse Rangueil, Université Paul Sabatier, Toulouse, France
| | - Thomas Hovasse
- Institut Cardiovasculaire Paris-Sud, Ramsay Générale de Santé, Massy and Quincy, France
| | - Philippe Garot
- Institut Cardiovasculaire Paris-Sud, Ramsay Générale de Santé, Massy and Quincy, France
| | - Rami El Mahmoud
- Hôpital Ambroise Paré Assistance Publique-Hôpitaux de Paris, Université Versailles-Saint Quentin en Yvelines, Versailles, France
| | - Christian Spaulding
- Service de Cardiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris Descartes University and Sudden Death Expert Center, Institut national de la santé et de la recherche médicale U990, Paris, France
| | - Gérard Helft
- Institut de Cardiologie, Hôpital Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie et Institut hospitalo-universitaire, Institute of Cardiometabolism and Nutrition, Hôpital Pitié-Salpétrière, Paris, France
| | | | - Salvatore Brugaletta
- Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | | | - Philippe Commeau
- Département de Cardiologie Interventionnelle, Polyclinique Les Fleurs, Ollioules, France
| | - Emmanuel Teiger
- Service de Cardiologie, Hôpital Henri Mondor Assistance Publique-Hôpitaux de Paris, Université Paris Est Créteil, Créteil, France
| | - Kris Bogaerts
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), Department of Public Health and Primary Care, Katholieke Universiteit Leuven, Leuven, Belgium; Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat), University Hasselt, Hasselt, Belgium
| | - Manel Sabate
- Interventional Cardiology Unit, Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | - Peter R Sinnaeve
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
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Motreff P, Lattuca B, Benamer H, Guerin P, Commeau P, Cayla G, Dupouy P, Monsegu J, Derimay F, Blanchard D, Puymirat E, Auffret V, Le Breton H, Koning R. France: coronary and structural heart interventions from 2010 to 2015. EUROINTERVENTION 2017; 13:Z25-Z31. [DOI: 10.4244/eij-d-16-00824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Williams RET, Angel CY, Bourkaib R, Brenot P, Commeau P, Fisher RK, Jackson R, Kay CH, Le Dref O, Riou JY, Rose J, Macdonald S. Multicenter Safety and Efficacy Analysis of Assisted Closure after Antegrade Arterial Punctures Using the StarClose Device. J Endovasc Ther 2016; 14:498-505. [PMID: 17696624 DOI: 10.1177/152660280701400410] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To evaluate the safety and efficacy of the StarClose device for closure of antegrade punctures following infrainguinal endovascular interventions. Methods: A retrospective review was conducted of 221 consecutive patients treated with the StarClose device in a 12-month period at 5 centers (4 French and 1 British). Of these, 107 patients (69 men; median age 75 years, range 44–93) were from the UK cohort (111 closures), and 94 patients (75 men; median age 67 years, range 32–95) were from the French cohort (111 closures). Technical success, complication rates, demographic data, medical history, and procedural details were gathered for all patients. Residual bleeding and the requirement for additional manual compression were recorded when the device failed. Clinical evaluation was performed at discharge; color-coded duplex ultrasonography was done in a subset of French patients. Results: The overall technical success rate was 94.6% (210/222; 95% CI 3.1%–9.2%). The results were similar in the 2 cohorts: 95.5% (106/111; 95% CI 1.9%–10.1%) in the UK and 93.7% (104/111; 95% CI 3.1%–12.4%) in France. The 12 failures (5 UK and 7 France) were due to several mechanisms: device failure (n=5), obesity (n=1), groin scarring (n=2), and unexplained (n=4). In 2 failed cases, open surgical closure of the arteriotomy was performed because pressure hemostasis failed. Two pseudoaneurysms were observed: one after immediate failure was successfully treated by prolonged pressure; the other, after apparent success of the device, required surgical therapy. The incidence of serious vascular complication was 1.8% (4/222; 95% CI 0.7%–4.5%); 2 patients from each cohort. Conclusion: The StarClose device safely and effectively closes antegrade punctures after infrainguinal endovascular intervention, even in patients who would be considered to be at high risk for puncture-site bleeding. However, a randomized trial would be required to support any definitive recommendations.
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Naber CK, Pyxaras SA, Nef H, IJsselmuiden AJ, Briguori C, Schlundt C, Wykrzykowska J, Eberli FR, Möllmann H, Galatius S, Rieber J, Commeau P, van Geuns RJ, Bouchez D, Mudra H. Final results of a self-apposing paclitaxel-eluting stent fOr the PErcutaNeous treatment of de novo lesions in native bifurcated coronary arteries study. EUROINTERVENTION 2016; 12:356-8. [DOI: 10.4244/eijy15m06_02] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yayehd K, N'da NW, Belle L, Bataille V, Hanssen M, Leddet P, Aupetit JF, Commeau P, Filippi E, Georges JL, Albert F, Rangé G, Meimoun P, Marcaggi X, Baleynaud S, Nallet O, Dibie A, Barnay C, Jouve B, Legrand M, Cattan S, Mulak G, Simon T, Danchin N, Dujardin JJ. Management of Takotsubo cardiomyopathy in non-academic hospitals in France: The Observational French SyndromEs of TakoTsubo (OFSETT) study. Arch Cardiovasc Dis 2015; 109:4-12. [PMID: 26507532 DOI: 10.1016/j.acvd.2015.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/07/2015] [Accepted: 08/10/2015] [Indexed: 01/16/2023]
Abstract
BACKGROUND Takotsubo cardiomyopathy (TTC) is a rare condition characterized by a sudden temporary weakening of the heart. TTC can mimic acute myocardial infarction and is associated with a minimal release of myocardial biomarkers in the absence of obstructive coronary artery disease. AIMS To provide an extensive description of patients admitted to hospital for TTC throughout France and to study the management and outcomes of these patients. METHODS In 14 non-academic hospitals, we collected clinical, electrocardiographic, biological, psychological and therapeutic data in patients with a diagnosis of TTC according to the Mayo Clinic criteria. RESULTS Of 117 patients, 91.5% were women, mean ± SD age was 71.4 ± 12.1 years and the prevalence of risk factors was high (hypertension: 57.9%, dyslipidaemia: 33.0%, diabetes: 11.5%, obesity: 11.5%). The most common initial symptoms were chest pain (80.5%) and dyspnoea (24.1%). A triggering psychological event was detected in 64.3% of patients. ST-segment elevation was found in 41.7% of patients and T-wave inversion in 71.6%. Anterior leads were most frequently associated with ST-segment elevation, whereas T-wave inversion was more commonly associated with lateral leads, and Q-waves with septal leads. The ratio of peak B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) level to peak troponin level was 1.01. No deaths occurred during the hospital phase. After 1 year of follow-up, 3 of 109 (2.8%) patients with available data died, including one cardiovascular death. Rehospitalizations occurred in 17.4% of patients: 2.8% due to acute heart failure and 14.7% due to non-cardiovascular causes. There was no recurrence of TTC. CONCLUSIONS This observational study of TTC included primarily women with atherosclerotic risk factors and mental stress. T-wave inversion was more common than ST-segment elevation. There were few adverse cardiovascular outcomes in these patients after 1-year follow-up.
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Affiliation(s)
- Komlavi Yayehd
- Department of Cardiology, Campus University Teaching Hospital, Lomé, Togo
| | - N'kenon W N'da
- Department of Cardiology, Campus University Teaching Hospital, Lomé, Togo
| | - Loïc Belle
- Department of Cardiology, Annecy Hospital, 74000 Annecy, France.
| | - Vincent Bataille
- Department of Cardiology and Epidemiology, Toulouse University Hospital, 31000 Toulouse, France
| | - Michel Hanssen
- Department of Cardiology, Haguenau Hospital, 67500 Haguenau, France
| | - Pierre Leddet
- Department of Cardiology, Haguenau Hospital, 67500 Haguenau, France
| | | | - Philippe Commeau
- Department of Cardiology, polyclinique Les Fleurs, 83190 Ollioules, France
| | - Emmanuelle Filippi
- Department of Cardiology, Bretagne-Atlantique Hospital, 56000 Vannes, France
| | | | - Franck Albert
- Department of Cardiology, Chartres Hospital, 28000 Chartres, France
| | - Grégoire Rangé
- Department of Cardiology, Chartres Hospital, 28000 Chartres, France
| | - Patrick Meimoun
- Department of Cardiology, Compiègne Hospital, 60200 Compiègne, France
| | - Xavier Marcaggi
- Department of Cardiology, Vichy Hospital, 03200 Vichy, France
| | - Serge Baleynaud
- Department of Cardiology, Bretagne Hospital, 56100 Lorient, France
| | - Olivier Nallet
- Department of Cardiology, Le Raincy-Montfermeil Intercity Hospital, 93370 Montfermeil, France
| | - Alain Dibie
- Institut mutualiste Montsouris, 75000 Paris, France
| | - Claude Barnay
- Department of Cardiology, Pays d'Aix Hospital, 13100 Aix-en-Provence, France
| | - Bernard Jouve
- Department of Cardiology, Pays d'Aix Hospital, 13100 Aix-en-Provence, France
| | - Maud Legrand
- Department of Cardiology, Le Mans Hospital, 72000 Le Mans, France
| | - Simon Cattan
- Department of Cardiology, Le Raincy-Montfermeil Intercity Hospital, 93370 Montfermeil, France
| | | | - Tabassome Simon
- Department of Clinical Pharmacology and Clinical Research, Saint-Antoine University Hospital, 75000 Paris, France
| | - Nicolas Danchin
- Department of Cardiology, Georges-Pompidou University Hospital, 75000 Paris, France
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Aubry P, Halna du Fretay X, Dupouy P, Boiffard E, Maillard L, Commeau P, Ou P, Juliard JM. Isolated proximal anomalous connections of the coronary arteries: A prospective observational cohort study of more than 450 patients (ANOCOR study). Arch Cardiovasc Dis 2014. [DOI: 10.1016/j.acvd.2014.07.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Naber C, Nef H, Külekçi K, Briguori C, Rittger H, Wykrzykowska JJ, Eberli F, Moellmann H, Galatius S, Rieber J, Commeau P, Van Geuns RJ, Bouchez D, Mudra HG. TCT-22 The STENTYS Self-Expanding Drug-Eluting Stent in Coronary Bifurcation Lesions at 6 Months Follow-up: Results from the OPEN II Trial. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Varenne O, Majwal T, Commeau P, Al-Nooryani AA, Henry P, Sinnaeve P, Ahmed W. TCT-317 Impact of Glycemic Control on Cardiovascular Outcomes in Secondary Prevention of Diabetic Patients after a First Coronary Event. Insights from an international registry including 1,036 patients. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Armero S, Bonello L, Paganelli F, Barragan P, Roquebert PO, Commeau P. [Role of angioplasty in the treatment of renal artery stenosis]. Ann Cardiol Angeiol (Paris) 2011; 60:361-5. [PMID: 22075189 DOI: 10.1016/j.ancard.2011.09.010] [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] [Indexed: 10/16/2022]
Abstract
Atherosclerotic renal artery stenosis is frequent and is associated with a high incidence of morbidity and mortality, with a strong correlation with coronary artery disease, (Kalra et al., 2005; Cheung et al., 2002; Guo et al., 2007 [1-3]). The atherosclerotic renal artery stenosis is an independent predictive factor of death (Conlon et al., 1998 [4]). The treatment of this lesion does not have strong evidence. A lot of studies in this area suggest the angioplasty is superior in a big majority between surgery, and angioplasty with stent is superior between balloon angioplasty, but some studies fail to prove the superiority of angioplasty versus medical treatment. These studies have sadly a lot of mistakes and nowadays we don't know what is the treatment for our patients in a lot of cases. The angioplasty is indicated when there is a failure of antihypertensive medications for control of blood pressure, when it is associated with a renal insufficiency quickly progressive or when there is a lesion on each renal artery. Other studies must be organized for prove the superiority of angioplasty when there is a real stenosis, maybe with the use of fractional flow reserve.
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Affiliation(s)
- S Armero
- Hôpital universitaire Nord, chemin de Sbourrelly, Marseille, France.
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Spaulding C, Teiger E, Commeau P, Varenne O, Bramucci E, Slama M, Beatt K, Tirouvanziam A, Polonski L, Stella PR, Clugston R, Fajadet J, de Boisgelin X, Bode C, Carrié D, Erglis A, Merkely B, Hosten S, Cebrian A, Wang P, Stoll HP, Henry P. Four-year follow-up of TYPHOON (trial to assess the use of the CYPHer sirolimus-eluting coronary stent in acute myocardial infarction treated with BallOON angioplasty). JACC Cardiovasc Interv 2011; 4:14-23. [PMID: 21251624 DOI: 10.1016/j.jcin.2010.10.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 10/04/2010] [Accepted: 10/15/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to assess the long-term safety and efficacy of the CYPHER (Cordis, Johnson and Johnson, Bridgewater, New Jersey) sirolimus-eluting coronary stent (SES) in percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). BACKGROUND Concern over the safety of drug-eluting stents implanted during PCI for STEMI remains, and long-term follow-up from randomized trials are necessary. TYPHOON (Trial to assess the use of the cYPHer sirolimus-eluting stent in acute myocardial infarction treated with ballOON angioplasty) randomized 712 patients with STEMI treated by primary PCI to receive either SES (n = 355) or bare-metal stents (BMS) (n = 357). The primary end point, target vessel failure at 1 year, was significantly lower in the SES group than in the BMS group (7.3% vs. 14.3%, p = 0.004) with no increase in adverse events. METHODS A 4-year follow-up was performed. Complete data were available in 501 patients (70%), and the survival status is known in 580 patients (81%). RESULTS Freedom from target lesion revascularization (TLR) at 4 years was significantly better in the SES group (92.4% vs. 85.1%; p = 0.002); there were no significant differences in freedom from cardiac death (97.6% and 95.9%; p = 0.37) or freedom from repeat myocardial infarction (94.8% and 95.6%; p = 0.85) between the SES and BMS groups. No difference in definite/probable stent thrombosis was noted at 4 years (SES: 4.4%, BMS: 4.8%, p = 0.83). In the 580 patients with known survival status at 4 years, the all-cause death rate was 5.8% in the SES and 7.0% in the BMS group (p = 0.61). CONCLUSIONS In the 70% of patients with complete follow-up at 4 years, SES demonstrated sustained efficacy to reduce TLR with no difference in death, repeat myocardial infarction or stent thrombosis. (The Study to Assess AMI Treated With Balloon Angioplasty [TYPHOON]; NCT00232830).
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Affiliation(s)
- Christian Spaulding
- Cochin Hospital, Assistance-Publique Hôpitaux de Paris, Paris Descartes University and INSERM U 970, Paris, France.
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Commeau P. [Management of acute myocardial infarction. How improve primary angioplasty?]. Presse Med 2011; 40:606-10. [PMID: 21498034 DOI: 10.1016/j.lpm.2011.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 02/07/2011] [Indexed: 11/28/2022] Open
Abstract
Besides the reduction of the delay for the myocardium reperfusion, the revascularization must be optimized by tools and techniques of percutaneous intervention. These are pharmacological, mechanical and procedural. The appeal to antiGP2b3a can be useful in the cathlab. Its intracoronary administration seems to improve drug efficiency. Among the protection devices against the coronary clot embolism, only thrombectomy by manual aspiration gives an evidence of its efficiency. During the primary angioplasty, the drug eluting stent could to be implanted only for the patients and the lesions with high risk of TLR. In some cases, still difficult to identify, a more controlled revascularization would allow to minimize the reperfusion injury. The radial access, decreasing the rate of haemorrhagic complications, must be preferred in first intention.
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Affiliation(s)
- Philippe Commeau
- Polyclinique Les Fleurs, cardiologie et radiologie vasculaire interventionnelle, 83190 Ollioules, France.
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49
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Biondi-Zoccai GGL, Sangiorgi G, Lotrionte M, Feiring A, Commeau P, Fusaro M, Agostoni P, Bosiers M, Peregrin J, Rosales O, Cotroneo AR, Rand T, Sheiban I. Infragenicular Stent Implantation for Below-the-Knee Atherosclerotic Disease: Clinical Evidence From an International Collaborative Meta-Analysis on 640 Patients. J Endovasc Ther 2009; 16:251-60. [PMID: 19642789 DOI: 10.1583/09-2691.1] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
Patients with below the knee (BTK) lesions may present either with intermittent claudication (IC) or with critical limb ischemia (CLI). Generally, these patients with a high incidence of diabetes have a high rate of myocardial infarction and mortality. So, even if, the surgery is potentially a very good technique with excellent results when the best conduit as a vein graft is used, the ratio benefice/risk seems too low for the IC patients. On another hand for the CLI patients a lot of reasons contraindicate or are unfair to the surgical option: lack of conduit, bad or unclear run-off or distal outflow site, bad local cutaneous conditions. Endovascular option by specialists with experience of coronary devices should be the treatment of choice. We review the different techniques and their recent upgrades in order to improve the percutaneous endovascular treatment of BTK lesions.
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Affiliation(s)
- P Commeau
- Département de cardiologie et radiologie vasculaire interventionnelles, polyclinique Les Fleurs, 83190 Ollioules, France.
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