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Windecker S, Gilard M, Achenbach S, Cribier A, Delgado V, Deych N, Drossart I, Eltchaninoff H, Fraser AG, Goncalves A, Hindricks G, Holborow R, Kappetein AP, Kilmartin J, Kurucova J, Lüscher TF, Mehran R, O'Connor DB, Perkins M, Samset E, von Bardeleben RS, Weidinger F. Device innovation in cardiovascular medicine: a report from the European Society of Cardiology Cardiovascular Round Table. Eur Heart J 2024; 45:1104-1115. [PMID: 38366821 DOI: 10.1093/eurheartj/ehae069] [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] [Indexed: 02/18/2024] Open
Abstract
Research performed in Europe has driven cardiovascular device innovation. This includes, but is not limited to, percutaneous coronary intervention, cardiac imaging, transcatheter heart valve implantation, and device therapy of cardiac arrhythmias and heart failure. An important part of future medical progress involves the evolution of medical technology and the ongoing development of artificial intelligence and machine learning. There is a need to foster an environment conducive to medical technology development and validation so that Europe can continue to play a major role in device innovation while providing high standards of safety. This paper summarizes viewpoints on the topic of device innovation in cardiovascular medicine at the European Society of Cardiology Cardiovascular Round Table, a strategic forum for high-level dialogue to discuss issues related to the future of cardiovascular health in Europe. Devices are developed and improved through an iterative process throughout their lifecycle. Early feasibility studies demonstrate proof of concept and help to optimize the design of a device. If successful, this should ideally be followed by randomized clinical trials comparing novel devices vs. accepted standards of care when available and the collection of post-market real-world evidence through registries. Unfortunately, standardized procedures for feasibility studies across various device categories have not yet been implemented in Europe. Cardiovascular imaging can be used to diagnose and characterize patients for interventions to improve procedural results and to monitor devices long term after implantation. Randomized clinical trials often use cardiac imaging-based inclusion criteria, while less frequently trials randomize patients to compare the diagnostic or prognostic value of different modalities. Applications using machine learning are increasingly important, but specific regulatory standards and pathways remain in development in both Europe and the USA. Standards are also needed for smart devices and digital technologies that support device-driven biomonitoring. Changes in device regulation introduced by the European Union aim to improve clinical evidence, transparency, and safety, but they may impact the speed of innovation, access, and availability. Device development programmes including dialogue on unmet needs and advice on study designs must be driven by a community of physicians, trialists, patients, regulators, payers, and industry to ensure that patients have access to innovative care.
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Affiliation(s)
- Stephan Windecker
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, CH-3010 Bern, Switzerland
| | - Martine Gilard
- Département de Cardiologie, Hospital La Cavale Blanche, La Cavale Blanche Hospital Boulevard Tanguy Prigent, 29200 Brest, France
| | - Stephan Achenbach
- Department of Cardiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen-Nürnberg, Germany
| | - Alain Cribier
- Department of Cardiology, Inserm U1096, Univ Rouen Normandie, F-76000 Rouen, France
| | - Victoria Delgado
- Department of Cardiology, University Hospital Germans Trias i Pujol, Badalona, Spain
| | - Nataliya Deych
- Regulatory Affairs, Edwards Lifesciences, Nyon, Switzerland
| | | | - Hélène Eltchaninoff
- Department of Cardiology, University Hospital Charles Nicolle, Rouen, France
| | - Alan G Fraser
- Department of Cardiology, University Hospital of Wales, Cardiff, UK
| | - Alexandra Goncalves
- Precision Diagnostics, Philips, Cambridge, MA, USA
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto Medical School, Porto, Portugal
| | - Gerhard Hindricks
- Department of Cardiology, German Heart Center Charite, Berlin, Germany
| | | | | | | | - Jana Kurucova
- Transcatheter Heart Valve Division, Edwards Lifesciences, Nyon, Switzerland
| | - Thomas F Lüscher
- Department of Cardiology, Royal Brompton and Harefield Hospitals and Imperial College and King's College, London, UK
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Roxana Mehran
- Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
| | | | - Mark Perkins
- GE Healthcare Cardiology Solutions, Harrogate, UK
| | - Eigil Samset
- GE Healthcare Cardiology Solutions, Oslo, Norway
- Department of Informatics, University of Oslo, Oslo, Norway
| | | | - Franz Weidinger
- 2nd Medical Department with Cardiology and Intensive Care Medicine, Klinik Landstrasse, Vienna, Austria
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Durand E, Levesque T, Fauvel C, Pibarot P, Eltchaninoff H. Reply to Association between prosthesis-patient mismatch and valve thrombosis: an independent link? Can J Cardiol 2024:S0828-282X(24)00288-5. [PMID: 38556124 DOI: 10.1016/j.cjca.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Affiliation(s)
- Eric Durand
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, Rouen, F-76000, France.
| | - Thomas Levesque
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, Rouen, F-76000, France
| | - Charles Fauvel
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, Rouen, F-76000, France
| | - Philippe Pibarot
- Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, QC, Canada
| | - Hélène Eltchaninoff
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, Rouen, F-76000, France
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Durand E, Beziau-Gasnier D, Michel M, Iung B, Tchetche D, Bonnet G, Lhermusier T, Gilard M, Souteyrand G, Bouleti C, Ohlmann P, Lefevre T, Beygui F, Chassaing S, Chevreul K, Eltchaninoff H. Reducing length of stay after transfemoral transcatheter aortic valve implantation: the FAST-TAVI II trial. Eur Heart J 2024; 45:952-962. [PMID: 38437633 DOI: 10.1093/eurheartj/ehae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/22/2023] [Accepted: 01/29/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND AND AIMS The length of stay (LOS) after transcatheter aortic valve implantation (TAVI) remains extremely variable whereas early discharge has been shown to be feasible and safe. The study objective was to evaluate the efficacy and safety of an intervention aimed at reducing LOS after transfemoral TAVI. METHODS FAST-TAVI II is a prospective, multicentre, cluster, randomized, controlled study including patients with severe symptomatic aortic stenosis, who had transfemoral TAVI. The intervention consisted in a dedicated training programme to implement 10 quality of care measures to reduce LOS with an implementation phase of eight weeks. The primary endpoint was the proportion of patients discharged early within 3 days. Secondary endpoints included: LOS, 30-day mortality and 30-day incidence of readmission for cardiovascular events. RESULTS During the study period, 969 patients were enrolled in the intervention group and 860 patients in the control group. Mean age was 81.9 ± 6.6 years and mean EuroSCORE II was 4.4 ± 4.5%. Early discharge was achieved in 563 (58.1%) patients in the intervention group vs. 364 (42.3%) patients in the control group (P < .0001). Median LOS was significantly reduced in the intervention group compared to the control group [3 (IQR: 3) vs. 4 days (IQR: 3), P < .0001]. Thirty-day mortality was low and similar in the two groups (0.5% vs. 0.9%, P = .30), as were 30-day readmissions (4.6% vs. 2.8%, P = .28). CONCLUSIONS The intervention was simple and fast to implement, and was effective and safe to reduce LOS and increase the proportion of patients discharged early after TAVI (NCT04503655).
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Affiliation(s)
- Eric Durand
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France
| | - Delphine Beziau-Gasnier
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, France
| | - Morgane Michel
- Université Paris Cité, Paris, France
- Inserm, ECEVE, Paris, France
- Clinical Epidemiology Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bernard Iung
- Cardiology Department, Bichat-Claude-Bernard Hospital Cardiology Service, Paris, France
| | | | - Guillaume Bonnet
- Unité médico-chirurgicale des valvulopathies, CHU de Bordeaux, 33600 Pessac, France
| | | | - Martine Gilard
- Department of Cardiology, CHRU Brest, 29200 Brest, France
| | | | - Claire Bouleti
- Clinical Investigation Center (INSERM 1204), Cardiology Department, ACTION and FACT study groups, University of Poitiers, Poitiers Hospital, France
| | - Patrick Ohlmann
- Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, Strasbourg, France
| | - Thierry Lefevre
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Ramsay Générale de santé, Massy, France
| | - Farzin Beygui
- Service de Cardiologie, ACTION Study Group, Centre Hospitalier Universitaire (CHU) de Caen Normandie, Normandie Univ, INSERM UMRS 1237, GIP Cyceron, Caen, France
| | - Stephan Chassaing
- Cardiology Department, Clinique NCT+-Saint Gatien-Alliance, Tours, France
| | - Karine Chevreul
- Université Paris Cité, Paris, France
- Inserm, ECEVE, Paris, France
- Clinical Epidemiology Unit, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène Eltchaninoff
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000 Rouen, 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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Durand E, Verrez T, Gillibert A, Levesque T, Barbe T, Koning R, Motreff P, Eltchaninoff H, Collet JP, Rangé G. Safety and efficacy of NOAC vs. VKA in patients treated by PCI: a retrospective study of the FRANCE PCI registry. Front Cardiovasc Med 2024; 10:1320001. [PMID: 38292452 PMCID: PMC10824844 DOI: 10.3389/fcvm.2023.1320001] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction Dual antithrombotic therapy (DAT) combining oral anticoagulation (OAC), preferentially Non-vitamin K antagonist OAC (NOAC) and single antiplatelet therapy (SAPT) for a period of 6-12 months is recommended after percutaneous coronary intervention (PCI) in patients with an indication for OAC. Objective To compare outcomes between vitamin K antagonist (VKA) and NOAC-treated patients in the nation-wide France PCI registry. Methods All consecutive patients from the France PCI registry treated by PCI and discharged with OAC between 2014 and 2020 were included and followed one-year. Major bleeding was defined as Bleeding Academic Research Consortium (BARC) classification ≥3 and major adverse cardiac events (MACE) as the composite of all-cause mortality, myocardial infarction (MI), and ischemic stroke. A propensity-score analysis was used. Results Of the 7,277 eligible participants, 2,432 (33.4%) were discharged on VKA and 4,845 (66.6%) on NOAC. After propensity-score adjustment, one-year major bleeding was less frequent in NOAC vs. VKA-treated participants [3.1% vs. 5.2%, -2.1% (-3.6% to -0.6%), p = 0.005 as well as the rate of MACE [9.2% vs. 11.9%, -2.7% (-5.0% to -0.4%), p = 0.02]. One-year mortality was also significantly decreased in NOAC vs. VKA-treated participants [7.4% vs. 9.9%, -2.6% (-4.7% to -0.5%), p = 0.02]. The area under ROC curves of the anticoagulant treatment propensity score was estimated at 0.93, suggesting potential indication bias. Conclusions NOAC seems to have a better efficacy and safety profile than VKA. However, potential indication bias were found.
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Affiliation(s)
- Eric Durand
- Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Thibault Verrez
- Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Andre Gillibert
- Department of Biostatistics, Normandie Univ, CHU Rouen, Rouen, France
| | - Thomas Levesque
- Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Thomas Barbe
- Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - René Koning
- Department of Cardiology, Clinique Saint Hilaire, Rouen, France
| | - Pascal Motreff
- Department of Cardiology, Clermont Ferrand University Hospital, Clermont-Ferrand, France
| | - Hélène Eltchaninoff
- Department of Cardiology, Normandie Univ, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Jean-Philippe Collet
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Gregoire Rangé
- Department of Cardiology, Hôpital de Chartres, Chartres, France
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Durand E, Eltchaninoff H. Robotic-assisted percutaneous coronary intervention: the future or the past? EUROINTERVENTION 2024; 20:19-20. [PMID: 38165114 PMCID: PMC10756215 DOI: 10.4244/eij-e-23-00064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Eric Durand
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, Rouen, France
| | - Hélène Eltchaninoff
- Univ Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, Rouen, France
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Levesque T, Eltchaninoff H, Chabannes R, Barbe T, Dosseh O, Tron C, Bettinger N, Bouhzam N, Hemery T, le Pessec G, Fauvel C, Cribier A, Pibarot P, Durand E. Impact of Prosthesis-Patient Mismatch After Transcatheter Aortic Valve Replacement. Can J Cardiol 2024; 40:113-122. [PMID: 37726077 DOI: 10.1016/j.cjca.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Data on the long-term impact of prosthesis-patient mismatch (PPM) on outcomes after transcatheter aortic valve replacement (TAVR) remain sparse. We therefore aimed to investigate the incidence, predictive factors, and long-term prognostic impact of PPM on bioprosthesis durability and mortality. METHODS This was a single-centre retrospective study including 2117 patients who underwent TAVR for aortic stenosis from 2002 to 2022. Moderate PPM was defined by indexed effective orifice area (iEOA) > 0.65 and ≤ 0.85 cm2/m2 (> 0.55 and ≤ 0.70 cm2/m2 if BMI ≥ 30 kg/m2) and severe PPM by an iEOA ≤ 0.65 cm2/m2 (≤ 0.55 cm2/m2 If BMI ≥ 30 kg/m2). RESULTS There were 351 patients (16.6%) with PPM, including 39 patients (1.8%) with severe PPM and 312 patients (14.7%) with moderate PPM. The mean follow-up duration was 31.2 ± 26.5 months. Factors independently associated with the occurrence of PPM were body surface area (odds ratio [OR] 3.32, 95% confidence interval [CI] 1.32-8.35; P = 0.01), valve-in-valve TAVR (OR 6.12, 95% CI 2.29-16.08; P < 0.001), small annulus (OR 2.42, 95% CI 1.41-4.07; P = 0.001), and the use of a balloon-expandable valve (OR 4.17, 95% CI 2.17-8.33; P < 0.001). PPM was associated with increased risk of mortality (hazard ratio [HR] 1.3, 95% CI 1.1-1.5, P = 0.004) and valve thrombosis (HR 4.2, 95% CI 1.4-12.6, P = 0.01), and a trend towards increased risk of structural valve deterioration (HR 1.7, 95% CI 0.9-2.9; P = 0.08). CONCLUSIONS The results of this study suggest that PPM has a negative long-term impact on outcomes after TAVR. These findings emphasise the importance of preventing PPM.
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Affiliation(s)
- Thomas Levesque
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Hélène Eltchaninoff
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Romain Chabannes
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Thomas Barbe
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Olivier Dosseh
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Christophe Tron
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Nicolas Bettinger
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Najime Bouhzam
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Thibaut Hemery
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Guillaume le Pessec
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Charles Fauvel
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Alain Cribier
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France
| | - Philippe Pibarot
- Department of Cardiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Québec, Canada
| | - Eric Durand
- Department of Cardiology, Normandie University, UNIROUEN, U1096, CHU Rouen, Rouen, France.
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Weizman O, Tea V, Marijon E, Eltchaninoff H, Manzo-Silberman S, Leclercq F, Albert F, Bataille V, Drouet E, Naccache N, Puymirat E, Ferrières J, Schiele F, Simon T, Danchin N. Very long-term outcomes after acute myocardial infarction in young men and women: Insights from the FAST-MI program. Arch Cardiovasc Dis 2023; 116:324-334. [PMID: 37391340 DOI: 10.1016/j.acvd.2023.05.006] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 07/02/2023]
Abstract
AIMS Conflicting data exists about long-term outcomes in young women and men experiencing acute myocardial infarction (AMI). METHODS The FAST-MI program consists of three nationwide French surveys carried out 5years apart from 2005 to 2015, including consecutive patients with AMI over a 1-month period with up to 10-year follow-up. The present analysis focused on adults≤50 yo according to their gender. RESULTS Women accounted for 17.5% (335) of the 1912 patients under 50 yo and had a similar age as men (43.9±5.1 vs. 43.9±5.5years, P=0.92). They received less percutaneous coronary interventions (PCI) than men (85.9% vs. 91.3%, P=0.005), even in ST-elevation myocardial infarction (83.6% vs. 93.5%, P<0.001). Recommended secondary prevention medications were less frequently prescribed at discharge in women (40.6% vs. 52.8%, P<0.001), a trend that persisted in 2015 (59.1% vs. 72.8% in 2015, P<0.001). Still, ten-year survival was similar in men (90.5%) and women (92.3%) (crude HR: 0.86 [95% CI: 0.55-1.35], P=0.52, adjusted HR: 0.63 [95% CI: 0.38-1.07], P=0.09); similar results were found for ten-year survival among hospital survivors (91.2% in men vs. 93.7% in women, adjusted HR: 0.87 [95% CI: 0.45-1.66], P=0.66). Of the 1684 patients alive at hospital discharge with morbidity follow-up≥6months available, death, AMI or stroke at 8years occurred in 12.9% men and 11.2% in women (adjusted HR: 0.90 [95% CI: 0.60-1.33], P=0.59). CONCLUSIONS Young women with AMI undergo less cardiac interventions and are less often prescribed secondary prevention treatment than men, even when significant coronary artery disease is present, but keep a similar long-term prognosis after AMI. Optimal management of these young patients, regardless of gender, is necessary to ensure best outcomes after this major cardiovascular event.
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Affiliation(s)
- Orianne Weizman
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Victoria Tea
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Eloi Marijon
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Hélène Eltchaninoff
- Normandie Université, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, 76000 Rouen, France
| | - Stéphane Manzo-Silberman
- Institut de Cardiologie, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Sorbonne Université, ACTION Study Group, Paris, France
| | - Florence Leclercq
- Centre Hospitalier Universitaire Arnaud-de-Villeneuve, Montpellier, France
| | | | - Vincent Bataille
- Toulouse University Hospital, Department of Cardiology B and Epidemiology, Toulouse, France; UMR INSERM 1027, Toulouse, France
| | - Elodie Drouet
- AP-HP, Hôpital Saint-Antoine, Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST), Paris, France; Université Pierre-et-Marie-Curie (UPMC-Paris 06), INSERM U-698, Paris, France
| | | | - Etienne Puymirat
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France
| | - Jean Ferrières
- Toulouse University Hospital, Department of Cardiology B and Epidemiology, Toulouse, France; UMR INSERM 1027, Toulouse, France
| | - François Schiele
- University Hospital Jean-Minjoz, Department of Cardiology, Besançon, France
| | - Tabassome Simon
- AP-HP, Hôpital Saint-Antoine, Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST), Paris, France; Université Pierre-et-Marie-Curie (UPMC-Paris 06), INSERM U-698, Paris, France
| | - Nicolas Danchin
- Assistance publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges-Pompidou (HEGP), Department of Cardiology, Paris, France; Université Paris-Descartes, Paris, France.
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9
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Chaumont C, Omouri L, Savouré A, Al Hamoud R, Fauvel C, Godin B, Eltchaninoff H, Anselme F. Is excessive ventricular irregularity predictive of rehospitalization in patients with permanent AF and HFpEF? ESC Heart Fail 2023; 10:2120-2126. [PMID: 36940720 DOI: 10.1002/ehf2.14349] [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: 11/24/2022] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS There are currently limited therapeutic approaches for patients with heart failure with preserved ejection fraction (HFpEF) who have developed permanent atrial fibrillation (AF). We aimed to analyse the impact of ventricular irregularity on heart failure rehospitalization in patients with permanent AF and HFpEF. METHODS AND RESULTS All 24 h ambulatory Holter monitoring performed in our centre within a month after a first heart failure hospitalization were screened. Patients with HFpEF and permanent AF were included in the retrospective analysis. The following parameters of ventricular irregularity were calculated over the 24 h recording period: standard deviation of all RR intervals (SDNN), coefficient of variation of SDNN (CV-SDNN = SDNN/mean RR), root of the mean squared differences of successive RR intervals (RMSSD), and percentage of consecutive RR intervals with difference over 50 ms (pNN50). The primary endpoint was rehospitalization for acute heart failure (HFrH). From 2010 to 2021, 51/216 screened patients were included. During a median follow-up of 3.13 years, 29/51 patients reached the primary endpoint. HFrH patients had higher SDNN (205 ± 65 vs. 154 ± 46 ms; P < 0.01), CV-SDNN (26 ± 8% vs. 19 ± 5%, P < 0.01), RMSSD (182 ± 47 vs. 138 ± 65 ms, P = 0.013), and pNN50 (76 ± 9 vs. 58 ± 26, P < 0.001) when compared with patients with no HFrH. In multivariate analysis, all those parameters remained significantly associated with HFrH. CONCLUSIONS In this pilot study, we found some evidences for a deleterious impact of excessive ventricular irregularity on HFrH in AF patients with HFpEF. Those new findings could pave the way for new prognosis and therapeutic approaches in this patients' population.
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Affiliation(s)
- Corentin Chaumont
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
- Department of Cardiology, Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, F-76000, Rouen, France
| | - Lisa Omouri
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
| | - Arnaud Savouré
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
| | | | - Charles Fauvel
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
- Department of Cardiology, Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, F-76000, Rouen, France
| | | | - Hélène Eltchaninoff
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
- Department of Cardiology, Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, F-76000, Rouen, France
| | - Frédéric Anselme
- Department of Cardiology, CHU Rouen, F-76000, Rouen, France
- Department of Cardiology, Univ Rouen Normandie, Inserm EnVI UMR 1096, CHU Rouen, F-76000, Rouen, France
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10
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Tarantini G, Tang G, Nai Fovino L, Blackman D, Van Mieghem NM, Kim WK, Karam N, Carrilho-Ferreira P, Fournier S, Pręgowski J, Fraccaro C, Vincent F, Campante Teles R, Mylotte D, Wong I, Bieliauskas G, Czerny M, Bonaros N, Parolari A, Dudek D, Tchétché D, Eltchaninoff H, de Backer O, Stefanini G, Sondergaard L. Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery. EUROINTERVENTION 2023; 19:37-52. [PMID: 36811935 PMCID: PMC10174192 DOI: 10.4244/eij-d-22-00958] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Significant coronary artery disease (CAD) is a frequent finding in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI), and the management of these two conditions becomes of particular importance with the extension of the procedure to younger and lower-risk patients. Yet, the preprocedural diagnostic evaluation and the indications for treatment of significant CAD in TAVI candidates remain a matter of debate. In this clinical consensus statement, a group of experts from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the European Society of Cardiology (ESC) Working Group on Cardiovascular Surgery aims to review the available evidence on the topic and proposes a rationale for the diagnostic evaluation and indications for percutaneous revascularisation of CAD in patients with severe aortic stenosis undergoing transcatheter treatment. Moreover, it also focuses on commissural alignment of transcatheter heart valves and coronary re-access after TAVI and redo-TAVI.
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Affiliation(s)
- Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Gilbert Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY, USA
| | - Luca Nai Fovino
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Daniel Blackman
- Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
| | | | | | - Nicole Karam
- Department of Cardiology, Hôpital Européen Georges-Pompidou, Paris, France
| | - Pedro Carrilho-Ferreira
- Serviço de Cardiologia, Hospital de Santa Maria, CHULN, and Centro de Cardiologia da Universidade de Lisboa, Faculdade de Medicina de Lisboa, Centro Académico de Medicina de Lisboa, Lisbon, Portugal
| | | | | | - Chiara Fraccaro
- Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Flavien Vincent
- Division of Cardiology, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | | | - Darren Mylotte
- Department of Cardiology, University Hospital Galway, Galway, Ireland
| | - Ivan Wong
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Gintautas Bieliauskas
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martin Czerny
- University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Alessandro Parolari
- Department of Biomedical Sciences for Health, University of Milano, Milan, Italy and University Cardiac Surgery, Policlinico San Donato IRCCS, Milan, Italy
| | - Darius Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.,Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Ravenna, Italy
| | | | | | - Ole de Backer
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Giulio Stefanini
- Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Rozzano-Milan, Italy
| | - Lars Sondergaard
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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11
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Messaoudi H, Levesque T, Perzo N, Berg E, Feugray G, Dumesnil A, Brunel V, Guerrot D, Eltchaninoff H, Richard V, Kamel S, Durand E, Bennis Y, Bellien J. Subtotal Nephrectomy Associated with a High-Phosphate Diet in Rats Mimics the Development of Calcified Aortic Valve Disease Associated with Chronic Renal Failure. J Clin Med 2023; 12:jcm12041539. [PMID: 36836075 PMCID: PMC9963294 DOI: 10.3390/jcm12041539] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction. This study addressed the hypothesis that subtotal nephrectomy associated with a high-phosphorus diet (5/6Nx + P) in rats represents a suitable animal model to mimic the cardiovascular consequences of chronic kidney disease (CKD) including calcified aortic valve disease (CAVD). Indeed, the latter contributes to the high morbidity and mortality of CKD patients and sorely lacks preclinical models for pathophysiological and pharmacological studies. Methods. Renal and cardiovascular function and structure were compared between sham-operated and 5/6 Nx rats + P 10 to 12 weeks after surgery. Results. As expected, 11 weeks after surgery, 5/6Nx + P rats developed CKD as demonstrated by their increase in plasma creatinine and urea nitrogen and decrease in glomerular filtration rate, estimated by using fluorescein-isothiocyanate-labelled sinistrin, anemia, polyuria, and polydipsia compared to sham-operated animals on a normal-phosphorus diet. At the vascular level, 5/6Nx + P rats had an increase in the calcium content of the aorta; a decrease in mesenteric artery dilatation in response to a stepwise increase in flow, illustrating the vascular dysfunction; and an increase in blood pressure. Moreover, immunohistology showed a marked deposition of hydroxyapatite crystals in the aortic valve of 5/6Nx + P rats. Echocardiography demonstrated that this was associated with a decrease in aortic valve cusp separation and an increase in aortic valve mean pressure gradient and in peak aortic valve velocity. Left-ventricular diastolic and systolic dysfunction as well as fibrosis were also present in 5/6Nx + P rats. Conclusion. This study demonstrates that 5/6Nx + P recapitulates the cardiovascular consequences observed in humans with CKD. In particular, the initiation of CAVD was shown, highlighting the interest of this animal model to study the mechanisms involved in the development of aortic stenosis and test new therapeutic strategies at an early stage of the disease.
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Affiliation(s)
- Hind Messaoudi
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Thomas Levesque
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Nicolas Perzo
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Elodie Berg
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Thoracic Surgery, CHU Rouen, F-76000 Rouen, France
| | - Guillaume Feugray
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of General Biochemistry, CHU Rouen, F-76000 Rouen, France
| | - Anaïs Dumesnil
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
| | - Valéry Brunel
- Department of General Biochemistry, CHU Rouen, F-76000 Rouen, France
| | - Dominique Guerrot
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Nephrology, CHU Rouen, F-76000 Rouen, France
| | - Hélène Eltchaninoff
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Vincent Richard
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Pharmacology, CHU Rouen, F-76000 Rouen, France
| | - Saïd Kamel
- UR UPJV 7517, Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV), Centre de Recherche Universitaire en Santé, Université de Picardie Jules Verne, F-80054 Amiens, France
- Department of Biochemistry, Amiens-Picardie University Hospital, F-80054 Amiens, France
| | - Eric Durand
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Cardiology, CHU Rouen, F-76000 Rouen, France
| | - Youssef Bennis
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- UR UPJV 7517, Mécanismes Physiopathologiques et Conséquences des Calcifications Cardiovasculaires (MP3CV), Centre de Recherche Universitaire en Santé, Université de Picardie Jules Verne, F-80054 Amiens, France
- Department of Pharmacology, Amiens-Picardie University Hospital, F-80054 Amiens, France
| | - Jérémy Bellien
- INSERM EnVI UMR 1096, University of Rouen Normandie, F-76000 Rouen, France
- Department of Pharmacology, CHU Rouen, F-76000 Rouen, France
- Correspondence: ; Tel.: +33-(0)2-35-14-83-68
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12
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Chaumont C, Martins RP, Viart G, Pavin D, Noirot-Cosson B, Huchette D, Savoure A, Godin B, Mirolo A, Achard J, Rivron S, Eltchaninoff H, Anselme F. RVOT premature ventricular contractions induce significant anatomical displacement during 3D mapping: A cause of mid-term ablation failure? Arch Cardiovasc Dis 2023; 116:62-68. [PMID: 36604192 DOI: 10.1016/j.acvd.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Catheter ablation is a first-line treatment for symptomatic right ventricular outflow tract (RVOT) premature ventricular complexes (PVCs). There is evidence of displacement of the ablation target site during PVCs relative to the location in sinus rhythm (SR). AIM To analyse the extent of displacement induced by RVOT PVCs and its effect on the ablation sites and the mid-term efficacy of ablation. METHODS In this multicentre French study, we retrospectively included 18 consecutive adults referred for ablation of RVOT PVCs using a three-dimensional (3D) mapping system. PVC activation maps were performed conventionally (initial map), then each PVC activation point was manually reannotated considering the 3D location on a previous SR beat (corrected map). The ablation-site locations on the initial or the corrected area, including the 10 best activation points, were analysed. Mid-term efficacy was evaluated. RESULTS The direction of map shift during PVCs relative to the map in SR occurred along a vertical axis in 16 of 18 patients. The mean activation-point displacement for each of the 18 mapped chambers was 5.6±2.2mm. Mid-term recurrence of RVOT PVCs occurred in 5 (28%) patients. In all patients with recurrences, no significant ablation lesion was located on the corrected (true) site of origin. CONCLUSIONS RVOT PVCs induce a vertical anatomical shift that can mislead physicians about the true location of the arrhythmia's site of origin. Our study highlights the association between mid-term PVC recurrence and the absence of spatial overlap between ablation points and the corrected site of origin.
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Affiliation(s)
- Corentin Chaumont
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France; FHU REMOD-VHF, Unirouen, Inserm U1096, 76000 Rouen, France
| | - Raphael P Martins
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | - Guillaume Viart
- Department of Cardiology, GCS-Groupement des hôpitaux de l'institut Catholique de Lille/Faculté Libre de Médecine, 59800 Lille, France
| | - Dominique Pavin
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, 35000 Rennes, France
| | | | - David Huchette
- Department of Cardiology, Lens Hospital, 62300 Lens, France
| | - Arnaud Savoure
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France
| | - Benedicte Godin
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France
| | - Adrian Mirolo
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France
| | - Jorys Achard
- Biosense Webster France, Johnson&Johnson, Issy-Les-Moulineaux, 92787, France
| | - Simon Rivron
- Biosense Webster France, Johnson&Johnson, Issy-Les-Moulineaux, 92787, France
| | - Hélène Eltchaninoff
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France; FHU REMOD-VHF, Unirouen, Inserm U1096, 76000 Rouen, France
| | - Frédéric Anselme
- Department of Cardiology, Rouen University Hospital, 76000 Rouen, France; FHU REMOD-VHF, Unirouen, Inserm U1096, 76000 Rouen, France.
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13
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Mirolo A, Chaumont C, Auquier N, Savouré A, Godin B, Vandevelde F, Eltchaninoff H, Anselme F. Left bundle branch pacing in patients with narrow, left, or right bundle branch block QRS patterns: Insights into electrocardiographic and echocardiographic features. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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14
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Willner N, Nguyen V, Eltchaninoff H, Burwash I, Michel M, Durand E, Gilard M, Iung B, Cribier A, Chevreul K, Messika-Zeitoun D. Aortic valve replacement for aortic stenosis in France – Influence of centers’ volumes on TAVR adoption rate and outcomes. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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15
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Barbe T, Levesque T, Verrez T, Hemery T, Tron C, Anselme F, Eltchaninoff H, Durand E. Evaluation of an expert consensus for the management of conductive disturbances after TAVI: A monocentric retrospective observational study at Rouen university hospital. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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16
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Levesque T, Perzo N, Berg E, Dovonou E, Messaoudi H, Herbet A, Colleville B, Eltchaninoff H, Boquet D, Richard V, Bellien J, Durand E. Evaluation of the role of endothelin in aortic stenosis. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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17
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Al-Hamoud R, Fauvel C, Chaumont C, Savouré A, Godin B, Eltchaninoff H, Anselme F. Incidence, predictive factors and prognosis of inappropriate sinus tachycardia after cryoballoon atrial fibrillation ablation. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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18
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Laissac Q, Levesque T, Bettinger N, Hemery T, Tron C, Guegan-Massardier E, Eltchaninoff H, Durand E. Incidence, predictive factors, and prognostic impact of residual shunt after percutenous patent foramen ovale closure. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Chaumont C, Martins R, Viart G, Pavin D, Noirot-Cosson B, Huchette D, Godin B, Savouré A, Eltchaninoff H, Anselme F. RVOT Premature ventricular contractions induce significant anatomical displacement during 3D mapping: A cause of mid-term ablation failure? Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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20
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Chaumont C, Mcdonnell E, Maury P, Boveda S, Savouré A, Rollin A, Albenque JP, Eltchaninoff H, Anselme F. Pulmonary vein isolation using pulse field ablation: Acute results from a multicentric registry. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Willner NA, Nguyen V, Eltchaninoff H, Burwash IG, Michel M, Durand E, Gilard M, Dindorf C, Iung B, Cribier A, Vahanian A, Chevreul K, Messika-Zeitoun D. Aortic valve replacement for aortic stenosis in France – influence of centers' volumes on TAVR adoption rate and outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Over the last decade, transcatheter aortic valve replacement (TAVR) became extensively used, now being the recommended as first line procedure for aortic valve replacement (AVR) in selected patients' populations. It is unknown whether TAVR adoption rate and variability in outcomes is influenced by centers' volume.
Methods
From a French administrative hospital-discharge database, we collected all AVR performed in France between 2007 and 2019. Centers were stratified to terciles based on their annual SAVR per year per center during 2007–2009 (“pre TAVR era”).
Results
There was 218,489 AVRs (153,747 SAVR and 74,732 TAVR) performed in 46 centers between 2007–2019. Number of total AVR and even more so number of number of TAVR significantly and linearly increased from 2007 to 2019 in all terciles but faster in the high volume tercile (+17, +17 and +31 AVR/center/year in the low, middle and high terciles respectively, P [ANCOVA]<0.001; +11, + 19 and +33 TAVR/center/year in the low, medium and high tercile respectively, P [ANCOVA] <0.00, Figure 1). The age of patients underwent TAVR remained grossly unchanged in all three terciles, however, the Charlson index declined from 2010 to 2019 (from 1.35±1.42 to 0.65±1.04, from 1.21±1.40 to 0.65±1.05 and from 1.53±1.58 to 0.81±1.21, in the low, middle and high terciles, P for trend <0.001, 0.021, and <0.001, respectively). Charlson score in the years 2017–2019, was higher in the high than middle and low terciles (0.87±1.22, 0.76±1.11 and 0.65±1.04, respectively, P<0.0001). The in-hospital mortality rate for TAVR significantly declined from 2010 to 2019 for TAVR in all terciles (from 8.3% to 2.1%, from 7.5% to 2.5% and from 8.2% to 2.1% for low, middle and high TAVR terciles, respectively; p for trend = 0.002, 0.001 and <0.001, respectively, Figure 2). Average mortality in 2017–2019 was similar in all terciles (2.3%, 2.5% and 2.2% for low, middle and high terciles, respectively, P=0.47). After adjusting for age, sex and Charlson score, mortality was higher in the low tercile compared with middle and high terciles (OR 1.15, P<0.001, confidence interval [CI] 1.0–1.2, and OR 1.18, P<0.001, CI 1.1–1.2, respectively).
Conclusions
From 2007 to 2019 total AVR linearly increased, mostly due to increase in TAVR, irrespective of centers' volume, but increase rate was higher in high volume centers. A constant decline in patients risk profile, with a striking decrease in mortality rate, was observed in all volume terciles. High-volume centers patients' have higher risk profile, with adjusted mortality slightly lower than medium and low volume centers.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - V Nguyen
- Centre Cardiologique du Nord (CCN) , Saint Denis , France
| | | | | | | | | | - M Gilard
- University Hospital of Brest , Brest , France
| | | | - B Iung
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
| | | | - A Vahanian
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
| | - K Chevreul
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
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22
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Weizman O, Tea V, Puymirat E, Eltchaninoff H, Cayla G, Ferrieres J, Schiele F, Simon T, Danchin N. Very long-term outcomes after acute myocardial infarction in young men and women. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
There is a paucity of data on very long-term outcomes in young women and men experiencing acute myocardial infarction (AMI).
Methods and results
The FAST-MI program consists of three nationwide French surveys carried out 5 years apart from 2005 to 2015, including consecutive AMI patients over a 1-month period with up to 10-year follow-up. The present analysis focused on adults ≤50 yo according to their gender. Women accounted for 17.5% (N=335) of the 1912 patients under 50 yo and were as old as men (43.9±5.5 vs. 43.9±5.1yo, p=0.92). Non-significant coronary artery disease was more frequent in women (12.8% vs. 5.8%, P<0.001). Women with significant coronary artery disease underwent less percutaneous coronary internvention (PCI) than men (85.9% vs. 91.3%, p=0.005), though primary PCI in ST-elevated myocardial infarction was as frequent in women (67.3% vs. 66.8%). Recommended secondary prevention medications were less prescribed at discharge in women (40.6% vs. 52.8%, p<0.001), a trend that persisted in 2015 (59.1% vs. 72.8% in 2015, p<0.001). Still, ten-year survival was similar in men (90.5%) and women (92.6%) (crude HR 0.87 [95% CI 0.55–1.57], adjusted HR 0.77 [95% CI 0.48–1.23], p=0.27) even among hospital survivors (adjusted HR 0.64 [95% CI 0.32–1.30], p=0.22). Ten-year survival was similar in patients with myocardial infarction with non-obstructive coronary arteries compared with those with significant coronary artery disease (91.8% vs. 91.0%, P=0.46)), both among men (91.6% vs. 90.7%) and women (92.9% vs. 93.0%). However, when taking into account early revascularization and discharge medications, in patients with significant coronary artery disease, adjusted 10-year mortality was significantly lower in women (HR 0.53, 95% CI 0.29–0.96, P=0.04).
Conclusions
Ten-year survival in young women with AMI is similar to that of men. However, in those with significant coronary artery disease, improving secondary prevention in women should result in better long-term outcome.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): French Society of Cardiology
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Affiliation(s)
- O Weizman
- University Hospital of Nancy , Nancy , France
| | - V Tea
- Hopital Europeen Georges Pompidou-University Paris Descartes, Cardiology , Paris , France
| | - E Puymirat
- Hopital Europeen Georges Pompidou-University Paris Descartes, Cardiology , Paris , France
| | | | - G Cayla
- University Hospital of Nimes , Nimes , France
| | - J Ferrieres
- Toulouse Rangueil University Hospital (CHU) , Toulouse , France
| | - F Schiele
- Regional University Hospital Jean Minjoz , Besancon , France
| | - T Simon
- Hospital Saint-Antoine , Paris , France
| | - N Danchin
- Hopital Europeen Georges Pompidou-University Paris Descartes, Cardiology , Paris , France
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23
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Manzo-Silberman S, Couturaud F, Bellemain-Appaix A, Vautrin E, Gompel A, Drouet L, Marliere S, Bal Dit Solier C, Uhry S, Eltchaninoff H, Bergot T, Motreff P, Cottin Y, Mounier-Vehier C, Gilard M. Characteristics of young women presenting with acute myocardial infarction: the prospective, multicentre, observational WAMIF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiovascular diseases are the leading cause of death in women, killing sevenfold more women than breast cancer. Rates of hospital death for myocardial infarction in women, although decreasing, remains significantly higher than in men (more than double), especially among women under the age of 50. The occurrence of myocardial infarction in non-menopausal women is not unusual, and the incidence continues to rise. While women under the age of 60 accounted for less than 12% of patients with myocardial infarction admitted in 1995, they accounted for more than 25% in 2015. In addition to the traditional cardiovascular risk factors, women present specific ones linked to hormonal modifications, inflammatory high-risk profiles, and thrombophilia.
Purpose
We comprehensively and systematically collected all clinical and biological data and the results of morphological explorations in all women admitted for myocardial infarction under the age of 50 in high-volume French centres. To date, no systematic descriptive analysis has been carried out incorporating not only clinical, morphological, and extraordinary characteristics, but biological characteristics, in particular hormonal and immunological parameters.
Methods
This prospective, observational study included all women admitted for myocardial infarction under the age of 50 years at 30 centres in France from May 2017 to June 2019.
Results
The population comprised 314 women (mean age 44.9 years): 192 presented with ST-segment elevation myocardial infarction and 122 with non-ST-segment elevation myocardial infarction, 75% were current smokers, 35 had a family history of cardiovascular disease, 33% had a complication of pregnancy, and 55% reported recent emotional stress. Ten had a normal coronary angiogram. Independent predictors of premature MI, <35 yo, were cannabis use and oral contraceptive therapy. No deaths, but 3 strokes, 3 recurrent myocardial infarctions, and 1 serious bleed occurred during hospitalization. At 12 months, 2 deaths occurred but linked to progressive cancer, 25 patients had recurrent PCI, 4 symptoms driven. Otherwise, 90.4% were event free and 72% completely symptoms free.
Conclusion
The WAMIF study showed that most young women with acute myocardial infarction reported typical symptoms of chest pain, and modifiable cardiovascular risk factors, most commonly tobacco use. Gynaecological status, history of pregnancy complications, and non-compliance with non-indication of combined contraception were overrepresented, emphasizing the urge for a better cardiological and gynaecological network. The overall prognosis for these women was better than previously reported despite the high rate of emergency consultations in the year following the index myocardial infarction, highlighting the need for more comprehensive follow-up following the myocardial infarction.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): French Society of CardiologyGrants from Indusctries Biosensors Europe SA, AstraZeneca, Boston Scientific Corporation, Abbott Medical Devices, Terumo Corporation, Daiichi Sankyo, Inc., Hexacath, France, Biotronik SE & Co. KG.
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Affiliation(s)
| | - F Couturaud
- University Hospital of Brest , Brest , France
| | | | - E Vautrin
- University Hospital of Grenoble , Grenoble , France
| | - A Gompel
- Cochin APHP Site of Paris Centre University Hospital, Gynécologie médicale, Port-Royal Cochin, aphp , Paris , France
| | - L Drouet
- Hospital Lariboisiere , Paris , France
| | - S Marliere
- University Hospital of Grenoble , Grenoble , France
| | | | - S Uhry
- Haguenau Hospital Centre , Haguenau , France
| | | | - T Bergot
- French Society of Cardiology , Paris , France
| | - P Motreff
- University Hospital Gabriel Montpied , Clermont-Ferrand , France
| | - Y Cottin
- University Hospital of Dijon , Dijon , France
| | | | - M Gilard
- University Hospital of Brest , Brest , France
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24
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Masiero G, Paradies V, Franzone A, Bellini B, De Biase C, Karam N, Sanguineti F, Mamas MA, Eltchaninoff H, Fraccaro C, Castiglioni B, Attisano T, Esposito G, Chieffo A. Sex-Specific Considerations in Degenerative Aortic Stenosis for Female-Tailored Transfemoral Aortic Valve Implantation Management. J Am Heart Assoc 2022; 11:e025944. [PMID: 36172929 DOI: 10.1161/jaha.121.025944] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 11/16/2022]
Abstract
The impact of sex on pathophysiological processes, clinical presentation, treatment options, as well as outcomes of degenerative aortic stenosis remain poorly understood. Female patients are well represented in transfemoral aortic valve implantation (TAVI) trials and appear to derive favorable outcomes with TAVI. However, higher incidences of major bleeding, vascular complications, and stroke have been reported in women following TAVI. The anatomical characteristics and pathophysiological features of aortic stenosis in women might guide a tailored planning of the percutaneous approach. We highlight whether a sex-based TAVI management strategy might impact on clinical outcomes. This review aimed to evaluate the impact of sex from diagnosis to treatment of degenerative aortic stenosis, discussing the latest evidence on epidemiology, pathophysiology, clinical presentation, therapeutic options, and outcomes. Furthermore, we focused on technical sex-oriented considerations in TAVI including the preprocedural screening, device selection, implantation strategy, and postprocedural management.
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Affiliation(s)
- Giulia Masiero
- Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy
| | - Valeria Paradies
- Department of Cardiology Maasstad Hospital Rotterdam The Netherlands
| | - Anna Franzone
- Department of Advanced Biomedical Sciences Federico II University of Naples Italy
| | - Barbara Bellini
- Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy
| | - Chiara De Biase
- Groupe CardioVasculaire Interventionnel Clinique Pasteur Toulouse France
| | - Nicole Karam
- Cardiology Department European Hospital Georges Pompidou Paris France
| | | | - Mamas A Mamas
- Keele Cardiovascular Research Group School of Medicine, Keele University Stoke-on-Trent United Kingdom.,Department of Cardiology Royal Stoke University Hospital Stoke-on-Trent United Kingdom.,Department of Medicine Thomas Jefferson University Philadelphia PA
| | | | - Chiara Fraccaro
- Department of Cardiac, Thoracic Vascular Science and Public Health, University of Padova Italy
| | | | - Tiziana Attisano
- Division of Interventional Cardiology Cardiovascular and Thoracic Department, San Giovanni di Dio e Ruggi Salerno Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences Federico II University of Naples Italy
| | - Alaide Chieffo
- Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute Milan Italy
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25
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Montalescot G, Redheuil A, Vincent F, Desch S, De Benedictis M, Eltchaninoff H, Trenk D, Serfaty JM, Charpentier E, Bouazizi K, Prigent M, Guedeney P, Salloum T, Berti S, Cequier A, Lefèvre T, Leprince P, Silvain J, Van Belle E, Neumann FJ, Portal JJ, Vicaut E, Collet JP. Apixaban and Valve Thrombosis After Transcatheter Aortic Valve Replacement: The ATLANTIS-4D-CT Randomized Clinical Trial Substudy. JACC Cardiovasc Interv 2022; 15:1794-1804. [PMID: 36137682 DOI: 10.1016/j.jcin.2022.07.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 04/21/2022] [Revised: 06/28/2022] [Accepted: 07/06/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Subclinical obstructive valve thrombosis after transcatheter aortic valve replacement (TAVR) is of uncertain frequency and clinical impact. OBJECTIVES The aim of this study was to determine the effects of apixaban vs standard of care on post-TAVR valve thrombosis detected by 4-dimensional (4D) computed tomography. METHODS The randomized ATLANTIS (Anti-Thrombotic Strategy to Lower All Cardiovascular and Neurologic Ischemic and Hemorrhagic Events After Trans-Aortic Valve Implantation for Aortic Stenosis) trial demonstrated that apixaban 5 mg twice daily was not superior to standard of care (vitamin K antagonists or antiplatelet therapy) after successful TAVR and was associated with similar safety but with more noncardiovascular deaths. Three months after randomization, 4D computed tomography was proposed to all patients to determine the percentage of patients with ≥1 prosthetic valve leaflet with grade 3 or 4 reduced leaflet motion or grade 3 or 4 hypoattenuated leaflet thickening (the primary endpoint) in the intention-to-treat population. RESULTS Seven hundred sixty-two participants had complete multiphase datasets and were included in the 4D computed tomographic analysis. The primary endpoint occurred in 33 (8.9%) and 51 (13.0%) patients in the apixaban and standard-of-care groups, respectively. It was reduced with apixaban vs antiplatelet therapy (OR: 0.51; 95% CI: 0.30-0.86) but not vs vitamin K antagonists (OR: 1.80; 95% CI: 0.62-5.25) (Pinteraction = 0.037). The composite of death, myocardial infarction, any stroke, or systemic embolism at 1 year occurred in 10.7% (n = 9 of 84) and 7.1% (n = 48 of 178) of patients with and without subclinical valve thrombosis at 90 days, respectively (HR: 1.68; 95% CI: 0.82-3.44). CONCLUSIONS Apixaban reduced subclinical obstructive valve thrombosis in the majority of patients who underwent TAVR without having an established indication for anticoagulation. This study was not powered for clinical outcomes. (Anti-Thrombotic Strategy After Trans-Aortic Valve Implantation for Aortic Stenosis [ATLANTIS]; NCT02664649).
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Affiliation(s)
- Gilles Montalescot
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Alban Redheuil
- Sorbonne Université, Laboratoire Imagerie Biomédicale, ICAN, ACTION Group, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Flavien Vincent
- CHU Lille, Institut Cœur Poumon, Pôle Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut Pasteur de Lille, EGID, Université de Lille, Lille, France
| | - Steffen Desch
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany
| | | | - Hélène Eltchaninoff
- Normandie Université, UNIROUEN, U1096, CHU Rouen, Département de Cardiologie, FHU CARNAVAL, Rouen, France
| | - Dietmar Trenk
- Division of Cardiology and Angiology II, University Heart Centre Freiburg, Bad Krozingen, Germany
| | - Jean-Michel Serfaty
- Hôpital Guillaume et René Laennec, Institut du Thorax-Clinique Cardiologique, Unité d'Imagerie Cardiaque et Vasculaire Diagnostique, Nantes, France
| | - Etienne Charpentier
- Sorbonne Université, Laboratoire Imagerie Biomédicale, ICAN, ACTION Group, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Khaoula Bouazizi
- Sorbonne Université, Laboratoire Imagerie Biomédicale, ICAN, ACTION Group, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Mikael Prigent
- Sorbonne Université, Laboratoire Imagerie Biomédicale, ICAN, ACTION Group, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Paul Guedeney
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Tomy Salloum
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Sergio Berti
- Fondazione Toscana G. Monasterio, Ospedale del Cuore G. Pasquinucci, Massa, Italy
| | - Angel Cequier
- Hospital Universitario de Bellvitge, University of Barcelona, Heart Disease Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Thierry Lefèvre
- Hôpital Privé Jacques Cartier, Institut Cardiovasculaire Paris Sud, Massy, France
| | - Pascal Leprince
- Sorbonne Université, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Chirurgie Cardiaque, Paris, France
| | - Johanne Silvain
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France
| | - Eric Van Belle
- CHU Lille, Institut Cœur Poumon, Pôle Cardiovasculaire et Pulmonaire, ACTION Group, Inserm U1011, Institut Pasteur de Lille, EGID, Université de Lille, Lille, France
| | - Franz-Josef Neumann
- Division of Cardiology and Angiology II, University Heart Centre Freiburg, Bad Krozingen, Germany
| | - Jean-Jacques Portal
- Unité de Recherche Clinique Lariboisière St-Louis, ACTION Group, Hôpital St-Louis & Fernand Widal, Paris, France
| | - Eric Vicaut
- Unité de Recherche Clinique Lariboisière St-Louis, ACTION Group, Hôpital St-Louis & Fernand Widal, Paris, France
| | - Jean-Philippe Collet
- Sorbonne Université, ACTION Group, INSERM UMRS 1166, Hôpital Pitié-Salpêtrière (AP-HP), Institut de Cardiologie, Paris, France.
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26
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Tang GHL, Amat-Santos IJ, De Backer O, Avvedimento M, Redondo A, Barbanti M, Costa G, Tchétché D, Eltchaninoff H, Kim WK, Zaid S, Tarantini G, Søndergaard L. Rationale, Definitions, Techniques, and Outcomes of Commissural Alignment in TAVR: From the ALIGN-TAVR Consortium. JACC Cardiovasc Interv 2022; 15:1497-1518. [PMID: 35926918 DOI: 10.1016/j.jcin.2022.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 10/16/2022]
Abstract
Given the expanding indications of transcatheter aortic valve replacement (TAVR) in younger patients with longer life expectancies, the ability to perform postprocedural coronary access represents a priority in their lifetime management. A growing body of evidence suggests that commissural (and perhaps coronary) alignment in TAVR impacts coronary access and valve hemodynamics as well as coronary flow and access after redo-TAVR. Recent studies have provided modified delivery system insertion and rotation techniques to obtain commissural alignment with available transcatheter heart valve devices. Moreover, patient-specific preprocedural planning and postprocedural imaging tools have been developed to facilitate and evaluate commissural alignment. Future efforts should aim to refine transcatheter heart valve and delivery system designs to make neocommissural alignment easier and more reproducible. The aim of this review is to present an in-depth insight of commissural alignment in TAVR, including its rationale, standardized definitions, technical steps, outcomes, and future directions.
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Affiliation(s)
- Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA.
| | | | - Ole De Backer
- Department of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Marisa Avvedimento
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alfredo Redondo
- CIRBERCV, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Department of Cardiology, Hospital Clinico Universitario de Santiago de Compostela, A Coruna, Spain
| | - Marco Barbanti
- Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy
| | - Giuliano Costa
- Division of Cardiology, A.O.U. Policlinico "G. Rodolico-San Marco," Catania, Italy
| | | | | | | | - Syed Zaid
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Giuseppe Tarantini
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy
| | - Lars Søndergaard
- Department of Cardiology, The Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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27
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Levesque T, Koning R, Gillibert A, Hohweyer J, Bonnet P, Lesault PF, Motreff P, Eltchaninoff H, Rangé G, Durand E. Impact of the Lubrizol factory fire in Rouen on coronary events: A retrospective study from the France PCI registry. Arch Cardiovasc Dis 2022; 115:467-475. [PMID: 35872078 DOI: 10.1016/j.acvd.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND On 26 September 2019, an industrial fire occurred in the Lubrizol factory in Rouen (France), exposing the population to the inhalation of many volatile toxic agents secondary to combustion. AIM To assess the impact of the Lubrizol factory fire on the incidence of coronary artery events. METHODS All coronary angiograms performed in Rouen (exposed) and Le Havre (unexposed) from May 2019 to December 2019 were extracted from the prospective France Percutaneous Coronary Intervention (France PCI) registry. To study the impact of the fire on coronary events, an interrupted time series analysis was performed in Rouen, with adjustment on Le Havre in an autoregressive moving average (ARMA)(1,1) model with the precision of 1 week. The primary outcome was the incidence of acute coronary syndrome, and the secondary outcome was the incidence of ST-segment elevation myocardial infarction. RESULTS The mean number of acute coronary syndromes per week in the exposed zone (Rouen) increased non-significantly from 37.5±9.4 before the fire to 43.2±6.2 after the fire, for an estimated effect of +5.5 (95% confidence interval -0.7 to 11.8; P=0.09) events per week. In municipalities exposed to the plume of smoke (subgroup of Rouen), the mean number of acute coronary syndromes increased non-significantly from 7.3±2.8 before the fire to 8.7±3.6 after the fire, for an estimated effect of +1.0 (95% confidence interval -2.0 to 4.0; P=0.51) events per week. The results were similar when taking into account only ST-segment elevation myocardial infarctions or all coronary events. CONCLUSIONS Our study did not find a significant effect of the Lubrizol factory fire on the incidence of acute coronary syndrome. Further studies are needed to investigate the impact of industrial accidents on air pollution and coronary events.
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Affiliation(s)
- Thomas Levesque
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - René Koning
- Department of Cardiology, Clinique Saint-Hilaire, 76031 Rouen, France
| | - André Gillibert
- U1096, Department of Biostatistics, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - Jeanne Hohweyer
- Department of Cardiology, Clinique Saint-Hilaire, 76031 Rouen, France
| | - Philippe Bonnet
- Department of Cardiology, Groupe Hospitalier du Havre, 76600 Le Havre, France
| | | | - Pascal Motreff
- Department of Cardiology, Clermont-Ferrand University Hospital, 63000 Clermont-Ferrand, France
| | - Hélène Eltchaninoff
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France
| | - Gregoire Rangé
- Department of Cardiology, Les Hôpitaux de Chartres, 28630 Le Coudray, France
| | - Eric Durand
- U1096, Department of Cardiology, FHU CARNAVAL, CHU de Rouen, Normandie University UNIROUEN, 76000 Rouen, France.
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28
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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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29
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Barbe T, Levesque T, Tron C, Hemery T, Bouhzam N, Bettinger N, Chaumont C, Anselme F, Eltchaninoff H, Durand E. Impact of conductive disturbances on length of stay after TAVI: A single-centre retrospective study. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.104] [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: 11/25/2022]
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30
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Levesque T, Koning R, Gillibert A, Hohweyer J, Bonnet P, Lesault PF, Rangé G, Motreff P, Eltchaninoff H, Durand E. Impact of Lubrizol factory fire in Rouen on coronary events: A retrospective study from the France PCI registry. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.010] [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: 10/17/2022]
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31
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Barbe T, Levesque T, Durand E, Tron C, Bouhzam N, Bettinger N, Hemery T, Littler PY, Beziau D, Cribier A, Eltchaninoff H. TAVI, the road to a minimalist “stent-like” procedure. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2022.04.100] [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: 10/17/2022]
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32
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Affiliation(s)
- Hélène Eltchaninoff
- Department of Cardiology, Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France.,Department of Cardiology, CHU Rouen, Rouen, France
| | - Martine Gilard
- Department of Cardiology, University of Brest, CHRU Brest, Brest, France
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33
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Onorato EM, Alamanni F, Muratori M, Smolka G, Wojakowski W, Pysz P, Zorinas A, Zakarkaite D, Eltchaninoff H, Litzer PY, Godart F, Calvert P, Christou C, Mussayev A, Missiroli B, Buzaev I, Curello S, Tesorio T, Bartorelli AL. Safety, Efficacy and Long-Term Outcomes of Patients Treated with the Occlutech Paravalvular Leak Device for Significant Paravalvular Regurgitation. J Clin Med 2022; 11:jcm11071978. [PMID: 35407584 PMCID: PMC8999580 DOI: 10.3390/jcm11071978] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 01/27/2023] Open
Abstract
Between December 2014 and March 2021, 144 patients with aortic (Ao) or mitral (Mi) paravalvular leaks (PVLs) were enrolled at 21 sites in 10 countries. Safety data were available for 137 patients, who were included in the safety analysis fraction (SAF), 93 patients with Mi PVLs and 44 patients with Ao PVLs. The full analysis set (FAS) comprised 112 patients with available stratum (aortic/mitral leak) as well as baseline (BL), 180-day or later assessments (2 years). Procedural success (implantation of the device with a proper closure of the PVL, defined as reduction in paravalvular regurgitation of ≥one grade as assessed by echocardiography post implantation) was achieved in 91.3% of FAS patients with Mi PVLs and in 90.0% of those with Ao PVLs. The proportion of patients suffering from significant or severe heart failure (HF), classified as New York Heart Association (NYHA) class III/IV, decreased from 80% at baseline to 14.1% at 2-year follow-up (FAS). The proportion of FAS patients needing hemolysis-related blood transfusion decreased from 35.5% to 3.8% and from 8.1% to 0% in Mi patients and Ao patients, respectively. In total, 35 serious adverse events (SAEs) were reported in 27 patients (19.7%) of the SAF population. The SAEs considered possibly or probably related to the device included device embolization (three patients), residual leak (two patients) and vascular complication (one patient). During follow-up, 12/137 (8.8%) patients died, but none of the deaths was considered to be device-related. Patients implanted with the Occlutech Paravalvular Leak Device (PLD) showed long-lasting improvements in clinical parameters, including NYHA class and a reduced dependency on hemolysis-related blood transfusions.
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Affiliation(s)
- Eustaquio Maria Onorato
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (F.A.); (M.M.); (A.L.B.)
- Correspondence:
| | - Francesco Alamanni
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (F.A.); (M.M.); (A.L.B.)
| | - Manuela Muratori
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (F.A.); (M.M.); (A.L.B.)
| | - Grzegorz Smolka
- 3rd Division of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (G.S.); (W.W.); (P.P.)
| | - Wojtek Wojakowski
- 3rd Division of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (G.S.); (W.W.); (P.P.)
| | - Piotr Pysz
- 3rd Division of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (G.S.); (W.W.); (P.P.)
| | - Aleksejus Zorinas
- Department of Cardiovascular Medicine, Vilnius University, 01513 Vilnius, Lithuania; (A.Z.); (D.Z.)
| | - Diana Zakarkaite
- Department of Cardiovascular Medicine, Vilnius University, 01513 Vilnius, Lithuania; (A.Z.); (D.Z.)
| | - Hélène Eltchaninoff
- Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, 76000 Rouen, France; (H.E.); (P.-Y.L.)
| | - Pierre-Yves Litzer
- Department of Cardiology and Cardiovascular Surgery, Hospital Charles Nicolle, 76000 Rouen, France; (H.E.); (P.-Y.L.)
| | - François Godart
- Department of Pediatric Cardiology and Congenital Heart Disease, University of Lille, 59000 Lille, France;
| | - Patrick Calvert
- Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge CB2 0AY, UK;
| | | | | | - Bindo Missiroli
- Gemelli Molise di Campobasso-Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, 86100 Campobasso, Italy;
| | - Igor Buzaev
- Cardiovascular Department, Bashkir State Medical University, 450008 Ufa, Russia;
| | | | - Tullio Tesorio
- Department of Invasive Cardiology, Clinica Montevergine, 83013 Mercogliano, Italy;
| | - Antonio Luca Bartorelli
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (F.A.); (M.M.); (A.L.B.)
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20122 Milan, Italy
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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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Barbe T, Levesque T, Durand E, Tron C, Bouhzam N, Bettinger N, Hemery T, Litzler PY, Beziau D, Cribier A, Eltchaninoff H. Transcatheter aortic valve implantation: The road to a minimalist “stent-like‿ procedure. Arch Cardiovasc Dis 2022; 115:196-205. [DOI: 10.1016/j.acvd.2022.03.004] [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: 02/16/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
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Gilard M, Eltchaninoff H, Iung B, Lefèvre T, Spaulding C, Dumonteil N, Mutuon P, Roussel C, Candolfi P, de Pouvourville G, Green M, Shore J. Cost-Effectiveness Analysis of SAPIEN 3 Transcatheter Aortic Valve Implantation Procedure Compared With Surgery in Patients With Severe Aortic Stenosis at Low Risk of Surgical Mortality in France. Value Health 2022; 25:605-613. [PMID: 35365304 DOI: 10.1016/j.jval.2021.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The clinical and cost-saving benefits of transcatheter aortic valve implantation (TAVI) over surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis who are at high or intermediate risk of surgical mortality are supported by a growing evidence base. The PARTNER 3 trial (Placement of AoRTic TraNscathetER Valve Trial) demonstrated clinical benefits with SAPIEN 3 TAVI compared with SAVR in selected patients at low risk of surgical mortality. This study uses PARTNER 3 outcomes in combination with a French national hospital claim database to inform a cost-utility model and examine the cost implications of TAVI over SAVR in a low-risk population. METHODS A 2-stage cost-utility analysis was developed to estimate changes in both direct healthcare costs and health-related quality of life using TAVI with SAPIEN 3 compared with SAVR. Early adverse events associated with TAVI were captured using the PARTNER 3 data set. These data fed into a Markov model that captured longer-term outcomes of patients, after TAVI or SAVR intervention. RESULTS TAVI with SAPIEN 3 offers meaningful benefits over SAVR in providing both cost saving (€12 742 per patient) and generating greater quality-adjusted life-years (0.89 per patient). These results are robust with TAVI with SAPIEN 3 remaining dominant across several scenarios and deterministic and probabilistic sensitivity analyses. CONCLUSIONS This model demonstrated that TAVI with SAPIEN 3 was dominant compared with SAVR in the treatment of patients with severe symptomatic aortic stenosis who are at low risk of surgical mortality. These findings should help policy makers in developing informed approaches to intervention selection for this patient population.
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Affiliation(s)
- Martine Gilard
- Centre Hospitalier Régional et Universitaire de Brest, Brest, France.
| | - Hélène Eltchaninoff
- Department of Cardiology, CHU Rouen, UNIROUEN, Normandie Univ, Rouen, France
| | - Bernard Iung
- Hôpital Bichat Claude-Bernard (APHP), Paris, France
| | - Thierry Lefèvre
- Hôpital Privé Jacques Cartier, Ramsay-générale de santé, Massy, France
| | | | | | | | | | | | | | - Michelle Green
- York Health Economics Consortium, University of York, York, England, UK
| | - Judith Shore
- York Health Economics Consortium, University of York, York, England, UK
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Levesque T, Koning R, Bonnet P, Lesault P, Hohweyer J, Rangé G, Motreff P, Eltchaninoff H, Durand E. Coronary events before and after Lubrizol factory fire in Rouen: A retrospective study from the France-PCI registry. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.010] [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: 10/19/2022]
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Eltchaninoff H, Gilard M, Leclercq C, Cohen A. Editorial. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chaumont C, Mirolo A, Savoure A, Godin B, Auquier N, Viart G, Hatrel A, Gillibert A, Eltchaninoff H, Anselme F. Very long-term outcomes after catheter ablation of atrioventricular nodal reentrant tachycardia: How does cryoenergy differ from radiofrequency? Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.185] [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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Eltchaninoff H, Gilard M, Leclercq C, Cohen A. JESFC 2022 : un congrès unique, du présentiel au digital. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.12.001] [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: 10/19/2022]
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Durand E, Sacri C, Levesque T, Tron C, Barbe T, Hemery T, Burdeau J, Dacher JN, Eltchaninoff H. Incidence, Predictive Factors, and Prognostic Impact of Right Ventricular Dysfunction Before Transcatheter Aortic Valve Implantation. Am J Cardiol 2021; 161:63-69. [PMID: 34794620 DOI: 10.1016/j.amjcard.2021.08.068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
Right ventricular dysfunction (RVD) is considered to be a late marker of aortic stenosis. However, there is a lack of consensus regarding the incidence, prognostic impact, and evolution of RVD in patients treated with transcatheter aortic valve implantation (TAVI). All patients treated with TAVI for severe aortic stenosis were included in a prospective single-center database. Patients who had a quantitative assessment of right ventricular (RV) function including tricuspid annular plane systolic excursion (TAPSE) and/or Doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S' wave) measurements were eligible for this study. RVD was defined as TAPSE <17 mm or S' <9.5 cm/s if TAPSE was not available. Between 2014 and 2019, 503 patients with RV function assessment were included. The incidence of RVD before TAVI was 18.7%. Predictors of RVD were diabetes (p = 0.03), atrial fibrillation (p = 0.001), impaired left ventricular ejection fraction (p <0.0001), left ventricular dilatation (p = 0.007), and previous cardiac surgery (p = 0.002). Long-term survival was worse in patients with RVD before TAVI compared with those without RVD (hazard ratio 1.97, 95% confidence interval 1.1 to 3.4, p = 0.01). One year after TAVI, 58.7% of patients with baseline RVD had normal RV function and had similar outcomes as compared with those without RVD at baseline. In contrast, patients with persistent RVD had the worst prognosis. In conclusion, RVD is not rare and has a deleterious prognostic impact in patients treated with TAVI. Recovery of normal RV function is frequent after TAVI, whereas persistence of RVD is associated with poor outcomes.
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Sacri C, Durand E, Tron C, Barbe T, Hemery T, Burdeau J, Dacher JN, Eltchaninoff H. Right ventricular dysfunction before transcatheter aortic valve implantation: incidence, predictive factors and prognostic impact. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Right ventricular dysfunction (RVD) is considered to be a late marker of advanced aortic stenosis (AS) and is associated with poor prognosis. Currently. there are conflicting data on the impact of RVD on clinical outcomes in patients with severe AS treated with TAVI. Moreover, few studies have studied the evolution (recovery or persistence) of RVD and its prognostic impact.
Objectives
To assess the incidence and predictive factors of RVD before TAVI, its prognostic impact and its evolution after TAVI.
Methods
All patients treated with TAVI for severe AS were included in a prospective single center database. Only patients who had a quantitative assessment of RV including Tricuspid Annular Plane Systolic Excursion (TAPSE) and/or doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S') measurements, were eligible to this study. RVD was defined by a TAPSE <17 mm or S' <9.5 cm/s if TAPSE was not available.
Results
Between May 2014 and April 2019, 503 patients with RV function evaluation were included. Incidence of RVD before TAVI was 18.7%. Predictors of RVD were diabetes (P=0.03), atrial fibrillation (P=0.001), altered left ventricular ejection fraction (P<0.0001), left ventricular dilatation (P=0.007), and previous cardiac surgery (P=0.002). Long-term survival was altered in patients with RVD before TAVI as compared to those without RVD (HR 1.97, 95% CI: 1.1–3.4, P=0.01). One year after TAVI, 58.7% of patients with baseline RVD had a normal RV function and had similar outcome as compared to those without RVD at baseline. In contrast, patients with persistent RVD had the worst prognosis.
Conclusions
RVD is not rare and has a deleterious prognostic impact in patients treated by TAVI. Recovery of normal RV function is frequent after TAVI whereas persistence of RVD is associated with poor outcomes.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Sacri
- INSERM U1096, Cardiology, Rouen, France
| | - E Durand
- INSERM U1096, Cardiology, Rouen, France
| | - C Tron
- INSERM U1096, Cardiology, Rouen, France
| | - T Barbe
- INSERM U1096, Cardiology, Rouen, France
| | - T Hemery
- INSERM U1096, Cardiology, Rouen, France
| | - J Burdeau
- INSERM U1096, Cardiology, Rouen, France
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Bouleti C, Michel M, Jobbe Duval A, Hemery T, Nicol PP, Didier R, Zeyons F, Zouaghi O, Tchetche D, Delon C, Delomez M, Dibie A, Attias D, Le Breton H, Cormier B, Obadia JF, Tribouilloy C, Lansac E, Chevreul K, Naccache N, Eltchaninoff H, Gilard M, Iung B. Current treatment of symptomatic aortic stenosis in elderly patients: Do risk scores really matter after 80 years of age? Arch Cardiovasc Dis 2021; 114:624-633. [PMID: 34600866 DOI: 10.1016/j.acvd.2021.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 06/10/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND According to the guidelines, surgical aortic valve replacement (SAVR) is recommended in patients at low surgical risk (EuroSCORE II<4%), whereas for other patients, the decision between transcatheter aortic valve implantation (TAVI) and surgery should be made by the Heart Team, with TAVI being favoured in elderly patients. AIM The RAC prospective multicentre survey assessed the respective contributions of age and surgical risk scores in therapeutic decision making in elderly patients with severe symptomatic aortic stenosis. METHODS In September and October 2016, 1049 consecutive patients aged ≥ 75 years were included in 32 centres with on-site TAVI and surgical facilities. The primary endpoint was the decision between medical management, TAVI or SAVR. RESULTS Mean age was 84±5 years and 53% of patients were female. The surgical risk was classified as high (EuroSCORE II>8%) in 18% of patients, intermediate (EuroSCORE II 4-8%) in 34% and low (EuroSCORE II≤4%) in 48%. TAVI was preferred in 71% of patients, SAVR in 19% and medical treatment in 10%. The choice of TAVI over SAVR was associated with older age (P<0.0001) and a higher EuroSCORE II (P=0.008). However, the weight of EuroSCORE II in therapeutic decision making markedly decreased after the age of 80 years. Indeed, 77% of patients aged ≥ 80 years were referred for TAVI, despite a low estimated surgical risk. CONCLUSIONS The impact of risk scores depends strongly on age, and decreases considerably after 80 years, most patients being referred for TAVI, independent of their estimated surgical risk. Despite medical advancements, 10% of patients were still denied any intervention.
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Affiliation(s)
- Claire Bouleti
- CIC Inserm 1402, Cardiology Department, Poitiers University Hospital, Poitiers University, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - Morgane Michel
- ECEVE UMR 1123, Inserm, Hôpital Robert-Debré, URC Eco, Hotel-Dieu, AP-HP, 75019 Paris, France
| | | | | | | | | | | | | | | | | | | | - Alain Dibie
- Institut Mutualiste Montsouris, 75014 Paris, France
| | - David Attias
- Centre Cardiologique du Nord, 93200 Saint-Denis, France
| | | | | | | | | | | | - Karine Chevreul
- ECEVE UMR 1123, Inserm, Hôpital Robert-Debré, URC Eco, Hotel-Dieu, AP-HP, 75019 Paris, France
| | - Nicole Naccache
- Commission des Registres, French Society of Cardiology, Paris, France
| | | | | | - Bernard Iung
- Bichat Hospital, DHU Fire, Université de Paris, AP-HP, 75018 Paris, France
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Patterson T, Clayton T, Dodd M, Khawaja Z, Morice MC, Wilson K, Kim WK, Meneveau N, Hambrecht R, Byrne J, Carrié D, Fraser D, Roberts DH, Doshi SN, Zaman A, Banning AP, Eltchaninoff H, Le Breton H, Smith D, Cox I, Frank D, Gershlick A, de Belder M, Thomas M, Hildick-Smith D, Prendergast B, Redwood S. ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic VAlve implantaTION): A Randomized Clinical Trial. JACC Cardiovasc Interv 2021; 14:1965-1974. [PMID: 34556269 DOI: 10.1016/j.jcin.2021.06.041] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [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: 06/11/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm). BACKGROUND PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice. METHODS Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR. The primary endpoint was a composite of all-cause death or rehospitalization at 1 year. Noninferiority testing (prespecified margin of 7.5%) was performed in the intention-to-treat population. RESULTS At 17 centers, 235 patients underwent randomization. At 1 year, the primary composite endpoint occurred in 48 (41.5%) of the PCI arm and 47 (44.0%) of the no-PCI arm. The requirement for noninferiority was not met (difference: -2.5%; 1-sided upper 95% confidence limit: 8.5%; 1-sided noninferiority test P = 0.067). On analysis of the as-treated population, the difference was -3.7% (1-sided upper 95% confidence limit: 7.5%; P = 0.050). Mortality was 16 (13.4%) in the PCI arm and 14 (12.1%) in the no-PCI arm. At 1 year, there was no evidence of a difference in the rates of stroke, myocardial infarction, or acute kidney injury, with higher rates of any bleed in the PCI arm (P = 0.021). CONCLUSIONS Observed rates of death and rehospitalization at 1 year were similar between PCI and no PCI prior to TAVR; however, the noninferiority margin was not met, and PCI resulted in a higher incidence of bleeding. (Assessing the Effects of Stenting in Significant Coronary Artery Disease Prior to Transcatheter Aortic Valve Implantation; ISRCTN75836930).
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Affiliation(s)
- Tiffany Patterson
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Tim Clayton
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Matthew Dodd
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zeeshan Khawaja
- Cardiology Department, Lewisham and Greenwich NHS Foundation Trust, United Kingdom
| | - Marie Claude Morice
- Institut Cardiovasculaire Paris Sud, Massy, France; Cardiovascular European Research Center, Massy, France
| | - Karen Wilson
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Won-Keun Kim
- Cardiology Department, Kerckhoff-Klinik Bad Nauheim Abteilung Kardiologie, Bad Nauheim, Germany
| | - Nicolas Meneveau
- Department of Cardiology, University Hospital Jean Minjoz, Besançon, France; EA3920, University of Burgundy Franche-Comté, Besançon, France
| | - Rainer Hambrecht
- Cardiology Department, Klinikum Links der Weser GmbH, Bremen, Germany
| | - Jonathan Byrne
- Cardiothoracic Department, King's College Hospital, London, United Kingdom
| | - Didier Carrié
- Cardiology Department, Hôpital Rangueil, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Doug Fraser
- Cardiology Department, Manchester Royal Infirmary, Manchester, United Kingdom
| | - David H Roberts
- Lancashire Cardiac Centre, Blackpool Victoria Hospital NHS Trust, Blackpool, United Kingdom
| | - Sagar N Doshi
- Cardiology Department, Queen Elizabeth Hospital, Birmingham, United Kingdom
| | - Azfar Zaman
- Cardiology Department, Newcastle upon Tyne Hospitals NHS Foundation Trust of the Freeman Hospital, Newcastle, United Kingdom
| | - Adrian P Banning
- Department of Cardiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Hélène Eltchaninoff
- Cardiology Department, Hôpital Charles-Nicolle, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Hervé Le Breton
- Service de Cardiologie, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - David Smith
- Cardiology Department, Morriston Hospital, Swansea, United Kingdom
| | - Ian Cox
- Cardiology Department, Derriford Hospital, Plymouth, United Kingdom
| | - Derk Frank
- Cardiology Department, Oberarzt Facharzt für Innere Medizin und Kardiologie, Kiel, Germany
| | - Anthony Gershlick
- Department of Cardiovascular Sciences, Glenfield Hospital, University of Leicester, Leicester, United Kingdom
| | - Mark de Belder
- Cardiology Department, Barts Heart Centre, London, United Kingdom
| | | | - David Hildick-Smith
- Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom
| | - Bernard Prendergast
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom
| | - Simon Redwood
- Cardiovascular Department, St Thomas' Hospital, Kings College London, London, United Kingdom.
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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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Chaumont C, Saoudi N, Savoure A, Latcu D, Eltchaninoff H, Anselme F. Electrophysiologic evidence of epicardial connections between low right atrium and remote right atrial region or coronary sinus musculature: Relevance for catheter ablation of typical atrial flutter. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Levesque T, Koning R, Bonnet P, Lesault P, Hohweyer J, Rangé G, Motreff P, Eltchaninoff H, Durand E. Coronary events before and after Lubrizol factory fire in Rouen: A retrospective study from the France-PCI registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chaumont C, Auquier N, Milhem A, Mirolo A, Al Arnaout A, Popescu E, Viart G, Godin B, Gillibert A, Savoure A, Eltchaninoff H, Anselme F. Can permanent His bundle pacing be safely started by operators new to this technique? Data from a multicenter registry. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Faroux L, Lhermusier T, Vincent F, Nombela-Franco L, Tchétché D, Barbanti M, Abdel-Wahab M, Windecker S, Auffret V, Campanha-Borges DC, Fischer Q, Muñoz-Garcia E, Trillo-Nouche R, Jorgensen T, Serra V, Toggweiler S, Tarantini G, Saia F, Durand E, Donaint P, Gutierrez-Ibanes E, Wijeysundera HC, Veiga G, Patti G, D'Ascenzo F, Moreno R, Hengstenberg C, Chamandi C, Asmarats L, Hernandez-Antolin R, Gomez-Hospital JA, Cordoba-Soriano JG, Landes U, Jimenez-Diaz VA, Cruz-Gonzalez I, Nejjari M, Roubille F, Van Belle É, Armijo G, Siddiqui S, Costa G, Elsaify S, Pilgrim T, le Breton H, Urena M, Muñoz-Garcia AJ, Sondergaard L, Bach-Oller M, Fraccaro C, Eltchaninoff H, Metz D, Tamargo M, Fradejas-Sastre V, Rognoni A, Bruno F, Goliasch G, Santaló-Corcoy M, Jimenez-Mazuecos J, Webb JG, Muntané-Carol G, Paradis JM, Mangieri A, Ribeiro HB, Campelo-Parada F, Rodés-Cabau J. ST-Segment Elevation Myocardial Infarction Following Transcatheter Aortic Valve Replacement. J Am Coll Cardiol 2021; 77:2187-2199. [PMID: 33926655 DOI: 10.1016/j.jacc.2021.03.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Among patients with acute coronary syndrome following transcatheter aortic valve replacement (TAVR), those presenting with ST-segment elevation myocardial infarction (STEMI) are at highest risk. OBJECTIVES The goal of this study was to determine the clinical characteristics, management, and outcomes of STEMI after TAVR. METHODS This was a multicenter study including 118 patients presenting with STEMI at a median of 255 days (interquartile range: 9 to 680 days) after TAVR. Procedural features of STEMI after TAVR managed with primary percutaneous coronary intervention (PCI) were compared with all-comer STEMI: 439 non-TAVR patients who had primary PCI within the 2 weeks before and after each post-TAVR STEMI case in 5 participating centers from different countries. RESULTS Median door-to-balloon time was higher in TAVR patients (40 min [interquartile range: 25 to 57 min] vs. 30 min [interquartile range: 25 to 35 min]; p = 0.003). Procedural time, fluoroscopy time, dose-area product, and contrast volume were also higher in TAVR patients (p < 0.01 for all). PCI failure occurred more frequently in patients with previous TAVR (16.5% vs. 3.9%; p < 0.001), including 5 patients in whom the culprit lesion was not revascularized owing to coronary ostia cannulation failure. In-hospital and late (median of 7 months [interquartile range: 1 to 21 months]) mortality rates were 25.4% and 42.4%, respectively (20.6% and 38.2% in primary PCI patients), and estimated glomerular filtration rate <60 ml/min (hazard ratio [HR]: 3.02; 95% confidence interval [CI]: 1.42 to 6.43; p = 0.004), Killip class ≥2 (HR: 2.74; 95% CI: 1.37 to 5.49; p = 0.004), and PCI failure (HR: 3.23; 95% CI: 1.42 to 7.31; p = 0.005) determined an increased risk. CONCLUSIONS STEMI after TAVR was associated with very high in-hospital and mid-term mortality. Longer door-to-balloon times and a higher PCI failure rate were observed in TAVR patients, partially due to coronary access issues specific to the TAVR population, and this was associated with poorer outcomes.
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Affiliation(s)
- Laurent Faroux
- Quebec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | | | - Flavien Vincent
- CHU Lille, Institut Coeur et Poumon, Cardiology, Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, Inserm U1011, Institut Pasteur de Lille, EGID, Université de Lille, Lille, France
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | | | - Marco Barbanti
- A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | | | | | - Vincent Auffret
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR1099, Rennes, France
| | | | - Quentin Fischer
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - Erika Muñoz-Garcia
- Hospital Universitario Virgen de la Victoria, Málaga, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Spain
| | | | | | - Vicens Serra
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | - Francesco Saia
- Institute of Cardiology, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Eric Durand
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, FHU CARNAVAL, F-76000, Rouen, France
| | - Pierre Donaint
- Centre Hospitalier Universitaire de Reims, Service de Cardiologie, Reims, France
| | | | | | - Gabriela Veiga
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Giuseppe Patti
- Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Science, Citta' della Salute e Della Scienza, University of Turin, Turin, Italy
| | - Raul Moreno
- Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | | | | | | | - Uri Landes
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | | | - Ignacio Cruz-Gonzalez
- University Hospital Salamanca, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Instituto de Investigación Biomédica de Salamanca, Salamanca, Spain
| | | | - François Roubille
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Cardiology Department, INI-CRT, CHU de Montpellier, France
| | - Éric Van Belle
- CHU Lille, Institut Coeur et Poumon, Cardiology, Department of Interventional Cardiology for Coronary, Valves and Structural Heart Diseases, Inserm U1011, Institut Pasteur de Lille, EGID, Université de Lille, Lille, France
| | - German Armijo
- Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain
| | | | - Giuliano Costa
- A.O.U. Policlinico "G. Rodolico-San Marco", Catania, Italy
| | - Sameh Elsaify
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | | | - Hervé le Breton
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR1099, Rennes, France
| | - Marina Urena
- Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France
| | - Antonio Jesus Muñoz-Garcia
- Hospital Universitario Virgen de la Victoria, Málaga, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Spain
| | | | | | | | - Hélène Eltchaninoff
- Normandie Univ, UNIROUEN, U1096, CHU Rouen, Department of Cardiology, FHU CARNAVAL, F-76000, Rouen, France
| | - Damien Metz
- Centre Hospitalier Universitaire de Reims, Service de Cardiologie, Reims, France
| | | | | | - Andrea Rognoni
- Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Francesco Bruno
- Division of Cardiology, Department of Medical Science, Citta' della Salute e Della Scienza, University of Turin, Turin, Italy
| | | | | | | | - John G Webb
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | | | - Jean-Michal Paradis
- Quebec Heart and Lung Institute, Laval University, Québec City, Québec, Canada
| | - Antonio Mangieri
- Invasive Cardiology Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | | | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Québec City, Québec, Canada; Hospital Clínic de Barcelona, Barcelona, Spain.
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Levesque T, Perzo N, Berg E, Messaoudi H, Herbet A, Colleville B, Dumesnil A, Doguet F, Eltchaninoff H, Boquet D, Richard V, Bellien J. Calcification of aortic valvular interstitial cells induced by endothelin receptor blockers. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2021.04.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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