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Courand P, Bozio A, Ninet J, Boussel L, Bakloul M, Galoin-Bertail C, Metton O, Mitchell J, Perouse De Montclos T, Walton C, Di-Filippo S. Diagnosis and treatment of anomalous aortic origin of coronary artery: A twenty-year retrospective study of experience and decision-making in children and young adults. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.017] [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: 11/29/2022]
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2
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Raissouni K, Henaine R, Ninet J. Congenital aortic insufficiency with ascending aortic aneurysm: Dealing with a challenging case. Progress in Pediatric Cardiology 2019. [DOI: 10.1016/j.ppedcard.2019.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Galoin Bertail C, Perouse De Montclos T, Bakloul M, Metton O, Mitchell J, Ninet J, Di Filippo S. P4375Value of echocardiography to diagnose coronary arteries patterns in transposition of great arteries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
The objective of this study was to evaluate the accuracy of echocardiographic to assess coronary arteries (CA) anatomy in transposition of the great arteries (TGA) and determine impact on outcomes.
Material and methods
Retrospective analysis of data in neonates diagnosed with TGA (isolated or associated with VSD). Preoperative echocardiographic (TTE) coronary artery pattern and surgical intraoperative reports (SURG) were compared. Mismatch between TTE and SURG, and its impact on perioperative outcome were assessed. Coronary patterns were classified in 4 groups: I= normal CA, II= CA with intramural course, III= CA loop, IV= CA loop and intramural segment.
Results
108 neonates who underwent arterial switch operation (ASO) for isolated TGA (67 cases) or TGA+VSD (41) were included in the study: 68 ranged in group I, 7 in group II, 32 in group III and 1 in group IV. Five patients died (4.6%), from coronary cause in 3. Survival rates were 96% at 1-month and 95.2% beyond. Intraoperative complications occurred in 10 cases. TTE and SURG CA diagnosis differed in 19 cases = 17.6% (mismatch). Diagnosis of CA anatomy differed in 4.4%, 42.8%, 37.5% and 100% of respectively groups I, II, III and IV. Mortality was 28.6% in group II (intramural CA) compared to 2.9% in group I, 3.1% in group III and 0% in group IV (p=0.002). Death rates was 15.8% if TTE/SURG mismatch and 2.2% if TTE and SURG were concordant (p=0.0108). Mortality in group II (intramural CA) increased up to 50% in case of mismach TTE/SURG versus 0% if concordance, and was similar in the other groups. Survival rates were 84.2% in TTE misdiagnosed CA anomalies compared to 97.6% if TTE assessment correlated with surgical reports. By multivariate analysis, groups II and III coronary anatomy were risk factors for mismatch between TTE and SURG (respectively p=0.008 and p=0.0005), and mismatch TTE/SURG was the only risk factor for perioperative mortality (p=0.045).
Conclusion
Echocardiography can accurately assess coronary artery anatomy in neonates with TGA. Intramural coronary course is often misdiagnosed. Missed diagnosis of coronary artery anomaly preoperatively may impact on perioperative mortality.
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Affiliation(s)
- C Galoin Bertail
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | | | - M Bakloul
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - O Metton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Mitchell
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Ninet
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
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Blondel De Joigny C, Metton O, Ninet J, Galoin Bertail C, Bakloul M, Perouse De Montclos T, Leconte C, Mulatier C, Di Filippo S. P4692Pronostic factors after arterial switch operation for transposition of the great arteries in children. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1073] [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
The objective of this study was to assess long-term outcome and factors associated wih mortality in children after arterial switch operation (ASO) for transposition of the great arteries (TGA).
Material and methods
Retrospective analysis of all ASO performed from 2000 to 2016 in patients with TGA. Demographics, clinical and biological data, surgical techniques, echocardiographic measurements, and outcomes were collected. Pronostic factors for mortality were assessed.
Results
364 patients were included (263 males). Antenatal diagnosis was made in 60,4%. Birth weight was 3207,5±511.2g, gestational age was 39.1±1.6weeks. Intramural coronary artery was present in 24 cases (6.6%). Long term follow-up was 9.2±4.8 years. Rashkind procedure was performed in 88.7% of the cases. Ventilatory support was needed in 56% and prostaglandins in 85% preoperatively. ASO occurred at the age of 7.44±6.26 days (1 to 56) and 5.6±4.6 days after admission. Bypass duration was 123.1±33.3mn. Overall and postoperative hospital stay were respectively 19.9±8.6 and 14.4±7.3 days. Survival rates were 95.3% at 1 month, 94.8% at 3, 6 and 12 months and 94.5% at 2.5 years and up to 18 years after surgery. Twenty patients died (5.5%): 17 early postoperatively (4.7%). Time from surgery to death was 64.2±207.9 days (0 to 919). Long-term events occurred in 49.6% of the patients: pulmonary stenosis, aortic or mitral regurgitation, residual shunt, coronary lesions (1.7%), arrhythmias (5.5%), cardiac failure. Freedom from late reintervention was 99.7%, 97.4%, 96.2% at 1, 3 and 6 months, 95.9%, 95%, 92.3% and 90.3% at respectively 1, 2, 5 and beyond 8 years after ASO. No Rashkind, postoperative ECMO support, delayed chest closure, bypass duration, troponine level and small birth weight were significant predictive factors of mortality (respectively p=0.006, p<0.0001, p=0.0007, p<0.0001, p=0.001 and p=0.044). Antenatal diagnosis, gender, gestational age, preoperative ventilatory support, prostaglandin infusion, and SpO2, coronary arteries anatomy or age at surgery were not associated with death.
Conclusion
This study showed that Rashkind procedure may have a favourable impact on prognosis of neonates with TGA. Postoperative ECMO support and troponine level, and small birth weight were associated with worse outcome.
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Affiliation(s)
| | - O Metton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Ninet
- University Claude Bernard of Lyon, Lyon, France
| | - C Galoin Bertail
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - M Bakloul
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | | | - C Leconte
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - C Mulatier
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
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Courand PY, Bozio A, Ninet J, Boussel L, Bakloul M, Perouse De Montclos T, Walton C, Metton O, Henaine R, Galoin Bertail C, Di Filippo S. P782Comparison of right coronary artery with left coronary artery arising from opposite sinus: clinical presentation and risk of suden death. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p782] [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: 11/12/2022] Open
Affiliation(s)
- P Y Courand
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - A Bozio
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - J Ninet
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - L Boussel
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - M Bakloul
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | | | - C Walton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - O Metton
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - R Henaine
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - C Galoin Bertail
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
| | - S Di Filippo
- University Hospital of Lyon - Hospital Louis Pradel, Lyon, France
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6
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Ninet J, Bachet P, Prandoni P, Ruol A, Vigo M, Barret A, Mericq O, Boneu B, Janvier G, Duroux P, Girard P, Laprevote-Heully MC, Sourou P, Robert D, Chagny M, Nenci G, Agnelli G, d’Addato M, Palumbo H, Bensaid J, Gouffault J, Leborgne P, Hellocco AL, Ducreux JC, Tempelhoff G, Sala-Planell E, Rosendo-Carrera A, Torres-Gomez A, Blettery B, Bachmann F, Gaux JC, Muntlak H, Caulin C, Bergmann JF. A Randomised Trial of Subcutaneous Low Molecular Weight Heparin (CY 216) Compared with lntravenous Unfractionated Heparin in the Treatment of Deep Vein Thrombosis. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1647660] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThe standard treatment of deep vein thrombosis is given by continuous intravenous infusion of unfractionated heparin. This entails hospitalisation, nursing care, immobility and repeated laboratory tests (e.g. activated partial thromboplastin time [APTT], platelet count). In addition approximately 10% of patients suffer major haemorrhages. The potential advantages of a low molecular weight heparin (CY 216) given subcutaneously were explored in a randomised trial with blind quantitative evaluation of venograms. The study included 166 patients and both “therapeutic efficacy” and “intention to-treat” analyses showed that subcutaneous CY 216 in fixed doses based only on body weight was more effective on the Arnesen and Marder phlebographic scores than continuous i. v. standard heparin with daily dose adjustment according to results of coagulation tests. There was no increase in the risks of pulmonary embolism, haemorrhage or clot extension.
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Bounameaux H, Banga JD, Bluhmki E, Coccheri S, Fiessinger JN, Haarmann W, Lockner D, Mahler F, Ninet J, Schneider PA, de Torrente A, van der Meer J, Verhaeghe AR. Double-Blind, Randomized Comparison of Systemic Continuous Infusion of 0.25 Versus 0.50 mg/kg/24 h of Alteplase over 3 to 7 Days for Treatment of Deep Venous Thrombosis in Heparinized Patients: Results of the European Thrombolysis with rt-PA in Venous Thrombosis (ETTT) Trial. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648437] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThirty-two patients with acute, proximal-vein thrombosis were treated with heparin and alteplase (0.25 versus 0.5 mg/kg/24 h during 3-7 days) in a randomized, double-blind, multicenter, European (ETTT) trial. The treatment resulted in a decrease of the venographic Marder’s score from 18 (6-25) to 13 (2-24) units (median, range) in Group I (0.25 mg/kg/24 h, n = 15, median decrease 3.0, p = 0.32) and from 17.5 (3-33) to 15.5 (0-27) in Group II (0.5 mg/kg/24 h, n = 16, median decrease 4.0, p = 0.23). Comparison of the sequential venograms could be performed in 14 cases of Group I and in 15 cases in Group II. A minority of patients showed substantial partial recanalization of the initially obstructed veins on the control venogram (one in each treatment group) and most of the control venograms showedThus, the results of the ETTT trial show that the used low dosages of alteplase administered intravenously over 3-7 days in heparinized patients cannot be recommended as a treatment for patients with deep venous thrombosis of lower limbs and/or pelvis. Further studies are needed to define a more suitable dosage regimen of alteplase in this indication.
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Affiliation(s)
- H Bounameaux
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - J D Banga
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - E Bluhmki
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - S Coccheri
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - J N Fiessinger
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - W Haarmann
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - D Lockner
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - F Mahler
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - J Ninet
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - P A Schneider
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - A de Torrente
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - J van der Meer
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
| | - and R Verhaeghe
- Geneva, Switzerland; Utrecht, The Netherlands; Bologna, Italy; Paris, France; Huddinge, Sweden; Bern, Switzerland; Lyon, France; La Chaux-de-Fonds, Switzerland; Groningen, The Netherlands; and Leuven, Belgium
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Chalayer E, Costedoat-Chalumeau N, Beyne-Rauzy O, Ninet J, Durupt S, Tebib J, Asli B, Lambotte O, Ffrench M, Vasselon C, Cathébras P. Bone marrow involvement in systemic lupus erythematosus. QJM 2017; 110:701-711. [PMID: 28525589 DOI: 10.1093/qjmed/hcx102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Besides peripheral cytopenias, bone marrow abnormalities, such as fibrosis, pure red cell aplasia and aplastic anemia have been reported in patients with systemic lupus erythematosus (SLE), suggesting that bone marrow may be a 25 target organ in SLE. AIM Our objective was to describe this bone marrow involvement. METHODS This registry is a nationwide retrospective study. Centers provided data concerning medical history, SLE manifestations, type of hematologic disorder, treatments and outcome. Bone marrow aspirations and/or biopsies were transferred for centralized review. RESULTS Thirty patients from 19 centers were included. Central hematologic manifestations comprised bone marrow fibrosis (n = 17; 57%), pure red cell aplasia (n = 8; 27%), myelodysplastic syndrome (n = 3; 10%), aplastic anemia and agranulocytosis (n = 1; 3% each). Bone marrow involvement was diagnosed concomitantly with SLE in 12 patients. Bone marrow biopsies showed fibrosis in 19 cases, including one case of pure red cell aplasia and one case of agranulocytosis and variable global marrow cellularity. Treatments included corticosteroids (90%), hydroxychloroquine (87%), rituximab (33%), intravenous immunoglobulins (30%), mycophenolate mofetil (20%) and ciclosporine (20%). After a median follow-up of 27 months (range: 1-142), 24 patients manifested complete improvement. No patient died. CONCLUSIONS This registry comprises the largest series of SLE patients with bone marrow involvement. It demonstrates the strong link between SLE and bone marrow fibrosis. Patients with atypical or refractory cytopenia associated with SLE should undergo bone marrow examination to enable appropriate, and often effective, treatment. Long-term prognosis is good.
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Affiliation(s)
- E Chalayer
- Clinical Investigation Center-CIC 1408, CHU Saint Etienne, France
| | - N Costedoat-Chalumeau
- Department of Internal Medicine, AP-HP, Referral Center for Rare Auto-Immune and Systemic Diseases, Cochin Hospital, Paris, France
- Paris Descartes-Sorbonne Paris Cité University, Paris, France
- INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - O Beyne-Rauzy
- Department of Internal Medicine, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - J Ninet
- Department of Internal Medicine Edouard Herriot, Centre Hospitalier Universitaire de Lyon, Lyon, France
| | - S Durupt
- Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - J Tebib
- Department of Rheumatology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - B Asli
- Assistance Publique-Hopitaux de Paris, Hematology Saint Louis, Paris, France
| | - O Lambotte
- Department of Internal Medicine, Hopital de Bicetre, Le Kremlin Bicêtre, France
| | - M Ffrench
- Department of Biological Hematology, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - C Vasselon
- Department of Biological Hematology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - P Cathébras
- Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
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Courand P, Bozio A, Veyrier M, Bakloul M, Galoin Bertail C, Ninet J, Boussel L, Di Filippo S. 964Experience in the management of abnormal origin of coronary artery from the opposite sinus at childhood age. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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10
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Dargaud Y, Rugeri L, Fleury C, Battie C, Gaucherand P, Huissoud C, Rudigoz RC, Desmurs-Clavel H, Ninet J, Trzeciak MC. Personalized thromboprophylaxis using a risk score for the management of pregnancies with high risk of thrombosis: a prospective clinical study. J Thromb Haemost 2017; 15:897-906. [PMID: 28231636 DOI: 10.1111/jth.13660] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Indexed: 12/30/2022]
Abstract
Essentials Pregnancy is a risk factor for thrombosis. Management of thrombosis risk in pregnancy remains a challenge. Prophylaxis needs to be personalized. Our score may be a helpful tool for the management of pregnancies at high risk of thrombosis. SUMMARY Background Patients with thrombophilia and/or a history of venous thromboembolism (VTE) are at risk of thrombosis during pregnancy. A risk score for pregnancies with an increased risk of VTE was previously described by our group (Lyon VTE score). Objectives The aim of this prospective study was to assess the efficacy and safety of our score-based prophylaxis strategy in 542 pregnancies managed between 2005 and 2015 in Lyon University Hospitals. Patients/Methods Of 445 patients included in the study, 36 had several pregnancies during the study period. Among these 445 patients, 279 had a personal history of VTE (62.7%), 299 patients (67.2%) had a thrombophilia marker, and 131 (29.4%) thrombophilic women had a personal history of VTE. During pregnancy, patients were assigned to one of three prophylaxis strategies according to the risk scoring system. Results In the antepartum period, low molecular weight heparin (LMWH) prophylaxis was prescribed to 64.5% of patients at high risk of VTE. Among them, 34.4% were treated in the third trimester only, and 30.1% were treated throughout pregnancy. During the postpartum period, all patients received LMWH for at least 6 weeks. Two antepartum-related VTEs (0.37%; one with a score of < 3 and the other with a score of > 6) and four postpartum-related VTEs (0.73%; three with scores of 3-5 and one with a score of > 6) occurred. No case of pulmonary embolism was observed during the study period. The rate of bleeding was 0.37%. No serious bleeding requiring transfusions or surgery occurred during the study period. Conclusion The use of a risk score may provide a rational decision process to implement safe and effective antepartum thromboprophylaxis in pregnant women at high risk of VTE.
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Affiliation(s)
- Y Dargaud
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
| | - L Rugeri
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
| | - C Fleury
- Laboratoire d'Explorations Vasculaires, pavillon M, Hopital Edouard Herriot, CHU de Lyon, France
| | - C Battie
- Service d'Obstetrique, Hopital Femme Mere Enfant, CHU de Lyon, France
| | - P Gaucherand
- Service d'Obstetrique, Hopital Femme Mere Enfant, CHU de Lyon, France
| | - C Huissoud
- Service d'Obstetrique, Hopital de la Croix Rousse, CHU de Lyon, France
| | - R C Rudigoz
- Service d'Obstetrique, Hopital de la Croix Rousse, CHU de Lyon, France
| | - H Desmurs-Clavel
- Service de Medecine Interne, pavillon O, Hopital Edouard Herriot, CHU de Lyon, France
| | - J Ninet
- Service de Medecine Interne, pavillon O, Hopital Edouard Herriot, CHU de Lyon, France
| | - M C Trzeciak
- Unite d'Hemostase Clinique, Hopital Cardiologique Louis Pradel, CHU de Lyon, France
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Tall F, Dechomet M, Riviere S, Cottin V, Ballot E, Tiev KP, Montin R, Morin C, Chantran Y, Grange C, Jullien D, Ninet J, Chretien P, Cabane J, Fabien N, Johanet C. The Clinical Relevance of Antifibrillarin (anti-U3-RNP) Autoantibodies in Systemic Sclerosis. Scand J Immunol 2017; 85:73-79. [PMID: 27864990 DOI: 10.1111/sji.12510] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 11/10/2016] [Indexed: 11/28/2022]
Abstract
Systemic sclerosis (SSc) is a heterogeneous autoimmune disease associated with several antinuclear autoantibodies useful to diagnosis and prognosis. The aim of the present multicentric study was to determine the clinical relevance of antifibrillarin autoantibodies (AFA) in patients with SSc. The clinical features of 37 patients with SSc positive for AFA (AFA+) and 139 SSc patients without AFA (AFA-) were collected retrospectively from medical records to enable a comparison between AFA- and AFA+ patients. Antifibrillarin autoantibodies were screened by an indirect immunofluorescence technique using HEp2 cells and identified by an in-house Western blot technique and/or an EliA test. Comparing AFA+ and AFA- patients, AFA+ patients were significantly younger at disease onset (36.9 versus 42.9; P = 0.02), more frequently male (P = 0.02) and of Afro-Caribbean descent (65% versus 7.7%; P < 0.001). At diagnosis, the Rodnan skin score evaluating the cutaneous manifestations was higher (13.3 versus 8.7; P = 0.01) and myositis was also more common in the AFA+ group (31.4% versus 12.2%; P < 0.01). Patients with AFA+ were not associated with diffuse cutaneous SSc or with lung involvement and no difference in survival was observed. Antifibrillarin autoantibodies are associated with patients of Afro-Caribbean origin and can identify patients with SSc who are younger at disease onset and display a higher prevalence of myositis.
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Affiliation(s)
- F Tall
- Immunology Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - M Dechomet
- Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon; Claude Bernard, Pierre-Benite, France
| | - S Riviere
- Internal Medicine Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - V Cottin
- Respiratory Diseases Department, Louis Pradel Hospital, Bron, France
| | - E Ballot
- Immunology Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - K P Tiev
- Internal Medicine Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - R Montin
- Immunology Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - C Morin
- Internal Medicine Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - Y Chantran
- Immunology Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - C Grange
- Internal Medicine Department, Lyon-Sud Hospital, Pierre-Bénite, France
| | - D Jullien
- Dermatology Department, Edouard Herriot Hospital, Lyon, France
| | - J Ninet
- Internal Medicine Department, Edouard Herriot Hospital, Lyon, France
| | - P Chretien
- Immunology Department, AP-HP Bicêtre Hospital, Kremlin Bicêtre, France
| | - J Cabane
- Internal Medicine Department, AP-HP Saint-Antoine Hospital, Paris, France
| | - N Fabien
- Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon; Claude Bernard, Pierre-Benite, France.,University Lyon I, University of Lyon, Pierre-Bénite, France
| | - C Johanet
- Immunology Department, AP-HP Saint-Antoine Hospital, Paris, France.,UFR 967, Faculte de medecine, University Pierre et Marie Curie, Paris6, France
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12
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Ankou B, Ninet J, Bozio A, Ducreux C, Bakloul M, Bertail-Galoin C, Di Filippo S. Impact of conversion from classic Fontan to total cavopulmonary connection on adults with single-ventricle short and long-term outcomes. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30336-1] [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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13
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Veyrier M, Ducreux C, Henaine R, Ninet J, Bertail-Galoin C, Bakloul M, Di Filippo S. Heart transplantation in infants and children on mechanical ventricular support. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30348-8] [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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14
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Pegat A, Perard L, Girard-Madoux MH, Aubineau M, Poutrel S, Giannoli C, Marie M, Ninet J, Hot A. Syndrome catastrophique des antiphospholipides familial chez deux sœurs. Existence d’un facteur génétique prédisposant ? Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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15
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Dhelft F, Laville M, Ninet J, Miossec P, Jullien D, Hot A. Une cohorte prospective sur la morbi/mortalité cardiovasculaire chez des patients atteints de sclérodermie systémique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.124] [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: 11/17/2022]
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16
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Verkimpe M, Ninet J, Girard-Madoux M, Aubineau M, Rouvière O, Hot A. Micro-anévrysmes rénaux chez des patients atteints de polyangéite microscopique. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.10.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Dargaud Y, Pariset C, Pinede L, Rugeri L, Mohammedi I, Trzeciak C, Negrier C, Ninet J. Multiple arterial thromboses in a patient with primary antiphospholipid syndrome receiving a bromocriptine therapy. Lupus 2016; 13:957-60. [PMID: 15645753 DOI: 10.1191/0961203304lu2016cr] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report a patient with a previously known primary antiphospholipid syndrome who had life threatening multiple arterial thromboses. The patient experienced a myocardial infarction with intraventricular thrombi under bromocriptine therapy in the puerperium, despite prophylactic low molecular weight heparin therapy. In this patient, no microvascular involvement was identified, thus eliminating the diagnosis of catastrophic antiphospholipid syndrome. Arterial thromboses may be explained by peripheral emboli originating from the intraventricular thrombi. This case emphasizes the necessity of a careful evaluation of the risk-benefit balance of bromocriptine therapy in patients with arterial risk factors. It also emphasizes the need for a correct diagnosis of catastrophic antiphospholipid syndrome allowing to limit the prescription of aggressive therapies.
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Affiliation(s)
- Y Dargaud
- Service d' Exploration Vasculaire, Hopital Edouard Herriot, Lyon, France.
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18
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Durel C, Achille A, Bienvenu B, Gombert B, Hachulla É, Ninet J, Maucort-Boulch D, Cuisset L, Touitou I, Moutschen M, Lequerré T, Hot A. Étude observationnelle d’une cohorte multicentrique de 23 patients atteints d’un déficit en mévalonate kinase diagnostiqué à l’âge adulte. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.248] [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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19
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Lopez M, Desmurs H, Bureau Du Colombier P, Bouchet J, Ninet J, Dargaud Y. Facteurs de risque de récidive clinicobiologique et échographique de la maladie thromboembolique veineuse après un premier épisode de thrombose veineuse profonde proximale : résultats d’une étude prospective sur 195 patients. Rev Med Interne 2016. [DOI: 10.1016/j.revmed.2016.04.302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Mathian A, Arnaud L, Adoue D, Agard C, Bader-Meunier B, Baudouin V, Belizna C, Bonnotte B, Boumedine F, Chaib A, Chauchard M, Chiche L, Daugas E, Ghali A, Gobert P, Gondran G, Guettrot-Imbert G, Hachulla E, Hamidou M, Haroche J, Hervier B, Hummel A, Jourde-Chiche N, Korganow AS, Kwon T, Le Guern V, Le Quellec A, Limal N, Magy-Bertrand N, Marianetti-Guingel P, Martin T, Martin Silva N, Meyer O, Miyara M, Morell-Dubois S, Ninet J, Pennaforte JL, Polomat K, Pourrat J, Queyrel V, Raymond I, Remy P, Sacre K, Sibilia J, Viallard JF, Viau Brabant A, Hanslik T, Amoura Z. Prévention des infections au cours du lupus systémique chez l’adulte et l’adolescent : élaboration de recommandations pour la pratique clinique, à partir d’une analyse de la littérature et de l’avis d’experts. Rev Med Interne 2016; 37:307-20. [DOI: 10.1016/j.revmed.2016.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 01/03/2016] [Accepted: 01/05/2016] [Indexed: 12/21/2022]
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21
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de Charry F, Sadoune K, Sebban C, Rey P, de Parisot A, Nicolas-Virelizier E, Belhabri A, Ghesquières H, Ninet J, Faurie P. [Association of lymphoma and granulomatosis: A case series]. Rev Med Interne 2015; 37:453-9. [PMID: 26611429 DOI: 10.1016/j.revmed.2015.10.344] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/24/2015] [Accepted: 10/23/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE The sarcoidosis-lymphoma syndrome is a recognised entity. However, the presence of granulomas in patients with a haematological disease should not lead too easily to a diagnosis of sarcoidosis. The presence of granulomatous lesions during the follow-up of these patients raises diagnostic and therapeutic issues. METHODS We included 25 patients followed by the department of haematology in a French hospital (Centre Léon-Bérard). These patients presented with granulomatous lesions. Patients with a history of sarcoidosis were excluded. We report the type of haematological disease, the time of onset of the granulomatous disease compared to that of lymphoma, associated symptoms, aetiology and outcome. Patients were divided into three groups according to the time of onset of the granulomatous lesions. RESULTS Granulomatous lesions appeared before the haematological disease in 4 cases, was concomitant in 8 cases and appeared later in 13 remaining cases. The two main subtypes of lymphoma encountered were: diffuse large cell lymphoma (36%) and Hodgkin's lymphoma (28%). Granulomatous lesions were related to the progression of the hematological disease in 11 cases, to sarcoidosis in 4 cases, to infection in 3 cases, to drug allergy in one case, to inflammatory bowel disease in one case, to granuloma annulare in one case and was isolated in 4 cases (no identified etiology). In the group where granulomas appeared after the haematological disease, mean SUV was 11 for the haematological disease versus 6.4 for granulomas. CONCLUSION Granulomatous diseases in lymphomas can be due to various aetiologies: infection, reaction to the haematological disease, or systemic sarcoidosis. It is an important challenge for clinicians, who can miss the diagnosis of lymphoma and or conclude to a treatment failure or a relapse. Computed tomography scan (CT-scan) or (18)F-deoxyglucose-positron emission tomography scan can help establish a diagnosis but do not replace biopsy.
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Affiliation(s)
- F de Charry
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France; Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France; Service de médecine interne, hôpital d'Instruction des Armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - K Sadoune
- Service de médecine nucléaire, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | - C Sebban
- Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | - P Rey
- Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | - A de Parisot
- Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | | | - A Belhabri
- Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | - H Ghesquières
- Service d'hématologie, centre Léon-Bérard, 28, rue Laënnec, 69003 Lyon, France
| | - J Ninet
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
| | - P Faurie
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France
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Desmurs H, Fleury C, Amaranto P, Rugeri L, Trzeciak M, Ninet J, Dargaud Y. Évaluation prospective sur 10ans du score de Lyon dans la prévention de la maladie thromboembolique chez la femme enceinte. Résultats sur 445 patientes à risque. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Dureau G, Chuzel M, Termet H, Frieh JP, Ninet J, Villard J, Alnashawati G, Dugres B, Saroul C, Germain MC. Graft condition and mortality in heart transplantation. Contrib Nephrol 2015; 71:138-40. [PMID: 2805689 DOI: 10.1159/000417265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- G Dureau
- Hôpital Cardiologique Louis Pradel de Lyon, INSERM, U 37, France
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24
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Zuily S, Rat AC, Regnault V, Kaminsky P, Mismetti P, Ninet J, Baillet N, Magy-Bertrand N, Pasquali JL, Lambert M, Pasquier E, Lorcerie B, Lecompte T, Guillemin F, Wahl D. Impairment of quality of life in patients with antiphospholipid syndrome. Lupus 2015; 24:1161-8. [PMID: 25862730 DOI: 10.1177/0961203315580871] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 12/29/2014] [Accepted: 03/17/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Health-related quality of life (HRQoL) has not been fully explored in antiphospholipid syndrome (APS); therefore, we compared HRQoL between APS patients and the general population and assessed the impact of thromboembolic history. METHODS HRQoL was measured in a multicentre cohort study by the Medical Outcomes Study Short-Form 36 (MOS-SF-36) questionnaire. HRQoL scores were compared to the French general population norms. Factors significantly associated with an impaired HRQoL were identified. RESULTS A total of 115 patients with aPL and/or systemic lupus erythematosus (SLE) were included (mean age 42.7 ± 14.1 years old, 86 women). In 53 patients APS was diagnosed. Compared to general population norms, patients with APS had an impaired HRQoL. SLE-associated APS patients had the worst HRQoL scores (physical component summary (PCS)=40.8 ± 10.6; mental component summary (MCS)=40.6 ± 16.5) in comparison with SLE or aPL patients without thromboembolic history. In APS patients, history of arterial thrombosis significantly impaired HRQoL (PCS score: 42.2 ± 9.4 vs 49.2 ± 8.5; MCS score: 33.9 ± 13.7 vs 44.6 ± 10.3). CONCLUSION Compared to the general population, APS patients experienced a lower HRQoL. In these patients, a history of arterial thrombosis significantly impaired HRQoL. Therefore, measurements of HRQoL should be included in APS patient management to assess the burden of the disease from a patient's perspective and to provide patients with the support they need.
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Affiliation(s)
- S Zuily
- CHU de Nancy, Vascular Medicine Division and Regional Competence Centre for Systemic and Autoimmune Diseases, Nancy, France Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France
| | - A-C Rat
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France Inserm, CIC-EC CIE6, Nancy, France CHU de Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France CHU de Nancy, Rheumatology Department, Nancy, France
| | - V Regnault
- Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France CHU de Nancy, Contrat d'interface, Nancy, France
| | - P Kaminsky
- Université de Lorraine, Nancy, France CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - P Mismetti
- CHU de Saint Etienne, Clinical Pharmacology Unit and EA 3065, Saint-Etienne, France
| | - J Ninet
- CHU de Lyon, Department of Internal Medicine, Lyon, France
| | - N Baillet
- Colmar Hospital, Department of Internal Medicine, Colmar, France
| | - N Magy-Bertrand
- CHU de Besançon, Internal Medicine and Clinical Immunology Department, Besançon, France
| | - J-L Pasquali
- CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, France
| | - M Lambert
- CHRU de Lille, Department of Internal Medicine, Lille, France
| | - E Pasquier
- CHU de Brest, Department of Internal Medicine and Chest Diseases and EA 3878, Brest, France
| | - B Lorcerie
- CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon, France
| | - T Lecompte
- Université de Lorraine, Nancy, France University Hospitals of Geneva, Division of Haematology, Geneva, Switzerland (T.L. current address)
| | - F Guillemin
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France CHU de Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France
| | - D Wahl
- CHU de Nancy, Vascular Medicine Division and Regional Competence Centre for Systemic and Autoimmune Diseases, Nancy, France Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France
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25
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De Parisot A, Raverot G, Langrand C, Gil H, Vinzio S, Berthier S, Le G, Perard L, Ninet J, Cordier J, Guillevin L, Sève P. Atteinte hypothalamohypophysaire au cours de la granulomatose avec polyangéite : analyse rétrospective de six cas et revue de la littérature. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.109] [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: 10/24/2022]
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26
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Durel C, Berthiller J, Caboni S, Jayne D, Ninet J, Hot A. Atteinte neurologique périphérique des granulomatoses éosinophiliques avec polyangéite : un facteur pronostique à prendre en compte. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.020] [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: 11/30/2022]
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27
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Mercier J, Durieu I, Kollop-Sarda M, Salles G, Hot A, Sebban C, Luc T, Ninet J, Vital-durand D, Lega J. Caractéristiques cliniques et pronostic de la vascularite cryoglobulinémique de type 1 : série monocentrique de 25 patients. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.112] [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: 11/30/2022]
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28
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Gerfaud-valentin M, Gaillard-Coadon A, Hot A, Ninet J, Durieu I, Broussolle C, Sève P. Atteintes parenchymateuses pulmonaires au cours de la maladie de Still de l’adulte. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.144] [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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29
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Gindre H, Perard L, Poutrel S, Girard C, Faurie P, Ninet J, Hot A. Vascularite à ANCA succédant à une vascularite à cellules géantes : à propos de deux cas. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.10.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Arnaud L, Mathian A, Adoue D, Bader-Meunier B, Baudouin V, Belizna C, Bonnotte B, Boumedine F, Chaib A, Chauchard M, Chiche L, Daugas E, Ghali A, Gobert P, Gondran G, Guettrot-Imbert G, Hachulla E, Hamidou M, Haroche J, Hervier B, Hummel A, Jourde-Chiche N, Korganow AS, Kwon T, Le Guern V, Le Quellec A, Limal N, Magy-Bertrand N, Marianetti-Guingel P, Martin T, Martin Silva N, Meyer O, Miyara M, Morell-Dubois S, Ninet J, Papo T, Pennaforte JL, Polomat K, Pourrat J, Queyrel V, Raymond I, Remy P, Sacre K, Schmidt J, Sibilia J, Viallard JF, Viau Brabant A, Wahl D, Bruckert E, Amoura Z. [Screening and management of cardiovascular risk factors in systemic lupus erythematosus: Recommendations for clinical practice based on the literature and expert opinion]. Rev Med Interne 2014; 36:372-80. [PMID: 25455954 DOI: 10.1016/j.revmed.2014.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 04/17/2014] [Accepted: 10/13/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To develop French recommendations about screening and management of cardiovascular risk factors in systemic lupus erythematosus (SLE). METHODS Thirty-nine experts qualified in internal medicine, rheumatology and nephrology have selected recommendations from a list developed based on evidence from the literature. For each recommendation, the level of evidence and the level of agreement among the experts were specified. RESULTS Experts recommended an annual screening of cardiovascular risk factors in SLE. Statins should be prescribed for primary prevention in SLE patients based on the level of LDL-cholesterol and the number of cardiovascular risk factors, considering SLE as an additional risk factor. For secondary prevention, experts have agreed on an LDL-cholesterol target of <0.7 g/L. Hypertension should be managed according to the 2013 European guidelines, using renin-angiotensin system blockers as first line agents in case of renal involvement. Aspirin can be prescribed in patients with high cardiovascular risk or with antiphospholipid antibodies. CONCLUSION These recommendations about the screening and management of cardiovascular risk factors in SLE can be expected to improve clinical practice uniformity and, in the longer term, to optimize the management of SLE patients.
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Affiliation(s)
- L Arnaud
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France.
| | - A Mathian
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - D Adoue
- Service de médecine interne et immunopathologie clinique, hôpital Purpan, Toulouse, France
| | - B Bader-Meunier
- Service d'immunologie et rhumatologie pédiatrique, centre de référence des maladies rares rhumatologiques et inflammatoires pédiatriques (CERHUMIP), hôpital Necker, Paris, France
| | - V Baudouin
- Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France
| | - C Belizna
- Service de médecine interne, CHU d'Angers, Angers, France
| | - B Bonnotte
- Service de médecine interne et immunologie clinique, CHU Bocage, Dijon, France
| | - F Boumedine
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Chaib
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Chauchard
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - L Chiche
- Service de médecine interne, hôpital de la Conception, Marseille, France
| | - E Daugas
- Service de néphrologie, hôpital Bichat, Paris, France
| | - A Ghali
- Service de médecine interne, CHU d'Angers, Angers, France
| | - P Gobert
- Service de médecine interne et néphrologie, centre hospitalier d'Avignon, Avignon, France
| | - G Gondran
- Service de médecine interne A, hôpital Dupuytren, CHU de Limoges, Limoges, France
| | - G Guettrot-Imbert
- Service de médecine interne, hôpital Gabriel-Montpied, CHU, Clermont-Ferrand, France
| | - E Hachulla
- Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France
| | - M Hamidou
- Service de médecine interne, Nantes, France
| | - J Haroche
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
| | - B Hervier
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Hummel
- Service de néphrologie adulte, hôpital Necker, Paris, France
| | - N Jourde-Chiche
- Service de néphrologie, hôpital de la Conception, Marseille, France
| | - A-S Korganow
- Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | - T Kwon
- Service de néphrologie pédiatrique, hôpital Robert-Debré, Paris, France
| | - V Le Guern
- Service de médecine interne, centre de référence maladies systémiques et auto-immunes rares, sclérodermies, vascularites, groupe hospitalier Cochin, Paris, France
| | - A Le Quellec
- Service de médecine interne A, hôpital Saint-Éloi, Montpellier, France
| | - N Limal
- Service de médecine interne, CHU Henri-Mondor, Créteil, France
| | - N Magy-Bertrand
- Service de médecine interne, CHU Jean-Minjoz, Besançon, France
| | | | - T Martin
- Service d'immunologie clinique, hôpital civil, CHU de Strasbourg, Strasbourg, France
| | | | - O Meyer
- Service de rhumatologie, hôpital Bichat-Claude-Bernard, Paris, France
| | - M Miyara
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - S Morell-Dubois
- Service de médecine interne, hôpital Claude-Huriez, CHRU de Lille, Lille, France
| | - J Ninet
- Service de médecine interne, hôpital Édouard-Herriot, CHRU de Lyon, Lyon, France
| | - T Papo
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - J-L Pennaforte
- Service de médecine interne, CHU de Reims, Reims, France
| | - K Polomat
- Service de médecine interne 5D, CHU de Martinique, Fort-de-France, Martinique
| | - J Pourrat
- Service de néphrologie, hôpital Rangueil, CHU, Toulouse, France
| | - V Queyrel
- Service de médecine interne, hôpital de l'Archet, Nice, France
| | - I Raymond
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France
| | - P Remy
- Service de néphrologie, groupe hospitalier Henri-Mondor, Créteil, France
| | - K Sacre
- Service de médecine interne, hôpital Bichat, Claude-Bernard, Paris, France
| | - J Schmidt
- Service de médecine interne, CHU Nord, Amiens, France
| | - J Sibilia
- Service de rhumatologie, CHU Hautepierre, Strasbourg, France
| | - J-F Viallard
- Service de médecine interne et maladies infectieuses, hôpital Haut-Lévêque, centre François-Magendie, Pessac, France
| | - A Viau Brabant
- Service de médecine interne, CHU de Reims, Reims, France
| | - D Wahl
- Inserm U 1116, service de médecine vasculaire, département de médecine interne, institut lorrain du cœur et des vaisseaux Louis-Mathieu, centre de compétence régional des maladies systémiques et auto-immunes rares, CHU de Nancy, université de Lorraine, Vandœuvre-lès-Nancy, France
| | - E Bruckert
- Service d'endocrinologie, métabolisme et prévention cardiovasculaire, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - Z Amoura
- Service de médecine interne 2, Centre national de référence du lupus systémique, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France; Sorbonne universités, UPMC université Paris 06, 75013 Paris, France
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Pasquet F, Pavic M, Ninet J, Hot A. [Auto-immune diseases and cancers. Second part: auto-immune diseases complicating cancers and their treatment]. Rev Med Interne 2014; 35:656-63. [PMID: 25106665 DOI: 10.1016/j.revmed.2014.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Revised: 01/27/2014] [Accepted: 04/14/2014] [Indexed: 12/18/2022]
Abstract
Autoimmune diseases may reveal or occur during the course of a neoplasia or its treatment. Autoimmune cytopenia, especially haemolytic anaemia, is common in lymphoproliferative disorders such as chronic lymphoid leukemia. The link between cancer and myositis is well established. Dermatomyositis is associated with an increased relative risk of cancer of 3.4 to 4.4. A combination of detection of antibodies against p155 and TEP-computed tomography may be the best approach to ascertain the presence of occult malignancy in patients with dermatomyositis. A cutaneous or a systemic vascularitis may reveal a cancer, most often a haematological malignancy such as hairy cell leukemia. Paraneoplastic polyarthritis have been described in particular with adenocardinoma of the lungs. Underlying neoplasia should be considered in male smokers patients with new onset polyarthritis and poor health status. The prevalence of autoimmune conditions in myelodysplastic syndromes is 10 to 30%. Vasculitis and relapsing polychondritis are the most commonly reported manifestations. Immune manifestations can also be related to treatment. The most common treatment complications are autoimmune haemolytic anaemia with fludarabine and thyroiditis related to interferon and cervical radiotherapy.
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Affiliation(s)
- F Pasquet
- Service de médecine interne-oncologie, hôpital d'instruction des armées Desgenettes, 108, boulevardd Pinel, 69003 Lyon, France.
| | - M Pavic
- Service de médecine interne-oncologie, hôpital d'instruction des armées Desgenettes, 108, boulevardd Pinel, 69003 Lyon, France
| | - J Ninet
- Service de médecine interne, hôpital Édouard-Hérriot, 5, place d'Arsonval, 69003 Lyon cedex 03, France
| | - A Hot
- Service de médecine interne, hôpital Édouard-Hérriot, 5, place d'Arsonval, 69003 Lyon cedex 03, France
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Di Filippo S, Henaine R, Veyrier M, Ducreux C, Ninet J, Sebbag L, Boissonnat P, Roussoulières A. Long-term experience with heart transplantation in children and patients with congenital heart disease. Arch Cardiovasc Dis 2014. [DOI: 10.1016/j.acvd.2014.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chevalier Y, Mandrillon G, Bestion A, Lega JC, Piquet P, Ninet J, Dargaud Y. Do heterozygous factor V Leiden and prothrombin G20210A mutations have different impact on the type and location of venous thromboembolism? INT ANGIOL 2014; 33:404-405. [PMID: 25056173] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Y Chevalier
- Unité d'Hémostase Clinique, CHU de Lyon, Lyon, France
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Roux S, Ferry T, Chidiac C, Bouaziz A, Ninet J, Pérard L, Farhat F, Broussolle C, Sève P. Anévrismes infectieux de l’aorte thoracique : présentation de 7 cas et revue de la littérature. Rev Med Interne 2014; 35:357-64. [DOI: 10.1016/j.revmed.2013.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 06/18/2013] [Accepted: 09/14/2013] [Indexed: 12/20/2022]
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Durel CA, Berthiller J, Caboni S, Jayne D, Ninet J, Hot A. L’atteinte ORL des granulomatoses éosinophiliques avec polyangéite : un facteur de bon pronostic sur la survenue de séquelles à long terme ? Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.016] [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: 10/25/2022]
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Virot E, Richard Colman G, Durand E, Maurice C, Ninet J, Bayarassou S, Laville M, Hot A. Risque vasculaire et lupus : premiers résultats du suivi d’une cohorte prospective de 100 patients français. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.068] [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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Leroy C, Girard C, Girard-Madoux M, Coppéré B, Desmurs-Clavel H, Pérard L, Hot A, Ninet J. Une sarcoïdose qui en a dans le ventre. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.243] [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: 11/12/2022]
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Chastang MC, Desjonqueres M, Hentgen V, Quartier Dit Maire P, Grateau G, Kone-Paut I, Durieu I, Ninet J, Cochat P. PReS-FINAL-2231: A series of 41 mutations of TNFRAF1A. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042902 DOI: 10.1186/1546-0096-11-s2-p221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Poutrel S, Virot E, Pondarre C, Coppere B, Raba M, Ninet J, Hot A. Efficacité du rituximab sur l’allo-immunisation tardive post transfusionnelle chez le patient drépanocytaire : 4 cas. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Pasquet F, Pavic M, Ninet J, Hot A. [Autoimmune diseases and cancers. Part I: cancers complicating autoimmune diseases and their treatment]. Rev Med Interne 2013; 35:310-6. [PMID: 24268698 DOI: 10.1016/j.revmed.2013.10.336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 01/14/2013] [Revised: 09/12/2013] [Accepted: 10/23/2013] [Indexed: 12/17/2022]
Abstract
The link between systemic disease and cancer is not fortuitous. An autoimmune disease can represent the starter for developing a non-Hodgkin lymphoma. This is particularly true for Sjögren's syndrome that is associated with the highest risk of lymphoma (odds ratio up to 44). Other systemic autoimmune diseases concerned are systemic lupus with an odds ratio of 4.5 and rheumatoid arthritis with an odds ratio of 2 to 3. It is now well established that high inflammatory activity, rather than immunosuppressive treatment, is the major risk determinant. The association between solid cancer and autoimmune systemic disease is uncommon and concerns in particular scleroderma and lung cancer. Concerning biotherapy-induced cancers, there is no demonstrated increased risk with anti-TNFα (except for cutaneous carcinoma and maybe melanoma) or with tocilizumab and abatacept even if studies with longer follow-up are needed at least for these two last drugs.
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Affiliation(s)
- F Pasquet
- Service de médecine interne-oncologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - M Pavic
- Service de médecine interne-oncologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - J Ninet
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon cedex 03, France
| | - A Hot
- Service de médecine interne, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon cedex 03, France
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Lensel AS, Lermusiaux P, Boileau C, Feugier P, Sérusclat A, Zerbib Y, Ninet J. [Is a patient's knowledge of cardiovascular risk factors better after the occurrence of a major ischemic event? Survey of 135 cases and 260 controls]. ACTA ACUST UNITED AC 2013; 38:360-6. [PMID: 24211108 DOI: 10.1016/j.jmv.2013.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 09/25/2013] [Indexed: 11/16/2022]
Abstract
AIM We hypothezised that patients (cases) who are hospitalized for a major ischemic event--myocardial infarction, stroke, decompensation of peripheral arterial disease--acquire better knowledge than a control population--atheromatous patients without a major ischemic event, patients consulting for a vein disease or a diabetes evaluation, and accompanists--about cardiovascular risk factors (smoking, hypertension, diabetes, dyslipidemia, obesity) and have a better understanding of the usefulness of making changes in their lifestyle (quit smoking, regular exercise, Mediterranean diet, low salt diet, weight control, diabetes care). METHODS A questionnaire was proposed at vascular surgery consultations and vascular and cardiac functional explorations, at the M Pavillon of the Édouard-Herriot hospital, Lyon, France. In five months, 395 questionnaires (135 cases and 260 controls) were analyzed. RESULTS The global knowledge score was statistically higher for cases than for controls (cases 3.23±1.81; controls 2.77±2.03; P=0.037). Cases did not abide by monitoring and dietary rules better, except as regards the management of diabetes. Regular physical activity was statistically more prevalent among controls than among cases. Cases mainly received their information from their doctors (general practitioner for 59% of controls and 78% of cases, cardiologist for 25% of controls and 57% of cases) while controls got their information more through magazines or advertising. CONCLUSION Our results show that after a major ischemic event, cases' knowledge of risk factors is better than the rest of the population without improved rules lifestyle changes. This suggests the usefulness of evaluating a therapeutic education program for atheromatous disease.
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Affiliation(s)
- A-S Lensel
- 76, avenue des Gobelins, 75013 Paris, France.
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Veyrier M, Ducreux C, Henaine R, Ninet J, Bozio A, Sassolas F, Di Filippo S. Long term follow-up after heart transplantation in very young children. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.4400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chalard A, Sanchez I, Gouton M, Henaine R, Salami FA, Ninet J, Douek PC, Di Filippo S, Boussel L. Effect of pulmonary valve replacement on left ventricular fucntion in patients with tetralogy of fallot. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lovric D, Thuny F, Carmona C, Schnell F, Ernande L, Thibault H, Bergerot C, Ninet J, Croisille P, Derumeaux GA. Myocardial extracellular volume fraction by cardiac magnetic resonance for early detection of left ventricular involvement in systemic sclerosis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Joly H, Soufi A, Henaine R, Sassolas F, Ninet J, Bozio A, Metton O, Di Filippo S. Long-term survival and functional status of adult patient with Eisenmenger syndrome. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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47
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Soufi A, Veyrier M, Ducreux C, Sassolas F, Henaine R, Metton O, Ninet J, Joly H, Bozio A, Di Filippo S. Infective endocarditis in adults with congenital heart disease. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Joly H, Soufi A, Bozio A, Sassolas F, Henaine R, Metton O, Ninet J, Di Filippo S. Long-term survival and functional status of adult patients with Eisenmenger Syndrome. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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49
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Veyrier M, Ducreux C, Henaine R, Bozio A, Sassolas F, Ninet J, Di Filippo S. Long-term follow-up after heart transplantation in very young children. Arch Cardiovasc Dis 2013. [DOI: 10.1016/j.acvd.2013.06.010] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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50
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Hot A, Guerry MJ, Amudala N, Guillevin L, Merkel PA, Ninet J, Jayne D. Traitement des syndromes de Churg et Strauss réfractaires par rituximab. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.247] [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: 10/26/2022]
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