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Michel V, Lazaro E, Fauthoux T, Cetran L, Contin-Bordes C, Blanco P, Seguy B, Baudinet T, Coste P, Gerbaud E. Systematic Aetiological Assessment of Myocarditis: A Prospective Cohort Study. J Clin Med 2024; 13:1025. [PMID: 38398340 PMCID: PMC10889734 DOI: 10.3390/jcm13041025] [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: 12/26/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Myocarditis is commonly diagnosed in the intensive care cardiology unit (ICCU). No current recommendation nor guideline aids exist for aetiological assessments. METHODS From September 2021 to October 2023, 84 patients with acute myocarditis underwent thorough and systematic serum and blood cell panel evaluations to determine the most common causes of myocarditis. RESULTS Of the 84 patients (median age 34 years, range 22-41 years, 79% male), 16 presented with complicated myocarditis. The systematic aetiological assessment revealed that 36% of patients were positive for lupus anticoagulant, 12% for antinuclear antibodies, 8% for anti-heart antibodies, and 12% for anti-striated muscle antibodies. Viral serology did not yield any significant results. After the aetiological assessment, one patient was diagnosed with an autoimmune inflammatory disorder (Still's disease). T-cell subset analyses indicated that myocarditis severity tended to increase with the T-cell lymphopenia status. CONCLUSIONS A comprehensive, systematic aetiological assessment was of limited value in terms of predicting the clinical or therapeutic outcomes in myocarditis patients presenting to the ICCU.
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Affiliation(s)
- Vincent Michel
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
| | - Estibaliz Lazaro
- Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest, Bâtiment des USN, Hôpital du Haut-Lévêque, 33604 Pessac, France
| | - Thomas Fauthoux
- Service de Médecine Interne, Centre de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest, Bâtiment des USN, Hôpital du Haut-Lévêque, 33604 Pessac, France
| | - Laura Cetran
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
| | - Cécile Contin-Bordes
- CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 33076 Bordeaux, Cedex, France
- Laboratoire d'Immunologie et Immunogénétique, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, 33076 Bordeaux, France
| | - Patrick Blanco
- CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 33076 Bordeaux, Cedex, France
- Laboratoire d'Immunologie et Immunogénétique, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, 33076 Bordeaux, France
| | - Benjamin Seguy
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
| | - Thomas Baudinet
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
| | - Pierre Coste
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
| | - Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France
- Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, 33076 Bordeaux, France
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Lesaine E, Francis F, Domecq S, Miganeh-Hadi S, Sevin F, Sibon I, Rouanet F, Pradeau C, Coste P, Cetran L, Vandentorren S, Saillour F. Social and clinical vulnerability in stroke and STEMI management during the COVID-19 pandemic: a registry-based study. BMJ Open 2024; 14:e073933. [PMID: 38171619 PMCID: PMC10773394 DOI: 10.1136/bmjopen-2023-073933] [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: 03/22/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE This study aims to evaluate whether the first wave of the COVID-19 pandemic resulted in a deterioration in the quality of care for socially and/or clinically vulnerable stroke and ST-segment elevation myocardial infarction (STEMI) patients. DESIGN Two cohorts of STEMI and stroke patients in the Aquitaine neurocardiovascular registry. SETTING Six emergency medical services, 30 emergency units, 14 hospitalisation units and 11 catheterisation laboratories in the Aquitaine region in France. PARTICIPANTS This study involved 9218 patients (6436 stroke and 2782 STEMI patients) in the neurocardiovascular registry from January 2019 to August 2020. PRIMARY OUTCOME MEASURES Care management times in both cohorts: first medical contact-to-procedure time for the STEMI cohort and emergency unit admission-to-imaging time for the stroke cohort. Associations between social (deprivation index) and clinical (age >65 years, neurocardiovascular history) vulnerabilities and care management times were analysed using multivariate linear mixed models, with an interaction on the time period (pre-wave, per-wave and post-first COVID-19 wave). RESULTS The first medical contact procedure time was longer for elderly (p<0.001) and 'very socially disadvantaged' (p=0.003) STEMI patients, with no interaction regarding the COVID-19 period (age, p=0.54; neurocardiovascular history, p=0.70; deprivation, p=0.64). We found no significant association between vulnerabilities and the admission imaging time for stroke patients, and no interaction with respect to the COVID-19 period (age, p=0.81; neurocardiovascular history, p=0.34; deprivation, p=0.95). CONCLUSIONS This study revealed pre-existing inequalities in care management times for vulnerable STEMI and stroke patients; however, these inequalities were neither accentuated nor reduced during the first COVID-19 wave. Measures implemented during the crisis did not alter the structured emergency pathway for these patients. TRIAL REGISTRATION NUMBER NCT04979208.
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Affiliation(s)
- Emilie Lesaine
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Florence Francis
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sandrine Domecq
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Sahal Miganeh-Hadi
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Floriane Sevin
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Igor Sibon
- Stroke Unit, CHU Bordeaux GH Pellegrin, Bordeaux, France
- CNRS UMR 5287, INCIA, Bordeaux, France
| | | | | | - Pierre Coste
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Laura Cetran
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Stephanie Vandentorren
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Sante publique France, Saint-Maurice, France
| | - Florence Saillour
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
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Lesaine E, Francis-Oliviero F, Domecq S, Bijon M, Cetran L, Coste P, Lhuaire Q, Miganeh-Hadi S, Pradeau C, Rouanet F, Sevin F, Sibon I, Saillour-Glenisson F. Effects of healthcare system transformations spurred by the COVID-19 pandemic on management of stroke and STEMI: a registry-based cohort study in France. BMJ Open 2022; 12:e061025. [PMID: 36130741 PMCID: PMC9494013 DOI: 10.1136/bmjopen-2022-061025] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To assess the impact of changes in use of care and implementation of hospital reorganisations spurred by the COVID-19 pandemic (first wave) on the acute management times of patients who had a stroke and ST-segment elevation myocardial infarction (STEMI). DESIGN Two cohorts of patients who had an STEMI and stroke in the Aquitaine Cardio-Neuro-Vascular (CNV) registry. SETTING 6 emergency medical services, 30 emergency units (EUs), 14 hospitalisation units and 11 cathlabs in the Aquitaine region. PARTICIPANTS This study involved 9218 patients (6436 patients who had a stroke and 2782 patients who had an STEMI) in the CNV Registry from January 2019 to August 2020. METHOD Hospital reorganisations, retrieved in a scoping review, were collected from heads of hospital departments. Other data were from the CNV Registry. Associations between reorganisations, use of care and care management times were analysed using multivariate linear regression mixed models. Interaction terms between use-of-care variables and period (pre-wave, per-wave and post-wave) were introduced. MAIN OUTCOME MEASURES STEMI cohort, first medical contact-to-procedure time; stroke cohort, EU admission-to-imaging time. RESULTS Per-wave period management times deteriorated for stroke but were maintained for STEMI. Per-wave changes in use of care did not affect STEMI management. No association was found between reorganisations and stroke management times. In the STEMI cohort, the implementation of systematic testing at admission was associated with a 41% increase in care management time (exp=1.409, 95% CI 1.075 to 1.848, p=0.013). Implementation of plan blanc, which concentrated resources in emergency activities, was associated with a 19% decrease in management time (exp=0.801, 95% CI 0.639 to 1.023, p=0.077). CONCLUSIONS The pandemic did not markedly alter the functioning of the emergency network. Although stroke patient management deteriorated, the resilience of the STEMI pathway was linked to its stronger structuring. Transversal reorganisations, aiming at concentrating resources on emergency care, contributed to maintenance of the quality of care. TRIAL REGISTRATION NUMBER NCT04979208.
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Affiliation(s)
- Emilie Lesaine
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Florence Francis-Oliviero
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sandrine Domecq
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Marine Bijon
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Laura Cetran
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
| | - Pierre Coste
- Coronary Care Unit, CHU de Bordeaux Hôpital Cardiologique, Pessac, France
- University of Bordeaux, Talence, France
| | - Quentin Lhuaire
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
| | - Sahal Miganeh-Hadi
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | | | | | - Floriane Sevin
- CIC-EC 14-01, CHU de Bordeaux, Bordeaux, France
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
| | - Igor Sibon
- Neurology, Stroke Unit, CHU de Bordeaux, Bordeaux, France
- INCIA CNRS UMR 5287, University of Bordeaux, Talence, France
| | - Florence Saillour-Glenisson
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux Population Health, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France
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Gerbaud E, Bouchard de La Poterie A, Baudinet T, Montaudon M, Beauvieux MC, Lemaître AI, Cetran L, Seguy B, Picard F, Vélayoudom FL, Ouattara A, Kabore R, Coste P, Domingues-Dos-Santos P, Catargi B. Glycaemic Variability and Hyperglycaemia as Prognostic Markers of Major Cardiovascular Events in Diabetic Patients Hospitalised in Cardiology Intensive Care Unit for Acute Heart Failure. J Clin Med 2022; 11:jcm11061549. [PMID: 35329874 PMCID: PMC8951492 DOI: 10.3390/jcm11061549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/05/2022] [Accepted: 03/09/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Hyperglycaemia and hypoglycaemia are both emerging risk factors for cardiovascular disease. Nevertheless, the potential effect of glycaemic variability (GV) on mid-term major cardiovascular events (MACE) in diabetic patients presenting with acute heart failure (AHF) remains unclear. This study investigates the prognostic value of GV in diabetic patients presenting with acute heart failure (AHF). (2) Methods: this was an observational study including consecutive patients with diabetes and AHF between January 2015 and November 2016. GV was calculated using standard deviation of glycaemia values during initial hospitalisation in the intensive cardiac care unit. MACE, including recurrent AHF, new-onset myocardial infarction, ischaemic stroke and cardiac death, were recorded. The predictive effects of GV on patient outcomes were analysed with respect to baseline characteristics and cardiac status. (3) Results: In total, 392 patients with diabetes and AHF were enrolled. During follow-up (median (interquartile range) 29 (6−51) months), MACE occurred in 227 patients (57.9%). In total, 92 patients died of cardiac causes (23.5%), 107 were hospitalised for heart failure (27.3%), 19 had new-onset myocardial infarction (4.8%) and 9 (2.3%) had an ischaemic stroke. Multivariable logistic regression analysis showed that GV > 50 mg/dL (2.70 mmol/L), age > 75 years, reduced left ventricular ejection fraction (LVEF < 30%) and female gender were independent predictors of MACE: hazard ratios (HR) of 3.16 (2.25−4.43; p < 0.001), 1.54 (1.14−2.08; p = 0.005), 1.47 (1.06−2.07; p = 0.02) and 1.43 (1.05−1.94; p = 0.03), respectively. (4) Conclusions: among other well-known factors of HF, a GV cut-off value of >50 mg/dL was the strongest independent predictive factor for mid-term MACE in patients with diabetes and AHF.
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Affiliation(s)
- Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
- Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, 33076 Bordeaux, France; (M.M.); (P.D.-D.-S.)
- Correspondence: ; Tel.: +33-524-549-188; Fax: +33-557-636-316
| | - Ambroise Bouchard de La Poterie
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
| | - Thomas Baudinet
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
| | - Michel Montaudon
- Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, 33076 Bordeaux, France; (M.M.); (P.D.-D.-S.)
| | - Marie-Christine Beauvieux
- Biochemistry Laboratory, Hôpital Cardiologique du Haut-Lévêque, Bordeaux University, 33600 Pessac, France;
- Centre de Résonance Magnétique des Systèmes Biologiques, UMR 5536, CNRS, Bordeaux University, 33076 Bordeaux, France
| | - Anne-Iris Lemaître
- Advanced Heart Failure Unit, Department of Cardiovascular Medicine, Hôpital Cardiologique du Haut-Lévêque, Bordeaux University, 33604 Pessac, France; (A.-I.L.); (F.P.)
| | - Laura Cetran
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
| | - Benjamin Seguy
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
| | - François Picard
- Advanced Heart Failure Unit, Department of Cardiovascular Medicine, Hôpital Cardiologique du Haut-Lévêque, Bordeaux University, 33604 Pessac, France; (A.-I.L.); (F.P.)
| | - Fritz-Line Vélayoudom
- Department of Diabetology-Endocrinology, University Hospital of Guadeloupe, 97159 Pointe-à-Pitre, France;
- Inserm UMR 1283, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, 59000 Lille, France
| | - Alexandre Ouattara
- Department of Anesthesia and Critical Care, Magellan Medico-Surgical Centre, Bordeaux University, 33600 Pessac, France;
- Biology of Cardiovascular Diseases Centre, U1034, Bordeaux University, 33600 Pessac, France
| | - Rémi Kabore
- Institut de Santé Publique, d’Épidémiologie et de Développement (ISPED), Bordeaux Population Health Research, U1219, Bordeaux University, 33000 Bordeaux, France;
| | - Pierre Coste
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, 33604 Pessac, France; (A.B.d.L.P.); (T.B.); (L.C.); (B.S.); (P.C.)
- Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, 33076 Bordeaux, France; (M.M.); (P.D.-D.-S.)
| | - Pierre Domingues-Dos-Santos
- Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, 33076 Bordeaux, France; (M.M.); (P.D.-D.-S.)
- Advanced Heart Failure Unit, Department of Cardiovascular Medicine, Hôpital Cardiologique du Haut-Lévêque, Bordeaux University, 33604 Pessac, France; (A.-I.L.); (F.P.)
- Institut de Rythmologie et Modélisation Cardiaque (IHU Liryc), Fondation Bordeaux Université, 33600 Pessac, France
| | - Bogdan Catargi
- Endocrinology-Metabolic Diseases, Hôpital Saint-André, Bordeaux University, 33000 Bordeaux, France;
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Rioufol G, Dérimay F, Roubille F, Perret T, Motreff P, Angoulvant D, Cottin Y, Meunier L, Cetran L, Cayla G, Harbaoui B, Wiedemann JY, Van Belle É, Pouillot C, Noirclerc N, Morelle JF, Soto FX, Caussin C, Bertrand B, Lefèvre T, Dupouy P, Lesault PF, Albert F, Barthelemy O, Koning R, Leborgne L, Barnay P, Chapon P, Armero S, Lafont A, Piot C, Amaz C, Vaz B, Benyahya L, Varillon Y, Ovize M, Mewton N, Finet G. Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease. J Am Coll Cardiol 2021; 78:1875-1885. [PMID: 34736563 DOI: 10.1016/j.jacc.2021.08.061] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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: 07/22/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is limited evidence that fractional flow reserve (FFR) is effective in guiding therapeutic strategy in multivessel coronary artery disease (CAD) beyond prespecified percutaneous coronary intervention or coronary graft surgery candidates. OBJECTIVES The FUTURE (FUnctional Testing Underlying coronary REvascularization) trial aimed to evaluate whether a treatment strategy based on FFR was superior to a traditional strategy without FFR in the treatment of multivessel CAD. METHODS The FUTURE trial is a prospective, randomized, open-label superiority trial. Multivessel CAD candidates were randomly assigned (1:1) to treatment strategy based on FFR in all stenotic (≥50%) coronary arteries or to a traditional strategy without FFR. In the FFR group, revascularization (percutaneous coronary intervention or surgery) was indicated for FFR ≤0.80 lesions. The primary endpoint was a composite of major adverse cardiac or cerebrovascular events at 1 year. RESULTS The trial was stopped prematurely by the data safety and monitoring board after a safety analysis and 927 patients were enrolled. At 1-year follow-up, by intention to treat, there were no significant differences in major adverse cardiac or cerebrovascular events rates between groups (14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97; 95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P = 0.06), and this was confirmed with a 24 months' extended follow-up. FFR significantly reduced the proportion of revascularized patients, with more patients referred to exclusively medical treatment (P = 0.02). CONCLUSIONS In patients with multivessel CAD, we did not find evidence that an FFR-guided treatment strategy reduced the risk of ischemic cardiovascular events or death at 1-year follow-up. (Functional Testing Underlying Coronary Revascularisation; NCT01881555).
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Affiliation(s)
- Gilles Rioufol
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France.
| | - François Dérimay
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | | | | | | | - Denis Angoulvant
- EA4245 T2i, Hôpital Trousseau, CHRU de Tours, Université de Tours, Tours, France
| | | | | | - Laura Cetran
- Hôpital Cardiologique, Centre Hospitalo-Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Guillaume Cayla
- Service de cardiologie, Hôpital Caremeau, Université de Montpellier, Nîmes, France
| | - Brahim Harbaoui
- Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Olivier Barthelemy
- Hôpital de La Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | - Antoine Lafont
- Hôpital Européen George Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Camille Amaz
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Bernadette Vaz
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Lakhdar Benyahya
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Yvonne Varillon
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Michel Ovize
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Nathan Mewton
- Centre d'investigation clinique de Lyon, INSERM 1407, Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
| | - Gérard Finet
- Hôpital Cardiologique et Pneumologique Louis Pradel, Hospices Civils de Lyon, Bron, France
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Baudinet T, Seguy B, Cetran L, Luttoo MK, Coste P, Gerbaud E. Bail-out therapy in ST-segment elevation myocardial infarction due to calcified lesion causing stent underexpansion: Intravascular lithotripsy is in the lead. J Cardiol Cases 2021; 23:264-266. [PMID: 34093904 DOI: 10.1016/j.jccase.2020.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 11/28/2022] Open
Abstract
A 52-year-old male was referred for an acute anterior ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed an acute left anterior descending artery occlusion. The patient was treated with a drug-eluting stent (DES). Despite long and repeated high-pressure inflations (>20 atm) of non-compliant balloons, OPN NCⓇ high-pressure balloon (SIS Medical AG; Frauenfeld, Switzerland), rotational atherectomy, and cutting balloon, there was a severe hourglass stent underexpansion caused by coronary calcification. Thus, intravascular lithotripsy (IVL) (Shockwave Medical, Fremont, CA, USA) was attempted to re-dilate this calcified lesion. Underexpansion was successfully treated after delivering 70 shockwaves to the narrowest segment. IVL delivers localized pulsatile sonic pressure waves inducing circumferential calcium modification and multiple fractures. Our observation illustrates the additional value of coronary lithotripsy as a bail-out procedure to tackle severely calcified, de novo coronary lesions causing stent underexpansion in the context of STEMI, when all other available techniques failed. <Learning objective: Severe coronary calcification may impair device delivery, stent apposition, and inhibit expansion, thus predisposing to stent thrombosis. Intravascular lithotripsy delivers localized pulsatile sonic pressure waves inducing circumferential calcium modification and multiple fractures. Our observation illustrates the additional value of coronary lithotripsy as a bail-out procedure to tackle severely calcified, de novo coronary lesions causing stent underexpansion in the context of ST-segment elevation myocardial infarction, when all other available techniques failed.>.
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Affiliation(s)
- Thomas Baudinet
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Benjamin Seguy
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Laura Cetran
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Muhammad Khaled Luttoo
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Pierre Coste
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Edouard Gerbaud
- Intensive Cardiology Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut-Lévêque, Pessac, France.,Bordeaux Cardio-Thoracic Research Centre, U1045, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France
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7
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Affiliation(s)
- Tatiana Hertzog
- Unité de Soins Intensifs de Cardiologie, CHU de Bordeaux, Bordeaux, France
| | - Laura Cetran
- Unité de Soins Intensifs de Cardiologie, CHU de Bordeaux, Bordeaux, France
| | - Magali Labadie
- Centre-Antipoison et Toxicovigilance de Nouvelle Aquitaine, CHU de Bordeaux, Bordeaux, France
| | - Coralie Braganca
- Centre-Antipoison et Toxicovigilance de Nouvelle Aquitaine, CHU de Bordeaux, Bordeaux, France
| | - Ruben Goncalves
- Laboratoire de Pharmacologie et Toxicologie, CHU de Bordeaux, Bordeaux, France.,INSERM, BPH, U1219, University of Bordeaux, Bordeaux, France
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8
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Bonnet G, Panagides V, Becker M, Rivière N, Yvorel C, Deney A, Lattuca B, Duband B, Moussa K, Juenin L, Pamart T, Semaan C, Uhry S, Noirclerc N, Vincent F, Vignac M, Palermo V, Martin AS, Zeitouni M, Van Belle E, Tirouvanziam A, Manchuelle A, Chamandi C, Kerneis M, Boukantar M, Belle L, De Poli F, Angoulvant D, Meneveau N, Robin M, Pansieri M, Bonello L, Motreff P, Bouisset F, Isaaz K, Cetran L, Khalife K, Lesizza P, Adjedj J, Benamer H, Cayla G. ST-segment elevation myocardial infarction: Management and association with prognosis during the COVID-19 pandemic in France. Arch Cardiovasc Dis 2021; 114:340-351. [PMID: 33926830 PMCID: PMC9056233 DOI: 10.1016/j.acvd.2021.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/11/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Systems of care have been challenged to control progression of the COVID-19 pandemic. Whether this has been associated with delayed reperfusion and worse outcomes in French patients with ST-segment elevation myocardial infarction (STEMI) is unknown. AIM To compare the rate of STEMI admissions, treatment delays, and outcomes between the first peak of the COVID-19 pandemic in France and the equivalent period in 2019. METHODS In this nationwide French survey, data from consecutive STEMI patients from 65 centres referred for urgent revascularization between 1 March and 31 May 2020, and between 1 March and 31 May 2019, were analysed. The primary outcome was a composite of in-hospital death or non-fatal mechanical complications of acute myocardial infarction. RESULTS A total of 6306 patients were included. During the pandemic peak, a 13.9±6.6% (P=0.003) decrease in STEMI admissions per week was observed. Delays between symptom onset and percutaneous coronary intervention were longer in 2020 versus 2019 (270 [interquartile range 150-705] vs 245 [140-646]min; P=0.013), driven by the increase in time from symptom onset to first medical contact (121 [60-360] vs 150 [62-420]min; P=0.002). During 2020, a greater number of mechanical complications was observed (0.9% vs 1.7%; P=0.029) leading to a significant difference in the primary outcome (112 patients [5.6%] in 2019 vs 129 [7.6%] in 2020; P=0.018). No significant difference was observed in rates of orotracheal intubation, in-hospital cardiac arrest, ventricular arrhythmias and cardiogenic shock. CONCLUSIONS During the first peak of the COVID-19 pandemic in France, there was a decrease in STEMI admissions, associated with longer ischaemic time, exclusively driven by an increase in patient-related delays and an increase in mechanical complications. These findings suggest the need to encourage the population to seek medical help in case of symptoms.
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Affiliation(s)
- Guillaume Bonnet
- Université de Paris, Paris Cardiovascular Research Center (PARCC), INSERM, UMR-S970, 75015 Paris, France
| | - Vassili Panagides
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, 13015 Marseille, France
| | - Mathieu Becker
- CHR Metz -Thionville, Metz Hôpital de Mercy, 57530 Metz, France
| | - Nicolas Rivière
- University of Bordeaux, Cardio-thoracic intensive care unit, CHU de Bordeaux, 33600 Pessac, France
| | - Cédric Yvorel
- Cardiology Department, CHU de Saint Etienne, 42270 Saint Priest-en-Jarez, France
| | - Antoine Deney
- Cardiology Department, Rangueil University Hospital, 31400 Toulouse, France
| | - Benoit Lattuca
- Cardiology Department, Nimes University Hospital, Montpellier University, 30029 Nîmes, France
| | - Benjamin Duband
- Cardiology Department, University Hospital Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Karim Moussa
- Cardiology Department, Avignon Hôpital Center, 84140 Avignon, France
| | - Léa Juenin
- Cardiology Department, University Hospital of Montpellier, University of Montpellier, 34000 Montpellier, France
| | - Thibault Pamart
- University of Burgundy Franche-Comté, EA3920, University Hospital Besancon, 25000 Besançon, France
| | - Carl Semaan
- Cardiology Department, University Hospital of Tours, 37000 Tours, France
| | - Sabrina Uhry
- Cardiology Department, CH de Haguenau, 67500 Haguenau, France
| | | | | | - Maxime Vignac
- Université de Paris, Paris Cardiovascular Research Center (PARCC), INSERM, UMR-S970, 75015 Paris, France
| | - Vincenzo Palermo
- Cardiology Department, Marie Lannelongue Hospital, 92350 Le Plessis-Robinson, France
| | - Anne Sophie Martin
- CHU Henri Mondor, Service de cardiologie interventionnelle, AP-HP, 94010 Créteil, France
| | - Michel Zeitouni
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | | | | | | | - Chekrallah Chamandi
- Cardiology Department, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Université de Paris, INSERM U970, 75015 Paris, France
| | - Mathieu Kerneis
- Sorbonne Université, ACTION Study Group, INSERM UMRS1166, Hôpital Pitié-Salpêtrière (AP-HP), 75013 Paris, France
| | - Madjid Boukantar
- CHU Henri Mondor, Service de cardiologie interventionnelle, AP-HP, 94010 Créteil, France
| | - Loïc Belle
- Centre Hospitalier Annecy Genevois, 74370 Epagny Metz-Tessy, France
| | - Fabien De Poli
- Cardiology Department, CH de Haguenau, 67500 Haguenau, France
| | - Denis Angoulvant
- Cardiology Department, University Hospital of Tours, 37000 Tours, France
| | - Nicolas Meneveau
- University of Burgundy Franche-Comté, EA3920, University Hospital Besancon, 25000 Besançon, France
| | - Marie Robin
- Cardiology Department, University Hospital of Montpellier, University of Montpellier, 34000 Montpellier, France
| | - Michel Pansieri
- Cardiology Department, Avignon Hôpital Center, 84140 Avignon, France
| | - Laurent Bonello
- Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, 13015 Marseille, France
| | - Pascal Motreff
- Cardiology Department, University Hospital Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Frédéric Bouisset
- Cardiology Department, Rangueil University Hospital, 31400 Toulouse, France; Department of Epidemiology, INSERM UMR 1027, 31000 Toulouse, France
| | - Karl Isaaz
- Cardiology Department, CHU de Saint Etienne, 42270 Saint Priest-en-Jarez, France
| | - Laura Cetran
- University of Bordeaux, Cardio-thoracic intensive care unit, CHU de Bordeaux, 33600 Pessac, France
| | - Khalifé Khalife
- CHR Metz -Thionville, Metz Hôpital de Mercy, 57530 Metz, France
| | | | - Julien Adjedj
- Arnaud Tzanck Institute, 06700 Saint Laurent du Var, France
| | - Hakim Benamer
- Institut Jacques Cartier, Ramsay Générale de Santé, ICPS, 91300 Massy, France
| | - Guillaume Cayla
- Cardiology Department, Nimes University Hospital, Montpellier University, 30029 Nîmes, France.
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9
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Kamakura T, Cetran L, Sacher F, Hocini M, Duchateau J. A case of anomalous aortic origin of coronary artery associated with a coved-type electrocardiogram. J Cardiovasc Electrophysiol 2021; 32:554-557. [PMID: 33421212 DOI: 10.1111/jce.14872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/04/2020] [Accepted: 01/02/2021] [Indexed: 11/29/2022]
Abstract
Brugada syndrome (BrS) is a sudden cardiac death syndrome characterized by a coved-type electrocardiogram (ECG). Different disorders, such as ischemia, can emulate a Brugada-pattern ECG (Brugada phenocopy). We report herein, the first case of surgical epicardial electrophysiological mapping in a successfully resuscitated patient with an anomalous aortic origin of the coronary artery (AAOCA) associated with a coved-type ECG. It was debatable whether the coved-type ECG and the abnormal arrhythmogenic substrate in the epicardial right ventricular outflow tract were derived from BrS or from repetitive ischemia due to AAOCA; however, the epicardial electrophysiological mapping helped in deciding the treatment strategy.
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Affiliation(s)
- Tsukasa Kamakura
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France
| | - Laura Cetran
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France
| | - Frédéric Sacher
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France
| | - Mélèze Hocini
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France
| | - Josselin Duchateau
- Department of Cardiac Pacing and Electrophysiology, IHU Liryc, Electrophysiology and Heart Modeling Institute, University of Bordeaux, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France
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10
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Cetran L, Lesaine E, Miganeh-Hadi S, Sevin F, Saillour-Glenisson F, Pradeau C, Coste P. Socioeconomic status influences delays in the management of acute ST-elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1656] [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
A prompt diagnosis to initiate the appropriate reperfusion therapy is crucial to improve clinical outcomes in acute ST-elevation myocardial infarction (STEMI) patients. Socio-economic status (SES) refers to parameters like income, educational status and occupation. A low SES negatively interferes with the prognosis of STEMI patients. However, the impact of SES on delay time in acute STEMI remains matter of debate.
Methods
We used databases from two French multicentric and prospective registries: ACIRA (patients undergoing coronary angiography in any catheterization laboratories of Aquitaine) and REANIM (acute STEMI patients supported by emergency medical system (EMS) in Aquitaine). An ecological indicator of social deprivation Fdep09 was calculated to describe geographical inequalities in health based on municipality of residence. The higher the value, the more disadvantaged the population. Low SES was defined as Fdep09 > median value.
Results
Two-thousand-eight-hundred-and-forty consecutive patients with acute STEMI undergoing coronary angiography from January 2017 to December 2018 in Aquitaine were included. Patients with lower SES were more often initially referred to emergency departments of non-percutaneous coronary intervention capable centers whereas patients with higher SES were more often directly transferred to PCI centers by the mobile emergency care units as recommended by the most recent European guidelines (p<10–4). Patients with low SES had longer delays from symptom onset to first medical contact (FMC) (116 [60–119] vs 98 [55–233] min, p=0.0078) and were more likely to receive fibrinolysis (9.9 vs 5.2%, p<10–4). Linear regression modeling showed that each point of the Fdep09 index was associated with increase in the delay from symptom onset to FMC by a factor 1.1 (95% CI: 1.04–1.17, p<10–3) after adjusting for potential confounders.
Conclusion
SES inequality has negative influence on the delays in the management of acute STEMI patients. Efforts to raise awareness of suspicious signs of acute MI among individuals in lower SES could be valuable.
FDep09 distribution
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): ARS Nouvelle-Aquitaine
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Affiliation(s)
- L Cetran
- Hospital Haut Leveque, Cardiac Intensive Care Unit, Bordeaux, France
| | - E Lesaine
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux, France
| | - S Miganeh-Hadi
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux, France
| | - F Sevin
- University of Bordeaux, ISPED, Centre INSERM U1219, Bordeaux, France
| | | | - C Pradeau
- Pellegrin Hospital Group - University Hospital Centre, Bordeaux, France
| | - P Coste
- Hospital Haut Leveque, Cardiac Intensive Care Unit, Bordeaux, France
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11
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Cetran L, Coste P, Douard H. [Acute coronary syndromes: iconography]. Rev Prat 2020; 70:e259. [PMID: 33739743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Laura Cetran
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
| | - Pierre Coste
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
| | - Hervé Douard
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
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12
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Cetran L, Coste P, Douard H. [Acute coronary syndromes]. Rev Prat 2020; 70:e249-e258. [PMID: 33739742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Laura Cetran
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
| | - Pierre Coste
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
| | - Hervé Douard
- Service des maladies coronariennes et vasculaires, hôpital du Haut-Lévêque, CHU de Bordeaux, France
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13
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Gerbaud E, Arabucki F, Nivet H, Barbey C, Cetran L, Chassaing S, Seguy B, Lesimple A, Cochet H, Montaudon M, Laurent F, Bar O, Tearney GJ, Coste P. OCT and CMR for the Diagnosis of Patients Presenting With MINOCA and Suspected Epicardial Causes. JACC Cardiovasc Imaging 2020; 13:2619-2631. [PMID: 32828786 DOI: 10.1016/j.jcmg.2020.05.045] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [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: 02/13/2020] [Revised: 04/07/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Among all patients presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA), epicardial causes may be suspected when there is a correlation between electrocardiogram (ECG) changes and regional wall motion abnormalities (WMAs). We evaluated the diagnostic yield of intravascular optical coherence tomography (OCT) and cardiac magnetic resonance (CMR) in this specific setting. BACKGROUND OCT is able to identify different morphologic features of coronary plaques that are well known causes of MINOCA. Furthermore, CMR has become the gold standard for detection of myocardial infarction in the setting of MINOCA. METHODS In a prospective 2-center study, consecutive patients with MINOCA including ECG features of ischemia associated with corresponding WMAs underwent OCT and CMR. RESULTS Forty patients (mean age: 50 ± 11 years, 62.5% male, 32.5% with ST-segment elevation) were enrolled. Coronary arteries were normal on coronary angiography in 10 patients (25%); 18 patients (45%) presented minimal lumen irregularities, whereas the remaining 12 patients (30%) showed mild to moderate (≥30% but <50%) coronary lesions. Plaque rupture, eruptive calcific nodule, plaque erosion, lone thrombus, and spontaneous coronary artery dissection were found in 14 (35%), 1 (2.5%), 12 (30%), 3 (7.5%), and 2 (5%) patients, respectively. Acute myocardial infarction was evident at CMR in 31 of 40 patients (77.5%). Twenty-three patients (57.5%) had a substrate and/or diagnosis supported by both techniques with an evident relationship between the findings obtained by the 2 techniques. By coupling OCT with CMR, a substrate and/or diagnosis was found in 100% of cases. CONCLUSIONS OCT coupled with CMR can provide a clear substrate and/or diagnosis in the vast majority of patients presenting with MINOCA including ECG features of ischemia associated with corresponding WMAs.
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Affiliation(s)
- Edouard Gerbaud
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France.
| | - Fabien Arabucki
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Hubert Nivet
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Christophe Barbey
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Laura Cetran
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Stephan Chassaing
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Benjamin Seguy
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Arnaud Lesimple
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France
| | - Hubert Cochet
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Michel Montaudon
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - François Laurent
- Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France; Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, Pessac, France
| | - Olivier Bar
- Interventional Cardiology and Department of Cardiovascular Imaging, Clinique Saint Gatien, Tours, France
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA; Harvard-MIT Health Sciences and Technology, Boston, Massachusetts, USA
| | - Pierre Coste
- Cardiology Intensive Care Unit and Interventional Cardiology, Hôpital Cardiologique du Haut Lévêque, Pessac, France; Bordeaux Cardio-Thoracic Research Centre, Bordeaux University, Hôpital Xavier Arnozan, Pessac, France
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14
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Benjamin Seguy, Gerbaud E, Cetran L, Casassus F, Coste P, Alexandre Ouattara, Laurent Barandon. TCT-755 Impella for cardiogenic shock : a tertiary care center experience (2011-2017). J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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15
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Fiore M, Gerbaud E, Coste P, Cetran L, Marchand H, Seguy B. Optimal platelet inhibition with cangrelor in comatose survivors of out-of-hospital cardiac arrest undergoing primary percutaneous coronary intervention. Resuscitation 2018; 130:e1-e2. [PMID: 29969644 DOI: 10.1016/j.resuscitation.2018.06.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Mathieu Fiore
- Laboratory of Hematology, Reference Center for Platelet Disorders, University Hospital of Bordeaux, Pessac, France.
| | - Edouard Gerbaud
- Cardiovascular Intensive Care Unit, Cardiologic Hospital, University Hospital of Bordeaux, Pessac, France
| | - Pierre Coste
- Cardiovascular Intensive Care Unit, Cardiologic Hospital, University Hospital of Bordeaux, Pessac, France
| | - Laura Cetran
- Cardiovascular Intensive Care Unit, Cardiologic Hospital, University Hospital of Bordeaux, Pessac, France
| | - Hugo Marchand
- Cardiovascular Intensive Care Unit, Cardiologic Hospital, University Hospital of Bordeaux, Pessac, France
| | - Benjamin Seguy
- Cardiovascular Intensive Care Unit, Cardiologic Hospital, University Hospital of Bordeaux, Pessac, France
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16
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Cetran L, Gerbaud E, Seguy B, Poustis P, Zirphile X, Coste P. Short-term coronary physiology parameters evolution in acute coronary syndrome patients with multivessel disease treated with ticagrelor. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.006] [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: 10/18/2022]
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17
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Cetran L, Casassus F, Tearney GJ, Seguy B, Poustis P, Coste P, Gerbaud E. Minimalist immediate mechanical intervention approach in the management of an acute proximal left anterior descending artery occlusion with extensive thrombus burden in the left main coronary artery. Minerva Cardioangiol 2016; 65:102-105. [PMID: 27910301 DOI: 10.23736/s0026-4725.16.04204-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Laura Cetran
- Soins Intensifs Cardiologiques, Plateau de Cardiologie Interventionnelle, CHU de Bordeaux, Hôpital du Haut Lévêque, Pessac, France -
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18
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Cetran L, Gerbaud E, Seguy B, Coste P. 0430 : Predictors of long-term clinical outcomes in acute coronary syndrome treated with everolimus-eluting stent. Archives of Cardiovascular Diseases Supplements 2016. [DOI: 10.1016/s1878-6480(16)30374-3] [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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Pernot M, Cetran L, Vinassa B, Couffinhal T, Duplaa C. 0331 : Pathophysiology of the ubiquitine ligase E3, PDZRN3, in the development of dilated cardiomyopathies. Archives of Cardiovascular Diseases Supplements 2015. [DOI: 10.1016/s1878-6480(15)30138-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Cetran L, Corneloup O, Dijos M, Montaudon M, Roudaut R, Coste P, Laurent F, Gerbaud E. [Caseous calcification of the mitral annulus, variable and revealing clinical picture, and the contribution of cardiac tomodensitometry to the diagnosis: report of two cases]. Ann Cardiol Angeiol (Paris) 2014; 63:114-118. [PMID: 23806861 DOI: 10.1016/j.ancard.2013.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 02/28/2013] [Accepted: 03/13/2013] [Indexed: 06/02/2023]
Abstract
Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification and a common echocardiographic finding. CCMA discovery is mostly incidental, considered as benign tumor and may be unrelated to patient symptoms. Multimodality imaging may have an additional value for the diagnosis of CCMA. We report the cases of two CCMA revealed by acute pulmonary oedema and stroke, respectively. The aims of this presentation are: to illustrate the variety of cardiac symptoms that led to the diagnosis of CCMA; and to highlight the usefulness of thoracic multisliced computed tomography for the diagnosis of CCMA.
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Affiliation(s)
- L Cetran
- Service de cardiologie et maladies vasculaires, hôpital cardiologique du Haut Lévêque, soins intensifs - plateau de cardiologie interventionnelle, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - O Corneloup
- Unité d'imagerie thoracique et cardiovasculaire, hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - M Dijos
- Service de cardiologie et d'échocardiographie, hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - M Montaudon
- Unité d'imagerie thoracique et cardiovasculaire, hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - R Roudaut
- Service de cardiologie et d'échocardiographie, hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - P Coste
- Service de cardiologie et maladies vasculaires, hôpital cardiologique du Haut Lévêque, soins intensifs - plateau de cardiologie interventionnelle, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - F Laurent
- Unité d'imagerie thoracique et cardiovasculaire, hôpital cardiologique du Haut Lévêque, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France
| | - E Gerbaud
- Service de cardiologie et maladies vasculaires, hôpital cardiologique du Haut Lévêque, soins intensifs - plateau de cardiologie interventionnelle, CHU de Bordeaux, avenue de Magellan, 33604 Pessac cedex, France.
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