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Nambiema A, Lisan Q, Vaucher J, Perier MC, Boutouyrie P, Danchin N, Thomas F, Guibout C, Solelhac G, Heinzer R, Jouven X, Marques-Vidal P, Empana JP. Healthy sleep score changes and incident cardiovascular disease in European prospective community-based cohorts. Eur Heart J 2023; 44:4968-4978. [PMID: 37860848 PMCID: PMC10719494 DOI: 10.1093/eurheartj/ehad657] [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: 05/27/2023] [Revised: 06/20/2023] [Accepted: 07/25/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND AND AIMS Evidence on the link between sleep patterns and cardiovascular diseases (CVDs) in the community essentially relies on studies that investigated one single sleep pattern at one point in time. This study examined the joint effect of five sleep patterns at two time points with incident CVD events. METHODS By combining the data from two prospective studies, the Paris Prospective Study III (Paris, France) and the CoLaus|PsyCoLaus study (Lausanne, Switzerland), a healthy sleep score (HSS, range 0-5) combining five sleep patterns (early chronotype, sleep duration of 7-8 h/day, never/rarely insomnia, no sleep apnoea, and no excessive daytime sleepiness) was calculated at baseline and follow-up. RESULTS The study sample included 11 347 CVD-free participants aged 53-64 years (44.6% women). During a median follow-up of 8.9 years [interquartile range (IQR): 8.0-10.0], 499 first CVD events occurred (339 coronary heart disease (CHD) and 175 stroke). In multivariate Cox analysis, the risk of CVD decreased by 18% [hazard ratio (HR) 0.82, 95% confidence interval (CI) 0.76-0.89] per one-point increment in the HSS. After a median follow-up of 6.0 years (IQR: 4.0-8.0) after the second follow-up, 262 first CVD events occurred including 194 CHD and 72 stroke. After adjusting for baseline HSS and covariates, the risk of CVD decreased by 16% (HR 0.84, 95% CI 0.73-0.97) per unit higher in the follow-up HSS over 2-5 years. CONCLUSIONS Higher HSS and HSS improvement over time are associated with a lower risk of CHD and stroke in the community.
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Affiliation(s)
- Aboubakari Nambiema
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Quentin Lisan
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marie-Cecile Perier
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pierre Boutouyrie
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Cellular, Molecular and Pathophysiological Mechanisms of Heart Failure, APHP, DMU CARTE, Pharmacology, Paris, France
| | - Nicolas Danchin
- Preventive and Clinical Investigation Center (IPC), Paris, France
| | | | - Catherine Guibout
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Geoffroy Solelhac
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Raphael Heinzer
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Xavier Jouven
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
| | - Pedro Marques-Vidal
- Center for Investigation and Research in Sleep, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jean-Philippe Empana
- Université Paris Cité, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease, 56 rue Leblanc, Paris 75015, France
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2
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Empana JP, Lerner I, Perier MC, Jabre P, Andrieu M, Climie RE, Van Sloten T, Vedie B, Geromin D, Marijon E, Danchin N, Thomas F, Boutouyrie P, Jouven X. Ultra-sensitive troponin-I and incident coronary heart disease, stroke, heart failure, cardiac arrhythmias, arterial aneurysms and venous thromboembolism hospitalizations. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2289] [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: 11/15/2022] Open
Abstract
Abstract
Background
Cardiac troponin I (cTnI) as measured by high-sensitive assays has been related to incident cardiovascular disease events (CVD) in the community. With the advent of ultra-sensitive assays, it is now possible to detect troponin I at very low concentration, far below the classical threshold of 1.9 pg/mL. However, the clinical relevance of these low concentrations for predicting CVD is largely unknown.
Purpose
To examine the association of cTnI as low as 0.013 pg/mL with incident cardiovascular disease events (CVDs) in the primary prevention setting.
Methods
cTnI was analyzed in the baseline plasma (2008–2012) of CVD free volunteers from the Paris Prospective Study III using for the first time a novel ultra-sensitive immunoassay (Simoa Troponin-I 2.0 Kit, Quanterix, Lexington) with a limit of detection (LOD) of 0.013 pg/mL. Incident CVD hospitalizations for coronary heart disease, stroke, arrhythmias, venous thromboembolism, arterial aneurysms and heart failure were validated by critical review of the hospital records. Hazard ratios were estimated per log-transformed standard deviation (SD) increase of cTnI in Cox models using age as the time scale. The added value (gain in discriminatory capacity) of cTnI for CVD risk prediction was examined by calculating the Harell's C-index boostraped difference of the SCORE 2 risk model with and without cTnI.
Results
There were 9503 CVD free participants (40% women) aged 59.6 (6.3) years at baseline. cTnI was detected in 99.6% of the participants (median value = 0.63 pg/mL, interquartile range [IQR] 0.39–1.09). After a median follow-up of 8.34 years (IQR, 8.0–10.07), 516 participants suffered 612 events. In fully-adjusted analysis, higher cTnI (per 1 SD increase of log cTnI) was significantly associated with CVD events combined (n=516, HR= 1.21; 1.06; 1.39). In univariate Cox analysis and compared to each single established risk factor, cTnI had the highest discrimination capacity for incident CVD events (C-index=0.6349) (Figure 1). Adding log cTnI to the SCORE 2 algorithm increased significantly albeit moderately discriminatory capacity (C-index 0.698 vs. 0.685; boostraped C index difference: 0.0135 (95% CI: 0.0131; 0.0138)).
Conclusion
cTnI concentrations as measured by a novel ultra-sensitive immunoassay is associated with a significant increased risk of incident CVD events in the primary prevention setting.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): ANR: French National Research AgencyEurope: Horizon 2020
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Affiliation(s)
- J P Empana
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - I Lerner
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M C Perier
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - P Jabre
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M Andrieu
- National Institute of Health and Medical Research (INSERM home) , Paris , France
| | - R E Climie
- Menzies Research Institute , Hobart , Australia
| | - T Van Sloten
- Cardiovascular Research Institute Maastricht (CARIM) , Maastricht , The Netherlands
| | - B Vedie
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - D Geromin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - E Marijon
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - N Danchin
- Hopital Europeen Georges Pompidou-University Paris Descartes , Paris , France
| | - F Thomas
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - P Boutouyrie
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - X Jouven
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
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3
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Nambiema A, Lisan Q, Perier MC, Thomas F, Danchin N, Boutouyrie P, Jouven X, Empana JP. Healthy sleep score and incident cardiovascular diseases: the Paris Prospective Study III (PPS3). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Most studies on the association between sleep habits and cardiovascular disease (CVD) have focused on one single sleep dimension, essentially sleep duration and sleep apnea.
Purpose
To examine the joint effect of several dimensions of sleep habits with incident CVD in a community-based prospective cohort.
Methods
Between 2008 and 2011, 10,157 men and women aged 50 to 75 years were recruited in a preventive medical center. They underwent a standard physical examination coupled with standard biological tests, and provided information related to lifestyle, personal and family medical history, current health status, and medication use on questionnaires. Sleep habits were self-reported on validated questionnaires that assess sleep duration and insomnia complaints (Pittsburg questionnaire), early chronotype, sleep apnea (Berlin questionnaire) and subjective daytime sleepiness (Epworth questionnaire). Each sleep dimension was assigned 1 point if optimal and 0 point otherwise. A healthy sleep score ranging from 0 to 5 (the higher the better) and reflecting the number of optimal sleep dimensions was computed: early chronotype, sleep duration of 7–8 h/day, never/rarely insomnia, no sleep apnea, and no frequent excessive daytime sleepiness. The occurrence of incident CVD events including coronary heart disease and stroke was followed every two years up to September 2020, and events were validated after review of the medical records. The multivariable association between higher healthy sleep score and CVD events was examined in proportional hazard Cox regression analysis. Population-attributable fractions were calculated to estimate the proportion of CVD cases that could be prevented by healthier sleep habits.
Results
This study included 7203 participants (62% of men, mean age: 59.7 years±6.2) who were free of CVD at baseline and had complete data on sleep habits and covariates. Among them, 6.9% had a poor sleep score (healthy sleep score of 0 or 1), and 10.4% had an optimal sleep score (score= 5). After a median follow-up of 8 years, 275 participants had incident CVD events. After adjustment for age, sex, total alcohol consumption, socioprofessional categories, smoking status, body mass index, physical activity, family history of heart diseases, LDL and HDL cholesterol, and diabetes status, the risk of CVD decreased by 22% (HR=0.78 [95% CI: 0.71–0.86]) per 1 point increment in the healthy sleep score, and there was a 74% risk reduction in CVD risk (HR=0.26 [0.13–0.51]) between participants with the highest (score of 5) and those with the lowest (score of 0–1) healthy sleep score (Table 1). Under the hypothesis that all the participants would achieve an optimal sleep score of 5, 70.8% of incident CVD could be potentially avoided each year.
Conclusion(s)
In this community-based prospective cohort, a higher healthy sleep score combining 5 sleep dimensions was associated with a lower risk of CHD or stroke.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The National Research Agency (ANR), The Region Ile de France (Domaine d'Intérêt Majeur)
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Affiliation(s)
- A Nambiema
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - Q Lisan
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - M C Perier
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - F Thomas
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - N Danchin
- Centre d Investigations Preventives et Cliniques , Paris , France
| | - P Boutouyrie
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - X Jouven
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
| | - J P Empana
- INSERM U970 Paris Cardiovascular Research Centre , Paris , France
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Chachques JC, Lila N, Soler-Botija C, Martinez-Ramos C, Valles A, Autret G, Perier MC, Mirochnik N, Monleon-Pradas M, Bayes-Genis A, Semino CE. Elastomeric cardiopatch scaffold for myocardial repair and ventricular support. Eur J Cardiothorac Surg 2021; 57:545-555. [PMID: 31539050 DOI: 10.1093/ejcts/ezz252] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/30/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Prevention of postischaemic ventricular dilatation progressing towards pathological remodelling is necessary to decrease ventricular wall deterioration. Myocardial tissue engineering may play a therapeutic role due to its capacity to replace the extracellular matrix, thereby creating niches for cell homing. In this experimental animal study, a biomimetic cardiopatch was created with elastomeric scaffolds and nanotechnologies. METHODS In an experimental animal study in 18 sheep, a cardiopatch was created with adipose tissue-derived progenitor cells seeded into an engineered bioimplant consisting of 3-dimensional bioabsorbable polycaprolactone scaffolds filled with a peptide hydrogel (PuraMatrix™). This patch was then transplanted to cover infarcted myocardium. Non-absorbable poly(ethyl) acrylate polymer scaffolds were used as controls. RESULTS Fifteen sheep were followed with ultrasound scans at 6 months, including echocardiography scans, tissue Doppler and spectral flow analysis and speckle-tracking imaging, which showed a reduction in longitudinal left ventricular deformation in the cardiopatch-treated group. Magnetic resonance imaging (late gadolinium enhancement) showed reduction of infarct size relative to left ventricular mass in the cardiopatch group versus the controls. Histopathological analysis at 6 months showed that the cardiopatch was fully anchored and integrated to the infarct area with minimal fibrosis interface, thereby promoting angiogenesis and migration of adipose tissue-derived progenitor cells to surrounding tissues. CONCLUSIONS This study shows the feasibility and effectiveness of a cardiopatch grafted onto myocardial infarction scars in an experimental animal model. This treatment decreased fibrosis, limited infarct scar expansion and reduced postischaemic ventricular deformity. A capillary network developed between our scaffold and the heart. The elastomeric cardiopatch seems to have a positive impact on ventricular remodelling and performance in patients with heart failure.
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Affiliation(s)
- Juan Carlos Chachques
- Laboratory Biosurgical Research, Alain Carpentier Foundation, Cardiac Surgery Pompidou Hospital, University Paris-Descartes, Paris, France
| | - Nermine Lila
- Laboratory Biosurgical Research, Alain Carpentier Foundation, Cardiac Surgery Pompidou Hospital, University Paris-Descartes, Paris, France
| | - Carolina Soler-Botija
- Research Cardiology Institute, Germans-Trias-Pujol Hospital, Badalona, Spain.,CIBER Cardiovascular, Carlos III Health Institute, Madrid, Spain
| | - Cristina Martinez-Ramos
- Center for Biomaterials and Tissue Engineering, Polytechnic University Valencia, Valencia, Spain
| | - Ana Valles
- Center for Biomaterials and Tissue Engineering, Polytechnic University Valencia, Valencia, Spain
| | - Gwennhael Autret
- Microcirculation Imaging Lab, Paris Cardiovascular Research Center (PARCC), University Paris, Paris, France
| | | | - Nicolas Mirochnik
- Cardiology Department, Pompidou Hospital, University Paris, Paris, France
| | - Manuel Monleon-Pradas
- Center for Biomaterials and Tissue Engineering, Polytechnic University Valencia, Valencia, Spain
| | - Antoni Bayes-Genis
- Research Cardiology Institute, Germans-Trias-Pujol Hospital, Badalona, Spain
| | - Carlos E Semino
- Bioengineering Department, IQS-School Engineering, Ramon-Llull University, Barcelona, Spain
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5
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Karam N, Jabre P, Narayanan K, Sharifzadehgan A, Perier MC, Tennenbaum J, Vandame M, Lahlou-laforet K, Jouven X, Marijon E. Psychological Support and Medical Screening of First-Degree Relatives of Sudden Cardiac Arrest Victims. JACC Clin Electrophysiol 2020; 6:586-587. [DOI: 10.1016/j.jacep.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/31/2020] [Accepted: 02/06/2020] [Indexed: 01/01/2023]
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Climie R, Boutouyrie P, Perier MC, Guibout C, van Slotten T, Thomas F, Danchin N, Sharman J, Laurent S, Jouven X, Empana JP. 1.6 Individual and Neighborhood Deprivation and Carotid Stiffness: The Paris Prospective III Study. Artery Res 2020. [DOI: 10.2991/artres.k.191224.005] [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: 11/01/2022] Open
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7
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Climie RE, Boutouyrie P, Perier MC, Chaussade E, Plichart M, Offredo L, Guibout C, van Sloten TT, Thomas F, Pannier B, Sharman JE, Laurent S, Jouven X, Empana JP. Association Between Occupational, Sport, and Leisure Related Physical Activity and Baroreflex Sensitivity. Hypertension 2019; 74:1476-1483. [DOI: 10.1161/hypertensionaha.119.13461] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Physical activity (PA) is a preventative behavior for noncommunicable disease. However, little consideration is given as to whether different domains of PA have differing associations with health outcomes. We sought to determine the association between occupational, sport, leisure, and total PA with baroreflex sensitivity (BRS), distinguishing between neural (nBRS) and mechanical (mBRS) BRS. In a cross-sectional analysis of 8649 adults aged 50 to 75 years, resting nBRS (estimated by low-frequency gain, from carotid distension rate and heart rate) and mBRS (carotid stiffness) were measured by high-precision carotid echo-tracking. PA was self-reported using the validated Baecke questionnaire. The associations between PA and nBRS and mBRS were quantified using multivariate linear regression analysis, separately in the working and nonworking population. In working adults (n=5039), occupational PA was associated with worse nBRS (unstandardized β=−0.02; [95% CI, −0.04 to −0.003];
P
=0.022) whereas sport PA was associated with better nBRS (β=0.04; [95% CI, 0.02–0.07];
P
=0.003) and mBRS (β=−0.05; [95% CI, −0.09 to −0.00001];
P
=0.049). Neither leisure PA nor total PA was associated with nBRS or mBRS. In nonworking adults (n=3610), sport PA and total PA were associated with better mBRS (β=−0.08; [95% CI, −0.15 to 0.02];
P
=0.012 and β=−0.05; [95% CI, −0.10 to 0.009];
P
=0.018) but not nBRS. These findings suggest differential associations between domains of PA and BRS and may provide insights into the mechanisms underlying the association between occupational PA and cardiovascular disease.
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Affiliation(s)
- Rachel E. Climie
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
- Baker Heart and Diabetes Institute, Melbourne, Australia (R.E.C.)
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | - Pierre Boutouyrie
- INSERM U970, Department of Pharmacology, APHP, Paris Descartes University, France (P.B., S.L.)
| | - Marie-Cecile Perier
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
| | | | | | - Lucile Offredo
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
| | - Catherine Guibout
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
| | - Thomas T. van Sloten
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
- Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.T.v.S.)
| | - Frederique Thomas
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., B.P.)
| | - Bruno Pannier
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., B.P.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | - Stephane Laurent
- INSERM U970, Department of Pharmacology, APHP, Paris Descartes University, France (P.B., S.L.)
| | - Xavier Jouven
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
| | - Jean-Philippe Empana
- From the University de Paris, INSERM, U970, Paris Cardiovascular Research Centre (PARCC), Integrative Epidemiology of Cardiovascular Disease Team, France (R.E.C., M.-C.P., L.O., C.G., T.T.v.S., X.J., J.-P.E.)
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8
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Bougouin W, Dumas F, Lamhaut L, Marijon E, Carli P, Combes A, Pirracchio R, Aissaoui N, Karam N, Deye N, Sideris G, Beganton F, Jost D, Cariou A, Jouven X, Adnet F, Agostinucci JM, Aissaoui-Balanant N, Algalarrondo V, Alla F, Alonso C, Amara W, Annane D, Antoine C, Aubry P, Azoulay E, Beganton F, Benhamou D, Billon C, Bougouin W, Boutet J, Bruel C, Bruneval P, Cariou A, Carli P, Casalino E, Cerf C, Chaib A, Cholley B, Cohen Y, Combes A, Crahes M, Da Silva D, Das V, Demoule A, Denjoy I, Deye N, Dhonneur G, Diehl JL, Dinanian S, Domanski L, Dreyfuss D, Duboc D, Dubois-Rande JL, Dumas F, Empana JP, Extramiana F, Fartoukh M, Fieux F, Gabbas M, Gandjbakhch E, Geri G, Guidet B, Halimi F, Henry P, Hidden Lucet F, Jabre P, Jacob L, Joseph L, Jost D, Jouven X, Karam N, Kassim H, Lacotte J, Lahlou-Laforet K, Lamhaut L, Lanceleur A, Langeron O, Lavergne T, Lecarpentier E, Leenhardt A, Lellouche N, Lemiale V, Lemoine F, Linval F, Loeb T, Ludes B, Luyt CE, Maltret A, Mansencal N, Mansouri N, Marijon E, Marty J, Maury E, Maxime V, Megarbane B, Mekontso-Dessap A, Mentec H, Mira JP, Monnet X, Narayanan K, Ngoyi N, Perier MC, Piot O, Pirracchio R, Plaisance P, Plu I, Raux M, Revaux F, Ricard JD, Richard C, Riou B, Roussin F, Santoli F, Schortgen F, Sharifzadehgan A, Sideris G, Spaulding C, Teboul JL, Timsit JF, Tourtier JP, Tuppin P, Ursat C, Varenne O, Vieillard-Baron A, Voicu S, Wahbi K, Waldmann V. Extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest: a registry study. Eur Heart J 2019; 41:1961-1971. [DOI: 10.1093/eurheartj/ehz753] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/26/2019] [Accepted: 10/01/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Out-of-hospital cardiac arrest (OHCA) without return of spontaneous circulation (ROSC) despite conventional resuscitation is common and has poor outcomes. Adding extracorporeal membrane oxygenation (ECMO) to cardiopulmonary resuscitation (extracorporeal-CPR) is increasingly used in an attempt to improve outcomes.
Methods and results
We analysed a prospective registry of 13 191 OHCAs in the Paris region from May 2011 to January 2018. We compared survival at hospital discharge with and without extracorporeal-CPR and identified factors associated with survival in patients given extracorporeal-CPR. Survival was 8% in 525 patients given extracorporeal-CPR and 9% in 12 666 patients given conventional-CPR (P = 0.91). By adjusted multivariate analysis, extracorporeal-CPR was not associated with hospital survival [odds ratio (OR), 1.3; 95% confidence interval (95% CI), 0.8–2.1; P = 0.24]. By conditional logistic regression with matching on a propensity score (including age, sex, occurrence at home, bystander CPR, initial rhythm, collapse-to-CPR time, duration of resuscitation, and ROSC), similar results were found (OR, 0.8; 95% CI, 0.5–1.3; P = 0.41). In the extracorporeal-CPR group, factors associated with hospital survival were initial shockable rhythm (OR, 3.9; 95% CI, 1.5–10.3; P = 0.005), transient ROSC before ECMO (OR, 2.3; 95% CI, 1.1–4.7; P = 0.03), and prehospital ECMO implantation (OR, 2.9; 95% CI, 1.5–5.9; P = 0.002).
Conclusions
In a population-based registry, 4% of OHCAs were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early ECMO implantation may improve outcomes. The initial rhythm and ROSC may help select patients for extracorporeal-CPR.
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Affiliation(s)
- Wulfran Bougouin
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Medical-Surgical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Florence Dumas
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Emergency Department, Cochin-Hotel-Dieu Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Lionel Lamhaut
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Eloi Marijon
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Pierre Carli
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Intensive Care Unit - SAMU 75, Necker-Enfants-Malades Hospital, APHP, 149 Rue de Sèvres, 75015 Paris, France
| | - Alain Combes
- Medical-Surgical Intensive Care Unit, iCAN, Institute of Cardiometabolism and Nutrition, Pitié-Salpétrière Hospital, APHP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Romain Pirracchio
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Surgical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nadia Aissaoui
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical ICU, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicole Karam
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
| | - Nicolas Deye
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Medical ICU, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Georgios Sideris
- Cardiology Department, Lariboisière Hospital, AP-HP, 2 Rue Ambroise Paré, 75010 Paris, France
| | - Frankie Beganton
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
| | - Daniel Jost
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Brigade de Sapeurs Pompiers de Paris (BSPP), 1 Place Jules Renard, 75017 Paris, France
| | - Alain Cariou
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- AfterROSC network, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Medical Intensive Care Unit, Cochin Hospital, APHP, 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Xavier Jouven
- Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, 56 rue Leblanc, 75787 Paris, France
- Paris Sudden Death Expertise Center, 56 rue Leblanc, 75787 Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, 12 Rue de l'École de Médecine, 75006 Paris, France
- Cardiology Department, Georges Pompidou European Hospital, AP-HP, 20 Rue Leblanc, 75015 Paris, France
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9
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Lima Correa B, El Harane N, Perotto M, Tence N, Pidial L, Desgres M, Barron E, Bellamy V, Perier MC, Renault NK, Gnecchi M, Silvestre JS, Menasche P. P1646Do Extracellular Vesicles repair chronic ischemic heart disease by replenishing the cardiomyocyte pool? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0405] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Extracellular Vesicles (EV) seem to mediate the benefits of cell therapy for ischemic heart failure. Although their mechanism of action remains poorly understood, one hypothesis is that they might trigger the generation of new cardiomyocytes.
The doubly transgenic fate-mapping MerCreMer/ZEG mice model was thus used to distinguish whether these putative new cardiomyocytes originated from the division of preexisting ones (GFP+, Troponin T [TnT+], EdU+) or differentiated from endogenous progenitors, in which case they would stain positive for TnT+/EdU+ but negative for GFP.
Methods
Myocardial infarction was induced in 35 MerCreMer/ZEG mice by permanent occlusion of the left anterior descending coronary artery. Three weeks later, the surviving mice (n=18) with a left ventricular ejection fraction (LVEF) ≤45% received transcutaneous echo-guided injections in the peri-infarct myocardium of either EV (from 1.4 million human iPS-derived cardiovascular progenitor cells; 10 billion particles, n=9) or PBS (n=9); osmotic pumps were implanted to deliver EdU for 7 days in order to track the proliferation of new and native cardiomyocytes. Four-6 weeks after treatment all mice were evaluated by echocardiography (n=9 per group) and MRI (7 in each group), and then sacrificed for histological assessment, blindly.
Results
Based on echocardiography (MRI data pending), EV improved LVEF by 16% relative to baseline while a decrease of 4% was observed in the PBS group (p=0.46).
The number of new cardiomyocytes (TnT+/EdU+/GFP+) did not significantly differ between the EV-treated hearts and the controls, and averaged 0.54% of the total heart cell content in infarct, peri-infarct and remote areas. However, EV treatment better preserved preexisting GFP+/WGA+/TnT+ cardiomyocytes in the peri-infarct area as their number was greater by 5.15% compared to PBS (32 sections analyzed for each mouse). Compared to the PBS control group, EV delivery was also associated with a 2.5% decrease in fibrosis, a reduction of infarct size by 14.9%, and an increase in angiogenesis in the peri-infarct area (with a between-group absolute difference of 71 capillaries, on the basis of isolectin staining).
Conclusions
EV secreted by iPS-derived cardiovascular progenitors improve the function of chronically infarcted hearts. Preservation of the existing cardiomyocyte pool and limitation of adverse remodeling and scarred tissue, likely favored by increased neoangiogenesis, are the main mechanisms mediated by the EV, while fate mapping allowed to exclude the generation of new cardiomyocytes.
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Affiliation(s)
- B Lima Correa
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - N El Harane
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - M Perotto
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - N Tence
- Hôpital Européen Georges-Pompidou, Cardiologie, Paris, France
| | - L Pidial
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - M Desgres
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - E Barron
- Hôpital Européen Georges-Pompidou, Cardiologie, Paris, France
| | - V Bellamy
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - M C Perier
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - N K Renault
- FujiFilm Cellular Dynamics, Inc., Madison, United States of America
| | | | - J S Silvestre
- Paris Cardiovascular Research Center (PARCC), Paris, France
| | - P Menasche
- Hôpital Européen Georges-Pompidou, Cardiologie, Paris, France
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10
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Diop IB, Antignac M, Nhavoto C, Sidy Ali A, Balde D, Empana JP, Dzudie A, Thiam S, Cavagna P, Adoubi A, Perier MC, Takombe JL, Ikama MS, Houenassi MD, Jouven X. P3459Research Network in Africa (RNA): gender differences in cardiovascular risk factors and complications in 12 African countries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiovascular diseases are rapidly growing epidemic in Sub-Saharan Africa. Unlike other regions of the world, death rates due to hypertension are greater for women than men in Africa. Scarce data were available on factors associated with gender in cardiovascular risk factors and complications in Sub-Saharan Africa.
Purpose
To assess gender differences in cardiovascular risk factors pattern in patients with hypertension in 12 Sub-Saharan countries.
Methods
We conducted a cross-sectional survey in urban clinics of twelve countries in Africa. Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. BP control was defined as BP<140/90 mmHg and hypertension grades were defined according to European Society of Cardiology guidelines. The separate association between women factors and BP control was investigated using Generalized Linear Mixed-Effects Models adjusted on age; A random effect on the country was added (generalized estimated equation models) to account for inter-country variability.
Results
The EIGHT study enrolled 2198 patients with hypertension in 12 sub-Saharan countries between January 2014 and November 2015. The proportion of women (60,2%) was higher than men and varied significantly according to countries (p<0.001), ranged from 33.7% (Guinea) to 71.9% (Gabon). Mean age was 57.7±12.0 years for women and 59.2±11.4 years for men (p<0.001).
Compared to men, women had a higher rate of family cardiovascular background (79% vs 70%, for women and men respectively) (p<0.0001), cardiovascular risk factors (74.3% vs 68.1) (p=0.008), such as obesity (25.8% vs 12.1%) (p<0.0001), sedentary behavior (42.1% vs 35.0%) (p=0,006). BP control didn't differ according to gender, the repartition of grades of hypertension was similar between women and men and proportion of uncontrolled BP was 77.2% in women and 77.8% in men (p=0.4), with same proportion of women and men receiving antihypertensive treatment (96 vs 97.5%) (NS).
However, African women had less cardiovascular complications than men (39% vs 52.4%) (p<0.0001) (OR: 0.50 [CI 95% 0.41–0.61]).
Conclusions
Our study highlighted gender differences in cardiovascular risk factors pattern in Sub-Saharan hypertensive patients. Tailoring medical (public health) programs to improve cardiovascular disease prevention that take into women characteristics may enhance their effectiveness.
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Affiliation(s)
- I B Diop
- CH FANN, Cardiology Department, Dakar, Senegal
| | - M Antignac
- Hospital Saint-Antoine - INSERM PARCC, Paris, France
| | - C Nhavoto
- Cardiology Institute, Cardiology Department, Maputo, Mozambique
| | - A Sidy Ali
- Cardiology Clinics, Cardiology Department, Nouakchott, Mauritania
| | - D Balde
- University Hospital of Conakry, Cardiology Department, Conakry, Guinea
| | - J P Empana
- Paris Cardiovascular Research Center (PARCC), INSERM U970, Paris, France
| | - A Dzudie
- Douala General Hospital, Douala, Cameroon
| | - S Thiam
- El hadj Ibrahima Niass, Cardiology Department, Kaolak, Senegal
| | - P Cavagna
- Hospital Saint-Antoine - INSERM PARCC, Paris, France
| | - A Adoubi
- Universitary Hospital of Bouake, Cardiology Department, Bouake, Côte d'Ivoire
| | - M C Perier
- Paris Cardiovascular Research Center (PARCC), INSERM U 970, Paris, France
| | - J L Takombe
- University Hospital of Kinshasa, Internal Medicine Department, Kinshasa, Congo (Democratic Republic of the)
| | - M S Ikama
- University Hospital, Cardiology Department, Brazzaville, Congo
| | - M D Houenassi
- National University Hospital of Hubert K. MAGA (CNHU-HKM), Cotonou, Benin
| | - X Jouven
- European G. Pompidou Hospital- INSERM U970 PARCC, Cardiology Department, Paris, France
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11
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Climie RE, Boutouyrie P, Perier MC, Guibout C, van Sloten TT, Thomas F, Danchin N, Sharman JE, Laurent S, Jouven X, Empana JP. Individual and Neighborhood Deprivation and Carotid Stiffness. Hypertension 2019; 73:1185-1194. [DOI: 10.1161/hypertensionaha.118.12186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Rachel E. Climie
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Baker Heart and Diabetes Institute; Melbourne, Australia (R.E.C.)
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Marie-Cecile Perier
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Catherine Guibout
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Thomas T. van Sloten
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
- Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, the Netherlands (T.T.v.S.)
| | - Frederique Thomas
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - Nicolas Danchin
- Investigations Préventives et cliniques (IPC), Paris, France (F.T., N.D.)
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia (R.E.C., J.E.S.)
| | | | - Xavier Jouven
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
| | - Jean-Philippe Empana
- From the INSERM, U970, Department of Epidemiology (R.E.C., MC.P., C.G., T.T.v.S., X.J., JP.E.)
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12
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Climie R, Boutouyrie P, Chaussade E, Perier MC, Plichart M, Offrendo L, Guibout C, van Sloten T, Thomas F, Pannier B, Sharman J, Laurent S, Jouven X, Empana JP. Abstract P171: Occupational, Sport and Leisure Physical Activity Have Contrasting Effects on Neural Baroreflex Sensitivity. The Paris Prospective Study III. Hypertension 2018. [DOI: 10.1161/hyp.72.suppl_1.p171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Physical activity (PA) is beneficial for baroreflex sensitivity (BRS), but it is unclear whether the type of PA has similar effects on the neural (nBRS) or vascular (carotid stiffness) components of BRS. We sought to determine this in healthy adults from a community- based study via assessment of occupational (OPA), sport (SPA), leisure (LPA) and total PA (TPA).
Methods:
In 8649 adults aged 50 to 75 years, resting nBRS (estimated by low frequency gain, from carotid distension rate and heart rate) and carotid stiffness were measured by high-precision carotid echotracking. PA was self-reported using the Baecke questionnaire, which distinguishes OPA, SPA, LPA and TPA. The associations between PA and nBRS and carotid stiffness were quantified using multivariate linear regression analysis. Analyses were conducted separately in the working and non- working population.
Results:
In working adults (n=5039), OPA was associated with lower nBRS function (p=0.026) and borderline higher carotid stiffness (p=0.08). The associations between OPA and nBRS remained independent after additionally adjusting for SPA (p=0.03) and exaggerated exercise blood pressure (p=0.005), a predictor of future hypertension and cardiovascular events. When examining the type of OPA separately (i.e. lifting heavy loads, standing or walking at work) lifting heavy loads only was associated with impaired nBRS (p=0.048). When stratified by education, this association remained only in those with less than tertiary education. SPA was associated with higher nBRS (p=0.0005) and borderline lower carotid stiffness (p=0.052). Neither LPA nor TPA was associated with nBRS or carotid stiffness. In non-working adults (n=3610), SPA and TPA were both associated with lower carotid stiffness (p=0.012 and p=0.020), but not nBRS. LPA was not associated with either parameter.
Conclusion:
Occupation-related PA, in particular lifting heavy loads, is associated with lower nBRS function, especially in those with lower education. Higher amounts of sport-related PA are associated with higher nBRS and lower carotid stiffness.
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Affiliation(s)
- Rachel Climie
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France, Paris, France
| | | | | | - Marie-Cecile Perier
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France
| | - Mathew Plichart
- APHP, Paris Descartes university, Paris, France, Paris, France
| | - Lucile Offrendo
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France
| | - Catherine Guibout
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France
| | - Thomas van Sloten
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France
| | | | - Bruno Pannier
- Investigations Préventives et cliniques (IPC), Paris, France
| | | | | | - Xavier Jouven
- INSERM, U970, Dept of Epidemiology; Paris Descartes university, Paris, France
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13
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Poirat L, Gaye B, Perier MC, Thomas F, Guibout C, Climie RE, Offredo L, Tafflet M, Lemogne C, Pannier B, Boutouyrie P, Jouven X, Empana JP. Perceived stress is inversely related to ideal cardiovascular health: The Paris Prospective Study III. Int J Cardiol 2018; 270:312-318. [PMID: 29936046 DOI: 10.1016/j.ijcard.2018.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/26/2018] [Accepted: 06/11/2018] [Indexed: 02/04/2023]
Affiliation(s)
- L Poirat
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
| | - B Gaye
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M C Perier
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - C Guibout
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - R E Climie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Baker Heart and Diabetes Institute, Melbourne, Australia; Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia
| | - L Offredo
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M Tafflet
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Psychiatry Department, Paris, France; INSERM, U894, Psychiatry and Neuroscience Center, Paris, France
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Pharmacology Department, Paris, France
| | - X Jouven
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Cardiology Department, Paris, France
| | - J P Empana
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
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14
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Climie R, Boutouyrie P, Perier MC, Chaussade E, Plichart M, Offredo L, Guilbout C, van Sloten T, Thomas F, Pannier B, Sharman J, Laurent S, Jouven X, Empana JP. 2.3 OCCUPATIONAL, SPORT AND LEISURE RELATED PHYSICAL ACTIVITY HAVE CONTRASTING EFFECTS ON NEURAL BAROREFLEX SENSITIVITY. THE PARIS PROSPECTIVE STUDY III. Artery Res 2018. [DOI: 10.1016/j.artres.2018.10.026] [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] Open
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15
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Escande W, Boveda S, Defaye P, Leclercq C, Sadoul N, Perier MC, Deharo JC, Fauchier L, Marijon E, Piot O. Outcomes in Guideline-Based Versus Off-Guideline Primary Prevention Implantable Cardioverter-Defibrillator Recipients. J Am Coll Cardiol 2017; 70:1302-1303. [DOI: 10.1016/j.jacc.2017.07.711] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 07/09/2017] [Accepted: 07/10/2017] [Indexed: 01/04/2023]
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16
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Providência R, Boveda S, Defaye P, Segal O, Algalarrondo V, Sadoul N, Lambiase P, Piot O, Klug D, Perier MC, Bouzeman A, Barra S, Bories MC, Gras D, Fauchier L, Bordachar P, Babuty D, Deharo JC, Leclercq C, Marijon E. Outcome of Primary Prevention Implantable Cardioverter Defibrillator Therapy According to New York Heart Association Functional Classification. Am J Cardiol 2016; 118:1225-1232. [PMID: 27561197 DOI: 10.1016/j.amjcard.2016.07.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 04/24/2016] [Revised: 07/10/2016] [Accepted: 07/10/2016] [Indexed: 11/29/2022]
Abstract
We aimed to assess if the outcome of primary prevention implantable cardioverter defibrillators (ICDs) without cardiac resynchronization therapy is dependent on New York Heart Association (NYHA) class. Among the participants of Défibrillateur Automatique Implantable-Prévention Primaire (DAI-PP; NCT01992458) multicenter cohort study, 155 patients in NYHA class I, 504 in NYHA class II, and 188 in NYHA class III had a QRS width <120 ms and were implanted with an ICD without cardiac resynchronization therapy and, thus, were eligible for the purpose of this analysis. Total and specific mortalities and the incidence of appropriate therapies were assessed for every NYHA. During 2,606 patient-years (3.1 ± 2.1 years), 104 (12.3%) subjects died and 188 (22.2%) experienced appropriate therapies. After adjustment, overall mortality increased with NYHA class (adjusted hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.11 to 2.41, p = 0.014), driven by an increase in cardiovascular death. Conversely, incidence of appropriate ICD intervention was comparable among the 3 NYHA groups (NYHA class I 7.43, NYHA class II 7.91, and NYHA class III 12.10 per 100 patient-years; HR 1.19, 95% CI 0.89 to 1.59, p = 0.231). Incidence of ICD-unresponsive sudden death was very low and also comparable (NYHA class I 0.22, NYHA class II 0.36, and NYHA class III 0.83 per 100 patient-years (HR 6.34, 95% CI 0.32 to 124.49, p = 0.224). No significant differences were observed in the other specific modes of death. In conclusion, although patients in NYHA class III have higher overall mortality, they experience a comparable incidence of appropriate ICD therapies. The low incidence of ICD-unresponsive sudden death in all assessed NYHA classes also supports the efficacy of ICDs, irrespective of NYHA class.
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Affiliation(s)
- Rui Providência
- Clinique Pasteur, Toulouse, France; Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
| | | | | | - Oliver Segal
- Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom
| | | | | | - Pier Lambiase
- Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; Institute of Cardiovascular Sciences, University College of London, London, United Kingdom
| | - Olivier Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | | | | | | | - Sergio Barra
- Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | | | | | | | | | | | - Eloi Marijon
- Hôpital Européen Georges Pompidou, Paris, France
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Empana JP, Perier MC, Singh-Manoux A, Gaye B, Thomas F, Prugger C, Plichart M, Wiernik E, Guibout C, Lemogne C, Pannier B, Boutouyrie P, Jouven X. Cross-sectional analysis of deprivation and ideal cardiovascular health in the Paris Prospective Study 3. Heart 2016; 102:1890-1897. [PMID: 27354274 DOI: 10.1136/heartjnl-2016-309502] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/18/2016] [Accepted: 05/30/2016] [Indexed: 11/04/2022] Open
Abstract
AIMS We hypothesised that deprivation might represent a barrier to attain an ideal cardiovascular health (CVH) as defined by the American Heart Association (AHA). METHODS AND RESULTS The baseline data of 8916 participants of the Paris Prospective Study 3, an observational cohort on novel markers for future cardiovascular disease, were used. The AHA 7-item tool includes four health behaviours (smoking, body weight, physical activity and optimal diet) and three biological measures (blood cholesterol, blood glucose and blood pressure). A validated 11-item score of individual material and psychosocial deprivation, the Evaluation de la Précarité et des Inégalités dans les Centres d'Examens de Santé-Evaluation of Deprivation and Inequalities in Health Examination centres (EPICES) score was used. The mean age was 59.5 years (standard deviation 6.2), 61.2% were men and 9.98% had an ideal CVH. In sex-specific multivariable polytomous logistic regression, the odds ratio (OR) for ideal behavioural CVH progressively decreased with quartile of increasing deprivation, from 0.54 (95% CI 0.41 to 0.72) to 0.49 (0.37 to 0.65) in women and from 0.61 (0.50 to 0.76) to 0.57 (0.46 to 0.71) in men. Associations with ideal biological CVH were confined to the most deprived women (OR=0.60; 95% CI 0.37 to 0.99), whereas in men, greater deprivation was related to higher OR of intermediate biological CVH (OR=1.28; 95% CI 1.05 to 1.57 for the third quartile vs the first quartile). CONCLUSIONS Higher material and psychosocial deprivation may represent a barrier to reach an ideal CVH. TRIAL REGISTRATION NUMBER NCT00741728.
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Affiliation(s)
- J P Empana
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M C Perier
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - A Singh-Manoux
- INSERM, U1018, Epidemiology of Ageing and Age Related Diseases, Villejuif, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, France
| | - B Gaye
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - C Prugger
- Institute of Public Health, Charité University Medicine Berlin, Berlin, Germany
| | - M Plichart
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Department of Geriatry, APHP, Hopital Broca, Paris, France
| | - E Wiernik
- INSERM, U1018, Epidemiology of Ageing and Age Related Diseases, Villejuif, France.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, France
| | - C Guibout
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Psychiatry Department, APHP, Georges Pompidou European Hospital, Paris, France.,INSERM, Centre for Psychiatry and Neuroscience, Paris, France
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Pharmacology Departments, APHP, Georges Pompidou European Hospital, Paris, France
| | - X Jouven
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Cardiology Department, APHP, Georges Pompidou European Hospital, Paris, France
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Gaye B, Prugger C, Perier MC, Thomas F, Plichart M, Guibout C, Lemogne C, Pannier B, Boutouyrie P, Jouven X, Empana JP. High level of depressive symptoms as a barrier to reach an ideal cardiovascular health. The Paris Prospective Study III. Sci Rep 2016; 6:18951. [PMID: 26743318 PMCID: PMC4705528 DOI: 10.1038/srep18951] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/25/2015] [Indexed: 11/09/2022] Open
Abstract
We hypothesized that depression might represent a barrier to reach an ideal cardiovascular health (CVH) as estimated by the 7-item tool proposed by the American Heart Association. Between 2008 and 2012, 9,417 subjects 50-75 years of age were examined in a large health center and enrolled in the Paris Prospective Study III (PPS3). Participants with 0-2, 3-4 and 5-7 health metrics at the ideal level were categorized as having poor, intermediate and ideal CVH, respectively. Participants with a score ≥ 7 on the 13-item Questionnaire of Depression 2nd version, Abridged or who were on antidepressants were referred as having high level of depressive symptoms (HLDS). The mean age of the 9417 study participants was 59.57 (SD 6.28) years and 61.16% were males. A total of 9.55% had HLDS. Poor, intermediate and ideal CVH was present in 40.38%, 49.52% and 10.10% of the participants. In multivariate polytomous logistic regression analysis, HLDS was inversely associated with ideal CVH (odds ratio = 0.70; 95% CI: 0.55;0.90). This was driven by an association with the behavioural component of the CVH. Participants with HLDS had a substantial reduced chance of reaching an ideal CVH.
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Affiliation(s)
- B Gaye
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Prugger
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M C Perier
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - M Plichart
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,APHP, Hospital Broca, Department of Geriatry, Paris, France
| | - C Guibout
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,APHP, Georges Pompidou European Hospital, Psychiatry Department, Paris, France.,INSERM U894, Neuropsychiatry, Paris, France
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,APHP, Georges Pompidou European Hospital, Pharmacology Departments, Paris, France
| | - X Jouven
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,APHP, Georges Pompidou European Hospital, Cardiology Department, Paris, France
| | - J P Empana
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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Marijon E, Leclercq C, Narayanan K, Boveda S, Klug D, Lacaze-Gadonneix J, Defaye P, Jacob S, Piot O, Deharo JC, Perier MC, Mulak G, Hermida JS, Milliez P, Gras D, Cesari O, Hidden-Lucet F, Anselme F, Chevalier P, Maury P, Sadoul N, Bordachar P, Cazeau S, Chauvin M, Empana JP, Jouven X, Daubert JC, Le Heuzey JY. Causes-of-death analysis of patients with cardiac resynchronization therapy: an analysis of the CeRtiTuDe cohort study. Eur Heart J 2015; 36:2767-76. [PMID: 26330420 PMCID: PMC4628644 DOI: 10.1093/eurheartj/ehv455] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 08/17/2015] [Indexed: 01/14/2023] Open
Abstract
Aims The choice of resynchronization therapy between with (CRT-D) and without (CRT-P) a defibrillator remains a contentious issue. Cause-of-death analysis among CRT-P, compared with CRT-D, patients could help evaluate the extent to which CRT-P patients would have additionally benefited from a defibrillator in a daily clinical practice. Methods and results A total of 1705 consecutive patients implanted with a CRT (CRT-P: 535 and CRT-D: 1170) between 2008 and 2010 were enrolled in CeRtiTuDe, a multicentric prospective follow-up cohort study, with specific adjudication for causes of death at 2 years. Patients with CRT-P compared with CRT-D were older (P < 0.0001), less often male (P < 0.0001), more symptomatic (P = 0.0005), with less coronary artery disease (P = 0.003), wider QRS (P = 0.002), more atrial fibrillation (P < 0.0001), and more co-morbidities (P = 0.04). At 2-year follow-up, the annual overall mortality rate was 83.80 [95% confidence interval (CI) 73.41–94.19] per 1000 person-years. The crude mortality rate among CRT-P patients was double compared with CRT-D (relative risk 2.01, 95% CI 1.56–2.58). In a Cox proportional hazards regression analysis, CRT-P remained associated with increased mortality (hazard ratio 1.54, 95% CI 1.07–2.21, P = 0.0209), although other potential confounders may persist. By cause-of-death analysis, 95% of the excess mortality among CRT-P subjects was related to an increase in non-sudden death. Conclusion When compared with CRT-D patients, excess mortality in CRT-P recipients was mainly due to non-sudden death. Our findings suggest that CRT-P patients, as currently selected in routine clinical practice, would not potentially benefit with the addition of a defibrillator.
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Affiliation(s)
- Eloi Marijon
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
| | | | | | | | - Didier Klug
- Lille University Hospital and University of Lille, Lille, France
| | - Jonathan Lacaze-Gadonneix
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France
| | - Pascal Defaye
- Arrhythmia Department, University Hospital, Grenoble, France
| | | | - Olivier Piot
- Centre Cardiologique du Nord, Saint Denis, France
| | | | | | | | | | | | - Daniel Gras
- Nouvelles Cliniques Nantaises, Nantes, France
| | | | | | | | | | - Philippe Maury
- Cardiology Division, Rangueil University Hospital, Toulouse, France
| | - Nicolas Sadoul
- Cardiology Division, Nancy University Hospital, Nancy, France
| | | | | | | | | | - Xavier Jouven
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
| | | | - Jean-Yves Le Heuzey
- Cardiology Department, European Georges Pompidou Hospital, Paris, France Paris Descartes University, Paris, France Paris Cardiovascular Research Centre, Paris, France
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Fauchier L, Marijon E, Defaye P, Piot O, Sadoul N, Perier MC, Gras D, Klug D, Algalarrondo V, Bordachar P, Deharo JC, Leclercq C, Babuty D, Boveda S, Boveda S, Marijon E, Algalarrondo V, Babuty D, Bordachar P, Bouzeman A, Providencia R, Defaye P, Gras D, Deharo JC, Klug D, Leclercq C, Piot O, Sadoul N, Beganton F, Perier MC. Effect of age on survival and causes of death after primary prevention implantable cardioverter-defibrillator implantation. Am J Cardiol 2015; 115:1415-22. [PMID: 25784518 DOI: 10.1016/j.amjcard.2015.02.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 02/11/2015] [Accepted: 02/11/2015] [Indexed: 10/24/2022]
Abstract
The benefit of implantable cardioverter-defibrillators (ICDs) remains controversial in elderly patients and may be attenuated by a greater risk of nonarrhythmic death. We examined the effect of age on outcomes after prophylactic ICD implantation. All patients with coronary artery disease or dilated cardiomyopathy implanted with an ICD for primary prevention of sudden cardiac death in 12 French medical centers were included in a retrospective observational study. The 5,534 ICD recipients were divided according to age: 18 to 59 years (n = 2,139), 60 to 74 years (n = 2,693), and ≥75 years (n = 702). Greater prevalences of coronary artery disease and atrial fibrillation at the time of implant were observed with increasing age (both p <0.0001). During a mean follow-up of 3.1 ± 2.0 years, the annual mortality rate increased with age: 3.1% per year for age 18 to 59 years, 5.7% per year for age 60 to 74 years, and 7.5% per year for age ≥75 years (p <0.001). Older age was independently associated with a greater risk of death (adjusted odds ratio 1.43, 95% confidence interval 1.14 to 1.80 for age 60 to 74 years; and adjusted odds ratio 1.65, 95% confidence interval 1.22 to 2.22 for age >75 years). Proportions of cardiac deaths (55.2%, 57.6%, and 57.0%, p = 0.84), including ICD-unresponsive sudden death (9.9%, 6.0%, and 10.6%, p = 0.08), and rates of appropriate ICD therapies were similar in the 3 age groups. Older age was independently associated with a higher rate of early complications and a lower rate of inappropriate therapies. In conclusion, older patients exhibited higher global mortality after ICD implantation for primary prevention, whereas rates of sudden deaths and of appropriate device therapies were similar across age groups.
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Providência R, Boveda S, Lambiase P, Defaye P, Algalarrondo V, Sadoul N, Piot O, Klug D, Perier MC, Bouzeman A, Gras D, Fauchier L, Bordachar P, Babuty D, Deharo JC, Leclercq C, Marijon E. Prediction of Nonarrhythmic Mortality in Primary Prevention Implantable Cardioverter-Defibrillator Patients With Ischemic and Nonischemic Cardiomyopathy. JACC Clin Electrophysiol 2015; 1:29-37. [DOI: 10.1016/j.jacep.2015.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/23/2015] [Accepted: 01/29/2015] [Indexed: 10/23/2022]
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