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Julliand S, Papaxanthis C, Delphin C, Mock A, Raumel MA, Gueugnon M, Ornetti P, Laroche D. IMPROVE study protocol, investigating post-stroke local muscle vibrations to promote cerebral plasticity and functional recovery: a single-blind randomised controlled trial. BMJ Open 2024; 14:e079918. [PMID: 38490651 PMCID: PMC10946362 DOI: 10.1136/bmjopen-2023-079918] [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: 09/15/2023] [Accepted: 02/27/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Spasticity is a frequent disabling consequence following a stroke. Local muscle vibrations (LMVs) have been proposed as a treatment to address this problem. However, little is known about their clinical and neurophysiological impacts when used repeatedly during the subacute phase post-stroke. This project aims to evaluate the effects of a 6-week LMV protocol on the paretic limb on spasticity development in a post-stroke subacute population. METHODS AND ANALYSIS This is an interventional, controlled, randomised, single-blind (patient) trial. 100 participants over 18 years old will be recruited, within 6 weeks following a first stroke with hemiparesis or hemiplegia. All participants will receive a conventional rehabilitation programme, plus 18 sessions of LMV (ie, continuously for 30 min) on relaxed wrist and elbow flexors: either (1) at 80 Hz for the interventional group or (2) at 40 Hz plus a foam band between the skin and the device for the control group.Participants will be evaluated at baseline, at 3 weeks and 6 weeks, and at 6 months after the end of the intervention. Spasticity will be measured by the modified Ashworth scale and with an isokinetic dynamometer. Sensorimotor function will be assessed with the Fugl-Meyer assessment of the upper extremity. Corticospinal and spinal excitabilities will be measured each time. ETHICS AND DISSEMINATION This study was recorded in a clinical trial and obtained approval from the institutional review board (Comité de protection des personnes Ile de France IV, 2021-A03219-32). All participants will be required to provide informed consent. The results of this trial will be published in peer-reviewed journals to disseminate information to clinicians and impact their practice for an improved patient's care. TRIAL REGISTRATION NUMBER Clinical Trial: NCT05315726 DATASET: EUDRAct.
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Affiliation(s)
- Sophie Julliand
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | | | - Corentin Delphin
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
| | - Anne Mock
- Physical Medicine and Rehabilitation, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
| | - Marc-Antoine Raumel
- Physical Medicine and Rehabilitation, Hospital Centre Chalon-sur-Saône, Chalon-sur-Saône, France
| | - Mathieu Gueugnon
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | - Paul Ornetti
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
| | - Davy Laroche
- INSERM CIC 1432, Plateforme d'Investigation Technologique, CHU Dijon, Dijon, Bourgogne-Franche-Comté, France
- INSERM U1093, Dijon, France
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2
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Mazel B, Delanne J, Garde A, Racine C, Bruel AL, Duffourd Y, Lopergolo D, Santorelli FM, Marchi V, Pinto AM, Mencarelli MA, Canitano R, Valentino F, Papa FT, Fallerini C, Mari F, Renieri A, Munnich A, Niclass T, Le Guyader G, Thauvin-Robinet C, Philippe C, Faivre L. FOXG1 variants can be associated with milder phenotypes than congenital Rett syndrome with unassisted walking and language development. Am J Med Genet B Neuropsychiatr Genet 2024:e32970. [PMID: 38459409 DOI: 10.1002/ajmg.b.32970] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 03/10/2024]
Abstract
Since 2008, FOXG1 haploinsufficiency has been linked to a severe neurodevelopmental phenotype resembling Rett syndrome but with earlier onset. Most patients are unable to sit, walk, or speak. For years, FOXG1 sequencing was only prescribed in such severe cases, limiting insight into the full clinical spectrum associated with this gene. Next-generation sequencing (NGS) now enables unbiased diagnostics. Through the European Reference Network for Rare Malformation Syndromes, Intellectual and Other Neurodevelopmental Disorders, we gathered data from patients with heterozygous FOXG1 variants presenting a mild phenotype, defined as able to speak and walk independently. We also reviewed data from three previously reported patients meeting our criteria. We identified five new patients with pathogenic FOXG1 missense variants, primarily in the forkhead domain, showing varying nonspecific intellectual disability and developmental delay. These features are not typical of congenital Rett syndrome and were rarely associated with microcephaly and epilepsy. Our findings are consistent with a previous genotype-phenotype analysis by Mitter et al. suggesting the delineation of five different FOXG1 genotype groups. Milder phenotypes were associated with missense variants in the forkhead domain. This information may facilitate prognostic assessments in children carrying a FOXG1 variant and improve the interpretation of new variants identified with genomic sequencing.
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Affiliation(s)
- Benoit Mazel
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - Julian Delanne
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Centre de référence Déficiences Intellectuelles de Causes Rares, CHU Dijon Bourgogne, Dijon, France
| | - Aurore Garde
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - Caroline Racine
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
| | - Ange-Line Bruel
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
- Laboratoire de Génomique Médicale, Unité Fonctionnelle Innovation en diagnostic génomique, Unité fonctionnelle innovation en diagnostic génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France
| | - Yannis Duffourd
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
- Laboratoire de Génomique Médicale, Unité Fonctionnelle Innovation en diagnostic génomique, Unité fonctionnelle innovation en diagnostic génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France
| | - Diego Lopergolo
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foudation, Pisa, Italy
| | - Filippo Maria Santorelli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Stella Maris Foudation, Pisa, Italy
| | - Viviana Marchi
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, IRCCS Fondazione Stella Maris Foundation, Pisa, Italy
| | - Anna Maria Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | | | - Roberto Canitano
- Division of Child and Adolescent Neuropsychiatry, University Hospital of Siena, Siena, Italy
| | - Floriana Valentino
- Medical Genetics Unit, University of Siena, Policlinico Le Scotte, Siena, Italy
| | | | - Chiara Fallerini
- Medical Genetics Unit, University of Siena, Policlinico Le Scotte, Siena, Italy
- Department of Medical Biotechnologies, Med Biotech Hub and Competence Center, University of Siena, Siena, Italy
| | - Francesca Mari
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Medical Genetics Unit, University of Siena, Policlinico Le Scotte, Siena, Italy
| | - Alessandra Renieri
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Medical Genetics Unit, University of Siena, Policlinico Le Scotte, Siena, Italy
- Department of Medical Biotechnologies, Med Biotech Hub and Competence Center, University of Siena, Siena, Italy
| | - Arnold Munnich
- Service de Génétique Médicale et Clinique, Hôpital Necker Enfants Malades, Paris, France
| | - Tanguy Niclass
- Service de Génétique Clinique, CHU de Poitiers, Poitiers, France
| | | | - Christel Thauvin-Robinet
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
- Centre de référence Déficiences Intellectuelles de Causes Rares, CHU Dijon Bourgogne, Dijon, France
- Laboratoire de Génomique Médicale, Unité Fonctionnelle Innovation en diagnostic génomique, Unité fonctionnelle innovation en diagnostic génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France
| | - Christophe Philippe
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
- Laboratoire de Génomique Médicale, Unité Fonctionnelle Innovation en diagnostic génomique, Unité fonctionnelle innovation en diagnostic génomique des maladies rares, CHU Dijon Bourgogne, Dijon, France
| | - Laurence Faivre
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD - CHU Dijon Bourgogne, Dijon, France
- Inserm UMR1231 GAD, Génétique des Anomalies du Développement, Université de Bourgogne, Dijon, France
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Denimal D, Ponnaiah M, Jeannin AC, Phan F, Hartemann A, Boussouar S, Charpentier E, Redheuil A, Foufelle F, Bourron O. Non-alcoholic fatty liver disease biomarkers estimate cardiovascular risk based on coronary artery calcium score in type 2 diabetes: a cross-sectional study with two independent cohorts. Cardiovasc Diabetol 2024; 23:69. [PMID: 38351039 PMCID: PMC10865592 DOI: 10.1186/s12933-024-02161-x] [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: 12/15/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Studies have demonstrated that coronary artery calcification on one hand and non-alcoholic fatty liver disease (NAFLD) on the other hand are strongly associated with cardiovascular events. However, it remains unclear whether NAFLD biomarkers could help estimate cardiovascular risk in individuals with type 2 diabetes (T2D). The primary objective of the present study was to investigate whether the biomarkers of NAFLD included in the FibroMax® panels are associated with the degree of coronary artery calcification in patients with T2D. METHODS A total of 157 and 460 patients with T2D were included from the DIACART and ACCoDiab cohorts, respectively. The coronary artery calcium score (CACS) was measured in both cohorts using computed tomography. FibroMax® panels (i.e., SteatoTest®, FibroTest®, NashTest®, and ActiTest®) were determined from blood samples as scores and stages in the DIACART cohort and as stages in the ACCoDiab cohort. RESULTS CACS significantly increased with the FibroTest® stages in both the DIACART and ACCoDiab cohorts (p-value for trend = 0.0009 and 0.0001, respectively). In DIACART, the FibroTest® score was positively correlated with CACS in univariate analysis (r = 0.293, p = 0.0002) and remained associated with CACS independently of the traditional cardiovascular risk factors included in the SCORE2-Diabetes model [β = 941 ± 425 (estimate ± standard error), p = 0.028]. In the ACCoDiab cohort, the FibroTest® F3-F4 stage was positively correlated with CACS in point-biserial analysis (rpbi = 0.104, p = 0.024) and remained associated with CACS after adjustment for the traditional cardiovascular risk factors included in the SCORE2-Diabetes model (β = 234 ± 97, p = 0.016). Finally, the prediction of CACS was improved by adding FibroTest® to the traditional cardiovascular risk factors included in the SCORE2-Diabetes model (goodness-of-fit of prediction models multiplied by 4.1 and 6.7 in the DIACART and ACCoDiab cohorts, respectively). In contrast, no significant relationship was found between FibroMax® panels other than FibroTest® and CACS in either cohort. CONCLUSIONS FibroTest® is independently and positively associated with the degree of coronary artery calcification in patients with T2D, suggesting that FibroTest® could be a relevant biomarker of coronary calcification and cardiovascular risk. TRIAL REGISTRATION ClinicalTrials.gov identifiers NCT02431234 and NCT03920683.
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Affiliation(s)
- Damien Denimal
- Center for Translational and Molecular Medicine, INSERM UMR 1231, Dijon, France
- Department of Clinical Biochemistry, Dijon Bourgogne University Hospital, Dijon, France
| | | | - Anne-Caroline Jeannin
- Sorbonne Université, Paris, France
- Department of Diabetology, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, 47‑83 Boulevard de l'Hôpital, Paris, France
| | - Franck Phan
- Sorbonne Université, Paris, France
- Centre de Recherche des Cordeliers, INSERM UMR_S 1138, Paris, France
- Department of Diabetology, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, 47‑83 Boulevard de l'Hôpital, Paris, France
| | - Agnès Hartemann
- Centre de Recherche des Cordeliers, INSERM UMR_S 1138, Paris, France
- Department of Diabetology, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, 47‑83 Boulevard de l'Hôpital, Paris, France
| | - Samia Boussouar
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France
- ICT Cardiovascular and Thoracic Imaging Unit, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié Salpêtrière University Hospital, Paris, France
| | - Etienne Charpentier
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France
- ICT Cardiovascular and Thoracic Imaging Unit, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié Salpêtrière University Hospital, Paris, France
| | - Alban Redheuil
- Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
- Laboratoire d'Imagerie Biomédicale INSERM_1146, CNRS_7371, Paris, France
- ICT Cardiovascular and Thoracic Imaging Unit, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié Salpêtrière University Hospital, Paris, France
| | - Fabienne Foufelle
- Centre de Recherche des Cordeliers, INSERM UMR_S 1138, Paris, France
| | - Olivier Bourron
- Sorbonne Université, Paris, France.
- Centre de Recherche des Cordeliers, INSERM UMR_S 1138, Paris, France.
- Department of Diabetology, Assistance Publique‑Hôpitaux de Paris (APHP), Pitié-Salpêtrière Hospital, 47‑83 Boulevard de l'Hôpital, Paris, France.
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4
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Viora-Dupont E, Denommé-Pichon A, Chevarin M, Patat O, Willems M, Bourgon N, Bruel A, Aubert-Mucca M, Galinier M, Itier R, Decramer S, Piton A, Gerard B, Billon C, Jeunemaitre X, Duffourd Y, Callier P, Thauvin C, Philippe C, Faivre L, Albuisson J, Vitobello A. Identification of the first homozygous intragenic deletion in the YY1AP1 gene in a consanguineous family: New insights into the phenotypic variability associated with Grange syndrome. Am J Med Genet A 2023; 191:2728-2735. [PMID: 37698238 DOI: 10.1002/ajmg.a.63394] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023]
Abstract
Grange syndrome (GRNG-MIM#135580) is a rare recessive disorder associating variable features including diffuse vascular stenosis, brachysyndactyly, osteopenia with increased bone fragility, cardiac malformations, and variable developmental delay. Since its first description in 1998, only 15 individuals from 10 families have been reported, carrying homozygous or compound heterozygous frameshift or nonsense variants in YY1AP1. In a patient with cutaneous and bone syndactyly and a hemorrhagic stroke at the age of 16 months, consistent with a clinical diagnosis of GRNG, we performed exome sequencing after negative array-CGH and congenital limb malformation panel results. Copy number variant analysis from exome data identified a homozygous intragenic out-of-frame deletion of 1.84 kb encompassing exons seven and eight of YY1AP1, confirming a molecular diagnosis of GRNG. Genetic counseling led to the identification of additional family members compatible with GRNG. Here, we provide new insights into the phenotypic variability associated with GRNG and highlight the utility of the detection of small copy number variants to identify the molecular causes of heterogeneous malformative genetic disorders.
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Affiliation(s)
- E Viora-Dupont
- Genetics Department and Reference Center for Developmental Disorders and Malformative Syndromes for East France, Dijon Bourgogne University Hospital, Dijon, France
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
| | - A Denommé-Pichon
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
| | - M Chevarin
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
| | - O Patat
- Service de Génétique Médicale, CHU Toulouse, France, Toulouse, France
| | - M Willems
- Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, Université de Montpellier, CHU de Montpellier, CLAD ASOOR Montpellier, Montpellier, France
- Institute for Neurosciences of Montpellier, Université de Montpellier, INSERM, Montpellier, France
| | - N Bourgon
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
| | - A Bruel
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
| | - M Aubert-Mucca
- Service de Génétique Médicale, CHU Toulouse, France, Toulouse, France
| | - M Galinier
- Fédération des Services de Cardiologie, CHU Toulouse-Rangueil, Toulouse, France
- UMR UT3 CNRS 5288 Evolutionary Medicine, Obesity and Heart Failure: Molecular and Clinical Investigations, INI-CRCT F-CRIN, GREAT Networks, Toulouse, France
- Université Paul Sabatier-Toulouse III, Faculté de Médecine, Toulouse, France
| | - R Itier
- UMR UT3 CNRS 5288 Evolutionary Medicine, Obesity and Heart Failure: Molecular and Clinical Investigations, INI-CRCT F-CRIN, GREAT Networks, Toulouse, France
| | - S Decramer
- Centre Hospitalier Universitaire de Toulouse, Service de Nephrologie Pediatrique, Hopital des Enfants, Centre De Reference des Maladies Rénales Rares du Sud-Ouest, Toulouse, France
| | - A Piton
- Unité de Génétique Moléculaire, Strasbourg University Hospital, Strasbourg, France
| | - B Gerard
- Laboratoire de Diagnostic Génétique, Institut de Génétique Médicale d'Alsace, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - C Billon
- Centre de Référence des Maladies Vasculaires Rares et Département de génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - X Jeunemaitre
- Centre de Référence des Maladies Vasculaires Rares et Département de génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - Y Duffourd
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
| | - P Callier
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
| | - C Thauvin
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
- Centre de Référence Déficiences Intellectuelles de Causes Rares, Hôpital d'Enfants, Dijon, France
| | - C Philippe
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
| | - L Faivre
- Genetics Department and Reference Center for Developmental Disorders and Malformative Syndromes for East France, Dijon Bourgogne University Hospital, Dijon, France
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
| | - J Albuisson
- Centre de Référence des Maladies Vasculaires Rares et Département de génétique, Hôpital Européen Georges Pompidou, Paris, France
| | - A Vitobello
- UMR1231 GAD "Génétique des Anomalies du Développement", FHU-TRANSLAD, UFR des Sciences de Santé, INSERM-University of Burgundy, Dijon, France
- Unité Fonctionnelle d'Innovation diagnostique des maladies rares, Dijon Bourgogne University Hospital, Dijon, France
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Putot A, Chagué F, Manckoundia P, Brunel P, Beer JC, Cottin Y, Zeller M. Post-Infectious Myocardial Infarction: Does Percutaneous Coronary Intervention Improve Outcomes? A Propensity Score-Matched Analysis. J Clin Med 2020; 9:E1608. [PMID: 32466424 PMCID: PMC7355802 DOI: 10.3390/jcm9061608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/23/2020] [Accepted: 05/25/2020] [Indexed: 02/06/2023] Open
Abstract
Acute infection is a frequent trigger of myocardial infarction (MI). However, whether percutaneous coronary intervention (PCI) improves post-infectious MI prognosis is a major but unsolved issue. In this prospective multicenter study from coronary care units, we performed propensity score-matched analysis to compare outcomes in patients with and without PCI for post-infectious MI with angiography-proven significant coronary stenosis (>50%). Among 4573 consecutive MI patients, 476 patients (10%) had a concurrent diagnosis of acute infection at admission, of whom 375 underwent coronary angiography and 321 patients had significant stenosis. Among the 321 patients, 195 underwent PCI. Before the matching procedure, patients without PCI had a similar age and sex ratio but a higher rate of risk factors (hypertension, diabetes, chronic renal failure, and prior coronary artery disease), pneumonia, and SYNTAX score than patients without PCI. After propensity score matching, neither in-hospital mortality (13% with PCI vs. 8% without PCI; p = 0.4) nor one-year mortality (24% with PCI vs. 19% without PCI, p = 0.5) significantly differed between the two groups. In this first prospective cohort of post-infectious MI in coronary care units, PCI might not improve short- and long-term prognosis in patients with angiography-proven significant coronary stenosis. If confirmed, these results do not argue for systematic invasive procedures after post-infectious MI.
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Affiliation(s)
- Alain Putot
- Geriatrics Internal Medicine Department, University Hospital of Dijon Bourgogne, 21079 Dijon CEDEX, France;
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460, University of Burgundy and Franche Comté, 21079 Dijon CEDEX, France; (F.C.); (Y.C.); (M.Z.)
| | - Frédéric Chagué
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460, University of Burgundy and Franche Comté, 21079 Dijon CEDEX, France; (F.C.); (Y.C.); (M.Z.)
- Cardiology Department, University Hospital of Dijon Bourgogne, 21079 Dijon CEDEX, France;
| | - Patrick Manckoundia
- Geriatrics Internal Medicine Department, University Hospital of Dijon Bourgogne, 21079 Dijon CEDEX, France;
| | - Philippe Brunel
- Cardiology Department, Hopital privé Dijon Bourgogne, 21000 Dijon, France;
| | - Jean-Claude Beer
- Cardiology Department, University Hospital of Dijon Bourgogne, 21079 Dijon CEDEX, France;
| | - Yves Cottin
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460, University of Burgundy and Franche Comté, 21079 Dijon CEDEX, France; (F.C.); (Y.C.); (M.Z.)
- Cardiology Department, University Hospital of Dijon Bourgogne, 21079 Dijon CEDEX, France;
| | - Marianne Zeller
- Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2), EA 7460, University of Burgundy and Franche Comté, 21079 Dijon CEDEX, France; (F.C.); (Y.C.); (M.Z.)
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