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Hascoët S, Smolka G, Brochet E, Bouisset F, Leurent G, Thambo JB, Combes N, Bauer F, Nejjari M, Pilliere R, Dauphin C, Bonnet G, Ketelers R, Dumonteil N, Ciobotaru V, Gallet R, Hammoudi N, Spaulding C, Champagnac D, Gérardin B. Predictors of clinical success after transcatheter paravalvular leak closure: An international prospective multicenter registry. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Le Ruz R, Guérin P, Leurent G, Leroux L, Lefevre T, Nejjari M, Champagnac D, Tchétché D, Lhermusier T, Caussin C, Delomez M, Bonnet G, Favereau X, Karam N, Gerbay A, Juthier F, Gilard M, Obadia JF, Iung B, Manigold T. Mitral valve-in-valve and valve-in-ring procedures: Midterm outcomes in a French nationwide registry. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, 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Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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4
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Hascoet S, Smolka G, Brochet E, Bouisset F, Leurent G, Thambo JB, Combes N, Bauer F, Nejjari M, Pilliere R, Dauphin C, Bonnet G, Ketelers R, Champagnac D, Gerardin B. Predictors of clinical success after transcatheter para-valvular leak closure: an international prospective multicentre registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2138] [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
Prosthetic paravalvular leaks (PVLs) are associated with congestive heart failure and haemolysis, for which the standard treatment is open-heart surgery with the attendant risks to the patient. Transcatheter closure has emerged as an alternative. Patient selection criteria for the best option are needed. We aimed to identify predictors of clinical success after transcatheter PVL closure.
Purpose
We aimed to identify predictors of clinical success after transcatheter PVL closure.
Methods
Consecutive patients referred to 24 European centres for transcatheter PVL closure in 2017–2019 were included in a prospective registry (Fermeture de Fuite ParaProthétique, FFPP). Clinical success was absence of any of the following within 1 month: re-admission for heart failure, blood transfusion, open-heart valvular surgery, and death.
Results
We included 216 symptomatic patients, who underwent 238 percutaneous PVL closure procedures on the mitral (64.3%), aortic (34.0%), or tricuspid (1.7%) valve. The prosthesis was mechanical in 53.3% and biological in 45.3% of procedures. All patients were symptomatic with heart failure, haemolytic anaemia, and the association of both conditions in 48.9%, 7.8% and 43.3%. One, two and three PVL were addressed during the same procedure in 69.6%, 26.6% and 3.8% respectively. Mitral and aortic PVL were severe in 35.3% and 13.8% (p<0.001). PVL was punctiform or extended to 1/8 or 1/4 of valve circumference in 18.6%, 52.4% and 28.1% of cases. A total of 331 devices were implanted. More than one device (up to 5) was implanted in 34.2% of procedures. Vascular plug 3, muscular ventricular septal defect occluder, vascular plug 2 and paravalvular leak device were the most frequently used devices, implanted in 45.0%, 16.0%, 14.2% and 13.6%, respectively. Successful device(s) implantation(s) within the leak and leak reduction ≤ grade 2 occurred in 85.0% and 91.4% of patients with mitral and aortic procedures, respectively (p=0.164), with major intra-procedural adverse event rates of 3.3% and 1.2%, respectively (p=0.371). The clinical success rates were 77.8% and 88.9% following mitral and aortic procedures, respectively (p=0.01). By multivariate logistic regression analysis, technical failure, mechanical valve and haemolytic anaemia were independently associated with absence of clinical success (odds ratios [95% CIs]: 7.7 [2.0–25.0], p=0.002; 3.6 [1.1–11.1], p=0.036 and 3.7 [1.2–11.9], p=0.025; respectively).
Conclusion
Transcatheter PVL closure is efficient and safe in symptomatic patients but is more challenging and associated with an increased risk of clinical failure when performed in patients with hemolysis and/or on a mechanical valve.
Funding Acknowledgement
Type of funding sources: Private hospital(s). Main funding source(s): The study is promoted and financially supported by Groupe Hospitalier Paris Saint Joseph
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Affiliation(s)
- S Hascoet
- Marie Lannelongue Hospital , Le Plessis Robinson , France
| | - G Smolka
- School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - E Brochet
- Bichat APHP Site of Paris Nord University Hospital , Paris , France
| | - F Bouisset
- Rangueil Hospital of Toulouse , Toulouse , France
| | - G Leurent
- Hospital Pontchaillou of Rennes , Rennes , France
| | - J B Thambo
- Hospital Haut Leveque , Bordeaux , France
| | - N Combes
- Clinic Pasteur , Toulouse , France
| | - F Bauer
- Rouen University Medical School , Rouen , France
| | - M Nejjari
- centre cardiologique du nord , Saint-Denis , France
| | - R Pilliere
- Clinique Ambroise Pare , Neuilly sur Seine , France
| | - C Dauphin
- University Hospital Gabriel Montpied , Clermont-Ferrand , France
| | - G Bonnet
- APHM La Timone Hospital , Marseille , France
| | | | - D Champagnac
- Medipole Lyon-Villeurbanne , Villeurbanne , France
| | - B Gerardin
- Marie Lannelongue Hospital , Le Plessis Robinson , France
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Bonnet G, Panagides V, Vincent F, Faroux L, Corona S, Modine T, Metz D, Van Belle E, Pibarot P, Leroux L, Rodes-Cabau J, Ternacle J. Bioprosthetic valve fracture during valve-in-valve transcatheter aortic valve replacement: multicenter propensity matched analysis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) can be completed by bioprosthetic valve fracture (BVF) to reduce final transvalvular gradients. The aim was to compare outcomes in ViV-TAVI patients with versus without BVF.
Methods
Consecutive patients undergoing ViV-TAVI procedure in four international centers were included, from 2010 to 2021. We used a 1:2 propensity score-matching method to compare postprocedural hemodynamic, complications, and long-term outcomes. Patients were matched for baseline characteristics, time since prior surgery, and characteristics of surgical bioprothesis (type and size).
Results
A total of 390 patients were analyzed, including 40 BVF. Propensity matching 1:2 yielded 38 patients in BVF group and 76 patients in no-BVF group. There was no difference in procedural complications rate and in-hospital deaths (5.1%) between the two groups. Post-procedural hemodynamic parameters significantly improved using BVF: aortic valve area (1.4 cm2 [IQR: 1.23 to 2.3] vs. 1.3 cm2 [IQR: 1.05 to 1.61], p=0.008), mean aortic gradient (12mmHg [IQR: 7.5 to 16.5] vs. 17mmHg [IQR: 11 to 22], p=0.008) and peak velocity (2.2m/s [IQR: 1.8 to 2.7] vs. 2.6m/s [IQR: 2.2 to 3.1], p=0.027). BVF had an additional benefit in the smallest surgical valve (≤21 mm). The use of BVF was independently associated with improved hemodynamic parameters. Overall survival in the matched cohort was 87.8±3.7% at 2-year follow-up, without difference between groups (87.5±6.9% in the BVF group vs. 88.4±4.2% in the no-BVF group, p=0.85).
Conclusion
Compared to ViV-TAVI alone, BVF was safe and improved immediate hemodynamic and long-term outcomes, especially in patients with small surgical aortic bioprosthesis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Bonnet
- Hospital Haut Leveque , Bordeaux , France
| | - V Panagides
- Quebec Heart and Lung Institute , Quebec , Canada
| | - F Vincent
- Chru De Lille - Institut Coeur-Poumons , Lille , France
| | - L Faroux
- Hospital Robert Debre - University Hospital Centre of Reims , Reims , France
| | - S Corona
- Hospital Haut Leveque , Bordeaux , France
| | - T Modine
- Hospital Haut Leveque , Bordeaux , France
| | - D Metz
- Hospital Robert Debre - University Hospital Centre of Reims , Reims , France
| | - E Van Belle
- Chru De Lille - Institut Coeur-Poumons , Lille , France
| | - P Pibarot
- Quebec Heart and Lung Institute , Quebec , Canada
| | - L Leroux
- Hospital Haut Leveque , Bordeaux , France
| | | | - J Ternacle
- Hospital Haut Leveque , Bordeaux , France
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Fauvel C, Trimaille A, Weizman O, Pezel T, Mika D, Waldmann V, Cohen A, Bonnet G. Cardiovascular manifestations secondary to COVID-19: A narrative review. Respir Med Res 2022; 81:100904. [PMID: 35525097 PMCID: PMC9065692 DOI: 10.1016/j.resmer.2022.100904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has spread rapidly, becoming a major threat to global health. In addition to having required the adaptation of healthcare workers for almost 2 years, it has been much talked about, both in the media and among the scientific community. Beyond lung damage and respiratory symptoms, the involvement of the cardiovascular system largely explains COVID-19 morbimortality. In this review, we emphasize that cardiovascular involvement is common and is associated with a worse prognosis, and that earlier detection by physicians should lead to better management. First, direct cardiac involvement will be discussed, in the form of COVID-19 myocarditis, then secondary cardiac involvement, such as myocardial injury, myocardial infarction and arrhythmias, will be considered. Finally, worsening of previous cardiovascular disease as a result of COVID-19 will be examined, as well as long-term COVID-19 effects and cardiovascular complications of COVID-19 vaccines.
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Affiliation(s)
- C. Fauvel
- Cardiology Department, Rouen University Hospital, Rouen 76000, France,Division of Cardiovascular Medicine, Wexner Medical Center, The Ohio State University, 410 West 10th Avenue, Columbus, OH 43210, USA,Corresponding author at: Division of Cardiovascular Medicine, Wexner Medical Center, The Ohio State University, 410 West 10th Avenue, Columbus, OH 43210, USA
| | - A. Trimaille
- Department of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg 67000, France
| | - O. Weizman
- Cardiology Department, Institut Lorrain du Cœur et des Vaisseaux, CHU de Nancy, 54500, France
| | - T. Pezel
- Cardiology Department, Lariboisière Hospital, AP-HP, Université de Paris, Paris 75010, France
| | - D. Mika
- Paris-Saclay University, Inserm, UMR-S 1180, Châtenay-Malabry 92296, France
| | - V. Waldmann
- Cardiology Department, Hôpital Européen Georges Pompidou, Université de Paris, Paris 75015, France
| | - A. Cohen
- Department of Cardiology, Saint Antoine and Tenon Hospital, AP-HP, INSERM UMRS-ICAN 1166 and Sorbonne University, Paris, France
| | - G. Bonnet
- Université de Bordeaux, 33000, France,Service Médico-Chirurgicale de Valvulopathies et Cardiomyopathies, Hôpital Cardiologique Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac 33600, France
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7
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Andrianiaina H, Bonnet G, Torras O, Arregle F, Nguyen N, Resseguier N, Bonnet JL, Habib G. Factors associated with favorable outcomes in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER) with the mitraclip device. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.226] [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
Funding Acknowledgements
Type of funding sources: None.
Introduction
Transcatheter edge-to-edge mitral valve repair (TEER) has over the years become a viable alternative to surgery in high-risk patients with severe symptomatic mitral regurgitation (MR). Selection of optimal candidates who will benefit from the procedure remains challenging.
Our study aims to determine clinical, echocardiographic and procedural factors associated with favorable outcomes after mitraclip implantation.
Methods
We retrospectively analyzed the data concerning patients who underwent MitraClip implantation for symptomatic severe MR in our institution.
All patients underwent a clinical evaluation and a transthoracic echocardiography before the procedure, and at follow up (between one and up to three months after the index procedure).
A clinical endpoint combining absence of cardiovascular death, absence of rehospitalization for heart failure and improvement of at least 1 class New York Heart Association NYHA at three months, was used to define a good response.
Results
Among 109 patients referred to our institution for TEER since January 2018, 106 had a successful clip implantation and were included in our study. 76 of them had a primary MR and 30 others a secondary mitral regurgitation (SMR). The primary endpoint was achieved in 65% of those patients. Reduction of MR severity to less than grade 2+ was achieved in 87% of the patients.
A high body mass index (p = 0.03), a high level of NT-proBNP at admission (p = 0.02), the association with at least a moderate tricuspid regurgitation prior to mitraclip implantation (p = 0.02) and a severe residual mitral regurgitation (p = 0.01) were predictive of a worse outcome in all patients. In the group of secondary MR, patients who reached the primary endpoint had significantly a lower telediastolic diameter (p = 0.02). A post procedural transvalvular mitral gradient superior to 4.4 mmHg was associated with a worse prognosis in patients with primary mitral regurgitation (p = 0.004) but not in the group of secondary mitral regurgitation (p = 0.7). Furthermore, the ratios EROA/LVEDV and VR/LVEDV defining proportionate mitral regurgitation were not correlated to any benefit in the secondary MR group.
Conclusion
Our study in real life patients found some elements supporting the results of former studies about predictors of outcomes after mitraclip treatment. Tricuspid regurgitation prior to the procedure and an elevated mitral valve pressure gradient after clip implantation are correlated with a worse prognosis. In accordance with recent literature, an elevate mean gradient seems to have less impact on prognosis in SMR, fostering to get optimal MR reduction in those patients. Identifying criteria that would predict insufficient benefit of Mitraclip implantation is necessary to avoid futility.
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Affiliation(s)
| | - G Bonnet
- APHM La Timone Hospital, Marseille, France
| | - O Torras
- APHM La Timone Hospital, Marseille, France
| | - F Arregle
- APHM La Timone Hospital, Marseille, France
| | - N Nguyen
- APHM La Timone Hospital, Marseille, France
| | | | - J-L Bonnet
- APHM La Timone Hospital, Marseille, France
| | - G Habib
- APHM La Timone Hospital, Marseille, France
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8
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Moal O, Roger E, Lamouroux A, Vuillet C, Bonnet G, Moal B, Lafitte S. Explicit and automatic ejection fraction assessment on 2D cardiac ultrasound. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): DESKi
Background
Left ventricular ejection fraction (EF) is a key parameter to assess cardiovascular functions in 2D cardiac ultrasound, but its manual assessment is time-consuming and subject to high inter and intra-observer variability.
Deep learning-based approaches have been proposed to automatically predict EF but can suffer from a lack of explainability and interpretability, which limit the trust of the clinician and prevent errors from being detected.
Purpose
In this context, we propose a fully automatic method to reliably evaluate the biplane left ventricular EF on 2D echocardiography while following the modified Simpson’s rule calculation steps to provide explicit details to clinicians.
Methods
A deep learning model based on U-Net architecture was trained on internal apical 4 and 2-chamber echocardiographic images to segment the left ventricle and locate the mitral valve. Predicted segmentations are then validated with a statistical shape model which detects potential failures that could impact the final EF evaluation. Finally, end-diastolic and end-systolic frames are identified thanks to a spline interpolated from the remaining LV segmentations’ areas, and the EF is estimated on all available cardiac cycles.
This approach was trained on a dataset of 783 patients. Its performances were evaluated on an internal dataset of 200 patients with a large diversity of EF and on an external openly available dataset containing 450 patients.
Results
On the internal dataset, EF assessment achieved a mean absolute error of 6.10% and a bias of 1.56 ± 7.58% using multiple cardiac cycles and removing failed segmentations. Regarding end-diastolic and end-systolic volumes, the mean absolute error was evaluated at 13.75mL and 10.70mL respectively. Segmentation performances were evaluated with the Dice and the Hausdorff distance, respectively at 0.92 ± 0.41 and 6.13 ± 2.9mm.
On the external dataset, the approach predicted EF with a mean absolute error of 5.39% and a bias of -0.74 ± 7.12%. The mean absolute error for end-diastolic volume was 15.40mL and for end-systolic volume 8.18mL.
Conclusions
Following the recommended guidelines, we proposed an end-to-end fully automatic approach achieving state-of-the-art performances in EF evaluation in 2D cardiac ultrasound while giving explicit details to the clinicians at each step of the assessment. Abstract Figure. End-to-end fully automatic approach
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Affiliation(s)
| | | | | | | | - G Bonnet
- University Hospital of Bordeaux, Ultrasound Laboratory, Bordeaux, France
| | | | - S Lafitte
- University Hospital of Bordeaux, Ultrasound Laboratory, Bordeaux, France
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Coutance G, Kransdorf E, Bonnet G, Loupy A, Jouven X, Kobashigawa J, Patel J. Development and validation of an individual predictive model for risk of biopsy-proven antibody-mediated rejection after heart transplantation. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Leurent G, Auffret V, Grinberg D, Le Ruz R, Saint Etienne C, Pierrard R, Champagnac D, Benard T, Lecoq G, Arnould M, Bonnet G, Lhermusier T, Corbineau H, Donal E. Transcatheter edge-to-edge mitral valve repair following surgical annuloplasty with ring implantation. Results from the multicenter “Clip-in-Ring” registry. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.128] [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: 11/15/2022]
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11
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Coutance G, Bonnet G, Kransdorf E, Loupy A, Leprince P, Kobashigawa J, Patel J. Development and validation of specific post-transplant risk scores according to the circulatory support status at transplant: A UNOS cohort analysis. Archives of Cardiovascular Diseases Supplements 2022. [DOI: 10.1016/j.acvdsp.2021.09.069] [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: 11/26/2022]
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12
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Munoz-Sanchez ML, Bessadet M, Lance C, Bonnet G, Veyrune JL, Nicolas E, Hennequin M, Decerle N. Survival Rate of CAD-CAM Endocrowns Performed by Undergraduate Students. Oper Dent 2021; 46:505-515. [PMID: 35486509 DOI: 10.2341/20-126-c] [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] [Accepted: 11/06/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study aimed to evaluate the success of computer-aided design-computer-aided manufacturing (CAD-CAM) endocrown restorations of endodontically treated teeth (ETT) performed by supervised undergraduate students. The study also intended to identify possible factors that may lead to failures. METHODS AND MATERIALS This observational open cohort study was based on clinical data from endocrown restorations performed by residents and undergraduate students in their 4th, 5th, and 6th year from July 2011 to May 2018. The presence of a tooth with an endocrown on the arch was the main criteria used to calculate the survival rate of restored teeth. The quality of the remaining endocrowns was evaluated referring to the FDI criteria. The cases of failure were categorized into either favorable or unfavorable. RESULTS A total of 343 ETT were restored with endocrowns in 315 patients. Among them, 199 patients encompassing 225 endocrowns were followed during a 56 ± 26 month period. The survival rate of restored teeth was found to be 81.8%, the estimated Kaplan-Meier survival rate being 71.8% at 9 years. Among the 41 failed cases, 32 were favorable (debonding and/or ceramic fractures) and 9 were unfavorable. CONCLUSION Endocrown restorations of posterior ETT using CAD-CAM technologies could be carried out by undergraduates with a low risk of failure. Teacher supervision could be reinforced, covering all steps of each endocrown procedure in order to avoid failures due to insufficient thickness or loss of retention.
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Affiliation(s)
- M L Munoz-Sanchez
- Marie Laure Munoz-Sanchez, DDS, University Clermont Auvergne CHU de Clermont-Ferrand, France
| | - M Bessadet
- Marion Bessadet, DDS, PhD, University Clermont Auvergne CHU de Clermont-Ferrand, France
| | - C Lance
- Cindy Lance, DDS, PhD, University Clermont Auvergne CHU de Clermont-Ferrand, France
| | - G Bonnet
- Guillaume Bonnet, DDS, PhD, University Clermont Auvergne CHU de Clermont-Ferrand, France
| | - J L Veyrune
- Jean Luc Veyrune, DDS, PhD, HDR, University Clermont Auvergne CHU de Clermont-Ferrand, France
| | - E Nicolas
- Emmanuel Nicolas, DDS, PhD, HDR, University Clermont Auvergne, CHU de Clermont-Ferrand, France
| | - M Hennequin
- *Martine Hennequin, DDS, PhD, HDR, University of Clermont Auvergne, Clermont-Ferrand, France
| | - N Decerle
- Nicolas Decerle, DDS, PhD, University Clermont Auvergne CHU de Clermont-Ferrand, France
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13
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Pezel T, Dillinger JG, Bonnet G, Vidal Trecan T, Asselin A, Sideris G, Logeart D, Manzo-Silberman S, Gautier JF, Riveline JP, Henry P. Cardiac troponin I and BNP for predicting zero Agatston score in patients with diabetes mellitus. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Coronary artery calcifications (CAC) scoring assessed by the Agatston score has shown an excellent prognostic value in large studies, particularly in diabetic patients, with a very low rate of cardiovascular events in patients with a zero Agatston score. Moreover, recent studies have suggested that high-sensitive cardiac troponin I (hs-cTnI) and brain natriuretic peptide (BNP) may be useful for detecting subclinical atherosclerosis, especially in diabetic patients. However, the link between hs-cTnI/BNP and the Agatston score has not been investigated in this population.
PURPOSE
The aim of this study was to investigate if hs-cTnI and BNP can bring additional value to predict zero Agatston score in patients with diabetes mellitus in addition to usual risk factors.
METHODS
Between 2015 and 2019, CAC score was prospectively performed in consecutive patients with diabetes mellitus with high cardiovascular risk. Patients with symptoms or known coronary artery disease were excluded. Within 24h from CT exam, peripheral blood samples were taken to measure hs-cTnI and BNP. The relationship between serum hs-cTnI/BNP concentrations and zero Agatston score was evaluated using univariate and multivariate binomial models. 77 variables have been used to build the model. The implication of hs-cTnI and BNP in this multivariate model was evaluated using nested models associated with Chi-squared test of independence.
RESULTS
A total of 844 patients with diabetes were enrolled (61 ± 7 years, 57% men, mean diabetes duration 18 years). In this population, 294 (35%) had a zero Agatston score, 253 (30%) an Agatston score from 1 to 100, 161 (19%) from 101 to 400, and 136 (16%) higher than 400. In univariate analysis, hs-cTnI and BNP concentrations were associated with a zero Agatston score (respectively OR, 2.63 [95% CI, 1.51-5.01]; p < 0.001 and OR, 1.09 [95% CI, 1.01-1.22]; p = 0.03). In multivariate analysis, hs-cTnI and BNP concentrations were associated with a zero Agatston score (respectively OR, 2.38 [95% CI, 1.51-4.76]; p = 0.009 and OR, 1.18 [95% CI, 1.07-1.32]; p = 0.001). Among the 77 variables, the multivariate model including age, gender, smoking, dyslipidaemia, duration of the diabetes, arterial hypertension, presence of diabetic neuropathy, hs-cTnI and BNP concentrations, significantly discriminated the zero Agatston score (AUC = 0.81; p < 0.001). The most discriminant threshold was ≤ 3ng/l for hs-cTnI and <17ng/l for BNP. In nested models, both hs-cTnI and BNP brought information to this multivariate model to predict a zero Agatston score (respectively p = 0.003 and p < 0.001 to the Chi-squared test). Moreover, removing hs-cTnI and BNP from the model results in a significant reduction in model performance (AUC = 0.79; p = 0.004).
CONCLUSIONS
Cardiac biomarkers hs-cTnI and BNP are associated with a zero Agatston score, which is correlated with a very low risk of cardiovascular events in asymptomatic patients with diabetes mellitus.
Abstract Figure. ROC curve to predict zero Agatston score
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Affiliation(s)
- T Pezel
- Hospital Lariboisiere, Paris, France
| | - JG Dillinger
- Hospital Lariboisiere, Department of Cardiology , Paris, France
| | - G Bonnet
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | | | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - G Sideris
- Hospital Lariboisiere, Department of Cardiology , Paris, France
| | - D Logeart
- Hospital Lariboisiere, Department of Cardiology , Paris, France
| | | | | | | | - P Henry
- Hospital Lariboisiere, Department of Cardiology , Paris, France
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Pezel T, Bonnet G, Garot P, Asselin A, Unterseeh T, Champagne S, Hovasse T, Kinnel M, Sanguineti F, Garot J. Additional prognostic value of vasodilator stress CMR in patients with inconclusive stress test to detect coronary artery disease. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.289] [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
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Guidelines recommend performing a non-invasive testing for ischemia to diagnose coronary artery disease (CAD). However, these tests are frequently inconclusive (25%). This population has been poorly studied because of its heterogeneity. In such cases, stress cardiac magnetic resonance (CMR) may be useful to improve diagnostic certainty. To date, no study has evaluated the prognostic value of stress CMR in these patients presenting with prior inconclusive test.
PURPOSE
To assess the additional prognostic value of vasodilator stress perfusion CMR in patients with a first inconclusive stress test to detect CAD.
METHODS
Between 2008 and 2018, consecutive patients with inconclusive stress test prospectively referred for vasodilator stress perfusion CMR with dipyridamole were followed for major adverse cardiovascular events (MACE) defined as cardiac death or myocardial infarction. Inconclusive stress test was defined by echocardiography or nuclear stress testing with uncertain conclusion about the diagnosis of CAD. To characterize this population, an unsupervised clustering analysis was performed using 18 variables. Univariable and multivariable Cox regressions were performed to determine the prognostic value of inducible ischemia by stress CMR in each cluster.
RESULTS
Of 1502 patients with inconclusive stress test (62 ± 12 years, 59% men), 1441 (96%) completed the CMR protocol and 1397(93%) completed the follow-up (median 5.5 ± 2.3 years). Stress CMR was well tolerated without occurrence of death or severe adverse event. The clustering analysis identified 3 clusters:
Cluster 1 (n = 524, 35%) had the highest prevalence of previous percutaneous coronary intervention (PCI), the highest presence of myocardial scar on CMR, the lowest LVEF(35 ± 7%) and the highest degree of LV dilatation.
Cluster 2 (n = 406, 27%) had the highest prevalence of previous coronary artery bypass grafting (CABG), preserved LVEF(54 ± 10%), absence of LV dilatation and rate of male(89%).
Cluster 3 (n = 572, 38%) had the lowest rate of previous PCI/CABG and of myocardial scar. This cluster gathered the oldest patients (73 ± 11 years), predominantly female (60%), with the highest rate of atrial fibrillation and body mass index.
Survival analysis found significant differences across clusters for the occurrence of MACE (p = 0.02). Moreover, inducible ischemia was significantly associated with the occurrence of MACE in each cluster (cluster 1, HR 2.28; [95%CI: 1.31-3.99]; p = 0.0028; cluster 2, HR 3.37; [95%CI, 1.97-5.75]; p < 0.0001; cluster 3, HR 2.73; [95%CI, 1.67-4.46]; p < 0.0001). In multivariable Cox regression, inducible ischemia was an independent predictor of a higher incidence of MACE in each cluster (p < 0.001).
CONCLUSIONS
Cluster analysis identified 3 different phenotypes of patients with inconclusive stress test that were associated with distinct clinical and prognostic profiles. Within these clusters, CMR stress has an additional prognostic value to predict the occurrence of MACE.
Abstract Figure. Kaplan-Meier for MACE in each cluster
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Affiliation(s)
- T Pezel
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - G Bonnet
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - P Garot
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - T Unterseeh
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - S Champagne
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - T Hovasse
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - M Kinnel
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - F Sanguineti
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - J Garot
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
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Weizman O, Mika D, Geneste L, Cellier J, Trimaille A, Pommier T, Panagides V, Chaumont C, Karsenty C, Duceau B, Sutter W, Fauvel C, Pezel T, Bonnet G, Cohen A, Waldmann V. Cardiovascular Comorbidities and Covid-19 in Women. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC8719934 DOI: 10.1016/j.acvdsp.2020.10.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background While women account for 40-50 % of patients hospitalized for coronavirus disease 2019 (Covid-19), no specific data have been reported in this population. Purpose Assess the burden of cardiovascular comorbidities on outcomes in women hospitalized for Covid-19. Methods We conducted a retrospective observational multicenter study from February 26 to April 20, 2020 in 24 French hospitals including all adults admitted for Covid-19. Primary composite outcome included transfer to intensive care unit (ICU) or in-hospital death. Results Among 2878 patients hospitalized for Covid-19, 1212 (42.1 %) were women. Women were significantly older (68.3 ± 18.0 vs. 65.4 ± 16.0 years, P < 0.001) but had less prevalent cardiovascular comorbidities than men. Among women, 276 (22.8 %) experienced the primary outcome, including 161 (13.3 %) transfer to ICU and 115 (9.5 %) deaths without transfer to ICU. The survival free from death or transfer to ICU was higher in women (HR 0.63, 95 %CI 0.53-0.73, P < 0.001), whereas the observed difference in in-hospital deaths did not reach statistical significance (P = 0.18). The proportion of women that experienced the primary outcome were 37.8 % in women with heart failure (n = 112), 30.9 % in women with coronary artery disease (n = 81), 29.1 % in women with diabetes (n = 254), 26.1 % in women with dyslipidemia (n = 315), and 26.0 % in women with hypertension (n = 632). Age (HR 1.05, 5 years increments, 95 %CI 1.01-1.10), body mass index (HR 1.06, 2 units increments, 95 %CI 1.02-1.10), chronic kidney disease (HR 1.57, 95 %CI 1.11-2.22), and heart failure (HR 1.52, 95 %CI 1.04-2.22) were independently associated with the primary outcome (Fig. 1). Conclusions Women hospitalized for Covid-19 were older and had less prevalent cardiovascular comorbidities than men. While female sex was associated with a lower risk of transfer to ICU or in-hospital death, Covid-19 remains associated with considerable morbi-mortality in women, especially in those with cardiovascular diseases.
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Gardenat A, Aldebert P, Deharo J, Bonnet J, Torras O, Deharo P, Bonnet G, Habib G. Safety and efficiency of multimodal imaging approach of patent foramen ovale closure in patients with cryptogenic stroke. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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Bonnet G, Panagides V, Palermo V, Gautier A, Pommier T, Weizman O, Noirclerc N, Adjedj J, Commeau P, Benamer H, Cayla G. Myocardial infarction rates overview during COVID-19 pandemic In France: Results of the MODIF registry. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC8719936 DOI: 10.1016/j.acvdsp.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background The emergence of Coronavirus disease 2019 (COVID-19) has evolved into a global pandemic. Systems of care have been reorganized worldwide in an effort to preserve hospital bed capacity. In France, from March 17 to May 11 2020, government imposed a complete lockdown on the whole population. Only urgent cardiac procedures have been ensured such as ST-elevation myocardial infarction (STEMI) revascularization. Some previously published studies suggest a reduction of admission for STEMI in many countries. Nevertheless, strong evidences and data across different French regions that have been affected variously by the outbreak are still lacking. Purpose We aimed to describe the incidence rates and characteristics of patients presenting with STEMI in order to evaluate the impact of the COVID-19 outbreak on STEMI care in France covering the lockdown period compared to same period one year ago. Methods We performed a retrospective multicenter registry across 60 French interventional cardiology centers including all consecutive STEMI patients referred for urgent revascularization in the heart catheterization laboratory between two periods: March 1st to May 31th 2020 compared with March 1st to May 31th 2019. Comprehensive data, including clinical, biological, COVID status and angiographic variables including time taken for care were recorded at admission. The primary outcome was a composite of invasive mechanical ventilation support or in-hospital death. The secondary outcome was the occurrence of myocardial infarction related complications during hospitalization. Enrollement is not complete at the time of the abstract submission. Conclusion This data collection between two periods with and without COVID19 will gave insights for a complete descriptive cartography of STEMI patients among different French regions which have been variously impacted by the outbreak.
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Bories M, Caudron J, Guillemain R, Varnous S, Leprince P, Marijon E, Loupy A, Jouven X. Determinants of sudden cardiac death after heart transplantation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.190] [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: 11/16/2022]
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19
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Fauvel C, Weizman O, Trimaille A, Mika D, Pace N, Douair A, Barbin E, Fraix A, Bouchot O, Benmansour O, Godeau G, Mecheri Y, Le Bourdon R, Yvorel C, Duceau B, Sutter W, Waldmann V, Bonnet G, Cohen A, Pezel T. Pulmonary Embolism in Covid-19 patients: A French Multicentre Cohort Study. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC8719940 DOI: 10.1016/j.acvdsp.2020.10.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background While pulmonary embolism (PE) appears to be a major issue in Covid-19, data remain sparse. Purpose We aimed to describe the risk factors and baseline characteristics of patients with PE in a large cohort of Covid-19 patients. Methods In a retrospective multicentric observational study, we included consecutive hospitalised patients for Covid-19. Patients without computed tomography pulmonary angiography (CTPA)-proven PE diagnosis, those who were directly admitted to an intensive care unit (ICU), and those still hospitalised without PE experience were excluded. Results Among 1240 patients (58.1% men, mean age 64 ± 17 years), 103 (8.3%) patients had PE confirmed by CTPA. The ICU transfer requirement and mechanical ventilation requirement were significantly higher in the PE group (P < 0.001 and P < 0.001, respectively). In an univariable analysis, traditional venous thromboembolic risk factors were not associated with PE (P > 0.05), while patients under therapeutic-dose anticoagulation before hospitalisation or prophylaxis-dose anticoagulation introduced during hospitalisation had lower PE occurrence (OR 0.40, 95%CI(0.14-0.91); P = 0.04 and OR 0.11, 95%CI(0.06-0.18); P < 0.001, respectively). In a multivariable analysis, the following variables (also statistically significant in univariable analysis) were associated with PE: male gender (OR 1.03, 95%CI(1.003-1.069); P = 0.04), anticoagulation with prophylaxis-dose (OR 0.83, 95%CI(0.79-0.85), P < 0.001) or therapeutic-dose (OR 0.87, 95%CI(0.82-0.92), P < 0.001), C-reactive protein (OR 1.03, 95%CI(1.01-1.04), P = 0.001) and time from symptom onset to hospitalisation (OR 1.02, 95%CI(1.006-1.038), P = 0.002) (Table 1). Conclusion Pulmonary embolism risk factors in Covid-19 context do not include traditional thromboembolic risk factors but rather independent clinical and biological findings at admission, including a major contribution to inflammation.
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Bories M, Caudron J, Rouvier P, Guillemain R, Varnous S, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Incidence of sudden cardiac death after heart transplantation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Identification of trajectories of cardiac allograft vasculopathy after heart transplantation: a nationwide comparison. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2696] [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
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. However, little is known about CAV trajectories at a population level.
Purpose
We aimed to identify the different profiles of CAV trajectories.
Methods
Heart transplant recipients receiving care at 4 academic centers (2004 to 2016) were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The mainoutcome was the CAV trajectories, identified with unsupervised latent class mixed models.
Results
Overall, 1,301 patients were included (609 in France, 206 in Belgium and 486 in the US). The median follow-up post-transplant was 6.6 years (IQR=4.7) with 4,710 coronary angiographies analyzed (3.6±1.6 CAV assessments per patient). In the French development cohort, we identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i) Patients without CAV at baseline and non-progression (n=317, 52.1%), ii) patients without CAV at baseline and late onset CAV progression (n=52, 8.5%), iii) patients with mild baseline CAV and mild progression (n=151, 24.8%), iv) patients with mild baseline CAV and accelerated CAV progression (n=89, 14.6%, discrimination 0.92). The 4 CAV trajectories were independently validated in the external validation cohorts from Belgium (discrimination=0.92) and the US (discrimination=0.97).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified and validated 4 distinct CAV trajectories corresponding to specific initial CAV grades and subsequent evolutions. Our results provide the basis for a trajectory-based assessment for risk stratification at early-stage post heart transplantation.
Figure 1. Cardiac allograft vasculopathy trajectories in France (n=609), in Belgium (n=206), in USA (n=486). Thick lines represent latent class trajectory; thin lines represent CAV individual patient trajectory.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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22
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Pezel T, Bonnet G, Garot P, Asselin A, Unterseeh T, Champagne S, Hovasse T, Kinnel M, Sanguineti F, Garot J. Additional prognostic value of vasodilator stress CMR in patients with inconclusive stress test to detect coronary artery disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Guidelines recommend performing a non-invasive testing for ischemia to diagnose coronary artery disease (CAD). However, these tests are frequently inconclusive (25%). This population has been poorly studied because of its heterogeneity. In such cases, stress cardiac magnetic resonance (CMR) may be useful to improve diagnostic certainty. To date, no study has evaluated the prognostic value of stress CMR in these patients presenting with prior inconclusive test.
Purpose
To assess the additional prognostic value of vasodilator stress perfusion CMR in patients with a first inconclusive stress test to detect CAD.
Material
Between 2008 and 2018, consecutive patients with inconclusive stress test prospectively referred for vasodilator stress perfusion CMR with dipyridamole were followed for major adverse cardiovascular events (MACE) defined as cardiac death or myocardial infarction. Inconclusive stress test was defined by echocardiography or nuclear stress testing with uncertain conclusion about the diagnosis of CAD. To characterize this population, an unsupervised clustering analysis was performed using 18 variables. Univariable and multivariable Cox regressions were performed to determine the prognostic value of inducible ischemia by stress CMR in each cluster.
Results
Of 1502 patients with inconclusive stress test (62±12 years, 59% men), 1441 (96%) completed the CMR protocol and 1397 (93%) completed the follow-up (median 5.5±2.3 years). Stress CMR was well tolerated without occurrence of death or severe adverse event. The clustering analysis identified 3 clusters:
Cluster 1 (n=524, 35%) had the highest prevalence of previous percutaneous coronary intervention (PCI), the highest presence of myocardial scar on CMR, the lowest LVEF (35±7%) and the highest degree of LV dilatation.
Cluster 2 (n=406, 27%) had the highest prevalence of previous coronary artery bypass grafting (CABG), preserved LVEF (54±10%), absence of LV dilatation and rate of male (89%).
Cluster 3 (n=572, 38%) had the lowest rate of previous PCI/CABG and of myocardial scar. This cluster gathered the oldest patients (73±11 years), predominantly female (60%), with the highest rate of atrial fibrillation and body mass index.
Survival analysis found significant differences across clusters for the occurrence of MACE (p=0.02). Moreover, inducible ischemia was significantly associated with the occurrence of MACE in each cluster (cluster 1, HR 2.28; [95% CI: 1.31–3.99]; p=0.0028; cluster 2, HR 3.37; [95% CI, 1.97–5.75]; p<0.0001; cluster 3, HR 2.73; [95% CI, 1.67–4.46]; p<0.0001). In multivariable Cox regression, inducible ischemia was an independent predictor of a higher incidence of MACE in each cluster (p<0.001).
Conclusions
Cluster analysis identified 3 different phenotypes of patients with inconclusive stress test that were associated with distinct clinical and prognostic profiles. Within these clusters, CMR stress has an additional prognostic value to predict the occurrence of MACE.
Kaplan-Meier for MACE in each cluster
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Pezel
- Institut Cardiovasculaire Paris Sud, Paris, France
| | - G Bonnet
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - P Garot
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - T Unterseeh
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - S Champagne
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - T Hovasse
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - M Kinnel
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - F Sanguineti
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - J Garot
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
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23
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Trajectories of Cardiac Allograft Vasculopathy After Heart Transplantation and association with mortality: a population-based study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. However, the associations between CAV trajectories and mortality remains poorly described.
Purpose
We aimed to identify the different evolutive profiles of CAV and to determine the respective association with all-cause mortality.
Methods
Heart transplant recipients receiving care at 4 academic centers were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The mainoutcome was a prediction for CAV trajectories using unsupervised latent class mixed models. We then identified their association with all-cause mortality (NCT04117152).
Results
Overall, 1,301 patients were included (815 and 486 in the development and validation cohorts, respectively). The median follow-up post-transplant was 6.6 years (IQR=4.7) with 4,710 coronary angiographies analyzed (3.6±1.6 CAV assessments per patient). We identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i)Patients without CAV at baseline and non-progression (n=823, 63.3%), ii) patients without CAV at baseline and late onset CAV progression (n=79, 6.1%), iii) patients with mild baseline CAV and mild progression (n=261, 20.1), iv) patients with mild baseline CAV and accelerated CAV progression (n=138, 10.6%, discrimination 0.95). The 4 CAV trajectories showed gradient for all-cause mortality (p<0.001). Trajectories #3 and #4 were associated with higher mortality rates (10-year patient survival of 73.43% [95% CI 65.18–80.02] and 51.89% [95% CI 38.76–63.51], respectively) as compared with trajectories #1, and #2 that were characterized by 10-year patient survival of 80.01 [95% CI 76.38–84.82] and 83.49% [95% CI 71.34–90.80], respectively (p<0.001).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified 4 robust CAV trajectories. These different profiles were associated with distinct prognosis. Our results provide the basis for a trajectory-based assessment of heart transplant patients for early patient risk stratification and patient monitoring.
Figure 1. Overall 10-year survival probability according to the CAV trajectory in the overall cohort (n=1,301). The left part represents the main profiles CAV grades identified with latent class mixed models. Thick lines represent latent class trajectory; thin lines represent CAV individual patient trajectory. The right part represent the Kaplan Meier curves of the different trajectories.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou - University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou - University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
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24
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Pezel T, Sanguineti F, Kinnel M, Bonnet G, Landon V, Hovasse T, Garot P, Unterseeh T, Champagne S, Louvard Y, Morice M, Garot J. Feasibility and prognostic value of vasodilator stress perfusion CMR in patients with atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Several studies have demonstrated the consistently high diagnostic and prognostic value of stress perfusion imaging with cardiovascular magnetic resonance (CMR). The feasibility and the prognostic value of vasodilator stress perfusion CMR in patients with atrial fibrillation (AF) is unknown, because most studies have excluded arrhythmic patients from analysis.
Purpose
The aim of our study was to assess the technical feasibility and the prognostic value of vasodilator stress perfusion CMR in patients with AF.
Material
Between 2008 and 2018, we prospectively included consecutive patients with AF referred for vasodilator stress perfusion CMR with dipyridamole. They were followed for the occurrence of major adverse cardiovascular events (MACE) defined as cardiac death or non-fatal myocardial infarction (MI). The secondary outcome was all-cause mortality. The diagnosis of AF was confirmed on 12-lead ECG before and after CMR, and patients with sinus rhythm during CMR were excluded. In the CMR protocol, to limit AF-related artifacts on cine images, an arrhythmia rejection algorithm, or real-time sequences were used. Univariable and multivariable Cox regressions for MACE were performed to determine the prognostic value of inducible ischemia or late gadolinium enhancement (LGE) by CMR.
Results
Of 639 patients with AF and suspected or stable chronic CAD (72±9 years, 77% men), 602 (94%) completed the CMR protocol, and among those 538 (89%) completed the follow-up (median follow-up 5.1 (3.3–7.1) years). Reasons for failure to complete CMR included AF-related ECG-gating problems (n=17), intolerance to stress agent (n=7), renal failure (n=6), declining participation (n=4) and claustrophobia (n=3).
Stress CMR was well tolerated without occurrence of death or severe disabling adverse event. Patients without inducible ischemia or LGE experienced a substantially lower annual event rate of MACE (1.2%) than those with ischemia and without LGE (8.9%), or those with both ischemia and LGE (9.8%; p<0.001 for all). Using Kaplan-Meier analysis, the presence of myocardial ischemia identified the occurrence of MACE (hazard ratio HR 7.56; 95% confidence interval CI: 4.86–11.80; p<0.001) (Figure).
In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, the presence of inducible ischemia was an independent predictor of a higher incidence of MACE (HR 5.88; 95% CI: 3.70–10.07; p<0.001) and all-cause mortality (HR 2.51; 95% CI: 1.47–4.17; p<0.001).
Conclusion
Stress CMR is technically feasible and has a good discriminative prognostic value to predict the occurrence of MACE and all-cause mortality in patients with AF.
Kaplan-Meier curves for MACE
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Pezel
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - F Sanguineti
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - M Kinnel
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - G Bonnet
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - V Landon
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - T Hovasse
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - P Garot
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - T Unterseeh
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - S Champagne
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - Y Louvard
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - M.C Morice
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
| | - J Garot
- Cardiovascular Institute Paris-Sud (ICPS), Department of Cardiovascular Imaging, Massy, France
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25
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Determinants of trajectories of cardiac allograft vasculopathy after heart transplantation: a population based study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1288] [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
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. Little is known about determinants of CAV trajectories at a population level.
Purpose
We aimed to identify the respective contribution of immune and non-immune factors in the different evolutive profiles of CAV.
Methods
Heart transplant recipients receiving care at 2 academic centers (2004 to 2016) were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The outcome was CAV trajectories, identified with unsupervised latent class mixed models. The independent, predictive factors of CAV trajectories were investigated with multinomial regressions (NCT04117152).
Results
Overall, 815 patients were included. The median follow-up post-transplant was 7.7 years (IQR=5.14) with 2,742 coronary angiographies analyzed. We identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i) Patients without CAV at baseline and non-progression (n=459, 56.3%), ii) patients without CAV at baseline and late onset CAV progression (n=62, 7.6%), iii) patients with mild baseline CAV and mild progression (n=188 23.1%), iv) patients with mild baseline CAV and accelerated CAV progression (n=106, 13.0%, discrimination 0.92). Six early independent predictors of CAV trajectories were identified: donor age (p<0.001), donor male gender (p<0.001), donor tobacco consumption (p=0.001), recipient post-transplant dyslipidemia (p=0.009), preexisting or de novo class II anti-HLA donor-specific antibodies (p=0.004) and episode of acute cellular rejection ≥2R during the first year post transplantation (p=0.028).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified 4 robust CAV trajectories and their respective immune and non-immune determinants. Our results provide the basis for a trajectory-based assessment of heart transplant patients for early patient risk stratification and patient monitoring.
Factors associated CAV trajectories in multivariate analyses in the derivation cohort. This table shows the association of clinical, immunological, functional and structural parameters associated with CAV trajectories in multivariate multinomial regression analysis. The trajectory of reference was trajectory #1, including patients with no CAV at baseline and stable CAV grade over time.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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26
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Racape M, Bories M, Varnous S, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Determinants of sudden cardiac death after heart transplantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1110] [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
Heart transplant recipients are at high-risk of sudden cardiac death (SCD). However, risk factors of SCD in heart recipients remained poorly described.
Objective
To assess the predictors of SCD beyond the first-year post-transplant.
Methods
We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We excluded patients deceased during the first year. Patients underwent an evaluation at the day of transplantation and during the first year, comprising clinical, biological, histological, immunological (circulating anti-HLA DSA) and interventional (cardiac allograft vasculopathy assessment) parameters. Echocardiographies were routinely performed in all included patients according to a prespecified protocol. According to the last consensus, SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms. Cox model analysis was used to determine the parameters associated with sudden death risk.
Results
A total of 913 patients were included. The median follow-up post-HT was 5.9 years (IQR=2.9–8.5). Among the 213 deaths after one year, 44 patients (21%) died from SCD. In this population, the incidence rate of SCD was 0,82 per 100 person-year (95% CI: 0,51–2,05). Among the 60 parameters tested in univariate analysis, we identified 2 independent factors of sudden death after 1 year post-HT: left ventricular ejection fraction (LVEF) ≤55% any time after transplantation ( HR 4.07, 95% CI 1.94–8.53, p<0.001) and the presence of circulating anti-HLA DSA at the time of transplantation (HR 2.79, 95% CI 1.37–5.68, p=0.005). The incidence rate of SCD was 2.17 per 100 person-year (95% CI: 1.42; 4.60) and 1.21 per 100 person-year (95% CI: 0.80; 2.58) in patients with FEVG<55% (n=73) and in patients with pre-formed DSA (n=260), respectively.
Conclusion
In a large multicentric and highly phenotyped cohort of heart transplant recipients, we identified two independent factors associated with SCD beyond the first year. This study provides fresh evidence of SCD assessment for improving risk stratification of HT recipients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | - V Waldmann
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - E Marijon
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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27
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Racape M, Bories M, Varnous S, Rouvier P, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Incidence of sudden cardiac death after heart transplantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0726] [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
Sudden cardiac death (SCD) is a major contributor to the rate of mortality after heart transplantation. However, little is known about the incidence of SCD in heart recipients.
Objective
To assess the incidence of SCD after heart transplantation.
Methods
We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We defined 7 main groups of causes of deaths: SCD, cardiovascular (including Cardiac allograft vasculopathy), infection, primary graft dysfunction, graft failure (including late graft dysfunction, rejection), malignancy and others. Causes of deaths were independently adjudicated by two senior cardiologists based on the analysis of death certificates and medical records. Discrepancies were resolved by discussion until a consensus was made. SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms.
Results
A total of 1,363 patients were included. The median follow-up post-transplant was 3.99 years (IQR=0.49–7.49). 450 patients (33%) deceased during the first year. The leading cumulative causes of death in the first year after transplantation were infection, primary graft failure, multiple organ failure during the period in intensiv car unit. Beyond the post-operativ high-risk period of the first year, the leading cumulative cause of death was SCD: among the 213 deaths that occurred beyond the first year, 44 patients (21%) died from SCD. In this period, the incidence rate of SCD reached 0,82 per 100 person-year (95% CI: 0.51–2.05).
Conclusion
In a large multicentric and highly phenotyped cohort of heart transplant recipients, the leading cumulative cause of death beyond the first-year post transplant was sudden cardiac death. Our results open discussion on management of heart recipient, such as the implementation of cardioverter-defibrillators.
Figure 1. Cumulative incidence of causes of death in heart transplant recipients beyond the first year (n=913).
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | - V Waldmann
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Rouvier
- Hospital Pitie-Salpetriere, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - E Marijon
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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28
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Pezel T, Dillinger J, Bonnet G, Vidal Trecan T, Asselin A, Sideris G, Logeart D, Manzo-Silberman S, Gautier J, Riveline J, Henry P. Cardiac troponin I and BNP for predicting zero Agatston score in patients with diabetes mellitus. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary artery calcifications (CAC) scoring assessed by the Agatston score has shown an excellent prognostic value in large studies, particularly in diabetic patients, with a very low rate of cardiovascular events in patients with a zero Agatston score. Moreover, recent studies have suggested that high-sensitive cardiac troponin I (hs-cTnI) and brain natriuretic peptide (BNP) may be useful for detecting subclinical atherosclerosis, especially in diabetic patients. However, the link between hs-cTnI/BNP and the Agatston score has not been investigated in this population.
Purpose
The aim of this study was to investigate if hs-cTnI and BNP can bring additional value to predict zero Agatston score in patients with diabetes mellitus in addition to usual risk factors.
Material
Between 2015 and 2019, CAC score was prospectively performed in consecutive patients with diabetes mellitus with high cardiovascular risk. Patients with symptoms or known coronary artery disease were excluded. Within 24h from CT exam, peripheral blood samples were taken to measure hs-cTnI and BNP. The relationship between serum hs-cTnI/BNP concentrations and zero Agatston score was evaluated using univariate and multivariate binomial models. 77 variables have been used to build the model. The implication of hs-cTnI and BNP in this multivariate model was evaluated using nested models associated with Chi-squared test of independence.
Results
A total of 844 patients with diabetes were enrolled (61±7 years, 57% men, mean diabetes duration 18 years). In this population, 294 (35%) had a zero Agatston score, 253 (30%) an Agatston score from 1 to 100, 161 (19%) from 101 to 400, and 136 (16%) higher than 400. In univariate analysis, hs-cTnI and BNP concentrations were associated with a zero Agatston score (respectively OR, 2.63 [95% CI, 1.51–5.01]; p<0.001 and OR, 1.09 [95% CI, 1.01–1.22]; p=0.03). In multivariate analysis, hs-cTnI and BNP concentrations were associated with a zero Agatston score (respectively OR, 2.38 [95% CI, 1.51–4.76]; p=0.009 and OR, 1.18 [95% CI, 1.07–1.32]; p=0.001). Among the 77 variables, the multivariate model including age, gender, smoking, dyslipidaemia, duration of the diabetes, arterial hypertension, presence of diabetic neuropathy, hs-cTnI and BNP concentrations, significantly discriminated the zero Agatston score (AUC = 0.81; p<0.001). The most discriminant threshold was ≤3ng/l for hs-cTnI and <17ng/l for BNP. In nested models, both hs-cTnI and BNP brought information to this multivariate model to predict a zero Agatston score (respectively p=0.003 and p<0.001 to the Chi-squared test). Moreover, removing hs-cTnI and BNP from the model results in a significant reduction in model performance (AUC = 0.79; p=0.004).
Conclusions
Cardiac biomarkers hs-cTnI and BNP are associated with a zero Agatston score, which is correlated with a very low risk of cardiovascular events in asymptomatic patients with diabetes mellitus.
ROC curve to predict zero Agatston score
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Pezel
- Hospital Lariboisiere, Department of Cardiology, Paris, France
| | - J.G Dillinger
- Hospital Lariboisiere, Department of Cardiology, Paris, France
| | - G Bonnet
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - T Vidal Trecan
- Hospital Lariboisiere, Universitary center for the study of diabetes and its complications, Paris, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Institut National de la Santé et de la Recherche Médicale Unit 970, Paris Cardiovascular Research Ce, Paris, France
| | - G Sideris
- Hospital Lariboisiere, Department of Cardiology, Paris, France
| | - D Logeart
- Hospital Lariboisiere, Department of Cardiology, Paris, France
| | | | - J.F Gautier
- Hospital Lariboisiere, Universitary center for the study of diabetes and its complications, Paris, France
| | - J.P Riveline
- Hospital Lariboisiere, Universitary center for the study of diabetes and its complications, Paris, France
| | - P Henry
- Hospital Lariboisiere, Department of Cardiology, Paris, France
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Abstract
La coronavirus disease 2019 (COVID-19) s’accompagne d’une incidence élevée d’événements thromboemboliques veineux (ETEV). Souvent asymptomatiques, ils ont un impact défavorable sur le pronostic des patients. En plus des facteurs de risque de thrombose veineuse auxquels les formes de COVID-19 nécessitant une hospitalisation exposent (alitement prolongée, hypoxémie, présence de matériel intraveineux), les caractéristiques des patients atteints des formes les plus sévères (âge élevé, obésité) expliquent en partie la fréquence des ETEV. De plus, la COVID-19 entraîne une maladie de l’endothélium vasculaire par une invasion directe des cellules endothéliales, à l’origine d’une endothéliite, et un état prothrombotique secondaire à l’intense réaction inflammatoire. L’ensemble de ces manifestations entraînent une immunothrombose localisée principalement au niveau du lit vasculaire pulmonaire. La stratification du risque thromboembolique veineux pour proposer aux patients un niveau d’anticoagulation adapté apparaît ainsi comme un des piliers du traitement de la COVID-19. Les recommandations émises jusqu’ici se basent sur des avis d’experts dans la mesure où les données sur l’anticoagulation au cours de la COVID-19 proviennent essentiellement d’études observationnelles. Des essais cliniques contrôlés et randomisés sont en cours et permettront d’améliorer la gestion de la maladie thromboembolique veineuse au cours de la COVID-19.
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Affiliation(s)
- A Trimaille
- Pôle d'activité médicochirurgicale cardiovasculaire, nouvel hôpital civil, centre hospitalier régional universitaire de Strasbourg, 67000 Strasbourg, France
| | - G Bonnet
- Unité Inserm U970, Paris centre de recherche cardiovasculaire (PARCC), université de Paris, 75015 Paris, France.
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Bonnet G, Pernot M, Welte N, Peltan J, Seguy B, Dijos M, Laurent F, Ouattara A, Lafitte S, Ritter P, Bordachar P, Labrousse L, Leroux L. Post-TAVR conduction disorders: Membranous septum role. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2019.09.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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31
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Boissonnet G, Bonnet G, Pasquet A, Bourhila N, Pedraza F. Evolution of thermal insulation of plasma-sprayed thermal barrier coating systems with exposure to high temperature. Ann Ital Chir 2019. [DOI: 10.1016/j.jeurceramsoc.2019.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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32
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Hascoët S, Smolka G, Bagate F, Hadeed K, Lavie-Badie Y, Bouvaist H, Dauphin C, Bauer F, Nejjari M, Mangin L, Bonnet G, Ciobotaru V, Leurent G, Hammoudi N, Aminian A, Karsenty C, Armero S, Champagnac D, Ternacle J, Isorni M. Multimodality imaging guidance for percutaneous paravalvular leak closure: Insights from the multicenter FFPP register. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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33
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Coutance G, Bonnet G, Van Keer J, Racapé M, Bruneval P, Van Huyen JD, Taupin J, Varnous S, Lecuyer L, Rouvier P, Jouven X, Loupy A. Identification of Risk Factors for Biopsy-Proven Rejection during the First Year Post Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Coutance G, Racapé M, Bonnet G, Van Keer J, Duong Van Huyen J, Bruneval P, Lecuyer L, Varnous S, Rouvier P, Taupin J, Jouven X, Loupy A. Risk Factors for Cellular and Antibody-Mediated Rejections in the First-Year Post-Transplant: A Population-Based Study. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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35
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Bonnet G, Pernot M, Zaouter C, Peltan J, Seguy B, Klotz N, Dijos M, Montaudon M, Ouattara A, Lafitte S, Ritter P, Labrousse L, Leroux L. Membranous septal length and valve implantation depth of TAVR: Predictors of new permanent pacemaker implantation after TAVR. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Bonnet G, Pradier J, Laksiri N, Casalta A, Bonnet J. Left atrial appendage closure in patients with or without previous embolic stroke/TIA. Data from the moncentric RESET registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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37
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Bonnet G, Racape M, Bories MC, Varnous S, Rouvier P, Guillemain R, Bruneval P, Taupin JL, Lefaucheur C, Loupy A, Jouven X. 3399Determinants and outcomes of cardiac allograft vasculopathy: major role of donor specific antibody. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M C Bories
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Rouvier
- Hospital Pitie-Salpetriere, Paris, France
| | - R Guillemain
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - P Bruneval
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - C Lefaucheur
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
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Bonnet G, Pradier J, Salaun E, Camus O, Cuisset T, Jacquier A, Bonnet J. Cardiac computed tomography angiography to detect residual peridevice leak after left atrial appendage occlusion with a Watchman device. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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39
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Deharo P, Quilici J, Bassez C, Bonnet G, Lambert M, Morange P, Alessi M, Fourcade L, Bonnet J, Cuisset T. Benefit of switching dual antiplatelet therapy after ACS according to platelet reactivity: A prespecified analysis of the TOPIC randomized study. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.035] [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: 11/16/2022]
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Bonnet G, Pradier J, Spychaj J, Salaun E, Pankert M, Cuisset T, Bonnet J. Left atrial appendage percutaneous closure with a watchman device in patients with a contraindication to long-term oral anticoagulation. One-year follow-up. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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41
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Deharo P, Quilici J, Bassez C, Bonnet G, Lambert M, Morange P, Alessi M, Bonnet J, Cuisset T. Impact of diabetes on benefit of switching dual antiplatelet therapy after acute coronary syndrome: A subanalysis of the TOPIC randomized study. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.005] [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: 11/25/2022]
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42
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Camus O, Bonnet G, Lemoine C, Resseguier N, Massoure P, Fourcade L, Bonnet J. The amount of material retrieved by thrombus aspiration in patients referred for an Acute Coronary Syndrome is associated with their clinical and angiographic characteristics. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.026] [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: 10/18/2022]
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43
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Deharo P, Quilci J, Bassez C, Bonnet G, Lambert M, Fourcade L, Morange P, Alessi M, Bonnet J, Cuisset T. Benefit of switching dual antiplatelet therapy after acute coronary syndrome: The TOPIC (Timing Of Platelet Inhibition after acute Coronary Syndrome) randomized study. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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44
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Deharo P, Quilci J, Bassez C, Bonnet G, Lambert M, Morange P, Alessi M, Fourcade L, Bonnet J, Cuisset T. Benefit of switching dual antiplatelet therapy after ACS on dual antiplatelet therapy adherence: A prespecified analysis of the TOPIC randomized study. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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45
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Bonnet G, Quilici J, Lambert M, Cuisset T, Mouret J, Bonnet J. Non-HDL Cholesterol is predictive of diffusion of coronary artery disease in young patients presenting with a myocardial infarction. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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46
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Batisse C, Bonnet G, Eschevins C, Hennequin M, Nicolas E. The influence of oral health on patients' food perception: a systematic review. J Oral Rehabil 2017; 44:996-1003. [DOI: 10.1111/joor.12535] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2017] [Indexed: 01/27/2023]
Affiliation(s)
- C. Batisse
- Université Clermont Auvergne; CROC; Clermont-Ferrand France
- CHU Clermont-Ferrand; Service Odontologie; Clermont-Ferrand France
| | - G. Bonnet
- Université Clermont Auvergne; CROC; Clermont-Ferrand France
- CHU Clermont-Ferrand; Service Odontologie; Clermont-Ferrand France
| | - C. Eschevins
- Université Clermont Auvergne; CROC; Clermont-Ferrand France
| | - M. Hennequin
- Université Clermont Auvergne; CROC; Clermont-Ferrand France
- CHU Clermont-Ferrand; Service Odontologie; Clermont-Ferrand France
| | - E. Nicolas
- Université Clermont Auvergne; CROC; Clermont-Ferrand France
- CHU Clermont-Ferrand; Service Odontologie; Clermont-Ferrand France
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Bonnet G, Salaun E, Deffarges S, Pankert M, Cuisset T, Bonnet J. Measurements by CT angiography of the left atrial appendage before percutaneous closure with a watchman device. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30178-7] [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: 11/26/2022]
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48
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Bonnet G, Salaun E, Deffarges S, Mouret J, Cuisset T, Bonnet J. Percutaneous closure of left atrial appendage with a watchman device: a single center study. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30212-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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49
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Corré J, Poustis P, Bonnet G, Robino P, Anthierens C, Faure M, Douard H. Rationalization of complementary tests in cardiology department. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30233-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Bonnet G, Salaun E, Deffarges S, Cuisset T, Bonnet J. Cardiac computed tomography angiography is helpful to select patients for left atrial appendage occlusion with a watchman device. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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