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Willner N, Nguyen V, Eltchaninoff H, Burwash I, Michel M, Durand E, Gilard M, Iung B, Cribier A, Chevreul K, Messika-Zeitoun D. Aortic valve replacement for aortic stenosis in France – Influence of centers’ volumes on TAVR adoption rate and outcomes. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.233] [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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2
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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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3
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Willner NA, Nguyen V, Eltchaninoff H, Burwash IG, Michel M, Durand E, Gilard M, Dindorf C, Iung B, Cribier A, Vahanian A, Chevreul K, Messika-Zeitoun D. Aortic valve replacement for aortic stenosis in France – influence of centers' volumes on TAVR adoption rate and outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1579] [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
Aims
Over the last decade, transcatheter aortic valve replacement (TAVR) became extensively used, now being the recommended as first line procedure for aortic valve replacement (AVR) in selected patients' populations. It is unknown whether TAVR adoption rate and variability in outcomes is influenced by centers' volume.
Methods
From a French administrative hospital-discharge database, we collected all AVR performed in France between 2007 and 2019. Centers were stratified to terciles based on their annual SAVR per year per center during 2007–2009 (“pre TAVR era”).
Results
There was 218,489 AVRs (153,747 SAVR and 74,732 TAVR) performed in 46 centers between 2007–2019. Number of total AVR and even more so number of number of TAVR significantly and linearly increased from 2007 to 2019 in all terciles but faster in the high volume tercile (+17, +17 and +31 AVR/center/year in the low, middle and high terciles respectively, P [ANCOVA]<0.001; +11, + 19 and +33 TAVR/center/year in the low, medium and high tercile respectively, P [ANCOVA] <0.00, Figure 1). The age of patients underwent TAVR remained grossly unchanged in all three terciles, however, the Charlson index declined from 2010 to 2019 (from 1.35±1.42 to 0.65±1.04, from 1.21±1.40 to 0.65±1.05 and from 1.53±1.58 to 0.81±1.21, in the low, middle and high terciles, P for trend <0.001, 0.021, and <0.001, respectively). Charlson score in the years 2017–2019, was higher in the high than middle and low terciles (0.87±1.22, 0.76±1.11 and 0.65±1.04, respectively, P<0.0001). The in-hospital mortality rate for TAVR significantly declined from 2010 to 2019 for TAVR in all terciles (from 8.3% to 2.1%, from 7.5% to 2.5% and from 8.2% to 2.1% for low, middle and high TAVR terciles, respectively; p for trend = 0.002, 0.001 and <0.001, respectively, Figure 2). Average mortality in 2017–2019 was similar in all terciles (2.3%, 2.5% and 2.2% for low, middle and high terciles, respectively, P=0.47). After adjusting for age, sex and Charlson score, mortality was higher in the low tercile compared with middle and high terciles (OR 1.15, P<0.001, confidence interval [CI] 1.0–1.2, and OR 1.18, P<0.001, CI 1.1–1.2, respectively).
Conclusions
From 2007 to 2019 total AVR linearly increased, mostly due to increase in TAVR, irrespective of centers' volume, but increase rate was higher in high volume centers. A constant decline in patients risk profile, with a striking decrease in mortality rate, was observed in all volume terciles. High-volume centers patients' have higher risk profile, with adjusted mortality slightly lower than medium and low volume centers.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - V Nguyen
- Centre Cardiologique du Nord (CCN) , Saint Denis , France
| | | | | | | | | | - M Gilard
- University Hospital of Brest , Brest , France
| | | | - B Iung
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
| | | | - A Vahanian
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
| | - K Chevreul
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T , Paris , France
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Manzo-Silberman S, Couturaud F, Bellemain-Appaix A, Vautrin E, Gompel A, Drouet L, Marliere S, Bal Dit Solier C, Uhry S, Eltchaninoff H, Bergot T, Motreff P, Cottin Y, Mounier-Vehier C, Gilard M. Characteristics of young women presenting with acute myocardial infarction: the prospective, multicentre, observational WAMIF study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiovascular diseases are the leading cause of death in women, killing sevenfold more women than breast cancer. Rates of hospital death for myocardial infarction in women, although decreasing, remains significantly higher than in men (more than double), especially among women under the age of 50. The occurrence of myocardial infarction in non-menopausal women is not unusual, and the incidence continues to rise. While women under the age of 60 accounted for less than 12% of patients with myocardial infarction admitted in 1995, they accounted for more than 25% in 2015. In addition to the traditional cardiovascular risk factors, women present specific ones linked to hormonal modifications, inflammatory high-risk profiles, and thrombophilia.
Purpose
We comprehensively and systematically collected all clinical and biological data and the results of morphological explorations in all women admitted for myocardial infarction under the age of 50 in high-volume French centres. To date, no systematic descriptive analysis has been carried out incorporating not only clinical, morphological, and extraordinary characteristics, but biological characteristics, in particular hormonal and immunological parameters.
Methods
This prospective, observational study included all women admitted for myocardial infarction under the age of 50 years at 30 centres in France from May 2017 to June 2019.
Results
The population comprised 314 women (mean age 44.9 years): 192 presented with ST-segment elevation myocardial infarction and 122 with non-ST-segment elevation myocardial infarction, 75% were current smokers, 35 had a family history of cardiovascular disease, 33% had a complication of pregnancy, and 55% reported recent emotional stress. Ten had a normal coronary angiogram. Independent predictors of premature MI, <35 yo, were cannabis use and oral contraceptive therapy. No deaths, but 3 strokes, 3 recurrent myocardial infarctions, and 1 serious bleed occurred during hospitalization. At 12 months, 2 deaths occurred but linked to progressive cancer, 25 patients had recurrent PCI, 4 symptoms driven. Otherwise, 90.4% were event free and 72% completely symptoms free.
Conclusion
The WAMIF study showed that most young women with acute myocardial infarction reported typical symptoms of chest pain, and modifiable cardiovascular risk factors, most commonly tobacco use. Gynaecological status, history of pregnancy complications, and non-compliance with non-indication of combined contraception were overrepresented, emphasizing the urge for a better cardiological and gynaecological network. The overall prognosis for these women was better than previously reported despite the high rate of emergency consultations in the year following the index myocardial infarction, highlighting the need for more comprehensive follow-up following the myocardial infarction.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): French Society of CardiologyGrants from Indusctries Biosensors Europe SA, AstraZeneca, Boston Scientific Corporation, Abbott Medical Devices, Terumo Corporation, Daiichi Sankyo, Inc., Hexacath, France, Biotronik SE & Co. KG.
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Affiliation(s)
| | - F Couturaud
- University Hospital of Brest , Brest , France
| | | | - E Vautrin
- University Hospital of Grenoble , Grenoble , France
| | - A Gompel
- Cochin APHP Site of Paris Centre University Hospital, Gynécologie médicale, Port-Royal Cochin, aphp , Paris , France
| | - L Drouet
- Hospital Lariboisiere , Paris , France
| | - S Marliere
- University Hospital of Grenoble , Grenoble , France
| | | | - S Uhry
- Haguenau Hospital Centre , Haguenau , France
| | | | - T Bergot
- French Society of Cardiology , Paris , France
| | - P Motreff
- University Hospital Gabriel Montpied , Clermont-Ferrand , France
| | - Y Cottin
- University Hospital of Dijon , Dijon , France
| | | | - M Gilard
- University Hospital of Brest , Brest , France
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5
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Mansour M, Harnay E, Al Ayouby A, Mansourati V, Jobic Y, Gilard M, Le Ven F, Mansourati J. One year outcome and analysis of peri-device leak of left atrial appendage occlusion devices. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0579] [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
The prevalence of peri-device leak (PDL) of left atrial appendage occlusion (LAAO) devices has been previously reported. However, there have been only few data that compared different existing devices. The aim of this study was to assess the incidence of PDL with both devices WATCHMAN® and AMPLAZER Amulet®, and to evaluate the clinical outcome at 12 months.
Methods
Consecutive patients who underwent LAAO between January 2018 and 2020 were randomly assigned to either WATCHMAN or AMPLATZER Amulet implantation based on a systematic two-week alternation between both devices. LAA measurements were assessed using cardiac computed tomography angiography (CCTA) prior to, and transesophageal echocardiography (TEE) during the procedure. At 8 weeks post-LAAO, patients underwent TEE and/or CCTA to identify the presence of PDL and/or device-related complications. Patients were then followed for 12 months to identify major adverse cardiovascular/embolic events.
Results
The cohort consisted of 51 patients (25 WATCHMAN, 26 AMPLATZER Amulet; mean age 76±7 years; male gender 76%). Both groups were identically matched for demographics, comorbidities and indication for LAAO. There were 19 patients who had PDL (13 WATCHMAN vs 6 AMPLATZER Amulet, P-value=0.033). Of them, 8 (15%) patients had significant PDL (7 WATCHMAN vs. 1 AMPLATZER Amulet, P-value=0.018). On CCTA, the landing zone maximal diameter of the AMPLATZER Amulet device had the strongest correlation with the final deployed device size (Spearman'rho 0.92, P-value<0.0001). In the multivariate analysis, male gender and device type were independent predictors of any PDL (P-values 0.016 and 0.031, respectively). On a mean follow-up of 12 months, the total number of events was more prevalent in the WATCHMAN group (P-value 0.008), but the incidence of cardio-embolic events reached borderline significance (16% vs. 0%, P-value=0.051).
Conclusions
Among patients who underwent LAAO, almost 15% had significant PDL with the majority belonging to the WATCHMAN group. Still, larger studies are warranted to evaluate its effectiveness in stroke prevention.
Funding Acknowledgement
Type of funding sources: None. Table 1Table 2
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Affiliation(s)
- M Mansour
- University Hospital of Brest, Brest, France
| | - E Harnay
- University Hospital of Brest, Brest, France
| | | | | | - Y Jobic
- University Hospital of Brest, Brest, France
| | - M Gilard
- University Hospital of Brest, Brest, France
| | - F Le Ven
- University Hospital of Brest, Brest, France
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6
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Pezel T, Besseyre Des Horts T, Schaaf M, Croisille P, Biere L, Garcia Dorado D, Jossan C, Roubille F, Tri Cung T, Prunier F, Elbaz M, Amaz C, Derumeaux G, De Poli F, Hovassse T, Gilard M, Bergerot C, Thibault H, Ovize M, Mewton N. Predictive value of early cardiac mri functional and geometric indexes on adverse left ventricular remodelling in anterior STEMI patients. A report from the CIRCUS study. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.010] [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: 10/22/2022]
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7
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Feliachi S, Le Moigne E, Le Ven F, Hoffmann C, Bressolette L, Didier R, Jobic Y, Gilard M, Mansourati J, Leroyer C, Couturaud F. Comparison between transthoracic echocardiography and transcranial Doppler for detection of PFO in patients in the acute phase of a pulmonary embolism. A Post-hoc analysis of EPIC-FOP. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2253] [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
Introduction
Patent foramen ovale is a fairly common defect found in a quarter of the population. PFO has always been associated with an increased risk of stroke, the mechanism of which has been attributed to the paradoxical embolism of venous thrombi passing through the PFO directly into the left atrium, however this mechanism remains debated to date.
For the detection of PFO, several modalities exist including transcranial doppler (TCD), transthoracic echocardiography (TTE) and transoesophageal echocardiography. This raises the question of the examination with the best diagnostic performance for its detection.
Purpose
The majority of studies comparing the different modalities of patient PFO diagnosis have been conducted in the context of stroke assessment. Very few studies have focused on the acute PE patient population. The interest of our study is therefore to evaluate the diagnostic performance of two modalities (TTE versus TCD) for the detection of shunts, especially since this population is at risk of stroke by paradoxical embolism due to the phenomenon of hyperpressure in the right heart chambers increasing the chances of having a paradoxical embolism.
Methods
We performed a post HOC analysis of the EPIC-FOP study which is a multicenter, prospective, French cohort study. Patients were recruited within 3 days of diagnosis of PE. Patients included were given a transthoracic echocardiography (TTE) with PFO screening by injection of saline contrast and magnetic resonance imaging (MRI) within 7 days of inclusion to look for signs of recent stroke. A proportion of the patients included in this study also received a transcranial doppler in search of PFO, the results of which were used in our study.
Results
The mean age of the patients was 62±14.66 years with a slight male predominance (55.6%). TCD was able to detect 97 right-left shunts while the TTE detected only 25 shunts. Concordance analysis by Cohen's Kappa Coefficient: 0.1767 [0.0427; 0.3107–p<0.001] is considered poor.
Using TTE as the reference examination, transcranial Doppler has a very good sensitivity 96.00% (79.65% to 99.90%) and a poor specificity 42.06% (33.33% to 51.18%). A good negative likelihood ratio 0.10 (0.01 to 0.66).
Using TCD, incidence of stroke in the acute phase of PE was significantly higher in the PFO population. In the ten strokes detected 9 had occurred in patients with PFO, RR=1.43 IC95% (1.1169 to 1.8228) p=0. 0044. The difference in proportion is calculated to be 26.92%.
Conclusion
It is the first study that compared TCD vs TEE in the setting of acute phase of PE for detection of PFO. TCD showed a good sensitivity and negative likelihood ratio that can be used as a first means to rule out PFO or associated with TTE. Also, our analysis confirms the increased risk of stroke following a PE episode when a PFO is present.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Feliachi
- University Hospital of Brest, Brest, France
| | | | - F Le Ven
- University Hospital of Brest, Brest, France
| | - C Hoffmann
- University Hospital of Brest, Brest, France
| | | | - R Didier
- University Hospital of Brest, Brest, France
| | - Y Jobic
- University Hospital of Brest, Brest, France
| | - M Gilard
- University Hospital of Brest, Brest, France
| | | | - C Leroyer
- University Hospital of Brest, Brest, France
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8
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Didier R, Le Ven F, Eltchaninoff H, Nasr B, Lefevre T, Fajadet J, Teiger E, Carrie D, Meneveau N, Ghostine S, Souteyrand G, Cuisset T, Le Breton H, Inug B, Gilard M. High post-procedural transvalvular gradient or delayed gradient increase after transcatheter aortic valve implantation: the FRANCE-2 registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1941] [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
Background
Mean gradient (MG) elevation can be detected immediately post-procedure or secondarily during follow-up. Comparison between these two parameters and impact on outcomes has not previously been investigated.
Objectives
The study aimed to identify incidence, influence on prognosis and parameters associated with immediate high post-procedural mean transvalvular gradient (PPMG) and delayed mean gradient increase (DMGI), in the FRANCE 2 (French Aortic National CoreValve and Edwards 2) registry.
Methods
The registry includes all consecutive symptomatic patients with severe aortic stenosis. Three groups were analyzed: 1) PPMG <20mmHg without DMGI >10 mmHg (control); 2) PPMG <20mmHg with DMGI >10 mmHg (group 1); 3) PPMG ≥20 mmHg (group 2).
Results
From January 2010 to January 2012, 4201 consecutive patients were prospectively enrolled in the registry. The control group comprised 2078 patients; the group 1, 131 patients; and the group 2, 144 patients. DMGI exceeded 10 mmHg in 5.6%, and was not associated with greater 4-year mortality than in control group (32.6% vs. 40.1%, p=0.27, respectively). PPMG was at least 20 mmHg in 6.1%, and was associated with higher 4-year mortality than in control group (48.7% versus 40.1%, p=0.005, respectively) (Figure 1). Two-thirds of patients with initial PPMG ≥20 mmHg had finally a MG <20 mmHg at 1 year, with mortality similar to controls (39.2% vs. 40.1%, p=0.73).
Conclusions
Patients with PPMG >20 mmHg 1 year post-TAVI had higher 4-year mortality than the general population of the registry, unlike patients with MG normalization at 1 year.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): French National Society of Cardiology
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Affiliation(s)
- R Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - F Le Ven
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | | | - B Nasr
- Hospital Cavale Blanche, Vascular Surgery, Brest, France
| | - T Lefevre
- Jacques Cartier Private Hospital, Massy, France
| | | | - E Teiger
- Henri Mondor University Hospital Chenevier APHP, Creteil, France
| | - D Carrie
- Rangueil Hospital of Toulouse, Toulouse, France
| | - N Meneveau
- University of Besançon, Besancon, France
| | - S Ghostine
- Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - G Souteyrand
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | - T Cuisset
- Hospital La Timone of Marseille, Marseille, France
| | - H Le Breton
- Hospital Pontchaillou of Rennes, Rennes, France
| | - B Inug
- Bichat Hospital, University Paris-Diderot, INSERM-UMR1148, FACT French Alliance for Cardiovascular T, Paris, France
| | - M Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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9
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Michel M, Hammami J, Vinet MA, Picot-Ngo C, Debroucker F, Gilard M, Chevreul K. Using e-health to shorten treatment delay in patients with severe aortic stenosis. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Transcatheter aortic valve replacement (TAVR) is a relatively new alternative to open surgery in patients with a severe aortic stenosis at high risk of surgery but there are important variations in treatment delay which can lead to increased morbidity and mortality. Those delays have many causes, including patients’ unawareness of the urgency, delays in obtaining the necessary preoperative tests and organizational factors at the hospital level. The aim of our study was to co-construct an e-health tool for patients and their families to empower them and improve knowledge on the disease and TAVR to ultimately decrease the delay between the medical decision for TAVR and the actual procedure.
Methods
A prospective study was first carried out to identify organizational factors associated with variations in treatment delay (both at the patient and hospital level). A preliminary survey was sent to all TAVR centers in France to understand and describe their organization. Descriptive analyses were then carried out on the answers. In a second step, two focus groups were carried with, the first with patients and carers and the second with healthcare professionals in order to elaborate the e-health tool.
Results
A website has been developed for patients and their families. It includes information in video form on aortic stenosis and its different treatments, on TAVR, the necessary tests required prior to TAVR (with a geolocalisation of available facilities nearby so that patients may know where to go), and what they can expect during the hospital admission and after their release. Patients undergoing TAVR will be informed of the website’s existence by their cardiologist. Web pages intended for healthcare professionals who are not TAVR specialists (general practitioners…) will also be available on the website.
Conclusions
A cluster randomized controlled trial will now test the efficacy and efficiency of the e-health tool in reducing TAVR treatment delay.
Key messages
We built a e-health tool in collaboration with patients, carers and healthcare professionals to increase patients’ knowledge on aortic stenosis and TAVR. The website will provide information through videos to empower patients and ultimately decrease treatment delay and its associated morbi-mortality.
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Affiliation(s)
- M Michel
- URC Eco, Assistance Publique-Hôpitaux de Paris, Paris, France
- UMR 1123, INSERM, Université de Paris, Paris, France
| | - J Hammami
- URC Eco, Assistance Publique-Hôpitaux de Paris, Paris, France
- UMR 1123, INSERM, Université de Paris, Paris, France
| | - M A Vinet
- URC Eco, Assistance Publique-Hôpitaux de Paris, Paris, France
- UMR 1123, INSERM, Université de Paris, Paris, France
| | - C Picot-Ngo
- UMR 1123, INSERM, Université de Paris, Paris, France
| | - F Debroucker
- Économie de la Santé & Remboursement, Medtronic France SAS, Boulogne-Billancourt, France
| | - M Gilard
- Department of Cardiology, University Hospital of Brest, Brest, France
| | - K Chevreul
- URC Eco, Assistance Publique-Hôpitaux de Paris, Paris, France
- UMR 1123, INSERM, Université de Paris, Paris, France
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10
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Payot L, Zabalawi A, Delaunay R, Hacot JP, Lognone T, Rouault G, Filippi-Codaccioni E, Druelles PH, Didier R, Gilard M, Auffret V, Coudert I, Cherfaoui T, Le Guellec M, Le Breton H. P5517Impact of admission during ON vs OFF hours on mortality in unselected ST-elevation myocardial infarction patients referred in percutaneous coronary intervention centers:insights from the ORBI registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0466] [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
The effect of admission during OFF-hours on patient's outcome in ST Segment Elevation Myocardial Infarction remains controversial when a strategy for reperfusion between primary Percutaneous Coronary Intervention (pPCI) and fibrinolysis is chosen. We aimed to evaluate the impact of time of admission on all cause mortality in unselected STEMI patients referred to pPCI centers.
Methods
Data from 10850 consecutive patients admitted in the nine interventional cardiology centers in Britany for STEMI in the 24 first hours following the beginning of symptoms were collected in a network registry. Characteristics and clinical outcome of patients admitted during ON-hours (Monday through Friday 8h am-6h30 pm) were compared to OFF-hours patients (night shifts, weekends and non-working Holydays). Clinical outcome was all-cause in hospital mortality, major bleeding, and mechanical complications in STEMI.
Results
A total of 4644 confirmed STEMI patients (57.2%) were admitted during OFF-hours and 6206 (42.8%) patients during ON-hours. Baseline characteristics were well balanced between the two groups including features of high risk STEMI such as ventricular fibrillation (3.7% vs 3.6% p=0, 8), cardiogenic shock (6.9% vs 7.6%, p=0.1), mechanical complications (3,2% vs 2,7%, p=0,2). The population was older in the ON group (63.7 vs 62.2, p<0.0001). Time from symptom onset to First Medical Contact (FMC) were slightly longer for patients presenting during on-hours (97 min vs. 95 min, p<0,03). Time from FMC to angiography was longer during OFF-hours compared to ON-hours (100 min vs. 92 min p<0,0001). Time from arrival in the PCI center to angioplasty was higher in the OFF period (40 mn vs 38 mn, p<0.0001). The reperfusion treatment was different between the two periods, with more fibrinolysis and less PCI in OFF group (PCI: 76.7% vs 79.6%, p<0,0001; Fibrinolysis: 11.4% vs 8.9%, p<0,0001).
The use of radial access (RA) was uniform in both group (66,8% and 66.6%; p=0,9) and not different whatever the admission time. The use of radial access increased meaningfully from 2008 for the two periods (RA OFF group: 84.4% vs 38,6%, RA ON group: 88.6% vs 38.7%) There was no impact of admission time on in-hospital all cause mortality in the entire population (5,3% vs 5,4% p=0,7), and on the Timi 3 flow for the patients treated with primary angioplasty (On group: 94% vs 94,3%, p=0.5). The bleeding complications were similar in both groups (2,5% vs 2,6%, p=0,8).
Conclusions
Even though the time of reperfusion is slightly longer in patients admitted for STEMI during off-hours, no difference was observed in the PTCA technique and success rates as well as in the in-hospital mortality and bleeding rates. A long term patient follow-up would be necessary before definite conclusions.
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Affiliation(s)
- L Payot
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - A Zabalawi
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - R Delaunay
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - J P Hacot
- Centre Hospitalier de Bretagne Sud, Cardiology, Lorient, France
| | - T Lognone
- Centre Hospitalier, Cardiology, Saint-Malo, France
| | - G Rouault
- CH Laennec, Cardiology, Quimper, France
| | | | - P H Druelles
- Polyclinic Saint Laurent of Rennes, Cardiology, Rennes, France
| | - R Didier
- Hospital Cavale Blanche, Cardiology, Brest, France
| | - M Gilard
- Hospital Cavale Blanche, Cardiology, Brest, France
| | - V Auffret
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
| | - I Coudert
- Centre Hospitalier, Saint-Brieuc, France
| | - T Cherfaoui
- Hospital Pontchaillou of Rennes, Rennes, France
| | - M Le Guellec
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
| | - H Le Breton
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
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11
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Eltchaninoff H, Cohen A, Gilard M. Éditorial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.01.039] [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]
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12
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Eltchaninoff H, Cohen A, Gilard M. Editorial. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.01.040] [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]
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13
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Avinee G, Eltchaninoff H, Tron C, Bettinger N, Bouhzam N, Gilard M, Verhoye J, Koning R, Lefevre T, Van Belle E, Leprince P, Iung B, Le Breton H, Durand E. Analysis of length of hospital stay after Transfemoral Transcatheter Aortic Valve Implantation: Results from the FRANCE TAVI (FRench Transcatheter Aortic Valve Implantation) Registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2019.02.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Auffret V, Cottin Y, Leurent G, Gilard M, Beer J, Zabalawi A, Filippi E, Brunet D, Hacot J, Brunel P, Mejri M, Lorgis L, Rouault G, Druelles P, Didier R, Loirat A, Bedossa M, Boulmier D, Zeller M, Le Breton H. Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: The ORBI risk score. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Beurtheret S, Karam N, Resseguier N, Com O, Gelisse R, Barra N, Tavildari A, Commeau P, Armero S, Pankert M, Siame S, Laskar M, Khanoyan P, Seitz J, Gilard M, Verhoye J, Eltchaninoff H, Leprince P, Le Breton H, Houel R. Outcomes of transcatheter aortic valve replacement according to femoral or non-femoral peripheral vascular access site: A propensity-matched comparison from the French TAVI Registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.155] [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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16
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Avinee G, Tron C, Bettinger N, Bouhzam N, Gilard M, Verhoye J, Koning R, Lefevre T, Van Belle E, Leprince P, Iung B, Le Breton H, Eltchaninoff H, Durand E. Analysis of disparities in length of hospital stay after transfemoral transcatheter aortic valve implantation: Results from the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) Registry. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.138] [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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Benamer H, Auffret V, Cayla G, Chevalier B, Dupouy P, Eltchaninoff H, Gilard M, Guerin P, Iung B, Koning R, Monsegu J, Lantelme P, Le Breton H, Lefèvre T, Verhoye JP, Commeau P, Motreff P. Position paper of French Interventional Group (GACI) for TAVI in France in 2018. Ann Cardiol Angeiol (Paris) 2018; 67:455-465. [PMID: 30376969 DOI: 10.1016/j.ancard.2018.09.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Aortic stenosis is a frequent disease in the elderly. Its prevalence is 0.4% with a sharp increase after the age of 65, and its outcome is very poor when the patient becomes symptomatic. The interventional procedure known as TAVI (trans-catheter aortic valve implantation), which was developed in France and carried out for the first time in Rouen by Prof. Alain Cribier and his team in 2002, has proven to be a valid alternative to surgical aortic valve replacement. At first, this technique was shown to be efficient in patients with contra-indications to surgical treatment or deemed to be at high surgical risk. Given the very promising outcomes achieved as a result of close heart team collaboration, appropriate patient selection, simplified procedures and reduced complication rates, transfemoral (TF) TAVI is now preferred in symptomatic intermediate risk patients>75 years old according to the latest ESC guidelines. In 2017, in France, TAVI is currently performed in 50 centers with on-site cardiac surgery. The 2016 TAVI outcomes recorded in the French national TAVI registry (France TAVI) are very encouraging and show that for 7133 patients treated (age 83.4±7 years, logistic Euroscore 14%), 87% of whom via the TF approach, cross-over to surgery was very low (0.5%) with a 3.0% in-hospital mortality rate. The substantial increase in TAVI indications and the improvement of its outcomes may in the near future call for a reconsideration of the number of high volume centers authorized to carry out this technique.
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Affiliation(s)
- H Benamer
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France.
| | - V Auffret
- Inserm U1099, service de cardiologie et maladies vasculaires, CIC-IT 804, laboratoire de traitement du signal et de l'image, université de Rennes 1, CHU Pontchaillou, 35000 Rennes, France
| | - G Cayla
- Service de cardiologie, université de Montpellier, CHU Nîmes, 34000 Nîmes, France
| | - B Chevalier
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France
| | - P Dupouy
- Hôpital privé d'Anthony, 25, rue De La Providence, 92160 Antony, France
| | - H Eltchaninoff
- Inserm U1096, department of cardiology, FHU REMOD-VHF, Rouen university hospital, Normandie Univ, Unirouen, 76000 Rouen, France
| | - M Gilard
- CHU La Cavale Blanche, boulevard Tanguy Prigent, 29609 Brest, France
| | - P Guerin
- CHU hôpital G R Laennec, boulevard Jacques Monod, 44800 St Herblain, France
| | - B Iung
- Hôpital Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75018 Paris, France
| | - R Koning
- Clinique Saint Hilaire, 2, place Saint Hilaire, 76000 Rouen, France
| | - J Monsegu
- Groupe hospitalier mutualiste de Grenoble, 8, rue du Dr Calmette, 38000 Grenoble cedex 1, France
| | - P Lantelme
- Hôpital Croix Rousse, 103, Gr De La Croix Rousse à Lyon, 34000 Lyon, France
| | - H Le Breton
- Inserm U1099, service de cardiologie et maladies vasculaires, CIC-IT 804, laboratoire de traitement du signal et de l'image, université de Rennes 1, CHU Pontchaillou, 35000 Rennes, France
| | - T Lefèvre
- ICPS Jacques Cartier, Ramsay générale de santé, 6, avenue du Noyer Lambert, 91300 Massy, France
| | - J-P Verhoye
- Service de chirurgie cardiaque, université de Rennes, CHU Pontchaillou, 35000 Rennes, France
| | - P Commeau
- Polyclinique Les Fleurs Quartier Quiez, 83190 Ollioules, France
| | - P Motreff
- Department of cardiology, Gabriel Montpied hospital, Clermont-Ferrand university hospital, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France
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18
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Avinee G, Durand E, Tron C, Bettinger N, Bouhzam N, Gilard M, Verhoye JP, Koning R, Lefevre T, Motreff P, Van Belle E, Leprince P, Iung B, Le Breton H, Eltchaninoff H. 230Analysis of disparities in length of hospital stay after transfemoral transcatheter aortic valve implantation: results from the FRANCE TAVI (FRench Transcatheter Aortic Valve Implantation) Registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.230] [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 Avinee
- Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, Rouen, France
| | - E Durand
- Rouen Univ Hosp, Dpt Cardiol, FHU REMOD-VHF, Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France
| | - C Tron
- Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, Rouen, France
| | - N Bettinger
- Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, Rouen, France
| | - N Bouhzam
- Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, Rouen, France
| | - M Gilard
- University Hospital of Brest, Brest, France
| | - J P Verhoye
- University Hospital of Rennes, Rennes, France
| | - R Koning
- Clinic Saint-Hilaire, Rouen, France
| | - T Lefevre
- Institut Hospitalier Jacques Cartier, Massy, France
| | - P Motreff
- University Hospital Gabriel Montpied, Clermont-Ferrand, France
| | | | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - B Iung
- Hospital Bichat-Claude Bernard, Paris, France
| | - H Le Breton
- University Hospital of Rennes, Rennes, France
| | - H Eltchaninoff
- Rouen Univ Hosp, Dpt Cardiol, FHU REMOD-VHF, Normandie Univ, UNIROUEN, INSERM U1096, Rouen, France
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19
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Didier R, Ouchiha M, Aidonidis M, Le Ven F, Nicol PP, Jobic Y, Mansourati J, Gilard M. 2398Impact of atmospheric pressure and temperature on onset of myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2398] [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: 11/14/2022] Open
Affiliation(s)
- R Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - M Ouchiha
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - M Aidonidis
- Head of the Weather Station Meteo France, Brest, France
| | - F Le Ven
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - P P Nicol
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - Y Jobic
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - J Mansourati
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - M Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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20
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Payot L, Zabalawi AZ, Delaunay RD, Hacot JP, Lognone T, Rouault G, Filippi-Codaccioni E, Druelles PH, Didier R, Gilard M, Auffret V, Coudert I, Cherfaoui T, Le Guellec M, Le Breton H. P6441Impact of admission during ON vs OFF hours on mortality in unselected ST-elevation myocardial infarction patients referred in percutaneous coronary intervention centers:Insights from the ORBI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6441] [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)
- L Payot
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - A Z Zabalawi
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - R D Delaunay
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - J P Hacot
- Centre Hospitalier de Bretagne Sud, Cardiology, Lorient, France
| | - T Lognone
- Centre Hospitalier, Saint-Malo, France
| | - G Rouault
- Centre Hospitalier, Cardiology, Quimper, France
| | | | - P H Druelles
- Polyclinic Saint Laurent of Rennes, Cardiology, Rennes, France
| | - R Didier
- University Hospital of Brest, Cardiology, Brest, France
| | - M Gilard
- University Hospital of Brest, Cardiology, Brest, France
| | - V Auffret
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
| | - I Coudert
- Centre Hospitalier, Emergency department, Saint-Brieuc, France
| | - T Cherfaoui
- Hospital Pontchaillou of Rennes, Emergency department, Rennes, France
| | - M Le Guellec
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
| | - H Le Breton
- Hospital Pontchaillou of Rennes, Cardiology, Rennes, France
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21
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Auffret V, Cottin Y, Leurent G, Gilard M, Beer JC, Zabalawi A, Chague F, Filippi E, Brunet D, Hacot JP, Loirat A, Lorgis L, Didier R, Zeller M, Le Breton H. P2482Prediction of in-hospital cardiogenic shock development among patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2482] [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)
- V Auffret
- University Hospital of Rennes - Hospital Pontchaillou, Cardiology and Vascular Disease, Rennes, France
| | - Y Cottin
- University Hospital of Dijon, Cardiology, Dijon, France
| | - G Leurent
- University Hospital of Rennes - Hospital Pontchaillou, Cardiology and Vascular Disease, Rennes, France
| | - M Gilard
- University Hospital of Brest, Brest, France
| | - J C Beer
- University Hospital of Dijon, Cardiology, Dijon, France
| | - A Zabalawi
- Centre Hospitalier, Cardiology, Saint-Brieuc, France
| | - F Chague
- University Hospital of Dijon, Cardiology, Dijon, France
| | - E Filippi
- Centre Hospitalier Bretagne Atlantique, Cardiology, Vannes, France
| | - D Brunet
- Clinique de Fontaine, Cardiology, Fontaine les Dijon, France
| | - J P Hacot
- Centre Hospitalier de Bretagne Sud, Cardiology, Lorient, France
| | - A Loirat
- University Hospital of Rennes - Hospital Pontchaillou, Cardiology and Vascular Disease, Rennes, France
| | - L Lorgis
- University Hospital of Dijon, Cardiology, Dijon, France
| | - R Didier
- University Hospital of Brest, Brest, France
| | - M Zeller
- University of Burgundy, Dijon, France
| | - H Le Breton
- University Hospital of Rennes - Hospital Pontchaillou, Cardiology and Vascular Disease, Rennes, France
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22
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Sokoloff A, Durand E, Urena-Alcazar M, Chevalier B, Chassaing S, Didier R, Litzler PY, Himbert D, Hovasse T, Bar O, Iung B, Blanchard D, Gilard M, Lefevre T, Eltchaninoff H. 3071Assessment of long-term structural deterioration of transcatheter aortic bioprosthetic valves using standardized new european definitions, a multicenter study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3071] [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)
- A Sokoloff
- University Hospital of Rouen, Department of Cardiology, Rouen, France
| | - E Durand
- University Hospital of Rouen, Department of Cardiology, Rouen, France
| | - M Urena-Alcazar
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - B Chevalier
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - S Chassaing
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - R Didier
- University Hospital of Brest, Department of Cardiology, Brest, France
| | - P Y Litzler
- University Hospital of Rouen, Department of Cardiac Surgery, Rouen, France
| | - D Himbert
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - T Hovasse
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - O Bar
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - B Iung
- Hospital Bichat-Claude Bernard, Department of Cardiology, Paris, France
| | - D Blanchard
- Clinique St Gatien, Department of Cardiology, Tours, France
| | - M Gilard
- University Hospital of Brest, Department of Cardiology, Brest, France
| | - T Lefevre
- Institut Hospitalier Jacques Cartier, Department of Cardiology, Massy, France
| | - H Eltchaninoff
- University Hospital of Rouen, Department of Cardiology, Rouen, France
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23
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Overtchouk P, Guedeney P, Montalescot G, Verhoye JP, Koning R, Lefevre TL, Van Belle E, Eltchaninoff H, Gilard M, Leprince P, Iung B, Barthelemy O, Silvain J, Le Breton H, Collet JP. 1213Post-TAVR antithrombotic treatment and one-year survival: insights from the FRANCE TAVI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - P Guedeney
- Hospital Pitie-Salpetriere, Paris, France
| | | | - J P Verhoye
- University Hospital of Rennes, Rennes, France
| | - R Koning
- Clinic Saint-Hilaire, Rouen, France
| | - T L Lefevre
- Institut Hospitalier Jacques Cartier, Massy, France
| | | | | | - M Gilard
- University Hospital of Brest, Brest, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - B Iung
- Hospital Bichat-Claude Bernard, Paris, France
| | | | - J Silvain
- Hospital Pitie-Salpetriere, Paris, France
| | - H Le Breton
- University Hospital of Rennes, Rennes, France
| | - J P Collet
- Hospital Pitie-Salpetriere, Paris, France
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24
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Didier R, Gilard M, Denolle T. [Resistant hypertension by unadvertised non-compliance detected by psychiatric expertise and drug dosages]. Ann Cardiol Angeiol (Paris) 2018; 67:222-225. [PMID: 29753423 DOI: 10.1016/j.ancard.2018.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/24/2018] [Indexed: 11/15/2022]
Abstract
The management of patients with resistant hypertension remains a major challenge in daily clinical practice in order to limit macro and microvascular impact. However, lack of compliance often remains one of the main etiologies of resistant hypertension. Through a clinical case of complex therapeutic non-compliance, we will detail the frequency, the screening and the management of therapeutic non-compliance. Finally, we will specify the contribution of drug dosages and psychological expertise in screening non-observant patients with presumed resistant hypertension.
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Affiliation(s)
- R Didier
- Department of Cardiology, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France.
| | - M Gilard
- Department of Cardiology, University Hospital of Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France
| | - T Denolle
- Hypertension center Rennes-Dinard, 35800 Dinard, France
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25
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Nicol P, Iung B, Bouleti C, Eltchaninoff H, Le Breton H, Cormier B, Obadia J, Tribouilloy C, Lansac E, Gilard M. Contemporary management of aortic stenosis in the elderly. Insights from a recent French registry. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2018.02.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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26
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Jobic Y, Le Moigne E, Timsit S, Ben Salem D, Didier R, Le Ven F, Hoffmann C, Dion A, Tromeur C, Pouliquen M, Le Gal G, Gilard M, Couturaud F, Mottier D. P4310Impact of patent foramen ovale on the prevalence of recent ischemic stroke in patients with acute pulmonary embolism: the EPIC FOP prospective multicenter study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4310] [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: 11/14/2022] Open
Affiliation(s)
- Y. Jobic
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - E. Le Moigne
- University Hospital of Brest, internal medecine, Brest, France
| | - S. Timsit
- University Hospital of Brest, of Neurology, Brest, France
| | - D. Ben Salem
- University Hospital of Brest, Radiology, Brest, France
| | - R. Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - F. Le Ven
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | | | - A. Dion
- University Hospital of Brest, Brest, France
| | - C. Tromeur
- University Hospital of Brest, Pneumology, Brest, France
| | - M.C. Pouliquen
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - G. Le Gal
- University Hospital of Brest, internal medecine, Brest, France
| | - M. Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - F. Couturaud
- University Hospital of Brest, Pneumology, Brest, France
| | - D. Mottier
- University Hospital of Brest, internal medecine, Brest, France
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27
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Didier R, Blanchard D, Puymirat E, Chassaing S, Bar O, Barbey C, Iung B, Fajadet J, Leprince P, Leguerrier A, Lievre M, Prat A, Teiger A, Eltchaninoff H, Gilard M. P458Impact of Coronary Artery Disease in Patients Undergoing Transcatheter aortic Valve Replacement: Inside The FRANCE-2 Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R. Didier
- Hospital Cavale Blanche, department of cardiology, Brest, France
| | - D. Blanchard
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - E. Puymirat
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - S. Chassaing
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - O. Bar
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - C. Barbey
- Clinique St Gatien, Interventional cardiology, Tours, France
| | - B. Iung
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - J. Fajadet
- Clinic Pasteur of Toulouse, Toulouse, France
| | - P. Leprince
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | | | - M. Lievre
- University Claude Bernard of Lyon, Lyon, France
| | | | - A. Teiger
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | | | - M. Gilard
- Hospital Cavale Blanche, department of cardiology, Brest, France
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28
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Auffret V, Leurent G, Gilard M, Hacot J, Filippi E, Delaunay R, Rialan A, Rouault G, Druelles P, Castellant P, Coudert I, Boulanger B, Treuil J, Bot E, Bedossa M, Boulmier D, Le Guellec M, Donal E, Le Breton H. Incidence, timing, predictors and impact of acute heart failure complicating ST-segment elevation myocardial infarction in patients treated by primary percutaneous coronary intervention. Archives of Cardiovascular Diseases Supplements 2017. [DOI: 10.1016/s1878-6480(17)30101-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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29
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Gilard M, Benamer H. [When will cardiology care be tailored to the specific needs of women?]. Ann Cardiol Angeiol (Paris) 2016; 65:383-384. [PMID: 28340899 DOI: 10.1016/j.ancard.2016.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- M Gilard
- Service de cardiologie, CHU La Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France
| | - H Benamer
- Ramsay générale de santé, ICPS Jacques-Cartier, 6, avenue du Noyer-Lambert, 91300 Massy, France; ICV-GVM La Roseraie, 120, avenue de la République, 93300 Aubervilliers, France; Hôpital Foch Suresnes, 40, rue Worth, 92151 Suresnes, France.
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Abstract
OBJECTIVES Exploring the discrepancy in sex-ratio among interventional cardiologists by analysing the population of the female interventionalist. BACKGROUND Despite an increase number of women who graduate from medical school in France during the last generation today, women represent only 24% of all cardiologists and 3% are interventional cardiologists. To face this international gender-based issue of interventional cardiology, committees were established in US (WIN) and recently within the EAPCI: the Women EAPCI chaired by Drs Mehilli and Mauri. In France, the Intervention'Elles committee emerged in order to participate in this concern. METHODS As a first initiative, the Intervention'Elles group launched an e-survey to obtain information on the population of French female interventional cardiologists, focused on demography, work patterns, maternity and radiation exposure. RESULTS Mean age is 40 years old (±7,4), 68% are working in large volume center, 28% have also structural interventional activity. Only 40% have left arm coverage. Despite 80% of French female interventional cardiologists wear personal dosimeters only 45% of them have a dosimetry feedback. Interestingly, even if 54% of women have children (mean: 1.9±1) 28% of them report that childbearing had interfered with their career plan. CONCLUSION This questionnaire identifies for the first time the women population in interventional cardiology in France and highlights some of the issues encountered in more detail. This first descriptive step would help to develop strategies for attaining gender equality in interventional cardiology.
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Affiliation(s)
- E Vautrin
- Cardiology department, university hospital, 38700 Grenoble, France
| | - S Marlière
- Cardiology department, university hospital, 38700 Grenoble, France
| | | | - M Gilard
- Cardiology department, Brest-university, 29609 Brest, France
| | - S Manzo-Silberman
- Inserm U942, cardiology department, Paris Diderot university, 75010 Paris, France.
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Tissier F, Didier R, Lautridou J, Boschat J, Desfontis J, Mallem Y, Mansourati J, Pichavant-Rafini K, Theron M, Gilard M. Effects of an early and low-dose hypolipidemic treatment of atherosclerosis: An OCT study in watanabe rabbits. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kristensen SD, Laut KG, Fajadet J, Kaifoszova Z, Kala P, Di Mario C, Wijns W, Clemmensen P, Agladze V, Antoniades L, Alhabib KF, De Boer MJ, Claeys MJ, Deleanu D, Dudek D, Erglis A, Gilard M, Goktekin O, Guagliumi G, Gudnason T, Hansen KW, Huber K, James S, Janota T, Jennings S, Kajander O, Kanakakis J, Karamfiloff KK, Kedev S, Kornowski R, Ludman PF, Merkely B, Milicic D, Najafov R, Nicolini FA, No c M, Ostojic M, Pereira H, Radovanovic D, Sabate M, Sobhy M, Sokolov M, Studencan M, Terzic I, Wahler S, Widimsky P. Corrigendum to: Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries. Eur Heart J 2014. [DOI: 10.1093/eurheartj/ehu333] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chopard R, Meneveau N, Gilard M, Laskar M, Eltchaninoff H, Iung B, Teiger E, Leguerrier A, Leprince P, Schiele F. Impact of chronic obstructive pulmonary disease on one year mortality after transcatheter aortic valve implantation. A substudy from the FRANCE 2 nationwide registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Van Belle E, Juthier F, Vincentelli A, Iung B, Eltchaninoff H, Leguerrier A, Laskar M, Prat A, Gilard M, Teiger E. Procedural predictors of Post-TAVR Aortic Regurgitation for Balloon-expendable and Self-expendable devices? Insights from the France 2 registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.3760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lucon A, Oger E, Bedossa M, Verhoye JP, Eltchaninoff H, Iung B, Leguerrier A, Laskar M, Gilard M, Le Breton H. Prognostic implications of pulmonary hypertension in patients with severe aortic stenosis undergoing transcatheter aortic-valve implantation: study from the FRANCE 2 registry. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.2582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Brami M, Gilard M, Voisin L. Un dispositif réglementaire permettant la diffusion d’une innovation médicale : la place du pmsi. À propos des bioprothèses valvulaires aortiques implantées par cathétérisme. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2011.12.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Tada H, Yamasaki H, Sekiguchi Y, Igarashi M, Kuroki K, Machino T, Yoshida K, Aonuma K, Heinzel FR, Forstner H, Lercher P, Bisping E, Rotman B, Fruhwald FM, Pieske BM, Dabrowski R, Kowalik I, Borowiec A, Smolis-Bak E, Trybuch A, Sosnowski C, Szwed H, Baturova MA, Lindgren A, Shubik YV, Olsson B, Platonov PG, Van Den Broek KC, Denollet J, Widdershoven J, Kupper N, Allam R, Allam RAGAB, Galal WAGDY, El-Damnhoury HAYAM, Mortada AYMAN, Jimenez-Candil J, Martin A, Hernandez J, Martin F, Gallego M, Martin-Luengo C, Quintanilla JG, Moreno Planas J, Molina-Morua R, Archondo T, Garcia-Torrent MJ, Perez-Castellano N, Macaya C, Perez-Villacastin J, Saiz J, Tobon C, Rodriguez JF, Hornero F, Ferrero JM, Ito K, Date T, Kawai M, Hioki M, Narui R, Matsuo S, Yoshimura M, Yamane T, Tabatabaei N, Lin G, Powell BD, Smairat R, Glockner JF, Brady PA, Fichtner S, Czudnochowsky U, Estner H, Reents T, Jilek C, Ammar S, Hessling G, Deisenhofer I, Shah DC, Kautzner J, Saoudi N, Herrera C, Jais P, Hindricks G, Neuzil P, Kuck KH, Wong KCK, Jones M, Qureshi N, Muthumala A, Betts TR, Bashir Y, Rajappan K, Vogtmann T, Wagner M, Schurig J, Hein P, Hamm B, Baumann G, Lembcke A, Saad B, Piwowarska W, Nessler J, Edvardsson N, Rieger G, Garutti C, Linker N, Jorge C, Silva Marques J, Veiga A, Cruz J, Slater C, Correia MJ, Sousa J, Miltenberger-Miltenyi G, Nunes Diogo A, Matic D, Mrdovic I, Stankovic G, Asanin M, Antonijevic N, Matic M, Oliveira LA, Kocev N, Vasiljevic Z, Ramirez-Marrero MA, Perez-Villardon B, Delgado-Prieto JL, Jimenez-Navarro M, De Teresa-Galvan E, De Mora-Martin M, Pietrucha AZ, Bzukala I, Elias R, Sztefko K, Wnuk M, Malek A, Piwowarska W, Nessler J, Szili-Torok T, Bauernfeind T, De Groot N, Shalganov T, Schalij M, Camiletti A, Jordaens L, Rivas N, Casaldaliga J, Roca I, Pijuan A, Perez-Rodon J, Dos L, Garcia-Dorado D, Moya A, Baruteau AE, Moura D, Behaghel A, Chatel S, Mabo P, Schott JJ, Daubert JC, Le Marec H, Probst V, Zorio Grima E, Navarro-Manchon J, Molina P, Maldonado P, Igual B, Cano O, Bermejo M, Giner J, Salvador A, Bourgonje VJA, Vos MA, Ozdemir S, Doisne N, Van Der Heyden MAG, Camanho LE, Van Veen AAB, Sipido K, Antoons G, Altieri PI, Escobales N, Crespo M, Banchs HL, Sciarra L, Bloise R, Allocca G, Bulava A, Marras E, Lioy E, Delise P, Priori S, Calo' L, Hanis J, Sitek D, Novotny A, Chik WB, Lim TW, Choon HK, See VA, Mccall R, Thomas L, Ross DL, Thomas SP, Chen J, De Bortoli A, Rossvoll O, Hoff PI, Solheim E, Sun LZ, Schuster P, Ohm OJ, Ardashev AV, Zhelyakov E, Rybachenko MS, Konev AV, Belenkov YUN, Gunawardene M, Chun KRJ, Schulte-Hahn B, Windhorst V, Kulikoglu M, Nowak B, Schmidt B, Albina GA, Rivera RS, Scazzuso F, Laino RL, Giniger GA, Arbelo E, Calvo N, Tamborero D, Andreu D, Borras R, Berruezo A, Brugada J, Mont L, Stefan L, Eisenberger M, Celentano E, Peytchev P, Bodea O, Geelen P, De Potter T, Oliveira MM, Silva N, Cunha PS, Feliciano J, Lousinha A, Toste A, Santos S, Ferreira RC, Matsuda H, Harada T, Soejima K, Ishikawa Y, Mizukoshi K, Sasaki T, Mizuno K, Miyake F, Adragao PP, Cavaco D, Miranda R, Santos M, Morgado F, Reis Santos K, Candeias R, Marcelino S, Zoppo F, Grandolino G, Zerbo F, Bertaglia E, Schlueter SM, Grebe O, Vester EG, Miracle Blanco AL, Arenal Maiz A, Atienza Fernandez F, Datino Romaniega T, Gonzalez Torrecilla E, Eidelman G, Hernandez Hernandez J, Fernandez Aviles F, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Richter B, Gwechenberger M, Socas A, Zorn G, Albinni S, Marx M, Wojta J, Goessinger H, Deneke T, Balta O, Paesler M, Buenz K, Anders H, Horlitz M, Muegge A, Shin DI, Natsuyama K, Yamaguchi KM, Nishida YN, De Bortoli A, Ohm OJ, Hoff PI, Solheim E, Schuster P, Sun LZ, Chen J, Kosiuk J, Bode K, Arya A, Piorkowski C, Gaspar T, Sommer P, Hindricks G, Bollmann A, Wichterle D, Peichl P, Simek J, Havranek S, Bulkova V, Cihak R, Kautzner J, Jurado Roman A, Salguero Bodes R, Lopez Gil M, Fontenla Cerezuela A, De Riva Silva M, Arribas Ynsaurriaga F, Fernandez Herranz AI, De Dios Perez S, Revishvili AS, Dishekov M, Tembotova Z, Barsamyan S, Vaccari D, Alvarenga C, Jesus I, Layher J, Takahashi A, Singh N, Siot P, Elkaim JP, Savelieva I, Mcclelland L, Lovegrove A, Jones S, Camm J, Folino AF, Breda R, Calzavara P, Comisso J, Borghetti F, Iliceto S, Buja G, Mlynarski R, Mlynarska A, Sosnowski M, Wilczek J, Mabo P, Carrault G, Bordachar P, Makdissi A, Duchemin L, Alonso C, Neri G, Masaro G, Vittadello S, Vaccari D, Gardin A, Barbetta A, Di Gregorio F, Sciaraffia E, Ginks MR, Gustafsson JS, Hollmark MC, Rinaldi CA, Blomstrom Lundqvist C, Brusich S, Tomasic D, Ferek-Petric B, Mavric Z, Kutarski A, Malecka B, Kolodzinska A, Grabowski M, Dovellini EV, Giurlani L, Cerisano G, Carrabba N, Valenti R, Antoniucci D, Kolodzinska A, Kutarski A, Grabowski M, Malecka B, Opolski G, Tomassoni G, Baker J, Corbisiero R, Martin D, Niazi I, Sheppard R, Sperzel J, Gutleben K, Petru J, Sediva L, Skoda J, Neuzil P, Mazzone P, Ciconte G, Vergara P, Marzi A, Paglino G, Sora N, Gulletta S, Della Bella P, Kutarski A, Pietura R, Czajkowski M, Cabanelas N, Martins VP, Alves M, Valente FX, Marta L, Francisco A, Silva R, Ferreira Da Silva G, Huo Y, Holmqvist F, Carlson J, Arya A, Wetzel U, Hindricks G, Bollmann A, Platonov P, Nof E, Abu Shama R, Kuperstein R, Feinberg MS, Eldar M, Glikson M, Luria D, Kubus P, Materna O, Gebauer RA, Matejka T, Gebauer R, Tlaskal T, Janousek J, Muessigbrodt A, Arya A, Wetzel U, Hindricks G, Richter S, Stockburger M, Boveda S, Defaye P, Stancak Branislav P, Kaliska G, Rolando M, Moreno J, Ohlow MAG, Lauer B, Buchter B, Schreiber M, Geller JC, Val-Mejias JE, Ouali S, Azzez S, Kacem S, Ben Salem H, Hammas S, Neffeti E, Remedi F, Boughzela E, Miyazaki H, Miyanaga S, Shibayama K, Tokuda M, Narui R, Kudo T, Yamane T, Yoshimura M, Coppola B, Shehada REN, Costandi P, Healey J, Hohnloser SH, Gold MR, Capucci A, Van Gelder IC, Carlson M, Lau CP, Connolly SJ, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Thibault B, Dubuc M, Karst E, Ryu K, Paiement P, Farazi T, Puetz V, Berndt C, Buchholz J, Dorszewski A, Mornos C, Cozma D, Ionac A, Petrescu L, Mornos A, Pescariu S, Puetz V, Berndt C, Buchholz J, Dorszewski A, Benser M, Roscoe G, De Jong S, Roberts G, Boileau P, Rec A, Ryu K, Folman C, Morttada A, Abd El Kader M, Samir R, Roushdy R, Khaled S, Abo El Maaty M, Van Gelder B, Houthuizen P, Bracke FA, Osca Asensi J, Tejada D, Sanchez JM, Munoz B, Cano O, Rodriguez M, Sancho-Tello MJ, Olague J, Hou W, Rosenberg S, Koh S, Poore J, Snell J, Yang M, Nirav D, Bornzin G, Deering T, Dan D, Wickliffe AC, Cazeau S, Karimzadeh K, Mukerji S, Loghin C, Kantharia B, Bogaard MD, Leenders GE, Maskara B, Tuinenburg AE, Loh P, Hauer RN, Doevendans PA, Meine M, Betts TR, Jones MA, Wong KCK, Qureshi N, Rajappan K, Bashir Y, Lamba J, Simpson CS, Redfearn DP, Michael KA, Fitzpatrick M, Baranchuk A, Heinke M, Ismer B, Kuehnert H, Surber R, Haltenberger AM, Prochnau D, Figulla HR, Delarche N, Bizeau O, Couderc P, Chapelet A, Amara W, Lazarus A, Kubus P, Krupickova S, Gebauer RA, Janousek J, Van Deursen CJM, Strik M, Vernooy K, Van Hunnik A, Kuiper M, Crijns HJGM, Prinzen FW, Islam N, Gras D, Abraham W, Calo L, Birgersdotter-Green U, Clyne C, Herre J, Sheppard R, Abraham W, Gras D, Birgersdotter-Green U, Calo L, Clyne C, Klein N, Herre J, Sheppard R, Kowalski O, Lenarczyk R, Pruszkowska P, Sokal A, Kukulski T, Zielinska T, Pluta S, Kalarus Z, Schwab JO, Gasparini M, Anselme F, Clementy J, Santini M, Martinez Ferrer J, Burrone V, Santi E, Nevzorov R, Porter A, Kusniec J, Golovchiner G, Ben-Gal T, Strasberg B, Haim M, Rordorf R, Savastano S, Sanzo A, Vicentini A, Petracci B, De Amici M, Striuli L, Landolina M, Tolosana JM, Martin AM, Hernandez-Madrid A, Macias A, Fernandez-Lozano I, Osca J, Quesada A, Mont L, Igarashi M, Tada H, Yamasaki H, Sekiguchi Y, Kuroki K, Yoshida K, Noguchi Y, Aonuma K, Shahrzad S, Karim Soleiman N, Tavoosi A, Taban S, Emkanjoo Z, Fukunaga M, Goya M, Hiroshima K, Ohe M, Hayashi K, Iwabuchi M, Nosaka H, Nobuyoshi M, Doiny D, Perez-Silva A, Castrejon Castrejon S, Estrada A, Ortega M, Lopez-Sendon JL, Merino JL, Garcia Fernandez FJ, Gallardo R, Pachon M, Almendral J, Gonzalez Torrecilla E, Martin J, Yahya D, Al-Mogheer B, Gouda S, Eweis E, El Ramly M, Abdelwahab A, Kassenberg W, Wittkampf FHM, Hof IE, Heijden JH, Neven KGEJ, Meine M, Hauer RNW, Loh P, Baratto F, Bignami E, Pappalardo F, Maccabelli G, Nicolotti D, Zangrillo A, Della Bella P, Hayashi K, Goya M, Hiroshima K, Nagashima M, An Y, Fukunaga M, Okreglicki A, Russouw C, Tilz R, Yoshiga Y, Mathew S, Fuernkranz A, Rillig A, Wissner E, Kuck KH, Ouyang F, De Sisti A, Tonet J, Gueffaf F, Amara W, Touil F, Aouate P, Hidden-Lucet F, Doiny D, Castrejon Castrejon S, Estrada A, Ortega M, Perez-Silva A, Lopez-Sendon JL, Merino JL, Makimoto H, Satomi K, Yamada Y, Okamura H, Noda T, Shimizu W, Aihara N, Kamakura S, Estrada A, Perez Silva A, Doiny D, Castrejon S, Gonzalez Vasserot M, Merino JL, Tilz R, Senges J, Brachmann J, Andresen D, Hoffmann E, Schumacher B, Willems S, Kuck KH, Reents T, Deisenhofer I, Ammar S, Springer B, Fichtner S, Jilek C, Kolb C, Hessling G, Akca F, Bauernfeind T, De Groot NMS, Schwagten B, Witsenburg M, Jordaens L, Szili-Torok T, Hata Y, Nakagami R, Watanabe T, Sato A, Watanabe H, Kabutoya T, Mituhashi T, Theuns DAMJ, Smith T, Pedersen SS, Dabiri-Abkenari L, Jordaens L, Prull MW, Unverricht S, Bittlinsky A, Wirdemann H, Sasko B, Wirdeier S, Trappe HJ, Zorio Grima E, Rueda J, Medina P, Jaijo T, Sevilla T, Osca J, Arnau MA, Salvador A, Starrenburg AH, Kraaier K, Pedersen SS, Scholten MF, Van Der Palen J, De Haan S, Commandeur J, De Boer K, Beek AM, Van Rossum AC, Allaart CP, Berne P, Porres JM, Fernandez-Lozano I, Arnaiz JA, Mont L, Berruezo A, Brugada R, Brugada J, Man S, Maan AC, Thijssen J, Van Der Wall EE, Schalij MJ, Burattini L, Burattini R, Swenne CA, Bonny A, Hidden-Lucet F, Ditah I, Larrazet F, Frank R, Fontaine G, Van Den Broek KC, Pedersen SS, Theuns DAMJ, Jordaens L, Van Der Voort PH, Alings M, Denollet J, Shimane A, Okajima K, Kanda G, Yokoi K, Yamada S, Taniguchi Y, Hayashi T, Kajiya T, Santos MC, Wright J, Betts J, Denman R, Dominguez-Perez L, Arias Palomares MA, Toquero J, Jimenez-Candil J, Olague J, Diaz-Infante E, Tercedor L, Valverde I, Miracle Blanco AL, Datino Romaniega T, Arenal Maiz A, Atienza Fernandez F, Gonzalez Torrecilla E, Eidelman G, Hernandez Hernandez J, Fernandez Aviles F, Napp A, Joosten S, Stunder D, Zink M, Marx N, Schauerte P, Silny J, Trucco ME, Arce M, Palazzolo J, Femenia F, Glad JM, Szymkiewicz SJ, Glad JM, Szymkiewicz SJ, Fernandez-Armenta J, Camara O, Mont LL, Andreu D, Diaz E, Silva E, Frangi A, Berruezo A, Brembilla-Perrot B, Laporte F, Jimenez-Candil J, Martin A, Gallego M, Morinigo J, Ledesma C, Martin-Luengo C, Hadid C, Almendral J, Ortiz M, Quesada A, Wolpert C, Cobo E, Navarro X, Arribas F, Miki Y, Naitoh S, Kumagai K, Goto K, Kaseno K, Oshima S, Taniguchi K, Rivera S, Scazzuso F, Albina G, Klein A, Laino R, Sammartino V, Giniger A, Fukumoto K, Takatsuki S, Kimura T, Nishiyama N, Aizawa Y, Sato T, Miyoshi S, Fukuda K, Muggenthaler M, Raju H, Papadakis M, Chandra N, Bastiaenen R, Behr ER, Sharma S, Samniah N, Radezishvsky Y, Omari H, Rosenschein U, Perez Riera AR, Ferreira M, Hopman WM, Mcintyre WF, Baranchuk AR, Wongcharoen W, Keanprasit K, Phrommintikul A, Chaiwarith R, Yagishita A, Hachiya H, Nakamura T, Tanaka Y, Higuchi K, Kawabata M, Hirao K, Isobe M, Havranek S, Simek J, Wichterle D, Stoickov V, Ilic S, Deljanin Ilic M, Aagaard P, Sahlen A, Bergfeldt L, Braunschweig F, Sousa A, Lebreiro A, Sousa C, Oliveira S, Correia AS, Rangel I, Freitas J, Maciel MJ, Asensio Lafuente E, Aguilera AAC, Corral MACC, Mendoza KLMC, Nava PEND, Rendon ALRC, Villegas LVC, Castillo LCM, Schaerf R, Develle R, Brembilla-Perrot B, Oliver C, Zinzius PY, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Borbola J, Abraham P, Foldesi CS, Kardos A, Miranda R, Almeida S, Santos MB, Cavaco D, Quaresma R, Morgado FB, Adragao P, Fatemi M, Didier R, Le Gal G, Etienne Y, Jobic Y, Gilard M, Boschat J, Mansourati J, Zubaid M, Rashed W, Alsheikh-Ali A, Almahmeed W, Shehab A, Sulaiman K, Asaad N, Amin H, Boersma LVA, Swaans M, Post M, Rensing B, Jarverud K, Broome M, Noren K, Svensson T, Hjelm S, Hollmark M, Bjorling A, Providencia RA, Botelho A, Trigo J, Nascimento J, Quintal N, Mota P, Leitao-Marques AM, Maeda K, Takagi M, Suzuki K, Tatsumi H, Yoshiyama M, Simeonidou E, Michalakeas C, Kastellanos S, Varounis C, Nikolopoulou A, Koniari C, Anastasiou-Nana M, Furukawa T, Maggi R, Bertolone C, Fontana D, Brignole M, Pietrucha AZ, Wnuk M, Bzukala I, Mroczek-Czernecka D, Konduracka E, Kruszelnicka O. Poster Session 4. Europace 2011. [DOI: 10.1093/europace/eur231] [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: 11/14/2022] Open
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Abstract
The recent and future advancements that are known in the field of cardiac imaging imply an optimal training of the operators. This training concerns medical specialists whether originating from radiology or cardiology. The training of the medical specialists in cardiac imaging entitles 3 main essential steps: The basic training taking place within each specialty, allowing the fellow to get acquainted with the clinical and technical basics. The specialized training, delivered principally in post-residency. This training must include an upgrading of each specialty in the domain that does not concern it (a technical base for the cardiologist, a physio-pathological and clinical base for the radiologist). It must include a specific theoretical training covering all aspects of cardiac imaging as well as practical training in a certified training centre. The continuous medical training and maintenance of skills that allow a sustained activity in the field and the obligation to regularly participate in the actions of specific validated training. The different aspects of these rules are exposed in this chapter.
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Affiliation(s)
- F Joffre
- Service de Radiologie, Hôpital Rangueil, 1 avenue Jean Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
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Cornily JC, Gilard M, Le Gal G, Pennec PY, Vinsonneau U, Blanc JJ, Mansourati J, Boschat J. Accuracy of 16-detector multislice spiral computed tomography in the initial evaluation of dilated cardiomyopathy. Clin Imaging 2007. [DOI: 10.1016/j.clinimag.2007.04.014] [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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Guevel-Jointret AL, Borel ML, Munier S, Cornily JC, Pennec PY, Gilard M, Mansourati J. [Tolerance and efficacy of early nicotine substitution after acute coronary syndromes]. Arch Mal Coeur Vaiss 2007; 100:514-8. [PMID: 17893633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The object of this study was to assess the cardiovascular tolerance and efficacy of early nicotine substitution therapy in 100 patients admitted to the Coronary Care Unit for acute coronary syndromes (ACS). The files of the first 100 consecutive patients having received nicotine substitution therapy immediately after an ACS were consulted retrospectively and a questionnaire was sent to all patients. A reply was obtained in 90% of cases. In this series, there was a 7% rate of cardiovascular events in the days following hospital discharge, comparable to previously reported results. The smoking relapse rate at six months after the ACS was 38.9%, a percentage which was less than in previously reported series. Although consultations to help stop smoking and nicotine substitution did not seem to have significant benefits in this study, the authors recommend continuing and improving the management of coronary patients who smoke.
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Affiliation(s)
- A-L Guevel-Jointret
- Département de Cardiologie, CHU de la Cavale Blanche, Boulevard Tanguy-Prigent, 29609 Brest cedex
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Blanchard D, Eltchaninoff H, Berland J, Carrie D, Dupouy P, Funck F, Gilard M, Louvard Y. [The best of interventional cardiology in 2006]. Arch Mal Coeur Vaiss 2007; 100 Spec No 1:65-9. [PMID: 17405567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The year 2006 was a landmark in interventional cardiology. Confirmations of results of large-scale trials and meta analyses, the commercialisation of new drug-elution stents, discussions about well established methods, questions about long-term outcomes of dilated patients, have made 2006 a particularly rich year in controversy, especially during its last three months.
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Gilard M, Arnaud B, Le Gal G, Abgrall JF, Boschat J. Influence of omeprazol on the antiplatelet action of clopidogrel associated to aspirin. J Thromb Haemost 2006; 4:2508-9. [PMID: 16898956 DOI: 10.1111/j.1538-7836.2006.02162.x] [Citation(s) in RCA: 189] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Cornily JC, Le Gal G, Tram-Lebaillif TN, Gilard M, Boschat J, Blanc JJ. [Acute pericarditis: results of a survey of treatment practices of cardiologists]. Arch Mal Coeur Vaiss 2006; 99:61-4. [PMID: 16479891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
UNLABELLED Benign acute pericarditis is a common disorder. Although, at first glance, its management appears well defined, the guidelines issued by professional societies with respect to optimal treatment and length of its administration remain vague. METHODS a brief, anonymous questionnaire probing into treatment practices was sent in April 2005 to all cardiologists of Brittany. RESULTS we collected 164 analyzable questionnaires out of 248 submitted (66%). The initial investigations in presence of acute pericarditis included an electrocardiogram in 100% of cases, an echocardiogram in 95%, and screening biochemistry in 93% of cases. Systematic hospitalisation was advised by only 24% of cardiologists. Aspirin was prescribed as first choice treatment in 92.5% of cases. Duration of treatment recommendations varied widely, from <5 days by 2.5%, between 5 and 10 days by 25.5%, 11 and 15 days by 23.0%, 16 to 21 days by 35.3%, and for >21 days by 14% of cardiologists. Hospital-based cardiologists were more likely to systematically hospitalise their patients than outpatient practice-based physicians (79.5% versus 5.1%; p<0.001) as well as to order an initial biochemical screening tests (100% versus 81.4%, p<0.01). Cardiologists <42 years of age recommended significantly fewer hospitalisations than older physicians (6.8% versus 36.4%: p<0.001). CONCLUSIONS the management of acute, benign pericarditis was limited nearly exclusively to the prescription of aspirin. Duration of treatment varied widely. These observations are concordant with data published in the literature (where the recommended duration of treatment is systematically missing).
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Affiliation(s)
- J C Cornily
- Département e cardiologie, CHU Cavale blanche, 29609 Brest Cedex.
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Eltchaninoff H, Gilard M, Blanchard D, Berland J, Carrié D, Chevalier B, Hansen M, Louvard Y. [The best of interventional cardiology in 2005]. Arch Mal Coeur Vaiss 2006; 99 Spec No 1:57-60. [PMID: 16479965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
During 2005, the evolution of interventional cardiology has largely been dominated by the trial of active endoprostheses, whose advantage has been consistently shown by various studies, mete-analyses and surveys. Extending their use to new indications and evaluating new drugs have also been studied. In parallel, clinical trials have been performed in the promising field of percutaneous treatment of valvular heart disease, particularly mitral insufficiency and calcified aortic stenosis in the adult.
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Affiliation(s)
- H Eltchaninoff
- Service de cardlologle, hôpital Charles Nicolle, 1, rue de Germont, 76031 Rouen.
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Chevalier B, Blanchard D, Berland J, Carrié D, Gilard M, Hanssen M, Louvard Y, Eltchaninoff H. [Drug-eluting stents: indications, limits and future development]. Arch Mal Coeur Vaiss 2005; 98:1013-21. [PMID: 16294549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- B Chevalier
- Service de cardiologie, hôpital Charles Nicolle, Rouen
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Géhanne A, Shayne A, Eltchaninoff H, Gilard M, Richard P, Range G, Hacot JP, Lefebvre E, Douillet R, Tirouvanziam A, Le Breton H. [Interventricular management of patients over the age of 75 with acute coronary syndromes without persistent ST elevation]. Arch Mal Coeur Vaiss 2005; 98:615-9. [PMID: 16007814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The aim ot tnis study was to assess the results of interventional strategy in patients over 75 years of age admitted to hospital with acute coronary syndromes (ACS) without persistent ST elevation. Over three months, patients over the age of 75 undergoing coronary angiography for ACS were included in a multicentre register and followed up for 6 months. A total of 126 patients with an average age of 79 were included: 70% had at least one poor prognostic factor. The treatment on admission included: Aspirin (84%), Clopidogrel (60%), anti GpIIb-IIIa (12%) and Heparin (81%, of which 3/4 of cases were low molecular weight heparins). Coronary angiography (average delay 80 hours) showed single, double and triple vessel disease in 21, 29 and 35% of cases respectively. Coronary angioplasty was proposed in 83 patients and carried out in 82. Eleven patients underwent coronary artery bypass grafting and 31 were treated medically. During the hospital phase, there were 3 major cardiovascular complications: 1 death during coronary angiography, 1 intra-stent thrombosis and 1 death in the group undergoing bypass grafting, with no major bleeding complications. At 6 months, there were 8 (6.5%) major cardiovascular adverse events with 6 in the "angioplasty" group; 5 deaths (3 cardiac deaths), 3 myocardial infarcts. Two thirds of patients were asymptomatic. The authors conclude that interventional strategy in ACS of elderly patients is associated with a low rate of major adverse events. The benefits of this strategy should be confirmed by randomised trial.
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Affiliation(s)
- A Géhanne
- Département de cardiologie, centre cardiopneumologique CHU Rennes
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Dupouy P, Gilard M, Morelle JF, Furber A, Aptecar E, Cazaux P, Slama M, Feldman LJ, Wittenberg O, Pernès JM, Huret B, Commeau P, Boschat J, Teiger E, Lafont A, Steg PG, Dubois Randé JL. Usefulness and clinical impact of a fractional flow reserve and angiographic targeted strategy for coronary artery stenting: FROST III, a multicenter prospective registry. EUROINTERVENTION 2005; 1:85-92. [PMID: 19758882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Fractional flow reserve (FFR) is correlated with angiographic and intravascular ultrasound assessments of stent placement. Post-stenting FFR has been described as a good predictor of clinical events after 6 months. OBJECTIVE To evaluate the feasibility and clinical impact of targeting an FFR > 0.95 via incremental in-stent inflation pressures. METHODS In this multicenter prospective study, 100 consecutive patients underwent FFR measurement at baseline, after balloon predilatation, and after stenting with 4-atm inflation pressure increments from 8 to 20 atmospheres. Inflations were stopped when FFR increased above 0.95 and angiographic stenosis was less than 20%. RESULTS FFR > 0.95 was achieved in 81% of cases; this FFR target was reached at 8 atm in 47% of patients, 12 atm in 16 %, 16 atm in 15%, and 20 atm in 3%. Fifty percent of patients with adequate angiographic result had an FFR less than 0.95 and needed further higher inflations. FFR was correlated with residual stenosis when the total procedure was evaluated, and this correlation persisted when in-stent inflations alone were considered. Final FFR was significantly correlated with anginal status after 6 months. CONCLUSIONS Angiography guided PCI does not allow optimization of FFR. Since optimal post stenting FFR is correlated to better anginal status at 6-months, this suggests that FFR guided PCI is required to achieve optimal functional results of PCI.
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Affiliation(s)
- P Dupouy
- Fédération de cardiologie, AP-HP, CHU Henri-Mondor, Université Paris XIIe, Créteil, France
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Abstract
OBJECTIVE To analyse coronary stents with multislice spiral computed tomography (MSCT) in comparison with coronary angiography. PATIENTS AND METHODS 310 patients referred for conventional coronary angiography underwent MSCT on the next day (16 x 0.75 mm cross section, 420 ms rotation, 110 ml contrast agent intravenously at 4 ml/s). Two independent blinded reviewers analysed the MSCT. RESULTS 143 patients had previous stenting (232 stents) and 190 (82%) of the 232 stents were detected. Intrastent lumen was interpretable in 126 (64%) of the detected stents. Lumen interpretability depended on stent diameter: for stent diameter > 3 mm, 81% of lumens were interpretable, as against 51% with < or = 3 mm stent diameter (p < 0.001). Restenosis detection likewise depended on stent diameter: with small stents (< or = 3 mm), sensitivity and specificity of MSCT were 54% and 100%, respectively; positive and negative predictive values were 100% and 94%. For stents with > 3 mm diameter, corresponding values were 86%, 100%, 100%, and 99%. CONCLUSION 16 slice MSCT allows analysis of in-stent lumen in about half of all stented angioplasties. It performs better when stent diameter is more than 3 mm and may offer a non-invasive alternative to conventional coronary angiography for monitoring stented coronary arteries. Technical progress may improve interpretability and hence increase the yield of MSCT in this application.
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Affiliation(s)
- M Gilard
- Department of Cardiology, Brest University Hospital, Brest, France.
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Fatemi M, Gilard M, Boschat J, Cornily J, Mansouraty J, Blanc J. P-492 Prevalence of patients with the madit II criteria in single European center. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b182b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- M. Fatemi
- Brest University Hospital
,
Brest, France
| | - M. Gilard
- Brest University Hospital
,
Brest, France
| | - J. Boschat
- Brest University Hospital
,
Brest, France
| | | | | | - J.J. Blanc
- Brest University Hospital
,
Brest, France
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