35 results on '"Danchin N"'
Search Results
2. Stent-Related Cardiac Events Beyond Three Years After Implantation of the Sirolimus-Eluting Stent (from the EVASTENT Patients)
- Author
-
Barone-Rochette G, Foote A, Motreff P, Vanzetto G, Quesada JL, Danchin N, Machecourt J, and EVASTENT Investigators
- Published
- 2011
3. Comparison of Efficacy and Safety of a Standard Versus a Loading Dose of Clopidogrel for Acute Myocardial Infarction in Patients >=75 Years of Age (from the FAST-MI Registry)
- Author
-
Puymirat E, Aïssaoui N, Coste P, Dentan G, Bataille V, Drouet E, Mulak G, Carrié D, Blanchard D, Simon T, and Danchin N
- Published
- 2011
4. Effect of early initiation of statins on survival in patients with acute myocardial infarction (the USIC 2000 Registry)
- Author
-
Ferrières J, Cambou J, Guéret P, Boutalbi Y, Lablanche J, Hanania G, Genès N, Cantet C, and Danchin N
- Published
- 2005
- Full Text
- View/download PDF
5. Increased C-reactive protein levels in patients with in-stent restenosis and its implications.
- Author
-
Angioi, Michael, Abdelmouttaleb, Idrissia, Rodriguez, Rosa-Maria, Aimone-Gastin, Isabelle, Adjalla, Charles, Guéant, Jean-Louis, Danchin, Nicolas, Angioi, M, Abdelmouttaleb, I, Rodriguez, R M, Aimone-Gastin, I, Adjalla, C, Guéant, J L, and Danchin, N
- Subjects
- *
C-reactive protein , *CORONARY restenosis , *ANGIOPLASTY - Abstract
Assesses whether higher levels of C-reactive protein (CRP) could be found in patients with in-stent restenosis compared with patients with no restenosis. Pre- and postcoronary angioplasty and follow-up angiograms; Measurement of serum CRP concentrations; Distribution of CRP levels according to the presence or absence of restenosis.
- Published
- 2001
- Full Text
- View/download PDF
6. Long-term outcome in patients treated by intracoronary stenting with ticlopidine and aspirin, and deleterious prognostic role of unstable angina pectoris.
- Author
-
Angioi, Michael, Danchin, Nicolas, Angioi, M, Danchin, N, Alla, F, Gangloff, C, Sunthorn, H, Rodriguez, R M, Preiss, J P, Grentzinger, A, Houplon, P, Juillière, Y, and Cherrier, F
- Subjects
- *
ANTICOAGULANTS , *TICLOPIDINE , *ASPIRIN , *ANGINA pectoris , *MYOCARDIAL infarction - Abstract
Compared with stable clinical conditions, unstable angina carries an increased risk of immediate and delayed cardiac adverse events after balloon coronary angioplasty. The influence of stent use in reducing these differences remains unknown. We analyzed the early (30 days) and late outcome of a cohort of 459 consecutive patients who underwent stent placement with ticlopidine and aspirin as antithrombotic regimen according to the presence (group 1, n = 151) or absence (group 2, n = 308) of unstable angina at rest (Braunwald classes II and III). Group 1 patients were older and more likely to be current or former smokers. In group 2, prior myocardial infarction was more frequent. Procedural, in-hospital results, and early outcome were similar in the 2 groups. However, over the long term, the incidence of myocardial infarction (11% vs 6%, p <0.04), target lesion revascularization (19% vs 13%, p <0.04), or any revascularization (30% vs 20%, p <0.01) was significantly higher in group 1. Kaplan-Meier probabilities of survival without myocardial infarction (85% vs 91%, p <0.05), survival without revascularization of the target lesion (73% vs 83%, p <0.01), survival without any revascularization (65% vs 77%, p <0.006), and survival without any events (61% vs 73%, p <0.009) were significantly worse in group 1. In addition, Cox multivariate analysis showed that unstable angina at rest was an independent predictor of target lesion revascularization, of survival without any revascularization, and without any events. Thus, unstable angina at rest remains an adverse prognostic indicator in patients treated with intracoronary stents, particularly with regard to subsequent requirement of revascularization procedures and event-free survival. [ABSTRACT FROM AUTHOR]
- Published
- 2000
- Full Text
- View/download PDF
7. "Rescue" abciximab for complicated percutaneous transluminal coronary angioplasty.
- Author
-
Garbarz, Eric, Farah, Bruno, Garbarz, E, Farah, B, Vuillemenot, A, André, F, Angioï, M, Machecourt, J, Bassand, J P, Wolf, J E, Danchin, N, Prendergast, B, Iung, B, and Vahanian, A
- Subjects
- *
TRANSLUMINAL angioplasty - Abstract
We studied the in-hospital outcome of 138 consecutive patients who received abciximab as a "rescue" intervention for complicated coronary angioplasty in a high-risk clinical setting. "Rescue" treatment with abciximab was associated with clinical and angiographic success rates of 83% and 84%, respectively, whereas the risk of bleeding was higher in patients of low body weight. [ABSTRACT FROM AUTHOR]
- Published
- 1998
- Full Text
- View/download PDF
8. Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry).
- Author
-
Puymirat E, Aissaoui N, Lemesle G, Cottin Y, Coste P, Schiele F, Ferrières J, Simon T, and Danchin N
- Subjects
- Adrenergic beta-Antagonists therapeutic use, Age Distribution, Aged, Aged, 80 and over, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Atherosclerosis epidemiology, Case-Control Studies, Cause of Death, Female, France, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Longitudinal Studies, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction epidemiology, Platelet Aggregation Inhibitors therapeutic use, Prognosis, Proportional Hazards Models, Prospective Studies, Risk Factors, Treatment Outcome, Cerebrovascular Disorders epidemiology, Coronary Artery Bypass, Coronary Artery Disease epidemiology, Mortality, Myocardial Infarction therapy, Percutaneous Coronary Intervention, Registries
- Abstract
The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI. Overall, patients with a history of atherosclerotic disease (or MI) were older compared with patients without known cardiovascular disease (71 ± 13 vs 63 ± 14 years) and had higher cardiovascular risk profiles and co-morbidities. Using fully adjusted Cox multivariate analysis, previous manifestations of atherosclerotic disease were associated with higher 3-year mortality (hazard ratio 1.80, 95% confidence interval 1.40 to 2.31; p <0.001) as history of previous MI alone (hazard ratio 1.32, 95% confidence interval 1.00 to 1.73; p = 0.048). Similar results were found in patients discharged alive. In conclusion, previous cardiovascular atherosclerotic disease represents 1/3 of patients with AMI and are strongly associated with worse long-term clinical outcomes. Intensive follow-up and therapy should be encouraged in this high-risk population., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
9. Factors Associated With Infarct-Related Artery Patency Before Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction (from the FAST-MI 2010 Registry).
- Author
-
Bailleul C, Puymirat E, Aissaoui N, Schiele F, Ducrocq G, Coste P, Blanchard D, Brasselet C, Elbaz M, Steg PG, Le Breton H, Bonnefoy-Cudraz E, Montalescot G, Cottin Y, Goldstein P, Ferrières J, Simon T, and Danchin N
- Subjects
- Coronary Vessels physiopathology, Female, Follow-Up Studies, France, Humans, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Myocardial Infarction therapy, Prospective Studies, Risk Factors, Vascular Patency, Coronary Angiography methods, Coronary Circulation physiology, Coronary Vessels diagnostic imaging, Electrocardiography, Myocardial Infarction diagnosis, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors therapeutic use, Preoperative Care methods
- Abstract
Early infarct-related artery (IRA) patency is associated with better clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Using the French Registry of ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated factors related to IRA patency (thrombolysis in myocardial infarction [TIMI] 2/3 flow) at the start of procedure in patients admitted for primary percutaneous coronary intervention. FAST-MI 2010 is a nationwide French registry including 4,169 patients with acute MI. Of 1,452 patients with STEMI with primary percutaneous coronary intervention, 466 (32%) had TIMI 2/3 flow of IRA before the procedure. Mean age (62 ± 14 years in both groups), Global Registry of Acute Coronary Event score (141 ± 31 vs 142 ± 34), and time from onset to angiography (472 ± 499 vs 451 ± 479 minutes) did not differ according to IRA patency (TIMI 2/3 vs TIMI 0/1). Using multivariate logistic regression analysis, IRA patency was more frequently found in patients having called earlier (time from onset to electrocardiogram [ECG] <120 minutes; odds ratio [OR] 1.49; 95% confidence interval [CI] 1.17 to 1.89), or receiving rapid-onset of action (prasugrel or glycoprotein IIb-IIIa) antiplatelet therapy in the prehospital setting (OR 1.59, 95% CI 1.14 to 2.21). Increasing time from diagnostic ECG to angiography was also associated with IRA patency (>90 minutes; OR 1.37, 95% CI 1.08 to 1.75). In conclusion, preprocedural IRA patency is observed in one third of patients with STEMI, it is more frequently found in patients having received fast-acting antiplatelet therapy before angiography, and in patients having called early. Higher IRA patency with increasing time delays from qualifying ECG to angiography suggests an additional role of spontaneous or medication-mediated fibrinolysis., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
10. Effectiveness of Pretreatment With Dual Oral Antiplatelet Therapy.
- Author
-
De Luca L, Danchin N, Valgimigli M, and Goldstein P
- Subjects
- Humans, Acute Coronary Syndrome therapy, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors therapeutic use, Premedication, Purinergic P2Y Receptor Antagonists therapeutic use
- Abstract
Several observational studies, randomized controlled trials, and meta-analyses suggested that pretreatment with clopidogrel in addition to aspirin could reduce the rate of ischemic events, especially in the setting of acute coronary syndromes. Newer P2Y12 inhibitors like prasugrel and ticagrelor, which provide faster and stronger platelet inhibition compared with clopidogrel, would enhance the benefits of pretreatment. However, 2 recent randomized trials, A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction and the Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST Elevation Myocardial Infarction to Open the Coronary Artery studies, aimed at assessing the effects of the timing of administration of novel P2Y12 inhibitors in acute coronary syndromes, failed to meet their primary end points. In this report, we review clinical data on pretreatment with dual oral antiplatelet therapy and comment on some criticisms raised from recent trials., (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
11. Effect of coronary thrombus aspiration during primary percutaneous coronary intervention on one-year survival (from the FAST-MI 2010 registry).
- Author
-
Puymirat E, Aissaoui N, Cottin Y, Vanzetto G, Carrié D, Isaaz K, Valy Y, Tchetche D, Schiele F, Steg PG, Simon T, and Danchin N
- Subjects
- Aged, Coronary Angiography, Coronary Thrombosis mortality, Female, France epidemiology, Humans, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction mortality, Propensity Score, Proportional Hazards Models, Suction methods, Survival Rate, Time-to-Treatment, Treatment Outcome, Coronary Thrombosis therapy, Myocardial Infarction therapy, Percutaneous Coronary Intervention methods, Registries, Thrombectomy methods
- Abstract
Results from randomized trials evaluating thrombus aspiration (TA) in patients with ST-elevation myocardial infarction (STEMI) are conflicting. We assessed 1-year survival in STEMI patients participating in the French Registry of Acute ST-Elevation and non-ST-Elevation Myocardial Infarction (FAST-MI) 2010 according to the use of TA during primary percutaneous coronary intervention (PCI). FAST-MI 2010 is a nationwide French registry that included 4,169 patients with acute myocardial infarction at the end of 2010 in 213 centers. Of those, 2,087 patients had STEMI, of whom 1,538 had primary PCI, with TA used in 671 (44%). Patients with TA were younger (61 ± 13.5 vs 63 ± 14 years), with a similar risk score of the Global Registry of Acute Coronary Events (140 ± 31 vs 143 ± 34) and a shorter median time from symptom onset (245 vs 285 minutes); location of acute myocardial infarction, history of myocardial infarction, PCI, or coronary artery bypass surgery did not differ significantly. Thirty-day mortality was 2.1% versus 2.1% (adjusted p = 0.18), and the rate of 1-year survival was 95.5% versus 94.8%. Using fully adjusted Cox multivariate analysis, hazard ratio for 1-year death was 1.13 (95% confidence interval 0.66 to 1.94). After propensity score matching (480 patients per group), 1-year survival was also similar with both strategies. In a real-world setting of patients admitted with STEMI, the use of TA during primary PCI was not associated with improved 1-year survival., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
12. Comparison of two antiplatelet therapy strategies in patients undergoing transcatheter aortic valve implantation.
- Author
-
Durand E, Blanchard D, Chassaing S, Gilard M, Laskar M, Borz B, Lafont A, Barbey C, Godin M, Tron C, Zegdi R, Chatel D, Le Page O, Litzler PY, Bessou JP, Danchin N, Cribier A, and Eltchaninoff H
- Subjects
- Aged, 80 and over, Female, Follow-Up Studies, France epidemiology, Heart Valve Prosthesis Implantation methods, Humans, Incidence, Male, Postoperative Complications, Prospective Studies, Stroke epidemiology, Survival Rate trends, Aortic Valve Stenosis therapy, Cardiac Catheterization standards, Heart Valve Prosthesis Implantation standards, Platelet Aggregation Inhibitors therapeutic use, Practice Guidelines as Topic, Stroke prevention & control
- Abstract
Dual antiplatelet therapy is commonly used in patients undergoing transcatheter aortic valve implantation (TAVI), but the optimal antiplatelet regimen is uncertain and remains to be determined. The objective of this study was to compare 2 strategies of antiplatelet therapy in patients undergoing TAVI. A strategy using monoantiplatelet therapy (group A, n = 164) was prospectively compared with a strategy using dual antiplatelet therapy (group B, n = 128) in 292 consecutive patients undergoing TAVI. The primary end point was a combination of mortality, major stroke, life-threatening bleeding (LTB), myocardial infarction, and major vascular complications at 30 days. All adverse events were adjudicated according to the Valve Academic Research Consortium. The primary end point occurred in 22 patients (13.4%) in the group A and in 30 patients (23.4%) in the group B (hazard ratio 0.51, 95% confidence interval 0.28 to 0.94, p = 0.026). LTB (3.7% vs 12.5%, p = 0.005) and major bleedings (2.4% vs 13.3%, p <0.0001) occurred less frequently in the group A, whereas the incidence of stroke (1.2% vs 4.7%, p = 0.14) and myocardial infarction (1.2% vs 0.8%, p = 1.0) was not significantly different between the 2 groups. The benefit of a strategy using mono versus dual antiplatelet therapy persisted after multivariate adjustment and propensity score analysis (hazard ratio 0.53, 95% confidence interval 0.28 to 0.95, p = 0.033). In conclusion, a strategy using mono versus dual antiplatelet therapy in patients undergoing TAVI reduces LTB and major bleedings without increasing the risk of stroke and myocardial infarction. The results of our study question the justification of dual antiplatelet therapy and require confirmation in a randomized trial., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
13. Presentation and revascularization patterns of patients admitted for acute coronary syndromes in France between 2004 and 2008 (from the National Observational Study of Diagnostic and Interventional Cardiac Catheterization [ONACI]).
- Author
-
Donataccio MP, Puymirat E, Vassanelli C, Blanchard D, le Breton H, Perier MC, Gilard M, Lefèvre T, Barragan P, Mulak G, Danchin N, Spaulding C, and Jouven X
- Subjects
- Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome epidemiology, Aged, Coronary Angiography, Electrocardiography, Female, Follow-Up Studies, France epidemiology, Hospital Mortality trends, Humans, Incidence, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Survival Rate trends, Acute Coronary Syndrome surgery, Cardiac Catheterization methods, Myocardial Revascularization methods, Postoperative Complications epidemiology, Registries
- Abstract
Patients with acute coronary syndrome (ACS) comprise a heterogeneous group. Despite clear guidelines, the management of ACS in clinical practice is variable. We aimed to evaluate clinical characteristics and myocardial revascularization patterns of patients presenting with ACS from a large French nationwide registry. The National Observational Study of Diagnostic and Interventional Cardiac Catheterization is a multicenter registry including all interventional cardiology procedures performed since 2004. Patient demographics and co-morbidities, invasive parameters, treatment options, and procedural techniques were prospectively collected. The present study is focused on data collected between 2004 and 2008. Patients were recruited in 99 hospitals (55% in private clinics, 45% in public institutions). Over a 5-year period, 64,932 patients with ACS were included (mean age 65.7 ± 13.3; 73% men, 31% ST-elevation myocardial infarction [STEMI]). Patients presenting with unstable angina pectoris and non-ST-elevation myocardial infarction weresimilar with regards to clinical presentation and coronary artery disease (CAD) extension. Overall, these patients were older, had a higher cardiovascular risk profile, and had more severe CAD compared with STEMI patients. In-hospital mortality during the first 24 hours was higher in STEMI patients. Patient's characteristics and CAD were highly dependent on the type of ACS. Patients with unstable angina/non-STEMI were older and had a more severe CAD. In-hospital complications were higher in STEMI patients., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
14. Study design and baseline characteristics of the national observational study of diagnostic and interventional cardiac catheterization by the French Society of Cardiology.
- Author
-
Puymirat E, Blanchard D, Perier MC, PiaDonataccio M, Gilard M, Lefèvre T, Mulak G, le Breton H, Danchin N, Spaulding C, and Jouven X
- Subjects
- Aged, Aged, 80 and over, Exercise Test, Female, Follow-Up Studies, France, Humans, Male, Middle Aged, Prospective Studies, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome therapy, Angina Pectoris diagnosis, Angina Pectoris therapy, Angioplasty, Balloon, Coronary, Cardiac Catheterization methods, Coronary Angiography methods, Coronary Disease diagnosis, Coronary Disease therapy, Myocardial Ischemia diagnosis, Myocardial Ischemia therapy, Registries, Societies, Medical
- Abstract
The national observational study of diagnostic and interventional cardiac catheterization (ONACI) is a prospective multicenter registry of the French Society of Cardiology including all interventional cardiology procedures performed from 2004. We aimed to evaluate "real-world" management of patients with coronary artery disease in France from this registry. The present study was focused on data collected from 2004 to 2008. Patient demographics and co-morbidities, invasive parameters, treatment options, and procedural techniques were prospectively collected. Patients were recruited from 99 hospitals (55% of patients were hospitalized in private clinics and 45% in public institutions). During a 5-year period, a total of 298,105 patients underwent coronary angiography and 176,166 patients underwent percutaneous coronary intervention. Diagnosis was acute coronary syndrome in 22%, stable angina or silent ischemia in 23%, and atypical chest pain in 9% of cases. Normal coronary arteries or nonsignificant coronary narrowing were found in 26% of patients. Radial access was increasingly used over the years regardless of the indication. The average number of percutaneous coronary interventions per procedure was 1.5 ± 0.7 (range, 1.3 ± 0.7 to 1.5 ± 0.7) and that of stents per procedure was 1.5 ± 0.8 (range, 1.5 ± 0.8 to 1.6 ± 0.8). Drug-eluting stents were used in 45% (range, 34% to 62%), increasing from 2004 to 2006, and then decreasing after the 2006 controversy. In conclusion, ONACI is one of the largest catheterization registries during this period, providing a detailed and comprehensive global description of the spectrum and management of patients with suspected coronary artery disease undergoing cardiac catheterization., (Copyright © 2013 Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
15. Comparison of efficacy and safety of a standard versus a loading dose of clopidogrel for acute myocardial infarction in patients ≥ 75 years of age (from the FAST-MI registry).
- Author
-
Puymirat E, Aïssaoui N, Coste P, Dentan G, Bataille V, Drouet E, Mulak G, Carrié D, Blanchard D, Simon T, and Danchin N
- Subjects
- Aged, Aged, 80 and over, Analysis of Variance, Blood Transfusion statistics & numerical data, Clopidogrel, Female, France epidemiology, Hemorrhage epidemiology, Hospital Mortality, Humans, Male, Myocardial Infarction mortality, Proportional Hazards Models, Registries, Risk Factors, Survival Rate, Ticlopidine administration & dosage, Treatment Outcome, Myocardial Infarction drug therapy, Platelet Aggregation Inhibitors administration & dosage, Ticlopidine analogs & derivatives
- Abstract
Data are lacking on the efficacy and safety of a loading dose (LD) of clopidogrel in elderly patients with acute myocardial infarction (AMI). FAST-MI is a nationwide registry that was carried out over a 1-month period in 2005 and included consecutive patients with AMI admitted to intensive care units <48 hours from symptom onset in 223 participating centers. We assessed the impact of a clopidogrel LD (≥300 mg) compared to a conventional dose (<300 mg) on bleeding, need for blood transfusion, and 30-day and 12-month survivals in 791 elderly patients (≥75 years old, mean age 81 ± 4 years, 48% women, 35% with ST-segment elevation MI) included in this registry. Fifty-nine percent (466 patients) received a clopidogrel LD. Follow-up was >99% complete. Major bleeding and blood transfusions were not significantly different in patients who received a clopidogrel LD (3.2% vs 3.7%, p = 0.72; 5.4% vs 6.2%, p = 0.64, respectively). Early mortality was also not significantly different (10.1 vs 10.8, p = 0.76). Using multivariate analyses, clopidogrel LD did not significantly affect major bleeding or transfusion (odds ratio 1.03, 95% confidence interval 0.49 to 2.17, p = 0.94) and 12-month mortality (hazard ratio 1.00, 95% confidence interval 0.72 to 1.40, p = 0.98). In conclusion, the present data showed that in elderly patients admitted for AMI, use of a LD of clopidogrel compared to a conventional dose was not associated with increased in-hospital bleeding, need for transfusion, or mortality. Large-scale randomized trials are still needed to identify the optimal LD of clopidogrel for elderly patients admitted for AMI., (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
16. Clinical benefits of a metabolic approach with trimetazidine in revascularized patients with angina.
- Author
-
Danchin N
- Subjects
- Angina Pectoris metabolism, Angina Pectoris surgery, Electrocardiography drug effects, Humans, Postoperative Period, Treatment Outcome, Angina Pectoris drug therapy, Myocardial Revascularization, Trimetazidine therapeutic use, Vasodilator Agents therapeutic use
- Abstract
As patients with coronary artery disease live longer and more often reach the stage where further myocardial revascularization procedures can no longer be performed, efficacious and well-tolerated antianginal medications are needed. Metabolic agents offer the advantage of controlling symptoms without untoward hemodynamic effects. This article reviews the epidemiology of stable angina and the use of antianginal medications in patients who have undergone myocardial revascularization. It also describes the clinical data on the anti-ischemic effects of metabolic agents in patients undergoing coronary artery bypass surgery or angioplasty, the latter in the setting of acute myocardial infarction and elective procedures. Lastly, the effects of trimetazidine on exercise tests in previously revascularized patients treated with beta-blockers, such as documented in the subgroup analysis of the Second Trimetazidine in Poland (TRIMPOL II) trial, are reported. In all, metabolic agents are likely to be beneficial in revascularized patients, with a documented anti-ischemic effect during myocardial revascularization procedures and the ability to improve exercise tolerance and symptoms in patients with chronic stable angina, despite myocardial revascularization.
- Published
- 2006
- Full Text
- View/download PDF
17. Effect of reperfusion therapy on long-term outcome in patients >70 years of age.
- Author
-
Danchin N, Angioi M, Demicheli T, Vaur L, Genes N, Ferrieres J, Etienne S, and Cambou JP
- Subjects
- Aged, Female, France, Health Services for the Aged, Humans, Intensive Care Units, Longitudinal Studies, Male, Proportional Hazards Models, Prospective Studies, Registries, Stroke Volume, Survival Analysis, Myocardial Infarction therapy, Myocardial Reperfusion mortality, Outcome Assessment, Health Care
- Published
- 2002
- Full Text
- View/download PDF
18. Comparison of effects of ioxaglate versus iomeprol on histamine and tryptase release in patients with ischemic cardiomyopathy.
- Author
-
Rodriguez RM, Guéant JL, Gastin IA, Angioi M, Abdelmoutaleb I, Saint-Laudy J, Gérard P, Namour F, Grentzinger A, Romano A, Juillière Y, and Danchin N
- Subjects
- Basophils immunology, Case-Control Studies, Female, Histamine Release drug effects, Humans, Iopamidol immunology, Male, Mast Cells immunology, Middle Aged, Prospective Studies, Tryptases, Contrast Media pharmacology, Coronary Angiography, Inflammation Mediators metabolism, Iopamidol analogs & derivatives, Ioxaglic Acid immunology, Myocardial Ischemia diagnostic imaging, Myocardial Ischemia immunology, Serine Endopeptidases metabolism
- Abstract
We observed a release of histamine, but not of tryptase, in arterial blood from 64 patients with ischemic heart disease and 24 patients without coronary disease, which was provoked by ioxaglate, a ionic compound, but was not provoked by iomeprol, a non-ionic radiocontrast compound. The release of histamine in arterial blood after ionic contrast medium injection was higher in patients with ischemic heart disease compared with patients without coronary disease, suggesting that an increased release from heart mast cells previously observed exists also for systemic blood basophils.
- Published
- 2001
- Full Text
- View/download PDF
19. Prognostic significance of angina pectoris > or = 30 days before acute myocardial infarction in patients > or = 75 years of age.
- Author
-
Jacquemin L, Danchin N, Suty-Selton C, Grentzinger A, Juilliere Y, Angioï M, and Cherrier F
- Subjects
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Multivariate Analysis, Myocardial Infarction complications, Prognosis, Retrospective Studies, Time Factors, Angina Pectoris complications, Myocardial Infarction mortality
- Abstract
We compared the prognostic significance of prior angina pectoris in 151 patients > or = 75 years of age admitted for acute myocardial infarction. There was a similar in-hospital course, but the long-term outcome was poorer in patients with prior angina.
- Published
- 1997
- Full Text
- View/download PDF
20. Changes in immediate outcome of percutaneous transluminal coronary angioplasty in multivessel coronary artery disease in 1990 to 1991 versus 1994 to 1995.
- Author
-
Danchin N, Angioï M, Cador R, Cuillière M, Juillière Y, Ethevenot G, Bischoff N, and Cherrier F
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Angioplasty, Balloon, Coronary, Coronary Disease therapy
- Abstract
Coronary angioplasty has undergone major technical changes since the period of inclusion in the randomized trials, comparing it with surgery, particularly with the increased use of coronary stents. This study shows improved in-hospital outcome in terms of primary success and complication rates in patients treated with coronary angioplasty for multivessel disease from 1994 to 1995, compared with the 1990 to 1991 period.
- Published
- 1997
- Full Text
- View/download PDF
21. Effect of late percutaneous angioplastic recanalization of total coronary artery occlusion on left ventricular remodeling, ejection fraction, and regional wall motion.
- Author
-
Danchin N, Angioï M, Cador R, Tricoche O, Dibon O, Juillière Y, Cuillière M, and Cherrier F
- Subjects
- Aged, Coronary Angiography, Coronary Disease diagnostic imaging, Coronary Disease etiology, Coronary Disease physiopathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Contraction physiology, Myocardial Infarction complications, Myocardial Infarction physiopathology, Recurrence, Stroke Volume, Angioplasty, Balloon, Coronary, Coronary Disease therapy, Ventricular Function, Left physiology
- Abstract
The clinical benefit of late recanalization of complete coronary occlusion is debated. Left ventricular (LV) function and volumes are major prognostic determinants in patients with coronary artery disease. We sought to assess comprehensively the evolution of global and regional LV function and LV volumes after percutaneous recanalization of chronic complete coronary artery occlusions. A consecutive series of 55 patients who underwent successful percutaneous recanalization of a chronic (> or = 10 days), total (Thrombolysis in Myocardial Infarction trial flow grade 0) occlusion of the left anterior descending or dominant right coronary arteries, and in whom a complete angiographic evaluation was available before angioplasty and at follow-up was studied. At follow-up, 38 patients had a patent artery (group 1) and 17 had a reocclusion (group 2). Baseline parameters were similar in the 2 groups. In group 1, LV ejection fraction increased from 55 +/- 14% to 62 +/- 13% (p <0.001), with an increase in fractional shortening in the occluded artery territory (0.43 +/- 0.30 to 0.71 +/- 0.34, p <0.001), while LV end-diastolic volume remained unchanged. In group 2, ejection fraction and regional wall motion were unchanged, while LV end-diastolic volume index increased (86 +/- 22 ml/m2 to 99 +/- 34 ml/m2, p <0.02). The evolution in LV global and regional function was similar in patients with or without previous myocardial infarction; however, prevention of LV remodeling was observed only in patients with previous infarction. Maintained potency after successful recanalization of totally occluded coronary arteries improves global and regional LV function and, in patients with previous myocardial infarction, avoids LV remodeling.
- Published
- 1996
- Full Text
- View/download PDF
22. Balloon angioplasty versus rotational angioplasty in chronic coronary occlusions (the BAROCCO study).
- Author
-
Danchin N, Cassagnes J, Juillière Y, Machecourt J, Bassand JP, LaBlanche JM, and Cherrier F
- Subjects
- Aged, Coronary Disease surgery, Cross-Over Studies, Female, Humans, Male, Middle Aged, Treatment Outcome, Angioplasty, Balloon, Coronary, Atherectomy, Coronary, Coronary Disease therapy
- Abstract
Chronic total coronary occlusion remains one of the limitations of percutaneous transluminal coronary angioplasty, and few therapeutic devices are specifically designed to address this problem. Among such devices, low-speed rotational angioplasty could improve the primary success rate of the procedure but has never been studied in a controlled trial. One hundred consecutive patients with total coronary occlusion (duration 10 days to 1 year) and an indication for myocardial revascularization were randomized to either rotational or conventional angioplasty if the occlusion morphology was judged suitable for either technique. All baseline variables were evenly distributed among the 2 groups. The primary success rate in the rotational angioplasty groupø was 66% (33 of 50) compared with 52% (26 of 50) in the conventional angioplasty group before crossover to the rotational technique (p=NS). According to lesion morphology, the respective primary success rates were 77% (10 of 13) versus 92% (11 of 12) for tapered occlusions (p=NS), and 61% (22 of 36) versus 38% (14 of 37) for "stump-like" occlusions (p < 0.05). After taking into account the crossovers after failed conventional angioplasty, there was no benefit in performing rotational angioplasty first versus conventional angioplasty first (primary success rates 66% vs 60%, p=NS). Thus, in chronic coronary occlusions of tapered morphology, rotational angioplasty is not superior to conventional angioplasty. In stump-like occlusions, the primary success rate is higher with the rotational angioplasty technique; however ther is a disadvantage in using rotational angioplasty as a second-line device if the conventional technique is unsuccessful.
- Published
- 1995
- Full Text
- View/download PDF
23. Spiral-computed tomography versus pulmonary angiography in the diagnosis of acute massive pulmonary embolism.
- Author
-
Blum AG, Delfau F, Grignon B, Beurrier D, Chabot F, Claudon M, Danchin N, and Regent D
- Subjects
- Acute Disease, Adolescent, Adult, Aged, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Prospective Studies, Pulmonary Artery diagnostic imaging, Pulmonary Embolism diagnostic imaging, Tomography, X-Ray Computed methods
- Published
- 1994
- Full Text
- View/download PDF
24. Comparison of right ventricular systolic function in idiopathic dilated cardiomyopathy and healed anterior wall myocardial infarction associated with atherosclerotic coronary artery disease.
- Author
-
Juillière Y, Buffet P, Marie PY, Berder V, Danchin N, and Cherrier F
- Subjects
- Cardiomyopathy, Dilated epidemiology, Case-Control Studies, Coronary Artery Disease complications, Coronary Artery Disease epidemiology, Female, Humans, Male, Middle Aged, Myocardial Infarction complications, Myocardial Infarction epidemiology, Prospective Studies, Pulmonary Wedge Pressure physiology, Stroke Volume physiology, Thermodilution, Cardiomyopathy, Dilated physiopathology, Coronary Artery Disease physiopathology, Myocardial Infarction physiopathology, Systole physiology, Ventricular Function, Right physiology
- Abstract
A case-controlled study assessed right ventricular (RV) systolic function in 10 patients with idiopathic dilated cardiomyopathy (IDC) and in 10 with healed anterior wall myocardial infarction associated with atherosclerotic coronary artery disease (CAD). Each patient was matched for sex, left ventricular ejection fraction +/- 5% and pulmonary artery mean pressure +/- 5 mm Hg. All patients had sinus rhythm and a left ventricular ejection fraction < 45%. A new, well-validated thermodilution technique was used to assess RV ejection fraction and volumes. RV ejection fraction was lower in the IDC than in the CAD group (25 +/- 14% vs 36 +/- 11%; p < 0.02). Linear correlations between RV parameters and pulmonary artery pressure were significantly present in both groups. However, the slopes of the equations were not statistically different. In comparison with healed anterior wall myocardial infarction with CAD and for similar levels of left ventricular dysfunction, RV systolic function appeared to be more altered in IDC.
- Published
- 1994
- Full Text
- View/download PDF
25. Usefulness of quantitative and qualitative angiographic lesion morphology, and clinical characteristics in predicting major adverse cardiac events during and after native coronary balloon angioplasty. CARPORT and MERCATOR Study Groups.
- Author
-
Hermans WR, Foley DP, Rensing BJ, Rutsch W, Heyndrickx GR, Danchin N, Mast G, Hanet C, Lablanche JM, and Rafflenbeul W
- Subjects
- Coronary Artery Bypass, Coronary Disease complications, Coronary Disease therapy, Female, Humans, Image Processing, Computer-Assisted, Male, Middle Aged, Recurrence, Risk Factors, Angioplasty, Balloon, Coronary adverse effects, Coronary Angiography methods, Coronary Disease diagnostic imaging, Death, Sudden, Cardiac etiology, Myocardial Infarction etiology
- Abstract
Major, adverse cardiac events (death, myocardial infarction, bypass surgery and reintervention) occur in 4 to 7% of all patients undergoing coronary balloon angioplasty. Prospectively collected clinical data, and angiographic quantitative and qualitative lesion morphologic assessment and procedural factors were examined to determine whether the occurrence of these events could be predicted. Of 1,442 patients undergoing balloon angioplasty for native primary coronary disease in 2 European multicenter trials, 69 had major, adverse cardiac procedural or in-hospital complications after > or = 1 balloon inflation and were randomly matched with patients who completed an uncomplicated in-hospital course after successful angioplasty. No quantitative angiographic variable was associated with major adverse cardiac events in univariate and multivariate analyses. Univariate analysis showed that major adverse cardiac events were associated with the following preprocedural variables: (1) unstable angina (odds ratio [OR] 3.11; p < 0.0001), (2) type C lesion (OR 2.53; p < 0.004), (3) lesion location at a bend > 45 degrees (OR 2.34; p < 0.004), and (4) stenosis located in the middle segment of the artery dilated (OR 1.88; p < 0.03); and with the following postprocedural variable: angiographically visible dissection (OR 5.39; p < 0.0001). Multivariate logistic analysis was performed to identify variables independently correlated with the occurrence of major adverse cardiac events. The preprocedural multivariate model entered unstable angina (OR 3.77; p < 0.0003), lesions located at a bend > 45 degrees (OR 2.87; p < 0.0005), and stenosis located in the middle portion of the artery dilated (OR 1.95; p < 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1993
- Full Text
- View/download PDF
26. Noninvasive estimation of right ventricular dP/dt in patients with tricuspid valve regurgitation.
- Author
-
Anconina J, Danchin N, Selton-Suty C, Isaaz K, Juilliere Y, Buffet P, Edel F, and Cherrier F
- Subjects
- Adult, Aged, Blood Flow Velocity, Blood Pressure, Cardiac Catheterization, Echocardiography, Doppler, Female, Humans, Male, Middle Aged, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency physiopathology, Ventricular Function, Right physiology
- Published
- 1993
- Full Text
- View/download PDF
27. Results of percutaneous transluminal coronary angioplasty of either the left anterior descending or left circumflex coronary artery in patients with chronic total occlusion of the right coronary artery.
- Author
-
Buffet P, Danchin N, Marc MO, Feldmann L, Juilliere Y, Anconina J, Selton-Suty C, Marie PY, and Cherrier F
- Subjects
- Constriction, Pathologic epidemiology, Constriction, Pathologic pathology, Constriction, Pathologic therapy, Coronary Angiography, Coronary Disease epidemiology, Coronary Disease pathology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Recurrence, Time Factors, Treatment Outcome, Ventricular Function, Left physiology, Angioplasty, Balloon, Coronary, Coronary Disease therapy, Coronary Vessels pathology
- Abstract
The acute and long-term results of percutaneous transluminal coronary angioplasty (PTCA) of the left coronary artery in 106 patients (group 1) with chronic occlusion of the right coronary artery were compared with those of 106 patients matched for sex (92 male) and age (56 +/- 10 years) undergoing left PTCA with a normal right coronary artery (group 2). Before the procedure, group 1 had more unstable angina (42 vs 29%; p < 0.05), more frequent prior myocardial infarction (80 vs 25%; p < 0.001), and a lower left ventricular ejection fraction (56 +/- 10% vs 65 +/- 11%; p < 0.005). Acute results were not different in the 2 groups with respect to primary success (group 1: 93%; and group 2: 89%) and complications (group 1: 2 with emergency coronary surgery, and 4 with periprocedural myocardial infarction and no death; and group 2: 1 with emergency coronary surgery, 1 death, and 3 with periprocedural myocardial infarction). At 6 months, 79 patients in group 1 and 71 patients in group 2 had reangiography; the rate of restenosis was 35% in group 1 and 42% in group 2. In both groups, left ventricular ejection fraction increased significantly in patients without restenosis (58 +/- 12% vs 63 +/- 10%, p < 0.001 [n = 44] in group 1; and 66 +/- 9% vs 70 +/- 10%, p < 0.001 [n = 29] in group 2). In group 1, improvement was significant only for patients without collaterals to the occluded right coronary artery (59 +/- 10% vs 66 +/- 7%; p < 0.003 [n = 24]).(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1993
- Full Text
- View/download PDF
28. Right ventricular overload and induced sustained ventricular tachycardia in operatively "repaired" tetralogy of Fallot.
- Author
-
Marie PY, Marçon F, Brunotte F, Briançon S, Danchin N, Worms AM, Robert J, and Pernot C
- Subjects
- Adolescent, Adult, Analysis of Variance, Cardiac Catheterization, Child, Child, Preschool, Female, Humans, Male, Radionuclide Ventriculography, Tachycardia physiopathology, Tetralogy of Fallot complications, Tetralogy of Fallot diagnostic imaging, Ventricular Function, Left, Tachycardia etiology, Tetralogy of Fallot physiopathology, Tetralogy of Fallot surgery, Ventricular Function, Right
- Abstract
The aim of the study was to evaluate the main predictors of the inducibility of sustained ventricular tachycardia (VT) in patients with repaired tetralogy of Fallot. Thirty-five patients (age 12 +/- 6 years) underwent right-sided cardiac catheterization, echocardiography, radionuclide angiography and ventricular stimulation; 10 had (group 1) and 25 had no (group 2) sustained VT. Group 1 patients were significantly older at the time of surgery and had longer follow-up periods (7 +/- 3 vs 4 +/- 4 years, p less than 0.02; and 12 +/- 4 vs 5 +/- 2 years, p less than 0.001, respectively). Right ventricular (RV) systolic pressure, end-systolic and end-diastolic normalized RV volumes were higher in group 1 (48 +/- 14 vs 38 +/- 11 mm Hg, p less than 0.05; 1.23 +/- 0.2 vs 0.86 +/- 0.17, p less than 0.001; and 2.35 +/- 0.37 vs 1.70 +/- 0.22, p less than 0.001, respectively). RV end-diastolic pressure, left ventricular and RV ejection fractions were similar in the 2 groups. A stepwise discriminant analysis was made to predict patients with inducible sustained VT (group 1): Time period from surgery to follow-up (p less than 0.001), normalized RV end-systolic volume (p less than 0.002) and RV systolic pressure (p = 0.01) were higher in group 1 and allowed classification of 90% of patients in group 1 and 96% in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1992
- Full Text
- View/download PDF
29. Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries.
- Author
-
Juillière Y, Marie PY, Danchin N, Karcher G, Bertrand A, and Cherrier F
- Subjects
- Aged, Angina Pectoris complications, Angina Pectoris diagnostic imaging, Arterial Occlusive Diseases complications, Arterial Occlusive Diseases diagnostic imaging, Chronic Disease, Coronary Disease complications, Coronary Disease diagnostic imaging, Electrocardiography, Exercise Test, Female, Follow-Up Studies, Humans, Male, Middle Aged, Radionuclide Ventriculography, Stroke Volume, Thallium Radioisotopes, Angina Pectoris physiopathology, Arterial Occlusive Diseases physiopathology, Collateral Circulation, Coronary Disease physiopathology, Ventricular Function, Left
- Abstract
Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery with well-developed collateral vessels. Five patients were successfully treated by coronary bypass grafting and 3 by coronary angioplasty. Among the 16 medically treated patients, 1 was lost to follow-up and 1 died (extracardiac death). The mean (+/- standard deviation) follow-up (14 patients) was 48 +/- 15 months. At follow-up, 8 patients still had clinical chest pain, 11 received antianginal therapy, 4 patients had no stress ischemia and the other 10 had greater than or equal to 1 sign of stress ischemia. All patients had a normal LV ejection fraction at rest (mean 60 +/- 3%; range 55 to 65%). Collateral circulation preserves LV function at the time of occlusion and, in some cases, prevents the development of myocardial ischemia; in patients with persisting myocardial ischemia after well-collateralized coronary occlusion, LV function is not impaired at long-term follow-up.
- Published
- 1991
- Full Text
- View/download PDF
30. Comparative effects of oral molsidomine and nifedipine on methylergometrine-induced coronary artery spasm.
- Author
-
Danchin N, Juillière Y, Anconina J, Perrin O, Selton-Suty C, and Cherrier F
- Subjects
- Coronary Angiography, Coronary Vasospasm chemically induced, Coronary Vessels drug effects, Double-Blind Method, Ergonovine analogs & derivatives, Female, Humans, Male, Middle Aged, Coronary Vasospasm drug therapy, Molsidomine therapeutic use, Nifedipine therapeutic use
- Abstract
Twelve consecutive patients (10 men and 2 women, mean +/- standard deviation age 49 +/- 9 years) with chest pain, angiographically normal coronary arteries and coronary artery spasm documented by methylergometrine testing received a single oral dose of molsidomine (4 mg) or nifedipine (10 mg) in a randomized, double-blind, crossover fashion at a 24-hour interval. Coronary artery spasm was documented during coronary angiography in 6 patients (left anterior descending artery, 3; right coronary artery, 2; left circumflex, 1). In the remaining 6 patients, coronary artery spasm was documented by a positive methylergometrine test performed at the bedside, which provoked ST-segment elevation in the inferior (n = 3), anterior (n = 1) or lateral (n = 2) leads. Ninety minutes after administration of the study medication, methylergometrine testing was performed at the bedside, using incremental doses of up to 0.4 mg of methylergometrine. After molsidomine, 10 patients (83%) had a negative and 2 had a positive test; after nifedipine, 9 patients (75%) had a negative and 3 a positive test. Only 1 patient had a methylergometrine test that remained positive after either molsidomine or nifedipine. Therefore, molsidomine appears as effective as nifedipine in suppressing methylergometrine-induced coronary artery spasm in patients with variant angina. In addition, patients not responding to 1 of the study medications may respond to the other.
- Published
- 1991
- Full Text
- View/download PDF
31. Role of previous angina pectoris and collateral flow to preserve left ventricular function in the presence or absence of myocardial infarction in isolated total occlusion of the left anterior descending coronary artery.
- Author
-
Juillière Y, Danchin N, Grentzinger A, Suty-Selton C, Lethor JP, Courtalon T, Pernot C, and Cherrier F
- Subjects
- Angiography, Coronary Angiography, Coronary Circulation physiology, Female, Humans, Male, Middle Aged, Myocardial Contraction physiology, Stroke Volume physiology, Time Factors, Angina Pectoris physiopathology, Collateral Circulation physiology, Coronary Disease physiopathology, Myocardial Infarction physiopathology
- Abstract
The aim of this study was to determine whether previous angina pectoris and collateral circulation influenced myocardial function after isolated coronary occlusion. In 58 consecutive patients, coronary angiography showed a complete isolated occlusion of the left anterior descending coronary artery; 43 patients (74%) had previous myocardial infarction. Duration of previous angina pectoris was defined as the time from the first ischemic symptom to the date of myocardial infarction or of coronary angiography in the absence of myocardial infarction. Left ventricular ejection fraction was measured on the 30 degrees right anterior oblique projection of the left ventricular angiogram. Collateral circulation was graded as follows: none or filling limited to side branches (group 1) and partial or complete filling of the epicardial arterial segment (group 2). Group 2 (40 patients) had higher ejection fraction (57 vs 38%; p less than 0.0001) and longer duration of previous angina pectoris (11 vs 0.1 months; p less than 0.002) than group 1 (18 patients). A longer duration of previous angina pectoris probably allows collateral development before coronary occlusion in 1-vessel coronary artery disease, thereby limiting myocardial damage.
- Published
- 1990
- Full Text
- View/download PDF
32. Right ventricular function during transient myocardial ischemia induced by percutaneous transluminal angioplasty of the proximal right coronary artery.
- Author
-
Danchin N, Juilliere Y, Schrijen F, and Cherrier F
- Subjects
- Cardiac Volume, Coronary Disease physiopathology, Coronary Disease therapy, Humans, Male, Middle Aged, Angioplasty, Balloon adverse effects, Coronary Circulation, Coronary Vessels, Stroke Volume
- Published
- 1989
- Full Text
- View/download PDF
33. Intracoronary streptokinase for acute myocardial infarction.
- Author
-
Danchin N
- Subjects
- Coronary Vessels, Humans, Injections, Myocardial Infarction drug therapy, Streptokinase administration & dosage
- Published
- 1986
- Full Text
- View/download PDF
34. Assessment of right ventricular outflow tract in children by two-dimensional echocardiography using a new subcostal view. Angiocardiographic and morphologic correlative study.
- Author
-
Isaaz K, Cloez JL, Danchin N, Marçon F, Worms AM, and Pernot C
- Subjects
- Angiocardiography, Child, Child, Preschool, Heart Defects, Congenital diagnostic imaging, Heart Ventricles physiopathology, Humans, Infant, Infant, Newborn, Stroke Volume, Echocardiography methods, Heart physiopathology, Heart Defects, Congenital physiopathology
- Abstract
Evaluation of the right ventricular (RV) outflow tract in congenital heart disease is extremely important for surgical management. Therefore, the value of 2-dimensional echocardiography (2-D echo) to assess the RV outflow tract was studied using a new approach: the subcostal elongated right oblique view. Twenty normal children and 49 children with congenital heart disease, aged 1 day to 11 years, were studied. Significant pulmonary infundibular obstruction was present in 22 patients with conotruncal malformations. To obtain the subcostal elongated right oblique view from the short-axis view at the aortic valve level, the transducer was slightly rotated clockwise with an anterior angulation of about 30 degrees so that the ascending aorta was seen in its long axis, providing an image similar to that obtained by a right ventriculogram in the elongated right anterior oblique view. The deviation of infundibular septum was appreciated by measurement of the angle alpha, defined by the long axis of the infundibular septum and the plane of aortic cusps. This view could be obtained in 64 patients (92%). In correlation with angiographic or anatomic data, the subcostal elongated right oblique view permitted recognition of several types of RV outflow tract: type I--normally formed RV outflow tract; type II--disorganized RV outflow tract with obstruction (alpha less than 90 degrees); type III and IV--disorganized RV outflow tract with obstruction (alpha greater than 90 degrees). This view could visualize the crista supraventricularis in type I, but also the anatomic components of RV outflow tract that may contribute to obstruction in the other types: infundibular septum, septoparietal trabeculations and trabecula septomarginalis.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1985
- Full Text
- View/download PDF
35. Significance of spontaneous obstruction of high degree coronary artery stenoses between diagnostic angiography and later percutaneous transluminal coronary angioplasty.
- Author
-
Danchin N, Oswald T, Voiriot P, Juillière Y, and Cherrier F
- Subjects
- Angiography, Collateral Circulation, Constriction, Pathologic pathology, Coronary Disease diagnostic imaging, Coronary Disease therapy, Coronary Vessels pathology, Female, Humans, Male, Middle Aged, Risk Factors, Time Factors, Angioplasty, Balloon, Coronary Angiography, Coronary Disease pathology
- Abstract
Among 265 patients with severe coronary artery stenoses amenable to percutaneous transluminal coronary angioplasty, 13 (5%) developed new total coronary occlusion of the vessel to be dilated during the period between diagnostic coronary angiography and repeat coronary angiography at the time of the operation. Time from diagnostic to "therapeutic" angiography (76 +/- 74 vs 31 +/- 31 days, p less than 0.0001), degree of coronary stenosis on diagnostic angiography (85 +/- 7 vs 80 +/- 8%, p less than 0.05) and impaired coronary flow distal to the narrowing (Thrombolysis in Myocardial Infarction grade 2: 38 vs 10%, p less than 0.01) were the only variables related to the occurrence of spontaneous coronary occlusion. The clinical course of the patients who developed new total coronary occlusion was remarkably favorable. Twelve of the 13 patients had unchanged or improved anginal symptoms. The electrocardiogram at rest remained unchanged in 11 patients and there was no transmural myocardial infarction. Eight patients had 2 ventriculograms and the mean ejection fraction remained unchanged (only 2 patients had greater than 5% decrease in ejection fraction between the 2 examinations). Spontaneous occlusion of high degree coronary artery stenoses is not unusual and is usually well tolerated, presumably due to the development of collateral circulation.
- Published
- 1989
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.