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1. Left atrial structure and function in atrial fibrillation: ENGAGE AF-TIMI 48

Author

Gupta, Deepak K, Shah, Amil M, Giugliano, Robert P, Ruff, Christian T, Antman, Elliott M, Grip, Laura T, Deenadayalu, Naveen, Hoffman, Elaine, Patel, Indravadan, Shi, Minggao, Mercuri, Michele, Mitrovic, Veselin, Braunwald, Eugene, Solomon, Scott D, Blanc, Jean-Jacques, Cardiovascular Division (SZG), Brigham and Women's Hospital [Boston], Cardiovascular Division, Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Male, medicine.medical_specialty, Pyridines, [SDV]Life Sciences [q-bio], Left atrial structure, Population, 030204 cardiovascular system & hematology, Ventricular Function, Left, Stroke risk, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Left atrial, Internal medicine, Atrial Fibrillation, Humans, Medicine, Sinus rhythm, Heart Atria, Prospective Studies, 030212 general & internal medicine, FASTTrack Clinical Research, education, Stroke, Aged, education.field_of_study, Ventricular Remodeling, business.industry, Anticoagulants, Stroke Volume, Atrial fibrillation, medicine.disease, Thiazoles, Echocardiography, Cardiology, Atrial Function, Left, Female, Cardiology and Cardiovascular Medicine, business, TIMI
Abstract

Aims The complex relationship between left atrial (LA) structure and function, electrical burden of atrial fibrillation (AF) and stroke risk is not well understood. We aimed to describe LA structure and function in AF. Methods and results Left atrial structure and function was assessed in 971 subjects enrolled in the echocardiographic substudy of ENGAGE AF-TIMI 48. Left atrial size, emptying fraction (LAEF), and contractile function were compared across AF types (paroxysmal, persistent, or permanent) and CHADS2 scores as an estimate of stroke risk. The majority of AF patients (55%) had both LA enlargement and reduced LAEF, with an inverse relationship between LA size and LAEF ( R = −0.57, P < 0.001). With an increasing electrical burden of AF and higher CHADS2 scores, LA size increased and LAEF declined. Moreover, 19% of AF subjects had impaired LAEF despite normal LA size, and LA contractile dysfunction was present even among the subset of AF subjects in sinus rhythm at the time of echocardiography. Conclusions In a contemporary AF population, LA structure and function were increasingly abnormal with a greater electrical burden of AF and higher stroke risk estimated by the CHADS2 score. Moreover, LA dysfunction was present despite normal LA size and sinus rhythm, suggesting that the assessment of LA function may add important incremental information in the evaluation of AF patients. Clinical Trial Registration: ; ID = [NCT00781391][1]. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00781391&atom=%2Fehj%2F35%2F22%2F1457.atom

Published
2013

2. Characteristics of a large sample of candidates for permanent ventricular pacing included in the Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization Study (BioPace)

Author

Funck, Reinhard C, Mueller, Hans-Helge, Lunati, Maurizio, Piorkowski, Christopher, De Roy , Luc, Paul, Vince, Wittenberg, Michael, Wuensch, David, Blanc, Jean-Jacques, BioPace study group, and UCL - (MGD) Service de cardiologie

Subjects
Male, medicine.medical_specialty, Comorbidity, law.invention, Cardiac Resynchronization Therapy, Atrial tachyarrhythmias, Age Distribution, Risk Factors, law, Physiology (medical), Internal medicine, Atrial Fibrillation, Bradycardia, Prevalence, medicine, Humans, cardiovascular diseases, Structural heart disease, Sex Distribution, Systole, Atrioventricular Block, Atrial tachycardia, Aged, Ejection fraction, Left bundle branch block, business.industry, Left ventricular function, Permanent ventricular pacing, Dilated cardiomyopathy, Atrial fibrillation, medicine.disease, Europe, Survival Rate, Sample Size, Anesthesia, QRS width, cardiovascular system, Cardiology, Artificial cardiac pacemaker, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Atrioventricular block
Abstract

Aims: The general clinical profile of European pacemaker recipients who require predominant ventricular pacing (VP) is scarcely known. We examined the demographic and clinical characteristics of the 1808 participants (out of 1833 randomized patients) of the ongoing Biventricular Pacing for Atrio-ventricular Block to Prevent Cardiac Desynchronization (BioPace) study. Methods and results: BioPace recruited patients between May 2003 and September 2007 predominantly in European medical centres. We analysed demographic data and described clinical characteristics and electrophysiological parameters prior to device implantation in 1808 enrolled patients. The mean age ± standard deviation (SD) of the 1808 patients was 73.5 ± 9.2 years, 1235 (68%) were men, 654 (36%) presented without structural heart disease, 547 (30%) had ischemic, 355 (20%) hypertensive, 146 (8%) valvular, and 102 (6%) non-ischemic dilated cardiomyopathy. Mean left ventricular ejection fraction was 55.4 ± 12.3%. The main pacing indications were (a) permanent and intermittent atrioventricular (AV) block in 973 (54%), (b) atrial fibrillation with slow ventricular rate in 313 (17%), and (c) miscellaneous bradyarrhythmias in 522 (29%) patients. Mean QRS duration was 118.5 ± 30.5 ms, left bundle branch block was present in 316 (17%), and atrial tachyarrhythmias in 426 (24%) patients. Conclusion: To the best of our knowledge, this sample is a representative source of description of the general profile of European pacemaker recipients who require predominant VP. Patients' characteristics included advanced age, predominantly male gender, preserved left ventricular systolic function, high-grade AV block, narrow QRS complex, and atrial tachyarrhythmias, the latter being present in nearly one-fourth of the cohort

Published
2013

4. Management and outcome of patients with established coronary artery disease: the Euro Heart Survey on coronary revascularization

Author

Lenzen, M. J., Boersma, E., Bertrand, M. E., Maier, W., Moris, C., Piscione, F., Sechtem, U., Stahle, E., Widimsky, P., De Jaegere, P., Scholte Op Reimer, W. J. M., Mercado, N., Wijns, W., Meier, B., Sergeant, P., Vos, J., Unger, F., Manini, Malika, Bramley, Claire, Laforest, Valérie, Taylor, Charles, Del Gaiso, Susan, Huber, Kurt, De Backer, Guy, Sirakova, Vera, Cerbak, Roman, Thayssen, Per, Lehto, Seppo, Blanc, Jean-Jacques, Delahaye, François, Kobulia, Bondo, Zeymer, Uwe, Cokkinos, Dennis, Karlocai, Kristof, Graham, Ian, Shelley, Emer, Behar, Shlomo, Maggioni, Aldo, Grabauskiene, Virginija, Deckers, Jaap, Asmussen, Inger, Stepinska, Janina, Gonçalves, Lino, Mareev, Vyacheslav, Riecansky, Igor, Kenda, Miran F., Alonso, Angeles, Lopez-Sendon, José Luis, Rosengren, Annika, Buser, Peter, Okay, Tugrul, Sychov, Oleg, Fox, Kevin, Wood, David, Boersma, Eric, Crijns, Harry, Fox, Kim, McGregor, Keith, Mulder, Barbara, Priori, Sylvia, Rydén, Lars, Tavazzi, Luigi, Vahanian, Alec, Vardas, Panos, Wijns, William, Sarkisyan, Karine, Glogar, H. D., Derntl, Michael, Frick, Matthias, Pachinger, O., Zwick, Ralf, Vrints, Christiaan, Van Hertbruggen, Els, Vercammen, Marc, Sysmans, Tineke, Schroeder, E., Domange, Juliette, De Pril, Hilde, De Vriese, Johan, Van Hecke, Tonny, Legrand, V., Gillon, Marie-France, Richardy, Michel, Doneux, P., Petrov, Ivo, Jorgova, J., Starcevic, Boris, Eeckhout, Eric, Berger, Alexandre, Prudent, Veronique, Camenzind, E., Masson, Nicolas, Zambartas, Costas, Kleanthous, Helen, Widimsky, Petr, Stellova, Blanka, Aschermann, Michael, Simek, Stanislav, Kautzner, J., Karmazin, Vladimir, Svab, P., Indrak, Jan, Branny, M., Hladilova, Kveta, Kala, P., Thayssen, P., Cappelen, Helle, Jensen, Lisette Okkels, Gitt, A., Gehrke, Konstanze, Erbel, R., Gutersohn, Achim, Eggebrecht, Holger, Al Khani, Murad, Sechtem, Udo, Rosenberger, Antje, Vogelsberg, Holger, Klepzig, H., Schmidt, Arnold, Silber, Sigmund, Mau, Birgit, Leuner, Christian, Czyborra, Karen, Reuschling, Christina, Muno, Eva, Kleber, F., Rux, Sascha, Zeymer, U., Saad, Aly, Ibrahim, B. S. S., Elabady, Maged, Castro Beiras, A., Fernandez, Jorge Salgado, Navarro Del Arno, Felipe, Iniguez Romo, A., Cruz Fernandez, J. M., Mayoreal, Alejandro Recio, Rebanal, Franciso Javier Rivero, De La Borbolla, Mariano Garcia, Chaparro, Marinela, Brotons, C., Permanyer Miralda, C., Vilai Perez, Srta Irma, Moris, Cesar, Fernandez Aviles, F., De La Fuente Galan, Luis, Vinuela, Paula Tejedor, Malpartida De Torres, F., Mora, Javier, Rodriguez, Ignacio Santos, Bustamante, Itziar Piedra, Sanchez Fernandez, Pedro L., Diago Torrent, J. L., Diez Gil, Jose L., Perpinan, Javier, Palacios Motilla, V., Soledad Alcasena Juango, M., Berjon-Reyero, Jesus, Melgares Moreno, R., Guerrero, Juan Carlos Fernandez, Lehto, S., Savolainen, Kirsti, Nieminen, M. S., Syvanne, Mikko, Cohen-Solal, A., Oboa, Antoine-Sylvain, Bassand, J. P., Espinosa, Denis Pales, Jouet, Veronique, Montalescot, G., Gallois, Vanessa, Daubert, J. C., Clerc, Jean Michel, Machecourt, Jacques, Cottin, Y., Walker, D., Holland, Fhiona, Wood, D., Prosser, Jenni, Muir, Lis, Barber, Kate, Cleland, J. G. F., Cook, Jocelyn, Chapichadze, Zaza, Christos, Ioannis Skoularigisn Athanasiou, Tsiavou, Nastasia, Chrysohoou, Christina, Manginas, Athanassios, Terrovitis, John, Kanakakis, John, Vavuranakis, Manolis, Drakos, Stavros, Farmakis, Thomas, Samara, C., Papakosta, Christina, Bourantas, Christos, Michalis, L. K., Christos, Mpourantas, Foussas, Stefanos, Adamopoulou, Evdokia, Vardas, P. E., Marketou, Mary, Alotti, N., Basa, Anna Maria, Vigh, Andras, Preda, Istvan, Csoti, Eva, Keltai, M., Kerkovits, G., Hendler, Alberto, Blatt, Alex, Beyar, R., Shefer, Arie, Halon, David, Bentzvi, Margalait, Avramovitch, Naomi, Bakst, Avinoam, Cafri, Carlos, Grosbard, Aviva, Margolis, Bella, Suleiman, Khalid, Banai, Shmuel, Meerkin, David, Mosseri, Morris, Guita, Pnina, Jabara, Rifat, Jafari, Jamal, Ben Shitrit, Debi, Ghasan, null, Salameh, null, Brezins, Marc, Van Den Akker-Berman, Lily, Guetta, Victor, Rozenman, Yoseph, Biagini, A., Berti, Sergio, Ferrero, Massimo, Colombo, A., Roccaforte, R., Milici, Caterina, Scarpino, L., Salvi, A., Desideri, Alessandro, Sabbadin, Daniela, Galassi, Alfredo, Giuffrida, Giuseppe, Rognoni, Andrea, Vassanelli, Corrado, Paffoni, Paola, Cioppa, Angelo, Rubino, Paolo, De Carlo, Marco, Petronio, Anna Sonia, Naccarella, F., Saia, Francesco, Marzocchi, Antonio, Maranga, Stefano Sdringola, Presbitero, P., Valsecchi, Fazya, Piscione, Federico, Esposito, Giovanni, Santini, Napoli M., Tubaro, Marco, Erglis, A., Narbute, Inga, Kavoliuniene, Ausra, Zaliunas, R., Navickas, Ramunas, Grabauskiene, V., Luckute, Davia, Subkovas, Eduardas, Wagner, Daniel, Vermeer, F., Lousberg, Aimee, Fransen, Heidi, Breeman, Arno, Tebbe, Henriette, De Boer, M. J., Van Der Wal, Metske, Deckers, J., Vos, Jeroen, Leenders, C. M., Veerhoek, M. J., Jansen, Chris, Bijl, M., Koppelaar, Colinda, Van Den Linden, null, Brons, R., Widdershofen, J. W. M. G., Broers, Herman, Kontny, F., Jonzon, Marianne, Wodniecki, Jan, Tomasik, Andrzej, Trusz-Gluza, M., Nowak, Seweryn, Ruzyllo, Witold, Deptuch, Tomasz, Marques, Jorge, Matias, F., Madeira, H., Oliveira, Joaquim, Sargento, Luis, Ionac, Adina, Dragulescu, Iosif Stefan, Mut-Vitcu, Bogdan, Maximov, Daniela, Dorobantu, M., Apetrei, E., Niculescu, Rodica, Petrescu, Virgil, Bucsa, Adrian, Deleanu, Dan, Benedek, I. S., Hintea, Theodora, Aronov, D., Tikhomirova, Elena, Kranjec, I., Prokselj, Katja, Kanic, Vojko, Sepetoglu, Ahmet, Aytekin, S., Aytekin, V., Catakoglu, Alp Burak, Parlar, Hayri, Tufekcioglu, Suavi, Ozyedek, Zeki, Baltali, Mehmet, Kiziltan, null, Vukovic, Milan, Neskovic, A. N., Lenzen, M. J, Boersma, E, Bertrand, Me, Maier, W, Moris, C, Esposito, Giovanni, Piscione, Federico, Sechtem, U, Stahle, E, Widimsky, P, de Jaegere, P, Scholte op Reimer, W. J. M, Mercado, N, Wijns, W., University of Zurich, Wijns, W, Lenzen, M. J., Boersma, E., Bertrand, M. E., Maier, W., Moris, C., Piscione, F., Sechtem, U., Stahle, E., Widimsky, P., De Jaegere, P., Scholte Op Reimer, W. J. M., Mercado, N., Meier, B., Sergeant, P., Vos, J., Unger, F., Manini, Malika, Bramley, Claire, Laforest, Valérie, Taylor, Charle, Del Gaiso, Susan, Huber, Kurt, De Backer, Guy, Sirakova, Vera, Cerbak, Roman, Thayssen, Per, Lehto, Seppo, Blanc, Jean-Jacque, Delahaye, Françoi, Kobulia, Bondo, Zeymer, Uwe, Cokkinos, Denni, Karlocai, Kristof, Graham, Ian, Shelley, Emer, Behar, Shlomo, Maggioni, Aldo, Grabauskiene, Virginija, Deckers, Jaap, Asmussen, Inger, Stepinska, Janina, Gonçalves, Lino, Mareev, Vyacheslav, Riecansky, Igor, Kenda, Miran F., Alonso, Angele, Lopez-Sendon, José Lui, Rosengren, Annika, Buser, Peter, Okay, Tugrul, Sychov, Oleg, Fox, Kevin, Wood, David, Boersma, Eric, Crijns, Harry, Fox, Kim, Mcgregor, Keith, Mulder, Barbara, Priori, Sylvia, Rydén, Lar, Tavazzi, Luigi, Vahanian, Alec, Vardas, Pano, Wijns, William, Sarkisyan, Karine, Glogar, H. D., Derntl, Michael, Frick, Matthia, Pachinger, O., Zwick, Ralf, Vrints, Christiaan, Van Hertbruggen, El, Vercammen, Marc, Sysmans, Tineke, Schroeder, E., Domange, Juliette, De Pril, Hilde, De Vriese, Johan, Van Hecke, Tonny, Legrand, V., Gillon, Marie-France, Richardy, Michel, Doneux, P., Petrov, Ivo, Jorgova, J., Starcevic, Bori, Eeckhout, Eric, Berger, Alexandre, Prudent, Veronique, Camenzind, E., Masson, Nicola, Zambartas, Costa, Kleanthous, Helen, Widimsky, Petr, Stellova, Blanka, Aschermann, Michael, Simek, Stanislav, Kautzner, J., Karmazin, Vladimir, Svab, P., Indrak, Jan, Branny, M., Hladilova, Kveta, Kala, P., Thayssen, P., Cappelen, Helle, Jensen, Lisette Okkel, Gitt, A., Gehrke, Konstanze, Erbel, R., Gutersohn, Achim, Eggebrecht, Holger, Al Khani, Murad, Sechtem, Udo, Rosenberger, Antje, Vogelsberg, Holger, Klepzig, H., Schmidt, Arnold, Silber, Sigmund, Mau, Birgit, Leuner, Christian, Czyborra, Karen, Reuschling, Christina, Muno, Eva, Kleber, F., Rux, Sascha, Zeymer, U., Saad, Aly, Ibrahim, B. S. S., Elabady, Maged, Castro Beiras, A., Fernandez, Jorge Salgado, Navarro Del Arno, Felipe, Iniguez Romo, A., Cruz Fernandez, J. M., Mayoreal, Alejandro Recio, Rebanal, Franciso Javier Rivero, De La Borbolla, Mariano Garcia, Chaparro, Marinela, Brotons, C., Permanyer Miralda, C., Vilai Perez, Srta Irma, Moris, Cesar, Fernandez Aviles, F., De La Fuente Galan, Lui, Vinuela, Paula Tejedor, Malpartida De Torres, F., Mora, Javier, Rodriguez, Ignacio Santo, Bustamante, Itziar Piedra, Sanchez Fernandez, Pedro L., Diago Torrent, J. L., Diez Gil, Jose L., Perpinan, Javier, Palacios Motilla, V., Soledad Alcasena Juango, M., Berjon-Reyero, Jesu, Melgares Moreno, R., Guerrero, Juan Carlos Fernandez, Lehto, S., Savolainen, Kirsti, Nieminen, M. S., Syvanne, Mikko, Cohen-Solal, A., Oboa, Antoine-Sylvain, Bassand, J. P., Espinosa, Denis Pale, Jouet, Veronique, Montalescot, G., Gallois, Vanessa, Daubert, J. C., Clerc, Jean Michel, Machecourt, Jacque, Cottin, Y., Walker, D., Holland, Fhiona, Wood, D., Prosser, Jenni, Muir, Li, Barber, Kate, Cleland, J. G. F., Cook, Jocelyn, Chapichadze, Zaza, Christos, Ioannis Skoularigisn Athanasiou, Tsiavou, Nastasia, Chrysohoou, Christina, Manginas, Athanassio, Terrovitis, John, Kanakakis, John, Vavuranakis, Manoli, Drakos, Stavro, Farmakis, Thoma, Samara, C., Papakosta, Christina, Bourantas, Christo, Michalis, L. K., Christos, Mpouranta, Foussas, Stefano, Adamopoulou, Evdokia, Vardas, P. E., Marketou, Mary, Alotti, N., Basa, Anna Maria, Vigh, Andra, Preda, Istvan, Csoti, Eva, Keltai, M., Kerkovits, G., Hendler, Alberto, Blatt, Alex, Beyar, R., Shefer, Arie, Halon, David, Bentzvi, Margalait, Avramovitch, Naomi, Bakst, Avinoam, Cafri, Carlo, Grosbard, Aviva, Margolis, Bella, Suleiman, Khalid, Banai, Shmuel, Meerkin, David, Mosseri, Morri, Guita, Pnina, Jabara, Rifat, Jafari, Jamal, Ben Shitrit, Debi, Ghasan, Null, Salameh, Null, Brezins, Marc, Van Den Akker-Berman, Lily, Guetta, Victor, Rozenman, Yoseph, Biagini, A., Berti, Sergio, Ferrero, Massimo, Colombo, A., Roccaforte, R., Milici, Caterina, Scarpino, L., Salvi, A., Desideri, Alessandro, Sabbadin, Daniela, Galassi, Alfredo, Giuffrida, Giuseppe, Rognoni, Andrea, Vassanelli, Corrado, Paffoni, Paola, Cioppa, Angelo, Rubino, Paolo, De Carlo, Marco, Petronio, Anna Sonia, Naccarella, F., Saia, Francesco, Marzocchi, Antonio, Maranga, Stefano Sdringola, Presbitero, P., Valsecchi, Fazya, Santini, Napoli M., Tubaro, Marco, Erglis, A., Narbute, Inga, Kavoliuniene, Ausra, Zaliunas, R., Navickas, Ramuna, Grabauskiene, V., Luckute, Davia, Subkovas, Eduarda, Wagner, Daniel, Vermeer, F., Lousberg, Aimee, Fransen, Heidi, Breeman, Arno, Tebbe, Henriette, De Boer, M. J., Van Der Wal, Metske, Deckers, J., Vos, Jeroen, Leenders, C. M., Veerhoek, M. J., Jansen, Chri, Bijl, M., Koppelaar, Colinda, Van Den Linden, Null, Brons, R., Widdershofen, J. W. M. G., Broers, Herman, Kontny, F., Jonzon, Marianne, Wodniecki, Jan, Tomasik, Andrzej, Trusz-Gluza, M., Nowak, Seweryn, Ruzyllo, Witold, Deptuch, Tomasz, Marques, Jorge, Matias, F., Madeira, H., Oliveira, Joaquim, Sargento, Lui, Ionac, Adina, Dragulescu, Iosif Stefan, Mut-Vitcu, Bogdan, Maximov, Daniela, Dorobantu, M., Apetrei, E., Niculescu, Rodica, Petrescu, Virgil, Bucsa, Adrian, Deleanu, Dan, Benedek, I. S., Hintea, Theodora, Aronov, D., Tikhomirova, Elena, Kranjec, I., Prokselj, Katja, Kanic, Vojko, Sepetoglu, Ahmet, Aytekin, S., Aytekin, V., Catakoglu, Alp Burak, Parlar, Hayri, Tufekcioglu, Suavi, Ozyedek, Zeki, Baltali, Mehmet, Kiziltan, Null, Vukovic, Milan, Neskovic, A. N., Cardiology, Lenzen, Mj, and Scholte op Reimer, Wj

Subjects
Practice survey, Male, Coronary Stenosi, Coronary angiography, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, Angina, Coronary artery disease, Myocardial Revascularization, Stent, Myocardial infarction, Coronary Artery Bypass, Angioplasty, Balloon, Coronary, CABG, PCI, Professional Practice, Health Survey, Middle Aged, Europe, Treatment Outcome, Epidemiologic Method, Practice Guidelines as Topic, Cardiology, Stents, Female, Guideline Adherence, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, outcome, Euro Heart Survey, 610 Medicine & health, Platelet Glycoprotein GPIIb-IIIa Complex, 142-005 142-005, 2705 Cardiology and Cardiovascular Medicine, Angioplasty, Internal medicine, medicine, Humans, Angina, Unstable, cardiovascular diseases, Interventional cardiology, Unstable angina, business.industry, Coronary Artery Bypa, Coronary Stenosis, Percutaneous coronary intervention, Length of Stay, medicine.disease, Health Surveys, Conventional PCI, 570 Life sciences, biology, Epidemiologic Methods, business
Abstract

AIMS: The purpose of the Euro Heart Survey Programme of the European Society of Cardiology is to evaluate to which extent clinical practice endorses existing guidelines as well as to identify differences in population profiles, patient management, and outcome across Europe. The current survey focuses on the invasive diagnosis and treatment of patients with established coronary artery disease (CAD). METHODS AND RESULTS: Between November 2001 and March 2002, 7769 consecutive patients undergoing invasive evaluation at 130 hospitals (31 countries) were screened for the presence of one or more coronary stenosis >50% in diameter. Patient demographics and comorbidity, clinical presentation, invasive parameters, treatment options, and procedural techniques were prospectively entered in an electronic database (550 variables+29 per diseased coronary segment). Major adverse cardiac events (MACE) were evaluated at 30 days and 1 year. Out of 5619 patients with angiographically proven coronary stenosis (72% of screened population), 53% presented with stable angina while ST elevation myocardial infarction (STEMI) was the indication for coronary angiography in 16% and non-ST segment elevation myocardial infarction or unstable angina in 30%. Only medical therapy was continued in 21%, whereas mechanical revascularization was performed in the remainder [percutaneous coronary intervention (PCI) in 58% and coronary artery bypass grafting (CABG) in 21%]. Patients referred for PCI were younger, were more active, had a lower risk profile, and had less comorbid conditions. CABG was performed mostly in patients with left main lesions (21%), two- (25%), or three-vessel disease (67%) with 4.1 diseased segments, on average. Single-vessel PCI was performed in 82% of patients with either single- (45%), two- (33%), or three-vessel disease (21%). Stents were used in 75% of attempted lesions, with a large variation between sites. Direct PCI for STEMI was performed in 410 cases, representing 7% of the entire workload in the participating catheterization laboratories. Time delay was within 90 min in 76% of direct PCI cases. In keeping with the recommendations of practice guidelines, the survey identified under-use of adjunctive medication (GP IIb/IIIa receptor blockers, statins, and angiotensin-converting enzyme-inhibitors). Mortality rates at 30 days and 1 year were low in all subgroups. MACE primarily consisted of repeat PCI (12%). CONCLUSION: The current Euro Heart Survey on coronary revascularization was performed in the era of bare metal stenting and provides a global European picture of the invasive approach to patients with CAD. These data will serve as a benchmark for the future evaluation of the impact of drug-eluting stents on the practice of interventional cardiology and bypass surgery.

Published
2005

5. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials

Author

Ruff, Christian T, Giugliano, Robert P, Braunwald, Eugene, Hoffman, Elaine B, Deenadayalu, Naveen, Ezekowitz, Michael D, Camm, A John, Weitz, Jeffrey I, Lewis, Basil S, Parkhomenko, Alexander, Yamashita, Takeshi, Antman, Elliott M, Blanc, Jean-Jacques, Cardiovascular Division (SZG), Brigham and Women's Hospital [Boston], Jefferson Medical College (JMC), Thomas Jefferson University Hospitals, Thrombosis and Atherosclerosis Research Institute (TARI), McMaster University [Hamilton, Ontario], Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, medicine.drug_class, [SDV]Life Sciences [q-bio], Embolism, Administration, Oral, 030204 cardiovascular system & hematology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Edoxaban, Internal medicine, Atrial Fibrillation, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Stroke, Randomized Controlled Trials as Topic, business.industry, Warfarin, Anticoagulants, Atrial fibrillation, General Medicine, Vitamin K antagonist, medicine.disease, 3. Good health, Surgery, Clinical trial, Treatment Outcome, chemistry, Apixaban, business, medicine.drug
Abstract

International audience; BACKGROUND: Four new oral anticoagulants compare favourably with warfarin for stroke prevention in patients with atrial fibrillation; however, the balance between efficacy and safety in subgroups needs better definition. We aimed to assess the relative benefit of new oral anticoagulants in key subgroups, and the effects on important secondary outcomes. METHODS: We searched Medline from Jan 1, 2009, to Nov 19, 2013, limiting searches to phase 3, randomised trials of patients with atrial fibrillation who were randomised to receive new oral anticoagulants or warfarin, and trials in which both efficacy and safety outcomes were reported. We did a prespecified meta-analysis of all 71 683 participants included in the RE-LY, ROCKET AF, ARISTOTLE, and ENGAGE AF-TIMI 48 trials. The main outcomes were stroke and systemic embolic events, ischaemic stroke, haemorrhagic stroke, all-cause mortality, myocardial infarction, major bleeding, intracranial haemorrhage, and gastrointestinal bleeding. We calculated relative risks (RRs) and 95% CIs for each outcome. We did subgroup analyses to assess whether differences in patient and trial characteristics affected outcomes. We used a random-effects model to compare pooled outcomes and tested for heterogeneity. FINDINGS: 42 411 participants received a new oral anticoagulant and 29 272 participants received warfarin. New oral anticoagulants significantly reduced stroke or systemic embolic events by 19% compared with warfarin (RR 0*81, 95% CI 0*73-0*91; p

Published
2013

6. Guidelines for cardiac pacing and cardiac resynchronization therapy

Author

Vardas, Panos E, Auricchio, Angelo, Blanc, Jean-Jacques, Daubert, Jean-Claude, Drexler, Helmut, Ector, Hugo, Gasparini, Maurizio, Linde, Cecilia, Morgado, Francisco Bello, Oto, Ali, Sutton, Richard, Trusz-Gluza, Maria, Vahanian, Alec, Camm, John, De Caterina, Raffaele, Dean, Veronica, Dickstein, Kenneth, Funck-Brentano, Christian, Filippatos, Gerasimos, Hellemans, Irene, Kristensen, Steen Dalby, McGregor, Keith, Sechtem, Udo, Silber, Sigmund, Tendera, Michal, Widimsky, Petr, Zamorano, José Luis, Priori, Silvia G, Blomström-Lundqvist, Carina, Brignole, Michele, Terradellas, Josep Brugada, Castellano, Perez, Cleland, John, Farre, Jeronimo, Fromer, Martin, Le Heuzey, Jean-Yves, Lip, Gregory Y H, Merino, Jose Luis, Montenero, Annibale Sandro, Ritter, Philippe, Schalij, Martin Jan, and Stellbrink, Christopher

Abstract

Udgivelsesdato: 2008-May

Published
2008

7. Atrial pacing for prevention of atrial fibrillation: assessment of simultaneously implemented algorithms

Author

Blanc, Jean-Jacques, De Roy, Luc, Mansourati, Jacques, Poezevara, Yann, Marcon, Jean-Louis, Schoels, Wolfgang, Hidden-Lucet, Françoise, Barnay, Claude, Renseigné, Non, Service de Cardiologie (BREST - Cardio), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Optimisation des régulations physiologiques (ORPHY (EA 4324)), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de Chirurgie cardiaque et thoracique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, 030204 cardiovascular system & hematology, Right atrial, 0302 clinical medicine, Clinical endpoint, Secondary Prevention, Single-Blind Method, 030212 general & internal medicine, Prospective Studies, MESH: Aged, MESH: Middle Aged, Cross-Over Studies, Cardiac Pacing, Artificial, Mode switch, Atrial fibrillation, MESH: Follow-Up Studies, Middle Aged, Cardiology, Female, Cardiology and Cardiovascular Medicine, Algorithm, Algorithms, Tachycardia, Ectopic Atrial, medicine.medical_specialty, MESH: Algorithms, MESH: Cardiac Pacing, Artificial, MESH: Bradycardia, MESH: Cross-Over Studies, Ddd pacing, 03 medical and health sciences, Physiology (medical), Internal medicine, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Bradycardia, Humans, Heart Atria, Aged, MESH: Humans, Atrial pacing, business.industry, Significant difference, Ventricular pacing, medicine.disease, MESH: Single-Blind Method, MESH: Prospective Studies, MESH: Male, MESH: Recurrence, MESH: Tachycardia, Ectopic Atrial, MESH: Heart Atria, business, MESH: Female, Follow-Up Studies
Abstract

Aims Several preliminary studies indicated that right atrial pacing could prevent atrial tachyarrhythmias (ATA). We sought to compare the safety and the efficacy of atrial-based pacing supplemented by dedicated combined algorithms with conventional atrial pacing in the prevention of ATA. Methods Fifty-five patients with a history of recurrent paroxysmal ATA implanted with a dual-chamber pacemaker were studied during two randomized cross-over pacing periods (conventional DDD and DDD with ATA prevention algorithms) of 6 months duration. The primary endpoint was the burden of ATA episodes recorded by the device mode switch algorithm. Results The cross-over analysis did not demonstrate any significant difference between the two pacing modes: 254+/-533 h of ATA during the control period versus 238+/-518 h during the ATA prevention period. Analysis of a subgroup of patients found that those with the lower percentage of ventricular pacing benefited from ATA prevention algorithms (120+/-182 h versus 225+/-350 h during thecontrot period; P

Published
2003

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