3 results on '"Isorni, Marc-Antoine"'
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2. Predictive factors of contrast-induced nephropathy in patients undergoing primary coronary angioplasty.
- Author
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Ivanes F, Isorni MA, Halimi JM, Fauchier L, Saint Etienne C, Babuty D, Angoulvant D, and Brunet-Bernard A
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- Aged, Area Under Curve, Biomarkers blood, Chi-Square Distribution, Creatinine blood, Decision Support Techniques, Female, France epidemiology, Glomerular Filtration Rate, Hospitals, University, Humans, Incidence, Kidney physiopathology, Kidney Diseases blood, Kidney Diseases epidemiology, Kidney Diseases physiopathology, Likelihood Functions, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction diagnosis, Myocardial Infarction epidemiology, Odds Ratio, Patient Selection, Predictive Value of Tests, ROC Curve, Retrospective Studies, Risk Assessment, Risk Factors, Shock, Cardiogenic epidemiology, Shock, Cardiogenic therapy, Time Factors, Treatment Outcome, Up-Regulation, Angioplasty, Balloon, Coronary adverse effects, Contrast Media adverse effects, Coronary Angiography adverse effects, Kidney drug effects, Kidney Diseases chemically induced, Myocardial Infarction therapy
- Abstract
Background: Contrast-induced nephropathy (CIN) severely impacts patient morbidity and mortality, especially in patients with ST-segment elevation myocardial infarction treated by primary coronary angioplasty, whose renal function is often unknown at the time of contrast exposure., Aim: We sought the incidence and factors predictive of CIN in patients treated by primary coronary angioplasty in our hospital; we also questioned the relevance of Mehran's risk score in this population., Methods: We considered all patients admitted for primary coronary angioplasty between January 2010 and December 2011, and included 322 patients with complete data on renal function. CIN was defined as a relative (≥25%) or absolute (≥44 μmol/L) increase in serum creatinine following contrast medium administration. We compared patients with or without CIN, to identify predictive factors, and investigated the effectiveness of Mehran's score using a receiver operating characteristic (ROC) curve, Youden's index and a likelihood ratio test., Results: The incidence of CIN was 9.1%. A multivariable analysis identified two independent risk factors for CIN: impaired glomerular filtration rate and cardiogenic shock at admission (P<0.05). An elevated Mehran's score was associated with increased incidence of CIN, but statistical analysis revealed this score to have poor sensitivity, especially in high-risk patients. Youden's index was very low and the area under the ROC curve was 0.59 in our population., Conclusion: Renal failure and cardiogenic shock at admission were independent predictors of CIN in our acute myocardial infarction population. Mehran's score added little to the discrimination of patients undergoing primary coronary angioplasty, particularly high-risk individuals., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)
- Published
- 2014
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3. Impact of gender on use of revascularization in acute coronary syndromes: the national observational study of diagnostic and interventional cardiac catheterization (ONACI)
- Author
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Isorni, Marc-Antoine, Blanchard, Didier, Teixeira, Nelson, Le Breton, Hervé, Renault, Nisa, Gilard, Martine, Lefevre, Thierry, Mulak, Geneviève, Danchin, Nicolas, Spaulding, Christian, Puymirat, Etienne, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 Cardiologie, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), 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 ), and Université de Brest ( UBO ) -Université de Brest ( UBO )
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Male ,Cardiac Catheterization ,Coronary Angiography ,Risk Assessment ,Severity of Illness Index ,Percutaneous Coronary Intervention ,Sex Factors ,Predictive Value of Tests ,Risk Factors ,gender ,Odds Ratio ,Humans ,[ SDV.IB ] Life Sciences [q-bio]/Bioengineering ,Hospital Mortality ,Registries ,Acute Coronary Syndrome ,Coronary Artery Bypass ,Healthcare Disparities ,Propensity Score ,Aged ,Aged, 80 and over ,Chi-Square Distribution ,Process Assessment, Health Care ,Age Factors ,Health Status Disparities ,Middle Aged ,Keys words: acute coronary syndrome ,Logistic Models ,Treatment Outcome ,myocardial revascularization ,Multivariate Analysis ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,France - Abstract
International audience; Objectives To assess the impact of gender on myocardial revascularization using data collected in a French nationwide registry: the national observational study of diagnostic and interventional cardiac catheterization (ONACI). Background Gender differences in management of patients with acute coronary syndromes (ACS) have been reported. Methods We analysed data from a nationwide French prospective multicentre registry including 64,932 suspected ACS patients recruited in 99 centres from 2004 to 2008. Results Overall, women were older (70.7 ± 12.7 vs. 63.8 ± 12.9 years), had a higher cardiovascular risk profile, and were more frequently admitted with non ST-elevation myocardial infarction or unstable angina (NSTEMI/UA) compared to men (73% vs. 68%). Women had significantly more angiographically normal coronary arteries or non-significant coronary artery disease (CAD) in both STEMI (6% vs. 3%) and NSTEMI/UA (21% vs. 11%) while men had more severe CAD. After adjusting for age, cardiovascular risk factors, and extent of disease, myocardial revascularization (defined as the use of percutaneous coronary intervention (PCI) or coronary artery bypass grafting) was less frequently used in women (adjusted OR = 0.78; 95% CI: 0.77–0.83). For those receiving PCI, in-hospital mortality within 24 hr of intervention was higher in women (3.6% vs. 1.2%; adjusted OR = 1.51; 95% CI: 1.22–1.87). Conclusions In the present study, despite having a higher cardiovascular risk profile, women more frequently had normal vessel/non-significant angiographic coronary artery disease. In patients with significant coronary artery disease, myocardial revascularization was less frequently used in women whatever the type of ACS. © 2015 Wiley Periodicals, Inc
- Published
- 2014
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