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51. Temporal Relationship between Atrial Fibrillation and Heart Failure Development Analysis from a Nationwide Database

Author

Cottin, Yves, primary, Maalem Ben Messaoud, Brahim, additional, Monin, Antoine, additional, Guilleminot, Pierre, additional, Bisson, Arnaud, additional, Eicher, Jean-Christophe, additional, Bodin, Alexandre, additional, Herbert, Julien, additional, Juillière, Yves, additional, Zeller, Marianne, additional, and Fauchier, Laurent, additional

Published
2021
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54. Major Bleeding of Transjugular Native Kidney Biopsies. A French Nationwide Cohort Study

Author

Hindricks, Gerhard, Potpara, Tatjana, Dagres, Nikolaos, Arbelo, Elena, Bax, Jeroen, Blomström-Lundqvist, Carina, Boriani, Giuseppe, Castella, Manuel, Dan, Gheorghe-Andrei, Dilaveris, Polychronis, Fauchier, Laurent, Filippatos, Gerasimos, Kalman, Jonathan, La Meir, Mark, Lane, Deirdre, Lebeau, Jean-Pierre, Lettino, Maddalena, Lip, Gregory, Pinto, Fausto, Thomas, G Neil, Valgimigli, Marco, van Gelder, Isabelle, van Putte, Bart, Watkins, Caroline, Kirchhof, Paulus, Kühne, Michael, Aboyans, Victor, Ahlsson, Anders, Balsam, Pawel, Bauersachs, Johann, Benussi, Stefano, Brandes, Axel, Braunschweig, Frieder, Camm, a John, Capodanno, Davide, Casadei, Barbara, Conen, David, Crijns, Harry, Delgado, Victoria, Dobrev, Dobromir, Drexel, Heinz, Eckardt, Lars, Fitzsimons, Donna, Folliguet, Thierry, Gale, Chris, Gorenek, Bulent, Haeusler, Karl Georg, Heidbuchel, Hein, Iung, Bernard, Katus, Hugo, Kotecha, Dipak, Landmesser, Ulf, Leclercq, Christophe, Lewis, Basil, Mascherbauer, Julia, Merino, Jose Luis, Merkely, Béla, Mont, Lluís, Mueller, Christian, Nagy, Klaudia, Oldgren, Jonas, Pavlović, Nikola, Pedretti, Roberto, Petersen, Steffen, Piccini, Jonathan, Popescu, Bogdan, Pürerfellner, Helmut, Richter, Dimitrios, Roffi, Marco, Rubboli, Andrea, Scherr, Daniel, Schnabel, Renate, Simpson, Iain, Shlyakhto, Evgeny, Sinner, Moritz, Steffel, Jan, Sousa-Uva, Miguel, Suwalski, Piotr, Svetlosak, Martin, Touyz, Rhian, Neil Thomas, G, Delassi, Tahar, Sisakian, Hamayak, Chasnoits, Alexandr, Pauw, Michel De, Smajić, Elnur, Shalganov, Tchavdar, Avraamides, Panayiotis, Kautzner, Josef, Gerdes, Christian, Alaziz, Ahmad Abd, Kampus, Priit, Raatikainen, Pekka, Boveda, Serge, Papiashvili, Giorgi, Vassilikos, Vassilios, Csanádi, Zoltán, Arnar, David, Galvin, Joseph, Barsheshet, Alon, Caldarola, Pasquale, Rakisheva, Amina, Bytyçi, Ibadete, Kerimkulova, Alina, Kalejs, Oskars, Njeim, Mario, Puodziukynas, Aras, Groben, Laurent, Sammut, Mark, Grosu, Aurel, Boskovic, Aneta, Moustaghfir, Abdelhamid, Groot, Natasja De, Poposka, Lidija, Anfinsen, Ole-Gunnar, Mitkowski, Przemyslaw, Cavaco, Diogo Magalhães, Siliste, Calin, Mikhaylov, Evgeny, Bertelli, Luca, Kojic, Dejan, Hatala, Robert, Fras, Zlatko, Arribas, Fernando, Juhlin, Tord, Sticherling, Christian, Abid, Leila, Atar, Ilyas, Sychov, Oleg, Bates, Matthew, Zakirov, Nodir, Halimi, Jean-Michel, Gatault, Philippe, Longuet, Hélène, Barbet, Christelle, Goumard, Annabelle, Gueguen, Juliette, Goin, Nicolas, Sautenet, Bénédicte, Herbert, Julien, Bisson, Arnaud, Universität Leipzig [Leipzig], University of Belgrade [Belgrade], Leiden University Medical Center (LUMC), Uppsala University, Università degli Studi di Modena e Reggio Emilia, Colentina University Hospital, University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), National and Kapodistrian University of Athens (NKUA), Université d'Athènes (UOA), Attikon University Hospital, The Royal Melbourne Hospital, University of Liverpool, San Gerardo Hospital of Monza, Aalborg University [Denmark] (AAU), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Faculdade de Medicina [Lisboa], Universidade de Lisboa (ULISBOA), Hospital de Santa Maria [Lisboa], Service de néphrologie et immunologie clinique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, and Université de Nantes (UN)-Université de Nantes (UN)

Subjects
medicine.medical_specialty, Framingham Risk Score, Percutaneous, business.industry, medicine.medical_treatment, kidney biopsy, Retrospective cohort study, Odds ratio, Lower risk, medicine.disease, transjugular, Nephrectomy, Surgery, [SHS]Humanities and Social Sciences, bleeding score, Hematoma, percutaneous, Nephrology, Clinical Research, medicine, epidemiology, business, ComputingMilieux_MISCELLANEOUS, Cohort study
Abstract

Introduction The risk of bleeding associated with transjugular kidney biopsies is unclear, and which patients are the best candidates for this route is unknown. Methods This was a retrospective cohort study comparing proportion of bleeding associated with transjugular versus percutaneous native kidney biopsies in all patients in France in the 2010–2019 period. Major bleeding at day 8 (i.e., blood transfusions, hemorrhage/hematoma, angiographic intervention, nephrectomy) and risk of death at day 30 were assessed, and we used a bleeding risk score initially developed for the percutaneous route. Results Our analysis included 60,331 patients (transjugular route: 5305; percutaneous route: 55,026 patients). The observed proportion of major bleeding varied widely (transjugular vs. percutaneous): 0.4% versus 0.5% for the lowest risk scores (0–4) to 19.1% versus 30.8% for the highest risk scores (≥35). Transjugular was more frequently used than percutaneous route (39% vs. 24%) when the risk score was ≥20 (15,133/60,331; 25% of all patients). Transjugular was associated with a lower risk of major bleeding than percutaneous route in multivariate analyses (odds ratio [OR]: 0.88 [0.78–0.99]), especially for scores ≥20 (OR: 0.83 [0.72–0.96], (i.e., 25% of patients). Major bleeding was associated with an increased risk of death both for transjugular (OR: 1.77 [1.00–3.14]) and percutaneous (OR: 1.80 [1.43–2.28]) routes. Conclusions The transjugular route is independently associated with a lower risk of bleeding than the percutaneous route, especially in high-risk patients identified by a preprocedure risk score ≥20 (i.e., 25% of patients). Major bleeding is associated with an increased risk of death for both routes., Graphical abstract

Published
2021

60. To the Editor—Fear does not avoid the danger!

Author

Sambola, Antonia, Rello, Pau, Soriano, Toni, Bhatt, Deepak, Pasupuleti, Vinay, Cannon, Christopher, Gibson, C. Michael, Dewilde, Willem J.M., Lip, Gregory Y.H., Peterson, Eric, Airaksinen, K.E. Juhani, Kiviniemi, Tuomas, Fauchier, Laurent, Räber, Lorenz, Ruiz-Nodar, Juan, Banach, Maciej, Bueno, Héctor, Hernandez, Adrian, Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Etienne, Christophe Saint, Porto, Alizée, Theron, Alexis, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, von Tokarski, Florent, Lemaignen, Adrien, Portais, Antoine, Hennekinne, Fanny, Sautenet, Bénédicte, Halimi, Jean-Michel, Legras, Annick, Patat, Frédéric, Mirguet, Christian, Bernard, Anne, Bernard, Louis, Clementy, Nicolas, Harvard Medical School [Boston] (HMS), Baim Institute for Clinical Research Boston MA, Beth Israel Deaconess Medical Center [Boston] (BIDMC), University of Liverpool, Liverpool Heart & Chest Hospital, Aalborg University [Denmark] (AAU), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Medical University of Łódź (MUL), University of Zielona Góra, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), Instituto de Salud Carlos III [Madrid] (ISC), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital de la Timone [CHU - APHM] (TIMONE), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine Interne et Maladies Infectieuses [Tours], MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Hôpital Bretonneau, Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de réanimation cardio-vasculaire et thoracique, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Pontchaillou, Centre de référence en infections ostéo-articulaires du grand-ouest [Rennes] (CRIOGO), and CHU Pontchaillou [Rennes]

Subjects
business.industry, Physiology (medical), Medicine, Fear, Medical emergency, Cardiology and Cardiovascular Medicine, business, medicine.disease, ComputingMilieux_MISCELLANEOUS, Defibrillators, Implantable, [SHS]Humanities and Social Sciences
Abstract

International audience

Published
2021

61. Thromboembolism, mortality, and bleeding in 2,435,541 atrial fibrillation patients with and without cancer: A nationwide cohort study

Author

Lantelme, Pierre, Bisson, Arnaud, Lacour, Thibaud, Herbert, Julien, Ivanes, Fabrice, Bourguignon, Thierry, Angoulvant, Denis, Harbaoui, Brahim, Bonnet, Marc, Babuty, Dominique, Saint Etienne, Christophe, Deharo, Pierre, Fauchier, Laurent, Pastori, Daniele, Marang, Amélie, Menichelli, Danilo, Lip, Gregory, Imagerie Ultrasonore, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Institut de Socio-économie des Entreprises et des ORganisations (ISEOR), Institut de socio-économie des entreprises et des organisations, Laboratoire de Recherche Magellan, Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Institut d'Administration des Entreprises (IAE) - Lyon, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), University of Liverpool, and Aalborg University [Denmark] (AAU)

Subjects
Adult, Cancer Research, medicine.medical_specialty, Hemorrhage, Gastroenterology, Risk Assessment, [SHS]Humanities and Social Sciences, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Uterine cancer, Risk Factors, Internal medicine, Neoplasms, Thromboembolism, Atrial Fibrillation, medicine, cancer, Humans, 030212 general & internal medicine, atrial fibrillation, bleeding, mortality, stroke, thromboembolism, Lung cancer, Stroke, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, business.industry, Cancer, Retrospective cohort study, medicine.disease, Oncology, 030220 oncology & carcinogenesis, Liver function, Liver cancer, business
Abstract

Background The number of patients with atrial fibrillation (AF) and cancer is rapidly increasing in clinical practice. The impact of cancer on clinical outcomes in this patient population is unclear, as is the performance of the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol) and CHA2 DS2 -VASc (Congestive Heart Failure, Hypertension, Age ≥ 75 years, Diabetes Mellitus, Stroke or Transient Ischemic Attack, Vascular Disease, Age 65 to 74 Years, Sex Category) scores. Methods This was an observational, retrospective cohort study including 2,435,541 adults hospitalized with AF. The authors investigated the incidence rates (IRs) of all-cause and cardiovascular mortality, ischemic stroke, major bleeding, and intracranial hemorrhage (ICH) according to the presence of cancer and cancer types. Results Overall, 399,344 (16.4%) had cancer, with the most common cancers being metastatic, prostatic, colorectal, lung, breast, and bladder. During a mean follow-up of 2.0 years, cancer increased all-cause mortality (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.99-2.01). The IR of ischemic stroke was higher with pancreatic cancer (2.8%/y), uterine cancer (2.6%/y), and breast cancer (2.6%/y), whereas it was lower with liver/lung cancer (1.9%/y) and leukemia/myeloma (2.0%/y), in comparison with noncancer patients (2.4%/y). Cancer increased the risk of major bleeding (HR, 1.27; 95% CI, 1.26-1.28) and ICH (HR, 1.07; 95% CI, 1.05-1.10). Leukemia, liver cancer, myeloma, and metastatic cancers showed the highest IRs for major bleeding/ICH. Major bleeding and ICH rates progressively increased with the HAS-BLED score, which showed generally good predictivity with C indexes > 0.70 for all cancer types. The CHA2 DS2 -VASc score's predictivity was slightly lower in AF patients with cancer. Conclusions Cancer increased all-cause mortality, major bleeding, and ICH risk in AF patients. The association between cancer and ischemic stroke differed among cancer types, and in some types, the risk of bleeding seemed to exceed the thromboembolic risk.

Published
2020

62. Major Bleeding and Risk of Death after Percutaneous Native Kidney Biopsies

Author

Halimi, Jean-Michel, Gatault, Philippe, Longuet, Hélène, Barbet, Christelle, Bisson, Arnaud, Sautenet, Bénédicte, Herbert, Julien, Buchler, Matthias, Grammatico-Guillon, Leslie, Fauchier, Laurent, and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
[SDV]Life Sciences [q-bio]
Abstract

International audience; Background and objectives The risk of major bleeding after percutaneous native kidney biopsy is usually considered low but remains poorly predictable. The aim of the study was to assess the risk of major bleeding and to build a preprocedure bleeding risk score. Design, setting, participants, & measurements Our study was a retrospective cohort study in all 52,138 patients who had a percutaneous native kidney biopsy in France in the 2010–2018 period. Measurements included major bleeding ( i.e. , blood transfusions, hemorrhage/hematoma, angiographic intervention, or nephrectomy) at day 8 after biopsy and risk of death at day 30. Exposures and outcomes were defined by diagnosis codes. Results Major bleeding occurred in 2765 of 52,138 (5%) patients (blood transfusions: 5%; angiographic intervention: 0.4%; and nephrectomy: 0.1%). Nineteen diagnoses were associated with major bleeding. A bleeding risk score was calculated (Charlson index [2–4: +1; 5 and 6: +2; >6: +3]; frailty index [1.5–4.4: +1; 4.5–9.5: +2; >9.5: +3]; women: +1; dyslipidemia: −1; obesity: −1; anemia: +8; thrombocytopenia: +2; cancer: +2; abnormal kidney function: +4; glomerular disease: −1; vascular kidney disease: −1; diabetic kidney disease: −1; autoimmune disease: +2; vasculitis: +5; hematologic disease: +2; thrombotic microangiopathy: +4; amyloidosis: −2; other kidney diagnosis: −1) + a constant of 5. The risk of bleeding went from 0.4% (lowest score group =0–4 points) to 33% (highest score group ≥35 points). Major bleeding was an independent risk of death (500 of 52,138 deaths: bleeding: 81 of 2765 [3%]; no bleeding: 419 of 49,373 [0.9%]; odds ratio, 1.95; 95% confidence interval, 1.50 to 2.54; P

Published
2020

63. Safety and efficacy of drug eluting stents vs bare metal stents in patients with atrial fibrillation: A systematic review and meta-analysis

Author

Lantelme, Pierre, Lacour, Thibaud, Bisson, Arnaud, Herbert, Julien, Ivanes, Fabrice, Bourguignon, Thierry, Quilliet, Laurent, Angoulvant, Denis, Harbaoui, Brahim, Babuty, Dominique, Etienne, Christophe Saint, Deharo, Pierre, Bernard, Anne, Fauchier, Laurent, Collart, Frederic, Cuisset, Thomas, Sambola, Antonia, Rello, Pau, Soriano, Toni, Bhatt, Deepak, Pasupuleti, Vinay, Cannon, Christopher, Gibson, C. Michael, Dewilde, Willem J.M., Lip, Gregory Y.H., Peterson, Eric, Airaksinen, K.E. Juhani, Kiviniemi, Tuomas, Räber, Lorenz, Ruiz-Nodar, Juan, Banach, Maciej, Bueno, Héctor, Hernandez, Adrian, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Harvard Medical School [Boston] (HMS), Baim Institute for Clinical Research Boston MA, Beth Israel Deaconess Medical Center [Boston] (BIDMC), University of Liverpool, Liverpool Heart & Chest Hospital, Aalborg University [Denmark] (AAU), Medical University of Łódź (MUL), University of Zielona Góra, Hospital Universitario 12 de Octubre [Madrid], Centro Nacional de Investigaciones Cardiovasculares Carlos III [Madrid, Spain] (CNIC), and Instituto de Salud Carlos III [Madrid] (ISC)

Subjects
medicine.medical_specialty, medicine.medical_treatment, Heart death, 030204 cardiovascular system & hematology, Prosthesis Design, Article, law.invention, [SHS]Humanities and Social Sciences, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, law, Risk Factors, Internal medicine, Antithrombotic, Atrial Fibrillation, medicine, Stent, Humans, Myocardial infarction, cardiovascular diseases, 610 Medicine & health, ComputingMilieux_MISCELLANEOUS, Antithrombotic therapy, business.industry, Bleeding, Atrial fibrillation, Drug-Eluting Stents, Hematology, medicine.disease, Meta-analysis, Clinical effectiveness, Treatment Outcome, 030220 oncology & carcinogenesis, Relative risk, Conventional PCI, Cardiology, Systematic review, Stents, Heart infarction, business, Mace
Abstract

Objective: A systematic review and meta-analysis was performed to evaluate the safety and efficacy of drug-eluting stents (DES) vs bare-metal stents (BMS) in atrial fibrillation (AF) patients. Methods: We systematically searched 5 engines until May 2019 for cohort studies and randomized controlled trials (RCTs). Primary outcomes were major bleeding and major adverse cardiac events (MACE) including cardiac death, myocardial infarction, target vessel revascularization (TVR) or stent thrombosis. Effects of inverse variance random meta-analyses were described with relative risks (RR) and their 95% confidence intervals (CI). We also stratified analyses by type (triple [TAT] vs dual [DAT]) and duration (short-vs long-term) of antithrombotic therapy. Results: Ten studies (3 RCTs; 7 cohorts) including 10,353 patients (DES: 59.6%) were identified. DES did not show higher risk of major bleeding than BMS (5.6% vs 6.9%, RR 1.07; 95%CI, 0.89–1.28, p = 0.47; I2 = 0%) or MACE (12% vs 13.6%; RR 0.96; 95%CI 0.81–1.13, p = 0.60; I2 = 44%). Although, DES almost decreased TVR risk (6.4% vs 8.4%, RR 0.78; 95%CI, 0.61–1.01, p = 0.06; I2 = 15%). Stratified analyses by type and duration of antithrombotic therapy showed no differences in major bleeding or MACE between both types of stents. In DES, long-term TAT showed higher major bleeding risk than long-term DAT (7.7% vs 4.7%, RR 1.48, 95%CI 1.08–2.03, p = 0.01; I2 = 12%). For both types of stents, MACE risk was similar between TAT and DAT. Conclusions: In patients with AF undergoing PCI, DES had similar rate of major bleeding and MACE than BMS. DAT seems to be a safer antithrombotic therapy compared with TAT.

Published
2020

64. Prognosis of Type 2 Myocardial Infarction Patients Implanted With a Prophylactic Defibrillator (from the Very-High-Rate Registry)

Author

Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Saint Etienne, Christophe, Grammatico-Guillon, Leslie, Porto, Alizée, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, Fauchier, Laurent, Garcia, Rodrigue, Boveda, Serge, Defaye, Pascal, Sadoul, Nicolas, Narayanan, Kumar, Perier, Marie-Cécile, Klug, Didier, Leclercq, Christophe, Babuty, Dominique, Bordachar, Pierre, Gras, Daniel, Deharo, Jean-Claude, Piot, Olivier, Providencia, Rui, Marijon, Eloi, Algalarrondo, Vincent, Theron, Alexis, David, Charlotte, André, Clémentine, Pierre, Bertrand, Bernard, Anne, Angoulvant, Denis, Clementy, Nicolas, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Unité d'Épidémiologie des données cliniques [Tours] (EpiDcliC), Hôpital de la Timone [CHU - APHM] (TIMONE), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Clinique Pasteur, Clinique Pasteur [Toulouse], Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), 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), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pontchaillou [Rennes], IHU-LIRYC, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Cardiopathies et mort subite [ERL 3147], Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre cardiologique du Nord (CCN), Barts Heart Centre [London, UK] (St Bartholomew’s Hospital), Barts Health NHS Trust [London, UK], Service de cardiologie [CHU Bichat], 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 Diderot, Sorbonne Paris Cité, Institut de neurophysiopathologie (INP), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), and EA4245 - Transplantation, Immunologie, Inflammation [Tours] (T2i)

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Cardiac resynchronization therapy, Myocardial Infarction, 030204 cardiovascular system & hematology, Risk Assessment, Ventricular Function, Left, [SHS]Humanities and Social Sciences, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Registries, Aged, Retrospective Studies, Ejection fraction, business.industry, Stroke Volume, Middle Aged, medicine.disease, Implantable cardioverter-defibrillator, Prognosis, Defibrillators, Implantable, Transplantation, Primary Prevention, Survival Rate, Death, Sudden, Cardiac, Treatment Outcome, Heart failure, Cardiology, Myocardial infarction complications, Female, France, Cardiology and Cardiovascular Medicine, business
Abstract

International audience; Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices. Methods: Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France. Results: A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10–599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P =0.005), cardiovascular death (relative risk, 0.82; corrected P =0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P

Published
2020

65. Impact of Sapien 3 Balloon-Expandable Versus Evolut R Self-Expandable Transcatheter Aortic Valve Implantation in Patients With Aortic Stenosis

Author

Saint Etienne, Christophe, Grammatico-Guillon, Leslie, Deharo, Pierre, Bisson, Arnaud, Herbert, Julien, Lacour, Thibaud, Saint, Christophe, Porto, Alizée, Collart, Frederic, Bourguignon, Thierry, Cuisset, Thomas, Fauchier, Laurent, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)

Subjects
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, heart valve prosthesis, transcatheter aortic valve replacement
Abstract

International audience; Background: Two competing transcatheter aortic valve replacement (TAVR) technologies are currently available. Head-to-head comparisons of the relative performances of these 2 devices have been published. However, long-term clinical outcome evaluation remains limited by the number of patients analyzed, in particular, for recent-generation devices.Methods:Based on the French administrative hospital-discharge database, the study collected information for all consecutive patients treated with a TAVR device commercialized in France between 2014 and 2018. Propensity score matching was used for the analysis of outcomes during follow-up. The objective of this study was to analyze the outcomes of TAVR according to Sapien 3 balloon-expandable (BE) versus Evolut R self-expanding TAVR technology at a nationwide level in France.Results:A total of 31 113 patients treated with either Sapien 3 BE or Evolut R self-expanding TAVR were found in the database. After matching on baseline characteristics, 20 918 patients were analyzed (10 459 in each group with BE or self-expanding valves). During follow-up (mean [SD], 358 [384]; median [interquartile range], 232 [10-599] days), BE TAVR was associated with a lower yearly incidence of all-cause death (relative risk, 0.88; corrected P=0.005), cardiovascular death (relative risk, 0.82; corrected P=0.002), and rehospitalization for heart failure (relative risk, 0.84; corrected P

Published
2020

76. MYOCARDIAL REVASCULARIZATION STRATEGIES IN ST ELEVATION MYOCARDIAL INFARCTION WITHOUT URGENT REVASCULARIZATION: INSIGHT FROM A NATIONWIDE STUDY

Author

Deharo, Pierre, Porto, Alizée, Bourguignon, Thierry, Herbert, Julien, Etienne, Christophe Saint, Semaan, Carl, Genet, Thibaud, Jaussaud, Nicolas, Morera, Pierre, Theron, Alexis, Gariboldi, Vlad, Collart, Frederic, Cuisset, Thomas, and Fauchier, Laurent

Abstract

To analyse the outcomes of patients presenting with ST elevation myocardial infarction (STEMI) without early (<48h) revascularization, according to percutaneous versus surgical revascularization.

Published
2021
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77. Dual-chamber vs. single-chamber pacemaker in patients in sinus rhythm with an atrioventricular block: a nationwide cohort study.

Author

Bodin A, Texier I, Bisson A, Pierre B, Herbert J, Jacobs M, Nasarre M, Bernard A, and Fauchier L

Subjects
Humans, Female, Male, Aged, Retrospective Studies, France epidemiology, Aged, 80 and over, Cardiac Pacing, Artificial methods, Cardiac Pacing, Artificial mortality, Middle Aged, Atrial Fibrillation mortality, Atrial Fibrillation therapy, Atrial Fibrillation physiopathology, Atrial Fibrillation diagnosis, Incidence, Heart Rate, Atrioventricular Block therapy, Atrioventricular Block mortality, Atrioventricular Block physiopathology, Pacemaker, Artificial
Abstract

Aims: In complete atrioventricular block (AVB) with underlying sinus rhythm, it is recommended to implant a dual-chamber pacemaker rather than a single-chamber pacemaker. However, no large-scale study has been able to demonstrate the superiority of this choice on hard clinical criteria such as morbimortality., Methods and Results: This retrospective observational study included all patients who received a primary pacemaker implantation in the indication of complete AVB with underlying sinus rhythm in France, based on the national administrative database between January 2013 and December 2022. After propensity score matching, we obtained two groups containing 19 219 patients each. The incidence of all-cause mortality was 9.22%/year for the dual-chamber pacemaker group, compared with 11.48%/year for the single-chamber pacemaker group (hazard ratio (HR) 0.807, P < 0.0001]. Similarly, there was a lower incidence of cardiovascular mortality (HR 0.766, P < 0.0001), heart failure (HR 0.908, P < 0.0001), atrial fibrillation (HR 0.778, P < 0.0001), and ischaemic stroke (HR 0.873, P = 0.008) in the dual-chamber pacemaker group than in the single-chamber pacemaker group. Regarding re-interventions and complications, there were fewer upgrades (addition of atrial lead or left ventricular lead) in the dual-chamber group (HR 0.210, P < 0.0001), but more haematomas (HR 1.179, P = 0.006) and lead repositioning (HR 1.123, P = 0.04)., Conclusion: In the indication of complete AVB with underlying sinus rhythm, our results are consistent with current recommendations to prefer implantation of a dual-chamber pacemaker rather than a single-chamber pacemaker for these patients. Implantation of a dual-chamber pacemaker is associated with a lower risk of mortality, heart failure, atrial fibrillation, and stroke during follow-up., Competing Interests: Conflict of interest: B.P.: consultant or speaker for Abbott, Biotronik, Boston Scientific, and Microport; L.F.: consultant or speaker for AstraZeneca, Bayer, BMS/Pfizer, Boehringer Ingelheim, Boston Scientific, Medtronic, Novartis, Novo, and Zoll. All remaining authors have declared no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2024
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78. Incidence of clinical atrial fibrillation and related complications using a screening algorithm at a nationwide level.

Author

Roger A, Cottin Y, Bentounes SA, Bisson A, Bodin A, Herbert J, Maille B, Zeller M, Deharo JC, Lip GYH, and Fauchier L

Subjects
Humans, Female, Adult, Middle Aged, Aged, Male, Incidence, Comorbidity, Risk Factors, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Atrial Fibrillation complications, Stroke diagnosis, Stroke epidemiology, Stroke prevention & control, Brain Ischemia epidemiology
Abstract

Aims: In a recent position paper, the European Heart Rhythm Association (EHRA) proposed an algorithm for the screening and management of arrhythmias using digital devices. In patients with prior stroke, a systematic screening approach for atrial fibrillation (AF) should always be implemented, preferably immediately after the event. Patients with increasing age and with specific cardiovascular or non-cardiovascular comorbidities are also deemed to be at higher risk. From a large nationwide database, the aim was to analyse AF incidence rates derived from this new EHRA algorithm., Methods and Results: Using the French administrative hospital discharge database, all patients hospitalized in 2012 without a history of AF, and with at least a 5-year follow-up (FU) (or if they died earlier), were included. The yearly incidence of AF was calculated in each subgroup defined by the algorithm proposed by EHRA based on a history of previous stroke, increasing age, and eight comorbidities identified via International Classification of Diseases 10th Revision codes. Out of the 4526 104 patients included (mean age 58.9 ± 18.9 years, 64.5% women), 1% had a history of stroke. Among those with no history of stroke, 18% were aged 65-74 years and 21% were ≥75 years. During FU, 327 012 patients had an incidence of AF (yearly incidence 1.86% in the overall population). Implementation of the EHRA algorithm divided the population into six risk groups: patients with a history of stroke (group 1); patients > 75 years (group 2); patients aged 65-74 years with or without comorbidity (groups 3a and 3b); and patients < 65 years with or without comorbidity (groups 4a and 4b). The yearly incidences of AF were 4.58% per year (group 2), 6.21% per year (group 2), 3.50% per year (group 3a), 2.01% per year (group 3b), 1.23% per year (group 4a), and 0.35% per year (group 4b). In patients aged < 65 years, the annual incidence of AF increased progressively according to the number of comorbidities from 0.35% (no comorbidities) to 9.08% (eight comorbidities). For those aged 65-75 years, the same trend was observed, i.e. increasing from 2.01% (no comorbidities) to 11.47% (eight comorbidities)., Conclusion: These findings at a nationwide scale confirm the relevance of the subgroups in the EHRA algorithm for identifying a higher risk of AF incidence, showing that older patients (>75 years, regardless of comorbidities) have a higher incidence of AF than those with prior ischaemic stroke. Further studies are needed to evaluate the usefulness of algorithm-based risk stratification strategies for AF screening and the impact of screening on major cardiovascular event rates., Competing Interests: Conflict of interest: None declared. Y.C. reports having received grants, consulting fees, honoraria, and/or delivering lectures for Servier, Novartis, Boehringer, Pfizer, and BMS. M.Z. received research grants from Amarin Corp. G.Y.H.L. is a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, Anthem. No fees are received personally. G.Y.H.L. is a co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 899871. L.F. is consultant and speaker activities of small amounts for AstraZeneca, Bayer, BMS/Pfizer, Boehringer Ingelheim, Medtronic, Novartis, Novo, XO, and Zoll. No conflict of interest to disclose for the other authors., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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79. Major Bleeding and Risk of Death after Percutaneous Native Kidney Biopsies: A French Nationwide Cohort Study.

Author

Halimi JM, Gatault P, Longuet H, Barbet C, Bisson A, Sautenet B, Herbert J, Buchler M, Grammatico-Guillon L, and Fauchier L

Subjects
Adult, Aged, Area Under Curve, Blood Transfusion statistics & numerical data, Female, France epidemiology, Hemorrhage etiology, Hemorrhage mortality, Hemorrhage therapy, Humans, Kidney pathology, Kidney Diseases diagnosis, Kidney Diseases pathology, Longitudinal Studies, Male, Middle Aged, ROC Curve, Retrospective Studies, Risk Assessment methods, Risk Factors, Biopsy adverse effects, Biopsy mortality, Hemorrhage epidemiology
Abstract

Background and Objectives: The risk of major bleeding after percutaneous native kidney biopsy is usually considered low but remains poorly predictable. The aim of the study was to assess the risk of major bleeding and to build a preprocedure bleeding risk score., Design, Setting, Participants, & Measurements: Our study was a retrospective cohort study in all 52,138 patients who had a percutaneous native kidney biopsy in France in the 2010-2018 period. Measurements included major bleeding ( i.e. , blood transfusions, hemorrhage/hematoma, angiographic intervention, or nephrectomy) at day 8 after biopsy and risk of death at day 30. Exposures and outcomes were defined by diagnosis codes., Results: Major bleeding occurred in 2765 of 52,138 (5%) patients (blood transfusions: 5%; angiographic intervention: 0.4%; and nephrectomy: 0.1%). Nineteen diagnoses were associated with major bleeding. A bleeding risk score was calculated (Charlson index [2-4: +1; 5 and 6: +2; >6: +3]; frailty index [1.5-4.4: +1; 4.5-9.5: +2; >9.5: +3]; women: +1; dyslipidemia: -1; obesity: -1; anemia: +8; thrombocytopenia: +2; cancer: +2; abnormal kidney function: +4; glomerular disease: -1; vascular kidney disease: -1; diabetic kidney disease: -1; autoimmune disease: +2; vasculitis: +5; hematologic disease: +2; thrombotic microangiopathy: +4; amyloidosis: -2; other kidney diagnosis: -1) + a constant of 5. The risk of bleeding went from 0.4% (lowest score group =0-4 points) to 33% (highest score group ≥35 points). Major bleeding was an independent risk of death (500 of 52,138 deaths: bleeding: 81 of 2765 [3%]; no bleeding: 419 of 49,373 [0.9%]; odds ratio, 1.95; 95% confidence interval, 1.50 to 2.54; P <0.001)., Conclusions: The risk of major bleeding after percutaneous native kidney biopsy may be higher than generally thought and is associated with a twofold higher risk of death. It varies widely but can be estimated with a score useful for shared decision making and procedure choice., (Copyright © 2020 by the American Society of Nephrology.)

Published
2020
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80. Mortality and cardiac resynchronization therapy with or without defibrillation in primary prevention.

Author

Gras M, Bisson A, Bodin A, Herbert J, Babuty D, Pierre B, Clementy N, and Fauchier L

Subjects
Aged, Cardiac Resynchronization Therapy Devices, Death, Sudden, Cardiac epidemiology, Death, Sudden, Cardiac prevention & control, Humans, Primary Prevention, Risk Factors, Treatment Outcome, Cardiac Resynchronization Therapy, Defibrillators, Implantable, Heart Failure diagnosis, Heart Failure therapy, Myocardial Ischemia
Abstract

Aims: Cardiac resynchronization therapy with (CRTD) or without (CRTP) defibrillator is recommended in selected patient with systolic chronic heart failure and wide QRS. There is no guideline firmly indicating choice between CRTP and CRTD in primary prevention, particularly in older patients., Methods and Results: Based on the French administrative hospital-discharge database, information was collected from 2010 to 2017 for all patients implanted with CRTP or CRTD in primary prevention. Outcome analyses were undertaken in the total study population and in propensity-matched samples. During follow-up (913 days, SD 841, median 701, IQR 151-1493), 45 697 patients were analysed (CRTP 19 266 and CRTD 26 431). Incidence rate (%patient/year) of all-cause mortality was higher in CRTP patients (11.6%) than in CRTD patients (6.8%) [hazard ratio (HR) 1.70, 95% confidence interval (CI) 1.63-1.76, P < 0.001]. After propensity-matched analyses, mortality of patients over 75 years old with non-ischaemic cardiomyopathy (NICM) was not different with CRTP and CRTD (HR 0.93, 95% CI 0.80-1.09, P = 0.39). The CRTP patients under 75 years old with NICM had a higher mortality than CRTD patients (HR 1.22, 95% CI 1.03-1.45, P = 0.02). Mortality rate was also higher with CRTP than with CRTD irrespectively of age in patients with ischaemic cardiomyopathy (ICM) (<75 years old: HR 1.22, 95% CI 1.08-1.37, P = 0.01; ≥75 years old: HR 1.13, 95% CI 1.04-1.22, P = 0.003)., Conclusion: In this real-life study, CRTD was associated with a significantly lower all-cause mortality than CRTP in patients with ICM and in patients with NICM under 75 years old. Patients over 75 years old with NICM did not have lower mortality with primary prevention CRTD implantation., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Published
2020
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