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1. Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease

Author

Gilles Rioufol, François Dérimay, François Roubille, Thibault Perret, Pascal Motreff, Denis Angoulvant, Yves Cottin, Ludovic Meunier, Laura Cetran, Guillaume Cayla, Brahim Harbaoui, Jean-Yves Wiedemann, Éric Van Belle, Christophe Pouillot, Nathalie Noirclerc, Jean-François Morelle, François-Xavier Soto, Christophe Caussin, Bernard Bertrand, Thierry Lefèvre, Patrick Dupouy, Pierre-François Lesault, Franck Albert, Olivier Barthelemy, René Koning, Laurent Leborgne, Pierre Barnay, Philippe Chapon, Sébastien Armero, Antoine Lafont, Christophe Piot, Camille Amaz, Bernadette Vaz, Lakhdar Benyahya, Yvonne Varillon, Michel Ovize, Nathan Mewton, Gérard Finet, Alexandre Fournier, Geneviève Jarry, François Leleu, Dorothée Malaquin, Anfani Mirode, Loïc Belle, Lionel Mangin, Jean-Lou Hirsch, Marc Metge, Michel Pansiery, FrançoisXavier Soto, Antoine Boge, Kamel HadjHamou, Ichem Miliani, Guillaume Molins, Stéphane Mourot, Marion Pelletier, Olivier Ressencourt, Frédéric Schaad, Pierre Coste, Warren Chasseriaud, Pierre Poustis, Jean-Francois Morelle, Thibaud Demicheli, Grégroire Range, Christophe Thuaire, Nicolas Barber-Chamoux, Nicolas Combaret, Guilhem Malclès, Géraud Souteyrand, Philippe Buffet, Aurélie Gudjonvick, Isabelle L’Huillier, Luc Lorgis, Carole Richard, Gilles Baronne-Rochette, Hélène Bouvaist, Stéphanie Marlière, Olivier Ormezzano, Gérald Vanzetto, Charlotte Trouillet, Yann Valy, Eric VanBelle, Christophe Bauters, Cédric Delhaye, Gilles Lemesle, Riadh Rihani, Pierre Graux, Jean-Michel Lemahieu, Cyril Besnard, Pierre-Yves Courand, Raphaël Dauphin, Pierre Lantelme, Jean-Raymond Caignault, Olivier Dubreuil, Sylvain Ranc, Bernard Ritz, Cyrille Bergerot, Thomas Bochaton, Eric Bonnefoy-Cudraz, Didier Bresson, Julie Dementhon, François Derimay, Lisa Green, Cyril Prieur, Ingrid Sanchez, Oualid Zouaghi, Sébastien Arméro, Hakim Ben-Amer, Bernard Chevalier, Philippe Garot, Thomas Hovasse, Yves Louvard, Marie-Claude Morice, Oscar Tavolaro, Thierry Unterseeh, DinhThienTri Cung, Jean-Christophe Macia, Gilles Levy, Olivier Roth, Laurent Jacquemin, Luc Cornillet, Bertrand Ledermann, Laurent Schmutz, Nicole Karam, Saliha Rahal, Nicolas Amabile, Philippe Girard, Aurélie Veugeois, Olivier Barthélémy, Jean-Philippe Collet, Gilles Montalescot, Jacques Berland, Matthieu Godin, Quentin Landolff, Bilel Zoghlami, Karim Bougrini, Christophe Geyer, Jens Glanenapp, Patrick Mascarel, Geoffray Rambaud, Richard ViFane, Bernard Desveaux, Fabrice Ivanes, Gérard Pacouret, Laurent-Emmanuel Quilliet, Christophe SaintEtienne, Christophe Bretelle, Stanislas Champin, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Long Term Adverse Effects, Coronary Artery Disease, Fractional flow reserve, 030204 cardiovascular system & hematology, Coronary Angiography, Revascularization, Risk Assessment, Severity of Illness Index, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, Postoperative Complications, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Clinical endpoint, Humans, Medicine, 030212 general & internal medicine, Coronary Artery Bypass, ComputingMilieux_MISCELLANEOUS, Aged, Intention-to-treat analysis, business.industry, Hazard ratio, Coronary Stenosis, Percutaneous coronary intervention, medicine.disease, Coronary Vessels, 3. Good health, Fractional Flow Reserve, Myocardial, Coronary arteries, medicine.anatomical_structure, Early Termination of Clinical Trials, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background There is limited evidence that fractional flow reserve (FFR) is effective in guiding therapeutic strategy in multivessel coronary artery disease (CAD) beyond prespecified percutaneous coronary intervention or coronary graft surgery candidates. Objectives The FUTURE (FUnctional Testing Underlying coronary REvascularization) trial aimed to evaluate whether a treatment strategy based on FFR was superior to a traditional strategy without FFR in the treatment of multivessel CAD. Methods The FUTURE trial is a prospective, randomized, open-label superiority trial. Multivessel CAD candidates were randomly assigned (1:1) to treatment strategy based on FFR in all stenotic (≥50%) coronary arteries or to a traditional strategy without FFR. In the FFR group, revascularization (percutaneous coronary intervention or surgery) was indicated for FFR ≤0.80 lesions. The primary endpoint was a composite of major adverse cardiac or cerebrovascular events at 1 year. Results The trial was stopped prematurely by the data safety and monitoring board after a safety analysis and 927 patients were enrolled. At 1-year follow-up, by intention to treat, there were no significant differences in major adverse cardiac or cerebrovascular events rates between groups (14.6% in the FFR group vs 14.4% in the control group; hazard ratio: 0.97; 95% confidence interval: 0.69-1.36; P = 0.85). The difference in all-cause mortality was nonsignificant, 3.7% in the FFR group versus 1.5% in the control group (hazard ratio: 2.34; 95% confidence interval: 0.97-5.18; P = 0.06), and this was confirmed with a 24 months’ extended follow-up. FFR significantly reduced the proportion of revascularized patients, with more patients referred to exclusively medical treatment (P = 0.02). Conclusions In patients with multivessel CAD, we did not find evidence that an FFR-guided treatment strategy reduced the risk of ischemic cardiovascular events or death at 1-year follow-up. (Functional Testing Underlying Coronary Revascularisation; NCT01881555 )

Published
2021

2. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)

Author

Konstantinides, Stavros V., Meyer, Guy, Becattini, Cecilia, Bueno, Hector, Geersing, Geert-Jan, Harjola, Veli-Pekka, Huisman, Menno V., Humbert, Marc, Jennings, Catriona Sian, Jimenez, David, Kucher, Nils, Lang, Irene Marthe, Lankeit, Mareike, Lorusso, Roberto, Mazzolai, Lucia, Meneveau, Nicolas, Ni Ainle, Fionnuala, Prandoni, Paolo, Pruszczyk, Piotr, Righini, Marc, Torbicki, Adam, Van Belle, Eric, Luis Zamorano, Jose, Nazzareno, Galié, J Simon, R Gibbs, Victor, Aboyans, Walter, Ageno, Stefan, Agewall, Ana, G Almeida, Felicita, Andreotti, Emanuele, Barbato, Johann, Bauersachs, Andreas, Baumbach, Farzin, Beygui, Jørn, Carlsen, Marco De Carlo, Marion, Delcroix, Victoria, Delgado, Pilar Escribano Subias, Donna, Fitzsimons, Sean, Gaine, Samuel, Z Goldhaber, Deepa, Gopalan, Gilbert, Habib, Sigrun, Halvorsen, David, Jenkins, Hugo, A Katus, Barbro, Kjellström, Mitja, Lainscak, Patrizio, Lancellotti, Geraldine, Lee, Grégoire Le Gal, Emmanuel, Messas, Joao, Morais, Steffen, E Petersen, Anna Sonia Petronio, Massimo Francesco Piepoli, Susanna, Price, Marco, Roffi, Aldo, Salvi, Olivier, Sanchez, Evgeny, Shlyakhto, Iain, A Simpson, Stefan, Stortecky, Matthias, Thielmann, Anton Vonk Noordegraaf, Cecilia, Becattini, Héctor, Bueno, Geert-Jan, Geersing, Veli-Pekka, Harjola, Menno, V Huisman, Marc, Humbert, Catriona Sian Jennings, David, Jiménez, Nils, Kucher, Irene Marthe Lang, Mareike, Lankeit, Roberto, Lorusso, Lucia, Mazzolai, Nicolas, Meneveau, Fionnuala Ní Áinle, Paolo, Prandoni, Piotr, Pruszczyk, Marc, Righini, Adam, Torbicki, Eric, Vanbelle, José, Luiszamorano, Stephan, Windecker, Colin, Baigent, Jean-Philippe, Collet, Veronica, Dean, Chris, P Gale, Diederick, Grobbee, Gerhard, Hindricks, Bernard, Iung, Peter, Jüni, Ulf, Landmesser, Christophe, Leclercq, Maddalena, Lettino, Basil, S Lewis, Bela, Merkely, Christian, Mueller, Dimitrios, J Richter, Miguel, Sousa-Uva, Rhian, M Touyz, Naima, Hammoudi, Hamlet, Hayrapetyan, Julia, Mascherbauer, Firdovsi, Ibrahimov, Oleg, Polonetsky, Mariya, Tokmakova, Bosko, Skoric, Ioannis, Michaloliakos, Martin, Hutyra, Søren, Mellemkjaer, Mansour, Mostafa, Julia, Reinmets, Pertti, Jääskeläinen, Denis, Angoulvant, George, Giannakoulas, Endre, Zima, Vizza, Carmine Dario, Akhmetzhan, Sugraliyev, Ibadete, Bytyçi, Aija, Maca, Egle, Ereminiene, Steve, Huijnen, Robert, Xuereb, Nadejda, Diaconu, Nebojsa, Bulatovic, Ilyasse, Asfalou, Marijan, Bosevski, Bożena, Sobkowicz, Daniel, Ferreira, Antoniu Octavian Petris, Olga, Moiseeva, Marco, Zavatta, Slobodan, Obradovic, Iveta, Šimkova, Peter, Radsel, Borja, Ibanez, Gerhard, Wikström, Drahomir, Aujesky, Cihangir, Kaymaz, Alexander, Parkhomenko, Joanna, Pepke-Zaba, University of Zurich, Konstantinides, Stavros V, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Konstantinides S.V., Meyer G., Bueno H., Galie N., Gibbs J.S.R., Ageno W., Agewall S., Almeida A.G., Andreotti F., Barbato E., Baumbach A., Beygui F., Carlsen J., De Carlo M., Delcroix M., Subias P.E., Gaine S., Goldhaber S.Z., Gopalan D., Habib G., Jenkins D., Kjellstrom B., Lainscak M., Lee G., Le Gal G., Messas E., Morais J., Piepoli M.F., Price S., Salvi A., Sanchez O., Stortecky S., Thielmann M., Noordegraaf A.V., Becattini C., Geersing G.-J., Harjola V.-P., Huisman M.V., Humbert M., Jennings C.S., Jimenez D., Kucher N., Lang I., Lankeit M., Lorusso R., Mazzolai L., Meneveau N., Ainle F.N., Prandoni P., Pruszczyk P., Righini M., Torbicki A., Van Belle E., Zamorano J.L., Windecker S., Aboyans V., Baigent C., Collet J.-P., Dean V., Delgado V., Fitzsimons D., Gale C.P., Grobbee D.E., Hindricks G., Iung B., Juni P., Katus H.A., Landmesser U., Leclercq C., Lettino M., Lewis B.S., Merkely B., Mueller C., Petersen S.E., Petronio A.S., Richter D.J., Roffi M., Shlyakhto E., Simpson I.A., Sousa-Uva M., Touyz R.M., Hammoudi N., Hayrapetyan H., Mascherbauer J., Ibrahimov F., Polonetsky O., Lancellotti P., Tokmakova M., Skoric B., Michaloliakos I., Hutyra M., Mellemkjaer S., Mansour M., Reinmets J., Jaaskelainen P., Angoulvant D., Bauersachs J., Giannakoulas G., Zima E., Vizza C.D., Sugraliyev A., Bytyci I., Maca A., Ereminiene E., Huijnen S., Xuereb R., Diaconu N., Bulatovic N., Asfalou I., Bosevski M., Halvorsen S., Sobkowicz B., Ferreira D., Petris A.O., Moiseeva O., Zavatta M., Obradovic S., Simkova I., Radsel P., Ibanez B., Wikstrom G., Aujesky D., Kaymaz C., Parkhomenko A., Pepke-Zaba J., CTC, MUMC+: MA Med Staf Spec CTC (9), and RS: Carim - V04 Surgical intervention

Subjects
ORAL ANTICOAGULANT-THERAPY, diagnosis, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, Embolectomy, Guideline, RECURRENT VENOUS THROMBOEMBOLISM, 0302 clinical medicine, Pregnancy, Daily practice, Diagnosis, Pulmonary medicine, Venous thrombosis, Pulmonary Medicine, Thrombolytic Therapy, DEEP-VEIN THROMBOSIS, Disease management (health), Societies, Medical, ComputingMilieux_MISCELLANEOUS, health care economics and organizations, Risk assessment, ddc:616, RIGHT-VENTRICULAR DYSFUNCTION, Disease Management, Shock, MOLECULAR-WEIGHT HEPARIN, Thrombolysis, humanities, 3. Good health, Pulmonary embolism, Europe, Anticoagulation, Biomarkers, Dyspnoea, Echocardiography, Guidelines, Heart failure, Right ventricle, Treatment, Venous thromboembolism, medicine.vein, Acute Disease, Medical emergency, Cardiology and Cardiovascular Medicine, guidelines, pulmonary embolism, venous thrombosis, shock dyspnoea, heart failure: right ventricle: diagnosis, risk assessment: echocardiography, biomarkers, treatment, anticoagulation, thrombolysis, pregnancy, venous thromboembolism, embolectomy, Diagnosi, education, Cardiology, MEDLINE, Thrombolysi, 610 Medicine & health, Inferior vena cava, 2705 Cardiology and Cardiovascular Medicine, EXTRACORPOREAL MEMBRANE-OXYGENATION, 03 medical and health sciences, Medical, medicine, Humans, RIGHT HEART THROMBI, VENTILATION-PERFUSION SCINTIGRAPHY, Health professionals, business.industry, INFERIOR VENA-CAVA, 10031 Clinic for Angiology, Anticoagulants, 030229 sport sciences, Biomarker, medicine.disease, INHALED NITRIC-OXIDE, Societies, business
Abstract

Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

Published
2019

3. Impact of QRS Duration on Decision of Early Removal of Pacing Catheter After Transcatheter Aortic Valve Replacement With CoreValve Device

Author

Gauthier Mouillet, Nicolas Lellouche, Ronan Deballon, Arnaud Sudre, Eric Vanbelle, Thomas Modine, Pascal Lim, Jean-Luc Dubois-Randé, Emmanuel Teiger, and Masao Takahashi

Subjects
Male, medicine.medical_specialty, Pacemaker, Artificial, Transcatheter aortic, medicine.medical_treatment, Decision Making, 030204 cardiovascular system & hematology, Risk Assessment, Cardiac Catheters, law.invention, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, QRS complex, Electrocardiography, 0302 clinical medicine, Valve replacement, law, Risk Factors, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Atrioventricular Block, Device Removal, Aged, 80 and over, business.industry, Incidence, Aortic Valve Stenosis, Prognosis, Intensive care unit, Surgery, Catheter, Heart Valve Prosthesis, Cardiology, Female, France, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business, Complication, Follow-Up Studies
Abstract

The purpose of this study was to determine the predictability of QRS duration (QRSd) for temporary pacing catheter removal in patients implanted with CoreValve. Permanent pacemaker implantation is a known complication after transcatheter aortic valve replacement (TAVI) with CoreValve. Although post-TAVI QRSd is highly predictive for advanced atrioventricular block (AVB), management of delayed AVB after TAVI remains unclear. We conducted a multicentric, prospective study of 156 consecutive patients who underwent TAVI with CoreValve between December 2010 and January 2013. Patients who had acute AVB after TAVI were excluded (n = 25). We classified the patients into 2 groups based on the post-TAVI QRSd. Patients with QRSd

Published
2017

4. Effect of ACE inhibitors on angiographic restenosis after coronary stenting (PARIS): a randomised, double-blind, placebo-controlled trial

Author

Christophe Bauters, Eric VanBelle, Eugène P. Mc Fadden, Xavier Hermant, Michel E. Bertrand, Jean-Marc Lablanche, Valérie Codron, Philippe Amouyel, and Thibaud Meurice

Subjects
Male, medicine.medical_specialty, Genotype, medicine.medical_treatment, Placebo-controlled study, Angiotensin-Converting Enzyme Inhibitors, Coronary Disease, Constriction, Pathologic, Peptidyl-Dipeptidase A, Coronary Angiography, Placebo, Statistics, Nonparametric, Double-Blind Method, Restenosis, Recurrence, Risk Factors, Tetrahydroisoquinolines, Internal medicine, Coronary stent, medicine, Clinical endpoint, Humans, Analysis of Variance, Polymorphism, Genetic, business.industry, Quinapril, Stent, General Medicine, Middle Aged, Isoquinolines, medicine.disease, Surgery, Treatment Outcome, ACE inhibitor, Cardiology, Female, Stents, business, Gene Deletion, medicine.drug
Abstract

Summary Background The DD genotype for the angiotensin-I converting enzyme (ACE I) deletion allele (D) polymorphism is a possible genetic risk factor for restenosis after coronary stent implantation. We aimed to establish whether or not blockade of ACE with high doses of ACE inhibitors could reduce this risk of angiographic restenosis. Methods We characterised the ACE I/D polymorphism in 345 consecutive patients who were undergoing coronary stenting. 115 had the DD genotype. We assigned 91 of these 115 patients to quinapril 40 mg daily (n=46) or placebo (n=45). Treatment was started within 48 h after stent implantation and continued for 6 months. 79 patients complied with the protocol and underwent follow-up angiography after 6 months. Findings Our primary endpoint of late loss in minimum lumen diameter (a quantitative index of restenosis) was significantly higher in the quinapril group than in the controls (mean 1–11 mm [SD 0–70] vs 0–76 mm [0–60]; p=0–018). Secondary endpoints also showed consistent trends towards increased angiographic restenosis in the treatment group. Interpretation Contrary to our expectations, ACE inhibitor treatment did not reduce restenosis after coronary stent implantation in patients with DD genotype, but was associated with an exaggerated restenotic process when compared with administration of placebo.

Published
2001

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