103 results on '"L'Allier PL"'
Search Results
2. Dual antiplatelet therapy duration after coronary stenting in clinical practice: results of an EAPCI survey
- Author
-
Valgimigli, M, Costa, F, Byrne, R, Haude, M, Baumbach, A, Windecker, S, Aaroe, J, Aasa, M, Abdel-Salam, Am, Alaarag, Af, Accardi, R, Adel, A, Alcazar De La Torre, E, Alejos, R, Alfonso Jimenez, V, Alhashimi, Hmm, Aljeboury, A, Almeida De Sousa, J, Almusawi, A, Alshaikha, M, Altaf, S, Altahmody, Kea, Alvarez Contreras, Lr, Amarasena, N, Amoroso, G, Anderson, R, Ando, G, Andrade, J, Andreou, Ay, Angulo, J, Antonio, T, Aprigliano, G, Aquilina, M, Arafa, Seo, Aramberry, L, Arampatzis, Ca, Araujo, Jj, Asher, E, Ates, I, Athanasias, D, Auer, J, Auffret, V, Ayala, Fj, Baba, C, Baglioni, P, Bagur, R, Balam-Ortiz, E, Balducelli, M, Bam Pas, G, Barbash, Im, Barbosa, Ahp, Barbosa, R, Barnay, P, Barroso, L, Basti, A, Bax, M, Bayet, G, Beijk, Ma, Beltran, R, Berenguer Jofresa, A, Berroth, R, Berti, S, Berumen Dominguez, Le, Bhasin, A, Bhaya, M, Bianco, M, Biasco, L, Bikicki, M, Bonarjee, Vvs, Bonechi, F, Borges Santos, M, Boshev, M, Bouferrouk, A, Bounartzidi, M, Bousoula, E, Brie, D, Brtko, M, Brugaletta, S, Brull, Dj, Buchter, B, Buendia, R, Burzotta, F, Butz, T, Buzzetti, F, Bychowiec, B, Cadeddu, M, Campanile, A, Carneiro, Jg, Carrilho-Ferreira, P, Carrillo Guevara, Je, Carter, Aj, Casal-Heredia, H, Castiglioni, B, Castro Fabiano, L, Cavalcante Silva, R, Cavalcanti De Oliveira, D, Cavalcanti, Rc, Cavazza, C, Centemero, Mp, Chabane, Hk, Chamie, D, Chatzis, D, Chaves, Aj, Cheng, S, Chinchilla, H, Ciabatti, N, Cirillo, P, Citaku, H, Claeys, Mj, Clifford, C, Coceani, M, Coggiola, J, Cohen, Dj, Conway, Dsg, Cornelis, K, Coroleu, Sf, Corral, Jm, Cortese, B, Coskun, U, Costa, Ra, Coste, P, Coufal, Z, Cox, S, Cozma, A, Crean, P, Crenshaw, Mh, Cristian, U, Cruz-Alvarado, Je, Cuculi, F, Cuenza, L, Cyrne Carvalho, H, D'Ascenzo, F, D'Urbano, M, Damonte, A, Dan Florin, F, Dana, A, Dangoisse, V, De Backer, O, De Cock, D, De Vita, M, Debski, A, Delgado, A, Devadathan, S, Dhamrait, S, Di Lorenzo, E, Di Serafino, D, Diego-Nieto, A, Dievart, F, Diez, Jl, Dimitriadis, K, Dina, C, Doerner, O, Donahue, M, Donis, J, Drieghe, B, Drissi, Mf, Du Fretay, H, Dziewierz, A, Echavarria-Pinto, M, Echeverria Romero, Rg, Economou, F, Eftychiou, C, Egdell, R, El Hosieny, A, El Meguid, K, Elabbassi, W, Elesgerli, S, Elghetany, H, Elizondo, Jc, Elkahlout, A, Elrowiny, R, Elserafy, As, Emam, A, Emara, A, Emmanouil, P, Ercilla, J, Erglis, A, Eslam Taha, E, Esmaeil, S, Esposito, G, Ettori, F, Eugenio, N, Everaert, B, Ezquerra Aguilar, W, Falu, R, Farag, E, Farjalla, J, Feldman, L, Feldman, M, Felice, H, Fernandez-Nofrerias, E, Fernandez-Rodriguez, D, Ferranti, F, Ferreira, Q, Ferrone, M, Fleischmann, C, Flessas, D, Formigli, D, Fozilov, H, Fraccaro, C, Freitas, Jo, Fresco, C, Fridrich, V, Furmaniuk, J, Gagnor, A, Galasso, G, Galeazzi, Gl, Galli, S, Galvez Villacorta, V, Gandolfo, C, Garcia, E, Garcia-Blas, S, Garducci, S, Garg, S, Garro, N, Gatto, L, Georgiou, Mg, Ghanem, I, Ghose, T, Giacchi, G, Giang, Pt, Giesler, T, Giovino, M, Girardi, P, Girasis, C, Giunio, L, Giustino, G, Glatthor, C, Glogar, Hd, Golledge, P, Gomez Moreno, J, Gomez Recio, M, Gommeaux, A, Grantalis, G, Greco, F, Grundeken, Mj, Grunert, S, Gudmundsdottir, I, Guenoun, M, Guerios, E, Gupta, R, Gupta, S, Gutierrez, C, Hafeez, I, Halvorsen, S, Hamed Hussein, Ga, Hammoudeh, A, Hansen, Pr, Harb, S, Hawas, Jm, Hayrapetyan, H, Heintzen, Mp, Hengstenberg, C, Herity, N, Hernandez, F, Heyse, A, Hicham, D, Hildick-Smith, D, Hill, J, Hillani, A, Hiltrop, N, Hiramori, A, Hobson, Ar, Homan, Dj, Hooda, A, Ielasi, A, Ierna, S, Iftikhar, Ak, Ilic, I, Imai, Y, Imperadore, F, Indolfi, C, Iorga, V, Ipek, E, Ito, S, Jacksch, R, Jae-Sik, J, James, S, Jamshidi, P, Jerbi, J, Jimenez Quevedo, P, Jimenez-Navarro, M, Jimenez-Santos, M, Jin, Qh, Joksas, V, Jovic, D, Junejo, S, Kallel, R, Kamal, A, Kamiya, H, Kannan, D, Kantaria, M, Kapetanopoulos, A, Kara Ali, B, Karjalainen, Pp, Karthikeyan, Vj, Kato, R, Katsikis, A, Kefer, J, Keta, D, Ketteler, T, Khan, M, Kharlamov, A, Kinani, A, Kinani, T, Kinnaird, T, Kislo, A, Kiviniemi, T, Kleiban, A, Kluck, B, Kocayigit, I, Kokis, A, Komiyama, N, Konstantinos, L, Kordalis, A, Kozak, M, Krecki, R, Kristensen, Sd, Krizanic, F, Krsticevic, L, Kuex, H, Kukreja, N, Kulic, M, Kulikovskikh, Yv, Kulkarni, P, Kumar, N, Kumar Soni, A, Kuzmenko, E, L'Allier, Pl, Langner, O, Lapin, O, Lauer, B, Leclercq, F, Leibundgut, G, Leon Aliz, E, Leon, C, Leon, K, Leoncini, M, Leone, Am, Leroux, L, Lesiak, M, Letilovic, T, Lev, E, Linares Vicente, Ja, Lindsay, S, Loh, Ph, Loncar, G, Loo, B, Lopez, Mb, Lopez-Cuellar, J, Lozano, I, Luigia, P, Lunde, K, Lyczywek, M, Macdougall, D, Mafrici, A, Magni, V, Magro, M, Mainar, V, Makarovic, Z, Malik, N, Maly, M, Mansour, S, Marenco, Re, Maresta, A, Marinho, Ge, Marino, Rl, Marinucci, L, Martins, Hc, Martins, J, Mashayekhi, K, Masood, A, Maurer, E, Mavrogianni, Ad, Mazurek, T, Medina, A, Mehilli, J, Mellwig, Kp, Mendez, M, Mendiz, Oa, Meneses, A, Mercado, La, Mereuta, A, Mezzapelle, G, Milanovic, N, Mohamed, Sm, Mohanad, A, Mohanty, A, Moorthy, N, Morales, Fj, More, R, Moreno Samos, Jc, Moreno-Martinez, Fl, Moscato, F, Mossmann, M, Mrevlje, B, Muller-Eichelberg, A, Musumeci, G, Nadir Khan, M, Najim, S, Nakamura, S, Nakao, F, Naveri, H, Negus, B, Nerla, R, Nguyen, Ht, Niess, Gs, Nikas, Dn, Niroomand, F, Niva, J, Nogueira, Jw, Nombela-Franco, L, Notrica, M, Nouri, B, Nugue, O, Nunes, Gl, Ober, M, Ochoa, J, J. H., O, Ojeda, S, Oktay Tureli, H, Olowe, Y, Oluseun, A, Opolski, G, Ornelas, Ce, Otasevic, P, Ozturk, A, Padilla, F, Pagny, Jy, Paolantonio, D, Papaioannou, Gi, Parodi, G, Patil, Sn, Pavei, A, Pavia, A, Pavlidis, A, Pell, A, Percoco, Gf, Pernasetti, Lv, Pescoller, F, Petropoulakis, P, Piatti, L, Picardi, E, Pieroni, Dm, Pina, J, Pinheiro, Lf, Pinto, Fj, Pipa, Jl, Piroth, Z, Pisano, F, Podbregar, M, Polak, G, Polimeni, A, Postadzhiyan, A, Postu, M, Poulimenos, Le, Pow Chon Long, F, Poyet, R, Pradhan, A, Predescu, Lm, Prida, Xe, Saad, A, Prog, R, Pulikal, Dga, Qiangzhong, Pi, Radu, Md, Rajendran, D, Ram Anil Raj, Mr, Ramazzotti, V, Rapacciuolo, A, Ratib, K, Raungaard, B, Raviola, E, Reppas, E, Reyes, Ja, Rezek, M, Riess, Gj, Rifaie, O, Rigattieri, S, Rissanen, T, Ristic, Ad, Rittger, H, Roberts, J, Rodriguez Saavedra, A, Roik, M, Roshan Rao, K, Routledge, H, Rubboli, A, Rudolph, T, Rudzitis, A, Ruiters, A, Ruiz Ros, Ja, Ruiz-Garcia, J, Ruiz-Nodar, Jm, Sabate, M, Sabnis, G, Sabouret, P, Sacra, C, Saghatelyan, M, Sahin, M, Said, S, Salachas, Aj, Salas Llamas, Jp, Salih, A, Sanchez, Od, Sanchez-Gila, J, Sanchez-Perez, I, Santarelli, A, Sardovski, Sarenac, D, Sarma, J, Sarno, G, Savonitto, S, Sayied Abdullah, A, Schafer, A, Scherillo, M, Schneider, H, Schuhlen, H, Sciahbasi, A, Seca, L, Sedlon, P, Semenka, J, Serra, La, Sesana, M, Sethi, A, Sgueglia, Ga, Shaheen, S, Shahri, H, Sheiban, I, Shyu, Kg, Silva, Cef, Sionis, D, Siqueira, Da, Siqueira, Mj, Smits, P, Sobhy, M, Sokolov, M, Soliman, S, Somani, An, Sridhar, G, Stakos, D, Stasek, J, Stefanini, G, Steigen, Tk, Stewart, Stipal, R, Stochino, Ml, Stoel, Mg, Subla, Rm, Suliman, A, Summaria, F, Stoyanov, N, Syed, Aa, Tanaka, Y, Tashani, A, Tauzin, S, Tawade, N, Tawfik, M, Tayeh, O, Terzic, I, Testa, L, Thevan, B, Thiam, M, Tiecco, F, Tierala, I, Tilea, I, Tilsted, Hh, Tomasik, Ar, Tonev, I, Torres Bosco, A, Tousek, P, Townend, J, Tran Ngoc, T, Triantafyllou, K, Tsigkas, G, Tsioufis, C, Turri, M, Tyligadis, G, Ugo, F, Ultramari, Ft, Urban, P, Uren, N, Uretsky, Bf, Uribe, Ce, Usman, B, Valadez Molina, F, Van Houwelingen, Kg, Vandormael, M, Varvarovsky, I, Vassilis, V, Velasquez, D, Verdoia, M, Vermeersch, P, Vidal-Perez, R, Vinesh, J, Violini, R, Vista, Jh, Vogt, F, Vogt, M, Vokac, D, Vom Dahl, J, Vranckx, P, Wahab, A, Wang, R, Wang, Td, Wani, S, Weisz, Sh, Werner, Gs, Wilkinson, Jr, Wolf, A, Youssef, A, Yumoto, K, Zaderenko, N, Zaghloul Darwish, Am, Zahn, R, Zaro, T, Zavalloni, D, Zbinden, R, Zekanovic, D, Zhang, B, Zhang, C, Zhang, Yj, Zhonghan, N, Zingarelli, A, Zueco, J, Zuhairy, H, Abbate, A, Abdel Hamid, M, Abdelmegid, Maf, Acuna-Valerio, J, Adriaenssens, T, Agostoni, P, Aikot, H, Alameda, M, Alcaraz, H, Almendro-Delia, M, Altug Cakmak, H, Amir, A, Arjomand, A, Assomull, R, Atalar, E, Avramides, D, Aytek Simsek, M, Aznaouridis, K, Azpeitia, Y, Barnabas, C, Barsness, Gw, Bartorelli, Al, Basoglu, A, Benezet, J, Benincasa, S, Berland, J, Berrocal, Dh, Bett, N, Boskovic, S, Brandao, V, Caporale, R, Caprotta, F, Carrabba, N, Cazaux, P, Cheniti, G, Chinchilla Calix, H, Chung, Wy, Cicco, Na, Cieza, T, Clapp, B, Commeau, P, Cuellar, C, De Benedictis, M, De La Torre Hernandez, Jm, De Vroey, F, Degertekin, M, Eberli, Fr, Eggebrecht, H, Ekicibasi, E, Elmaraghi, M, Elod, P, Ergene, Ao, Fadlalla, Vf, Farah, Ma, Fernandez Vina, R, Ferro, A, Fischer, D, Flore, V, Foley, Dp, Gafoor, S, Gallo, S, Gaspardone, A, Gavrilescu, D, Gentiletti, A, Gilard, M, Giovannelli, F, Gonzalez Pacheco, I, Gonzalo, N, Grajek, S, Gurgel De Medeiros, Jp, Haine, S, Hakim, D, Hakim Vista, Jj, Hallani, H, Hamid, M, Helft, G, Heppell, Rm, Hernandez-Enriquez, M, Hlinomaz, O, Ho Choo, E, Huqi, A, Hurtado, Eo, Iakovou, I, Iosseliani, D, Janssens, L, Jean, M, Jensen, Jk, Jesudason, P, Jimenez Diaz, Va, Karchevsky, D, Karpovskii, A, Katsimagklis, G, Kereiakes, D, Kersanova, Nc, Kesavan, S, Khaled, H, Khalil, Sa, Kiatchoosakun, S, Kim, Ks, Kirma, C, Koltowski, L, Konteva, M, Kozinski, L, Kuehn, Cr, Kumar, S, Kyriakakis, Cg, Laanmets, P, Labrunie, A, Ladwiniec, A, Lai, G, Laine, M, Latib, A, Lattuca, B, Lazarevic, Am, Lee, Ks, Legrand, V, Leiva, G, Lester, N, Levchyshyna, O, Livia, G, Londero, Hf, Luha, O, Lupi, A, Lupkovics, G, Maaliki, S, Maeng, M, Mahr, Nc, Mantyla, P, Mariano, E, Marsit, N, Mcdonough, Tj, Medda, M, Mejia Viana, S, Merigo Azpir, Ca, Mitreski, S, Moreno, R, Moreu, J, Muehler, M, Muir, D, Munoz Molina, R, Musilli, N, Myc, J, Nadra, I, Nagy, Cd, Narayanan, A, Neugebauer, P, Nguyen, M, Nick, H, Nicolino, A, Obradovic, Sd, Paizis, I, Panagiotis, P, Park, Sd, Park, Sj, Pasquetto, G, Patel, D, Paunovic, D, Pedon, L, Pereira Machado, F, Pershukov, H, Petrou, E, Pinton, Fa, Preti, G, Puri, R, Pyxaras, Sa, Quintanilla, J, Rhouati, A, Ribeiro De Oliveira, I, Rivetti, L, Rodriguez, Ae, Rotevatn, S, Rubartelli, P, Sachdeva, R, Sanchez-Perez, H, Sangiorgi, G, Santoro, Gm, Saporito, F, Scappaticci, M, Schmermund, A, Schmidt, Je, Schmitz, T, Schneider, Ti, Schuchlenz, H, Sepulveda Varela, P, Shaw, E, Silva Marques, J, Skalidis, E, Slhessarenko, J, Spaulding, C, Stankovic, G, Suwannasom, P, Synetos, A, Szuster, E, Taha, S, Tavano, D, Tebet, M, Thury, A, Toutouzas, K, Triantafyllis, As, Tsikaderis, D, Tumscitz, C, Tzanogiorgis, I, Udovichenko, A, Ulrike, N, Unikas, R, Valerio, Mg, Van Mieghem, C, Vandendriessche, T, Vavlukis, M, Vigna, C, Vilar, Jv, Vizzari, G, Voudris, V, Wafa, S, Wagner, Dr, Wichter, T, Wiedemann, S, Williams, Pd, Woody, W, Yding, A, Zachow, G, Webster, M, Valgimigli, M., Costa, F., Byrne, R., Haude, M., Baumbach, A., Windecker, S., Aaroe, J., Aasa, M., Abdel-Salam, A. M., Alaarag, A. F., Accardi, R., Adel, A., Alcazar De La Torre, E., Alejos, R., Alfonso Jimenez, V., Alhashimi, H. M. M., Aljeboury, A., Almeida De Sousa, J., Almusawi, A., Alshaikha, M., Altaf, S., Altahmody, K. E. A., Alvarez Contreras, L. R., Amarasena, N., Amoroso, G., Anderson, R., Ando, G., Andrade, J., Andreou, A. Y., Angulo, J., Antonio, T., Aprigliano, G., Aquilina, M., Arafa, S. E. O., Aramberry, L., Arampatzis, C. A., Araujo, J. J., Asher, E., Ates, I., Athanasias, D., Auer, J., Auffret, V., Ayala, F. J., Baba, C., Baglioni, P., Bagur, R., Balam-Ortiz, E., Balducelli, M., Bam Pas, G., Barbash, I. M., Barbosa, A. H. P., Barbosa, R., Barnay, P., Barroso, L., Basti, A., Bax, M., Bayet, G., Beijk, M. A., Beltran, R., Berenguer Jofresa, A., Berroth, R., Berti, S., Berumen Dominguez, L. E., Bhasin, A., Bhaya, M., Bianco, M., Biasco, L., Bikicki, M., Bonarjee, V. V. S., Bonechi, F., Borges Santos, M., Boshev, M., Bouferrouk, A., Bounartzidi, M., Bousoula, E., Brie, D., Brtko, M., Brugaletta, S., Brull, D. J., Buchter, B., Buendia, R., Burzotta, F., Butz, T., Buzzetti, F., Bychowiec, B., Cadeddu, M., Campanile, A., Carneiro, J. G., Carrilho-Ferreira, P., Carrillo Guevara, J. E., Carter, A. J., Casal-Heredia, H., Castiglioni, B., Castro Fabiano, L., Cavalcante Silva, R., Cavalcanti De Oliveira, D., Cavalcanti, R. C., Cavazza, C., Centemero, M. P., Chabane, H. K., Chamie, D., Chatzis, D., Chaves, A. J., Cheng, S., Chinchilla, H., Ciabatti, N., Cirillo, P., Citaku, H., Claeys, M. J., Clifford, C., Coceani, M., Coggiola, J., Cohen, D. J., Conway, D. S. G., Cornelis, K., Coroleu, S. F., Corral, J. M., Cortese, B., Coskun, U., Costa, R. A., Coste, P., Coufal, Z., Cox, S., Cozma, A., Crean, P., Crenshaw, M. H., Cristian, U., Cruz-Alvarado, J. E., Cuculi, F., Cuenza, L., Cyrne Carvalho, H., D'Ascenzo, F., D'Urbano, M., Damonte, A., Dan Florin, F., Dana, A., Dangoisse, V., De Backer, O., De Cock, D., De Vita, M., Debski, A., Delgado, A., Devadathan, S., Dhamrait, S., Di Lorenzo, E., Di Serafino, D., Diego-Nieto, A., Dievart, F., Diez, J. L., Dimitriadis, K., Dina, C., Doerner, O., Donahue, M., Donis, J., Drieghe, B., Drissi, M. F., Du Fretay, H., Dziewierz, A., Echavarria-Pinto, M., Echeverria Romero, R. G., Economou, F., Eftychiou, C., Egdell, R., El Hosieny, A., El Meguid, K., Elabbassi, W., Elesgerli, S., Elghetany, H., Elizondo, J. C., Elkahlout, A., Elrowiny, R., Elserafy, A. S., Emam, A., Emara, A., Emmanouil, P., Ercilla, J., Erglis, A., Eslam Taha, E., Esmaeil, S., Esposito, G., Ettori, F., Eugenio, N., Everaert, B., Ezquerra Aguilar, W., Falu, R., Farag, E., Farjalla, J., Feldman, L., Feldman, M., Felice, H., Fernandez-Nofrerias, E., Fernandez-Rodriguez, D., Ferranti, F., Ferreira, Q., Ferrone, M., Fleischmann, C., Flessas, D., Formigli, D., Fozilov, H., Fraccaro, C., Freitas, J. O., Fresco, C., Fridrich, V., Furmaniuk, J., Gagnor, A., Galasso, G., Galeazzi, G. L., Galli, S., Galvez Villacorta, V., Gandolfo, C., Garcia, E., Garcia-Blas, S., Garducci, S., Garg, S., Garro, N., Gatto, L., Georgiou, M. G., Ghanem, I., Ghose, T., Giacchi, G., Giang, P. T., Giesler, T., Giovino, M., Girardi, P., Girasis, C., Giunio, L., Giustino, G., Glatthor, C., Glogar, H. D., Golledge, P., Gomez Moreno, J., Gomez Recio, M., Gommeaux, A., Grantalis, G., Greco, F., Grundeken, M. J., Grunert, S., Gudmundsdottir, I., Guenoun, M., Guerios, E., Gupta, R., Gupta, S., Gutierrez, C., Hafeez, I., Halvorsen, S., Hamed Hussein, G. A., Hammoudeh, A., Hansen, P. R., Harb, S., Hawas, J. M., Hayrapetyan, H., Heintzen, M. P., Hengstenberg, C., Herity, N., Hernandez, F., Heyse, A., Hicham, D., Hildick-Smith, D., Hill, J., Hillani, A., Hiltrop, N., Hiramori, A., Hobson, A. R., Homan, D. J., Hooda, A., Ielasi, A., Ierna, S., Iftikhar, A. K., Ilic, I., Imai, Y., Imperadore, F., Indolfi, C., Iorga, V., Ipek, E., Ito, S., Jacksch, R., Jae-Sik, J., James, S., Jamshidi, P., Jerbi, J., Jimenez Quevedo, P., Jimenez-Navarro, M., Jimenez-Santos, M., Jin, Q. H., Joksas, V., Jovic, D., Junejo, S., Kallel, R., Kamal, A., Kamiya, H., Kannan, D., Kantaria, M., Kapetanopoulos, A., Kara Ali, B., Karjalainen, P. P., Karthikeyan, V. J., Kato, R., Katsikis, A., Kefer, J., Keta, D., Ketteler, T., Khan, M., Kharlamov, A., Kinani, A., Kinani, T., Kinnaird, T., Kislo, A., Kiviniemi, T., Kleiban, A., Kluck, B., Kocayigit, I., Kokis, A., Komiyama, N., Konstantinos, L., Kordalis, A., Kozak, M., Krecki, R., Kristensen, S. D., Krizanic, F., Krsticevic, L., Kuex, H., Kukreja, N., Kulic, M., Kulikovskikh, Y. V., Kulkarni, P., Kumar, N., Kumar Soni, A., Kuzmenko, E., L'Allier, P. L., Langner, O., Lapin, O., Lauer, B., Leclercq, F., Leibundgut, G., Leon Aliz, E., Leon, C., Leon, K., Leoncini, M., Leone, A. M., Leroux, L., Lesiak, M., Letilovic, T., Lev, E., Linares Vicente, J. A., Lindsay, S., Loh, P. H., Loncar, G., Loo, B., Lopez, M. B., Lopez-Cuellar, J., Lozano, I., Luigia, P., Lunde, K., Lyczywek, M., Macdougall, D., Mafrici, A., Magni, V., Magro, M., Mainar, V., Makarovic, Z., Malik, N., Maly, M., Mansour, S., Marenco, R. E., Maresta, A., Marinho, G. E., Marino, R. L., Marinucci, L., Martins, H. C., Martins, J., Mashayekhi, K., Masood, A., Maurer, E., Mavrogianni, A. D., Mazurek, T., Medina, A., Mehilli, J., Mellwig, K. P., Mendez, M., Mendiz, O. A., Meneses, A., Mercado, L. A., Mereuta, A., Mezzapelle, G., Milanovic, N., Mohamed, S. M., Mohanad, A., Mohanty, A., Moorthy, N., Morales, F. J., More, R., Moreno Samos, J. C., Moreno-Martinez, F. L., Moscato, F., Mossmann, M., Mrevlje, B., Muller-Eichelberg, A., Musumeci, G., Nadir Khan, M., Najim, S., Nakamura, S., Nakao, F., Naveri, H., Negus, B., Nerla, R., Nguyen, H. T., Niess, G. S., Nikas, D. N., Niroomand, F., Niva, J., Nogueira, J. W., Nombela-Franco, L., Notrica, M., Nouri, B., Nugue, O., Nunes, G. L., Ober, M., Ochoa, J., Oh, J. H., Ojeda, S., Oktay Tureli, H., Olowe, Y., Oluseun, A., Opolski, G., Ornelas, C. E., Otasevic, P., Ozturk, A., Padilla, F., Pagny, J. Y., Paolantonio, D., Papaioannou, G. I., Parodi, G., Patil, S. N., Pavei, A., Pavia, A., Pavlidis, A., Pell, A., Percoco, G. F., Pernasetti, L. V., Pescoller, F., Petropoulakis, P., Piatti, L., Picardi, E., Pieroni, D. M., Pina, J., Pinheiro, L. F., Pinto, F. J., Pipa, J. L., Piroth, Z., Pisano, F., Podbregar, M., Polak, G., Polimeni, A., Postadzhiyan, A., Postu, M., Poulimenos, L. E., Pow Chon Long, F., Poyet, R., Pradhan, A., Predescu, L. M., Prida, X. E., Saad, A., Prog, R., Pulikal, D. G. A., Qiangzhong, P. I., Radu, M. D., Rajendran, D., Ram Anil Raj, M. R., Ramazzotti, V., Rapacciuolo, A., Ratib, K., Raungaard, B., Raviola, E., Reppas, E., Reyes, J. A., Rezek, M., Riess, G. J., Rifaie, O., Rigattieri, S., Rissanen, T., Ristic, A. D., Rittger, H., Roberts, J., Rodriguez Saavedra, A., Roik, M., Roshan Rao, K., Routledge, H., Rubboli, A., Rudolph, T., Rudzitis, A., Ruiters, A., Ruiz Ros, J. A., Ruiz-Garcia, J., Ruiz-Nodar, J. M., Sabate, M., Sabnis, G., Sabouret, P., Sacra, C., Saghatelyan, M., Sahin, M., Said, S., Salachas, A. J., Salas Llamas, J. P., Salih, A., Sanchez, O. D., Sanchez-Gila, J., Sanchez-Perez, I., Santarelli, A., Sardovski, Sarenac, D., Sarma, J., Sarno, G., Savonitto, S., Sayied Abdullah, A., Schafer, A., Scherillo, M., Schneider, H., Schuhlen, H., Sciahbasi, A., Seca, L., Sedlon, P., Semenka, J., Serra, L. A., Sesana, M., Sethi, A., Sgueglia, G. A., Shaheen, S., Shahri, H., Sheiban, I., Shyu, K. G., Silva, C. E. F., Sionis, D., Siqueira, D. A., Siqueira, M. J., Smits, P., Sobhy, M., Sokolov, M., Soliman, S., Somani, A. N., Sridhar, G., Stakos, D., Stasek, J., Stefanini, G., Steigen, T. K., Stewart, Stipal, R., Stochino, M. L., Stoel, M. G., Subla, R. M., Suliman, A., Summaria, F., Stoyanov, N., Syed, A. A., Tanaka, Y., Tashani, A., Tauzin, S., Tawade, N., Tawfik, M., Tayeh, O., Terzic, I., Testa, L., Thevan, B., Thiam, M., Tiecco, F., Tierala, I., Tilea, I., Tilsted, H. H., Tomasik, A. R., Tonev, I., Torres Bosco, A., Tousek, P., Townend, J., Tran Ngoc, T., Triantafyllou, K., Tsigkas, G., Tsioufis, C., Turri, M., Tyligadis, G., Ugo, F., Ultramari, F. T., Urban, P., Uren, N., Uretsky, B. F., Uribe, C. E., Usman, B., Valadez Molina, F., Van Houwelingen, K. G., Vandormael, M., Varvarovsky, I., Vassilis, V., Velasquez, D., Verdoia, M., Vermeersch, P., Vidal-Perez, R., Vinesh, J., Violini, R., Vista, J. H., Vogt, F., Vogt, M., Vokac, D., Vom Dahl, J., Vranckx, P., Wahab, A., Wang, R., Wang, T. D., Wani, S., Weisz, S. H., Werner, G. S., Wilkinson, J. R., Wolf, A., Youssef, A., Yumoto, K., Zaderenko, N., Zaghloul Darwish, A. M., Zahn, R., Zaro, T., Zavalloni, D., Zbinden, R., Zekanovic, D., Zhang, B., Zhang, C., Zhang, Y. J., Zhonghan, N., Zingarelli, A., Zueco, J., Zuhairy, H., Abbate, A., Abdel Hamid, M., Abdelmegid, M. A. F., Acuna-Valerio, J., Adriaenssens, T., Agostoni, P., Aikot, H., Alameda, M., Alcaraz, H., Almendro-Delia, M., Altug Cakmak, H., Amir, A., Arjomand, A., Assomull, R., Atalar, E., Avramides, D., Aytek Simsek, M., Aznaouridis, K., Azpeitia, Y., Barnabas, C., Barsness, G. W., Bartorelli, A. L., Basoglu, A., Benezet, J., Benincasa, S., Berland, J., Berrocal, D. H., Bett, N., Boskovic, S., Brandao, V., Caporale, R., Caprotta, F., Carrabba, N., Cazaux, P., Cheniti, G., Chinchilla Calix, H., Chung, W. Y., Cicco, N. A., Cieza, T., Clapp, B., Commeau, P., Cuellar, C., De Benedictis, M., De La Torre Hernandez, J. M., De Vroey, F., Degertekin, M., Eberli, F. R., Eggebrecht, H., Ekicibasi, E., Elmaraghi, M., Elod, P., Ergene, A. O., Fadlalla, V. F., Farah, M. A., Fernandez Vina, R., Ferro, A., Fischer, D., Flore, V., Foley, D. P., Gafoor, S., Gallo, S., Gaspardone, A., Gavrilescu, D., Gentiletti, A., Gilard, M., Giovannelli, F., Gonzalez Pacheco, I., Gonzalo, N., Grajek, S., Gurgel De Medeiros, J. P., Haine, S., Hakim, D., Hakim Vista, J. J., Hallani, H., Hamid, M., Helft, G., Heppell, R. M., Hernandez-Enriquez, M., Hlinomaz, O., Ho Choo, E., Huqi, A., Hurtado, E. O., Iakovou, I., Iosseliani, D., Janssens, L., Jean, M., Jensen, J. K., Jesudason, P., Jimenez Diaz, V. A., Karchevsky, D., Karpovskii, A., Katsimagklis, G., Kereiakes, D., Kersanova, N. C., Kesavan, S., Khaled, H., Khalil, S. A., Kiatchoosakun, S., Kim, K. S., Kirma, C., Koltowski, L., Konteva, M., Kozinski, L., Kuehn, C. R., Kumar, S., Kyriakakis, C. G., Laanmets, P., Labrunie, A., Ladwiniec, A., Lai, G., Laine, M., Latib, A., Lattuca, B., Lazarevic, A. M., Lee, K. S., Legrand, V., Leiva, G., Lester, N., Levchyshyna, O., Livia, G., Londero, H. F., Luha, O., Lupi, A., Lupkovics, G., Maaliki, S., Maeng, M., Mahr, N. C., Mantyla, P., Mariano, E., Marsit, N., Mcdonough, T. J., Medda, M., Mejia Viana, S., Merigo Azpir, C. A., Mitreski, S., Moreno, R., Moreu, J., Muehler, M., Muir, D., Munoz Molina, R., Musilli, N., Myc, J., Nadra, I., Nagy, C. D., Narayanan, A., Neugebauer, P., Nguyen, M., Nick, H., Nicolino, A., Obradovic, S. D., Paizis, I., Panagiotis, P., Park, S. D., Park, S. J., Pasquetto, G., Patel, D., Paunovic, D., Pedon, L., Pereira Machado, F., Pershukov, H., Petrou, E., Pinton, F. A., Preti, G., Puri, R., Pyxaras, S. A., Quintanilla, J., Rhouati, A., Ribeiro De Oliveira, I., Rivetti, L., Rodriguez, A. E., Rotevatn, S., Rubartelli, P., Sachdeva, R., Sanchez-Perez, H., Sangiorgi, G., Santoro, G. M., Saporito, F., Scappaticci, M., Schmermund, A., Schmidt, J. E., Schmitz, T., Schneider, T. I., Schuchlenz, H., Sepulveda Varela, P., Shaw, E., Silva Marques, J., Skalidis, E., Slhessarenko, J., Spaulding, C., Stankovic, G., Suwannasom, P., Synetos, A., Szuster, E., Taha, S., Tavano, D., Tebet, M., Thury, A., Toutouzas, K., Triantafyllis, A. S., Tsikaderis, D., Tumscitz, C., Tzanogiorgis, I., Udovichenko, A., Ulrike, N., Unikas, R., Valerio, M. G., Van Mieghem, C., Vandendriessche, T., Vavlukis, M., Vigna, C., Vilar, J. V., Vizzari, G., Voudris, V., Wafa, S., Wagner, D. R., Wichter, T., Wiedemann, S., Williams, P. D., Woody, W., Yding, A., Zachow, G., and Webster, M.
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Percutaneous ,Time Factor ,Psychological intervention ,Alternative medicine ,MEDLINE ,Practice Patterns ,Drug Administration Schedule ,acute coronary syndrome ,Settore MED/11 ,Percutaneous Coronary Intervention ,Pharmacotherapy ,Drug Therapy ,Physicians ,Surveys and Questionnaires ,drug-eluting stent ,Humans ,Surveys and Questionnaire ,Medicine ,Practice Patterns, Physicians' ,health care economics and organizations ,clopidogrel ,dual antiplatelet therapy (DAPT) ,stable coronary artery disease ,Drug Therapy, Combination ,Evidence-Based Medicine ,Health Care Surveys ,Platelet Aggregation Inhibitors ,Practice Guidelines as Topic ,Practice Patterns, Physicians ,Treatment Outcome ,Stents ,business.industry ,Platelet Aggregation Inhibitor ,Coronary stenting ,Evidence-based medicine ,Middle Aged ,Surgery ,Clinical trial ,Health Care Survey ,Combination ,Emergency medicine ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
AIMS Our aim was to report on a survey initiated by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) concerning opinion on the evidence relating to dual antiplatelet therapy (DAPT) duration after coronary stenting. METHODS AND RESULTS Results from three randomised clinical trials were scheduled to be presented at the American Heart Association Scientific Sessions 2014 (AHA 2014). A web-based survey was distributed to all individuals registered in the EuroIntervention mailing list (n=15,200) both before and after AHA 2014. A total of 1,134 physicians responded to the first (i.e., before AHA 2014) and 542 to the second (i.e., after AHA 2014) survey. The majority of respondents interpreted trial results consistent with a substantial equipoise regarding the benefits and risks of an extended versus a standard DAPT strategy. Two respondents out of ten believed extended DAPT should be implemented in selected patients. After AHA 2014, 46.1% of participants expressed uncertainty about the available evidence on DAPT duration, and 40.0% the need for clinical guidance. CONCLUSIONS This EAPCI survey highlights considerable uncertainty within the medical community with regard to the optimal duration of DAPT after coronary stenting in the light of recent reported trial results. Updated recommendations for practising physicians to guide treatment decisions in routine clinical practice should be provided by international societies.
- Published
- 2015
3. Immediate vs. delayed stenting in acute myocardial infarction: a systematic review and meta-analysis
- Author
-
Géraud Souteyrand, Jolicœur Em, L Allier Pl, Loic Belle, Lawrence Joseph, Jean-François Tanguay, and Xavier Freixa
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,Balloon ,Angioplasty ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Aged ,Randomized Controlled Trials as Topic ,business.industry ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Confidence interval ,Surgery ,Meta-analysis ,Relative risk ,Conventional PCI ,Cardiology ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims To conduct a meta-analysis of studies comparing immediate versus delayed stenting in populations where primary percutaneous coronary intervention (PCI) or early invasive revascularisation was the initial mode of reperfusion. Methods and results We identified five non-randomised studies and one randomised trial for a total of 590 patients in studies comparing immediate to delayed stenting in populations where primary PCI or early invasive revascularisation was the initial mode of reperfusion. In non-randomised studies, delayed stenting was associated with a reduction of procedure-related angiographic events (OR=0.13, 95% credible interval [CrI]: 0.03- 0.36). No differences were observed in the rates of major bleeding (OR=0.81, 95% CrI: 0.01-13.42) and major adverse cardiac events (OR=0.40, 95% CrI: 0.09-1.91), between delayed and immediate stenting. In one randomised trial, delayed stenting was associated with a reduction in myocardial infarction during hospitalisation (39% vs. 60%; relative risk [RR]=0.55, 95% confidence interval [CI]: 0.39-0.80). None of the patients assigned to delayed stenting experienced a major adverse cardiac event in the interval between the initial angiogram and the stenting. Conclusions Delayed stent implantation is associated with better angiographic outcomes. Randomised trials are required to assess whether delayed stenting translates into better long-term cardiac outcomes.
- Published
- 2013
4. Effects of reconstituted high-density lipoprotein infusions on coronary atherosclerosis: a randomized controlled trial.
- Author
-
Tardif J, Grégoire J, L'Allier PL, Ibrahim R, Lespérance J, Heinonen TM, Kouz S, Berry C, Basser R, Lavoie M, Guertin M, Rodés-Cabau J, Effect of rHDL on Atherosclerosis-Safety and Efficacy Investigators, Tardif, Jean-Claude, Grégoire, Jean, L'Allier, Philippe L, Ibrahim, Reda, Lespérance, Jacques, Heinonen, Therese M, and Kouz, Simon
- Abstract
Context: High-density lipoprotein (HDL) cholesterol is an inverse predictor of coronary atherosclerotic disease. Preliminary data have suggested that HDL infusions can induce atherosclerosis regression.Objective: To investigate the effects of reconstituted HDL on plaque burden as assessed by intravascular ultrasound (IVUS).Design and Setting: A randomized placebo-controlled trial was conducted at 17 centers in Canada. Intravascular ultrasound was performed to assess coronary atheroma at baseline and 2 to 3 weeks after the last study infusion.Patients: Between July 2005 and October 2006, 183 patients had a baseline IVUS examination and of those, 145 had evaluable serial IVUS examinations after 6 weeks.Intervention: Sixty patients were randomly assigned to receive 4 weekly infusions of placebo (saline), 111 to receive 40 mg/kg of reconstituted HDL (CSL-111); and 12 to receive 80 mg/kg of CSL-111.Main Outcome Measures: The primary efficacy parameter was the percentage change in atheroma volume. Nominal changes in plaque volume and plaque characterization index on IVUS and coronary score on quantitative coronary angiography were also prespecified end points.Results: The higher-dosage CSL-111 treatment group was discontinued early because of liver function test abnormalities. The percentage change in atheroma volume was -3.4% with CSL-111 and -1.6% for placebo (P = .48 between groups, P<.001 vs baseline for CSL-111). The nominal change in plaque volume was -5.3 mm3 with CSL-111 and -2.3 mm3 with placebo (P = .39 between groups, P<.001 vs baseline for CSL-111). The mean changes in plaque characterization index on IVUS (-0.0097 for CSL-111 and 0.0128 with placebo) and mean changes in coronary score (-0.039 mm for CSL-111 and -0.071 mm with placebo) on quantitative coronary angiography were significantly different between groups (P = .01 and P =.03, respectively). Administration of CSL-111 40 mg/kg was associated with mild, self-limiting transaminase elevation but was clinically well tolerated.Conclusions: Short-term infusions of reconstituted HDL resulted in no significant reductions in percentage change in atheroma volume or nominal change in plaque volume compared with placebo but did result in statistically significant improvement in the plaque characterization index and coronary score on quantitative coronary angiography. Elevation of HDL remains a valid target in vascular disease and further studies of HDL infusions, including trials with clinical end points, appear warranted.Trial Registration: clinicaltrials.gov Identifier: NCT00225719 [ABSTRACT FROM AUTHOR]- Published
- 2007
- Full Text
- View/download PDF
5. Comparison of intravascular ultrasound and quantitative coronary angiography for the assessment of coronary artery disease progression.
- Author
-
Berry C, L'Allier PL, Grégoire J, Lespérance J, Levesque S, Ibrahim R, Tardif JC, Berry, Colin, L'Allier, Philippe L, Grégoire, Jean, Lespérance, Jacques, Levesque, Sylvie, Ibrahim, Reda, and Tardif, Jean-Claude
- Published
- 2007
6. Effects of the acyl coenzyme A:cholesterol acyltransferase inhibitor avasimibe on human atherosclerotic lesions.
- Author
-
Tardif J, Grégoire J, L'Allier PL, Anderson TJ, Bertrand O, Reeves F, Title LM, Alfonso F, Schampaert E, Hassan A, McLain R, Pressler ML, Ibrahim R, Lespérance J, Blue J, Heinonen T, Rodés-Cabau J, Avasimibe and Progression of Lesions on UltraSound Investigators, Tardif, Jean-Claude, and Grégoire, Jean
- Published
- 2004
7. Commentary
- Author
-
L’Allier, PL
- Published
- 2004
- Full Text
- View/download PDF
8. Effects of succinobucol (AGI-1067) after an acute coronary syndrome: a randomised, double-blind, placebo-controlled trial.
- Author
-
Tardif JC, McMurray JJ, Klug E, Small R, Schumi J, Choi J, Cooper J, Scott R, Lewis EF, L'Allier PL, Pfeffer MA, and Aggressive Reduction of Inflammation Stops Events (ARISE) Trial Investigators
- Published
- 2008
- Full Text
- View/download PDF
9. Low-Dose Colchicine in Patients With Type 2 Diabetes and Recent Myocardial Infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT).
- Author
-
Roubille F, Bouabdallaoui N, Kouz S, Waters DD, Diaz R, Maggioni AP, Pinto FJ, Grégoire JC, Gamra H, Kiwan GS, Berry C, López-Sendón J, Koenig W, Delorme L, Elbaz M, Coste P, Provencher M, Bassevitch Z, Blondeau L, L'Allier PL, Guertin MC, and Tardif JC
- Subjects
- Humans, Colchicine therapeutic use, Colchicine adverse effects, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 chemically induced, Cardiovascular System, Myocardial Infarction drug therapy, Myocardial Infarction prevention & control, Coronary Artery Disease drug therapy
- Abstract
Objective: The cardiovascular benefits of low-dose colchicine have been demonstrated in patients with coronary disease. Its effects were evaluated in this prespecified analysis in patients with type 2 diabetes (T2D) from the Colchicine Cardiovascular Outcomes Trial (COLCOT)., Research Design and Methods: COLCOT was a randomized, double-blinded trial of colchicine, 0.5 mg daily, versus placebo initiated within 30 days after a myocardial infarction., Results: There were 959 patients with T2D enrolled and monitored for a median of 22.6 months. A primary end point event occurred in 8.7% of patients in the colchicine group and in 13.1% in the placebo group (hazard ratio 0.65; 95% CI 0.44-0.96; P = 0.03). Nausea was reported in 2.7% and 0.8% in the study groups (P = 0.03), and pneumonia occurred in 2.4% and 0.4% (P = 0.008)., Conclusions: Among patients with T2D and a recent myocardial infarction, colchicine, 0.5 mg daily, leads to a large reduction of cardiovascular events. These results support the conduct of the COLCOT-T2D trial in primary prevention., (© 2024 by the American Diabetes Association.)
- Published
- 2024
- Full Text
- View/download PDF
10. Mediterranean diet and time-restricted eating as a cardiac rehabilitation approach for patients with coronary heart disease and pre-diabetes: the DIABEPIC-1 protocol of a feasibility trial.
- Author
-
Iglesies-Grau J, Dionne V, Latour É, Gayda M, Besnier F, Gagnon D, Debray A, Gagnon C, Pelletier V, Nigam A, L'Allier PL, Juneau M, Bouabdallaoui N, and Bherer L
- Subjects
- Humans, Feasibility Studies, Glucose, Cardiac Rehabilitation methods, Coronary Disease, Diabetes Mellitus, Type 2, Diet, Mediterranean, Prediabetic State
- Abstract
Introduction: Despite proven programmes, implementing lifestyle interventions for pre-diabetes and type 2 diabetes is challenging. Cardiac rehabilitation, provide a valuable opportunity to promote the adoption of healthy lifestyle behaviours for patients with atherosclerotic cardiovascular disease (ASCVD). However, only a limited number of studies have explored the potential for reversing the underlying causes of ASCVD in this setting., Objectives: The DIABEPIC1 study is an ongoing single-arm lifestyle clinical trial to assess the feasibility of an upgraded 6-month intensive cardiac rehabilitation programme combining an innovative diet assignment with exercise training to reverse newly onset pre-diabetes (glycated haemoglobin 5.7%-6.4%) to normal glucose concentrations in patients with coronary heart disease., Methods and Analysis: 36 patients referred from the Montreal Heart Institute for cardiac rehabilitation, aged ≥40 years with a recent diagnosis of pre-diabetes in the last 6 months, will be offered to participate in the upgraded programme. Interventions will include four sessions of nutritional counselling on ultra-processed foods intake reduction and a moderate-carbohydrate (<40%) ad libitum Mediterranean diet coupled with 36 1-hour sessions of supervised exercise training (continuous and interval aerobic training, and resistance training) and educational intervention. Phase 2 will continue the same interventions adding 8:16 hour time-restricting eating (TRE) at least 5 days per week. During this second phase, exercise training will be performed with autonomy. The primary objectives will be to evaluate the recruitment rate, the completion rates at 3 and 6 months, and the compliance of participants. The secondary objectives will be to assess the proportion of prediabetic participants in remission of pre-diabetes at the programme's end and to characterise the factors associated with remission., Ethics and Dissemination: The DIABEPIC1 feasibility study is approved by the Research Ethics Board of the Montreal Heart Institute (Project Number ICM 2022-3005). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences., Conclusions: The DIABEPIC1 trial will examine the feasibility and effectiveness of an enhanced cardiac rehabilitation programme combining exercise training with an ultra-processed food reduction intervention, a Mediterranean diet, and TRE counselling to remit pre-diabetes to normal glucose concentrations., Trial Registration Number: NCT05459987., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2023
- Full Text
- View/download PDF
11. Metabolic Improvements and Remission of Prediabetes and Type 2 Diabetes: Results From a Multidomain Lifestyle Intervention Clinic.
- Author
-
Iglesies-Grau J, Dionne V, Bherer L, Bouabdallaoui N, Aubut L, Besnier F, Bertholet J, Berthiaume A, Bisaillon M, Gayda M, Gagnon C, Hamrioui N, Latour É, L'Allier PL, Marie-Hélène MC, Nigam A, Pelletier V, Tessier G, and Juneau M
- Subjects
- Humans, Glycated Hemoglobin, Retrospective Studies, Blood Glucose metabolism, Life Style, Glucose, Diabetes Mellitus, Type 2 therapy, Prediabetic State
- Abstract
Objectives: Although lifestyle interventions are first-line treatment for individuals living with prediabetes and type 2 diabetes (T2D), they are rarely implemented effectively in routine clinical care., Methods: We present a retrospective analysis of a 12-month, single-centre, structured multidomain lifestyle intervention clinic offered to individuals living with prediabetes and type 2 diabetes. The intervention consisted of expert-guided educational and nutritional counselling combined with a personalized physical exercise prescription, with the main goal of improving metabolic health and reaching remission. Anthropometric parameters, glucose, basal insulin, glycated hemoglobin (A1C), and lipid levels were measured at baseline and at 3, 6, and 12 months after the lifestyle intervention initiation. Remission of prediabetes and T2D were defined as a return of A1C at 6 months to <6.5% (or <5.7% for prediabetes) and persisting for at least 3 months in the absence of glucose-lowering pharmacotherapy., Results: After a multidomain, expert-guided lifestyle intervention, 117 individuals living with prediabetes and T2D had significantly improved metabolic profiles: Mean weight change at 12 months was -4.9 kg (95% confidence interval [CI], -4.0 to -5.7; p<0.001), and mean change in A1C at 12 months was -0.6% (95% CI, -0.4 to -0.7; p<0.001). A substantial proportion of individuals reached the criteria for remission (20% among participants with prediabetes and 12% among those with T2D)., Conclusions: The results of this study suggest that prioritizing lifestyle changes in a multifaceted, progressive, 12-month intervention in this population improves anthropometric and insulin resistance measures, and has the potential to normalize metabolic values, even to the point of reaching the criteria of remission., (Copyright © 2022 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
12. Large scale genome-wide association analyses identify novel genetic loci and mechanisms in hypertrophic cardiomyopathy.
- Author
-
Tadros R, Zheng SL, Grace C, Jordà P, Francis C, Jurgens SJ, Thomson KL, Harper AR, Ormondroyd E, West DM, Xu X, Theotokis PI, Buchan RJ, McGurk KA, Mazzarotto F, Boschi B, Pelo E, Lee M, Noseda M, Varnava A, Vermeer AM, Walsh R, Amin AS, van Slegtenhorst MA, Roslin N, Strug LJ, Salvi E, Lanzani C, de Marvao A, Roberts JD, Tremblay-Gravel M, Giraldeau G, Cadrin-Tourigny J, L'Allier PL, Garceau P, Talajic M, Pinto YM, Rakowski H, Pantazis A, Baksi J, Halliday BP, Prasad SK, Barton PJ, O'Regan DP, Cook SA, de Boer RA, Christiaans I, Michels M, Kramer CM, Ho CY, Neubauer S, Matthews PM, Wilde AA, Tardif JC, Olivotto I, Adler A, Goel A, Ware JS, Bezzina CR, and Watkins H
- Abstract
Hypertrophic cardiomyopathy (HCM) is an important cause of morbidity and mortality with both monogenic and polygenic components. We here report results from the largest HCM genome-wide association study (GWAS) and multi-trait analysis (MTAG) including 5,900 HCM cases, 68,359 controls, and 36,083 UK Biobank (UKB) participants with cardiac magnetic resonance (CMR) imaging. We identified a total of 70 loci (50 novel) associated with HCM, and 62 loci (32 novel) associated with relevant left ventricular (LV) structural or functional traits. Amongst the common variant HCM loci, we identify a novel HCM disease gene, SVIL , which encodes the actin-binding protein supervillin, showing that rare truncating SVIL variants cause HCM. Mendelian randomization analyses support a causal role of increased LV contractility in both obstructive and non-obstructive forms of HCM, suggesting common disease mechanisms and anticipating shared response to therapy. Taken together, the findings significantly increase our understanding of the genetic basis and molecular mechanisms of HCM, with potential implications for disease management.
- Published
- 2023
- Full Text
- View/download PDF
13. Pharmacogenetics-guided dalcetrapib therapy after an acute coronary syndrome: the dal-GenE trial.
- Author
-
Tardif JC, Pfeffer MA, Kouz S, Koenig W, Maggioni AP, McMurray JJV, Mooser V, Waters DD, Grégoire JC, L'Allier PL, Wouter Jukema J, White HD, Heinonen T, Black DM, Laghrissi-Thode F, Levesque S, Guertin MC, and Dubé MP
- Subjects
- Adenylyl Cyclases genetics, Adenylyl Cyclases therapeutic use, Amides, Double-Blind Method, Esters, Humans, Pharmacogenetics, Retrospective Studies, Sulfhydryl Compounds, Acute Coronary Syndrome drug therapy, Acute Coronary Syndrome genetics, Anticholesteremic Agents therapeutic use, Heart Arrest, Myocardial Infarction drug therapy, Myocardial Infarction genetics, Stroke drug therapy
- Abstract
Aims: In a retrospective analysis of dal-Outcomes, the effect of dalcetrapib on cardiovascular events was influenced by an adenylate cyclase type 9 (ADCY9) gene polymorphism. The dal-GenE study was conducted to test this pharmacogenetic hypothesis., Methods and Results: dal-GenE was a double-blind trial in patients with an acute coronary syndrome within 1-3 months and the AA genotype at variant rs1967309 in the ADCY9 gene. A total of 6147 patients were randomly assigned to receive dalcetrapib 600 mg or placebo daily. The primary endpoint was the time from randomization to first occurrence of cardiovascular death, resuscitated cardiac arrest, non-fatal myocardial infarction, or non-fatal stroke. After a median follow-up of 39.9 months, the primary endpoint occurred in 292 (9.5%) of 3071 patients in the dalcetrapib group and 327 (10.6%) of 3076 patients in the placebo group [hazard ratio 0.88; 95% confidence interval (CI) 0.75-1.03; P = 0.12]. The hazard ratios for the components of the primary endpoint were 0.79 (95% CI 0.65-0.96) for myocardial infarction, 0.92 (95% CI 0.64-1.33) for stroke, 1.21 (95% CI 0.91-1.60) for death from cardiovascular causes, and 2.33 (95% CI 0.60-9.02) for resuscitated cardiac arrest. In a pre-specified on-treatment sensitivity analysis, the primary endpoint event rate was 7.8% (236/3015) in the dalcetrapib group and 9.3% (282/3031) in the placebo group (hazard ratio 0.83; 95% CI 0.70-0.98)., Conclusion: Dalcetrapib did not significantly reduce the risk of occurrence of the primary endpoint of ischaemic cardiovascular events at end of study. A new trial would be needed to test the pharmacogenetic hypothesis that dalcetrapib improves the prognosis of patients with the AA genotype., Clinical Trial Registration: Trial registration dal-GenE ClinicalTrials.gov Identifier: NCT02525939., Competing Interests: Conflict of interest: J.C.T. has received research grant and honoraria from Amarin; research grant from AstraZeneca; research grant, honoraria, and minor equity interest from DalCor; research grant from Esperion; research grant from Ionis; research grant and honoraria from Sanofi; research grant and honoraria from Servier; a patent on pharmacogenomics-guided CETP inhibition was obtained, and J.C.T. and M.P.D. are mentioned as authors. M.P.D. has a minor equity interest in DalCor and has received honoraria from DalCor. M.A.P. receives research support from Novartis; he serves as a consultant for AstraZeneca, Corvidia, DalCor, GlaxoSmithKline, Jazz, MyoKardia, Novartis, Novo Nordisk, Roche, Sanofi, Servier, and Takeda; and has equity in DalCor. D.D.W. has received remuneration for participation in clinical trial committees from CSL Ltd, Daiichi Sankyo, DalCor, the Medicines Company, Novo Nordisk, Regeneron, Resverlogix, and Sanofi, and honoraria for lectures from DalCor and Pfizer. W.K. reports personal fees (consulting) from DalCor and consulting fees from AstraZeneca, Novartis, Pfizer, The Medicines Company, Kowa, a Corvidia, Esperion, Genentech, Omeicos, Novo Nordisk, Daiichi Sankyo, and Amgen; personal fees (honorarium for lectures) from AstraZeneca, Novartis, Amgen, Sanofi, Bristol-Myers-Squibb, and Berlin-Chemie; grants and non-financial support (provision of reagents for biomarker measurements free of charge) from Roche Diagnostics, Beckmann, Singulex, and Abbott, outside the submitted work. A.P.M. has received personal fees for participation in study committee from DalCor, and personal fees for participation in study committees from AstraZeneca, Bayer, Novartis, and Fresenius. J.J.V.M. reports grants paid to his institution and fees as steering committee member from DalCor Pharma UK for the Dal-GenE study, during the conduct of the study; grants paid to his institution and fees as steering committee member from Oxford University and Bayer; grants paid to his institution from Theracos; grants paid to his institution and fees as steering committee from Abbvie; grants paid to his institution from Pfizer, Merck AstraZeneca, GlaxoSmithKline, and Novartis. J.W.J. and his department have received research grants from and/or was speaker (with or without lecture fees) in CME-accredited meetings sponsored by Amgen, Athera, Biotronik, Boston Scientific, Dalcor, Daiichi Sankyo, Lilly, Medtronic, Merck-Schering-Plough, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi-Aventis, The Medicine Company, The Netherlands Heart Foundation, CardioVascular Research The Netherlands (CVON), The Netherlands Heart Institute and the European Community Framework KP7 Programme. H.D.W. reports grants paid to his institution and fees as steering committee member from DalCor Pharma UK for the Dal-GenE study, during the conduct of the study; grants paid to his institution and fees as steering committee member from Sanofi-Aventis, Regeneron Pharmaceutics, National Institutes of Health (USA), CSL Behring, American Regent, Sanofi-Aventis Australia Pty Ltd, and Esperion Therapeutics Inc, outside the submitted work. F.L.T., T.H., and D.M.B. are employed by and have minor equity interest in DalCor. Other authors report no conflicts of interest., (© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology.)
- Published
- 2022
- Full Text
- View/download PDF
14. Colchicine for Prevention of Atherothrombotic Events in Patients With Coronary Artery Disease: Review and Practical Approach for Clinicians.
- Author
-
Marquis-Gravel G, Goodman SG, Anderson TJ, Bell AD, Bewick D, Cox J, Grégoire JC, Gupta A, Huynh T, Kertland H, Kouz S, L'Allier PL, Madan M, Mancini GBJ, McPherson R, So DYF, Welsh RC, Wong G, and Tardif JC
- Subjects
- Coronary Artery Disease complications, Gout Suppressants pharmacology, Humans, Peripheral Arterial Disease complications, Colchicine pharmacology, Coronary Artery Disease prevention & control, Peripheral Arterial Disease prevention & control, Plaque, Atherosclerotic prevention & control
- Abstract
A better understanding of the central role of inflammation in the development of coronary artery disease (CAD) has been the impetus for the evaluation of therapeutic strategies targeting the interleukin-1ß/interleukin-6 cytokine signaling pathway, involved in both chronic atherogenesis and in triggering of atherosclerotic plaque rupture. As an inexpensive pharmacologic agent with relatively few adverse effects that tend to be mild and tolerable, the role of colchicine in secondary prevention of atherothrombotic events has been the focus of multiple recent large-scale randomized controlled trials involving patients with stable CAD (Low-Dose Colchicine [LoDoCo] and LoDoCo2 trials), a recent myocardial infarction (Colchicine Cardiovascular Outcome Trial [COLCOT], Colchicine in Patients With Acute Coronary Syndrome [COPS], and Colchicine and Spironolactone in Patients With Myocardial Infarction/Synergy Stent Registry [CLEAR SYNERGY] trials), and undergoing percutaneous coronary interventions (Colchicine in Percutaneous Coronary Intervention [COLCHICINE-PCI] trial). Based on this evidence, low-dose colchicine (0.5 mg once daily) should be considered in patients with recent myocardial infarctions-within 30 days and, ideally, within 3 days-or with stable CAD to improve cardiovascular outcomes. Colchicine should not be used in patients with severe renal or hepatic disease because of the risk of severe toxicity. No serious adverse effect was associated with the combined use of colchicine and high-intensity statin therapy in large trials. The impact of colchicine in high-risk populations of patients with peripheral arterial disease and in those with diabetes for the primary prevention of CAD remains to be established., (Copyright © 2021 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
15. Peripheral Interventions Radiation Exposure Reduction Using a Sensor-Based Navigation System: A Proof-of-Concept Study.
- Author
-
L'Allier PL, Richer LP, McSpadden LC, and Dorval JF
- Abstract
Background: Intravascular catheter positioning is done with radiography imaging. Increasing evidence indicates excessive ionizing radiation exposure for patients and physicians during catheterization procedures, making solutions to reduce radiation exposure a priority. This study evaluated the feasibility and impact of using sensor-based magnetic navigation on (i) fluoroscopy time and (ii) positioning accuracy and safety of a peripheral angioplasty balloon catheter., Methods: All patients (n = 10) underwent a balloon-positioning protocol using 2 navigation methods sequentially: (i) magnetic navigation with minimal fluoroscopy; (ii) fluoroscopic navigation. The navigation method order was randomized, and 4 consecutive placements per method were performed. A target vascular bifurcation was used as a fiduciary landmark for both methods to determine accuracy., Results: Balloon placements were successful with both navigation methods in all subjects, and no adverse events occurred. Magnetic guidance led to significant reductions in fluoroscopy time (0.37 ± 1.5 vs 15.0 ± 8.1 seconds, P < 0.001) and dose (0.3 ± 1.2 vs 24.1 ± 23.8 μGy.m
2 , P < 0.01). The time duration for balloon alignment was similar for the 2 navigation methods (4.8 ± 1.4 vs 4.8 ± 2.3 seconds, P = 0.89), and the accuracy was almost identical (0.51 ± 0.41 vs 0.51 ± 0.32 mm, P = 0.97)., Conclusions: These results demonstrate the feasibility of using sensor-based magnetic guidance during simple peripheral interventional procedures; a significant reduction in ionizing radiation was achieved, with excellent positioning accuracy and safety. The clinical applications of magnetic guidance for device navigation during more complex percutaneous procedures should be evaluated., (© 2021 The Authors.)- Published
- 2021
- Full Text
- View/download PDF
16. Cost-effectiveness of low-dose colchicine after myocardial infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT).
- Author
-
Samuel M, Tardif JC, Khairy P, Roubille F, Waters DD, Grégoire JC, Pinto FJ, Maggioni AP, Diaz R, Berry C, Koenig W, Ostadal P, Lopez-Sendon J, Gamra H, Kiwan GS, Dubé MP, Provencher M, Orfanos A, Blondeau L, Kouz S, L'Allier PL, Ibrahim R, Bouabdallaoui N, Mitchell D, Guertin MC, and Lelorier J
- Subjects
- Canada epidemiology, Cost-Benefit Analysis, Humans, Quality-Adjusted Life Years, Colchicine therapeutic use, Myocardial Infarction complications, Myocardial Infarction drug therapy
- Abstract
Aims: In the randomized, placebo-controlled Colchicine Cardiovascular Outcomes Trial (COLCOT) of 4745 patients enrolled within 30 days after myocardial infarction (MI), low-dose colchicine (0.5 mg once daily) reduced the incidence of the primary composite endpoint of cardiovascular death, resuscitated cardiac arrest, MI, stroke, or urgent hospitalization for angina leading to coronary revascularization. To assess the in-trial period and lifetime cost-effectiveness of low-dose colchicine therapy compared to placebo in post-MI patients on standard-of-care therapy., Methods and Results: A multistate Markov model was developed incorporating the primary efficacy and safety results from COLCOT, as well as healthcare costs and utilities from the Canadian healthcare system perspective. All components of the primary outcome, non-cardiovascular deaths, and pneumonia were included as health states in the model as both primary and recurrent events. In the main analysis, a deterministic approach was used to estimate the incremental cost-effectiveness ratio (ICER) for the trial period (24 months) and lifetime (20 years). Over the in-trial period, the addition of colchicine to post-MI standard-of-care treatment decreased the mean overall per-patient costs by 47%, from $502 to $265 Canadian dollar (CAD), and increased the quality-adjusted life years (QALYs) from 1.30 to 1.34. The lifetime per-patient costs were further reduced (69%) and QALYs increased with colchicine therapy (from 8.82 to 11.68). As a result, both in-trial and lifetime ICERs indicated colchicine therapy was a dominant strategy., Conclusion: Cost-effectiveness analyses indicate that the addition of colchicine to standard-of-care therapy after MI is economically dominant and therefore generates cost savings., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2021
- Full Text
- View/download PDF
17. Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial.
- Author
-
Tardif JC, Bouabdallaoui N, L'Allier PL, Gaudet D, Shah B, Pillinger MH, Lopez-Sendon J, da Luz P, Verret L, Audet S, Dupuis J, Denault A, Pelletier M, Tessier PA, Samson S, Fortin D, Tardif JD, Busseuil D, Goulet E, Lacoste C, Dubois A, Joshi AY, Waters DD, Hsue P, Lepor NE, Lesage F, Sainturet N, Roy-Clavel E, Bassevitch Z, Orfanos A, Stamatescu G, Grégoire JC, Busque L, Lavallée C, Hétu PO, Paquette JS, Deftereos SG, Levesque S, Cossette M, Nozza A, Chabot-Blanchet M, Dubé MP, Guertin MC, and Boivin G
- Subjects
- Administration, Oral, Ambulatory Care methods, Ambulatory Care statistics & numerical data, Anti-Inflammatory Agents administration & dosage, Anti-Inflammatory Agents adverse effects, Double-Blind Method, Drug Monitoring methods, Female, Hospitalization statistics & numerical data, Humans, Intention to Treat Analysis, Male, Middle Aged, Outcome Assessment, Health Care, Risk Assessment, SARS-CoV-2 isolation & purification, COVID-19 diagnosis, COVID-19 epidemiology, Colchicine administration & dosage, Colchicine adverse effects, COVID-19 Drug Treatment
- Abstract
Background: Evidence suggests a role for excessive inflammation in COVID-19 complications. Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis, and coronary disease. We aimed to investigate the effect of colchicine on the composite of COVID-19-related death or hospital admission., Methods: The present study is a phase 3, randomised, double-blind, adaptive, placebo-controlled, multicentre trial. The study was done in Brazil, Canada, Greece, South Africa, Spain, and the USA, and was led by the Montreal Heart Institute. Patients with COVID-19 diagnosed by PCR testing or clinical criteria who were not being treated in hospital were eligible if they were at least 40 years old and had at least one high-risk characteristic. The randomisation list was computer-generated by an unmasked biostatistician, and masked randomisation was centralised and done electronically through an automated interactive web-response system. The allocation sequence was unstratified and used a 1:1 ratio with a blocking schema and block sizes of six. Patients were randomly assigned to receive orally administered colchicine (0·5 mg twice per day for 3 days and then once per day for 27 days thereafter) or matching placebo. The primary efficacy endpoint was the composite of death or hospital admission for COVID-19. Vital status at the end of the study was available for 97·9% of patients. The analyses were done according to the intention-to-treat principle. The COLCORONA trial is registered with ClinicalTrials.gov (NCT04322682) and is now closed to new participants., Findings: Trial enrolment began in March 23, 2020, and was completed in Dec 22, 2020. A total of 4488 patients (53·9% women; median age 54·0 years, IQR 47·0-61·0) were enrolled and 2235 patients were randomly assigned to colchicine and 2253 to placebo. The primary endpoint occurred in 104 (4·7%) of 2235 patients in the colchicine group and 131 (5·8%) of 2253 patients in the placebo group (odds ratio [OR] 0·79, 95·1% CI 0·61-1·03; p=0·081). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 96 (4·6%) of 2075 patients in the colchicine group and 126 (6·0%) of 2084 patients in the placebo group (OR 0·75, 0·57-0·99; p=0·042). Serious adverse events were reported in 108 (4·9%) of 2195 patients in the colchicine group and 139 (6·3%) of 2217 patients in the placebo group (p=0·051); pneumonia occurred in 63 (2·9%) of 2195 patients in the colchicine group and 92 (4·1%) of 2217 patients in the placebo group (p=0·021). Diarrhoea was reported in 300 (13·7%) of 2195 patients in the colchicine group and 161 (7·3%) of 2217 patients in the placebo group (p<0·0001)., Interpretation: In community-treated patients including those without a mandatory diagnostic test, the effect of colchicine on COVID-19-related clinical events was not statistically significant. Among patients with PCR-confirmed COVID-19, colchicine led to a lower rate of the composite of death or hospital admission than placebo. Given the absence of orally administered therapies to prevent COVID-19 complications in community-treated patients and the benefit of colchicine in patients with PCR-proven COVID-19, this safe and inexpensive anti-inflammatory agent could be considered for use in those at risk of complications. Notwithstanding these considerations, replication in other studies of PCR-positive community-treated patients is recommended., Funding: The Government of Quebec, the Bill & Melinda Gates Foundation, the National Heart, Lung, and Blood Institute of the US National Institutes of Health, the Montreal Heart Institute Foundation, the NYU Grossman School of Medicine, the Rudin Family Foundation, and philanthropist Sophie Desmarais., (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
18. Genetics of symptom remission in outpatients with COVID-19.
- Author
-
Dubé MP, Lemaçon A, Barhdadi A, Lemieux Perreault LP, Oussaïd E, Asselin G, Provost S, Sun M, Sandoval J, Legault MA, Mongrain I, Dubois A, Valois D, Dedelis E, Lousky J, Choi J, Goulet E, Savard C, Chicoine LM, Cossette M, Chabot-Blanchet M, Guertin MC, de Denus S, Bouabdallaoui N, Marchand R, Bassevitch Z, Nozza A, Gaudet D, L'Allier PL, Hussin J, Boivin G, Busseuil D, and Tardif JC
- Subjects
- Adult, COVID-19 genetics, COVID-19 pathology, COVID-19 virology, Chromosomes, Human, Pair 5 genetics, Chromosomes, Human, Pair 9 genetics, Double-Blind Method, Female, Gene Frequency, Genotype, Humans, Male, Middle Aged, Outpatients, Placebo Effect, Proportional Hazards Models, Remission Induction, Risk Factors, SARS-CoV-2 isolation & purification, Severity of Illness Index, Colchicine therapeutic use, Genome-Wide Association Study, COVID-19 Drug Treatment
- Abstract
We conducted a genome-wide association study of time to remission of COVID-19 symptoms in 1723 outpatients with at least one risk factor for disease severity from the COLCORONA clinical trial. We found a significant association at 5p13.3 (rs1173773; P = 4.94 × 10
-8 ) near the natriuretic peptide receptor 3 gene (NPR3). By day 15 of the study, 44%, 54% and 59% of participants with 0, 1, or 2 copies of the effect allele respectively, had symptom remission. In 851 participants not treated with colchicine (placebo), there was a significant association at 9q33.1 (rs62575331; P = 2.95 × 10-8 ) in interaction with colchicine (P = 1.19 × 10-5 ) without impact on risk of hospitalisations, highlighting a possibly shared mechanistic pathway. By day 15 of the study, 46%, 62% and 64% of those with 0, 1, or 2 copies of the effect allele respectively, had symptom remission. The findings need to be replicated and could contribute to the biological understanding of COVID-19 symptom remission.- Published
- 2021
- Full Text
- View/download PDF
19. A Rare Case of Coronary Artery Dilatation and Giant Pseudoaneurysm.
- Author
-
De Marco C, Boulet J, Aldhaheri E, Grondin S, Pham M, L'Allier PL, Bouchard D, and Basmadjian AJ
- Abstract
Coronary artery fistula are anomalous connections with coronary vessels or cardiac chambers, potentially resulting in coronary dilatation and pseudoaneurysm formation. We present the case of a 68-year-old woman referred to our institution for a voluminous coronary pseudoaneurysm secondary to coronary artery fistula presenting as a nearly completely obstructive left atrial mass. ( Level of Difficulty: Intermediate. )., Competing Interests: The authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© 2021 The Authors.)
- Published
- 2021
- Full Text
- View/download PDF
20. Pharmacogenomics of the Efficacy and Safety of Colchicine in COLCOT.
- Author
-
Dubé MP, Legault MA, Lemaçon A, Lemieux Perreault LP, Fouodjio R, Waters DD, Kouz S, Pinto FJ, Maggioni AP, Diaz R, Berry C, Koenig W, Lopez-Sendon J, Gamra H, Kiwan GS, Asselin G, Provost S, Barhdadi A, Sun M, Cossette M, Blondeau L, Mongrain I, Dubois A, Rhainds D, Bouabdallaoui N, Samuel M, de Denus S, L'Allier PL, Guertin MC, Roubille F, and Tardif JC
- Subjects
- Aged, Cardiovascular Diseases pathology, Colchicine adverse effects, Female, Gastrointestinal Diseases etiology, Genome-Wide Association Study, Genotype, Humans, Male, Middle Aged, Phosphotransferases genetics, Placebo Effect, Polymorphism, Single Nucleotide, Proportional Hazards Models, Randomized Controlled Trials as Topic, Treatment Outcome, Cardiovascular Diseases drug therapy, Colchicine therapeutic use, Pharmacogenetics
- Abstract
Background: The randomized, placebo-controlled COLCOT (Colchicine Cardiovascular Outcomes Trial) has shown the benefits of colchicine 0.5 mg daily to lower the rate of ischemic cardiovascular events in patients with a recent myocardial infarction. Here, we conducted a post hoc pharmacogenomic study of COLCOT with the aim to identify genetic predictors of the efficacy and safety of treatment with colchicine., Methods: There were 1522 participants of European ancestry from the COLCOT trial available for the pharmacogenomic study of COLCOT trial. The pharmacogenomic study's primary cardiovascular end point was defined as for the main trial, as time to first occurrence of cardiovascular death, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina requiring coronary revascularization. The safety end point was time to the first report of gastrointestinal events. Patients' DNA was genotyped using the Illumina Global Screening array followed by imputation. We performed a genome-wide association study in colchicine-treated patients., Results: None of the genetic variants passed the genome-wide association study significance threshold for the primary cardiovascular end point conducted in 702 patients in the colchicine arm who were compliant to medication. The genome-wide association study for gastrointestinal events was conducted in all 767 patients in the colchicine arm and found 2 significant association signals, one with lead variant rs6916345 (hazard ratio, 1.89 [95% CI, 1.52-2.35], P =7.41×10
-9 ) in a locus which colocalizes with Crohn disease, and one with lead variant rs74795203 (hazard ratio, 2.51 [95% CI, 1.82-3.47]; P =2.70×10-8 ), an intronic variant in gene SEPHS1 . The interaction terms between the genetic variants and treatment with colchicine versus placebo were significant., Conclusions: We found 2 genomic regions associated with gastrointestinal events in patients treated with colchicine. Those findings will benefit from replication to confirm that some patients may have genetic predispositions to lower tolerability of treatment with colchicine.- Published
- 2021
- Full Text
- View/download PDF
21. Shared genetic pathways contribute to risk of hypertrophic and dilated cardiomyopathies with opposite directions of effect.
- Author
-
Tadros R, Francis C, Xu X, Vermeer AMC, Harper AR, Huurman R, Kelu Bisabu K, Walsh R, Hoorntje ET, Te Rijdt WP, Buchan RJ, van Velzen HG, van Slegtenhorst MA, Vermeulen JM, Offerhaus JA, Bai W, de Marvao A, Lahrouchi N, Beekman L, Karper JC, Veldink JH, Kayvanpour E, Pantazis A, Baksi AJ, Whiffin N, Mazzarotto F, Sloane G, Suzuki H, Schneider-Luftman D, Elliott P, Richard P, Ader F, Villard E, Lichtner P, Meitinger T, Tanck MWT, van Tintelen JP, Thain A, McCarty D, Hegele RA, Roberts JD, Amyot J, Dubé MP, Cadrin-Tourigny J, Giraldeau G, L'Allier PL, Garceau P, Tardif JC, Boekholdt SM, Lumbers RT, Asselbergs FW, Barton PJR, Cook SA, Prasad SK, O'Regan DP, van der Velden J, Verweij KJH, Talajic M, Lettre G, Pinto YM, Meder B, Charron P, de Boer RA, Christiaans I, Michels M, Wilde AAM, Watkins H, Matthews PM, Ware JS, and Bezzina CR
- Subjects
- Cardiomyopathy, Dilated mortality, Cardiomyopathy, Dilated physiopathology, Cardiomyopathy, Hypertrophic mortality, Cardiomyopathy, Hypertrophic physiopathology, Case-Control Studies, Gene Frequency, Genetic Predisposition to Disease, Genome-Wide Association Study, Heart Ventricles physiopathology, Humans, Kaplan-Meier Estimate, Linkage Disequilibrium, Polymorphism, Single Nucleotide, Quantitative Trait Loci, Ventricular Function, Left genetics, Cardiomyopathy, Dilated genetics, Cardiomyopathy, Hypertrophic genetics
- Abstract
The heart muscle diseases hypertrophic (HCM) and dilated (DCM) cardiomyopathies are leading causes of sudden death and heart failure in young, otherwise healthy, individuals. We conducted genome-wide association studies and multi-trait analyses in HCM (1,733 cases), DCM (5,521 cases) and nine left ventricular (LV) traits (19,260 UK Biobank participants with structurally normal hearts). We identified 16 loci associated with HCM, 13 with DCM and 23 with LV traits. We show strong genetic correlations between LV traits and cardiomyopathies, with opposing effects in HCM and DCM. Two-sample Mendelian randomization supports a causal association linking increased LV contractility with HCM risk. A polygenic risk score explains a significant portion of phenotypic variability in carriers of HCM-causing rare variants. Our findings thus provide evidence that polygenic risk score may account for variability in Mendelian diseases. More broadly, we provide insights into how genetic pathways may lead to distinct disorders through opposing genetic effects.
- Published
- 2021
- Full Text
- View/download PDF
22. Time-to-treatment initiation of colchicine and cardiovascular outcomes after myocardial infarction in the Colchicine Cardiovascular Outcomes Trial (COLCOT).
- Author
-
Bouabdallaoui N, Tardif JC, Waters DD, Pinto FJ, Maggioni AP, Diaz R, Berry C, Koenig W, Lopez-Sendon J, Gamra H, Kiwan GS, Blondeau L, Orfanos A, Ibrahim R, Grégoire JC, Dubé MP, Samuel M, Morel O, Lim P, Bertrand OF, Kouz S, Guertin MC, L'Allier PL, and Roubille F
- Subjects
- Humans, Angina Pectoris, Colchicine therapeutic use, Time-to-Treatment, Treatment Outcome, Myocardial Infarction drug therapy, Stroke drug therapy
- Abstract
Aims: The COLchicine Cardiovascular Outcomes Trial (COLCOT) demonstrated the benefits of targeting inflammation after myocardial infarction (MI). We aimed to determine whether time-to-treatment initiation (TTI) influences the beneficial impact of colchicine., Methods and Results: In COLCOT, patients were randomly assigned to receive colchicine or placebo within 30 days post-MI. Time-to-treatment initiation was defined as the length of time between the index MI and the initiation of study medication. The primary efficacy endpoint was a composite of cardiovascular death, resuscitated cardiac arrest, MI, stroke, or urgent hospitalization for angina requiring coronary revascularization. The relationship between endpoints and various TTI (<3, 4-7 and >8 days) was examined using multivariable Cox regression models. Amongst the 4661 patients included in this analysis, there were 1193, 720, and 2748 patients, respectively, in the three TTI strata. After a median follow-up of 22.7 months, there was a significant reduction in the incidence of the primary endpoint for patients in whom colchicine was initiated < Day 3 compared with placebo [hazard ratios (HR) = 0.52, 95% confidence intervals (CI) 0.32-0.84], in contrast to patients in whom colchicine was initiated between Days 4 and 7 (HR = 0.96, 95% CI 0.53-1.75) or > Day 8 (HR = 0.82, 95% CI 0.61-1.11). The beneficial effects of early initiation of colchicine were also demonstrated for urgent hospitalization for angina requiring revascularization (HR = 0.35), all coronary revascularization (HR = 0.63), and the composite of cardiovascular death, resuscitated cardiac arrest, MI, or stroke (HR = 0.55, all P < 0.05)., Conclusion: Patients benefit from early, in-hospital initiation of colchicine after MI., Trial Registration: COLCOT ClinicalTrials.gov number, NCT02551094., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2020
- Full Text
- View/download PDF
23. Low-Dose Colchicine after Myocardial Infarction. Reply.
- Author
-
Tardif JC, L'Allier PL, and Guertin MC
- Subjects
- C-Reactive Protein, Humans, Colchicine, Myocardial Infarction
- Published
- 2020
- Full Text
- View/download PDF
24. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction.
- Author
-
Tardif JC, Kouz S, Waters DD, Bertrand OF, Diaz R, Maggioni AP, Pinto FJ, Ibrahim R, Gamra H, Kiwan GS, Berry C, López-Sendón J, Ostadal P, Koenig W, Angoulvant D, Grégoire JC, Lavoie MA, Dubé MP, Rhainds D, Provencher M, Blondeau L, Orfanos A, L'Allier PL, Guertin MC, and Roubille F
- Subjects
- Aged, Angina Pectoris epidemiology, Anti-Inflammatory Agents adverse effects, Biomarkers blood, C-Reactive Protein analysis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases mortality, Colchicine adverse effects, Double-Blind Method, Female, Humans, Incidence, Intention to Treat Analysis, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction therapy, Percutaneous Coronary Intervention, Proportional Hazards Models, Recurrence, Stroke epidemiology, Anti-Inflammatory Agents administration & dosage, Colchicine administration & dosage, Myocardial Infarction drug therapy
- Abstract
Background: Experimental and clinical evidence supports the role of inflammation in atherosclerosis and its complications. Colchicine is an orally administered, potent antiinflammatory medication that is indicated for the treatment of gout and pericarditis., Methods: We performed a randomized, double-blind trial involving patients recruited within 30 days after a myocardial infarction. The patients were randomly assigned to receive either low-dose colchicine (0.5 mg once daily) or placebo. The primary efficacy end point was a composite of death from cardiovascular causes, resuscitated cardiac arrest, myocardial infarction, stroke, or urgent hospitalization for angina leading to coronary revascularization. The components of the primary end point and safety were also assessed., Results: A total of 4745 patients were enrolled; 2366 patients were assigned to the colchicine group, and 2379 to the placebo group. Patients were followed for a median of 22.6 months. The primary end point occurred in 5.5% of the patients in the colchicine group, as compared with 7.1% of those in the placebo group (hazard ratio, 0.77; 95% confidence interval [CI], 0.61 to 0.96; P = 0.02). The hazard ratios were 0.84 (95% CI, 0.46 to 1.52) for death from cardiovascular causes, 0.83 (95% CI, 0.25 to 2.73) for resuscitated cardiac arrest, 0.91 (95% CI, 0.68 to 1.21) for myocardial infarction, 0.26 (95% CI, 0.10 to 0.70) for stroke, and 0.50 (95% CI, 0.31 to 0.81) for urgent hospitalization for angina leading to coronary revascularization. Diarrhea was reported in 9.7% of the patients in the colchicine group and in 8.9% of those in the placebo group (P = 0.35). Pneumonia was reported as a serious adverse event in 0.9% of the patients in the colchicine group and in 0.4% of those in the placebo group (P = 0.03)., Conclusions: Among patients with a recent myocardial infarction, colchicine at a dose of 0.5 mg daily led to a significantly lower risk of ischemic cardiovascular events than placebo. (Funded by the Government of Quebec and others; COLCOT ClinicalTrials.gov number, NCT02551094.)., (Copyright © 2019 Massachusetts Medical Society.)
- Published
- 2019
- Full Text
- View/download PDF
25. Perioperative Right Ventricular Pressure Monitoring in Cardiac Surgery.
- Author
-
Raymond M, Grønlykke L, Couture EJ, Desjardins G, Cogan J, Cloutier J, Lamarche Y, L'Allier PL, Ravn HB, Couture P, Deschamps A, Chamberland ME, Ayoub C, Lebon JS, Julien M, Taillefer J, Rochon A, and Denault AY
- Subjects
- Cardiac Surgical Procedures adverse effects, Humans, Ventricular Dysfunction, Right surgery, Ventricular Function, Right physiology, Cardiac Surgical Procedures methods, Monitoring, Intraoperative methods, Perioperative Care methods, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right physiopathology, Ventricular Pressure physiology
- Abstract
Right ventricular (RV) dysfunction is a cause of increased morbidity and mortality in both cardiac surgery and noncardiac surgery and in the intensive care unit. Early diagnosis of this condition still poses a challenge. The diagnosis of RV dysfunction traditionally is based on a combination of echocardiography, hemodynamic measurements, and clinical symptoms. This review describes the method of using RV pressure waveform analysis to diagnose and grade the severity of RV dysfunction. The authors describe the technique, optimal use, and pitfalls of this method, which has been used at the Montreal Heart Institute since 2002, and review the current literature on this method. The RV pressure waveform is obtained using a pulmonary artery catheter with the capability of measuring RV pressure by connecting a pressure transducer to the pacemaker port. The authors describe how RV pressure waveform analysis can facilitate the diagnosis of systolic and diastolic RV dysfunction, the evaluation of RV-arterial coupling, and help diagnose RV outflow tract obstruction. RV pressure waveform analysis also can be used to guide pharmacologic treatment and fluid resuscitation strategies for RV dysfunction., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
26. In Vivo Near-Infrared Fluorescence Imaging of Atherosclerosis Using Local Delivery of Novel Targeted Molecular Probes.
- Author
-
Bertrand MJ, Abran M, Maafi F, Busseuil D, Merlet N, Mihalache-Avram T, Geoffroy P, Tardif PL, Abulrob A, Arbabi-Ghahroudi M, Ni F, Sirois M, L'Allier PL, Rhéaume É, Lesage F, and Tardif JC
- Subjects
- Animals, Aorta metabolism, Aorta pathology, Atherosclerosis diagnosis, Atherosclerosis metabolism, Collagen Type I metabolism, Feasibility Studies, Fluorescent Dyes metabolism, Humans, Intercellular Adhesion Molecule-1 metabolism, Male, Plaque, Atherosclerotic diagnosis, Plaque, Atherosclerotic diagnostic imaging, Plaque, Atherosclerotic metabolism, Rabbits, Reproducibility of Results, Ultrasonography, Interventional methods, Atherosclerosis diagnostic imaging, Fluorescent Dyes chemistry, Molecular Probes chemistry, Optical Imaging methods, Spectroscopy, Near-Infrared methods
- Abstract
This study aimed to evaluate the feasibility and accuracy of a technique for atherosclerosis imaging using local delivery of relatively small quantities (0.04-0.4 mg/kg) of labeled-specific imaging tracers targeting ICAM-1 and unpolymerized type I collagen or negative controls in 13 rabbits with atheroma induced by balloon injury in the abdominal aorta and a 12-week high-cholesterol diet. Immediately after local infusion, in vivo intravascular ultrasonography (IVUS)-NIRF imaging was performed at different time-points over a 40-minute period. The in vivo peak NIRF signal was significantly higher in the molecular tracer-injected rabbits than in the control-injected animals (P < 0.05). Ex vivo peak NIRF signal was significantly higher in the ICAM-1 probe-injected rabbits than in controls (P = 0.04), but not in the collagen probe-injected group (P = 0.29). NIRF signal discrimination following dual-probe delivery was also shown to be feasible in a single animal and thus offers the possibility of combining several distinct biological imaging agents in future studies. This innovative imaging strategy using in vivo local delivery of low concentrations of labeled molecular tracers followed by IVUS-NIRF catheter-based imaging holds potential for detection of vulnerable human coronary artery plaques.
- Published
- 2019
- Full Text
- View/download PDF
27. Elevated level of lecithin:cholesterol acyltransferase (LCAT) is associated with reduced coronary atheroma burden.
- Author
-
Gebhard C, Rhainds D, He G, Rodés-Cabau J, Lavi S, Spence JD, Title L, Kouz S, L'Allier PL, Grégoire J, Ibrahim R, Cossette M, Guertin MC, Beanlands R, Rhéaume E, and Tardif JC
- Subjects
- Aged, Biomarkers blood, Canada, Case-Control Studies, Coronary Angiography, Coronary Artery Disease blood, Female, Humans, Lipids blood, Male, Middle Aged, Predictive Value of Tests, Protective Factors, Risk Factors, Severity of Illness Index, Up-Regulation, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease enzymology, Coronary Vessels diagnostic imaging, Phosphatidylcholine-Sterol O-Acyltransferase blood, Plaque, Atherosclerotic, Ultrasonography, Interventional
- Abstract
Background and Aims: Lecithin:cholesterol acyltransferase (LCAT), a key enzyme in high-density lipoprotein (HDL) metabolism and reverse cholesterol transport (RCT), has been associated with atheroprotection. However, its relation to plaque characteristics has not been confirmed to date. We aimed to determine the relationship between plasma LCAT mass concentration and plaque burden in a multi-center imaging study., Methods: Two hundred sixty-seven patients with angiographically proven coronary artery disease (CAD) underwent intravascular ultrasonography (IVUS) imaging. Ninety-six patients without CAD served as controls for biochemistry assessments., Results: Plasma LCAT mass concentration was higher in CAD patients as compared to controls (8.94 ± 2.51 μg/mL vs. 7.89 ± 2.99 μg/mL, p = 0.003), while cholesterol esterification rate (CER) was downregulated (253.6 ± 83.9 μM/2 h vs. 315.3 ± 115.0 μM/2 h, p<0.0001). Both parameters correlated inversely with total atheroma volume (r = -0.14, p = 0.027 and r = -0.14, p = 0.024, respectively), while only LCAT mass was found to be a significant predictor of atheroma volume (β-coefficient -0.18, p = 0.0047) when tested in a stepwise linear regression model against known CAD risk factors as predictor variables. Accordingly, patients with LCAT mass in the highest quartile had significantly less atheroma burden than those in the lower quartiles (39.7 ± 10.7% vs. 45.4 ± 10.4%, p = 0.0014 for highest vs. lowest quartile of LCAT mass)., Conclusions: Plasma LCAT mass concentration is upregulated in CAD patients and inversely related to plaque volume, suggesting atheroprotective effects. LCAT mass concentration outperformed LCAT activity in risk prediction models for atheroma burden, suggesting that LCAT mass is a key variable in atheroprotection. Further studies assessing LCAT as a therapeutic target in cardiovascular disease are warranted., (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
28. Management of Acute Coronary Syndromes.
- Author
-
Tardif JC, L'Allier PL, and Fitchett DH
- Subjects
- Acute Coronary Syndrome epidemiology, Humans, Prognosis, Acute Coronary Syndrome prevention & control, Anticholesteremic Agents therapeutic use, Diabetes Mellitus physiopathology, Practice Guidelines as Topic standards
- Published
- 2018
- Full Text
- View/download PDF
29. Bioresorbable vascular scaffold to treat in-stent restenosis: Single-center experience.
- Author
-
Picard F, Avram R, Marquis-Gravel G, Tadros VX, Ly HQ, de Hemptinne Q, Dorval JF, L'allier PL, and Tanguay JF
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Absorbable Implants, Coronary Restenosis therapy, Drug-Eluting Stents, Percutaneous Coronary Intervention, Tissue Scaffolds
- Abstract
Aims: The management of patients with in-stent restenosis (ISR) is still a major clinical challenge even in the era of drug-eluting stents (DES). Recent studies have demonstrated acceptable clinical outcomes for the everolimus-eluting bioresorbable vascular scaffold (BVS) ABSORB™ in patients with stable coronary artery disease but data are scarce on its use in patients with ISR. We report the long-term results of our preliminary experience with this novel approach at our institution., Methods and Results: We investigated the safety and efficacy of BVS implantation to treat ISR. 34 consecutive patients (37 lesions) underwent PCI for ISR with BVS implantation between May 2013 and June 2015 at our institution and were included in the current analysis. Follow-up was available in 91.9% of the patients. Mean follow-up period was 801.9 ± 179 days. One patient had definite scaffold thrombosis (ScT) 2 months after stent implantation which was treated with DES. Five patients (six lesions) experienced target lesion revascularization (TLR). The composite endpoint rate of TLR, ScT, myocardial infarction, and death occured in 6/37 lesions at follow-up (16.2%)., Conclusions: These real-world data using BVS in patients with ISR demonstrates that ISR treatment with ABSORB™ BVS is feasible but could have slightly higher target lesion failure rates as compared to DES. This proof of concept could be hypothesis-generating for larger randomized controlled studies., (© 2017, Wiley Periodicals, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
30. Effect of stenosis eccentricity on the functionality of coronary bifurcation lesions-a numerical study.
- Author
-
Pagiatakis C, Tardif JC, L'Allier PL, and Mongrain R
- Subjects
- Algorithms, Computer Simulation, Coronary Stenosis diagnostic imaging, Coronary Vessels diagnostic imaging, Hemodynamics physiology, Humans, Coronary Angiography methods, Coronary Stenosis physiopathology, Coronary Vessels physiopathology, Models, Cardiovascular
- Abstract
Interventional cardiologists still rely heavily on angiography for the evaluation of coronary lesion severity, despite its poor correlation with the presence of ischemia. In order to improve the accuracy of the current diagnostic procedures, an understanding of the relative influence of geometric characteristics on the induction of ischemia is required. This idea is especially important for coronary bifurcation lesions (CBLs), whose treatment is complex and is associated with high rates of peri- and post-procedural clinical events. Overall, it is unclear which geometric and morphological parameters of CBLs influence the onset of ischemia. More specifically, the effect of stenosis eccentricity is unknown. Computational fluid dynamic simulations, under a geometric multiscale framework, were executed for seven CBL configurations within the left main coronary artery bifurcation. Both concentric and eccentric stenosis profiles of mild to severe constriction were considered. By using a geometric multiscale framework, the fractional flow reserve, which is the gold-standard clinical diagnostic index, could be calculated and was compared between the eccentric and concentric profiles for each case. The results suggested that for configurations where the supplying vessel is stenosed, eccentricity could have a notable effect on and therefore be an important factor that influences configuration functionality.
- Published
- 2017
- Full Text
- View/download PDF
31. Everolimus-eluting bioresorbable vascular scaffold implantation to treat saphenous vein graft disease, single-center initial experience.
- Author
-
Picard F, Marquis-Gravel G, Avram R, Ly HQ, Dorval JF, Doucet S, de Hemptinne Q, L'allier PL, and Tanguay JF
- Subjects
- Aged, Cohort Studies, Coronary Artery Disease etiology, Coronary Artery Disease surgery, Female, Humans, Male, Middle Aged, Saphenous Vein transplantation, Treatment Outcome, Absorbable Implants, Coronary Artery Bypass adverse effects, Everolimus administration & dosage, Immunosuppressive Agents administration & dosage, Percutaneous Coronary Intervention, Tissue Scaffolds
- Abstract
Aims: Recent studies have shown favorable outcomes with everolimus-eluting bioresorbable vascular scaffold (BVS) in patients with stable coronary artery disease. Data on the use of BVS in saphenous vein graft disease (SVG) is currently lacking., Methods and Results: A total of 10 consecutive patients (13 lesions, including 6 in-stent restenosis) who underwent BVS for SVG disease between May 2013 and June 2015 at a tertiary care institution were included. Median follow-up period was 874 (720-926) days. One patient had scaffold thrombosis (ScT) 15 months after implantation, which was treated medically. Another patient had target lesion revascularization (TLR) in two different lesions, where BVS was used to treat in-stent restenosis. The composite endpoint of TLR, ScT, target vessel myocardial infarction, and cardiac death, was reached in two patients CONCLUSIONS: This first real-world data on the use of the ABSORB™ BVS in patients with SVG disease shows that its implantation is technically feasible. The observed rate of target lesion revascularization was similar to those observed with drug-eluting stents in similar settings. Larger studies are required to better define the optimal use of BVS to treat SVG disease., (© 2017, Wiley Periodicals, Inc.)
- Published
- 2017
- Full Text
- View/download PDF
32. Bioresorbable Vascular Scaffold During ST-Elevation Myocardial Infarction: A Systematic Review.
- Author
-
Picard F, de Hemptinne Q, Avram R, Ly HQ, L'Allier PL, and Tanguay JF
- Subjects
- Humans, Prosthesis Design, Absorbable Implants, ST Elevation Myocardial Infarction surgery, Stents, Tissue Scaffolds
- Abstract
Background: The bioresorbable vascular scaffold (BVS) represents a novel technology designed to overcome the long-term limitations of metallic coronary stent implantation in percutaneous coronary intervention. In this context, primary percutaneous coronary intervention in ST-elevation myocardial infarction (STEMI) could be a preferred scenario for BVS implantation. Nevertheless, data on efficacy and safety are lacking in this specific subset of patients., Methods: We conducted a systematic review to examine the safety and efficacy of BVS use in STEMI patients. We searched PubMed, EMBASE, and the Cochrane Library through June 2016 for studies that included outcome data for BVS implantation in STEMI patients. Outcomes of interest included cardiac death, myocardial infarction, scaffold thrombosis, target lesion revascularization, restenosis, and composite end points., Results: We identified 9 eligible articles, which included 1 randomized controlled trial and 8 cohort studies (5 controlled), for a total of 846 patients. These studies varied in size (11-290) and follow-up duration (1-24 months). The incidence of major cardiac events ranged from 1.1% to 13%, with no statistically significant difference between BVS and control groups in studies that included a comparison group. Although there was a trend toward an increase in scaffold thrombosis in the largest controlled registries, no statistically significant increase was found., Conclusions: Current clinical data are scarce, but suggest that BVS might represent a reasonable alternative to drug-eluting stents in STEMI patients. The lack of large randomized controlled trials with extended follow-up periods and the scaffold thrombosis signal are limiting factors for widespread use before additional large-scale trials are available., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
33. Effect of treatment with 5-lipoxygenase inhibitor VIA-2291 (atreleuton) on coronary plaque progression: a serial CT angiography study.
- Author
-
Matsumoto S, Ibrahim R, Grégoire JC, L'Allier PL, Pressacco J, Tardif JC, and Budoff MJ
- Subjects
- Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome etiology, Adult, Aged, Aged, 80 and over, Disease Progression, Dose-Response Relationship, Drug, Follow-Up Studies, Humans, Hydroxyurea administration & dosage, Lipoxygenase Inhibitors administration & dosage, Middle Aged, Plaque, Atherosclerotic complications, Plaque, Atherosclerotic diagnosis, Prospective Studies, Time Factors, Treatment Outcome, Acute Coronary Syndrome drug therapy, Computed Tomography Angiography methods, Coronary Vessels diagnostic imaging, Hydroxyurea analogs & derivatives, Multidetector Computed Tomography methods, Plaque, Atherosclerotic drug therapy
- Abstract
Background: Inflammation has a key role in the process of atherosclerosis. Production of leukotrienes by 5-lipoxygenase has been linked to atherosclerotic plaques and cardiovascular events., Hypothesis: In this study, a selective 5-LO inhibitor will slow plaque progression using serial cardiac computed tomographic angiography (CCTA)., Methods: Patients with recent acute coronary syndrome (ACS) were prospectively assigned to one of 3 VIA-2291 doses (25 mg, 50 mg, 100 mg) or placebo by oral administration. All groups underwent CCTA at baseline and at 6 months' follow-up. Plaque types such as low-attenuation plaque (LAP), fibro-fatty tissue (FF), fibro-calcified plaque (FC), and dense calcium plaque (DC) were measured based upon predefined density threshold, and changes from baseline CCTA were analyzed., Results: The final analysis included 54 patients (age, 56 ± 9 years; 85.1% male) with CCTA at baseline and 24 weeks. Evaluating on treatment VIA-2291 (all 3 doses, n = 37) demonstrated significant reductions in plaque progression compared with placebo (n = 17). VIA-2291 significantly reduced LAP (5.9 ± 20.7 mm
3 vs -9.7 ± 33.3 mm3 ), FF (11.1 mm3 ± 13.3 mm3 vs -0.9 ± 2.7 mm3 ), and FC (-0.1 ± 6.22 mm3 vs -14.3 ± 6.2 mm3 ; all P < 0.05) and retarded the progression of DC (3.9 ± 3.2 mm3 vs 0.2 ± 0.4 mm3 ) compared with placebo., Conclusions: VIA-2291 resulted in slowed plaque progression compared with placebo across different plaque subtypes in patients with recent ACS (http://ClinicalTrials.gov NCT00358826)., (© 2016 Wiley Periodicals, Inc.)- Published
- 2017
- Full Text
- View/download PDF
34. Alcohol septal ablation for hypertrophic obstructive cardiomyopathy in a patient with a chronic total occlusion of the right coronary artery: "beware of collateral damage".
- Author
-
de Hemptinne Q, Picard F, and L'Allier PL
- Abstract
Alcohol septal ablation (ASA) is an effective semi-invasive alternative to surgical myectomy in selected patients for the management of severely symptomatic and drug-refractory hypertrophic obstructive cardiomyopathy (HOCM). One contraindication of this procedure is the presence of collateral flow originating from the target septal perforator to a remote myocardial territory. In such circumstances, ethanol injection could cause remote non-target myocardial necrosis in the collateralized territory. Percutaneous revascularization of the collateralized vessel prior to ASA might cope with this contraindication by restoring normal antegrade flow in the occluded artery. We report a case that illustrates the feasibility and efficacy of such strategy., Competing Interests: The authors have no conflicts of interest to declare.
- Published
- 2017
- Full Text
- View/download PDF
35. Early Multiple Coronary Micro Aneurysms After Bioresorbable Vascular Scaffold Implantation.
- Author
-
Picard F, L'allier PL, and Tanguay JF
- Subjects
- Coronary Aneurysm diagnosis, Coronary Angiography, Coronary Vessels diagnostic imaging, Follow-Up Studies, Humans, Male, Microaneurysm diagnosis, Middle Aged, Non-ST Elevated Myocardial Infarction diagnosis, Non-ST Elevated Myocardial Infarction surgery, Time Factors, Absorbable Implants adverse effects, Coronary Aneurysm etiology, Coronary Vessels surgery, Microaneurysm etiology, Percutaneous Coronary Intervention adverse effects, Tissue Scaffolds adverse effects
- Abstract
Bioresorbable vascular scaffold (BVS) is a novel technology designed to overcome the long-term limitations of permanent metallic stent implantation in percutaneous coronary intervention. However, little is known about the development of coronary aneurysms after the use of BVSs, and additional experience is needed to establish the entire spectrum of complications related to the use of these emerging materials. We hereby report an unusual case of early multiple coronary artery micro aneurysms formation after BVS implantation., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
36. Outcomes of Patients With ST-Elevation Myocardial Infarction Receiving and Not Receiving Reperfusion Therapy: The Importance of Examining All Patients.
- Author
-
Lambert LJ, Brophy JM, Racine N, Rinfret S, L'Allier PL, Brown KA, Boothroyd LJ, Ross D, Segal E, Kouz S, Maire S, Harvey R, Kezouh A, Nasmith J, and Bogaty P
- Subjects
- Female, Hospitals statistics & numerical data, Humans, Male, Middle Aged, Patient Transfer statistics & numerical data, Quebec epidemiology, Fibrinolytic Agents therapeutic use, Percutaneous Coronary Intervention statistics & numerical data, ST Elevation Myocardial Infarction mortality, ST Elevation Myocardial Infarction therapy
- Abstract
Background: Hospitals treating patients with ST-elevation myocardial infarction (STEMI) may show good results with reperfusion treatment (fibrinolysis or primary percutaneous coronary intervention [PPCI]), but a comprehensive evaluation should factor in outcomes of patients with STEMI who do not receive reperfusion. We compared outcomes of patients receiving and not receiving reperfusion within a complete system of STEMI care by hospital type: PPCI centres, fibrinolysis centres, centres that only transfer for PPCI, and centres providing a mix of fibrinolysis and PPCI transfer., Methods: All patients presenting to 82 Quebec hospitals with characteristic symptoms, a final diagnosis of acute myocardial infarction, and core-laboratory confirmed STEMI over two 6-month periods were studied., Results: Of the total 3731 patients with STEMI, 2918 (78.2%) received reperfusion treatment (81% PPCI, 19% fibrinolysis); 813 (21.8%) did not. For reperfusion-treated patients, 30-day mortality was 5.4% in PPCI centres, 5.4% in fibrinolysis centres, 6.9% in transfer PPCI centres, and 6.0% in mixed centres (P = 0.55). For untreated patients, 30-day mortality was 15.7% (PPCI centres), 16.1% (fibrinolysis centres), 21.8% (transfer PPCI), and 24.6% (mixed) (P = 0.08). Adjusted mortality odds ratios for all patients were 1.00 (PPCI centres), 1.50 (95% CI: 0.97-2.32; fibrinolysis centres), 1.30 (0.95-1.78; transfer PPCI centres), and 1.58 (1.09-2.29; mixed centres). PPCI was within recommended delays in 35.4%, 11.9%, and 1.2% of PPCI, transfer, and mixed centres, respectively., Conclusions: Mixed centres had the highest crude and adjusted all-patient 30-day STEMI mortality. Relatively good outcomes of reperfusion-treated patients, despite long treatment delays, can misrepresent overall performance if untreated patients are not examined., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
37. Sealing Intermediate Nonobstructive Coronary Saphenous Vein Graft Lesions With Drug-Eluting Stents as a New Approach to Reducing Cardiac Events: A Randomized Controlled Trial.
- Author
-
Rodés-Cabau J, Jolly SS, Cairns J, Mansour S, L'Allier PL, Teefy PJ, Graham JJ, Le May MR, Cantor WJ, Wood D, Balasubramanian K, DeLarochellière R, and Dzavik V
- Subjects
- Aged, Canada, Cardiovascular Agents adverse effects, Constriction, Pathologic, Coronary Angiography, Coronary Artery Bypass mortality, Female, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular mortality, Graft Occlusion, Vascular physiopathology, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction etiology, Myocardial Infarction prevention & control, Paclitaxel adverse effects, Percutaneous Coronary Intervention adverse effects, Prosthesis Design, Risk Factors, Saphenous Vein diagnostic imaging, Saphenous Vein physiopathology, Severity of Illness Index, Time Factors, Treatment Outcome, Vascular Patency, Cardiovascular Agents administration & dosage, Coronary Artery Bypass adverse effects, Drug-Eluting Stents, Graft Occlusion, Vascular therapy, Paclitaxel administration & dosage, Percutaneous Coronary Intervention instrumentation, Saphenous Vein transplantation
- Abstract
Background: The objective of this study was to assess the efficacy of sealing intermediate nonobstructive coronary saphenous vein graft (SVG) lesions with drug-eluting stents (DES; paclitaxel- or everolimus-eluting stents) for reducing major adverse cardiac events (MACE)., Methods and Results: This was a randomized controlled multicenter clinical trial that enrolled patients with a previous coronary artery bypass graft who had developed at least 1 intermediate nonobstructive SVG lesion (30%-60% diameter stenosis by visual estimation). Patients were randomized (1:1) to DES implantation (SVG-DES) or medical treatment (SVG-MT) of the target SVG lesion. The primary efficacy outcome was the first occurrence of MACE defined as the composite of cardiac death, myocardial infarction, or coronary revascularization related to the target SVG during the duration of follow-up (minimum of 2 years). Secondary efficacy outcomes included MACE related to the target SVG lesion and overall MACE. A total of 125 patients (mean age 70±9 years, 87% men) were included, with a mean time from coronary artery bypass graft of 12±5 years. Sixty and 65 patients were allocated to the SVG-DES and SVG-MT groups, respectively. There were no events related to the target SVG at 30 days. After a median follow-up of 3.4 (interquartile range: 2.8-3.9) years, the MACE rate related to the target SVG was not significantly different in the 2 groups (SVG-DES: 15.0%, SVG-MT: 20.0%; hazard ratio, 0.65; 95% confidence interval, 0.23-1.53; P=0.33). There were no significant differences between groups in MACE related to the target SVG lesion (SVG-DES: 10.0%, SVG-MT: 16.9%; hazard ratio, 0.53; 95% confidence interval, 0.20-1.43; P=0.21) or global MACE (SVG-DES: 36.7%, SVG-MT: 44.6%; hazard ratio, 0.73; 95% confidence interval, 0.42-1.27; P=0.26)., Conclusions: Sealing intermediate nonobstructive SVG lesions with DES was safe but was not associated with a significant reduction of cardiac events at 3-year follow-up., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01223443., (© 2016 American Heart Association, Inc.)
- Published
- 2016
- Full Text
- View/download PDF
38. A Novel Minimally Invasive Approach for Surgical Septal Myectomy.
- Author
-
Mazine A, Ghoneim A, Bouhout I, Fortin W, Berania I, L'Allier PL, Garceau P, and Bouchard D
- Subjects
- Adult, Aged, Cohort Studies, Echocardiography, Transesophageal, Female, Heart Septum diagnostic imaging, Humans, Male, Middle Aged, Pacemaker, Artificial statistics & numerical data, Postoperative Complications, Sternotomy, Ventricular Outflow Obstruction surgery, Cardiomyopathy, Hypertrophic surgery, Heart Septum surgery, Minimally Invasive Surgical Procedures, Thoracotomy methods
- Abstract
Background: Transaortic septal myectomy is the gold standard for the treatment of symptomatic hypertrophic obstructive cardiomyopathy that is refractory to medical therapy. The aim of this study was to assess early outcomes of minimally invasive septal myectomy performed through a right anterior minithoracotomy., Methods: Between 2011 and 2014, 24 consecutive patients underwent isolated septal myectomy through a 4-5-cm right parasternal minithoracotomy. Perioperative clinical and echocardiographic outcomes in these patients were compared with those of a historical cohort of 26 consecutive patients who underwent isolated septal myectomy performed through a median sternotomy between 2002 and 2010., Results: Age and sex distribution were similar between the groups. Median aortic cross-clamp time was 57 minutes in the minithoracotomy group vs 43 minutes in the sternotomy group (P = 0.149). There was no in-hospital mortality in either group. Intraoperative conversion to sternotomy was required in 1 patient. Postoperative permanent pacemaker implantation was required in 5 patients from each group (P = 0.999). Both groups demonstrated similar reductions in left ventricular outflow tract gradient and septal thickness. Residual obstructive systolic anterior motion of the mitral valve was observed in 2 patients (8%) in the minithoracotomy group and 1 patient (4%) in the sternotomy group (P = 0.602)., Conclusions: This study demonstrates the feasibility of transaortic septal myectomy through a right minithoracotomy. Our early results suggest that this technique yields clinical and echocardiographic outcomes similar to those obtained with standard sternotomy., (Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
39. Arterial Effects of Canakinumab in Patients With Atherosclerosis and Type 2 Diabetes or Glucose Intolerance.
- Author
-
Choudhury RP, Birks JS, Mani V, Biasiolli L, Robson MD, L'Allier PL, Gingras MA, Alie N, McLaughlin MA, Basson CT, Schecter AD, Svensson EC, Zhang Y, Yates D, Tardif JC, and Fayad ZA
- Subjects
- Antibodies, Monoclonal, Humanized, Double-Blind Method, Female, Humans, Male, Middle Aged, Antibodies, Monoclonal pharmacology, Antibodies, Monoclonal therapeutic use, Arteries drug effects, Atherosclerosis complications, Atherosclerosis drug therapy, Diabetes Mellitus, Type 2 complications, Glucose Intolerance complications, Interleukin-1beta antagonists & inhibitors
- Abstract
Background: Evidence suggests that interleukin (IL)-1β is important in the pathogenesis of atherosclerosis and its complications and that inhibiting IL-1β may favorably affect vascular disease progression., Objectives: The goal of this study was to evaluate the effects of IL-1β inhibition with canakinumab versus placebo on arterial structure and function, determined by magnetic resonance imaging., Methods: Patients (N = 189) with atherosclerotic disease and either type 2 diabetes mellitus or impaired glucose tolerance were randomized to receive placebo (n = 94) or canakinumab 150 mg monthly (n = 95) for 12 months. They underwent magnetic resonance imaging of the carotid arteries and aorta., Results: There were no statistically significant differences between canakinumab compared with placebo in the primary efficacy and safety endpoints. There was no statistically significant change in mean carotid wall area and no effect on aortic distensibility, measured at 3 separate anatomic sites. The change in mean carotid artery wall area was -3.37 mm
2 after 12 months with canakinumab versus placebo. High-sensitivity C-reactive protein was significantly reduced by canakinumab compared with placebo at 3 months (geometric mean ratio [GMR]: 0.568; 95% confidence interval [CI]: 0.436 to 0.740; p < 0.0001) and 12 months (GMR: 0.56; 95% CI: 0.414 to 0.758; p = 0.0002). Lipoprotein(a) levels were reduced by canakinumab compared with placebo (-4.30 mg/dl [range: -8.5 to -0.55 mg/dl]; p = 0.025] at 12 months), but triglyceride levels increased (GMR: 1.20; 95% CI: 1.046 to 1.380; p = 0.01). In these patients with type 2 diabetes mellitus or impaired glucose tolerance, canakinumab had no effect compared with placebo on any of the measures assessed by using a standard oral glucose tolerance test., Conclusions: There were no statistically significant effects of canakinumab on measures of vascular structure or function. Canakinumab reduced markers of inflammation (high-sensitivity C-reactive protein and interleukin-6), and there were modest increases in levels of total cholesterol and triglycerides. (Safety & Effectiveness on Vascular Structure and Function of ACZ885 in Atherosclerosis and Either T2DM or IGT Patients; NCT00995930)., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)- Published
- 2016
- Full Text
- View/download PDF
40. Epidemiology, Management Strategies, and Outcomes of Patients With Chronic Total Coronary Occlusion.
- Author
-
Azzalini L, Jolicoeur EM, Pighi M, Millán X, Picard F, Tadros VX, Fortier A, L'Allier PL, and Ly HQ
- Subjects
- Age Factors, Aged, Aged, 80 and over, Angina Pectoris epidemiology, Angina Pectoris therapy, Chronic Disease, Clinical Decision-Making, Coronary Occlusion epidemiology, Coronary Occlusion mortality, Coronary Occlusion physiopathology, Female, Humans, Male, Middle Aged, Mortality, Multivariate Analysis, Myocardial Infarction epidemiology, Myocardial Revascularization statistics & numerical data, Prevalence, Proportional Hazards Models, Stroke Volume, Tachycardia, Ventricular epidemiology, Ventricular Fibrillation epidemiology, Conservative Treatment, Coronary Artery Bypass, Coronary Occlusion therapy, Percutaneous Coronary Intervention
- Abstract
Factors influencing the management of patients with chronic total occlusion (CTO) are poorly described. We sought to analyze the clinical and angiographic variables influencing the decision-making process of patients with CTO. Consecutive patients with at least 1 coronary artery CTO were included and categorized as managed either by percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG), or medical therapy (MT). Patients with previous CABG were excluded. The CTO SYNTAX score (CTO-SS) was defined as the ratio between the score attributed to the CTO lesion in the SYNTAX score calculation and the total SYNTAX score. Independent predictors of management strategies were sought. A total of 510 patients were included (CTO incidence: 20%): 9% were treated with PCI, 34% with CABG, and 57% with MT. SYNTAX score was lowest in PCI (14.8 [11.0 to 18.5]) and highest in CABG (31.5 [25.0 to 38.8], p <0.0001). PCI was attempted more often in patients with higher CTO-SS (i.e., those with higher contribution to the overall SYNTAX score from the CTO lesion; 88% had a CTO-SS >0.5). Conversely, CABG was preferred in subjects with lower CTO-SS (61% had a CTO-SS ≤0.5, p <0.0001). Age, ejection fraction, SYNTAX score, and age of the CTO were independent predictors of revascularization. At mid-term follow-up, unsuccessful revascularization or MT was independently associated with death (hazard ratio 7.2, p = 0.0005). In conclusion, CTOs are frequently documented in clinical practice. However, less than a half is revascularized. Management strategies are influenced by angiographic variables such as the SYNTAX score and the newly proposed CTO-SS., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
41. Genotype-Dependent Effects of Dalcetrapib on Cholesterol Efflux and Inflammation: Concordance With Clinical Outcomes.
- Author
-
Tardif JC, Rhainds D, Brodeur M, Feroz Zada Y, Fouodjio R, Provost S, Boulé M, Alem S, Grégoire JC, L'Allier PL, Ibrahim R, Guertin MC, Mongrain I, Olsson AG, Schwartz GG, Rhéaume E, and Dubé MP
- Subjects
- Adenylyl Cyclases genetics, Adenylyl Cyclases metabolism, Aged, Amides, Animals, Anticholesteremic Agents adverse effects, Atherosclerosis blood, Atherosclerosis enzymology, Atherosclerosis genetics, Biomarkers blood, C-Reactive Protein metabolism, Cell Line, Cholesterol Ester Transfer Proteins antagonists & inhibitors, Cholesterol Ester Transfer Proteins metabolism, Cholesterol, HDL blood, Cholesterol, LDL blood, Double-Blind Method, Dyslipidemias blood, Dyslipidemias enzymology, Dyslipidemias genetics, Esters, Female, Humans, Inflammation blood, Inflammation enzymology, Inflammation genetics, Macrophages metabolism, Male, Mice, Middle Aged, Pharmacogenetics, Pharmacogenomic Variants, Polymorphism, Single Nucleotide, Sulfhydryl Compounds adverse effects, Time Factors, Treatment Outcome, Anticholesteremic Agents therapeutic use, Atherosclerosis drug therapy, Cholesterol blood, Dyslipidemias drug therapy, Inflammation drug therapy, Macrophages drug effects, Sulfhydryl Compounds therapeutic use
- Abstract
Background: Dalcetrapib effects on cardiovascular outcomes are determined by adenylate cyclase 9 gene polymorphisms. Our aim was to determine whether these clinical end point results are also associated with changes in reverse cholesterol transport and inflammation., Methods and Results: Participants of the dal-OUTCOMES and dal-PLAQUE-2 trials were randomly assigned to receive dalcetrapib or placebo in addition to standard care. High-sensitivity C-reactive protein was measured at baseline and at end of study in 5243 patients from dal-OUTCOMES also genotyped for the rs1967309 polymorphism in adenylate cyclase 9. Cholesterol efflux capacity of high-density lipoproteins from J774 macrophages after cAMP stimulation was determined at baseline and 12 months in 171 genotyped patients from dal-PLAQUE-2. Treatment with dalcetrapib resulted in placebo-adjusted geometric mean percent increases in high-sensitivity C-reactive protein from baseline to end of trial of 18.1% (P=0.0009) and 18.7% (P=0.00001) in participants with the GG and AG genotypes, respectively, but the change was -1.0% (P=0.89) in those with the protective AA genotype. There was an interaction between the treatment arm and the genotype groups (P=0.02). Although the mean change in cholesterol efflux was similar among study arms in patients with GG genotype (mean: 7.8% and 7.4%), increases were 22.3% and 3.5% with dalcetrapib and placebo for those with AA genotype (P=0.005). There was a significant genetic effect for change in efflux for dalcetrapib (P=0.02), but not with placebo., Conclusions: Genotype-dependent effects on C-reactive protein and cholesterol efflux are supportive of dalcetrapib benefits on atherosclerotic cardiovascular outcomes in patients with the AA genotype at polymorphism rs1967309., Clinical Trials Registration: ClinicalTrials.gov; Unique Identifiers: NCT00658515 and NCT01059682., (© 2016 The Authors.)
- Published
- 2016
- Full Text
- View/download PDF
42. Imaging and functional assessment of bioresorbable scaffolds.
- Author
-
Pighi M, Tanguay JF, and L'allier PL
- Subjects
- Bioprosthesis, Coronary Artery Disease, Drug-Eluting Stents, Humans, Percutaneous Coronary Intervention methods, Absorbable Implants, Blood Vessel Prosthesis, Blood Vessels diagnostic imaging, Tissue Scaffolds
- Abstract
Bioresorbable vascular scaffolds (BRS) are novel devices designed to provide transient vessel support to drug-delivery capability without the potential long-term limitations of metallic drug-eluting stents. The technology, heralded as the latest revolution in the field of percutaneous coronary intervention, could overcome many of the long-term safety concerns associated with metallic stents and possibly even convey a further clinical benefit. However, despite its theoretical advantages, the safety and efficacy of the first generation BRS remain unclear in all-comer patient populations. Invasive imaging modalities and methodologies were developed to guide BRS implantation and monitor the interaction between the scaffold and the vessel at long-term follow-up. These tools are helpful to avoid some of the pitfalls associated with BRS implantation and may improve the clinical outcome of these devices. The present review aims to report the most recent data regarding multi-imaging modalities as guidance and follow-up of coronary interventions involving the use of BRS.
- Published
- 2016
43. Clinical Profiles Related to Timing of Death, Including In-Hospital Deaths Before Admission, in Patients With ST-Elevation Myocardial Infarction.
- Author
-
Bogaty P, L'Allier PL, Segal E, Rinfret S, Racine N, Harvey R, Ross D, Maire S, Kouz S, Carroll C, Boothroyd LJ, Kezouh A, Azzi L, Brown KA, Nasmith J, and Lambert LJ
- Subjects
- Aged, Cause of Death trends, Female, Follow-Up Studies, Hospital Mortality trends, Humans, Male, Myocardial Infarction diagnosis, Quebec epidemiology, Retrospective Studies, Time Factors, Electrocardiography, Emergency Medical Services statistics & numerical data, Myocardial Infarction mortality, Patient Admission statistics & numerical data, Registries
- Abstract
Patients with ST-elevation myocardial infarction (STEMI) who die in hospital before inpatient admission are generally not included in clinical studies and registries, and the clinical profiles of patients who die earlier versus later are not well defined. We aimed to characterize all patients with STEMI who arrived at emergency departments in the province of Quebec (Canada) based on inpatient admission status and when they died. All patients who presented with symptoms and core laboratory-confirmed STEMI or left bundle branch block during 6 months in 82 hospitals in Quebec were included. Death certificates were used to identify nonadmitted deaths. Of the 2017 patients with STEMI, 340 (16.9%) died within 1 year. Of the latter, 63 (18.5%) were nonadmitted deaths (group A), 179 (52.6%) were deaths after admission but within 30 days (group B), and 98 (28.8%) were deaths after 30 days to 1 year (group C). Group A was younger and most often hemodynamically unstable, followed for both features by B then C. Earliest presentation from symptom onset and most frequent ambulance use were found in group A, followed by B, then C. Presenting electrocardiogram (ECG) features were most severe in A, then B, then C (more arrhythmias, more anterior STEMI, more leads with ST elevation, and higher ST elevation). Patients who died earliest had the least frequency of previous myocardial infarction, coronary revascularization, vascular disease, and heart failure, and the least noncardiac co-morbidity. In conclusion, patients with STEMI dying in hospital before inpatient admission contributed substantially to overall STEMI mortality. Although dying patients who presented earlier had severer presenting clinical profiles, they were paradoxically younger and had less co-morbidity. Previous co-morbidities may favor adaptive protective mechanisms on initial presentation with STEMI., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
44. Effects of P-Selectin Antagonist Inclacumab in Patients Undergoing Coronary Artery Bypass Graft Surgery: SELECT-CABG Trial.
- Author
-
Stähli BE, Tardif JC, Carrier M, Gallo R, Emery RW, Robb S, Cournoyer D, Blondeau L, Johnson D, Mann J, Lespérance J, Guertin MC, and L'Allier PL
- Subjects
- Aged, Cardiovascular Agents administration & dosage, Cardiovascular Agents adverse effects, Coronary Angiography methods, Double-Blind Method, Female, Humans, Male, Middle Aged, Treatment Outcome, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome drug therapy, Acute Coronary Syndrome etiology, Antibodies, Monoclonal administration & dosage, Antibodies, Monoclonal adverse effects, Coronary Artery Bypass adverse effects, P-Selectin antagonists & inhibitors, Postoperative Complications diagnosis, Postoperative Complications drug therapy
- Published
- 2016
- Full Text
- View/download PDF
45. The Benefits Conferred by Radial Access for Cardiac Catheterization Are Offset by a Paradoxical Increase in the Rate of Vascular Access Site Complications With Femoral Access: The Campeau Radial Paradox.
- Author
-
Azzalini L, Tosin K, Chabot-Blanchet M, Avram R, Ly HQ, Gaudet B, Gallo R, Doucet S, Tanguay JF, Ibrahim R, Grégoire JC, Crépeau J, Bonan R, de Guise P, Nosair M, Dorval JF, Gosselin G, L'Allier PL, Guertin MC, Asgar AW, and Jolicœur EM
- Subjects
- Cardiac Catheterization methods, Female, Femoral Artery, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Odds Ratio, Percutaneous Coronary Intervention methods, Postoperative Complications etiology, Quebec epidemiology, Radial Artery, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Cardiac Catheterization adverse effects, Coronary Artery Disease surgery, Percutaneous Coronary Intervention adverse effects, Postoperative Complications epidemiology, Vascular Access Devices adverse effects
- Abstract
Objectives: The purpose of this study was to assess whether the benefits conferred by radial access (RA) at an individual level are offset by a proportionally greater incidence of vascular access site complications (VASC) at a population level when femoral access (FA) is performed., Background: The recent widespread adoption of RA for cardiac catheterization has been associated with increased rates of VASCs when FA is attempted., Methods: Logistic regression was used to calculate the adjusted VASC rate in a contemporary cohort of consecutive patients (2006 to 2008) where both RA and FA were used, and compared it with the adjusted VASC rate observed in a historical control cohort (1996 to 1998) where only FA was used. We calculated the adjusted attributable risk to estimate the proportion of VASC attributable to the introduction of RA in FA patients of the contemporary cohort., Results: A total of 17,059 patients were included. At a population level, the VASC rate was higher in the overall contemporary cohort compared with the historical cohort (adjusted rates: 2.91% vs. 1.98%; odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.17 to 1.89; p = 0.001). In the contemporary cohort, RA patients experienced fewer VASC than FA patients (adjusted rates: 1.44% vs. 4.19%; OR: 0.33, 95% CI: 0.23 to 0.48; p < 0.001). We observed a higher VASC rate in FA patients in the contemporary cohort compared with the historical cohort (adjusted rates: 4.19% vs. 1.98%; OR: 2.16, 95% CI: 1.67 to 2.81; p < 0.001). This finding was consistent for both diagnostic and therapeutic catheterizations separately. The proportion of VASCs attributable to RA in the contemporary FA patients was estimated at 52.7%., Conclusions: In a contemporary population where both RA and FA were used, the safety benefit associated with RA is offset by a paradoxical increase in VASCs among FA patients. The existence of this radial paradox should be taken into consideration, especially among trainees and default radial operators., (Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
46. A numerical investigation of the functionality of coronary bifurcation lesions with respect to lesion configuration and stenosis severity.
- Author
-
Pagiatakis C, Tardif JC, L'Allier PL, and Mongrain R
- Subjects
- Coronary Stenosis physiopathology, Hemodynamics, Humans, Hydrodynamics, Imaging, Three-Dimensional, Coronary Stenosis pathology, Models, Biological
- Abstract
The intervention of coronary bifurcation lesions is associated with higher rates of peri- and post-procedural clinical events compared to the treatment of isolated lesions. Overall, the factors that influence the dynamics of these types of configurations are still not well understood. A geometric multiscale model, consisting of a 3D representation of the left main coronary artery bifurcation and a 0D representation of the rest of the cardiovascular system, was developed. Computational fluid dynamics simulations of the 3D domain were executed by implementing the multiscale algorithm, in order to characterize the functionality of different multilesional configurations as a function of stenosis severity. The investigation found that coronary branch steal has a significant impact on the functionality of the disease and can render a two-lesion configuration more severe compared to a three-lesion configuration. As a result of the complexity of this phenomenon, it was also suggested that certain lesion configurations could result in false negatives in diagnosis when employing a pullback pressure recording across the tandem lesions. In conclusion, this study showed that coronary bifurcation lesions are subject to intricate haemodynamic interactions which render the characterization of their functionality complex and could have significant clinical implications with regards to their diagnosis and prognosis., (Copyright © 2015 Elsevier Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
47. Novel anti-inflammatory therapies for the treatment of atherosclerosis.
- Author
-
Khan R, Spagnoli V, Tardif JC, and L'Allier PL
- Subjects
- Animals, Arteries immunology, Arteries metabolism, Arteries pathology, Atherosclerosis diagnosis, Atherosclerosis immunology, Atherosclerosis metabolism, Drug Discovery, Humans, Hypolipidemic Agents therapeutic use, Inflammation diagnosis, Inflammation immunology, Inflammation metabolism, Inflammation Mediators immunology, Inflammation Mediators metabolism, Lipids blood, Molecular Targeted Therapy, Signal Transduction drug effects, Anti-Inflammatory Agents therapeutic use, Arteries drug effects, Atherosclerosis drug therapy, Inflammation drug therapy, Inflammation Mediators antagonists & inhibitors
- Abstract
The underlying role of inflammation in atherosclerosis has been characterized. However, current treatment of coronary artery disease (CAD) predominantly consists of targeted reductions in serum lipoprotein levels rather than combating the deleterious effects of acute and chronic inflammation. Vascular inflammation acts by a number of different molecular and cellular pathways to contribute to atherogenesis. Over the last decades, both basic studies and clinical trials have provided evidence for the potential benefits of treatment of inflammation in CAD. During this period, development of pharmacotherapies directed towards inflammation in atherosclerosis has accelerated quickly. This review will highlight specific therapies targeting interleukin-1β (IL-1β), P-selectin and 5-lipoxygenase (5-LO). It will also aim to examine the anti-inflammatory effects of serpin administration, colchicine and intravenous HDL-directed treatment of CAD. We summarize the mechanistic rationale and evidence for these novel anti-inflammatory treatments at both the experimental and clinical levels., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
48. Very late bioresorbable vascular scaffold thrombosis: a new clinical entity.
- Author
-
Azzalini L, Al-Hawwas M, and L'Allier PL
- Subjects
- Aged, 80 and over, Anterior Wall Myocardial Infarction diagnosis, Anterior Wall Myocardial Infarction etiology, Brachytherapy, Clopidogrel, Coronary Angiography, Coronary Restenosis diagnosis, Coronary Restenosis etiology, Coronary Stenosis complications, Coronary Stenosis diagnosis, Coronary Thrombosis diagnosis, Coronary Thrombosis therapy, Drug-Eluting Stents, Female, Humans, Metals, Myocardial Infarction diagnosis, Myocardial Infarction etiology, Percutaneous Coronary Intervention adverse effects, Platelet Aggregation Inhibitors administration & dosage, Prosthesis Design, Severity of Illness Index, Ticlopidine administration & dosage, Ticlopidine analogs & derivatives, Time Factors, Tomography, Optical Coherence, Treatment Outcome, Absorbable Implants, Coronary Restenosis therapy, Coronary Stenosis therapy, Coronary Thrombosis etiology, Myocardial Infarction therapy, Percutaneous Coronary Intervention instrumentation, Stents
- Published
- 2015
- Full Text
- View/download PDF
49. Pharmacogenomic determinants of the cardiovascular effects of dalcetrapib.
- Author
-
Tardif JC, Rhéaume E, Lemieux Perreault LP, Grégoire JC, Feroz Zada Y, Asselin G, Provost S, Barhdadi A, Rhainds D, L'Allier PL, Ibrahim R, Upmanyu R, Niesor EJ, Benghozi R, Suchankova G, Laghrissi-Thode F, Guertin MC, Olsson AG, Mongrain I, Schwartz GG, and Dubé MP
- Subjects
- Aged, Amides, Carotid Intima-Media Thickness, Esters, Female, Humans, Male, Middle Aged, Adenylyl Cyclases genetics, Atherosclerosis diagnostic imaging, Atherosclerosis drug therapy, Atherosclerosis genetics, Chromosomes, Human, Pair 16 genetics, Linkage Disequilibrium, Pharmacogenetics, Polymorphism, Genetic, Sulfhydryl Compounds administration & dosage
- Abstract
Background: Dalcetrapib did not improve clinical outcomes, despite increasing high-density lipoprotein cholesterol by 30%. These results differ from other evidence supporting high-density lipoprotein as a therapeutic target. Responses to dalcetrapib may vary according to patients' genetic profile., Methods and Results: We conducted a pharmacogenomic evaluation using a genome-wide approach in the dal-OUTCOMES study (discovery cohort, n=5749) and a targeted genotyping panel in the dal-PLAQUE-2 imaging trial (support cohort, n=386). The primary endpoint for the discovery cohort was a composite of cardiovascular events. The change from baseline in carotid intima-media thickness on ultrasonography at 6 and 12 months was evaluated as supporting evidence. A single-nucleotide polymorphism was found to be associated with cardiovascular events in the dalcetrapib arm, identifying the ADCY9 gene on chromosome 16 (rs1967309; P=2.41×10(-8)), with 8 polymorphisms providing P<10(-6) in this gene. Considering patients with genotype AA at rs1967309, there was a 39% reduction in the composite cardiovascular endpoint with dalcetrapib compared with placebo (hazard ratio, 0.61; 95% confidence interval, 0.41-0.92). In patients with genotype GG, there was a 27% increase in events with dalcetrapib versus placebo. Ten single-nucleotide polymorphism in the ADCY9 gene, the majority in linkage disequilibrium with rs1967309, were associated with the effect of dalcetrapib on intima-media thickness (P<0.05). Marker rs2238448 in ADCY9, in linkage disequilibrium with rs1967309 (r(2)=0.8), was associated with both the effects of dalcetrapib on intima-media thickness in dal-PLAQUE-2 (P=0.009) and events in dal-OUTCOMES (P=8.88×10(-8); hazard ratio, 0.67; 95% confidence interval, 0.58-0.78)., Conclusions: The effects of dalcetrapib on atherosclerotic outcomes are determined by correlated polymorphisms in the ADCY9 gene., Clinical Trial Information: URL: http://www.clinicaltrials.gov. Unique identifiers: NCT00658515 and NCT01059682., (© 2015 American Heart Association, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
50. Direct stenting versus pre-dilation in ST-elevation myocardial infarction: a systematic review and meta-analysis.
- Author
-
Azzalini L, Millán X, Ly HQ, L'Allier PL, and Jolicoeur EM
- Subjects
- Arrhythmias, Cardiac, Brugada Syndrome, Cardiac Conduction System Disease, Heart Conduction System abnormalities, Humans, Myocardial Infarction mortality, Myocardial Infarction physiopathology, Myocardial Infarction therapy, Percutaneous Coronary Intervention, Stents
- Abstract
Objectives: This study aimed at comparing direct stenting (DS) versus stenting with pre-dilation (SP) in patients with ST-elevation myocardial infarction (STEMI), using a systematic review and meta-analysis of published evidence., Background: There is conflicting evidence whether stenting strategy impacts clinical outcomes in patients with STEMI., Methods: We searched EMBASE, MEDLINE, and CENTRAL, from inception to December 2014. The primary endpoint was mortality. Secondary endpoints included major adverse cardiac events (MACEs), ST-segment resolution, and angiographic outcomes., Results: A total of 9,331 patients enrolled in 12 studies (3 randomized controlled trials, RCTs; 9 non-randomized studies, NRSs) were included. DS was associated with lower mortality (OR 0.55; 95%CI: 0.33-0.94; P = 0.03) in NRSs, and overall (OR 0.56; 95%CI: 0.37-0.86; P = 0.008). Mortality was non-significantly reduced in RCTs (OR 0.56; 95%CI: 0.26-1.23; P = 0.15). DS was also associated with lower MACE rate (OR 0.71; 95%CI 0.60-0.84; P < 0.0001) in NRSs, but not in RCTs (OR 0.99; 95%CI: 0.61-1.60; P = 0.96). ST-segment resolution, no reflow, final thrombolysis in myocardial infarction (TIMI) flow and final TIMI myocardial perfusion or blush grade were significantly better with DS in NRSs, and non-significantly better in RCTs., Conclusions: The available evidence suggests that DS in STEMI might be associated with better clinical and procedural outcomes, as compared with SP. However, the fact that RCTs account for the minority of available data and that most of the available studies poorly reflect current clinical practice, as well as the existence of publication bias, preclude drawing definitive conclusions., (© 2015, Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.