Descriptor: "MESH: Myocardial Infarction" - Searchworks@Jio Institute Digital Library Search Results

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125 results on '"MESH: Myocardial Infarction"'

1. Étude de l'efficacité et de la sécurité des traitements anticoagulants chez les patients porteurs d'un thrombus intraventriculaire gauche

Author: Beaufrere, Caroline, Thèses d'exercice et mémoires - UFR de Médecine Montpellier-Nîmes, Université de Montpellier (UM), and Camille Soullier
Subjects: MESH: Myocardial infarction, Antithrombotiques, Antithrombotic, Thrombotic regression, MESH: Mortality, MESH: Mortalité, Anticoagulant oral direct, Thrombus ventriculaire gauche, MESH: Infarctus du myocarde, Left ventricular thrombus, Régression thrombotique, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Direct oral anticoagulant
Abstract: Background: Direct Oral Anticoagulants (DOA) are used in clinical practice for the treatment of left ventricular thrombus (LVT), despite the lack of scientific evidence of their efficacy and safety in this indication.The aim of this study was to describe the effect of anticoagulation therapy (vitamin K antagonists (VKA) or DAO) on LVT; and second, to identify predictors of LVT regression and clinical outcomes.Methods: from january 2012 to december 2020, all adult patients with a diagnosis of LVT and at least a 4 months follow-up were retrospectively included. The type of anticoagulant and antithrombotic treatment was collected, as well as the evolution of the thrombus. Biological, ultrasound and clinical data were collected, as well as Major Cardiac and Cerebrovascular Events (MACCE), which included death, stroke or transient ischemic attack, myocardial infarction, peripheral arterial embolism and major bleeding.Results: 90 patients were eligible. 3 patients were excluded due to exclusive heparin treatment. The population was young (mean age 62±11 years), mostly men (82%), with 78% ischemic cardiomyopathies, largely severe (LVEF 35% on average). 77% of patients were treated with VKA and 23% with DOA. 80% of patients received at least one antiplatelet therapy in combination. 80.2% of LVT disappeared completely, with no significant difference between the VKA and DOA groups. LVT reappeared in 8 patients (2 on VKA, 6 off treatment). The factors associated with a non-disappearance of LVT were a plan LVT (52.9% vs 23.2%; p=0.02), a low LVEF (29.5%±8.6 vs 36%±10, 3; p=0.0194) and a calcified thrombus (41.2% vs 0%; p
Published: 2020

2. Imagerie endocoronaire par OCT chez les patients survivant un arrêt cardiaque sans élévation du segment ST à l’électrocardiogramme

Author: Brami, Pierre, Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), and Olivier Varenne
Subjects: MESH: Out-of-Hospital Cardiac Arrest, MESH: Myocardial Infarction, Infarctus du Myocarde, Arrêt cardiaque extrahospitalier, Angioplastie coronaire percutanée, MESH: Coronary Balloon Angioplasties, Coronarographie, Optical Coherence Tomography, MESH: Percutaneous Coronary Intervention, MESH: Coronary Angiography, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Tomographie à Cohérence Optique
Abstract: Ischemic heart disease is the leading cause of out-of-hospital cardiac arrest. In survivors of cardiac arrest, coronary angioplasty is an independent factor of survival and it appears to be as important to select patients with a high probability of underlying acute coronary lesion as it is to optimally identify the culprit lesion. Yet the angiographic aspect alone lacks performance in this task, particularly in non-ST elevation acute coronary syndromes. Among patients without ST-segment elevation on the ECG after restoration of spontaneous circulation, the use of endocoronary OCT imaging could lead to an optimized guided revascularization and avoid inappropriate management. We have performed in survivors of out-of-hospital cardiac arrest without obvious extracardiac cause or ST segment elevation, OCT runs when coronary angiography showed only moderate atheroma (30-70% stenosis). Without considering acute angiographic thrombotic occlusions in 8% of patients, endocoronary OCT imaging in 22 patients with moderate atheroma identified in 11 of them (50%) a culprit lesion subject to an angioplasty. These results underline the need to a better guided revascularization in these most severe patients and OCT appears to be an extremely reliable technique, with no excess risk (no iatrogenic complications in our cohort) and good diagnostic performance. We need randomized controlled studies to assess the prognostic impact of routine use of OCT in this population.; La cardiopathie ischémique est la première cause d’arrêts cardiaques extrahospitaliers. Chez les survivants, l’angioplastie coronaire est un facteur prédictif de survie et il apparait tout aussi important de sélectionner les patients avec forte probabilité de lésion aigue coronaire sous-jacente que d’identifier de manière optimale la lésion cible à traiter. Pourtant l’aspect angiographique seul manque de performance dans cette tâche, en particulier dans les syndromes coronaires aigus non-ST+. Parmi les patients sans élévation du segment-ST à l’ECG post restauration de l’activité cardiocirculatoire spontanée, l’utilisation d’imagerie endocoronaire par OCT pourrait permettre de mieux guider la revascularisation et éviter des prises en charge inappropriées. Nous avons réalisé chez des survivants d’arrêt cardiaque sans cause extracardiaque évidente ni élévation du segment ST des runs d’OCT lorsque la coronarographie ne retrouvait que de l’athérome modéré (sténose 30-70%). Sans prendre en compte les occlusions thrombotiques aigues angiographiques chez 8% des patients, la réalisation d’une imagerie endocoronaire par OCT chez 22 patients présentant de l’athérome modéré a permis d’identifier chez 11 d’entre eux (soit 50%) une lésion coupable relevant d’une angioplastie. Ces résultats soulignent la nécessité de mieux guider la revascularisation chez ces patients les plus graves et l’OCT apparaît comme une technique extrêmement fiable, sans surrisque (aucune complication iatrogène dans notre série) et avec une bonne rentabilité diagnostique. Des études contrôlées randomisées sont nécessaires pour évaluer l’impact pronostic de l’emploi en routine d’OCT dans cette population.
Published: 2020

3. Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel

Author: Dominick J. Angiolillo, Davide Capodanno, Thomas O. Bergmeijer, Tabassome Simon, Dirk Sibbing, Nicolas Danchin, Jurriën M. ten Berg, Matthew J. Price, Centre de Ressources Biologiques APHP-SU (PASS-CRB-APHP-SU), Unité Mixte de Service Production et Analyse de données en Sciences de la vie et en Santé (PASS), and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH: Coronary Thrombosis, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, outcomes, MESH: Risk Assessment, 0302 clinical medicine, P2Y12, MESH: Risk Factors, risk factors, MESH: Obesity, 030212 general & internal medicine, Myocardial infarction, MESH: Treatment Outcome, 2. Zero hunger, MESH: Aged, Framingham Risk Score, MESH: Middle Aged, Clopidogrel, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, MESH: Myocardial Infarction, MESH: Platelet Aggregation Inhibitors, MESH: Drug Resistance, MESH: Purinergic P2Y Receptor Antagonists, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, medicine.drug, medicine.medical_specialty, MESH: Diabetes Mellitus, MESH: Renal Insufficiency, Chronic, CYP2C19, genetic testing, MESH: Body Mass Index, MESH: Clinical Decision Rules, 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, MESH: Age Factors, clopidogrel, MESH: Pharmacogenomic Variants, MESH: Humans, business.industry, MESH: Time Factors, MESH: Clopidogrel, medicine.disease, MESH: Databases, Factual, MESH: Male, MESH: Randomized Controlled Trials as Topic, MESH: Cytochrome P-450 CYP2C19, business, Body mass index, MESH: Female, Kidney disease
Abstract: Objectives The aim of this study was to develop a risk score integrating cytochrome P450 2C19 loss-of-function genotypes with clinical risk factors influencing clopidogrel response that would allow the identification with more precision of subjects at risk for high platelet reactivity (HPR) and adverse clinical outcomes. Background Clopidogrel is the most broadly used platelet P2Y12 inhibitor. However, a considerable number of patients achieve inadequate platelet inhibition, with persistent HPR, an established marker of increased thrombotic risk, underscoring the need for tools to help identify these subjects. Although carriers of loss-of-function alleles of the cytochrome P450 2C19 enzyme have reduced clopidogrel metabolism leading to increased rates of HPR and thrombotic complications, this explains only a fraction of the pharmacodynamic response to clopidogrel, and a number of clinical factors have also been shown to have contributing roles. Methods Three prospective and independent studies were used to: 1) develop a risk score integrating genetic and clinical factors to identify patients with HPR while on clopidogrel; 2) investigate the external validity of the risk score; and 3) define clinical outcomes associated with the risk score in a cohort of patients with myocardial infarction treated with clopidogrel. Results A risk score ABCD-GENE (Age, Body Mass Index, Chronic Kidney Disease, Diabetes Mellitus, and Genotyping) was developed incorporating 5 independent predictors of HPR: 4 clinical (age >75 years, body mass index >30 kg/m2, chronic kidney disease [glomerular filtration rate Conclusions The ABCD-GENE score is a simple tool to identify patients with HPR on clopidogrel and who are at increased risk for adverse ischemic events, including mortality, following an acute myocardial infarction. In patients with a high ABCD-GENE score, long-term oral P2Y12 inhibitors other than clopidogrel should be considered.
Published: 2020

4. Polymer-free sirolimus-eluting stent use in Europe and Asia: Ethnic differences in demographics and clinical outcomes

Author: Myung Ho Jeong, Christophe Piot, Jérôme Rischner, Fernando Lozano, Tae Hoon Ahn, Bruno García del Blanco, Victoria Vilalta del Olmo, Byung-Chun Jung, Peter Krajči, Petr Tousek, Matthias Waliszewski, Lucie Wachowiak, Koldobika Garcia-San Roman, Michel Pansieri, Matthias Leschke, Eduard Fernandez Nofrerias, Kyu-Rock Han, Wan Azman Wan Ahmad, Milan Trenčan, Laurent Sebagh, Bronislav Janek, Viktor Kočka, Imanol Otaegui Irurueta, Florian Krackhardt, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], B. Braun Melsungen AG, University of Malaya [Kuala Lumpur, Malaisie], University Hospital Kralovské Vinohrady, Institute for Clinical and Experimental Medicine (IKEM), Matej Bel University (UMB), Hospital General de Ciudad Real (HGUCR), University of Castilla-La Mancha (UCLM), Hospital Universitario Cruces = Cruces University Hospital, Vall d'Hebron University Hospital [Barcelona], B. Braun Medical (Saint-Cloud), Hospital Universitario Germans Trias I Pujol, Chonnam National University [Gwangju], Daegu Fatima Hospital, Kangdong Sacred Heart Hospital, Hallym University, Clinique du Millénaire - Oc Santé [Montpellier], Oc Santé [Montpellier], Clinique Turin, Hôpital Albert Schweitzer, Centre Hospitalier Henri Duffaut (Avignon), Städtische Kliniken, and Gachon University Gil Medical Center [Incheon, Republic of Korea]
Subjects: Male, Cardiovascular Procedures, Epidemiology, Polymers, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, 030204 cardiovascular system & hematology, Pathology and Laboratory Medicine, Antiplatelet Therapy, Geographical Locations, Coronary artery disease, Endocrinology, 0302 clinical medicine, MESH: Mediterranean Region, Medicine and Health Sciences, Ethnicity, Clinical endpoint, Prospective Studies, 030212 general & internal medicine, MESH: Coronary Artery Disease, MESH: Incidence, Prospective cohort study, MESH: Aged, Multidisciplinary, MESH: Middle Aged, Pharmaceutics, Mediterranean Region, Incidence, Incidence (epidemiology), Drug-Eluting Stents, MESH: Follow-Up Studies, Middle Aged, Prognosis, 3. Good health, MESH: Polymers, Europe, MESH: Malaysia, MESH: Myocardial Infarction, Medicine, Female, MESH: Ethnic Groups, MESH: Immunosuppressive Agents, MESH: Percutaneous Coronary Intervention, Immunosuppressive Agents, Research Article, MESH: Drug-Eluting Stents, MESH: Republic of Korea, medicine.medical_specialty, Asia, Coronary Stenting, Endocrine Disorders, Science, Surgical and Invasive Medical Procedures, MESH: Prognosis, Ethnic Epidemiology, 03 medical and health sciences, Signs and Symptoms, Percutaneous Coronary Intervention, Drug Therapy, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Diagnostic Medicine, South Korea, Internal medicine, Angioplasty, Republic of Korea, Diabetes Mellitus, medicine, Humans, Aged, Sirolimus, MESH: Humans, business.industry, Malaysia, Stent, medicine.disease, MESH: Male, MESH: Prospective Studies, Metabolic Disorders, People and Places, Stent Implantation, Lesions, Observational study, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Sirolimus, MESH: Europe, business, MESH: Female, Mace, Follow-Up Studies
Abstract: Background The objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe. Methods Two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months. Results Of the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe. Conclusions PF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.
Published: 2020

5. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial

Author: Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf, JORGELINA SALA, LUIS CARTASEGNA, MARISA VICO, MIGUEL ANGEL HOMINAL, EDUARDO HASBANI, ALBERTO CACCAVO, CESAR ZAIDMAN, DANIEL VOGEL, ADRIAN HRABAR, PABLO OMAR SCHYGIEL, CARLOS CUNEO, HUGO LUQUEZ, IGNACIO J. MACKINNON, RODOLFO ANDRES AHUAD GUERRERO, JUAN PABLO COSTABEL, INES PALMIRA BARTOLACCI, OSCAR MONTANA, MARIA BARBIERI, OSCAR GOMEZ VILAMAJO, RUBEN OMAR GARCIA DURAN, LILIA BEATRIZ SCHIAVI, MARCELO GARRIDO, ADRIAN INGARAMO, ANSELMO PAULINO BORDONAVA, MARIA JOSE PELAGAGGE, LEONARDO NOVARETTO, JUAN PABLO ALBISU DI GENNERO, LUZ MARIA IBANEZ SAGGIA, MOIRA ALVAREZ, NESTOR ALEJANDRO VITA, STELLA MARIS MACIN, RICARDO DARIO DRAN, MARCELO CARDONA, LUIS GUZMAN, RODOLFO JUAN SARJANOVICH, JESUS CUADRADO, SEBASTIAN NANI, MARCOS RAUL LITVAK BRUNO, CAROLINA CHACON, LAURA ELENA MAFFEI, DIEGO GRINFELD, NATALIA VENSENTINI, CLAUDIO RODOLFO MAJUL, HECTOR LUCAS LUCIARDI, PATRICIA DEL CARMEN GONZALEZ COLASO, FREDY ANTONI FERRE PACORA, PAUL VAN DEN HEUVEL, PETER VERHAMME, BAVO ECTOR, PHILIPPE DEBONNAIRE, PHILIPPE VAN DE BORNE, JEAN LEROY, HERMAN SCHROE, PASCAL VRANCKX, IVAN ELEGEERT, ETIENNE HOFFER, KARL DUJARDIN, CLARISSE INDIO DO BRASIL, DALTON PRECOMA, JOSE ANTONIO ABRANTES, EULER MANENTI, GILMAR REIS, JOSE SARAIVA, LILIA MAIA, MAURO HERNANDES, PAULO ROSSI, FABIO ROSSI DOS SANTOS, SERGIO LUIZ ZIMMERMANN, RAFAEL RECH, EDUARDO ABIB JR, PAULO LEAES, ROBERTO BOTELHO, OSCAR DUTRA, WEIMAR SOUZA, MARIA BRAILE, NILO IZUKAWA, JOSE CARLOS NICOLAU, LUIZ FERNANDO TANAJURA, CARLOS VICENTE SERRANO JUNIOR, CESAR MINELLI, LUIZ ANTONIO NASI, LIVIA OLIVEIRA, MARCELO JOSE DE CARVALHO CANTARELLI, RICHARD TYTUS, SHEKHAR PANDEY, EVA LONN, JAMES CHA, SAUL VIZEL, MOHAN BABAPULLE, ANDRE LAMY, KEVIN SAUNDERS, JOSEPH BERLINGIERI, BOB KIAII, RAKESH BHARGAVA, PRAVINSAGAR MEHTA, LAURIE HILL, DAVID FELL, ANDY LAM, FAISAL AL-QOOFI, CRAIG BROWN, ROBERT PETRELLA, JOSEPH A RICCI, ANTHONY GLANZ, NICOLAS NOISEUX, KEVIN BAINEY, FATIMA MERALI, MICHAEL HEFFERNAN, ANTHONY DELLA SIEGA, GILLES R DAGENAIS, FRANCOIS DAGENAIS, STEEVE BRULOTTE, MICHEL NGUYEN, MICHAEL HARTLEIB, RANDOLPH GUZMAN, RONALD BOURGEOIS, DENNIS RUPKA, YAARIV KHAYKIN, GILBERT GOSSELIN, THAO HUYNH, CLAUDE PILON, JEAN CAMPEAU, FRANCIS PICHETTE, ARIEL DIAZ, JAMES JOHNSTON, PRAVIN SHUKLE, GREGORY HIRSCH, PAUL RHEAULT, WLODZIMIERZ CZARNECKI, ANNIE ROY, SHAH NAWAZ, STEPHEN FREMES, DINKAR SHUKLA, GABRIEL JANO, JORGE LEONARDO COBOS, RAMON CORBALAN, MARCELO MEDINA, LEONARDO NAHUELPAN, CARLOS RAFFO, LUIS PEREZ, SERGIO POTTHOFF, BENJAMIN STOCKINS, PABLO SEPULVEDA, CHRISTIAN PINCETTI, MARGARITA VEJAR, HONGYAN TIAN, XUESI WU, YUANNAN KE, KAIYING JIA, PENGFEI YIN, ZHAOHUI WANG, LITIAN YU, SHULIN WU, ZONGQUI WU, SHAO WEN LIU, XIAO JUAN BAI, YANG ZHENG, PING YANG, YUN MEI YANG, JIWEI ZHANG, JUNBO GE, XIAO PING CHEN, JUNXIA LI, TAO HONG HU, RUIYAN ZHANG, ZHE ZHENG, XIN CHEN, LIANG TAO, JIANPING LI, WEIJIAN HUANG, GUOSHENG FU, CHUNJIAN LI, YUGANG DONG, CHUNSHENG WANG, XINMIN ZHOU, YE KONG, ARISTIDES SOTOMAYOR, JOSE LUIS ACCINI MENDOZA, HENRY CASTILLO, MIGUEL URINA, GUSTAVO AROCA, MARITZA PEREZ, DORA INES MOLINA DE SALAZAR, GREGORIO SANCHEZ VALLEJO, MANZUR J FERNANDO, HENRY GARCIA, LUIS HERNANDO GARCIA, EDGAR ARCOS, JUAN GOMEZ, FRANCISCO CUERVO MILLAN, FREDY ALBERTO TRUJILLO DADA, BORIS VESGA, GUSTAVO ADOLFO MORENO SILGADO, EVA ZIDKOVA, JEAN-CLAUDE LUBANDA, MARKETA KALETOVA, RADIM KRYZA, GABRIEL MARCINEK, MAREK RICHTER, JINDRICH SPINAR, JIRI MATUSKA, MARTIN TESAK, ZUZANA MOTOVSKA, MARIAN BRANNY, JIRI MALY, MARTIN MALY, MARTIN WIENDL, LENKA FOLTYNOVA CAISOVA, JOSEF SLABY, PETR VOJTISEK, JAN PIRK, LENKA SPINAROVA, MIROSLAVA BENESOVA, JULIA CANADYOVA, MIROSLAV HOMZA, JINDRICH FLORIAN, ROSTISLAV POLASEK, ZDENEK COUFAL, VLADIMIRA SKALNIKOVA, RADIM BRAT, MIROSLAV BRTKO, PETR JANSKY, JAROSLAV LINDNER, PAVEL MARCIAN, ZBYNEK STRAKA, MARTIN TRETINA, YAN CARLOS DUARTE, FREDDY POW CHON LONG, MAYRA SANCHEZ, JOSE LOPEZ, CARMITA PERUGACHI, RICARDO MARMOL, FREDDY TRUJILLO, PABLO TERAN, JAAKKO TUOMILEHTO, HENRI TUOMILEHTO, MARJA-LEENA TUOMINEN, ILKKA KANTOLA, GABRIEL STEG, VICTOR ABOYANS, FLORENCE LECLERCQ, EMILE FERRARI, FRANCK BOCCARA, EMMANUEL MESSAS, PATRICK MISMETTI, MARIE ANTOINETTE SEVESTRE, GUILLAUME CAYLA, PASCAL MOTREFF, STEFAN STOERK, HANS-DIRK DUENGEN, CHRISTOPH STELLBRINK, OSMAN GUEROCAK, CHRISTOPH KADEL, RUEDIGER BRAUN-DULLAEUS, MICHAEL JESERICH, CHRISTIAN OPITZ, HANS-FRIEDRICH VOEHRINGER, KARL-FRIEDRICH APPEL, BERNHARD WINKELMANN, THOMAS DORSEL, SIGRID NIKOL, HARALD DARIUS, JURGEN RANFT, SEBASTIAN SCHELLONG, WOLFGANG JUNGMAIR, PIROZE DAVIERWALA, MARC VORPAHL, LASZLO BAJNOK, ZOLTAN LASZLO, EBRAHIM NOORI, GABOR VERESS, ANDRAS VERTES, ANDRAS ZSARY, ERNO KIS, LASZLO KORANYI, JUDIT BAKAI, ZOLTAN BODA, FERENC POOR, ZOLTAN JARAI, VENDEL KEMENY, JOHN BARTON, BRENDAN MCADAM, ANDREW MURPHY, PETER CREAN, NIALL MAHON, RONAN CURTIN, BRIAIN MACNEILL, SEAN DINNEEN, MAJDI HALABI, REUVEN ZIMLICHMAN, DAVID ZELTSER, YOAV TURGEMAN, ELIEZER KLAINMAN, BASIL LEWIS, AMOS KATZ, SHAUL ATAR, EUGENIA NIKOLSKY, STEFANO BOSI, MONICA NALDI, POMPILIO FAGGIANO, DEBORA ROBBA, LUCIO MOS, GIANFRANCO SINAGRA, FRANCO COSMI, LUIGI OLTRONA VISCONTI, DE MATTEIS CARMINE, GIUSEPPE DI PASQUALE, MATTEO DI BIASE, SARA MANDORLA, MARINO BERNARDINANGELI, GIOVANNI CARLO PICCINNI, MICHELE MASSIMO GULIZIA, MARCELLO GALVANI, FLAVIO VENTURI, GIORGIO MOROCUTTI, MARIA GRAZIA BALDIN, CARLO OLIVIERI, GIAN PIERO PERNA, VINCENZO CIRRINCIONE, TAKAYASU KANNO, HIROYUKI DAIDA, YUKIO OZAKI, NAOMASA MIYAMOTO, SHINICHI HIGASHIUE, HIROSHI DOMAE, SHINOBU HOSOKAWA, HIROO KOBAYASHI, TAKEHIKO KURAMOCHI, KENSHI FUJII, KAZUAKI MIZUTOMI, KEIJIRO SAKU, KAZUO KIMURA, YOSHIHARU HIGUCHI, MITSUNORI ABE, HARUHITO OKUDA, TOSHIYUKI NODA, TERUAKI MITA, ATSUSHI HIRAYAMA, HARUHIKO ONAKA, MORIAKI INOKO, MITSUGU HIROKAMI, MUNENORI OKUBO, YUTAKA AKATSUKA, MIZUHO IMAMAKI, HARUO KAMIYA, MAMORU MANITA, TOSHIHARU HIMI, HIDEKI UENO, YUJI HISAMATSU, JUNYA AKO, YASUHIRO NISHINO, HIDEO KAWAKAMI, YUTAKA YAMADA, YUKIHIRO KORETSUNE, TAKAHISA YAMADA, TETSURO YOSHIDA, HIDEKI SHIMOMURA, NORIYUKI KINOSHITA, AKIHIKO TAKAHASHI, KHALID YUSOFF, WAN AZMAN WAN AHMAD, MUHAMMAD RADZI ABU HASSAN, SAZZLI KASIM, AIZAI AZAN ABDUL RAHIM, DIMON MOHD ZAMRIN, MASAHARU MACHIDA, YORIHIKO HIGASHINO, NORIAKI UTSU, AKIHIKO NAKANO, SHIGERU NAKAMURA, TETSUO HASHIMOTO, KENJI ANDO, TOMOHIRO SAKAMOTO, F.J. PRINS, DIRK LOK, JOHANNES GERT-JAN MILHOUS, ERIC VIERGEVER, FRANK WILLEMS, HENK SWART, MARCO ALINGS, ROB BREEDVELD, KEES-JAN DE VRIES, ROGER VAN DER BORGH, FANNY OEI, STIENEKE ZOET-NUGTEREN, HANS KRAGTEN, JEAN PAUL HERRMAN, PAUL VAN BERGEN, MARCEL GOSSELINK, EDUARD HOEKSTRA, ERWIN ZEGERS, EELKO RONNER, FRANK DEN HARTOG, GERARD BARTELS, PETER NIEROP, COEN VAN DER ZWAAN, JACOB VAN ECK, EDWIN VAN GORSELEN, BJORN GROENEMEIJER, PIETER HOOGSLAG, MARC ROBERT DE GROOT, ALDRIN LOYOLA, DENNIS JOSE SULIT, NANNETTE REY, MARIA TERESA ABOLA, DANTE MORALES, ELLEN PALOMARES, MARC EVANS ABAT, GREGORIO ROGELIO, PHILIP CHUA, JOSE CARLO DEL PILAR, JOHN DENNIS ALCARAZ, GERALDINE EBO, LOUIE TIRADOR, JOSEFINA CRUZ, JOHN ANONUEVO, ARTHUR PITARGUE, MARIANNA JANION, TOMASZ GUZIK, GRZEGORZ GAJOS, MACIEJ ZABOWKA, ANDRZEJ RYNKIEWICZ, MARLENA BRONCEL, ANDRZEJ SZUBA, DANUTA CZARNECKA, PAWEL MAGA, IRINA STRAZHESKO, YURY VASYUK, ZHANNA SIZOVA, YURY POZDNYAKOV, OLGA BARBARASH, MIKHAIL VOEVODA, TATIANA POPONINA, ALEXEY REPIN, IRINA OSIPOVA, ANNA EFREMUSHKINA, NINA NOVIKOVA, OLEG AVERKOV, DMITRY ZATEYSHCHIKOV, ARKADIY VERTKIN, AZA AUSHEVA, PATRICK COMMERFORD, SAADIYA SEEDAT, LOUIS VAN ZYL, JAN ENGELBRECHT, ELLEN MAKONLI MAKOTOKO, CATHARINA ELIZABETH PRETORIUS, ZAID MOHAMED, ADRIAN HORAK, THOMAS MABIN, ERIC KLUG, JANG-HO BAE, CHEOLHO KIM, CHONG-JIN KIM, DONG-SOO KIM, YONG JIN KIM, SEUNGJAE JOO, JONG-WON HA, CHUL SOO PARK, JANG YOUNG KIM, YOUNG-KWON KIM, CHRISTINA JARNERT, THOMAS MOOE, MIKAEL DELLBORG, INGEMAR TORSTENSSON, PER ALBERTSSON, LARS JOHANSSON, FARIS AL-KHALILI, HENRIK ALMROTH, TOMMY ANDERSSON, EMIL PANTEV, BENGT-OLOV TENGMARK, BO LIU, GUNDARS RASMANIS, CARL-MAGNUS WAHLGREN, TIZIANO MOCCETTI, ALEXANDER PARKHOMENKO, VIRA TSELUYKO, VOLODYMYR VOLKOV, OLENA KOVAL, LYUDMYLA KONONENKO, OLEKSANDR PROKHOROV, VALERIY VDOVYCHENKO, ANDRIY BAZYLEVYCH, LEONID RUDENKO, VADYM VIZIR, OLEKSANDR KARPENKO, YAROSLAV MALYNOVSKY, VALENTYNA KOVAL, BORYS STOROZHUK, JAMES COTTON, ASOK VENKATARAMAN, ANDREW MORIARTY, DEREK CONNOLLY, PATRICK DAVEY, ROXY SENIOR, INDERPAUL BIRDI, JOHN CALVERT, PATRICK DONNELLY, JASPER TREVELYAN, JUSTIN CARTER, AARON PEACE, DAVID AUSTIN, NEVILLE KUKREJA, THOMAS HILTON, SUNNY SRIVASTAVA, RONALD WALSH, RONALD FIELDS, JOSEPH HAKAS, EDWARD PORTNAY, HARINDER GOGIA, ABRAHAM SALACATA, JOHN J. HUNTER, J MICHAEL BACHARACH, NICOLAS SHAMMAS, DAMODHAR SURESH, RICKY SCHNEIDER, PAUL GURBEL, SUBHASH BANERJEE, PAUL GRENA, NOEL BEDWELL, STEPHEN SLOAN, STEVEN LUPOVITCH, ANAND SONI, KATHLEEN GIBSON, RENEE SANGRIGOLI, RAJENDRA MEHTA, PETER I-HSUAN TSAI, EVE GILLESPIE, STEPHEN DEMPSEY, GLENN HAMROFF, ROBERT BLACK, ELLIS LADER, JOHN B. KOSTIS, VERA BITTNER, WILLIAM MCGUINN, KELLEY BRANCH, VINAY MALHOTRA, STEPHEN MICHAELSON, MICHAEL VACANTE, MATTHEW MCCORMICK, RALUCA ARIMIE, ALAN CAMP, GEORGE DAGHER, N. MATHEW KOSHY, STEPHEN THEW, FREDERICK COSTELLO, MARK HEIMAN, ROBERT CHILTON, MICHAEL MORAN, FREDRIC ADLER, ANTHONY COMEROTA, ANDREW SEIWERT, WILLIAM FRENCH, HARVEY SEROTA, ROBERT HARRISON, FAISAL BAKAEEN, SHUAB OMER, LOKESH CHANDRA, ALAN WHELAN, ANDREW BOYLE, PHILIP ROBERTS-THOMSON, JAMES ROGERS, PATRICK CARROLL, DAVID COLQUHOUN, JAMES SHAW, PETER BLOMBERY, JOHN AMERENA, CHRIS HII, ALISTAIR ROYSE, BHUWAN SINGH, JOSEPH SELVANAYAGAM, SHIRLEY JANSEN, WINGCHI LO, CHRISTOPHER HAMMETT, ROHAN POULTER, SESHASAYEE NARASIMHAN, HENRIK WIGGERS, HENRIK NIELSEN, GUNNAR GISLASON, LARS KOBER, KIM HOULIND, VIBEKE BOENELYKKE SOERENSEN, ULRIK DIXEN, JENS REFSGAARD, ELISABETH ZEUTHEN, PETER SOEGAARD, MARIAN HRANAI, LUDOVIT GASPAR, DANIEL PELLA, KATARINA HATALOVA, ERIKA DROZDAKOVA, IOAN COMAN, DOINA DIMULESCU, DRAGOS VINEREANU, MIRCEA CINTEZA, CRINA SINESCU, CATALINA ARSENESCU, IMRE BENEDEK, ELENA BOBESCU, DAN DOBREANU, DAN GAITA, ADRIAN IANCU, ADRIANA ILIESIU, DANIEL LIGHEZAN, LUCIAN PETRESCU, OCTAVIAN PIRVU, IULIA TEODORESCU, DAN TESLOIANU, MARIUS MARCIAN VINTILA, OVIDIU CHIONCEL, Divisions of Cardiology and Thromboembolism McMaster University Hamiton, Population Health Research Institute, McMaster University [Hamilton, Ontario], Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Research Center [Associazione Nazionale Medici Cardiologi Ospedalieri] (ANMCO Research Center), Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Department of Statistics, University of Haifa [Haifa], Cardiology, University and Emergency Hospital, University of Edinburgh, VA Boston Healthcare System, Hamilton General Hospital, Universidad Autonoma de Madrid (UAM), Cardiology Department, Dipartimento di Bioscienze, University of Parma, University of Barcelona, Hospital Clinic Barcelona, Laval University and Hospital Heart and Lung Institute, UVSQ - UFR des sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), University Hospital Brno, Masaryk University, Department of Public Health, Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Pasteur [Nice] (CHU), Service de Cardiologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), CHU Gabriel Montpied (CHU), CHU Clermont-Ferrand, Department of Medicine (DEBRECEN - Dpt Medicine), University of Debrecen, University of Trieste, Lab Dev Cell Biol,Bunkyo Ku, The University of Tokyo, The Netherlands Organisation for Applied Scientific Research (TNO), Regional Specialist Hospital in Wroclaw, Research and Development Centre, Kamienskiego, Division of Angiology, Wroclaw Medical University, Sahlgrenska University Hospital/Östra, Cardiocentro Ticino [Lugano], University of Zürich [Zürich] (UZH), Danylo Halytskyi Lviv National Medical University, Department of Cardiology, Sandwell General Hospital, Physiopathologie et thérapie des déficits sensoriels et moteurs, Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Rigshospitalet [Copenhagen], Université de Médecine Carol Davila, Cardiology Department [Târgu Mureș], University of Medicine and Pharmacy of Târgu Mureș, Institute for Cardiovascular Diseases C.C. Iliescu, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Associazione Nazionale Medici Cardiologi Ospedalieri [Firenze] (ANMCO), University of Parma = Università degli studi di Parma [Parme, Italie], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Gabriel Montpied [Clermont-Ferrand], The University of Tokyo (UTokyo), Universität Zürich [Zürich] = University of Zurich (UZH), and Copenhagen University Hospital
Subjects: Carotid Artery Diseases, Male, Myocardial Infarction, MESH: Lower Extremity, 030204 cardiovascular system & hematology, THERAPY, Stroke/epidemiology, MESH: Dose-Response Relationship, Drug, 0302 clinical medicine, Rivaroxaban, prevention, Hemorrhage/chemically induced, MESH: Peripheral Arterial Disease, MESH: Double-Blind Method, guidelines, MESH: Incidence, 030212 general & internal medicine, Cardiovascular Diseases/mortality, risk, RISK, MESH: Aged, MESH: Middle Aged, Incidence, General Medicine, Middle Aged, 3. Good health, Stroke, MESH: Myocardial Infarction, Lower Extremity, Cardiovascular Diseases, MESH: Platelet Aggregation Inhibitors, Factor Xa Inhibitors/administration & dosage, Drug Therapy, Combination, Female, MESH: Factor Xa Inhibitors, OUTPATIENTS, MESH: Rivaroxaban, management, MESH: Hemorrhage, metaanalysis, Lower Extremity/blood supply, Rivaroxaban/administration & dosage, Hemorrhage, MESH: Drug Administration Schedule, Amputation, Surgical, Drug Administration Schedule, MESH: Stroke, Peripheral Arterial Disease, 03 medical and health sciences, Double-Blind Method, atherothrombosis, Myocardial Infarction/epidemiology, MANAGEMENT, Humans, MESH: Amputation, MESH: Aspirin, Aspirin/administration & dosage, Platelet Aggregation Inhibitors/administration & dosage, METAANALYSIS, Aged, MESH: Humans, Aspirin, Dose-Response Relationship, Drug, MESH: Carotid Artery Diseases, MORTALITY, MESH: Cardiovascular Diseases, cardiovascular event rates, PREVENTION, CARDIOVASCULAR EVENT RATES, MESH: Male, outpatients, atrial-fibrillation, MESH: Drug Therapy, Combination, MESH: Morbidity, Carotid Artery Diseases/complications, lower-extremity amputation, Peripheral Arterial Disease/complications, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Morbidity, MESH: Female, Platelet Aggregation Inhibitors, Amputation/statistics & numerical data, Factor Xa Inhibitors
Abstract: BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications.METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90. After a 30-day run-in period, patients were randomly assigned (1:1:1) to receive oral rivaroxaban (2·5 mg twice a day) plus aspirin (100 mg once a day), rivaroxaban twice a day (5 mg with aspirin placebo once a day), or to aspirin once a day (100 mg and rivaroxaban placebo twice a day). Randomisation was computer generated. Each treatment group was double dummy, and the patient, investigators, and central study staff were masked to treatment allocation. The primary outcome was cardiovascular death, myocardial infarction or stroke; the primary peripheral artery disease outcome was major adverse limb events including major amputation. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants.FINDINGS: Between March 12, 2013, and May 10, 2016, we enrolled 7470 patients with peripheral artery disease from 558 centres. The combination of rivaroxaban plus aspirin compared with aspirin alone reduced the composite endpoint of cardiovascular death, myocardial infarction, or stroke (126 [5%] of 2492 vs 174 [7%] of 2504; hazard ratio [HR] 0·72, 95% CI 0·57-0·90, p=0·0047), and major adverse limb events including major amputation (32 [1%] vs 60 [2%]; HR 0·54 95% CI 0·35-0·82, p=0·0037). Rivaroxaban 5 mg twice a day compared with aspirin alone did not significantly reduce the composite endpoint (149 [6%] of 2474 vs 174 [7%] of 2504; HR 0·86, 95% CI 0·69-1·08, p=0·19), but reduced major adverse limb events including major amputation (40 [2%] vs 60 [2%]; HR 0·67, 95% CI 0·45-1·00, p=0·05). The median duration of treatment was 21 months. The use of the rivaroxaban plus aspirin combination increased major bleeding compared with the aspirin alone group (77 [3%] of 2492 vs 48 [2%] of 2504; HR 1·61, 95% CI 1·12-2·31, p=0·0089), which was mainly gastrointestinal. Similarly, major bleeding occurred in 79 (3%) of 2474 patients with rivaroxaban 5 mg, and in 48 (2%) of 2504 in the aspirin alone group (HR 1·68, 95% CI 1·17-2·40; p=0·0043).INTERPRETATION: Low-dose rivaroxaban taken twice a day plus aspirin once a day reduced major adverse cardiovascular and limb events when compared with aspirin alone. Although major bleeding was increased, fatal or critical organ bleeding was not. This combination therapy represents an important advance in the management of patients with peripheral artery disease. Rivaroxaban alone did not significantly reduce major adverse cardiovascular events compared with asprin alone, but reduced major adverse limb events and increased major bleeding.FUNDING: Bayer AG.
Published: 2018

6. Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry)

Author: Etienne Puymirat, Nicolas Danchin, Yves Cottin, Nadia Aissaoui, Tabassome Simon, Jean Ferrières, Gilles Lemesle, Francois Schiele, Pierre Coste, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Lille 2 - Faculté de Médecine, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital cardiologique du Haut Leveque, Université de Bordeaux Ségalen [Bordeaux 2], Département de Cardiologie (Dep Cardio - BESANCON), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Saint-Antoine [APHP], Université Pierre et Marie Curie - Paris 6 (UPMC), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de cardiologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Département de Cardiologie ( Dep Cardio - BESANCON ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Plateforme de recherche clinique de l'est parisien ( URCEST-CRCEST ), Service de pharmacologie clinique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Université Pierre et Marie Curie - Paris 6 ( UPMC ), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Faculté de Médecine Henri Warembourg - Université de Lille, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, MESH : Atherosclerosis, medicine.medical_treatment, MESH : Mortality, Myocardial Infarction, MESH : Aged, MESH : Prospective Studies, Angiotensin-Converting Enzyme Inhibitors, Coronary Artery Disease, Disease, MESH : Cerebrovascular Disorders, 0302 clinical medicine, Medicine, Longitudinal Studies, Prospective Studies, MESH: Coronary Artery Disease, Myocardial infarction, Coronary Artery Bypass, MESH: Treatment Outcome, Cause of death, Aged, 80 and over, education.field_of_study, MESH: Middle Aged, Hazard ratio, MESH : Platelet Aggregation Inhibitors, Prognosis, MESH: Case-Control Studies, 3. Good health, MESH: Myocardial Infarction, MESH: Angiotensin Receptor Antagonists, MESH : Angiotensin-Converting Enzyme Inhibitors, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, MESH : Case-Control Studies, medicine.medical_specialty, MESH : Angiotensin Receptor Antagonists, MESH: Prognosis, 03 medical and health sciences, Percutaneous Coronary Intervention, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, MESH : Middle Aged, MESH : Coronary Artery Disease, MESH : Aged, 80 and over, MESH: Hydroxymethylglutaryl-CoA Reductase Inhibitors, education, MESH: Age Distribution, Aged, MESH: Humans, MESH: Mortality, Proportional hazards model, MESH: Coronary Artery Bypass, MESH : Humans, Case-control study, MESH : Proportional Hazards Models, medicine.disease, MESH : Coronary Artery Bypass, Case-Control Studies, MESH: Female, MESH: Registries, MESH : Age Distribution, 030204 cardiovascular system & hematology, MESH: Atherosclerosis, MESH: Proportional Hazards Models, MESH: Cause of Death, MESH: Aged, 80 and over, MESH : Percutaneous Coronary Intervention, Risk Factors, MESH: Risk Factors, Cause of Death, MESH : Female, Registries, 030212 general & internal medicine, MESH: Longitudinal Studies, MESH : Longitudinal Studies, MESH: Aged, MESH : Prognosis, MESH: Angiotensin-Converting Enzyme Inhibitors, MESH: Adrenergic beta-Antagonists, Middle Aged, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, Treatment Outcome, MESH: Platelet Aggregation Inhibitors, Cardiology, Female, MESH: Cerebrovascular Disorders, France, MESH : Male, Adrenergic beta-Antagonists, MESH : Adrenergic beta-Antagonists, Population, MESH : Treatment Outcome, MESH: Multivariate Analysis, Angiotensin Receptor Antagonists, Age Distribution, Internal medicine, Mortality, MESH : France, Proportional Hazards Models, MESH : Cause of Death, business.industry, MESH : Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH : Multivariate Analysis, Percutaneous coronary intervention, Atherosclerosis, MESH: Male, MESH: Prospective Studies, MESH: France, Cerebrovascular Disorders, Multivariate Analysis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH : Myocardial Infarction, business, Platelet Aggregation Inhibitors, MESH : Registries
Abstract: IF 3.398; International audience; The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI. Overall, patients with a history of atherosclerotic disease (or MI) were older compared with patients without known cardiovascular disease (71 ± 13 vs 63 ± 14 years) and had higher cardiovascular risk profiles and co-morbidities. Using fully adjusted Cox multivariate analysis, previous manifestations of atherosclerotic disease were associated with higher 3-year mortality (hazard ratio 1.80, 95% confidence interval 1.40 to 2.31; p
Published: 2017

7. Response by Puymirat et al to Letter Regarding Article, 'Acute Myocardial Infarction Changes in Patient Characteristics, Management, and 6-Month Outcomes Over a Period of 20 Years in the FAST-MI Program (French Registry of Acute ST Elevation or Non-ST-Elevation Myocardial Infarction) 1995 to 2015'

Author: Tabassome Simon, Etienne Puymirat, Nicolas Danchin, Centre de Ressources Biologiques HUEP-UPMC (CRB HUEP-UPMC), UMS omique (OMIQUE), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, MESH: Registries, [SDV]Life Sciences [q-bio], Myocardial Infarction, Autopsy, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, St elevation myocardial infarction, Physiology (medical), Internal medicine, medicine, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Registries, MESH: ST Elevation Myocardial Infarction, Non-ST Elevated Myocardial Infarction, ComputingMilieux_MISCELLANEOUS, MESH: Humans, business.industry, ST elevation, medicine.disease, Infarct size, Acute stage, 3. Good health, MESH: Myocardial Infarction, MESH: Non-ST Elevated Myocardial Infarction, Coagulative necrosis, cardiovascular system, Cardiology, ST Elevation Myocardial Infarction, Cardiology and Cardiovascular Medicine, business
Abstract: We appreciate Dr Rodriguez-Granillo’s comment on the likely impact of a progressive reduction infarct size on the reduction in mortality observed at the acute stage of myocardial infarction. Indeed, their autopsy findings in the prethrombolysis era show that a large infarct extent together with coagulative necrosis was common, leading to lethal complications such as ventricular arrhythmias or ventricular rupture, which have now become quite uncommon. We certainly share their view that the decline in mortality is most certainly linked to a …
Published: 2018

8. Rationale and design of a randomized, double‐blind, event‐driven, multicentre study comparing the efficacy and safety of oral rivaroxaban with placebo for reducing the risk of death, myocardial infarction or stroke in subjects with heart failure and significant coronary artery disease following an exacerbation of heart failure: the <scp>COMMANDER HF</scp> trial

Author: Stefan D. Anker, Mandeep R. Mehra, William M. Byra, Roger M. Mills, John G.F. Cleland, Faiez Zannad, Barry H. Greenberg, Mihai Gheorghiade, Dirk J. van Veldhuisen, Min Fu, Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Department of Medicine [San Diego], University of California [San Diego] (UC San Diego), University of California-University of California, National Heart & Lung Institute, Imperial College London, Center for Cardiovascular Innovation, Feinberg School of Medicine, Northwestern University [Evanston]-Northwestern University [Evanston], University Medical Center Groningen [Groningen] (UMCG), Brigham and Women's Hospital [Boston], University Medical Center Göttingen (UMG), Janssen Research & Development, and Cardiovascular Centre (CVC)
Subjects: Cardiac & Cardiovascular Systems, Exacerbation, IMPACT, Myocardial Infarction, Administration, Oral, heart failure, Coronary Artery Disease, Cardiorespiratory Medicine and Haematology, antithrombotic, Cardiovascular, Coronary artery disease, Rivaroxaban, Risk Factors, MESH: Risk Factors, MESH: Double-Blind Method, Prospective Studies, MESH: Coronary Artery Disease, Myocardial infarction, THROMBIN GENERATION, rivaroxaban, OUTCOMES, Ejection fraction, MESH: Research Design, Atrial fibrillation, thrombin, Thrombosis, 3. Good health, Stroke, Survival Rate, MESH: Myocardial Infarction, Heart Disease, Research Design, 6.1 Pharmaceuticals, Administration, MESH: Administration, Oral, Cardiology, Patient Safety, MESH: Factor Xa Inhibitors, Cardiology and Cardiovascular Medicine, Life Sciences & Biomedicine, MESH: Rivaroxaban, coronary artery disease, medicine.drug, Oral, medicine.medical_specialty, MESH: Survival Rate, Clinical Trials and Supportive Activities, ANTICOAGULANTS, COAGULATION, 1102 Cardiovascular Medicine And Haematology, MESH: Stroke, WARFARIN, Double-Blind Method, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Clinical Research, Internal medicine, MANAGEMENT, medicine, Humans, Heart Disease - Coronary Heart Disease, Heart Failure, Science & Technology, MESH: Humans, business.industry, MORTALITY, Evaluation of treatments and therapeutic interventions, medicine.disease, R1, MESH: Prospective Studies, ASPIRIN, Cardiovascular System & Hematology, Heart failure, MESH: Heart Failure, Cardiovascular System & Cardiology, business, Factor Xa Inhibitors
Abstract: Aims: \ud \ud Thrombin is a critical element of crosstalk between pathways contributing to worsening of established heart failure (HF). The aim of this study is to explore the efficacy and safety of rivaroxaban 2.5 mg bid compared with placebo (with standard care) after an exacerbation of HF in patients with reduced ejection fraction (HF-rEF) and documented coronary artery disease.\ud Methods: \ud \ud This is an international prospective, multicentre, randomized, double-blind, placebo-controlled, event-driven study of approximately 5000 patients for a targeted 984 events. Patients must have a recent symptomatic exacerbation of HF, increased plasma concentrations of natriuretic peptides (B-type natriuretic peptide ≥200 pg/mL or N-terminal pro–B-type natriuretic peptide ≥800 pg/mL), with left ventricular ejection fraction ≤40% and coronary artery disease. Patients requiring anticoagulation for atrial fibrillation or other conditions will be excluded. After an index event (overnight hospitalization, emergency department or observation unit admission, or unscheduled outpatient parenteral treatment for worsening HF), patients will be randomized 1:1 to rivaroxaban or placebo (with standard of care). The primary efficacy outcome event is a composite of all-cause mortality, myocardial infarction or stroke. The principal safety outcome events are the composite of fatal bleeding or bleeding into a critical space with potential permanent disability, bleeding events requiring hospitalization and major bleeding events according to International Society on Thrombosis and Haemostasis bleeding criteria.\ud Conclusion: \ud \ud COMMANDER HF is the first prospective study of a target-specific oral antithrombotic agent in HF. It will provide important information regarding rivaroxaban use following an HF event in an HF-rEF patient population with coronary artery disease.
Published: 2015

9. Impact du diabète sur la présentation clinique, la prise en charge et le pronostic de l’infarctus du myocarde en France : analyse du registre multicentrique français FAST-MI 2010

Author: Moisson, Louis, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Jean-Guillaume Dillinger
Subjects: Insuline, MESH: Myocardial Infarction, Revascularisation, MESH: Diabetes Mellitus, Diabète, Pronostic, Infarctus du myocarde, MESH: Insulin, MESH: Myocardial Revascularization, MESH: Prognosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Introduction: diabetes is a common disease with a steadily increasing prevalence. It predisposes to cardiovascular diseases including myocardial infarction. The aim of the study is to analyse the impact of diabetes on clinical presentation, management and prognosis on patients with myocardial infarction in a modern therapeutic context. Methods: the data were collected from the national multicentric registry (Fast-MI 2010) which included 4169 consecutive patients admitted for myocardial infarction in october 2010 and with a clinical follow-up of 36 months. Results: diabetes was found at admission in 835 patients (20.0%) of the cohort of whom 236 patients (5.7%) were treated with insulin. These patients are older (70.1 vs. 63.3 years, p
Published: 2017

10. Incremental predictive value of mean platelet volume/platelet count ratio in in-hospital stroke after acute myocardial infarction

Author: Yves Cottin, Fabien Garnier, Karim Stamboul, Yannick Béjot, Thibault Leclercq, Olivier Hachet, Nobila Valentin Yaméogo, Charles Guenancia, Emmanuel De Maistre, Luc Lorgis, Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry, Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service d'Hématologie Clinique (CHU de Dijon), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), and Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
Subjects: Male, Time Factors, MESH : Stroke, Myocardial Infarction, MESH : Aged, MESH: Comorbidity, Comorbidity, MESH: Hospitalization, 030204 cardiovascular system & hematology, MESH : Platelet Count, law.invention, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, law, MESH: Risk Factors, Odds Ratio, [ SDV.MHEP.HEM ] Life Sciences [q-bio]/Human health and pathology/Hematology, MESH : Female, Myocardial infarction, MESH : Biomarkers, Stroke, MESH: Blood Platelets, Aged, 80 and over, MESH: Aged, Ejection fraction, MESH: Middle Aged, MESH : Prognosis, biology, MESH : Mean Platelet Volume, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, General Medicine, Middle Aged, Prognosis, Intensive care unit, stroke, MESH : Risk Factors, 3. Good health, Hospitalization, MESH: Myocardial Infarction, risk factor, platelets, MESH : Comorbidity, Cardiology, MESH : Hospitalization, Female, Mean Platelet Volume, MESH : Time Factors, Blood Platelets, medicine.medical_specialty, MESH : Male, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Acute myocardial infarction, MESH: Prognosis, MESH: Stroke, C-reactive protein, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Platelet Count, cardiovascular diseases, Risk factor, Mean platelet volume, MESH : Aged, 80 and over, Survival analysis, Aged, Proportional Hazards Models, MESH: Humans, Platelet Count, business.industry, [ SDV.BC ] Life Sciences [q-bio]/Cellular Biology, MESH: Time Factors, MESH : Humans, MESH : Blood Platelets, medicine.disease, MESH : Proportional Hazards Models, MESH: Odds Ratio, MESH: Male, MESH: Mean Platelet Volume, biology.protein, MESH: Biomarkers, MESH : Odds Ratio, MESH : Myocardial Infarction, business, MESH: Female, Biomarkers, 030217 neurology & neurosurgery
Abstract: IF 2.558; International audience; Stroke is a serious complication after acute myocardial infarction (AMI) and is associated with an increased risk of death. Though the pathophysiological mechanisms are not exactly known, increased inflammation and platelet reactivity could play an important role in the occurrence of stroke during AMI. We aimed to investigate the relationship between both mean platelet volume (MPV), a parameter of platelet function, and C-reactive protein (CRP) and the occurrence of in-hospital ischemic stroke (IHS) after AMI. Data were obtained from a French regional survey for AMI that included 5976 patients admitted to an intensive care unit (ICU) between 2001 and 2010. Patients were divided into two groups according to the occurrence of IHS. MPV, platelet count (PC), and CRP were routinely measured at admission to the ICU; 99 (1.6%) IHSs were recorded during hospitalization after admission for AMI. In multivariate analysis, IHS was independently associated with a history of stroke (OR: 1.99%, CI: 1.1-3.49, p = 0.01), impaired left ventricular ejection fraction 10 mg/l (OR: 2.19, 95% CI: 1.44-3.33, p < 0.001), and MPV/PC ratio (OR: 1.04, 95% CI: 1.01-1.08, p = 0.023). Compared with the first to fourth quintiles, the last quintile of the MPV/PC ratio was associated with higher rates of IHS on survival curve analysis (p = 0.014). At hospital admission, a high MPV/PC ratio and a high level of CRP might help to identify patients at increased risk of IHS. Moreover, these results provide new insights into the potential role played by increased inflammation and platelet reactivity in the occurrence of stroke after AMI.
Published: 2017

11. Effect of eplerenone in percutaneous coronary intervention-treated post-myocardial infarction patients with left ventricular systolic dysfunction: a subanalysis of the EPHESUS trial

Author: Julian Gunn, Iain B. Squire, David Adlam, Renaud Fay, Yasir Parviz, Faiez Zannad, Bertram Pitt, Javaid Iqbal, University of Sheffield [Sheffield], Sheffield Teaching Hospitals, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Glenfield Hospital, University of Michigan [Ann Arbor], University of Michigan System, Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: Male, medicine.medical_treatment, MESH: Comorbidity, Comorbidity, Spironolactone, 030204 cardiovascular system & hematology, Angina, Ventricular Dysfunction, Left, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Ventricular Dysfunction, Left, MESH: Double-Blind Method, 030212 general & internal medicine, Myocardial infarction, Mineralocorticoid Receptor Antagonists, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Standard treatment, Middle Aged, 3. Good health, Eplerenone, MESH: Myocardial Infarction, Treatment Outcome, surgical procedures, operative, MESH: Spironolactone, Cohort, Cardiology, Female, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, therapeutics, medicine.drug, medicine.medical_specialty, Heart failure, MESH: Mineralocorticoid Receptor Antagonists, 03 medical and health sciences, Percutaneous Coronary Intervention, Double-Blind Method, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, MESH: Humans, business.industry, Angioplasty, Percutaneous coronary intervention, medicine.disease, MESH: Male, Clinical trial, Conventional PCI, business, MESH: Female
Abstract: Aims EPHESUS was a multicentre, double-blind clinical trial in which 6632 patients with acute myocardial infarction (AMI) complicated by LV systolic dysfunction (LVSD) were randomized to receive eplerenone (n = 3319) or placebo (n = 3313). A total of 1580 EPHESUS patients were treated with PCI, which is now the standard treatment for AMI. This EPHESUS substudy examined the effects of eplerenone upon cardiovascular outcomes in PCI-treated patients. Methods and results EPHESUS patients were divided into PCI-treated and non-PCI-treated cohorts, and the effect of eplerenone upon mortality and other major adverse cardiovascular outcomes was assessed in each cohort. The PCI-treated patients (n = 1580) were younger, and had better renal function and fewer co-morbidities than non-PCI-treated patients (n = 5052). Cardiovascular mortality was significantly lower in PCI-treated patients as compared with non-PCI-treated patients (7% vs. 16%, P < 0.0001). However, the incidence of non-fatal events was similar in PCI-treated and non-PCI-treated cohorts. There was no statistical difference between the PCI-treated and non-PCI-treated cohorts in the primary or secondary outcomes of the trial. Eplerenone administration, compared with placebo, in the PCI-treated cohort did not affect PCI-related clinical outcomes, including recurrence of angina, the occurrence of acute coronary syndromes, or the need for further revascularization. Conclusions The beneficial effects of eplerenone in the EPHESUS trial exist for both PCI- and non-PCI-treated AMI patients with LVSD. Eplerenone has minimal, if any, effect upon reducing PCI-related adverse events in the PCI-treated cohort.
Published: 2014

12. Heart failure with systolic dysfunction complicating acute myocardial infarction – differential outcomes but similar eplerenone efficacy by ST-segment or non-ST-segment elevation: A post hoc substudy of the EPHESUS trial

Author: Bertram Pitt, Santosh C. Sutradhor, Michael Angioi, Sylvain Carillo, John Vincent, Renaud Fay, Ali Ahmed, Yan Zhang, Faiez Zannad, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Alabama at Birmingham [ Birmingham] (UAB), Birmingham VA Medical Center, University of Alabama [Tuscaloosa] (UA), Clinique Louis-Pasteur, Pfizer, University of California [Davis] (UC Davis), University of California, University of Michigan [Ann Arbor], University of Michigan System, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: MESH: Coronary Thrombosis, Male, medicine.medical_treatment, Myocardial Infarction, MESH: Comorbidity, MESH: Myocardial Revascularization, Comorbidity, Spironolactone, MESH: Proportional Hazards Models, MESH: Cause of Death, Electrocardiography, Mineralocorticoid receptor, Cause of Death, Myocardial Revascularization, ST segment, Multicenter Studies as Topic, Myocardial infarction, MESH: Treatment Outcome, Mineralocorticoid Receptor Antagonists, Randomized Controlled Trials as Topic, MESH: Aged, MESH: Middle Aged, Ejection fraction, General Medicine, Middle Aged, Prognosis, 3. Good health, Eplerenone, MESH: Myocardial Infarction, Treatment Outcome, Cardiovascular Diseases, MESH: Spironolactone, Cardiology, Disease Progression, MESH: Disease Progression, Female, MESH: Cardiovascular Agents, IDM ST+, Cardiology and Cardiovascular Medicine, medicine.drug, medicine.medical_specialty, Post hoc, MESH: Mineralocorticoid Receptor Antagonists, Éplérénone, Revascularization, MESH: Prognosis, STEMI, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, IDM ST–, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Retrospective Studies, Heart Failure, MESH: Humans, business.industry, Coronary Thrombosis, MESH: Cardiovascular Diseases, MESH: Retrospective Studies, Cardiovascular Agents, medicine.disease, MESH: Male, MESH: Electrocardiography, Insuffisance cardiaque, NSTEMI, MESH: Randomized Controlled Trials as Topic, Heart failure, MESH: Heart Failure, MESH: Multicenter Studies as Topic, business, MESH: Female
Abstract: International audience; BACKGROUND:Differential outcomes in patients with acute systolic heart failure (HF) complicating acute myocardial infarction (AMI) and the efficacy of mineralocorticoid receptor antagonists according to non-ST-segment and ST-segment elevation myocardial infarction (NSTEMI, STEMI) status has not been specifically investigated.METHODS:In the EPHESUS study, 6632 patients with acute HF and left ventricular ejection fraction
Published: 2014
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13. Aortic Calcifications Present the Next Challenge After TAVR

Author: Loic Boussel, Raphael Dauphin, Olivier Jegaden, Paul Charles, Pierre-Yves Courand, Brahim Harbaoui, Pierre Lantelme, Olivier Dubreuil, Guy de Gevigney, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Institut National de la Recherche Agronomique (INRA)
Subjects: Male, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, MESH: Vascular Stiffness, 0302 clinical medicine, Valve replacement, Medicine, Aortic calcifications, 030212 general & internal medicine, Aorta, MESH: Aortic Valve Stenosis, ComputingMilieux_MISCELLANEOUS, MESH: Middle Aged, Heart Failure/mortality, Aorta/*pathology, MESH: Aorta, Middle Aged, MESH: Myocardial Infarction, medicine.anatomical_structure, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Transcatheter Aortic Valve Replacement, Transcatheter aortic, Aortic Valve Stenosis/pathology/therapy, Aortography, 03 medical and health sciences, Vascular Stiffness, Internal medicine, MESH: Aortography, Humans, In patient, Contraindication, Myocardial Infarction/mortality, Heart Failure, MESH: Humans, business.industry, Aortic Valve Stenosis, medicine.disease, MESH: Male, Surgery, Stenosis, Ventricle, MESH: Heart Failure, MESH: Transcatheter Aortic Valve Replacement, business, MESH: Female
Abstract: In the presence of aortic stenosis, the left ventricle (LV) faces a double challenge: a valvular load and an arterial load [(1)][1]. Transcatheter aortic valve replacement (TAVR) has now become a safe and effective alternative to surgery in patients with a contraindication or at high risk [(2)][2
Published: 2015

14. Characteristics and outcomes for acute heart failure in elderly patients presenting to the ED

Author: Pierre-Géraud Claret, Lisa A. Calder, Catherine M. Clement, Justin W. Yan, Brian H. Rowe, Ian G. Stiell, Jeffrey J. Perry, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Ottawa Hospital Research Institute [Ottawa] (OHRI), and University of Alberta
Subjects: Male, [SDV]Life Sciences [q-bio], Myocardial Infarction, Blood Pressure, 030204 cardiovascular system & hematology, Electrocardiography, 0302 clinical medicine, MESH: Aged, 80 and over, Patient Admission, Heart Rate, Urea, Myocardial infarction, Prospective Studies, MESH: Heart Rate, Prospective cohort study, Aged, 80 and over, education.field_of_study, Age Factors, General Medicine, MESH: Blood Pressure, 3. Good health, MESH: Myocardial Infarction, MESH: Emergency Service, Hospital, Acute Disease, Emergency Medicine, MESH: Acute Disease, Female, Emergency Service, Hospital, Anti-Arrhythmia Agents, MESH: Noninvasive Ventilation, medicine.medical_specialty, Population, Patient Readmission, 03 medical and health sciences, Heart rate, medicine, Intubation, Intratracheal, Humans, education, Intensive care medicine, Adverse effect, Aged, MESH: Age Factors, Heart Failure, Noninvasive Ventilation, MESH: Intubation, Intratracheal, business.industry, MESH: Patient Admission, 030208 emergency & critical care medicine, MESH: Anti-Arrhythmia Agents/therapeutic use, Emergency department, medicine.disease, MESH: Electrocardiography, Pleural Effusion, Blood pressure, Heart failure, Emergency medicine, business, MESH: Female
Abstract: International audience; IntroductionThe first aim of this study was to investigate the characteristics for elderly patients with acute heart failure presenting to the emergency department (ED). The second aim was to determine the characteristics of these elderly patients associated with serious adverse events.MethodsThe population was divided into 2 age groups
Published: 2016

15. Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study

Author: Didier Carrié, Jean-Bernard Ruidavets, Marion Pouche, Luc Lorgis, Nicolas Danchin, Hervé Douard, Tabassome Simon, Philippe Brunel, Vincent Bataille, Jean Ferrières, Marie-Christine Iliou, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Réadaptation Cardiaque et Prévention Secondaire [Hôpital Corentin-Celton], Hôpital Corentin Celton [Issy-les-Moulineaux], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), hôpital cardiologique (CHU de Bordeaux), CHU Bordeaux [Bordeaux], Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) (LPPCM), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Nouvelles Cliniques Nantaises, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Pfizer, Servier, Caisse nationale d'assurance maladie des travailleurs salariés, Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpitaux Universitaires Paris Ouest - Hôpital Corentin Celton [Issy-les-Moulineaux], Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) ( LPPCM ), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Plateforme de recherche clinique de l'est parisien ( URCEST-CRCEST ), CHU Saint-Antoine [APHP], Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, and Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Européen Georges Pompidou [APHP] ( HEGP )
Subjects: Male, MESH: Chi-Square Distribution, medicine.medical_treatment, MESH : Acute Coronary Syndrome, Myocardial Infarction, MESH : Aged, MESH : Prospective Studies, Cardiac rehabilitation, MESH: Risk Assessment, 0302 clinical medicine, Myocardial infarction, Prospective Studies, Referral and Consultation, MESH: Treatment Outcome, Rehabilitation, MESH: Middle Aged, General Medicine, MESH: Follow-Up Studies, 3. Good health, MESH: Myocardial Infarction, MESH : Patient Discharge, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Acute myocardial infarction, Mortalité, Risk Assessment, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, MESH : Middle Aged, Acute Coronary Syndrome, MESH: Kaplan-Meier Estimate, Aged, Chi-Square Distribution, MESH: Humans, MESH : Chi-Square Distribution, Proportional hazards model, MESH: Patient Discharge, MESH : Humans, Patient survival, MESH : Follow-Up Studies, medicine.disease, MESH : Proportional Hazards Models, MESH: Acute Coronary Syndrome, ST-segment elevation myocardial infarction, MESH: Female, Time Factors, MESH: Registries, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, MESH : Referral and Consultation, MESH: Proportional Hazards Models, Older patients, Risk Factors, MESH: Risk Factors, MESH : Female, 030212 general & internal medicine, Registries, MESH : Risk Assessment, MESH: Aged, Ejection fraction, Non–ST-segment elevation myocardial infarction, Middle Aged, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, Patient Discharge, Treatment Outcome, Female, France, MESH : Time Factors, MESH : Male, MESH : Treatment Outcome, MESH: Multivariate Analysis, MESH : Kaplan-Meier Estimate, MESH: Referral and Consultation, Internal medicine, Infarctus du myocarde sans sus-décalage du segment ST, medicine, In patient, cardiovascular diseases, Medical prescription, Mortality, Réadaptation cardiaque, MESH : France, Proportional Hazards Models, business.industry, Infarctus du myocarde avec sus-décalage du segment ST, MESH: Time Factors, MESH : Multivariate Analysis, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, Infarctus du myocarde aigu, Multivariate Analysis, MESH : Myocardial Infarction, business, MESH : Registries, Follow-Up Studies
Abstract: IF 2.271; International audience; Background. - Clinical studies have shown a beneficial effect of cardiac rehabilitation (CR) on mortality.Objective. - To study the effect of CR prescription at discharge on 5-year mortality in patients with acute myocardial infarction (AMI).Methods. - Participants, from the 2005 French FAST-MI hospital registry, were 2894 survivors at discharge, divided according to AMI type: ST-segment elevation myocardial infarction (STEMI; n=1523) and non-STEMI (NSTEMI; n=1371). The effect of CR prescription on mortality was analysed using a Cox proportional hazards model.Results. - At discharge, 22.1% of patients had a CR prescription. Patients referred to CR were younger (62.4 vs. 67.5 years), were more frequently men and more had presented with STEMI (67.8% vs. 48.3%) than non-referred patients. Ninety-four (14.7%) deaths occurred among patients referred to CR and 585 (25.9%) among non-referred patients (P= 60 years) and AMI type showed that the inverse association was stronger in men (HR 0.64, 95% CI 0.48-0.87) than in women (HR 0.95, 95% CI 0.64-1.39), in younger (HR 0.34, 95% CI 0.15-0.77) than in older patients (HR 0.84, 95% CI 0.65-1.07) and in NSTEMI (HR 0.63, 95% CI 0.46-0.88) than in STEMI (HR 0.99, 95% CI 0.69-1.40).Conclusion. - After hospitalization for AMI, referral to CR remains a significant predictor of improved patient survival; some subgroups seem to gain greater benefit. (C) 2015 Elsevier Masson SAS. All rights reserved.
Published: 2016

16. Serum uric acid is associated with mortality and heart failure hospitalizations in patients with complicated myocardial infarction: findings from the High-Risk Myocardial Infarction Database Initiative

Author: Thomas G, von Lueder, Nicolas, Girerd, Dan, Atar, Stefan, Agewall, Zohra, Lamiral, Mehmet, Kanbay, Bertram, Pitt, Kenneth, Dickstein, Faiez, Zannad, Patrick, Rossignol, Oslo University Hospital [Oslo], Center for Heart Failure Research [Oslo] (CHFR), Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Karolinska Institute, karolinska institute, Koc University, School of Medicine, Istanbul, University of Michigan [Ann Arbor], University of Michigan System, and Stavanger University Hospital
Subjects: Male, Statistics as Topic, Heart failure, MESH: Hospitalization, MESH: Prognosis, MESH: Uric Acid, MESH: Proportional Hazards Models, Ventricular Dysfunction, Left, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Risk Factors, MESH: Risk Factors, MESH: Ventricular Dysfunction, Left, Humans, MESH: Statistics as Topic, Aged, Proportional Hazards Models, MESH: Aged, Left ventricular dysfunction, MESH: Humans, MESH: Middle Aged, Middle Aged, Prognosis, MESH: Male, MESH: Predictive Value of Tests, Hospitalization, Myocardial infarction, MESH: Myocardial Infarction, MESH: Heart Failure, MESH: Biomarkers, Female, Uric acid, MESH: Female, Biomarkers
Abstract: International audience; AIMS:Serum uric acid (SUA) levels are associated with poorer outcomes in healthy cohorts and patients with stable and unstable coronary heart disease. We investigated the relationship between SUA and clinical outcomes in subjects with acute myocardial infarction (MI) complicated by reduced left ventricular (LV) function, heart failure (HF), or both.METHODS AND RESULTS:Univariable and multivariable Cox proportional hazards modelling was performed to study the association of baseline SUA and all-cause mortality, cardiovascular (CV) mortality, and HF hospitalization in an individual patient meta-analysis of four merged large randomized trials (CAPRICORN, EPHESUS, OPTIMAAL, and VALIANT). Three trials (excluding VALIANT) reported SUA, which was available in a total of 12 677 subjects. The ranges of SUA for quartiles I-IV were 45-280, 281-344, 345-420, and 420-1640 mmol/L, respectively. While almost 90% of patients in the lowest SUA quartile were alive after a mean follow-up of 23 ± 11 months
Published: 2015

17. Diagnostic contributions of cardiac magnetic resonance imaging in patients presenting with elevated troponin, acute chest pain syndrome and unobstructed coronary arteries

Author: Dominique Boulmier, Pierre-Axel Lentz, Marc Bedossa, Hervé Le Breton, Guillaume Leurent, B. Langella, A. Larralde, Claire Fougerou, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC-IT Rennes, Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Myocardite, MESH: Chi-Square Distribution, Cardiac magnetic resonance, Myocardial Infarction, Contrast Media, MESH: Takotsubo Cardiomyopathy, 030204 cardiovascular system & hematology, Coronary Angiography, Chest pain, Coronary artery disease, 0302 clinical medicine, MESH: Up-Regulation, MESH: Coronary Vessels, MESH: Syndrome, Prospective Studies, 030212 general & internal medicine, Myocardial infarction, MESH: Myocardial Perfusion Imaging, Ejection fraction, biology, medicine.diagnostic_test, MESH: Chest Pain, Syndrome de takotsubo, Myocardial Perfusion Imaging, MESH: Magnetic Resonance Imaging, Cine, Syndrome, General Medicine, Syndrome coronaire aigu, Coronary Vessels, MESH: Predictive Value of Tests, Troponin, Up-Regulation, 3. Good health, MESH: Myocardial Infarction, Myocarditis, MESH: Young Adult, Acute Disease, cardiovascular system, Cardiology, MESH: Acute Disease, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, Acute coronary syndrome, France, Radiology, medicine.symptom, Takotsubo syndrome, Cardiology and Cardiovascular Medicine, Adult, Chest Pain, medicine.medical_specialty, Magnetic Resonance Imaging, Cine, Infarctus du myocarde, MESH: Meglumine, Young Adult, 03 medical and health sciences, Meglumine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Myocarditis, Predictive Value of Tests, Takotsubo Cardiomyopathy, Cardiac magnetic resonance imaging, MESH: Contrast Media, Internal medicine, Organometallic Compounds, medicine, Humans, MESH: Humans, Chi-Square Distribution, business.industry, MESH: Biological Markers, MESH: Adult, MESH: Organometallic Compounds, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Coronary Angiography, MESH: France, IRM cardiaque, biology.protein, MESH: Troponin, Myocardial infarction diagnosis, business, human activities, MESH: Female, Biomarkers
Abstract: International audience; AIMS: Myocardial infarction with unobstructed coronary artery disease represents a serious diagnostic challenge. The role of cardiac magnetic resonance in the management of cardiomyopathies is increasing. We examined the diagnostic contributions of cardiac magnetic resonance in patients presenting with acute chest pain syndrome, elevated serum cardiac troponin concentrations and no significant coronary artery stenoses. METHODS: Over a 3-year period, 107 consecutive patients (mean age 43.5 years; 62% men) presented to our institution with acute onset of chest pain, elevated serum troponin concentration and unobstructed coronary arteries, and underwent 3-tesla cardiac magnetic resonance at a mean delay of 6.9 days. A diagnosis was made based on: wall motion abnormalities and pericardial effusion on cine mode; myocardial oedema on T2-weighted imaging; abnormalities on first-pass perfusion imaging; and late gadolinium enhancement on T1-weighted imaging. RESULTS: Cardiac magnetic resonance was normal in 10.3% of patients and contributed a diagnosis in 89.7%, including myocarditis in 59.9%, stress cardiomyopathy (takotsubo syndrome) in 14% and myocardial infarction in 15.8%. Patients with normal cardiac magnetic resonance had a significantly lower mean peak troponin concentration (2.6ng/mL) than patients with diagnostic cardiac magnetic resonance (9.7ng/mL; P=0.01). CONCLUSION: Cardiac magnetic resonance contributed a diagnosis in nearly 90% of patients presenting with acute chest pain, elevated serum troponin and unobstructed coronary arteries.
Published: 2011
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18. Inappropriate dispatcher decision for emergency medical service users with acute myocardial infarction

Author: Pierre Casez, Anne-Sophie Lucas, Gérald Vanzetto, Loic Belle, José Labarère, Hélène Bouvaist, Patrice François, Magali Fourny, Guillaume Debaty, Unité de qualitique et d'évaluation médicale - pole Santé Publique, CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, SAMU, Service de Cardiologie, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Radiopharmaceutiques biocliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), BCM, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble
Subjects: Male, Emergency Medical Services, Time Factors, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, 0302 clinical medicine, Medical advice, Odds Ratio, MESH: Myocardial Reperfusion, Emergency medical services, Thrombolytic Therapy, Hospital Mortality, 030212 general & internal medicine, Myocardial infarction, Telephone triage, MESH: Aged, MESH: Thrombolytic Therapy, MESH: Middle Aged, General Medicine, Middle Aged, 3. Good health, MESH: Myocardial Infarction, Catheter Ablation, MESH: Emergency Medical Services, Emergency Medicine, Female, Medical emergency, Mobile intensive care unit, medicine.medical_specialty, Myocardial Reperfusion, 03 medical and health sciences, Reperfusion therapy, medicine, Humans, Service user, MESH: Hospital Mortality, Aged, MESH: Humans, MESH: Catheter Ablation, business.industry, MESH: Time Factors, Percutaneous coronary intervention, medicine.disease, MESH: Odds Ratio, MESH: Male, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; OBJECTIVES: Current guidelines recommend utilization of prehospital emergency medical services (EMSs) by patients with ST-elevation myocardial infarction (STEMI). The aims of this study were to estimate the percentage of inappropriate initial dispatcher decisions and determine their impact on delays in reperfusion therapy for EMS users with STEMI. METHODS: As part of a prospective regional registry of patients with STEMI, we analyzed the original data for 245 patients who called a university hospital-affiliated EMS call center in France. The primary study outcome was time to reperfusion therapy calculated from the documented date and time of the first patient call. RESULTS: The initial EMS dispatcher's decision was appropriate (ie, dispatching a mobile intensive care unit staffed by an emergency or critical care physician) for 171 (70%) patients and inappropriate for 74 (30%) patients. Inappropriate decisions included referring the patient to a family physician (n = 59), providing medical advice (n = 9), and dispatching an ambulance (n = 6). Inappropriate initial decisions resulted in increased median time to reperfusion for 140 patients receiving fibrinolysis (95 vs 53 minutes; P < .001) and 91 patients undergoing primary percutaneous coronary intervention (170 vs 107 minutes; P < .001). In-hospital mortality was not different between the 2 study groups (6.8% vs 9.9%; P = .42). CONCLUSION: The initial dispatcher's decision is inappropriate for 30% of EMS users with STEMI and results in substantial delays in time to reperfusion therapy. Accuracy of telephone triage should be improved for patients who activate EMSs in response to symptoms suggestive of acute coronary syndrome.
Published: 2011

19. Cardiac magnetic resonance demonstrates myocardial oedema in remote tissue early after reperfused myocardial infarction

Author: Jean-Nicolas Dacher, Alain Manrique, Alain Lebon, Edouard Gerbaud, David Bertrand, Geneviève Derumeaux, Alain Cribier, Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), GIP Cyceron (Cyceron), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Département de cardiologie, CHU Bordeaux [Bordeaux]-Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Department of Cardiology, Hospices Civils de Lyon (HCL), Service de cardiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'imagerie médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Breton, Céline
Subjects: Male, MESH: Angioplasty, Transluminal, Percutaneous Coronary, Time Factors, No-reflow (NR), Myocardial Infarction, No-reflow, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, Edema, Medicine, Thrombolytic Therapy, Prospective Studies, Myocardial infarction, Angioplasty, Balloon, Coronary, MESH: Treatment Outcome, MESH: Aged, Edema, Cardiac, MESH: Thrombolytic Therapy, MESH: Middle Aged, Fourier Analysis, medicine.diagnostic_test, General Medicine, Middle Aged, Control subjects, Magnetic Resonance Imaging, MESH: Case-Control Studies, Troponin, MESH: Predictive Value of Tests, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Myocardial Infarction, Treatment Outcome, MESH: No-Reflow Phenomenon, Cardiology, cardiovascular system, Female, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, TIMI, MRI, IRM, Œdème, Adult, medicine.medical_specialty, MESH: Edema, Cardiac, MESH: Myocardium, Reperfused myocardial infarction, Infarctus du myocarde, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Predictive Value of Tests, Internal medicine, Image Interpretation, Computer-Assisted, Humans, In patient, cardiovascular diseases, Aged, MESH: Humans, business.industry, Myocardium, MESH: Time Factors, MESH: Biological Markers, Magnetic resonance imaging, MESH: Adult, medicine.disease, MESH: Male, MESH: Prospective Studies, Oedema, Radiography, MESH: Stents, Case-Control Studies, No-Reflow Phenomenon, MESH: Troponin, business, Cardiac magnetic resonance, MESH: Female, MESH: Image Interpretation, Computer-Assisted, Biomarkers, MESH: Fourier Analysis
Abstract: International audience; BACKGROUND: Cardiac magnetic resonance can detect myocardial oedema using myocardial transverse relaxation time (T2)-weighted sequences but quantitative data are lacking in patients evaluated early after acute myocardial infarction. AIM: To assess the spatial distribution of T2 in patients with recent acute myocardial infarction. METHODS: Twenty-four consecutive patients (mean age 60+/-11 years) with acute myocardial infarction (anterior, n=12; inferior, n=12) were evaluated prospectively. T2 was determined using a series of breath-hold T2-weighted segmented half-Fourier turbo-spin echo sequences. No-reflow was defined as the association of early hypoenhancement and delayed enhancement in an akinetic region after a bolus injection of DOTA-Gd (0.2 mmol/kg). RESULTS: No-reflow was present in 13 (54%) patients and absent in 11 (46%) patients. Mean T2 was increased in the infarct region (84.9+/-23.7 ms) compared with in the remote myocardium (62.8+/-10.3 ms, p=0.0001) and in control subjects (55.7+/-4.6 ms, p
Published: 2009
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20. Aspirin and Extended-Release Dipyridamole versus Clopidogrel for Recurrent Stroke

Author: Sacco, Rl, Diener, Hc, Yusuf, S, Cotton, D, Ounpuu, S, Lawton, Wa, Palesch, Y, Martin, Rh, Albers, Gw, Bath, P, Bornstein, N, Chan, Bp, Chen, St, Cunha, L, Dahlöf, B, DE KEYSER, J, Donnan, Ga, Estol, C, Gorelick, P, Gu, V, Hermansson, K, Hilbrich, L, Kaste, M, Lu, C, Machnig, T, Pais, P, Roberts, R, Skvortsova, V, Teal, P, Toni, Danilo, Vandermaelen, C, Voigt, T, Weber, M, Yoon, Bw, Lembo, Giuseppe, Rasura, Maurizia, Sacchetti, Maria Luisa, Faculteit Medische Wetenschappen/UMCG, Gerontology, Department of neurology, University of Miami Leonard M. Miller School of Medicine (UMMSM)-University of Miami [Coral Gables], Universität Duisburg-Essen [Essen], Boehringer Ingelheim GmbH, Boehringer Ingelheim Pharmaceuticals, Population Health Research Institute, McMaster University [Hamilton, Ontario]-Hamilton General Hospital, Boehringer Ingelheim, Boehringer Ingelheim Ltd, Department of biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina [Charleston] (MUSC), Neurology and Neurological Sciences, Stanford University, Stroke Trials Unit, University of Nottingham, UK (UON), Neurology Department, Ichilov Medical Center, Division of Neurology, Department of Medicine, National University Hospital Singapore, Department of Neurology, Chang Gung Memorial Hospital [Taipei] (CGMH), Neurology department, Universidade de Coimbra [Coimbra], Institute of Medicine, Sahlgrenska University Hospital [Gothenburg], University Medical Center Groningen [Groningen] (UMCG), National Stroke Research Institute, University of Melbourne, Neurological Center for Treatment and Research, Department of Neurology and Rehabilitation, University of Illinois System, Boehringer Ingelheim Shanghai Pharmaceuticals Co Ltd, Boehringer Ingelheim AB, Helsinki University Central Hospital, Huashan Hospital [Shangai], Saint John's Medical College, Clinical Trials Methodoloy Group, McMaster University [Hamilton, Ontario], Neurology & Neurosurgery Clinic, Russian State Medical University, Department of Medicine, Neurology, Faculty of Medicine, University of British Columbia (UBC), Department of Neurological Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Cardiology Department, SUNY Downstate Medical Center, State University of New York (SUNY)-State University of New York (SUNY), Seoul National University Hospital, Service de Neurologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Sacco, Rl, Diener, Hc, Yusuf, S, Cotton, D, Ounpuu, S, Lawton, Wa, Palesch, Y, Martin, Rh, Albers, Gw, Bath, P, Bornstein, N, Chan, Bp, Chen, St, Cunha, L, Dahlof, B, DE KEYSER, J, Donnan, Ga, Estol, C, Gorelick, P, Gu, V, Hermansson, K, Hilbrich, L, Kaste, M, Lu, C, Machnig, T, Pais, P, Roberts, R, Skvortsova, V, Teal, P, Toni, D, Vandermaelen, C, Voigt, T, Weberm, Yoon, Bw, and Comi, Giancarlo
Subjects: Male, Myocardial Infarction, Angiotensin-Converting Enzyme Inhibitors, MESH: Cognition, Brain Ischemia, NON-INFERIORITY TRIALS, 0302 clinical medicine, aspirina, Secondary Prevention, Aspirin, MESH: Middle Aged, MESH: Risk, Hazard ratio, MESH: Disability Evaluation, MESH: Brain Ischemia, Dipyridamole, MESH: Follow-Up Studies, ARTERIAL ORIGIN ESPRIT, General Medicine, RANDOMIZED CONTROLLED-TRIAL, 3. Good health, MESH: Myocardial Infarction, Platelet aggregation inhibitor, Drug Therapy, Combination, MESH: Hemorrhage, medicine.medical_specialty, MESH: Ticlopidine, MESH: Delayed-Action Preparations, MESH: Drug Delivery Systems, MESH: Factor Analysis, Statistical, Hemorrhage, MESH: Drug Administration Schedule, MESH: Stroke, 03 medical and health sciences, MESH: Severity of Illness Index, Humans, Vascular Diseases, ACTIVE CONTROLLED-TRIALS, MESH: Kaplan-Meier Estimate, Aged, ictus, trial clinico, MESH: Humans, Proportional hazards model, MESH: Angiotensin II Type 1 Receptor Blockers, MESH: Retrospective Studies, medicine.disease, MESH: Benzoates, PREVENTION, MESH: International Cooperation, Delayed-Action Preparations, Benzimidazoles, Factor Analysis, Statistical, MESH: Mental Status Schedule, MESH: Female, 030217 neurology & neurosurgery, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Benzoates, MESH: Proportional Hazards Models, DOUBLE-BLIND, MESH: Double-Blind Method, Telmisartan, Stroke, MESH: Aged, MESH: Angiotensin-Converting Enzyme Inhibitors, Middle Aged, Clopidogrel, MESH: Platelet Aggregation Inhibitors, Anesthesia, MESH: Vascular Diseases, Cardiology, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.drug, Risk, Double-Blind Method, TICLOPIDINE, Internal medicine, medicine, cardiovascular diseases, MESH: Aspirin, Ticlopidine, HIGH-RISK PATIENTS, Proportional Hazards Models, CEREBRAL-ISCHEMIA, business.industry, MESH: Male, MESH: Recurrence, MESH: Drug Therapy, Combination, TRANSIENT ISCHEMIC ATTACK, MESH: Dipyridamole, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Benzimidazoles, business, Platelet Aggregation Inhibitors
Abstract: Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial; International audience; BACKGROUND: Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared the efficacy and safety of two antiplatelet regimens--aspirin plus extended-release dipyridamole (ASA-ERDP) versus clopidogrel. METHODS: In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive 25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive 75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke. The secondary outcome was a composite of stroke, myocardial infarction, or death from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075), followed by superiority testing, was planned. RESULTS: A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke occurred in 916 patients (9.0%) receiving ASA-ERDP and in 898 patients (8.8%) receiving clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for ASA-ERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events among ASA-ERDP recipients (419 [4.1%]) than among clopidogrel recipients (365 [3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage (hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major hemorrhagic event was similar in the two groups (1194 ASA-ERDP recipients [11.7%], vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11). CONCLUSIONS: The trial did not meet the predefined criteria for noninferiority but showed similar rates of recurrent stroke with ASA-ERDP and with clopidogrel. There is no evidence that either of the two treatments was superior to the other in the prevention of recurrent stroke. (ClinicalTrials.gov number, NCT00153062.)
Published: 2008

21. The Triggering Receptor Expressed on Myeloid cells-1: A new player during acute myocardial infarction

Author: Lemarié Jérémie, Derive Marc, Boufenzer Amir, Gibot Sébastien, Service de Réanimation Médicale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Faculté de Médecine [Nancy], Université de Lorraine (UL), INOTREM SA, and Université de Lorraine (UL)-Université de Lorraine (UL)
Subjects: MESH: Inflammation, Chemokine, TREM-1, Myeloid, MESH: Membrane Glycoproteins, MESH: Lauric Acids, Inflammation, 030204 cardiovascular system & hematology, MESH: Rhodamines, Peripheral blood mononuclear cell, Proinflammatory cytokine, MESH: Leukocytes, 03 medical and health sciences, 0302 clinical medicine, Immune system, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine, Leukocytes, Animals, Humans, Myeloid Cells, MESH: Animals, Receptors, Immunologic, Receptor, MESH: Receptors, Immunologic, 030304 developmental biology, Pharmacology, 0303 health sciences, Innate immune system, Membrane Glycoproteins, MESH: Humans, biology, business.industry, Rhodamines, Lauric Acids, MESH: Triggering Receptor Expressed on Myeloid Cells-1, MESH: Myeloid Cells, Triggering Receptor Expressed on Myeloid Cells-1, Myocardial infarction, MESH: Myocardial Infarction, medicine.anatomical_structure, Immunology, Acute Disease, biology.protein, MESH: Acute Disease, medicine.symptom, business, Oligopeptides
Abstract: International audience; Following myocardial ischemia, an intense activation of the immune system occurs that leads to inflammatory cytokines and chemokines production and to the recruitment of neutrophils and mononuclear cells in the infarcted area. Although pro-inflammatory signals initiate the cellular events necessary for scar formation, excessive and prolonged inflammation promotes deleterious cardiac remodeling and dysfunction. The triggering receptor expressed on myeloid cells-1 (TREM-1) is a highly conserved immune-receptor expressed by neutrophils and monocytes that acts as an amplifier of the innate immune response. Blockade of TREM-1 activation protects from hyper-responsiveness and death during severe infections. Here we review the role of TREM-1 in orchestrating the inflammatory response that follows MI. TREM-1 deletion (Trem-1-/-) or modulation by the use of a short inhibitory peptide (LR12) dampens myocardial inflammation, limits leukocyte recruitment, and improves heart function and survival in mice or pigs. Moreover, the soluble form of TREM-1 (sTREM-1) is found in the plasma of patients suffering from an acute MI and its concentration is an independent predictor of death. This suggests that TREM-1 may constitute a new therapeutic target during acute MI.
Published: 2015

22. Heart failure and mortality outcomes in patients with type 2 diabetes taking alogliptin versus placebo in EXAMINE: a multicentre, randomised, double-blind trial

Author: William B. White, Craig A. Wilson, Faiez Zannad, Cyrus R. Mehta, Hung Lam, Stuart Kupfer, William C. Cushman, Alfonso Perez, Penny R. Fleck, Christopher P. Cannon, Venu Menon, George L. Bakris, Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Brigham and Women's Hospital [Boston], The University of Tennessee Health Science Center [Memphis] (UTHSC), Memphis Veterans Affairs Medical Center, The Pritzker School of Medicine, Cleveland Clinic Foundation, Cleveland Clinic, Takeda Development Center Americas, Harvard School of Public Health, Calhoun Cardiology Center [University of Connecticut], School of Medicine [University of Connecticut], University of Connecticut (UCONN)-University of Connecticut (UCONN), and Takeda Development Center Americas.
Subjects: medicine.medical_specialty, Acute coronary syndrome, MESH: Hospitalization, Placebo, MESH: Stroke, MESH: Angina, Unstable, Angina, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Risk Factors, Internal medicine, MESH: Hypoglycemic Agents, medicine, MESH: Double-Blind Method, Myocardial infarction, MESH: Natriuretic Peptide, Brain, MESH: Diabetic Cardiomyopathies, MESH: Peptide Fragments, MESH: Aged, MESH: Uracil, MESH: Middle Aged, MESH: Humans, business.industry, Unstable angina, General Medicine, medicine.disease, MESH: Acute Coronary Syndrome, MESH: Male, 3. Good health, Surgery, MESH: Myocardial Infarction, MESH: Piperidines, Heart failure, MESH: Heart Failure, business, MESH: Female, Alogliptin, Mace, MESH: Diabetes Mellitus, Type 2
Abstract: Summary Background The EXAMINE trial showed non-inferiority of the DPP-4 inhibitor alogliptin to placebo on major adverse cardiac event (MACE) rates in patients with type 2 diabetes and recent acute coronary syndromes. Concerns about excessive rates of in-hospital heart failure in another DPP-4 inhibitor trial have been reported. We therefore assessed hospital admission for heart failure in the EXAMINE trial. Methods Patients with type 2 diabetes and an acute coronary syndrome event in the previous 15–90 days were randomly assigned alogliptin or placebo plus standard treatment for diabetes and cardiovascular disease prevention. The prespecified exploratory extended MACE endpoint was all-cause mortality, non-fatal myocardial infarction, non-fatal stroke, urgent revascularisation due to unstable angina, and hospital admission for heart failure. The post-hoc analyses were of cardiovascular death and hospital admission for heart failure, assessed by history of heart failure and brain natriuretic peptide (BNP) concentration at baseline. We also assessed changes in N-terminal pro-BNP (NT-pro-BNP) from baseline to 6 months. This study is registered with ClinicalTrials.gov, number NCT00968708. Findings 5380 patients were assigned to alogliptin (n=2701) or placebo (n=2679) and followed up for a median of 533 days (IQR 280–751). The exploratory extended MACE endpoint was seen in 433 (16·0%) patients assigned to alogliptin and in 441 (16·5%) assigned to placebo (hazard ratio [HR] 0·98, 95% CI 0·86–1·12). Hospital admission for heart failure was the first event in 85 (3·1%) patients taking alogliptin compared with 79 (2·9%) taking placebo (HR 1·07, 95% CI 0·79–1·46). Alogliptin had no effect on composite events of cardiovascular death and hospital admission for heart failure in the post hoc analysis (HR 1·00, 95% CI 0·82–1·21) and results did not differ by baseline BNP concentration. NT-pro-BNP concentrations decreased significantly and similarly in the two groups. Interpretation In patients with type 2 diabetes and recent acute coronary syndromes, alogliptin did not increase the risk of heart failure outcomes. Funding Takeda Development Center Americas.
Published: 2015

23. Meta-Analysis of Cell-based CaRdiac stUdiEs (ACCRUE) in patients with acute myocardial infarction based on individual patient data

Author: Gyongyosi, M., Wojakowski, W., Lemarchand, P., Lunde, K., Tendera, M., Bartunek, J., Marban, E., Assmus, B., Henry, T.D., Traverse, J.H., Moye, L.A., Surder, D., Corti, R., Huikuri, H., Miettinen, J., Wohrle, J., Obradovic, S., Roncalli, J., Malliaras, K., Pokushalov, E., Romanov, A., Kastrup, J., Bergmann, M.W., Atsma, D.E., Diederichsen, A., Edes, I., Benedek, I., Benedek, T., Pejkov, H., Nyolczas, N., Pavo, N., Bergler-Klein, J., Pavo, I.J., Sylven, C., Berti, S., Navarese, E.P., Maurer, G., ACCRUE Investigators, Department of Cardiology [Vienna], Medizinische Universität Wien = Medical University of Vienna, Third Division of Cardiology, Medical University of Silesia, unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Department of Cardiology, Rikshospitalet-Oslo University Hospital [Oslo], department organization Studies, Boston College (BC), Cedars-Sinai Medical Center, Department of Medicine III, Goethe-Universität Frankfurt am Main, Dpt of Neurology [Minneapolis], University of Minnesota [Twin Cities] (UMN), University of Minnesota System-University of Minnesota System, Minneapolis Heart Institute, University of Minnesota System-University of Minnesota System-Abbott Northwestern Hospital, Coordinating Center for Clinical Trials, The University of Texas Health Science Center at Houston (UTHealth), Cardiocentro Ticino [Lugano], Universität Zürich [Zürich] = University of Zurich (UZH), Milieux aquatiques, écologie et pollutions (UR MALY), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), Medical Research Center Oulu, University of Oulu, Cardiology Department [Ulm], Universität Ulm - Ulm University [Ulm, Allemagne], Clinic of Emergency Medicine, Military Medical Academy [Serbia], Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], State Research Institute of Circulation Pathology, Department of Drug Design and Pharmacology [Copenhagen] (ILF), Faculty of Health and Medical Sciences, University of Copenhagen = Københavns Universitet (KU)-University of Copenhagen = Københavns Universitet (KU), Asklepios Klinik St. Georg, Cardiology Department [Leiden], Leiden University Medical Center (LUMC), Cardiology Department [Odense], Odense University Hospital (OUH), Cardiology Department [Debrecen], University of Debrecen, Cardiology Department [Târgu Mureș], University of Medicine and Pharmacy of Târgu Mureș, University Clinic for Cardiology, Medical Centre [Budapest], Hungarian Defense Forces -Ministry of Defence [Budapest], Karolinska Institutet [Stockholm], Invasive Cardiology [Pisa], National Research Council Institute of Clinical Physiology (CNR-IFC), Internal Medicine [Düsseldorf], Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf]-Division of Cardiology, Pulmonology and Vascular Medicine, TIME and LateTIME were supported by a grant from the National Heart, Lung, and Blood Institute under the cooperative agreement 5 UM1 HL087318-01. Part of the study was supported by European Union structural funds (Innovative Economy Operational Program POIG.01.01.02-00-109/09-00) to Dr Wojakowski., Medical University of Silesia (SUM), Unité de recherche de l'institut du thorax (ITX-lab), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), University of Copenhagen = Københavns Universitet (UCPH)-University of Copenhagen = Københavns Universitet (UCPH), Lemarchand, Patricia, University of Zurich, Gyongyosi, M, Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of Minnesota [Twin Cities], University of Zürich [Zürich] (UZH), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Odense University Hospital, and Heinrich-Heine-Universität Düsseldorf [Düsseldorf]-Division of Cardiology, Pulmonology and Vascular Medicine
Subjects: Male, Time Factors, MESH: Chi-Square Distribution, Databases, Factual, Physiology, analysis, MESH: Myocardial Contraction, Myocardial Infarction, heart failure, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, MESH: Stroke Volume, Ventricular Function, Left, MESH: Ventricular Function, Left, MESH: Proportional Hazards Models, 0302 clinical medicine, Recurrence, Risk Factors, MESH: Risk Factors, Myocardial infarction, Prospective Studies, MESH: Bone Marrow Transplantation, Stroke, Bone Marrow Transplantation, Randomized Controlled Trials as Topic, MESH: Treatment Outcome, MESH: Aged, 0303 health sciences, Ejection fraction, MESH: Middle Aged, Ventricular Remodeling, Hazard ratio, MESH: Regeneration, Stroke volume, Middle Aged, MESH: Recovery of Function, 3. Good health, MESH: Myocardial Infarction, Treatment Outcome, Cardiology, Female, MESH: Cerebrovascular Disorders, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, MESH: Myocardium, 610 Medicine & health, MESH: Ventricular Remodeling, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, meta, Disease-Free Survival, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, stem cells, Internal medicine, medicine, Humans, Regeneration, cardiovascular diseases, Ventricular remodeling, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, outcome assessment, End-systolic volume, MESH: Kaplan-Meier Estimate, 030304 developmental biology, Aged, Proportional Hazards Models, Chi-Square Distribution, MESH: Humans, business.industry, Myocardium, MESH: Time Factors, Stroke Volume, Recovery of Function, 1314 Physiology, medicine.disease, Myocardial Contraction, MESH: Databases, Factual, anterior wall myocardial infarction, MESH: Male, MESH: Prospective Studies, MESH: Recurrence, meta-analysis, Cerebrovascular Disorders, MESH: Randomized Controlled Trials as Topic, Heart failure, MESH: Disease-Free Survival, business, MESH: Female
Abstract: Rationale : The meta-Analysis of Cell-based CaRdiac study is the first prospectively declared collaborative multinational database, including individual data of patients with ischemic heart disease treated with cell therapy. Objective : We analyzed the safety and efficacy of intracoronary cell therapy after acute myocardial infarction (AMI), including individual patient data from 12 randomized trials (ASTAMI, Aalst, BOOST, BONAMI, CADUCEUS, FINCELL, REGENT, REPAIR-AMI, SCAMI, SWISS-AMI, TIME, LATE-TIME; n=1252). Methods and Results : The primary end point was freedom from combined major adverse cardiac and cerebrovascular events (including all-cause death, AMI recurrance, stroke, and target vessel revascularization). The secondary end point was freedom from hard clinical end points (death, AMI recurrence, or stroke), assessed with random-effects meta-analyses and Cox regressions for interactions. Secondary efficacy end points included changes in end-diastolic volume, end-systolic volume, and ejection fraction, analyzed with random-effects meta-analyses and ANCOVA. We reported weighted mean differences between cell therapy and control groups. No effect of cell therapy on major adverse cardiac and cerebrovascular events (14.0% versus 16.3%; hazard ratio, 0.86; 95% confidence interval, 0.63–1.18) or death (1.4% versus 2.1%) or death/AMI recurrence/stroke (2.9% versus 4.7%) was identified in comparison with controls. No changes in ejection fraction (mean difference: 0.96%; 95% confidence interval, −0.2 to 2.1), end-diastolic volume, or systolic volume were observed compared with controls. These results were not influenced by anterior AMI location, reduced baseline ejection fraction, or the use of MRI for assessing left ventricular parameters. Conclusions : This meta-analysis of individual patient data from randomized trials in patients with recent AMI revealed that intracoronary cell therapy provided no benefit, in terms of clinical events or changes in left ventricular function. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01098591.
Published: 2015

24. Common variation in PHACTR1 is associated with susceptibility to cervical artery dissection

Author: Debette, Stéphanie, Kamatani, Yoichiro, Wolf, Christiane, Agabiti Rosei, Enrico, Lanfranconi, Silvia, Ferrarese, Carlo, Susani, Emanuela, Bicocca, Milano, Giacalone, Giacomo, Paolucci, Stefano, Palmirotta, Raffaele, Paciaroni, Maurizio, Ballabio, Elena, Dittrich, Ralf, Parati, Eugenio A, Ciusani, Emilio, Fluri, Felix, Hatz, Florian, Gisler, Dominique, Amort, Margareth, Bevan, Steve, James, Tom, Olsson, Sandra, Holmegaard, Lukas, Touzé, Emmanuel, Altintas, Ayse, Martin, Juan José, Kittner, Steven, MItchell, Braxton, Stine, Colin, O'Connell, Jeff, Dueker, Nicole, Koudstaal, Peter J, de Lau, Lonneke M L, Hofman, Albert, Southerland, Andrew M, Verhaaren, Benjamin F, Uitterlinden, Andre G, Montaner, Joan, Mendioroz, Maite, Yadav, Sunaina, Khan, Muhammad Saleem, Wilder, Michael, van Dijk, Ewoud, Maaijwee, Noortje, Rutten-Jacobs, Loes, Samson, Yves, Kramer, Jamie, Malik, Shaneela, Brott, Thomas G, Brown, Robert D, Singleton, Andrew, Hardy, John, Rich, Stephen S, Tanislav, Christian, Jungehülsing, Jan, Abboud, Shérine, Béjot, Yannick, Caso, Valeria, Bersano, Anna, Gschwendtner, Andreas, Metso, Tiina M, Sessa, Maria, Cole, John, Lamy, Chantal, Medeiros, Elisabeth, Beretta, Simone, Bonati, Leo H, Grau, Armin J, Michel, Patrik, Majersik, Jennifer J, Sharma, Pankaj, Kloss, Manja, Kalashnikova, Ludmila, Nazarova, Maria, Dobrynina, Larisa, Bartels, Eva, Guillon, Benoit, van den Herik, Evita G, Fernandez-Cadenas, Israel, Jood, Katarina, Nalls, Michael A, De Leeuw, Frank-Erik, Chauhan, Ganesh, Jern, Christina, Cheng, Yu-Ching, Werner, Inge, Metso, Antti J, Lichy, Christoph, Lyrer, Philippe A, Brandt, Tobias, Boncoraglio, Giorgio B, Wichmann, Heinz-Erich, Gieger, Christian, Engelter, Stefan T, Johnson, Andrew D, Böttcher, Thomas, Castellano, Maurizio, Arveiler, Dominique, Ikram, M Arfan, Breteler, Monique M B, Padovani, Alessandro, Meschia, James F, Kuhlenbäumer, Gregor, Rolfs, Arndt, Pezzini, Alessandro, Worrall, Bradford B, Consortium, International Stroke Genetics, Ringelstein, Erich-Bernd, Zelenika, Diana, Tatlisumak, Turgut, Lathrop, Mark, Leys, Didier, Amouyel, Philippe, Dallongeville, Jean, Group, CADISP, Thijs, Vincent, Lemmens, Robin, Pandolfo, Massimo, Bodenant, Marie, Louillet, Fabien, Mas, Jean-Louis, Deltour, Sandrine, Leder, Sara, Léger, Anne, Canaple, Sandrine, Godefroy, Olivier, Markus, Hugh S, Giroud, Maurice, Jacquin, Agnès, Moulin, Thierry, Vullier, Fabrice, Tzourio, Christophe, Dos Santos, Michael, Malik, Rainer, Hausser, Ingrid, Thomas-Feles, Constanze, Weber, Ralf, Dichgans, Martin, Grond-Ginsbach, Caspar, Hacke, Werner, Giossi, Alessia, Volonghi, Irene, Costa, Paolo, del Zotto, Elisabetta, Morotti, Andrea, Poli, Loris, Lorenza Muiesan, Maria, Salvetti, Massimo, Epidémiologie des maladies chroniques: impact des intéractions gène environnement sur la santé des populations, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Epidemiologie-Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux Ségalen [Bordeaux 2], Centre National de Génotypage (CNG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), RIKEN Center for Integrative Medical Sciences [Yokohama] (RIKEN IMS), RIKEN - Institute of Physical and Chemical Research [Japon] (RIKEN), Helsinki University Central Hospital [Finland] (HUCH), Heidelberg University Hospital [Heidelberg], University Hospital Basel [Basel], Università degli Studi di Brescia = University of Brescia (UniBs), University Hospitals Leuven [Leuven], Leuven Center for Cancer Biology (VIB-KU-CCB), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-Vlaams Instituut voor Biotechnologie [Ghent, Belgique] (VIB), University of Cambridge [UK] (CAM), Institute for Stroke and Dementia Research (ISD), Klinikum der Universität [München]-Ludwig Maximilian University [Munich] (LMU), Ludwig-Maximilians-Universität München (LMU), University Hospital Münster - Universitaetsklinikum Muenster [Germany] (UKM), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Neurologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), University of Virginia, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Neurochirurgie Expérimentale [Brussels] (ULB 257), Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Università degli Studi di Perugia = University of Perugia (UNIPG), Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Munich Cluster for systems neurology [Munich] (SyNergy), Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne] (TUM)-Ludwig-Maximilians-Universität München (LMU), Ospedale San Raffaele, University of Maryland School of Medicine, University of Maryland System, Service de neurologie [Amiens], CHU Amiens-Picardie, Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Klinikum Ludwigshafen [Germany], Service of Neurology [CHUV, Lausanne, Switzerland], Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), University of Utah School of Medicine [Salt Lake City], Institute of Cardiovascular Research (ICR2UL), Royal Holloway [University of London] (RHUL), Ashford and St Peter's hospitals NHS foundation trust, Russian Academy of Sciences [Moscow] (RAS), Centre for Cognition and Decision Making [HSE, Moscow], Institut of Cognitive Neuroscience [HSE, Moscow] (ICN), Vysšaja škola èkonomiki = National Research University Higher School of Economics [Moscow] (HSE)-Vysšaja škola èkonomiki = National Research University Higher School of Economics [Moscow] (HSE), Zentrum für neurologische Gefäßdiagnostik - Center for Neurological Vascular Diagnostics [Munich, Germany], Service de neurologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Department of Neurology [Erasmus MC, Rotterdam], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Hospital Universitario Mutua de Terrassa, Vall d'Hebron University Hospital [Barcelona], Insitute of Neuroscience and Physiology, University of Gothenburg (GU), National Institute on Aging [Bethesda, USA] (NIA), National Institutes of Health [Bethesda] (NIH), Donders Institute for Brain, Cognition and Behaviour, Radboud University [Nijmegen], Schmieder Klinik [Heidelberg, Germany], Helmholtz Zentrum München = German Research Center for Environmental Health, Framingham Heart Study, Boston University [Boston] (BU)-National Heart, Lung, and Blood Institute [Bethesda] (NHLBI), University Hospital Rostock, Progression tumorale et microenvironnement. Approches translationnelles et épidémiologie, Université de Strasbourg (UNISTRA)-CHU Strasbourg-Les Hôpitaux Universitaires de Strasbourg (HUS)-Institut Régional du Cancer-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC), Netherlands Consortium for Healthy Aging [Leiden, Netherlands] (NCHA), German Research Center for Neurodegenerative Diseases - Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), University of Brescia, Mayo Clinic [Jacksonville], Institute of Experimental Medicine - Institut für Experimentelle Medizin [Kiel, Germany] (IEM), Christian-Albrechts-Universität zu Kiel (CAU), Westfälische Wilhelms-Universität Münster = University of Münster (WWU), Centre d'Etude du Polymorphisme Humain (CEPH), Université Paris Diderot - Paris 7 (UPD7)-Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Fondation Jean Dausset, McGill University and Genome Quebec Innovation Centre, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Pharmacologie de la mort neuronale et de la plasticité cérébrale, IFR114-Université de Lille, Droit et Santé, Réseau International des Instituts Pasteur (RIIP), Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, The CADISP study has been supported by INSERM, Lille 2 University, Institut Pasteur de Lille and Lille University Hospital and received funding from the European Regional Development Fund (FEDER funds) and Région Nord-Pas-de-Calais in the framework of Contrat de Projets Etat-Region 2007–2013 Région Nord-Pas-de-Calais (grant 09120030), Centre National de Génotypage, the Emil Aaltonen Foundation, the Paavo Ilmari Ahvenainen Foundation, the Helsinki University Central Hospital Research Fund, the Helsinki University Medical Foundation, the Päivikki and Sakari Sohlberg Foundation, the Aarne Koskelo Foundation, the Maire Taponen Foundation, the Aarne and Aili Turunen Foundation, the Lilly Foundation, the Alfred Kordelin Foundation, the Finnish Medical Foundation, the Orion Farmos Research Foundation, the Maud Kuistila Foundation, the Finnish Brain Foundation, the Biomedicum Helsinki Foundation, Projet Hospitalier de Recherche Clinique Régional, Fondation de France, Génopôle de Lille, Adrinord, the Basel Stroke Funds, the Käthe-Zingg-Schwichtenberg-Fonds of the Swiss Academy of Medical Sciences and the Swiss Heart Foundation.L.H.B., S.T.E. and P.A.L. were supported, in part, by a grant from the Swiss National Science Foundation (33CM30-124119). S.D. is supported by a Chair of Excellence from the French National Research Agency (ANR). S.D. and M.D. are supported by a grant from the Leducq Foundation. M.D. is supported by the Vascular Dementia Research Foundation. I.F.-C. is supported by the Miguel Servet programme (CP12/03298) from the Spanish Ministry of Health (Instituto de Salud Carlos III). G.K. is a member of the Deutsche Forschungsgemeinschaft Cluster of Excellence 'Inflammation at Interfaces'. P.S. is supported by a Department of Health (UK) senior fellowship. A.M.S. is supported by the American Heart Association/American Stroke Association National Clinical Research Program (AHA 3CRP14140001). V.T. is supported by Fonds Wetenschappelijk Onderzoek Flanders., CADISP Group, RIKEN Center for Integrative Medical Science, Università degli Studi di Brescia [Brescia], University of Virginia [Charlottesville], Service des Urgences Cérébro-Vasculaires [CHU Pitié-Salpêtrière]], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Laboratoire de Neurologie Expérimentale [ULB, Brussels, Belgium] (ULB 257), Université Libre de Bruxelles [Bruxelles] (ULB)-Hôpital Erasme (Bruxelles), Università degli Studi di Perugia (UNIPG), Technische Universität München [München] (TUM)-Ludwig-Maximilians-Universität München (LMU), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), National Research University Higher School of Economics [Moscow] (HSE)-National Research University Higher School of Economics [Moscow] (HSE), Radboud university [Nijmegen], Helmholtz-Zentrum München (HZM), Westfälische Wilhelms-Universität Münster (WWU), The authors thank the staff and participants of all CADISP centers for their important contributions., Service des Urgences Cérébro-Vasculaires [CHU Pitié-Salpétriêre], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Fondation Jean Dausset-Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Erasmus MC other, Epidemiology, Debette, S, Kamatani, Y, Metso, T, Kloss, M, Chauhan, G, Engelter, S, Pezzini, A, Thijs, V, Markus, H, Dichgans, M, Wolf, C, Dittrich, R, Touzé, E, Southerland, A, Samson, Y, Abboud, S, Béjot, Y, Caso, V, Bersano, A, Gschwendtner, A, Sessa, M, Cole, J, Lamy, C, Medeiros, E, Beretta, S, Bonati, L, Grau, A, Michel, P, Majersik, J, Sharma, P, Kalashnikova, L, Nazarova, M, Dobrynina, L, Bartels, E, Guillon, B, Van Den Herik, E, Fernandez Cadenas, I, Jood, K, Nalls, M, De Leeuw, F, Jern, C, Cheng, Y, Werner, I, Metso, A, Lichy, C, Lyrer, P, Brandt, T, Boncoraglio, G, Wichmann, H, Gieger, C, Johnson, A, Böttcher, T, Castellano, M, Arveiler, D, Ikram, M, Breteler, M, Padovani, A, Meschia, J, Kuhlenbäumer, G, Rolfs, A, Worrall, B, Ringelstein, E, Zelenika, D, Tatlisumak, T, Lathrop, M, Leys, D, Amouyel, P, Dallongeville, J, Lemmens R, P, and Ferrarese, C
Subjects: Male, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Myocardial Infarction, Genome-wide association study, Carotid Artery, Internal, Dissection, Gastroenterology, epidemiology [Carotid Artery, Internal, Dissection], Brain Ischemia, 0302 clinical medicine, Migraine Disorder, Odds Ratio, Finland, Vertebral Artery Dissection, 0303 health sciences, education.field_of_study, epidemiology [Hypercholesterolemia], MESH: Middle Aged, MESH: Polymorphism, Single Nucleotide, Phactr-1 protein, human, MESH: Brain Ischemia, MESH: Follow-Up Studies, 3. Good health, MESH: Myocardial Infarction, Human, medicine.medical_specialty, Migraine Disorders, Hypercholesterolemia, MESH: Vertebral Artery Dissection, Lower risk, genetics [Brain Ischemia], Article, Follow-Up Studie, MESH: Carotid Artery, Internal, Dissection, 03 medical and health sciences, Genetic, SDG 3 - Good Health and Well-being, genetics [Carotid Artery, Internal, Dissection], Genetics, Genetic predisposition, epidemiology [Brain Ischemia], Humans, epidemiology [Vertebral Artery Dissection], Polymorphism, education, Alleles, MESH: Humans, genetics [Vertebral Artery Dissection], MESH: Adult, Odds ratio, Microfilament Protein, medicine.disease, Adult, Female, Follow-Up Studies, Genetic Pleiotropy, Genetic Predisposition to Disease, Genome-Wide Association Study, Hypertension, Microfilament Proteins, Middle Aged, Obesity, Risk Factors, Polymorphism, Single Nucleotide, MESH: Genome-Wide Association Study, Carotid Artery, MESH: Female, 030217 neurology & neurosurgery, epidemiology [Finland], Cervical Artery, Vertebral artery dissection, epidemiology [Hypertension], MESH: Hypertension, MESH: Risk Factors, MESH: Obesity, Stroke, Allele, Dissection, MESH: Finland, MESH: Genetic Predisposition to Disease, MESH: Hypercholesterolemia, Single Nucleotide, MESH: Migraine Disorders, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], epidemiology [Myocardial Infarction], [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Population, MESH: Genetic Pleiotropy, physiology [Microfilament Proteins], Biology, MESH: Microfilament Proteins, Internal medicine, ddc:570, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, 030304 developmental biology, epidemiology [Obesity], Risk Factor, MESH: Alleles, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Internal, MESH: Odds Ratio, MESH: Male, epidemiology [Migraine Disorders], genetics [Microfilament Proteins]
Abstract: Item does not contain fulltext Cervical artery dissection (CeAD), a mural hematoma in a carotid or vertebral artery, is a major cause of ischemic stroke in young adults although relatively uncommon in the general population (incidence of 2.6/100,000 per year). Minor cervical traumas, infection, migraine and hypertension are putative risk factors, and inverse associations with obesity and hypercholesterolemia are described. No confirmed genetic susceptibility factors have been identified using candidate gene approaches. We performed genome-wide association studies (GWAS) in 1,393 CeAD cases and 14,416 controls. The rs9349379[G] allele (PHACTR1) was associated with lower CeAD risk (odds ratio (OR) = 0.75, 95% confidence interval (CI) = 0.69-0.82; P = 4.46 x 10(-10)), with confirmation in independent follow-up samples (659 CeAD cases and 2,648 controls; P = 3.91 x 10(-3); combined P = 1.00 x 10(-11)). The rs9349379[G] allele was previously shown to be associated with lower risk of migraine and increased risk of myocardial infarction. Deciphering the mechanisms underlying this pleiotropy might provide important information on the biological underpinnings of these disabling conditions.
Published: 2015

25. Early eplerenone treatment in patients with acute ST-elevation myocardial infarction without heart failure: The Randomized Double-Blind Reminder Study

Author: Rolf Wachter, Gerald Tremblay, Harry Shi, Anoop Chauhan, Antonio Fernández Ortiz, Miguel Fiol Sala, Jerzy Lewczuk, Andrew Grieve, Rainer Hambrecht, Pierre Coste, Jean-Philippe Collet, J. M. Ten Berg, Jan Vojacek, J. Herrman, Witold Zmuda, Juan Ramon Rey Blas, Emmanuel Teiger, Jaroslav Sumbal, David Smith, Faiez Zannad, Geza Lupkovics, Karol Micko, Johann Bauersachs, Minakshi Madan, Cosme Garcia Garcia, Jerzy Gorny, Marcus Flather, Robert C. Welsh, Carlos Perez Muñoz, David Fitchett, Ruth H. Strasser, Karsten Sydow, Robin A.P. Weir, Miguel Orri, Michel Barboteu, Thomas Münzel, Gilles Montalescot, Georg Noll, Harald Mudra, János Tomcsányi, Serge Lepage, W. Stuart Hillis, Jiri Kettner, Roman Margoczy, Csaba András Dézsi, Thomas N. Martin, Jacek Kubica, Gilles Zemour, Franciso Ridocci Soriano, Dawn L. Adamson, Stephan Steiner, Marian Hranai, Filippatos Gerasimos, Farqad Alamgir, Jean-Lucien Rouleau, Bruce Sussex, Martin Hutyra, Gregory Y.H. Lip, Dimitros Alexopoulos, Michael Böhm, Graham C. Wong, Dominique Ducos, Michel Galinier, Bertram Pitt, Eva Turgonyi, Petr Ostadal, Christian W. Hamm, Freek W.A. Verheugt, Carsten Tschöpe, Esteban López de Sá, Vlassios N Pyrgakis, Jindrich Spinar, Blair J. O'Neill, Hubertus Heuer, Gerhard Hauf, John Vincent, Nikos Werner, David E. Newby, Frantisek Kovar, Dimitrios Babalis, Yves Cottin, Peter Polgar, Gerry P McCann, Xavier Bosch Genover, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University of Michigan [Ann Arbor], University of Michigan System, Hospital Universitario La Paz, Kerckhoff-Klinik, Norwich Medical School, University of East Anglia [Norwich] (UEA), Onze Lieve Vrouwe Gasthuis (OLVG), Pfizer, Pfizer Ltd, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Pontchaillou [Rennes], LAboratoire de Modélisation Pluridisciplinaire et Simulations (LAMPS), Université de Perpignan Via Domitia (UPVD), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Avancé de Spectroscopie pour les Intéractions la Réactivité et l'Environnement - UMR 8516 (LASIRE), Institut de Chimie du CNRS (INC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Conception, synthèse et vectorisation de biomolécules. (CSVB), Université Paris Descartes - Paris 5 (UPD5)-Institut Curie [Paris]-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Departamento de Fisica Teorica C-XI (FTUAM), Universidad Autónoma de Madrid (UAM), LAboratoire de Mathématiques et PhySique (LAMPS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Chimie du CNRS (INC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Centrale Lille Institut (CLIL), Université Paris Descartes - Paris 5 (UPD5)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut Curie [Paris], Universidad Autonoma de Madrid (UAM), Institut de Physique du Globe de Paris (IPGP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut national des sciences de l'Univers (INSU - CNRS)-IPG PARIS-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Laboratoire de Spectrochimie Infrarouge et Raman - UMR 8516 (LASIR), Centre National de la Recherche Scientifique (CNRS)-Université de Lille, and Institut Curie-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)
Subjects: Male, 030204 cardiovascular system & hematology, Spironolactone, MESH: Length of Stay, 0302 clinical medicine, Clinical endpoint, MESH: Double-Blind Method, 030212 general & internal medicine, Myocardial infarction, MESH: Treatment Outcome, Ejection fraction, MESH: Middle Aged, Hazard ratio, Middle Aged, Brain natriuretic peptide, 3. Good health, Eplerenone, MESH: Myocardial Infarction, Treatment Outcome, MESH: Spironolactone, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.drug, medicine.medical_specialty, MESH: Mineralocorticoid Receptor Antagonists, Placebo, Patient Readmission, Mineralocorticoid receptor antagonists, 03 medical and health sciences, Double-Blind Method, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, MESH: Patient Readmission, Humans, cardiovascular diseases, Heart Failure, MESH: Humans, business.industry, Length of Stay, medicine.disease, MESH: Male, B-type natriuretic peptide, Heart failure, MESH: Heart Failure, Potassium, business, MESH: Female
Abstract: International audience; AIMS:We aimed to assess the impact of eplerenone on cardiovascular (CV) outcomes in STEMI without known heart failure, when initiated within 24 h of symptom onset.METHODS AND RESULTS:In this randomized, placebo-controlled, double-blind trial, we assigned 1012 patients with acute STEMI and without a history of heart failure to receive either eplerenone (25-50 mg once daily) or placebo in addition to standard therapy. The primary endpoint was the composite of CV mortality, re-hospitalization, or, extended initial hospital stay, due to diagnosis of HF, sustained ventricular tachycardia or fibrillation, ejection fraction ≤40%, or elevated BNP/NT-proBNP at 1 month or more after randomization. BNP elevation was defined as BNP levels or values above 200 pg/mL or NT-proBNP values above 450 pg/mL (in patients aged below 50); above 900 pg/mL (age 50-75 years) or above 1800 pg/mL (patients older than 75). After a mean follow-up of 10.5 months, the primary endpoint occurred in 92 patients (18.2%) in the eplerenone group and in 149 patients (29.4%) in the placebo group [adjusted hazard ratio (HR), 0.58; 95% confidence interval (CI), 0.45-0.76; P < 0.0001]. The primary endpoint was driven by a high BNP/NT-proBNP level (adjusted HR, 0.60; 95% CI, 0.45-0.79; P < 0.0003). Adverse event rates were similar in both groups. Serum potassium levels exceeded 5.5 mmol/L in 5.6 vs. 3.2% (P = 0.09) and were below 3.5 mmol/L in 1.4 vs. 5.6% of patients (P = 0.0002), in the eplerenone and placebo groups, respectively.CONCLUSION:The addition of eplerenone during the acute phase of STEMI was safe and well tolerated. It reduced the primary endpoint over a mean 13 months follow-up mostly because of significantly lower BNP/NT-proBNP levels. Additional studies are needed to clarify the role of early use of MRAs in STEMI patients without heart failure.CLINICAL TRIAL REGISTRATION:NCT01176968.
Published: 2014

26. Determinants of improved one-year survival in non-ST-segment elevation myocardial infarction patients: insights from the French FAST-MI program over 15 years

Author: Vincent Bataille, Simon Cattan, Nicolas Danchin, Etienne Puymirat, Geneviève Mulak, Jean Ferrières, Tabassome Simon, Didier Blanchard, Laurence Berard, Philippe Gabriel Steg, Marc-Antoine Isorni, Pascal Gueret, Francois Schiele, Patrick Goldstein, Johanne Silvain, Centre de Ressources Biologiques HUEP-UPMC (CRB HUEP-UPMC), UMS omique (OMIQUE), and Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, MESH: Registries, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Myocardial Infarction, Coronary artery disease, Electrocardiography, Medicine, ST segment, Myocardial infarction, Registries, MESH: Aged, MESH: Follow-Up Studies, Prognosis, 3. Good health, Survival Rate, MESH: Myocardial Infarction, Female, France, MESH: Cardiovascular Agents, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, MESH: Forecasting, medicine.medical_specialty, MESH: Survival Rate, MESH: Prognosis, Percutaneous Coronary Intervention, Intensive care, Humans, In patient, Mortality, Intensive care medicine, Aged, Retrospective Studies, MESH: Humans, business.industry, Percutaneous coronary intervention, MESH: Retrospective Studies, Cardiovascular Agents, medicine.disease, MESH: Male, MESH: Electrocardiography, MESH: France, Emergency medicine, Non-ST-elevation myocardial infarction, business, MESH: Female, Follow-Up Studies, Forecasting
Abstract: Improved early outcome in non-ST elevation myocardial infarction (NSTEMI) patients has been mainly attributed to a broader use of invasive strategies. Little is known about the impact of other changes in early management.We aimed to assess 15-year trends in one-year mortality and their determinants in NSTEMI patients. We used data from 4 one-month French registries, conducted 5 years apart from 1995 to 2010 including 3903 NSTEMI patients admitted to intensive care units.From 1995 to 2010, no major change was observed in patient characteristics, while therapeutic management evolved considerably. Early use of antiplatelet agents, β-blockers, ACE-inhibitors and statins increased over time (P0.001); use of newer anticoagulants (low-molecular-weight heparin, bivalirudin or fondaparinux) increased from 40.8% in 2000 to 78.9% in 2010 (P0.001); percutaneous coronary intervention (PCI)≤ 3 days of admission rose from 7.6% to 48.1% (P0.001). One-year death decreased from 20% to 9.8% (HR adjusted for baseline parameters, 2010 vs. 1995 = 0.47, 95% CI: 0.35-0.62). Early PCI (HR = 0.67; 95% CI: 0.49-0.90), use of newer anticoagulants (HR = 0.62; 95% CI: 0.48-0.78) and early use of evidence based medical therapy (HR = 0.54; 95% CI: 0.40-0.72) were predictors of improved one year-survival.One-year mortality of NSTEMI patients decreased by 50% in the past 15years. Our data support current guidelines recommending early invasive strategies and use of newer anticoagulants for NSTEMI, and also show a strong positive association between early use of appropriate medical therapies and one-year survival, suggesting that these medications should be used from the start.
Published: 2014

27. Saxagliptin, alogliptin, and cardiovascular outcomes

Author: Benjamin M, Scirica, Eugene, Braunwald, Deepak L, Bhatt, UL, DCAC, Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Male, medicine.medical_specialty, MEDLINE, Myocardial Infarction, Adamantane, Saxagliptin, MESH: Angina, Unstable, chemistry.chemical_compound, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Piperidines, MESH: Hypoglycemic Agents, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Angina, Unstable, Uracil, ComputingMilieux_MISCELLANEOUS, MESH: Uracil, Dipeptidyl-Peptidase IV Inhibitors, MESH: Dipeptidyl-Peptidase IV Inhibitors, MESH: Humans, business.industry, General Medicine, Dipeptides, medicine.disease, MESH: Male, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Myocardial Infarction, MESH: Piperidines, chemistry, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Female, business, MESH: Female, Cardiovascular outcomes, Alogliptin, MESH: Diabetes Mellitus, Type 2
Abstract: To the Editor: Besides showing futility in the use of dipeptidyl peptidase 4 (DPP-4) inhibitors to reduce cardiovascular outcomes, the studies by Scirica et al.(1) and White et al.(2) (Oct. 3 issue) have raised concerns regarding increased rates of heart failure associated with these agents. The Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR)-Thrombolysis in Myocardial Infarction (TIMI) 53 (SAVOR-TIMI 53) trial, reported by Scirica et al., showed a 27% increase in hospitalization for heart failure among patients with diabetes who received saxagliptin as compared with patients with diabetes who received placebo (3.5% vs. 2.8%; hazard ...
Published: 2014

28. Acute myocardial infarction

Author: Courand, Pierre-Yves, Sibellas, Franck, Gonidec, Sophie, Mechtouff, Laura, Kirkorian, Gilbert, Bonnefoy, Eric, Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon
Subjects: MESH: Humans, MESH: Middle Aged, [SDV]Life Sciences [q-bio], MESH: Cognition, MESH: Diffusion Magnetic Resonance Imaging, MESH: Predictive Value of Tests, MESH: Coronary Angiography, MESH: Male, MESH: Electrocardiography, MESH: Myocardial Infarction, MESH: Risk Factors, MESH: Amnesia, Transient Global, MESH: Memory, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2014

29. [Acute myocardial infarction in metropolitan France from 1995 to 2010: evolution of patient characteristics, management and outcomes]

Author: Danchin, Nicolas, Puymirat, Étienne, Carli, Pierre, Ferrières, Jean, Simon, Tabassome, Centre de Ressources Biologiques HUEP-UPMC (CRB HUEP-UPMC), UMS omique (OMIQUE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and BRUNEL, Nadège
Subjects: Male, MESH: Aged, MESH: Humans, MESH: Middle Aged, Urban Population, [SDV]Life Sciences [q-bio], Myocardial Infarction, Middle Aged, Health Surveys, MESH: Male, [SDV] Life Sciences [q-bio], MESH: Angioplasty, Balloon, Coronary, MESH: France, MESH: Urban Population, MESH: Myocardial Infarction, MESH: Health Surveys, Fibrinolytic Agents, Humans, MESH: Fibrinolytic Agents, Female, France, cardiovascular diseases, Angioplasty, Balloon, Coronary, MESH: Female, Aged
Abstract: International audience; Cardiovascular disease is still one of the main causes of death in France, and acute myocardial infarction is one of its most severe complications. Data from four nationwide surveys conducted from 1995 to 2010 show that ST-elevation myocardial infarction (STEMI) has tended to affect younger subjects in recent years, while age of onset of non-ST-elevation myocardial infarction (NSTEMI) has remained relatively stable. Both the organization and the modalities of patient management have undergone profound modifications, with an increase in the use of invasive strategies and secondary medical prevention. Early mortality has fallen from 13.7% to 4.4% in STEMI patients, and from 10.9% to 3.0% in NSTEMI patients.
Published: 2014

30. Hypothermic liquid ventilation prevents early hemodynamic dysfunction and cardiovascular mortality after coronary artery occlusion complicated by cardiac arrest in rabbits

Author: Clovis Adam, Lys Darbera, Matthias Kohlhauer, Jean-Luc Dubois-Randé, Bijan Ghaleh, Mourad Chenoune, Benoît Vivien, Alain Berdeaux, Jean-Damien Ricard, Patrick Bruneval, Fanny Lidouren, Pierre Carli, Renaud Tissier, INSERM U955, équipe 3, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Anatomie Pathologique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Laboratoire de Recherche en Imagerie : Méthodes d'imagerie des Échanges transcapillaires (LRI - EA4062), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anesthésie Réanimation [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pharmacie-Toxicologie, École nationale vétérinaire - Alfort (ENVA)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Ecologie et Evolution des Microorganismes (EEM), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), This st udy was supported by a grant (ABYSS- R12031JJ) from the 'Agence Nationale pour la Recher che' (Paris, France). R. Tissier was a recipient of a 'Contrat d'Interface INSERM-ENV'. R. Tissier and A. Berdeaux are named as inventors on a patent application (13/039415)., ANR-11-TECS-0007,ABYSS,Hypothermie thérapeutique par ventilation liquide totale dans les suites d'un arrêt cardiaque réanimé(2011), Guellaen, Georges, Technologie pour la santé et l'autonomie - Hypothermie thérapeutique par ventilation liquide totale dans les suites d'un arrêt cardiaque réanimé - - ABYSS2011 - ANR-11-TECS-0007 - TecSan - VALID, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), École nationale vétérinaire d'Alfort (ENVA)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10 - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Bicêtre, Université Paris Descartes - Paris 5 (UPD5) - Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Necker - Enfants Malades [AP-HP], Ecole Nationale Vétérinaire d'Alfort - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris 13 (UP13) - Université Paris Diderot - Paris 7 (UPD7) - Université Sorbonne Paris Cité (USPC) - Institut National de la Santé et de la Recherche Médicale (INSERM), and ANR : ABYSS- R12031JJ, ABYSS- R12031JJ
Subjects: Male, Cardiac output, MESH: Heart Arrest, Time Factors, MESH: Random Allocation, MESH: Cardiopulmonary Resuscitation, Hemodynamics, MESH: Rabbits, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Random Allocation, 0302 clinical medicine, Heart Rate, Hypothermia, Induced, Hypotherm ia, Occlusion, MESH: Animals, Prospective Studies, Myocardial infarction, Cardiac Output, MESH: Heart Rate, MESH: Liquid Ventilation, Cardiac arrest, 3. Good health, Survival Rate, MESH: Myocardial Infarction, Liquid ventilation, Anesthesia, Cardiology, Rabbits, medicine.symptom, medicine.medical_specialty, MESH: Survival Rate, Resuscitation, MESH: Nervous System Diseases, MESH: Coronary Occlusion, Article, 03 medical and health sciences, Internal medicine, medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Animals, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH: Hypothermia, Induced, business.industry, MESH: Cardiac Output, MESH: Time Factors, Hypothermia, medicine.disease, Cardiopulmonary Resuscitation, MESH: Prospective Studies, MESH: Male, Heart Arrest, Coronary Occlusion, Respiratory failure, Coronary occlusion, Ventricular fibrillation, Nervous System Diseases, business, 030217 neurology & neurosurgery
Abstract: International audience; OBJECTIVES: Ultrafast and whole-body cooling can be induced by total liquid ventilation with temperature-controlled perfluorocarbons. Our goal was to determine whether this can afford maximal cardio- and neuroprotections through cooling rapidity when coronary occlusion is complicated by cardiac arrest. DESIGN: Prospective, randomized animal study. SETTING: Academic research laboratory. SUBJECTS: Male New Zealand rabbits. INTERVENTIONS: Chronically instrumented rabbits were submitted to coronary artery occlusion and ventricular fibrillation. After 8 minutes of cardiac arrest, animals were resuscitated and submitted to a normothermic follow-up (control group) or to 3 hours of mild hypothermia induced by total liquid ventilation (total liquid ventilation group) or by combination of cold saline infusion and cold blankets application (saline group). Coronary reperfusion was permitted 40 minutes after the onset of occlusion. After awakening, rabbits were followed up during 7 days. MEASUREMENTS AND MAIN RESULTS: Ten animals were resuscitated in each group. In the control group, all animals secondarily died of cardiac/respiratory failure (8 of 10) or neurological dysfunction (2 of 10). In the saline group, the target temperature of 32°C was achieved within 30-45 minutes after cooling initiation. This slightly reduced infarct size versus control (41% ± 16% vs 54% ± 8% of risk zone, respectively; p < 0.05) but failed to significantly improve cardiac output, neurological recovery, and survival rate (three survivors, six death from cardiac/respiratory failure, and one from neurological dysfunction). Conversely, the 32°C temperature was achieved within 5-10 minutes in the total liquid ventilation group. This led to a dramatic reduction in infarct size (13% ± 4%; p < 0.05 vs other groups) and improvements in cardiac output, neurological recovery, and survival (eight survivors, two deaths from cardiac/respiratory failure). CONCLUSIONS: Achieving hypothermia rapidly is critical to improve the cardiovascular outcome after cardiac arrest with underlying myocardial infarction.
Published: 2013

31. Effect of Chronic Severe Diabetes on Myocardial Stunning in the Dog

Author: J. Delaye, G Hadour, Michel de Lorgeril, Rémi Forrat, René Ferrera, Laurent Sebbag, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Pôle Médico-Chirurgical de Transplantation Cardiaque Adulte, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel [CHU - HCL], Hospices Civils de Lyon (HCL), Laboratoire d'Etudes du Comportement à Long Terme des matériaux de conditionnement (LCLT), Département de recherche sur les technologies pour l'enrichissement, le démantèlement et les déchets (DE2D), CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Cardioprotection, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), and Département de recherche sur les Procédés et Matériaux pour les Environnements complexes (DPME)
Subjects: Male, medicine.medical_specialty, MESH: Myocardial Contraction, Radioactive microsphere technique, Myocardial Infarction, Ischemia, MESH: Coronary Circulation, 030204 cardiovascular system & hematology, Diabetes Mellitus, Experimental, 030218 nuclear medicine & medical imaging, MESH: Dogs, 03 medical and health sciences, Coronary circulation, Dogs, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Coronary Circulation, Internal medicine, Diabetes mellitus, MESH: Diabetes Mellitus, Experimental, medicine, Animals, MESH: Animals, Myocardial infarction, MESH: Myocardial Stunning, Molecular Biology, Myocardial Stunning, Myocardial stunning, business.industry, Heart, medicine.disease, Myocardial Contraction, MESH: Male, 3. Good health, MESH: Heart, MESH: Myocardial Infarction, medicine.anatomical_structure, Regional Blood Flow, Coronary occlusion, Cardiology, Female, MESH: Regional Blood Flow, Cardiology and Cardiovascular Medicine, business, MESH: Female, Reperfusion injury
Abstract: International audience; In this study, we examined whether chronic severe diabetes may affect ischaemic and post-ischaemic regional myocardial dysfunction in vivo in the dog. Diabetes was chemically induced in randomized animals and major metabolic alterations were observed confirming the severity and chronicity of the diabetes. After 70 days, halothane-anaesthetized dogs underwent a 20-min coronary occlusion, followed by reperfusion. During ischaemia, global left ventricle function (dP/dtmax) was more altered (P
Published: 1998

32. Sustained therapeutic perfusion outside transplanted sites in chronic myocardial infarction after stem cell transplantation

Author: Yihua Liu, Sylvain Poussier, Gilles Karcher, Nguyen Tran, Pierre-Yves Marie, Pablo Maureira, Fatiha Maskali, Fengxu Yu, Frederique Groubatch, Ecole de Chirurgie [Université de Lorraine], Faculté de Médecine [Nancy], Université de Lorraine (UL)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Chirurgie Cardio-vasculaire [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), and Service de Médecine Nucléaire [Nancy]
Subjects: Time Factors, Cell, Myocardial Infarction, 030204 cardiovascular system & hematology, Cell therapy, 0302 clinical medicine, Medicine, MESH: Animals, Myocardial infarction, MESH: Indium Radioisotopes, Cells, Cultured, MESH: Myocardial Perfusion Imaging, Indium Radioisotopes, Myocardial Perfusion Imaging, MESH: Regeneration, MESH: Technetium Tc 99m Sestamibi, MESH: Recovery of Function, 3. Good health, MESH: Myocardial Infarction, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Cardiology, Stem cell, MESH: Stem Cell Transplantation, Cardiology and Cardiovascular Medicine, Perfusion, MESH: Radiopharmaceuticals, MESH: Cells, Cultured, Technetium Tc 99m Sestamibi, medicine.medical_specialty, MESH: Myocardium, MESH: Rats, MESH: Coronary Circulation, MESH: Tomography, Emission-Computed, Single-Photon, 03 medical and health sciences, Paracrine signalling, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Coronary Circulation, Internal medicine, Animals, Regeneration, Radiology, Nuclear Medicine and imaging, Rats, Wistar, Tomography, Emission-Computed, Single-Photon, business.industry, Myocardium, MESH: Time Factors, Recovery of Function, MESH: Rats, Wistar, medicine.disease, Rats, Surgery, Transplantation, Disease Models, Animal, Ventricle, Radiopharmaceuticals, MESH: Disease Models, Animal, business, Stem Cell Transplantation
Abstract: International audience; This study aimed at comparing long-term variations in the perfusion of chronic myocardial infarction (MI) areas after local injections of autologous bone marrow stem cells (BMSCs). 14 coronary ligated rats with transmural chronic MI (4 months) were used: a control group (n = 7) versus a treated group (n = 7) in which (111)In labeled-BMSCs were directly engrafted on MI areas. By using (111)In/(99m)Tc SPECT and Sestamibi gated-SPECT,. left ventricle perfusion and function were monitored in all animals by serial (99m)Tc-Sestamibi pinhole gated-SPECT over a period of 6 months. Post-therapeutic myocardial perfusion improved as early as 48 h following injection in the 2 groups. This benefice was sustained during the 6-month follow-up in the non-engrafted MI-areas from treated rats (at 6-months: +10 ± 5 %), whereas the engrafted ones, as well as the MI areas from control rats, exhibited progressive deterioration over time (at 6-months: -9 ± 10 % and -5 ± 3 %, respectively). Perfusion enhancement of the chronic MI areas treated by BMSCs transplantation is: (1) marked in the following days, presumably because of an unspecific inflammatory reaction, and (2) sustained over the long term but only outside the sites of cell engraftment, suggesting a distant paracrine effect of transplanted cells.
Published: 2013

33. First evidence of increased plasma serotonin levels in Tako-Tsubo cardiomyopathy

Author: Odile Spreux-Varoquaux, Michel Galinier, Caroline Biendel-Picquet, Nicolas Boudou, Angelo Parini, Clément Delmas, Didier Carrié, C. Rouzaud Laborde, Nicolas Dumonteil, Nathalie Pizzinat, Olivier Lairez, Jeanne Mialet-Perez, Service de Pharmacie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Centre Hospitalier de Versailles André Mignot (CHV), Centre d'Imagerie Cardiaque, Service de Médecine Nucléaire [Toulouse], Simon, Marie Francoise, Service Pharmacologie Clinique [CHU Toulouse], Pôle Santé publique et médecine publique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Médecine Nucléaire - Pierre-Paul Riquet [CHU Toulouse], and Pôle imagerie médicale [CHU Toulouse]
Subjects: Male, [SDV]Life Sciences [q-bio], Cardiomyopathy, Myocardial Infarction, lcsh:Medicine, 030204 cardiovascular system & hematology, MESH: Takotsubo Cardiomyopathy, 0302 clinical medicine, MESH: Aged, 80 and over, 030212 general & internal medicine, Myocardial infarction, MESH: Stress, Physiological, MESH: Myocardial Stunning, Aged, 80 and over, Myocardial Stunning, MESH: Aged, MESH: Middle Aged, MESH: Stress, Psychological, General Medicine, Middle Aged, MESH: Case-Control Studies, Pathophysiology, [SDV] Life Sciences [q-bio], MESH: Myocardial Infarction, Cardiology, Female, medicine.medical_specialty, Serotonin, Article Subject, Serotonergic, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Stress, Physiological, Takotsubo Cardiomyopathy, Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Myocardial stunning, MESH: Humans, General Immunology and Microbiology, business.industry, lcsh:R, Case-control study, medicine.disease, MESH: Male, Case-Control Studies, Clinical Study, Plasma serotonin, MESH: Serotonin, business, MESH: Female, Stress, Psychological
Abstract: Background. There is no data about the serotonergic activity during the acute phase of Tako-Tsubo Cardiomyopathy (TTC). The objective of our study was to investigate evidence of serotonin release from patients with TTC in comparison with patients with ST elevation myocardial infarction (STEMI) and healthy control subjects (HCS).Methods and Results. Plasma serotonin levels in 14 consecutive patients with TTC were compared with those in 14 patients with STEMI and 14 HCS. Plasma serotonin levels at admission were markedly higher in patients with TTC and STEMI as compared to HCS (3.9±4.6,P=0.02versus control;5.7±5.6,P=0.001versus control; and1±0.4 ng/mL, resp.). There was no difference in serotonin levels between patients with TTC and those with STEMI (P=0.33).Conclusion. This finding suggests that serotonin could participate to the pathophysiology of TTC.
Published: 2013

34. Cell-derived microparticles in atherosclerosis: biomarkers and targets for pharmacological modulation?

Author: Morgane Baron, Anne Tailleux, Bart Staels, Chantal M. Boulanger, Récepteurs nucléaires, maladies cardiovasculaires et diabète ( EGID ), Université de Lille, Droit et Santé-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Pasteur de Lille, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 (RNMCD), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Derudas, Marie-Hélène
Subjects: MESH : Stroke, MESH : Atherosclerosis, Peroxisome Proliferator-Activated Receptors, Myocardial Infarction, MESH: Peroxisome Proliferator-Activated Receptors, MESH : Cell-Derived Microparticles, MESH: Flow Cytometry, Disease, 030204 cardiovascular system & hematology, Bioinformatics, Cardiovascular System, Antioxidants, MESH: Atherosclerosis, 0302 clinical medicine, Cell-Derived Microparticles, Risk Factors, MESH: Risk Factors, MESH: Cell-Derived Microparticles, Medicine, MESH: Animals, Pharmacological modulation, Myocardial infarction, MESH: Hypolipidemic Agents, Prospective cohort study, Stroke, Hypolipidemic Agents, microparticles, 0303 health sciences, MESH : Hypolipidemic Agents, MESH: Enzyme-Linked Immunosorbent Assay, Flow Cytometry, Thrombosis, MESH : Risk Factors, MESH : Enzyme-Linked Immunosorbent Assay, Pathophysiology, 3. Good health, MESH : Thrombosis, MESH: Myocardial Infarction, Molecular Medicine, MESH : Antioxidants, MESH : Flow Cytometry, Reviews, Enzyme-Linked Immunosorbent Assay, MESH: Stroke, 03 medical and health sciences, MESH : Cardiovascular System, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Animals, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH: Thrombosis, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology, 030304 developmental biology, MESH: Humans, business.industry, MESH: Cardiovascular System, MESH: Antioxidants, MESH : Humans, MESH: Biological Markers, biomarkers, Cell Biology, Atherosclerosis, medicine.disease, MESH : Disease Models, Animal, MESH : Peroxisome Proliferator-Activated Receptors, cardiovascular diseases, MESH : Biological Markers, Disease Models, Animal, Immunology, MESH : Animals, MESH: Disease Models, Animal, MESH : Myocardial Infarction, business
Abstract: International audience; Cardiovascular diseases remain an important cause of morbi-mortality. Atherosclerosis, which predisposes to cardiovascular disorders such as myocardial infarction and stroke, develops silently over several decades. Identification of circulating biomarkers to evaluate cardiovascular event risk and pathology prognosis is of particular importance. Microparticles (MPs) are small vesicles released from cells upon apoptosis or activation. Microparticles are present in blood of healthy individuals. Studies showing a modification of their concentrations in patients with cardiovascular risk factors and after cardiovascular events identify MPs as potential biomarkers of disease. Moreover, the pathophysiological properties of MPs may contribute to atherosclerosis development. In addition, pharmacological compounds, used in the treatment of cardiovascular disease, can reduce plasma MP concentrations. Nevertheless, numerous issues remain to be solved before MP measurement can be applied as routine biological tests to improve cardiovascular risk prediction. In particular, prospective studies to identify the predictive values of MPs in pathologies such as cardiovascular diseases are needed to demonstrate whether MPs are useful biomarkers for the early detection of the disease and its progression.
Published: 2012

35. Implementation of primary angioplasty in Europe: stent for life initiative progress report

Author: Manel Sabaté, Jean Fajadet, Jorgova J, Hélder Pereira, Martine Gilard, C.J. Vrints, William Wijns, Giulio Guagliumi, Zuzana Kaifoszova, Omer Goktekin, Petr Widimsky, Kristina G. Laut, Di Mario C, Dan Deleanu, Miodrag Ostojic, Mohamed Sobhy, Steen Dalby Kristensen, John Kanakakis, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre for the Environment, and Trinity College Dublin
Subjects: Research Report, Percutaneous, Time Factors, medicine.medical_treatment, Psychological intervention, Myocardial Infarction, 030204 cardiovascular system & hematology, Health Services Accessibility, 0302 clinical medicine, MESH: Practice Guidelines as Topic, Medicine, 030212 general & internal medicine, Myocardial infarction, MESH: Quality of Health Care, Angioplasty, Balloon, Coronary, MESH: Treatment Outcome, MESH: Health Services Accessibility, MESH: Program Evaluation, Delivery of Health Care, Integrated, Mortality rate, 3. Good health, Europe, MESH: Angioplasty, Balloon, Coronary, MESH: Myocardial Infarction, Treatment Outcome, General partnership, Practice Guidelines as Topic, MESH: Guideline Adherence, Stents, Medical emergency, Guideline Adherence, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Primary angioplasty, 03 medical and health sciences, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, cardiovascular diseases, Quality of Health Care, MESH: Humans, business.industry, MESH: Time Factors, Percutaneous coronary intervention, Stent, medicine.disease, MESH: Stents, Emergency medicine, MESH: Research Report, Human medicine, MESH: Europe, business, MESH: Delivery of Health Care, Integrated, Program Evaluation
Abstract: International audience; AIMS: Primary percutaneous coronary intervention (PPCI) is the recommended treatment for patients with acute ST-segment elevation myocardial infarction (STEMI). Despite substantial evidence of its effectiveness, a 2007 study reported that only 40-45% of European STEMI patients were treated with PPCI, with large variations in treatment availability between countries. In 2008, the Stent for Life (SFL) initiative was launched by the European Association of Percutaneous Cardiovascular Interventions and EuroPCR in partnership with the European Society of Cardiology (ESC) Working Group on Acute Cardiac Care and country-specific national cardiac societies. The aim is to promote the prioritisation of percutaneous coronary intervention treatment towards those who will benefit most, namely STEMI patients. The following countries are currently participating: Bulgaria, Egypt, France, Greece, Italy, Portugal, Romania, Serbia, Spain and Turkey. METHODS AND RESULTS: Since SFL was launched, several activities have been initiated in the participating countries. Preliminary reports suggest that major increases have been seen in the numbers of PPCI performed, with some countries reporting very significant increases in PPCI use from 2008-2010. Improvements in STEMI mortality rates have also been observed. CONCLUSIONS: This report summarises the progress of the SFL initiative in the 10 target countries.
Published: 2012

36. Vorapaxar in the secondary prevention of atherothrombotic events

Author: Jose Nicolau, Andrzej Rynkiewicz, Keith Fox, Vahid Mansouri, Fausto Miranda Junior, Jose Antônio Marin-Neto, Carlos Tauil, Yves Samson, Giovanni ESPOSITO, David Morrow, Wojciech Sobiczewski, James Spratt, Jacek Kubica, Miguel Urina, STEFANO CARUGO, Majken Karoline Jensen, Frans Van de Werf, Stavros Konstantinides, Oscar Ayo-Martin, Lucia Mazzolai, Isabella TRITTO, ERIC HERNANDEZ-TRIANA, Philip Bath, Diana Gorog, Graeme Hankey, Juhani Airaksinen, Marco Vatrano, Jose Faria Neto, Peter Sinnaeve, Roman Herzig, Serge Timsit, Urszula Fiszer, Attila Csányi, Marcia Chaves, Robert Mikulik, Marek Roik, Mónica Jaramillo, Michel GALINIER, Helle Klingenberg Iversen, Bassem A. Samad, Philippe Gabriel STEG, Elizabeth Coetsee, Guillermo Isasti, Domenico Scrutinio, Silvia Reverté Villarroya, Malcolm Robert Macleod, Michael Lim, Amos Katz, Meyer ELBAZ, Derek Chew, Hanne Christensen, Markus Theurl, Simona Marcheselli, Patricia Simal, Michal Bar, Isabelle Quere, Geert Vanhooren, Piotr Ponikowski, Xavier Garcia-Moll, Elena Corrada, Robert Welsh, Helge Wuttig, Philip Aylward, Carl Magnus Wahlgren, Marco Stramba-Badiale, Fernando Manzur, LAURENT SUISSA, Thierry Moulin, Giancarlo Marenzi, Gian Battista Danzi, Bogumił Ramotowski, Caitrin McDonough, Afanasiev Stanislav, RAUL CARLOS REY, Emilia Solinas, Cardiovascular Division (SZG), Brigham and Women's Hospital [Boston], Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia [Buenos Aires] (FLENI), FLENI, Milpark Hospital (Milpark Hospital), Milpark Hospital, Division of Cardiovascular Research (EDINBURGH - DCVR), University of Edinburgh, Heart Institute (SAO PAULO - Heart Institute), University of São Paulo Medical School, Canisius-Wilhelmina Hospital [Nijmegen, The Netherlands], Instituto de Investigaciones Clinicas Rosario (CIC ROSARIO), CIC ROSARIO, University Hospital Brno, Montreal Heart Institute (MONTREAL HEART INSTITUTE), Service de Neurologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Morrow, DA, Braunwald, E, Bonaca, MP, Ameriso, SF, Dalby, AJ, Fish, MP, Fox, KA, Lipka, LJ, Liu, X, Nicolau, JC, Ophuis, AJ, Paolasso, E, Scirica, BM, Spinar, J, Theroux, P, Wiviott, SD, Strony, J, Murphy, SA, Novo, s, Morrow, Da, Bonaca, Mp, Ameriso, Sf, Dalby, Aj, Fish, Mp, Fox, Kaa, Lipka, Lj, Nicolau, Jc, Ophuis, Ajo, Scirica, Bm, Theroux, P., Wiviott, Sd, Strony, J., Murphy, Sa, Esposito, Giovanni, TRA 2P TIMI 50 Steering Comm, Inves, Diener, Hans Christoph (Beitragende*r), Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière (NEMESIS-CRICM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (MGD) Service de neurologie, Morrow David, A., Braunwald, Eugene, Bonaca Marc, P., Ameriso Sebastian, F., Dalby Anthony, J., Fish Mary, Polly, Fox Keith, A. A., Lipka Leslie, J., Liu, Xuan, Nicolau Jose, Carlo, Ophuis A. J., Oude, Paolasso, Ernesto, Scirica Benjamin, M., Spinar, Jindrich, Theroux, Pierre, Wiviott Stephen, D., Strony, John, Murphy Sabina, A., Golino, Paolo, and Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)
Subjects: Male, Pyridines, [SDV]Life Sciences [q-bio], Myocardial Infarction, Medizin, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Brain Ischemia, Lactones, 0302 clinical medicine, MESH: Peripheral Arterial Disease, Secondary Prevention, MESH: Double-Blind Method, 030212 general & internal medicine, Myocardial infarction, Stroke, Vorapaxar, MESH: Aged, Aspirin, MESH: Middle Aged, MESH: Risk, Cardiovascular diseases [NCEBP 14], MESH: Secondary Prevention, Hazard ratio, MESH: Brain Ischemia, General Medicine, Middle Aged, Clopidogrel, 3. Good health, MESH: Receptor, PAR-1, MESH: Myocardial Infarction, vorapaxar, secondary prevention, atherothrombotic events, Cardiovascular Diseases, MESH: Platelet Aggregation Inhibitors, Anesthesia, Retreatment, Platelet aggregation inhibitor, Female, Intracranial Hemorrhages, MESH: Hemorrhage, MESH: Intracranial Hemorrhages, MESH: Lactones, circulatory and respiratory physiology, medicine.drug, Risk, ISQUEMIA CEREBRAL, Hemorrhage, Placebo, MESH: Stroke, Peripheral Arterial Disease, 03 medical and health sciences, Double-Blind Method, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, medicine, Humans, Receptor, PAR-1, MESH: Retreatment, MESH: Kaplan-Meier Estimate, Aged, MESH: Humans, business.industry, MESH: Pyridines, MESH: Cardiovascular Diseases, medicine.disease, Settore MED/11 - Malattie Dell'Apparato Cardiovascolare, MESH: Male, business, MESH: Female, Platelet Aggregation Inhibitors
Abstract: BACKGROUND: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1. METHODS: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage. RESULTS:At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P
Published: 2012

37. ACE inhibition prevents diastolic Ca2+ overload and loss of myofilament Ca2+ sensitivity after myocardial infarction.: Molecular effects of delapril on cardiomyocytes

Author: Zalvidea, Santiago, Andre, Lucas, Loyer, Xavier, Cassan, Cécile, Sainte-Marie, Yannis, Thireau, Jérôme, Sjaastad, Ivar, Heymes, Christophe, Pasquié, Jean-Luc, Cazorla, Olivier, Aimond, Franck, Richard, Sylvain, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Experimental Medical Research, Oslo University Hospital [Oslo], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
Subjects: MESH: Diastole, MESH: Myocardial Contraction, MESH: Angiotensin-Converting Enzyme Inhibitors, heart failure, sarcoplasmic reticulum Ca2+ ATPase, excitation-contraction coupling, MESH: Ventricular Remodeling, MESH: Male, MESH: Ryanodine Receptor Calcium Release Channel, MESH: Myofibrils, MESH: Myocardial Infarction, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Excitation Contraction Coupling, MESH: Calcium, Angiotensin-converting enzyme inhibitors, MESH: Sarcoplasmic Reticulum, MESH: Animals, MESH: Disease Models, Animal, hypertrophy, MESH: Mice, ComputingMilieux_MISCELLANEOUS, myofilaments
Abstract: International audience
Published: 2012

38. Detection of high-risk atherosclerotic plaque: report of the NHLBI Working Group on current status and future directions

Author: Fleg, Jerome L, Stone, Gregg W, Fayad, Zahi A, Granada, Juan F, Hatsukami, Thomas S, Kolodgie, Frank D, Ohayon, Jacques, Pettigrew, Roderic, Sabatine, Marc S, Tearney, Guillermo J, Waxman, Sergio, Domanski, Michael J, Srinivas, Pothur R, Narula, Jagat, dyctim, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Laboratory of Integrative Cardiovascular Imaging Science, and National Institutes of Health [Bethesda] (NIH)
Subjects: Carotid Artery Diseases, Diagnostic Imaging, [SDV]Life Sciences [q-bio], Embolism, Myocardial Infarction, Coronary Artery Disease, MESH: Risk Assessment, Risk Assessment, Severity of Illness Index, MESH: Prognosis, MESH: Stroke, Article, MESH: Risk Factors, Predictive Value of Tests, Risk Factors, MESH: Severity of Illness Index, MESH: Coronary Vessels, Animals, Humans, MESH: Animals, MESH: Plaque, Atherosclerotic, MESH: Coronary Artery Disease, Genetic Testing, MESH: Rupture, Spontaneous, MESH: Humans, MESH: Genetic Testing, Rupture, Spontaneous, MESH: Carotid Artery Diseases, MESH: Diagnostic Imaging, MESH: Biological Markers, imaging, high-risk plaque, Prognosis, cardiovascular event, Coronary Vessels, MESH: Predictive Value of Tests, Plaque, Atherosclerotic, Stroke, MESH: Myocardial Infarction, Disease Models, Animal, vulnerable plaque, MESH: Disease Models, Animal, MESH: Embolism, Biomarkers
Abstract: International audience; The leading cause of major morbidity and mortality in most countries around the world is atherosclerotic cardiovascular disease, most commonly caused by thrombotic occlusion of a high-risk coronary plaque resulting in myocardial infarction or cardiac death, or embolization from a high-risk carotid plaque resulting in stroke. The lesions prone to result in such clinical events are termed vulnerable or high-risk plaques, and their identification may lead to the development of pharmacological and mechanical intervention strategies to prevent such events. Autopsy studies from patients dying of acute myocardial infarction or sudden death have shown that such events typically arise from specific types of atherosclerotic plaques, most commonly the thin-cap fibroatheroma. However, the search in human beings for vulnerable plaques before their becoming symptomatic has been elusive. Recently, the PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study demonstrated that coronary plaques that are likely to cause future cardiac events, regardless of angiographic severity, are characterized by large plaque burden and small lumen area and/or are thin-cap fibroatheromas verified by radiofrequency intravascular ultrasound imaging. This study opened the door to identifying additional invasive and noninvasive imaging modalities that may improve detection of high-risk atherosclerotic lesions and patients. Beyond classic risk factors, novel biomarkers and genetic profiling may identify those patients in whom noninvasive imaging for vulnerable plaque screening, followed by invasive imaging for risk confirmation is warranted, and in whom future pharmacological and/or device-based focal or regional therapies may be applied to improve long-term prognosis.
Published: 2012

39. ACE inhibition prevents diastolic Ca2+ overload and loss of myofilament Ca2+ sensitivity after myocardial infarction

Author: Zalvidea, Santiago, Andre, Lucas, Loyer, Xavier, Cassan, Cécile, Sainte-Marie, Yannis, Thireau, Jérôme, Sjaastad, Ivar, Heymes, Christophe, Pasquié, Jean Luc, Cazorla, Olivier, Aimond, Franck, Richard, Sylvain, Richard, Sylvain, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Experimental Medical Research, Oslo University Hospital [Oslo], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)
Subjects: MESH: Diastole, MESH: Myocardial Contraction, MESH: Angiotensin-Converting Enzyme Inhibitors, heart failure, excitation-contraction coupling, sarcoplasmic reticulum Ca2+ ATPase, MESH: Ventricular Remodeling, MESH: Male, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Ryanodine Receptor Calcium Release Channel, MESH: Myofibrils, MESH: Myocardial Infarction, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Excitation Contraction Coupling, MESH: Calcium, Angiotensin-converting enzyme inhibitors, MESH: Sarcoplasmic Reticulum, MESH: Animals, MESH: Disease Models, Animal, hypertrophy, MESH: Mice, ComputingMilieux_MISCELLANEOUS, myofilaments
Abstract: International audience
Published: 2012

40. Mesenchymal stem cell delivery into rat infarcted myocardium using a porous polysaccharide-based scaffold: a quantitative comparison with endocardial injection

Author: Sofiane Hamidi, Catherine Le Visage, Richard Isnard, Françoise Norol, Didier Letourneur, Najah Benguirat, James A. Flanders, Olivier Gournay, Jean-Baptiste Michel, Nathalie Mougenot, Laetitia Chaussumier, Stéphane N. Hatem, Hémostase, bio-ingénierie et remodelage cardiovasculaires (LBPC), Université Paris Diderot - Paris 7 (UPD7)-Université Paris 13 (UP13)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Galilée, Génétique, pharmacologie et physiopathologie des maladies cardiovasculaires, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hematopoïese et cellules souches normales et pathologiques (U790), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Coeur, Muscle et Vaisseaux, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department Clinical Sciences, Cornell University [New York], Service de biothérapies [CHU Pitié-Salpétrière], Departement Hospitalo- Universitaire - Inflammation, Immunopathologie, Biothérapie [Paris] (DHU - I2B), Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), This work was supported by Inserm, Universities Paris 7 and Paris 13 and in part by Fondation de France, Fondation de l'Avenir (IM7-475) and grants from Agence Nationale de la Recherche (ANR- 09-EBIO-001 3D and ANR-08-BIOT-012). Olivier Gournay was a recipient of ' Société Française de Cardiologie '., Le Visage, Catherine, Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Cardiac Catheterization, Scaffold, 02 engineering and technology, Biochemistry, Green fluorescent protein, Electrocardiography, chemistry.chemical_compound, Fibrosis, MESH: Reverse Transcriptase Polymerase Chain Reaction, MESH: Tissue Scaffolds, MESH: Animals, Polysaccharide, Ultrasonography, 0303 health sciences, Tissue Scaffolds, Reverse Transcriptase Polymerase Chain Reaction, Heart, 021001 nanoscience & nanotechnology, MESH: Heart Catheterization, Cell biology, Vascular endothelial growth factor, MESH: Myocardial Infarction, MESH: Rats, Inbred Lew, 0210 nano-technology, Porosity, MESH: Rats, Green Fluorescent Proteins, Biomedical Engineering, Bioengineering, Mesenchymal Stem Cell Transplantation, MESH: Prosthesis Implantation, Article, Injections, Viral vector, Prosthesis Implantation, Biomaterials, 03 medical and health sciences, MESH: Porosity, MESH: Green Fluorescent Proteins, Polysaccharides, MESH: Endocardium, medicine, Animals, MESH: Injections, MESH: Mesenchymal Stem Cell Transplantation, [SDV.IB.BIO]Life Sciences [q-bio]/Bioengineering/Biomaterials, Endocardium, 030304 developmental biology, Transplantation, Mesenchymal stem cell, medicine.disease, Rats, MESH: Electrocardiography, [SDV.IB.BIO] Life Sciences [q-bio]/Bioengineering/Biomaterials, Myocardial infarction, MESH: Mesenchymal Stem Cells, MESH: Polysaccharides, chemistry, Rats, Inbred Lew, Mesenchymal stem cells, Biomedical engineering
Abstract: International audience; The use of mesenchymal stem cells (MSCs) for tissue regeneration is often hampered by modest engraftment in host tissue. This study was designed to quantitatively compare MSCs engraftment rates after delivery using a polysaccharide-based porous scaffold or endocardial (EC) injection in a rat myocardial infarction model. Cellular engraftment was measured by quantitative reverse transcription-polymerase chain reaction using MSCs previously transduced with a lentiviral vector that expresses green fluorescent protein (GFP). The use of a scaffold promoted local cellular engraftment and survival. The number of residual GFP(+) cells was greater with the scaffold than after EC injection (9.7% vs. 5.1% at 1 month and 16.3% vs. 6.1% at 2 months, respectively [n=5]). This concurred with a significant increase in mRNA vascular endothelial growth factor level in the scaffold group (p
Published: 2012

41. Strategies for multivessel revascularization in patients with diabetes

Author: Michael E, Farkouh, Michael, Domanski, Lynn A, Sleeper, Flora S, Siami, George, Dangas, Michael, Mack, May, Yang, David J, Cohen, Yves, Rosenberg, Scott D, Solomon, Akshay S, Desai, Bernard J, Gersh, Elizabeth A, Magnuson, Alexandra, Lansky, Robin, Boineau, Jesse, Weinberger, Krishnan, Ramanathan, J Eduardo, Sousa, Jamie, Rankin, Balram, Bhargava, John, Buse, Whady, Hueb, Craig R, Smith, Victoria, Muratov, Sameer, Bansilal, Spencer, King, Michel, Bertrand, Valentin, Fuster, Zile Sing, Meharwal, Jakob, Heinz G. (Beitragende*r), Kamler, Markus (Beitragende*r), Mount Sinai School of Medicine, Icahn School of Medicine at Mount Sinai [New York] (MSSM), Peter Munk Cardiac Centre, University of Toronto, Li Ka Shing Knowledge Institute, New England Research Institutes (NERI), Cardiovascular Research Foundation, Baylor University Medical Center, Baylor College of Medecine, St. Luke's Mid-America Heart Institute, University of Missouri [Kansas City] (UMKC), University of Missouri System-University of Missouri System, National Heart, Lung, and Blood Institute [Bethesda] (NHLBI), Cardiovascular Division, Brigham and Women's Hospital [Boston], Mayo Clinic, Yale University School of Medicine, University of British Columbia (UBC), Dante Pazzanese Hospital, University of São Paulo Medical School, Royal Perth Hospital, All India Institute of Medical Sciences, University of North Carolina [Chapel Hill] (UNC), University of North Carolina System (UNC), Heart Institute InCor, New York Presbyterian Medical Center, New York Presbyterian Hospital, St. Joseph's Hospital, Université de Lille, Centro Nacional de Investigaciones Cardiovasculares, FREEDOM Trial Investigators, and Yale School of Medicine [New Haven, Connecticut] (YSM)
Subjects: Male, medicine.medical_treatment, Medizin, Myocardial Infarction, Coronary, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Coronary artery disease, 0302 clinical medicine, MESH: Coronary Artery Disease, 030212 general & internal medicine, Myocardial infarction, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Settore MED/23 - CHIRURGIA CARDIACA, Stroke, MESH: Aged, MESH: Middle Aged, Drug-Eluting Stents, General Medicine, Middle Aged, MESH: Diabetes Complications, 3. Good health, MESH: Angioplasty, Balloon, Coronary, MESH: Myocardial Infarction, surgical procedures, operative, Cardiovascular Diseases, Cardiology, Female, revascularization, MESH: Drug-Eluting Stents, medicine.medical_specialty, Hybrid coronary revascularization, Revascularization, MESH: Stroke, Diabetes Complications, 03 medical and health sciences, Internal medicine, Angioplasty, medicine, Humans, cardiovascular diseases, MESH: Kaplan-Meier Estimate, Aged, MESH: Humans, business.industry, MESH: Coronary Artery Bypass, MESH: Cardiovascular Diseases, Percutaneous coronary intervention, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, MESH: Male, Conventional PCI, business, MESH: Female, Balloon
Abstract: International audience; BACKGROUND: In some randomized trials comparing revascularization strategies for patients with diabetes, coronary-artery bypass grafting (CABG) has had a better outcome than percutaneous coronary intervention (PCI). We sought to discover whether aggressive medical therapy and the use of drug-eluting stents could alter the revascularization approach for patients with diabetes and multivessel coronary artery disease. METHODS: In this randomized trial, we assigned patients with diabetes and multivessel coronary artery disease to undergo either PCI with drug-eluting stents or CABG. The patients were followed for a minimum of 2 years (median among survivors, 3.8 years). All patients were prescribed currently recommended medical therapies for the control of low-density lipoprotein cholesterol, systolic blood pressure, and glycated hemoglobin. The primary outcome measure was a composite of death from any cause, nonfatal myocardial infarction, or nonfatal stroke. RESULTS: From 2005 through 2010, we enrolled 1900 patients at 140 international centers. The patients' mean age was 63.1±9.1 years, 29% were women, and 83% had three-vessel disease. The primary outcome occurred more frequently in the PCI group (P=0.005), with 5-year rates of 26.6% in the PCI group and 18.7% in the CABG group. The benefit of CABG was driven by differences in rates of both myocardial infarction (P
Published: 2012

42. E4F1 dysfunction results in autophagic cell death in myeloid leukemic cells

Author: Claude Sardet, Geneviève Rodier, Elodie Hatchi, Laurent Le Cam, Institut de Génétique Moléculaire de Montpellier ( IGMM ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ), Institut de recherche en cancérologie de Montpellier ( IRCM ), Université Montpellier 1 ( UM1 ) -CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Supported by funding from the Centre National de la Recherche Scientifique, the Agence Nationale pour la Recherche, the Association pour la Lutte contre le Cancer, the INSERM Avenir program, the Leukemia Program from the Fondation de France, the British Association for International Cancer Research foundation, and la Fondation pour la Recherche Médicale., Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Institut de recherche en cancérologie de Montpellier (IRCM - U896 Inserm - UM1), CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1), Université Montpellier 1 (UM1)-CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Le Ster, Yves, and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SDV.MHEP.HEM] Life Sciences [q-bio]/Human health and pathology/Hematology, Myeloid, MESH: Leukemia, Myeloid, MESH : Reactive Oxygen Species, Mitochondrion, medicine.disease_cause, MESH : RNA, Small Interfering, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Mice, leukemic cells, 0302 clinical medicine, MESH: RNA, Small Interfering, [ SDV.MHEP.HEM ] Life Sciences [q-bio]/Human health and pathology/Hematology, MESH: Animals, RNA, Small Interfering, reactive oxygen species, 0303 health sciences, MESH : Cell Survival, MESH: Middle Aged, MESH: Reactive Oxygen Species, Myeloid leukemia, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, 3. Good health, Cell biology, mitochondria, MESH : Bacterial Infections, MESH: Myocardial Infarction, Leukemia, Cell Transformation, Neoplastic, medicine.anatomical_structure, cell death, MESH: Cell Survival, MESH: Repressor Proteins, Leukemia, Myeloid, MESH : Mouth Diseases, 030220 oncology & carcinogenesis, MESH : Leukemia, Myeloid, MESH : Repressor Proteins, Programmed cell death, autophagy, MESH: Bacterial Infections, Cell Survival, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Biology, histiocytic sarcoma, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH : Mice, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH: Cerebral Infarction, medicine, MESH: Autophagy, Animals, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH : Middle Aged, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, MESH: Mice, Molecular Biology, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology, 030304 developmental biology, MESH : Cerebral Infarction, Punctum, MESH: Humans, [ SDV.BC ] Life Sciences [q-bio]/Cellular Biology, Autophagy, MESH : Humans, MESH : Cell Transformation, Neoplastic, Cell Biology, medicine.disease, MESH : Autophagy, MESH : Disease Models, Animal, Repressor Proteins, Disease Models, Animal, E4F1, MESH: Cell Transformation, Neoplastic, Cell culture, Cancer research, MESH: Mouth Diseases, MESH : Animals, MESH: Disease Models, Animal, MESH : Myocardial Infarction, Carcinogenesis
Abstract: International audience; The multifunctional E4F1 protein was originally identified as a cellular target of the E1A adenoviral oncoprotein. Although E4F1 is implicated in several key oncogenic pathways, its roles in tumorigenesis remain unclear. Using a genetically engineered mouse model of myeloid leukemia (histiocytic sarcomas, HS) based on the genetic inactivation of the tumor suppressor Ink4a/Arf locus, we have recently unraveled an unsuspected function of E4F1 in the survival of leukemic cells. In vivo, genetic ablation of E4F1 in established myeloid tumors results in tumor regression. E4F1 inactivation results in a cascade of alterations originating from dysfunctional mitochondria that induce increased reactive oxygen species (ROS) levels and ends in massive autophagic cell death in HS transformed, but not normal myeloid cells. E4F1 depletion also induces cell death in various human myeloid leukemic cell lines, including acute myeloid leukemic (AML) cell lines. Interestingly, the E4F1 protein is overexpressed in a large proportion of human AML samples. These data provide new insights into E4F1-associated survival functions implicated in tumorigenesis and could open the path for new therapeutic strategies.
Published: 2011

43. Smoking and FOS expression from blood leukocyte transcripts in patients with coronary artery disease

Author: Julie Lorin, Sylviane Ragot, Luc Lorgis, Luc Rochette, Pierre Sicard, Anne Donzel, Catherine Vergely, Jean-Raymond Teyssier, Claude Touzery, Sebastien Saliques, Yves Cottin, Juliane Berchoud, Marianne Zeller, Laboratoire de Physiopathologie et de Pharmacologie Cardiovasculaire Expérimentale (LPPCE), Université de Bourgogne (UB), Laboratoire de génétique moléculaire (hôpital général, CHU Dijon), Hôpital général (CHU Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Cardiologie (hôpital général, CHU Dijon), This work was supported by the University Hospital of Dijon, the Association de Cardiologie de Bourgogne and by grants from the Union Régionale des Caisses d'Assurance Maladie de Bourgogne (URCAM), Agence Régionale d'Hospitalisation (ARH) et Agence Régionale de Santé (ARS) de Bourgogne, Conseil Régional de Bourgogne and Fédération Franc¸ aise de Cardiologie (FFC)., Vergely, Catherine, Laboratoire de Physiopathologie et de Pharmacologie Cardiovasculaire Expérimentale ( LPPCE ), Université de Bourgogne ( UB ), Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), and Service de Cardiologie
Subjects: Male, MESH : RNA, Messenger, MESH: Chi-Square Distribution, MESH : Leukocytes, MESH : Prospective Studies, MESH : Aged, Myocardial Infarction, Smoking Prevention, MESH: Risk Assessment, c-Fos, MESH : Coronary Angiography, 0302 clinical medicine, MESH : Genetic Markers, Prospective Studies, MESH: Coronary Artery Disease, Aged, 80 and over, 0303 health sciences, MESH: Middle Aged, Genes, fos, MESH: Smoking Cessation, 3. Good health, MESH : Smoking, MESH: Myocardial Infarction, Osteosarcoma, Smoking status, Cardiology and Cardiovascular Medicine, Genetic Markers, medicine.medical_specialty, Risk Assessment, MESH: Leukocytes, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, MESH : Middle Aged, RNA, Messenger, MESH : Coronary Artery Disease, Risk factor, MESH : Aged, 80 and over, Aged, Chi-Square Distribution, MESH: Humans, MESH : Chi-Square Distribution, MESH : Smoking Cessation, MESH : Humans, medicine.disease, MESH: Coronary Angiography, Linear Models, MESH: Female, Blood leukocyte transcriptome, MESH : Genes, fos, 030204 cardiovascular system & hematology, MESH: Genetic Markers, Bioinformatics, Coronary Angiography, Coronary artery disease, MESH: Linear Models, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, MESH : Linear Models, Leukocytes, MESH : Female, MESH : Risk Assessment, MESH: Aged, biology, Smoking, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Middle Aged, MESH : Risk Factors, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Cardiology, Female, France, medicine.symptom, Inflammation Mediators, MESH: Smoking, MESH : Male, MESH: Inflammation Mediators, Inflammation, MESH: Genes, fos, MESH: Multivariate Analysis, MESH : Inflammation Mediators, Internal medicine, medicine, In patient, MESH : France, 030304 developmental biology, MESH: RNA, Messenger, business.industry, MESH : Multivariate Analysis, MESH: Male, MESH: Prospective Studies, MESH: France, Multivariate Analysis, biology.protein, Smoking Cessation, MESH : Myocardial Infarction, business
Abstract: International audience; OBJECTIVE: Analysis of the leukocyte transriptome, in particular the Finkel-Biskis-Jinkins Osteosarcoma (c-Fos) gene, which has a prominent role in inflammation, provides new insights into atherosclerosis mechanisms. Although smoking is a major risk factor, the links between smoking status and coronary artery disease (CAD) remains unclear. We aimed to analyze the relationship between smoking status and c-Fos expression in circulating leukocytes of patients with CAD. METHODS: c-Fos expression was measured by RT-Q-PCR, from blood leukocytes of 239 consecutive patients after acute myocardial infarction (MI). The patients were asked about their smoking status and stratified into 3 groups: current smokers (CS) (N = 85), past smokers (PS) (N = 78) and never smokers (NS) (N = 76). RESULTS: NS had a higher risk profile including hypertension, and CS were younger than PS and NS (-13 years and 17 years respectively). There was only a trend towards lower CRP levels in NS and PS than in CS. The mean c-Fos transcript level was slightly higher in CS than in PS and NS (0.924 vs. 0.908 and 0.861 AU, respectively; p = 0.005). By univariate analysis, neither age, nor sex, nor CRP nor white blood cell count was associated with c-Fos transcript levels. By multivariate analysis, CS (vs. PS + NS) was the strongest predictor of the c-Fos transcript level, (B = 0.042 ± 0.014, p = 0.003), even after adjustment for confounding factors (i.e. hypertension, chronic medication, family history of CAD, and prior MI). CONCLUSION: Our work suggests that c-Fos transcript level in blood leukocyte could be considered a cumulative biomarker of smoking. As the c-Fos gene has been put forward as a new factor in the progression and severity of atherosclerosis, it could be considered a novel potential pathway of tobacco toxicity in coronary artery disease.
Published: 2011

44. Early and long-term results of unprotected left main coronary artery stenosis with paclitaxel-eluting stents: the FRIEND (French multicentre RegIstry for stenting of uNprotecteD LMCA stenosis) registry

Author: Jean Fajadet, Thierry Lefèvre, Martine Gilard, Philippe Brunel, Jean Marc Lablanche, Didier Carrié, Didier Blanchard, Alain Dibie, Olivier Darremont, René Koning, Friend Investigators, Marc Silvestri, Anouska Moynagh, Hélène Eltchaninoff, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), and Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)
Subjects: Male, Target lesion, Time Factors, MESH: Chi-Square Distribution, MESH: Registries, medicine.medical_treatment, Myocardial Infarction, MESH: Logistic Models, 030204 cardiovascular system & hematology, Coronary Angiography, MESH: Risk Assessment, Severity of Illness Index, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, MESH: Coronary Restenosis, Hospital Mortality, Prospective Studies, Registries, 030212 general & internal medicine, Angioplasty, Balloon, Coronary, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH: Middle Aged, Drug-Eluting Stents, Middle Aged, 3. Good health, Survival Rate, MESH: Angioplasty, Balloon, Coronary, MESH: Myocardial Infarction, Treatment Outcome, MESH: Survival Analysis, Female, MESH: Cerebrovascular Disorders, France, MESH: Cardiovascular Agents, Cardiology and Cardiovascular Medicine, MESH: Prosthesis Design, MESH: Drug-Eluting Stents, Adult, medicine.medical_specialty, Paclitaxel, MESH: Survival Rate, Population, Left Main Coronary Artery Stenosis, Prosthesis Design, Risk Assessment, Disease-Free Survival, Coronary Restenosis, 03 medical and health sciences, MESH: Coronary Stenosis, MESH: Severity of Illness Index, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, cardiovascular diseases, MESH: Hospital Mortality, MESH: Paclitaxel, education, Survival rate, Aged, Chi-Square Distribution, MESH: Humans, business.industry, MESH: Time Factors, Coronary Stenosis, Stent, Percutaneous coronary intervention, Cardiovascular Agents, MESH: Adult, medicine.disease, Survival Analysis, MESH: Male, MESH: Prospective Studies, MESH: Coronary Angiography, Surgery, MESH: France, Cerebrovascular Disorders, Stenosis, Logistic Models, Conventional PCI, MESH: Disease-Free Survival, business, MESH: Female
Abstract: International audience; AIMS: To evaluate the angiographic and clinical outcome of patients undergoing paclitaxel-eluting stent (PES) implantation for unprotected left main coronary artery (ULMCA) stenosis in a "real-world" multicentre, prospective registry. Percutaneous coronary intervention (PCI) is an increasingly utilised method of revascularisation in patients with ULMCA. METHODS AND RESULTS: A prospective registry including all patients with a significant (>50%) ULMCA stenosis. Of 151 such patients, the target lesion involved the distal bifurcation in 100 patients (66%), which was treated predominantly by a "provisional T-stenting" strategy. In the distal ULMCA disease group, 72% had only one stent implantation while 28% had multiple (either two or three) stents implanted. At a median follow-up of 1,123±80 days, cardiac death occurred in five patients (3.3%) and major adverse cardiac and cerebrovascular events (MACCE) in 32 patients (21.2%). The three-year survival rate was 93.3%. CONCLUSIONS: In the drug-eluting stent era, paclitaxel-eluting stent implantation of ULMCA stenosis provided excellent immediate and long-term results in this selected population, suggesting that this approach may be considered as a safe and effective alternative to CABG for selected patients with ULMCA who are treated in experienced institutions performing large numbers of PCI procedures.
Published: 2011

45. Reduction of heart failure by pharmacological inhibition or gene deletion of protein tyrosine phosphatase 1B

Author: Antoine Ouvrard-Pascaud, Magali Vercauteren, Paul Mulder, Aurélie Waget, Elodie Gomez, Vincent Richard, Rémy Burcelin, Rob Hooft van Huijsduijnen, Baptiste Kurtz, Jean-Paul Henry, Christian Thuillez, Michel L. Tremblay, Marie Besnier, Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), MSPRI [Geneva, Switzerland], Goodman Cancer Research Center [Montréal] (GCRC), McGill University = Université McGill [Montréal, Canada], Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), Brakenhielm, Ebba, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Simon, Marie Francoise, Nouvelles Cibles Pharmacologiques de la Protection Endothéliale et de l'Insuffisance Cardiaque (EnVI), CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de médecine moléculaire de Rangueil (I2MR), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), MS Project - Initiation (MSPRI), Apollo SSC Genève, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Cardiac output, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, Cardiac fibrosis, [SDV.MHEP.PHY] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine.medical_treatment, Myocardial Infarction, Gene Expression, 030204 cardiovascular system & hematology, Mice, 0302 clinical medicine, MESH: Animals, Enzyme Inhibitors, Protein Tyrosine Phosphatase, Non-Receptor Type 1, 0303 health sciences, Mice, Inbred BALB C, Ventricular Remodeling, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, MESH: Myocardial Infarction, MESH: Insulin Resistance, medicine.anatomical_structure, MESH: Enzyme Inhibitors, Echocardiography, Cardiology, cardiovascular system, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH: Nitric Oxide Synthase, Cardiology and Cardiovascular Medicine, hormones, hormone substitutes, and hormone antagonists, medicine.medical_specialty, MESH: Hemodynamics, MESH: Myocardium, MESH: Gene Expression, Endothelium, [SDV.IMM] Life Sciences [q-bio]/Immunology, MESH: Mice, Inbred BALB C, MESH: Ventricular Remodeling, 03 medical and health sciences, Insulin resistance, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH: Mice, Inbred C57BL, Internal medicine, Diabetes mellitus, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Animals, Ventricular remodeling, Molecular Biology, MESH: Mice, 030304 developmental biology, Heart Failure, business.industry, Insulin, Myocardium, Hemodynamics, medicine.disease, MESH: Male, MESH: Protein Tyrosine Phosphatase, Non-Receptor Type 1, [SDV.BIO] Life Sciences [q-bio]/Biotechnology, Mice, Inbred C57BL, Disease Models, Animal, Endocrinology, MESH: Gene Deletion, Heart failure, MESH: Heart Failure, MESH: Echocardiography, MESH: Disease Models, Animal, Insulin Resistance, Nitric Oxide Synthase, business, Gene Deletion
Abstract: International audience; Protein tyrosine phosphatase 1B (PTP1B) regulates tyrosine kinase receptor-mediated responses, and especially negatively influences insulin sensitivity, thus PTP1B inhibitors (PTP1Bi) are currently evaluated in the context of diabetes. We recently revealed another important target for PTP1Bi, consisting in endothelial protection. The present study was designed to test whether reduction of PTP1B activity may be beneficial in chronic heart failure (CHF). We evaluated the impact of either a 2 month pharmacological inhibition, or a gene deletion of PTP1B (PTP1B(-/-)) in CHF mice (2 months post-myocardial infarction). PTP1Bi and PTP1B deficiency reduced adverse LV remodeling, and improved LV function, as shown by the increased LV fractional shortening and cardiac output (measured by echocardiography), the increased LV end systolic pressure, and the decreased LV end diastolic pressure, at identical infarct sizes. This was accompanied by reduced cardiac fibrosis, myocyte hypertrophy and cardiac expression of ANP. In vitro vascular studies performed in small mesenteric artery segments showed a restored endothelial function (i.e. improved NO-dependent, flow-mediated dilatation, increased eNOS phosphorylation) after either pharmacological inhibition or gene deletion. PTP1B(-/-) CHF also displayed an improved insulin sensitivity (assessed by euglycemic-hyperinsulinemic clamp studies), when compared to wild-type CHF associated with an increased insulin mediated mesenteric artery dilation. Thus, chronic pharmacological inhibition or gene deletion of PTP1B improves cardiac dysfunction and cardiac remodeling in the absence of changes in infarct size. Thus this enzyme may be a new therapeutic target in CHF. Diabetic patients with cardiac complications may potentially benefit from PTP1B inhibition via two different mechanisms, reduced diabetic complications, and reduced heart failure.
Published: 2011

46. Improved diagnosis of post-operative myocardial infarction by contrast echocardiography after coronary artery bypass graft surgery

Author: Gaelle Kervio, Anne Bernard, Hervé Le Breton, Frédéric Schnell, Christophe Thebault, Erwan Flecher, Bernard Lelong, Alain Leguerrier, Hervé Corbineau, Erwan Donal, Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Service de cardiologie et maladies vasculaires [Rennes], Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, Time Factors, MESH: Chi-Square Distribution, Statistics as Topic, Myocardial Infarction, Contrast Media, 030204 cardiovascular system & hematology, Postoperative Complications, 0302 clinical medicine, MESH: Postoperative Complications, Troponin I, Medicine, Contrast (vision), 030212 general & internal medicine, Myocardial infarction, Coronary Artery Bypass, Post operative, Ultrasonography, media_common, MESH: Aged, Ejection fraction, General Medicine, MESH: Myocardial Infarction, medicine.anatomical_structure, Post-operative myocardial infarction, Cardiology, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Cardiology and Cardiovascular Medicine, Cardiac wall motion, Artery, medicine.medical_specialty, MESH: Hemodynamics, Contrast enhancement, Heart Ventricles, media_common.quotation_subject, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, MESH: Contrast Media, Contrast echocardiography, Humans, Radiology, Nuclear Medicine and imaging, MESH: Statistics as Topic, Aged, Chi-Square Distribution, MESH: Humans, business.industry, MESH: Coronary Artery Bypass, MESH: Time Factors, Hemodynamics, MESH: Biological Markers, medicine.disease, MESH: Male, Surgery, MESH: Heart Ventricles, business, MESH: Female, Biomarkers
Abstract: International audience; OBJECTIVE: Contrast echocardiography is a more accurate means of assessment of left ventricular (LV) regional motion compared with non-enhanced echocardiography. Despite new tests, the diagnosis of post-operative myocardial infarction (MI) remains difficult. The aim of this study was to determine whether contrast echocardiography can facilitate this diagnosis. METHODS: We performed standard and contrast echocardiography in 79 consecutive patients before and up to 10 days after they underwent isolated coronary artery bypass graft (CABG) surgery. RESULTS: The post-operative intra- and interobserver reproducibility of echocardiographic measurements of the LV ejection fraction and wall motion score was significantly higher with than without contrast enhancement. The proportion of non-visualized LV myocardial segments was significantly greater with non-enhanced (6.6%) than with contrast (0.3%) echocardiography (P< 0.0001). The mean peak serum cardiac troponin (cTnI) concentration was significantly higher in the group of patients with new wall motion abnormalities detected with contrast-enhanced echocardiography. A correlation was found (r = -0.43, P< 0.01) between peak cTnI and changes in wall motion score only when a contrast agent was used. CONCLUSION: Contrast echocardiography facilitated the detection of new LV wall motion abnormalities after CABG. This observation, added to other markers, might facilitate the diagnosis of post-operative MI.
Published: 2011

47. Inhibition of cardiac leptin expression after infarction reduces subsequent dysfunction

Author: Bela Juhasz, J. de Leiris, Stéphane Tanguy, Jean-Luc Coll, P. Calabrese, Cécile Moro, M. C. Toufektsian, François Boucher, S. Grauzam, O. Ormezzano, Arpad Tosaki, Istvan Bak, Physiologie cardio-Respiratoire Expérimentale Théorique et Appliquée (TIMC-IMAG-PRETA), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Radiopharmaceutiques biocliniques (LRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut Albert Bonniot - Ontogénèse et oncogénèse moléculaires, CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Department of Pharmacology, and University of Debrecen
Subjects: Leptin, Male, Time Factors, Interleukin-1beta, Myocardial Infarction, Infarction, 030204 cardiovascular system & hematology, Ventricular Dysfunction, Left, 0302 clinical medicine, MESH: Interleukin-1beta, MESH: Ventricular Dysfunction, Left, MESH: Animals, Myocardial infarction, Elméleti orvostudományok, left ventricular dysfunction, 0303 health sciences, MESH: Enzyme-Linked Immunosorbent Assay, Heart, MESH: DNA, Antisense, Articles, Orvostudományok, MESH: Myocardial Infarction, Echocardiography, Cardiology, Molecular Medicine, medicine.medical_specialty, MESH: Myocardium, MESH: Rats, Adipokine, Enzyme-Linked Immunosorbent Assay, Context (language use), DNA, Antisense, 03 medical and health sciences, Internal medicine, medicine, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Animals, Rats, Wistar, Autocrine signalling, 030304 developmental biology, Interleukin-6, business.industry, Myocardium, antisense oligodesoxynucleotides, MESH: Time Factors, Cell Biology, MESH: Rats, Wistar, MESH: Leptin, medicine.disease, MESH: Interleukin-6, cytokines, MESH: Male, Rats, MESH: Heart, Endocrinology, Coronary occlusion, Heart failure, reperfused myocardial infarction, MESH: Echocardiography, business
Abstract: International audience; Leptin is known to exert cardiodepressive effects and to induce left ventricular (LV) remodelling. Nevertheless, the autocrine and/or paracrine activities of this adipokine in the context of post-infarct dysfunction and remodelling have not yet been elucidated. Therefore, we have investigated the evolution of myocardial leptin expression following myocardial infarction (MI) and evaluated the consequences of specific cardiac leptin inhibition on subsequent LV dysfunction. Anaesthetized rats were subjected to temporary coronary occlusion. An antisense oligodesoxynucleotide (AS ODN) directed against leptin mRNA was injected intramyocardially along the border of the infarct 5 days after surgery. Cardiac morphometry and function were monitored by echocardiography over 11 weeks following MI. Production of myocardial leptin and pro-inflammatory cytokines interleukin (IL)-1β and IL-6 were assessed by ELISA. Our results show that (1) cardiac leptin level peaks 7 days after reperfused MI; (2) intramyocardial injection of leptin-AS ODN reduces early IL-1β and IL-6 overexpression and markedly protects contractile function. In conclusion, our findings demonstrate that cardiac leptin expression after MI could contribute to the evolution towards heart failure through autocrine and/or paracrine actions. The detrimental effect of leptin could be mediated by pro-inflammatory cytokines such as IL-1β and IL-6. Our data could constitute the basis of new therapeutic approaches aimed to improve post-MI outcome.
Published: 2011

48. Single high-dose erythropoietin administration immediately after reperfusion in patients with ST-segment elevation myocardial infarction: results of the erythropoietin in myocardial infarction trial

Author: Stéphane Delépine, Karine Warin-Fresse, Olivier Genée, Antoine Lafont, Jean-Jacques Bauchart, Fabrice Prunier, Wissam Abi-Khalil, Alain Furber, Patrice Guerin, Jacques Boschat, Bernard Charbonnier, Martine Gilard, Loïc Bière, Frédéric Mouquet, Thomas Benard, Eric Durand, Luc Christiaens, Optimisation des régulations physiologiques (ORPHY (EA 4324)), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Interface sang vaisseaux et réparation cardiovasculaire, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Soins Intensifs et Urgences Cardiologiques, Centre Hospitalier Universitaire d'Angers (CHU Angers), and PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)
Subjects: Male, Time Factors, Myocardial Infarction, 030204 cardiovascular system & hematology, Coronary Angiography, MESH: Dose-Response Relationship, Drug, law.invention, MESH: Recombinant Proteins, Electrocardiography, 0302 clinical medicine, Randomized controlled trial, law, MESH: Myocardial Reperfusion, Clinical endpoint, Medicine, ST segment, MESH: Double-Blind Method, Myocardial infarction, Prospective Studies, Prospective cohort study, MESH: Treatment Outcome, 0303 health sciences, MESH: Middle Aged, medicine.diagnostic_test, MESH: Follow-Up Studies, MESH: Magnetic Resonance Imaging, Cine, Middle Aged, Recombinant Proteins, 3. Good health, MESH: Myocardial Infarction, Treatment Outcome, Anesthesia, Injections, Intravenous, Female, Cardiology and Cardiovascular Medicine, medicine.drug, Magnetic Resonance Imaging, Cine, Myocardial Reperfusion, MESH: Postoperative Care, 03 medical and health sciences, Double-Blind Method, [SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Humans, MESH: Erythropoietin, cardiovascular diseases, Erythropoietin, 030304 developmental biology, Postoperative Care, MESH: Humans, Dose-Response Relationship, Drug, business.industry, MESH: Time Factors, medicine.disease, MESH: Injections, Intravenous, MESH: Coronary Angiography, MESH: Male, MESH: Prospective Studies, MESH: Electrocardiography, Myocardial infarction diagnosis, business, MESH: Female, Follow-Up Studies
Abstract: International audience; BACKGROUND: Preclinical studies and pilot clinical trials have shown that high-dose erythropoietin (EPO) reduces infarct size in acute myocardial infarction. We investigated whether a single high-dose of EPO administered immediately after reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) would limit infarct size. METHODS: A total of 110 patients undergoing successful primary coronary intervention for a first STEMI was randomized to receive standard care either alone (n = 57) or combined with intravenous administration of 1,000 U/kg of epoetin β immediately after reperfusion (n = 53). The primary end point was infarct size assessed by gadolinium-enhanced cardiac magnetic resonance after 3 months. Secondary end points included left ventricular (LV) volume and function at 5-day and 3-month follow-up, incidence of microvascular obstruction (MVO), and safety. RESULTS: Erythropoietin significantly decreased the incidence of MVO (43.4% vs 65.3% in the control group, P = .03) and reduced LV volume, mass, and function impairment at 5-day follow-up (all P < .05). After 3 months, median infarct size (interquartile range) was 17.5 g (7.6-26.1 g) in the EPO group and 16.0 g (9.4-28.2 g) in the control group (P = .64); LV mass, volume, and function were not significantly different between the 2 groups. The same number of major adverse cardiac events occurred in both groups. CONCLUSIONS: Single high-dose EPO administered immediately after successful reperfusion in patients with STEMI did not reduce infarct size at 3-month follow-up. However, this regimen decreased the incidence of MVO and was associated with transient favorable effects on LV volume and function.
Published: 2011

49. Intracoronary autologous mononucleated bone marrow cell infusion for acute myocardial infarction: results of the randomized multicenter BONAMI trial

Author: Emmanuel Teiger, Bernard Klein, Frédéric Mouquet, Jerome Roncalli, Guillaume Lamirault, Alain Manrique, Philippe Bourin, Yannick Neuder, Christophe Piot, Jean-Michel Nguyen, Michel Galinier, Eric Van Belle, Philippe Le Corvoisier, Marie-Jeanne Richard, Gérald Vanzetto, Dominique Crochet, Virginia Gaxotte, Sophie Susen, Anne-Sophie Polge, Hélène Rouard, Jean-Paul Beregi, Didier Carrié, Pierre Croisille, Béatrice Delasalle, Denis Agostini, Patricia Lemarchand, Thierry Le Tourneau, Angelo Parini, Jean-Noël Trochu, Catherine Sportouch, Fédération de Cardiologie, CHU Toulouse [Toulouse], Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Interface sang vaisseaux et réparation cardiovasculaire, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut de recherche en biothérapie (IRB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CIC - CHU Henri Mondor, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Radiopharmaceutiques biocliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe coeur et ischémie, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Therapies Interventionnelles Assistees Par l'Image et la Simulation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), GIP Cyceron (Cyceron), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Pôle de Pathologie cardiologie-vasculaire, Institut d'Hématologie-Transfusion-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Thérapie Cellulaire [Grenoble], CHU Grenoble-EFS, Laboratoire de thérapie cellulaire (EFS), Etablissement Français du Sang, PIMESP, Université de Nantes (UN), PHRC national, AFM (téléthon), Fondation de France, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Therapies Interventionnelles Assistees Par l'Image et la Simulation - U 703 (Thiais), Fédération de Cardiologie [CHU Toulouse], Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Lemarchand, Patricia, Université de Toulouse (UT)-Université de Toulouse (UT)- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Infarction, MESH: Magnetic Resonance Angiography, 030204 cardiovascular system & hematology, Coronary Angiography, MESH: Stroke Volume, law.invention, Ventricular Dysfunction, Left, 0302 clinical medicine, Randomized controlled trial, law, MESH: Ventricular Dysfunction, Left, Clinical endpoint, Medicine, MESH: Coronary Vessels, Myocardial infarction, MESH: Bone Marrow Transplantation, Bone Marrow Transplantation, MESH: Treatment Outcome, MESH: Aged, 0303 health sciences, Ejection fraction, MESH: Middle Aged, medicine.diagnostic_test, Smoking, Middle Aged, Coronary Vessels, MESH: Transplantation, Autologous, 3. Good health, MESH: Leukocytes, Mononuclear, MESH: Myocardial Infarction, Treatment Outcome, MESH: Young Adult, Cardiology, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Adolescent, Cells, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Transplantation, Autologous, Article, MESH: Tomography, Emission-Computed, Single-Photon, Young Adult, 03 medical and health sciences, Radionuclide angiography, Reperfusion therapy, Internal medicine, Humans, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Aged, 030304 developmental biology, Tomography, Emission-Computed, Single-Photon, MESH: Adolescent, MESH: Humans, business.industry, Stroke Volume, MESH: Adult, medicine.disease, MESH: Male, MESH: Coronary Angiography, Transplantation, Leukocytes, Mononuclear, business, MESH: Female, Magnetic Resonance Angiography
Abstract: International audience; AIMS: Intracoronary administration of autologous bone marrow cells (BMCs) leads to a modest improvement in cardiac function, but the effect on myocardial viability is unknown. The aim of this randomized multicentre study was to evaluate the effect of BMC therapy on myocardial viability in patients with decreased left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI) and to identify predictive factors for improvement of myocardial viability. METHODS AND RESULTS: One hundred and one patients with AMI and successful reperfusion, LVEF ≤45%, and decreased myocardial viability (resting Tl201-SPECT) were randomized to either a control group (n = 49) or a BMC group (n = 52). Primary endpoint was improvement of myocardial viability 3 months after AMI. Baseline mean LVEF measured by radionuclide angiography was 36.3 ± 6.9%. Bone marrow cell infusion was performed 9.3 ± 1.7 days after AMI. Myocardial viability improved in 16/47 (34%) patients in the BMC group compared with 7/43 (16%) in the control group (P = 0.06). The number of non-viable segments becoming viable was 0.8 ± 1.1 in the control group and 1.2 ± 1.5 in the BMC group (P = 0.13). Multivariate analysis including major post-AMI prognostic factors showed a significant improvement of myocardial viability in BMC vs. control group (P = 0.03). Moreover, a significant adverse role for active smoking (P = 0.04) and a positive trend for microvascular obstruction (P = 0.07) were observed. CONCLUSION: Intracoronary autologous BMC administration to patients with decreased LVEF after AMI was associated with improvement of myocardial viability in multivariate-but not in univariate-analysis. A large multicentre international trial is warranted to further document the efficacy of cardiac cell therapy and better define a group of patients that will benefit from this therapy. Clinical Trial Registration Information: URL: http://www.clinicaltrials.gov. Unique identifier NCT00200707.
Published: 2011

50. Quality of care for myocardial infarction at academic and nonacademic hospitals

Author: Didier Vilarem, Elodie Drouet, Michel Hanssen, Nicolas Danchin, José Labarère, Tabassome Simon, Jean Ferrières, Loic Belle, Jean-Jacques Dujardin, Magali Fourny, Geneviève Mulak, Philippe Bonnet, BCM, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), IT University of Copenhagen, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de cardiologie [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, and Normandie Université (NU)
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, Myocardial Infarction, Myocardial Reperfusion, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, medicine, MESH: Myocardial Reperfusion, Survival advantage, Humans, 030212 general & internal medicine, Myocardial infarction, MESH: Quality of Health Care, Quality of care, Prospective cohort study, Intensive care medicine, MESH: Cohort Studies, MESH: Teaching, MESH: Academic Medical Centers, Aged, Quality of Health Care, MESH: Aged, Academic Medical Centers, MESH: Humans, MESH: Middle Aged, business.industry, Teaching, Percutaneous coronary intervention, General Medicine, Process of care, Middle Aged, medicine.disease, MESH: Hospitals, Confidence interval, Frequent use, MESH: Male, Hospitals, 3. Good health, MESH: France, MESH: Myocardial Infarction, Emergency medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, business, MESH: Female
Abstract: International audience; BACKGROUND: Whether academic hospitals provide better quality of care for patients with acute myocardial infarction is widely debated. The aim of this study was to compare processes of care and mortality between academic and nonacademic hospitals in the contemporary era of acute myocardial infarction management. METHODS: We analyzed the original data from a prospective cohort study of 3059 patients, including 1714 with ST-segment elevation and 1345 with non-ST-segment elevation myocardial infarction, enrolled at 39 and 183 academic and nonacademic hospitals, respectively, in France. RESULTS: Unadjusted 1-year mortality for academic and nonacademic hospitals was 10% versus 15% for patients with ST-segment elevation myocardial infarction (P=.01) and 13% versus 14% for patients with non-ST-segment elevation myocardial infarction (P=.75). Patients treated in academic or nonacademic hospitals with percutaneous coronary intervention capability were more likely to receive reperfusion and recommended drug therapies than those treated in nonacademic hospitals without percutaneous coronary intervention capability. After adjusting for baseline characteristics, the hazards of death associated with admission to nonacademic hospitals with and without percutaneous coronary intervention capability relative to academic hospitals were 1.13 (95% confidence interval [CI], 0.79-1.62) and 1.65 (95% CI, 1.09-2.49) for those with ST-segment elevation myocardial infarction and 0.95 (95% CI, 0.66-1.36) and 1.06 (95% CI, 0.72-1.58) for those with non-ST-segment elevation myocardial infarction, respectively. Further adjustment for receipt of acute reperfusion and recommended drug therapies eliminated all differences in mortality between the study groups. CONCLUSION: Admission to academic hospitals was associated with a more frequent use of recommended therapies, conveying a survival advantage for patients with ST-segment elevation myocardial infarction.
Published: 2011

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