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  1. Article ; Online: Use of ADAM-C and CHA2DS2-VASc scores to predict complex aortic atheroma after brain ischemia: A prospective observational study.

    Nicot, Florence / Charbonnel, Clément / Jego, Christophe / Jourda, François / Vinsonneau, Ulric / Garçon, Philippe / Turlotte, Guillaume / Rivière, Jean François / Maurin, Marion / Lubret, Rémy / Meimoun, Patrick / Akret, Chrystelle / Cournot, Maxime / Sokic, Charles / Michel, Laurent / Lescure, Maryse / Kenizou, David / Melay, Marie / Fayard, Maxime /
    Chauvat, Anthony / Fouché, Renaud / Cartigny, Guillaume / Dijoux, Nicolas / Martin, Anne Céline / Tho-Agostini, Aurélia / Mann, Hubert / Magnin, Dominique / Goralski, Marc / Pico, Fernando / Georges, Jean-Louis / Belle, Loïc

    Echocardiography (Mount Kisco, N.Y.)

    2021  Volume 38, Issue 4, Page(s) 612–622

    Abstract: Background and aims: Complex aortic atheroma (CAA) is a common cause of acute brain ischemia (BI), including ischemic stroke (IS) and transient ischemic attack (TIA), and is associated with recurrence. The CHA2DS2-VASc score is a useful tool for ... ...

    Abstract Background and aims: Complex aortic atheroma (CAA) is a common cause of acute brain ischemia (BI), including ischemic stroke (IS) and transient ischemic attack (TIA), and is associated with recurrence. The CHA2DS2-VASc score is a useful tool for predicting stroke in patients with atrial fibrillation (AF), and can also predict cardiovascular events in other populations, including non-AF populations. The ADAM-C score is a new risk score for predicting the diagnostic yield of transesophageal echocardiography (TEE) after BI. We aimed to evaluate the ability of CHA2DS2-VASc and ADAM-C scores to predict CAA after BI.
    Methods: This prospective, multicenter, observational study included 1479 patients aged over 18 years who were hospitalized for BI. CAA was defined as the presence of one or more of the following criteria: thrombus, ulcerated plaque, or plaque thickening ≥ 4 mm.
    Results: CAA was diagnosed in 216 patients (14.6%). CHA2DS2-VASc and ADAM-C scores were significantly higher in the CAA group versus the non-CAA group (P < .0001 for both). The CHA2DS2-VASc and ADAM-C scores appear to be good predictors of CAA (AUC 0.699 [0.635, 0.761] and 0.759 [0.702, 0.814], respectively). The sensitivity, specificity, predictive positive value (PPV), and negative predictive value (NPV) of the scores for detecting CAA were 94%, 22%, 17%, and 96%, respectively, for a CHA2DS2-VASc score < 2, and 90%, 46%, 22%, and 96%, respectively, for an ADAM-C score < 3 CONCLUSIONS: CHA2DS2-VASc and ADAM-C scores are able to predict CAA after BI. CHA2DS2-VASc < 2 and ADAM-C < 3 both have an interesting NPV of 96%.
    Language English
    Publishing date 2021-03-25
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/echo.15034
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  2. Article ; Online: ADAM-C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia.

    Charbonnel, Clément / Jego, Christophe / Jourda, François / Vinsonneau, Ulric / Garçon, Philippe / Turlotte, Guillaume / Rivière, Jean François / Maurin, Marion / Lubret, Rémy / Meimoun, Patrick / Akret, Chrystelle / Cournot, Maxime / Sokic, Charles / Michel, Laurent / Lescure, Maryse / Kenizou, David / Melay, Marie / Fayard, Maxime / Gallet, Bruno /
    Fouche, Rémi / Janin-Manificat, Luc / Dijoux, Nicolas / Martin, Anne Céline / Tho-Agostini, Aurélia / Mann, Hubert / Ricard, Cécile / Pico, Fernando / Georges, Jean Louis / Belle, Loïc / Jourdain, Patrick

    Echocardiography (Mount Kisco, N.Y.)

    2018  Volume 35, Issue 8, Page(s) 1171–1182

    Abstract: Background and aim: The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which ... ...

    Abstract Background and aim: The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE.
    Methods: This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI. TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model.
    Results: Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE. Accordingly, the ADAM-C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi-territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of detecting discriminant TEE were 88% (95% CI 85-90), 44% (95% CI 41-47), 21% (95% CI 19-27), and 95% (95% CI 94-97), respectively.
    Conclusion: A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE. Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94-97).
    MeSH term(s) Aged ; Brain Ischemia/complications ; Echocardiography, Transesophageal/methods ; Female ; Follow-Up Studies ; Heart Diseases/complications ; Heart Diseases/diagnosis ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Risk Factors ; Thrombosis/complications ; Thrombosis/diagnosis
    Language English
    Publishing date 2018-05-14
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/echo.14010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2170: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)
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  3. Article ; Online: Clinical predictors of successful thrombectomy with the Export® aspiration catheter in the acute phase of myocardial infarction. Data from the RICO survey working group.

    Lorgis, Luc / Fayard, Maxime / Dentan, Gilles / Richard, Carole / Buffet, Philippe / L'Huillier, Isabelle / Mock, Laurent / Ravisy, Jack / Zeller, Marianne / Cottin, Yves

    Archives of cardiovascular diseases

    2010  Volume 103, Issue 10, Page(s) 522–529

    Abstract: Background: Thrombus aspiration is applicable in a large majority of patients with acute myocardial infarction (AMI) and results in better reperfusion and clinical outcomes compared with percutaneous coronary intervention alone. Some aspiration ... ...

    Abstract Background: Thrombus aspiration is applicable in a large majority of patients with acute myocardial infarction (AMI) and results in better reperfusion and clinical outcomes compared with percutaneous coronary intervention alone. Some aspiration procedures are, however, ineffective. To date, few clinical data are available on the predictors of successful thrombectomy in the acute phase of myocardial infarction.
    Aims: To determine the baseline clinical and angiographic characteristics associated with successful thrombectomy.
    Methods: Consecutive patients with ST elevation myocardial infarction with a baseline TIMI flow of 0 or 1, who underwent thrombus aspiration and primary or rescue angioplasty, were included. The main criterion for evaluation was an effective or ineffective aspiration defined, respectively, by the presence or absence of atherothrombotic material in the aspirate samples.
    Results: Among the 180 patients included, material was collected in 155 patients (86%). Patients with the presence of material were younger (61 vs 74 years, P=0.015), less frequently hypertensive (41% vs 68%, P=0.023) and had a lower systolic blood pressure at admission (135 vs 148 mmHg, P=0.031). No difference was observed between the two groups for angiographic parameters except for visible thrombus (61% vs 28%, P=0.005) and calcification (37% vs 60%, P=0.048). In multivariable analysis, the ability to remove the clot was affected by: age greater than 70 years (odds ratio 0.18, 95% confidence interval 0.06-0.51; P=0.001), admission systolic blood pressure (0.97, 0.95-0.99; P=0.003) and thrombus seen on angiography (4.54, 1.54-13.45, P=0.006).
    Conclusion: The present study showed that manual thrombus aspiration is effective in most, but not all, patients. Further studies are needed to develop more efficient aspiration techniques and other aspiration devices to improve the results of such procedures.
    MeSH term(s) Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Catheters ; Chi-Square Distribution ; Coronary Angiography ; Coronary Thrombosis/complications ; Coronary Thrombosis/diagnostic imaging ; Coronary Thrombosis/therapy ; Equipment Design ; Female ; Health Care Surveys ; Humans ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/etiology ; Myocardial Infarction/therapy ; Odds Ratio ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Suction ; Thrombectomy/adverse effects ; Thrombectomy/instrumentation ; Treatment Outcome
    Language English
    Publishing date 2010-10
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2010.10.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ui IV Zs 8: Show issues Location:
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