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  1. Artikel ; Online: Phenotypic clustering of patients hospitalized in intensive cardiac care units: Insights from the ADDICT-ICCU study.

    Hamzi, Kenza / Gall, Emmanuel / Roubille, François / Trimaille, Antonin / Elbaz, Meyer / El Ouahidi, Amine / Noirclerc, Nathalie / Fard, Damien / Lattuca, Benoit / Fauvel, Charles / Goralski, Marc / Alvain, Sean / Chaib, Aures / Piliero, Nicolas / Schurtz, Guillaume / Pommier, Thibaut / Bouleti, Claire / Tron, Christophe / Bonnet, Guillaume /
    Nhan, Pascal / Auvray, Simon / Léquipar, Antoine / Dillinger, Jean-Guillaume / Vicaut, Eric / Henry, Patrick / Toupin, Solenn / Pezel, Théo

    Archives of cardiovascular diseases

    2024  

    Abstract: Background: Intensive cardiac care units (ICCUs) were created to manage ventricular arrhythmias after acute coronary syndromes, but have diversified to include a more heterogeneous population, the characteristics of which are not well depicted by ... ...

    Abstract Background: Intensive cardiac care units (ICCUs) were created to manage ventricular arrhythmias after acute coronary syndromes, but have diversified to include a more heterogeneous population, the characteristics of which are not well depicted by conventional methods.
    Aims: To identify ICCU patient subgroups by phenotypic unsupervised clustering integrating clinical, biological, and echocardiographic data to reveal pathophysiological differences.
    Methods: During 7-22 April 2021, we recruited all consecutive patients admitted to ICCUs in 39 centers. The primary outcome was in-hospital major adverse events (MAEs; death, resuscitated cardiac arrest or cardiogenic shock). A cluster analysis was performed using a Kamila algorithm.
    Results: Of 1499 patients admitted to the ICCU (69.6% male, mean age 63.3±14.9 years), 67 (4.5%) experienced MAEs. Four phenogroups were identified: PG1 (n=535), typically patients with non-ST-segment elevation myocardial infarction; PG2 (n=444), younger smokers with ST-segment elevation myocardial infarction; PG3 (n=273), elderly patients with heart failure with preserved ejection fraction and conduction disturbances; PG4 (n=247), patients with acute heart failure with reduced ejection fraction. Compared to PG1, multivariable analysis revealed a higher risk of MAEs in PG2 (odds ratio [OR] 3.13, 95% confidence interval [CI] 1.16-10.0) and PG3 (OR 3.16, 95% CI 1.02-10.8), with the highest risk in PG4 (OR 20.5, 95% CI 8.7-60.8) (all P<0.05).
    Conclusions: Cluster analysis of clinical, biological, and echocardiographic variables identified four phenogroups of patients admitted to the ICCU that were associated with distinct prognostic profiles.
    Trial registration: ClinicalTrials.gov identifier: NCT05063097.
    Sprache Englisch
    Erscheinungsdatum 2024-05-23
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ZDB-ID 2408778-6
    ISSN 1875-2128 ; 1875-2136
    ISSN (online) 1875-2128
    ISSN 1875-2136
    DOI 10.1016/j.acvd.2024.03.004
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: The IC-D score for predicting prophylactic cardioverter-defibrillator implantation following acute myocardial infarction.

    Clementy, Nicolas / Bensaid, Reda / Bouteau, Jérémie / Fedida, Joël / Kiavue, Yoann / Socie, Pierre / Ackermann, Romain / Goralski, Marc / Fauchier, Laurent / Bernard, Anne / Angoulvant, Denis / Babuty, Dominique

    Pacing and clinical electrophysiology : PACE

    2021  Band 44, Heft 6, Seite(n) 973–979

    Abstract: Background: A reduced left ventricular ejection fraction (LVEF) ≤35% ≥6 weeks following an acute myocardial infarction (MI) may indicate prophylactic implantation of a cardioverter-defibrillator (ICD). We sought to find predictors of absence of ... ...

    Abstract Background: A reduced left ventricular ejection fraction (LVEF) ≤35% ≥6 weeks following an acute myocardial infarction (MI) may indicate prophylactic implantation of a cardioverter-defibrillator (ICD). We sought to find predictors of absence of significant left ventricular (LV) remodeling post-MI.
    Methods: All consecutive patients hospitalized for acute MI with an LVEF ≤35% at discharge in our institution from 2010 were retrospectively included. Patients were assigned to two groups according to the persistence of an LVEF ≤35% (ICD+) or a recovery >35% (ICD-). Logistic regression was performed to build a predictive score, which was then externally validated.
    Results: Among a total of 1533 consecutive MI patients, 150 met inclusion criteria, 53 (35%) in the ICD+ group and 97 in the ICD group. After multivariable analyses, an LVEF ≤25% at discharge (adjusted OR 6.23 [2.47 to 17.0], p < .0001) and a CPK peak at the MI acute phase >4600 UI/L (adjusted OR 9.99 [4.27 to 25.3], p < .0001) both independently predicted non-recovery at 6 weeks. The IC-D (Increased Cpk-LV Dysfunction) score predicted persistent LVEF ≤35% with areas under curve of 0.83 and 0.73, in the study population and in a multicenter validation cohort of 150 patients, respectively (p < .0001).
    Conclusions: The association of a severely reduced LVEF and a major release of myocardial necrosis biomarkers at the acute phase of MI predict unfavorable remodeling, and prophylactic ICD implantation.
    Mesh-Begriff(e) Aged ; Anticoagulants/therapeutic use ; Biomarkers/blood ; Defibrillators, Implantable ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; ST Elevation Myocardial Infarction/physiopathology ; ST Elevation Myocardial Infarction/prevention & control ; Stroke Volume
    Chemische Substanzen Anticoagulants ; Biomarkers
    Sprache Englisch
    Erscheinungsdatum 2021-04-24
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1111/pace.14244
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Prevalence and impact of recreational drug use in patients with acute cardiovascular events.

    Pezel, Théo / Dillinger, Jean-Guillaume / Trimaille, Antonin / Delmas, Clément / Piliero, Nicolas / Bouleti, Claire / Pommier, Thibaut / El Ouahidi, Amine / Andrieu, Stéphane / Lattuca, Benoit / Rossanaly Vasram, Reza / Fard, Damien / Noirclerc, Nathalie / Bonnet, Guillaume / Goralski, Marc / Elbaz, Meyer / Deney, Antoine / Schurtz, Guillaume / Docq, Clemence /
    Roubille, Francois / Fauvel, Charles / Bochaton, Thomas / Aboyans, Victor / Boccara, Franck / Puymirat, Etienne / Batisse, Anne / Steg, Gabriel / Vicaut, Eric / Henry, Patrick

    Heart (British Cardiac Society)

    2023  Band 109, Heft 21, Seite(n) 1608–1616

    Abstract: Objective: While recreational drug use is a risk factor for cardiovascular events, its exact prevalence and prognostic impact in patients admitted for these events are not established. We aimed to assess the prevalence of recreational drug use and its ... ...

    Abstract Objective: While recreational drug use is a risk factor for cardiovascular events, its exact prevalence and prognostic impact in patients admitted for these events are not established. We aimed to assess the prevalence of recreational drug use and its association with in-hospital major adverse events (MAEs) in patients admitted to intensive cardiac care units (ICCU).
    Methods: In the Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study, systematic screening for recreational drugs was performed by prospective urinary testing all patients admitted to ICCU in 39 French centres from 7 to 22 April 2021. The primary outcome was prevalence of recreational drug detection. In-hospital MAEs were defined by death, resuscitated cardiac arrest, or haemodynamic shock.
    Results: Of 1499 consecutive patients (63±15 years, 70% male), 161 (11%) had a positive test for recreational drugs (cannabis 9.1%, opioids 2.1%, cocaine 1.7%, amphetamines 0.7%, 3,4-methylenedioxymethamphetamine (MDMA) 0.6%). Only 57% of these patients declared recreational drug use. Patients who used recreational drugs exhibited a higher MAE rate than others (13% vs 3%, respectively, p<0.001). Recreational drugs were associated with a higher rate of in-hospital MAEs after adjustment for comorbidities (OR 8.84, 95% CI 4.68 to 16.7, p<0.001). After adjustment, cannabis, cocaine, and MDMA, assessed separately, were independently associated with in-hospital MAEs. Multiple drug detection was frequent (28% of positive patients) and associated with an even higher incidence of MAEs (OR 12.7, 95% CI 4.80 to 35.6, p<0.001).
    Conclusion: The prevalence of recreational drug use in patients hospitalised in ICCU was 11%. Recreational drug detection was independently associated with worse in-hospital outcomes.
    Clinical trial registration: NCT05063097.
    Sprache Englisch
    Erscheinungsdatum 2023-10-12
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 1303417-0
    ISSN 1468-201X ; 1355-6037
    ISSN (online) 1468-201X
    ISSN 1355-6037
    DOI 10.1136/heartjnl-2023-322520
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Wearable cardioverter-defibrillator in patients with a transient risk of sudden cardiac death: the WEARIT-France cohort study.

    Garcia, Rodrigue / Combes, Nicolas / Defaye, Pascal / Narayanan, Kumar / Guedon-Moreau, Laurence / Boveda, Serge / Blangy, Hugues / Bouet, Jérôme / Briand, Florent / Chevalier, Philippe / Cottin, Yves / Da Costa, Antoine / Degand, Bruno / Deharo, Jean-Claude / Eschalier, Romain / Extramiana, Fabrice / Goralski, Marc / Guy-Moyat, Benoit / Guyomar, Yves /
    Hermida, Jean-Sylvain / Jourda, François / Lellouche, Nicolas / Mahfoud, Mohanad / Manenti, Vladimir / Mansourati, Jacques / Martin, Angéline / Pasquié, Jean-Luc / Ritter, Philippe / Rollin, Anne / Tibi, Thierry / Yalioua, Arab / Gras, Daniel / Sadoul, Nicolas / Piot, Olivier / Leclercq, Christophe / Marijon, Eloi

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2021  Band 23, Heft 1, Seite(n) 73–81

    Abstract: Aims: We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability.: Methods and results: Across 88 French centres, the WEARIT- ... ...

    Abstract Aims: We aimed to provide contemporary real-world data on wearable cardioverter-defibrillator (WCD) use, not only in terms of effectiveness and safety but also compliance and acceptability.
    Methods and results: Across 88 French centres, the WEARIT-France study enrolled retrospectively patients who used the WCD between May 2014 and December 2016, and prospectively all patients equipped for WCD therapy between January 2017 and March 2018. All patients received systematic education session through a standardized programme across France at the time of initiation of WCD therapy and were systematically enrolled in the LifeVest Network remote services. Overall, 1157 patients were included (mean age 60 ± 12 years, 16% women; 46% prospectively): 82.1% with ischaemic cardiomyopathy, 10.3% after implantable cardioverter-defibrillator explant, and 7.6% before heart transplantation. Median WCD usage period was 62 (37-97) days. Median daily wear time of WCD was 23.4 (22.2-23.8) h. In multivariate analysis, younger age was associated with lower compliance [adjusted odds ratio (OR) 0.97, 95% confidence interval (CI) 0.95-0.99, P < 0.01]. A total of 18 participants (1.6%) received at least one appropriate shock, giving an incidence of appropriate therapy of 7.2 per 100 patient-years. Patient-response button allowed the shock to be aborted in 35.7% of well-tolerated sustained ventricular arrhythmias and in 95.4% of inappropriate ventricular arrhythmia detection, finally resulting in an inappropriate therapy in eight patients (0.7%).
    Conclusion: Our real-life findings reinforce previous studies on the efficacy and safety of the WCD in the setting of transient high-risk group in selected patients. Moreover, they emphasize the fact that when prescribed appropriately, in concert with adequate patient education and dedicated follow-up using specific remote monitoring system, compliance with WCD is high and the device well-tolerated by the patient.
    Mesh-Begriff(e) Aged ; Cohort Studies ; Death, Sudden, Cardiac/epidemiology ; Death, Sudden, Cardiac/prevention & control ; Defibrillators ; Defibrillators, Implantable ; Electric Countershock ; Female ; France/epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Wearable Electronic Devices
    Sprache Englisch
    Erscheinungsdatum 2021-01-19
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euaa268
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; 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  Band 38, Heft 4, Seite(n) 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%.
    Sprache Englisch
    Erscheinungsdatum 2021-03-25
    Erscheinungsland United States
    Dokumenttyp 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
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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