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3. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E, Mauri, L, OʼNeill, W, Serruys, P W, Steg, PhG, Wijns, W, Verheugt, FWA, Bertrand, ME, Califf, R, DeMets, D, Wallentin, L, Bocksch, W, Bosmans, J, Garcia, H, Garg, S, Hanet, C, Herrman, J-PR, Kelbaek, H, Mc Fadden, E, Radke, PW, Rutsch, W, Tilsted, HH, Wykrzykowska, J, Alvarez, C, Rodriguez, A, Meredith, I, Muller, D, Whitbourn, R, Worthley, S, Whelan, A, Walters, D, Shetty, S, New, G, Cox, S, Batra, R, van Gaal, W, Bellamy, G, Mayr, H, Heigert, M, Huber, K, Leisch, F, Wijns, W, Desmet, W, Boland, J, Schroeder, E, Chenu, P, Legrand, V, Labinaz, M, Teefy, P, Bertrand, O, Gao, R, Ge, J, Kala, P, Cervinka, P, Ureña, P, Hartikainen, J, Steg, G, Fajadet, J, Carrie, D, Gilard, M, Barragan, P, Lablanche, J-M, Koning, R, Eltchaninoff, H, Darremont, O, Leroy, F, Bertrand, B, Robert, G, Schiele, F, Chassaing, S, Bressollette, E, Brunel, P, Quilliet, L, Brunet, J, Pansieri, M, Sideris, G, Stratiev, V, Teiger, E, Lebreton, H, Bonnet, J-L, Karsenty, B, Delarche, N, Lusson, J-R, Cassagnes, J, Brachmann, J, Kurowski, V, Buerke, M, Schieffer, B, Scholtz, W, Wiemer, M, Fichtlscherer, S, Schächinger, V, Kupatt, C, Boekstegers, P, Genth-Zotz, S, Bode, C, Frey, N, Neumann, F-J, Witzenbichler, B, Pels, K, Strasser, R, Kuck, K-H, Hauptmann, K-E, Baldus, S, Heitzer, T, Haude, M, Hoffmann, E, Jung, W, Hoffmann, S, Schmitt, C, Dissmann, M, Pauschinger, M, Werner, G, Braun-Delleus, R, Burkhardt, D, Manz, M, Voudris, V, Sionis, D, Kang-Yin, M-L, Tse, T-S, Merkely, B, Mehta, A, Parikh, K, Kumar, V, Chandra, P, Rath, P, Hiremath, S, Crean, P, Daly, K, Kornowski, R, Kerner, A, Mosseri, M, Jafari, G, Giudice, P, Trani, C, Manari, A, Prati, F, Pangrazi, A, Bolognese, L, Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A, Kalnins, A, Wagner, D, Zambahari, R, Ong, T-K, Sim, K, den Heijer, P, Appelman, Y, Suttorp, M-J, de Smet, B, Koolen, J, Stella, P, Harding, S, Warwick, J, Maslowski, A, Abernethy, M, Devlin, G, Rotevatn, S, Myreng, Y, Ciecwierz, D, Peruga, J, Reczuch, K, Campante Teles, R, Farto, P, Abreu, E, Leitão-Marques, A, Pereira, H, Vinereanu, D, Alkasab, S, Mhish, H, Al Kurdi, M, Al Turki, F, Wong, P, Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M, Bethencourt Gonzalez, A, Iñiguez Romo, A, López Minguez, J, Hernández García, J-M, Diaz Fernández, J, Ruiz Salmeron, R, Martinez Elbal, L, Zueco, J, López-Palop, RF, Melgares, R, Diderholm, E, Kåregren, A, Herterich, O, Olivencrona, G, Fröbert, O, Roffi, M, Verin, V, Girod, G, Vuilliomenet, A, Hsieh, I-C, Wu, C-J, Gershlick, A, Densem, C, Doshi, S, Manoharan, G, McCarthy, P, De Belder, M, Mills, J, Fath-Ordoubadi, F, Simpson, I, Greenwood, J, Chamberlain-Webber, R, Khan, Z, Cotton, J, Gunning, M, Smith, D, Talwar, S, Holmberg, S, Purcell, I, Anderson, R, Alamgir, F, Beatt, K, Kelly, P, Moussavian, M, Aji, J, Prashad, R, Zankar, A, Banerjee, S, Lewis, S, McLaurin, B, Douglas, J, Brener, S, Gupta, A, Walters, L, Driesman, M, Aycock, R, Mego, C, Fisher, D, Frankel, R, and Satler, L

Published
2014
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5. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., and Satler, L.

Subjects
animal structures, cardiovascular diseases, equipment and supplies
Abstract

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

Published
2017

8. Intravenous NPA for the treatment of infarcting myocardium early; InTIME-II, a double-blind comparison of single-bolus lanoteplase vs accelerated alteplase for the treatment of patients with acute myocardial infarction

Author

Braunwald, E., Neuhaus, K. -L., Antman, E., Chew, P., Skene, A., Wilcox, R., Ambrosioni, E., Anderson, J., Apetrei, E., Bata, I., Carrageta, M., Col, J., Dalby, A., Davies, R., Deckers, J., Eichman, D., Grande, P., Greene, R., Gurfinkel, E., Heikkilä, J., Henry, T., Hillis, D., Hochman, J., Huber, K., Kostis, J., Klinke, P., López-Sendón, J., Mckendall, G., Móller, B., Moore, P., Morris, A., Mueller, H., Östör, E., Oto, A., Ruda, M., Sadowski, Z., Schweiger, M., Sequeira, R., Shah, P., Shannon, R., Smith, B., Sobel, B., Steingart, R., Tebbe, U., Toman, J., Traboulsi, M., Vahanian, A., Warnica, J. W., Willerson, J., Deitchman, D., Davidson, L., Folgia, T., Foxley, A., Goodman, J., Hauck, C., Henry, D., Mccabe, C., Pangerl, A., Thomson, A., Wagner, M., Kennedy, J. W., Cairns, J., Demets, D., Julian, D., Simoons, M., Charlesworth, A., Easton, J. D., Ferbert, A., Feske, S., Kuhn, P., Moseley, J., Rogg, J. M., Reichmann, H., Sloan, M., von Kummer, R., Zamani, A., Coulter, S., Giugliano, R., Skene, A. M., Ardill, R., Ince, Y., Peters, A., Ward, K., Wolf, L., Curtis, N., De Brés, J., Stead, S., Watson, S., Cutler, S., Friedman, J., Helfrick, R., Williams, S., Klimovsky, J., Kumagai, S., Adams, E., Anderson, C., Bauhuber, I., Bennett, L., Biro, E., Boyce, E., Bregman, B., Carvalho, P., Ciganovic, D., Csukas, M., Cuenca, P., De Cuyper, S., Diez, P., Dijkhuizen, M., Dille-Amo, C., Gonzalez-Santis, A., Gursoy, M., Hammarstrom, K., Harasta, E., Ingman, E., Kelemen, B., Keulen, I., Koren, A., Langthaler, G., Lemaire, F., Little, I., Montalban, C., Nijssen, K., Neumueller, I., Palander, M., Pekuri, T., Persson, U., Pilz, J., Oudotova, S., Pisklakov, V., Proinov, F., Ptaszynska, A., Read, J., Retei, S., Romeyer, F., Romanini, M., Saar, L., Salein, D., Samsonov, M., Simeon-Dubach, D., Simmonds, J., Skaza, M., Skvortsova, N., Smidlova, Z., Spitzerova, H., Strijdveen, I., Szajewski, T., Ugurnal, B., Valcarce, M., van Rompaey, I., Walker, A., Zak, E., Zimova, N., Barrero, C., Beck, E., Bruno, M. L., Caccavo, A., Cagide, A., Campo, A., Cermesoni, R., Chahin, M., Dutra, O., Estrada, J., Falu, E. A., Gagliardi, J., Garre, L. E., Liprandi, A. S., Luciardi, H., Mautner, B., Muntaner, J., Nau, G., Salzberg, S., Santopinto, J., Sinisi, A., Torres, H., Eber, B., Elliott, P., Hiemetsberger, H., Juhasz, M., Kühn, P., Leisch, F., Niktardjam, M., Reisinger, J., Schmalix, G., Schuster, R., Sihorsch, K., Silberhauer, K., Slany, J., Steinbach, K., Tragl, K. H., Valentin, A., Al Shwafi, K., Dasnoy, P., De Clippel, M., de Meester, A., De Raedt, H. J. L. P., Emonts, M., Evrard, P., Eycken, M., Geboers, M., Heyndrickx, G., Lauwers, K., Mitrie, K., Pirenne, B., Renard, M., Somers, Y., Timmermans, P., Van Kuyk, M., Van Mieghem, W., Vermeulen, J., Verrostte, J. M., Albuquerque, D., Ayoub, J. C. A., Carvalho, A., Cesar, L., Gebara, O., Golin, V., Knobel, E., Leaes, P., Neto, J. A. M., Nicolau, J. C., Piegas, L. S., Rabelo, A., Rassi, A., Sila, L., Simao, A. F., Ashton, T., Baillie, H., Bhargava, R., Bota, G., Cameron, W., Chan, N., Chan, Y. K., Daly, P. A., Darcel, I., Davies, E., Desjardin, L., Dhingra, S., Ducas, J., Ervin, F. L., Fortin, C., Fowlis, R., Fulop, J., Furey, M., Gagnon, S., Gebhardt, V., Giannaccro, P., Gosselin, G., Graham, J., Grondin, F., Heath, J. W., Henderson, M., Hilton, D. R., Hiscock, J., Hui, W., Kaza, L., Kesselman, T., Kouz, S., Kucerak, M., Lahoude, N., Lamothe, M., Lebouthillier, P., Lenis, J., Levesque, P., Lopez, J. F., Lubelsky, B., Macritchie, D., Mayer, J. -P., Mcdowell, J. D., Montigny, M., Orestien-Lyall, T., Parekh, P., Pistawka, K., Price, J. B., Pruneau, G., Quinn, B., Reid, B. R., Richmond, M., Rose, B., Schuld, R., Sharma, N. K., Shetty, P., Stanton, E., Strauss, H. D., Sussex, B., Theroux, P., Turabian, M., Turner, C., Vizel, S., Walker, M., Weeks, A., Winkler, L., Zacharias, G., Zimmerman, R., Bartolucci, J., Castro, P., Diaz, M. A., Illanes, G., Potthoff, S., Sanchez, E. C., Silva, L. M., Yovanovich, J., Zanetti, F. L., Alan, D., Balázová, K., Boček, P., Cerny, J., Fischerova, B., Holub, M., Hradec, J., Janota, T., Janský, P., Kasper, J., Klimsa, Z., Motovská, Z., Pleva, L., Pluhacek, L., Pšenčka, M., Semrád, B., Spinar, J., Staněk, V., Štípal, R., Suítil, P., Vítovec, J., Wichterie, D., Widimský, P., Zeman, K., Andersen, C. B., Kriegbaum, J., Nielsen, N., Nielsen, P. E., Schou, J. B., Teesalu, R., Voitk, J., Haapamäki, H. V. H., Halkosaari, M., Härkönen, M., Jägerholm, S., Kärjä-Koskenkari, P., Karthunen, P., Kesäniemi, Y. A., Koskivirta, H., Lehto, P., Lilja, M., Paakkinen, S., Palomäki, A. K., Pietilä, K., Tuominen, J., Viopio-Pulkki, L., Ylönen, H., Adi, I., Admant, P., Akadirik, A., Alagha, Z., Alhabaj, S., Amat, G., Andre, A. A., Apffel, F., Aswad, K., Baradat, G., Bareiss, P., Barthers, F. B., Baudet, M., Baudouy, M., Bearez, E. M., Berthou, J. D., Berzin, B., Bessede, G., Blanc, J. J., Bocara, A., Bonneau, A., Bourdad, C., Bouvier, J. M., Cassagnes, J., Cassat, A., Cazaux, P., Charbonnier, B., Clementy, J., Cohen, A., Coisne, D., Colin, P., Croizier, O., D’Hautefeuille, B., D’Ivernois, C., Daumas, P. L., Dauphin, C. L., Deforet, M. F., Degand, B., Dequeker, J. L., Dickele, M. C., Dugrand, P., Durand, S., Ebagosti, A., Elharrar, C., Equine, O., Fichter, E., Flork, L., Fouche, R., Fourchard, V., Fourme, T., Fournier, P. Y., Funck, F., Galley, D., Garbarz, E., Ghadban, W., Gladin, M., Grall, J. Y., Grand, A., Gryman, R., Guillard, N., Guillo, P., Haftel, Y., Hannebicque, G., Henry, R., Huret, J. F., Janin-Magnificat, L., Jarnier, J., Joly, A., Kamal, H., Khalife, A., Roynard, J. L., Lang, M., Lapeyssonnie, A., Ledain, L., Lejeune, P., Lemetayer, L., Lepori, R., Lombart, A., Lusson, J. R., Magnin, O., Marquand, A., Martelet, M. M., Martelli, A., Mathurin, C., Mentre, B., Messager, D., Morizot, M., Mouallem, M. J., Mouhoub, O., Mycimski, C., Nallet, O., Olive, T., Pacouret, G., Palcoux, M. C., Poulard, J. E., Pruvost, A., Quiret, J. C., Richard, C., Richard, P., Rickaud, P., Riehl-Aleil, V., Rifai, A., Rocher, R., Rotreff, P., Segrestin, B., Slama, M. S., Sultan, P., Tabone, X., Talbodec, A., Tissot, M. T., Toussaint, C., Veyrat, A., Zerrouk, Z., Adamczak, M., Altmann, E., Altybernd, B., Andreassen, G., Andresen, D., Appenrodt, H., Bachmann, S., Bäcker, U., Beckert, U., Behr, H. M., Beier, W., Beier, T., Berger, D., Bernsmeier, R., Beythien, R. D., Biechl, E., Biedermann, G., Bischoff, K. O., Blerich, J., Boch, H. B., Bonzel, T., Both, A. R., Breidenbach, K., Breuer, M., Breuer, H. W. M., Brunkhorst, F. B., Bruns, A., Bundschu, H. D., Burkhardt, W., Busse, H. J., Caesar, K., Cailloud, J., Chlosta, A., Chorlanopoulos, E., Consemüller, S., Decker, W., Dichgans, M., Dick, R., Diederich, K. W., Dienst, C., Dietz, A., Dißmann, R., Ditter, H., Doering, W., Drost, H., Dundalek, E. D., Eckardt, D., Edelmann, A., Eggeling, T., Eggert, G., Eichner, R., Endres, C., Engberding, R., Engel, H. J., Faehnrich, A., Fischer, J. L., Flor, A., Forycki, F. Z. F., Froböse, H. J., Fruehauf, T., Fuchs, M., Geiser, R., Geletneky, J., Gerdes, H., Gerecke, B., Gesing, S., Gieser, H., Girth, E., Glogner, P., Glover, M., Goetz, J., Goetz, H., Göttfert, G., Gottwik, M., Gregori, B., Grieshaber, M., Großmann, C., Gruber, G., Gunold, H., Häßler, W. H., Hackenjos, B., Hader, O., Hamer, H., Harmjanz, D., Hasst, G., Haun, H., Hauptmann, K. E., Hegge, F. J., Heinze, A., Heinze, R., Henrichs, K. J., Hergenröther, H., Herrmann, F., Herzig, C., Hey, D., Hill, S., Hinzmann, S., Hoffmann, S., Höfs, T., Höhler, H., Holle, G., Höltman, B. J., Horacek, T., Hossmann, V., Hübner, F. S., Hülskamp, C., Hunecke, R., Hust, M., Jaeckh, G., Jebens, C., Jennen, E., Jost, M., Justiz, R., Kallmann, L., Kalscheur, F., Kaschner, W., Kaspar, W., Kauder, E., Keitel, B., Keller, H., Kemkes, T., Kerler, N., Kester, M., Kettner, W., Kilp, M., Kirklies, A., Klaus, A., Klein, H. H., Klenböck, J. R., Kley, H. K., Klingenbeck, R., Koch, H., Kohler, B., Kohler, J., Kolloch, R., Konermann, M., Körber, H. G., Kother, T. K., Kötter, V., Kottwitz, B., Kozariszcsuk, G., Kracht, T., Kratzsch, G., Kreft, H. U., Kreuter, G., Krönert, H., Krönig, B., Krueger, E., Krülls-Münch, J., Kuckuk, H., Kuelschbach, M., Kuhrt-Lassay, O. W., Kummerhoff, P. W., Kunevt, R., Kurth, C. U., Lang, C., Lange, C., Langhoff, R., Laskus, A., Lazarus, P., Lehmann, H. U., Lenga, P., Lengfelder, W., Leupolz, W., Limbourg, P., Loos, U., Lucanus, W., Machill, K., Mäckel, P., Mackes, K. G., Maier, S., Makowski, B., Mandok, J., Manz, M., Mäurer, W., Meier, F., Meier, J., Menges, M., Merx, W., Meurers, G., Michels, U., Mickeler, C. H., Mons, D., Moos, E., Mueller, R., Müller, G., Nast, H. P., Naumann, G., Nebelsieck, H., Neubaur, J., Niederer, W., Nitsch, J., Noack, J., Nogai, K. F. W., Oberheiden, A., Obst, R., Ochs, H. R., Odemar, F., Odenthal, H. J. B., Offers, E., Öhl, S., Ohlmeier, H. A. R. M., Patzer, P., Pech, A., Peters, U., Petry, U., Pietschmann, G. J., Pistner, W., Plappert, B., Pohlmann, W. K., Pollock, B., Presser, H. J., Przytarski, K., Puerner, K. L., Raouf, N., Reike, N., Reil, G. H., Reinhard, U., Riebeling, V., Ritzmann, M., Rödder, J., Roth, E., Rüdelstein, R., Saborowski, F., Sauter, B., Sceffler, N., Schartl, A., Schifferdecker, E., Schlotterbeck, K. P., Schmidt, J., Schmidt-Dannert, D. R., Schmidt-Klewitz, H., Schmitz, H. J., Schnebelt, T., Schneider, H. L., Schneider, F. J., Schoeller, R., Scholz, D., Schoppe, W. D., Schreiner, G., Schroeder, J., Schuh, N., Schulte, K. L., Schulze, H., Schulze, H. D., Schuster, P., Schuster, H. P., Schweizer, P., Sechtem, U., Sedlmaier, H. P., Segel, S., Sehnert, W., Seidel, F., Siedentopf, K., Simon, H., Sodomann, C. P., Solbach, C., Sorges, E., Stabenow, S., Stadler, K. P., Stammwitz, E., Stein, U., Sternberg, H., Stiepak, C., Stockmann, M., Straus, W., Striegel, H., Struch, E., Strupp, G., Taubert, T. B. 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S., Gruchaka, M., Janicki, K., Janion, M., Jaworska, K., Jezewska, M., Kakol, J., Kizciuk, M., Kleinrok, A., Kolodziej, P., Komorowski, P., Konopka, A., Kopaczewski, J., Korecki, J., Kornacewicz-Jach, Z., Kowalewski, M., Kratochwil, D., Krolczyk, J., Krzminska-Pakula, M., Kurek, P., Kurowski, M., Kurpesa, M., Kurzawski, J., Kwiecien, R., Lenartowski, L., Lewandowski, M., Loboz-Grudzieñ, K., Luczak, G., Maliñski, A., Michalski, M., Musial, W., Nartowicz, E., Nowicka, A., Odyniec, A., Pasyk, S., Prastowski, W., Przybylski, A., Raczynska, A., Rodzik, J., Romanowski, M., Rynkiewicz, A., Rzyman, M., Sidorowicz, A., Sledziona, M., Sobiczewski, W., Sobkowicz, B., Sobolewska, J., Sokalski, L., Stepinska, J., Sterlinski, M., Stopinski, M., Świątecka, G., Szpernal, Z., Tarnowska, H., Trzos, E., Ujda, M., Wierzchowiecki, M., Wodynska, T., Wojciechowski, D., Wrabec, K., Wrzesinski, K., Zuk, P., Albuquergue, A., Costa, A., Cunha, D., Ferreira, D., Ferreira, R., Gaog Leiria, J. M., Pimenta, A., Rufino, E., Vasconcelos, J., Aldica, M., Balanescu, S., Bruckner, I. V., Capalneanu, R., Florescu, N., Georgescu, C. S., Cherasim, L., Ginshina, C., Merenta, A., Parvu, O., Radutiu, S., Savulescu, I., Vita, I., Averkov, O., Bokarev, I. N., Gratsiansky, N., Grigoriev, Y., Gruzdev, A., Kakhnovsky, I., Kheevehuk, T. V., Khrustalev, O., Kobalava, Y., Konoratieva, T. B., Koukline, Vladimir, Martiouchov, S., Pavlikova, E., Poskotinov, I., Rogalev, K., Sinopainikov, A., Syrkin, A., Tereschenko, S. T., Yavelov, I., Zavolghin, S., Čurilla, E., Kohn, R., Kovář, F., Murín, J., Poliačik, P., Drinovec, I., Horvat, M., Krivec, B., Markež, J., Pareznik, R., Pehnec, Z., Resman, J., Sifrer, F., Skale, R., Trinkaus, D., Voga, G., Baig, M. M. E., Blomerus, P., Botha, B. P., Burgess, L., Duncan, D., Duncan, D. I., Gillmer, D., Govender, N., Jardine, R. J., Kok, A., Manga, P., Naidu, R. K., Rajput, M. C., Ranjith, N., Roos, J. S., Snyders, F. A., Steingo, L., Stern, A., Tayob, F. Z., Vythilingum, S., Alonso-Orcajo, N., Arribas Jimenez, A., Ayestaran, J. I., Balsera, B. B. G., Barras, C., Castro, A., Cobo, N., Duque, A., Garcia, M. J., Goiriena, P., Gonzalez-Valdayo, M., Gulias Lopez, J. M., Jimenez Gomez, P., Lopez Garanda, V., Martín Santos, F., Nogueira, R., Pabon Osuna, P., Ponce De Leon, E., Quesada Dorador, A., Paya Serrano, R., Rodriguez, L., Rodriguez, M., Rubio, F., Ruiz-Salmeron, R., Solar, J., Toquero, J., Velasco, J., Vilar Herrero, V., Vizcaino, M., Wancisidor, X., Basilier, E., Birgersdotter, V., Björnsdotter, E., Bjurman, A., Hagström, D., Hallin, I., Hansen, O., Hemmingson, L. O., Lundkvist, L., Lycksell, M., Möller, B., Nolgard, P., Sjölund, G., Stjerna, A., Angehrn, W., de Benedetti, E., Diethelm, M., Gallino, A., Plebani, G., Vögelin, H. P., Wojtyna, W., Akgöz, H., Akgün, G., Akyürek, O., Batur, M. K., Bayata, S., Deger, N., Emel, O., Gürgün, C., Korkmaz, M. E., Kozan, O., Kumbasar, D., Muderrisoglu, H., Nisanci, Y., Ozin, B., Ozsaruhan, O., Payzin, S., Postaci, N., Sozcuer, H., Tamci, B., Topuzoglu, F., Türkoglu, C., Tutar, E., Ulucam, M., Ulusoy, T., Umman, B., Yalçinkaya, S., Yesil, M., Zoghi, M., Adams, P. C., Ahir, S., Ahsan, A. J., Akhtar, J., Albers, C. J., Al-Khafaji, M. N., Anderson, N., Bailey, R. J., Bain, R. J. I., Basu, A., Beal, A., Boyle, R. M., Brown, N., Campbell, S., Card, D., Cross, S. J., Davies, P., Davis, E. T. L., Dean, J. W., Deaner, A., Devine, M. A., Dhawan, J., Doig, J. C., Dubrey, S., Dunn, P. G., Dwight, J., Ecob, R., Fitzpatrick, H., Fletcher, S., Francis, C. M., Gershlick, A. H., Glennon, P. E., Goodfield, N. E., Grabau, W. J., Gray, M., Gray, K. E., Heath, J., Hendry, W. G., Highland, J., Hogg, K., Irving, J. B., James, M. A., Jennings, K., Joy, M., Kadr, H. H., Kahn, S., Keeling, P. J., Keir, P. M., Kemp, T. M., Kinaird, J., Kinsey, C., Knowles, K., Kooner, J. S., Lahiri, A., Lawson, C., Lewis, R., Macdermott, A. F. N., Mackay, A., Macleod, D. C., Mccance, A. J., Morrison, A., Mortimer, M., Mulvey, D., Murphy, J. J., Murray, S., Muthusamy, R., Myers, A., Nicolson, V. G., Northridge, D., Odemuyiwa, S., Oldroyd, K. G., Oliver, R. M., Pell, A. C. H., Pohl, J. E. F., Price, B., Quereshi, N., Rae, A. P., Reader, S., Reid, D. S., Reynolds, G. W., Robinson, A., Robson, R. H., Rodger, J. C., Rodrigues, E., Rose, E. L., Rowlands, D. B., Rowley, J. M., Rozkovec, A., Shreeve, J., Siklos, P., Smith, R. H., Sneddon, J. F., Somasundram, U., Squire, I., Stephens, J. D., Stephens-Lloyd, A., Strand, J. M., Stuart, J., Sutaria, N., Swan, J., Tait, G. W., Thomas, R. D., Thompson, M. A., Tildesley, G., Travill, C. M., Treadgold, J. A., Trelawney, J. M. S., Turner, D., Vallance, B. D., Wallbridge, D., Weissberg, P. L., White, E., Wicks, M., Wilcox, R. G., Wilkinson, P., Wiltshire, J. E., Wright, A., Andrea, B., Attassi, K., Bahr, R., Banas, J., Baran, K., Belknap, M., Bensman, M., Bertolet, B., Besley, D., Bethala, V., Betzu, R., Bhalla, R., Bhargava, M., Binder, A., Birkhead, R., Bodine, K., Brewer, D., Carey, S., Chengot, M., Coppola, J., Cragg, D., D’Arcy, B., Denny, D. M., Dilorenzo, P., Dixon, E., Doorey, A., Doty, D., Doty, W., Drossner, M., Eisenberg, P., Falco, T., Feldman, R., Freman, I., Frey, M., Garcia, J., Glassman, J., Goldman, S., Gomez, M., Gonzalez, M., Goodfield, P., Gottlieb, S., Grech, D., Hack, T., Haffey, T., Hanson, J., Havranek, E., Hermany, P., Hernandez, H., Herron, R., Hession, W., Hines, J., Hundley, R., Jacobs, W. C., Jerjes-Sanchez, C., Jerome, S., Josephson, R., Kalan, J., Kawalsky, D., Khan, A., Kmetzo, K., Kraemer, M., Lader, E., Landis, J., Lash, J., Leber, R., Leimbach, W., Leiva Garza, J. -L., Maddox, W., Magorien, R., Mahapatra, S., Mantecon, I., Mendelson, R., Miklin, J., Milas, J., Miller, R., Molk, B., Monrad, E. S., Morrison, J., Morse, H., Neustel, M., Nichols, D., Niederman, A., Nygaard, T., O’Connor, R., O’Riordan, W., Obermueller, S., Palmeri, S., Patel, R., Paul, T., Phiambolis, T., Piana, R., Polansky, B., Polinski, W., Ponce, G., Ribeiro, P., Roccario, E., Rogers, C. P., Rogers, W., Rosenblatt, A., Runyon, J. P., Scheel, F., Schmidt, P., Schneider, R., Schwartz, H., Shelhamer, L., Sheridan, F., Shine, W., Shook, T., Siskind, S., Slama, R., Spear, E., Stouffer, G., Strunk, B., Thadani, U., Timmis, G., Trautloff, R., Tse, A., Wohl, B., Zarren, H., Zucker, R., Kuster, F., and Pardie, J. P.

Subjects
Male, Risk, Infusions, medicine.medical_treatment, Myocardial Infarction, Bolus lytic therapy, Acute myocardial infarction, Tissue plasminogen activator, Thrombolytic drug, Double-Blind Method, Fibrinolytic Agents, medicine, Humans, Thrombolytic Therapy, Myocardial infarction, Infusions, Intravenous, Stroke, Aged, business.industry, ST elevation, Lanoteplase, Emergency department, Middle Aged, medicine.disease, Survival Analysis, Regimen, Relative risk, Anesthesia, Tissue Plasminogen Activator, Female, Intracranial Hemorrhages, Cardiology and Cardiovascular Medicine, business, Intravenous, medicine.drug
Abstract

AIMS To compare the efficacy and safety of lanoteplase, a single-bolus thrombolytic drug derived from alteplase tissue plasminogen activator, with the established accelerated alteplase regimen in patients presenting within 6 h of onset of ST elevation acute myocardial infarction. METHODS AND RESULTS 15,078 patients were recruited from 855 hospitals worldwide and randomized in a 2:1 ratio to receive either lanoteplase 120 KU. kg(-1)as a single intravenous bolus, or up to 100 mg accelerated alteplase given over 90 min. The primary end-point was all-cause mortality at 30 days and the hypothesis was that the two treatments would be equivalent. By 30 days, 6.61% of alteplase-treated patients and 6.75% lanoteplase-treated patients had died (relative risk 1.02). Total stroke occurred in 1.53% alteplase- and 1.87% lanoteplase-treated patients (ns); haemorrhagic stroke rates were 0.64% alteplase and 1.12% lanoteplase (P=0.004). The net clinical deficit of 30-day death or non-fatal disabling stroke was 7.0% and 7.2%, respectively. By 6 months, 8.8% of alteplase-treated patients and 8.7% of lanoteplase-treated patients had died. CONCLUSION Single-bolus weight-adjusted lanoteplase is an effective thrombolytic agent, equivalent to alteplase in terms of its impact on survival and with a comparable risk-benefit profile. The single-bolus regimen should shorten symptoms to treatment times and be especially convenient for emergency department or out-of-hospital administration.

Published
2000

24. Detection of myocarditis during the first year after discovery of a dilated cardiomyopathy by endomyocardial biopsy and gallium-67 myocardial scintigraphy: prospective multicentre French study of 91 patients.

Author

BOUHOUR, J. B., HELIAS, J., DE LAJARTRE, A. Y., PETITIER, H., KOMAJDA, M., LEGER, A., DELCOURT, A., SACREZ, A., BAREISS, P., CONSTANTINESCO, A., BELLOCQ, J. P., FERRIERE, M., CHEVALIER, C., BALDET, P., CASSAGNES, J., PEYCELON, P., KANTELIP, B., GESLIN, P., PEZARD, P., and SAINT-ANDRE, J. P.

Abstract

The purpose of this study was to assess the frequency of inflammatory lesions in the myocardium of subjects with dilated cardiomyopathy and to determine if there was any correlation between the results of two methods of evaluation, one (endomyocardial biopsy) invasive and the other (gallium-67 scintigraphy) noninvasive. Of 115 subjects recruited in seven centres, 91 met the inclusion criteria (left ventricular dilatation ≥ 100 ml m and ejection fraction <55% with normal coronary arteriography) and had endomyocardial biopsy (mean five specimens) and Ga-67 myocardial scintigraphy after several days. Scanning was considered doubtful 19 times and positive 13 times. The histologic count of mononuclear cells in the myocardial interstitium in 20 fields was greater than 5 cells field in only four cases. No correlation was found between the two methods. Subjectivity in the choice of the criterion of positivity of Ga-67 scintigraphy and difficulties in identifying lymphocytes upon pathological examination were the major problems encountered. Despite limitations, both techniques suggest that cellular infiltrates are minimal and quite infrequent in dilated cardiomyopathy. [ABSTRACT FROM PUBLISHER]

Published
1988
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25. Adaptation of the left ventricular function parameters to dynamic exercise in aortic stenosis.

Author

Bassand, J. P., Ba, S.A., Ducellier, D., Lusson, J. R., Peycelon, P., Faivre, R., Cardot, J. C., Cassagnes, J., Jallut, J., and Maurat, J. P.

Abstract

The left ventricular volumes, the left ventricular ejection fraction, the stroke volume index and the cardiac index were non-invasively determined in 47 patients suffering from moderate to severe pure aortic stenosis using radionuclide angiography at rest and at peak supine exercise. Each patient was previously submitted to right and left heart catheterization and to selective coronary angiography. The left ventricular ejection fraction decreased significantly during exercise (0·62±0·09 to 0·59±0·09, P<0·01). End-systolic voiwne, end-diastolic volume, stroke volume index and cardiac index increased significantly. The stroke volume variations were linked to the end-diastolic volume variations by a strong relationship (r=0·84, P<0·001) and to left ventricular mass by a weak, but significant, inverse relationship (r=−0·42, P<0·05). No relation existed between stroke volume index variations and any other variables, particularly systolic gradient, aortic valve area and resting left ventricular ejection fraction.The results suggest that, in aortic stenosis, the adaptation of the left ventricular pump function during exercise is mostly dependent upon the diastolic properties of the left ventricular wall and is limited by the progression of left ventricular hypertrophy, i.e. diastolic stiffness. By contrast, the role of the basal systolic pump function and of the severity of the valvular obstruction seems of limited importance. [ABSTRACT FROM PUBLISHER]

Published
1988
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27. Modifying effect of dual antiplatelet therapy on incidence of stent thrombosis according to implanted drug-eluting stent type

Author

Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., Satler, L., Camenzind, Edoardo, Boersma, Eric, Wijns, William, Mauri, Laura, Rademaker-Havinga, Tessa, Ordoubadi, Farzin Fath, Suttorp, Maarten J., Al Kurdi, Mohammad, Steg, Ph Gabriel, Camenzind, E., Mauri, L., O'Neill, W., Serruys, P W., Steg, PhG, Wijns, W., Verheugt, FWA, Bertrand, ME, Califf, R., DeMets, D., Wallentin, L., Bocksch, W., Bosmans, J., Garcia, H., Garg, S., Hanet, C., Herrman, J-PR, Kelbaek, H., Mc Fadden, E., Radke, PW, Rutsch, W., Tilsted, HH, Wykrzykowska, J., Alvarez, C., Rodriguez, A., Meredith, I., Muller, D., Whitbourn, R., Worthley, S., Whelan, A., Walters, D., Shetty, S., New, G., Cox, S., Batra, R., van Gaal, W., Bellamy, G., Mayr, H., Heigert, M., Huber, K., Leisch, F., Desmet, W., Boland, J., Schroeder, E., Chenu, P., Legrand, V., Labinaz, M., Teefy, P., Bertrand, O., Gao, R., Ge, J., Kala, P., Cervinka, P., Ureña, P., Hartikainen, J., Steg, G., Fajadet, J., Carrie, D., Gilard, M., Barragan, P., Lablanche, J-M, Koning, R., Eltchaninoff, H., Darremont, O., Leroy, F., Bertrand, B., Robert, G., Schiele, F., Chassaing, S., Bressollette, E., Brunel, P., Quilliet, L., Brunet, J., Pansieri, M., Sideris, G., Stratiev, V., Teiger, E., Lebreton, H., Bonnet, J-L, Karsenty, B., Delarche, N., Lusson, J-R, Cassagnes, J., Brachmann, J., Kurowski, V., Buerke, M., Schieffer, B., Scholtz, W., Wiemer, M., Fichtlscherer, S., Schächinger, V., Kupatt, C., Boekstegers, P., Genth-Zotz, S., Bode, C., Frey, N., Neumann, F-J, Witzenbichler, B., Pels, K., Strasser, R., Kuck, K-H, Hauptmann, K-E, Baldus, S., Heitzer, T., Haude, M., Hoffmann, E., Jung, W., Hoffmann, S., Schmitt, C., Dissmann, M., Pauschinger, M., Werner, G., Braun-Delleus, R., Burkhardt, D., Manz, M., Voudris, V., Sionis, D., Kang-Yin, M-L, Tse, T-S, Merkely, B., Mehta, A., Parikh, K., Kumar, V., Chandra, P., Rath, P., Hiremath, S., Crean, P., Daly, K., Kornowski, R., Kerner, A., Mosseri, M., Jafari, G., Giudice, P., Trani, C., Manari, A., Prati, F., Pangrazi, A., Bolognese, L., Jeong, M-H, Kim, M-Y, Kim, H-S, Park, S-J, Erglis, A., Kalnins, A., Wagner, D., Zambahari, R., Ong, T-K, Sim, K., den Heijer, P., Appelman, Y., Suttorp, M-J, de Smet, B., Koolen, J., Stella, P., Harding, S., Warwick, J., Maslowski, A., Abernethy, M., Devlin, G., Rotevatn, S., Myreng, Y., Ciecwierz, D., Peruga, J., Reczuch, K., Campante Teles, R., Farto, P., Abreu, E., Leitão-Marques, A., Pereira, H., Vinereanu, D., Alkasab, S., Mhish, H., Al Kurdi, M., Al Turki, F., Wong, P., Teo, S-G, Goicolea Ruigomez, F-J, Valdés Chávarri, M., Bethencourt Gonzalez, A., Iñiguez Romo, A., López Minguez, J., Hernández García, J-M, Diaz Fernández, J., Ruiz Salmeron, R., Martinez Elbal, L., Zueco, J., López-Palop, RF, Melgares, R., Diderholm, E., Kåregren, A., Herterich, O., Olivencrona, G., Fröbert, O., Roffi, M., Verin, V., Girod, G., Vuilliomenet, A., Hsieh, I-C, Wu, C-J, Gershlick, A., Densem, C., Doshi, S., Manoharan, G., McCarthy, P., De Belder, M., Mills, J., Fath-Ordoubadi, F., Simpson, I., Greenwood, J., Chamberlain-Webber, R., Khan, Z., Cotton, J., Gunning, M., Smith, D., Talwar, S., Holmberg, S., Purcell, I., Anderson, R., Alamgir, F., Beatt, K., Kelly, P., Moussavian, M., Aji, J., Prashad, R., Zankar, A., Banerjee, S., Lewis, S., McLaurin, B., Douglas, J., Brener, S., Gupta, A., Walters, L., Driesman, M., Aycock, R., Mego, C., Fisher, D., Frankel, R., and Satler, L.

Abstract

Aim To investigate the putative modifying effect of dual antiplatelet therapy (DAPT) use on the incidence of stent thrombosis at 3 years in patients randomized to Endeavor zotarolimus-eluting stent (E-ZES) or Cypher sirolimus-eluting stent (C-SES). Methods and results Of 8709 patients in PROTECT, 4357 were randomized to E-ZES and 4352 to C-SES. Aspirin was to be given indefinitely, and clopidogrel/ticlopidine for ≥3 months or up to 12 months after implantation. Main outcome measures were definite or probable stent thrombosis at 3 years. Multivariable Cox regression analysis was applied, with stent type, DAPT, and their interaction as the main outcome determinants. Dual antiplatelet therapy adherence remained the same in the E-ZES and C-SES groups (79.6% at 1 year, 32.8% at 2 years, and 21.6% at 3 years). We observed a statistically significant (P = 0.0052) heterogeneity in treatment effect of stent type in relation to DAPT. In the absence of DAPT, stent thrombosis was lower with E-ZES vs. C-SES (adjusted hazard ratio 0.38, 95% confidence interval 0.19, 0.75; P = 0.0056). In the presence of DAPT, no difference was found (1.18; 0.79, 1.77; P = 0.43). Conclusion A strong interaction was observed between drug-eluting stent type and DAPT use, most likely prompted by the vascular healing response induced by the implanted DES system. These results suggest that the incidence of stent thrombosis in DES trials should not be evaluated independently of DAPT use, and the optimal duration of DAPT will likely depend upon stent type (Clinicaltrials.gov number NCT00476957)

33. Regressive Aortic Valve and Infundibular Tumors During Idiopathic Hypereosinophilic Syndrome

Author

Dauphin, C., Motreff, P., Ruivard, M., Rieu, V., Cloix, J.J., Lamaison, D., Cassagnes, J., and Lusson, J.R.

Abstract

Fibroblastic endocarditis is a classic complication of prolonged hypereosinophilic syndrome, whatever the cause. In France, it is most frequently encountered in cases of idiopathic hypereosinophilic syndrome. It commonly involves the apex of the ventricles, with a clinical picture of restrictive cardiomyopathy of unfavorable prognosis, and the auriculoventricular valves. We report the case of a 77-year-old man in whom atypical cardiac involvement disclosed idiopathic hypereosinophilic syndrome. In addition to the usual features of obliteration of the apex and restrictive cardiomyopathy, echocardiographic examination showed severe left ventricular dysfunction and intracardiac tumors, one of which was unusually localized to an aortic valve. Treatment, which comprised strict control of the eosinophilic process, standard treatment for cardiac failure, and anticoagulation therapy, produced rapid and long-lasting improvement of his clinical status and left systolic and diastolic ventricular function, and on echocardiography the intracardiac tumors had totally disappeared. The patient suddenly died of septic shock 16 months after first being seen.

Published
2005
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38. Utilisation des objets connectés en recherche clinique.

Author

Dhainaut JF, Huot L, Bouchara Pomar V, Dubray C, Augé P, Barthélémy P, Belghiti J, Bureau S, Cassagnes J, Deblois S, Di Palma M, Dorsay G, Duchossoy L, Durand-Salmon F, Escudier T, Fiorini M, Franc S, Gelpi O, Laporte S, Lavallée E, Lethiec F, Meunier JP, Peyret O, Samalin L, and Vicaut E

Published
2018
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39. Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial.

Author

Vaillant-Roussel H, Laporte C, Pereira B, Tanguy G, Cassagnes J, Ruivard M, Clément G, Le Reste JY, Lebeau JP, Chenot JF, Pouchain D, Dubray C, and Vorilhon P

Subjects
Aged, Chronic Disease, Disease Management, Female, France, Humans, Male, Middle Aged, Treatment Outcome, Heart Failure therapy, Patient Education as Topic methods, Primary Health Care methods, Quality of Life
Abstract

Background: Chronic heart failure, is increasing due to the aging population and improvements in heart disease detection and management. The prevalence is estimated at ~10% of the French general practice patient population over 59 years old. The primary objective of this study is to improve the quality of life for heart failure patients though a complex intervention involving patient and general practitioner (GP) education in primary care., Methods: A randomised, cluster controlled trial, stratified over 4 areas of the Auvergne region in France comparing intervention and control groups. The inclusion criteria are: patients older than 50 years with New York Heart Association (NYHA) stage I, II, or III heart failure, with reduced ejection fraction or with preserved ejection fraction. Heart failure should be confirmed by the patient's cardiologist according to the European Society of Cardiology guidelines criteria. The exclusion criteria include: severe cognitive disorders, living in an institution, participating in another clinical trial, having NYHA stage IV heart failure, or a lack of French language skills. The complex intervention consists of training at the GP practice with an interactive 2-day workshop to provide a patient's education programme. GPs are trained to perform case management, lifestyle counselling and motivational interviewing, to educate patients on the main topics including clinical alarm signs, physical activity, diet and cardiovascular risk factors. The patients' education sessions are scheduled at 1, 4, 7, 10, 13 and 19 months following the start of the trial. The primary outcome to be assessed is the impact on the quality of life as determined using two questionnaires: the Minnesota Living with Heart Failure Questionnaire and SF-36. To detect a difference in the mean quality of life at 19 months, we anticipate studying a minimum of 400 patients from 80 GPs., Discussion: This trial will provide insight into the effectiveness of a complex intervention to educate patients with heart failure including a 2-day GP workshop and patients' education programme in the setting of a GP consultation to improve the quality of life in patients with chronic heart failure. This complex intervention tool could be used during initial and further medical training., Trial Registration: ETIC is a cluster-randomised, controlled trial registered on ClinicalTrials.gov [ NCT01065142 , 2010, Feb 8] and the French drug agency [Agence Nationale de Sécurité du Médicament et des produits de santé; registration number: 2009-A01142-55, on March 5th, 2010].

Published
2014
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41. [The limits of patient education in short-term hospitalization: the case of cardiovascular patients].

Author

Thiam Y, Gerbaud L, Grondin MA, Blanquet M, Marty L, Pruilhere Vaquier S, Llorca PM, and Cassagnes J

Subjects
Attitude to Health, Female, Humans, Male, Middle Aged, Risk Factors, Cardiovascular Diseases prevention & control, Hospitalization, Patient Education as Topic
Abstract

The purpose of this study was to examine the limitations of therapeutic education for patients with cardiovascular risk factors during short hospital stays. The paper presents the results of a qualitative study conducted over the course of a year involving 18 case studies of professional practices and 18 interviews with 5 health professionals and 13 patients. The results show that professionals and patients have conflicting views about the time spent in hospital, as well as conflicting concerns and expectations, thus limiting the effectiveness of educational care. The findings suggest that after acute myocardial infarction or a stroke, patients tend to view themselves as survivors during their experience of short-term hospitalization in a care unit. As a result, short-term hospitalization may not be conducive to the mobilization of patients' cognitive and emotional capacities in a therapeutic education program.

Published
2012

42. High-resolution coronary imaging by optical coherence tomography: Feasibility, pitfalls and artefact analysis.

Author

Motreff P, Levesque S, Souteyrand G, Sarry L, Ouchchane L, Citron B, Cassagnes J, and Lusson JR

Subjects
Adult, Aged, Angioplasty, Balloon, Coronary instrumentation, Clinical Competence, Coronary Artery Disease pathology, Coronary Vessels diagnostic imaging, Feasibility Studies, Female, France, Humans, Image Enhancement, Male, Middle Aged, Predictive Value of Tests, Registries, Stents, Treatment Outcome, Ultrasonography, Interventional, Artifacts, Coronary Artery Disease diagnosis, Coronary Artery Disease therapy, Coronary Vessels pathology, Tomography, Optical Coherence adverse effects
Abstract

Background: Optical coherence tomography is an imaging method that enables cardiologists to study atheromatous plaques, and to check the implantation and evolution of coronary stents. It is an invasive technique, providing high-resolution (10 microm) in vivo images, but with limitations and artefacts that need to be understood before the field of application can be extended., Aim: To determine the feasibility and limitations of optical coherence tomography coronary imaging from a single-centre experience., Methods: We analysed the first 301 optical coherence tomography (version M2, LightLab Imaging) sequences obtained in our department from examination of 73 patients., Results: Results showed that 92% of sequences for selected lesions were usable, with a mean examination time of 17 min. Only one complication occurred (ventricular fibrillation, reduced by external electroshock). In our registry, sequence quality depended on operator experience (improving after 20 examinations), and was impaired by artefacts, especially in right coronary analysis and in arteries of greater than 3.5 mm calibre., Conclusions: Proximal coronary occlusion and the distal flush quality currently required for quality imaging should no longer be indispensable with the new generation of optical coherence tomography systems., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Published
2010
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43. Comparative analysis of neointimal coverage with paclitaxel and zotarolimus drug-eluting stents, using optical coherence tomography 6 months after implantation.

Author

Motreff P, Souteyrand G, Levesque S, Ouchchane L, Dauphin C, Sarry L, Cassagnes J, and Lusson JR

Subjects
Adult, Aged, Angioplasty adverse effects, Cell Proliferation drug effects, Coronary Angiography, Coronary Restenosis etiology, Coronary Restenosis pathology, Coronary Thrombosis etiology, Coronary Thrombosis pathology, Female, Humans, Hyperplasia, Male, Middle Aged, Platelet Aggregation Inhibitors therapeutic use, Predictive Value of Tests, Sirolimus administration & dosage, Time Factors, Treatment Outcome, Tunica Intima pathology, Angioplasty instrumentation, Cardiovascular Agents administration & dosage, Coronary Artery Disease therapy, Coronary Restenosis prevention & control, Coronary Thrombosis prevention & control, Drug-Eluting Stents, Paclitaxel administration & dosage, Sirolimus analogs & derivatives, Tomography, Optical Coherence, Tunica Intima drug effects
Abstract

Background: Intrastent thrombosis, while rare, has a poor prognosis. Strut non-coverage is one causal factor, especially in cases of resistance to or premature discontinuation of dual antiplatelet therapy., Aim: To compare neointimal coverage with paclitaxel and zotarolimus drug-eluting stents, using optical coherence tomography (OCT)., Methods: Twenty-two drug-eluting stents (11 paclitaxel-eluting stents and 11 zotarolimus-eluting stents) were examined by OCT, 6 months after implantation. Mean neointimal strut-coverage thickness and percentage neointimal hyperplasia were measured every millimetre. On each OCT image, struts were classified into one of four categories: well-apposed to vessel wall with apparent neointimal coverage; well-apposed to vessel wall without neointimal coverage; malapposed to the vessel wall; or located on a major side branch., Results: OCT analysis showed a lower percentage of neointimal hyperplasia with paclitaxel-eluting stents than with zotarolimus-eluting stents (17% vs 38% and mean thickness 154 microm vs 333 microm, respectively; p<0.0001). The rate of strut-coverage was greater with zotarolimus-eluting stents than with paclitaxel-eluting stents (99.1% vs 87.1%, respectively; p<0.0001). A non-covered/covered strut ratio greater than 0.3 was observed in 0.5% of zotarolimus-eluting stent OCT images compared with 18% of paclitaxel-eluting stent OCT images (p<0.0001)., Conclusion: Six months after implantation, neointimal hyperplasia was greater with zotarolimus-eluting stents compared with paclitaxel-eluting stents. Conversely, neointimal strut-coverage was better with zotarolimus-eluting stents.

Published
2009
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44. [Primary school prevention program targeting cardiovascular diseases and cancers: "To be and to behave, the health school", assessment of an intervention involving 2207 children].

Author

Grondin MA, Berges AS, D'Agrosa-Boiteux MC, Azais-Braesco V, Tissier M, Cassagnes J, and Gerbaud L

Subjects
Child, France epidemiology, Health Knowledge, Attitudes, Practice, Humans, Pilot Projects, Program Evaluation, Surveys and Questionnaires, Cardiovascular Diseases prevention & control, Health Behavior, Health Education methods, Neoplasms prevention & control, School Health Services, Schools statistics & numerical data, Students statistics & numerical data
Published
2009
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45. Comparison of INR stability between self-monitoring and standard laboratory method: preliminary results of a prospective study in 67 mechanical heart valve patients.

Author

Dauphin C, Legault B, Jaffeux P, Motreff P, Azarnoush K, Joly H, Geoffroy E, Aublet-Cuvelier B, Camilleri L, Lusson JR, Cassagnes J, and de Riberolles C

Subjects
Acenocoumarol therapeutic use, Aged, Anticoagulants adverse effects, Blood Coagulation drug effects, Drug Monitoring instrumentation, Female, France, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Hemorrhage chemically induced, Hemorrhage prevention & control, Humans, Male, Middle Aged, Patient Dropouts, Phenindione analogs & derivatives, Phenindione therapeutic use, Pilot Projects, Point-of-Care Systems, Prospective Studies, Thromboembolism blood, Thromboembolism etiology, Time Factors, Treatment Outcome, Anticoagulants therapeutic use, Clinical Laboratory Techniques, Drug Monitoring methods, Heart Valve Prosthesis Implantation adverse effects, International Normalized Ratio instrumentation, Self Care instrumentation, Thromboembolism prevention & control
Abstract

Introduction: Thromboembolic accidents and haemorrhage are the main complications observed during long-term follow-up of mechanical heart valve patients. Several suggestions for improving anticoagulation quality have been made, including international normalised ratio (INR) self-monitoring., Objectives: We report the preliminary results of a single-centre, open, randomised study (scheduled population of 200 patients), which compares monthly laboratory monitoring (group A) versus weekly self-monitoring of INR (group B). The primary aim is INR stability improvement within the target range, and the secondary aim is adverse events reduction., Patients and Methods: Between May 2004 and June 2005, 67 patients with an average age of 56.6 years (+/-9.6), were enrolled in the study (group A: 34 patients, group B: 33 patients). The mean follow-up was 47 weeks (+/-11.5). The two groups differed only in the sex ratio (44.1 and 21.2% of women in groups A and B respectively, p=0.0459). Mechanical heart valves were aortic in 73% of patients, mitral in 13.5%, and multiple in 13.5%. Sixty-five patients (97%) were treated with fluindione, the others with acenocoumarol. The intraclass correlation coefficient between the self- and laboratory-monitored INR was 0.75., Results: The time spent in the INR target range (group A: 53+/-19%, group B: 57+/--19%, p=0.45) and the time spent in the INR therapeutic range, between 2 and 4.5, (group A: 86+/-14%, group B: 91+/-7%, p=0.07) are longer in group B, but not significantly so. For patients outside the range, the absolute mean deviation of INR from the target or therapeutic range (range standardized between 0 and 100) is lower for the self-monitoring group (41.1+/-39.3 and 11.27+/-11.2) than for the control group (62.4+/-72.6 and 39.2+/-52.8). This difference is significant (p=0.0004 and p=0.0005). Eighteen adverse events were reported: 17 haemorrhages, 13 in group A (9 mild, 4 serious) and four in group B (all mild), and one sudden death in group B, two days after the patient's discharge. No thromboembolic events were reported. Six patients (8.8 %), 3 in each group, dropped out of the study., Conclusion: This first study evaluating INR self-monitoring in France shows that this method leads to better stability of the INR within the target range. On the basis of these preliminary data, this appears to be related to a decrease in serious haemorrhages (11.8% serious haemorrhage cases in group A versus 0% in group B, p=0.06, NS).

Published
2008
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46. Right atrial tear associated with a tumour in the right atrium after blunt chest trauma.

Author

Souteyrand G, Combes S, Dauphin C, Geoffroy E, Motreff P, Joly H, Cassagnes J, and Lusson JR

Subjects
Accidents, Traffic, Cardiac Tamponade etiology, Cardiac Tamponade surgery, Echocardiography, Transesophageal, Heart Injuries etiology, Heart Injuries surgery, Humans, Male, Rupture, Thrombosis etiology, Thrombosis surgery, Young Adult, Heart Atria injuries, Heart Injuries diagnostic imaging, Thrombosis diagnostic imaging, Wounds, Nonpenetrating complications
Abstract

Occult cardiac injury following blunt trauma is more common than generally suspected. Myocardial contusion is not rare, however, it is generally a benign disorder which often remains undiagnosed. We report a case of a right atrial rupture after blunt chest trauma causing a tamponade. A 24-year-old man was involved in a violent car accident and he presented in a state of collapse. A multislice computed tomography indicated a pericardial effusion (Figure 1). A transthoracic echocardiography was performed and confirmed pericardial effusion which was hyperechoic (Figure 2, Movie 1). Concerns about a possible mass in the right atrium led to examination with transesophageal echocardiography (Figure 3, Movie 2) which revealed the presence of a voluminous mass in the right atrium. The patient successfully underwent cardiac surgery to remove the mass, identified as a blood clot, and to repair the atrial tear. The present case is of special interest because of the rarity of documented incidents of blunt chest trauma causing right atrial tear and illustrates the usefulness of transesophageal echocardiography in completing the diagnosis in the event of haemopericardium.

Published
2008
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47. [Kawasaki disease is also a disease of adults: report of six cases].

Author

Dauphin C, Motreff P, Souteyrand G, Laurichesse H, Gourdon F, Lesens O, Lamaison D, Beytout J, Cassagnes J, and Lusson JR

Subjects
Adult, Coronary Aneurysm diagnosis, Coronary Angiography, Decision Trees, Diagnosis, Differential, Echocardiography, Electrocardiography, Female, Humans, Immunoglobulins therapeutic use, Immunologic Factors therapeutic use, Male, Middle Aged, Myocarditis diagnosis, Pericardial Effusion diagnosis, Pericarditis diagnosis, Mucocutaneous Lymph Node Syndrome diagnosis
Abstract

Kawasaki disease is an inflammatory arterial disease of unknown cause usually affecting young children, the principal complication of which is coronary artery aneurysm. Early treatment with immunoglobulins and aspirin prevents this complication. The diagnosis requires expert clinical criteria and, in atypical forms, a more recent decisional diagnostic tree has to be used. The authors report 6 cases of adult Kawasaki disease. As in the other sixty or so cases in the literature, hepatic forms were the commonest (5/6). Only three of the six cases met the classical clinical criteria and the diagnosis was made by the decisional tree or after coronary complications in the oldest subject. The five treated patients progressed favourably after a course of immunoglobulins. Echocardiography detected 100% of children with coronary disease but it was more difficult in adults in whom new non-invasive methods of coronary imaging (fast CT and MRI) and stress testing should complete the investigations. The association of prolonged pyrexia, clinical criteria and a biological inflammatory syndrome should, after exclusion of the differential diagnoses, suggest a diagnosis of Kawasaki disease in the adult as in the child. The possibility of coronary disease, even though extremely rare, should be recognised by the cardiologist and lead to diagnostic and therapeutic managements as aggressive as in children.

Published
2007

48. [Implantation of mechanical pulmonary and tricuspid valve prostheses at a distance from complete repair of Tetralogy of Fallot].

Author

Ngoy Nkulu D, Dauphin C, Motreff P, Joly H, Souteyrand G, Lamaison D, Cassagnes J, de Riberolles C, and Lusson JR

Subjects
Adult, Female, Humans, Pulmonary Valve Insufficiency etiology, Reoperation, Tetralogy of Fallot complications, Treatment Outcome, Tricuspid Valve Insufficiency etiology, Postoperative Complications surgery, Prosthesis Implantation, Pulmonary Valve Insufficiency surgery, Tetralogy of Fallot surgery, Tricuspid Valve Insufficiency surgery
Abstract

The authors report the case of a 39 years old woman operated for tetralogy of Fallot at the age of 6. Multiple complications due to postoperative atrioventricular block and a poor surgical result on the pulmonary outflow tract led to several reoperations. Right ventricular dysfunction with pulmonary regurgitation and mitral tricuspid valve disease in a context of endocarditis on the pacing catheter led to double pulmonary and tricuspid valve replacement with mechanical prostheses. The outcome at follow-up at 3 years is good. To the authors' knowledge, this is the first reported case of double mechanical valve replacement of the right heart after complete repair of tetralogy of Fallot.

Published
2006

49. [Sudden transformation of pulmonary stenosis to trilogy of Fallot in a 65 year old patient].

Author

Combes S, Dauphin C, Motreff P, Joly H, Rodrigues R, Jean F, Lamaison D, Cassagnes J, and Lusson JR

Subjects
Echocardiography, Female, Humans, Middle Aged, Stents, Treatment Outcome, Cardiac Catheterization, Pulmonary Valve Stenosis complications, Trilogy of Fallot etiology, Trilogy of Fallot pathology
Abstract

The authors report the case of a 64 year old woman with typical valvular pulmonary stenosis in whom spontaneous and sudden reopening of the foramen ovale resulted in cyanosis. Transthoracic echocardiography with injection of contrast provides a complete diagnosis: valvular pulmonary stenosis with a mean pressure gradient of 83 mmHg and massive right-to-left interatrial shunt. The malformation was treated by interventional catheterisation in a two-stage procedure: pulmonary valvuloplasty followed by closure of the foramen ovale because of the persistence of a right-to-left interatrial shunt. The functional improvement was followed by the appearance of effort angina. Coronary angiography showed single vessel disease of the left anterior descending artery treated by stenting. The long-term outcome was satisfactory.

Published
2005

50. [The place of telemedicine in rhythmology and cardiac pacing].

Author

Lamaison D, Motreff P, Jean F, Geoffroy E, Rodriguez R, Souteyrand G, Chanseaume S, Terrazoni S, and Cassagnes J

Subjects
Computer Storage Devices, Defibrillators, Implantable, Humans, Pacemaker, Artificial, Software, Telecommunications trends, Arrhythmias, Cardiac diagnosis, Arrhythmias, Cardiac therapy, Cardiac Pacing, Artificial trends, Telemedicine trends
Abstract

Rapid advancement in telecommunication technology has made possible automatic periodic transmission of pacemaker and implantable defibrillator data to the attending physician (home monitoring). Furthermore, technology using remote control software allows, through device programmers, interrogation of the device memory, permitting remote monitoring by physicians or technical support of the manufacturer. Potential applications of these two capabilities include a close watch over the functioning of the devices, ability to obtain an earlier diagnosis (and management) of arrhythmic events, and assistance at the time of implant procedure and routine follow up. Finally these new tools raise several questions concerning safety aspects (including reliability of transmission, encrypted transfer, restricted access of the central database), economic aspects, and physician and manufacturer's liability.

Published
2004

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