Archives of Cardiovascular Diseases最新文献

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Long-term clinical outcomes in patients with acute myocardial infarction with multivessel disease and complete revascularization: Insights from the FLOWER-MI trial, the FRAME-AMI trial and the FAST-MI 2015 registry 急性心肌梗死合并多血管疾病和完全血运重建术患者的长期临床结果:来自FLOWER-MI试验、FRAME-AMI试验和FAST-MI 2015登记的见解
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.10.329
Thibault Remy , Nicolas Danchin , Etienne Puymirat
{"title":"Long-term clinical outcomes in patients with acute myocardial infarction with multivessel disease and complete revascularization: Insights from the FLOWER-MI trial, the FRAME-AMI trial and the FAST-MI 2015 registry","authors":"Thibault Remy , Nicolas Danchin , Etienne Puymirat","doi":"10.1016/j.acvd.2024.10.329","DOIUrl":"10.1016/j.acvd.2024.10.329","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 199-201"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnosis of cancer therapy-related cardiovascular toxicities: A multimodality integrative approach and future developments
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.12.012
Simon Travers , Joachim Alexandre , Lauren A. Baldassarre , Joe Elie Salem , Mariana Mirabel
{"title":"Diagnosis of cancer therapy-related cardiovascular toxicities: A multimodality integrative approach and future developments","authors":"Simon Travers ,&nbsp;Joachim Alexandre ,&nbsp;Lauren A. Baldassarre ,&nbsp;Joe Elie Salem ,&nbsp;Mariana Mirabel","doi":"10.1016/j.acvd.2024.12.012","DOIUrl":"10.1016/j.acvd.2024.12.012","url":null,"abstract":"<div><div>Diagnosing cancer therapy-related cardiovascular toxicities may be a challenge. The interplay between cancer and cardiovascular diseases, beyond shared cardiovascular and cancer risk factors, and the increasingly convoluted cancer therapy schemes have complicated cardio-oncology. Biomarkers used in cardio-oncology include serum, imaging and rhythm modalities to ensure proper diagnosis and prognostic stratification of cardiovascular toxicities. For now, troponin and natriuretic peptides, multimodal cardiovascular imaging (led by transthoracic echocardiography combined with cardiac magnetic resonance or computed tomography angiography) and electrocardiography (12-lead or Holter monitor) are cornerstones in cardio-oncology. However, the imputability of cancer therapies is sometimes difficult to assess, and more refined biomarkers are currently being studied to increase diagnostic accuracy. Advances reside partly in pathophysiology-based serum biomarkers, improved cardiovascular imaging through new technical developments and remote monitoring for rhythm disorders. A multiparametric omics approach, enhanced by deep-learning techniques, should open a new era for biomarkers in cardio-oncology in the years to come.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 185-198"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost-effectiveness analysis of simulation-based training in transoesophageal echocardiography: Insights from the SIMULATOR randomized clinical trial 经食管超声心动图模拟训练的成本-效果分析:来自模拟器随机临床试验的见解。
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.10.330
Théo Pezel , Clémence Thébaut , Yohann Bohbot , Charles Fauvel , Basile Mouhat , Yoan Lavie Badie , Lee S. Nguyen , Loïc Bière , Florent Le Ven , Sophie Ribeyrolles , Julien Dreyfus , Jennifer Cautela , Théo Cambet , Thierry Le Tourneau , Erwan Donal , Nicolas Mansencal , Julien Magne , Anne Bernard , Augustin Coisne , on behalf of the SIMULATOR investigators
{"title":"Cost-effectiveness analysis of simulation-based training in transoesophageal echocardiography: Insights from the SIMULATOR randomized clinical trial","authors":"Théo Pezel ,&nbsp;Clémence Thébaut ,&nbsp;Yohann Bohbot ,&nbsp;Charles Fauvel ,&nbsp;Basile Mouhat ,&nbsp;Yoan Lavie Badie ,&nbsp;Lee S. Nguyen ,&nbsp;Loïc Bière ,&nbsp;Florent Le Ven ,&nbsp;Sophie Ribeyrolles ,&nbsp;Julien Dreyfus ,&nbsp;Jennifer Cautela ,&nbsp;Théo Cambet ,&nbsp;Thierry Le Tourneau ,&nbsp;Erwan Donal ,&nbsp;Nicolas Mansencal ,&nbsp;Julien Magne ,&nbsp;Anne Bernard ,&nbsp;Augustin Coisne ,&nbsp;on behalf of the SIMULATOR investigators","doi":"10.1016/j.acvd.2024.10.330","DOIUrl":"10.1016/j.acvd.2024.10.330","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 202-204"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From bench to bedside: The critical need for standardized senescence detection
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.12.008
Jagrut Shah, Amel Al-Hashimi, Magela Benedetto, Prashant Jay Ruchaya
{"title":"From bench to bedside: The critical need for standardized senescence detection","authors":"Jagrut Shah,&nbsp;Amel Al-Hashimi,&nbsp;Magela Benedetto,&nbsp;Prashant Jay Ruchaya","doi":"10.1016/j.acvd.2024.12.008","DOIUrl":"10.1016/j.acvd.2024.12.008","url":null,"abstract":"<div><div>Cellular senescence, identified as a state of permanent cell cycle arrest, has become central to understanding aging and disease. Initially seen as a cellular aging mechanism, it is now recognized for its roles in development, tissu repair and tumour suppression. However, the accumulation of senescent cells with age contributes to chronic diseases such as diabetes, atherosclerosis and neurodegeneration. Recent efforts have focused on “senotherapeutics”, including senolytics, which aim to eliminate senescent cells to mitigate age-related decline. Despite significant advances, senescence research faces critical challenges because of inconsistent detection methods. Common markers, such as p16INK4a and senescence-associated β-galactosidase, vary across tissues and contexts, complicating cross-study comparisons and clinical applications. A standardized multifaceted approach to senescence detection is essential, and should incorporate complementary methods, clear thresholds for senescence classification and considerations for cell type-specific variations. Such standardization would enhance reproducibility, streamline research and facilitate clinical translation, advancing therapeutic applications in aging and disease management.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 205-211"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beta-blockers after myocardial infarction: An evergreen therapy?
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2025.02.001
Niki Procopi, Gilles Montalescot, Johanne Silvain
{"title":"Beta-blockers after myocardial infarction: An evergreen therapy?","authors":"Niki Procopi,&nbsp;Gilles Montalescot,&nbsp;Johanne Silvain","doi":"10.1016/j.acvd.2025.02.001","DOIUrl":"10.1016/j.acvd.2025.02.001","url":null,"abstract":"","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 141-143"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Same-day discharge strategy in a heart rhythm management clinic: The patient-reported experience 心律管理诊所的当日出院策略:患者报告的经验。
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.11.002
Sarah Zeriouh , Vasileios Sousonis , Jean-Paul Albenque , Sophie Jacob , Roberto Menè , Christelle Cardin , Quentin Voglimacci-Stephanopoli , Nicolas Combes , Stéphane Combes , Jean-Claude Deharo , Serge Boveda
{"title":"Same-day discharge strategy in a heart rhythm management clinic: The patient-reported experience","authors":"Sarah Zeriouh ,&nbsp;Vasileios Sousonis ,&nbsp;Jean-Paul Albenque ,&nbsp;Sophie Jacob ,&nbsp;Roberto Menè ,&nbsp;Christelle Cardin ,&nbsp;Quentin Voglimacci-Stephanopoli ,&nbsp;Nicolas Combes ,&nbsp;Stéphane Combes ,&nbsp;Jean-Claude Deharo ,&nbsp;Serge Boveda","doi":"10.1016/j.acvd.2024.11.002","DOIUrl":"10.1016/j.acvd.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Same-day discharge (SDD) has been adopted for interventional cardiology procedures, however, data on patient experience are scarce.</div></div><div><h3>Aims</h3><div>To investigate patient-reported experience after various SDD electrophysiology procedures.</div></div><div><h3>Methods</h3><div>Consecutive patients undergoing electrophysiology procedures, who fulfilled pre-defined eligibility criteria for SDD, completed the questionnaire before discharge. Procedures suitable for SDD included non/minimally-invasive (e.g. electric cardioversions, tilt tests) and invasive procedures (e.g. cardiac device replacements, catheter ablations). The questionnaire assessed patient experience before and during the procedure, satisfaction with the provided information and understanding of the discharge instructions.</div></div><div><h3>Results</h3><div>The questionnaire was completed by 501 patients (57.5% men). Invasive procedures accounted for 56.7% of SDD procedures. Most patients (88.9%) described SDD as a good or quite good experience, while 95.3% would not hesitate to undergo a second SDD procedure if necessary. A direct interview with a healthcare team member was the preferred method of obtaining information. At discharge, a considerable number of patients were unsure about the provided instructions, including those related to anticoagulation. Patient-reported satisfaction did not differ between invasive and non/minimally-invasive procedures (<em>P<!--> </em>=<!--> <!-->0.06). However, after an invasive procedure, patients had a better understanding of discharge instructions (59.5% vs 41.9%; <em>P</em> <!-->&lt;<!--> <!-->0.001). Most patients who underwent a procedure under general anaesthesia reported a good or quite good experience (87.7% vs 84.2% of sedation patients; <em>P<!--> </em>=<!--> <!-->0.16).</div></div><div><h3>Conclusion</h3><div>SDD was generally a positive experience for patients undergoing invasive or non/minimally-invasive procedures. However, discharge instructions and patient understanding require improvement.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 170-177"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.11.003
Fangyuan Chen, Ping Liu, Ling Bai, Juanli Li, Tao Chen
{"title":"Effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction","authors":"Fangyuan Chen,&nbsp;Ping Liu,&nbsp;Ling Bai,&nbsp;Juanli Li,&nbsp;Tao Chen","doi":"10.1016/j.acvd.2024.11.003","DOIUrl":"10.1016/j.acvd.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>The role of sodium-glucose cotransporter-2 inhibitors in patients with acute myocardial infarction remains elusive.</div></div><div><h3>Aim</h3><div>To evaluate the effect of early application of a sodium-glucose cotransporter-2 inhibitor on ventricular remodelling and prognosis in patients with anterior wall acute myocardial infarction.</div></div><div><h3>Methods</h3><div>In this prospective study, 102 patients diagnosed with anterior wall acute myocardial infarction were enrolled and divided into intervention and control groups according to the use of dapagliflozin within 24<!--> <!-->hours after admission. Demographic and clinical data, including age, sex, associated co-morbidities, number of lesions, length of hospital stay, N-terminal prohormone of brain natriuretic peptide, left ventricular ejection fraction, left ventricular end-systolic and end-diastolic diameters and drug-related adverse reactions, were collected and analysed between the two groups. All patients were followed up 1, 3 and 6 months after discharge.</div></div><div><h3>Results</h3><div>At 6 months, left ventricular ejection fraction was higher (55.98<!--> <!-->±<!--> <!-->7.17% vs. 52.71<!--> <!-->±<!--> <!-->7.78%; <em>P</em> <!-->=<!--> <!-->0.03) and N-terminal prohormone of brain natriuretic peptide was lower (141.52<!--> <!-->±<!--> <!-->83.18 vs. 203.69<!--> <!-->±<!--> <!-->152.13<!--> <!-->pg/mL; <em>P</em> <!-->=<!--> <!-->0.01) in the intervention group versus the control group. Left ventricular end-systolic diameter (35.68<!--> <!-->±<!--> <!-->4.32 vs. 38.00<!--> <!-->±<!--> <!-->5.01<!--> <!-->mm; <em>P</em> <!-->=<!--> <!-->0.01) and left ventricular end-diastolic diameter (50.48<!--> <!-->±<!--> <!-->4.90 vs. 52.67<!--> <!-->±<!--> <!-->4.91<!--> <!-->mm; <em>P</em> <!-->=<!--> <!-->0.03) were smaller in the intervention group versus the control group. Event-free survival rates were better in the intervention group than in the control group (90% vs. 74.5%; <em>P</em> <!-->=<!--> <!-->0.03). The cumulative incidence of drug-related adverse reactions was similar in the two groups (14% vs. 4.0%; <em>P</em> <!-->=<!--> <!-->0.15).</div></div><div><h3>Conclusions</h3><div>Use of dapagliflozin within 24<!--> <!-->hours after admission can improve cardiac function, inhibit ventricular remodelling, improve clinical prognosis and have high safety in patients with anterior wall acute myocardial infarction during 6-month follow-up.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 144-151"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In-hospital outcomes following an acute coronary syndrome in patients with recent cannabis use 近期吸食大麻的急性冠状动脉综合征患者的院内预后。
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-03-01 DOI: 10.1016/j.acvd.2024.10.321
Antoine Léquipar , Jean-Guillaume Dillinger , Eric Bonnefoy-Cudraz , Emeric Albert , Sabir Attou , Simon Auvray , Sonia Azzakani , Albert Boccara , Océane Bouchot , Jean-Baptiste Brette , Marjorie Canu , Anne Solene Chaussade , Martine Gilard , Valentin Dupasquier , Anthony Elhadad , Nacim Ezzouhairi , Arthur Clément , Emmanuel Gall , Patrick Henry , Théo Pezel
{"title":"In-hospital outcomes following an acute coronary syndrome in patients with recent cannabis use","authors":"Antoine Léquipar ,&nbsp;Jean-Guillaume Dillinger ,&nbsp;Eric Bonnefoy-Cudraz ,&nbsp;Emeric Albert ,&nbsp;Sabir Attou ,&nbsp;Simon Auvray ,&nbsp;Sonia Azzakani ,&nbsp;Albert Boccara ,&nbsp;Océane Bouchot ,&nbsp;Jean-Baptiste Brette ,&nbsp;Marjorie Canu ,&nbsp;Anne Solene Chaussade ,&nbsp;Martine Gilard ,&nbsp;Valentin Dupasquier ,&nbsp;Anthony Elhadad ,&nbsp;Nacim Ezzouhairi ,&nbsp;Arthur Clément ,&nbsp;Emmanuel Gall ,&nbsp;Patrick Henry ,&nbsp;Théo Pezel","doi":"10.1016/j.acvd.2024.10.321","DOIUrl":"10.1016/j.acvd.2024.10.321","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence and short-term cardiovascular consequences of recent cannabis use in patients admitted to an intensive cardiac care unit for acute coronary syndrome is not well established.</div></div><div><h3>Aims</h3><div>To assess the prevalence of recent cannabis use detected by prospective systematic screening, and its prognostic value in predicting the occurrence of in-hospital major adverse events in consecutive patients with acute coronary syndrome.</div></div><div><h3>Methods</h3><div>From 07 to 22 April 2021, all consecutive patients admitted to an intensive cardiac care unit in 39 centres throughout France were studied prospectively. Systematic recreational drug screening was performed on admission by urine assay in all patients. The primary outcome was the prevalence of recent cannabis use. The secondary outcome was in-hospital major adverse events, defined by death, resuscitated cardiac arrest and cardiogenic shock requiring medical or mechanical haemodynamic support.</div></div><div><h3>Results</h3><div>A total of 772 patients were hospitalized for acute coronary syndrome (mean age 64<!--> <!-->±<!--> <!-->13<!--> <!-->years; 74% male). Among those, 86 patients (11.1%) had a positive urine test for cannabis. Patients with cannabis detected were younger (53<!--> <!-->±<!--> <!-->12 vs. 65<!--> <!-->±<!--> <!-->12<!--> <!-->years, respectively; <em>P</em> <!-->&lt;<!--> <!-->0.001) and were more frequently male (88% vs. 72%, respectively; <em>P</em> <!-->=<!--> <!-->0.001). After a median hospitalization duration of 2<!--> <!-->days, 33 (4.3%) in-hospital major adverse events occurred. The detection of cannabis was associated with a higher rate of in-hospital major adverse events after adjustment for prior co-morbidities (odds ratio 3.28; <em>P</em> <!-->=<!--> <!-->0.015) and after adjustment for known predictors of severity (odds ratio 3.68; <em>P</em> <!-->=<!--> <!-->0.009).</div></div><div><h3>Conclusions</h3><div>The prevalence of recent cannabis use in patients hospitalized for acute coronary syndrome was 11.1%. The detection of recent cannabis use was independently associated with a higher occurrence of in-hospital major adverse events.</div></div>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":"118 3","pages":"Pages 152-160"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessment of quitting versus using aspirin therapy in patients with stabilized coronary artery disease after stenting who require long-term oral anticoagulation: Rationale for and design of the AQUATIC double-blind randomized trial.
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-02-15 DOI: 10.1016/j.acvd.2025.01.006
Romain Didier, Gilles Lemesle, Gilles Montalescot, P H Gabriel Steg, Eric Vicaut, Dominique Mottier, Christophe Bauters, Philippe Mabo, Tabassome Simon, Claire Bouleti, Stephane Andrieu, Denis Angoulvant, Gerald Vanzetto, Mathieu Kerneis, Guillaume Cayla, Martine Gilard
{"title":"Assessment of quitting versus using aspirin therapy in patients with stabilized coronary artery disease after stenting who require long-term oral anticoagulation: Rationale for and design of the AQUATIC double-blind randomized trial.","authors":"Romain Didier, Gilles Lemesle, Gilles Montalescot, P H Gabriel Steg, Eric Vicaut, Dominique Mottier, Christophe Bauters, Philippe Mabo, Tabassome Simon, Claire Bouleti, Stephane Andrieu, Denis Angoulvant, Gerald Vanzetto, Mathieu Kerneis, Guillaume Cayla, Martine Gilard","doi":"10.1016/j.acvd.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.01.006","url":null,"abstract":"<p><strong>Background: </strong>Antithrombotic management in patients with chronic coronary syndrome and previous stent implantation who require long-term oral anticoagulation is highly challenging in daily practice, especially in those at high residual risk of coronary and vascular events. Dual therapy with oral anticoagulation and aspirin may lead to a higher risk of bleeding, whereas stopping aspirin in high-risk patients with coronary artery disease after percutaneous coronary intervention may lead to recurrent ischaemic events.</p><p><strong>Aim: </strong>To assess the optimal antithrombotic regimen that should be pursued long term (often lifelong) in these patients.</p><p><strong>Methods: </strong>The AQUATIC study is a prospective, randomized, double-blind, placebo-controlled, parallel-group, multicentre study conducted in patients with chronic coronary syndrome at high risk of ischaemic events (i.e., stent implantation [> 6 months before inclusion] in a context of previous acute coronary syndrome and/or with high-risk features of ischaemic event recurrences) and requiring long-term oral anticoagulation. For superiority, we ensure 80% power at level α=0.05 to detect a 25% reduction in hazard in the experimental group relative to the control group. Overall, 2000 patients will be randomized in a 1:1 ratio to receive either oral anticoagulation and aspirin or oral anticoagulation and placebo. The primary efficacy endpoint is a composite of cardiovascular death, myocardial infarction, stroke, systemic embolism, coronary revascularization and acute limb ischaemia. Major bleeding according to the International Society on Thrombosis and Haemostasis definition is a secondary safety endpoint that will be assessed as a priority.</p><p><strong>Conclusion: </strong>The AQUATIC trial will test the efficacy and safety of adding aspirin to long-term oral anticoagulation in patients with chronic coronary syndrome and previous coronary stenting who are at high residual risk of recurrent ischaemic events and require oral anticoagulation.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous coronary intervention in patients with acute coronary syndromes and increased platelet count.
IF 2.3 3区 医学
Archives of Cardiovascular Diseases Pub Date : 2025-02-13 DOI: 10.1016/j.acvd.2025.01.005
Yang Zhang, Yongchen Hao, Jun Liu, Na Yang, Sidney C Smith, Yong Huo, Gregg C Fonarow, Junbo Ge, Louise Morgan, Zhaoqing Sun, Danqing Hu, Yiqian Yang, Chang-Sheng Ma, Dong Zhao, Yaling Han, Jing Liu, Yong Zeng
{"title":"Percutaneous coronary intervention in patients with acute coronary syndromes and increased platelet count.","authors":"Yang Zhang, Yongchen Hao, Jun Liu, Na Yang, Sidney C Smith, Yong Huo, Gregg C Fonarow, Junbo Ge, Louise Morgan, Zhaoqing Sun, Danqing Hu, Yiqian Yang, Chang-Sheng Ma, Dong Zhao, Yaling Han, Jing Liu, Yong Zeng","doi":"10.1016/j.acvd.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.acvd.2025.01.005","url":null,"abstract":"<p><strong>Background: </strong>In patients with acute coronary syndromes (ACS) requiring percutaneous coronary intervention (PCI), abnormally elevated platelet counts are often associated with an increased risk of stent thrombosis and bleeding.</p><p><strong>Aims: </strong>To explore the associations between clinical benefits and PCI in patients with ACS and elevated platelet counts.</p><p><strong>Methods: </strong>Between July 2017 and December 2019, 50,009 patients with ACS were enrolled in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome Project. This study included patients with platelet count≥300×10<sup>9</sup>/L. The primary outcome was net adverse clinical events (NACE), including major adverse cardiovascular or cerebrovascular events (MACCE; all-cause death, myocardial infarction, ischaemic stroke and stent thrombosis) and major bleeding during the index hospitalization. The difference in the risk of NACE between PCI and non-PCI groups was analysed using multivariable analysis and inverse probability of treatment weighting.</p><p><strong>Results: </strong>Among 4501 patients, PCI rates decreased as platelet count increased, with 3029 patients ultimately undergoing PCI. These patients exhibited a lower rate of NACE (adjusted odds ratio [OR]: 0.53, 95% confidence interval [95% CI]: 0.37-0.77; P=0.001) and a reduced risk of MACCE (OR: 0.44, 95% CI: 0.29-0.67; P<0.001). No significant differences in major bleeding were observed (adjusted OR: 1.40, 95% CI: 0.62-3.16; P=0.417). Inverse probability of treatment weighting confirmed these findings.</p><p><strong>Conclusion: </strong>In patients with ACS and increased platelet counts who have more complex thrombohaemorrhagic profiles, PCI can effectively reduce the risk of ischaemic events without increasing the risk of bleeding.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT02306616.</p>","PeriodicalId":55472,"journal":{"name":"Archives of Cardiovascular Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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