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Serum Tenascin-C is independently associated with increased major adverse cardiovascular events and death in patients with type II diabetes
156 different algorithms taking into account hospital diagnosis, antihypertensive treatment deliveries and differential diagnosis. Results Between 2010 and 2016, 4,991,308 deliveries occurred in France corresponding to 3,786,510 women. A total of 7.8% of all pregnancies were associated with at least one hypertensive disorder. Chronic hypertension occurred in the year preceding 1.7% of pregnancies and persisted in 1.1% of cases. Gestational hypertension was recorded in 5.2% of pregnancies and Preeclampsia/Eclampsia in 2% of pregnancies. Preeclampsia occurred before 32 weeks of amenorrhea in 17% of cases, between 32 weeks and delivery in 61% of cases and after delivery in 22% of cases. Preeclampsia was not preceded by any other hypertensive disorder in 44.1% of pregnancies. In 11.6% and 44.3% of pregnancies, preeclampsia was preceded by chronic hypertension and by gestational hypertension respectively. Conclusion Hypertensive disorders affected 7.8% of pregnancies in France between 2010 and 2016. It is necessary to pay particular attention to these women in assessing their future cardio-vascular risk. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.321 360
Serum Tenascin-C is independently associated with increased major adverse cardiovascular events and death in patients with type II diabetes B. Gellen 1,∗ , N. Thorin-Trescases 2 , E. Thorin 2 , E. Gand 3 , P. Sosner 3 , S. Brishoual 3 , M. Fraty 3 , S. Hadjadj 3 , P.J. Saulnier 3 1 ELSAN—Polyclinique de Poitiers, Poitiers, France 2 Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada 3 CHU de Poitiers Centre d’Investigation Clinique, Poitiers, France ∗ Corresponding author. E-mail address: [email protected] (B. Gellen) Background Tenascin-C (TNC) is an extracellular matrix glycoprotein highly expressed in inflammatory and cardiovascular (CV) pathologies. In heart failure or after myocardial infarction, elevated TNC is associated with adverse outcomes. Serum TNC has not yet been studied specifically in patients with type II diabetes, a condition associated with chronic low-grade inflammation and increased CV risk. We hypothesized that high serum TNC measured at enrolment in a large cohort of type II diabetic patients is associated with major adverse CV events (MACE) and death during follow-up. Methods A prospective, monocentric cohort of consecutive type 2 diabetes patients (the SURDIAGENE cohort; total of 1338 patients; 58% men, mean ± SD age 64 ± 11 years) was followed for a median of 89 months for death as primary endpoint and MACE (i.e. CV death, myocardial infarction or stroke) as a secondary endpoint. Patients with stage ≥ 4 renal disease were excluded. Results During follow-up, 448 patients (representing 4.4% of the total person-years) died and 506 patients (representing 5.2% of the total person-years) presented with MACE. Cox multivariate analysis showed that increased serum TNC concentrations were significantly associated with death (HR per 10 ng/mL: 1.03 (1.01—1.05) P = 0.0095) and MACE (HR per 10 ng/mL: 1.02 (1.00—1.04) P = 0.0162), after adjustment for sex, age, established modifiable CV risk factors (active smoking, hypertension, hypercholesterolemia) and NT-proBNP levels. Conclusions In patients with type 2 diabetes, we show for the first time that increased serum TNC concentrations are independently associated with MACE and death. These findings suggest that elevated TNC expression might be implicated in the increased CV
Prevention—Epidemiology—Nutrition risk associated with diabetes, and might be useful for CV risk stratification in this context. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.322 284
Psychosocial and behavioral characteristics of still smokers at 6 months after acute cerebro or cardiovascular events: Findings from INEV@L, a prospective pilot study M. Zeller 1,∗ , E. Sales-Wuillemin 2 , S. Guinchard 3 , J. Chappé 2 , F. Chagué 3 , H. Ayari 3 , M. Maza 3 , C. Aboa-Eboule 4 , C. Truchot 5 , L. Lorgis 3 , M. Giroud 4 , Y. Cottin 3 , Y. Béjot 4 1 PEC2, EA 7460, UFR Sciences de Santé 2 Laboratoire PSY-DREPI, EA 7458, Université Bourgogne Franche-Comté 3 Service de Cardiologie 4 Service de Neurologie, CHU Dijon-Bourgogne, Dijon 5 Psychologie, Université Bourgogne Franche-Comté, Besanc ¸on, France ∗ Corresponding author. E-mail address: [email protected] (M. Zeller) Introduction Considering the benefits of smoking cessation, and evolving new tobacco-product consumption, such as e-cigarettes (e-cig), contemporary behavioral and psychosocial factors (PSF) associated with smoking after acute stroke or myocardial infarction (MI) remain to be investigated. Methods From INEV@L, a prospective pilot study in 128 workers hospitalized for MI or stroke (MI/stroke: 199/57) < 65 y, between 2016 and 2017 in CHU Dijon. Among them, 67 (52%) current smokers were analyzed. PSF (education level (EL), socioeconomic status (SES), perceived disease severity (PDS), anxiety/depression), and health behavior (adhesion to Mediterranean diet (AMD), BMI, physical activity (PA), smoking) were collected at the acute phase and at 6 months follow-Up. Patients who quit smoking were compared with non-quitting patients at FU. Results Still smokers at FU were frequent (30(45%)) and had similar risk factors including age (51 ± 7 y) than quitters. Rate of overweight/obese patients and AMD were similar (52 vs. 65%, P = 0.281 and 29 ± 6 vs. 26 ± 7, P = 0.207). SES and EL were slightly higher in still smokers group. The level of anxiety or depression was as high in the 2 groups (63 vs. 68%, and 19 vs. 20%, P = 0.717 and 0.911). Although similar at the acute phase (P = 0.867), PDS at 6M FU, trended to be lower in non-quitters (57 vs. 78%, P = 0.057). At FU, only few returned to work (57% for both groups). Overweight/obese who reduced their weight were more common in non-quitters (60 vs. 38%, P = 0.170). Patients who improved AMD or PA level were similar (62 vs. 78%, P = 0.166, and 67 vs. 92%, P = 0.317). The vast majority of non-quitters introduced the use of e-cig (80% vs. 0%, P < 0.001). Conclusion Our pilot study in young workers highlights the low rate of smoking cessation, and generalized dual use of electronic + conventional cigarette at mid-term after acute MI or stroke. Our findings further suggest specific PSF pattern of non-quitters, associated with loss of perceived disease severity. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.323
Serum Tenascin-C is independently associated with increased major adverse cardiovascular events and death in patients with type II diabetes B. Gellen 1,∗ , N. Thorin-Trescases 2 , E. Thorin 2 , E. Gand 3 , P. Sosner 3 , S. Brishoual 3 , M. Fraty 3 , S. Hadjadj 3 , P.J. Saulnier 3 1 ELSAN—Polyclinique de Poitiers, Poitiers, France 2 Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal Heart Institute, Montreal, Canada 3 CHU de Poitiers Centre d’Investigation Clinique, Poitiers, France ∗ Corresponding author. E-mail address: [email protected] (B. Gellen) Background Tenascin-C (TNC) is an extracellular matrix glycoprotein highly expressed in inflammatory and cardiovascular (CV) pathologies. In heart failure or after myocardial infarction, elevated TNC is associated with adverse outcomes. Serum TNC has not yet been studied specifically in patients with type II diabetes, a condition associated with chronic low-grade inflammation and increased CV risk. We hypothesized that high serum TNC measured at enrolment in a large cohort of type II diabetic patients is associated with major adverse CV events (MACE) and death during follow-up. Methods A prospective, monocentric cohort of consecutive type 2 diabetes patients (the SURDIAGENE cohort; total of 1338 patients; 58% men, mean ± SD age 64 ± 11 years) was followed for a median of 89 months for death as primary endpoint and MACE (i.e. CV death, myocardial infarction or stroke) as a secondary endpoint. Patients with stage ≥ 4 renal disease were excluded. Results During follow-up, 448 patients (representing 4.4% of the total person-years) died and 506 patients (representing 5.2% of the total person-years) presented with MACE. Cox multivariate analysis showed that increased serum TNC concentrations were significantly associated with death (HR per 10 ng/mL: 1.03 (1.01—1.05) P = 0.0095) and MACE (HR per 10 ng/mL: 1.02 (1.00—1.04) P = 0.0162), after adjustment for sex, age, established modifiable CV risk factors (active smoking, hypertension, hypercholesterolemia) and NT-proBNP levels. Conclusions In patients with type 2 diabetes, we show for the first time that increased serum TNC concentrations are independently associated with MACE and death. These findings suggest that elevated TNC expression might be implicated in the increased CV
Prevention—Epidemiology—Nutrition risk associated with diabetes, and might be useful for CV risk stratification in this context. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.322 284
Psychosocial and behavioral characteristics of still smokers at 6 months after acute cerebro or cardiovascular events: Findings from INEV@L, a prospective pilot study M. Zeller 1,∗ , E. Sales-Wuillemin 2 , S. Guinchard 3 , J. Chappé 2 , F. Chagué 3 , H. Ayari 3 , M. Maza 3 , C. Aboa-Eboule 4 , C. Truchot 5 , L. Lorgis 3 , M. Giroud 4 , Y. Cottin 3 , Y. Béjot 4 1 PEC2, EA 7460, UFR Sciences de Santé 2 Laboratoire PSY-DREPI, EA 7458, Université Bourgogne Franche-Comté 3 Service de Cardiologie 4 Service de Neurologie, CHU Dijon-Bourgogne, Dijon 5 Psychologie, Université Bourgogne Franche-Comté, Besanc ¸on, France ∗ Corresponding author. E-mail address: [email protected] (M. Zeller) Introduction Considering the benefits of smoking cessation, and evolving new tobacco-product consumption, such as e-cigarettes (e-cig), contemporary behavioral and psychosocial factors (PSF) associated with smoking after acute stroke or myocardial infarction (MI) remain to be investigated. Methods From INEV@L, a prospective pilot study in 128 workers hospitalized for MI or stroke (MI/stroke: 199/57) < 65 y, between 2016 and 2017 in CHU Dijon. Among them, 67 (52%) current smokers were analyzed. PSF (education level (EL), socioeconomic status (SES), perceived disease severity (PDS), anxiety/depression), and health behavior (adhesion to Mediterranean diet (AMD), BMI, physical activity (PA), smoking) were collected at the acute phase and at 6 months follow-Up. Patients who quit smoking were compared with non-quitting patients at FU. Results Still smokers at FU were frequent (30(45%)) and had similar risk factors including age (51 ± 7 y) than quitters. Rate of overweight/obese patients and AMD were similar (52 vs. 65%, P = 0.281 and 29 ± 6 vs. 26 ± 7, P = 0.207). SES and EL were slightly higher in still smokers group. The level of anxiety or depression was as high in the 2 groups (63 vs. 68%, and 19 vs. 20%, P = 0.717 and 0.911). Although similar at the acute phase (P = 0.867), PDS at 6M FU, trended to be lower in non-quitters (57 vs. 78%, P = 0.057). At FU, only few returned to work (57% for both groups). Overweight/obese who reduced their weight were more common in non-quitters (60 vs. 38%, P = 0.170). Patients who improved AMD or PA level were similar (62 vs. 78%, P = 0.166, and 67 vs. 92%, P = 0.317). The vast majority of non-quitters introduced the use of e-cig (80% vs. 0%, P < 0.001). Conclusion Our pilot study in young workers highlights the low rate of smoking cessation, and generalized dual use of electronic + conventional cigarette at mid-term after acute MI or stroke. Our findings further suggest specific PSF pattern of non-quitters, associated with loss of perceived disease severity. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2019.09.323