- Email: [email protected]
The EYE-MI study: A prospective acute coronary syndrome cohort evaluated by retinal optical coherence tomography angiography
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01-Coronary artery disease
but the delays of management and reperfusion of patients are long, more than 5 h. The rate of intra-hospital complications is relatively low and may have several explanations, the most important seems to be of which is the low risk of patients enrolled. This is probably related to the current management of STEMI in Algeria, the most severe patients do not arrive at cardiac centers. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.012 577
The EYE-MI study: A prospective acute coronary syndrome cohort evaluated by retinal optical coherence tomography angiography A. Azemar 1 , L. Arnould 2 , C. Guenancia 1 , C. Meillon 2 , M. Zeller 3,∗ , F. Bichat 1 , A. Bron 2 , C. Creuzot-Garcher 2 , Y. Cottin 1 1 Service de cardiologie, CHU de Dijon, Dijon, France 2 Service d’ophtalmologie CHU de Dijon, Dijon, France 3 Laboratoire PEC2, UFR sciences de santé, université Bourgogne-Franche Comté, Dijon, France ∗ Corresponding author. E-mail address: [email protected] (M. Zeller) Background Retinal artery calibre correlates with the risk of cardiovascular events, and could serve as an inexpensive and reproducible biomarker for cardiovascular diseases. Recently, a non-invasive approach for retinal imaging with OCT angiography has been proposed to evaluate retinal blood vessel density. Methods The EYE-MI study prospectively included all consecutive patients admitted to our University Hospital for acute coronary syndrome (ACS) between October, 1st and December, 31st 2016. Patients with retinal diseases were excluded. Retinal OCT angiography was performed within 2 days after admission to assess inner retina vascular density (IRVD), based on blood flow. Results Of 212 patients admitted for ACS, 173 were included. Age was 62 ± 12 years and 79% were male. When compared with the higher tertiles of IVRD, patients with the lowest tertile were older, had more often hypertension, diabetes and previous renal failure. Strikingly, AHA and SCORE risks were higher. Moreover, patients in the lowest IRVD tertile had higher SYNTAX and GRACE scores, lower LVEF and a higher heart rate and systolic blood pressure, despite similar rates of beta-blockers and RAAS inhibitors. After multivariate analysis, only AHA risk score (OR (95% CI): 1.07 (1.04—1.10),) and LVEF (OR (95% CI): 0.95 (0.92—0.98)) were associated with the lowest retinal vascular density. The strong association between the AHA risk score and IRVD was confirmed by Pearson correlation coefficient (r = −0.48, P < 0.001) (Fig. 1). Conclusion In patients admitted for ACS, IRVD measured by OCT angiography was strongly associated with cardiovascular risk and with impaired LVEF. These preliminary results could help to target a specific population at high risk for cardiovascular events.
Fig. 1
Low and high vascular density pattern by OCT angiography.
Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2017.11.013 233
Prognostic impact of pre-percutaneous coronary intervention TIMI flow in ST and non-ST elevation myocardial infarction patients: Results from the FAST-MI 2010 registry C. Bailleul 1 , N. Aissaoui 1 , G. Cayla 2 , J. Dillinger 3 , B. Jouve 4 , F. Schiele 5 , T. Simon 6 , N. Danchin 7 , E. Puymirat 1,∗ 1 Hôpital européen Georges-Pompidou, Paris, France 2 CHU de Nîmes, Nîmes, France 3 Cardiologie, Lariboisière, Paris, France 4 Hôpital d’Aix-en-Provence, Aix-en-Provence, France 5 Service de cardiologie, CHU Jean-Minjoz, Besanc ¸on, France 6 Service de pharmacologie, hôpital Saint-Antoine, AP—HP, France 7 Hôpital européen G.-Pompidou, AP—HP, Paris, France ∗ Corresponding author. E-mail address: [email protected] (E. Puymirat) Background Thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3 before percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) is associated with improved outcomes. No recent data, however, are available on its impact beyond one year and/or by type of AMI. Aims To assess the prognostic impact of pre-PCI TIMI flow at 30 days and 3 years in ST-elevation (STEMI) and non-ST-elevation (NSTEMI) AMI patients. Methods We compared long-term outcomes associated with TIMI flow grade 2/3 versus 0/1 in patients referred for PCI in the FAST-MI 2010 nationwide French registry. Results TIMI flow grade 2/3 was found in 41% of STEMI and 69% of NSTEMI patients. It was associated with lower 30-day death in STEMI patients (OR: 0.30; 95% CI: 0.12 to 0.77, P = 0.01) but not in NSTEMI patients (OR 0.57; 95% CI: 0.22 to 1.42, P = 0.23). TIMI grade flow 2/3 was also associated with lower risk of 3-year death in STEMI patients (HR: 0.69; 95% CI: 0.49 to 0.98, P = 0.04) but not in NSTEMI patients (HR 0.79; 95% CI: 0.56 to 1.11, P = 0.17). Conclusion TIMI flow grade 2/3 is observed more often in NSTEMI patients. It represents an independent predictor of early and late survival in STEMI patients but is not significantly related to early or long-term survival in NSTEMI patients. Clinicaltrials.gov identifier: NCT01237418. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.014 243
In-hospital acute coronary syndrome management in Europe: Pharmacological treatment trends, adequacy to the latest guidelines and its impact on vital status at discharge S. Huo Yung Kai 1,∗ , I. Roman Dégano 2 , I. Kirschberger 3 , D. Farmakis 4 , L. Tavazzi 5 , J. Marrugat 2 , J. Ferrières 6 1 Myocardial infarction registry of Haute-Garonne, Toulouse university hospital, Toulouse, France 2 Cardiovascular epidemiology and genetics group, IMIM (Hospital del Mar Medical Research Institute), Barcelone, Spain 3 MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany 4 Cardiology, Attikon university hospital, Athens, Greece
01-Coronary artery disease
but the delays of management and reperfusion of patients are long, more than 5 h. The rate of intra-hospital complications is relatively low and may have several explanations, the most important seems to be of which is the low risk of patients enrolled. This is probably related to the current management of STEMI in Algeria, the most severe patients do not arrive at cardiac centers. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.012 577
The EYE-MI study: A prospective acute coronary syndrome cohort evaluated by retinal optical coherence tomography angiography A. Azemar 1 , L. Arnould 2 , C. Guenancia 1 , C. Meillon 2 , M. Zeller 3,∗ , F. Bichat 1 , A. Bron 2 , C. Creuzot-Garcher 2 , Y. Cottin 1 1 Service de cardiologie, CHU de Dijon, Dijon, France 2 Service d’ophtalmologie CHU de Dijon, Dijon, France 3 Laboratoire PEC2, UFR sciences de santé, université Bourgogne-Franche Comté, Dijon, France ∗ Corresponding author. E-mail address: [email protected] (M. Zeller) Background Retinal artery calibre correlates with the risk of cardiovascular events, and could serve as an inexpensive and reproducible biomarker for cardiovascular diseases. Recently, a non-invasive approach for retinal imaging with OCT angiography has been proposed to evaluate retinal blood vessel density. Methods The EYE-MI study prospectively included all consecutive patients admitted to our University Hospital for acute coronary syndrome (ACS) between October, 1st and December, 31st 2016. Patients with retinal diseases were excluded. Retinal OCT angiography was performed within 2 days after admission to assess inner retina vascular density (IRVD), based on blood flow. Results Of 212 patients admitted for ACS, 173 were included. Age was 62 ± 12 years and 79% were male. When compared with the higher tertiles of IVRD, patients with the lowest tertile were older, had more often hypertension, diabetes and previous renal failure. Strikingly, AHA and SCORE risks were higher. Moreover, patients in the lowest IRVD tertile had higher SYNTAX and GRACE scores, lower LVEF and a higher heart rate and systolic blood pressure, despite similar rates of beta-blockers and RAAS inhibitors. After multivariate analysis, only AHA risk score (OR (95% CI): 1.07 (1.04—1.10),) and LVEF (OR (95% CI): 0.95 (0.92—0.98)) were associated with the lowest retinal vascular density. The strong association between the AHA risk score and IRVD was confirmed by Pearson correlation coefficient (r = −0.48, P < 0.001) (Fig. 1). Conclusion In patients admitted for ACS, IRVD measured by OCT angiography was strongly associated with cardiovascular risk and with impaired LVEF. These preliminary results could help to target a specific population at high risk for cardiovascular events.
Fig. 1
Low and high vascular density pattern by OCT angiography.
Disclosure of interest peting interest.
The authors declare that they have no com-
https://doi.org/10.1016/j.acvdsp.2017.11.013 233
Prognostic impact of pre-percutaneous coronary intervention TIMI flow in ST and non-ST elevation myocardial infarction patients: Results from the FAST-MI 2010 registry C. Bailleul 1 , N. Aissaoui 1 , G. Cayla 2 , J. Dillinger 3 , B. Jouve 4 , F. Schiele 5 , T. Simon 6 , N. Danchin 7 , E. Puymirat 1,∗ 1 Hôpital européen Georges-Pompidou, Paris, France 2 CHU de Nîmes, Nîmes, France 3 Cardiologie, Lariboisière, Paris, France 4 Hôpital d’Aix-en-Provence, Aix-en-Provence, France 5 Service de cardiologie, CHU Jean-Minjoz, Besanc ¸on, France 6 Service de pharmacologie, hôpital Saint-Antoine, AP—HP, France 7 Hôpital européen G.-Pompidou, AP—HP, Paris, France ∗ Corresponding author. E-mail address: [email protected] (E. Puymirat) Background Thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3 before percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) is associated with improved outcomes. No recent data, however, are available on its impact beyond one year and/or by type of AMI. Aims To assess the prognostic impact of pre-PCI TIMI flow at 30 days and 3 years in ST-elevation (STEMI) and non-ST-elevation (NSTEMI) AMI patients. Methods We compared long-term outcomes associated with TIMI flow grade 2/3 versus 0/1 in patients referred for PCI in the FAST-MI 2010 nationwide French registry. Results TIMI flow grade 2/3 was found in 41% of STEMI and 69% of NSTEMI patients. It was associated with lower 30-day death in STEMI patients (OR: 0.30; 95% CI: 0.12 to 0.77, P = 0.01) but not in NSTEMI patients (OR 0.57; 95% CI: 0.22 to 1.42, P = 0.23). TIMI grade flow 2/3 was also associated with lower risk of 3-year death in STEMI patients (HR: 0.69; 95% CI: 0.49 to 0.98, P = 0.04) but not in NSTEMI patients (HR 0.79; 95% CI: 0.56 to 1.11, P = 0.17). Conclusion TIMI flow grade 2/3 is observed more often in NSTEMI patients. It represents an independent predictor of early and late survival in STEMI patients but is not significantly related to early or long-term survival in NSTEMI patients. Clinicaltrials.gov identifier: NCT01237418. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2017.11.014 243
In-hospital acute coronary syndrome management in Europe: Pharmacological treatment trends, adequacy to the latest guidelines and its impact on vital status at discharge S. Huo Yung Kai 1,∗ , I. Roman Dégano 2 , I. Kirschberger 3 , D. Farmakis 4 , L. Tavazzi 5 , J. Marrugat 2 , J. Ferrières 6 1 Myocardial infarction registry of Haute-Garonne, Toulouse university hospital, Toulouse, France 2 Cardiovascular epidemiology and genetics group, IMIM (Hospital del Mar Medical Research Institute), Barcelone, Spain 3 MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany 4 Cardiology, Attikon university hospital, Athens, Greece