Characteristics of Young Women Presenting With Acute Myocardial Infarction: The Prospective, Multicenter, Observational Young Women Presenting Acute Myocardial Infarction in France Study.

Background: The percentage of women <50 years of age hospitalized with myocardial infarction is increasing. We describe the clinical, morphological, and biological characteristics, as well as the clinical outcomes of this population.

Methods And Results: This prospective, observational study included consecutive women <50 years of age admitted for myocardial infarction at 30 centers in France (May 2017-June 2019).

Deep phenotyping and biomarkers of various dairy fat intakes in an 8-week randomized clinical trial and 2-year swine study.

Health effects of dairy fats (DF) are difficult to evaluate, as DF intakes are hard to assess epidemiologically and DF have heterogeneous compositions that influence biological responses. We set out to find biomarkers of DF intake and assess biological response to a summer DF diet (R2), a winter DF diet (R3), and a R3 supplemented with calcium (R4) compared to a plant-fat-based diet (R1) in a randomized clinical trial (n=173) and a 2-year study in mildly metabolically disturbed downsized pigs (n=32). Conventional clinical measures were completed by LC/MS plasma metabolomics/lipidomics.

Is platelet function testing at the acute phase under P2Y inhibitors helpful in predicting bleeding in real-life patients with acute coronary syndrome? The AVALANCHE study.

Background: In patients with acute coronary syndrome (ACS), current international guidelines recommend newer potent and predictable P2Y inhibitors as first-line treatment despite a greater bleeding risk compared with clopidogrel.

Aim: To determine if platelet function testing can predict bleeding in real-life patients with ACS treated with newer P2Y inhibitors.

Methods: In this retrospective study, all consecutive adults admitted to the Lariboisière University Hospital for ACS, whatever the P2Y inhibitor prescribed, who had platelet function testing (vasodilator-stimulated phosphoprotein phosphorylation [VASP] index and aggregation tests) during the initial hospital stay were included.

Effect of milk fat on LDL cholesterol and other cardiovascular risk markers in healthy humans: the INNOVALAIT project.

Background: Milk has a specific saturated fatty acid profile and its calcium content may change the kinetics of fat absorption.

Objective: The goal of this study was to compare the effect on LDL Cholesterol and other risk markers of four isolipidic diets differing by their fat food source, vegetable fat, spring milk fat, winter milk fat or winter milk fat supplemented with calcium, in healthy moderately hypercholesterolemic humans.

Individuals And Methods: This double-blind, randomized trial with four parallel arms included 172 healthy adults with plasma LDL cholesterol (LDL-C) from 130 to 220 mg/dL and triglycerides below 300 mg/dL.

Six months two years of oral anticoagulation after a first episode of unprovoked deep-vein thrombosis. The PADIS-DVT randomized clinical trial.

The optimal duration of anticoagulation after a first episode of unprovoked deep-vein thrombosis is uncertain. We aimed to assess the benefits and risks of an additional 18 months of treatment with warfarin placebo, after an initial 6 months of anticoagulation for a first unprovoked proximal deep-vein thrombosis. We conducted a multicenter, randomized, double-blind, controlled trial comparing an additional 18 months of warfarin with placebo in patients with a unprovoked proximal deep-vein thrombosis initially treated for 6 months (treatment period: 18 months; follow up after treatment period: 24 months).

A novel experimental thrombotic myocardial infarction and primary angioplasty model in swine.

Aims: We sought to develop a reproducible animal model for acute myocardial infarction (AMI) in adult atherosclerosis-prone pigs.

Methods And Results: A coil was placed in the right coronary artery or the left anterior descending artery in 26 downsized spontaneously hypercholesterolaemic pigs and left untreated until thrombotic occlusion. Then, we crossed the thrombotic occlusion with a guidewire, followed by predilatation, thrombus visualisation with optical coherence tomography (OCT) imaging and, finally, deployment of a stent and repeated OCT.

Bivalirudin infusion to reduce ventricular infarction: the open-label, randomised Bivalirudin Infusion for Ventricular InfArction Limitation (BIVAL) study.

Aims: The aim of the study was to investigate whether bivalirudin versus unfractionated heparin (UFH) reduces infarct size (IS) for primary percutaneous coronary intervention (PPCI) in large acute myocardial infarction (AMI).

Methods And Results: This multicentre open-label trial randomised 78 patients undergoing PPCI for large AMI to bivalirudin or UFH. The primary endpoint was IS, assessed by cardiac magnetic resonance (CMR) five days after PPCI.

Enoxaparin chains stored during chronic treatment are mobilized by a bolus of unfractionated heparin: insights from the STACKENOX study.

The initial STACKENOX (STACK-on to ENOXaparin) study investigated the effect of stacking unfractionated heparin (UFH) onto a chronic treatment with enoxaparin, a common practice in interventional cardiology when a patient treated with enoxaparin receives an additional bolus of UFH at the time of percutaneous coronary intervention. The study brought to light some unexpected consequences on coagulation tests and hemorrhagic risk. This substudy was performed to provide a pharmacological explanation for these observations.

Measuring non-vitamin K antagonist oral anticoagulant levels: When is it appropriate and which methods should be used?

Background: Although the need for an emergency intervention may merit laboratory measurement of non-vitamin K antagonist oral anticoagulant (NOAC) concentration or anticoagulant activity, NOACs are not supposed to require routine monitoring due to their stable pharmacological profiles compared with warfarin.

Aims: To examine situations where NOAC measurement may be useful and to provide information about methodologies available to measure NOAC-related anticoagulation activity.

Summary Of Review: The routine coagulation tests, including prothrombin time, thrombin time, activated partial thromboplastin time, and international normalized ratio, have variable sensitivities to NOACs.

High platelet reactivity on aspirin in patients with acute ST elevation myocardial infarction.

Background: Despite dual antiplatelet treatment, major ischemic events are common following ST elevation myocardial infarction (STEMI). We aimed to assess high platelet reactivity on aspirin (HPR-aspirin) and its association with P2Y12i (HPR-P2Y12i) during the acute phase of STEMI.

Methods: We included all consecutive patients admitted for STEMI treated by primary angioplasty in our center for 1year.

Impaired biological response to aspirin in therapeutic hypothermia comatose patients resuscitated from out-of-hospital cardiac arrest.

Aim Of The Study: Acute coronary syndrome is one of the main causes of out-of-hospital cardiac arrest (OHCA). OHCA patients are particularly exposed to high platelet reactivity (HPR) under aspirin (ASA) treatment. The aim was to evaluate HPR-ASA in therapeutic hypothermia comatose patients resuscitated from OHCA.

Accuracy of point of care coagulometers compared to reference laboratory measurements in patients on oral anticoagulation therapy.

Background: Vitamin K antagonists (VKA) are widely prescribed throughout the world. Patients on VKA therapy require international normalized ratio (INR) monitoring of venous blood to ensure the response remains within the therapeutic window. Point-of-care devices (POC-INR) can safely and easily monitor VKA efficacy but need to be evaluated in practice.

Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial.

Importance: The optimal duration of anticoagulation after a first episode of unprovoked pulmonary embolism is uncertain.

Objectives: To determine the benefits and harms of an additional 18-month treatment with warfarin vs placebo, after an initial 6-month nonrandomized treatment period on a vitamin K antagonist.

Design, Setting, And Participants: Randomized, double-blind trial (treatment period, 18 months; median follow-up, 24 months); 371 adult patients who had experienced a first episode of symptomatic unprovoked pulmonary embolism (ie, with no major risk factor for thrombosis) and had been treated initially for 6 uninterrupted months with a vitamin K antagonist were randomized and followed up between July 2007 and September 2014 in 14 French centers.

Predictors of high on-aspirin platelet reactivity in high-risk vascular patients treated with single or dual antiplatelet therapy.

Aspirin is the key treatment in the secondary prevention of atherothrombosis. Interindividual variability of response has been linked to a higher risk for ischemic events. The aim of this study was to identify clinical and biologic factors predicting high on-aspirin platelet reactivity (HPR) in a high-risk, "real-world" population of vascular patients.

Absorption and efficacy of acetylsalicylic acid in patients with short bowel syndrome.

Background: The patients with a short bowel (SB) frequently require antiplatelet therapy. Resection of the bowel is likely to modify the absorption and first-pass effect of drugs. No data on the absorption and efficacy of the cardiovascular dose of aspirin (75-160 mg) in these patients have been published.

Monitoring persistent platelet reactivity in patients with unprotected left main stenting.

Objective: This study sought to determine the rate and potential clinical impact of persistent platelet reactivity (PPR) in unprotected left main (ULMD) stenting.

Background: PPR under aspirin or thienopyridines is associated with acute events after angioplasty.

Methods: We prospectively included 125 patients referred for ULMD stenting.

Biological efficacy of twice daily aspirin in type 2 diabetic patients with coronary artery disease.

Background: Diabetes is associated with a high rate of events after acute coronary syndrome and percutaneous coronary intervention despite aspirin treatment. Once daily aspirin might not provide 24-hour stable biological efficacy in patients with diabetes. We compared the biological efficacy of the same daily dose of aspirin given either once (OPD) or divided twice per day in a population of diabetic patients with previous coronary artery disease.

In vivo effect of proton-pump inhibitors on gastric plasmin-dependent fibrinolysis: a study in a porcine model.

Introduction: Alkalization of gastric fluids could inhibit plasmin-mediated and/or pepsin-mediated fibrinolysis. We evaluated the gastric antifibrinolytic effect of proton pump inhibitors in a live porcine model.

Material And Methods: Six pigs were randomly assigned to treatment with proton pump inhibitors vs no treatment.

A multicentric prospective study in usual care: D-dimer and cardiovascular events in patients with atrial fibrillation.

Aim: Atrial fibrillation (AF), the most frequent arrhythmia, is a major independent cardiovascular (CV) risk factor, especially in elderly patients. The interest of Ddimer (DD) measurement for predicting CV risk has been suggested in some subgroups of patients with AF but little is known about the negative prognostic value of DD measurement. The primary aim was to assess whether DD measurement and monitoring could predict the occurrence of subsequent CV events, defined as MI, stroke or transient ischemic attack and arterial embolic events.