Impact of betablockers on general and local outcome in patients hospitalized for lower extremity peripheral artery disease: The COPART Registry.

Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure.

Comparison of one-year prognosis of patients classified as chronic critical lower limb ischaemia according to TASC II or European consensus definition in the COPART cohort.

Background: We compared one-year amputation and survival rates in patients fulfilling 1991 European consensus critical limb ischaemia (CLI) definition to those clas, sified as CLI by TASC II but not European consensus (EC) definition.

Patients And Methods: Patients were selected from the COPART cohort of hospitalized patients with peripheral occlusive arterial disease suffering from lower extremity rest pain or ulcer and who completed one-year follow-up. Ankle and toe systolic pressures and transcutaneous oxygen pressure were measured.

Changes in hospitalization rates for acute coronary syndrome after a two-phase comprehensive smoking ban.

Aims: The impact of a comprehensive stepwise smoking ban (2007 and 2008) was assessed by analysing the hospitalization rate for acute coronary syndrome (ACS) in France, between 2003 and 2009.

Methods And Results: Between 2003 and 2009, 867,164 hospitalizations for ACS were observed among about 23 million administrative reports. The age-and gender-standardized hospitalization rates were calculated and their variation before and after the smoking ban implementation was investigated by Poisson regression that included the ACS seasonal variations and the historical trend.

Chronic kidney disease and the short-term risk of mortality and amputation in patients hospitalized for peripheral artery disease.

Objective: The aim of the present study was to determine the prevalence of chronic kidney disease (CKD) and its prognostic value in patients hospitalized for lower extremity peripheral artery disease (PAD).

Methods: Data from the COhorte des Patients ARTériopathes registry, a prospective multicenter, observational study of consecutive patients hospitalized for PAD in academic hospitals of southwestern France, were analyzed. All the subjects were in Rutherford grade ≥ 3, and 55.

Novel risk factors for premature peripheral arterial occlusive disease in non-diabetic patients: a case-control study.

Background: This study aimed to determine the prevalence of genetic and environmental vascular risk factors in non diabetic patients with premature peripheral arterial disease, either peripheral arterial occlusive disease or thromboangiitis obliterans, the two main entities of peripheral arterial disease, and to established whether some of them are specifically associated with one or another of the premature peripheral arterial disease subgroups.

Methods And Results: This study included 113 non diabetic patients with premature peripheral arterial disease (diagnosis <45-year old) presenting either a peripheral arterial occlusive disease (N = 64) or a thromboangiitis obliterans (N = 49), and 241 controls matched for age and gender. Both patient groups demonstrated common traits including cigarette smoking, low physical activity, decreased levels of HDL-cholesterol, apolipoprotein A-I, pyridoxal 5'-phosphate (active form of B6 vitamin) and zinc.

Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myocardial infarction.

Context: The contemporary decline in mortality reported in patients with ST-segment elevation myocardial infarction (STEMI) has been attributed mainly to improved use of reperfusion therapy.

Objective: To determine potential factors-beyond reperfusion therapy-associated with improved survival in patients with STEMI over a 15-year period.

Design, Setting, And Patients: Four 1-month French nationwide registries, conducted 5 years apart (between 1995, 2000, 2005, 2010), including a total of 6707 STEMI patients admitted to intensive care or coronary care units.

Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French nationwide registries.

Aim: The historical evolution of incidence and outcome of cardiogenic shock (CS) in acute myocardial infarction (AMI) patients is debated. This study compared outcomes in AMI patients from 1995 to 2005, according to the presence of CS.

Method And Results: Three nationwide French registries were conducted 5 years apart, using a similar methodology in consecutive patients admitted over a 1-month period.

Arterial ultrasound screening as a tool for coronary risk assessment in asymptomatic men and women.

One of the imaging tests most commonly used to assess cardiovascular diseases (CVDs) in daily practice is Doppler ultrasonography of the carotid and femoral arteries. We included 2709 participants with no history or symptoms of CVD; they had a risk factor assessment and a carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during a median follow-up of 6 years.

Impact of type of preadmission sulfonylureas on mortality and cardiovascular outcomes in diabetic patients with acute myocardial infarction.

Background: The impact of antidiabetic medications on clinical outcomes in patients developing acute myocardial infarction (MI) is controversial. We sought to determine whether in-hospital outcomes in patients who were on sulfonylureas (SUs) when they developed their MIs differed from that of diabetic patients not receiving SUs and whether clinical outcomes were related to the pancreatic cells specificity of SUs.

Methods And Results: We analyzed the outcomes of the 1310 diabetic patients included in the nationwide French Registry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction in 2005.

Impact of polyvascular disease on baseline characteristics, management and mortality in acute myocardial infarction. The Alliance project.

Background: A substantial number of patients with acute myocardial infarction (AMI) have polyvascular disease (PolyVD), defined as cerebrovascular disease (CVD), peripheral arterial disease (PAD) or both.

Aim: To investigate the impact of PolyVD on baseline characteristics, management and outcomes.

Methods: The Alliance project is a multicentre, cross-sectional database of patients with myocardial infarction throughout France from 2000 to 2005.

Six-item self-administered questionnaires in the waiting room: an aid to explain uncontrolled hypertension in high-risk patients seen in general practice.

We designed a cross-sectional study to determine whether 6-item self-administered questionnaires addressing difficulties in taking treatment provide independent and relevant information on uncontrolled hypertension in high-risk cardiovascular patients seen in general practice. Patients with both treated hypertension and a history of vascular diseases-myocardial infarction, stroke, or peripheral artery disease-were included. Risk factors, treatment, history of vascular diseases, blood pressure, and difficulties in taking treatment were assessed by 6-item self-administered questionnaires and recorded.

Association of influenza vaccination with reduced risk of venous thromboembolism.

Influenza vaccination can reduce the risk of cardiovascular events in patients with coronary heart disease, but its impact on the risk of venous thromboembolism (VTE) has not been studied. It was the aim of this study to investigate whether influenza vaccination reduces the risk of VTE. We conducted a case-control study involving 1,454 adults enrolled in 11 French centers between 2003 and 2007, comprising 727 consecutive cases with a first documented episode of VTE and 727 age- and sex-matched controls.

Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention.

Background: The choice of noninvasive tests used in primary prevention of cardiovascular diseases must be based on medical evidence. The aim of this study was to assess the additional prognostic value, over conventional risk factors, of physical examination, exercise testing, and arterial ultrasonography, in predicting a first coronary event.

Methods: A prospective cohort study was conducted between 1996 and 2004 (n = 2,709), with follow-up in 2006 (response rate 96.

Prevalence of unknown peripheral arterial disease in patients with coronary artery disease: data in primary care from the IPSILON study.

Background: Peripheral arterial disease (PAD) is a marker of increased risk of cardiovascular events and of poor prognosis in patients with coronary artery disease (CAD). The prevalence of unknown PAD among patients with CAD varies between studies according to the mode of diagnosis.

Aims: To evaluate the prevalence of unknown PAD, diagnosed using the ankle-brachial index (ABI), in patients from the IPSILON study with a CAD diagnosis; to assess the profile of these patients; and to determine predictors of PAD.

Heart rate distribution and predictors of increased heart rate among French hypertensive patients with stable coronary artery disease. Data from the LHYCORNE cohort.

Background: Heart rate is a key determinant of both myocardial ischaemia and prognosis in patients with coronary disease. Reducing heart rate is known to relieve ischaemia and improve cardiovascular prognosis. Currently there is no information about heart rate distribution and predictors of high heart rate in patients with stable coronary artery disease (CAD).

Determinants and prognostic impact of compliance with guidelines in reperfusion therapy for ST-segment elevation myocardial infarction: results from the ESTIM Midi-Pyrénées Area.

Background: Early reperfusion therapy has proven benefit in reducing mortality in patients with ST-segment elevation myocardial infarction (STEMI). Expert guideline committees have defined recommendations to improve the management of patients with STEMI and decrease their mortality rates.

Aims: To identify predictors of compliance with American College of Cardiology/American Heart Association guidelines for reperfusion therapy in STEMI and to determine the prognostic impact of compliance.

Patterns of statin prescription in acute myocardial infarction: the French registry of Acute ST-elevation or non-ST-elevation Myocardial Infarction (FAST-MI).

Objective: Early use of high-dose statins in acute coronary artery disease is controversial. Our aim was to use the French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) to analyse patterns of statin prescription during the acute phase of myocardial infarction, and to identify factors associated with prescription strategies.

Methods: We analysed statin prescription in 2509 patients with an acute myocardial infarction enrolled at 223 hospitals in France who were enrolled in the FAST-MI study and survived to hospital discharge.

Persistence of combination of evidence-based medical therapy in patients with acute coronary syndromes.

Objective: To analyse long-term adherence persistence of evidence-based medical therapy in 'real-world' patients with coronary disease.

Methods: Cardiologists recruited the first three consecutive patients seen in either hospital clinics or private practice in 2006 who had been hospitalized for an acute coronary syndrome (ACS) in 2005 in France. Demographic characteristics, medical history, current treatments and medications at hospital discharge were recorded.

Comparison of thrombolysis followed by broad use of percutaneous coronary intervention with primary percutaneous coronary intervention for ST-segment-elevation acute myocardial infarction: data from the french registry on acute ST-elevation myocardial infarction (FAST-MI).

Background: Intravenous thrombolysis remains a widely used treatment for ST-elevation myocardial infarction; however, it carries a higher risk of reinfarction than primary PCI (PPCI). There are few data comparing PPCI with thrombolysis followed by routine angiography and PCI. The purpose of the present study was to assess contemporary outcomes in ST-elevation myocardial infarction patients, with specific emphasis on comparing a pharmacoinvasive strategy (thrombolysis followed by routine angiography) with PPCI.

Accuracy of the screening physical examination to identify subclinical atherosclerosis and peripheral arterial disease in asymptomatic subjects.

Objectives: This study assessed the accuracy of the screening vascular physical examination for predicting asymptomatic peripheral arterial disease (PAD) or subclinical atherosclerosis in asymptomatic and apparently healthy subjects.

Methods: A standardized physical examination and a carotid and femoral ultrasonography were administered to 2736 men and women aged 20 to 90 years old, with no personal history of cardiovascular disease (CVD) and no complaint of neurologic, coronary, or lower limb symptom. We assessed the accuracy of auscultation for bruits and pulse palpation for identifying the presence of significant carotid stenosis, carotid plaque, femoral plaque, and ankle-brachial index (ABI) <0.

Outcomes of myocardial infarction in hospitals with percutaneous coronary intervention facilities.

Background: Despite evidence on the efficacy and safety of percutaneous coronary intervention (PCI) for patients with acute myocardial infarction, it is unclear whether patients admitted to hospitals with on-site PCI facilities (herein after, PCI hospitals) have improved outcomes in routine practice.

Methods: We compared processes of care, hospital outcomes, and 1-year mortality rate for 1176 consecutive patients admitted to 126 PCI hospitals and 738 patients admitted to 190 non-PCI hospitals in France from November 1 to November 30, 2000.

Results: Patients admitted to PCI hospitals were more likely to receive evidence-based acute (within 48 hours of admission) and discharge medications and to undergo PCI within 48 hours of admission than those admitted to non-PCI hospitals (54% vs 6.

Prognosis at 6 months for coronary and cerebrovascular patients: impact of antiplatelet agents and statins: results from the Prevenir III study.

Purpose: The aim of the Prevenir III study was to assess, in secondary prevention, the risk after 6 months of subsequent coronary and cerebrovascular events in a population of patients in private practice.

Methods: A prospective observational survey, including patients diagnosed with previous myocardial infarction, unstable angina or stroke, was carried out by French general practitioners and cardiologists.

Results: 9556 patients were selected by 3746 physicians representative of French physicians.

[Changes in the prescription of cardiovascular prevention drugs in France between 1995 and 2003: factors influencing the gap between evidence base medicine and clinical practice].

Dramatic progresses have occurred during the past 10 years in the field of cardiovascular secondary prevention. Many randomized trials have established the efficacy of statins, antiplatelet agents, beta-blockers and ACE inhibitors for reducing cardiovascular mortality, myocardial infarction and stroke in patients with coronary heart disease. Since 2002, American and European guidelines have emphasized the importance of optimal utilization of those four main therapeutic classes.

[Combination therapy at hospital discharge in the USIC 2000 survey].

Unlabelled: We tried to determine the prognostic impact of triple (antiplatelet agents, statins and beta-blockers) and quadruple (the same+ACE inhibitors) combination therapy at hospital discharge after acute myocardial infarction. The USIC 2000 survey is nationwide registry of consecutive patients admitted to intensive care units for acute myocardial infarction in November 2000 in France. Of the 2119 patients discharged alive, 1095 (52%) were prescribed a combination of antiplatelet agents, beta-blockers and statins (triple therapy), including 567 (27%) with a similar combination plus ACE inhibitors (quadruple therapy).

[Reasons for the under-use of secondary prevention therapies in coronary patients over the age of 70 years].

Introduction: Although platelet antiaggregants, beta-blockers and statins have proved their efficacy as secondary prevention in all types of patients with arterial and thrombotic disease, these therapeutic categories remain under-used in the elderly. The reasons for this under-prescription are poorly understood. The aim of this study was to determine the reasons for not prescribing the principal secondary prevention therapies in elderly coronary patients.