Publications by authors named "Range G"
Medical registries play a crucial role in contemporary medicine by providing valuable information for clinical practice, research, and health policies. Systematic performance assessment, including patient input, linkage with medical-administrative databases, integration of randomized studies, and the use of artificial intelligence, mark an exciting new era for medical registries. These advancements will transform the way we understand, prevent, and treat diseases, paving the way for a more personalized, predictive, efficient, and likely cost-effective medicine.
View Article and Find Full Text PDFBackground: Despite improvement in devices, in-stent restenosis remains a frequent and challenging complication of percutaneous coronary interventions.
Methods And Results: The RESTO (Morphological Parameters of In-Stent Restenosis Assessed and Identified by OCT [Optical Coherence Tomography]; study NCT04268875) was a prospective multicenter registry including patients presenting with coronary syndromes related to in-stent restenosis. All patients underwent preintervention OCT analysis, which led to analysis of in-stent restenosis phenotype, number of strut layers, and presence of stent underexpansion.
[Outpatient PCI in France: data from the France PCI registry].
Ann Cardiol Angeiol (Paris)
November 2024
Percutaneous coronary intervention (PCI) is the preferred method of revascularization for chronic coronary syndromes. Outpatient PCI has demonstrated, in addition to its reliability and safety, the comfort of patients and the reduction of costs that weigh on our healthcare systems. Nevertheless, it remains largely underutilized in France, with significant disparities between centers, particularly between private and public ones.
View Article and Find Full Text PDFBackground: The appropriate duration of treatment with beta-blocker drugs after a myocardial infarction is unknown. Data are needed on the safety and efficacy of the interruption of long-term beta-blocker treatment to reduce side effects and improve quality of life in patients with a history of uncomplicated myocardial infarction.
Methods: In a multicenter, open label, randomized, noninferiority trial conducted at 49 sites in France, we randomly assigned patients with a history of myocardial infarction, in a 1:1 ratio, to interruption or continuation of beta-blocker treatment.
Article Synopsis
- The study aimed to analyze whether ticagrelor is more effective than clopidogrel in reducing heart damage during elective coronary procedures for patients with and without prior clopidogrel treatment.
- Out of 1,882 participants, those who were not on clopidogrel had a lower rate of heart injury compared to those who had been, but overall, ticagrelor did not show significant benefits over clopidogrel for reducing complications.
- The findings suggest that clopidogrel-naive patients generally experienced fewer complications due to a lower risk profile and simpler procedures, with no notable differences in outcomes based on previously taking clopidogrel.
Background: In patients with multivessel disease with successful primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction, the FLOWER-MI trial (Flow Evaluation to Guide Revascularization in Multivessel ST-Elevation Myocardial Infarction) showed that a fractional flow reserve (FFR)-guided strategy was not superior to an angiography-guided strategy for treatment of noninfarct-related artery lesions regarding the 1-year risk of death from any cause, myocardial infarction, or unplanned hospitalization leading to urgent revascularization. The extension phase of the trial was planned using the same primary outcome to determine whether a difference in outcomes would be observed with a longer follow-up.
Methods: In this multicenter trial, we randomly assigned patients with ST-segment-elevation myocardial infarction and multivessel disease with successful percutaneous coronary intervention of the infarct-related artery to receive complete revascularization guided by either FFR (n=586) or angiography (n=577).
Article Synopsis
- * In a study involving 772 patients with cardiogenic shock, 21.3% had CKD, and these patients were generally older and had more health issues, which contributed to increased mortality.
- * Renal replacement therapy (RRT) was associated with a higher risk of death regardless of CKD status, highlighting the need for collaborative care between cardiac and kidney specialists to better manage these patients.
Article Synopsis
- The study aimed to assess the effectiveness of ticagrelor versus clopidogrel in preventing cardiovascular events among chronic coronary syndrome patients undergoing complex percutaneous coronary interventions (PCI).
- Among 1,866 patients in the trial, nearly half were identified as having complex PCI, which was associated with significantly higher rates of myocardial infarction and other complications.
- Despite the increased risk associated with complex PCI, ticagrelor did not demonstrate any advantage over clopidogrel in reducing these adverse events.
Introduction: Dual antithrombotic therapy (DAT) combining oral anticoagulation (OAC), preferentially Non-vitamin K antagonist OAC (NOAC) and single antiplatelet therapy (SAPT) for a period of 6-12 months is recommended after percutaneous coronary intervention (PCI) in patients with an indication for OAC.
Objective: To compare outcomes between vitamin K antagonist (VKA) and NOAC-treated patients in the nation-wide France PCI registry.
Methods: All consecutive patients from the France PCI registry treated by PCI and discharged with OAC between 2014 and 2020 were included and followed one-year.
The French PCI Registry collects up to 150 clinical, procedural, and one-year follow-up data on all coronary angiographies and angioplasties performed in the 61 participating centers in September 2023. Thanks to the support of the GACI, the DGOS, the ARS, and numerous hospitals, the registry is continuing to expand its coverage across the entire territory, with 90 centers expected to participate in 2024, accounting for nearly half of the French centers. The high quality of this data has already led to the publication of 18 studies in international journals, and around twenty others are currently being written.
View Article and Find Full Text PDFBackground: Obstructive coronary artery disease is the main cause of death worldwide. By tracking events and gaining feedback on patient management, the most relevant information is provided to public health services to further improve prognosis.
Aims: To create an inclusive and accurate registry of all percutaneous coronary intervention (PCI) procedures performed in France, to assess and improve the quality of care and create research incentives.
Article Synopsis
- The study aimed to investigate the effects of the timing of P2Y inhibitor administration on myocardial necrosis during elective percutaneous coronary intervention (PCI), utilizing data from the ALPHEUS trial.
- Results revealed that patients who received P2Y inhibitors closer to the PCI procedure had higher rates of myocardial necrosis compared to those who were given the medication earlier, with improved outcomes seen in groups that received longer loading times.
- While the study found a correlation between timing and myocardial injury, it noted that bleeding complications were minimal and did not vary significantly among the different timing groups, leaving long-term clinical effects unclear.
Background: while the duration of dual antiplatelet therapy (DAPT) following coronary angioplasty for chronic coronary syndrome (CCS) recommended by the European Society of Cardiology has decreased over the last decade, little is known about the adherence to those guidelines in clinical practice in France.
Aim: To analyze the real duration of DAPT post coronary angioplasty in CCS, as well as the factors affecting this duration.
Methods: Between 2014 and 2019, 8.
Based on the latest knowledge and technological advancements, it is still debatable whether a modern revascularisation approach in the setting of acute myocardial infarction (AMI), including complete revascularisation (in patients with significant non-culprit lesions) with newer-generation highly biocompatible drug-eluting stents, requires prolonged dual antiplatelet therapy (DAPT). TARGET-FIRST (ClinicalTrials.gov: NCT04753749) is a prospective, open-label, multicentre, randomised controlled study comparing short (one month) DAPT versus standard (12 months) DAPT in a population of patients with non-ST/ST-segment elevation myocardial infarction, completely revascularised at index or staged procedure (within 7 days), using Firehawk, an abluminal in-groove biodegradable polymer rapamycin-eluting stent.
View Article and Find Full Text PDFArticle Synopsis
- Despite advancements in stent technology, there's still a notable risk of in-stent restenosis (ISR) after procedures like PCI, and comprehensive data on this issue is limited.
- A study analyzed data from the France-PCI registry between 2014 and 2018, focusing on patients with ISR lesions, finding that 7.3% of the patients treated had ISR PCI, mostly involving older individuals with comorbidities like diabetes.
- The results revealed that those undergoing ISR PCI had higher rates of complications after one year compared to non-ISR patients, indicating a need for further research and improved techniques in managing ISR.
Background: The long-term use of β-blocker after myocardial infarction (MI) when global left ventricular ejection fraction (LVEF) is preserved has not been studied in the era of modern myocardial reperfusion and secondary prevention therapies. It is unknown whether β-blockers are useful in stable post-MI patients without reduced LVEF and without heart failure.
Methods: The Assessment of β-blocker interruption 1 Year after an uncomplicated myocardial infarction on Safety and Symptomatic cardiac events requiring hospitalization (ABYSS) Trial enrolled in 49 centers in France, 3,700 patients with a prior (>6 months) history of MI and a LVEF >40%, chronically treated with a β-blocker and without any major cardiovascular event (MACE) in the past 6 months.
[Penetration of endocoronary imaging in France (data from France PCI): The French exception].
Ann Cardiol Angeiol (Paris)
December 2022
Purpose: Evaluate intravascular coronary imaging (ICI) utilization in France and compare it with other countries.
Methodology: We included in our study all PCI performed between 2014 and 2021 in all participating centers of France PCI registry.
Results: The percentage of ICI use during PCI varied from 1.
Early mortality post-ST-segment elevation myocardial infarction (STEMI) in France remains high. The multicentre France Percutaneous Coronary Intervention Registry includes every patient undergoing coronary angiography in France. We analyzed the prevalence and impact of unmodifiable and modifiable risk factors on 30-day survival in patients experiencing STEMI.
View Article and Find Full Text PDFBackground: On 26 September 2019, an industrial fire occurred in the Lubrizol factory in Rouen (France), exposing the population to the inhalation of many volatile toxic agents secondary to combustion.
Aim: To assess the impact of the Lubrizol factory fire on the incidence of coronary artery events.
Methods: All coronary angiograms performed in Rouen (exposed) and Le Havre (unexposed) from May 2019 to December 2019 were extracted from the prospective France Percutaneous Coronary Intervention (France PCI) registry.
Background: Intravascular lithotripsy (IVL) is a promising new technology for disrupting de-novo calcified coronary lesions (DNL) before percutaneous coronary intervention (PCI). We assessed 12-month outcomes of IVL in patients undergoing PCI for DNL or intra stent restenosis (ISR) lesions related to device underexpansion.
Methods: Prospective analysis of patients in the multicentre all-comers French Shock Initiative IVL registry.
Objectives: We sought to compare, in a national French registry (FrancePCI), the clinical impact of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with angio-guided PCI at 1 year.
Background: FFR has become the invasive gold standard to quantify myocardial ischemia generated by a coronary stenosis in patients with chronic coronary syndrome, but in clinical practice it is still underutilised to guide PCI compared to angiography (angio).
Methods: We extracted from the FrancePCI database all chronic coronary syndrome patients treated with PCI for coronary stenosis <90% between 2014 and 2019.
Article Synopsis
- The study examines the relationship between first medical contact-to-balloon time and 1-year mortality in patients with ST-elevation myocardial infarction (STEMI), focusing on the effects of direct vs. indirect transfer to cardiac catheterization laboratories (CCLs).
- Out of 2,206 STEMI patients, those indirectly admitted to CCL had a higher mortality rate (14.6%) compared to direct admissions (7.7%), highlighting that indirect admissions correlate with worse outcomes despite similar FMC-to-balloon times.
- Key factors influencing indirect admission included older age and the type of initial medical contact (like paramedic response), indicating a need for better population education and care coordination, especially for elderly
[stent thrombosis : A won battle ? (data from the France PCI registry)].
Ann Cardiol Angeiol (Paris)
December 2021
Goal: The aim of the study is to assess the incidence, risk factors and prognosis of definite stent thrombosis (ST) at 1 year in the France PCI multicenter prospective registry.
Patients And Methods: Only patients who underwent coronary angioplasty with at least one stent implantation between 1 January 2014 and 31 December 2019 were included. The population was separated into 2 groups: the "ST" group with stent thrombosis and the "control" group without stent thrombosis.