Publications by authors named "Trimaille A"
Background And Objectives: Initially described as a benign acute cardiomyopathy, Takotsubo syndrome has been linked to elevated mortality rates. Emerging evidence suggests that unresolved myocardial inflammation may contribute to this adverse prognosis. This study aimed to evaluate the incremental prognostic utility of C-reactive protein (CRP) in conjunction with the InterTAK prognosis score for stratifying long-term mortality in Takotsubo syndrome.
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- The study focused on the use of a machine learning model using initial transthoracic echocardiography (TTE) to predict in-hospital major adverse events (MAEs) in patients admitted to intensive cardiac care units (ICCU).
- A total of 1,499 patients were evaluated, and the model showed significant accuracy, highlighting five key TTE parameters that contributed to its predictions.
- The machine learning model outperformed traditional scoring methods, indicating it could serve as a better tool for risk stratification in heart patients.
Article Synopsis
- - Pathological tissues produce various substances, including extracellular vesicles (EVs) from active or dying cells.
- - EVs found in diseased heart valves may play a significant role in the development of valve thrombosis.
- - In cases of human aortic stenosis, EVs can activate valvular endothelial cells, causing dysfunction and increasing the chances of blood clotting.
Background: Intensive cardiac care units (ICCUs) were created to manage ventricular arrhythmias after acute coronary syndromes, but have diversified to include a more heterogeneous population, the characteristics of which are not well depicted by conventional methods.
Aims: To identify ICCU patient subgroups by phenotypic unsupervised clustering integrating clinical, biological, and echocardiographic data to reveal pathophysiological differences.
Methods: During 7-22 April 2021, we recruited all consecutive patients admitted to ICCUs in 39 centers.
Article Synopsis
- The study investigated the prognostic value of the TAPSE/sPAP ratio in patients hospitalized for acute coronary syndrome (ACS), focusing on its link to in-hospital major adverse cardiovascular events (MACEs).
- In a cohort of 481 patients, a TAPSE/sPAP ratio below 0.55 was found to significantly predict the occurrence of MACEs, with odds ratios indicating a very strong association even after accounting for other health factors.
- The findings highlight that a lower TAPSE/sPAP ratio improves risk assessment beyond conventional factors, suggesting it could serve as a critical marker for patient prognosis during hospitalization for ACS.
Background: The effects of pharmacological therapy on cardiogenic shock (CS) survivors have not been extensively studied. Thus, this study investigated the association between guideline-directed heart failure (HF) medical therapy (GDMT) and one-year survival rate in patients who are post-CS.
Methods And Results: FRENSHOCK (French Observatory on the Management of Cardiogenic Shock in 2016) registry was a prospective multicenter observational survey, conducted in metropolitan French intensive care units and intensive cardiac care units.
Article Synopsis
- Smoking cigarettes leads to elevated carbon monoxide (CO) levels in the blood, which can reduce oxygen capacity and potentially worsen outcomes for smokers experiencing acute cardiac events.
- A study of 1,379 patients in France found that 27% were active smokers and those with CO levels above 11 parts per million (ppm) had a significantly higher risk of death and major adverse cardiac events (MAE).
- Elevated CO levels were shown to be independently linked to a 6-fold increase in one-year mortality and a 10-fold increase in in-hospital MAE among smokers, regardless of other health factors.
Background: COVID-19 is associated with an increased risk of cardiovascular complications. Although cytokines have a predominant role in endothelium damage, the precise molecular mechanisms are far from being elucidated.
Objectives: The present study hypothesized that inflammation in patients with COVID-19 contributes to endothelial dysfunction through redox-sensitive SGLT2 overexpression and investigated the protective effect of SGLT2 inhibition by empagliflozin.
Article Synopsis
- Transcatheter aortic valve replacement (TAVR) is the preferred treatment for severe aortic stenosis, and a study of 705 patients at Strasbourg University Hospital examined long-term survival rates after the procedure.
- The study found a 45.8% all-cause mortality rate over an average of 5.4 years, with no significant survival differences based on the type of valve used.
- Key factors influencing mortality included being aged 90 or older, having diabetes, experiencing post-TAVR stroke, and acute kidney injury, while more than half of the participants survived beyond 5 years post-procedure.
Background: Cardiovascular disease and cancer are the two leading causes of mortality worldwide, and their association presents a therapeutic challenge. Current data regarding the prognosis of active cancer in patients undergoing transcatheter aortic valve replacement are conflicting.
Aim: To determine the impact and prognosis of active cancer in transcatheter aortic valve replacement.
Background: Bioprosthetic valve thrombosis is a complication of transcatheter aortic valve replacement (TAVR). It is believed to be platelet independent, mainly driven by contact phase activation, and more likely to be targeted by oral anticoagulant (OAC).
Case Summary: We report case of an 86-year-old man with history of TAVR, who presented an early TAVR aortic valve thrombosis occurring in the context of heparin-induced thrombocytopenia (HIT) and pulmonary embolism.
Article Synopsis
- The study investigated the prevalence of recreational drug use among patients admitted to intensive cardiac care units (ICCU) and its effect on major adverse events (MAEs) during hospitalization.
- Out of 1499 patients tested, 11% were positive for recreational drugs, with cannabis being the most common, yet only 57% self-reported their use.
- Patients using recreational drugs experienced significantly higher rates of in-hospital MAEs compared to non-users, with drugs like cannabis, cocaine, and MDMA showing independent associations with worse outcomes.
Transcatheter aortic valve implantation (TAVI) has become an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis in elderly and comorbid population. Significant improvement in heart function has been observed in patients undergoing TAVI, but numerous patients are readmitted to hospital for heart failure (HF). Moreover, repeat HF hospitalization is strongly associated with an adverse prognosis and increases the financial burden of health care.
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- * The study found that a prolonged closure time of adenosine diphosphate (CT-ADP) after the procedure, defined as greater than 180 seconds, further increased this risk, particularly in patients with AF.
- * Multivariate analysis indicated that AF patients with CT-ADP >180 seconds were 3.9 times more likely to experience MLBCs, highlighting the importance of monitoring hemostatic disorders in this population.
Aortic stenosis (AS) affects more than 10% of the population over 80 years of age and constitutes a major risk factor for heart failure, thromboembolic stroke, and death. A better understanding of the disease, including its interaction with the haemostatic system, is a prerequisite to develop prophylactic treatments. AS pathogenesis is a dynamic process involving endothelial dysfunction, inflammation, fibrosis, and calcification.
View Article and Find Full Text PDFBackground: The evolution of patients hospitalized with coronavirus disease 2019 (COVID-19) is still hard to predict, even after several months of dealing with the pandemic.
Aims: To develop and validate a score to predict outcomes in patients hospitalized with COVID-19.
Methods: All consecutive adults hospitalized for COVID-19 from February to April 2020 were included in a nationwide observational study.