: Gender differences in STEMI

International audienceBACKGROUND: Gender differences in presentation, management and outcome in patients with ST-segment elevation myocardial infarction (STEMI) have been reported. AIM: To determine whether female gender is associated with higher inhospital mortality. METHODS: Data from ORBI, a regional STEMI registry of 5 years' standing, were analysed. The main data on presentation, management, inhospital outcome and prescription at discharge were compared between genders. Various adjusted hazard ratios were then calculated for inhospital mortality (women versus men). RESULTS: The analysis included 5000 patients (mean age 62.6±13 years), with 1174 women (23.5%). Women were on average 8 years older than men, with more frequent co-morbidities. Median ischaemia time was 215 minutes (26 minutes longer in women; P<0.05). Reperfusion strategies in women less frequently involved fibrinolysis, coronary angiography, radial access and thrombo-aspiration. Female gender, especially in patients aged<60 years, was associated with poorer inhospital prognosis (including higher inhospital mortality: 9% vs. 4% in men; P<0.0001), and underutilization of recommended treatments at discharge. Moreover, excess female inhospital mortality was independent of presentation, revascularization time and reperfusion strategy (hazard ratio for women 1.33, 95% confidence interval 1.01-1.76; P=0.04). CONCLUSIONS: One in four patients admitted for STEMI was female, with significant differences in presentation. Female gender was associated with less-optimal treatment, both in the acute-phase and at discharge. Efforts should be made to reduce these differences, especially as female gender was independently associated with an elevated risk of inhospital mortality

Cardiac MR1 and peripartum cardiomyopathy.

Published in "International Journal of Cardiology" vol.142, n°3Letter to the Editor. Cardiac MRI brings great benefits in the comprehension of the mechanism(s) involved in the genesis of peripartum cardiomyopathy (PPC). Cardiac MRI may also procure prognostic information. Because this is a rare affection, it seems necessary to systematically study PPC with this safe, non invasive and reliable tool. Creation of a multicentric register with a systematic application of cardiac MRI in this pathology may be considered

Biomarkers in the Diagnosis of ST-Segment Elevation Myocardial Infarction

International audienceno abstrac

Management and prognosis of myopericericarditis.

Published in "International Journal of Cardiology" vol.141, n°2Letter to the Edito

Prognostics factors of neurologie outcome in patients treated by mild theapeutic hypothermia for an out-of-hospital cardiac arrest

Le but de l'étude est de déterminer les facteurs pronostics des patients hospitalisés en USIC dans les suites d'un arrêt cardiaque (AC) à l'ère de l'hypothermie thérapeutique (HT). Méthode: Les patients hospitalisés de 2008 à 2011, dans les suites d'un AC, et traités par HT, ont rétrospectivement été analysés et comparés en fonction de leur statut neurologique à la sortie de l'hôpital. Résultats: 70 patients ont été inclus dont 35 avec un bon pronostic, et 34 décédés. Les délais moyens de retour à un rythme spontané étaient significativement plus courts dans le groupe de bon pronostic (p= 0.005). 57 patients ont bénéficié d'une coronarographie et 28 d'une angioplastie à la phase précoce. L'analyse multivariée a retrouvé 2 facteurs protecteurs: la présence d'un témoin (OR= 0.18) et la réalisation d'une angioplastie coronaire (OR= 0.11), et 2 facteurs délétères: délai entre l'AC et le retour à un rythme spontané efficace >=25 min (OR= 6.05) et une créatininémie d'entrée >=104 mol/L (OR= 4.62).RENNES1-BU Santé (352382103) / SudocSudocFranceF

Right Ventricular–Pulmonary Artery Coupling After Transcatheter Aortic Valve Replacement: Closer to Optimal Prognosis Assessment?

International audience[No abstract available

Prise en charge des morsures de chien aux urgences

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

The Tricuspid Valve

International audienceNo abstract availabl

Percutaneous Treatment of Mitral Regurgitation With the PASCAL Device: A Full Grasp of the Pathology?

International audienc

Right Ventricular-Pulmonary Artery Coupling: A Simple Marker to Guide Complex Clinical Decisions?

International audienc