Valeur pronostique du rapport des diamètres télé-diastoliques du ventricule droit sur le ventricule gauche à l'échographie cardiaque dans l'embolie pulmonaire aiguë

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Prise en charge pré-hospitalière et hospitalière des infarctus ST+ en Indre-Et-Loire et Loir-Et-Cher (évaluation à un an d'un protocole interdépartemental)

TOURS-BU Médecine (372612103) / SudocSudocFranceF

INFLUENCE DE L'ANGOR PREALABLE, STABLE OU INSTABLE, SUR LA MORBI-MORTALITE HOSPITALIERE DE L'INFARCTUS DU MYOCARDE (RESULTATS D'UNE SERIE CONTINUE DE 1910 PATIENTS)

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intérêt du NT-proBNP dans l'embolie pulmonaire sévère (étude prospective)

TOURS-BU Médecine (372612103) / SudocSudocFranceF

Revascularization algorithm in acute STEMI should take into account age

International audienc

Prognostic Factors for Pulmonary Embolism: The PREP Study, A Prospective Multicenter Cohort Study.

International audienceRATIONALE: The short-term prognosis of pulmonary embolism (PE) depends on hemodynamic status and underlying disease. The prognostic value of right ventricular dysfunction and injury is less well established. OBJECTIVES: To evaluate prognostic factors of PE in a multicenter prospective cohort study. METHODS: Echocardiography, brain natriuretic peptide (BNP), N-terminal-proBNP and cardiac troponin I measurements were done on admission of 570 consecutive patients with an acute PE. A predictive model was based on independent predictors of thirty-day adverse events defined as death, secondary cardiogenic shock or recurrent venous thromboembolism. MEASUREMENTS AND MAIN RESULTS: At 30 days, 42 patients (7.4%; 95% confidence interval (CI), 5.5% to 9.8%) had adverse events. On multivariate analysis, altered mental state (OR 6.8; 95% CI, 2.0 to 23.3), shock on admission (OR 2.8; 95% CI, 1.1 to 7.5), cancer (OR 2.9; 95% CI, 1.2 to 6.9), BNP (OR 1.3 for an increase of 250 ng/L; 95% CI, 1.1 to 1.6) and right to left ventricle diameter ratio (OR 1.2 for an increase of 0.1; 95% CI, 1.1 to 1.4) were associated with 30-day adverse events. The predictive performance of the model was good (area under receiver operating characteristics curve 0.84 (95% CI, 0.78 to 0.90)), making it possible to develop a bedside prognostic score. CONCLUSION: BNP and echocardiography may be useful determinants of the short-term outcome for patients with PE, together with clinical findings. PE patients can be stratified according to the initial risk of adverse outcome, using a simple score based on clinical, echocardiographic and biochemical variables

Echocardiography and pulmonary embolism severity index have independent prognostic roles in pulmonary embolism

We analysed a cohort of patients with normotensive pulmonary embolism (PE) in order to assess whether combining echocardiography and biomarkers with the pulmonary embolism severity index (PESI) improves the risk stratification in comparison to the PESI alone. The PESI was calculated in normotensive patients with PE who also underwent echocardiography and assays of cardiac troponin I and brain natriuretic peptide. 30-day adverse outcome was defined as death, recurrent PE or shock. 529 patients were included, 25 (4.7%, 95% CI 3.2-6.9%) had at least one outcome event. The proportion of patients with adverse events increased from 2.1% in PESI class I-II to 8.4% in PESI class III-IV, and to 14.3% in PESI class V (p<0.001). In PESI class I-II, the rate of outcome events was significantly higher in patients with abnormal values of biomarkers or right ventricular dilatation. In multivariate analysis, the PESI (class III-IV versus I-II, OR 3.1, 95% CI 1.2-8.3; class V versus I-II, OR 5.5, 95% CI 1.5-25.5 and echocardiography (right ventricular/left ventricular ratio, OR (for an increase of 0.1) 1.3, 95% CI 1.1-1.5) were independent predictors of an adverse outcome. In patients with normotensive PE, biomarkers and echocardiography provided additional prognostic information to the PESI

Comparison of Degree of Stenosis and Plaque Volume for the Assessment of Carotid Atherosclerosis Using 2-D Ultrasound

International audienc

Fractional Flow Reserve to Guide Treatment of Patients With Multivessel Coronary Artery Disease

International audienc