313 Probability of significant coronary artery disease in Southern France: A need for distinctive predictive models

Como podrá establecerse en el desarrollo de esta investigación, la búsqueda de derroteros para la solución a este grave problema de “falta de vivienda”, ha determinado que los estados se preocupen por integrar a sus cartas magnas los derechos de las personas a contar con el apoyo de ellos para la satisfacción de su necesidad de contar con una vivienda, y a los organismos internacionales así mismo a interesarse por apoyar a los estados, en el estudio de la problemática y a dispensar recursos humanos y económicos para coadyuvar en la solución sobre todo, en beneficio de los sectores económicamente menos favorecidos. Por otro lado hay que entender que el problema de la vivienda es estructural y por lo tanto debe ser enfrentado desde los aspectos, teóricos, poblacionales, de desarrollo urbano, diseño, tecnología, factores económicos, sociales, políticos y culturales y sobre todo del aprovechamiento los recursos adaptándolos a la realidad existente en un mundo tan velozmente cambiante por la globalización. Además hay que destacar la importancia que para los países, conlleva el establecimiento de políticas de vivienda con tecnologías apropiadas, sobre todo en la Vivienda de Interés Social, que de manera integral y pragmática determinen acciones novedosas y dinámicas, que sostenidas en el tiempo y el espacio se conviertan en Objetivo Nacional Permanente, que permita elevar el bienestar y el mejoramiento de las condiciones de vida de los pueblos.1. Antecedentes 2.Aspectos Normativos Institucionales 3.Situación de la Vivienda en el Ecuador durante los períodos censales 4. Política de Vivienda 5.Propuesta 6.Conclusiones y Recomendacione

Development of Complex Mathematical Model of Light Naphtha Isomerization and Rectification Processes

The technique of developing a mathematical model of catalytic isomerization of light naphtha is stated Using experimental data from an industrial isomerization unit shows adequacy of the mathematical model to the real process. The paper presents a method for optimizing the operation of the plant together with catalytic isomerization unit and separation columns. Selection of optimal modes of separation columns allows achieving the desired flow separation between units, as well as extension of the life of the catalyst SI-2

Association of the PHACTR1/EDN1 genetic locus with spontaneous coronary artery dissection

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for several vascular diseases, including FMD and coronary artery disease, with the putative causal noncoding variant at the rs9349379 locus acting as a potential enhancer for the endothelin-1 (EDN1) gene. Objectives: This study sought to test the association between the rs9349379 genotype and SCAD. Methods: Results from case control studies from France, United Kingdom, United States, and Australia were analyzed to test the association with SCAD risk, including age at first event, pregnancy-associated SCAD (P-SCAD), and recurrent SCAD. Results: The previously reported risk allele for FMD (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 (95% confidence interval [CI]: 1.50 to 1.86) per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was found to be higher for the association with SCAD in patients without FMD (OR: 1.89; 95% CI: 1.53 to 2.33) than in SCAD cases with FMD (OR: 1.60; 95% CI: 1.28 to 1.99). There was no effect of genotype on age at first event, P-SCAD, or recurrence. Conclusions: The first genetic risk factor for SCAD was identified in the largest study conducted to date for this condition. This genetic link may contribute to the clinical overlap between SCAD and FMD

Assessment of the trackability, flexibility, and conformability of coronary stents: A comparative analysis

The efficacy and safety of coronary stent implantation depend on the mechanical features of these devices when deployed in atheromatous lesions of various morphologies. We evaluated the trackability, flexibility, and conformability of 17 coronary stents using specific mechanical bench tests. The quantifications used a dynamometer for assessment of trackability (maximal strength) and flexibility (stiffness) and a 3D optical gauging machine for assessment of conformability (distance between stent and arterial wall in a curvature). The maximal strength (measuring the trackability) ranged respectively from 0.24 ± 0.06 and 0.38 ± 0.03 N (Seaquest) to 1.31 ± 0.42 and 1.34 ± 0.35 N (Carbostent), concerning respectively curvatures of 90° (P < 0.0001) and 135° (P < 0.0001). The stiffness (measuring the flexibility) ranged from 0.53 ± 0.16 (Seaquest) to 1.28 ± 0.10 N/mm (NIR Royal; P < 0.0001). The mean distance between stent and external curvature (external conformability) ranged from 0.15 ± 0.06 mm (S7) to 0.57 ± 0.4 mm (NIR Royal; P < 0.0001). The mean distance between stent and internal curve (internal conformability) ranged from 0.26 ± 0.13 (S7) to 0.44 ± 0.12 mm (S670; P < 0.0001). These results may influence the choice of a particular stent adapted to a specific coronary anatomy

Evolution of TAVI patients and techniques over the past decade: The French TAVI registries

International audienceBackground. - The French transcatheter aortic valve implantation (TAVI) registries, linked with the nationwide administrative databases, have collected data on TAVI procedures from the first experience to current practices.Objective. - To investigate changes over the past decade in patient and procedural characteristics, major complications and mortality after TAVI.Methods. - Data from the France TAVI and FRANCE 2 registries, collected between 2010 and 2021, were linked using a probabilistic algorithm to the French national health single-payer claims database (SNDS). The algorithm created patient profiles from TAVI procedures in SNDS, matching them as closely as possible to the profiles in the registry databases.Results. - A total of 84,783 TAVI patients were included during the study period. The median age was 83 years (quartile 1, 79 years; quartile 3, 87 years) and remained stable over time. The median EuroSCORE 1 surgical risk score was 12.8 (quartile 1, 7.9; quartile 3, 21.0), and decreased over time. The number of procedures increased linearly, from 1556 in 2010 to 14,114 in 2021. The prevalence of iliofemoral access increased, whereas use of the other approaches decreased. Rates of in-hospital, 30-day and 1-year mortality per year were lower in patients undergoing TAVI after 2015, regardless of the surgical risk score. Finally, hospital length of stay decreased progressively, from 8 days in 2010 to 4 days in 2021.Conclusion. - The TAVI registries provide the cornerstone for recording changes in TAVI. Over the past decade, patient profiles have improved whereas their age has remained stable. Simplification of the procedure reduced rates of death and major complications as well as length of hospital stay

Systematic primary aspiration in acute myocardial percutaneous intervention: a multicentre randomised controlled trial of the export aspiration catheter.

International audienceAIMS: It is unclear whether primary aspiration can prevent distal embolisation and thereby improve myocardial perfusion in patients presenting with acute myocardial infarction (AMI) within 12 hours after onset. METHODS AND RESULTS: At 24 centres in Europe and India, 249 AMI patients were randomised to primary aspiration with the Export aspiration catheter (Medtronic Vascular, Santa Rosa, CA, U.S.A.) followed by stenting (N=120) or to conventional stenting without primary aspiration (N=129). There were no significant differences between the 2 groups in baseline characteristics or target lesion TIMI scores. Procedure time was 36.7 +/- 18.0 minutes for primary aspiration followed by stenting versus 34.5 +/- 21.5 minutes for conventional stenting (P=0.08). Debris was obtained by primary aspiration from 85.3% of the arteries. The use of a bailout technique was significantly lower for primary aspiration than for conventional stenting (5.8% vs. 14.7%, P=0.02). For the primary endpoint of the combined rate of myocardial blush grade 3 and/or ST-segment resolution >50% to assess myocardial perfusion, primary aspiration followed by stenting was superior to conventional stenting (85.0% vs. 71.9%, P=0.025). Immediately postprocedure, the rate of myocardial blush grade 3 was 35.8% for primary aspiration followed by stenting versus 25.4% for conventional stenting (P=0.094). At 60 minutes post procedure, the rate of ST-segment resolution >50% was 73.5% for primary aspiration followed by stenting versus 64.8% for conventional stenting (P=0.218). Primary aspiration was also associated with a significantly higher postprocedure corrected TIMI frame count than conventional stenting (20 +/- 14.9 vs. 22.8 +/- 14, P=0.02). At 30 days, there were no differences between the treatments in the rate of major adverse cardiac and cerebral events. CONCLUSIONS: Compared with conventional stenting, primary aspiration with the Export aspiration catheter followed by stenting improved myocardial reperfusion in AMI patients presenting with TIMI flow grade 0 to 1. Further study of primary aspiration involving larger numbers of patients is warranted to assess its effect on longer-term clinical outcome