CLARIVATE ANALYTICS JOURNAL CITATION REPORTS® 2022 IMPACT FACTOR 3 Archives of Cardiovascular Diseases Formerly Archives des maladies du cœur et des vaisseaux Volume 117 – no. 1 Supplement – January 2024 ISSN 1875-2136 99311 Société Française de Cardiologie 5 rue des Colonnes du Trône - 75012 Paris www.sfcardio.fr Find all the news of the JESFC 2024 on www.cardio-online.fr January 17-19, 2024 Congress Center, Porte Maillot - Paris The 34th Journées Européennes de la Société Française de Cardiologie
Archives of Cardiovascular Diseases Formerly Archives des maladies du cœur et des vaisseaux Official journal of the French Society of Cardiology Editor in Chef: Ariel A. Cohen Deputy editor: Bernard Iung Editorial board Victor Aboyans Philippe Acar Laurence Amar Denis Angoulvant Franck Boccara Haran Burri Yves Cottin Shinichi Goto Roberto Lang Guillaume Lebreton Christophe Leclercq Gilles Lemesle Paul Milliez Agnès Pasquet Philippe Pibarot Etienne Puymirat Statistical consultant Julien Magne Technical editor Sophie Rushton-Smith How to contact the journal Ariel A. Cohen Service de cardiologie Hôpital Saint-Antoine (pavillon Lemierre) 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12 Tel.: 33 (0)1 49282886 E-mail: clarisse.barille@aphp.fr or ariel.cohen@aphp.fr Scientific committee E. Aliot (France), P. Amouyel (France), M. Böehm (Germany), P. Bonhoeffer (United Kingdom), D. Bonnet (France), E. Bruckert (France), T. Carrel (Switzerland), M. Cohen (United States), A. Cribier (France), N. Danchin (France), J.-C. Daubert (France), J. Davignon (Canada), G. Derumeaux (France), E. Eeckhout (Switzerland), F. Follath (Switzerland), B. Gerber (Belgium), P. Guéret (France), G. Habib (France), A. Hagege (France), M. Komadja (France), B. Kreitmann (France), R. Lang (United States), S. Laurent (France), H. le Marec (France), J. Lima (United States), N. Ludwig (United Kingdom), Z. Mallat (France), G. Marx (United States), J.-L. Monin (France), E. Mousseaux (France), P. Nataf (France), P. Nihoyannopoulos (United Kingdom), G. Parati (Italy), L. Perrault (Canada), L. Pierard (Belgium), B. Prendergast (United Kingdom), S. Priori (Italy), D. Revel (France), V. Roger (United States), R. Rosenhek (Austria), M. Safar (France), M. Sarano (United States), E.J. Schaefer (United States), M. Scherrer Crosbie (United States), J. Schwitter (Switzerland), P. Serruys (Netherlands), M. Simoons (Netherlands), P.G. Steg (France), G. Tomaselli (United States), P. Tornos (Spain), C. Tribouilloy (France), A. Vahanian (France) Archives of Cardiovascular Diseases (ISSN 1875-2136) 2024 (volume 117) One year, 12 issues. See complete subscription rates online: www.elsevier-masson.fr/revue/ACVD. Address order and payment to Elsevier Masson SAS, Service Abonnements, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex: payment by check or credit card (CB, EuroCard, MasterCard or Visa: indicate no, and expiration date); « La Banque Postale », Centre de Paris, nº RIB 20041 00001 1904540H020 95. Subscriptions begin 4 weeks after receipt of payment and start with the first issue of the calendar year. Back issues and volumes are available from the publisher. Claims for missing issues should be made within 6 months of publication. Includes air delivery. Journal manager – Fabienne Loÿe. E-mail: acvd@elsevier.com Head of Content Solutions – Monika Giergielewicz. E-mail : m.giergielewicz@elsevier.com Partnerships and Supplements – Claire Ebersold. +33 (0)1 71 16 51 14 c.ebersold@elsevier.com Advertising – Nicolas Zarjevski. +33 (0)1 71 16 51 38 n.zarjevski@elsevier.com Subscriptions – Tel.: (33) 01 71 16 55 99. Fax: (33) 01 71 16 55 77. http://www.em-consulte.com/infos Publisher – Anne-Elisabeth Fournié. E-mail: a.fournie@elsevier.com Publishing director – Daniel Rodriguez Author enquiries The contents of each issue as well as the abstracts of the articles published in Archives of Cardiovascular Diseases are available on the website of Elsevier: em-consulte.com Printed in France by Imprimé par Dupliprint, 733 rue Saint Léonard, 53100 Mayenne. CPPAP: 0123T81475 Dépôt légal à parution. Archives of Cardiovascular Diseases
Maison du Cœur | 5, rue des Colonnes du Trône l 75012 PARIS l France Tél. : +33 (0)1 43 22 33 33 | Fax : +33 (0)1 43 22 63 61 Secretariat scientifi que : Karine LESFAR – Tél : +33(0)1 43 22 29 71 - karine.lesfar@sfcardio.fr Christelle SCHOENAUER - Tél. : +33(0)1 43 22 12 72 - christelle.schoenauer@sfcardio.fr Bureau | Board Members PRÉSIDENT Christophe LECLERCQ Victor ABOYANS Hélène ELTCHANINOFF Anne BERNARD Bernard IUNG Ariel COHEN Damien LOGEART Jean-Claude DEHARO Olivier PIOT Membres invités au Bureau | Board invited members Franck ALBERT Jean-Yves ARTIGOU Stéphane LAFITTE Jean-Jacques MONSUEZ Conseil d’administration | Board of directors Philippe ACAR Luc CHRISTIAENS Serge KOWNATOR Walid AMARA Philippe COMMEAU Philippe MABO Denis ANGOULVANT Nicolas DANCHIN Paul-Ursmar MILLIEZ Gilles BARONE-ROCHETTE François DIEVART Jean-Luc PASQUIE Guillaume BONNET Erwan DONAL Bruno PAVY Claire BOULETI Jean FERRIERES Théo PEZEL Jean-Sébastien HULOT Catherine VERGELY Membres invités au Conseil d’administration | Board Commitee invited members Walid AMARA Martine GILARD Jean-Jacques MONSUEZ Jean-Yves ARTIGOU Albert Alain HAGEGE Vincent PRADEAU Xavier Benoît D’JOURNO Gérard HELFT Pierre SABOURET Sylvie DI FILIPPO Michel KOMAJDA Catherine SPORTOUCH Béatrice DULY-BOUHANICK Stéphane LAFITTE Jean-Noël TROCHU Jérémy FAUCONNIER Carole METTE Marc VILLACEQUE Charles FAUVEL Président honoraires | Honorary Presidents Michel BERTRAND Jean-Paul FAUCHIER Robert HAIAT Jean-Paul BOUNHOURE Martine GILARD Michel KOMAJDA Jean-Paul BROUSTET Pascal GUERET Jean-Marc LABLANCHE Nicolas DANCHIN Claude GUEROT Jean-Yves LE HEUZEY Jean-Claude DAUBERT Albert Alain HAGEGE André VACHERON Geneviève DERUMEAUX Journaux | Journals Archives of Cardiovascular Diseases : Directeur du Comité de Rédaction : Pr Ariel COHEN Archives pratiques : Directeur du Comité de Rédaction : Dr Jean-Jacques MONSUEZ ELSEVIER MASSON : 65 rue Camille Desmoulin - 92130 ISSY LES MOULINEAUX - Tél. : +33 (0)1 71 16 55 00 Maison du Cœur | 5, rue des Colonnes du Trône l 75012 PARIS l France Tél. : +33 (0)1 43 22 33 33 | Fax : +33 (0)1 43 22 63 61 E-mail : jesfc@sfcardio.fr | Internet : www.sfcardio.fr
PRÉSIDENT du Congrès l PRESIDENT of the Congress Christophe LECLERCQ Comité d’Organisation l Organization committee Victor ABOYANS Hélène ELTCHANINOFF Anne BERNARD Bernard IUNG Ariel COHEN Damien LOGEART Jean-Claude DEHARO Olivier PIOT Secrétaire scientifi que l Scientifi c secretary Victor ABOYANS Comité scientifi que l Scientifi c Committee Philippe BORDIER Hakim BEN AMER Sylvie DI FILIPPO Eric BRUCKERT Erwan DONAL Pascal DEFAYE Jérémy FAUCONNIER François DIEVART Charles FAUVEL Béatrice DULY-BOUHANICK Mohamed GHANNEM Stéphane EDERHY Carole METTE Etienne PUYMIRAT Jean-Jacques MONSUEZ Thomas MODINE Catherine SPORTOUCH - DUKHAN François ROUBILLE
Archives of Cardiovascular Disease 117 (2024) v CONTENTS Abstracted in: Current Contents/Clinical Medicine; MEDLINE/Index Medicus; EMBASE/Excerpta Medica; Pascal (INIST/CNRS); Scopus Available online at www.sciencedirect.com ScienceDirect Editorial JESFC 2024: Citius, Fortius, Altius! Faster, higher, stronger! V. Aboyans, A. Bernard, A. Cohen, B. Iung and C. Leclercq ......................................................................................... S1 Abstracts 01 – Coronary artery disease ............................................................................................................................................. S3 02 – Heart failure and cardiomyopathy........................................................................................................................... S30 03 – Echocardiography and imaging ................................................................................................................................ S56 04 – Valvular heart disease ................................................................................................................................................. S73 05 – Rhythmology and stimulation .................................................................................................................................. S87 06 – Arterial hypertension, vascular disease and Metabolism ................................................................................ S102 07 – Basic research and translational............................................................................................................................... S105 08 – Epidemiology and prevention, rehabilitation and sport, sleep ..................................................................... S109 09 – Pediatrics and congenital cardiopathies ............................................................................................................... S126 10 – General cardiology / Ethics ....................................................................................................................................... S134 11 – Paramedics ...................................................................................................................................................................... S137 12 – Emergency care and intensive cardiac care ......................................................................................................... S139 13 – Cardio-oncology ............................................................................................................................................................ S149 14 – Tropical cardiology ....................................................................................................................................................... S151 15 – Digital health ................................................................................................................................................................. S153 16 – Education/ Training and simulation ....................................................................................................................... S158 Index .......................................................................................................................................................................................... I1
Archives of Cardiovascular Disease 117 (2024) S1–S2 Disponible en ligne sur ScienceDirect www.sciencedirect.com Editorial JESFC 2024: Citius, Fortius, Altius! Faster, higher, stronger! The 34th European Days of the French Society of Cardiology will open its doors from 17–19th January 2024, in Paris. As every year, these days are the privileged moment of the French and French-speaking cardiology community, gathering the spectrum of healthcare professionals involved in managing the cardiac patient. In 2023, more than 6500 attendees, including cardiologists, fellows and allied healthcare professionals, paced the floors of the Palais des Congrès over 3 days, confirming our organizational choices. We hope this record will be beaten in 2024! Other records are likely to be surpassed in Paris later this year, during the Summer 2024 Olympic Games. Sports, and more generally physical activity, are a pillar of well-being and good health. We considered it naturally opportunistic to highlight this global sporting event. We have placed the emphasis on this aspect of cardiovascular disease prevention and management of cardiac patients, with 17 sessions focusing on physical activity as the redline of the scientific programme. We have invited several French and European experts, including Aaron Bagguish, a world-renowned specialist in sports medicine. For the climax of the congress, we invite, for the first time for the “exceptional conference” of the year, French Olympic champion Jean Galfione, gold medallist pole vaulteur during the 1996 Olympics in Atlanta. This sport discipline is a symbol of the taste for effort, transcending humankind to unexpected heights. While the wealth of our congress always relates to the expertise of speakers from French and French-speaking countries, this year we wish to increase the participation of other European experts, with several joint sessions with different components of the European Society of Cardiology (ESC). Do not miss the Conference européenne (European talk) by Thomas Lüscher, President Elect of the ESC, on the evolution in the management of coronary artery disease. Among other eminent members of the ESC, Panagiotis Vardas, Past President of the ESC, will give a talk at the opening ceremony, presenting data from France and other French-speaking countries within the ESC Atlas of Cardiology. For the second consecutive year, Filippo Crea, Editor-in-Chief of the European Heart Journal will chair the session on the most important findings of 2023 in cardiology, published in this prestigious journal. Many experts, representing several Associations of the ESC, including the EAPC (prevention), EACVI (imaging), EHRA (arrhythmia) and HFA (heart failure), are also invited, so to make the most from their expertise, and let them know about the quality of this congress and its participants. Beyond, a joint session with the ESH will broadcast the updated guidelines on the management of hypertension, and Giuseppe Mancia, eminent specialist of this society, will present a talk on this topic. Other talks given by Holger Thiele and Robert Gil, Presidents of the German and Polish societies of cardiology, respectively, will justify more than ever the name European Days of the congress. We are also proud to announce Peter Libby, world-renowned specialist on atherosclerosis, for the Conference américaine (American talk) of this congress. Among other eminent experts, we are happy to announce the talks of Bernard Chevalier, Thibaud Damy, Mathieu Kerneis, Francesco Maisano, Roland N’Guetta (African conference), Renaud Tamisier, as well as Pierre Amarenco and Michel Haissaguerre. The management of patients is evolving, with the increasing need for multidisciplinary teams, putting patients at the crossroads with other specialties. European Days has a tradition of joint sessions with French sister societies. For 2024, we have extended the number of these joint sessions, inviting colleagues from new disciplines to the congress, including psychiatry, oral surgery, urology and terminal care, while maintaining partnerships with cardiac surgeons, radiologists, chest specialists, internists, intensive care and emergency specialists, pharmacologists, vascular and haemostasis physicians, neurologists, nephrologists, geriatricians and specialists in lipidology and smoking cessation. In parallel with the scientific programme, other educational sessions have been organized, including Continuing Medical Education sessions, as well as seminars and masterclasses for our fellows. Finally, the abstract sessions are promising, with high scores awarded during the selection process. These sessions “carry the flame” of research in cardiology. How can we put all our knowledge into practice? This is why we present, every year, the (Olympic!) Simulation Village, to teach younger and older cardiologists different techniques or how to face diverse situations. Its great success in recent years has fostered our will to evolve and diversify the programme. You will not be disappointed! To succeed in our ambitions, the involvement of all components of the French Society of Cardiology (FSC) is essential: this congress is the fruit of the brainstorming and commitment of all the scientific groups of the FSC in the scientific committee. We also wholeheartedly thank the assistants of the congress cell of the FSC, who have https://doi.org/10.1016/j.acvd.2023.12.001 1875-2136/© 2023 Published by Elsevier Masson SAS.
V. Aboyans, A. Bernard, A. Cohen et al. Archives of Cardiovascular Disease 117 (2024) S1–S2 devoted the entire year to preparing for the meeting, as well as the professionalism of the Europa agency for arranging the logistics. Our special thanks also to our industrial partners, without whom the organization of such an event would be impossible. Their symposia and training centres offer great benefits to the scientific programme. The programme of the 228 sessions is available at https://www.cardio-online.fr/Congres/Le-programme-des-JESFC2024. We hope that the updated knowledge and training provided during this congress will help you manage your patients faster, with higher levels of expertise and stronger efficacy. Citius, Fortius, Altius – the Olympic Games moto – aligns with our ambitions for cardiology! On behalf the Scientific and Organization Committees of the European Days 2024, we wish you an excellent congress. Disclosure of interest The authors have not supplied their declaration of competing interest. Victor Aboyans∗ Anne Bernard Ariel Cohen Bernard Iung Christophe Leclercq Société franc¸ aise de cardiologie, 5, rue des Colonnes du Trône, 75012 Paris, France ∗Corresponding author. E-mail address: victor.aboyans@unilim.fr (V. Aboyans) S2
Archives of Cardiovascular Disease 117 (2024) S3–S29 Disponible en ligne sur ScienceDirect www.sciencedirect.com 01–Coronary artery disease 290 Impacts of illicit drug use on coronary angiographic findings in a multicenter registry of patients with acute coronary syndrome A. Léquipar1,∗, T. Pezel1, C. Delmas2, A. Trimaille3, F. Boccara4, F. Roubille5, A. Lafont1, E. Gall1, N. El Beze1, P. Guiraud-Chaumeil1, M. Singh1, E. Gerbaud6, F. Picard7, P. Henry1, J.-G. Dillinger1 1 Cardiologie, hôpital Lariboisière AP–HP, Paris 2 Cardiologie, CHU de Toulouse hôpital de Rangueil, Toulouse 3 Cardiologie, CHU de Strasbourg, Strasbourg 4 Cardiologie, hôpital Saint-Antoine AP–HP, Paris 5 Cardiologie, CHU, Montpellier 6 Department of cardiology intensive care unit and interventional cardiology, CHU de Haut Leveque, Pessac 7 Cardiologie, Hôpital Cochin, Paris ∗ Corresponding author. Adresse e-mail : antoine.lequipar@gmail.com (A. Léquipar) Introduction Although illicit drug use may induce acute coronary syndrome (ACS), its impacts on coronary angiographic characteristics and the coronary artery disease (CAD) burden are a matter of debate. Objective To assess the association between illicit drugs use and coronary angiographic findings in patients with ACS. Method From April 7 to 22, 2021, the Addiction in Intensive Cardiac Care Unit (ADDICT-ICCU) study included prospectively 1,499 patients admitted to ICCUs with a systematic urine multidrug test in 39 ICCUs across France. This prespecified study focuses on patients admitted for ACS with an angiography analysed by an independent Angiographic Core Laboratory. Patients with history of coronary artery bypass graft surgery were excluded. We compared coronary angiographic findings between illicit drugs users and others for the following parameters: the prevalence, location, type, and severity of CAD obstruction (stenosis≥50%), SYNTAX score, residual SYNTAX score, and the characteristics of percutaneous coronary intervention (PCI). Results Among the 283 patients with ACS (62±13 years, 77% men), 38 (13.4%) had a positive test for illicit drugs (cannabis: 12%, cocaine: 1.1%, MDMA: 0.7%) (Figure 1A). Drug users were younger than other patients (51±12 vs 64±12 years, p< 0.001), but there were no significant difference in sex ratio (89.5% vs 75.5%, p=0.088). There was no significant difference in the rate of STEMI (52.6% vs 45.7%, p= 0.535) and NTSEMI (47.4% vs 54.3%, p= 0.535) between drug users and others. Regarding the CAD burden, drug users had Figure1 Diagram and findings according to illicit drug use. A. Rate of ACS analysed with Core Laboratory. B. Angiographic findings according to illicit drug use. significantly less obstructive coronary lesions (1.6±1.1vs2.2±1.4, p= 0.012), less multivessel obstructive CAD (31% vs 61%, p=0.001), and a trend for a lower initial SYNTAX score (8.3±7.8vs10.8±8.4; p= 0.084) compared to others. Concerning culprit lesion, drug users had less bifurcation lesions (p= 0.008), a trend for more left anterior descending (LAD) artery lesions (p= 0.091), a higher thrombus burden score (p= 0.057), and less lesions above 20 mm (p=0.183) (Figure 1B). Conclusion In patients with ACS, recent illicit drug use is associated with less number of significant lesions and less multivessel CAD. Concerning culprit lesions, illicit drugs use is associated with less bifurcation lesions, with a trend for more LAD lesions and a higher thrombus burden score. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvd.2023.10.008 170 Standard modifiable risk factors and mortality in patients with ST-segment elevation myocardial infarction: Findings from the FRENCHIE cohort M. Zeller1,∗, N. Danchin2, Y. Cottin3, A. Rousseau4, D.G. Sauze4, P. Goube5, G. Cayla6, C. Prieur7, V. Auffret8, T. Simon9, P.G. Steg10 1 Laboratoire pec2, EA 7460, UFR Sciences de Santé, Université de Bourgogne, Dijon 2 Service de Cardiologie, Hôpital Européen Georges Pompidou AP-HP, Paris 3 Service de cardiologie, CHU Dijon Bourgogne, Dijon 1875-2136/
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 4 Unité de Recherche Clinique de l’Est Parisien (URC-Est), Hôpital Saint-Antoine AP-HP, Paris 5 Service de Cardiologie, Centre Hospitalier Sud Francilien, Corbeil-Essonnes 6 Service de cardiologie, CHU de Nîmes, Nîmes 7 Usic, hôpital Cardiologique Louis Pradel, Bron 8 Cardiologie et maladies vasculaires, CHU de Rennes–hôpital Pontchaillou, Rennes 9 Cardiologie, hôpital Saint-Antoine AP–HP, Paris 10 Cardiologie, hôpital Bichat, Paris ∗ Corresponding author. Adresse e-mail : marianne.zeller@u-bourgogne.fr (M. Zeller) Introduction Recent large observational studies have reported that an increasing and sizable proportion of acute myocardial infarction (AMI) patients have no main standard modifiable cardiovascular (CV) risk factors (SMuRFs) (i.e. hypertension (HTN), diabetes, hypercholesterolemia, and smoking) and that SMURFless patients have (counterintuitively) worse outcomes than patients with at least one SMuRF. Objective Using a French nationwide MI registry, we aimed to describe the proportion, characteristics and in-hospital mortality of ST-segment elevation MI (STEMI) patients according to the burden of SMuRFs. Method The French Cohort of Myocardial Infarction Evaluation (FRENCHIE) is a large ongoing MI cohort, which collects data from all patients hospitalized for AMI < 48 h of symptom onset in 21 french centres. For the present analysis, STEMI without prior coronary artery disease (CAD) admitted in 2019 and 2020 were studied. Results Among 4692 STEMI patients, 986(21%) were SMuRFless, 2001(43%) had 1 SMuRF, and 1705(36%) had ≥2 SMuRFs. Among patients with SMuRFs, smoking (51.8%) and HTN (51.1%) were the most frequent SMuRF and HTN + hypercholesterolemia (10.3%) and HTN + smoking (8.3%) the most frequent SMuRFs associations. When compared with patients with 1 or ≥2 SMuRFs, SMuRFless patients were characterized by older age (64.1 vs 60.2 and 62.8 y, respectively), but lower rate of female sex (21.7 vs 22.2 and 26.2%, respectively), LVEF < 40% (24.5 vs 26.7 and 26.2%), and lower admission CRP (14.8±38.3 vs 15.3±38.7 and 17.3±40.1mg/L, respectively). There was a slight increase in BMI with increasing SMURFs (0 SMURF: 26±3.9; 1 SMuRF: 26.3±4.5; ≥2 SMuRFs: 28.0±5kg/m2). SMuRFless patients were less frequently under chronic CV medications (7.9 vs 23.5 and 57.7%, respectively). Crude in-hospital mortality showed a trend toward an increase with the number of SMuRFs (p= 0.123). By multivariate logistic regression analysis, the number of SMURFs was associated with increasing inhospital mortality (Figure 1). In stratified analyses, the odds were similar for both sexes. Conclusion In French patients with an inaugural STEMI, one in 5 patient was SMURFless. The burden of risk factors was independently correlated to worse in-hospital survival. These observations emphasize the importance of standard RF on acute MI outcomes. Figure1 Forest plot on SMuRF and in-hospital death [age and sex adjusted OR(95%CI)]. Disclosure of interest Yes Research grants from Amarin. Lecture fees from Organon https://doi.org/10.1016/j.acvd.2023.10.009 487 Appropriate ischemic criteria for type 4a myocardial infarction: Insights from the ALPHEUS trial V. Roule1,∗, M. Zeitouni2, P. Guedeney2, F. Beygui3, M. El Kasty4, N. Braïk5, G. Rangé6, Z. Motovska7, G. Cayla8, E. Vicaut9, G. Montalescot2, J. Silvain2 1 Cardiologie, CHU de Caen Normandie, Caen 2 Cardiologie, hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris 3 Cardiologie, CHU Caen, Caen 4 Cardio, CH Jossigny, Jossigny 5 Cardiologie, CH évequemont, Évecquemont 6 Cardiologie, Hopital, Chartres 7 Cardiology, University Hospital Královské Vinohrady, Prague, République Tchèque 8 Service de cardiologie, CHU de Nîmes, Nîmes 9 Urc, Hôpital Lariboisière AP–HP, Paris ∗ Auteur correspondant. Adresse e-mail : v.roule@hotmail.fr (V. Roule) Introduction Different troponin thresholds have been proposed to define periprocedural myocardial injury based on post PCI troponin increase only, whereas the definition of type 4a MI needs the association of post procedural troponin and one ischemic criterion. Objective We aimed to describe rates of type 4a MI additional diagnostic criteria among the ranges of post PCI troponin elevation in the randomized ALPHEUS trial which compared ticagrelor to clopidogrel in high-risk elective PCI patients. Method 1698 patients with normal pre-PCI troponin values and centralized core laboratory angiogram analyzes were divided into 4 groups according to maximal post PCI troponin elevations (≤1x upper reference limit (URL) for group 1; > 1xURL and ≤5xURL for group 2; > 5xURL and <35xURL for group 3 and≥35xURL for group 4). The type 4a MI additional criteria (ischaemic imaging changes, ischaemic ECG changes, chest pain and angiographic complications) as defined by the 3rd and 4th UDMI were reported and the different angiographic complications were detailed for each group. Figure1 S4
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 Results The most prevalent additional ischemic criterion was the presence of angiographic complications detected by the core laboratory. The rate of angiographic complications increased in a stepwise manner with higher post PCI troponin elevation (Figure 1). Interestingly, we found a similar rate of angiographic complications in patients without any increase in post PCI troponin and troponin elevations below the 5xURL threshold (8.4% and 9.9% respectively). Most angiographic complications were related to transient main branch dissection and/or thrombosis, and transient or permanent side branch occlusions (Figure 1). ECG changes and chest pain ischemic criteria also increased in a stepwise manner and were rarely found below the 5-fold threshold increase, although they might be underreported. Conclusion When using a core laboratory, angiographic complications are found even in patients with no or minor troponin elevation. Above the 5 xURL threshold the rates of angiographic complications are 2 to 3-fold more frequent, and ECG changes and chest pain ischaemic criteria are likely to be present. Our findings support the use of angiographic core laboratory in clinical trial using periprocedural MI as an endpoint; similarly, chest pain -which disappeared from the 4th UDMI- should be reconsidered as a diagnostic ischemic criterion. Disclosure of interest Yes Grant to Institution: AstraZeneca France Consulting Fees or Lecture Fees: AstraZeneca, Bayer HealthCare SAS, Boehringer Ingelheim France, BPI France, CSL Behring SA, Gilead Science, Sanofi-Aventis France and Zoll Travel Support: Abbott Medical France SAS, Terumo France SAS Stockholder: 4PPharma https://doi.org/10.1016/j.acvd.2023.10.010 292 Machine learning for major adverse cardiac events prediction in patients with acute coronary syndrome: Results from ADDICT-ICCU study E. Gall1,∗, J.-G. Dillinger1, K. Hamzi1, E.Meyer2, E. Gerbaud3, N. El Beze4, A. Léquipar1, S. Toupin5, F. Picard6, A. Trimaille7, M. Goralski8, M. Bedossa9, A. Boccara10, T. Pezel11, P. Henry1 1 Cardiologie, hôpital Lariboisière AP–HP, Paris 2 Cardiologie, hôpital Rangueil, Toulouse 3 Cardiologie, CHU de Bordeaux–Site Pellegrin, Bordeaux 4 Cardiologie, hôpital Lariboisière, Paris 5 Scientific Partnerships, Siemens Heathcare France, Saint-Denis 6 Cardiologie, hôpital Cochin, Paris 7 Cardiologie, CHU de Strasbourg, Strasbourg 8 Cardiologie, CH Régional D’orléans hôpital de La Source, Orléans 9 Cardiologie et maladies vasculaires, CHU de Rennes–hôpital Pontchaillou, Rennes 10 Cardiologie, hôpital, Montreuil 11 Cardiologie, hôpital Lariboisière AP–HP, Paris ∗ Corresponding author. Adresse e-mail : emmanuel gall@hotmail.fr (E. Gall) Introduction Acute coronary syndrome (ACS) remains a major cause of mortality worldwide. However, the accuracy of current prediction tools for in-hospital cardiac events after an ACS remains insufficient for individualized patient management strategies. Objective To assess in patients with ACS the feasibility and accuracy of machine learning (ML)-based model using all data available at admission to predict in-hospital cardiac events. Method We conducted a sub-study of ADDICT-ICCU registry, an observational prospective study including all consecutive patients admitted to intensive cardiac care unit (ICCU) in 39 centres throughout France between 7 and 22 April 2021. We evaluated 16 clinical, 4 biological and 6 Transthoracic echocardiogram (TTE) features. ML involved automated feature selection with XGBoost then model building by random forest (RF), and hyperparameter tuning was done by repeated cross-validation. The primary outcome was the Figure 1 Machine learning model for in hospital major adverse events prediction. occurrence of composite outcomes defined by death, resuscitated cardiac arrest or cardiogenic shock requiring medical and/or mechanical haemodynamic support. Results Of 1,499 consecutive patients, 765 (mean age 63±15 years, 70% male) were admitted for ACS. The overall in-hospital cardiac events rate for ACS patients was 4.0%. Feature selection was performed using XGBoost with the log-rank–based variable importance, and 4 of the available features at admission were selected for the RF model (4 from TTE) including cardiac output, filling pressures, tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure (Figure 1, Panel A). The ML model exhibited a higher area under the curve compared with TIMI score, GRACE score, and traditional stepwise model score for in hospital major adverse events prediction (ML score: 0.96 vs TIMI: 0.54, GRACE: 0.68, traditional stepwise score: 0.87; all P< 0.001) (Figure 1, Panel B). Conclusion The ML-model exhibited a higher prognostic value to predict in-hospital cardiac events compared with all traditional scores. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvd.2023.10.011 S5
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 498 P2Y12 inhibitor loading time before elective PCI and the prevention of myocardial necrosis V. Roule1,∗, F. Beygui1, G. Cayla2, G. Rangé3, Z. Motovska4, N. Delarche5, F. Jourda6, P. Goube7, P. Guedeney8, M. Zeitouni8, M. El Kasty9, M. Laredo8, E. Vicaut10, G. Montalescot8, J. Silvain8 1 Cardiologie, CHU de Caen, Caen 2 Service de cardiologie, CHU de Nîmes, Nîmes 3 Cardiologie, hôpital, Chartres 4 Cardiology, University Hospital Královské Vinohrady, Prague, République Tchèque 5 Cardiologie, CH Franc¸ ois Mitterand, Fécamp 6 Cardiologie, CH d’Auxerre, Auxerre 7 Service de Cardiologie, Centre Hospitalier Sud Francilien, Corbeil-Essonnes 8 Cardiologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris 9 Cardio, CH Jossigny, Jossigny 10 Urc, hôpital Lariboisière AP–HP, Paris ∗ Corresponding author. Adresse e-mail : v.roule@hotmail.fr (V. Roule) Introduction There is dated and conflicting data about the optimal timing of initiation of P2Y12 inhibitors in elective percutaneous coronary intervention (PCI). Peri-PCI myocardial necrosis is frequent and associated with poor outcome. Objective We aimed to assess the impact of the P2Y12 inhibitor loading time (time from loading to PCI) on peri-procedural myocardial necrosis in the elective PCI population of the randomized ALPHEUS trial. Method 1809 patients of the ALPHEUS trial were divided into quartiles of loading time (0 to 0.2 h, 0.2 to 1.7 h, 1.7 to 4.1 h and 4.1 to 24 h). The ALPHEUS primary outcome was used (type 4 (a or b) myocardial infarction or major myocardial injury) as well as the main secondary outcome including minor myocardial injury. The risk of events was adjusted in a multivariate model. Results Patients in the first quartile group (Q1) presented higher rates of the primary outcome (p= 0.01). When compared to Q1, incidences of the primary outcome decreased in patients with longer loading times (adjOR 0.70 [0.52–0.95]; p= 0.02 for Q2; adjOR 0.65 [0.48–0.88]; p< 0.01 for Q3; adjOR 0.66 [0.49–0.89]; p<0.01 for Q4; Figure 1). Concordant results were found for the main secondary outcome (Figure 2). There was no interaction with the study drug allocated by randomization (clopidogrel or ticagrelor). Bleeding complications and clinical ischemic events were rare and did not differ between groups. Figure1 Forest plots of the primary efficacy outcome (composite of PCI-related myocardial infarction type 4a or 4b, or major myocardial injury) in the different quartiles of loading time compared to quartile 1 (CI: confidence interval; UDMI: Universal definition of myocardial infarction). Figure 2 Forest plots of the main secondary efficacy outcome (composite of PCI-related myocardial infarction type 4a or 4b, or any type of myocardial injury) in the different quartiles of loading time compared to quartile 1 (CI: confidence interval; UDMI: Universal definition of myocardial infarction). Conclusion In elective PCI for chronic coronary syndrome, administration of the loading dose of oral P2Y12 inhibitor at the time of PCI is associated with more frequent peri-procedural myocardial necrosis than an earlier administration. Disclosure of interest Yes Dr Roule has received research grants from Medtronic; speaker fees from Bristol-Myers Squibb, AstraZeneca. https://doi.org/10.1016/j.acvd.2023.10.012 552 Prognosis of acute myocardial infarction patients in the setting of COVID-19 : A French observational study A. Abou Hamed∗, T. Genet , C. Saint-Etienne , D. Angoulvant , L. Fauchier , F. Ivanes Cardiologie, CHRU Hôpitaux de Tours, Tours ∗ Corresponding author. Adresse e-mail : ahmad.abouhamed.med@gmail.com (A. Abou Hamed) Introduction The prognosis of acute myocardial infarction (AMI) patients in the setting of COVID-19 remains uncertain. Objective To evaluate patients’ prognosis after an AMI concomitant with COVID-19. Method This retrospective observational cohort was based on the administrative hospital-discharge database from the French population. Primary outcomes were incidences of all-cause death, cardiovascular death, heart failure, recurrence of MI, ischemic stroke, incident atrial fibrillation (AF), ventricular tachycardia/ventricular fibrillation (VT/VF), and cardiac arrest. Results 288,408 patients hospitalized for AMI in France from March 1st, 2020, to January 31st, 2023, were included; 26 879 had a COVID-19-positive test between 15 days prior to admission up to 5 days after. COVID-19-positive patients were older (71,4 vs 68,5), had more frequently diabetes mellitus (27,8% vs 24,9%) and a higher obesity rate (21.6% vs 19.5%) but were less frequently smokers (22,5% vs 24,1%). At baseline, COVID-19positive patients had less STEMI presentation (49.7% vs 52.1%) and more frequently lung disease (16.4% v 12.4%). Propensity score matching analysis included 26 879 COVID-19 patients versus 26 879 patients without COVID-19 in this AMI population. The two groups were matched for all-baseline characteristics. COVID-19 patients had a higher incidence of all-cause death (HR, 1.255; 95%CI, 1.203–1.308; p< 0.0001), heart failure (HR, 1.205; 95%CI, 1.159–1.254; p< 0.0001), ischemic stroke (HR, 1.237; 95%CI, 1.084–1.411; p= 0.002), incident AF (HR, 1.160; 95%CI, 1.070–1.258; p= 0.0003), VT/VF (1.360; 95%CI, 1.200–1.540; S6
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 p< 0.0001). Cardiovascular death incidence was lower in COVID-19 patients (HR, 0.932; 95%CI, 0.879–0.988; p= 0.02). No statistical difference was found for cardiac arrest incidence (HR, 1.156; 95%CI, 0.983–1.361; p= 0.08) or recurrence of MI (HR, 1.013; 95%CI, 0.967–1.061; p=0.60). Conclusion In this large French nationwide cohort study, occurrence of AMI when being infected with SARS-Cov2 increases all-cause death incidence, yet this decreased prognosis is not due to cardiovascular death. Further investigations are needed to elucidate aetiologies of death in this population. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvd.2023.10.013 218 Ticagrelor versus clopidogrel for complex percutaneous coronary intervention in chronic coronary syndrome: A post-hoc analysis of the ALPHEUS study B. Lattuca1,∗, C.Mazeau1, G. Cayla1, G. Ducrocq2, P. Guedeney3, P. Kala4, M. Nejjari5, O.Morel6, F. Leclercq7, L. Payot8, F. Beygui9, G. Rangé10, Z. Motovska11, E. Vicaut12, J.-P. Collet3, G. Montalescot3, J. Silvain3 1 Cardiologie, CHU de Nîmes, Nîmes 2 Cardiologie, hôpital Bichat–Claude-Bernard, Paris 3 Cardiologie, hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris 4 Cardiology, University Hospital Brno, Brno, République Tchèque 5 Cardiologie, Centre Cardiologique du Nord, Saint-Denis 6 Cardiologie, CHU Strasbourg, Strasbourg 7 Cardiologie, CHU, Montpellier 8 Cardiologie, CH de Saint Brieuc, Saint-Brieuc 9 Cardiologie, CHU Caen, Caen 10 Cardiologie, hôpital, Chartres 11 Cardiology, University Hospital Královské Vinohrady, Prague, République Tchèque 12 Urc, hôpital Lariboisière AP–HP, Paris ∗ Corresponding author. Adresse e-mail : benoit.lattuca@gmail.com (B. Lattuca) Introduction Whether the use of ticagrelor in chronic coronary syndrome patients undergoing complex percutaneous coronary intervention (PCI) can prevent type 4 myocardial infarction (MI) or myocardial injury as compared to clopidogrel is unknown. Objective To evaluate outcomes of complex PCI in stable coronary patients and the efficacy of ticagrelor versus clopidogrel in these patients randomized in the ALPHEUS trial. Method All PCI procedures were blindly reviewed by two core laboratory readers and classified as complex if they had at least one of the following criteria: stent length≥60 mm, two-stent bifurcation, use of atherectomy, left main, bypass graft, chronic total occlusion, use of guide catheter extensions, multiwire technique, multiple stents. The primary endpoint was a composite of type 4a or b MI and major myocardial injury, defined by the 3rd and 4th universal definition of MI, during the 48 h after PCI. Angiographic complications and the composite of death, MI, stroke at 48 hours and at 30 days were also evaluated. We compared the event rates in the randomized groups according to the presence or not of complex PCI criteria and evaluated interaction with ticagrelor or clopidogrel. Results Among the 1866 patients randomized, 910 (48.3%) PCI were classified as complex PCI. Multiple criteria of complex PCI were found in 14.4% (2 criteria) and 9.1% (≥3 criteria) of the patients. The primary endpoint was more frequent in complex PCI (45.6% vs 26.6%; p< 0.001) driven by higher rates of type 4MI and angiographic complications (12.2% vs 4.8%; p< 0.001 and 19.3% vs 8.6%; p< 0.05, respectively). The composite of death, MI, stroke at 48 hours (12.7% vs 5.1%; p< 0.05) and at 30 days (13.4% vs 5.3%; Figure1 Methodology and main results of the study. CTO: chronic coronary total occlusion; MI means myocardial infarction; PCI, percutaneous coronary intervention. *Technical complexity is defined by the use of more than one guidewire in the same vessel, use of a guiding catheter extension or use of atherectomy. p< 0.05) were also more frequent in complex PCI. No interaction was found between the complexity of PCI and the randomized treatment for the primary endpoint (p for interaction = 0.35) nor the secondary endpoints (Figure 1). Conclusion Complex PCI patients have higher rates of periprocedural and cardiovascular events which are not reduced by ticagrelor as compared with clopidogrel. Disclosure of interest Yes BL reports disclosures but outside the submitted work: research grants from Biotronik, Boston Scientific, Daiichi-Sankyo, Fédération Franc¸ aise de Cardiologie, and Institute of CardioMetabolism and Nutrition, consulting fees from DaiichiSankyo and Eli Lilly, and lecture fees from AstraZeneca, Medtronic, and Novartis https://doi.org/10.1016/j.acvd.2023.10.014 177 Usefulness of the quick-SOFA Score in Cardiovascular intensive care unit to Predict prognosis in Acute Coronary Syndrome A. Bouchlarhem1,∗, N. Ismaili1, N. El Ouafi2 1 Cardiologie, CHU Mohammed VI, Oujda, Maroc 2 Cardiologie USIC, Centre Hospitalier Universitaire Mohammed VI, Oujda, Maroc ∗ Corresponding author. Adresse e-mail : aminbouchlarhem63@gmail.com (A. Bouchlarhem) Introduction Triage of patients with acute coronary syndrome (ACS) at high risk of in-hospital complications is essential to individualize management according to the degree of severity of the patient. Objective In this work, we evaluated the quick SOFA score (qSOFA) as a tool to predict the prognosis of patients admitted to the CICU for ACS. Method We analysed 30-day mortality and in-hospital major adverse cardiovascular events (MACEs) in 968 patients admitted for ACS to the CICU in Oujda over 2 years. Discrimination for 30-day mortality, MACEs and cardiogenic shock was assessed using area S7
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 Figure 1 Kaplan–Meier Curve for 30-days all cause of mortality Patients Based qSOFA Score on Admission (A), and in-hospital MACE (B). Comparison of Receiver-operating characteristic (ROC) curves for predicting 30-days all cause of mortality (C) and in hospital-MACE (D). under the receiver-operating characteristic curve (AUROC) values. A comparison with the CADILLAC and ZWOLLE score is made using the De-long test. The Kaplan-Meier method was used to estimate survival and the Log-Rank test was used to assess hypotheses. Results The risk of 30-days all causes of mortality was independently associated with qSOFA > 1 at admission (HR = 2.76, 95%CI 1.32–5.74, p= 0.007) (Figure 1A) For MACEs, qSOFA > 2 at admission was a predictive factor with (OR = 2.42, 95%CI 1.37–4.36, p=0.002) (Figure 1B). A qSOFA-2 on admission had an AUC of 0.729 (95%CI [0.694; 0.762]), with good specificity of 91.6% for 30-days all causes of mortality (Figure 1C), an AUC of 0.759 (95%CI [0.726; 0.792]) for cardiogenic shock with specificity of 92.5%, and a negative predictive value of 0.95. For MACEs (Figure 1D), an AUC of 0.702 (95%CI [0.64; 0.700] with a specificity of 95%, and a positive predictive value of 0.90. The ZWOLLE score is not superior to the qSOFA score in predicting prognosis (De long test > 0.05), and for the CADILLAC score, it does better in predicting 30-days mortality (AUC á 0.829 and De long á 0.03), however, for cardiogenic shock, the qSOFA is not inferior to the CADILLACs (De long test =0.08) Conclusion The use of qSOFA in CICU remains a horizon to predict the prognosis of patients with ACS, especially for cardiogenic shock with a very good specificity and PVN, as well as for mortality and less for MACEs Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvd.2023.10.015 285 Machine-Learning Score using Stress CMR and CCTA for prediction of cardiovascular events in patients with obstructive CAD S. Toupin1,∗, T. Pezel2, P. Garot3, K. Hamzi4, T. Hovasse3, T. Lefevre3, B. Chevalier3, T. Unterseeh3, F. Sanguineti3, S. Champagne3, H. Benamer3, A. Neylon3, T. Ah-Sing5, L. Hamzi6, T. Goncalves4, J.-G. Dillinger4, P. Henry4, V. Bousson5, J. Garot3 1 Scientific Partnerships, Siemens Healthineers France, Courbevoie 2 Cardiologie, hôpital Lariboisière AP–HP, Paris 3 Cardiologie, Institut Cardiovasculaire Paris Sud (ICPS), Massy 4 Cardiologie, hôpital Lariboisière AP–HP, Paris 5 Radiologie, hôpital Lariboisière AP–HP, Paris 6 Cardiologie, AP–HP hôpital Lariboisière, Paris ∗ Corresponding author. Adresse e-mail : solenn.toupin@gmail.com (S. Toupin) Introduction In patients with newly diagnosed coronary artery disease (CAD), traditional prognostic risk assessment is based on a limited selection of clinical and imaging findings as coronary computed tomography angiography (CCTA) and stress cardiovascular magnetic resonance (CMR). Machine learning (ML) methods can take into account a greater number and complexity of variables. Objective To investigate the feasibility and accuracy of ML using both stress CMR and CCTA data to predict major adverse cardiovascular events (MACE) in patients with newly diagnosed CAD, and compared its performance with existing clinical, CMR or CCTA scores. Method Between 2008–2020, consecutive symptomatic patients without known CAD referred for CCTA were screened. Patients with obstructive CAD (at least 1 ≥ 50% stenosis on CCTA) were further referred for stress CMR. Twenty clinical, 9 CCTA and 12 CMR parameters were evaluated. ML involved automated feature selection by LASSO, model building with a XGBoost algorithm (Figure 1A). The primary composite outcome was MACE defined by cardiovascular death or nonfatal myocardial infarction. The external validation cohort of the ML score was performed in another center (Lariboisiere Hospital). Results Of 2,210 patients who completed CMR, 2,038 (47% male, age 69±12 years) completed the follow-up (median 6.8 [IQR 5.9–9.2] years), and 281 experienced a MACE (13.8%). The ML score exhibited a higher area under the curve compared with ESC risk score, QRISK3 score, Framingham risk score, SIS-core and CCTA or stress CMR data alone for prediction of MACE (ML-score: 0.85 vs. SIS-score: 0.71, stress CMR-score: 0.66, C-CMR-10-score: 0.62, QRISK3-score: 0.60, ESC-score: 0.55, FRS: 0.50, all p< 0.001, Figure 1 B). The ML score also exhibited a good area under the curve in the external cohort (0.85). Conclusion The ML score including multimodality imaging data with both CCTA and stress CMR findings exhibited a higher prognostic value to predict MACE compared with any existing traFigure 1 A. Machine learning workflow. B. ROC curves for MACE prediction. S8
01–Coronary artery disease Archives of Cardiovascular Disease 117 (2024) S3–S29 ditional method, traditional scores, and scores using only CCTA or CMRdata. Disclosure of interest Yes Clinical Scientist at Siemens Healthcare France https://doi.org/10.1016/j.acvd.2023.10.016 180 Sport-related acute myocardial infarction and tobacco smoking; findings from a regional prospective multicentre survey F. Chagué1,∗, M.I.M. Kouamé1, I. Lhuillier1, M. Vincent-Martin1, F. Bichat1, M.Maza1, N. Braghini1, M. Saint-Jalmes1, G. Porot2, P. Brunel2, G.Molins2, J. Ravisy2, L.Mock2, Y. Cottin1, M. Zeller3 1 Service de cardiologie, CHU Dijon Bourgogne, Dijon 2 Service de cardiologie, hôpital privé Dijon Bourgogne, Dijon 3 Laboratoire pec2, EA 7460, UFR sciences de santé, université de Bourgogne, Dijon ∗ Corresponding author. Adresse e-mail : frederic.chague@gmail.com (F. Chagué) Introduction Cigarette consumption is a major cardiovascular (CV) risk factor, especially when smoking just before or during exercise. Only few data are available on smoking in sport-related myocardial infarction (SR-MI). Objective To determine if smoking status is associated with different patterns among patients admitted for a SR-MI. Method We analysed characteristics of the smokers of IMACS, a regional prospective multicentre cohort including all patients hospitalised for a SR-MI. SR-MI was defined as MI onset occurring during sport or within the 1st hour of recovery. A one-year follow-up was performed by phone call (no lost to follow up). Results From April 1st 2018 to February 22nd 2023, 140 SRMI were included, of whom 13 (9.3%) were female, median age was 61y and 37(26.4%) were current smokers, of whom only 1 was woman (Table 1). When compared with non-smokers, smokers were 6-y younger. However, the rate of CV risk factor, STEMI, CV history and prodromal symptoms before the sport session were similar whatever smoking status. Cycling was the most frequent sport and the type of sport slightly differed between the 2 groups (p= 0.049) wth a lower prevalence of cycling, hiking and jogging among smokers (Figure 1). Out of hospital cardiac arrest (OHCA) occurred in 14(10%) of patients, more commonly among patients with prior coronary artery disease (CAD) (p= 0.011). OHCA showed a trend toward a higher frequency in smokers (p= 0.052), in particular among daily smokers and a significant rate smoked within the 2 hours before the sport session (24/37[64.9%]). At follow-up, only one patient suddenly died 8 days after discharge. Among the 96 survivors, most (70 [72.9%]) underwent a rehabilitation program, probably explaining the high rate of smoking cessation (SC) (21[84.0%]). Among the quitters, 4 switched to electronic cigarette. Conclusion Although smoking is at high CV risk, especially in the setting of sport, the rate of smokers remains high (>25%) in patients hospitalised for SR-MI. Moreover, almost two-third had smoked Table1 Main characteristics. N (%) or median (IQR). Figure1 Main sports. just before the event and appeared associated with occurrence of OCHA. These data underline the need for prevention programs aiming to reduce the risk of tobacco, especially in sport setting. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvd.2023.10.017 320 One year mortality after stent thrombosis: A retrospective versus prospective comparaison F. Eggenspieler∗, E. Camenzind , B. Popovic , J. Varlot , P.A. Metzdorf Department of cardiology, University Hospital of Nancy-Brabois, Nancy ∗ Corresponding author. Adresse e-mail : florian.eggenspieler@outlook.fr (F. Eggenspieler) Introduction Although many studies showed the predictive factors of stent thrombosis (ST) occurrence, there is few data about clinical outcomes and recurrent ST after percutaneous coronary intervention (PCI) for ST. Furthermore, it is uncertain which factors can cause adverse clinical events including MACE. Objective To compare one year mortality between two periods of interest: 2008–2014 (first period) and 2015–2021 (second period). Secondary endpoint was occurrence of MACE at 1 year. Method This study examined the clinical outcomes after treatment for definite ST. Among 27,232 stents implanted between January 2008 and December 2021, 275 consecutive patients who suffered definite ST were enrolled in this study. The overall incidence of ST was 1.01% (Drug Eluting Stent 0.98% and Bare-Metal Stent 1.06%). Results Study endpoint occurred in 42 patients (15.3%) during the 1-year follow-up after the initial ST. There was no statistical difference between two groups on primary endpoint (14.6% vs 16.9% p= 0.764). Figure 1 represents survival free from occurrence of MACE during time according to the two periods of interest. In multivariate analysis, severe kidney injury (OR: 3.37 95% CI [1.35;8.42] p= 0.00929), cardiogenic shock (OR: 2.92 95% CI [1.17;7.28] p= 0.02); cardiac arrest (OR: 15.3 95% CI [6.62;35.39] p< 0.0001) and early stent thrombosis (OR: 3.3 95% CI [1.52;7.15] p= 0.002) were strongly associated with higher risk of death. Conclusion Death during the first year after the initial ST event occurred in 15% of patients treated for definite ST. Severe kidney injury, cardiogenic shock, cardiac arrest, and early ST were associated with adverse events. S9
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