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Coronary Artery Disease: HELP
Articles by Jean-Phillippe Collet
Based on 37 articles published since 2010
(Why 37 articles?)
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Between 2010 and 2020, J-P Collet wrote the following 37 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline Case-based implementation of the 2017 ESC Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease. 2018

Collet, Jean-Philippe / Roffi, Marco / Byrne, Robert A / Costa, Francesco / Valgimigli, Marco / Anonymous1890925 / Anonymous1900925 / Anonymous1910925. · ·Eur Heart J · Pubmed #29088328.

ABSTRACT: -- No abstract --

2 Guideline 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS. 2018

Valgimigli, Marco / Bueno, Héctor / Byrne, Robert A / Collet, Jean-Philippe / Costa, Francesco / Jeppsson, Anders / Jüni, Peter / Kastrati, Adnan / Kolh, Philippe / Mauri, Laura / Montalescot, Gilles / Neumann, Franz-Josef / Petricevic, Mate / Roffi, Marco / Steg, Philippe Gabriel / Windecker, Stephan / Zamorano, Jose Luis / Levine, Glenn N / Anonymous7100923. · ·Eur J Cardiothorac Surg · Pubmed #29045581.

ABSTRACT: -- No abstract --

3 Guideline 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). 2018

Valgimigli, Marco / Bueno, Héctor / Byrne, Robert A / Collet, Jean-Philippe / Costa, Francesco / Jeppsson, Anders / Jüni, Peter / Kastrati, Adnan / Kolh, Philippe / Mauri, Laura / Montalescot, Gilles / Neumann, Franz-Josef / Petricevic, Mate / Roffi, Marco / Steg, Philippe Gabriel / Windecker, Stephan / Zamorano, Jose Luis / Levine, Glenn N / Anonymous4980918 / Anonymous4990918 / Anonymous5000918. · ·Eur Heart J · Pubmed #28886622.

ABSTRACT: -- No abstract --

4 Guideline [2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS.] 2017

Valgimigli, Marco / Bueno, Héctor / Byrne, Robert A / Collet, Jean-Philippe / Costa, Francesco / Jeppsson, Anders / Jüni, Peter / Kastrati, Adnan / Kolh, Philippe / Mauri, Laura / Montalescot, Gilles / Neumann, Franz-Josef / Peticevic, Mate / Roffi, Marco / Steg, Philippe Gabriel / Windecker, Stephan / Zamorano, Jose Luis. ·Cardiology, Inselspital, Bern. marco.valgimigli@insel.ch. ·Kardiol Pol · Pubmed #29251754.

ABSTRACT: -- No abstract --

5 Guideline 2014 ESC/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). 2014

Kolh, Philippe / Windecker, Stephan / Alfonso, Fernando / Collet, Jean-Philippe / Cremer, Jochen / Falk, Volkmar / Filippatos, Gerasimos / Hamm, Christian / Head, Stuart J / Jüni, Peter / Kappetein, A Pieter / Kastrati, Adnan / Knuuti, Juhani / Landmesser, Ulf / Laufer, Günther / Neumann, Franz-Josef / Richter, Dimitrios J / Schauerte, Patrick / Sousa Uva, Miguel / Stefanini, Giulio G / Taggart, David Paul / Torracca, Lucia / Valgimigli, Marco / Wijns, William / Witkowski, Adam / Anonymous7870804 / Zamorano, Jose Luis / Achenbach, Stephan / Baumgartner, Helmut / Bax, Jeroen J / Bueno, Héctor / Dean, Veronica / Deaton, Christi / Erol, Çetin / Fagard, Robert / Ferrari, Roberto / Hasdai, David / Hoes, Arno W / Kirchhof, Paulus / Knuuti, Juhani / Kolh, Philippe / Lancellotti, Patrizio / Linhart, Ales / Nihoyannopoulos, Petros / Piepoli, Massimo F / Ponikowski, Piotr / Sirnes, Per Anton / Tamargo, Juan Luis / Tendera, Michal / Torbicki, Adam / Wijns, William / Windecker, Stephan / Anonymous7880804 / Sousa Uva, Miguel / Achenbach, Stephan / Pepper, John / Anyanwu, Anelechi / Badimon, Lina / Bauersachs, Johann / Baumbach, Andreas / Beygui, Farzin / Bonaros, Nikolaos / De Carlo, Marco / Deaton, Christi / Dobrev, Dobromir / Dunning, Joel / Eeckhout, Eric / Gielen, Stephan / Hasdai, David / Kirchhof, Paulus / Luckraz, Heyman / Mahrholdt, Heiko / Montalescot, Gilles / Paparella, Domenico / Rastan, Ardawan J / Sanmartin, Marcelo / Sergeant, Paul / Silber, Sigmund / Tamargo, Juan / ten Berg, Jurrien / Thiele, Holger / van Geuns, Robert-Jan / Wagner, Hans-Otto / Wassmann, Sven / Wendler, Olaf / Zamorano, Jose Luis / Anonymous7890804 / Anonymous7900804. ·(Belgium) philippe.kolh@chu.ulg.ac.be stephan.windecker@insel.ch. · (Switzerland) philippe.kolh@chu.ulg.ac.be stephan.windecker@insel.ch. · (Spain). · (France). · (Germany). · (Switzerland). · (Greece). · (Netherlands). · (Finland). · (Austria). · (Portugal). · (UK). · (Italy). · (Belgium). · (Poland). · (Turkey). · (Israel). · (Germany/UK). · (Czech Republic). · (Norway). · (USA). · (UK/Germany). ·Eur J Cardiothorac Surg · Pubmed #25173601.

ABSTRACT: -- No abstract --

6 Guideline 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). 2014

Anonymous7760804 / Windecker, Stephan / Kolh, Philippe / Alfonso, Fernando / Collet, Jean-Philippe / Cremer, Jochen / Falk, Volkmar / Filippatos, Gerasimos / Hamm, Christian / Head, Stuart J / Jüni, Peter / Kappetein, A Pieter / Kastrati, Adnan / Knuuti, Juhani / Landmesser, Ulf / Laufer, Günther / Neumann, Franz-Josef / Richter, Dimitrios J / Schauerte, Patrick / Sousa Uva, Miguel / Stefanini, Giulio G / Taggart, David Paul / Torracca, Lucia / Valgimigli, Marco / Wijns, William / Witkowski, Adam. · ·Eur Heart J · Pubmed #25173339.

ABSTRACT: -- No abstract --

7 Review Antiplatelet Agents for the Treatment and Prevention of Coronary Atherothrombosis. 2017

Patrono, Carlo / Morais, Joao / Baigent, Colin / Collet, Jean-Philippe / Fitzgerald, Desmond / Halvorsen, Sigrun / Rocca, Bianca / Siegbahn, Agneta / Storey, Robert F / Vilahur, Gemma. ·Department of Pharmacology, Catholic University School of Medicine, Rome, Italy. Electronic address: carlo.patrono@unicatt.it. · Division of Cardiology, Santo Andre's Hospital, Leiria, Portugal. · MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. · Sorbonne Université Paris 6, ACTION Study Group, Institut de Cardiologie Hôpital Pitié-Salpêtrière (APHP), INSERM UMRS 1166, Paris, France. · University of Limerick, Limerick, Ireland. · Department of Cardiology, Oslo University Hospital Ullevål, and University of Oslo, Oslo, Norway. · Department of Pharmacology, Catholic University School of Medicine, Rome, Italy. · Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden. · Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom. · Cardiovascular Science Institute-ICCC IIB-Sant Pau, CiberCV, Hospital de Sant Pau, Barcelona, Spain. ·J Am Coll Cardiol · Pubmed #28958334.

ABSTRACT: Antiplatelet drugs provide first-line antithrombotic therapy for the management of acute ischemic syndromes (both coronary and cerebrovascular) and for the prevention of their recurrence. Their role in the primary prevention of atherothrombosis remains controversial because of the uncertain balance of the potential benefits and risks when combined with other preventive strategies. The aim of this consensus document is to review the evidence for the efficacy and safety of antiplatelet drugs, and to provide practicing cardiologists with an updated instrument to guide their choice of the most appropriate antiplatelet strategy for the individual patient presenting with different clinical manifestations of coronary atherothrombosis, in light of comorbidities and/or interventional procedures.

8 Review Oral anticoagulants in coronary heart disease (Section IV). Position paper of the ESC Working Group on Thrombosis - Task Force on Anticoagulants in Heart Disease. 2016

De Caterina, Raffaele / Husted, Steen / Wallentin, Lars / Andreotti, Felicita / Arnesen, Harald / Bachmann, Fedor / Baigent, Colin / Collet, Jean-Philippe / Halvorsen, Sigrun / Huber, Kurt / Jespersen, Jørgen / Kristensen, Steen Dalby / Lip, Gregory Y H / Morais, João / Rasmussen, Lars Hvilsted / Ricci, Fabrizio / Sibbing, Dirk / Siegbahn, Agneta / Storey, Robert F / Ten Berg, Jurriën / Verheugt, Freek W A / Weitz, Jeffrey I. ·Raffaele De Caterina, MD, PhD, Institute of Cardiology, "G. d'Annunzio" University - Chieti, Ospedale SS. Annunziata, Via dei Vestini, 66013 Chieti, Italy, E-mail: rdecater@unich.it. ·Thromb Haemost · Pubmed #26952877.

ABSTRACT: Until recently, vitamin K antagonists (VKAs) were the only available oral anticoagulants evaluated for long-term treatment of patients with coronary heart disease (CHD), particularly after an acute coronary syndrome (ACS). Despite efficacy in this setting, VKAs are rarely used because they are cumbersome to administer. Instead, the more readily manageable antiplatelet agents are the mainstay of prevention in ACS patients. This situation has the potential to change with the introduction of non-VKA oral anticoagulants (NOACs), which are easier to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring. The NOACs include dabigatran, which inhibits thrombin, and apixaban, rivaroxaban and edoxaban, which inhibit factor Xa. Apixaban and rivaroxaban were evaluated in phase III trials for prevention of recurrent ischaemia in ACS patients, most of whom were also receiving dual antiplatelet therapy with aspirin and clopidogrel. Although at the doses tested rivaroxaban was effective and apixaban was not, both agents increased major bleeding. The role for the NOACs in ACS management, although promising, is therefore complicated, because it is uncertain how they compare with newer antiplatelet agents, such as prasugrel, ticagrelor or vorapaxar, and because their safety in combination with these other drugs is unknown. Ongoing studies are also now evaluating the use of NOACs in non-valvular atrial fibrillation patients, where their role is established, with coexistent ACS or coronary stenting. Focusing on CHD, we review the results of clinical trials with the NOACs and provide a perspective on their future incorporation into clinical practice.

9 Review Dual antiplatelet therapy: optimal timing, management, and duration. 2015

Sabouret, Pierre / Rushton-Smith, Sophie K / Kerneis, Mathieu / Silvain, Johanne / Collet, Jean-Philippe / Montalescot, Gilles. ·Institut du Cœur, Pitié-Salpêtrière Hospital (AP-HP), Pierre and Marie Curie University, 47-83, boulevard de l'Hôpital, Paris 75013, France, ACTION Group, www.action-coeur.org. · Thrombosis Research Institute, London, UK. · Institut du Cœur, Pitié-Salpêtrière Hospital (AP-HP), Pierre and Marie Curie University, 47-83, boulevard de l'Hôpital, Paris 75013, France, ACTION Group, www.action-coeur.org gilles.montalescot@psl.aphp.fr. ·Eur Heart J Cardiovasc Pharmacother · Pubmed #27533996.

ABSTRACT: Platelet activation and aggregability play a key role in the genesis of arterial thrombus secondary to plaque rupture. For coronary patients, inhibition of platelet function is crucial to decrease the rate of major adverse cardiac events but may expose them to excess bleeding risk. Switching P2Y12 inhibitors is common, yet the clinical consequences are unknown. The aim of this review is to provide an overview of the evidence from randomized, clinical trials and epidemiological studies, with a focus on the optimal duration of dual antiplatelet therapy (DAPT) and appropriate agent and dose selection. The report discusses the latest evidence regarding switching therapies during DAPT, the potential benefits of a personalized strategy, management of the preoperative period, and other clinical perspectives in this complex and rapidly changing field. Ongoing trials will be useful to answer to some important unresolved questions.

10 Review Coronary revascularization in the diabetic patient. 2014

Silvain, Johanne / Vignalou, Jean-Baptiste / Barthélémy, Olivier / Kerneis, Mathieu / Collet, Jean-Philippe / Montalescot, Gilles. ·From the ACTION Coeur Research Group, Institut de Cardiologie, Pitié-Salpêtrière Hospital (APHP), Sorbonne Universités, (UPMC), INSERM, UMRS 1166, Paris, France. · From the ACTION Coeur Research Group, Institut de Cardiologie, Pitié-Salpêtrière Hospital (APHP), Sorbonne Universités, (UPMC), INSERM, UMRS 1166, Paris, France. gilles.montalescot@psl.aphp.fr. ·Circulation · Pubmed #25199665.

ABSTRACT: -- No abstract --

11 Review Open issues in transcatheter aortic valve implantation. Part 1: patient selection and treatment strategy for transcatheter aortic valve implantation. 2014

Bax, Jeroen J / Delgado, Victoria / Bapat, Vinayak / Baumgartner, Helmut / Collet, Jean P / Erbel, Raimund / Hamm, Christian / Kappetein, Arie P / Leipsic, Jonathon / Leon, Martin B / MacCarthy, Philip / Piazza, Nicolo / Pibarot, Philippe / Roberts, William C / Rodés-Cabau, Josep / Serruys, Patrick W / Thomas, Martyn / Vahanian, Alec / Webb, John / Zamorano, Jose Luis / Windecker, Stephan. ·Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC, Leiden, The Netherlands j.j.bax@lumc.nl. · Department of Cardiology, Leiden University Medical Center, Albinusdreef 2 2300 RC, Leiden, The Netherlands. · Department of Cardiology and Cardiothoracic Surgery, St Thomas' Hospital, London, UK. · Division of Adult Congenital and Valvular Heart Disease, Department of Cardiovascular Medicine, University Hospital Muenster, Muenster, Germany. · Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. · Department of Cardiology, West-German Heart Center Essen, University Duisburg Essen, Essen, Germany. · Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany. · Erasmus Medical Center, Rotterdam, The Netherlands. · St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. · Columbia University Medical Center, Center for Interventional Vascular Therapy, New York Presbyterian Hospital, New York, USA. · Cardiovascular Department, King's College Hospital, London, UK. · Interventional Cardiology, McGill University Health Center, Montreal, Canada Cardiovascular Surgery, German Heart Center Munich, Bavaria, Germany. · Quebec Heart and Lung Institute, Québec, Canada. · Baylor Heart and Vascular Institute and the Departments of Internal Medicine (Division of Cardiology) and Pathology, Baylor University Medical Center, Dallas, TX, USA. · Department of Cardiology, Laval University, Quebec, Canada. · Bichat Hospital, University Paris VII, Paris, France. · Cardiac Imaging Department, University Hospital Ramon y Cajal, Madrid, Spain. · Department of Cardiology, Bern University Hospital, Bern, Switzerland. ·Eur Heart J · Pubmed #25062952.

ABSTRACT: An exponential increase in the use of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis has been witnessed over the recent years. The current article reviews different areas of uncertainty related to patient selection. The use and limitations of risk scores are addressed, followed by an extensive discussion on the value of three-dimensional imaging for prosthesis sizing and the assessment of complex valve anatomy such as degenerated bicuspid valves. The uncertainty about valvular stenosis severity in patients with a mismatch between the transvalvular gradient and the aortic valve area, and how integrated use of echocardiography and computed tomographic imaging may help, is also addressed. Finally, patients referred for TAVI may have concomitant mitral regurgitation and/or coronary artery disease and the management of these patients is discussed.

12 Review Association of clopidogrel pretreatment with mortality, cardiovascular events, and major bleeding among patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis. 2012

Bellemain-Appaix, Anne / O'Connor, Stephen A / Silvain, Johanne / Cucherat, Michel / Beygui, Farzin / Barthélémy, Olivier / Collet, Jean-Philippe / Jacq, Laurent / Bernasconi, François / Montalescot, Gilles / Anonymous2490746. ·Service de Cardiologie-La FontonneHospital, Antibes, France. ·JAMA · Pubmed #23287889.

ABSTRACT: CONTEXT: Clopidogrel pretreatment is recommended for patients with acute coronary syndromes (ACS) and stable coronary artery disease who are scheduled for percutaneous coronary intervention (PCI), but whether using clopidogrel as a pretreatment for PCI is associated with positive clinical outcomes has not been established. OBJECTIVE: To evaluate the association of clopidogrel pretreatment vs no treatment with mortality and major bleeding after PCI. DATA SOURCES: MEDLINE, EMBASE, Cochrane Controlled Trials Register databases, and reference lists of qualifying articles. STUDY SELECTION Studies reporting clinical data on mortality and major bleeding were included. Of the 392 titles identified, 15 articles published between August 2001 and September 2012 met the inclusion criteria: 6 randomized controlled trials (RCTs), 2 observational analyses of RCTs, and 7 observational studies. DATA EXTRACTION: Quality of studies was assessed with the Ottawa Scale and the Jadad Score as appropriate. Results were independently extracted by 2 reviewers. A random-effect model was applied. Pretreatment was defined as the administration of clopidogrel before PCI or catheterization. The main analysis was performed on RCTs and confirmed by observational analyses and observational studies. Prespecified subgroups--clinical presentation and clopidogrel loading dose--were analyzed. The primary efficacy and safety end points were all-cause mortality and major bleeding. Secondary end points included major cardiac events. RESULTS: Of the 37 814 patients included in the meta-analysis, 8608 patients had participated in RCTs; 10,945, in observational analyses of RCTs; and 18,261, in observational studies. Analysis of RCTs showed that clopidogrel pretreatment was not associated with a reduction of death (absolute risk, 1.54% vs 1.97%; OR, 0.80; 95% CI, 0.57-1.11; P = .17) but was associated with a lower risk of major cardiac events (9.83% vs 12.35%; OR, 0 .77; 95% CI, 0.66-0.89; P < .001). There was no significant association between pretreatment and major bleeding overall (3 .57% vs 3.08%; OR, 1.18; 95% CI, 0.93-1.50; P = .18). Analyses from observational analyses of RCTs and observational studies were consistent for all results. CONCLUSIONS: Among patients scheduled for PCI, clopidogrel pretreatment was not associated with a lower risk of mortality but was associated with a lower risk of major coronary events.

13 Review Antiplatelet agents for the treatment and prevention of atherothrombosis. 2011

Patrono, Carlo / Andreotti, Felicita / Arnesen, Harald / Badimon, Lina / Baigent, Colin / Collet, Jean-Philippe / De Caterina, Raffaele / Gulba, Dietrich / Huber, Kurt / Husted, Steen / Kristensen, Steen Dalby / Morais, João / Neumann, Franz-Josef / Rasmussen, Lars Hvilsted / Siegbahn, Agneta / Steg, Philippe-Gabriel / Storey, Robert F / Van de Werf, Frans / Verheugt, Freek. ·Department of Pharmacology, Catholic University School of Medicine, Rome, Italy. carlo.patrono@rm.unicatt.it ·Eur Heart J · Pubmed #22019823.

ABSTRACT: The clinical pharmacology of antiplatelet drugs has been reviewed previously by the European Society of Cardiology (ESC) Task force and by the 8th American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guidelines. Moreover, information on the efficacy and safety of antiplatelet drugs in the treatment and prevention of atherothrombosis is provided by collaborative meta-analyses of 287 secondary prevention trials and 6 primary prevention trials. The present document intends to provide practicing physicians with an updated instrument to guide their choice of the most suitable antiplatelet strategy for the individual patient at risk, or with different clinical manifestations, of atherothrombosis.

14 Article Long-Term Evolution of Premature Coronary Artery Disease. 2019

Collet, Jean-Philippe / Zeitouni, Michel / Procopi, Niki / Hulot, Jean-Sébastien / Silvain, Johanne / Kerneis, Mathieu / Thomas, Daniel / Lattuca, Benoit / Barthelemy, Olivier / Lavie-Badie, Yoan / Esteve, Jean-Baptiste / Payot, Laurent / Brugier, Delphine / Lopes, Izolina / Diallo, Abdourahmane / Vicaut, Eric / Montalescot, Gilles / Anonymous1131188. ·Sorbonne Université, ACTION Study Group, INSERM UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France. · Université Paris-Descartes, Sorbonne Paris Cité, Paris Cardiovascular Research Center (PARCC), INSERM UMRS 970, Hôpital Européen Georges Pompidou, AP-HP, Paris, France. · Centre Hospitalo-Universitaire Rangueil, Imagerie Cardiovasculaire, Toulouse, France. · Infirmerie Protestante de Lyon, Cardiologie, Caluire, France. · Centre Hospitalier, Cardiologie, Saint-Brieuc, France. · ACTION Study Group, Hôpital Lariboisière (AP-HP), Unité de Recherche Clinique, Paris, France. · Sorbonne Université, ACTION Study Group, INSERM UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (AP-HP), Paris, France. Electronic address: gilles.montalescot@aphp.fr. ·J Am Coll Cardiol · Pubmed #31601367.

ABSTRACT: BACKGROUND: The long-term evolution of premature coronary artery disease (CAD) is unknown. OBJECTIVES: The objective of this study was to describe the evolution of coronary atherosclerosis in young patients and identify the risk factors of poor outcomes. METHODS: Participants age ≤45 years with acute or stable obstructive CAD were prospectively enrolled and followed. The primary endpoint was all-cause death, myocardial infarction (MI), refractory angina requiring coronary revascularization, and ischemic stroke. RESULTS: Eight hundred-eighty patients with premature CAD were included. They were age 40.1 ± 5.7 years, mainly men, smokers, with a family history of CAD or hypercholesterolemia. At baseline presentation, 91.2% underwent coronary revascularization, predominantly for acute MI (78.8%). Over a follow-up of 20 years, one-third (n = 264) of patients presented with a total of 399 ischemic events, and 36% had at least a second recurrent event. MI was the most frequent first recurrent event (n = 131 of 264), mostly related to new coronary lesions (17.3% vs. 7.8%; p = 0.01; hazard ratio [HR]:1.45; 95% confidence interval [CI]: 1.09 to 1.93 for new vs. initial culprit lesion). All-cause death (n = 55; 6.3%) occurred at 8.4 years (median time). Ethnic origin (sub-Saharan African vs. Caucasian, adjusted hazard ratio [adjHR]: 1.95; 95% CI: 1.13 to 3.35; p = 0.02), inflammatory disease (adjHR: 1.58; 95% CI: 1.05 to 2.36; p = 0.03), and persistent smoking (adjHR: 2.32; 95% CI: 1.63 to 3.28; p < 0.01) were the strongest correlates of a first recurrent event. When considering all recurrent events, the same factors and Asian ethnicity predicted poor outcome, but persistent smoking had the greatest impact on prognosis. CONCLUSIONS: Premature CAD is an aggressive disease despite the currently recommended prevention measures, with high rates of recurrent events and mortality. Ethnicity and concomitant inflammatory disease are associated with poor prognoses, along with insufficient control of risk factors.

15 Article Systematic detection of polyvascular disease combined with aggressive secondary prevention in patients presenting with severe coronary artery disease: The randomized AMERICA Study. 2018

Collet, Jean-Philippe / Cayla, Guillaume / Ennezat, Pierre-Vladimir / Leclercq, Florence / Cuisset, Thomas / Elhadad, Simon / Henry, Patrick / Belle, Loic / Cohen, Ariel / Silvain, Johanne / Barthelemy, Olivier / Beygui, Farzin / Diallo, Abdourahmane / Vicaut, Eric / Montalescot, Gilles / Anonymous4700935. ·Sorbonne Université Paris 6, ACTION Study Group, Institut de Cardiologie Hôpital Pitié-Salpêtrière (APHP), INSERM UMRS, 1166 Paris, France. Electronic address: jean-philippe.collet@psl.aphp.fr. · ACTION Study Group, Cardiologie, CHU Carémeau, Université de Montpellier, Nîmes, France. · Cardiologie, Pôle Thorax et Vaisseaux, CHU La Tronche, Grenoble, France. · Cardiologie, Hôpital Arnaud de Villeneuve-CHU Montpellier, France. · Department of Cardiology, CHU Timone and Aix-Marseille Univ, INSERM UMR1062, INRA UMR1260, Nutrition, Obesity and Risk of Thrombosis, Faculty of Medicine, F-13385 Marseille, France. · Cardiologie, CH de Lagny-Marne la Vallée, Jossigny, France. · Cardiologie, CHU Lariboisière (APHP), Paris, France. · Cardiologie, Centre Hospitalier d'Annecy, France. · Cardiologie, CHU Saint-Antoine (APHP), Paris, France. · Sorbonne Université Paris 6, ACTION Study Group, Institut de Cardiologie Hôpital Pitié-Salpêtrière (APHP), INSERM UMRS, 1166 Paris, France. · Cardiologie, Hôpital de la Côte de Nacre, Caen, France. · ACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), France and Université Denis Diderot, Paris, France. ·Int J Cardiol · Pubmed #29407124.

ABSTRACT: BACKGROUND: The prevalence and associated-risk of asymptomatic multisite artery disease (MSAD) in high risk coronary patients are unknown. Whether systematic identification and aggressive management of asymptomatic MSAD is clinically relevant in high risk coronary patients has not been evaluated. METHODS: We randomly assigned 521 high risk coronary patients defined by the presence of three-vessel coronary disease (n=304) or recent acute coronary syndrome beyond the age of 75years (n=215) to either a strategy of systematic detection of asymptomatic MSAD combined with an aggressive secondary prevention (n=263) or to a more conventional strategy based on treatment of coronary artery disease only with standard of care (n=258). The primary end point was the time to first occurrence of death, any organ failure or ischemic event leading to re-hospitalization through two years of follow-up. RESULTS: The pro-active strategy identified asymptomatic MSAD in 21.7% of patients with few revascularizations (3.6%); the pro-active pharmacological secondary prevention was obtained in >85% of patients and life-style changes in <60% of patients. At 2-year follow-up, the primary end point occurred in 44.9% of patients in the pro-active group and 43.0% of patients in the conventional group (HR 1.03; 95% confidence interval [CI], 0.80 to 1.34]. The rate of major bleeding did not differ significantly between groups (4.6% vs 5.0%; HR, 0.97; 95% CI, 0.40 to 1.91). CONCLUSION: In high risk coronary patients, there is no apparent benefit of a systematic detection of asymptomatic extra-coronary atherothrombotic disease and intensified treatment over a 2-year follow-up period. (Funded by the Academic Allies in Cardiovascular Trials Initiatives and Organized Networks and Institut de l'Athérothrombose; AMERICA ClinicalTrials.gov number, NCT00445835).

16 Article Outcome after revascularisation of acute myocardial infarction with cardiogenic shock on extracorporeal life support. 2018

Overtchouk, Pavel / Pascal, Julien / Lebreton, Guillaume / Hulot, Jean-Sebastien / Luyt, Charles-Edouard / Combes, Alain / Kerneis, Mathieu / Silvain, Johanne / Barthelemy, Olvier / Leprince, Pascal / Brechot, Nicolas / Montalescot, Gilles / Collet, Jean-Philippe. ·Sorbonne Université, ACTION Study Group, INSERM UMR_S 1166, Institut de Cardiologie, Département de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France. ·EuroIntervention · Pubmed #29400656.

ABSTRACT: AIMS: The aim of the study was to identify independent correlates of survival in patients undergoing PCI for refractory cardiogenic shock due to myocardial infarction (RCS-MI) with the need for extracorporeal life support (ECLS). METHODS AND RESULTS: This observational single tertiary centre study enrolled 106 consecutive patients (52.7±10.4 years) with ECLS placed before or after the PCI. Half of the patients had triple vessel disease and PCI was attempted whenever possible (74.5%). The 30-day mortality rate was 63.2%. Left main culprit vessel disease (19% of patients) (adj. HR [95% CI]: 2.31 [1.27-4.18], p=0.006) and sepsis-related organ failure assessment ≥13 (adj. HR 2.17 [1.25-3.75], p=0.005) were independently associated with 30-day mortality. The use of intra-aortic balloon pump (IABP) combined with ECLS was an independent protective factor (adj. HR 0.48 [0.28-0.80], p=0.006). Neither complete (p=0.66) nor successful (p=0.69) myocardial revascularisation was associated with 30-day survival. CONCLUSIONS: RCS in MI patients often reveals a severe multivessel coronary artery disease with no impact of early percutaneous coronary revascularisation on clinical outcome. The survival advantage of IABP when combined with ECLS further suggests that achieving an early effective haemodynamic support should be the major goal in this young patient population.

17 Article Questions and answers on diagnosis and management of patients with Peripheral Arterial Diseases: a companion document of the 2017 ESC Guidelines for the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Endorsed by: the European Stroke Organisation (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). 2018

Aboyans, Victor / Björck, Martin / Brodmann, Marianne / Collet, Jean-Philippe / Czerny, Martin / De Carlo, Marco / Naylor, A Ross / Roffi, Marco / Tendera, Michal / Vlachopoulos, Charalambos / Ricco, Jean-Baptiste / Anonymous1980925. · ·Eur Heart J · Pubmed #29088383.

ABSTRACT: -- No abstract --

18 Article Impact of coronary artery disease in patients undergoing transcatheter aortic valve replacement: Insights from the FRANCE-2 registry. 2017

Puymirat, Etienne / Didier, Romain / Eltchaninoff, Hélène / Lung, Bernard / Collet, Jean-Philippe / Himbert, Dominique / Durand, Eric / Leguerrier, Alain / Leprince, Pascal / Fajadet, Jean / Teiger, Emmanuel / Chevreul, Karine / Lièvre, Michel / Tchetché, Didier / Leclercq, Florence / Chassaing, Stéphan / Le Breton, Hervé / Donzeau-Gouge, Patrick / Lefèvre, Thierry / Carrié, Didier / Gillard, Martine / Blanchard, Didier. ·Department of Cardiology, European Hospital of Georges Pompidou, Public Assistance Hospitals of Paris, Paris Descartes University, Paris, France. · Department of Cardiology, Brest University Hospital, Brest, France. · Department of Cardiology, Rouen University Hospital, Rouen, France. · Department of Cardiology, Bichat University Hospital, Paris, France. · Department of Cardiology, Pitié Salpetrière University Hospital, Paris, France. · Department of Cardiology and Surgery, Rennes University Hospital, Rennes, France. · Department of Surgery, Pitié Salpetrière University Hospital, Paris, France. · Department of Cardiology, Clinique Pasteur, Toulouse, France. · Department of URC-ECO and Cardiology, Creteil University Hospital, Paris, France. · Public Assistance Hospitals of Paris, Hotel Dieu Hospital, Clinical Research Unit, Paris, France. · UMR and Department of Cardiology, Lyon University Hospital, Lyon, France. · Department of Cardiology, Montpellier University Hospital, Montpellier, France. · Department of Cardiology, Clinique Saint-Gatien, Tours, France. · Department of Cardiology, Rennes University Hospital, Rennes, France. · Department of Cardiology and Surgery, I Cardiovascular Institute Paris Sud, Private Hospital Jacques Cartier, Massy, France. · Department of Cardiology, CHU Toulouse Rangueil, University Paul Sabatier, Toulouse, France. ·Clin Cardiol · Pubmed #29247516.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) is common in patients undergoing transcatheter aortic valve replacement (TAVR). However, the impact of CAD distribution before TAVR on short- and long-term prognosis remains unclear. HYPOTHESIS: We hypothesized that the long-term clinical impact differs according to CAD distribution in patients undergoing TAVR using the FRench Aortic National CoreValve and Edwards (FRANCE-2) registry. METHODS: FRANCE-2 is a national French registry including all consecutive TAVR performed between 2010 and 2012 in 34 centers. Three-year mortality was assessed in relation to CAD status. CAD was defined as at least 1 coronary stenosis >50%. RESULTS: A total of 4201 patients were enrolled in the registry. For the present analysis, we excluded patients with a history of coronary artery bypass. CAD was reported in 1252 patients (30%). Half of the patients presented with coronary multivessel disease. CAD extent was associated with an increase in cardiovascular risk profile and in logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) (from 19.3% ± 12.8% to 21.9% ± 13.5%, P < 0.001). Mortality at 30 days and 3 years was 9% and 44%, respectively, in the overall population. In multivariate analyses, neither the presence nor the extent of CAD was associated with mortality at 3 years (presence of CAD, hazard ratio [HR]: 0.90; 95% confidence interval [CI]: 0.78-1.07). A significant lesion of the left anterior descending (LAD) was associated with higher 3-year mortality (HR: 1.42; 95% CI: 1.10-1.87). CONCLUSIONS: CAD is not associated with decreased short- and long-term survival in patients undergoing TAVR. The potential deleterious effect of LAD disease on long-term survival and the need for revascularization before or at the time of TAVR should be validated in a randomized control trial.

19 Article Management of antithrombotic therapy after bleeding in patients with coronary artery disease and/or atrial fibrillation: expert consensus paper of the European Society of Cardiology Working Group on Thrombosis. 2017

Halvorsen, Sigrun / Storey, Robert F / Rocca, Bianca / Sibbing, Dirk / Ten Berg, Jurrien / Grove, Erik Lerkevang / Weiss, Thomas W / Collet, Jean-Philippe / Andreotti, Felicita / Gulba, Dietrich C / Lip, Gregory Y H / Husted, Steen / Vilahur, Gemma / Morais, Joao / Verheugt, Freek W A / Lanas, Angel / Al-Shahi Salman, Rustam / Steg, Philippe Gabriel / Huber, Kurt / Anonymous8210885. ·Department of Cardiology, Oslo University Hospital Ulleval and University of Oslo, Oslo, Norway. · Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK. · Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy. · Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany and DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. · Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands. · Department of Cardiology, Aarhus University Hospital, and Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. · 3rd Department of Internal Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital, Montleartstrasse 37, Vienna, A-1160, Austria. · Univ Paris 06 (UPMC), ACTION Study Group, INSERM UMR_S 1166, ICAN, Institut de Cardiologie, Pitié-Salpêtrière Hospital (AP-HP), Paris, France. · Institute of Cardiology, Catholic University Medical School, Rome, Italy. · Clinic for Internal Medicine and Pneumology, Katholisches Klinikum Oberhausen GmbH, St. Marien Hospital, Oberhausen, Germany. · University of Birmingham Institute of Cardiovascular Sciences, City Hospital, United Kingdom; and Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark. · Medical Department, Region Hospital West, Herning/Holstebro. · Cardiovascular Research Center, CSIC-ICCC, HSCSP-Barcelona, Spain. · Department of Cardiology, Leiria Hospital Centre, Portugal. · Emeritus Professor of Cardiology, P.C. Hooftstraat 188, CH Amsterdam, 1071, Netherlands. · Service of Digestive Diseases. University Hospital. University of Zaragoza. CIBERehd. IIS Aragón. Zaragoza, Spain. · Centre for Clinical Brain Sciences, University of Edinburgh, UK. · Université Paris-Diderot, Sorbonne Paris Cité, DHU FIRE, AP-HP and INSERM U-1148, all in Paris, France. NHLI, Imperial College, Royal Brompton Hospital, London, UK. ·Eur Heart J · Pubmed #27789570.

ABSTRACT: -- No abstract --

20 Article Exome sequencing of extreme clopidogrel response phenotypes identifies B4GALT2 as a determinant of on-treatment platelet reactivity. 2016

Scott, S A / Collet, J-P / Baber, U / Yang, Y / Peter, I / Linderman, M / Sload, J / Qiao, W / Kini, A S / Sharma, S K / Desnick, R J / Fuster, V / Hajjar, R J / Montalescot, G / Hulot, J-S. ·Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Sorbonne Universités, UPMC Univ Paris 06, Faculty of Medicine, UMRS_1166 ICAN, Institute of Cardiometabolism and Nutrition, AP-HP, Pitié-Salpêtrière Hospital, Institute of Cardiology, Paris, France. · Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA. ·Clin Pharmacol Ther · Pubmed #27213804.

ABSTRACT: Interindividual variability in platelet aggregation is common among patients treated with clopidogrel and both high on-treatment platelet reactivity (HTPR) and low on-treatment platelet reactivity (LTPR) increase risks for adverse clinical outcomes. CYP2C19 influences clopidogrel response but only accounts for ∼12% of the variability in platelet reactivity. To identify novel variants implicated in on-treatment platelet reactivity, patients with coronary artery disease (CAD) with extreme pharmacodynamic responses to clopidogrel and wild-type CYP2C19 were subjected to exome sequencing. Candidate variants that clustered in the LTPR subgroup subsequently were genotyped across the discovery cohort (n = 636). Importantly, carriers of B4GALT2 c.909C>T had lower on-treatment P2Y12 reaction units (PRUs; P = 0.0077) and residual platelet aggregation (P = 0.0008) compared with noncarriers, which remained significant after adjusting for CYP2C19 and other clinical variables in both the discovery (P = 0.0298) and replication (n = 160; PRU: P = 0.0001) cohorts. B4GALT2 is a platelet-expressed galactosyltransferase, indicating that B4GALT2 c.909C>T may influence clopidogrel sensitivity through atypical cell-surface glycoprotein processing and platelet adhesion.

21 Article Clinical Outcome of First- vs Second-Generation DES According to DAPT Duration: Results of ARCTIC-Generation. 2016

Collet, Jean-Philippe / Silvain, Johanne / Kerneis, Mathieu / Cuisset, Thomas / Meneveau, Nicolas / Boueri, Ziad / Barthélémy, Olivier / Rangé, Grégoire / Cayla, Guillaume / Belle, Eric Van / Elhadad, Simon / Carrié, Didier / Caussin, Christophe / Rousseau, Hélène / Aubry, Pierre / Monségu, Jacques / Sabouret, Pierre / O'Connor, Stephen A / Abtan, Jérémie / Saint-Etienne, Christophe / Beygui, Farzin / Vicaut, Eric / Montalescot, Gilles / Anonymous3270858. ·Univ Paris 06 (UPMC), ACTION Study Group, Institut de Cardiologie, Hôpital Pitié-Salpêtrière (APHP), Paris, France. · Department of Cardiology, CHU La Timone, Marseille, France. · Department of Cardiology, CHU Jean Minjoz, Besançon, France. · Department of Cardiology, CH de Bastia, France. · Department of Cardiology, Les Hôpitaux de Chartres, Le Coudray, France. · ACTION Study Group, Department of Cardiology, CHU Carémeau, Nîmes, France. · Department of Cardiology, Lille University Hospital, Lille, France. · Department of Cardiology, CH de Lagny-Marne la Vallée, Lagny-sur-Marne, France. · Department of Cardiology, CHU Rangueil, Toulouse, France. · Department of Cardiology, Institut Mutualiste Montsouris, Paris, France. · ACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), Paris, France. · Université Denis Diderot, Paris, France. · Department of Cardiology, Centre Hospitalier Bichat (APHP), Paris, France. · Department of cardiology, Groupe Hospitalier Mutualiste, Grenoble, France. · Department of Cardiology, CHU Trousseau, Tours, France. · ACTION Study Group, CHU Côte de Nacre, Caen, France. ·Clin Cardiol · Pubmed #26880570.

ABSTRACT: There is an apparent benefit with extension of dual antiplatelet therapy (DAPT) beyond 1 year after implantation of drug-eluting stents (DES). Assessment by a Double Randomization of a Conventional Antiplatelet Strategy vs a Monitoring-Guided Strategy for Drug-Eluting Stent Implantation, and of Treatment Interruption vs Continuation One Year After Stenting (ARCTIC)-Generation assessed whether there is a difference of outcome between first- vs second-generation DES and if there is an interaction with DAPT duration in the ARCTIC-Interruption study. ARCTIC-Interruption randomly allocated 1259 patients 1 year after stent implantation to a strategy of interruption of DAPT (n = 624), in which aspirin antiplatelet treatment only was maintained, or DAPT continuation (n = 635) for 6 to 18 additional months. The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, or urgent revascularization. A total of 520 and 722 patients received a first- and a second-generation DES, respectively. After a median follow-up of 17 months (interquartile range, 15-18 months) after randomization, the primary endpoint occurred in 32 (6.2%) and 19 (2.6%) patients with first- and second-generation DES, respectively (hazard ratio: 2.31, 95% confidence interval: 1.31-4.07, P = 0.004). This was observed irrespective of the strategy of interruption or continuation of DAPT and timing of study recruitment. Major bleeding events occurred in 4 (0.8%) and 3 patients (0.4%) with first- and second-generation DES, respectively (hazard ratio: 1.79, 95% confidence interval: 0.40-8.02, P = 0.44). Results did not change after multiple adjustments for potential confounding variables. ARCTIC-Generation showed worse clinical outcome with first- vs second-generation DES, a difference that appeared to persist even with prolonged DAPT.

22 Article Impact of renal failure on all-cause mortality and other outcomes in patients treated by percutaneous coronary intervention. 2015

Loncar, Goran / Barthelemy, Olivier / Berman, Emmanuel / Kerneis, Mathieu / Petroni, Thibault / Payot, Laurent / Choussat, Remi / Silvain, Johanne / Collet, Jean-Philippe / Helft, Gérard / Montalescot, Gilles / Le Feuvre, Claude. ·Institut de cardiologie, université Paris 6, CHU Pitié-Salpêtrière, AP-HP, Paris, France; Cardiology Department, Clinical Hospital Zvezdara, Belgrade, Serbia. · Institut de cardiologie, université Paris 6, CHU Pitié-Salpêtrière, AP-HP, Paris, France. Electronic address: olivier.barthelemy@psl.aphp.fr. · Institut de cardiologie, université Paris 6, CHU Pitié-Salpêtrière, AP-HP, Paris, France. ·Arch Cardiovasc Dis · Pubmed #26184868.

ABSTRACT: BACKGROUND: Patients with renal failure (RF) have been systematically excluded from clinical trials; consequently their outcomes have not been well studied in the setting of percutaneous coronary intervention (PCI). AIMS: To compare cardiovascular outcomes after contemporary PCI in patients with versus without RF, according to clinical presentation (ST-segment elevation myocardial infarction [STEMI], acute coronary syndrome [ACS] or stable coronary artery disease [sCAD]). METHODS: Consecutive patients undergoing PCI with stent were prospectively included from 2007 to 2012. RF was defined as creatinine clearance<60mL/min. The primary endpoint was all-cause mortality; secondary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE: composite of cardiovascular death, myocardial infarction, stroke and target lesion revascularization [TLR]), TLR and Academic Research Consortium definite/probable stent thrombosis (ST) at 1 year. RESULTS: Among 5337 patients, 23% had PCI for STEMI, 34% for ACS and 43% for sCAD, while 27% had RF. RF patients had a higher unadjusted death rate than those with preserved renal function (nRF) in all PCI indication groups (STEMI, 41% vs. 7.5%; ACS, 19% vs. 6%; sCAD, 10% vs. 3%; P<0.0001 for all). The rate of MACCE was also higher in RF patients whatever the PCI indication (STEMI, 45% vs. 15%; ACS, 23% vs. 14%; sCAD, 14% vs. 9%; P<0.05 for all). Rates of TLR (5.5-7.4%) and ST (<2.5%) were similar (P>0.05 for both). sCAD-RF and STEMI-nRF patients had similar rates of mortality (P=0.209) and MACCE (P=0.658). RF was independently associated with mortality, with a doubled relative risk in STEMI versus ACS and sCAD groups (odds ratio 5.3, 95% confidence interval 3.627-7.821 vs. 2.1, 1.465-3.140 and 2.3, 1.507-3.469, respectively; P<0.0001). CONCLUSION: RF is a stronger independent predictor of death after PCI in STEMI than in ACS or sCAD patients. sCAD-RF and STEMI-nRF patients had similar prognoses.

23 Article Omeprazole, pantoprazole, and CYP2C19 effects on clopidogrel pharmacokinetic-pharmacodynamic relationships in stable coronary artery disease patients. 2015

Simon, Nicolas / Finzi, Jonathan / Cayla, Guillaume / Montalescot, Gilles / Collet, Jean-Philippe / Hulot, Jean-Sébastien. ·Aix-Marseille Université, INSERM, UMR912 (SESSTIM), 13003, Marseille, France, nicolas.simon@ap-hm.fr. ·Eur J Clin Pharmacol · Pubmed #26071277.

ABSTRACT: PURPOSE: Proton-pump Inhibitors use and CYP2C19 loss-of-function alleles are associated with reduced responsiveness to standard clopidogrel doses and increased cardiovascular events. METHODS: Post-myocardial infarction patients heterozygous (wild type [wt]/*2, n = 41) or homozygous (*2/*2, n = 7) for the CYP2C19*2 genetic variant were matched with patients not carrying the variant (wt/wt, n = 58). All patients were randomized to a 300- or 900-mg clopidogrel loading dose. A PK/PD model was defined using the variation of the P2Y12 reaction unit relative to baseline. RESULTS: Carriage of CYP2C19*2 allele and the use of omeprazole/esomeprazole were associated with the inter-individual variability in the active metabolite clearance. The relationship between inhibition of platelet aggregation (IPA, %) and the active metabolite AUC (h*μg/L) was described by a sigmoid function (Emax 56 ± 5%; EAUC50 15.9 ± 0.8 h*μg/L) with a gamma exponent (7.04 ± 2.26). CONCLUSION: This on/off shape explains that a small variation of exposure may have a clinical relevance.

24 Article Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial. 2014

Collet, Jean-Philippe / Silvain, Johanne / Barthélémy, Olivier / Rangé, Grégoire / Cayla, Guillaume / Van Belle, Eric / Cuisset, Thomas / Elhadad, Simon / Schiele, François / Lhoest, Nicolas / Ohlmann, Patrick / Carrié, Didier / Rousseau, Hélène / Aubry, Pierre / Monségu, Jacques / Sabouret, Pierre / O'Connor, Stephen A / Abtan, Jérémie / Kerneis, Mathieu / Saint-Etienne, Christophe / Beygui, Farzin / Vicaut, Eric / Montalescot, Gilles / Anonymous6300800. ·ACTION Study Group, Institut de Cardiologie Hôpital Pitié-Salpêtrière (APHP), Université Paris 6, INSERM, Paris, France. · Les Hôpitaux de Chartres, Le Coudray, France. · ACTION Study Group, Cardiologie, CHU Carémeau, Nîmes, France. · CHRU de Lille, Lille, France. · Département de Cardiologie, CHU La Timone, Marseille, France. · Cardiologie, CH de Lagny-Marne-la-Vallée, Lagny-sur-Marne, France. · CHU Jean Minjoz, Besançon, France. · GH du Centre Alsace, France. · CHR Strasbourg, France. · CHU Rangueil, Toulouse, France. · CHRU de Lille, Lille, France; ACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), and Université Denis Diderot, Paris, France. · Centre Hospitalier Bichat (APHP), Paris, France. · Institut Mutualiste Montsouris, Paris, France. · CHU Trousseau, Tours, France. · ACTION study Group, CHU Caen, France. · ACTION Study Group, Unité de Recherche Clinique-Hôpital Lariboisière (APHP), and Université Denis Diderot, Paris, France. · ACTION Study Group, Institut de Cardiologie Hôpital Pitié-Salpêtrière (APHP), Université Paris 6, INSERM, Paris, France. Electronic address: gilles.montalescot@psl.aphp.fr. ·Lancet · Pubmed #25037988.

ABSTRACT: BACKGROUND: Optimum duration of dual antiplatelet treatment (DAPT) after coronary stenting remains uncertain, with an unknown efficacy to safety ratio of extended treatment leading to discrepancies between international guidelines and clinical practice. We assessed whether DAPT continuation beyond 1 year after coronary stenting is beneficial. METHODS: This analysis was a planned extension of the previously published ARCTIC-Monitoring trial, in which we randomly allocated 2440 patients to a strategy of platelet function testing with antiplatelet treatment adjustment or a conventional strategy after coronary stenting with drug-eluting stent (DES). We recruited patients (aged 18 years or older) scheduled for planned DES implantation at 38 centres in France. After 1 year of follow-up, patients without contraindication to interruption of DAPT were eligible for a second randomisation to this second phase of the study (ARCTIC-Interruption). Using a computer-generated randomisation sequence (1:1; stratified by centre), we allocated patients to a strategy of interruption of DAPT where the thienopyridine was interrupted and single aspirin antiplatelet treatment was maintained (interruption group) or a strategy of DAPT continuation for 6-18 months (continuation group). The primary endpoint was the composite of death, myocardial infarction, stent thrombosis, stroke, or urgent revascularisation, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00827411. FINDINGS: Between Jan 4, 2011, and March 3, 2012, 1259 eligible patients were randomly allocated to treatment in ARCTIC-Interruption: 624 to the interruption group and 635 to the continuation group. After a median follow-up of 17 months (IQR 15-18), the primary endpoint occurred in 27 (4%) patients in the interruption group and 24 (4%) patients in the continuation group (hazard ratio [HR] 1·17 [95% CI 0·68-2·03]; p=0·58). STEEPLE major bleeding events occurred more often in the continuation group (seven [1%] patients) compared with the interruption group (one [<0·5%] patient; HR 0·15 [0·02-1·20]; p=0·073). Major or minor bleedings were also more common in the continuation group compared with the interruption group (12 [2%] patients vs three [1%] patients; HR 0·26 [0·07-0·91]; p=0·04). INTERPRETATION: Our finding suggests no apparent benefit but instead harm with extension of DAPT beyond 1 year after stenting with DES when no event has occurred within the first year after stenting. No conclusion can be drawn for high-risk patients who could not be randomised. The consistency between findings from all trials of such interruption suggests the need for a reappraisal of guidelines for DAPT after coronary stenting towards shorter duration of treatment. FUNDING: Allies in Cardiovascular Trials Initiatives and Organized Networks (ACTION Study Group), Fondation de France, Sanofi-Aventis, Cordis, Medtronic, Boston Scientific, Fondation SGAM.

25 Article Prasugrel but not high dose clopidogrel overcomes the lansoprazole neutralizing effect of P2Y12 inhibition: Results of the randomized DOSAPI study. 2014

Collet, Jean-Philippe / Hulot, Jean-Sébastien / Abtan, Jérémie / Anzaha, Ghalia / Kerneis, Mathieu / Silvain, Johanne / Cayla, Guillaume / O'Connor, Stephen A / Barthélémy, Olivier / Beygui, Farzin / Galier, Sophie / Brugier, Delphine / Stanek, Eric J / Charland, Scott L / Gallois, Vanessa / Montalescot, Gilles / Anonymous700800. ·ACTION Study Group, Hôpital Pitié-Salpêtrière (APHP), Institut de Cardiologie, INSERM, UMR_S 1166, Pitié-Salpêtrière Hospital (AP-HP), Université Pierre et Marie Curie (UPMC Paris 6), 75013, Paris, France. ·Eur J Clin Pharmacol · Pubmed #25012577.

ABSTRACT: AIMS: The potential negative metabolic interaction between proton pump inhibitors and clopidogrel is an unsolved issue. We hypothesized that doubling the clopidogrel maintenance dose (150 mg) would be less effective than switching to prasugrel 10 mg maintenance dose (MD) to overcome this negative interaction. METHOD AND RESULTS: In a randomized study with a factorial design, 82 stable coronary artery disease patients treated with 75 mg clopidogrel MD and aspirin were assigned to receive in a double blind fashion lansoprazole (30 mg/day) or placebo and to receive in an open fashion 150 mg clopidogrel MD or 10 mg prasugrel MD. The primary endpoint was the relative change in residual platelet reactivity over the 14-day study period [(RPA14day-RPAbaseline)/RPAbaseline]. The effect of doubling the clopidogrel MD on relative change in RPA was neutralized by lansoprazole (-53.6±48.4% versus +0.8±53.7% without and with lansoprazole, respectively, p = 0.02) whereas 10 mg of prasugrel MD dramatically reduced RPA irrespective of lansoprazole co-administration (-81.8 %±24.8% vs. -72.9%±32.9% without and with lansoprazole, respectively, p = NS). Lansoprazole exposure was the only parameter with a significant interaction with RPA among subgroups. CONCLUSION: The higher platelet inhibitory effect obtained by doubling the clopidogrel MD was totally neutralized by the co-administration of lansoprazole. This drug interaction was not observed with prasugrel 10 mg.

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