0000000000116081

AUTHOR

Loic Belle

Five-Year Survival in Patients With ST-Segment–Elevation Myocardial Infarction According to Modalities of Reperfusion Therapy

Background— Although primary percutaneous coronary intervention (pPCI) is the preferred reperfusion method for ST-segment–elevation myocardial infarction, it remains difficult to implement in many areas, and fibrinolytic therapy is still widely used. Methods and Results— We assessed 5-year mortality in patients with ST-segment–elevation myocardial infarction from the French Registry of Acute ST-Elevation or Non-ST Elevation Myocardial Infarction (FAST-MI) 2005 according to use and type of reperfusion therapy. Of 1492 patients with ST-segment–elevation myocardial infarction with a first call ≤12 hours from onset, 447 (30%) received fibrinolysis (66% prehospital; 97% with subsequent angiogra…

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Long-term outcomes after acute myocardial infarction in patients with familial hypercholesterolemia: The French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction program.

Patients with familial hypercholesterolemia (FH) are prone to develop acute myocardial infarction (AMI) at a younger age.The aim of the present study was to assess 5-year outcomes after AMI according to the presence of FH in a large multicenter cohort of patients.The French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction consists of nationwide surveys recruiting patients over a 1- to 2-month period every 5 years. Patients recruited in 2005 and 2010 were followed up to 5 years.Of 5147 patients discharged alive and in whom FH status could be assessed, 2.8% had probable/definite FH, using an adapted Dutch Lipid Clinic score. They were 12 years younger, on average, tha…

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ST-segment elevation myocardial infarction: Management and association with prognosis during the COVID-19 pandemic in France.

Systems of care have been challenged to control progression of the COVID-19 pandemic. Whether this has been associated with delayed reperfusion and worse outcomes in French patients with ST-segment elevation myocardial infarction (STEMI) is unknown.Aim: To compare the rate of STEMI admissions, treatment delays, and outcomes between the first peak of the COVID-19 pandemic in France and the equivalent period in 2019.Methods: In this nationwide French survey, data from consecutive STEMI patients from 65 centres referred for urgent revascularization between 1 March and 31 May 2020, and between 1 March and 31 May 2019, were analysed. The primary outcome was a composite of in-hospital death or no…

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0349: Transfer of acute coronary syndrome patients in the Alps (SCA-Alpes). Data from the RESURCOR network

RationaleIn France, the transfer of patients with an acute coronary syndrome (ACS) from one centre to another is usually done by SMUR, with on-board medical staff. However, SMUR is not always available. In this study from the RESURCOR network, we investigated clinical outcomes in ACS patients transferred in private ambulances without on-board medical staff.MethodIn the French Alps, the RESURCOR network arranges “SCAAlpes” transfers in private ambulances with no medical doctors on board but with non-medically trained staff who follow strict management protocols. Ambulances are equipped with an automatic external defibrillator and patients are not under heart monitoring. These transfers are f…

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Influence of gender on delays and early mortality in ST-segment elevation myocardial infarction: Insight from the first French Metaregistry, 2005–2012 patient-level pooled analysis

International audience; Background - Women show greater mortality after acute myocardial infarction. We decided to investigate whether gender affects delays and impacts in-hospital mortality in a large population.Methods and results - We performed a patient-level analysis of 7 French MI registries from different regions from January 2005 to December 2012. All patients with acute STEMI were included within 12 h from symptom onset and a first medical contact with a mobile intensive care unit an emergency department of a hospital with percutaneous coronary intervention facility. Primary study outcomes were STEMI, patient and system, delays. Secondary outcome was in-hospital mortality. 16,733 p…

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Five-year outcomes following timely primary percutaneous intervention, late primary percutaneous intervention, or a pharmaco-invasive strategy in ST-segment elevation myocardial infarction: the FAST-MI programme

Abstract Aims ST-segment elevation myocardial infarction (STEMI) guidelines recommend primary percutaneous coronary intervention (pPCI) as the default reperfusion strategy when feasible ≤120 min of diagnostic ECG, and a pharmaco-invasive strategy otherwise. There is, however, a lack of direct evidence to support the guidelines, and in real-world situations, pPCI is often performed beyond recommended timelines. To assess 5-year outcomes according to timing of pPCI (timely vs. late) compared with a pharmaco-invasive strategy (fibrinolysis with referral to PCI centre). Methods and results The French registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) programme c…

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