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Статті в журналах з теми "Syndrome coronarien aigu – Pronostic (médecine)":
Lenglet, A., F. Balen, S. Charpentier, A. Sourbes, D. Arcuset, V. Delonglée, P. A. Fort, V. Bounes, and B. Charriton Dadone. "Événements indésirables au cours de transfert interhospitalier de patients présentant un syndrome coronaire aigu non ST+." Annales françaises de médecine d’urgence 9, no. 6 (October 21, 2019): 369–74. http://dx.doi.org/10.3166/afmu-2019-0188.
Cahuzac, C., T. H. Ta, A. Henaoui, F. X. Laborne, N. Briole, M. Porche, L. Lamhaut, D. Sapir, and H. Andrianjafy. "Évaluation du délai DIDO (door in-door out) des syndromes coronariens aigus dans les hôpitaux sans cardiologie interventionnelle du réseau RESSIF." Annales françaises de médecine d’urgence 8, no. 2 (April 2018): 94–99. http://dx.doi.org/10.3166/afmu-2018-0017.
Zouzou, Hanane. "Atrial fibrillation during acute coronary syndrome with ST elevation." Batna Journal of Medical Sciences (BJMS) 7, no. 2 (November 9, 2020): 79–83. http://dx.doi.org/10.48087/bjmsoa.2020.7203.
Gore, J. M., M. Marre, P. G. Steg, D. Brieger, A. Quill, and S. G. Goodman. "O51 Syndrome coronarien aigu chez les diabétiques : est-ce que son pronostic s’améliore avec le temps ?" Diabetes & Metabolism 34 (March 2008): H25. http://dx.doi.org/10.1016/s1262-3636(08)72861-1.
Richard, Christian. "Le syndrome de Takotusbo (STK)." Médecine Intensive Réanimation 29, no. 2 (July 24, 2020): 65–74. http://dx.doi.org/10.37051/mir-00008.
Bui, Huu Tri, Coralie Barbe, Pierre Nazeyrollas, Damien Metz, and Anne Long. "Le pronostic cardio-vasculaire à un an des patients présentant un syndrome coronarien aigu est lié à l'anévrysme de l’aorte abdominal malgré sa petite taille." Annales de Chirurgie Vasculaire 25, no. 7 (October 2011): 974–80. http://dx.doi.org/10.1016/j.acvfr.2012.10.028.
Дисертації з теми "Syndrome coronarien aigu – Pronostic (médecine)":
Gauthier, Victoria. "Étude du pronostic des accidents vasculaires cérébraux et des syndromes coronaires aigus en population : étude réalisée à partir du registre des AVC de Lille et des trois registres français des syndromes coronaires aigus." Electronic Thesis or Diss., Université de Lille (2022-....), 2023. http://www.theses.fr/2023ULILS004.
Cardiovascular diseases are an important cause of morbidity and mortality. The monitoring of epidemiological indicators of stroke and Acute Coronary Syndromes (ACS) through population registers plays an important role in the evaluation of public policies. In addition, as acute-phase care progresses rapidly over time, it is essential to be able to monitor its evolution, to estimate the potential impact of new treatments in real life. Our objective was to characterize the prognosis of strokes and ACS in the population and it was organized according to 3 axes.In a first study, we studied lethality after stroke in the Lille stroke registry. Lethality at 28 days, in subjects aged >=35 years, was 48% after hemorrhagic stroke, 3% after large artery atherosclerosis or lacunar stroke and varied from 15 to 20% for the other subtypes of ischemic strokes. In the acute phase, the time between the onset of symptoms and first contact with the care services was exceeded in 40% of patients, not allowing revascularization. Age, severity and stroke etiology were the main predictors of 28-day case fatality. The higher lethality observed in women compared to men was mainly explained by their advanced age. AF, an underdiagnosed and undertreated comorbidity found in 57% of cardioembolic strokes, was also a risk factor associated with lethality.In a second work we studied the evolution of the management and the lethality of ACS in the French registers of ACS between 2006 and 2016. In patients aged 35-74, residing in one of the 3 geographical areas monitored by MONICA registries and hospitalized for an ACS, the lethality was 8% at 28 days. These rates varied by type of ACS (9% after STEMI, 6% after NSTEMI at 1 year), but did not differ between men and women. On the therapeutic level, our results showed a more qualitative than quantitative evolution with an improvement in the effectiveness of management in the acute phase and prescriptions related to new generation therapies. However, while the characteristics of the events tend to converge between men and women, a slight deficit in management was still observed in women compared to men.In a third part, we focused on patients who had survived their incident event to study the risk of recurrence after an ACS in the French ACS registers. The recurrence rate after an incident ACS remained high (~20% over 9 years), mainly the year following the incident event (6.7%) and did not depend on the type of the first event (STEMI/NSTEMI/UA), or sex. Impaired LVEF and complications from the incident event were major risk factors for recurrence. Recurrence rates decreased between 2009 and 2017.In conclusion, acute vascular events remain diseases with a serious prognosis whose etiology and physiopathological mechanism are an important and independent source of prognostic variability. It is important to continue improving the management of women for whom the progression is not as optimal as for men and to pay particular attention to the severity factors of stroke and ACS. Thus, by providing precise epidemiological indicators, the continuous recording of acute vascular events in a geographically defined territory, has enabled the monitoring of the state of vascular health in the population and has enabled us to study the prognosis of strokes and ACS according to the precise characteristics of the event
Puymirat, Etienne. "Evolution de la prise en charge et du pronostic des syndromes coronariens aigus en France entre 1995 et 2010." Phd thesis, Université René Descartes - Paris V, 2013. http://tel.archives-ouvertes.fr/tel-00926886.
Freund, Yonathan. "Approche multimarqueurs en médecine d'urgence." Thesis, Paris 6, 2015. http://www.theses.fr/2015PA066123/document.
The added value of biomarkers in the emergency settings is well reported, in various pathologies. Since the burst of myoglobin and troponine for the diagnosis of myocardial infarction (MI), various biomarkers have been developed and adopted for diagnostic purposes in different pathologies. Some of them are part of the very definition of specific syndrom or disease (MI with troponin, or severe sepsis with lactate). We present here the multimarker approach in the emergency department – a strategy that combines the results of several different biomarkers to enhance diagnostic or prognostic performances. We made the hypothesis that the association of a sensitive and generalist biomarker, with an organ or syndrome specific one, would result in better performances.We illustrate here this strategy in three particular cases: the prediction of severe sepsis, the diagnosis of acute coronary syndrome, and the risk stratification after a convulsive seizure. Several methods are considered for the combination of biomarkers, and we will focus on the determination of the best linear combination
Charpentier, Sandrine. "Evaluation des tests biologiques pour le diagnostic d'évènements coronariens aigus en médecine d'urgence." Toulouse 3, 2010. http://thesesups.ups-tlse.fr/1002/.
We studied the performance of cardiac biomarkers for diagnosis of non ST elevation acute coronary syndrome (ACS) in emergency medicine and performed a critical analysis of methods used to evaluate these markers in the literature. We conducted a multidisciplinary study, single center evaluation of diagnostic tests. Consecutive patients admitted in the emergency department for a chest pain suspected of ACS were included. The performances of three markers were studied: h-Fatty Acid Binding Protein (h-FABP), Ischemia Modified Albumin (IMA) and hyperglycemia. We found that: 1 / The performances of the IMA were insufficient for the diagnosis of SCA. 2 / h-FABP measured with a qualitative test, was a diagnostic marker of non ST ACS but did not add information to a predictive model that included the usual diagnostic tools. 3 / h-FABP measured with a quantitative test also did not add incremental information in the predictive model of ACS. Concordance between the qualitative and quantitative test was poor (kappa = 0. 4). 4 / Hyperglycemia was an independent factor associated with the diagnosis of ACS, but did not change the patient classification measured by the c-statistic. In the second part of this work we wanted to know why our results were discordant compared to literature data. We have developed a checklist of methodological expertise for performance analysis of ACS diagnostic tests, which we applied to the articles selected in Medline. The analysis of the literature showed that studies were often methodologically weak, conducted on selected population and with endpoints improving test performance. Then, we considered steps and conditions that lead a diagnostic test from its technical development to its use in practice routine
Huang, Jianfeng. "Etude de l'angioplastie guidée par tomographie en cohérence optique." Thesis, Bourgogne Franche-Comté, 2018. http://www.theses.fr/2018UBFCE007/document.
Optical Coherence Tomography (OCT) imaging is promising in decision making during Percutaneus Coronary Interventions {PCI) procedures, including evaluating controversial plaque lesions, assessing stent implantation, and surveying stent-related vascular injury. Thus, OCT has potential to guide interventional cardiologists throughout the stent implantation procedure, impacting on planned interventional strategy. In addition, OCT is the most novel image technology to predict stent edge dissection for patients with non-ST-segment elevation ACS, enabling risk stratification of patients who are at a higher risk of this complication. Large-scale randomized trials are now warranted to assess whether OCT results and guidance during de procedure improve long-term clinical outcomes of PCis
Khoury, Carlos H. El. "Modélisation des stratégies de reperfusion de l’infarctus du myocarde." Thesis, Lyon, 2016. http://www.theses.fr/2016LYSE1026/document.
Objective. Acute myocardial infarction (AMI) annually affects more than 120 000 people in France. We studied the management of ST elevation MI (STEMI). Two reperfusion strategies are available: intravenous thrombolysis (TL) and primary percutaneous coronary intervention (PPCI). Our study aimed to evaluate the impact of these strategies in the acute phase of myocardial infarction through the establishment of an emergency network based on a shared protocol with interventional cardiology. Methods. We established a regional emergency cardiovascular network (RESCUe Network) that covers a population of 3 million inhabitants across five administrative counties, including urban and rural territories. All nineteen MICUs, thirty seven emergency departments and 10 catheterization laboratories participate in the network. We edited regularly updated guidelines, set up a doctors’ training program and implemented an evaluation registry. Results. We setup the AGIR-2 study, a multicenter, controlled, randomized study, to explore prehospital high-dose tirofiban in patients undergoing PPCI. Three hundred and twenty patients with STEMI were included over a period of 12 months. All of them received 250 mg of aspirin, 600 mg of clopidogrel and 60 IU/kg bolus of high molecular weight heparin before admission to the catheterization laboratory. If prehospital initiation of high-dose bolus of tirofiban did not improve outcome, AGIR-2 study reinforced the collaborative network between emergency medicine and interventional cardiology. Since then, PPCI has gradually become the reference reperfusion strategy for STEMI in our network. Using data from our registry, we studied STEMI patients treated in mobile intensive care units (MICUs) between 2009 and 2013. Among 2418 patients, 2119 (87.6%) underwent PPCI and 299 (12.4%) prehospital TL (94.0% of whom went on to undergo PPCI). Use of PPCI increased from 78.4% in 2009 to 95.9% in 2013 (Ptrend<0.001). Median delays included: first medical contact (FMC)–PCI centre 48 min, FMC–balloon inflation 94 min, and PCI centre– balloon inflation 43 min. Times from symptom onset to FMC and FMC to TL remained stable during 2009 to 2013, but times from symptom onset to first balloon inflation and FMC to PCI centre to first balloon inflation decreased (P<0.001). In total, 2146 (89.2%) had an FMC–PCI centre delay ≤90 min with PPCI use up to 97.7% in 2013 in accordance with guidelines. Inhospital (4–6%) and 30-day (6–8%) mortalities remained stable from 2009 to 2013. Finally, we sought to assess the effect of strict adherence to current international guidelines on 1-year all-cause mortality in a prospective cohort of patients with STEMI. After multivariable adjustment, the association between the optimal therapy (OT) group (Betablockers, Antiplatelet agents, Statins, angiotensin-converting enzyme [ACE] Inhibitors, and Correction of all risk factors) and survival remained significant, with a hazard ratio of 0.12 (95% CI 0.07–0.22; P<0.001). Of the 5161 patients discharged alive, 2991 (58%) were prescribed OT. Patients characteristics in the under treatment (UT) group were worse than those in the OT group because of contraindications to optimal treatment (renal failure, bleeding risk). Conclusion. The establishment of an emergency network in our area resulted in an increased use of PPCI in accordance with ESC guidelines with no effect on early mortality. Reduction of one year mortality was observed in patients who received optimal secondary prevention treatment
Jabor, Bashar. "Lipoprotein-associated phospholipase A2 (Lp-PLA2) in acute coronary syndrome." Thèse, 2014. http://hdl.handle.net/1866/13006.
Lipoprotein associated phospholipase A2 (Lp-PLA2) is a biomarker of several inflammatory diseases and syndromes. An elevated Lp-PLA2 level is associated with unstable atherosclerotic plaques. Bound to plasma lipoproteins (LDL and HDL), Lp-PLA2 prevents the formation of biologically active oxidized phospholipids on their surface such as oxidized phosphatidylcholine (oxPC). Nevertheless, the products of Lp-PLA2 action, lysophosphatidylcholine (LPC) and non-esterified fatty acids (NEFA) are both known to aggravate inflammation. Thus, understanding the metabolism of Lp-PLA2 could help us better understand its role in plaque formation, as studies have shown high expression of Lp-PLA2 and LPCs in unstable plaques. Moreover, studies showed correlation between increased Lp-PLA2 mass and activity and increased risk of coronary artery disease, stroke, and death. The inhibition of Lp-PLA2 with a small molecule, Darapladib, has not demonstrated benefit in reduction of cardiovascular events in two clinical studies. Here, the first chapter will focus on Lp-PLA2 and cardiovascular disease in man, highlighting the latest updates in the literature. The second and third chapters will introduce experimental work on Lp-PLA2 in the setting of acute coronary syndrome.
Частини книг з теми "Syndrome coronarien aigu – Pronostic (médecine)":
Olivier, Pierre-Yves, Julien Demiselle, Pierre Asfar, Alain Mercat, and Nicolas Lerolle. "Syndrome coronarien aigu en réanimation." In Petit manuel de survie en médecine intensive-réanimation, 72–74. Elsevier, 2023. http://dx.doi.org/10.1016/b978-2-294-77693-9.00021-6.