Martine Gilard

Background: Glycemic variability is associated with worse outcomes after cardiac surgery, but the prognosis value of early glycemic variability after transcatheter aortic valve implantation is not known. This study was therefore designed to analyze the prognosis significance of post-procedural glycemic variability within 30 days after transcatheter aortic valve implantation. Methods: A post hoc analysis of patients from our center included in the FRANCE and FRANCE-2 registries was conducted. Post-procedural glycemic variability was assessed by calculating the mean daily δ blood glucose during the first 2 days after transcatheter aortic valve implantation. Major complications within 30 days were death, stroke, myocardial infarction, acute heart failure, and life-threatening cardiac arrhythmias. Results: We analyzed 160 patients (age (median [interquartile] = 84 [80–88] years; diabetes mellitus (n) = 41 (26%) patients; logistic Euroscore = 20 [12–32]). The median value of mean daily δ blood glucose was 4.3 mmol l⁻¹. The rate of major complications within 30 days after procedure among patients with the lowest quartile of glycemic variability was 12%, increasing from 12 to 26%, and 39% in the second, third, and fourth quartiles, respectively. In multivariate analysis, glycemic variability was independently associated with an increased risk of major complications within 30 days after the procedure (odds ratio [95% CI] = 1.83 [1.19–2.83]; p = 0.006). Conclusions: This study showed that post-procedural glycemic variability was associated with an increased risk of major complications within 30 days after transcatheter aortic valve implantation. Trial registration Clinical trial registration number https://www.clinicaltrials.gov/; identifier: NCT02726958; date: April 4th, 2016

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Background: The effect of admission during OFF-hours on patient's outcome in ST Segment Elevation Myocardial Infarction (STEMI) remains controversial when a strategy for reperfusion between primary Percutaneous Coronary Intervention (pPCI) and fibrinolysis is chosen. We aimed to evaluate the impact of time of admission on all cause mortality in unselected STEMI patients referred to pPCI centers.

Introduction: The optimal anti-thrombotic treatment (ATT) after TAVR remains a matter of debate. Dual antiplatelet therapy (DAPT) is recommended but single antiplatelet therapy and oral anticoagulation (OAC) are frequently used when the bleeding risk is high or when there is a compelling indication. Whether this may impact clinical outcome is unknown.

Aims: To derive and validate a simple risk score to identify patients at high-risk of in-hospital STEMI-related CS.

Background: In the context of extension of transcatheter aortic valve implantation (TAVI) indications to lower-risk patients, long-term durability of transcatheter aortic bioprosthetic valves (TABV) is a crucial issue. There is a paucity of data, especially beyond 5 years of follow-up. Recently, new definitions have been proposed to assess structural valve deterioration (SVD) and bioprosthetic valve failure (BVF).

Background: The link between ischemic stroke and patent foramen ovale (PFO) remains a subject of debate. Small studies highlight a concomitant silent stroke in patients with PFO and acute pulmonary embolism as compare to patient without PFO, suggesting a paradoxical embolism.