Annales de cardiologie et d'angéiologie
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Ann Cardiol Angeiol (Paris) · Nov 2003
Review Comparative Study[Anticoagulation of valvular prostheses].
Prosthetic valve replacement has transformed the outcome of patients with severe or poorly tolerated valvular heart disease. Between the two main families of prostheses, only mechanical prostheses require indefinite anticoagulant therapy to lower the thromboembolic risk. National and international guidelines have been published within the past decade. ⋯ And their use is supported by the most recent guidelines, several favorable publications, and the excellent results obtained with them in treating other thromboembolic pathologies. Indispensable to lower the rate of thromboembolic events, anticoagulant therapy bears a hemorrhagic risk that is higher for prolonged and marked anticoagulation. On the other hand, despite effective anticoagulation, the occurrence of thromboemboli can lead to considering the adjunction, in certain cases, of anti-platelet aggregating agents, particularly favored in North America, and recommended in Europe for patients with a predilection for atheromas.
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Ann Cardiol Angeiol (Paris) · Nov 2003
Comparative Study[Precipitating factors associated with diastolic heart failure in the elderly].
Beside basal myocardial dysfunction, acute heart failure involves associated factors, which increase pulmonary capillary pressure or decrease colloid osmotic pressure. The aim of this study was to evaluate the prevalence of these precipitating factors in a population presenting with acute heart failure with preserved left ventricular systolic function. ⋯ Besides diastolic dysfunction, factors leading to a critical decrease in the oncotic pressure such as pulmonary capillary pressure gradient are found in most of the elderly patients presenting acute diastolic heart failure and must be checked systematically.
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Ann Cardiol Angeiol (Paris) · Nov 2003
Comparative Study[FACT: French national registry of acute coronary syndromes. Specific study of French general hospital centers].
The FACT registry is currently the French registry including the greatest number of patients with acute coronary syndromes. ⋯ The FACT registry and the data from the general hospitals give the opportunity to think about the possibilities to improve the delays of call to the first intervening party (more particularly to the SAMU) but it also allows us to think about how to better organize the geographical distribution giving access to a medical equipment for angioplasty. All these information will also help the cardiologists to gather around the recommendations by convincing them that the benefit/risk ratio is positive.