Objectifs du cours
Les patients Multivasculaires (plusieurs sites athéromateux), encore appelés polyvasculaires, représente 15% des patients explorés et présentent les lésions les plus sévères et de mauvais pronostic.On a l'habitude de dire que ces malades les plus graves sont les plus négligés.
Des progrès importants sont à faire pour améliorer leur dépistage, leur évaluation (échographique & radiologique) et leur traitement.
Du fait de la nécessité d’une évaluation globale de ces patients avec angiographie holistique et combinaison scanner –IRM et de l’insuffisance de formation des praticiens à ce type de patients, il parait justifié d'initier un cours de formation sur la gestion des patients multivasculaires qui s'enrichira progressivement au fil du temps.
Contenu du cours
A partir de ces enregistrements, nous diffuserons de façon régulière et périodique sur les thèmes suivants:
- gestion des patients avec insuffisance coronaire et artérite
- gestion des patients avec insuffisance coronaire et anévrysme de l’aorte abdominale
- gestion des patients avec insuffisance coronaire et atteinte carotide
- gestion des patients avec insuffisance coronaire et atteinte rénale
References
1 - Valentijn TM, Stolker RJ.
Lessons from the REACH Registry in Europe
Curr Vasc Pharmacol. 2012 Nov;10(6):725-7.
http://www.ncbi.nlm.nih.gov/pubmed/23259566
2 - Welten GM, Schouten O, Chonchol M, Hoeks SE, Bax JJ, Van Domburg RT, Poldermans D.
Prognosis of patients with peripheral arterial disease.
J Cardiovasc Surg (Torino). 2009 Feb;50(1):109-21.
http://www.ncbi.nlm.nih.gov/pubmed/19179996
3 - Sirimarco G, Amarenco P, Labreuche J, Touboul PJ, Alberts M, Goto S, Rother J,
Mas JL, Bhatt DL, Steg PG; REACH Registry Investigators.
Carotid atherosclerosis and risk of subsequent coronary event in outpatients with
atherothrombosis.
Stroke. 2013 Feb;44(2):373-9. doi: 10.1161/STROKEAHA.112.673129. Epub 2013 Jan 10.
http://www.ncbi.nlm.nih.gov/pubmed/23306325
More
1. Komorovsky R, Desideri A, Coscarelli S, Cortigiani L, Tonello D, Visonà
A, et al. Predictive value of associations between carotid and coronary
artery disease in patients with acute coronary syndromes. Am J Cardiol.
2005;95:116–119.
2. Keo HH, Baumgartner I, Hirsch AT, Duval S, Steg PG, Pasquet B, et al;
REACH Registry Investigators. Carotid plaque and intima-media thickness
and the incidence of ischemic events in patients with atherosclerotic
vascular disease. Vasc Med. 2011;16:323–330.
3. van der Meer IM, Bots ML, Hofman A, del Sol AI, van der Kuip DA,
Witteman JC. Predictive value of noninvasive measures of atherosclerosis
for incident myocardial infarction: the Rotterdam Study. Circulation.
2004;109:1089–1094.
4. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of
clinical cardiovascular events with carotid intima-media thickness: a systematic
review and meta-analysis. Circulation. 2007;115:459–467.
5. Young W, Gofman JW, Tandy R, Malamud N, Waters ES. The quantitation
of atherosclerosis. II. Quantitative aspects of the relationship
of blood pressure and atherosclerosis. Am J Cardiol. 1960;6:
294–299.
6. Wofford JL, Kahl FR, Howard GR, McKinney WM, Toole JF, Crouse
JR III. Relation of extent of extracranial carotid artery atherosclerosis as
measured by B-mode ultrasound to the extent of coronary atherosclerosis.
Arterioscler Thromb. 1991;11:1786–1794.
7. Amarenco P, Lavallée PC, Labreuche J, Ducrocq G, Juliard JM, Feldman
L, et al. Prevalence of coronary atherosclerosis in patients with cerebral
infarction. Stroke. 2011;42:22–29.
8. Calvet D, Touzé E, Varenne O, Sablayrolles JL, Weber S, Mas JL.
Prevalence of asymptomatic coronary artery disease in ischemic stroke
patients: the PRECORIS study. Circulation. 2010;121:1623–1629.
9. Polak JF, Pencina MJ, Pencina KM, O’Donnell CJ, Wolf PA, D’Agostino
RB Sr. Carotid-wall intima-media thickness and cardiovascular events. N
Engl J Med. 2011;365:213–221.
10. Touboul PJ, Labreuche J, Vicaut E, Amarenco P; GENIC Investigators.
Carotid intima-media thickness, plaques, and Framingham risk score as
independent determinants of stroke risk. Stroke. 2005;36:1741–1745.
11. Held C, Hjemdahl P, Eriksson SV, Björkander I, Forslund L, Rehnqvist
N. Prognostic implications of intima-media thickness and plaques in the
carotid and femoral arteries in patients with stable angina pectoris. Eur
Heart J. 2001;22:62–72.
12. Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al;
REACH Registry Investigators. International prevalence, recognition,
and treatment of cardiovascular risk factors in outpatients with atherothrombosis.
JAMA. 2006;295:180–189.
13. Ohman EM, Bhatt DL, Steg PG, Goto S, Hirsch AT, Liau CS, et al;
REACH Registry Investigators. The REduction of Atherothrombosis
for Continued Health (REACH) Registry: an international, prospective,
observational investigation in subjects at risk for atherothrombotic
events-study design. Am Heart J. 2006;151:786.e1–786.e10.
14. Steg PG, Bhatt DL, Wilson PW, D’Agostino R Sr, Ohman EM, Röther
J, et al; REACH Registry Investigators. One-year cardiovascular event
rates in outpatients with atherothrombosis. JAMA. 2007;297:1197–1206.
15. Alberts MJ, Bhatt DL, Mas JL, Ohman EM, Hirsch AT, Röther J,
et al; REduction of Atherothrombosis for Continued Health Registry
Investigators. Three-year follow-up and event rates in the international
REduction of Atherothrombosis for Continued Health Registry. Eur
Heart J. 2009;30:2318–2326.
16. Bhatt DL, Eagle KA, Ohman EM, Hirsch AT, Goto S, Mahoney EM,
et al; REACH Registry Investigators. Comparative determinants of
4-year cardiovascular event rates in stable outpatients at risk of or with
atherothrombosis. JAMA. 2010;304:1350–1357.
17. Aichner FT, Topakian R, Alberts MJ, Bhatt DL, Haring HP, Hill MD,
et al; REACH Registry Investigators. High cardiovascular event rates in
patients with asymptomatic carotid stenosis: the REACH Registry. Eur J
Neurol. 2009;16:902–908.
18. Ghali WA, Quan H, Brant R, van Melle G, Norris CM, Faris PD, et al;
APPROACH (Alberta Provincial Project for Outcome Assessment in
Coronary Heart Disease) Investigators. Comparison of 2 methods for
calculating adjusted survival curves from proportional hazards models.
JAMA. 2001;286:1494–1497.
19. Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M,
Nicolaides AN, et al. Carotid plaque, intima media thickness, cardiovascular
risk factors, and prevalent cardiovascular disease in men and
women: The British Regional Heart Study. Stroke. 1999;30:841–850.
20. Prati P, Vanuzzo D, Casaroli M, Di Chiara A, De Biasi F, Feruglio GA,
et al. Prevalence and determinants of carotid atherosclerosis in a general
population. Stroke. 1992;23:1705–1711.
21. Rundek T, Arif H, Boden-Albala B, Elkind MS, Paik MC, Sacco RL.
Carotid plaque, a subclinical precursor of vascular events: The Northern
Manhattan Study. Neurology. 2008;70:1200–1207.
22. Nambi V, Chambless L, Folsom AR, He M, Hu Y, Mosley T, et al. Carotid
intima-media thickness and presence or absence of plaque improves prediction
of coronary heart disease risk: the ARIC (Atherosclerosis Risk In
Communities) study. J Am Coll Cardiol. 2010;55:1600–1607.
23. Peters SA, den Ruijter HM, Bots ML, Moons KG. Improvements in risk
stratification for the occurrence of cardiovascular disease by imaging subclinical
atherosclerosis: a systematic review. Heart. 2012;98:177–184.
24. Spence JD, Hegele RA. Noninvasive phenotypes of atherosclerosis.
Arterioscler Thromb Vasc Biol. 2004;24:e188; author reply e188–e188;
author reply e189.
25. Craven TE, Ryu JE, Espeland MA, Kahl FR, McKinney WM, Toole JF,
et al. Evaluation of the associations between carotid artery atherosclerosis
and coronary artery stenosis. A case–control study. Circulation.
1990;82:1230–1242.
26. Honda O, Sugiyama S, Kugiyama K, Fukushima H, Nakamura S,
Koide S, et al. Echolucent carotid plaques predict future coronary
events in patients with coronary artery disease. J Am Coll Cardiol.
2004;43:1177–1184.
27. Lombardo A, Biasucci LM, Lanza GA, Coli S, Silvestri P, Cianflone
D, et al. Inflammation as a possible link between coronary and carotid
plaque instability. Circulation. 2004;109:3158–3163.
28. Tegos TJ, Sohail M, Sabetai MM, Robless P, Akbar N, Pare G, et al.
Echomorphologic and histopathologic characteristics of unstable carotid
plaques. Am J Neuroradiol. 2000;21:1937–1944.
29. Saito D, Shiraki T, Oka T, Kajiyama A, Doi M, Masaka T. Morphologic
correlation between atherosclerotic lesions of the carotid and coronary
arteries in patients with angina pectoris. Jpn Circ J. 1999;63:522–526.
30. Solberg LA, McGarry PA, Moossy J, Tejada C, Loken AC, Robertson
WB, et al. Distribution of cerebral atherosclerosis by geographic location,
race, and sex. Lab Invest. 1968;18:604–612.
31. Gongora-Rivera F, Labreuche J, Jaramillo A, Steg PG, Hauw JJ,
Amarenco P. Autopsy prevalence of coronary atherosclerosis in patients
with fatal stroke. Stroke. 2007;38:1203–1210.
32. Coull AJ, Lovett JK, Rothwell PM; Oxford Vascular Study. Population
based study of early risk of stroke after transient ischaemic attack or
minor stroke: implications for public education and organisation of services.
BMJ. 2004;328:326.
33. Jørgensen HS, Nakayama H, Reith J, Raaschou HO, Olsen TS. Stroke
recurrence: predictors, severity, and prognosis. The Copenhagen Stroke
Study. Neurology. 1997;48:891–895.
0Join the discussion
Multivascular patients management - Discussio
5Leave us a comment
Commented videos
