Tome 15 – no. 1 – January 2023 ISSN 1878-6480 Supplements Les 33es Journées Européennes de la Société Française de Cardiologie Du mercredi 11 au vendredi 13 janvier 2023 Palais des Congrès, Porte Maillot - Paris Société Française de Cardiologie - 5 rue des Colonnes du Trône - 75012 Paris 01 43 22 33 33 - contact@sfcardio.fr Plus d’informations www.sfcardio.fr & www.cardio-online.fr Inscriptions - www.cardio-online.fr Archives of Cardiovascular Diseases
E. Aliot (France), P. Amouyel (France), M. Böehm (Germany), P. Bonhoeffer (United Kingdom), D. Bonnet (France), E. Bruckert (France), T. Carrel (Switzerland), M. Cohen (United States), A. Cribier (France), N. Danchin (France), J.-C. Daubert (France), J. Davignon (Canada), G. Derumeaux (France), E. Eeckhout (Switzerland), F. Follath (Switzerland), B. Gerber (Belgium), P. Guéret (France), G. Habib (France), A. Hagege (France), M. Komadja (France), B. Kreitmann (France), R. Lang (United States), S. Laurent (France), H. le Marec (France), J. Lima (United States), N. Ludwig (United Kingdom), Z. Mallat (France), G. Marx (United States), J.-L. Monin (France), E. Mousseaux (France), P. Nataf (France), P. Nihoyannopoulos (United Kingdom), G. Parati (Italy), L. Perrault (Canada), L. Pierard (Belgium), B. Prendergast (United Kingdom), S. Priori (Italy), D. Revel (France), V. Roger (United States), R. Rosenhek (Austria), M. Safar (France), M. Sarano (United States), E.J. Schaefer (United States), M. Scherrer Crosbie (United States), J. Schwitter (Switzerland), P. Serruys (Netherlands), M. Simoons (Netherlands), P.G. Steg (France), G. Tomaselli (United States), P. Tornos (Spain), C. Tribouilloy (France), A. Vahanian (France) Archives of Cardiovascular Diseases Supplements (ISSN 1878-6480) 2023 (volume 15) One year, 4 issues. Address order and payment to Elsevier Masson SAS, Service Abonnements, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux cedex: payment by check or credit card (CB, EuroCard, MasterCard or Visa: indicate no, and expiration date); « La Banque Postale », Centre de Paris, nº RIB 20041 00001 1904540H020 95. Subscriptions begin 4 weeks after receipt of payment and start with thefirstissueofthecalendaryear . Back issues and volumes are available from the publisher. Claims for missing issues should be made within 6 months of publication. Includes air delive.ry Journal manager – Fabienne Loÿe. Tel.: (33) 01 71 16 54 04. E-mail: f.loye@elsevier.com. Commercial manager – Advertising – Tel.: (33) 01 71 16 51 03. Fax: (33) 01 71 16 51 84. E-mail: Claire Ebersold c.ebersold@elsevier.com Subscriptions – Tel.: (33) 01 71 16 55 99. Fax: (33) 01 71 16 55 77. http://www.em-consulte.com/infos Publisher – Anne-Elisabeth Fournié. E-mail: a.fournie@elsevier.com Publishing director – Daniel Rodriguez Dépôt légal à parution. Arcvhivses of Cardiovascular Diseases Supplements Archives of Cardiovascular Diseases Formerly Archives des maladies du cœur et des vaisseaux Official journal of the French Society of Cardiology Editor-in-Chief Ariel A Cohen Deputy editors Bernard Iung Yves Cottin Editorial board Victor Aboyans Philippe Acar Denis Angoulvant Jean Ferrières Bernard Iung Pierre Lantelme Guillaume Lebreton Christophe Leclercq Gilles Lemesle Paul Milliez Agnès Pasquet Etienne Puymirat Statistical consultant Julien Magne Technical editor Sophie Rushton-Smith How to contact the journal Clarisse Barillé Service de cardiologie Hôpital Saint-Antoine (pavillon Lemierre) 184, rue du Faubourg-Saint-Antoine, 75571 Paris cedex 12 Tel.: 33 (0)1 49282886 E-mail: clarisse.barille@aphp.fr Scientific committee
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Maison du Cœur | 5, rue des Colonnes du Trône l 75012 PARIS l France Tél. : +33 (0)1 43 22 33 33 | Fax : +33 (0)1 43 22 63 61 Secretariat scientifique : Karine LESFAR – Tél : +33(0)1 43 22 29 71 - karine.lesfar@sfcardio.fr Tatiana DJIKOLE – Tél : +33(0)1 43 22 12 72 - tatiana.djikole@sfcardio.fr Bureau | Board Members PRÉSIDENT Christophe LECLERCQ Victor ABOYANS Hélène ELTCHANINOFF Anne BERNARD Bernard IUNG Ariel COHEN Damien LOGEART Jean-Claude DEHARO Olivier PIOT Membres invités au Bureau | Board invited members Franck ALBERT Jean-Yves ARTIGOU Stéphane LAFITTE Jean-Jacques MONSUEZ Conseil d’administration | Board of directors Philippe ACAR Luc CHRISTIAENS Serge KOWNATOR Walid AMARA Philippe COMMEAU Philippe MABO Denis ANGOULVANT Nicolas DANCHIN Paul-Ursmar MILLIEZ Gilles BARONE-ROCHETTE François DIEVART Jean-Luc PASQUIE Guillaume BONNET Erwan DONAL Bruno PAVY Claire BOULETI Jean FERRIERES Théo PEZEL Catherine VERGELY Membres invités au Conseil d’administration | Board Commitee invited members Franck ALBERT Alain FURBER Atul PATHAK Jean-Yves ARTIGOU Martine GILARD Vincent PRADEAU Régis BARBET Albert Alain HAGEGE Pierre SABOURET Sylvie DI FILIPPO Michel KOMAJDA Catherine SPORTOUCH Jérémy FAUCONNIER Stéphane LAFITTE Jean-Noël TROCHU Charles FAUVEL Jean-Jacques MONSUEZ Jean-Philippe VERHOYE Marc VILLACEQUE Président honoraires | Honorary Presidents Michel BERTRAND Jean-Paul FAUCHIER Robert HAIAT Jean-Paul BOUNHOURE Martine GILARD Michel KOMAJDA Jean-Paul BROUSTET Yves GROSGOGEAT Jean-Marc LABLANCHE Nicolas DANCHIN Pascal GUERET Jean-Yves LE HEUZEY Jean-Claude DAUBERT Claude GUEROT André VACHERON Geneviève DERUMEAUX Albert Alain HAGEGE Journaux | Journals Archives of Cardiovascular Diseases : Directeur du Comité de Rédaction : Pr Ariel COHEN Archives pratiques : Directeur du Comité de Rédaction : Pr Jean-Yves ARTIGOU ELSEVIER MASSON : 65 rue Camille Desmoulin - 92130 ISSY LES MOULINEAUX - Tél. : +33 (0)1 71 16 55 00 Maison du Cœur | 5, rue des Colonnes du Trône l 75012 PARIS l France Tél. : +33 (0)1 43 22 33 33 | Fax : +33 (0)1 43 22 63 61 E-mail : jesfc@sfcardio.fr | Internet : www.sfcardio.fr
PRÉSIDENT du Congrès l PRESIDENT of the Congress Christophe LECLERCQ Comité d’Organisation l Organization committee Victor ABOYANS Hélène ELTCHANINOFF Anne BERNARD Bernard IUNG Ariel COHEN Damien LOGEART Jean-Claude DEHARO Olivier PIOT Secrétaire scientifique l Scientific secretary Victor ABOYANS Comité scientifique l Scientific Committee Régis BARBET Hakim BEN AMER Philippe BORDIER Eric BRUCKERT Frédérique CLAUDOT Pascal DEFAYE Sylvie DI FILIPPO François DIEVART Erwan DONAL Stéphane EDERHY Jérémy FAUCONNIER Atul PATHAK Charles FAUVEL Etienne PUYMIRAT Mohamed GHANNEM Thomas MODINE Jean-Jacques MONSUEZ François ROUBILLE Catherine SPORTOUCH - DUKHAN
Archives of Cardiovascular Disease Supplements (2023) 15 , v CONTENTS Abstracted in: Current Contents/Clinical Medicine; MEDLINE/Index Medicus; EMBASE/Excerpta Medica; Pascal (INIST/CNRS); Scopus Available online at www.sciencedirect.com ScienceDirect Editorial JESFC 2023 : Le grand retour de la célébration de la cardiologie française et francophone V. Aboyans, A. Bernard, B. Iung, A. Cohen and C. Leclercq ................................................. 1 JESFC 2023: The return to the great celebration of the French-speaking cardiology community V. Aboyans, A. Bernard, B. Iung, A. Cohen and C. Leclercq ................................................. 3 Abstracts 01 – Coronary artery disease ........................................................................................... 5 02 – Heart failure and cardiomyopathy .............................................................................. 28 03 – Echocardiography and imaging ................................................................................... 60 04 – Valvular heart disease ............................................................................................. 74 05 – Rhythmology and stimulation .................................................................................... 88 06 – Arterial hypertension, vascular disease and metabolism .................................................... 107 07 – Basic research and translational ................................................................................. 115 08 – Epidemiology and prevention, rehabilitation and sport, sleep ............................................. 123 09 – Pediatrics and congenital cardiopathies ........................................................................ 135 10 – General cardiology/Ethics ........................................................................................ 150 11 – Paramedics .......................................................................................................... 156 12 – Emergency care and intensive cardiac care ................................................................... 158 13 – Cardio-oncology .................................................................................................... 167 14 – Tropical cardiology ................................................................................................. 170 15 – Digital health ....................................................................................................... 172 16 – Education/Training and simulation .............................................................................. 175
Archives of Cardiovascular Disease Supplements 15 (2023) 1—2 Available online at ScienceDirect www.sciencedirect.com JESFC 2023 : Le grand retour de la célébration de la cardiologie fran¸caise et francophone Les 33èmes Journées Européennes de la Société Fran¸caise de Cardiologie (JESFC) ouvriront leurs portes au Palais de Congrès de Paris, du 11 au 13 janvier 2023. Ce congrès est « le » moment attendu de l’année de toute la cardiologie francophone. Si le pari d’un congrès à nouveau présentiel a été tenu en 2022, nous espérons pouvoir faire de 2023 le rendez-vous incontournable réunissant tous nos collègues de la francophonie, car rien ne remplace les échanges humains et le partage de science et d’expérience en présentiel. Le congrès débutera pleinement dès le mercredi après-midi, et se terminera le vendredi après-midi, afin d’augmenter le temps d’interaction. Nous garderons le rythme plus soutenu et plus dense des sessions d’une heure, permettant à chacun d’assister à une plus grande variété de thématiques chaque jour. Le comité scientifique a porté une attention toute particulière pour couvrir l’ensemble des actualités de la cardiologie, sans oublier la pratique de la cardiologie clinique. Afin d’aider chaque congressiste à retrouver ses sessions d’intérêt dans ce programme dense (jusqu’à 15 sessions simultanées), un parcours spécifique est proposé pour chaque thème, qui peut être aisément identifié via l’application JESFC 2023. Vous aurez ainsi la possibilité de parcourir le même thème sur les 3 jours, ou de passer d’un thème à un autre selon votre gré. Ce congrès donnera une place encore plus importante aux jeunes, notamment à travers l’organisation concomitante au palais des congrès de séminaires d’enseignements et de masterclasses spécifiques le mercredi pour les internes en formation. Ils auront ainsi l’occasion de découvrir ce congrès et avoir envie d’y revenir dans les années futures. Cette richesse du programme est le reflet d’une collaboration intense de l’ensemble des membres groupes, filiales et cercles de notre SFC. Saluons à cet égard l’engagement tout particulier de nos plus jeunes collègues à travers le Collège des Cardiologues en Formation (CCF). À ces collaborations s’ajoutent celles établies de longue date avec les sociétés savantes fran¸caises des disciplines voisines, ainsi que nos partenariats avec les sociétés de cardiologie de nos amis d’Europe, du pourtour Méditerranéen et de l’Afrique. Leur assiduité et leur fidélité aux JESFC garantissent chaque année un succès croissant. https://doi.org/10.1016/j.acvdsp.2022.12.002 1878-6480/© 2022 Published by Elsevier Masson SAS.
JESFC 2023 : Le grand retour de la célébration de la cardiologie fran¸caise et francophone L’ESC sera activement présente à ce congrès, représentée par son président, le Pr Franz Weidinger, ainsi que le Pr Filippo Crea, l’éditeur en chef de l’European Heart Journal. Des sessions sous un nouveau format, « Des recommandations de l’ESC à la pratique », permettront d’aborder les nouvelles recommandations de l’ESC à travers des cas cliniques. La SFC a voulu marquer sa solidarité envers les cardiologues de l’Ukraine en offrant un moment particulier à leur égard : une conférence est spécialement programmée avec les responsables de l’association ukrainienne de cardiologie sur la prise en charge des patients cardiaques en temps de guerre. Nous gardons la tradition d’un temps de réflexion au-delà de notre pratique cardiologique, en invitant d’éminents orateurs de la société civile : Michel Eltchaninoff, philosophe et essayiste, rédacteur en chef du mensuel Philosophie Magazine, nous fera l’honneur d’être notre invité pour la conférence exceptionnelle, et Dominique Pon, PDG de la clinique Pasteur à Toulouse et ancien chargé du chantier numérique gouvernemental Ma santé 2022, partagera sa vision lors de la cérémonie d’ouverture du congrès. Comme chaque année, le congrès des JESFC est une belle opportunité pour communiquer sur les dernières recherches réalisées en France et ailleurs. Nous avons voulu donner aux jeunes chercheurs la possibilité de pouvoir partager leurs travaux de la meilleure manière, en proposant exclusivement la présentation orale, permettant un échange interactif plus riche. Nous vous invitons tous à assister à ces sessions de communication orale, ou au « Hub » pour des présentations « flash ». L’expérience présentielle du congrès est enrichie depuis l’avènement du « village de la simulation », plébiscité en 2022. Forts de ce succès, nous avons étendu les thématiques et les périodes de tenue des sessions (dès le mercredi aprèsmidi) pour répondre à cette forte demande. N’oubliez pas de vous pré-inscrire si vous souhaitez y assister, car la demande est forte et le nombre de places limité ! Nous n’oublions pas pour autant tous ceux qui ne peuvent pas se rendre à Paris. Nous diffuserons des sessions sélectionnées sur les deux chaines «live»du congrès. Ces sessions seront d’autant plus «vivantes »qu’elles accueilleront aussi le public présent sur place. Toutes les sessions seront enregistrées et accessibles sur Cardio-onlineen exclusivité dès le lendemain pour les inscrits au congrès, et un mois plus tard pour l’ensemble des membres de la SFC et/ou abonnés à Cardio-online. Avec toutes les communautés de la SFC, nous remercions chaleureusement nos partenaires industriels qui soutiennent fidèlement cet évènement incontournable pour les cardiologues. Ce partenariat permet la mise en place de nombreuses sessions thématiques, symposia, ateliersdébats et training centers, autant d’occasions permettant d’échanger dans un cadre convivial, et de partager expériences et connaissances, au plus près de l’actualité diagnostique, du médicament innovant et des dispositifs médicaux. Enfin, le comité d’organisation salue le dévouement tout au long de l’année du personnel de la SFC et notamment de la cellule congrès, sans qui cette fête annuelle de la cardiologie ne peut avoir lieu, et remercie tout aussi sincèrement la société EUROPA Organisation pour son investissement remarquable. Au plaisir de vous retrouver à Paris ou « on line » ! Victor Aboyans∗, Anne Bernard , Bernard Iung , Ariel Cohen , Christophe Leclercq ∗Auteur correspondant. E-mail address: victor.aboyans@unilim.fr (V. Aboyans) 2
Archives of Cardiovascular Disease Supplements 15 (2023) 3—4 Available online at ScienceDirect www.sciencedirect.com EDITORIAL JESFC 2023: The return to the great celebration of the French-speaking cardiology community The 33rd European Days of the French Society of Cardiology (JESFC 2023) will be held at the Palais de Congrès in Paris, from 11 to 13 January 2023. This congress is ‘‘the’’ greatly anticipated annual event of the entire French-speaking cardiology community. While we succeeded in having a physical congress in 2022 despite the pandemic, we hope that the 2023 opus will bring us back to the unavoidable and dynamic ‘‘live’’ event for all French-speaking cardiologists, as nothing can replace face-to-face brainstorming as well as science- and experience-sharing. To maximize congress time and opportunities for interaction, the congress will start with a full programme on Wednesday afternoon and will finish on Friday afternoon. We will keep the intense pace of 1-hour sessions, giving everyone the opportunity to attend a broad range of topics each day. The scientific committee has made a particular effort to cover all news in cardiology, without forgetting clinical cardiology in daily practice. To assist attendees identify sessions of interest within a dense programme (with up to 15 simultaneous sessions), a specific track is proposed for each topic. These tracks can be easily found on the app: JESFC 2023. So you can either follow the same topic by following a single track or change from one topic to another as you wish. The congress will give even greater room to young cardiologists, especially through the setting of seminars and masterclasses for residents in cardiology, which will take place on Wednesday. This will give them the opportunity to discover our annual congress, share the thrill of the event, and encourage their aspiration to return. The wealthy programme reflects the close collaboration of all communities — councils, working groups and circles — of our French Society of Cardiology. We thank the Council of Young Cardiologists for their remarkable commitment. We also have a long-term collaboration with other French societies of sister specialties, and cherish our partnership with the societies of cardiology in other European, Mediterranean and African countries. The ESC will be actively present through the attendance of its president, Pr Franz Weidinger, as well as Editor-in-Chief of theEuropean Heart Journal, Pr Filippo Crea. A new format of sessions — ‘‘From ESC Guidelines to Practice’’ — will tackle the new guidelines through clinical cases. The French Society of Cardiology wanted to express its solidarity with Ukrainian cardiologists, by holding a special conference by the authorities of the Ukrainian Association of Cardiology on the management of cardiac patients during wartime. https://doi.org/10.1016/j.acvdsp.2022.12.001 1878-6480/© 2022 Published by Elsevier Masson SAS.
V. Aboyans, A. Bernard, B. Iung et al. We keep our tradition of a special moment for meditation, by inviting eminent speakers from civil society: Michel Eltchaninoff, philosopher and essayist, Editor-in-Chief of Philosophie Magazine, will honour us with a talk on medical ethics. We have also invited Dominique Pon, CEO of the Pasteur Clinic in Toulouse and past chair of the government digital project Ma Santé 2022, who will share his thoughts during the opening ceremony. As ever, the JESFC congress is a great opportunity to share the results of the latest research in France and elsewhere. We wanted to give young researchers the opportunity to share their works at best, by proposing exclusively oral communications for the best abstracts selected, either for a full oral presentation or a short ‘‘flash’’ presentation. We invite you to come to the oral sessions and the Hub, for thriving live, interactive events. The face-to-face experience at the congress is enriched by the advent of the ‘‘village of simulation’’, acclaimed in 2022. On the strength of its success, we have extended the topics and periods of these sessions (starting as soon as Wednesday), to respond to the increasing demands. Do not forget to pre-register to secure your seat! We will not forget those who cannot come to Paris. We will broadcast selected sessions on two ‘‘live’’ channels of the virtual congress. These sessions will be hybrid, as those attending the congress can also watch in the studios. Besides, all sessions of the congress will be recorded and accessible on theCardio-onlinewebsite, exclusively for those who registered for the congress. All sessions will be accessible 1 month later for the members of the French Society of Cardiology and Cardio-online subscribers. Along with all communities of the FSC, we warmly thank our industry partners, who have faithfully supported our event for a long time. This partnership enables us to set several theme sessions, symposiums, workshops and training centres, offering great opportunities for exchange in a friendly atmosphere, and for the sharing of knowledge and experiences following at best the news on diagnostic tools, drugs and medical devices. Finally, the organization committee salutes our devoted FSC staff, especially the congress cell, without whom this yearly annual celebration could not exist. We also sincerely thank Europa Organisation for their remarkable commitment. See you all soon in Paris, or online! Victor Aboyans∗, Anne Bernard , Bernard Iung , Ariel Cohen , Christophe Leclercq ∗Corresponding author. E-mail address: victor.aboyans@unilim.fr (V. Aboyans) 4
Archives of Cardiovascular Disease Supplements 15 (2023) 5—27 Available online at ScienceDirect www.sciencedirect.com 01 — Coronary artery disease 058 Clonal hematopoiesis of indeterminate potential is highly prevalent among elderly patients with a first cardiovascular event and is associated with increased inflammation and more frequent complications S. Fawaz1,∗, S. Marti2, Y. Pucheu1, A. Gaufroy1, J. Broitman1, A. Bidet2, C. James2, O. Mansier2, T. Couffinhal3 1 Maladies coronaires et vasculaires, CHU Haut Leveque, Pessac 2 Laboratoire d’hématologie, CHU de Bordeaux, Pessac 3 Équipe ‘‘cellules endothéliales et thrombose’’, Inserm U1034 Biologie des maladies cardiovasculaires, Pessac ∗ Corresponding author. E-mail address: samifawaz@yahoo.fr (S. Fawaz) Introduction Clonal hematopoiesis of indeterminate potential (CHIP) is defined as an expansion of hematopoietic cells in response to the acquisition of a somatic mutation associated with leukemias, without any sign of hematological malignancy, with a variant allele frequency (VAF)≥2%. It has been described several years ago with a frequency below 20% in the general population and associated with a higher risk of myocardial infarction (MI) and stroke. Experimental data tend to show that the link between CHIP and atherosclerosis would mainly be mediated by a pro-inflammatory phenotype of mutated monocytes infiltrating the atheromatous plaque. To date, few data are available in human pathology. Objective Our study aims to assess the prevalence of CHIP in elderly patients experiencing their first myocardial infarction, and to explore links between CHIP, inflammation and atherosclerosis. Method We conducted a prospective, single-center study, including patients≥75 years experiencing their first MI. Patients were included 4 (±2) months after the event. DNA was extracted from total leukocytes, and the presence of CHIP was determined using Next Generation Sequencing on a panel of 56 genes. Inflammation was evaluated through the plasmatic level of high-sensitive CRP (hsCRP) and cytokines (IL-1ß, IL-6, IL-10, IL-18, TNFa). Patients also benefited from a Doppler of the supra-aortic trunks with 3D quantification of the atheromatous volume. The recurrence of cardiovascular events was also evaluated. Results In total, 149 consecutive patients were included, aged 82.2±4.8 years in mean. Fifty-three percent carried a CHIP, mainly with mutation in DNMT3A (50.6%) and TET2 (32.9%) genes. The CHIP (+) population was older (83.1 vs. 81.1 years in mean, P= 0.011) and less likely to have diabetes (23% vs. 41%, P= 0.021) than the CHIP (−) population. CHIP (+) had a higher hsCRP level than CHIP (−) (2.68mg/L vs. 1.75mg/L, P= 0.0019). No difference was found in the levels of IL-1ß, IL-6, IL-10, IL-18 and TNF a, nor in the atheroma burden. Post-MI complications were found in 17.5% of CHIP (+) participants that carried large clones (VAF≥5%) vs. 3.1% of participants who were CHIP (−) (P= 0.013). Conclusion CHIP is very common in elderly patients with myocardial infarction and appears to be associated with a higher level of inflammation measured by hsCRP and an increased rate of early post-MI complications. On the other hand, the atheroma burden does not seem to be influenced by the presence of a mutation. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.002 039 Relationship between cumulative adverse childhood experiences and myocardial infarction in adulthood: A meta-analysis M. Jacquet-Smailovic∗, M.J. Brennstuhl , C. Tarquinio UR 4360 APEMAC, Université de Lorraine, Metz ∗ Corresponding author. E-mail address: murielle.smailovic@ch-avesnes.fr (M. Jacquet-Smailovic) Introduction Adverse childhood experiences (ACEs) are some of the most intensive stressors and traumatic events that occur during the first 18 years of a child’s life. They may be defined and characterized as recurring childhood maltreatment (physical, emotional, and sexual abuse, and neglect), household dysfunction (for example, witnessing violence between parents or caregivers) that deprive the sense of stability, safety and development of a child. Despite the well-documented associations between the individual contribution of some form of ACEs (physical abuse, emotional abuse, and neglect) and cardiovascular diseases in adulthood, there are no meta-analysis summarizing specifically the relationships between cumulative ACEs and the onset of myocardial infarction (MI). Objective The aim of this meta-analysis was to estimate the relationship between ACEs and MI in adulthood and to examine the role of potential confounding factors that may have contributed to the association. Method Studies examining the association of cumulative ACEs with MI among adults were identified by searching PubMed/MEDLINE, PsycINFO, ScienceDirect, and ProQuest Dissertations and Thesis. Individual estimates of odds ratios 1878-6480/
01 — Coronary artery disease were pooled using random effects meta-analysis. Articles were pooled separately according to whether findings were adjusted for sociodemographic factors, cardiovascular disease (CVD) risk factors, and psychological factors. Several moderators were also examined: age, gender, race/ethnicity, type of MI assessment, type of cumulative ACEs assessment, and quality assessment of included studies. Results A total of 10 eligible studies met our inclusion criteria. The pooled ORs for the magnitude of the relationship between ACEs and MI were OR = 1.88; 95% CI: 1.40—2.53, before adjustment for CVD risk factors, and OR = 1.78; 95% CI: 1.24—2.57, after adjustment for CVD risk factors. The association between ACEs and MI was OR = 2.09; 95% CI: 1.43—3.06, after further adjustment for psychological factors. Effect sizes were larger when studies included participants predominantly over 55 years of age than younger participants. Conclusion Cumulative ACEs is associated with an increased risk of MI in adulthood. However, further prospective studies are needed to better understand potential moderators that attenuate or amplify observed relations. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.003 565 Prognosis of illicit drug use in patients with acute ST-elevation myocardial infarction: Insights from the ADDICT-ICCU trial A. Clément1,∗, T. Pezel1, A. Ramonatxo2, V. Roule3, F. Picard4, E. Thevenet5, F. Swedsky6, M. Hauguel-Moreau7, D. Sulman8, M. Stevenard9, N. Amri10, D. Martinez11, L. Maitre Ballesteros12, T. Landemaine13, A. Coppens14, N. Bouali15, E. Gall1, A. Léquipar1, P. Henry1, J.-G. Dillinger1 1 Cardiologie, hôpital Lariboisière, AP—HP, Paris 2 Cardiologie, CHU de Poitiers Site de la Milétrie, Poitiers 3 Cardiologie, CHU de Caen Normandie, Caen 4 Cardiologie, hôpital Cochin, Paris 5 Cardiologie, CHU Fort-de-France, Fort-de-France, Martinique 6 Cardiologie, CH d’Avignon, Avignon 7 Cardiologie, hôpital Ambroise-Paré, AP—HP, Boulogne-Billancourt 8 Cardiologie, hôpital Bichat — Claude-Bernard, Paris 9 Cardiologie, hôpital d’Instruction des Armées Percy, Clamart 10 Cardiologie, hôpitaux universitaires de Marseille Timone, Marseille 11 Cardiologie, CHU de Nîmes, Nîmes 12 Cardiologie, CHU Grenoble Universitaire, La Tronche 13 Cardiologie, CHU Amiens-Picardie (site sud), Amiens 14 Cardiologie, hôpital André-Grégoire, Montreuil 15 Cardiologie, CHU Poitiers, Poitiers ∗ Corresponding author. E-mail address: arthur.clementvt@gmail.com (A. Clément) Introduction Although illicit drug use may induce ST-elevated myocardial infarction (STEMI), its prevalence in patients hospitalized in intensive cardiac care units (ICCUs) for STEMI, as well as its short-term cardiovascular consequences, remain unknown. Objective To assess the prevalence of illicit drug use and its prognostic value to predict the occurrence of in-hospital major adverse cardiac events (MAEs) in STEMI patients admitted to the intensive cardiac care unit (ICCU). Method From 7 to 22 April 2021, screening for illicit drug was performed prospectively by systematic urinary testing in all consecutive patients admitted for STEMI in 39 centres throughout France. The primary endpoint was the prevalence of the illicit drugs detected. The secondary outcome was MAEs defined by death, resuscitated cardiac arrest or cardiogenic shock. Results Among 342 consecutive patients admitted for STEMI (age 62±13 years, 79% male), 43 (12.1%) had a positive test (cannabis: 88%, opioids: 36%, cocaine: 10%, 3,4methylenedioxymethamphetamine: 5%). Patients with illicit drug use were more frequently male (93% vs. 77%, P= 0.02), younger (50±12 years vs. 63±13, P< 0.001). Active smoking was more frequent (78% vs. 34%. P< 0.001). After a median duration of hospitalisation of 4.5 days, 17 in-hospital MAEs occurred (5.2%). The detection of illicit drugs was associated with a higher rate of MAEs after adjustment for known comorbidities (OR = 13.1; 95% CI: 3.44—54.6), for known predictors of severity on admission (OR = 30.0; 95% CI: 6.08—184), or after using a propensity score adjustment (OR = 14.3; 95% CI: 3.55—61.0, all P< 0.001). High-sensitivity cardiac troponin peak and left ventricular ejection fraction assessing the infarct size were higher in patients illicit drug use compared to others (P< 0.001) (Fig. 1). Conclusion The prevalence of illicit drug use in patients hospitalized for STEMI was 12.1%. Illicit drugs detection was independently associated with a higher occurrence of in-hospital MAEs, despite a younger population, with less comorbidities. Fig. 1 Illicit drug use repartition in STEMI patients. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.004 6
Archives of Cardiovascular Disease Supplements 15 (2023) 5—27 149 2 years outcomes in patients with or without ARC-HBR criteria undergoing PCI with polymer-free biolimus coated stents: The Biofreedom France Study P. Garot1,∗, P. Brunel2, A. Dibie3, J.-F. Morelle4, M. Abdellaoui5, R. Levy6, D. Carrié7, B. Karsenty6, C. Robin8, J. Berland9, S. Copt10, S. Sadozai10, K. Olroyd (Chief medical officer)11, M.-C. Morice (Chief executive officer)12, J. Lipiecki13 1 Angio, Institut cardiovasculaire Paris Sud (ICPS), Massy 2 Cardiologie, Institut cardiovasculaire Dijon Bourgogne, Dijon 3 Cardiologie, L’Institut Mutualiste Montsouris, Paris 4 Cardiologie, hôpital privé Saint-Martin — Ramsay Santé, Caen 5 Cardiologie, Avec le Groupe Hospitalier Mutualiste de Grenoble, Grenoble 6 Cardiologie, hôpital privé Saint-Martin — ELSAN, Pessac 7 Cardiologie, CHU Rangueil, Toulouse 8 Cardiologie, clinique Convert — Ramsay Santé, Bourg-en-Bresse 9 Cardiologie, clinique Saint-Hilaire, Rouen 10 Biostatistiques, Biosensors Europe SA, Morges, Switzerland 11 Biosensors Europe SA, Morges, Switzerland 12 CERC, Massy 13 Cardiologie, Pôle Santé République — ELSAN, Clermont-Ferrand ∗ Corresponding author. E-mail address: pgarot@angio-icps.com (P. Garot) Introduction The polymer-free biolimus coated stent (BiofreedomÔ) was shown to be superior to bare metal stents in the LEADERS FREE randomized trial in high-bleeding risk (HBR) patients treated with one-month dual antiplatelet therapy (DAPT). However, there is limited outcome data with this device in real-world all-comers’ population. Objective We aimed to conduct a prospective single-arm study of patients undergoing PCI with the polymer-free biolimus coated stent in 25 centers in France with wide inclusion criteria including multivessel disease, complex lesions and acute coronary syndromes. Method The primary endpoint was the incidence of target lesion failure (TLF), a composite of cardiac death or target vessel myocardial infarction (MI) or clinically indicated target lesion revascularization (ci-TLR). The patient population was classified according to the presence (or not) of HBR criteria according to the ARC-HBR definition. Results Between April 2019 and April 2020, 1497, patients were enrolled. There were 491 HBR patients (32.8%) and 1006 non-HBR patients. HBR patients were older and had more comorbidities. Compared to non-HBR patients, they had higher rates of diabetes, prior coronary artery disease, congestive heart failure and prior cerebrovascular accident. The median duration of DAPT was 74 days in the HBR group vs. 348 days in the non-HBR group (P< 0.0001). At 1-year the rate of clinical events was low, TLF occurred in 101 (6.9%) patients, including cardiac death in 35 (2.4%), target vessel MI in 20 (1.4%) and ci-TLR in 65 (4.5%) of them. TLF ocurred in 44 (9.2%) of the HBR group and in 57 (5.8%) of the non-HBR group (relative risk 1.62 [95% CI: 1.10—2.41], P= 0015). The 2-years clinical outcomes of patients included in the Biofreedom France study will be presented at the meeting. Conclusion In this multicenter real world all-comers study, patients treated with a polymer-free biolimus coated stent had low rates of MI, stent thrombosis and ci-TLR at 1 year. The 2 years outcomes of patients included in the Biofreedom France Study will be available for the meeting. Disclosure of interest Directeur médical de CERC, Honoraires d’orateur de Abbott, Biosensors, Boston Scientific, Edwards LifeSciences, General Electric HealthCare. https://doi.org/10.1016/j.acvdsp.2022.10.005 478 Five-year clinical outcomes using the bioresorbable vascular scaffold: Insights from the FRANCE ABSORB registry Q. Landolff1,∗, T. Lefevre2, H. Le Breton3, R. Koning1 1 Cardiologie, clinique Saint-Hilaire, Rouen 2 Cardiologie, Institut cardiovasculaire Paris Sud (ICPS), Massy 3 Cardiologie et maladies vasculaires, CHU Rennes, hôpital Pontchaillou, Rennes ∗ Corresponding author. E-mail address: quentin.landolff@gmail.com (Q. Landolff) Introduction Randomized trials comparing the first-generation Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, CA, USA) with a drug-eluting stent showed a moderate but significant increase in the rate of 3-year major adverse cardiac events and scaffold thrombosis, followed by a decrease in adverse events after 3 years. Objective The aim of this study was to assess the 5-year outcomes of patients treated with at least one Absorb BVS and included in the FRANCE ABSORB registry. Method All patients treated in France with an Absorb BVS were prospectively included in a large nationwide multicentre registry. The primary efficacy outcome was the occurrence of 5-year major adverse cardiac events. Secondary efficacy outcomes were the rates of 5-year target vessel revascularization and definite/probable scaffold thrombosis. Results Between September 2014 and April 2016, 2070 patients were included in 86 centers (mean age 55±11 years; 80% men; 49% with acute coronary syndrome). The rates of 1-, 3- and 5-year major adverse cardiac events were 3.9%, 9.4% and 12.1%, respectively (including cardiac death in 2.5% and target vessel revascularization in 10.4%). By multivariable analysis, diabetes, oral anticoagulation, the use of multiple Absorb BVSs and the use of a 2.5mm diameter Absorb BVS were associated with 5-year major adverse cardiac events. The rates of 1-, 3- and 5-year definite/probable scaffold thrombosis were 1.5%, 3.1% and 3.6%, respectively. By multivariable analysis, older age, diabetes, anticoagulation at discharge and the use of a 2.5mm diameter Absorb BVS were associated with 5-year scaffold thrombosis. Conclusion Absorb BVS implantation was associated with low rates of 1-year major adverse cardiac events, which increased significantly at 3-year follow-up. There was a clear decrease in the rates of scaffold thrombosis and major adverse cardiac events after 3 years. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.006 7
01 — Coronary artery disease 151 Safety and efficacy of dual vs. triple antithrombotic therapy in patients with indication of anticoagulation treated by PCI: A retrospective analysis of the FRANCE PCI registry T. Verrez1,∗, T. Barbe1, T. Levesque1, A. Verrez2, R. Koning3, P. Motreff4, H. Eltchaninoff1, G. Rangé5, E. Durand1 1 Normandie univ, unirouen, u1096, CHU Rouen, department of cardiology, 76000 Rouen, France 2 Ingénierie, École des Mines de Paris, université PSL, Paris 3 Cardiologie, clinique Saint-Hilaire, Rouen 4 Cardiologie, CHU Clermont-Fd: site Gabriel-Montpied, Clermont-Ferrand 5 Department of cardiology, CH de Chartres, Chartres ∗ Corresponding author. E-mail address: thibault.verrez@gmail.com (T. Verrez) Introduction In patients with long-term oral anticoagulant (OAC) therapy treated with percutaneous coronary intervention (PCI), the 2020 European guidelines recommend a dual antithrombotic therapy (DAT) combining an OAC and a single antiplatelet therapy (SAPT) for a period of 6 to 12months according on the clinical context. Objective Our study aims to assess real-life practices using data from the France PCI registry. Method All consecutive patients from the France PCI registry treated by PCI and on OAC therapy between 2014 and 2019 were included. Two groups of patients were determined. Patients with DAT (1 oral anticoagulant and SAPT) or a triple therapy (TAT) < 1month were included in the DAT group. Patients with OAC and DAPT > 1month constituted the TAT group. The primary endpoint was defined as significant bleeding according to the BARC classification (≥3) at one-year follow-up. The secondary endpoint was a composite endpoint of ischemic events including death, myocardial infarction, stroke, unscheduled revascularization or stent thrombosis. Two secondary analyses were performed using a 1:1 patient matching with a propensity score to balance the 2 populations comparing DAT vs. TAT and vitamin K antagonist (VKA) vs. direct OAC (DOAC). Results Between 2014 and 2019, 5768 consecutive patients were discharged with TAT (n= 3993; 69.2%) or DAT (n= 1775; 30.8%). The incidence of bleeding events was significantly increased in the DAT group as compared to the TAT group (7.1% vs. 5.1%, HR: 1.41; 95% CI: 1.41—1.76; P< 0.01). In contrast, there was no significant difference in the incidence of ischemic events (13.4% vs. 15.2%, HR: 0.88; 95% CI: 0.75—1.02; P= 0.08). After propensity score matching, there was no more significant difference in bleeding complications (7.0% vs. 5.4%, P= 0.09). On the other hand, the incidence of hemorrhagic events was significantly lower in patients on DOAC compared to those on VKA (4.2% vs. 7.1%, P< 0.01), the rate of ischemic events did not differ significantly between the two groups (13.6% vs. 14.3%, P= 0.67). Conclusion The results of our study suggest that DAT is used in France in only 30% of cases and unlike randomized studies, does not reduce bleeding complications compared to TAT. Ischemic complications were similar between the 2 strategies. Furthermore, our study underlines the superiority of DOAC over VKA in patients with OAC requiring PCI. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.007 223 Elevated levels of Lp(a) are associated with coronary lesion complexity in patients hospitalized for an acute myocardial infarction: Data from the French RICO Survey M.I.M. Kouamé1,∗, F. Chagué1, M. Farnier2, F. Bichat1, M. Maza1, M. Zeller2, Y. Cottin1 1 Service de cardiologie, CHU Dijon Bourgogne, Dijon 2 Laboratoire PEC2, EA 7460, UFR sciences de santé, Université de Bourgogne, Dijon ∗ Corresponding author. E-mail address: kwmeisabelle@hotmail.fr (M.I.M. Kouamé) Introduction Although patients with elevated Lp(a) are at highrisk of acute myocardial infarction (MI), coronary artery disease (CAD) burden associated with Lp(a) remains poorly investigated. Objective We aim to characterize coronary lesion complexity in patients with acute MI according to Lp(a) circulating levels. Method Single-center study including all consecutive patients hospitalized for an acute MI in coronary care unit from the RICO database (2019—2021) who underwent coronary angiography and blood sample for Lp(a) assessment on admission. Coronary lesion complexity was retrospectively assessed by SYNTAX score and pre-specified angiographic criteria. Patients were compared according to their Lp(a) levels: < 50mg/dL (normal), ≥50mg/dL and≤100mg/dL (high) and > 100mg/dL (very high). Results In total, 921 patients were included, of whom 177 (19.2%) had elevated Lp(a) > 50mg/dL, including 121 (13.1%) with high and 56 (6.1%) with very high Lp(a). Median (IQR) age was similar across the 3 groups [normal: 68 (58—78) y; high: 70 (60—80) y; very high: 69 (61—78) y, P= 0.381]. When compared with patients with normal Lp(a), patients with high and very high Lp(a) levels had increased prevalence of personal history of CAD (19%, 28% and 29%, respectively, P= 0.026) and family history of CAD (19%, 26% and 29%, P= 0.032, respectively). Women had more frequently a very high Lp(a) level than normal and high groups (29%, 33% and 46%, respectively, P= 0.016,). Rate of ST-segment elevation MI was similar for the 3 groups (P= 0.961). At coronary angiography, CAD burden, as assessed by SYNTAX score was much higher in elevated Lp(a) groups [11 (6—19), 15 (8—24), 17 (7—25), P= 0.001, respectively]. Moreover, patients with elevated Lp(a) had more complex coronary lesions (P= 0.034), characterized by left main (P= 0.021), and calcified lesions (P= 0.002) (Fig. 1). In-hospital mortality gradually increased across the 3 groups (2.8%, 6.6%, 8.9%, P= 0.010, respectively). Conclusion This retrospective study in patients with acute MI shows that elevated Lp(a) were common, associated with high-risk for in-hospital mortality. Patients with high Lp(a) were characterized by severe CAD burden, with complex anatomy features including left main and calcified lesions. The long-term prognostic impact of Lp(a)-associated CAD burden needs to be explored. 8
Archives of Cardiovascular Disease Supplements 15 (2023) 5—27 Fig. 1 Complexity of coronary lesions according to Lp(a) level. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.008 411 Description and 30-day prognosis of same-day discharge after elective percutaneous coronary intervention in elderly patients: A single-centre registry A. Léquipar1,∗, F. Picard2, T. Chicheportiche3, J. Anconina2, X. Favereau2, G. Dambrin2, A. Jegou2 1 Cardiologie, hôpital Lariboisière, AP—HP, Paris 2 Cardiologie, hôpital privé de Parly 2 — Ramsay Santé, rue Moxouris, Le Chesnay-Rocquencourt, France 3 Cardiologie, CH Intercommunal Poissy, Poissy ∗ Corresponding author. E-mail address: antoine.lequipar@gmail.com (A. Léquipar) Introduction Same-day discharge after elective percutaneous coronary intervention (PCI) has shown good safety. Although, elderly patients have more comorbidities and less favourable coronary and peripheral anatomy, which may compromise same-day discharge after PCI. The prognosis of these patients is not well established. Objective to evaluate whether same-day discharge in elderly patients was associated with increase adverse events. Method A total of 645 patients undergoing elective PCI in a single centre (hôpital privé Parly 2) between 2013 and 2019 were included in the study. We compared the outcomes of a group of elderly patients (75-year-old or older) to a control group of patients under the age of 75. The primary endpoint was a composite of all-cause death, target lesion revascularisation, stroke, myocardial infarction, and unplanned cardiovascular hospitalization. The secondary endpoint was a composite of all-cause death, target lesion revascularisation, stroke, myocardial infarction, and unplanned hospitalization from any cause. Results Of the 645 patients, 148 (22.9%) were aged 75 or older. The elderly patients were more likely males, hypertensive, and presented more frequently with atrial fibrillation, chronic kidney disease, heart failure with reduced ejection fraction, and known coronary artery disease. The complexity of the lesions treated was similar in both groups. However, elderly patients had a higher rate of coronary artery bypass graft lesions and intrastent restenosis, but a lower rate of bifurcations lesions and chronic total occlusions. At 30-day follow-up, there were no significant differences between the 2 groups in the primary endpoint (2.7% in the younger group versus 0.0% in the elderly group, P= 0.05). However, 30-day secondary endpoint occurred significantly more in younger patients (4.5% in the younger group versus 0.7% in the elderly group, P= 0.04) (Fig. 1). Conclusion For selected patients, elderly patients have not a higher risk of 30-day complications after same-day discharge PCI. Same-day discharge PCI seems to be safe and feasible for most patients aged of 75 or more. Fig. 1 Comparison of same-day discharge after elective percutaneous coronary intervention in elderly patients aged of 75 or more to control patients under the age of 75 years. Value are n (%) or mean±SD. Abbreviations: HFeEF: heart failure with reduced ejection fraction. * 30-day primary endpoint: composite of allcause death, target lesion revascularisation, stroke, myocardial infarction, and unplanned cardiovascular hospitalization. ** 30-day secondary endpoint: composite of all-cause death, target lesion revascularisation, stroke, myocardial infarction, and unplanned hospitalization from any cause. Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.acvdsp.2022.10.009 231 Characteristics and outcomes of COVID-19 infection among patients with a history of coronary artery: Results from TASC GP study A. Ben Halima1,∗, N. Cherif2, M. Elafrit3, M. Benkhelifa3, A. Benammar3, K. Talmoudi4 1 Service de cardiologie, hôpital Abderrahmen Mami, Tunis, Tunisia 2 Cardiologie, hôpital des forces de sécurité intérieure de La Marsa, Marsa, Tunisia 3 Private sector, Arc freelance, Tunis, Tunisia 4 Observatoire national des maladies nouvelles et émergeantes, Observatoire national des maladies nouvelles et émergeantes, Tunis, Tunisia ∗ Corresponding author. E-mail address: afefbenhalima.abh@gmail.com (A. Ben Halima) Introduction Among patients with Coronavirus disease 2019 (COVID-19), coronary artery disease (CAD) has been identified as a high-risk condition. The TASC GP study (Tunisian Anticoagulation Survey in COVID-19 patient General Practice experience) is an observational, multicenter survey in ambulatory patients with COVID-19. Objective The aim of this sub study was to assess the clinical characteristics and outcomes among patients with COVID-19 and a history of CAD. Method We examined between July 2021 and October 2021 ambulatory patients with COVID-19. Baseline characteristics and mortality rates were compared between those with history of CAD and those without history of CAD. CAD was defined as a history of prior percutaneous coronary intervention, prior coronary artery bypass grafting or CAD that was being medically treated. Results The study population included 3412 ambulatory patients with COVID-19. History of CAD was reported in 158 patients (4.6%). Patients with CAD were older 66.6±11.2 years vs. 51±15.4 years (P< 0.001), had more hypertension 84% vs. 28% (P< 0.001), diabetes 9
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