References of "Legrand, Victor"
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See detailAntiagregants: doit-on les arreter avant un acte invasif?
Maeyns, K.; Legrand, Victor ULg; Pierard, Luc ULg et al

in Revue Médicale de Liège (2008), 63(3), 136-40

Antiplatelet therapy is the leading therapy for the primary and secondary prevention for the atherosclerotic arterial disease. The practical question of withdraw alavoiding or continuation of oral ... [more ▼]

Antiplatelet therapy is the leading therapy for the primary and secondary prevention for the atherosclerotic arterial disease. The practical question of withdraw alavoiding or continuation of oral antiplatelet agents accurs currently before any invasive procedure. It is important to compare the relative thrombotic vs hemorrhagic risk. For most interventions, it is recommended to continue antiplatelet therapy. It is particularly important in patients who benefited from drug-eluting stents where the thrombotic risk is major. [less ▲]

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See detailL'image du mois. Les valvules cardiaques en tomodensitometrie multidetecteur et echo 3D.
Davin, Laurent ULg; Bruyere, Pierre-Julien ULg; Gach, Olivier ULg et al

in Revue Médicale de Liège (2008), 63(10), 577-8

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See detailRapport benefice/risque des endoprotheses coronaires pharmaco-actives. 1ere partie: analyse dans la population generale.
Nyssen, Astrid ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2008), 63(9), 542-8

Coronary drug-eluting stents (DES) are increasingly used in interventional cardiology. Stents coated with pharmacological substances such as sirolimus or paclitaxel, capable of reducing endothelial ... [more ▼]

Coronary drug-eluting stents (DES) are increasingly used in interventional cardiology. Stents coated with pharmacological substances such as sirolimus or paclitaxel, capable of reducing endothelial proliferation, have been proposed to replace bare-metal stents (BMS) in order to reduce the risk of restenosis. The survey of the literature confirms a major and significant reduction in the risk of restenosis with both sirolimus and paclitaxel DES as compared to BMS in the global population. This effect leads to a diminished requirement for new revascularisation procedures. However, such DES may increase the risk of very late stent thrombosis, presumably due to a defect of endothelialisation, which requires long-term effective antiplatelet therapy. The impact on major clinical coronary events shows no significant difference in mortality between DES and BMS. However, the incidence of myocardial infarct may be, slightly but significantly, reduced with sirolimus DES. In a next paper, the same analysis will be specifically performed in the diabetic population, which is well known to be at high risk of coronary heart disease, but is also expected to particularly benefit from DES. [less ▲]

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See detailEndoprotheses coronaires pharmaco-actives chez les patients diabetiques.
Nyssen, Astrid; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale Suisse (2008), 4(168), 1806-10

In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is ... [more ▼]

In diabetic patients, the use of drug-eluting stents (paclitaxel-PES or sirolimus-SES) reduces the risk of restenosis as compared to bare-metal stents. However, the risk of (very) late thrombosis is higher with drug-eluting stents than with bare-metal stents. All together, the incidence of major cardiovascular events is reduced with drug-eluting stents, mainly resulting from a diminution of revascularisation procedures rather than from a reduction in myocardial infarcts or cardiovascular deaths. Attempts to compare SES and PES gave discordant results in both randomised trials and registries. Efficacious antiplatelet therapy in the long run is mandatory in all diabetic patients treated with drug-eluting stents. [less ▲]

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See detailDiagnostic accuracy of computed tomography coronary angiography in routine practice
Davin, Laurent ULg; LANCELLOTTI, Patrizio ULg; Bruyere, P. J. et al

in Acta Cardiologica (2007), 62(4), 339-344

Objectives - The recent newer advances in computed tomography have dramatically changed our approach to imaging cardiac disease. This study sought to compare the diagnostic value of 16-multi-detector ... [more ▼]

Objectives - The recent newer advances in computed tomography have dramatically changed our approach to imaging cardiac disease. This study sought to compare the diagnostic value of 16-multi-detector spiral computed tomography (MSCT) for detecting coronary artery stenosis. Methods - A total of 88 consecutive patients (52 men, mean age 68 +/- 8 years) with atypical chest pain, stable angina or suspicion of ischaemia at stress test were studied by MSCT and invasive coronary angiography (ICA). The MSCT images and multiplanar reconstructions were analysed regarding the presence of >= 50% coronary artery lesion. Results - All 88 scans obtained at a mean heart rate of 68 8 beats/min were interpretable. Sixteen coronary segments were evaluated in each patient. Of the 1320 segments examined, 148 (11 %) showed poor image quality. A total of 150 significant lesions were detected using ICA, and 80 of 150 (53%) were detected by MSCT Sensitivity, specificity, positive and negative predictive values were as follows: 53%, 97%, 68%, and 94%. Fifty-four patients had >= 50% coronary stenosis. The diagnosis was confirmed by MSCT in 42 patients and correctly ruled out in 30. By patient-based analysis, positive and negative predictive values were 91 % and 71 %. Conclusion - Although its specificity is high, the sensitivity of 16-slice MSCT for detecting 2: 50% coronary stenosis in non-selected patients submitted to ICA is rather low suggesting that for daily practice the diagnostic value of this technique should be improved. [less ▲]

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See detailLong-term prognostic significance of high-sensitivity C-reactive protein before and after coronary angioplasty in patients with stable angina pectoris
Gach, Olivier ULg; Legrand, Victor ULg; Biessaux, Yves ULg et al

in American Journal of Cardiology (2007), 99(1), 31-35

We examined whether an increase in high-sensitivity C-reactive protein (hs-CRP) after percutaneous coronary intervention (PCI) predicts long-term prognosis in patients with stable angina pectoris. hs-CRP ... [more ▼]

We examined whether an increase in high-sensitivity C-reactive protein (hs-CRP) after percutaneous coronary intervention (PCI) predicts long-term prognosis in patients with stable angina pectoris. hs-CRP is an inflammatory marker that predicts future cardiovascular events in healthy subjects and patients with unstable and stable coronary syndromes. Long-term evaluation of pre- and postprocedural inflammatory markers has not been widely reported. In particular, the effect of the magnitude of increase in hs-CRP after PCI in stable patients is unknown. We prospectively analyzed 89 stable patients treated by PCI for stable angina pectoris. Patients were recruited between August 1998 and May 1999, and the population was followed until August 2005 (mean follow-up 79.5 +/- 10.3 months). A major adverse cardiac event (MACE) was defined as the occurrence of cardiac death, myocardial infarction, or recurrent angina requiring repeat PCI or coronary artery bypass grafting. During the follow-up period, 36 patients presented with > or =1 MACE. In multivariate analysis, independent predictors of the occurrence of MACEs were previous myocardial infarction and a significant increase in hs-CRP after PCI (p = 0.004 and 0.003, respectively). A significant increase in hs-CRP after PCI was found to be more predictive of MACEs than hs-CRP before and after PCI. In conclusion, in stable coronary artery disease, inflammation is associated with long-term adverse events, but the magnitude of the inflammatory reaction after PCI appears more predictive than the baseline value. [less ▲]

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See detailActualites therapeutiques en cardiologie
Legrand, Victor ULg; Lancellotti, Patrizio ULg; Waleffe, André ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 244-53

Cardiovascular diseases are the leading cause of mortality in the so-called industrial countries. An appropriate management is mandatory and its modalities should be known and applied by physicians ... [more ▼]

Cardiovascular diseases are the leading cause of mortality in the so-called industrial countries. An appropriate management is mandatory and its modalities should be known and applied by physicians. European and American recommendations are regularly published and updated. They are available on the web sites of the European Society of Cardiology (www.escardio.org), the American Heart Association (www.aha.org) and the American College of Cardiology (www.acc.org This article describes the recent therapeutic options of some cardiovascular diseases, especially coronary artery disease, valvular diseases, atrial fibrillation and implantable defibrillator, but is far to be exhaustive. [less ▲]

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See detailDissection coronaire et traumatisme thoracique ferme
Brasseur, Edmond ULg; Ghuysen, Alexandre ULg; Mommens, Véronique et al

in Annales de Cardiologie et d'Angeiologie (2006), 55(4), 233-9

The occurrence of an acute myocardial infarction after non-penetrating chest trauma is an extremely rare complication. We report a case of dissection of the left anterior descending artery in a 43 year ... [more ▼]

The occurrence of an acute myocardial infarction after non-penetrating chest trauma is an extremely rare complication. We report a case of dissection of the left anterior descending artery in a 43 year old man after being punched in the chest. Using data from a literature search relish revealed 76 cases; we review the characteristics of the pathology and its incidence. We also characterize its etiology, anatomy and path physiology. We then consider the diagnostic and therapeutic implications. [less ▲]

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See detailAcute neutrophil activation in direct stenting: comparison of stable and unstable angina patients.
Gach, Olivier ULg; Nys, Monique ULg; Deby, Ginette ULg et al

in International Journal of Cardiology (2006), 112(1), 59-65

BACKGROUND: Polymorphonuclear neutrophils have been implicated in the pathophysiology of atherosclerosis. A substantial body of evidence has emerged to implicate the role of specific leucocyte derived ... [more ▼]

BACKGROUND: Polymorphonuclear neutrophils have been implicated in the pathophysiology of atherosclerosis. A substantial body of evidence has emerged to implicate the role of specific leucocyte derived enzyme myeloperoxidase in atherogenesis, since its initiation through progression until destabilization. The aim of the study was to determine the presence of polymorphonuclear neutrophils activation after coronary stenting, to compare this activation between stable and unstable setting and to evaluate the kinetic relation of this activation with inflammatory response following atherosclerotic plaque rupture. METHODS: Myeloperoxidase, lactoferrin, elastase, C-reactive protein and cytokine plasma levels were assessed in 15 patients undergoing direct coronary stenting for unstable angina (Group A) and compared to 11 patients undergoing this procedure for stable angina (Group B). Serial sampling starting before arteriography and continued for 24 h was carried out in all patients. RESULTS: A significant elevation in myeloperoxidase and lactoferrin levels was observed after stenting in both group A (p<0.0001) and group B (p<0.0001), but was higher in group A. Interleukin-8, interleukin-12 and interleukin-6 levels increased temporarily after stenting in the 2 groups. Baseline values of C-reactive protein were similar in the 2 groups and a progressive increase was observed after the intervention. CONCLUSIONS: Direct coronary artery stenting is associated with an early polymorphonuclear neutrophils activation followed by release of inflammatory cytokines (interleukin-6, interleukin-8, interleukin-12) and C-reactive protein elevation in both stable and unstable patients. We conclude that stenting by itself is associated with myeloperoxidase liberation with a significantly enhanced response in unstable patients. [less ▲]

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See detailEarly release of neutrophil markers of activation after direct stenting in patients with unstable angina
Gach, Olivier ULg; Biemar, Christian; Nys, Monique ULg et al

in Coronary Artery Disease (2005), 16(1), 59-65

Objective To assess polymorphonuclear neutrophils activation after stenting in acute coronary syndromes studied by myeloperoxydase, lactoferrin and elastase release in this clinical setting. Methods ... [more ▼]

Objective To assess polymorphonuclear neutrophils activation after stenting in acute coronary syndromes studied by myeloperoxydase, lactoferrin and elastase release in this clinical setting. Methods Myeloperoxydase, lactoferrin, elastase, C-reactive protein and cytokines serum levels were assessed in 20 patients undergoing catheterization for unstable angina. Serial sampling starting before arteriography and continued up to 24 h was carried out in 15 patients undergoing direct stenting (group A) and in five patients assessed by coronary angiography only (group B). Results Myeloperoxydase, lactoferrin and elastase levels remained unchanged following catheterization, whereas a significant increase in myeloperoxydase (P=0.0009) and lactoferrin (P=0.004) was observed after stenting. No change in levels of tumour necrosis factor alpha, interleukin (IL)-8 and IL-12 was found in group B after catheterization at the different sampling times, although IL-8 and IL-12 levels increased transiently following stenting. IL-6 values increased in both groups. Baseline values of C-reactive protein were similar in each group. A progressive increase in C-reactive protein was noted in both groups and appeared to be larger following stenting (group A: P=0.0002; group B: P=0.01). Conclusions In patients with unstable angina, stenting is associated by immediate neutrophil activation followed by release of inflammatory cytokines (IL-6, IL-8, IL-12) and C-reactive protein elevation. This study points out a potential role of myeloperoxydase as a trigger for inflammatory reaction in patients with unstable coronary syndromes undergoing percutaneous coronary intervention. (C) 2005 Lippincott Williams WillZins. [less ▲]

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See detailImage du mois. Fibrodysplasie musculaire de l'artère rénale.
Gach, Olivier ULg; Pierard, Luc ULg; Legrand, Victor ULg

in Revue Médicale de Liège (2004), 59(11), 624-5

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See detailDrug-eluting stents: meta-analysis in diabetic patients.
Scheen, André ULg; Warzee, Fabian ULg; Legrand, Victor ULg

in European heart journal (2004), 25(23), 2167-82168-9

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See detailAngioplastie percutanee coronaire chez le patient diabetique Partie 1 : echecs relatifs lies a la restenose apres angioplastie simple.
Warzee, Fabian ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(10), 584-90

Diabetes mellitus, essentially type 2 diabetes, is markedly associated with a high risk of cardiovascular diseases, especially coronary artery disease (CAD). Revascularization techniques, first coronary ... [more ▼]

Diabetes mellitus, essentially type 2 diabetes, is markedly associated with a high risk of cardiovascular diseases, especially coronary artery disease (CAD). Revascularization techniques, first coronary artery bypass graft (CABG) and second percutaneous transluminal coronary angioplasty (PTCA), have drastically changed the management of patients with CAD. Unfortunately, overall results of such revascularization procedures are less impressive in diabetic patients than in nondiabetic subjects, because of a worse vascular bed due to a more diffuse disease including small vessels. The diabetic population is indeed characterized by higher rates of both post-CABG thrombosis and post-PTCA restenosis, as compared to the corresponding rates observed in a nondiabetic population. Such vascular complications result in a higher incidence of coronary events leading to greater morbidity and mortality in both the short (weeks-months) and long (years) term. The bad quality of blood glucose control appears to play a crucial role in the risk of restenosis and further complications. The use of endovascular stents, especially new drug-eluting stents reducing the risk of restenosis, may represent a new opportunity for the management of a high-risk population such as diabetic patients. [less ▲]

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See detailAngioplastie percutanee coronaire chez le patient diabetique. Partie 2: Espoirs apportes par les protheses endovasculaires.
Warzee, Fabian ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(11), 653-8

Coronary artery revascularization procedures provide less favourable results in diabetic patients than in non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is associated with ... [more ▼]

Coronary artery revascularization procedures provide less favourable results in diabetic patients than in non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is associated with a higher rate of restenosis and recurrence of cardiac morbidity and death. In diabetic patients, PTCA should, if possible, be combined with a stent. Bare-stents allow to reduce approximately by half the risk of restenosis, but unfortunately their efficacy decreases as the vessel diameter decreases, a common finding among diabetic patients with angiopathy. ARTS ("Arterial Revascularization Therapy Study") recently showed that diabetic patients have a worse prognosis even when bare-stents are combined with PTCA as compared to non-diabetic subjects and as compared to diabetic patients treated with coronary artery bypass graft. These results open new perspectives in favour of the use of drug-eluting stents containing pharmacological agents capable of preventing restenosis. Such new stents might improve the management of diabetic patients with coronary heart disease. [less ▲]

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See detailAngioplastie percutanee coronaire chez le patient diabetique. Partie 3: Nouvelles perspectives apportees par les stents enrobes.
Warzee, Fabian ULg; Legrand, Victor ULg; Scheen, André ULg

in Revue Médicale de Liège (2004), 59(12), 711-6

Coronary revascularization procedures are associated with less favourable outcomes in diabetic patients as compared to non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is ... [more ▼]

Coronary revascularization procedures are associated with less favourable outcomes in diabetic patients as compared to non-diabetic individuals. Especially, percutaneous coronary angioplasty (PTCA) is associated with a high level of restenosis and recurrent cardiac morbidity and mortality. In diabetic patients, PTCA should ideally be combined with stents. Bare-metal stents reduce by almost half the risk of restenosis, but this favourable effect decreases with the vessel calibre, a common finding in diabetic patients. Drug-eluting stents containing pharmacological agents that can reduce the risk of restenosis (sirolimus, paclitaxel) provide better angiographic results, including in small coronary arteries, and this effect has been shown to be accompanied by significant reduction of both morbidity and mortality. Such preliminary results obtained in the general population (including around 20% of diabetic subjects) deserve further confirmation in a large clinical trial specifically devoted to diabetic patients. Drug-eluting stents may represent a major advance in the management of diabetic patients with coronary heart disease in the near future. [less ▲]

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See detailL'etude clinique du mois. L'etude EUROPA: protection cardio-vasculaire avec le perindopril chez les patients avec coronaropathie stable.
Scheen, André ULg; Legrand, Victor ULg

in Revue Médicale de Liège (2003), 58(11), 713-6

The multicentre placebo-controlled double-blind "EUropean trial on Reduction Of cardiac events with Perindopril in patients with stable coronary Artery disease" (EUROPA) assessed whether the angiotensin ... [more ▼]

The multicentre placebo-controlled double-blind "EUropean trial on Reduction Of cardiac events with Perindopril in patients with stable coronary Artery disease" (EUROPA) assessed whether the angiotensin-converting-enzyme inhibitor perindopril reduces cardiovascular risk in a population with stable coronary heart disease and no apparent heart failure, whatever the associated cardiovascular risk. Patients were randomly assigned perindopril 8 mg once daily (n = 6110) or matching placebo (n = 6108). After a mean follow-up of 4.2 years, a relative risk reduction of 20% (95% CI 9-29, p = 0.0003) was observed in the combined primary endpoint (cardiovascular death, myocardial infarction, or cardiac arrest) in the group treated with perindopril as compared to placebo. About 50 patients needed to be treated for a period of 4 years to prevent one major cardiovascular event. This benefit was consistent in all predefined subgroups. According to these results, treatment with perindopril, on top of other preventive medications, should be considered in all patients with stable coronary heart disease. [less ▲]

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See detailPeriodontal condition in Belgian patients with acute or chronic heart disease
Geerts, Sabine ULg; Charpentier, Joseph ULg; Albert, Adelin ULg et al

in Journal of Dental Research (2002, December), 81(Sp. Iss. B), 240-240

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See detailSystemic release of endotoxins induced by gentle mastication: Association with periodontitis severity
Geerts, Sabine ULg; Nys, Monique ULg; De Mol, Patrick ULg et al

in Journal of Dental Research (2002, December), 81(Sp. Iss. B), 235-235

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