References of "LEGRAND, Victor"
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See detailHeart Team Liege - Session Video Link
PIERARD, Luc ULg; vahanian, Alec; LANCELLOTTI, Patrizio ULg et al

Conference (2016, September)

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See detailHeart Team Session
PIERARD, Luc ULg; LANCELLOTTI, Patrizio ULg; PETERMANS, Jean ULg et al

Conference (2016, August)

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See detailApport du cathétérisme cardiaque dans le diagnostic et le traitement de la maladie coronarienne avant 40 ans
MEURICE, Caroline; LEGRAND, Victor ULg; PIERARD, Luc ULg

in Revue Médicale de Liège (2016), 71(3), 129-136

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See detailAngioplastie ou chirurgie chez le patient coronarien stable ?
LEGRAND, Victor ULg

in La Revue du praticien (2015), 65(3), 352-6

Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) must be considered among stable angina pectoris patients who remained symptomatic despite optimal medical treatment and ... [more ▼]

Percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) must be considered among stable angina pectoris patients who remained symptomatic despite optimal medical treatment and to improve prognosis of patients with large myocardial lschemia when occurring at low workload. PCI is preferred for single coronary artery stenosis, while CABG is recommended for severe multivessel disease patients, particularly when diabetes is present. There is no simple decisional algorithm, and, for patients with multivessel disease, each situation must be debated within a multidisciplinary decision-making team (Heart Team), taking into consideration risks and benefits of PCI vs CABG, patients' comorbidities and local experience. [less ▲]

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See detailDeferral vs. performance of percutaneous coronary intervention of functionally non-significant coronary stenosis: 15-year follow-up of the DEFER trial
Zimmermann, Frederik M.; Ferrara, Angela; Johnson, Nils P. et al

in European Heart Journal (2015), 36

Deferral of PCI of a functionally non-significant stenosis is associated with a favourable very long-term follow-up without signs of late ‘catch-up’ phenomenon.

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See detailMidterm clinical outcome following Edwards SAPIEN or Medtronic Corevalve transcatheter aortic valve implantation (TAVI): Results of the Belgian TAVI registry.
Collas, Valerie M.; Dubois, Christophe ULg; LEGRAND, Victor ULg et al

in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2015), 86(3), 528-35

OBJECTIVE: To assess midterm (3 years) clinical outcomes of transcatheter aortic valve implantation (TAVI) in Belgium using the Edwards SAPIEN valve or the Medtronic CoreValve transcatheter heart valve ... [more ▼]

OBJECTIVE: To assess midterm (3 years) clinical outcomes of transcatheter aortic valve implantation (TAVI) in Belgium using the Edwards SAPIEN valve or the Medtronic CoreValve transcatheter heart valve (THV). BACKGROUND: Medium and long term follow-up data of both THVs are still relatively scarce, although of great clinical relevance for a relatively new but rapidly expanding treatment modality. Therefore, reporting mid- and long term clinical outcome data, coming from large "real world" national registries, remains contributive. METHODS: Between December 2007 and March 2012, 861 "real world" patients who were not candidates for surgical aortic valve replacement as decided by the local heart teams, underwent TAVI at 23 sites. Eleven sites exclusively used SAPIEN THV (n = 460), while 12 exclusively used CoreValve THV (n = 401). Differences in clinical outcomes by valve system were assessed, according to access route and baseline EuroSCORE risk profile (<10%: low, 10-20%: intermediate and >20%: high risk). RESULTS: Overall cumulative survival at 3 years was 51% for SAPIEN vs. 60% for CoreValve (P = 0.021). In transfemorally treated patients, SAPIEN and CoreValve had similar survival at 3 years for each of the baseline EuroSCORE cohorts (low risk: 72% vs. 76%, P = 0.45; intermediate risk: 62% vs. 59%, P = 0.94; high risk: 48% vs. 53%, P = 0.65). CONCLUSION: Cumulative midterm 3 year survival after transfemoral TAVI in "real world" patients refused for surgery with similar baseline EuroSCORE risk profile is not different between SAPIEN or CoreValve. [less ▲]

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See detailEnvironmental triggers of acute myocardial infarction: results of a nationwide multiple-factorial population study
Claeys, Marc J; Coenen, Sarah; Colpaert, Charlotte et al

in Acta Cardiologica (2015), 70

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See detailTreatment and clinical outcomes of transcatheter heart valve thrombosis.
Latib, Azeem; Naganuma, Toru; Abdel-Wahab, Mohamed et al

in Circulation. Cardiovascular interventions (2015), 8(4),

BACKGROUND: Valve thrombosis has yet to be fully evaluated after transcatheter aortic valve implantation. This study aimed to report the prevalence, timing, and treatment of transcatheter heart valve (THV ... [more ▼]

BACKGROUND: Valve thrombosis has yet to be fully evaluated after transcatheter aortic valve implantation. This study aimed to report the prevalence, timing, and treatment of transcatheter heart valve (THV) thrombosis. METHODS AND RESULTS: THV thrombosis was defined as follows (1) THV dysfunction secondary to thrombosis diagnosed based on response to anticoagulation therapy, imaging modality or histopathology findings, or (2) mobile mass detected on THV suspicious of thrombus, irrespective of dysfunction and in absence of infection. Between January 2008 and September 2013, 26 (0.61%) THV thromboses were reported out of 4266 patients undergoing transcatheter aortic valve implantation in 12 centers. Of the 26 cases detected, 20 were detected in the Edwards Sapien/Sapien XT cohort and 6 in the Medtronic CoreValve cohort. In patients diagnosed with THV thrombosis, the median time to THV thrombosis post-transcatheter aortic valve implantation was 181 days (interquartile range, 45-313). The most common clinical presentation was exertional dyspnea (n=17; 65%), whereas 8 (31%) patients had no worsening symptoms. Echocardiographic findings included a markedly elevated mean aortic valve pressure gradient (40.5+/-14.0 mm Hg), presence of thickened leaflets or thrombotic apposition of leaflets in 20 (77%) and a thrombotic mass on the leaflets in the remaining 6 (23%) patients. In 23 (88%) patients, anticoagulation resulted in a significant decrease of the aortic valve pressure gradient within 2 months. CONCLUSIONS: THV thrombosis is a rare phenomenon that was detected within the first 2 years after transcatheter aortic valve implantation and usually presented with dyspnea and increased gradients. Anticoagulation seems to have been effective and should be considered even in patients without visible thrombus on echocardiography. [less ▲]

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See detailOne-year clinical outcomes after sirolimus-eluting coronary stent implantation in diabetics enrolled in the worldwide e-SELECT registry.
Bartorelli, Antonio L.; Egidy Assenza, Gabriele; Abizaid, Alexandre et al

in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (2015)

BACKGROUND: Diabetes mellitus has worse outcome after percutaneous coronary intervention. AIM: We assessed stent thrombosis (ST), major adverse cardiac events (MACE), and major bleeding rates at 1 year ... [more ▼]

BACKGROUND: Diabetes mellitus has worse outcome after percutaneous coronary intervention. AIM: We assessed stent thrombosis (ST), major adverse cardiac events (MACE), and major bleeding rates at 1 year after implantation of sirolimus-eluting stents (SES) in patients with diabetes mellitus in a large multicenter registry. METHODS: From May 2006 to April 2008, 15,147 unselected consecutive patients were enrolled at 320 centers in 56 countries in a prospective, observational registry after implantation of >/= 1 SES. Source data were verified in 20% randomly chosen patients at > 100 sites. Adverse events were adjudicated by an independent Clinical Event Committee. RESULTS: Complete follow-up at 1 year was obtained in 13,693 (92%) patients, 4,577 (30%) of whom were diabetics. Within diabetics, 1,238 (9%) were insulin-treated diabetics (ITD). Diabetics were older (64 vs. 62 years, P < 0.001), with higher incidence of major coronary risk factors, co-morbidities, and triple-vessel coronary artery disease. Coronary lesions had smaller reference vessel diameter (2.88 +/- 0.46 vs. 2.93 +/- 0.45 mm, P < 0.001) and were more often heavily calcified (26.1% vs. 22.6%, P < 0.001). At 1 year, diabetics had higher MACE rate (6.8% vs. 3.9%, P < 0.001) driven by ITD (10.6% vs. 5.5%, P < 0.001). Finally, diabetics had significant increase in ST (1.7% vs. 0.7%, P < 0.001), principally owing to ITD (3.4% vs. 1.1%, P < 0.001). There was an overall low risk of major bleeding during follow-up, without significant difference among subgroups. CONCLUSIONS: In the e-SELECT registry, diabetics represented 30% of patients undergoing SES implantation and had significantly more co-morbidities and complex coronary lesions. Although 1-year follow-up documented good overall outcome in diabetics, higher ST and MACE rates were observed, mainly driven by ITD. (c) 2015 Wiley Periodicals, Inc. [less ▲]

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See detailSummary 2014 ESC guidelines.
Claeys, Marc J.; LEGRAND, Victor ULg; Mairesse, Georges H. et al

in Acta cardiologica (2015), 70(1), 73-9

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See detailThe STIB score: a simple clinical test to predict clopidogrel resistance.
Legrand, Delphine; Barbato, Emanuele; Chenu, Patrick et al

in Acta Cardiologica (2015), 70

STIB HPR score allows identification of patients with a high probability of resistance to clopidogrel based on diabetes, Hb<13.9g/dl and BMI > 28kg/m². This bedside clinical test could be useful for the ... [more ▼]

STIB HPR score allows identification of patients with a high probability of resistance to clopidogrel based on diabetes, Hb<13.9g/dl and BMI > 28kg/m². This bedside clinical test could be useful for the indentification of patients in whom another P2Y12 inhibitor should be recommended before and after PCI. [less ▲]

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See detailOne-year outcomes in 1,010 unselected patients treated with the PROMUS Element everolimus-eluting stent: the multicentre PROMUS Element European Post-Approval Surveillance Study
Thomas, MR; Birkemeyer, R; Schwimmbeck, P et al

in EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2015), 10

Aims: The PROMUS™ Element™ European Post-Approval Surveillance Study (PE-Prove) is a prospective, open-label, multicentre observational study designed to assess outcomes following PROMUS Element ... [more ▼]

Aims: The PROMUS™ Element™ European Post-Approval Surveillance Study (PE-Prove) is a prospective, open-label, multicentre observational study designed to assess outcomes following PROMUS Element everolimus-eluting stent implantation in an unselected patient population. Methods and results: A total of 1,010 patients were enrolled at 40 clinical sites in Europe, including 24.9% with medically treated diabetes, 50.0% with Type B2/C lesions, 6.1% with chronic total occlusion, 17.8% with acute myocardial infarction (MI ≤24 hours pre-procedure), and 20.1% with unstable angina. The target lesion was the culprit for ST-segment elevation MI in 7.3% of patients. The one-year, per patient target vessel failure rate was 6.2% (60/975), 3.4% (33) being related to the PROMUS Element stent. Rates of cardiac death, MI, and Academic Research Consortium (ARC) definite/probable stent thrombosis were 1.7%, 3.5%, and 0.6%, respectively. The target vessel revascularisation rate was 3.2% (31/975), 2.1% (20) being related to the PROMUS Element stent. Conclusions: In a large and relatively complex group of “real-world” patients, coronary artery revascularisation with the PROMUS Element everolimus-eluting stent provides favourable results with low event rates consistent with those reported for other contemporary drug-eluting stents. [less ▲]

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See detailImpact of gender difference in hospital outcomes following percutaneous coronary intervention. Results of the Belgian Working Group on Interventional Cardiology (BWGIC) registry
LEMPEREUR, Mathieu ULg; Magne, Julien; Cornelis, Kristoff et al

in EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2014)

Aims: To determine whether there are gender-based differences in in-hospital outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods and results: We studied a large cohort ... [more ▼]

Aims: To determine whether there are gender-based differences in in-hospital outcomes among patients undergoing percutaneous coronary intervention (PCI). Methods and results: We studied a large cohort using clinical data from a registry of 130,985 PCI procedures in Belgium, from January 2006 to February 2011. Compared to males, females were significantly older (70.3 vs. 64.8 years), and were more frequently diabetic or hypertensive. Men smoked more and more frequently had previous myocardial infarction (MI), previous PCI or previous coronary artery bypass graft (CABG) surgery. Coronary artery disease (CAD) was less severe in women, and PCI to the left anterior descending artery was more common in female patients. Unadjusted in-hospital mortality rates were higher in females versus males (2.5% for women and 1.6% for men, p<0.0001). After multivariable analysis, female gender remained an independent predictor of mortality (odds ratio 1.35, 95% CI: 1.22-1.49, p<0.0001). Conclusions: Gender-based differences in hospital mortality rates after PCI were observed in this large registry. Female sex remained an independent predictor of mortality after multivariable adjustment. [less ▲]

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See detailProjected inhibition of platelet aggregation with ticagrelor twice daily vs. clopidogrel once daily based on patient adherence data (the TWICE project)
Vrijens, Bernard ULg; Claeys, M.J.; LEGRAND, Victor ULg et al

in British Journal of Clinical Pharmacology (2014), 77(5), 746-755

Abstract Aim Twice daily dosing is often perceived as inferior to once daily dosing due to a higher likelihood of missing a dose. However, more important is the extent to which drug action is maintained ... [more ▼]

Abstract Aim Twice daily dosing is often perceived as inferior to once daily dosing due to a higher likelihood of missing a dose. However, more important is the extent to which drug action is maintained when doses are delayed or missed. We compared the estimated inhibition of platelet aggregation (eIPA) for ticagrelor twice daily and clopidogrel once daily, based on their pharmacokinetic/ pharmacodynamic relationships and patient dosing history data. Methods Drug dosing histories of 5014 patients prescribed cardiovascular medications (primarily antihypertensive medicines) were extracted from an electronically compiled dosing history database. eIPA levels were simulated for 677 twice daily and 677 once daily dosing histories over a 30 day period, based on published onset/offset models for ticagrelor and clopidogrel IPA characteristics. Results While many patients treated twice daily missed at least one dose in 30 days, only 25.7% missed two consecutive doses. By comparison, 46.8% of patients treated once daily missed at least one dose. Simulations based on patient adherence over time showed that the average mean eIPA for ticagrelor twice daily remained significantly higher than for clopidogrel once daily (81.1% vs. 55.0%, P < 0.001). Ticagrelor twice daily patients had an eIPA below 10% for 0.20% of the 30 day period compared with 2.05% for clopidogrel once daily (P = 0.0001). Conclusions The projected level of platelet inhibition remained higher for ticagrelor twice daily than clopidogrel once daily, mainly due to the higher eIPA level achieved with ticagrelor and the relatively low likelihood of missing two consecutive twice daily doses. This modelling and simulation study suggests a therapeutic benefit of ticagrelor over clopidogrel when taking into account the most common dosing omissions. © 2013 The British Pharmacological Society. [less ▲]

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See detailTreatment of aortic stenosis with a self-expanding transcatheter valve: the International Multi-centre ADVANCE Study
Linke, Axel; Wenaweser, Peter; Gerckens, Ulrich et al

in European Heart Journal (2014)

Aim Transcatheter aortic valve implantation has become an alternative to surgery in higher risk patients with symptomatic aortic stenosis. The aim of the ADVANCE study was to evaluate outcomes following ... [more ▼]

Aim Transcatheter aortic valve implantation has become an alternative to surgery in higher risk patients with symptomatic aortic stenosis. The aim of the ADVANCE study was to evaluate outcomes following implantation of a self-expanding transcatheter aortic valve system in a fully monitored, multi-centre ‘real-world’ patient population in highly experienced centres. Methods and results Patients with severe aortic stenosis at a higher surgical risk inwhomimplantation of theCoreValve Systemwas decided by the Heart Teamwere included. Endpointswere a composite of major adverse cardiovascular and cerebrovascular events (MACCE; all-cause mortality, myocardial infarction, stroke, or reintervention) and mortality at 30 days and 1 year. Endpoint- related eventswere independently adjudicated based on Valve AcademicResearch Consortiumdefinitions.Atotal of 1015 patients [mean logistic EuroSCORE 19.4+12.3% [median (Q1,Q3), 16.0% (10.3, 25.3%)], age 81+6 years] were enrolled. Implantation of the CoreValve System led to a significant improvement in haemodynamics and an increase in the effective aortic valve orifice area. At 30 days, theMACCErate was 8.0% (95% CI: 6.3–9.7%), all-cause mortalitywas 4.5% (3.2–5.8%), cardiovascular mortality was 3.4% (2.3–4.6%), and the rate of stroke was 3.0% (2.0–4.1%). The lifethreatening or disabling bleeding rate was 4.0% (2.8–6.3%). The 12-month rates of MACCE, all-cause mortality, cardiovascular mortality, and stroke were 21.2% (18.4–24.1%), 17.9% (15.2–20.5%), 11.7% (9.4–14.1%), and 4.5% (2.9–6.1%), respectively. The 12-month rates of all-cause mortality were 11.1, 16.5, and 23.6% among patients with a logistic Euro- SCORE ≤10%, EuroSCORE 10–20%, and EuroSCORE .20% (P , 0.05), respectively. Conclusion The ADVANCE study demonstrates the safety and effectiveness of the CoreValve System with low mortality and stroke rates in higher risk real-world patients with severe aortic stenosis. [less ▲]

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See detailWhen the heart has its reason: the Takotsubo Syndrome
DAVIN, Laurent ULg; LEGRAND, Victor ULg; LANCELLOTTI, Patrizio ULg et al

in Acta Psychiatrica Belgica (2014)

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See detailContribution du scanner coronaire au diagnostic de maladie coronarienne.
PIRLET, Charles ULg; Pierard, Luc ULg; Lancellotti, Patrizio ULg et al

in Revue medicale de Liege (2014), 69(7-8), 422-7

Coronary computed tomography is an emerging technique for the diagnosis of coronary heart disease. Based on a clinical case, we discuss the diagnostic evaluation of chest pain and the role of coronary CT.

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See detailDepth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study.
Lenders, Guy D.; Collas, Valerie; Hernandez, Jose Maria et al

in International journal of cardiology (2014)

BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However ... [more ▼]

BACKGROUND: Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However, conduction disturbances and the need for Permanent Pacemaker (PPM) implantation after TAVI with the CoreValve prosthesis still remain frequent. METHODS AND RESULTS: We aimed to evaluate the implantation depth, the incidence and predictors of new conduction disturbances, and the need for PPM implantation within the first month after TAVI, using the new Accutrak CoreValve delivery system (ACV), compared to the previous generation CoreValve (non-ACV). In 5 experienced TAVI-centers, a total of 120 consecutive non-ACV and 112 consecutive ACV patients were included (n=232). The mean depth of valve implantation (DVI) was 8.4+/-4.0mm in the non-ACV group and 7.1+/-4.0mm in the ACV group (p=0.034). The combined incidence of new PPM implantation and new LBBB was 71.2% in the non-ACV group compared to 50.5% in the ACV group (p=0.014). DVI (p=0.002), first degree AV block (p=0.018) and RBBB (p<0.001) were independent predictors of PPM implantation. DVI (p<0.001) and pre-existing first degree AV-block (p=0.021) were identified as significant predictors of new LBBB. CONCLUSION: DVI is an independent predictor of TAVI-related conduction disturbances and can be reduced by using the newer CoreValve Accutrak delivery system, resulting in a significantly lower incidence of new LBBB and new PPM implantation. [less ▲]

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See detailPlatelet reactivity and cardiovascular events after percutaneous coronary intervention in patients with stable coronary artery disease: the Stent Thrombosis In Belgium (STIB) trial
LEGRAND, Victor ULg; CUISSET, T; CHENU, P et al

in EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology (2014), 10

PR measured before PCI in stable patients undergoing elective PCI who are preloaded with 500 mg of aspirin and 600 mg of clopidogrel is not predictive of periprocedural myocardial injury or adverse ... [more ▼]

PR measured before PCI in stable patients undergoing elective PCI who are preloaded with 500 mg of aspirin and 600 mg of clopidogrel is not predictive of periprocedural myocardial injury or adverse ischaemic complications up to 30 days. [less ▲]

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