Aldosterone and long-term outcome after myocardial infarction : A substudy of the french nationwide Observatoire sur la Prise en charge hospitalière, l'Evolution à un an et les caRactéristiques de patients présentant un infArctus du myocarde avec ou sans onde Q (OPERA) study
Identifieur interne : 001245 ( Main/Exploration ); précédent : 001244; suivant : 001246Aldosterone and long-term outcome after myocardial infarction : A substudy of the french nationwide Observatoire sur la Prise en charge hospitalière, l'Evolution à un an et les caRactéristiques de patients présentant un infArctus du myocarde avec ou sans onde Q (OPERA) study
Auteurs : Farzin Beygui [France] ; Gilles Montalescot [France] ; Eric Vicaut [France] ; Stephanie Rouanet [France] ; Eric Van Belle [France] ; Cathrine Baulac [France] ; Alexia Degrandsart [France] ; Jean Dallongeville [France]Source :
- The American heart journal [ 0002-8703 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
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Abstract
Background High plasma aldosterone levels at presentation are correlated to poor outcome after ST elevation acute myocardial infarction (AMI). Whether there is a relationship between aldosterone levels and outcome in a broader spectrum of patients admitted for AMI defined by the new definition based on troponin levels remains unknown. Methods Plasma aldosterone, C-reactive protein, and brain natriuretic peptide (BNP) were measured in 471 patients, 24 and 72 hours after admission for AMI defined by the new definition. The primary outcome was the composite of death, resuscitated cardiac arrest, recurrent/extended myocardial infarction, recurrent ischemia, heart failure, and stroke. Results The highest aldosterone levels quartile at 24 hours was significantly associated with the occurrence of the primary outcome (P <.0001), death (P <.05), heart failure (P <.05), ventricular (P <.0001) and supraventricular arrhythmias (P <.05), and acute renal failure (P <.01) during the in-hospital period, and higher rates of mortality (P < .05) at 1-year follow-up. Independent correlates of the primary outcome at 1 year were age >73 (odds ratio [OR] 2.22 [1.38-3.57]), heart failure (OR 6.46 [1.99-20.98]), 24-hour aldosterone ≥103.6 pg.mL-1 (OR 1.72 [1.07-2.77]), and BNP >389 pg.mL-1 (OR 2.35 [1.44-3.84]) concentrations. The model applied to the 72-hour variables, identified the same correlates. Conclusions Using the new definition of AMI, based on troponin levels, regardless of ST-segment elevation and management strategies, high aldosterone concentration is associated with major adverse in-hospital events and is an independent correlate of clinical outcome at 1 year. These findings warrant trials assessing the benefit of early aldosterone blockade in such patients.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Aldosterone and long-term outcome after myocardial infarction : A substudy of the french nationwide Observatoire sur la Prise en charge hospitalière, l'Evolution à un an et les caRactéristiques de patients présentant un infArctus du myocarde avec ou sans onde Q (OPERA) study</title><author><name sortKey="Beygui, Farzin" sort="Beygui, Farzin" uniqKey="Beygui F" first="Farzin" last="Beygui">Farzin Beygui</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cardiologie and INSERM U856, Pitié-Salpétrière University Hospital, APHP</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cardiologie and INSERM U856, Pitié-Salpétrière University Hospital, APHP</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Vicaut, Eric" sort="Vicaut, Eric" uniqKey="Vicaut E" first="Eric" last="Vicaut">Eric Vicaut</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Hopital F. VIDAL</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Rouanet, Stephanie" sort="Rouanet, Stephanie" uniqKey="Rouanet S" first="Stephanie" last="Rouanet">Stephanie Rouanet</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>THERAPHARM Recherches</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Van Belle, Eric" sort="Van Belle, Eric" uniqKey="Van Belle E" first="Eric" last="Van Belle">Eric Van Belle</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Hôpital Cardiologique</s1><s2>Lille</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Baulac, Cathrine" sort="Baulac, Cathrine" uniqKey="Baulac C" first="Cathrine" last="Baulac">Cathrine Baulac</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Laboratoires PFIZER</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Degrandsart, Alexia" sort="Degrandsart, Alexia" uniqKey="Degrandsart A" first="Alexia" last="Degrandsart">Alexia Degrandsart</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Laboratoires PFIZER</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dallongeville, Jean" sort="Dallongeville, Jean" uniqKey="Dallongeville J" first="Jean" last="Dallongeville">Jean Dallongeville</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Institut Pasteur</s1><s2>Lille</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Lille</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0215048</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0215048 INIST</idno><idno type="RBID">Pascal:09-0215048</idno><idno type="wicri:Area/PascalFrancis/Corpus">000244</idno><idno type="wicri:Area/PascalFrancis/Curation">000304</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000204</idno><idno type="wicri:doubleKey">0002-8703:2009:Beygui F:aldosterone:and:long</idno><idno type="wicri:Area/Main/Merge">001259</idno><idno type="wicri:Area/Main/Curation">001245</idno><idno type="wicri:Area/Main/Exploration">001245</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Aldosterone and long-term outcome after myocardial infarction : A substudy of the french nationwide Observatoire sur la Prise en charge hospitalière, l'Evolution à un an et les caRactéristiques de patients présentant un infArctus du myocarde avec ou sans onde Q (OPERA) study</title><author><name sortKey="Beygui, Farzin" sort="Beygui, Farzin" uniqKey="Beygui F" first="Farzin" last="Beygui">Farzin Beygui</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cardiologie and INSERM U856, Pitié-Salpétrière University Hospital, APHP</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institut de Cardiologie and INSERM U856, Pitié-Salpétrière University Hospital, APHP</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Vicaut, Eric" sort="Vicaut, Eric" uniqKey="Vicaut E" first="Eric" last="Vicaut">Eric Vicaut</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Hopital F. VIDAL</s1><s2>Paris</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Rouanet, Stephanie" sort="Rouanet, Stephanie" uniqKey="Rouanet S" first="Stephanie" last="Rouanet">Stephanie Rouanet</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>THERAPHARM Recherches</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Van Belle, Eric" sort="Van Belle, Eric" uniqKey="Van Belle E" first="Eric" last="Van Belle">Eric Van Belle</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Hôpital Cardiologique</s1><s2>Lille</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Baulac, Cathrine" sort="Baulac, Cathrine" uniqKey="Baulac C" first="Cathrine" last="Baulac">Cathrine Baulac</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Laboratoires PFIZER</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Degrandsart, Alexia" sort="Degrandsart, Alexia" uniqKey="Degrandsart A" first="Alexia" last="Degrandsart">Alexia Degrandsart</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Laboratoires PFIZER</s1><s2>Paris</s2><s3>FRA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dallongeville, Jean" sort="Dallongeville, Jean" uniqKey="Dallongeville J" first="Jean" last="Dallongeville">Jean Dallongeville</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Institut Pasteur</s1><s2>Lille</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Lille</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">The American heart journal</title><title level="j" type="abbreviated">Am. heart j.</title><idno type="ISSN">0002-8703</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The American heart journal</title><title level="j" type="abbreviated">Am. heart j.</title><idno type="ISSN">0002-8703</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aldosterone</term><term>Cardiology</term><term>Cardiovascular disease</term><term>Circulatory system</term><term>Evolution</term><term>Human</term><term>Long term</term><term>Myocardial infarction</term><term>Prognosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Infarctus du myocarde</term><term>Pathologie de l'appareil circulatoire</term><term>Aldostérone</term><term>Long terme</term><term>Pronostic</term><term>Evolution</term><term>Homme</term><term>Appareil circulatoire</term><term>Cardiologie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background High plasma aldosterone levels at presentation are correlated to poor outcome after ST elevation acute myocardial infarction (AMI). Whether there is a relationship between aldosterone levels and outcome in a broader spectrum of patients admitted for AMI defined by the new definition based on troponin levels remains unknown. Methods Plasma aldosterone, C-reactive protein, and brain natriuretic peptide (BNP) were measured in 471 patients, 24 and 72 hours after admission for AMI defined by the new definition. The primary outcome was the composite of death, resuscitated cardiac arrest, recurrent/extended myocardial infarction, recurrent ischemia, heart failure, and stroke. Results The highest aldosterone levels quartile at 24 hours was significantly associated with the occurrence of the primary outcome (P <.0001), death (P <.05), heart failure (P <.05), ventricular (P <.0001) and supraventricular arrhythmias (P <.05), and acute renal failure (P <.01) during the in-hospital period, and higher rates of mortality (P < .05) at 1-year follow-up. Independent correlates of the primary outcome at 1 year were age >73 (odds ratio [OR] 2.22 [1.38-3.57]), heart failure (OR 6.46 [1.99-20.98]), 24-hour aldosterone ≥103.6 pg.mL<sup>-1</sup> (OR 1.72 [1.07-2.77]), and BNP >389 pg.mL<sup>-1</sup> (OR 2.35 [1.44-3.84]) concentrations. The model applied to the 72-hour variables, identified the same correlates. Conclusions Using the new definition of AMI, based on troponin levels, regardless of ST-segment elevation and management strategies, high aldosterone concentration is associated with major adverse in-hospital events and is an independent correlate of clinical outcome at 1 year. These findings warrant trials assessing the benefit of early aldosterone blockade in such patients.</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Lille</li><li>Paris</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Beygui, Farzin" sort="Beygui, Farzin" uniqKey="Beygui F" first="Farzin" last="Beygui">Farzin Beygui</name></noRegion><name sortKey="Baulac, Cathrine" sort="Baulac, Cathrine" uniqKey="Baulac C" first="Cathrine" last="Baulac">Cathrine Baulac</name><name sortKey="Dallongeville, Jean" sort="Dallongeville, Jean" uniqKey="Dallongeville J" first="Jean" last="Dallongeville">Jean Dallongeville</name><name sortKey="Degrandsart, Alexia" sort="Degrandsart, Alexia" uniqKey="Degrandsart A" first="Alexia" last="Degrandsart">Alexia Degrandsart</name><name sortKey="Montalescot, Gilles" sort="Montalescot, Gilles" uniqKey="Montalescot G" first="Gilles" last="Montalescot">Gilles Montalescot</name><name sortKey="Rouanet, Stephanie" sort="Rouanet, Stephanie" uniqKey="Rouanet S" first="Stephanie" last="Rouanet">Stephanie Rouanet</name><name sortKey="Van Belle, Eric" sort="Van Belle, Eric" uniqKey="Van Belle E" first="Eric" last="Van Belle">Eric Van Belle</name><name sortKey="Vicaut, Eric" sort="Vicaut, Eric" uniqKey="Vicaut E" first="Eric" last="Vicaut">Eric Vicaut</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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