Risultati per: Position paper della French Headache Society sul trattamento dell'emicrania

Circulation, Volume 146, Issue Suppl_1, Page A13342-A13342, November 8, 2022. Introduction:Newly developed Systematic Coronary Risk Evaluation-2 (SCORE-2) and the version for older people [(SCORE2-OP) ≥70 years] algorithms for 10-yr incident cardiovascular disease (CVD) have been derived incorporating European and US populations. Its performance has not been externally validated in community-based populations representative of real-world clinical practice.Hypothesis:We tested the hypothesis that the SCORE-2 and SCORE2-OP algorithms will accurately estimate 10-yr risk of first-onset CVD in this population.Methods:Consecutive patients who, between 1998-2000, sought primary care in Olmsted county, MN, and were followed-up using the Rochester Epidemiology Project. Inclusion criteria were set as those used in the derivation of the original algorithm. The composite outcome of CVD was defined as first myocardial infarction, ischemic stroke, or cardiovascular mortality. We compared predicted and observed events and generated C-statistics across predefined risk subgroups.Results:We included 22,858 adults, mean age of 55.11±11.58 (13.50% >70 yr) 54% females. After a mean follow-up of 9.55±1.5 yr, 2,145 events were observed. 6.39% of subjects for SCORE-2 and 59.88% using SCORE2-OP were considered at high risk. Overall, the SCORE-2 had better discrimination than the SCORE2-OP (C-statistic: 0.72 and 0.64, respectively) (Fig B-D). The algorithms performed better in individuals 50-69 yr while underpredicting in younger individuals and overpredicting CVD in ages above 70 (in the low and moderate risk group) (Fig A-C). Prediction was mostly similar between men, women and middle-aged individuals but demonstrated pronounced underprediction in older men (Fig B-D).Conclusions:The SCORE-2 Risk prediction tool performed with marginal results whereas the SCORE2-OP had poor performance when predicting CVD events in a community cohort representing real-world clinical practice in a non-European population.

Circulation, Volume 146, Issue Suppl_1, Page A12737-A12737, November 8, 2022. Introduction:Carotid sinus massage (CSM) has been used to evaluate carotid sinus hypersensitivity. Its role in evaluating a vasodepressor response has not been well studied. CSM can also result in a vasodepressor response in the absence of significant bradycardia. Its role in predicting the subsequent outcome of head-up tilt testing (HUT) is not well defined.Hypothesis:A vasodepressor response elicited with baseline carotid sinus massage (CSM) may predict the subsequent outcome of HUT.Methods:In this prospective study Consecutive patients with a history suggestive of a reflex neurocardiogenic etiology underwent HUT. Patients underwent HUT testing using a standard protocol, including baseline CSM in the supine posture followed by HUT testing at 60 degrees for 30 minutes. If negative, a repeat of CSM was performed in the upright posture. Then, isoproterenol was infused in incremental dose 1 to 3 mcg/minute.Results:25 patients (20 females and 5 males) with a mean age of 52.87±6.77 years underwent HUT. 5 out of 25 (20%) patients had a positive tilt result for a vasodepressor response. 4 of these 5 patients had a significant vasodepressor response (symptomatic hypotension BP drop less than 30 mmHg) without significant bradycardia (HR less than 50 BPM) during CSM in the supine posture. Of these patients, 3 patients became positive during HUT and 1 patient became positive during isoproterenol infusion. The positive predictive value was 0.8. Sensitivity was 67%. 20 out of 25 (80%) patients had a negative tilt result for a vasodepressor response despite protocol completion. 18 of these 20 patients had no drop in BP during CSM and no significant bradycardia. The negative predictive value was 0.9. The specificity was 94.74%. 2 of these patients had a negative response on CSM but a borderline response at HUT with borderline symptoms with the isoproterenol. These 2 had a transient drop in BP when CSM was repeated at the end of 30 minutes during the head-up position.Conclusions:In this population of patients, a negative CSM in the supine posture predicted a subsequent negative Tilt test. Baseline CSM can be performed at the bedside and may obviate the need for full tilt table testing even for patients with a clinical diagnosis of reflex syncope (vasodepressor).

Circulation, Volume 146, Issue Suppl_1, Page A9901-A9901, November 8, 2022. Introduction:Postoperative atrial fibrillation (POAF) is associated with worse in-hospital and post-discharge morbidity and mortality. However, current estimates vary widely among published studies due to limited study centers and differing patient populations. The objective of this study was to assess the risk-adjusted in-hospital and 30-day post-discharge clinical outcomes associated with POAF in the United States.Methods:A contemporary, retrospective study was conducted using the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery database. The sample consisted of patients aged 40 to 90 who underwent open-chest coronary artery bypass and/or valvular surgery between 2011 to 2019. In-hospital and 30-day post-discharge clinical outcomes were compared between those who experienced POAF and those who did not (controls). Outcomes were risk-adjusted, where appropriate, for baseline demographics and prior medical and surgical history using a multivariable regression approach.Results:A total of 424,590 patients with a mean age of 69.3 (SD 9.2) years and 1,105,200 patients with a mean age of 64.8 (SD 10.2) years were identified in the POAF and control cohorts respectively, representing a POAF cumulative incidence of 27.8%. POAF patients experienced on average a postoperative length of stay that was 2.4 days longer (p < 0.001) and 32 additional hours (p < 0.001) in the intensive care unit compared to control patients. After risk adjustment, POAF was associated with 64% higher odds of in-hospital stroke (OR 1.64, 95% CI 1.59, 1.69), 158% higher odds of in-hospital renal failure (OR 2.58, 95% CI 2.52, 2.64), 29% higher odds of in-hospital mortality (OR 1.29, 95% CI 1.26, 1.32), 23% higher odds of 30-day readmission (OR 1.23 95% CI 1.21, 1.25), and 27% higher odds of 30-day mortality (OR 1.27, 95% CI 1.24, 1.30).Conclusions:POAF is associated with a significantly increased risk of both in-hospital and 30-days post-discharge morbidity and mortality. This study highlights the unmet need for more effective POAF prevention strategies.

Circulation, Volume 146, Issue Suppl_1, Page A10572-A10572, November 8, 2022. Introduction:Diversity and inclusion remain a concern in the field of cardiology. Female cardiologists have less opportunity to chair sessions in scientific meetings than men. However, cardiologists’ awareness and perspectives on feasibility of chairing sessions is poorly understood.Methods:A web-based survey on awareness regarding the commitment of chairing sessions was sent to 14,798 certificated cardiologists registered with the Japanese Circulation Society (JCS).Results:A total of 3,412 valid responses were obtained, including 523 women and 2,889 men. Female cardiologists exhibited less interest in serving as chairpersons in Japanese and English sessions (71% women vs. 82% men, P

Circulation, Volume 146, Issue Suppl_1, Page A9931-A9931, November 8, 2022. Introduction:Diversity of authors of the international Clinical Practice Guidelines (CPG) will ensure raising broader concerns and contributing different perspectives. There is lack of data regarding gender and global distribution of authors of cardiovascular CPG.Purpose:To assess gender and geographic distribution of authors of ESC CPG and compare these over the contemporary years (2015 – 2021) vs earlier years (prior to 2015).Methods:ESC website was searched to include CPG. Sex and affiliating country of authors were determined by searching ESC 365 platform, Google Scholar, ResearchGate, LinkedIn platforms, social media or author’s affiliating institution website.Results:Thirty-eight documents were analyzed (26 contemporary documents vs 12 earlier documents). The documents included 28 CPG and 10 non-CPG documents (i.e., position papers, expert consensus, scientific statements, or task force reports). Total number of authors =748, 18.85% were women (21.84% in contemporary documents vs 8.02% in earlier documents, p

Annals of Internal Medicine, Ahead of Print.

Studio esamina i dati di 13mila partecipanti

Annals of Internal Medicine, Ahead of Print.

Circulation, Volume 146, Issue 14, Page 1103-1104, October 4, 2022.

Introduction
Understanding the complexities of change in eating behaviours, mental health, well-being and weight is crucial to inform healthcare and service provision, particularly in light of the exacerbating effects of the COVID-19 pandemic. This study aims to address the need for more comprehensive cross-sectional and longitudinal evidence, by tracking eating behaviours, mental health, health related behaviours and weight over a 12-month period, in a sample of young adults (18–35 years) in the UK and Australia.

Methods and analysis
Online surveys administered via the Prolific online research platform will be used for data collection at baseline, 6 months and 12 months. The survey (approximately 45 min) measures demographics, the impact of COVID-19, body mass index (BMI), weight management and health service usage, eating behaviours, personality, mental health, and health-related behaviours. An optional substudy component at each time point aims to validate self-reported weight in the main survey through images. Study inclusion criteria are; aged 18–34 years at baseline, BMI ≥20 kg/m2, and residing in the UK or Australia. A target of 500 participants at baseline was set, recruited through Prolific, and with recruitment stratified by BMI, sex and country. The proposed analyses include creating static predictive models using baseline data (eg, using latent class analysis, factor analysis or similar), and mapping changes longitudinally (eg, using multivariate regressions). These analyses will enable changes in the study measures to be identified, as well as predictors and outcomes of change.

Ethics and dissemination
Ethical approval was granted by Leeds Beckett University, UK (reference number 86004) and the University of Newcastle, Australia (reference number H-2022–0110). Study findings will be disseminated through scientific journals, conferences, institute websites and social media, and briefings tailored to policy, practice and the public, with the intention to help inform the future development of health and well-being care and support for young adults across Australia and the UK.

Introduction
Sleep disorders are still often underestimated in patient care management even though they are present in the criteria of the American College of Rheumatology for the diagnosis of fibromyalgia syndrome (FMS). The objective of this study will be to assess the current situation of sleep disorders in patients with FMS in France and to estimate its prevalence.

Methods and analysis
The FIBOBS study is a multicentred, prospective, observational trial performed by 46 specialised chronic pain structures in France. Patients with FMS visiting for a first consultation or follow-up (if they have already been followed up for less than a year with a pain management service) will be included after giving their informed consent. Data will be collected through the physician questionnaire filled during the inclusion visit. Patient self-questionnaires will be completed from home. The primary outcome of the study will be to estimate the prevalence of sleep disorders classified into three categories: (a) poor sleep quality in general, (b) sleep apnoea syndrome and (c) restless legs syndrome, using self-administered questionnaires.

Ethics and dissemination
This protocol is approved by the ethics committee Comité de Protection des Personnes ‘Ile de France II’ in accordance with French regulations. The results will be disseminated through peer-reviewed journals and conferences.

Trial registration number
NCT04775368.