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Articles by Patrick Rossignol
Aprocitentan in Patients With Chronic Kidney Disease and Resistant Hypertension
NOVELTY AND RELEVANCE This is the first report on aprocitentan, a drug targeting the endothelin pathway, in patients with chronic kidney disease and resistant hypertension, a group of difficult-to-treat patients with a high risk of morbidity and mortality and limited treatment options.
Safety and efficacy of steroidal mineralocorticoid receptor antagonists in patients with kidney failure requiring dialysis: a systematic review and meta-analysis of randomised controlled trials
Get full text access Log in, subscribe or purchase for full access. References 1. Bikbov, B ∙ Purcell, CA ∙ Levey, AS ∙ et al., the GBD Chronic Kidney Disease Collaboration Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 Lancet. 2020; 395:709-733 2. Foreman, KJ ∙ Marquez, N ∙ Dolgert, A ∙ et al.
Spironolactone in patients on chronic haemodialysis at high risk of adverse cardiovascular outcomes (ALCHEMIST): a multicentre, double-blind, randomised, placebo-controlled trial and updated meta-analysis
aAssociation ALTIR, Nancy, France bAssociation pour l'Utilisation du Rein Artificiel, Paris, France cAssociation AURAL-Strasbourg, Haguenau, France dAssociation AURAL-Strasbourg, Mulhouse, France eAssociation AURAL-Strasbourg, Strasbourg, France fAssociation ALURAD, Limoges, France gErasme University Hospital, Brussels, Belgium hRISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal iUniversity Paul Sabatier, INSERM UMR 1291, Toulouse...
Spironolactone in patients on chronic haemodialysis at high risk of adverse cardiovascular outcomes (ALCHEMIST): a multicentre, double-blind, randomised, placebo-controlled trial and updated meta-analysis
Get full text access Log in, subscribe or purchase for full access. References 1. Ortiz, A ∙ Covic, A ∙ Fliser, D ∙ et al. Epidemiology, contributors to, and clinical trials of mortality risk in chronic kidney failure Lancet. 2014; 383:1831-1843 2. Rossignol, P ∙ Frimat, L ∙ Zannad, F The safety of mineralocorticoid antagonists in maintenance hemodialysis patients: two steps forward Kidney Int. 2019; 95:747-749 3. Drechsler, C ∙ Ritz, E ∙ Tomaschitz, A ∙ et al.
Albuminuria as a diagnostic criterion and a therapeutic target in heart failure and other cardiovascular disease
Introduction Individually, chronic kidney disease (CKD) and cardiovascular disease (CVD) are associated with substantial global disease burden.1, 2 Pre-existing CKD increases the risk of developing CVD and heart failure (HF) (Figure 1).3-14 CKD is also highly prevalent in people with CVD, and is the cause of approximately 1.9 million cardiovascular (CV)-related deaths annually.15 Approximately 50% of people with stage G4–5 CKD (estimated glomerular filtration rate [eGFR] 15–29 ml/min/1.73 m2...
Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial - Hypertension Research
Abstract None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to usual treatment with or without spironolactone (25–50 mg/day). The current substudy included 113 controls and 114 patients assigned spironolactone, who all completed the incremental shuttle walk test at baseline and months 1 and 9.
Fast Five Quiz: Chronic Kidney Disease Differential Diagnosis
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Chronic kidney disease, or CKD, is a progressive condition that affects over 800 million people worldwide. It is a leading cause of mortality, and prevalence is expected to rise owing to the aging population.
Fast Five Quiz: Chronic Kidney Disease Diagnostic Tests
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Chronic kidney disease (CKD) is a complex syndrome characterized by renal dysfunction that can lead to end-stage kidney disease. Despite its high global prevalence, the majority of cases are not detected until patients are in advanced stages, as early kidney disease is often clinically silent.
Desafio diagnóstico: Mulher de 69 anos com deficiência de ferro e piora da insuficiência cardíaca
close Tem certeza que quer sair? Sair Cancelar Uma paciente de 69 anos foi internada no hospital com piora aguda da insuficiência cardíaca e deficiência de ferro, necessitando de suporte inotrópico. Ela tem 1,68 m de altura, pesa 65,8 kg e seu índice de massa corporal é de 23,4 kg/m2. Sua frequência cardíaca era de 98 batimentos por minuto e ritmo sinusal; frequência respiratória de 24 incursões por minuto; pressão arterial de 100 × 50 mmHg e temperatura de 36,7 °C.
A Woman With HF and Iron Deficiency
Authors and Disclosures Marco Guazzi, MD, PhD Professor of Cardiology, University of Milano; Head of Heart Failure Unit, Cardiology Division at IRCCS, San Donato University Hospital, Milano, Italy Disclosure: Marco Guazzi, MD, PhD, has disclosed the following relevant financial relationships: Serve(d) as an advisor or consultant for: Acceleron; Merck; Novartis Serve(d) as a speaker or a member of a speakers bureau for: Novartis Patrick Rossignol, MD Chef de Service de Spécialités Médicales et...
Congestion in heart failure: a circulating biomarker‐based perspective. A review from the Biomarkers Working Group of the Heart Failure Association, European Society of Cardiology
Congestion in heart failure (HF) is defined as signs and symptoms of extracellular fluid accumulation that result from increased cardiac filling pressures.1 It is induced and perpetuated by an imbalance between neurohormonal axes with opposite actions: sodium/water retention and vasoconstriction (mainly adrenergic, renin–angiotensin–aldosterone, and vasopressin systems) versus natriuretic and vasodilatation (mainly cardiac endocrine function).1-4 Congestion is also a central component in the...
Fast Five Quiz: Chronic Kidney Disease and Heart Failure
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Chronic kidney disease (CKD) is a progressive condition that affects > 800 million individuals worldwide. Heart failure is common in patients with CKD and can be both a cause and a consequence of CKD.
The Association of Smoking with Hospitalization and Mortality Differs According to Sex in Patients with Heart Failure Following Myocardial Infarction
Introduction Smoking is a major risk factor for coronary heart disease (CHD), cerebrovascular disease, and atherosclerotic cardiovascular disease.1 It increases all-cause and cardiovascular mortality.2 In patients with established CHD, persistent smoking increases the risk of reinfarction, sudden cardiac death, and overall mortality.3,4 In contrast, smokers have been observed to have lower mortality rates following acute myocardial infarction (MI) in unadjusted analysis; a phenomenon that is...
RAAS Inhibition Enablement as a Therapeutic Target in CKD
Renin–angiotensin–aldosterone system inhibitor (RAASi) use is of paramount importance in patients with diabetes, hypertension, heart failure and reduced ejection fraction (HFrEF) [the latter frequently treated with a combination of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and mineralocorticoid receptor antagonists (MRAs)] and chronic kidney disease (CKD) with albuminuria.
Interplay between worsening kidney function and cardiovascular events in patients with type 2 diabetes: an analysis from the ACCORD trial
Cardiovascular and metabolic risk Interplay between worsening kidney function and cardiovascular events in patients with type 2 diabetes: an analysis from the ACCORD trial http://orcid.org/0000-0002-2304-6138João Pedro Ferreira1,2, Diana Ferrao2, Patrick Rossignol1, Faiez Zannad1, Abhinav Sharma3, Francisco Vasques-Novoa2, Adelino Leite-Moreira2 1Université de Lorraine, Inserm, Centre d'Investigations Cliniques, - Plurithématique 14-33, Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and...
Patiromer to Enable Spironolactone in Patients with Resistant Hypertension and Chronic Kidney Disease (AMBER)
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The Best of Both Worlds in HFrEF
The concomitant use of multiple medicines in an individual patient is referred to as polypharmacy. Polypharmacy is commonly used in patients with multiple comorbidities, as each medication may be useful to treat each comorbid condition. Polypharmacy has had bad publicity, because it is commonly associated with high rates of adverse outcomes and multiple poorly understood pharmacological interactions.
Fast Five Quiz: Chronic Kidney Disease (CKD) Management
close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Chronic kidney disease (CKD) is defined as a persistent abnormality in kidney structure or function (ie, persistent estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 or persistent urine albumin-to-creatinine ratio (ACR) ≥30 mg/g) for more than 3 months.
Mineralocorticoid Receptor Antagonists and SGLT2 Inhibitor Therapy: The Best of Both Worlds in HFrEF ∗
Introduction The concomitant use of multiple medicines in an individual patient is referred to as polypharmacy. Polypharmacy is commonly used in patients with multiple comorbidities, as each medication may be useful to treat each comorbid condition. Polypharmacy has had bad publicity, because it is commonly associated with high rates of adverse outcomes and multiple poorly understood pharmacological interactions.
Challenges of Cardio-Kidney Composite Outcomes in Large-Scale Clinical Trials
Ravi B. Patel Ravi B. Patel https://orcid.org/0000-0001-5037-5554 Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL , , João Pedro Ferreira João Pedro Ferreira https://orcid.org/0000-0002-2304-6138 Université de Lorraine, INSERM, Centre d'Investigations Cliniques - 1433, INI CRCT, and INSERM U1116, CHRU Nancy, France , Finnian R. Mc Causland Finnian R.
Individual patient risk assessment and cost-benefit analysis of patiromer in AMBER - Authors' reply
Eoin O'Sullivan and Iain MacIntyre raise important questions about the relevance of the AMBER study, relating to individual-level decision making and the cost–benefit of our approach. 1 Agarwal R Rossignol P Romero A et al. Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial. Lancet.
Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): results in the pre‐specified subgroup with heart failure
Abstract Aims The AMBER trial demonstrated that concomitant use of patiromer enabled the more persistent use of spironolactone by reducing the risk of hyperkalaemia in patients with resistant hypertension and advanced chronic kidney disease. We report herein the pre‐specified subgroup analysis in patients with heart failure (HF).
Unravelling the interplay between hyperkalaemia, renin-angiotensin-aldosterone inhibitor use and clinical outcomes. Data from 9222 chronic heart failure patients of the ESC‐HFA‐EORP Heart Failure Long‐Term Registry - Rossignol - - European Journal of Hear
Research Article Patrick Rossignol Corresponding Author E-mail address: p.rossignol@chru‐nancy.fr Université de Lorraine, Centre d'Investigation Clinique Plurithématique 1433‐INSERM‐CHRU de Nancy, Inserm U1116 & FCRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France Corresponding author. Centre d'Investigations Cliniques‐INSERM‐CHRU de Nancy, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 Rue du Morvan, 54500 Vandoeuvre lès Nancy, France.
Hypo‐ and hyperkalaemia in heart failure. Navigating between Scylla and Charybdis
Editorial Comment Patrick Rossignol Corresponding Author E-mail address: p.rossignol@chru‐nancy.fr Université de Lorraine, Centre d'Investigation Clinique Plurithématique 1433 ‐ INSERM‐ CHRU de Nancy, Inserm U1116 & FCRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists), Vandoeuvre‐les‐Nancy, France Corresponding author. Centre d'Investigations Cliniques‐INSERM CHRU de Nancy, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 rue du Morvan, 54500 Vandoeuvre lès Nancy, France.
Cardiovascular risk associated with serum potassium in the context of mineralocorticoid receptor antagonist use in patients with heart failure and left ventricular dysfunction
Research Article Patrick Rossignol Corresponding Author E-mail address: p.rossignol@chru‐nancy.fr Université de Lorraine, Inserm, Centre d'Investigations Cliniques‐ Plurithématique 14‐33, and Inserm U1116, CHRU de Nancy, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France Corresponding author. Centre d'Investigations Cliniques‐INSERM CHRU de Nancy, Institut lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 rue du Morvan, 54500 Vandoeuvre Lès Nancy, France.
Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial
Summary Background Spironolactone is effective at reducing blood pressure in patients with uncontrolled resistant hypertension. However, the use of spironolactone in patients with chronic kidney disease can be restricted by hyperkalaemia. We evaluated use of the potassium binder patiromer to allow more persistent use of spironolactone in patients with chronic kidney disease and resistant hypertension.
Effect of the mineralocorticoid receptor antagonist eplerenone on liver fat and metabolism in patients with type 2 diabetes: a randomized, double‐blind, placebo‐controlled trial (MIRAD trial) - Johansen - - Diabetes, Obesity and Metabolism - Wiley Online
ORIGINAL ARTICLE Effect of the mineralocorticoid receptor antagonist eplerenone on liver fat and metabolism in patients with type 2 diabetes: a randomized, double‐blind, placebo‐controlled trial (MIRAD trial) Flemming Dela Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark Department of Geriatrics, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Copenhagen, Denmark Search for more papers by this...
Heart failure drug treatment
Summary Heart failure is the most common cardiovascular reason for hospital admission for people older than 60 years of age. Few areas in medicine have progressed as remarkably as heart failure treatment over the past three decades. However, progress has been consistent only for chronic heart failure with reduced ejection fraction.
Spironolactone effective as HFpEF treatment regardless of kidney function, but safety less clear
The efficacy of spironolactone in patients with HF with preserved ejection fraction was consistent across the range of kidney function, although adverse events were higher in those with chronic kidney disease, researchers reported. “These data supported use of spironolactone to treat HFpEF patients with advanced chronic kidney disease only when close laboratory surveillance is possible,” Iris E.
Fibrosis mechanistic phenotyping and antifibrotic response determination with biomarkers in heart failure: one single biomarker may not fit all settings - Rossignol - - European Journal of Heart Failure - Wiley Online Library
Corresponding Author E-mail address:p.rossignol@chru-nancy.fr Université de Lorraine, Inserm, Centre, d'Investigations Cliniques‐Plurithématique 14‐33, and Inserm U1116, Nancy CHRU, F‐CRIN INI‐CRCT (Cardiovascular and Renal Clinical Trialists)Nancy, France Corresponding author. Centre d'Investigations Cliniques‐INSERM CHU de Nancy, Institut Lorrain du Cœur et des Vaisseaux Louis Mathieu, 4 rue du Morvan, 54500 Vandoeuvre Lès Nancy, France.
Chronic Kidney Disease
Authors and Disclosures Vecihi Batuman, MD Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine, New Orleans, Louisiana; Chief, Renal Section, Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana Disclosure: Vecihi Batuman, MD, has disclosed no relevant financial relationships.
Impact of the interruption of a large heart failure regional disease management programme on hospital admission rates: a population‐based study
Inserm, CIC‐1433, CHRU de Nancy, Nancy, France UMR 1116, Université de Lorraine, Nancy, France Département de Médecine Générale, Université de Lorraine, Nancy, FranceSearch for more papers by this author
Heart rate prediction of outcome in heart failure following myocardial infarction depend on heart rhythm status an analysis from the high-risk myocardial infarction database initiative - International Journal of Cardiology
Publication HistoryPublished online: September 24, 2017Accepted: September 20, 2017; Received in revised form: August 22, 2017; Received: January 24, 2017;
Performing lung ultrasound at rest and/or after an exercise stress test to better identify high-risk ambulatory patients with heart failure
Previous article in Early View: Extracorporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): the need for a better definition of refractory cardiogenic shock Previous article in Early View: Extracorporeal membrane oxygenation in the therapy of cardiogenic shock (ECMO-CS): the need for a better definition of refractory cardiogenic shock Next article in Early View: Biomarkers and prognostication in heart failure with reduced and preserved ejection fraction: similar but...
National Kidney Foundation stakeholders’ conference will give patients a voice in setting research priorities
Getty Images/iStockphoto/ThinkStock The National Kidney Foundation will hold a Patient Centered Outcomes Research Stakeholders’ Conference in conjunction with the National Kidney Foundation Spring Clinical Meetings in Orlando in April, 2017. The conference will bring together 100 patients, caregivers, stakeholders and academics to identify patient-centered research priorities—and challenges—for kidney disease.
Air pollution linked to increased rates of kidney disease
Air pollution linked to increased rates of kidney disease Regions with high levels of fine particulate air pollution had the highest rates of membranous nephropathy in China A new study published the Journal of the American Society of Nephrology indicates that air pollution causes damage to the kidneys. Air pollution has become a serious problem in many cities in China, but the extent of its impact on individuals’ health is unclear.
AAKP accepting applications for Jenny Kitsen Patient Safety Award
AAKP accepting applications for Jenny Kitsen Patient Safety Award Applications for the Jenny Kitsen Patient Safety Award are available from the American Association of Kidney Patients. The deadline for submissions is quickly approaching – July 31, 2016. The Jenny Kitsen Patient Safety Award funds an annual lecture or presentation that will advance patient safety by exploring innovation in health systems management.
Representatives introduce bill to give ESRD patients access to Medicare Advantage
Representatives introduce bill to give ESRD patients access to Medicare Advantage Getty Images/iStockphoto/ThinkStock On July 8, Representatives Jason Smith, R-Missouri, John Lewis, D-Ga., Gus Bilirakis, R-Fla., and Kurt Schrader, D-Ore., introduced legislation that would give end-stage renal disease patients the choice to enroll in Medicare Advantage plans.
Heart failure with reduced ejection fraction
Introduction The heart failure pandemic Acute heart failure (AHF) is the most common cardiovascular reason for hospital admission of patients over the age of 60.1 Over 20% of patients who develop AHF die before they ever reach a hospital. Within 6 months after discharge from a HF admission, the mortality rate is 20% while the readmission rate is over 30%.
The association between serum potassium and mortality in patients with hypertension: ‘a wake-up call’
This editorial refers to ‘Short-term mortality risk of serum potassium levels in hypertension: a retrospective analysis of nationwide registry data’, by M. Krogager et al.
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