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The aim of this study was to evaluate post-percutaneous coronary intervention (PCI) outcomes in relation to pre-procedural glycated hemoglobin (HbA

) levels from a large, contemporary cohort.

There are limited data evaluating associations between HbA

, a marker of glycemic control, and ischemic risk following PCI.

All patients with known HbA

levels undergoing PCI at a single institution between 2009 and 2017 were included. Patients were divided into 5 groups on the basis of HbA

level≤5.5%, 5.6% to 6.0%, 6.1% to 7.0%, 7.1% to 8.0%, and >8.0%. The primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death or myocardial infarction (MI), at 1-year follow-up.

A total of 13,543 patients were included (HbA

≤5.5%, n=1,214; HbA

5.6% to 6.0%, n=2,202; HbA

6.1% to 7.0%, n=4,130; HbA

7.1% to 8.0%, n=2,609; HbA

>8.0%, n=3,388). selleck inhibitor Patients with both low (HbA

≤5.5%) and high (HbA

>8.0%) levels displayed an increased risk for MACE compared with those with values between 6.1% and 7.0%. Excess risk was driven primarily by higher rates of all-cause death among those with low HbA

levels, while higher values were strongly associated with greater MI risk. Patterns of risk were unchanged among patients with serial HbA

levels and persisted after multivariate adjustment.

Among patients undergoing PCI, pre-procedural HbA

levels display a U-shaped association with 1-year MACE risk, a pattern that reflects greater risk for death in the presence of low HbA

(≤5.5%) and higher risk for MI with higher values (>8.0%).

8.0%).

The aim of this study was to compare the rate of proximal radial artery occlusion (RAO) with Doppler ultrasound between distal and conventional radial access 24h and 30days after a transradial coronary procedure.

The use of distal radial access to prevent proximal RAO (PRAO) in the proximal segment at 24h and 30days after a procedure, compared with conventional radial access, is unknown.

This was a prospective, comparative, longitudinal, randomized study. A total of 282 patients were randomized to either proximal radial access (n=142) or distal radial access (n=140) to evaluate the superiority of the distal approach in the prevention of PRAO with Doppler ultrasound 24h and 30days after a transradial coronary procedure.

In the per protocol analysis, the rates of PRAO at 24h and 30days were 8.4% and 5.6% in the proximal group and 0.7% and 0.7% in the distal group, respectively (24 h odds ratio [OR] 12.8; 95% confidence interval [CI] 1.6 to 100.0; p=0.002; 30days OR 8.2; 95%CI 1.0 to 67.2; p=0.019). In an intention-to-treat analysis, the 24-h and 30-day rates of PRAO were 8.8% and 6.4% for proximal radial access and 1.2% and 0.6% in the distal radial access group (24 h OR 7.4; 95%CI 1.6 to 34.3; p=0.003; 30days OR 10.6; 95%CI 1.3 to 86.4; p=0.007).

Distal radial access prevents RAO in the proximal segment at 24h and 30days after the procedure compared with conventional radial access.

Distal radial access prevents RAO in the proximal segment at 24 h and 30 days after the procedure compared with conventional radial access.

The aim of this study was to assess the impact of access-site crossover in patients with acute coronary syndrome undergoing invasive management via radial or femoral access.

There are limited data on the clinical implications of access-site crossover.

In the MATRIX (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox)-Access trial, 8,404 patients with acute coronary syndrome were randomized to radial or femoral access. Patients undergoing access-site crossover or successful access site were investigated. Thirty-day coprimary outcomes were a composite of death, myocardial infarction, or stroke (major adverse cardiovascular events [MACE]) and a composite of MACE or Bleeding Academic Research Consortium type 3 or 5 bleeding (net adverse clinical events [NACE]).

Access-site crossover occurred in 183 of 4,197 patients (4.4%) in the radial group (mainly to femoral access) and 108 of 4,207 patients (2.6%) in the femoral group (mainly to radial access). In ml radial or femoral access. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox [MATRIX]; NCT01433627).

Crossover from radial to femoral access abolishes the bleeding benefit offered by the radial over femoral artery but does not appear to increase the risk for MACE or NACE compared with successful radial or femoral access. (Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox [MATRIX]; NCT01433627).As a recent public policy, the prevention of radicalisation has been built in response to an evolving phenomenon. The implementation of tools for reporting and monitoring people undergoing radicalisation will begin in 2014. Although there is no standard profile of radicalised people, the target group for these systems is mainly young people, adults or minors. In terms of prevention of radicalisation, care covers a broad spectrum of interventions and professionals.In an era where terrorism has become modernized and globalized, the international community and the French authorities remain cautious about an invisible, yet very present army, that of the "fighters in becoming ", whose indoctrination is privileged by the Islamic State the minors. In these times of crisis, what legal apprehension can be brought to caregivers confronted with radicalised minor patients or undergoing radicalisation? Several limitations can be pointed out on this subject in the international response. Despite this, it is possible to give some guidance to caregivers confronted with situations of radicalized minors, or undergoing radicalisation, facing the dangers they represent for themselves and for society.Today's generation of children is confronted with a reality that their parents' generations did not know, that of the risk of terrorism. While mass attacks in recent months have given way to occasional attacks involving a single perpetrator and fewer victims, the risk remains omnipresent. Living with a permanent threat is not insignificant at an age where security in each other and in the future is fundamental to growing up serenely. How then can we best support children and adolescents in such a context?