Marie-Claude Guertin

• Principal biostatistician at Montreal Heart Institute

OBJECTIVES The Ross procedure has been associated with better long-term outcomes in selected patients. Nevertheless, its complexity has limited its adoption. The aim of this study was to assess the learning curve of the Ross procedure and to evaluate the impact of new surgeons joining an experienced Ross program. METHODS From 2011 to 2023, 673 con...

Anxiety, pain and poor well-being are major issues in older people. Complementary interventions, such as music and hypnosis, are increasingly used to address these issues. The objectives of this study were to assess immediate changes in anxiety, pain and well-being during personalized pre-recorded music and hypnosis interventions compared to contro...

Background Patients can experience persistent cognitive complaints and deficits in long-COVID. Inflammation and capillary damage may contribute to symptoms by interfering with tissue oxygenation. Methods This was an exploratory pilot crossover study designed to describe the effects of supplemental oxygen (portable oxygen concentrator, POC) on cogn...

Clonal hematopoiesis involves mutations in hematopoietic stem/progenitor cells, which increase the risk of cardiovascular disease, particularly under pro-inflammatory conditions. This study assessed the impact of the anti-inflammatory medication colchicine on clonal hematopoiesis in patients with recent myocardial infarction from the COLCOT trial....

Background There is a paucity of data regarding sex-related differences on cardiac outcomes in the context of transposition of the great arteries (TGA) with a systemic right ventricle and biventricular physiology (sRV-biV). Moreover, the long-term impact of pregnancy on cardiac outcomes remains unknown. Objectives The purpose of this study was to...

OBJECTIVE The cardiovascular benefits of low-dose colchicine have been demonstrated in patients with coronary disease. Its effects were evaluated in this prespecified analysis in patients with type 2 diabetes (T2D) from the COLchicine Cardiovascular Outcomes Trial (COLCOT). RESEARCH DESIGN AND METHODS COLCOT was a randomized, double-blinded trial...

Background: Despite chronic therapies, atrial fibrillation (AF) leads to rapid ventricular rates (RVR) often requiring intravenous treatments. Etripamil is a fast-acting, calcium-channel blocker administered intranasally affecting the atrioventricular-node within minutes. Methods: ReVeRA evaluated efficacy and safety of etripamil for the reduction...

Patients with new-onset left bundle branch block (LBBB) after transcatheter aortic valve implantation (TAVI) are at risk of developing delayed high-degree atrioventricular block. Management of new-onset LBBB post-TAVI remains controversial. In the Comparison of a Clinical Monitoring Strategy Versus Electrophysiology-Guided Algorithmic Approach in P...

Background: Polymorphisms in the adenylate cyclase 9 (ADCY9) gene influence the benefits of the cholesteryl ester transfer protein (CETP) modulator dalcetrapib on cardiovascular events after acute coronary syndrome. We hypothesized that Adcy9 inactivation could improve cardiac function and remodeling following myocardial infarction (MI) in absence...

Background: Clinical evidence has suggested that the oat soluble fiber β-glucan might have lipid-lowering effects. Objective: The present clinical trial was conducted to evaluate the efficacy and safety of high-medium molecular weight β-glucan on serum low-density lipoprotein cholesterol (LDL-C) and other lipid subfractions in subjects with hype...

The presence of a systemic right ventricle (sRV) with biventricular physiology (biV) is associated with increased patient morbidity and mortality. To date, no pharmacologic therapy for heart failure has been proven effective for patients with systolic dysfunction of the sRV-biV. We designed a randomized, double-blind, placebo-controlled crossover t...

Background: Although the role of the 21-gene Breast Recurrence Score® assay is well established to predict response to adjuvant chemotherapy in the setting of node-negative hormone receptor (HR)-positive, HER2-negative breast cancers (BC), fewer studies have evaluated the assay in the neoadjuvant setting. Due to the correlation between a high Recur...

Background Long-term psychological impacts of the COVID-19 pandemic on healthcare workers remain unknown. We aimed to determine the one-year progression of burnout and mental health since pandemic onset, and verify if protective factors against psychological distress at the beginning of the COVID-19 pandemic (Cyr et al. in Front Psychiatry; 2021) r...

COVID-19 symptoms can cause substantial disability, yet no therapy can currently reduce their frequency or duration. We conducted a double-blind placebo-controlled trial of hesperidin 1000 mg once daily for 14 days in 216 symptomatic nonvaccinated COVID-19 subjects. Thirteen symptoms were recorded after 3, 7, 10, and 14 days. The primary endpoint w...

Background Vitamin K antagonists (VKAs) are frequently prescribed to patients with congenital heart disease (CHD) for atrial arrhythmias or Fontan palliation but there is a paucity of data regarding time spent in the therapeutic range (TTR). We sought to determine the TTR in patients with CHD and atrial arrhythmias or Fontan palliation prescribed V...

Aims In a retrospective analysis of dal-Outcomes, the effect of dalcetrapib on cardiovascular events was influenced by an adenylate cyclase type 9 (ADCY9) gene polymorphism. The dal-GenE study was conducted to test this pharmacogenetic hypothesis. Methods and results dal-GenE was a double-blind trial in patients with an acute coronary syndrome wit...

Background The 21-gene Breast Recurrence Score (RS) assay, “the assay”, has led to a paradigm shift for patients with hormone receptor-positive, node-negative early breast cancer and is emerging as an important tool to assist physician-patient decisions in foregoing chemotherapy in node-positive patients. We wanted to better understand the impact o...

Aims The adenylate cyclase type 9 (ADCY9) gene appears to determine atherosclerotic outcomes in patients treated with dalcetrapib. In mice, we recently demonstrated that Adcy9 inactivation potentiates endothelial function and inhibits atherogenesis. The objective of this study was to characterize the contribution of ADCY9 to the regulation of endot...

Aims: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients. Methods and results: Five hundred and twenty-eight patients with a definite diagnosis and no histor...

Increased production of reactive oxygen species plays an essential role in the pathogenesis of several diseases, including cardiac hypertrophy. In our search to identify redox-sensitive targets that contribute to redox signaling, we found that protein tyrosine phosphatase 1B (PTP1B) was reversibly oxidized and inactivated in hearts undergoing hyper...

Objective A predictive model for hospitalization due to COVID-19 or death was developed in the placebo group (N=2084) from a large clinical trial of colchicine in COVID-19 patients (N = 4159). Results The seven variables retained in the predictive model were age, sex, body-mass index, history of respiratory disease, use of diabetes drugs, use of a...

Background The COVID-19 pandemic has put chronic pressure on worldwide healthcare systems. While the literature regarding the prevalence of psychological distress and associated risk factors among healthcare workers facing COVID-19 has exploded, biological variables have been mostly overlooked. Methods 467 healthcare workers from Quebec, Canada, a...

COVID-19 symptoms can cause substantial disability, yet no therapy can currently reduce their frequency or duration. We conducted a double-blind placebo-controlled trial of hesperidin 1000 mg once-daily for 14 days in 216 symptomatic non-vaccinated COVID-19 subjects. Thirteen symptoms were recorded after 3, 7, 10 and 14 days. The primary endpoint w...

Background and aims The anti-inflammatory agent colchicine is gaining interest as a treatment for coronary artery disease. However, the effects of colchicine in atherosclerotic animal models are mostly unknown. This study aimed to evaluate colchicine in a rabbit model of atherosclerosis. Methods Twenty-two rabbits were fed a 0.5% cholesterol-enric...

Background: Although ketamine, a NMDA-receptor antagonist, tends to increase the bispectral index (BIS), it remains a widely used analgesic whenever administered in low doses during major surgery. Objective: The objective of this study was to compare the impact of intravenous ketamine (given either as a continuous infusion or as a bolus) on BIS...

Introduction The number of elderly patients undergoing major surgery is rapidly increasing. They are particularly at risk of developing postoperative neurocognitive disorders (NCD). Earlier studies suggested that processed electroencephalographic (EEG) monitors may reduce the incidence of postoperative NCD. However, none of these studies controlled...

Objective: This study examined how best to identify modifiable protective and risk factors for burnout in healthcare workers in the face of the COVID-19 pandemic. Individual, occupational, organizational and social factors were investigated. The study also assessed the impact of these factors on post-traumatic stress disorder (PTSD), anxiety, and d...

Background Evidence suggests a role for excessive inflammation in COVID-19 complications. Colchicine is an oral anti-inflammatory medication beneficial in gout, pericarditis, and coronary disease. We aimed to investigate the effect of colchicine on the composite of COVID-19-related death or hospital admission. Methods The present study is a phase...

We conducted a genome-wide association study of time to remission of COVID-19 symptoms in 1723 outpatients with at least one risk factor for disease severity from the COLCORONA clinical trial. We found a significant association at 5p13.3 (rs1173773; P = 4.94 × 10–8) near the natriuretic peptide receptor 3 gene (NPR3). By day 15 of the study, 44%, 5...

Background Hypertension is a risk factor for the development and exacerbation of atrial fibrillation (AF). Angiotensin-converting enzyme inhibitors (ACEi) are a standard-of-care treatment option for patients with hypertension, however, there is conflicting evidence about their effects on AF recurrence. Therefore, our objective was to assess the eff...

PurposeThe effect of direct laryngoscopy using a Macintosh blade (MAC) vs GlideScope™ videolaryngoscopy using a Spectrum LoPro blade (GVL) on nociceptive stimulation has not been quantitatively studied. This study used the new nociception level (NOL) index to compare the nociceptive response induced by GVL or MAC during laryngoscopy with or without...

We conducted a genome-wide association study of time to remission of COVID-19 symptoms in 1723 outpatients with at least one risk factor for disease severity from the COLCORONA clinical trial. We found a significant association at 5p13.3 (rs1173773; P = 4.94 × 10 ⁻⁸ ) near the natriuretic peptide receptor 3 gene ( NPR3 ). By day 15 of the study, 44...

Background - The randomized, placebo-controlled COLchicine Cardiovascular Outcomes Trial (COLCOT) has shown the benefits of colchicine 0.5 mg daily to lower the rate of ischemic cardiovascular events in patients with a recent myocardial infarction. Here, we conducted a post-hoc pharmacogenomic study of COLCOT with the aim to identify genetic predic...

Objective PTSD is increasingly recognized following medical traumas although is highly heterogeneous. It is difficult to judge which medical contexts have the most traumatic potential and where to concentrate further research and clinical attention for prevention, early detection and treatment. The objective of this study was to compare PTSD preval...

Background Evidence suggests the role of an inflammatory storm in COVID-19 complications. Colchicine is an orally administered, anti-inflammatory medication beneficial in gout, pericarditis and coronary disease. Methods We performed a randomized, double-blind trial involving non-hospitalized patients with COVID-19 diagnosed by polymerase chain reac...

Background Evidence suggests the role of an inflammatory storm in COVID-19 complications. Colchicine is an orally administered, anti-inflammatory medication beneficial in gout, pericarditis and coronary disease. Methods We performed a randomized, double-blind trial involving non-hospitalized patients with COVID-19 diagnosed by polymerase chain reac...

Background We previously demonstrated that high-density lipoprotein (HDL) infusions may improve left ventricular diastolic dysfunction (LVDD) in an aortic valve stenosis (AVS) model. Whether the benefit was direct or mediated by the observed reduction in AVS severity is not clear. Here, we aimed to test the direct effect of an ApoA-I mimetic on LVD...

Abstract Objectives: Direct comparisons between direct laryngoscopy (DL) (MacIntosh blade (MAC)) versus videolaryngoscopy (GlideScopeTM, GVL) over their nociceptive stimulation has not been quantitatively studied. This study compared, using the new NOL index, the nociceptive response induced by GVL or MAC during laryngoscopy+/-intubation. Methods:...

Background/Introduction Experimental and clinical evidence supports the role of inflammation in atherosclerosis and its complications. Colchicine is an orally administered, potent anti-inflammatory medication that was shown to significantly lower the risk of ischemic cardiovascular events compared to placebo among subjects with a recent myocardial...

Background: Reduction of inflammation with colchicine has emerged as a therapeutic option for secondary cardiovascular prevention in patients with coronary artery disease (CAD). Our objective was to consolidate evidence from randomized controlled trials (RCTs) evaluating the efficacy and safety of low-dose colchicine for secondary cardiovascular p...

Aims: The COLchicine Cardiovascular Outcomes Trial (COLCOT) demonstrated the benefits of targeting inflammation after myocardial infarction (MI). We aimed to determine whether time-to-treatment initiation (TTI) influences the beneficial impact of colchicine. Methods and results: In COLCOT, patients were randomly assigned to receive colchicine or...

Aims: In the randomized, placebo-controlled Colchicine Cardiovascular Outcomes Trial (COLCOT) of 4745 patients enrolled within 30 days after myocardial infarction, low-dose colchicine (0.5 mg once daily) reduced the incidence of the primary composite endpoint of cardiovascular death, resuscitated cardiac arrest, myocardial infarction (MI), stroke,...

Late-Breaking Clinical Trial Presentation (Featured Clinical Research I)

The objectives of precision medicine are to better match patient characteristics with the therapeutic intervention to optimize the chances of beneficial actions while reducing the exposure to unneeded adverse drug experiences. In a retrospective genome-wide association study of the overall neutral placebo-controlled dal-Outcomes trial, the effect o...

Background: Experimental and clinical evidence supports the role of inflammation in atherosclerosis and its complications. Colchicine is an orally administered, potent antiinflammatory medication that is indicated for the treatment of gout and pericarditis. Methods: We performed a randomized, double-blind trial involving patients recruited withi...

Objectives: To assess the effect of DuraGraft (Somahlution Inc, Jupiter, Fla), an intraoperative graft treatment, on saphenous vein grafts in patients undergoing isolated coronary artery bypass grafting. Methods: Within patients, 2 saphenous vein grafts were randomized to DuraGraft or heparinized saline. Multidetector computed tomography angiogr...

Aims: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVC) is characterized by ventricular arrhythmias (VAs) and sudden cardiac death (SCD). We aimed to develop a model for individualized prediction of incident VA/SCD in ARVC patients. Methods and results: Five hundred and twenty-eight patients with a definite diagnosis and no histor...

Graft‐versus‐host disease (GVHD) is a major cause of transplant‐related mortality (TRM) after allogeneic haematopoietic stem cell transplantation (HSCT) and presents a challenge in haploidentical HSCT. GVHD may be prevented by ex vivo graft T‐cell depletion or in vivo depletion of proliferating lymphocytes. However, both approaches pose significant...

Background: Compelling evidence showing a link between atrial fibrillation (AF) and cognitive decline and dementia is accumulating. Methods: Blinded Randomized Trial of Anticoagulation to Prevent Ischemic Stroke and Neurocognitive Impairment in Atrial Fibrillation (BRAIN-AF) is a prospective, multicentric, double-blind, randomized-controlled tri...

Background: Comorbidity indexes derived from administrative databases are essential tools of research in global health. We sought to develop and validate a novel cardiac-specific comorbidity index, and to compare its accuracy with the generic Charlson-Deyo and Elixhauser comorbidity indexes. Methods: We derived the cardiac-specific comorbidity i...

Purpose: To assess sex- and gender-related factors associated with cardiac rehabilitation (CR) enrollment following acute coronary syndrome among systematically referred patients. Methods: This secondary analysis of a randomized controlled trial used an exploratory approach to examine the TRANSITion process for patients between the coronary care...

Mineralocorticoid receptor antagonists (MRAs) decrease morbidity and mortality in patients with heart failure (HF). However, spironolactone, a non-selective MRA, has been shown to exert a harmful effect on glucose homeostasis. The objective of this multicenter, randomized, controlled, double-blind trial was to compare the effects of spironolactone...

Background and aims: Lecithin:cholesterol acyltransferase (LCAT), a key enzyme in high-density lipoprotein (HDL) metabolism and reverse cholesterol transport (RCT), has been associated with atheroprotection. However, its relation to plaque characteristics has not been confirmed to date. We aimed to determine the relationship between plasma LCAT ma...

[This corrects the article DOI: 10.1371/journal.pone.0189944.].

Pharmacogenomic studies have shown that ADCY9 genotype determines the effects of the cholesteryl ester transfer protein (CETP) inhibitor dalcetrapib on cardiovascular events, atherosclerosis imaging and body weight variation. The underlying mechanisms responsible for the interactions between ADCY9 and CETP have not yet been determined. Adcy9 -inact...

Aim: To evaluate the impact of AGTR1 A1166C (rs5186) on the response to candesartan in patients with heart failure. Materials & methods: Prospective, multicentre, open-label study. We studied 299 symptomatic patients with heart failure presenting a left ventricular ejection fraction ≤40%. Results: Reductions in the primary end points of natriu...

Background -Pharmacogenomic studies have shown that ADCY9 genotype determines the effects of the cholesteryl ester transfer protein (CETP) inhibitor dalcetrapib on cardiovascular events and atherosclerosis imaging. The underlying mechanisms responsible for the interactions between ADCY9 and CETP activity have not yet been determined. Methods -Adcy...

Aims: Patients suffering from out-of-hospital cardiac arrest (OHCA) are frequently transported to the closest hospital. Percutaneous coronary intervention (PCI) is often indicated following OHCA. This study's primary objective was to determine the association between being transported to a PCI-capable hospital and survival to discharge for patient...

Purpose To implement a statistical framework for assessing the precision of several quantitative MRI metrics sensitive to myelin in the human spinal cord: T1, Magnetization Transfer Ratio (MTR), saturation imposed by an off-resonance pulse (MTsat) and Macromolecular Tissue Volume (MTV). Methods Thirty-three healthy subjects within two age groups (...

Data processing pipeline. This section describes the data processing steps performed to estimate MTR, MTsat, T1 and MTV maps and to register those maps to the MNI-Poly-AMU template [55] and WM atlas [56]. (PDF)

Background: Illness management after an acute coronary syndrome (ACS) is crucial to prevent cardiac complications, to foster participation in a cardiac rehabilitation (CR) program, and to optimize recovery. Web-based tailored interventions have the potential to provide individualized information and counseling to optimize patient’s illness manageme...

PurposeThe adrenomedullin receptor is densely expressed in the pulmonary vascular endothelium. PulmoBind, an adrenomedullin receptor ligand, was developed for molecular diagnosis of pulmonary vascular disease. We evaluated the safety of PulmoBind SPECT imaging and its capacity to detect pulmonary vascular disease associated with pulmonary hypertens...

Background: 1-methylnicotinamide, a nicotinic acid metabolite, is TRIA-662’s active component. As part of a pilot study, we assessed TRIA-662’s effects on inflammatory biomarkers and blood lipids. Methods: Patients aged 18-80 years with mean serum triglycerides (TG) 2.26-5.65 mmol/L, low-density lipoprotein-cholesterol levels not needing drug thera...

Background: Vascular inflammation is increased in patients with psoriasis. Purpose: This randomized, double-blind, multicenter study evaluated the effects of the tumor necrosis factor alpha (TNF-α) antagonist adalimumab on vascular inflammation in patients with psoriasis. Method: 107 patients were randomized (1:1) to receive adalimumab for 52...

Background: Patients may experience anxiety and reduced quality of life after implantable cardioverter defibrillator (ICD) device implantation. Objective: To assess the feasibility, acceptability, and preliminary efficacy of the Approach Caring and Cognitive Behavioural (PRO-CARE) intervention, aimed at improving ICD device acceptance and psycho-fu...

Background High-density lipoproteins (HDL) favorably affect endothelial progenitor cells (EPC). Circulating progenitor cell level and function are impaired in patients with acute coronary syndrome (ACS). This study investigates the short-term effects of reconstituted HDL (rHDL) on circulating progenitor cells in patients with ACS. Methods and Find...

In vitro exposure of peripheral blood mononuclear cells (PBMCs) to CSL-111. Total adherent (left), CD34+(middle) and apoptotic (right) cell count in the absence (control) or presence of CSL-111 (1 mg/mL). D, day. (PPTX)

Endothelial progenitor cell count in patients with acute coronary syndrome. Left panel: CD34+ progenitor cells before and after treatment with reconstituted high-density lipoprotein (rHDL) compared to controls (Placebo treatment). Right panel: CD34+/KDR+ endothelial progenitor cells before and after treatment with reconstituted high-density lipopro...

Serum stromal cell-derived factor-1 (SDF-1) in patients with acute coronary syndrome after treatment with reconstituted high-density lipoprotein (rHDL). (PPTX)

Supplementary Figures and Protocols. (DOCX)

Endothelial progenitor cell count in patients with acute coronary syndrome (ACS) and controls. CD34+ (left) and CD34+/KDR+ (right) endothelial progenitor cell counts at baseline in patients with ACS and patients with normal coronary arteries (normal) as assessed by coronary angiography. (PPTX)

Effect of CSL-111 on migratory capacity of endothelial progenitor cells derived from healthy donors. Chemotactic index of endothelial progenitor cells indicating their capacity to migrate along an SDF-1 gradient following treatment with CSL-111 for different periods of time. (PPTX)

Background The Effects of the P‐Selectin Antagonist Inclacumab on Myocardial Damage After Percutaneous Coronary Intervention for Non‐ST‐Segment Elevation Myocardial Infarction (SELECT‐ACS) trial suggested beneficial effects of inclacumab, a monoclonal antibody directed against P‐selectin, on periprocedural myocardial damage. This study evaluated th...

Background: Mitral regurgitation (MR) is a common valvular heart disorder requiring intervention once it becomes severe. Transcatheter mitral repair with the MitraClip device is a safe and effective therapy for selected patients denied surgery. We sought to evaluate the clinical outcomes and economic impact of this therapy compared to medical mana...

Background Self-care practices in heart failure (HF) contribute to quality of life, symptom stabilization, and extended life expectancy. However, adherence to practices such as liquid and salt restriction or symptom monitoring require high motivation on a daily basis. The aim was to assess the feasibility, acceptability, and potential effectiveness...

Background: -Dalcetrapib effects on cardiovascular outcomes are determined by adenylate cyclase 9 (ADCY9) gene polymorphisms. Our aim was to determine whether these clinical endpoint results are also associated with changes in reverse cholesterol transport and inflammation. Methods and results: -Participants of the dal-OUTCOMES and dal-PLAQUE-2...

Background: The management of paediatric asthma exacerbations is based on trials in children of all ages. Recent studies from 2009 raised the possibility that preschoolers (younger than 6 years) with viral-induced wheezing and children exposed to tobacco smoke might be at an increased risk of treatment failure. The study objective was to identify...

Objective: The objective of this study was to evaluate the safety and efficacy of external beam radiation (EBR) in preventing restenosis after superficial femoral artery (SFA) stenting in comparison with a control group treated with SFA stenting only. Methods: In this Institutional Review Board-approved study, patients who provided written infor...

Objectives: The purpose of this study was to assess whether the benefits conferred by radial access (RA) at an individual level are offset by a proportionally greater incidence of vascular access site complications (VASC) at a population level when femoral access (FA) is performed. Background: The recent widespread adoption of RA for cardiac cat...

BACKGROUND Although oral corticosteroids (OCS) are the cornerstone of acute asthma management in the emergency department (ED), recent trials have questioned the efficacy of OCS in preschool-aged children presenting with viral-induced wheezing episodes. OBJECTIVES The aim of the study was to determine the magnitude, and potential determinants, of...

Background—Dalcetrapib did not improve clinical outcomes despite increasing high-density lipoprotein cholesterol by 30%. These results differ from other evidence supporting HDL as a therapeutic target. Responses to dalcetrapib may vary according to patients' genetic profile. Methods and Results—We conducted a pharmacogenomic evaluation using a gen...