Use of iron sucrose and red blood cell transfusions in anaemic cancer patients in France (OncoFer study).

PURPOSE: This report describes the results of an observational, retrospective cohort study, evaluating the use of iron sucrose (IS) and red blood cell (RBC) transfusions in patients with cancer in routine clinical practice in France. A parallel investigated cohort treated with ferric carboxymaltose (FCM) has been reported earlier. METHODS: Data of patients with a solid tumour or haematological malignancy who have received IS or an RBC transfusion during 2010 from 3 months prior (M-3) to 3 months post first treatment (M+3) were analysed. RESULTS: Data from 46 patients who had received IS (400 mg median total iron dose) and 357 patients who had received RBC transfusions as first treatment (baseline) were included. Median haemoglobin levels improved from 9.9 g/dL (interquartile range 9.2; 11.0 g/dL) at baseline to 12.4 g/dL (11.4; 13.1 g/dL) at M+3 in IS-treated patients and from 8.2 g/dL (7.8; 8.8 g/dL) at baseline to 10.1 g/dL (8.8; 11.1 g/dL) in transfused patients. An erythropoiesis-stimulating agent was given to 54.3 and 28.9% of patients in the IS and the RBC transfusion groups, respectively, resulting in slightly better mean haemoglobin increase in both groups (2.4 vs 1.5 g/dL and 2.0 vs 1.6 g/dL, respectively). No severe nor serious adverse reaction and no hypersensitivity reactions were reported. CONCLUSION: Both IS and RBC transfusions effectively increased Hb levels in patients with cancer. IS was safe and well tolerated in this population. Considering prior reported results with FCM, using FCM may reduce ESA dose requirements and the required number of infusions.

Country-based reference values and impact of cardiovascular risk factors on carotid intima-media thickness in a French population: the 'Paroi Artérielle et Risque Cardio-Vasculaire' (PARC) Study.

AIM: To define reference values for mean common carotid artery intima-media thickness (CCAIMT(mean)) from subjects without conventional cardiovascular risk factors. METHODS: This nationwide study involved cardiologists at 246 centres in France. A total of 5,433 subjects with and without conventional cardiovascular risk factors participated. RESULTS: In subjects without risk factors, CCAIMT(mean) was 0.712 +/- 0.122 mm in men and 0.682 +/- 0.105 mm in women (p < 0.0001). Age explained 27.7% (men) and 33.9% (women) of the variance in CCAIMT(mean). Each 10-year increment in age was associated with a sex-adjusted increase in CCAIMT(mean) of 0.049 mm. In subjects with 1 risk factor, CCAIMT(mean) was 0.765 +/- 0.121 (p < 0.0001 vs. subjects without risk factors). CCAIMT(mean) increased continuously with increasing number of risk factors, irrespective of age group. In multivariable analysis, age, sex and number of cardiovascular risk factors appeared independently associated with CCAIMT(mean). CONCLUSION: CCAIMT(mean) may help to identify the population at intermediate cardiovascular risk. As an integrator of both conventional and genetic cardiovascular risk factors at the individual level, its additive value versus other risk scores must be evaluated, particularly in patients in their fourth and sixth decades.

Correlation between the Framingham risk score and intima media thickness: the Paroi Artérielle et Risque Cardio-vasculaire (PARC) study.

AIMS: Carotid intima media thickness (IMT) is associated with an increased risk of cardio-vascular events, but its correlation with the absolute cardio-vascular risk is not well known in large populations. The Paroi Artérielle et Risque Cardio-vasculaire (PARC) study was designed to evaluate the relationship between conventional assessment of the global cardio-vascular risk by means of the Framimgham score and measurement of IMT of the common carotid artery (CCAIMT). METHODS AND RESULTS: About 246 French cardiologists selected 6416 subjects. CCAIMT measurements were performed using a specific methodology designed to harmonize the acquisition and processing of B-mode ultrasound images. The Framingham cardio-vascular score was determined for each individual. The relationship between CCAIMT and Framingham scores was evaluated using linear or polynomial models of regression. We found a significant correlation between CCAIMT and all components of the Framingham score (p < 0.005 for all parameters). The Framingham score and CCAIMT values were non-linearly related (coefficients of determination R2 were 19% and 20% in men, 28% and 29% in women, for subjects with and without personal history of cardio-vascular disease, respectively). The younger the subjects, the steeper the relationship, when the analysis was performed according to decades. CONCLUSIONS: The Framingham score and CCAIMT values were significantly correlated. However variations in CCAIMT only explained a modest part of the Framingham score and vice versa.

Association of menopause and hormone replacement therapy with large artery remodeling.

OBJECTIVE: To evaluate the remodeling of large arteries according to age at menopause, duration of menopause, and use of hormone therapy (HT). DESIGN: A cross-sectional study consisting of baseline measurements of a multicentric randomized trial were used to evaluate arterial parameters. SETTING: The study was conducted in France, Belgium, and the Netherlands in academic hospitals and private clinics. PATIENT(S): Postmenopausal women (n = 538) with mild hypercholesterolemia. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Common carotid artery intima-media thickness (CCA-IMT), central pulse pressure, and aortic stiffness (carotid-femoral pulse wave velocity) were measured and centrally controlled for quality. Multivariate regression analysis was used to assess the possible covariates associated with arterial parameters. RESULT(S): Women were 58 ± 6 (mean ± SD) years of age with an age of 50 ± 5 at menopause and a mean duration of menopause of 8 ± 7 years. Lower age at menopause, time since menopause, and absence of HT use were independently associated with worsening of the arterial parameters. After multivariate analysis, HT was associated with a lower CCA-IMT (-40 µm [range -64 to -1]), whereas lower age at menopause and menopause duration were respectively associated with a CCA-IMT increase (25 µm/5 y and 27 µm/5 y). Similarly, values of central pulse pressure and pulse wave velocity were lower in HT users (-3.1 mm Hg [-5.1 to -0.9] and -0.31 m/s [-0.63 to -0.02], respectively) but worsened with age at menopause and menopause duration. CONCLUSION(S): The age at menopause, the time since menopause, and the use of HT are independently associated with the thickening and stiffening of the large arteries. CLINICAL TRIAL REGISTRATION NUMBER: NCT00163163.