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With designing, organizing and carrying out major clinical trials we are committed to enhance knowledge and improve the care of patients suffering cardiac diseases.
Action Group has carried out several major internationally recognized randomized trials, enrolling thousands of patients, testing new treatment strategies. These trials have directly impacted the international guidelines and the daily care-take of patients. Among these studies we can mention:
ACTION Group explores the mechanisms and determining factors of the coronary thrombosis and has contributed to a better understanding of the thrombus (clot) constituents in acute coronary syndrome with ST segment elevation (Silvain et al. JACC 2010). This is essential to better apprehend therapies.
ACTION Group is part of the research team who discovered the genetic resistance to clopidogrel (Hulot et al. Blood 2006, Collet et al. Lancet 2009), a major risk factor in stent thrombosis and recurrent events (Cayla et al. JAMA 2011), nothwithstanding a good compliance with the prescribed drug. This research lead ACTION to carry out various clinical trials with the purpose of testing a customized treatment based on each patient genotype or on the biological response to treatment in order to improve, in fine, the patient prognosis (Collet et al. NEJM 2012, Collet et al. Thromb Haemost. 2015).
ACTION Group also studies new therapeutic options to improve the care take of complications which may arise with acute coronary syndromes. Treatments such as blood transfusion, used since decades, are examined in terms of efficiency and safety in the specific field of coronary thrombosis with bleeding (Silvain et al. Eur Heart J 2010 and JACC 2014). These studies were the basis of a randomized trial designed and carried out by the ACTION network of researchers with the aim of providing a practical clinical solution.
A true revolution in treatment of myocardial infarct, the first coronary stent, an implantable device, affixed on the artery wall narrowed by a cholesterol plaque, celebrated its 40th anniversary in 2016.
Wether it is an endocoronary prothesis, a percutaneous valve or an auricular closing device, interventional cardiology is simply the instrumental care take of the cardiac disease.
ACTION Group takes interest in the new, so-called self-expendable, stents, which enable an improved apposition to the coronary artery wall. ACTION also looks into the techniques of endo-coronary imaging to guarantee an immediate good result when implanting a stent and avoid complications, in particular stent thrombosis linked to wrong apposition.
Structural cardiology, this new discipline, which originated less than 15 years ago, consists in treating narrowed (aortic stenosis) or leaking (mitral insufficiency) cardiac valves or closing some communications (inter-atrial communication, patent foramen ovale) causing embolization from cardiac origin (hence stroke). This is done percutaneously: no need to anaesthetize the patient and open the heart !
ACTION Group and its network endeavour to find the best pharmacological treatments once the percutaneous valves (TAVI) are placed or the atrial appendages have been closed.
Heart failure is a chronic disease which represents a real issue for public health as it concerns over one million people in France with a death toll representing 5% of overall deaths each year. Moreover with thousands of patients hospitalized each year, it represents 1% of the health budget, i.e. 1 billion euro per annum. This chronic disease causes major functional, psychological and social consequences in patients, also causing numerous re-hospitalizations for cardiac decompensation and associated complications.
The care take of these patients requires a global and multidisciplinary strategy: cardiological monitoring, consultation on nutrition, improvement of the quality of life, the autonomy and the psychological state.
Following a myocardial infarct, valve pathology or myocarditis, a chemotherapy or a genetic anomaly, the function and structure of the heart may be severely damaged. This alteration causes the cardiac muscle to be incapable to deliver the blood flow (4 to 5 L/min for women, 5 to 6 L/min for men) necessary for the functioning of the body: this is heart failure. As a consequence, patients suffer breathlessness, edema of the lower limbs and a significant alteration of their health. Thanks to its leading edge research on these causal diseases, ACTION Group contributes to the prevention and the care take of chronic heart failure with patients suffering cardiovascular diseases.
In 2015, ACTION Group initiated a therapeutic trial, AGENT-HF, in 5 centers in France aiming at improving the cardiac function of patients with a severe left ventricular dysfunction with major symptoms, evaluating the promising and innovative hypothesis related to the benefit of an intra-coronary transfer of the SERCA2 gene to improve the systolic and diastolic function of the left ventricular.
Myocarditis, defined as inflammation of the cardiac muscle, with various symptoms, ranging from just a chest pain to a state of shock, was for a long time a pathology the diagnosis of which requested a biopsy of the heart. The emergence of MRI has made the diagnosis and the care take easier. However, despite the progress in diagnosis realized over the last 15 years, myocarditis still represents the second cause of sudden death in young patients and the cause of 10% of dilated heart diseases.
There are multiple causes to myocarditis: mainly of infectious, including viral, origin, they can also be of bacterial, fungal, toxic, allergic origin or associated with a system disease. If the prognosis of so-called fulgurating myocarditis exposes to a transplant and death risk, the long term prognosis is often good. The long term evolution of acute myocarditis remains nevertheless poorly understood and can lead to complete recuperation of the myocardiac function, to a dilated heart disease evolution, the occurrence of heart rhythm disorder or relapse.
Because of its clinical and etiological variability, and its globally positive prognosis, myocarditis is the poor cousin of cardiovascular research, compared to coronary diseases, arterial hypertension or valvulopathies. As proof: the absence of specific treatment as well as the weak level of proof in the international guidelines.
ACTION Group initiated an academic research, ARAMIS, nationally funded, to evaluate the treatment of acute myocarditis with interleukin 1.