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Masarone D, Lombardi C, Falco L, Coscioni E, Metra M. Recent Advances across the Spectrum of Heart Failure and Heart Transplant. J Clin Med 2024; 13:1427. [PMID: 38592320 PMCID: PMC10932249 DOI: 10.3390/jcm13051427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
In recent years, remarkable progress has been accomplished in the heart failure (HF) landscape, with novel drugs and groundbreaking device approaches [...].
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Affiliation(s)
- Daniele Masarone
- Heart Failure Unit, AOS dei Colli-Monaldi Hospital, 80121 Naples, Italy;
| | - Carlo Lombardi
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (C.L.); (M.M.)
| | - Luigi Falco
- Heart Failure Unit, AOS dei Colli-Monaldi Hospital, 80121 Naples, Italy;
| | - Enrico Coscioni
- Cardiac Surgery Division, AOU San Leonardo, 84100 Salerno, Italy;
| | - Marco Metra
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy; (C.L.); (M.M.)
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Santarpino G, Di Mauro M, De Feo M, Menicanti L, Paparella D, Mastroroberto P, Speziale G, Pollari F, Mauro M, Torella M, Coscioni E, Barili F, Parolari A. Mechanical heart valves and oral anticoagulation: a survey of the Italian Society of Cardiac Surgery. J Cardiovasc Med (Hagerstown) 2024; 25:38-43. [PMID: 38051658 DOI: 10.2459/jcm.0000000000001525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
In the latest European guidelines for the management of valvular heart disease, mechanical valve prostheses maintain a strategic role, particularly for certain patient subsets and age groups. Despite the high number of devices implanted in clinical practice, particularly in non-European and North American regions, current scientific literature and debate seem to suggest a limited use of mechanical heart valves. The cardiac surgery community seems to be highly interested in biological and transcatheter valve prostheses but less interested in mechanical heart valves, including possible strategies for self-management of anticoagulation therapy. In this respect, the Italian Society of Cardiac Surgery (SICCH), in particular the Italian Group of Research for Outcome in Cardiac Surgery (GIROC), has promoted a survey among its members to stimulate the interest in this topic and express their opinion on this issue that, due to the prevalence of the affected population and the new treatment options for improving patients' quality of life, should be more appraised and debated in the cardiac surgery community. The recorded results, obtained on the answers to 111 questionnaires, seem to divide the specialists into 'pros' and 'contras' on a useful tool for the entire cardiac surgery community. For this reason, SICCH proposes in conclusion to declare its unified and institutional opinion on this topic.
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Affiliation(s)
- Giuseppe Santarpino
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro
- Department of Cardiac Surgery, Città di Lecce Hospital, GVM Care and Research, Lecce, Italy
- Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Michele Di Mauro
- Cardio-Thoracic Surgery Department, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Marisa De Feo
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Napoli
| | - Lorenzo Menicanti
- Department of Cardiac Surgery, IRCCS, Policlinico San Donato, San Donato Milanese
| | - Domenico Paparella
- Department of Medical and Surgical Sciences, Division of Cardiac Surgery, University of Foggia, Foggia
- Division of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, Bari
| | - Pasquale Mastroroberto
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro
| | - Giuseppe Speziale
- Division of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari
| | - Francesco Pollari
- Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University Nuremberg, Nuremberg, Germany
| | - Marianna Mauro
- Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro
| | - Michele Torella
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Napoli
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Fabio Barili
- Department of Cardiac Surgery, Santa Croce Hospital, Cuneo
| | - Alessandro Parolari
- University Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
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Santarpino G, Di Mauro M, De Feo M, Paparella D, Menicanti L, Mastroroberto P, Speziale G, Pollari F, Mauro M, Giancotti M, Cardetta F, Torella M, Coscioni E, Barili F, Parolari A. [Choosing a tailored prosthetic valve in cardiac surgery: what is the current role of mechanical prostheses?]. G Ital Cardiol (Rome) 2024; 25:36-41. [PMID: 38140996 DOI: 10.1714/4165.41590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
The choice of the mechanical/biological heart valve prosthesis is a topic currently debated in the light of the transcatheter prosthetic models and the results obtained/expected with the new biological valve models. Consequently, it seems that increasingly younger patients would be indicated for an implantation of a biological prosthesis. This is also in order to improve the quality of life of patients who want to avoid oral anticoagulant therapy. On the other hand, the guidelines for the treatment of heart valve disease assign a central role to the use of mechanical valve prostheses, particularly for certain patient subsets and age groups. This means that mechanical prostheses are still widely used worldwide, especially in non-European or North American regions. The cardiac surgery community therefore seems to be very interested in biological prostheses and transcatheter implants and scarcely interested in mechanical prostheses, including possible strategies for self-management of anticoagulant therapy. Recently, the Italian Society of Cardiac Surgery promoted a survey among its members to stimulate interest in the cardiac surgery community. This review article aims to summarize the most current results recorded with the use of mechanical prostheses and possible strategies, especially for the management of oral anticoagulant therapy, which can improve the patient's quality of life.
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Affiliation(s)
- Giuseppe Santarpino
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi "Magna Graecia", Catanzaro - Dipartimento di Cardiochirurgia, Città di Lecce Hospital, GVM Care & Research, Lecce - Dipartimento di Cardiochirurgia, Klinikum Nürnberg, Paracelsus Medical University Nuremberg, Norimberga, Germania
| | - Michele Di Mauro
- Dipartimento Cardio-Toracico, Heart & Vascular Centre, Maastricht University Medical Centre (MUMC), Maastricht, Olanda
| | - Marisa De Feo
- Dipartimento di Scienze Mediche Traslazionali, Università della Campania "Luigi Vanvitelli", Napoli
| | - Domenico Paparella
- Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Foggia - Dipartimento di Cardiochirurgia, Santa Maria Hospital, GVM Care & Research, Bari
| | - Lorenzo Menicanti
- Dipartimento di Cardiochirurgia, IRCCS Policlinico San Donato, San Donato Milanese (MI)
| | - Pasquale Mastroroberto
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi "Magna Graecia", Catanzaro
| | - Giuseppe Speziale
- Dipartimento di Cardiochirurgia, Anthea Hospital, GVM Care & Research, Bari
| | - Francesco Pollari
- Dipartimento di Cardiochirurgia, Klinikum Nürnberg, Paracelsus Medical University Nuremberg, Norimberga, Germania
| | - Marianna Mauro
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi "Magna Graecia", Catanzaro
| | - Monica Giancotti
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi "Magna Graecia", Catanzaro
| | | | - Michele Torella
- Dipartimento di Scienze Mediche Traslazionali, Università della Campania "Luigi Vanvitelli", Napoli
| | - Enrico Coscioni
- Dipartimento di Cardiochirurgia, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Fabio Barili
- Dipartimento di Cardiochirurgia, Azienda Ospedaliera Santa Croce e Carle, Cuneo
| | - Alessandro Parolari
- Dipartimento Universitario di Cardiochirurgia, IRCCS Policlinico San Donato, San Donato Milanese (MI)
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Benincasa G, Donatelli F, Strozziero MG, Miceli A, Coscioni E, Napoli C. Epigenetics and outcome prediction in heart transplantation after circulatory death: A clinical perspective. Clin Transplant 2023; 37:e15154. [PMID: 37800543 DOI: 10.1111/ctr.15154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Affiliation(s)
- Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Donatelli
- Department of Clinical and Community Sciences, University of Milan, Milan, Italy
- IRCCS Galeazzi Sant'Ambrogio, Milan, Italy
| | | | | | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggid'Aragona, Salerno, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, Italy
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Mucherino S, Dima AL, Coscioni E, Vassallo MG, Orlando V, Menditto E. Longitudinal Trajectory Modeling to Assess Adherence to Sacubitril/Valsartan among Patients with Heart Failure. Pharmaceutics 2023; 15:2568. [PMID: 38004547 PMCID: PMC10674925 DOI: 10.3390/pharmaceutics15112568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Medication adherence in chronic conditions is a long-term process. Modeling longitudinal trajectories using routinely collected prescription data is a promising method for describing adherence patterns and identifying at-risk groups. The study aimed to characterize distinct long-term sacubitril/valsartan adherence trajectories and factors associated with them in patients with heart failure (HF). Subjects with incident HF starting sac/val in 2017-2018 were identified from the Campania Regional Database for Medication Consumption. We estimated patients' continuous medication availability (CMA9; R package AdhereR) during a 12-month period. We selected groups with similar CMA9 trajectories (Calinski-Harabasz criterion; R package kml). We performed multinomial regression analysis, assessing the relationship between demographic and clinical factors and adherence trajectory groups. The cohort included 4455 subjects, 70% male. Group-based trajectory modeling identified four distinct adherence trajectories: high adherence (42.6% of subjects; CMA mean 0.91 ± 0.08), partial drop-off (19.6%; CMA 0.63 ± 0.13), moderate adherence (19.3%; CMA 0.54 ± 0.11), and low adherence (18.4%; CMA 0.17 ± 0.12). Polypharmacy was associated with partial drop-off adherence (OR 1.194, 95%CI 1.175-1.214), while the occurrence of ≥1 HF hospitalization (OR 1.165, 95%CI 1.151-1.179) or other hospitalizations (OR 1.481, 95%CI 1.459-1.503) were associated with low adherence. This study found that tailoring patient education, providing support, and ongoing monitoring can boost adherence within different groups, potentially improving health outcomes.
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Affiliation(s)
- Sara Mucherino
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (V.O.)
| | - Alexandra Lelia Dima
- Health Technology Assessment in Primary Care and Mental Health (PRISMA), Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain;
| | - Enrico Coscioni
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy; (E.C.); (M.G.V.)
| | - Maria Giovanna Vassallo
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy; (E.C.); (M.G.V.)
| | - Valentina Orlando
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (V.O.)
| | - Enrica Menditto
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (S.M.); (V.O.)
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Bernardi FF, Mascolo A, Sarno M, Capoluongo N, Trama U, Ruggiero R, Sportiello L, Fusco GM, Bisogno M, Coscioni E, Iervolino A, Di Micco P, Capuano A, Perrella A. Thromboembolic Events after COVID-19 Vaccination: An Italian Retrospective Real-World Safety Study. Vaccines (Basel) 2023; 11:1575. [PMID: 37896978 PMCID: PMC10611339 DOI: 10.3390/vaccines11101575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/29/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Real-world safety studies can provide important evidence on the thromboembolic risk associated with COVID-19 vaccines, considering that millions of people have been already vaccinated against COVID-19. In this study, we aimed to estimate the incidence of thromboembolic events after COVID-19 vaccination and to compare the Oxford-AstraZeneca vaccine with other COVID-19 vaccines. METHODS We conducted a retrospective real-world safety study using data from two different data sources: the Italian Pharmacovigilance database (Rete Nazionale di Farmacovigilanza, RNF) and the Campania Region Health system (Sistema INFOrmativo saNità CampanIA, SINFONIA). From the start date of the COVID-19 vaccination campaign (27 December 2021) to 27 September 2022, information on COVID-19 vaccinations and thromboembolic events were extracted from the two databases. The reporting rate (RR) and its 95% confidence interval (95%CI) of thromboembolic events for 10,000 doses was calculated for each COVID-19 vaccine. Moreover, the odds of being vaccinated with the Oxford-AstraZeneca vaccine vs. the other COVID-19 vaccines in cases with thromboembolic events vs. controls without thromboembolic events were computed. RESULTS A total of 12,692,852 vaccine doses were administered in the Campania Region, of which 6,509,475 (51.28%) were in females and mostly related to the Pfizer-BioNtech vaccine (65.05%), followed by Moderna (24.31%), Oxford-AstraZeneca (9.71%), Janssen (0.91%), and Novavax (0.02%) vaccines. A total of 641 ICSRs with COVID-19 vaccines and vascular events were retrieved from the RNF for the Campania Region, of which 453 (70.67%) were in females. Most ICSRs reported the Pfizer-BioNtech vaccine (65.05%), followed by Oxford-AstraZeneca (9.71%), Moderna (24.31%), and Janssen (0.91%). A total of 2451 events were reported in the ICSRs (3.8 events for ICSRs), of which 292 were thromboembolic events. The higher RRs of thromboembolic events were found with the Oxford-AstraZeneca vaccine (RR: 4.62, 95%CI: 3.50-5.99) and Janssen vaccine (RR: 3.45, 95%CI: 0.94-8.82). Thromboembolic events were associated with a higher likelihood of exposure to the Oxford-AstraZeneca vaccine compared to Pfizer-BioNtech (OR: 6.06; 95%CI: 4.22-8.68) and Moderna vaccines (OR: 6.46; 95%CI: 4.00-10.80). CONCLUSION We observed a higher reporting of thromboembolic events with viral-vector-based vaccines (Oxford-AstraZeneca and Janssen) and an increased likelihood of being exposed to the Oxford-AstraZeneca vaccine compared to the mRNA vaccines (Pfizer-BioNtech and Moderna) among thromboembolic cases.
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Affiliation(s)
- Francesca Futura Bernardi
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy; (F.F.B.); (U.T.); (G.M.F.)
| | - Annamaria Mascolo
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (R.R.); (L.S.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy
| | - Marina Sarno
- Unit Emerging Infectious Disease, Ospedali dei Colli, P.O. D. Cotugno, 80131 Naples, Italy; (M.S.); (N.C.); (A.P.)
| | - Nicolina Capoluongo
- Unit Emerging Infectious Disease, Ospedali dei Colli, P.O. D. Cotugno, 80131 Naples, Italy; (M.S.); (N.C.); (A.P.)
| | - Ugo Trama
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy; (F.F.B.); (U.T.); (G.M.F.)
| | - Rosanna Ruggiero
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (R.R.); (L.S.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy
| | - Liberata Sportiello
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (R.R.); (L.S.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy
| | - Giovanni Maria Fusco
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy; (F.F.B.); (U.T.); (G.M.F.)
| | - Massimo Bisogno
- Regional Special Office for Digital Transformation, Campania Region, 80100 Naples, Italy;
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy;
| | - Anna Iervolino
- Directorate-General AORN Ospedali dei Colli, Campania Region, 80131 Naples, Italy;
| | - Pierpaolo Di Micco
- General Medicine, Santa Maria delle Grazie Hospital, ASL NA2 Nord, 80078 Pozzuoli, Italy;
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (R.R.); (L.S.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, Via Costantinopoli 16, 80138 Naples, Italy
| | - Alessandro Perrella
- Unit Emerging Infectious Disease, Ospedali dei Colli, P.O. D. Cotugno, 80131 Naples, Italy; (M.S.); (N.C.); (A.P.)
- Regional Observatory for Infectious Disease, Campania Region, 80131 Naples, Italy
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Meuris B, Roussel JC, Borger MA, Siepe M, Stefano P, Laufer G, Langanay T, Theron A, Grabenwöger M, Binder K, Demers P, Pessotto R, van Leeuwen W, Bourguignon T, Canovas S, Mariscalco G, Coscioni E, Dagenais F, Wendler O, Polvani G, Eden M, Botta B, Bramlage P, De Paulis R. Durability of bioprosthetic aortic valve replacement in patients under the age of 60 years - 1-year follow-up from the prospective INDURE registry. Interdiscip Cardiovasc Thorac Surg 2023; 37:ivad115. [PMID: 37462612 PMCID: PMC10576637 DOI: 10.1093/icvts/ivad115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/16/2023] [Accepted: 07/01/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES We report 1-year safety and clinical outcomes in patients <60 years undergoing bioprosthetic surgical aortic valve intervention. METHODS The INSPIRIS RESILIA Durability Registry is a prospective, multicentre registry to assess clinical outcomes of patients <60 years. Patients with planned SAVR with or without concomitant replacement of the ascending aorta and/or coronary bypass surgery were included. Time-related valve safety, haemodynamic performance and quality of life (QoL) at 1 year were assessed. RESULTS A total of 421 patients were documented with a mean age of 53.5 years, 76.5% being male and 27.2% in NYHA class III/IV. Outcomes within 30 days included cardiovascular-related mortality (0.7%), time-related valve safety (VARC-2; 5.8%), thromboembolic events (1.7%), valve-related life-threatening bleeding (VARC-2; 4.3%) and permanent pacemaker implantation (3.8%). QoL was significantly increased at 6 months and sustained at 1 year. Freedom from all-cause mortality at 1 year was 98.3% (95% confidence interval 97.1; 99.6) and 81.8% were NYHA I versus 21.9% at baseline. No patient developed structural valve deterioration stage 3 (VARC-3). The mean aortic pressure gradient was 12.6 mmHg at 1 year and the effective orifice area was 1.9 cm2. CONCLUSIONS The 1-year data from the INSPIRIS RESILIA valve demonstrate good safety and excellent haemodynamic performance as well as an early QoL improvement. CLINICAL TRIAL REGISTRATION clinicaltrials.gov: NCT03666741.
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Affiliation(s)
- Bart Meuris
- Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | - Michael A Borger
- Department for Cardiac Surgery, Leipzig Heart Center, University of Leipzig, Leipzig, Germany
| | - Matthias Siepe
- Department of Cardiovascular Surgery, University Heart Center, University Hospital Freiburg, Freiburg, Germany
- Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, Germany
- Department of Cardiac Surgery, University Hospital Bern, University of Bern, Switzerland
| | - Pierluigi Stefano
- Division of Cardiac Surgery, Careggi University Hospital, Florence, Italy
| | - Günther Laufer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Thierry Langanay
- Thoracic and Cardiovascular Surgery, Rennes University Hospital Center, Rennes, France
| | - Alexis Theron
- Cardio-Thoracic Surgery Department, Hospital de la Timone, Marseille, France
| | - Martin Grabenwöger
- Department of Cardiovascular Surgery, HZH Heart Center Hietzing, Austria
| | - Konrad Binder
- Heart Center University St. Pölten, St. Pölten, Austria
| | - Philippe Demers
- Department of surgery, Montreal Heart Institute, University of Montreal, Montreal, Canada
| | - Renzo Pessotto
- Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Wouter van Leeuwen
- Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Thierry Bourguignon
- Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
| | - Sergio Canovas
- Cardiovascular Surgery Department, Hospital University Virgen de la Arrixaca, Murcia, Spain
| | - Giovanni Mariscalco
- National Institute for Health Research Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, England
| | - Enrico Coscioni
- Division of Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | | | - Olaf Wendler
- Department of Cardiothoracic Surgery, King’s College Hospital NHS Foundation Trust, London, UK
| | - Gianluca Polvani
- Department of Cardiovascular Surgery, Cardiology Center Monzino, Milan, Italy
| | - Matthias Eden
- Department for Internal Medicine III, Molecular Cardiology and Angiology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Beate Botta
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
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Napoli C, Coscioni E, Trama U, Strozziero MG, Benincasa G. An evidence-based debate on epigenetics and immunosenescence in COVID-19. Curr Res Immunol 2023; 4:100069. [PMID: 37781451 PMCID: PMC10539895 DOI: 10.1016/j.crimmu.2023.100069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/03/2023] Open
Abstract
Immunosenescence contributes to the decline of immune function leading to a reduced ability to respond to severe coronavirus disease 2019 (COVID-19) in elderly patients. Clinical course of COVID-19 is widely heterogeneous and guided by the possible interplay between genetic background and epigenetic-sensitive mechanisms underlying the immunosenescence which could explain, at least in part, the higher percentage of disease severity in elderly individuals. The most convincing evidence regards the hypomethylation of the angiotensin-converting enzyme 2 (ACE2) promoter gene in lungs as well as the citrullination of histone H3 in neutrophils which have been associated with worsening of COVID-19 outcome in elderly patients. In contrast, centenarians who have showed milder symptoms have been associated to a younger "epigenetic age" based on DNA methylation profiles at specific genomic sites (epigenetic clock). Some large prospective studies showed that the acceleration of epigenetic aging as well as the shortening of telomeres were significantly associated with lymphopenia and poor outcome suggesting prognostic biomarkers in elderly COVID-19 patients. Furthermore, randomized clinical trials showed that statins, L-arginine, and resveratrol could mediate anti-inflammatory effects via indirect epigenetic interference and might improve COVID-19 outcome. Here, we discuss the epigenetic-sensitive events which might contribute to increase the risk of severity and mortality in older subjects and possible targeted therapies to counteract immunosenescence.
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Affiliation(s)
- Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy
- U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggid'Aragona, 84131, Salerno, Italy
| | - Ugo Trama
- Regional Pharmaceutical Unit, Campania Region, 80143 Naples, Italy
| | - Maria Grazia Strozziero
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy
- IRCCS Synlab SDN Naples Italy
| | - Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania “Luigi Vanvitelli”, Naples, Italy
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Palmieri V, Montisci A, Vietri MT, Colombo PC, Sala S, Maiello C, Coscioni E, Donatelli F, Napoli C. Artificial intelligence, big data and heart transplantation: Actualities. Int J Med Inform 2023; 176:105110. [PMID: 37285695 DOI: 10.1016/j.ijmedinf.2023.105110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND As diagnostic and prognostic models developed by traditional statistics perform poorly in real-world, artificial intelligence (AI) and Big Data (BD) may improve the supply chain of heart transplantation (HTx), allocation opportunities, correct treatments, and finally optimize HTx outcome. We explored available studies, and discussed opportunities and limits of medical application of AI to the field of HTx. METHOD A systematic overview of studies published up to December 31st, 2022, in English on peer-revied journals, have been identified through PUBMED-MEDLINE-WEB of Science, referring to HTx, AI, BD. Studies were grouped in 4 domains based on main studies' objectives and results: etiology, diagnosis, prognosis, treatment. A systematic attempt was made to evaluate studies by the Prediction model Risk Of Bias ASsessment Tool (PROBAST) and the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD). RESULTS Among the 27 publications selected, none used AI applied to BD. Of the selected studies, 4 fell in the domain of etiology, 6 in the domain of diagnosis, 3 in the domain of treatment, and 17 in that of prognosis, as AI was most frequently used for algorithmic prediction and discrimination of survival, but in retrospective cohorts and registries. AI-based algorithms appeared superior to probabilistic functions to predict patterns, but external validation was rarely employed. Indeed, based on PROBAST, selected studies showed, to some extent, significant risk of bias (especially in the domain of predictors and analysis). In addition, as example of applicability in the real-world, a free-use prediction algorithm developed through AI failed to predict 1-year mortality post-HTx in cases from our center. CONCLUSIONS While AI-based prognostic and diagnostic functions performed better than those developed by traditional statistics, risk of bias, lack of external validation, and relatively poor applicability, may affect AI-based tools. More unbiased research with high quality BD meant for AI, transparency and external validations, are needed to have medical AI as a systematic aid to clinical decision making in HTx.
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Affiliation(s)
- Vittorio Palmieri
- Azienda Ospedaliera dei Colli Monaldi-Cotugno-CTO, Department of Cardiac Surgery and Transplantation, Naples, Italy.
| | - Andrea Montisci
- Division of Cardiothoracic Intensive Care, Cardiothoracic Department, ASST Spedali Civili, Brescia, Italy
| | - Maria Teresa Vietri
- Department of Precision Medicine, "Luigi Vanvitelli" University of Campania School of Medicine, Naples, Italy
| | - Paolo C Colombo
- Milstein Division of Cardiology, Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Silvia Sala
- Chair of Anesthesia and Intensive Care, University of Brescia, Brescia, Italy
| | - Ciro Maiello
- Azienda Ospedaliera dei Colli Monaldi-Cotugno-CTO, Department of Cardiac Surgery and Transplantation, Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Francesco Donatelli
- Department of Cardiac Surgery, Istituto Clinico Sant'Ambrogio, Milan, Italy; Chair of Cardiac Surgery, University of Milan, Milan, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), "Luigi Vanvitelli" University of Campania School of Medicine, Naples, Italy
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Palmieri V, Vietri MT, Montalto A, Montisci A, Donatelli F, Coscioni E, Napoli C. Cardiotoxicity, Cardioprotection, and Prognosis in Survivors of Anticancer Treatment Undergoing Cardiac Surgery: Unmet Needs. Cancers (Basel) 2023; 15:cancers15082224. [PMID: 37190153 DOI: 10.3390/cancers15082224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Anticancer treatments are improving the prognosis of patients fighting cancer. However, anticancer treatments may also increase the cardiovascular (CV) risk by increasing metabolic disorders. Atherosclerosis and atherothrombosis related to anticancer treatments may lead to ischemic heart disease (IHD), while direct cardiac toxicity may induce non-ischemic heart disease. Moreover, valvular heart disease (VHD), aortic syndromes (AoS), and advanced heart failure (HF) associated with CV risk factors and preclinical CV disease as well as with chronic inflammation and endothelial dysfunction may also occur in survivors of anti-carcer treatments. METHODS Public electronic libraries have been searched systematically looking at cardiotoxicity, cardioprotection, CV risk and disease, and prognosis after cardiac surgery in survivors of anticancer treatments. RESULTS CV risk factors and disease may not be infrequent among survivors of anticancer treatments. As cardiotoxicity of established anticancer treatments has been investigated and is frequently irreversible, cardiotoxicity associated with novel treatments appears to be more frequently reversible, but also potentially synergic. Small reports suggest that drugs preventing HF in the general population may be effective also among survivors of anticancer treatments, so that CV risk factors and disease, and chronic inflammation, may lead to indication to cardiac surgery in survivors of anticancer treatments. There is a lack of substantial data on whether current risk scores are efficient to predict prognosis after cardiac surgery in survivors of anticancer treatments, and to guide tailored decision-making. IHD is the most common condition requiring cardiac surgery among survivors of anticancer treatments. Primary VHD is mostly related to a history of radiation therapy. No specific reports exist on AoS in survivors of anticancer treatments. CONCLUSIONS It is unclear whether interventions to dominate cancer- and anticancer treatment-related metabolic syndromes, chronic inflammation, and endothelial dysfunction, leading to IHD, nonIHD, VHD, HF, and AoS, are as effective in survivors of anticancer treatments as in the general population. When CV diseases require cardiac surgery, survivors of anticancer treatments may be a population at specifically elevated risk, rather than affected by a specific risk factor.
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Affiliation(s)
- Vittorio Palmieri
- Unit of Cardiac Surgery, Cardiovascular Department, Azienda Ospedaliera di Rilevanza Nazionale "San Sebastiano e Sant'Anna", 81100 Caserta, Italy
| | - Maria Teresa Vietri
- Department of Precision Medicine, School of Medicine, "Luigi Vanvitelli" University of Campania, 80100 Naples, Italy
| | - Andrea Montalto
- Unit of Cardiac Surgery, Cardiovascular Department, Azienda Ospedaliera di Rilevanza Nazionale "San Sebastiano e Sant'Anna", 81100 Caserta, Italy
| | - Andrea Montisci
- Division of Cardiothoracic Intensive Care, Cardiothoracic Department, ASST Spedali Civili, 25123 Brescia, Italy
| | - Francesco Donatelli
- Department of Cardiac Surgery, Istituto Clinico Sant'Ambrogio, 20161 Milan, Italy
- Cardiac Surgery, University of Milan, 20122 Milan, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), "Luigi Vanvitelli" University of Campania School of Medicine, 80100 Naples, Italy
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11
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Torre M, Longobardi A, Vassallo MG, Oppido G, Coscioni E. Postinfarction ventricular septal defect: a new surgical option without left ventriculotomy. JTCVS Tech 2023. [DOI: 10.1016/j.xjtc.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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12
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Benincasa G, Viglietti M, Coscioni E, Napoli C. "Transplantomics" for predicting allograft rejection: real-life applications and new strategies from Network Medicine. Hum Immunol 2023; 84:89-97. [PMID: 36424231 DOI: 10.1016/j.humimm.2022.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/23/2022]
Abstract
Although decades of the reductionist approach achieved great milestones in optimizing the immunosuppression therapy, traditional clinical parameters still fail in predicting both acute and chronic (mainly) rejection events leading to higher rates across all solid organ transplants. To clarify the underlying immune-related cellular and molecular mechanisms, current biomedical research is increasingly focusing on "transplantomics" which relies on a huge quantity of big data deriving from genomics, transcriptomics, epigenomics, proteomics, and metabolomics platforms. The AlloMap (gene expression) and the AlloSure (donor-derived cell-free DNA) tests represent two successful examples of how omics and liquid biopsy can really improve the precision medicine of heart and kidney transplantation. One of the major challenges in translating big data in clinically useful biomarkers is the integration and interpretation of the different layers of omics datasets. Network Medicine offers advanced bioinformatic-molecular strategies which were widely used to integrate large omics datasets and clinical information in end-stage patients to prioritize potential biomarkers and drug targets. The application of network-oriented approaches to clarify the complex nature of graft rejection is still in its infancy. Here, we briefly discuss the real-life clinical applications derived from omics datasets as well as novel opportunities for establishing predictive tests in solid organ transplantation. Also, we provide an original "graft rejection interactome" and propose network-oriented strategies which can be useful to improve precision medicine of solid organ transplantation.
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Affiliation(s)
- Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
| | - Mario Viglietti
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", 80138, Naples, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, 84131, Salerno, Italy
| | - Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", 80138, Naples, Italy; U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Department of Internal Medicine and Specialistics, University of Campania "Luigi Vanvitelli", Naples, Italy
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13
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Bonadies D, Carpentiero G, Palumbo R, Grossi A, Cristiano M, Vassallo M, Torre M, Coscioni E, Galasso G. 1112 DOUBLE RUPTURE OF INTERVENTRICULAR SEPTUM AFTER MYOCARDIAL INFRACTION. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Ventricular septal rupture (VSR) is a mechanical complication of acute myocardial infarction (MI). VSR and early surgical repair is associated with a high mortality rate and suboptimal results with frequent postoperative residual shunt. Rapid diagnosis and proper management are critical.
We present the case of a 73-year-old patient who came to our Emercency Room (ER) reporting oppressive chest pain and profuse sweating .
The physical examination showed a 4/6 L rude holosystolic murmur in right parasternal location. Electrocardiogram (ECG) showed inferior MI. Hematochemicals tests detected an increase of myocardial necrosis markers. Two-dimensional and three-dimensional transthoracic echocardiography (TTE) showed normal-sized left ventricle with akinesia of inferior and posterolateral walls and akinesia of posterior basal septum with ventricular septal rupture at this level. Coronary angiography showed total occlusion in mid right coronary artery (RCA). An intra-aortic balloon pump (IABP) was inserted to promote hemodynamic stability of the patient and as a bridge. Afterload was reduced using vasodilatators. A preoperative transesophageal echocardiography (TOE) showed the presence of an additional septal rupture into middle posterior interventricular septum. The role of echocardiographic assessment in VSR, therapeutic management, IABP use and timing of surgery are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Mario Torre
- Universita’ Degli Studi Di Napoli Federico II
| | | | - Gennaro Galasso
- Universita’ Degli Studi Di Salerno
- Aou San Giovanni Di Dio E Ruggi D’aragona
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14
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Perrella A, Bisogno M, D’Argenzio A, Trama U, Coscioni E, Orlando V. Risk of SARS-CoV-2 Infection Breakthrough among the Non-Vaccinated and Vaccinated Population in Italy: A Real-World Evidence Study Based on Big Data. Healthcare (Basel) 2022; 10:healthcare10061085. [PMID: 35742137 PMCID: PMC9222607 DOI: 10.3390/healthcare10061085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 infection after vaccination can occur because COVID-19 vaccines do not offer 100% protection. The study aim was to assess duration of vaccination coverage, disease symptoms and type of hospitalization among non-vaccinated and vaccinated subjects to evaluate the vaccination trend over time. A retrospective cohort study was carried out among people testing COVID-19 positive in Campania Region using information from the Health Information System of Campania Region (Sinfonia). Vaccination status was assessed considering: no vaccination, partial vaccination and effective vaccination. Univariate and multivariate logistic regression models were constructed to evaluate the association between ICU admissions caused by COVID-19 and gender, age groups and vaccine type. Vaccine coverage duration trends were investigated using segmented linear regression and breakpoint estimations. Vaccination coverage was assessed by analyzing COVID-19 positive subjects in the 9 months after an effective dose vaccination. A significant risk of hospitalization in the ICU was caused by vaccination status: subjects non-vaccinated (OR: 7.14) and partially vaccinated (OR: 3.68) were 3 and 7 times more at risk of hospitalization, respectively, than subjects effectively vaccinated. Regarding subjects with an effective vaccination, the vaccine’s ability to protect against infection in the months following vaccination decreased. The risk of contracting COVID-19 after vaccination was higher 5 months (β = 1441, p < 0.001) and 7 months (β = 3110, p < 0.001) after administration of an effective dose. COVID-19 vaccines were demonstrated to protect from symptomatic infection by significantly reducing hospitalization risk, and their full protection against SARS-CoV-2 was demonstrated to decrease after 5 months regardless of age, gender or vaccine type.
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Affiliation(s)
- Alessandro Perrella
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- UOC Emerging Infectious Disease with High Contagiousness AORN Ospedali dei Colli P.O.C. Cotugno, 80131 Naples, Italy
- Correspondence: (A.P.); (V.O.)
| | - Massimo Bisogno
- Sinfonia Regional Health Information System of Campania Region, 80143 Naples, Italy;
| | - Angelo D’Argenzio
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
| | - Ugo Trama
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
| | - Enrico Coscioni
- Regional Task Force COVID-19, Campania Region, 80143 Naples, Italy; (A.D.); (U.T.); (E.C.)
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Valentina Orlando
- Directorate-General for Health Protection, Campania Region, 80143 Naples, Italy
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: (A.P.); (V.O.)
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15
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Benincasa G, Coscioni E, Napoli C. Cardiovascular risk factors and molecular routes underlying endothelial dysfunction: Novel opportunities for primary prevention. Biochem Pharmacol 2022; 202:115108. [DOI: 10.1016/j.bcp.2022.115108] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/23/2022]
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16
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Folino G, Scaffa R, Salica A, Weltert L, D'Aleo S, Guerrieri L, Irace F, Coscioni E, Gerosa G, De Paulis R. The black root: Aortic valve sparing in alkaptonuria. J Card Surg 2022; 37:1413-1415. [DOI: 10.1111/jocs.16331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Giulio Folino
- Department of Cardio‐Thoracic and Vascular Sciences University of Padua Padua Italy
| | - Raffaele Scaffa
- Department of Cardiac Surgery European Hospital Rome Italy
- Division of Cardiac Surgery A.O.U. San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
| | - Andrea Salica
- Department of Cardiac Surgery European Hospital Rome Italy
| | - Luca Weltert
- Department of Cardiac Surgery European Hospital Rome Italy
| | - Salvo D'Aleo
- Department of Cardiac Surgery European Hospital Rome Italy
| | | | - Francesco Irace
- Department of General and Specialized Surgery Paride Stefanini Sapienza University Rome Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery A.O.U. San Giovanni di Dio e Ruggi d'Aragona Salerno Italy
| | - Gino Gerosa
- Department of Cardio‐Thoracic and Vascular Sciences University of Padua Padua Italy
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Riccardo F, Guzzetta G, Mateo Urdiales A, Del Manso M, Andrianou X, Bella A, Pezzotti P, Carbone S, De Vito T, Maraglino F, Demicheli V, Dario C, Coscioni E, Rezza G, Urbani A, Merler S, Brusaferro S. COVID-19 response: effectiveness of weekly rapid risk assessments, Italy. Bull World Health Organ 2022. [DOI: 10.2471/blt.20.286317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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18
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Riccardo F, Guzzetta G, Urdiales AM, Del Manso M, Andrianou XD, Bella A, Pezzotti P, Carbone S, De Vito T, Maraglino F, Demicheli V, Dario C, Coscioni E, Rezza G, Urbani A, Merler S, Brusaferro S. COVID-19 response: effectiveness of weekly rapid risk assessments, Italy. Bull World Health Organ 2022; 100:161-167. [PMID: 35125541 PMCID: PMC8795855 DOI: 10.2471/blt.21.286317] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/27/2022] Open
Abstract
Problem After Italy’s first national restriction measures in 2020, a robust approach was needed to monitor the emerging epidemic of coronavirus disease 2019 (COVID-19) at subnational level and provide data to inform the strengthening or easing of epidemic control measures. Approach We adapted the European Centre for Disease Prevention and Control rapid risk assessment tool by including quantitative and qualitative indicators from existing national surveillance systems. We defined COVID-19 risk as a combination of the probability of uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 and of an unsustainable impact of COVID-19 cases on hospital services, adjusted in relation to the health system’s resilience. The monitoring system was implemented with no additional cost in May 2020. Local setting The infectious diseases surveillance system in Italy uses consistent data collection methods across the country’s decentralized regions and autonomous provinces. Relevant changes Weekly risk assessments using this approach were sustainable in monitoring the epidemic at regional level from 4 May 2020 to 24 September 2021. The tool provided reliable assessments of when and where a rapid increase in demand for health-care services would occur if control or mitigation measures were not increased in the following 3 weeks. Lessons learnt Although the system worked well, framing the risk assessment tool in a legal decree hampered its flexibility, as indicators could not be changed without changing the law. The relative complexity of the tool, the impossibility of real-time validation and its use for the definition of restrictions posed communication challenges.
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Affiliation(s)
- Flavia Riccardo
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | | | | | - Martina Del Manso
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | | | - Antonino Bella
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Patrizio Pezzotti
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | | | | | | | | | | | | | | | | | | | - Silvio Brusaferro
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
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19
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Perrella A, Orlando V, Trama U, Bernardi FF, Menditto E, Coscioni E. Pre-Exposure Prophylaxis with Hydroxychloroquine Does Not Prevent COVID-19 nor Virus Related Venous Thromboembolism. Viruses 2021; 13:v13102052. [PMID: 34696482 PMCID: PMC8537634 DOI: 10.3390/v13102052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/20/2021] [Accepted: 09/27/2021] [Indexed: 02/05/2023] Open
Abstract
Different and several public health strategies have been planned to reduce transmission of pandemic due to SARS-CoV-2 since it started. None drugs have been confirmed as able to prevent viral transmission. Hydroxychloroquine with its immunomodulatory properties has been proposed as potential anti-viral drug in particular for prevention once viral exposure has been happen or in first phases of infection. Furthermore, in several immunological systemic disease hydroxychloroquine was able to reduce the number of thrombotic complications. So, because COVID-19 was associated to immunological imbalance and to thrombotic complications, we retrospectively analyzed the rate of infection in those patients being under treatment with this drug during COVID-19 epidemic outbreak from 8 March until 28 April in particular comparing those with pre-exposure to this treatment and those that were not taking this medication before SARS-CoV-2 viral infections.
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Affiliation(s)
- Alessandro Perrella
- Hospital Health Direction, Infectious Disease Unit, Hospital A. Cardarelli, 80131 Naples, Italy
- Correspondence:
| | - Valentina Orlando
- CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80131 Naples, Italy; (V.O.); (E.M.)
| | - Ugo Trama
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (U.T.); (F.F.B.)
| | - Francesca F. Bernardi
- Regional Direction for Health Management, Pharmaceutical Unit, 80131 Naples, Italy; (U.T.); (F.F.B.)
| | - Enrica Menditto
- CIRFF, Center of Pharmacoeconomics, University of Naples Federico II, 80131 Naples, Italy; (V.O.); (E.M.)
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy;
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20
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Scaffa R, Torre M, Longobardi A, Ferrara D, Vassallo MG, Itri F, Coscioni E. Giant Distal Anastomotic Pseudoaneurysm 35 Years after Bentall Operation Mimicking an “Elephant Trunk”. Aorta (Stamford) 2021; 9:193-195. [PMID: 34879402 PMCID: PMC8654511 DOI: 10.1055/s-0041-1732399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We present the case of a giant distal aortic pseudoaneurysm 35 years after a classic mechanical Bentall operation. Computed tomography and coronary angiography showed that this originated from the distal suture line. The proximal suture and coronary ostia appeared to be intact. At reoperation, we found a complete dehiscence of distal suture line: the graft was floating in the pseudoaneurysm, mimicking an “elephant trunk” procedure. This complication suggested a systematic and accurate follow-up of patients who underwent an original Bentall procedure.
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Affiliation(s)
- Raffaele Scaffa
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Mario Torre
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Antonio Longobardi
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - David Ferrara
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Maria G. Vassallo
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Francesco Itri
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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21
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Torre M, Vassallo MG, Longobardi A, Ferrara D, Scaffa R, Spagnuolo M, Bottigliero M, Coscioni E. [The completion Bentall procedure: aortic root and ascending aorta replacement after prior aortic valve replacement]. G Ital Cardiol (Rome) 2021; 22:851-853. [PMID: 34570119 DOI: 10.1714/3666.36516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We describe the case of a patient with an ascending aorta and aortic root aneurysm who underwent aortic valve replacement, 14 years earlier, with a mechanical prosthesis, which was normally functioning at time of reoperation. We describe the "completion Bentall" technique - a modified Bentall technique -, a procedure for prosthesis-sparing aortic root replacement. This technique simplifies the original procedure in reinterventions, reducing complication rates and aortic cross-clamping and cardiopulmonary bypass times, with a good surgical result.
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Affiliation(s)
- Mario Torre
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno - Divisione di Cardiochirurgia, A.O.U. Federico II, Università degli Studi di Napoli Federico II, Napoli
| | | | - Antonio Longobardi
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - David Ferrara
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Raffaele Scaffa
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Mattia Spagnuolo
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno - Divisione di Cardiochirurgia, A.O.U. Federico II, Università degli Studi di Napoli Federico II, Napoli
| | - Matteo Bottigliero
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Enrico Coscioni
- Divisione di Cardiochirurgia, A.O. OO.RR. San Giovanni di Dio e Ruggi d'Aragona, Salerno
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22
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Montisci A, Donatelli F, Cirri S, Coscioni E, Maiello C, Napoli C. Veno-arterial Extracorporeal Membrane Oxygenation as Bridge to Heart Transplantation: The Way Forward. Transplant Direct 2021; 7:e720. [PMID: 34258387 PMCID: PMC8270578 DOI: 10.1097/txd.0000000000001172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/19/2022] Open
Abstract
Advanced heart failure (HF) represents a public health priority due to the increase of affected patients and the meaningful mortality. Durable mechanical circulatory support (MCS) and heart transplantation (HTx) are unique therapies for end-stage HF (ESHF), with positive early and long-term outcomes. The patients who underwent HTx have a 1-y survival of 91% and a median survival of 12-13 y, whereas the median survival of ESHF is <12 mo. Short-term MCS with veno-arterial extracorporeal membrane oxygenation (VA ECMO) can be used as a bridge to transplantation strategy. Patients bridged with VA ECMO have significantly lower survival in comparison with non-MCS bridged and left ventricular assist device-bridged patients. VA ECMO represents an effective, and sometimes unique, system to obtain rapid hemodynamic stabilization, but possible negative effects on patients' outcomes after HTx must be considered. Here, we discuss the use of VA ECMO as bridge to transplantation.
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Affiliation(s)
- Andrea Montisci
- Department of Anesthesia and Intensive Care, Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, Milan, Italy
| | - Francesco Donatelli
- Department of Cardiac Surgery, Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Silvia Cirri
- Department of Anesthesia and Intensive Care, Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, Milan, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Ciro Maiello
- Cardiac Transplantation Unit, Department of Cardiac Surgery and Transplantation, Ospedali dei Colli, Naples, Italy
| | - Claudio Napoli
- Clinical Department of Internal Medicine and Specialistic Units, Regional Referring Centre for Clinical Immunology of Organ Transplantation (LIT), University Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli,” Naples, Italy
- IRCCS-SDN, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
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23
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Ilardi F, Gargiulo G, Paolillo R, Ferrone M, Cimino S, Giugliano G, Schiattarella GG, Verde N, Stabile E, Perrino C, Cirillo P, Coscioni E, Morisco C, Esposito G. Impact of chronic kidney disease on platelet aggregation in patients with acute coronary syndrome. J Cardiovasc Med (Hagerstown) 2021; 21:660-666. [PMID: 32520854 DOI: 10.2459/jcm.0000000000000981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Chronic kidney disease (CKD) is associated with increased thrombotic events and seems to influence platelet reactivity. Conflicting results have been published on platelet response in CKD patients with stable coronary artery disease. The aim of our study was to investigate the impact of CKD on platelet aggregation in acute coronary syndrome (ACS) patients receiving dual antiplatelet therapy, included the more potent P2Y12 inhibitors. METHODS We enrolled 206 patients with ACS, divided in two groups, according to the presence or the absence of moderate/severe CKD. Platelet aggregation was performed with light transmission aggregometry and results are expressed as percentage of maximum platelet aggregation. High residual platelet reactivity (HRPR) was defined as maximum platelet aggregation more than 59%. RESULTS Patients with CKD [estimate glomerular filtration rate (eGFR) < 60 ml/min/1.73 m, n = 28] were prevalent older, diabetic, had previous coronary revascularization. In these patients, platelet aggregation was significantly higher than in those with eGFR ≥ 60 ml/min/1.73 m (ADP 10 μmol/l: 28.46 ± 26.19 vs. 16.64 ± 12.79, P < 0.001; ADP 20 μmol/l: 30.07 ± 25.89 vs. 17.46 ± 12.82, P < 0.001). HRPR was observed in 4.4% of patients, with higher prevalence in those with eGFR less than 60 ml/min/1.73 m [21.4 vs. 1.7%, P < 0.001, odds ratio (OR) [95% confidence interval (CI)] = 15.91 (3.71-68.17), P < 0.001]. At multivariate analysis, after correction for baseline confounders, eGFR [adjusted OR (95% CI) = 0.95 (0.91-0.98), P = 0.007], together with the use of clopidogrel [adjusted OR (95% CI) = 23.59 (4.01-138.82), P < 0.001], emerged as determinants of HRPR. CONCLUSION In patients with ACS receiving dual antiplatelet therapy, CKD is associated with an increasing ADP-induced platelet aggregation and higher prevalence of HRPR, which is mainly correlated to clopidogrel use.
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Affiliation(s)
- Federica Ilardi
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples.,Mediterranea Cardiocentro, Naples
| | - Giuseppe Gargiulo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Roberta Paolillo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Marco Ferrone
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Sara Cimino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giugliano
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Gabriele G Schiattarella
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples.,Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nicola Verde
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Eugenio Stabile
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Cinzia Perrino
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Plinio Cirillo
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Enrico Coscioni
- Department of Heart Surgery, San Giovanni di Dio e Ruggi d'Aragona Hospital, Salerno, Italy
| | - Carmine Morisco
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples
| | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples.,Mediterranea Cardiocentro, Naples
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24
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Napoli C, Bontempo P, Palmieri V, Coscioni E, Maiello C, Donatelli F, Benincasa G. Epigenetic Therapies for Heart Failure: Current Insights and Future Potential. Vasc Health Risk Manag 2021; 17:247-254. [PMID: 34079271 PMCID: PMC8164213 DOI: 10.2147/vhrm.s287082] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022] Open
Abstract
Despite the current reductionist approach providing an optimal indication for diagnosis and treatment of patients with heart failure with reduced ejection fraction (HFrEF), there are no standard pharmacological therapies for heart failure with preserved ejection fraction (HFpEF). Although in its infancy in cardiovascular diseases, the epigenetic-based therapy ("epidrugs") is capturing the interest of physician community. In fact, an increasing number of controlled clinical trials is evaluating the putative beneficial effects of: 1) direct epigenetic-oriented drugs, eg, apabetalone, and 2) repurposed drugs with a possible indirect epigenetic interference, eg, metformin, statins, sodium glucose transporter inhibitors 2 (SGLT2i), and omega 3 polyunsaturated fatty acids (PUFAs) in both HFrEF and HFpEF, separately. Apabetalone is the first and unique direct epidrug tested in cardiovascular patients to date, and the BETonMACE trial has reported a reduction in first HF hospitalization (any EF value) and cardiovascular death in patients with type 2 diabetes and recent acute coronary syndrome, suggesting a possible role in secondary prevention. Patients with HFpEF seem to benefit from supplementation to the standard therapy with statins, metformin, and SGLT2i owing to their ability in reducing mortality. In contrast, the vasodilator hydralazine, with or without isosorbide dinitrate, did not provide beneficial effects. In HFrEF, metformin and SGLT2i could reduce the risk of incident HF and mortality in affected patients whereas clinical trials based on statins provided mixed results. Furthermore, PUFAs diet supplementation was significantly associated with reduced cardiovascular risk in both HFpEF and HFrEF. Future large trials will reveal whether direct and indirect epitherapy will remain a work in progress or become a useful way to customize the therapy in the real-world management of HFpEF and HFrEF. Our goal is to discuss the recent advancement in the epitherapy as a possible way to improve personalized therapy of HF.
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Affiliation(s)
- Claudio Napoli
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Paola Bontempo
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Vittorio Palmieri
- Department of Cardiac Surgery and Transplantation, Heart Transplantation Unit in Adults of the 'Ospedali dei Colli Monaldi-Cotugno-CTO', Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ciro Maiello
- Department of Cardiovascular Surgery and Transplants, Monaldi Hospital, Azienda dei Colli, Naples, Italy
| | - Francesco Donatelli
- Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant'Ambrogio, University of Milan, Milan, Italy
| | - Giuditta Benincasa
- Department of Advanced Medical and Surgical Sciences (DAMSS), University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
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25
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Limongelli G, Iucolano S, Monda E, Elefante P, De Stasio C, Lubrano I, Caiazza M, Mazzella M, Fimiani F, Galdo M, De Marchi G, Esposito M, Rubino M, Cirillo A, Fusco A, Esposito A, Trama U, Esposito S, Scarano G, Sepe J, Andria G, Orlando V, Menditto E, Chiodini P, Iolascon A, Franzese A, Sanduzzi Zamparelli A, Tessitore A, Romano A, Venosa A, Nunzia Olivieri A, Bianco A, La Manna A, Cerbone AM, Spasiano A, Agnese Stanziola A, Colao A, De Bellis A, Gambale A, Toriello A, Tufano A, Ciampa A, Maria Risitano A, Pisani A, Russo A, Volpe A, De Martino B, Amato B, De Fusco C, Piscopo C, Selleri C, Tucci C, Pignata C, Cioffi D, Melis D, Pasquali D, De Brasi D, Spitaleri D, De Brasi D, Russo D, Martellotta D, De Michele E, Varricchio E, Miraglia Del Giudice E, Coscioni E, Cimino E, Pane F, Tranfa F, Pollio F, Lonardo F, Nuzzi F, Simonelli F, Trojsi F, Habetswallner F, Valentini G, Cerbone G, Parenti G, Tedeschi G, Capasso G, Battista Rossi G, Gaglione G, Sarnelli G, Argenziano G, Bellastella G, De Michele G, Fiorentino G, Spadaro G, Scala I, Santoro L, Zeppa L, Auricchio L, Elio Adinolfi L, Alessio M, Amitrano M, Savanelli MC, Russo MG, Ferrucci MG, Carbone MT, Pellecchia MT, Salerno M, Melone M, Del Donno M, Vitale M, Triggiani M, Della Monica M, Lo Presti M, Tenuta M, Mignogna MD, Schiavulli M, Zacchia M, Brunetti-Pierri N, Iovino P, Moscato P, Iandoli R, Scarpa R, Russo R, Troisi S, Sbordone S, Perrotta S, Fecarotta S, Sampaolo S, Cicalese V. Diagnostic issues faced by a rare disease healthcare network during Covid-19 outbreak: data from the Campania Rare Disease Registry. J Public Health (Oxf) 2021; 44:586-594. [PMID: 33982102 PMCID: PMC8194710 DOI: 10.1093/pubmed/fdab137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 12/16/2022] Open
Abstract
Background The aims of this study were: to investigate the capacity of the rare disease healthcare network in Campania to diagnose patients with rare diseases during the outbreak of Covid-19; and to shed light on problematic diagnoses during this period. Methods To describe the impact of the Covid-19 pandemic on the diagnosis of patients with rare diseases, a retrospective analysis of the Campania Region Rare Disease Registry was performed. A tailored questionnaire was sent to rare disease experts to investigate major issues during the emergency period. Results Prevalence of new diagnoses of rare disease in March and April 2020 was significantly lower than in 2019 (117 versus 317, P < 0.001 and 37 versus 349, P < 0.001, respectively) and 2018 (117 versus 389, P < 0.001 and 37 versus 282, P < 0.001, respectively). Eighty-two among 98 rare disease experts completed the questionnaire. Diagnostic success (95%), access to diagnosis (80%) and follow-up (72%), lack of Personal Protective Equipment (60%), lack of Covid-19 guidelines (50%) and the need for home therapy (78%) were the most important issues raised during Covid-19 outbreak. Conclusions This study describes the effects of the Covid-19 outbreak on the diagnosis of rare disease in a single Italian region and investigates potential issues of diagnosis and management during this period.
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Affiliation(s)
| | - Stefano Iucolano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Emanuele Monda
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Pasquale Elefante
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Chiara De Stasio
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Imma Lubrano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Martina Caiazza
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | | | - Fabio Fimiani
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Maria Galdo
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Giulia De Marchi
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Martina Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Marta Rubino
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Annapaola Cirillo
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Adelaide Fusco
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Augusto Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Ugo Trama
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Salvatore Esposito
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Gioacchino Scarano
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Joseph Sepe
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Generoso Andria
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Valentina Orlando
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Enrica Menditto
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
| | - Paolo Chiodini
- Centro di Coordinamento Malattie Rare, Regione Campania Naples 80131, Italy
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26
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Scavone C, Mascolo A, Rafaniello C, Sportiello L, Trama U, Zoccoli A, Bernardi FF, Racagni G, Berrino L, Castaldo G, Coscioni E, Rossi F, Capuano A. Therapeutic strategies to fight COVID-19: Which is the status artis? Br J Pharmacol 2021; 179:2128-2148. [PMID: 33960398 PMCID: PMC8239658 DOI: 10.1111/bph.15452] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023] Open
Abstract
COVID‐19 is a complex disease, and many difficulties are faced today especially in the proper choice of pharmacological treatments. The role of antiviral agents for COVID‐19 is still being investigated and evidence for immunomodulatory and anti‐inflammatory drugs is quite conflicting, whereas the use of corticosteroids is supported by robust evidence. The use of heparins in hospitalized critically ill patients is preferred over other anticoagulants. There are conflicting data on the use of convalescent plasma and vitamin D. According to the World Health Organization (WHO), many vaccines are in Phase III clinical trials, and some of them have already received marketing approval in European countries and in the United States. In conclusion, drug repurposing has represented the main approach recently used in the treatment of patients with COVID‐19. At this moment, analysis of efficacy and safety data of drugs and vaccines used in real‐life context is strongly needed.
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Affiliation(s)
- Cristina Scavone
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Annamaria Mascolo
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Ugo Trama
- Regional Pharmaceutical Unit, U.O.D. 06 Politica del Farmaco e Dispositivi, Naples, Italy
| | - Alice Zoccoli
- Clinical Innovation Office, Università Campus Bio-Medico, Rome, Italy
| | - Francesca Futura Bernardi
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy.,Regional Pharmaceutical Unit, U.O.D. 06 Politica del Farmaco e Dispositivi, Naples, Italy
| | - Giorgio Racagni
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Liberato Berrino
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Napoli Federico II, Naples, Italy.,CEINGE-Advanced Biotechnology Scarl, Naples, Italy
| | - Enrico Coscioni
- Agenzia nazionale per i servizi sanitari regionali, Rome, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy.,Clinical Innovation Office, Università Campus Bio-Medico, Rome, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, Università degli studi della Campania 'Luigi Vanvitelli', Naples, Italy
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27
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Orlando V, Coscioni E, Guarino I, Mucherino S, Perrella A, Trama U, Limongelli G, Menditto E. Drug-utilisation profiles and COVID-19. Sci Rep 2021; 11:8913. [PMID: 33903671 PMCID: PMC8076316 DOI: 10.1038/s41598-021-88398-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 03/24/2021] [Indexed: 02/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has substantially challenged healthcare systems worldwide. By investigating population characteristics and prescribing profiles, it is possible to generate hypotheses about the associations between specific drug-utilisation profiles and susceptibility to COVID-19 infection. A retrospective drug-utilisation study was carried out using routinely collected information from a healthcare database in Campania (Southern Italy). We aimed to discover the prevalence of drug utilisation (monotherapy and polytherapy) in COVID-19 versus non-COVID-19 patients in Campania (~ 6 million inhabitants). The study cohort comprised 1532 individuals who tested positive for COVID-19. Drugs were grouped according to the Anatomical Therapeutic Chemical (ATC) classification system. We noted higher prevalence rates of the use of drugs in the ATC categories C01, B01 and M04, which was probably linked to related comorbidities (i.e., cardiovascular and metabolic). Nevertheless, the prevalence of the use of drugs acting on the renin-angiotensin system, such as antihypertensive drugs, was not higher in COVID-19 patients than in non-COVID-19 patients after adjustments for age and sex. These results highlight the need for further case-control studies to define the effects of medications and comorbidities on susceptibility to and associated mortality from COVID-19.
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Affiliation(s)
- Valentina Orlando
- CIRFF, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy.
- Department of Pharmacy, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy.
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio E Ruggi d'Aragona, 84131, Salerno, Italy
| | - Ilaria Guarino
- CIRFF, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy
| | - Sara Mucherino
- CIRFF, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy
- Department of Pharmacy, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy
| | - Alessandro Perrella
- Infectious Disease of Healthcare Direction, AORN Antonio Cardarelli, 80131, Naples, Italy
| | - Ugo Trama
- Regional Pharmaceutical Unit, Campania Region, 80143, Naples, Italy
| | - Giuseppe Limongelli
- Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Monaldi Hospital, 80131, Naples, Italy
| | - Enrica Menditto
- CIRFF, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy.
- Department of Pharmacy, Center of Drug Utilisation and Pharmacoeconomics, University of Naples Federico II, 80131, Naples, Italy.
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28
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Orlando V, Rea F, Savaré L, Guarino I, Mucherino S, Perrella A, Trama U, Coscioni E, Menditto E, Corrao G. Development and validation of a clinical risk score to predict the risk of SARS-CoV-2 infection from administrative data: A population-based cohort study from Italy. PLoS One 2021; 16:e0237202. [PMID: 33471809 PMCID: PMC7816996 DOI: 10.1371/journal.pone.0237202] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The novel coronavirus (SARS-CoV-2) pandemic spread rapidly worldwide increasing exponentially in Italy. To date, there is lack of studies describing clinical characteristics of the people at high risk of infection. Hence, we aimed (i) to identify clinical predictors of SARS-CoV-2 infection risk, (ii) to develop and validate a score predicting SARS-CoV-2 infection risk, and (iii) to compare it with unspecific scores. METHODS Retrospective case-control study using administrative health-related database was carried out in Southern Italy (Campania region) among beneficiaries of Regional Health Service aged over than 30 years. For each person with SARS-CoV-2 confirmed infection (case), up to five controls were randomly matched for gender, age and municipality of residence. Odds ratios and 90% confidence intervals for associations between candidate predictors and risk of infection were estimated by means of conditional logistic regression. SARS-CoV-2 Infection Score (SIS) was developed by generating a total aggregate score obtained from assignment of a weight at each selected covariate using coefficients estimated from the model. Finally, the score was categorized by assigning increasing values from 1 to 4. Discriminant power was used to compare SIS performance with that of other comorbidity scores. RESULTS Subjects suffering from diabetes, anaemias, Parkinson's disease, mental disorders, cardiovascular and inflammatory bowel and kidney diseases showed increased risk of SARS-CoV-2 infection. Similar estimates were recorded for men and women and younger and older than 65 years. Fifteen conditions significantly contributed to the SIS. As SIS value increases, risk progressively increases, being odds of SARS-CoV-2 infection among people with the highest SIS value (SIS = 4) 1.74 times higher than those unaffected by any SIS contributing conditions (SIS = 1). CONCLUSION Conditions and diseases making people more vulnerable to SARS-CoV-2 infection were identified by the current study. Our results support decision-makers in identifying high-risk people and adopting of preventive measures to minimize the spread of further epidemic waves.
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Affiliation(s)
- Valentina Orlando
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, University of Naples Federico II, Naples, Italy
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Federico Rea
- National Centre for Healthcare Research & Pharmacoepidemiology, at the University of Milano-Bicocca, Milan, Italy
- Department of Statistics and Quantitative Methods, Laboratory of Healthcare Research & Pharmacoepidemiology, Unit of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Laura Savaré
- National Centre for Healthcare Research & Pharmacoepidemiology, at the University of Milano-Bicocca, Milan, Italy
- Department of Statistics and Quantitative Methods, Laboratory of Healthcare Research & Pharmacoepidemiology, Unit of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
| | - Ilaria Guarino
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, University of Naples Federico II, Naples, Italy
| | - Sara Mucherino
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, University of Naples Federico II, Naples, Italy
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Alessandro Perrella
- Infectious Disease of Healthcare Direction, AORN Antonio Cardarelli, Naples, Italy
| | - Ugo Trama
- Regional Pharmaceutical Unit, Campania Region, Naples, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Enrica Menditto
- CIRFF, Center of Drug Utilization and Pharmacoeconomics, University of Naples Federico II, Naples, Italy
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Giovanni Corrao
- National Centre for Healthcare Research & Pharmacoepidemiology, at the University of Milano-Bicocca, Milan, Italy
- Department of Statistics and Quantitative Methods, Laboratory of Healthcare Research & Pharmacoepidemiology, Unit of Biostatistics, Epidemiology and Public Health, University of Milano-Bicocca, Milan, Italy
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Attisano T, Ferraioli M, Silverio A, Bellino M, Esposito L, Di Muro FM, Baldi C, Coscioni E, Galasso G. 234 The role of preprocedural assessment of aortic valve calcium volume for the optimization of percutaneous aortic bioprosthesis implantation (TAVI). Eur Heart J Suppl 2020. [DOI: 10.1093/eurheartj/suaa197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
Paravalvular leaks (PVL) and conduction disorders requiring permanent pacemaker implantation (PPI) in patients with severe Aortic Valvular Stenosis (SA) undergoing percutaneous aortic valve prosthesis (TAVI) still have a significant and unacceptable incidence for patients at medium and low surgical risk, who represent, with increasing scientific evidence, the prevalent population. The appearance of these complications seems to be related to clinical, anatomical and procedural factors, which influence the decision-making process of the type and size of bioprosthesis to be implanted. Particular attention has been paid to the role of the volume of calcium present at the native aortic valve (VCA) as a predictor of these complications, in order to optimize the percutaneous procedure. The VCA can be quantified using algorithms derived from Multilayer Computed Computed Axial Tomography (MSCT), an examination that has become a pivotal element in the evaluation of the patient's eligibility for TAVI.The aim of our study was to document the pre-procedural added value of VCA in terms of possible containment of adverse events and how much it may affect the choice of the type of bioprosthesis to be implanted.
Methods and results
111 patients underwent TAVIs at the Interventional Cardiology Unit of the AOU S. Giovanni di Dio and Ruggi D'Aragona, between 2017 and 2020, subsequently divided into 2 groups: group A (self-expandable bioprosthesis, Medtronic Evolut R or Evolut Pro) and group B (balloon expandable bioprosthesis, Edward Sapien 3).The clinical, electrocardiographic, echocardiographic and anatomical parameters of the enrolled patients were analyzed, and the VCA in the preprocedural phase was quantified for each of them, using an algorithm extracted from the MSCT reading software, OsiriX (OsiriX-MD v.2.8.2 64-bit).
A univariate logistic regression analysis was performed for the risk of developing the composite event of significant PVL and IPP.In Group B, no significant variables were found, while in Group A, the VCA (OR: 1.001; 95% CI, 1.000-1.002; p < 0.043) and incomplete left branch block (OR: 5.781; 95% CI, 0.013-32.988; p < 0.048) were significant. Subsequently, these two variables were tested in a multivariate regression model according to which only the VCA emerged as an independent predictor for the composite event (OR: 1.001; 95% CI, 1.000-1.002; p < 0.039).
Conclusion
VCA is significantly associated with the risk of moderate to severe PVL and rhythm disturbances requiring PPI, in the group of patients in whom a self-expandable bioprosthesis was implanted, unlike patients who received a balloon-expandable bioprosthesis where this association is not significant.
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Affiliation(s)
- Tiziana Attisano
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Mario Ferraioli
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Angelo Silverio
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Michele Bellino
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Luca Esposito
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | | | - Cesare Baldi
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Enrico Coscioni
- Cardiothoracic Surgery Unit. Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
| | - Gennaro Galasso
- Interventional Cardiology Unit Heart Department AOU S. Giovanni di dio e Ruggi D’Aragona
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30
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Donatelli F, Miceli A, Glauber M, Cirri S, Maiello C, Coscioni E, Napoli C. Adult cardiovascular surgery and the coronavirus disease 2019 (COVID-19) pandemic: the Italian experience. Interact Cardiovasc Thorac Surg 2020; 31:755-762. [PMID: 33099647 PMCID: PMC7665554 DOI: 10.1093/icvts/ivaa186] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected all health care professionals. The outbreak required a thorough reorganization of the Italian regional local health care system to preserve resources such as ventilators, beds in intensive care units and surgical and anaesthesiological staff. Levels of priority were created, together with a rigorous triage procedure for patients with COVID-19, which led to postponement of all elective procedures. Urgent cases were discussed with the local heart team and percutaneous approaches were selected as the first treatment option to reduce hospital stay. COVID-19 and COVID-19-free pathways were created, including adequate preparation of the operating room, management of anaesthesiological procedures, transportation of patients and disinfection. It was determined that patients with chronic diseases were at increased risk of adverse outcomes. Systemic inflammation, cytokine storm and hypercoagulability associated with COVID-19 increased the risk of heart failure and cardiac death. In this regard, the early use of extracorporeal membrane oxygenation could be life-saving in patients with severe forms of acute respiratory distress syndrome or refractory heart failure. The goal of this paper was to report the Italian experience during the COVID-19 pandemic in the setting of cardiovascular surgery.
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Affiliation(s)
- Francesco Donatelli
- Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, University of Milan, Milan, Italy
| | - Antonio Miceli
- Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, University of Milan, Milan, Italy
| | - Mattia Glauber
- Chair of Cardiac Surgery, Department of Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, University of Milan, Milan, Italy
| | - Silvia Cirri
- Department of Anaesthesia and Intensive Care, Cardiothoracic Center, Istituto Clinico Sant’Ambrogio, Milan, Italy
| | - Ciro Maiello
- Cardiac Transplantation Unit, Department of Cardiac Surgery and Transplantation, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Claudio Napoli
- Clinical Department of Internal Medicine and Specialists, Azienda Ospedaliera Universitaria, and University Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
- IRCCS-SDN, Istituto di Ricovero e Cura a Carattere Scientifico, Naples, Italy
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31
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Napoli C, Tritto I, Mansueto G, Coscioni E, Ambrosio G. Immunosenescence exacerbates the COVID-19. Arch Gerontol Geriatr 2020; 90:104174. [PMID: 32653765 PMCID: PMC7333612 DOI: 10.1016/j.archger.2020.104174] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Claudio Napoli
- Clinical Department of Internal Medicine and Specialistic Units, Division of Clinical Immunology, Immunohematology, and Transplantation and University Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy; IRCCS SDN, Naples, Italy.
| | - Isabella Tritto
- Cardiology and Cardiovascular Pathophysiology, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia", University of Perugia, Perugia, Italy
| | - Gelsomina Mansueto
- Clinical Department of Internal Medicine and Specialistic Units, Division of Clinical Immunology, Immunohematology, and Transplantation and University Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Enrico Coscioni
- Department of Cardiac Surgery, Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Giuseppe Ambrosio
- Cardiology and Cardiovascular Pathophysiology, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia", University of Perugia, Perugia, Italy; Cardiovascular Department, MultiMedica IRCCS, Sesto San Giovanni, Milan, Italy
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32
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Meuris B, Borger MA, Bourguignon T, Siepe M, Grabenwöger M, Laufer G, Binder K, Polvani G, Stefano P, Coscioni E, van Leeuwen W, Demers P, Dagenais F, Canovas S, Theron A, Langanay T, Roussel JC, Wendler O, Mariscalco G, Pessotto R, Botta B, Bramlage P, de Paulis R. Durability of bioprosthetic aortic valves in patients under the age of 60 years - rationale and design of the international INDURE registry. J Cardiothorac Surg 2020; 15:119. [PMID: 32460798 PMCID: PMC7251702 DOI: 10.1186/s13019-020-01155-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an ever-growing number of patients requiring aortic valve replacement (AVR). Limited data is available on the long-term outcomes and structural integrity of bioprosthetic valves in younger patients undergoing surgical AVR. METHODS The INSPIRIS RESILIA Durability Registry (INDURE) is a prospective, open-label, multicentre, international registry with a follow-up of 5 years to assess clinical outcomes of patients younger than 60 years who undergo surgical AVR using the INSPIRIS RESILIA aortic valve. INDURE will be conducted across 20-22 sites in Europe and Canada and intends to enrol minimum of 400 patients. Patients will be included if they are scheduled to undergo AVR with or without concomitant root replacement and/or coronary bypass surgery. The primary objectives are to 1) determine VARC-2 defined time-related valve safety at one-year (depicted as freedom from events) and 2) determine freedom from stage 3 structural valve degeneration (SVD) presenting as morphological abnormalities and severe haemodynamic valve degeneration at 5 years. Secondary objectives include the assessment of the haemodynamic performance of the valve, all stages of SVD, potential valve-in-valve procedures, clinical outcomes (in terms of New York Heart Association [NYHA] function class and freedom from valve-related rehospitalisation) and change in patient quality-of-life. DISCUSSION INDURE is a prospective, multicentre registry in Europe and Canada, which will provide much needed data on the long-term performance of bioprosthetic valves in general and the INSPIRIS RESILIA valve in particular. The data may help to gather a deeper understanding of the longevity of bioprosthetic valves and may expand the use of bioprosthetic valves in patients under the age of 60 years. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03666741 (registration received September, 12th, 2018).
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Affiliation(s)
- Bart Meuris
- Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | | | | | - Matthias Siepe
- Heart Center University of Freiburg, Freiburg and Bad Krozingen, Germany
| | | | | | - Konrad Binder
- Heart Center University St. Pölten, St. Pölten, Austria
| | | | | | - Enrico Coscioni
- University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | | | | | | | - Sergio Canovas
- Hospital University Virgen de la Arrixaca, Murcia, Spain
| | | | | | | | - Olaf Wendler
- King's College Hospital NHS Foundation Trust, London, UK
| | | | | | - Beate Botta
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
| | - Peter Bramlage
- Institute for Pharmacology and Preventive Medicine, Cloppenburg, Germany
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Perrella A, Trama U, Bernardi FF, Russo G, Monastra L, Fragranza F, Orlando V, Coscioni E. Editorial - COVID-19, more than a viral pneumonia. Eur Rev Med Pharmacol Sci 2020; 24:5183-5185. [PMID: 32432786 DOI: 10.26355/eurrev_202005_21216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- A Perrella
- Hospital Health Direction, Infectious Disease Unit, A. Cardarelli Hospital, Naples, Italy.
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34
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Stabile E, Coscioni E, Scalise M, Franzese M, Gerardi D, Esposito G. Embolic protection: assessing the options. Ital J Vasc Endovasc Surg 2020. [DOI: 10.23736/s1824-4777.19.01425-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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35
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Santulli G, Pascale V, Finelli R, Visco V, Giannotti R, Massari A, Morisco C, Ciccarelli M, Illario M, Iaccarino G, Coscioni E. We are What We Eat: Impact of Food from Short Supply Chain on Metabolic Syndrome. J Clin Med 2019; 8:jcm8122061. [PMID: 31771147 PMCID: PMC6947359 DOI: 10.3390/jcm8122061] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Food supply in the Mediterranean area has been recently modified by big retail distribution; for instance, industrial retail has favored shipments of groceries from regions that are intensive producers of mass food, generating a long supply chain (LSC) of food that opposes short supply chains (SSCs) that promote local food markets. However, the actual functional role of food retail and distribution in the determination of the risk of developing metabolic syndrome (MetS) has not been studied hitherto. The main aim of this study was to test the effects of food chain length on the prevalence of MetS in a population accustomed to the Mediterranean diet. We conducted an observational study in Southern Italy on individuals adhering to the Mediterranean diet. We examined a total of 407 subjects (41% females) with an average age of 56 ± 14.5 years (as standard deviation) and found that being on the Mediterranean diet with a SSC significantly reduces the prevalence of MetS compared with the LSC (SSC: 19.65%, LSC: 31.46%; p: 0.007). Our data indicate for the first time that the length of food supply chain plays a key role in determining the risk of MetS in a population adhering to the Mediterranean diet.
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Affiliation(s)
- Gaetano Santulli
- Dept. of Medicine, Division of Cardiology, and Dept. of Molecular Pharmacology, Montefiore University Hospital, Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine (AECOM), New York, NY 10461, USA
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
- Correspondence: or (G.S.); (G.I.)
| | - Valeria Pascale
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rosa Finelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Valeria Visco
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Rocco Giannotti
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Angelo Massari
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
| | - Carmine Morisco
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
| | - Michele Ciccarelli
- Dept. of Medicine, Surgery and Dentistry, University of Salerno, 8408 Baronissi, Italy; (V.P.); (R.F.); (V.V.); (R.G.); (M.C.)
| | - Maddalena Illario
- Health’s Innovation, Campania Regional Government, 80132 Naples, Italy;
- Dept. of Public Health, Federico II University, 80131 Naples, Italy
| | - Guido Iaccarino
- Dept. of Advanced Biomedical Science, Federico II University, 80131 Naples, Italy;
- International Translational Research and Medical Education Consortium (ITME), 80131 Naples, Italy
- Correspondence: or (G.S.); (G.I.)
| | - Enrico Coscioni
- “San Giovanni di Dio e Ruggi d’Aragona” University Hospital, 84131 Salerno, Italy; (A.M.); (E.C.)
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36
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Salzano A, Marra AM, Arcopinto M, D'Assante R, Triggiani V, Coscioni E, Pasquali D, Rengo G, Suzuki T, Bossone E, Cittadini A. Combined effects of growth hormone and testosterone replacement treatment in heart failure. ESC Heart Fail 2019; 6:1216-1221. [PMID: 31696666 PMCID: PMC6989300 DOI: 10.1002/ehf2.12520] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/09/2019] [Accepted: 08/25/2019] [Indexed: 12/16/2022] Open
Abstract
Aims Although preliminary studies have demonstrated safety and effectiveness of single replacement therapy for growth hormone deficiency or testosterone deficiency in heart failure (HF), no data are available regarding the combined treatment with both GH and T in this setting. Thus, the aim of the present hypothesis generating pilot study was to evaluate the effectiveness and safety of multiple hormonal replacement therapies in chronic HF. Methods and results Five stable HF with reduced ejection fraction patients, with a concomitant diagnosis of growth hormone deficiency and testosterone deficiency, on top of guideline‐based HF treatment underwent 1 year of GH replacement therapy by subcutaneous injections of somatotropin at a dose of 0.012 mg/kg every second day. After 12 months, a T replacement treatment was added at a dosage of 1000 mg every 3 months. Each patient underwent a complete M‐mode, two‐dimensional, and Doppler echocardiographic examination, and an incremental symptom‐limited cardiopulmonary exercise test on a bicycle ergometer at baseline (BL), after 1 year of GH treatment (V1), and after 1 year of combined GH + T treatments (V2). One‐year of GH treatment resulted in a significant improvement in left ventricular ejection fraction (+5.4%, P < 0.01), New York Heart Association functional class (P < 0.05), and peak oxygen consumption (VO2 peak) (+19.3%, P < 0.01), and in a significant reduction in NT‐proBNP levels (−35.1%, P < 0.01). Notably, one additional year of combined GH and T replacement therapy induced a further increase in VO2 peak (+27.7%, final delta change + 52.44%, P < 0.01), as well as a significant improvement in muscular strength, as assessed by handgrip dynamometry (+17.5%, final delta change + 25.8%, P < 0.01). These beneficial effects were paralleled with an improvement of the overall clinical status (as assessed by New York Heart Association class). Of note, neither adverse effects nor cardiovascular events were reported during the follow‐up period. Conclusions Our preliminary data suggest for the first time that combined replacement therapy with GH and T could be considered safe and therapeutic in HF patients with multiple hormone deficiencies, supporting the hypothesis that multiple hormone deficiencies syndrome can be considered as a novel and promising therapeutic target in HF. Further studies with a more robust design and larger population are needed.
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Affiliation(s)
- Andrea Salzano
- IRCCS SDN, Diagnostic and Nuclear Research Institute, Naples, Italy
| | - Alberto M Marra
- IRCCS SDN, Diagnostic and Nuclear Research Institute, Naples, Italy
| | - Michele Arcopinto
- Department of Translational Medical Sciences, Division of Internal Medicine & Metabolism & Rehabilitation, Federico II University, Naples, Italy
| | - Roberta D'Assante
- Department of Translational Medical Sciences, Division of Internal Medicine & Metabolism & Rehabilitation, Federico II University, Naples, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine, Section of Internal Medicine, Geriatrics, Endocrinology, and Rare Diseases, University Aldo Moro, Bari, Italy
| | - Enrico Coscioni
- Department 'Cuore', University Hospital San Giovanni di Dio e Rungi d'Aragona, Salerno, Italy
| | - Daniela Pasquali
- Department of Neurological, Metabolic, and Geriatric Sciences, Endocrinology Unit, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Division of Internal Medicine & Metabolism & Rehabilitation, Federico II University, Naples, Italy.,Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), Telese Terme, Benevento, Italy
| | - Toru Suzuki
- Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | | | - Antonio Cittadini
- Department of Translational Medical Sciences, Division of Internal Medicine & Metabolism & Rehabilitation, Federico II University, Naples, Italy.,Interdisciplinary Research Centre in Biomedical Materials (CRIB), Naples, Italy
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Franzese M, Coscioni E, Scalise M, Gerardi D, Giugliano G, Esposito G, Stabile E. [Antithrombotic therapy in lower extremity arterial disease]. G Ital Cardiol (Rome) 2019; 20:632-640. [PMID: 31697270 DOI: 10.1714/3254.32224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Lower extremity arterial disease (LEAD) affects over 200 million people worldwide but, as of today, is not adequately treated and represents an important cause of morbidity, mortality and disability. Although the use of antithrombotic therapy is recommended to prevent cardiovascular adverse events, patients with LEAD often receive inadequate prescription for antithrombotic agents (antiplatelets and anticoagulants). Historically, the inadequate use of antithrombotic drugs in this clinical setting has been ascribed to the lack of high quality scientific data obtained from clinical trials enrolling patients with LEAD. However, the results of more recent clinical trials support the use of antithrombotic drugs for these patients. The aim of this article is to summarize the available evidence supporting the prescription of antithrombotic agents in patients with LEAD.
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Affiliation(s)
- Michele Franzese
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
| | - Enrico Coscioni
- Divisione di Cardiochirurgia, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno
| | - Martina Scalise
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
| | - Donato Gerardi
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
| | - Giuseppe Giugliano
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
| | - Giovanni Esposito
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
| | - Eugenio Stabile
- Dipartimento di Scienze Biomediche Avanzate, A.O.U. "Federico II", Napoli
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Bossone E, Ranieri B, Coscioni E, Baliga RR. Community health and prevention: It takes a village to reduce cardiovascular risk! Let us do it together! Eur J Prev Cardiol 2019; 26:1840-1842. [DOI: 10.1177/2047487319867505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Eduardo Bossone
- Division of Cardiology, A. Cardarelli Hospital, Naples, Italy
| | | | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Ragavendra R Baliga
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, 200 Davis Heart and Lung Research Institute, Columbus, USA
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Fiordelisi A, Iaccarino G, Morisco C, Coscioni E, Sorriento D. NFkappaB is a Key Player in the Crosstalk between Inflammation and Cardiovascular Diseases. Int J Mol Sci 2019; 20:ijms20071599. [PMID: 30935055 PMCID: PMC6480579 DOI: 10.3390/ijms20071599] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/21/2019] [Accepted: 03/26/2019] [Indexed: 02/08/2023] Open
Abstract
Inflammation is a key mechanism of cardiovascular diseases. It is an essential component of atherosclerosis and a significant risk factor for the development of cardiovascular events. In the crosstalk between inflammation and cardiovascular diseases, the transcription factor NFκB seems to be a key player since it is involved in the development and progression of both inflammation and cardiac and vascular damage. In this review, we deal with the recent findings of the role of inflammation in cardiac diseases, focusing, in particular, on NFκB as a functional link. We describe strategies for the therapeutic targeting of NFκB as a potential strategy for the failing heart.
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Affiliation(s)
- Antonella Fiordelisi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Carmine Morisco
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, 84131 Salerno, Italy.
| | - Daniela Sorriento
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Napoli, Italy.
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40
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Cipolletta E, Gambardella J, Fiordelisi A, Del Giudice C, Di Vaia E, Ciccarelli M, Sala M, Campiglia P, Coscioni E, Trimarco B, Sorriento D, Iaccarino G. Antidiabetic and Cardioprotective Effects of Pharmacological Inhibition of GRK2 in db/db Mice. Int J Mol Sci 2019; 20:ijms20061492. [PMID: 30934608 PMCID: PMC6470575 DOI: 10.3390/ijms20061492] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 03/17/2019] [Accepted: 03/20/2019] [Indexed: 12/17/2022] Open
Abstract
Despite the availability of several therapies for the management of blood glucose in diabetic patients, most of the treatments do not show benefits on diabetic cardiomyopathy, while others even favor the progression of the disease. New pharmacological targets are needed that might help the management of diabetes and its cardiovascular complications at the same time. GRK2 appears a promising target, given its established role in insulin resistance and in systolic heart failure. Using a custom peptide inhibitor of GRK2, we assessed in vitro in L6 myoblasts the effects of GRK2 inhibition on glucose extraction and insulin signaling. Afterwards, we treated diabetic male mice (db/db) for 2 weeks. Glucose tolerance (IGTT) and insulin sensitivity (ITT) were ameliorated, as was skeletal muscle glucose uptake and insulin signaling. In the heart, at the same time, the GRK2 inhibitor ameliorated inflammatory and cytokine responses, reduced oxidative stress, and corrected patterns of fetal gene expression, typical of diabetic cardiomyopathy. GRK2 inhibition represents a promising therapeutic target for diabetes and its cardiovascular complications.
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Affiliation(s)
- Ersilia Cipolletta
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Jessica Gambardella
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Antonella Fiordelisi
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Carmine Del Giudice
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Eugenio Di Vaia
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy.
| | - Marina Sala
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy.
| | - Pietro Campiglia
- Department of Pharmacy, University of Salerno, 84084 Fisciano, Italy.
| | - Enrico Coscioni
- AOU San Giovanni di Dio e Ruggi d'Aragona, 84131 Salerno, Italy.
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Daniela Sorriento
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
| | - Guido Iaccarino
- Department of Advanced Biomedical Sciences, "Federico II" University of Naples, 80131 Napoli, Italy.
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De Luca V, Tramontano G, Del Giudice C, Grimaldi I, Romano R, Liguori I, Carpinelli Mazzi M, Di Carluccio N, Riccio PA, Speranza P, Iavarone A, Abete P, Postiglione A, Cataldi M, Vallone C, Giallauria F, Cittadini A, Triggiani M, Savastano S, Menditto E, Leonardini L, Colao A, Triassi M, Iaccarino G, Postiglione A, Coscioni E, Illario M. Innovative Approaches to Active and Healthy Ageing: Campania Experience to Improve the Adoption of Innovative Good Practices. Transl Med UniSa 2019; 19:116-123. [PMID: 31360676 PMCID: PMC6581492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level.
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Affiliation(s)
- V De Luca
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,
| | - G Tramontano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - C Del Giudice
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Grimaldi
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - R Romano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Liguori
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Carpinelli Mazzi
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - PA Riccio
- Associazione Progetto Alfa Onlus, Marigliano NA, Italy
| | - P Speranza
- Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - A Iavarone
- Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy
| | - P Abete
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Cataldi
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy
| | - C Vallone
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - F Giallauria
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Cittadini
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triggiani
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy
| | - S Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - E Menditto
- Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - L Leonardini
- Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy
| | - A Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - G Iaccarino
- Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy
| | - E Coscioni
- Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - M Illario
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy,Consorzio Farmacie Servizi (COFASER), Sarno SA, Italy,Associazione Progetto Alfa Onlus, Marigliano NA, Italy,Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy,Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy,Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy,Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy,Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy,Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy,Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy,Unità Operativa Dipartimentale Promozione e potenziamento di programmi Health Innovation (DG04), Regione Campania, Naples, Italy
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42
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Illario M, Coscioni E, De Luca V, Cataldi M, Postiglione A, Iaccarino G. Editorial: Multi-Actor Collaboration in Healthcare to Address the Emerging Health Needs of an Aging Population. Transl Med UniSa 2019; 19:1-4. [PMID: 31360660 PMCID: PMC6581499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M Illario
- Campania Region Division for Health Innovation, and Department of Public Health, Federico II University and Hospital, Naples, Italy
| | - E Coscioni
- Department of Heart Surgery, San Giovanni di Dio e Ruggi d’Aragona Hospital, Salerno, Italy
| | - V De Luca
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - M Cataldi
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - A Postiglione
- General Directorate for Health Protection and the Coordination of Regional Health System, Campania Region, Naples, Italy
| | - G Iaccarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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43
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Bousquet J, Illario M, Farrell J, Batey N, Carriazo AM, Malva J, Hajjam J, Colgan E, Guldemond N, Perälä-Heape M, Onorato GL, Bedbrook A, Leonardini L, Stroetman V, Birov S, Abreu C, Abrunhosa A, Agrimi A, Alalääkkölä T, Allegretti N, Alonso-Trujillo F, Álvarez-Benito M, Angioli S, Apóstolo J, Armitage G, Arnavielhe S, Baena-ParejoI M, Bamidis PD, Balenović A, Barbolini M, Baroni I, Blain H, Bernard PL, Bersani M, Berti E, Bogatyrchuk L, Bourret R, Brehm J, Brussino L, Buhr D, Bultje D, Cabeza E, Cano A, De Capitani C, Carantoña E, Cardoso A, Coll Clavero JI, Combe B, Conforti D, Coppola L, Corti F, Coscioni E, Costa E, Crooks G, Cunha A, Daien C, Dantas, Darpón Sierra J, Davoli M, Dedeu Baraldes A, De Luca V, De Nardi L, Di Ciano M, Dozet A, Ekinci B, Erve S, Espinoza Almendro JM, Fait A, Fensli R, Fernandez Nocelo S, Gálvez-Daza P, Gámez-Payá J, García Sáez M, Garcia Sanchez I, Gemicioğlu B, Goetzke W, Goossens E, Geurdens M, Gütter Z, Hansen H, Hartman S, Hegendörfer G, Heikka H, Henderson D, Héran D, Hirvonen S, Iaccarino G, Jansson N, Kallasvaara H, Kalyoncu F, Kirchmayer U, Kokko JA, Korpelainen J, Kostka T, Kuna P, Lajarín Ortega T, Lama CM, Laune D, Lauri D, Ledroit V, Levato G, Lewis L, Liotta G, Lundgren L, Lupiañez-Villanueva F, Mc Garry P, Maggio M, Manuel de Keenoy E, Martinez C, Martínez-Domene M, Martínez-Lozano Aranaga B, Massimilliano M, Maurizio A, Mayora O, Melle C, Mendez-Zorilla A, Mengon H, Mercier G, Mercier J, Meyer I, Millet Pi-Figueras A, Mitsias P, Molloy DW, Monti R, Moro ML, Muranko H, Nalin M, Nobili A, Noguès M, O’Caoimh R, Pais S, Papini D, Parkkila P, Pattichis C, Pavlickova A, Peiponen A, Pereira S, Pépin JL, Piera Jiménez J, Portheine P, Potel L, Pozzi AC, Quiñonez P, Ramirez Lauritsen X, Ramos MJ, Rännäli-Kontturi A, Risino A, Robalo-Cordeiro C, Rolla G, Roller R, Romano M, Romano V, Ruiz-Fernández J, Saccavini C, Sachinopoulou A, Sánchez Rubio MJ, Santos L, Scalvini S, Scopetani E, Smedberg D, Solana-Lara R, Sołtysik B, Sorlini M, Stericker S, Stramba Badiale M, Taillieu I, Tervahauta M, Teixeira A, Tikanmäki H, Todo-Bom A, Tooley A, Tuulonen A, Tziraki C, Ussai S, Van der Veen S, Venchiarutti A, Verdoy-Berastegi D, Verissimo M, Visconti L, Vollenbroek-Hutten M, Weinzerl K, Wozniak L, Yorgancıoğlu A, Zavagli V, Zurkuhlen AJ. The Reference Site Collaborative Network of the European Innovation Partnership on Active and Healthy Ageing. Transl Med UniSa 2019; 19:66-81. [PMID: 31360670 PMCID: PMC6581486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.
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Affiliation(s)
- J Bousquet
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France,VIMA, INSERM U 1168, VIMA : Ageing and chronic diseases. Epidemiological and public health approaches, Villejuif, Université Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France, Euforea, Brussels, Belgium, and Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin, Germany
| | - M Illario
- Division for Health Innovation, Campania Region and Federico II University Hospital Naples (R&D and DISMET) Naples, Italy
| | - J Farrell
- LANUA International Healthcare Consultancy, Down, UK
| | - N Batey
- EIPonAHA Reference Site Collaborative network, Head of EU & International Funding, Health and Social Services Group, Welsh Government, Cardiff, UK
| | - AM Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - J Malva
- Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra; Coimbra, and Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - J Hajjam
- CENTICH Mutualité Française Anjou Mayenne, Angers, France
| | - E Colgan
- Department of Health, Social Services and Public Safety, Northern Ireland Belfast, UK
| | - N Guldemond
- Institute of Health Policy and Management iBMG, Erasmus University, Rotterdam, The Netherlands
| | | | - GL Onorato
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - A Bedbrook
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
| | - L Leonardini
- Veneto Region, Mattone Internazionale Program, Italy
| | - V Stroetman
- Empirica Communication and Technology Research, Bonn, Germany
| | - S Birov
- Empirica Communication and Technology Research, Bonn, Germany
| | - C Abreu
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - A Abrunhosa
- Comissão de Coordenação e Desenvolvimento Regional do Centro (CCDRC), Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - A Agrimi
- Aprulia Region - Research, Innovation and Capacity Building department, Bari – Italy
| | | | | | - F Alonso-Trujillo
- Agency for Social Services and Dependency of Andalusia, Seville, Spain
| | | | - S Angioli
- Campania Councillor for European Funds, Euromediterranean Basin and Youth Policies, Naples, Italy
| | - J Apóstolo
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - G Armitage
- Newcastle University, Operations Director, National Innovation Centre for Ageing, New Castle, UK
| | | | | | - PD Bamidis
- Medical Education Informatics; Lab of Medical Physics; Medical School; Aristotle University of Thessaloniki, Greece
| | - A Balenović
- Health Care Center Zagreb, City of Zagreb, AHA Reference site, Zagreb, Croatia
| | - M Barbolini
- Regione Emilia Romagna - Agenzia Sanitaria e Sociale, Regional Health and Social Agency Emilia-Romagna, Reference Site of the European Innovation Partnership on Healthy and Active Ageing, Bologna, Italy, and EU Commission Senior Public Health Expert
| | | | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France,EUROMOV. EA 2991, Euromov, University of Montpellier, France
| | - PL Bernard
- Sport Faculty, University of Montpellier, France
| | - M Bersani
- Head Unit Plans and Projects; DG Welfare – Region of Lombardy, Milano (Italy)
| | - E Berti
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - L Bogatyrchuk
- The medical improving center “Elbrus”, Zhytomir, Ukraine
| | - R Bourret
- Centre Hospitalier Valenciennes, France
| | - J Brehm
- Health region CologneBonn, Köln, Germany
| | - L Brussino
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - D Buhr
- University of Tuebingen / Steinbeis Transfercenter for Social and Technological Innovation, Tuebingen, Germany
| | - D Bultje
- Healthy Ageing Network Northern Netherlands, Groningen, The Netherlands
| | - E Cabeza
- Cap de Servei de Promoció de la Salut, Direcció General de Salut Pública i Participació, Palma de Mallorca, Spain
| | - A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain,INCLIVA, Valencia, Spain
| | - C De Capitani
- Lombardy Cluster Technologies for Living Environments, Lecco (LC), Italy
| | - E Carantoña
- Consejería de Presidencia y Participación Ciudadana, Oviedo, Spain
| | - A Cardoso
- Nursing School of Coimbra, Ageing@Coimbra, Coimbra, Portugal
| | - JI Coll Clavero
- Innovation and new technologies, Hospital de Barbastro Servicio Aragones de Salud Aragon, Spain
| | - B Combe
- Department of Rheumotology, University Hospital, Montpellier, France
| | - D Conforti
- Autonomous Province of Trento, Health and Social Solidarity Department & TrentinoSalute4.0, Trento, Italy
| | - L Coppola
- Head Unit Health Promotion and Screening; DG Welfare – Region of Lombardy, Milan, Italy
| | - F Corti
- FIMMG, Federazione Italiana Medici di Medicina Generale, Milan, Italy
| | - E Coscioni
- Department of Heart Surgery, San Giovanni di Dio e Ruggi d’Aragona Hospital, Salerno, Italy
| | - E Costa
- UCIBIO, REQUIMTE, Faculty of Pharmacy of University of Porto, Porto4ageing Reference Site, University of Porto, PORTO, Portugal
| | - G Crooks
- Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A Cunha
- Instituto Pedro Nunes, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - C Daien
- Department of Rheumotology, University Hospital, Montpellier, France
| | - Dantas
- Cáritas Diocesana de Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | | | - M Davoli
- Department of Epidemiology, ASL Roma 1, Lazio Regional Health Service, Roma, Italy
| | - A Dedeu Baraldes
- Agency for Health Quality & Assessment of Catalonia of the Ministry of Health of Catalonia – AquAs, Barcelona, Spain
| | - V De Luca
- R&D Unit, Federico II University Hospital, Naples, Italy
| | - L De Nardi
- Health Information System International Projects, Lombardia Informatica SpA, Milano, Italy
| | - M Di Ciano
- InnovaPuglia - Inhouse ICT company of Regione Puglia and Reference Site Puglia WI-FI Management, Bari, Italy
| | - A Dozet
- Health economist, Region Skåne, Sweden
| | - B Ekinci
- Head Chronic Disease Department, Ministry of Health, Ankara, Turkey
| | - S Erve
- CENTICH Mutualité Française Anjou Mayenne, Angers, France
| | | | - A Fait
- Health and Social Care Directorate, ATS Città Metropolitana (Health and Social Care Agency), Milano, Italy
| | - R Fensli
- Centre of eHealth and Health Care Technology, University of Agder, Faculty of Engineering and Science, Grimstad, Norway
| | - S Fernandez Nocelo
- Galician Health Knowledge Agency (ACIS), Regional Ministry of Public Health of Galicia
| | - P Gálvez-Daza
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - M García Sáez
- Agency for Social Services and Dependency of Andalusia, Seville, Spain
| | | | - B Gemicioğlu
- Department of Pulmonary Diseases, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - W Goetzke
- Health region CologneBonn, Köln, Germany
| | - E Goossens
- Center for Gastrology, School of Gastrologic Sciences and Primary Food Care, Leuven, Belgium
| | - M Geurdens
- Center of Expertise in Primary Food Care, Center for Research and Innovation in Care (CRIC), Antwerp, Belgium
| | - Z Gütter
- University Hospital Olomouc - NTMC, National eHealth Centre, Olomouc, Czech Republic
| | - H Hansen
- EU Consultant & Project Manager, South Denmark European Office, Brussels, Belgium
| | - S Hartman
- Department of Social Services and Health Care, Business Development, HELSINGIN KAUPUNKI, City of Helsinki, Finland
| | | | | | - D Henderson
- Head of European Engagement, NHS 24, Glasgow, UK
| | | | | | - G Iaccarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - N Jansson
- Network Ecosystem, BusinessOulu, Oulu, Finland
| | - H Kallasvaara
- Helsinki-Uusimaa Regional Council, Helsinki, Finland
| | - F Kalyoncu
- Hacettepe University, School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Ankara, Turkey
| | - U Kirchmayer
- Department of Epidemiology, ASL Roma 1, Lazio Regional Health Service, Roma, Italy
| | - JA Kokko
- Department of Healthcare and Social Welfare, Technology Specialist, Oulu, Finland
| | - J Korpelainen
- Oulu University Hospital OYS, Hospital District, Oulu, Finland
| | - T Kostka
- Department of Geriatrics, Medical University of Lodz, Healthy Ageing Research Centre (HARC), Lodz, Poland
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Poland
| | - T Lajarín Ortega
- Committee of Representatives of People with disabilities and their Families, Region de Murcia, Spain
| | - CM Lama
- Regional Ministry of Health of Andalusia, Seville, Spain
| | | | | | - V Ledroit
- Alsace Lorraine Champagne Ardenne, Bureau Europe Grand Est, Bruxelles, Belgique
| | - G Levato
- SIFMED, Scuola Italiana Di Formazione E Ricerca In Medicina Di Famiglia, Milan, Italy
| | - L Lewis
- Head of Research and Development, International Foundation for Integrated Care and EIP on AHA B3 Action Group Chair, Wolfson College, Oxford, UK
| | - G Liotta
- Biomedicine and Prevention Department, University of Rome Tor Vergata, Rome, Italy
| | - L Lundgren
- Development Department, Region Norrbotten, Sweden
| | | | - P Mc Garry
- Greater Manchester Ageing Hub, Greater Manchester Combined Authority, Manchester, UK
| | - M Maggio
- Department of Medicine and Surgery - Geriatric Clinic Unit Department of Medicine Geriatric Rehabilitation, University Hospital of Parma, Italy
| | - E Manuel de Keenoy
- Kronikgune, International Centre of Excellence in Chronicity Research, Barakaldo, Bizkaia, Spain
| | - C Martinez
- Costa Cálida Cares-Senior Tourism and Services, Region de Murcia, Spain
| | - M Martínez-Domene
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - M Massimilliano
- Financial Range for Innovation, Research, International care and health sector; Friuli Venezia Giulia Autonomous Region, Central Directorate for Health, Social Health Integration, Social Policies and Family, Trieste, Italy
| | - A Maurizio
- Plans and Projects Unit, DG Welfare – Region of Lombardy, Italy
| | - O Mayora
- Bruno Kessler Foundation, eHealth Unit and TrentinoSalute4.0, Trento, Italy
| | - C Melle
- Care Management Unit, Hausach, Gesundes Kinzigtal GmbH, Kizingtal, Germany
| | | | - H Mengon
- Autonomous Province of Trento, Health and Social Solidarity Department & TrentinoSalute4.0, Trento, Italy
| | - G Mercier
- Unité Médico-Economie, Département de l’Information Médicale, University Hospital, Montpellier, France
| | - J Mercier
- Department of Physiology, CHRU, University Montpellier, PhyMedExp, INSERM U1046, CNRS UMR 9214, France
| | - I Meyer
- Care Management Unit, Hausach, Gesundes Kinzigtal GmbH, Kizingtal, Germany
| | | | - P Mitsias
- Department of Neurology, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - DW Molloy
- Centre for Gerontology and Rehabilitation, School of Medicine, UCC @ St Finbarr’s Hospital, Cork, Ireland
| | - R Monti
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - ML Moro
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - H Muranko
- GEWI Institute, Regional Innovation Partnership on Active and Healthy Ageing, Köln, Germany
| | | | - A Nobili
- Mario Negri Institute for Pharmacological Research, IRCCS; Clinical Pharmacology, Geriatrics, Internal Medicine, Milano, Italy
| | | | - R O’Caoimh
- Centre for Gerontology and Rehabilitation, School of Medicine, UCC @ St Finbarr’s Hospital, Cork, Ireland,Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Ireland
| | - S Pais
- Center for Biomedical Research-CBMR, Department of Biomedical Sciences and Medicine, International Center on Ageing-CENIE, University of Algarve, Portugal
| | - D Papini
- Regional Health and Social Agency Emilia-Romagna, Bologna, Italy
| | - P Parkkila
- Oulu University Hospital OYS, Hospital District, Oulu, Finland
| | - C Pattichis
- Dept of Computer Science, University of Cyprus, Cyprus, Greece
| | - A Pavlickova
- European Service Development Manager, NHS 24, Glasgow, UK
| | - A Peiponen
- Social services and health care division, Hospital, rehabilitation and care services, Southern service district, City of Helsinki, FINLAND
| | - S Pereira
- University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | - JL Pépin
- Université Grenoble Alpes, Laboratoire HP2, Grenoble, INSERM, U1042 and CHU de Grenoble, France
| | - J Piera Jiménez
- Information and R&D Officer, Badalona Serveis Assistencials, Badalona, Spain
| | - P Portheine
- Coöperatie Slimmer Leven, Eindhoven, The Netherlands
| | - L Potel
- International Affairs & Public Procurement of Innovation, Hospital Procurement Network, Paris, France
| | - AC Pozzi
- IML, Lombardy Medical Initiative, Bergamo, Italy
| | - P Quiñonez
- Agency for Social Services and Dependency of Andalusia, Seville, Spain,Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | | | - MJ Ramos
- UCIBIO, REQUIMTE, Faculty of Sciences of University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | | | - A Risino
- Health Innovation Manchester, Manchester, UK
| | - C Robalo-Cordeiro
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - G Rolla
- Department of Medical Sciences, Allergy and Clinical Immunology Unit, University of Torino & Mauriziano Hospital, Torino, Italy
| | - R Roller
- Medical University of Graz, Department of Internal Medicine, Graz, Austria
| | | | - V Romano
- IRES - Institute for Economic and Social Research - Piedmont, Torino, Italy
| | | | - C Saccavini
- Arsenàl.IT, Veneto’s Research Centre for eHealth Innovation, Venice, Italy
| | - A Sachinopoulou
- Oulu University, Center of Health and Technology, Oulu, Finland
| | - MJ Sánchez Rubio
- Regional Ministry of Equality and Social Policies of Andalusia, Seville, Spain
| | - L Santos
- Odem dos Farmacêuticos, Secção Regional do Centro, Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - S Scalvini
- Cardiology Rehabilitation Division, Salvatore Maugeri Foundation IRCCS, Institute of Lumezzane, Brescia, Italy
| | - E Scopetani
- Tuscany Region, Directorate Citizenship rights and social cohesion, Firenze, Italy
| | - D Smedberg
- RISE Research Institutes of Sweden, Division Safety and Transport - Measurement Science and Technology, Lund, Sweden
| | - R Solana-Lara
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - B Sołtysik
- Department of Geriatrics, Medical University of Lodz, Healthy Ageing Research Centre (HARC), Lodz, Poland
| | - M Sorlini
- International Affairs & Public Procurement of Innovation, Hospital Procurement Network, Paris, France
| | - S Stericker
- Head of Programmes, Yorkshire & Humber Academic Health Science Network, Wakefield, UK
| | - M Stramba Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - I Taillieu
- Coördinator Zorgeconomie, Fabrieken voor de Toekomst, Brugge, Belgium
| | | | - A Teixeira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Ageing@Coimbra EIP-AHA Reference Site, Portugal
| | - H Tikanmäki
- Life Science Industries and Company Networks, BusinessOulu, Oulu, Finland
| | - A Todo-Bom
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - A Tooley
- University of Porto and Porto4Ageing Reference Site, Porto, Portugal
| | - A Tuulonen
- Tays Eye Centre, Tampere University Hospital, Pirkanmaa Hospital District, Tampere, Finland
| | - C Tziraki
- Research and Evaluation Department, Municipality of Jérusalem, Israël,Medicine and Health Care Science, Allilegi Community Based Organization for AD and Active Healthy Aging, Heraklion, Crete, Heraklion-Crete Reference Site Region, Greece
| | - S Ussai
- DG Welfare, Lombardy Region, Italy
| | - S Van der Veen
- Department of Med Hum, Amsterdam University Medical Centers, VU University, NL
| | - A Venchiarutti
- Friuli Venezia Giulia Autonomous Region, Central Directorate for Health, Social Health Integration, Social Policies and Family, Trieste, Italy
| | - D Verdoy-Berastegi
- Kronikgune, International Centre of Excellence in Chronicity Research, Barakaldo, Bizkaia, Spain
| | - M Verissimo
- Faculty of Medicine, University of Coimbra, Portugal, Ageing@Coimbra EIP-AHA Reference Site
| | - L Visconti
- LifeTechValley, Life Sciences Incubator BioVille, Diepenbeek, Belgium
| | - M Vollenbroek-Hutten
- University of Twente, Biomedical systems and signal group/telemedicine, Twente, The Netherlands
| | - K Weinzerl
- Human.technology Styria GmbH, Graz, Austria
| | - L Wozniak
- Research and International Relations, Department of Structural Biology, Medical University of Lodz, Lodz, Poland
| | - A Yorgancıoğlu
- Celal Bayar University, School of Medicine, Department of Pulmonology, Manisa, Turkey
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Illario M, De Luca V, Leonardini L, Kucharczyk M, Parent AS, Dantas C, Jegundo AL, van Staalduinen W, Ganzarain J, Comisso L, Bramezza C, Carriazo AM, Maritati A, Tramontano G, Capozzi P, Goossens E, Cotrone C, Costantini A, Ciliberti M, Femiano M, d’Amore A, Forlenza M, Ruggiero R, Bianchi A, Augustin L, Marrazzo V, Dello Ioio T, Capaldo S, Crudeli A, De Cesare G, Cuccaro F, Bracale G, Tramontano D, Postiglione A, Matera C, Coscioni E, Bousquet J. Health tourism: an opportunity for sustainable development. Transl Med UniSa 2019; 19:109-115. [PMID: 31360675 PMCID: PMC6581494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In February 2017, the "Programma Mattone Internazionale Salute" (ProMis), that is the Italian Program for Internationalization of Regional Health Systems of the Ministry of Health (MoH), presented the first version of its Position Paper on Health Tourism, which embeds a first shared approach to the recommendations expressed by the European Committee of Regions (CoR) on "Age-Friendly" tourism. The CoR stresses the importance of local and regional authorities in the coordination of multi-sectoral policies such as healthcare, social assistance, transport, urban planning and rural development in relation to the promotion of mobility, security, accessibility of services, including health care and social services. "Age-friendly" tourism is an example of an innovative tourist offer that strives to meet the health needs of the entire "traveling" population, with an integrated and cross-sector approach that involves various organizations operating in sectors such as healthcare, accessibility and transport. The aim of the workshop was to explore the interest of the stakeholders to participate in a systemic action in the field of "health" tourism, and to identify priority implementation areas that offer opportunities to take advantage of validated, innovative experiences that strengthen the accessibility to health and social services in regional, national and international contexts. This effort provides the opportunity to take advantage of aligning the European Structural and Investment Funds (ESIF) to the development of tourism, coherently with the needs and resources of local and regional health authorities.
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Affiliation(s)
- M Illario
- Health Innovation Division of Campania Region (DG04), Federico II University and Hospital, Naples, Italy
| | - V De Luca
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - L Leonardini
- Programma Mattone Internazionale Salute, Italian Ministry of Health, San Donà di Piave VE, Italy
| | | | - AS Parent
- AGE Platform Europe Network, Brussels, Belgium
| | - C Dantas
- Caritas Coimbra, Coimbra, Portugal
| | | | | | - J Ganzarain
- Academy on Age-friendly Environments BV, Gouda, the Netherlands
| | - L Comisso
- Azienda per i Servizi Sanitari n.5 “Bassa Friulana”, Udine, Italy
| | - C Bramezza
- Azienda ULSS n. 4 Veneto Orientale, San Donà di Piave VE, Italy
| | | | - A Maritati
- Programma Mattone Internazionale Salute, Italian Ministry of Health, San Donà di Piave VE, Italy
| | - G Tramontano
- Research and Development Unit, Federico II University Hospital, Naples, Italy
| | - P Capozzi
- Health Innovation Division of Campania Region (DG04), Federico II University and Hospital, Naples, Italy
| | - E Goossens
- Center for Gastrology, Brussels, Belgium
| | - C Cotrone
- Relations with European and extra-European countries Division, Campania Region, Naples, Italy
| | - A Costantini
- Azienda Sanitaria Locale Napoli 3 Sud, Castellamare di Stabia NA, Italy
| | - M Ciliberti
- Azienda Sanitaria Locale Napoli 3 Sud, Castellamare di Stabia NA, Italy
| | - M Femiano
- Azienda Sanitaria Locale Napoli 2 Nord, Frattamaggiore NA, Italy
| | - A d’Amore
- Azienda Sanitaria Locale Napoli 2 Nord, Frattamaggiore NA, Italy
| | - M Forlenza
- Azienda Sanitaria Locale Napoli 1 Centro, Naples, Italy
| | - R Ruggiero
- Azienda Sanitaria Locale Napoli 1 Centro, Naples, Italy
| | - A Bianchi
- Istituto Nazionale Tumori Pascale, Naples, Italy
| | - L Augustin
- Istituto Nazionale Tumori Pascale, Naples, Italy
| | - V Marrazzo
- Regional Coordination of Tourism Districts of Campania, Naples, Italy
| | - T Dello Ioio
- Parco regionale dei Monti Lattari, Castellammare di Stabia NA, Italy
| | - S Capaldo
- Federalberghi Terme, Rome, Italy
- Federterme, Rome, Italy
| | | | - G De Cesare
- Centro Mediterranea Diagnostica Srl, Castellamare di Stabia NA, Italy
| | - F Cuccaro
- Centro Mediterranea Diagnostica Srl, Castellamare di Stabia NA, Italy
| | - G Bracale
- Mediterranean Federation for Advancing Vascular Surgery, Naples, Italy
| | - D Tramontano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy
| | - A Postiglione
- General Directorate for Health Protection and the coordination of Regional Health System, Campania Region, Naples, Italy
| | - C Matera
- Regional Ministry for Tourism, Campania Region, Naples, Italy
| | - E Coscioni
- Department of Heart Surgery, San Giovanni di Dio e Ruggi d’Aragona Hospital, Salerno, Italy
| | - J Bousquet
- Department of Pneumology and Addictology, Montpellier University Hospital Center, Montpellier, France
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Pascale AV, Finelli R, Giannotti R, Visco V, Fabbricatore D, Matula I, Mazzeo P, Ragosa N, Massari A, Izzo R, Coscioni E, Illario M, Ciccarelli M, Trimarco B, Iaccarino G. Vitamin D, parathyroid hormone and cardiovascular risk: the good, the bad and the ugly. J Cardiovasc Med (Hagerstown) 2018; 19:62-66. [PMID: 29252600 PMCID: PMC5757656 DOI: 10.2459/jcm.0000000000000614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
25-Hydroxyvitamin D insufficiency and increased cardiovascular risk (CVR) association is still debated. The vitamin D (VitD)-dependent parathyroid hormone (PTH) is considered as the possible actuator of VitD effects on CVR. To investigate the association of CVR, PTH and VitD, we carried out blood pressure measurements and blood samples and collected information on dietary habits, anamnestic, clinical and metabolic data of 451 participants in the Salerno area (Southern Italy) during the World Hypertension Day (17 May). CVR was calculated according to the Framingham CVR charts. The overall population mean age was 51.6 ± 0.7 years, and female sex was slightly prevalent (55%). VitD deficiency (<20 ng/ml) was most frequent (59.7%). In this population, VitD and CVR did not correlate. VitD and PTH inversely correlated (r = −0.265, P < 0.001) as expected. PTH was in direct correlation (r = 0.225, P < 0.001) with CVR. Elevated PTH (75 percentile; ≥49.5 pg/ml) levels identify a population with higher CVR (11.8 ± 0.5 vs. 8.5 ± 0.3, P < 0.001). In a multivariate analysis, both age and PTH correlate to CVR, but not VitD. In conclusion, VitD does not directly affect CVR in the overall population. Rather, increased PTH might be a better predictor of CVR.
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Affiliation(s)
| | - Rosa Finelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Rocco Giannotti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Davide Fabbricatore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Ida Matula
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Pietro Mazzeo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Nicola Ragosa
- Department of Cardiology, San Luca Hospital, Vallo della Lucania
| | - Angelo Massari
- San Giovanni di Dio e Rugi d'Aragona University Hospital, Salerno, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, Federico II University
| | - Enrico Coscioni
- San Giovanni di Dio e Rugi d'Aragona University Hospital, Salerno, Italy
| | - Maddalena Illario
- Division of Health Innovation, Directorate General for Health Protection and Coordination of the Regional Health System.,Depatment of Medical and Translational Sciences, Federico II University and Hospital, Napoli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Federico II University
| | - Guido Iaccarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
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Pascale V, Finelli R, Giannotti R, Coscioni E, Izzo R, Rozza F, Caputo D, Moscato P, Iaccarino G, Ciccarelli M. Cardiac eccentric remodeling in patients with rheumatoid arthritis. Sci Rep 2018; 8:5867. [PMID: 29651025 PMCID: PMC5897374 DOI: 10.1038/s41598-018-24323-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/28/2018] [Indexed: 01/05/2023] Open
Abstract
It is known that patients with rheumatoid arthritis (RA) have a higher risk of coronary heart disease and sudden cardiac death. Abnormalities in cardiac geometry appear to be involved in the setting of the cardiovascular risk, but it has never been specifically investigated in RA. We enrolled 44 patients with RA compared to 131 subjects without RA (normal, N): The RA aged between 18 and 70 years (mean 48.3 ± 2.1), 25 females, BMI 27.6 ± 0.9; N, of equal age (48.6 ± 1.2, n.s.), included 80 females (BMI 26.7 ± 0.2, ns). Cardiac Ultrasounds showed an increase of the diameter of the left ventricle but not in the septum with reduction of relative wall thickness (RWT) in the RA population compared to N. Relative wall thickness inversely correlates with biochemical parameters of inflammatory response (gamma globulin, p < 0.03; F = 5,660) and anti citrullinated peptides antibody (anti-CCP Ab) (p < 0.02; F = 7,1620) We conclude that unfavorable cardiac remodeling can increase cardiovascular risk in patients with RA.
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Affiliation(s)
- Valeria Pascale
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rosa Finelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Rocco Giannotti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | - Enrico Coscioni
- Department "Cuore", University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Salerno, Italy
| | - Francesco Rozza
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Salerno, Italy
| | - Dario Caputo
- Department of Medicine, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Paolo Moscato
- Department of Medicine, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Guido Iaccarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy.
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
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Abstract
Clinical and epidemiological studies demonstrate that short- and long-term exposure to air pollution increases mortality due to respiratory and cardiovascular diseases. Given the increased industrialization and the increased sources of pollutants (i.e., cars exhaust emissions, cigarette smoke, industry emissions, burning of fossil fuels, incineration of garbage), air pollution has become a key public health issue to solve. Among pollutants, the particulate matter (PM) is a mixture of solid and liquid particles which differently affects human health depending on their size (i.e., PM10 with a diameter <10 μm reach the lung and PM2.5 with a diameter <2.5 μm penetrate deeper into the lung). In particular, the acute exposure to PM10 and PM2.5 increases the rate of cardiovascular deaths. Thus, appropriate interventions to reduce air pollution may promote great benefits to public health by reducing the risk of cardiovascular diseases. Several biological mechanisms have been identified to date which could be responsible for PM-dependent adverse cardiovascular outcomes. Indeed, the exposure to PM10 and PM2.5 induces sustained oxidative stress and inflammation. PM2.5 is also able to increase autonomic nervous system activation. Some potential therapeutic approaches have been tested both in pre-clinical and clinical studies, based on the intake of antioxidants from dietary or by pharmacological administration. Studies are still in progress to increase the knowledge of PM activation of intracellular pathways and propose new strategies of intervention.
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Affiliation(s)
- Antonella Fiordelisi
- I.O.S, Southern Italy Hospital Institute, Medicina Futura Research, 80100, Naples, Italy
| | - Prisco Piscitelli
- I.O.S, Southern Italy Hospital Institute, Medicina Futura Research, 80100, Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University Federico II of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Via Largo d'Ippocrate, 84131, Salerno, Italy
| | - Guido Iaccarino
- Division of Cardiac Surgery, AOU San Giovanni di Dio e Ruggi d'Aragona, Via Largo d'Ippocrate, 84131, Salerno, Italy
- Department of Medicine and Surgery, University of Salerno, Via Salvator Allende, 84081, Baronissi, SA, Italy
| | - Daniela Sorriento
- Department of Advanced Biomedical Sciences, University Federico II of Naples, Via Pansini 5, 80131, Naples, Italy.
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Femminella GD, Candido C, Conte M, Provenzano S, Rengo C, Coscioni E, Ferrara N. Cognitive Function and Heart Failure: The Role of the Adrenergic System. ACTA ACUST UNITED AC 2017; 10:40-49. [PMID: 27173155 DOI: 10.2174/1872214810666160513150244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Heart Failure (HF) and cognitive impairment (CI) represent two high incident diseases worldwide, with extremely elevated mortality and morbidity rates. Their prevalence is expected to further increase in the next years due to the aging population, thus they pose enormous clinical, social and economic challenges. Sympathetic nervous system hyperactivity is known to play a pivotal role in HF pathophysiology and progression. In fact, increased cardiac and circulating catecholamine levels are responsible for several molecular and structural abnormalities with detrimental effects on the failing heart. The proof of this latter concept is represented by the clinical success of .-Blocker therapy that is able to attenuate HF-related morbidity and mortality. Recently, adrenergic system alterations have been implied also in the pathogenesis of CI and dementia opening the window for new fascinating and promising therapeutic opportunities. OBJECTIVE Assess the state of the art on the relationship between cognitive impairment and heart failure. METHOD In the present manuscript, we propose an updated review of literature and patent on the role of sympathetic nervous system derangement in the pathogenesis of HF and CI. CONCLUSION We have discussed recent findings allowing the identification of new molecular targets that hopefully will contribute to the generation of effective therapeutic strategies for HF and dementia. In this article, the patents US20100048479, US7060871, WO2006052857, US7351401, US5721243, WO1994009155, US5449604, WO1999058981, US5985581, EP2319511, EP2377534, EP2650303, WO2006004939, WO2010132128 and EP1779858 are summarized.
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Affiliation(s)
| | | | | | | | | | | | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, Via S. Pansini, 5 - 80131 - Naples, Italy.
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Cioppa A, Stabile E, Salemme L, Popusoi G, Pucciarelli A, Iacovelli F, Arcari A, Coscioni E, Trimarco B, Esposito G, Tesorio T. Combined use of directional atherectomy and drug-coated balloon for the endovascular treatment of common femoral artery disease: immediate and one-year outcomes. EUROINTERVENTION 2017; 12:1789-1794. [DOI: 10.4244/eij-d-15-00187] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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50
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Giordano A, Ferraro P, Corcione N, Messina S, Maresca G, Coscioni E, Avellino R, Giordano G, Peruzzi M, Marullo AGM, Napolitano G, Romano MF, Biondi-Zoccai G. Comparison of Biolimus Versus Everolimus for Drug-Eluting Stents in the Percutaneous Treatment of Infra-Inguinal Arterial Disease. Curr Vasc Pharmacol 2017; 15:257-264. [PMID: 28117007 DOI: 10.2174/1570161115666170123094523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 12/30/2016] [Accepted: 12/30/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Drug-eluting stents (DES) are now considered the most promising device to treat peripheral artery disease (PAD) and minimize restenosis. There is uncertainty however on the best antirestenotic drug for such devices. In particular, biolimus (i.e. umirolimus) and everolimus are two of the most promising agents, given the extensive data in support of their coronary safety and efficacy, but their comparative effectiveness for peripheral interventions is not established. METHODS Building upon our extensive experience in the percutaneous treatment of infra-inguinal artery disease with DES, we compared the acute and longterm outlook of patients treated with biolimus-eluting stents (BES) and everolimus-eluting stents (EES). We collected baseline, procedural and outcome details on all patients undergoing infra-inguinal BES or EES implantation. The endpoints of interest were death, amputation, revascularization, their composite, and change in Fontaine class. A total of 80 patients were included (20 treated with BES and 60 with EES). Most features were similar in the two groups, despite longer lesions in the EES group. Unadjusted analysis showed similar results irrespective of the drug used, with composite endpoint occurring, respectively, in 4 (20.0%) and 10 (16.7%) (p=0.741). RESULTS AND CONCLUSION However, analysis with inverse probability of treatment weighting showed significant differences in the risk of revascularization (hazard ratio of BES vs EES=9.55 [95% confidence interval 2.16-42.23], p=0.003) and composite endpoint (hazard ratio=5.11 [1.33-19.62], p=0.018). In conclusion, EES appear superior to BES for endovascular therapy of infrainguinal artery disease. Dedicated randomized trials are required to definitely confirm or disprove these findings.
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Affiliation(s)
- Arturo Giordano
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
| | - Paolo Ferraro
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
| | - Nicola Corcione
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
| | - Stefano Messina
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
| | - Gennaro Maresca
- Unità Operativa di Interventistica Cardiovascolare, Presidio Ospedaliero Pineta Grande, Castel Volturno, Italy
| | - Enrico Coscioni
- Division of Cardiac Surgery, San Giovanni di Dio e Ruggi D`Aragona Hospital, Salerno, Italy
| | - Raffaella Avellino
- Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Gabriele Giordano
- Unità Operativa di Emodinamica, Casa di Salute Santa Lucia, San Giuseppe Vesuviano, Italy
| | - Mariangela Peruzzi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Antonino G M Marullo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Giovanni Napolitano
- Cardiology and Coronary Care Unit, Presidio Ospedaliero S. Giuliano, Giugliano, ASL Napoli 2 Nord, Italy
| | - Maria Fiammetta Romano
- Department of Molecular Medicine and Medical Biotechnology, University of Naples "Federico II", Via S. Pansini 5, 80131 Napoli, Italy
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