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Pighi M, Tomai F, Fezzi S, Pesarini G, Petrolini A, Spedicato L, Tarantini G, Ferlini M, Calabro P, Loi B, Tovar Forero N, Daemen J, Ribichini FT. Everolimus-eluting bioresorabable scaffold system in the treatment of cardiac allograft vasculopathy: the cardiac allograft reparative therapy (CART) prospective multicentre pilot study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2648] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is still the main drawback of heart transplantation (HTx) and percutaneous coronary intervention (PCI) is a palliative measure because of the high incidence of PCI failure. The bioresorbable scaffolds (BRS) could represent a potential novel therapeutic tool for the treatment of coronary obstructions in CAV.
Purpose
To investigates the effects of BRS implantation in CAV patients in a Nationwide prospective study.
Methods
Multicentre, single-arm, prospective, open-label study that included patients affected by advanced CAV treated with PCI and second-generation ABSORB BRS. The primary endpoint was the incidence of 12-month angiographic in-segment scaffold restenosis (ISSR). Secondary endpoints were the composite of cardiac death, myocardial infarction, and target lesion revascularisation at 12-and 36-month follow-up and the incidence of ISSR at 36 months. A paired analysis of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) at baseline and follow-up was also performed.
Results
Between 2015–2017 35 HTx patients were enrolled and treated on 44 coronary lesions with 51 BRS. The primary endpoint occurred in 13.5% of the lesions (5/37), with a cumulative ISSR rate up to 3 years of 16.2% (6/37).Angiographic lumen loss was 0.40±0.62mm at 12 months and 0.53±0.57mm at 36 months. Overall survival was 91.4% and 74.3%, and MACEs 14.2% and 31.4% at 12 and 36 months, respectively. At the paired intracoronary imaging analysis a significant increase of the vessel external elastic membrane area in the treated segment of the BRS was described at the OCT, while some progression of CAV was detected proximally at the IVUS assessment.
Conclusions
BRS in CAV was feasible and safe, with an ISSR incidence similar to drug-eluting stents. For the first time, a positive remodeling was observed in HTx patients after PCI. Vessel enlargement and the lack of metallic stents may allow repeated PCI avoiding the vessel shrinkage caused by the addition of multiple metal layers, being CAV a complex clinical scenario with a high incidence of MACEs, mainly driven by PCI failure.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Partial funding by Abbott Vascular Italy
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Affiliation(s)
- M Pighi
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | - F Tomai
- European Hospital , Rome , Italy
| | - S Fezzi
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | - G Pesarini
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
| | | | - L Spedicato
- Citta di Udine C.D.C Health Centre , Udine , Italy
| | | | - M Ferlini
- I.R.C.C.S. San Matteo Polyclinic , Pavia , Italy
| | - P Calabro
- Luigi Vanvitelli University Hospital , Naples , Italy
| | - B Loi
- AO Brotzu Hospital , Cagliari , Italy
| | - N Tovar Forero
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - J Daemen
- Erasmus University Medical Centre , Rotterdam , The Netherlands
| | - F T Ribichini
- University of Verona, Department of Biomedical and Surgical Sciences, Section of Cardiology , Verona , Italy
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2
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Kajana V, Primi R, Gentile F, Compagnoni S, Baldi E, Mandurino Mirizzi A, Repetto A, Ferrario M, Ferlini M, Marinoni B, Bendotti S, Currao A, Oltrona Visconti L, Savastano S. C26 COMPLETE REVASCULARISATION IMPROVES SURVIVAL OF PATIENTS RESUSCITATED AFTER AN OUT–OF–HOSPITAL CARDIAC ARREST. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.025] [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: 11/13/2022]
Abstract
Abstract
Background
Sudden cardiac death is a major issue in industrialised countries and survival of patients after out–of–hospital cardiac arrest (OHCA) remains low. Acute myocardial infarction (AMI) is the principal cause of OHCA and myocardial revascularisation plays a positive role on survival. In this setting little is known about the role of complete (CR) versus culprit–only revascularisation (IR) on survival.
Purpose
The aim of this study was to assess whether CR could lead to a better one–year survival as compared to IR. Methods. Among patients prospectively enrolled in the Lombardia CARe OHCA registry from January 1 2015 to May 1 2021, who underwent a coronary angiography (CAG) at the Fondazione IRCCS Policlinico San Matteo were enrolled in this study. CAGs were retrospectively reviewed by two interventional cardiologists. Prehospital and survival data were retrieved from the registry.
Results
We enrolled 239 patients [mean age 63.7±12.4 years; male 79.9%; shockable presenting rhythm 84.1%; AMI at post ROSC ECG 67.9%; ejection fraction 37% (30–45), circulatory support with ECMO 10.9%]. Among the 119 (50%) patients with multi–vessel disease, 82 (69%) received IR whereas 37 (31%) received CR [8 during the first procedure, 29 in a second procedure with a median time after OHCA of 5 (2.5–10) days]. This latter group showed significantly higher one–year survival (54.9% vs 16.2%, p < 0.001). At univariable logistic regression only a shockable presenting rhythm and the presence of chronic total occlusion (CTO) were significantly associated with the probability of receiving a CR [OR 5.1 (95%CI 1.1–22), p = 0.03; OR 0.37 (95%CI 0.16–0.85), p = 0.02 respectively]. However, at multivariable regression analysis only CTO was significantly associated with the probability of receiving a CR [OR 0.36 (95%CI 0.15–0.9), p = 0.007]. At Cox multivariable regression model cardiac arrest duration (longer that the median value of 24 min) and CR were independently associated with the probability of death [HR 3.6 (95%CI 1.9–6.9), p < 0.001; HR 0.2 (95%CI 0.1–0.9), p = 0.02]. Similarly, cardiac arrest duration, CR and a shockable presenting rhythm were associated with the probability of death or poor neurologic outcome [HR 3.3 (95%CI 1.8–6), p < 0.001; HR 0.5 (95%CI 0.3–0.9), p = 0.03 and HR 0.2 (95%CI 0.1–0.5), p < 0.001].
Conclusions
Complete revascularisation is independently associated with a better one–year survival in patients resuscitated from an out–of–hospital cardiac arrest.
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Affiliation(s)
- V Kajana
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - R Primi
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - F Gentile
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | | | - E Baldi
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | | | - A Repetto
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - M Ferrario
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - M Ferlini
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - B Marinoni
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - S Bendotti
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | - A Currao
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
| | | | - S Savastano
- FONDAZIONE IRCCS POLICLINICO SAN MATTEO, PAVIA
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3
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Montalto C, Russo FA, Uccello A, Carli S, Gazmawi R, Galazzi M, Tua L, Acquaro M, Ferlini M, Mandurino-Mirizzi A, Marinoni B, Gnecchi M, Costantino I, Oltrona-Visconti L, Leonardi S. Clinical utility of the academic research consortium new proposed criteria for high bleeding risk definition in patients with acute coronary syndromes. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1415] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria have been proposed to stratify the bleeding risk of patients undergoing percutaneous coronary intervention (PCI). While most criteria were established, 4 criteria have been proposed on a de novo basis.
Purpose
We assessed the prevalence and prognosis of new ARC-HBR criteria in a contemporary, prospective, multicenter, quality-improvement registry of all-comers patients with acute coronary syndromes.
Methods
Between 2016 and 2020, consecutive subjects were enrolled; baseline characteristics and medications were prospectively collected, and patients were followed-up at 1 year. All clinical events (including bleeding) were adjudicated by an independent committee. All 17 ARC-HBR criteria were individually evaluated by reviewing patients' charts.
Results
Of the 2804 patients enrolled, 782 (28.0%) met the ARC-HBR definition and 47 (6%) of them experienced a major BARC 3 or 5) bleeding at 1-year. HBR patients had a significantly higher risk of BARC 3–5 bleedings (HR for: 3.07; 95% CI: 2.02–4.67; p<0.0001; Fig. 1A), BARC 2–5 (HR: 1.845; 95% CI: 1.4–2.42; p<0.0001). Fig. 1B indicates the proportion of patients meeting each criterion. Age, (moderate or severe) chronic kidney disease, (moderate or severe) anemia and oral anticoagulant therapy included 88% of HBR patients.
The 4 new ARC-HBR criteria, all together, were present in only 1.7% of our population: 1.0% was planned for major surgery while on dual antiplatelet therapy, 0.5% had a recent intracranial hemorrhage/ictus or brain arteriovenous malformations, 0.1% had hepatic cirrhosis with portal hypertension and 0.1% had a recent surgery or trauma. In a multivariable Cox regression analysis including individual ARC-HBR criteria, only CKD (major and minor criteria), anemia (major and minor criteria) and cancer were the independent predictors of BARC 3–5 events with a concordance-index for this model of 0.698 (p<0.001). In a second model including only CKD (major criterion), anemia (major criterion), age and oral anticoagulation therapy, all these criteria were independent predictors of BARC 3–5 events with a concordance index of 0.674 (pmodel<0.001 for the model) (Fig. 2).
Conclusion
Almost one third of contemporary ACS patients was at HBR according to the ARC-HBR definition and these patients presented a significantly higher risk of bleedings at 1-year. The most common 4 criteria (age, CKD, anemia, and oral anticoagulant therapy) allowed the identification of 88% of HBR patients. The newly proposed HBR criteria were extremely rare and therefore challenging to validate and of uncertain clinical utility. These data may inform and simplify clinical decision making and provide priority for future directions of HBR definitions.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
| | | | | | - S Carli
- University of Pavia, Pavia, Italy
| | | | | | - L Tua
- University of Pavia, Pavia, Italy
| | | | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Mandurino-Mirizzi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - B Marinoni
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | | | - I Costantino
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - L Oltrona-Visconti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
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4
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Casula M, Taietti I, Galazzi M, Zeqaj I, Fortuni F, Cornara S, Somaschini A, Leonardi S, Camporotondo R, Totaro R, Ferlini M, Gnecchi M. Prognostic impact of achieving LDL cholesterol guidelines-recommended target in secondary prevention: a real-world study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2551] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Lipid management plays a key role in secondary prevention after acute coronary syndrome. The 2019 European Society of Cardiology guidelines recommend a more ambitious target than the previous guidelines version (i.e., to achieve LDL cholesterol [LDL-C] <55 mg/dL, and to reduce it ≥50% form baseline vs LDL-C<70 mg/dl or reduced ≥50% form baseline). Currently, data on the reduction of cardiovascular events in patients achieving the 2019 goals in a real-world population are missing.
Purpose
The aim of this study was to determine the risk of major adverse cardiovascular events (MACE) during follow-up in post myocardial infarction (PMI) patients according to the achievement of the guidelines-recommended goals in terms of LDL-C reduction.
Methods
We conducted a retrospective analysis of a monocentric observational registry prospectively enrolling patients admitted to our hospital for ST segment elevation myocardial infarction and followed-up in our dedicated PMI ambulatory. The analysis considered the patients enrolled between January 2011 and February 2019. Demographical and clinical data were extracted from a dedicated digital database, and the clinical events occurred during follow-up were obtained by telephone interviews or clinical records. We considered a combined endpoint of MACE defined as all-cause death, non-fatal MI, non-fatal stroke and unplanned revascularization. LDL-C was collected at baseline and at 1, 6 and 12 months after the event. The lower value collected at follow-up was used to define the achievement of the target goals. We conducted a Kaplan-Meier analysis and log-rank test comparing patients who achieved LDL-C <55 mg/dL and ≤50% from baseline (group 2019) vs those with LDL-C <70 mg/dL or ≤50% from baseline (group 2016). Continue variable are presented as median (interquartile range).
Results
A total of 1201 patients (23% female) were included in our analysis. Median age was 63 (54–72) years, 56% had hypertension, 17% diabetes, and 38% were smoker. Baseline LDL-C was 123 (97–148) mg/dL, the median LDL-C at follow-up was 63 (52–78) mg/dL, significantly reduced from baseline (P<0.0001). Between 6 and 12 months 83% of patients were treated with statin therapy alone (73% high intensity), and 17% with the addition of ezetimibe. The 2016 target was achieved in 828 patients (69%), while 270 patients (22.5%) obtained also the 2019 target. Median follow-up was 60 (40–77) months. The net incidence of MACE was 12.9% in group 2019 vs 23.7% in group 2016 (HR 0.61; 95% CI 0.42–0.88; P log-rank=0.0087; Number Needed to Treat=9; see Figure).
Conclusion
Our data from a real-world cohort of PMI patients emphasize the importance of achieving the guideline-recommended secondary prevention goals of LDL-C<55 mg/dl and ≤50% from baseline in order to reduce MACE.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Casula
- University of Pavia, Pavia, Italy
| | | | | | - I Zeqaj
- University of Pavia, Pavia, Italy
| | | | | | | | | | - R Camporotondo
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlin, Pavia, Italy
| | - R Totaro
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlin, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
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5
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Cornara S, Rordorf R, Demarchi A, Somaschini A, Baldi E, Mandurino Mirizzi A, Camporotondo R, Crimi G, Ferlini M, Gnecchi M, Oltrona Visconti L, De Servi S, De Ferrari GM. P376Prognostic impact of atrial fibrillation in STEMI patients treated by primary percutaneous coronary intervention: a focus on cardiogenic shock. Europace 2020. [DOI: 10.1093/europace/euaa162.030] [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: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a common finding in patients with ST elevation myocardial infarction (STEMI). However, its prognostic influence in MI remains controversial. Almost all previous studies were performed before the era of primary percutaneous coronary intervention (pPCI), and there is a lack of data in patients with STEMI complicated by cardiogenic shock (CS). The aim of our study was to evaluate the prognostic impact of AF in a large real-world population of STEMI undergoing pPCI stratified by the presence of CS.
Methods
Our registry included 3017 consecutive patients with STEMI undergoing pPCI in our department in 2005-2017. The presence of a persistent (>30 min) systolic blood pressure < 90 mmHg associated with signs of pulmonary congestion/impaired end organ perfusion needing catecholamine infusion or mechanical support devices qualified for CS. Firstly we performed mortality analysis in all patients with AF during hospitalization; secondly, we compared patients with the first episode of AF and patients with AF during hospitalization but known AF in anamnesis. The analysis was stratified for the presence of CS. Univariate (cross-tables and Kaplan-Meier curves with log-rank test) and multivariate mortality analysis (Cox regressions) were performed. In STEMI patients without CS we also performed a propensity-matched analysis including all variables known before STEMI that could influence the occurrence of a first episode of AF.
Results
AF was present in 337 (11.3%) patients during hospitalization; in 193 (57.3%) of them was the first episode. CS occurred in 250 patients (8.4%), 27.2% of whom were affected by an AF episode (86.5% as the first episode). Among patients without CS, AF occurred in 269 patients (9.7%) and for the 77.5% was the first episode. In CS patients, AF was not associated with increased mortality, neither at 30 days (43.5% vs 43.7%, p = 0.867) nor at 1 year (47.5% vs 53.1%, p = 0.633). In the population without CS, AF was an independent predictor of mortality both at 30 days (HR 2.25 (1.05; 4.82), p = 0.037) and at 1 year (HR 1.87 (1.094; 3.18), p = 0.022); only new-onset AF was an independent predictor of mortality. We successfully matched 175 pairs of patients with similar propension to experience the first episode of AF. Among them the first episode of AF was confirmed to be an indipendent predictor of mortality (figure).
Conclusion
In the present large real-world cohort of unselected patients with STEMI, the presence of an episode of AF during hospitalization was an independent predictor of mortality in patients not complicated by cardiogenic shock. Conversely, AF did not show a significant prognostic impact in patients with STEMI complicated by CS. Furthermore, the presence of a first episode of AF was confirmed to be an independent predictor of mortality, while an AF episode in patients with known AF was not found to have prognostic impact.
Abstract Figure
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Affiliation(s)
- S Cornara
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - A Demarchi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - A Somaschini
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - E Baldi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | | | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - M Gnecchi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | | | - S De Servi
- IRCCS MultiMedica Sesto San Giovanni, Cardiology, Sesto San Giovanni, Italy
| | - G M De Ferrari
- A.O.U. Citta della Salute e della Scienza di Torino, Cardiology, Turin, Italy
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6
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Cornara S, Somaschini A, Ferlini M, Demarchi A, Mandurino Mirizzi A, Camporotondo R, Crimi G, Mauri S, Gnecchi M, Oltrona Visconti L, De Servi S, De Ferrari GM. P1763Derivation and validation of a risk score to predict incomplete ST segment resolution in STEMI patients undergoing primary PCI: association with the benefit of Glycoprotein IIb-IIIa inhibitors Use. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0516] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Incomplete ST segment resolution (iSTR) is a well-known marker of poor outcome in patients undergoing primary percutaneous coronary intervention (pPCI) for ST elevation myocardial infarction (STEMI). The use of glycoprotein IIbIIIa inhibitors (GPIs) was suggested to be associated with a survival benefit in high-risk patients. A simple score to predict the risk for developing iSTR could help early identification of these patients and could allow a tailored use of pharmacological tools, such as GPIs.
The aim of this study was to create and validate a numerical score to predict iSTR occurrence in STEMI patients undergoing pPCI and to assess its association with the potential benefit of GPIs use.
We prospectively enrolled all STEMI patients undergoing pPCI in our University Hospital (2005–2017). iSTR was defined as a <70% resolution of initial ST segment shift in the lead with maximal ST deviation 60 min after reperfusion. Our population was randomly divided in two group: a derivation cohort (60%) and a validation cohort (40%). Potential predictors of iSTR were selected at univariate analysis and were then inserted in a multivariate binary stepwise-backward logistic regression. To create a risk score, numerical values were obtained considering the odds ratio of each independent predictor rounding to the nearest unit or half. A ROC curve with its c-statistic was then used to test the discrimination power of the score both in the derivation and in the validation cohort.
Out of a total of 2959 patients, 1774 were included in the derivation: 480 (27%) of them presented iSTR. All-cause mortality at 30 days was significantly higher in patients with iSTR (OR 3.2, 95% CI 2.1–4.9, p<0.001). Anterior MI (OR 2.46, 95% CI 1.90–3.14, p<0.001, score 2.5), anemia at admission (OR 1.76, 95% CI 1.29–2.4, p<0.001, score 2), blood glucose >198 mg/dl at admission (OR 1.77, 95% CI 1.29–2.49, p<0.001, score 2), age >75 years (OR 1.54, 95% CI 1.15–2.10, p=0.004, score 1.5), female sex (OR 1.41, 95% CI 1.06–1.88, p=0.02, score 1.5) and Killip class >2 (OR 1.44, 95% CI 1.05–1.98, p=0.024, score 1.5) were identified as independent predictors of iSTR, creating a ISTR-score that ranged from 0 to 11. The validation cohort consisted in 1185 patients, with 31% showing iSTR. The c-statistic was 0.67 and 0.66 in the derivation and validation cohorts. Patients with score ≥4 versus <4 showed present a worst prognosys but a similar GPI use. Notably, GPIs were associated with a significant survival benefit among patients≥4 but not among patients <4 (Figure). The use of GPIs was not associated to any clinically relevant difference, the increase in bleeding risk appeared similar.
A simple pre-procedural risk score may predict iSTR following pPPCI, allowing a rapid risk stratification and the identification of patients who show a favorable risk/benefit ratio for the use of more aggressive strategies such as GPIs. These findings deserve a prospective, randomized evaluation.
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Affiliation(s)
- S Cornara
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - A Somaschini
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Section of Cardiology, Pavia, Italy
| | - A Demarchi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - A Mandurino Mirizzi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - R Camporotondo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Section of Cardiology, Pavia, Italy
| | - S Mauri
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - M Gnecchi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Section of Cardiology, Pavia, Italy
| | - S De Servi
- IRCCS MultiMedica Sesto San Giovanni, Sesto San Giovanni, Italy
| | - G M De Ferrari
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
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7
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Ferlini M, Rossini R, Musumeci G, Grieco N, Trabattoni D, Cornara S, Cardile A, Calchera I, Russo F, Ielasi A, Faggiano P, Castiglioni B, Lettieri C, Klersy C, Oltrona Visconti L. P5531A systematic follow-up strategy after percutaneous coronary intervention based on patient risk profile: the prospective POST-PCI registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0478] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Redundant clinical and non-invasive examinations after percutaneous coronary intervention (PCI) increase the cost of medical care with no outcome improve. A multidisciplinary consensus document (MCD) providing a follow-up (FU) strategy based on 3 clinical and angiographic risk profile (A high, B intermediate, and C low) has been recently proposed.
Aim
To evaluate the potential reduction of cardiologic consults (CC), stress tests (ST), and echocardiograms (EC) with the application of the MCD after PCI.
Methods
The Post-PCI registry is a multicenter, observational, prospective data collection carried out during a four-week period that included consecutive patients undergoing PCI at 31 Italian Hospitals both for acute coronary syndromes (ACS) or stable coronary artery disease (SCAD). FU strategies were left at investigator's discretion. A comparison between the CC, ST and EC performed in the first 12-months with the potential suggested by the MCD was evaluated.
Results
A total of 1113 patients were included; 12-months follow up was available in 90% of the cases (mean age 68±11 years old, 58% ACS). Based on MCD risk profile 17% were in A, 74% in B and 9% in C strategy. On average observed CC and ST were significantly lower compared to the expected based on MCD (respectively 1.63±1.07 vs 1.91±0.28, and 0.41±0.59 vs 0.61±0.84; on the contrary EC were significantly higher (0.64±0.73 vs 0.34±0.75, all: p<0.001). The excess rate for CC, ST and EC as compared to MCD was respectively 25%, 14% and 8% for the strategy A, 14%, 25% and 50% for the strategy B and 26%, 54% and 40% for the strategy C. At multivariable logistic analysis the MCD strategy was an independent predictor (in a model with age, sex, consulting physician, public or private hospital) of an increased number of cardiac examination in patients at intermediated and low risk [B group OR 2.56 (95% CI 1.38–4.75), C group 27.00 (95% CI 8.13–89.62)]. The other independent predictor was age, with a reduced number of examination for elderly (>75 years old) patients [OR 0.59 (CI 95% 0.43–0.80)].
Conclusion
Our data suggest that in a real word population of patients undergoing PCI, a follow-up strategy based on clinical and anatomical risk profile would allow to a reduction of cardiac tests and consultations, particularly in patients at intermediated and low risk leading to an increase of appropriateness of prescription and to a cost reduction of medical care.
Acknowledgement/Funding
The Post-PCI registry was supported by the Italian Society of Interventional Cardiology (SICI-GISE) receiving an unrestricted grant from Astra Zeneca
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Affiliation(s)
- M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | | | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - F Russo
- Sant'Anna Hospital, Como, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | | | | | - C Klersy
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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8
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Baldi E, Demarchi A, Mauri S, Di Giacomo C, Ferrario Ormezzano M, Ferlini M, Savastano S, Petracci B, Sanzo A, Aiello M, Gazzoli F, Pelenghi S, Oltrona Visconti L, De Ferrari GM, Rordorf R. 6118Mid- and long-term percentage of ventricular pacing in patients implanted with a pacemaker after a transcatheter aortic valve replacement procedure: potential clinical implications. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0144] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac conduction disturbances frequently occur following transcatheter aortic valve replacement (TAVR). As this procedure is getting more and more common, more research efforts should focus on post procedural rhythm disturbances and their evolution over time
Purpose
To evaluate the percentage of pacing in patients who underwent a TAVR procedure and developed a conduction disturbance requiring a transvenous pacemaker (PM) implantation
Methods
We considered all the patients who underwent a TAVR procedure between march 2009 and november 2018 in our centre. Patients implanted with a PM or an ICD before the TAVR procedure or 30 days after the TAVR were not considered eligible for our analysis, because likely not related to TAVR. The percentage of effective right ventricular pacing was assessed both at mid- and long-term follow-up
Results
265 patients underwent TAVR in the study period (45% males, 81±6 years). 20 patients already had a PM and were excluded. 39 of the 245 patients (16%) were implanted with a PM after TAVR, 26 of them were implanted within 30 days (median time TAVR-PM implant: 8±7 days). The rate of PM implant within 30 days after TAVR was 8% (20/246) for patients implanted with an Edward Sapien valve, 25% (4/16) for patients with an Evolute Pro valve and 66% (2/3) in patients with a Lotus Edge valve. The indication for PM implant was a permanent 3rd degree A-V block in 12 patients, a paroxysmal A-V block in 4, a bifascicular A-V block with an infra-hisian disease in 5, a II degree Mobitz II A-V block in 2, an atrial fibrillation with slow A-V conduction in 2 and a 2:1 A-V block with infra-hisian disease in 1. The first follow-up after the PM implantation was available in 24 patients (mean 78±87 days after PM implant) and the second in 15 patients (372±267 days after PM implant). The patients were divided into two groups based on the presence/absence of permanent 3rd degree AV block at the time of implantation. At the first follow-up the percentage of pacing was significantly higher in patients implanted with vs. without a permanent 3rd degree AV block (98.5% vs 11%, p<0.001). Notably, in none of the patients without a permanent 3rd AV block at baseline conduction disturbances progressed toward a permanent AV block during long-term follow-up. Accordingly, at the second follow-up patients without permanent 3rd AV block at baseline showed a significantly lower percentage of pacing (1% vs 100%; p<0.01)
Conclusion
Patients implanted with a PM after TAVR in the absence of a permanent 3rd AV block have a very low likelihood of progression to a permanent AV conduction disturbance and show a negligible percentage of pacing during follow-up. Our results may impact the choice of the correct timing of PM implantation after TAVR and the potential indication for a leadless PM.
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Affiliation(s)
- E Baldi
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - A Demarchi
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - S Mauri
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - C Di Giacomo
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | | | - M Ferlini
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
| | - S Savastano
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
| | - B Petracci
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - A Sanzo
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - M Aiello
- Foundation IRCCS Policlinic San Matteo, Department of Cardiothoracic Surgery, Pavia, Italy
| | - F Gazzoli
- Foundation IRCCS Policlinic San Matteo, Department of Cardiothoracic Surgery, Pavia, Italy
| | - S Pelenghi
- Foundation IRCCS Policlinic San Matteo, Department of Cardiothoracic Surgery, Pavia, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Policlinic San Matteo, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
| | - R Rordorf
- Foundation IRCCS Policlinic San Matteo - University of Pavia, Pavia, Italy
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9
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Mandurino Mirizzi A, Cornara S, Somaschini A, Demarchi A, Galazzi M, Puccio S, Crimi G, Ferlini M, Camporotondo R, Gnecchi M, Ferrario M, De Servi S, Oltrona Visconti L, De Ferrari GM. P6395Elevated serum uric acid is associated with a greater inflammatory response and with short- and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percu. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0991] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Elevated serum uric acid (eSUA) has been identified as independent risk factors for cardiovascular diseases, including coronary artery disease, and it has been associated with increased mortality in the general population. However, whether eSUA is associated with adverse outcomes in the setting of ST-segment elevation myocardial infarction (STEMI) is still controversial. Although the mechanisms of this possible relationship is similarly unsettled it has been suggested that eSUA could trigger oxidative stress and inflammatory response.
Aim
This study sought to investigate the association between eSUA with short- and long-term mortality and with inflammatory response in patients with STEMI treated with primary percutaneous coronary intervention (pPCI).
Methods
We prospectively enrolled all STEMI patients undergoing pPCI in our hospital between 2005 and 2017. Blood samples were collected on admission and at 24 and 48 hours after pPCI: SUA and the inflammatory biomarkers C-reactive protein (CRP), neutrophil count and neutrophil to lymphocytes ratio (NLR) were parameter of interest. NLR was obtained by dividing the total count of neutrophil by the total count of lymphocyte. eSUA was defined as >6.8 mg/dl. Cumulative 30-days and 1-year mortalities were estimated using the Kaplan-Meyer analysis and compared with the long-rank test. Landmark analysis was set at 365 days. Multivariable analyses were performed by Cox proportional hazard models.
Results
Out of the dataset of 2959 STEMI patients treated with pPCI, we analyzed 2369 patients who had SUA data. Overall age was 63 (p25-p75: 54–73) years, men were 2295 (75.5%), anterior MI 1390 (45.8%). eSUA was present in 563 patients (23.8%). 30-day mortality was 5.8% (n=31) among patients with eSUA and 2% (n=34) among patient with normal SUA level (p<0.001); 1-year mortality was 8.5% (n=46) vs 4% (n=70), respectively (p<0.001). Landmark analysis is shown in Figure 1. At multivariable analyses eSUA was an independent predictor after adjusting for age, female gender, BMI, diabetes, previous MI, serum creatinine, Hb, acute glycemia, Killip class >2 (30-day mortality HR 1.196, 95% CI 1.006–1.321, p=0.042; 1-year mortality HR 1.178, 95% CI 1.052–1.320, p=0.005). On admission CRP was higher in the group with eSUA as compared with the group with normal SUA levels (respectively, 1.27 [0.57–3.37] mg/dl vs 0.72 [0.30–1.8] mg/dl, p<0.001). On admission neutrophil count and NLR did not differ among the groups (respectively, p=0.205 and p=0.399), but eSUA patients presented higher values in neutrophil count and NLR at 24 hours (respectively, p=0.020 and p<0.001) and at 48 hours (p=0.018 and both p<0.001).
Figure 1
Conclusions
Elevated serum uric acid is associated with higher short- and long-term mortality and with a greater inflammatory response after reperfusion in patients with STEMI treated with primary PCI.
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Affiliation(s)
- A Mandurino Mirizzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - S Cornara
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - A Somaschini
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - A Demarchi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - M Galazzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - S Puccio
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - M Gnecchi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - M Ferrario
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - S De Servi
- IRCCS Multimedica of Milan, Milan, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - G M De Ferrari
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
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10
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Somaschini A, Cornara S, Demarchi A, Mandurino Mirizzi A, Puccio S, Galazzi M, Camporotondo R, Crmi M, Ferlini M, Gnecchi M, Oltrona Visconti L, De Servi S, De Ferrari GM. P5733IABP use in patients with STEMI complicated by cardiogenic shock: time for rehabilitation? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0673] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Evidence from a large randomized clinical trial has led international guidelines to downgrade to Class III the recommendation level for the routine use of intra-aortic balloon pump (IABP) in patients with STEMI complicated by cardiogenic shock (CS). Despite this, its use in clinical practice remains high.
Purpose
The aim of our study was to evaluate whether IABP use could provide a prognostic benefit in a large real-world population of STEMI patients undergoing primary PCI (pPCI).
Methods
Our registry included 2958 consecutive patients undergoing primary pPCI for STEMI in our department from 2005 to 2017. The presence of a persistent (>30 min) systolic blood pressure <90 mmHg and signs of pulmonary congestion or impaired end organ perfusion needing catecholamine infusion qualified for CS. Among patients with CS we compared mortality between those with and those without IABP in the whole population and in the pre-specified subgroup with anterior STEMI. Univariate (cross-tables and Kaplan-Meier curves with log-rank test) and multivariate mortality analysis (Cox regressions) were performed.
Results
CS occurred in 246 patients (8.3%); among these patients, 145 (60%) had anterior AMI. Mortality at 30 days was 3.7 in inferior vs 7.1% in anterior STEMI (p<0.001). In these two groups of patients, IABP was used in 32% and 66.7% of cases, respectively. In the whole CS group, IABP use was associated with a lower 30-day mortality (39% vs 53%, p=0.020 – see figure panel A); this figure was confirmed at multivariable analysis (HR 0.49, 95% CI 0.27–0.87, p=0.016) after adjusting for age, CK peak, triple-vessel disease, eGFR and all-TIMI bleeding during hospital stay. IABP use in CS patients was not associated with major complications or an increased rate of Hb drop (>3 mg/dL) during hospital stay. In the subgroup of patients with anterior STEMI, there was a marked survival benefit at univariate analysis (30-day mortality 41% vs 61%, p=0.013 – see figure panel B), confirmed at multivariable analysis (HR 0.40, 95% CI 0.19–0.88, p=0.023) after adjusting for the same variables of the previous model. In the subgroup of patients with inferior STEMI, IABP use was not significantly associated with a lower 30-day mortality (32% vs 41%, p=0.380).
Figure 1
Conclusion
In the present large real-world cohort of unselected patients with STEMI, the use of IABP in case of CS was found to improve survival. This finding suggests that IABP could still play a role in patient with STEMI complicated by CS, especially when additional risk features are present, such as anterior MI. We suggest that additional careful prospective studies are needed before abandoning or markedly limiting the use of IABP in this clinical setting.
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Affiliation(s)
- A Somaschini
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - S Cornara
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - A Demarchi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - A Mandurino Mirizzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - S Puccio
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - M Galazzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - M Crmi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M Gnecchi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - S De Servi
- IRCCS MultiMedica Sesto San Giovanni, Cardiology, Sesto San Giovanni, Italy
| | - G M De Ferrari
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology - University of Pavia, Pavia, Italy
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11
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Mandurino Mirizzi A, Crimi G, Gritti V, Scotti V, Strozzi C, Silvestri A, Montalto C, D'Ascenzo F, Repetto A, Ferlini M, Marinoni B, De Servi S, Ferrario M, Klersy C, Oltrona Visconti L. P970DK-crush is the best treatment strategy to reduce stent oriented clinical outcome, results from a network meta-analysis of twenty-six randomized clinical trials comparing different stent techniques. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0564] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Coronary bifurcation disease (CBD) accounts for approximately 20% of all and is associated with worse short- and long- term clinical outcomes. Provisional stenting (PS) is the preferred choice, however, this approach may not be suitable in all CBD anatomies, therefore several elective two-stents techniques have been described, however there is lack of randomized evidence to guide interventionalist across different stent techniques. Objectives. To identify the best percutaneous coronary interventions (PCI) technique for CBD.
Methods
We systematically review randomized clinical (RCTs) of patients receiving CBD PCI with either PS or six type of elective two-stent techniques (DK-crush, TAP, culotte, dedicated bifurcation stents, crushing, T-stenting) and compare device oriented clinical events (DOCE) in a network meta-analysis. DOCE was defined as composite of cardiac death, target-vessel myocardial infarction, stent thrombosis, target lesion revascularization OR target vessel revascularisation.
Results
We included 26 RCTs leading to a pooled population of 10339 patients-years with 1229 DOCE. Compared to PS, the DK-crush technique had a lower DOCE with RR=0.62, [0.42–0.92]. Figure. DK-crush had the highest likelihood (model likelihood=90.2%, SUCRA=98.0%) of being the best treatment to reduce DOCE.
Figure 1
Conclusions
In the management CBD, when a two-stent technique is required as upfront strategy, the DK- Crush technique should be privileged as it showed to reduce stent-related clinical outcomes (DOCE) when compared to other bifurcation techniques.
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Affiliation(s)
- A Mandurino Mirizzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - V Gritti
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - V Scotti
- Policlinic Foundation San Matteo IRCCS, Service of Biometry and Clinical Epidemiology, Pavia, Italy
| | - C Strozzi
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - A Silvestri
- Policlinic Foundation San Matteo IRCCS, Service of Biometry and Clinical Epidemiology, Pavia, Italy
| | - C Montalto
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Pavia, Italy
| | - F D'Ascenzo
- University of Turin, Department of Cardiology, Turin, Italy
| | - A Repetto
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - B Marinoni
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - S De Servi
- IRCCS Multimedica of Milan, Cardiology Department, Milan, Italy
| | - M Ferrario
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
| | - C Klersy
- Policlinic Foundation San Matteo IRCCS, Service of Biometry and Clinical Epidemiology, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Cardiology Department, Pavia, Italy
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12
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Colombo P, Cardile A, Calchera I, Marino M, Ielasi A, Pedretti R, Lettieri C, Oltrona Visconti L. 2227Perceived or calculated bleeding risk in patients undergoing percutaneous coronary intervention: inside the post-pci prospective registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2227] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - P Colombo
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - A Cardile
- AO Ospedale Treviglio, Treviglio, Italy
| | | | - M Marino
- Maggiore Hospital of Crema, Crema, Italy
| | - A Ielasi
- Bolognini Hospital, Seriate, Italy
| | - R Pedretti
- Fondazione Salvatore Maugeri, Tradate, Italy
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13
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Mandurino Mirizzi A, Demarchi A, Crimi G, Ferlini M, Ruffinazzi M, Camporotondo R, Ravera A, Ferrario M, Oltrona-Visconti L, De Ferrari GM. P1686Role of hypoalbuminemia in myocardial reperfusion after primary PCI in patients with ST-elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1686] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M Ruffinazzi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit, Pavia, Italy
| | - A Ravera
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - M Ferrario
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - L Oltrona-Visconti
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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14
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Rossini R, Iorio A, Musumeci G, Savonitto S, Trabattoni D, Lettino M, Molfese M, Lettieri C, Ferlini M, Oltrona Visconti L, Piccaluga E, Masiero G, Caporale R, Calchera I, Tarantini G. P2686Role of optimal medical therapy on perioperative outcome in patients with heart failure and coronary artery disease undergoing surgery: insights from the SAS registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2686] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Iorio
- Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | - D Trabattoni
- Centro Cardiologico Monzino, IRCCS, Milano, Milano, Italy
| | - M Lettino
- Istituto Clinico Humanitas, Milano, Italy
| | | | | | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | | | | | - G Masiero
- University Hospital of Padova, Padua, Italy
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15
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Buratti S, Crimi G, Somaschini A, Cornara S, Camporotondo R, Gnecchi M, Ferlini M, Fedele M, Belotti S, Iannone A, Beccaria F, Bartolini D, Oltrona Visconti L, Rubartelli P, De Ferrari GM. 2166STEMI in women undergoing primary PCI: time to make a (gender) difference. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2166] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Buratti
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - G Crimi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - R Camporotondo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - M Fedele
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - S Belotti
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - A Iannone
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - F Beccaria
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - D Bartolini
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - P Rubartelli
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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16
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Collaku E, Trabattoni D, Savonitto S, Musumeci G, Calchera I, Lettino M, Molfese M, Piatti L, Tarantini G, Piccaluga E, Oltrona Visconti L, Ferlini M, Caporale R, Masiero G, Rossini R. P2644The Surgery after Stent (SAS) Registry: a gender-based analysis on clinical outcomes in women undergoing cardiac and non-cardiac surgery. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2644] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Collaku
- Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - D Trabattoni
- Centro Cardiologico Monzino, IRCCS, Milano, Milano, Italy
| | | | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | | | - M Lettino
- Istituto Clinico Humanitas, Milan, Italy
| | | | - L Piatti
- Alessandro Manzoni Hospital, Lecco, Italy
| | | | | | | | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | | | - G Masiero
- University Hospital of Padova, Padua, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
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Fortuni F, Rolando M, Foglia D, Crimi G, Leonardi S, Ferlini M, Ferrario M, Oltrona Visconti L, De Ferrari GM. P5103There is no time like the present - a meta-analysis on complete versus culprit-only revascularization in acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5103] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Fortuni
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - M Rolando
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - D Foglia
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - G Crimi
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - S Leonardi
- Fondazione IRCCS Policlinico San Matteo., Coronary Care Unit, Pavia, Italy
| | - M Ferlini
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - M Ferrario
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | | | - G M De Ferrari
- Fondazione IRCCS Policlinico San Matteo., Coronary Care Unit, Pavia, Italy
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Ferlini M, Fortuni F, Potenza A, Crimi G, Mauri S, Cornara S, Somaschini A, Balduini A, De Ferrari GM, Oltrona Visconti L. P1716Three for two - a meta-analysis on the optimal antithrombotic regimen in patients undergoing coronary stent implantation with an indication to anticoagulation therapy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1716] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Ferlini
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - F Fortuni
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - A Potenza
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - G Crimi
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - S Mauri
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - S Cornara
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - A Somaschini
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - A Balduini
- IRCCS Policlinico San Matteo., Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Fondazione IRCCS Policlinico San Matteo., Coronary Care Unit, Pavia, Italy
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Somaschini A, Cornara S, Demarchi A, Crimi G, Ferlini M, Camporotondo R, Gnecchi M, Ferrario Ormezzano M, Oltrona Visconti L, De Servi S, De Ferrari GM. P3484The acute inflammatory response in elderly STEMI patients leads to greater microvascular dysfunction? A new perspective on inflammaging. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3484] [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: 11/14/2022] Open
Affiliation(s)
- A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Demarchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | | | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S De Servi
- IRCCS MultiMedica Sesto San Giovanni, Department of Cardiology, Sesto San Giovanni, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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Somaschini A, Crimi G, Cornara S, Buratti S, Ferlini M, Camporotondo R, Gnecchi M, Bartolini D, Belotti S, Fedele M, Iannone A, Beccaria F, Oltrona Visconti L, Rubartelli P, De Ferrari GM. P6399The obesity paradox in STEMI patients treated with primary PCI: is it a matter of sex? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6399] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - G Crimi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - S Buratti
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Camporotondo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - D Bartolini
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - S Belotti
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - M Fedele
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - A Iannone
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - F Beccaria
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - P Rubartelli
- ASL3 Genovese Villa Scassi Hospital, Department of Cardiology, Genoa, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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Somaschini A, Cornara S, Ferlini M, Crimi G, Camporotondo R, Gnecchi M, Ferrario Ormezzano M, Oltrona Visconti L, De Ferrari GM, De Servi S. P2728Identification of clinical and laboratory predictors of incomplete ST segment resolution in patients undergoing primary percutaneous intervention for ST elevation myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2728] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - M Ferlini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - G Crimi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - R Camporotondo
- Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | | | - L Oltrona Visconti
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S De Servi
- IRCCS MultiMedica Sesto San Giovanni, Department of Cardiology, Sesto San Giovanni, Italy
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Galiffa VA, Crimi G, Gritti V, Scotti V, Ferrario M, Ferlini M, Repetto A, Marinoni B, De Ferrari GM, Bongo AS, Oltrona Visconti L, Klersy C. P6027Drug eluting are superior to bare metal stents in patients with end-stage renal disease on dialysis: a meta-analysis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V A Galiffa
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - V Gritti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - V Scotti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M Ferrario
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Repetto
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - B Marinoni
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - G M De Ferrari
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A S Bongo
- Hospital Maggiore Della Carita, Coronary Care Unit and Catheterization Laboratory, Novara, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - C Klersy
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
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23
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Demarchi A, Cornara S, Somaschini A, Crimi G, Ferlini M, Camporotondo R, Ferrario Ormezzano M, Gnecchi M, Oltrona Visconti L, De Servi S, De Ferrari GM. P1679Acute glycaemia in non diabetic patients with ST elevation myocardial infarction: could it be a direct mediator of myocardial damage? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1679] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Demarchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit, Pavia, Italy
| | | | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - L Oltrona Visconti
- Policlinic Foundation San Matteo IRCCS, Department of Cardiology, Pavia, Italy
| | - S De Servi
- IRCCS Multimedica, Sesto San Giovanni, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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Cornara S, Crimi G, Buratti S, Somaschini A, Ferlini M, Camporotondo R, Gnecchi M, Bartolini D, Belotti S, Fedele M, Iannone A, Beccaria F, Oltrona Visconti L, Rubartelli P, De Ferrari GM. P6366The use of intra-aortic balloon pump in a large population of STEMI patients treated by primary percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6366] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Cornara
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - G Crimi
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - S Buratti
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - A Somaschini
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - M Ferlini
- Policlinic Foundation San Matteo IRCCS, Cardiology, Pavia, Italy
| | - R Camporotondo
- Policlinic Foundation San Matteo IRCCS, Coronary Care Unit, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit – Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Pavia, Italy
| | - D Bartolini
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | - S Belotti
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | - M Fedele
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | - A Iannone
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | - F Beccaria
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | | | - P Rubartelli
- ASL3 genovese Villa Scassi Hospital, Cardiology, Genova, Italy
| | - G M De Ferrari
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
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Ferlini M, Musumeci G, Grieco N, Rossini R, Demarchi A, Cornara S, Somaschini A, Trabattoni D, Zavalloni Parenti D, Martinoni A, Castiglioni B, Faggiano P, Oliva F, Lettiieri C, Oltrona Visconti L. 2228Are perceived or calculated bleeding risk related to dapt choice in patients undergoing percutaneous coronary intervention? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2228] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Ferlini
- Policlinic Foundation San Matteo IRCCS, Pavia, Italy
| | - G Musumeci
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - N Grieco
- Niguarda Ca' Granda Hospital, Milan, Italy
| | - R Rossini
- Santa Croce E Carle Hospital, Cuneo, Italy
| | - A Demarchi
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - S Cornara
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | - A Somaschini
- Foundation IRCCS Polyclinic San Matteo - University of Pavia, Pavia, Italy
| | | | | | | | | | - P Faggiano
- Civil Hospital of Brescia, Brescia, Italy
| | - F Oliva
- Niguarda Ca' Granda Hospital, Milan, Italy
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Cornara S, Somaschini A, Demarchi A, Ferlini M, Crimi G, Camporotondo R, Gnecchi M, Ormezzano Ferrario M, Oltrona Visconti L, De Ferrari G. P5544Inflammation, microvascular dysfunction and smoker's paradox in ST elevation myocardial infarction patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5544] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bergamaschi L, Avondo S, Cornara S, Somaschini A, Buratti S, Baldo A, Camporotondo R, Crimi G, Ferlini M, Oltrona Visconti L, De Ferrari G. P2120The obesity paradox in ST elevation myocardial infarction treated with primary percutaneous coronary intervention: role of infarct size. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2120] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bergamaschi L, Avondo S, Buratti S, Somaschini A, Cornara S, Baldo A, Camporotondo R, Crimi G, Ferlini M, Oltrona Visconti L, De Ferrari G. P1393No-reflow after primary percutaneous coronary interventions in STEMI is an independent predictor of contrast induced acute kidney injury. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1393] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cornara S, Somaschini A, De Servi S, Crimi G, Ferlini M, Baldo A, Camporotondo R, Gnecchi M, Oltrona Visconti L, De Ferrari G. P1067The prognostic impact of bleeding in STEMI patients treated by primary PCI depends on Killip class at presentation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1067] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Demarchi A, Mandurino-Mirizzi A, Ruffinazzi M, Crimi G, Ravera A, Ferlini M, Camporotondo R, De Ferrari G. P1796Inflammatory response and myocardial reperfusion in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1796] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Iannopollo G, Savastano S, Ferlini M, Ferrario M, Camporotondo R, Somaschini A, Cornara S, Baldo A, Oltrona Visconti L, De Ferrari G. P4666Long term outcome of STEMI survivors with cardiogenic shock at presentation treated with primary percutaneous coronary intervention. What happens after the first year? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4666] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Leonardi S, Saturi G, Arpellini M, Repetto A, Camporotondo R, Ferlini M, Mandurino-Mirizzi A, Mauri S, Ottani F, Castelli C, Barengo A, Raisaro A, Ferrario M, Oltrona-Visconti L, De Ferrari G. P3019Blood transfusions and high haemoglobin thresholds for transfusion are associated with increased mortality in patients with acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Somaschini A, Demarchi A, Cornara S, Ferlini M, Crimi G, Ravera A, Mandurino-Mirizzi A, Camporotondo R, Oltrona Visconti L, De Ferrari G, De Servi S. P1756Vagal activity reduces inflammatory response in patients with STEMI treated with primary PCI and GPIIbIIIa inhibitors. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1756] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Demarchi A, Somaschini A, Cornara S, Ferlini M, Ravera A, Mandurino-Mirizzi A, Camporotondo R, Ferrario Ormezzano M, Oltrona Visconti L, De Ferrari G. P3440Inflammation and microvascular dysfunction in elderly patients with ST elevation acute myocardial infarction treated with primary PCI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3440] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Somaschini A, Cornara S, Ferlini M, Crimi G, Baldo A, Camporotondo R, Ormezzano Ferrario M, Oltrona Visconti L, De Ferrari G, De Servi S. P3697Prognostic role of non-ST resolution and glycoprotein IIbIIIa inhibitors use in STEMI patients treated with primary PCI. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3697] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bozzani A, Ferlini M, Rossini R, Musumeci G, Arici V, Bramucci E, Setacci C. Antiplatelet therapy management in patients with coronary stent undergoing vascular surgery. J Cardiovasc Surg (Torino) 2015; 56:681-683. [PMID: 25008060] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- A Bozzani
- Division of Vascular Surgery, Foundation I.R.C.C.S. Policlinico San Matteo, Pavia, Italy -
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Russolillo N, Ferrero A, Vigano' L, Langella S, Briozzo A, Ferlini M, Migliardi M, Capussotti L. Impact of perioperative symbiotic therapy on infectious morbidity after Hpb Surgery in jaundiced patients: a randomized controlled trial. Updates Surg 2014; 66:203-10. [PMID: 25099747 DOI: 10.1007/s13304-014-0259-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/15/2014] [Indexed: 01/18/2023]
Abstract
This study aimed at evaluating whether the administration of symbiotic therapy in jaundiced patients could reduce their postoperative infectious complications. The study was conducted between November 2008 and February 2011. Jaundiced patients scheduled for elective extrahepatic bile duct resection without liver cirrhosis, intestinal malabsorption or intolerance to symbiotic therapy were randomly assigned to receive [Group A] or not [Group B] symbiotics perioperatively. The primary endpoint was the infectious morbidity rate. Forty patients were included in the analysis (20 in each group). The patients in Group B presented a higher overall morbidity (70 vs 50%) and infectious morbidity rate (50 vs 25%), but the differences were not significant. Eleven patients in Group A (Group ndA) and 13 in Group B (Group ndB) did not receive preoperative biliary drainage. The results of the two groups were comparable. Infectious complications were higher in Group B [5 (34%) vs 0, p = 0.030], while the prevalence of natural killer (NK) cells was higher in Group ndA the day before surgery (17% ± 5.1 vs 10% ± 5.3, p < 0.01) and on post-operative day (POD) 7 (13.1% ± 4.1 vs 7.7% ± 3.4, p < 0.01). The rates of lymph node colonization were similar. The symbiotic therapy failed to reduce the rate of infectious morbidity in jaundiced patients. Further studies investigating the place of symbiotic in no-drainage patients are required.
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Affiliation(s)
- N Russolillo
- Department of General and Oncological Surgery, 'Umberto I' Mauriziano Hospital, Largo Turati, 62-10128, Turin, Italy,
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38
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Mojoli F, Venti A, Pellegrini C, De Ferrari GM, Ferlini M, Zanierato M, Maurelli M, Iotti GA, D'Armini AM, Braschi A. Hospital survival and long term quality of life after emergency institution of venoarterial ECMO for refractory circulatory collapse. Minerva Anestesiol 2013; 79:1147-1155. [PMID: 24002458] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Thanks to significant technical improvements, VA-ECMO is increasingly used to reverse circulatory collapse refractory to standard treatments. METHODS We studied patients who underwent VA-ECMO due to primary cardiogenic shock or cardiac arrest between January 2008 and June 2011 at our institution. Variables related to hospital survival were analyzed. Long-term survival and health-related quality of life were checked. RESULTS VA-ECMO was instituted in 23 patients: 17 outpatients and 6 inpatients. Seven of the outpatients were admitted to hospital under ongoing CPR. In these pts, time to CPR was 7 min (6-8) and time to ECMO 93 min (74-107); after 20 hours (16-22), all these pts died. Among remaining 16 pts, 6 were bridged to heart transplant and 4 to heart recovery, 8 survived to hospital discharge and 7 were alive with high health-related quality of life after 46 months (36-54). Ongoing CPR, inotropic score and lactates at cannulation did not differ between survivors and non-survivors; duration of shock, SOFA score and serum creatinine at ECMO institution, and lactates and fluid balance after 36 hours were higher in non-survivors. Patients could be kept on spontaneous breathing for >30% of time while on VA-ECMO. CONCLUSION Emergency VA-ECMO institution can reverse refractory acute cardiovascular collapse, provided it is carried out before significant organ dysfunction occurs. Light sedation and spontaneous breathing while on VA-ECMO can be well tolerated by patients, but related clinical benefits should be proved. Patients successfully bridged to heart recovery or transplant are candidates for long-term good quality of life.
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Affiliation(s)
- F Mojoli
- S. C. di Anestesia e Rianimazione I, Dipartimento di Emergenza Urgenza, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia -
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Corvaglia L, Zama D, Gualdi S, Ferlini M, Aceti A, Faldella G. Gastro-oesophageal reflux increases the number of apnoeas in very preterm infants. Arch Dis Child Fetal Neonatal Ed 2009; 94:F188-92. [PMID: 18786960 DOI: 10.1136/adc.2008.143198] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To document the existence of a relationship between apnoea of prematurity (AOP) and gastro-oesophageal reflux (GER) in preterm infants. SETTING Neonatal intensive care unit. PATIENTS Twenty-six preterm infants (gestational age < or =32 weeks) with recurrent apnoeas. INTERVENTION Simultaneous and synchronised recording of polysomnography and pH-impedance monitoring (pH-MII). Polysomnography detects and characterises apnoeas, by recording of breathing movement, nasal airflow, electrocardiogram and pulse oximeter saturation. pH-MII is the state-of-the-art methodology for GER detection in preterm newborns. MAIN OUTCOME MEASURES Relationship between AOP and GER, which were considered temporally related if both started within 30 seconds of each other. RESULTS One hundred and fifty-four apnoeas out of 1136 were temporally related to GER. The frequency of apnoea during the 1-minute time around the onset of GER was significantly higher than the frequency detected in the GER-free period (p = 0.03). Furthermore, the frequency of apnoea in the 30 seconds after GER (GER-triggered apnoeas) was greater than that detected in the 30 seconds before (p = 0.01). A great inter-individual variability was documented in the proportion of GER-triggered apnoeas. A strong correlation between total number of apnoeas and the difference between apnoeas detected 30 seconds after and before GER was found (p = 0.034). CONCLUSIONS Our data show that a variable rate of apnoeas can be triggered by GER in very preterm infants. Further studies are needed to recognise clinical features that identify those patients who are more susceptible to GER-triggered apnoeas.
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Affiliation(s)
- L Corvaglia
- Neonatology and Neonatal Intensive Care Unit, University of Bologna, Bologna, Italy.
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Ferraresi R, Centola M, Ferlini M, Da Ros R, Caravaggi C, Assaloni R, Sganzaroli A, Pomidossi G, Bonanomi C, Danzi G. Long-term Outcomes after Angioplasty of Isolated, Below-the-knee Arteries in Diabetic Patients with Critical Limb Ischaemia. Eur J Vasc Endovasc Surg 2009; 37:336-42. [DOI: 10.1016/j.ejvs.2008.12.001] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Accepted: 12/02/2008] [Indexed: 11/24/2022]
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41
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Ferraresi R, Centola M, Ferlini M, Da Ros R, Caravaggi C, Assaloni R, Sganzaroli A, Pomidossi G, Bonanomi C, Danzi G. Long-term Outcomes after Angioplasty of Isolated, Below-the-knee Arteries in Diabetic Patients with Critical Limb Ischaemia. J Vasc Surg 2009. [DOI: 10.1016/j.jvs.2009.01.053] [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: 10/21/2022]
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42
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Danzi GB, Ferlini M, Rizzuti T, Ferraresi R, Parazzini C, Centola M, Colli AM. Multiple cardiac rhabdomyomas at routine fetal ultrasonography. Minerva Cardioangiol 2008; 56:259. [PMID: 18319705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Portaluppi F, Montanari L, Ferlini M, Vergnani L, Bagni B, Degli Uberti EC. Differences in blood pressure regulation of congestive heart failure, before and after treatment, correlate with changes in the circulating pattern of atrial natriuretic peptide. Eur Heart J 1992; 13:990-6. [PMID: 1386572 DOI: 10.1093/oxfordjournals.eurheartj.a060305] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The mechanisms underlying altered BP regulation in congestive heart failure are unknown. This study examines the possibility that differences in circadian blood pressure (BP) regulation between the normal and the failing heart correlate with changes in the circulating pattern of atrial natriuretic peptide (ANP). Twelve normotensive patients with coronary artery disease were studied over two separate 24-h periods, the first during acute exacerbation of congestive heart failure (radionuclide-determined ejection fraction at rest was less than 30%) and the second after therapy-induced functional recovery (ejection fraction was more than 40%). BP monitoring at 10-min intervals and intra-atrial blood samples for ANP assays at hourly intervals were obtained. Significant correlation between ejection fraction and the indexes of circadian BP variability (standard deviation of the 24-h pressure mean and day-night pressure difference) were found both before and after treatment. Ejection fraction was independent of the BP means (24-h, daytime and night-time). BP variability, 24-h mean and daytime mean were higher after treatment. ANP means were lower after treatment, whereas ANP variability was higher. The indexes of BP and ANP variability correlated both before and after treatment, whereas the BP and the ANP means were independent. These findings demonstrate that differences in BP regulation of CHF before and after effective treatment correlate with changes in the circulating pattern of ANP. We speculate that by modulating ANP release, the heart could be actively involved in BP regulation as part of the compensatory mechanisms aimed at protecting against circulatory overload.
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Affiliation(s)
- F Portaluppi
- Endocrinology Section, University of Ferrara, Italy
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Portaluppi F, Montanari L, Ferlini M, Vergnani L, D'Ambrosi A, Cavallini AR, Bagni B, degli Uberti E. Consistent changes in the circadian rhythms of blood pressure and atrial natriuretic peptide in congestive heart failure. Chronobiol Int 1991; 8:432-9. [PMID: 1840179 DOI: 10.3109/07420529109059178] [Citation(s) in RCA: 25] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We demonstrated in previous works that the circadian rhythms of blood pressure (BP) and atrial natriuretic peptide (ANP) are antiphasic in normal subjects and in essential hypertension. The aim of the present study was to assess the circadian rhythms of BP and ANP in 20 patients with stable congestive heart failure (CHF), divided into two groups of 10 according to their New York Heart Association functional class. A matched control group of 10 normal volunteers was also studied. Noninvasive BP monitoring at 15-min intervals was performed for 24 h. Peripheral blood samples were also obtained at 4-h intervals starting from 08:00 h. The mean (+/- SEM) circadian mesors of ANP plasma levels were 13.4 +/- 1.7 pmol/L in the control group, 28.6 +/- 2.4 pmol/L in the group of 10 patients in class II, and 81.5 +/- 12 pmol/L in the group of 10 patients in class III-IV. In normal subjects, plasma ANP concentration was highest at 04:00 h (21.5 +/- 2.7 pmol/L) and lowest at 16:00 h (8.8 +/- 2.4 pmol/L; p less than 0.01). Both groups of patients with CHF showed no significant circadian change in the plasma levels of ANP and also a significantly blunted circadian rhythm of BP. Cosinor analysis confirmed the loss of the circadian rhythms of ANP and BP in CHF patients. Our findings support the existence of a causal relationship between the circadian rhythms of ANP and BP.
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Affiliation(s)
- F Portaluppi
- Chair of Internal Medicine, University of Ferrara, Italy
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Alfano AM, Calia F, Ferlini M, Franceschini Beghini M, Vicelli R. [An epidemiological study on syphilis conducted at the laboratory of the Mauriziano Hospital (USL 37) of Lanzo Torinese in 1988]. Minerva Med 1990; 81:567-9. [PMID: 2381554] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The study conducted in 1988 was designed to assess the value of blanket serum tests for syphilis on hospitalised and outpatients. The incidence of syphilis encountered was particularly low and primarily confined to patients over 50. Apart from specific requests, mass scanning for the disease does not therefore seem necessary though it does seem advisable to test hospitalised and pregnant women.
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Affiliation(s)
- A M Alfano
- Laboratorio Analisi, Ospedale Mauriziano, Lanzo Torinese
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Portaluppi F, Bagni B, degli Uberti E, Montanari L, Cavallini R, Trasforini G, Margutti A, Ferlini M, Zanella M, Parti M. Circadian rhythms of atrial natriuretic peptide, renin, aldosterone, cortisol, blood pressure and heart rate in normal and hypertensive subjects. J Hypertens 1990; 8:85-95. [PMID: 2157761 DOI: 10.1097/00004872-199001000-00013] [Citation(s) in RCA: 92] [Impact Index Per Article: 2.7] [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: 12/30/2022]
Abstract
The occurrence and extent of a circadian rhythm in the circulating concentrations of atrial natriuretic peptide (ANP) are still matters of controversy. Only a few data are available in humans relating the time structure of plasma ANP levels with the circadian patterns of other hormones and cardiovascular variables. In a group of hospitalized normal volunteers (six men and four women, 16-76 years old), and in a group of hospitalized hypertensives (seven men and three women, 18-76 years old), we investigated the circadian variability of ANP and its temporal relationship with the circadian rhythms of blood pressure (BP) and heart rate (HR), and plasma renin activity (PRA), plasma aldosterone (PA) and plasma cortisol (PC) levels, by using a chronobiological inferential statistic method. At the end of a synchronizing period of 1 week (the diet and daily schedule were standardized), the subjects underwent automatic BP and HR monitoring, and blood sampling for 24 h. A statistically significant mean circadian rhythm was demonstrated for ANP, BP, HR, PRA, PA and PC in both normal and hypertensive subjects. The mean circadian acrophase of ANP (calculated to occur at around 04.00 h) anticipated the corresponding acrophases of the other hormones; BP and HR rhythms appeared to be in antiphase with ANP rhythm, i.e. the peak of BP and HR rhythms more or less coincided with the trough in ANP rhythm. A significant increase in the daily levels (assessed by the circadian mesor) of ANP was present in hypertensive subjects when compared with normal controls. In essential hypertension the circadian rhythm of ANP was set at higher circulating levels, but otherwise it was similar to the circadian rhythm found in normals. ANP mesors correlated significantly with renin and aldosterone mesors in normal subjects but not in hypertensive patients. ANP appears to anticipate awakening in its circadian periodic rise. On the basis of the considerable acrophase asynchronism, it seems possible to exclude any causal relations between the periodic changes of ANP and the rhythmic fluctuations of the other hormones that we studied. In contrast, important relations may be hypothesized between ANP levels and BP and HR values, on the basis of their antiphase rhythms.
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Affiliation(s)
- F Portaluppi
- Institute of 'Clinica Medica', University of Ferrara, Italy
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Calia F, Ferlini M, Alfano AM, Vicelli R, Ronchi R. [Prevalence of HBsAG carriers in a population of Northern Italy in 1987]. Minerva Med 1989; 80:1111-3. [PMID: 2812469] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In view of the high incidence of hepatitis B in Italy, the prevalence of carriers of HBsAg in one area of Piedmont and comparison with data obtained in other areas of Northern and Southern Italy has been assessed. HBsAg was sought in the serum of 2242 patients of the Lanzo Torinese Hospital. Average prevalence observed (0.66%) was related to recent national statistics and shows a slightly lower percentage than mean values for Northern Italy and much below what is found in the South of Italy.
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Affiliation(s)
- F Calia
- Laboratorio Analisi, Ospedale Mauriziano di Lanzo Torinese
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Abstract
The aim of this study was to assess the possible correlations between casual measurements and automatic monitoring analyzed with the chronobiologic technique in hospitalized hypertensive patients. Forty-three patients (24 men and 19 women) with mild to moderate essential hypertension were studied in an open hospital ward 5 to 7 days after admission. Meal times, sleep times, and visiting hours were standardized. A clinical value of blood pressure was calculated as the arithmetic mean of three sphygmomanometric measurements taken in the morning (patient seated; 5-min interval between measurements). Then, a basal value of blood pressure was considered as the lowest systolic and the lowest diastolic blood pressure among six sphygmomanometric measurements obtained every 5 min (patient supine). Noninvasive, automatic recording of blood pressure was also obtained every 15 min for 24 hours by a quasiportable oscillometric instrument. Blood pressure recordings were analyzed according to the "cosinor" method of Halberg. On average, clinical blood pressure was 160/96 +/- 14/10 mmHg, significantly higher (p less than 0.005) than either basal blood pressure (150/91 +/- 12/8 mmHg) or 24-h recorded blood pressure mesor (144/88 +/- 13/9 mmHg). The differences were not entirely due to diurnal variations, since morning casual measurements were significantly higher than daytime average blood pressure. A chronobiologic assessment of hypertension in hospitalized patients is more representative of true blood pressure behavior, not only because of the multiple recordings but also because of the absence of an alarm reaction that may trigger a pressor response.
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Affiliation(s)
- F Portaluppi
- Institute of Clinica Medica, University of Ferrara, Italy
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