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Background. The in-hospital reduction in low-density lipoprotein cholesterol (LDL-C) levels following acute coronary syndrome (ACS) is recommended in the current clinical guidelines. However, the efficacy of proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitors in those patients undergoing coronary artery bypass graft (CABG) has never been demonstrated. Methods. From January 2022 to July 2023, we retrospectively analyzed 74 ACS patients characterized by higher LDL-C levels than guideline targets and who underwent coronary bypass surgery. In the first period (January 2022–January 2023), the patients increased their statin dosage and/or added Ezetimibe (Group STEZE, 43 patients). At a later time (February 2023–July 2023), the patients received not only statins and Ezetimibe but also Evolocumab 140 mg every 2 weeks starting as early as possible (Group STEVO, 31 patients). After one and three months post-discharge, the patients underwent clinical and laboratory controls with an evaluation of the efficacy lipid measurements and every adverse event. Results. The two groups did not differ in terms of preoperative risk factors and Euroscore II (STEVO: 2.14 ± 0.75 vs. STEZE: 2.05 ± 0.6, p = 0.29). Also, there was no difference between the groups in terms of ACS (ST-, Instable angina, or NSTE) and time of symptoms onset regarding total cholesterol, LDL-C, and HDL-C trends from the preprocedural period to 3-month follow-up, but there was a more significant reduction in LDL-C and total cholesterol in the STEVO group (p = 0.01 and p = 0.04, respectively) and no difference in HDL-C rise (p = 0.12). No deaths were reported. In three STEZE group patients, angina recurrence posed the need for percutaneous re-revascularization. No STEVO patients developed significant adverse events. The statistical difference in these serious events, 7% in STEZE vs. 0% in STEVO, was not significant (p = 0.26). Conclusions. Evolocumab initiated "as soon as possible" in ACS patients submitted to CABG with high-intensity statin therapy and Ezetimibe was well tolerated and resulted in a substantial and significant reduction in LDL-C levels at discharge, 1 month, and 3 months. This result is associated with a reduction but without a statistical difference between groups. [ABSTRACT FROM AUTHOR]

In this study, an advanced analysis of the three-dimensional (3-D) surface microtexture of anodic porous alumina (APA) arrays was conducted to investigate their efficacy in confining cyanine fluorophore Cy3. The microstructural characterization of APA plays a pivotal role in enhancing the understanding of the material's surface properties, especially when applied to biological arrays and fluorescent dye confinement. To achieve this, Atomic Force Microscopy (AFM) was employed to obtain precise 3-D surface microtexture data. These measurements were complemented by stereometric analyses, adhering to ISO 25178‐2: 2012 standards, ensuring a robust quantitative and qualitative evaluation of the surface micromorphology. The analysis revealed a clear correlation between surface roughness parameters and micromorphological changes as a function of varied processing conditions. Notably, the increase in certain fabrication parameters led to significant alterations in the superficial texture, with observable changes in the fractal dimension of the surface structure. The APA arrays, fabricated using a specialized anodization technique followed by a tailored annealing procedure, exhibited extraordinarily large pore sizes, ranging from 1 to 2 μm, which are well-suited for accommodating the Cy3 dye molecules. These pore dimensions offer an enhanced capacity for dye confinement, providing a stable environment for the cyanine fluorophore while promoting optimal fluorescence behavior. [Display omitted] [ABSTRACT FROM AUTHOR]

Thermal effects in polycarbonate (PC) induced by lanthanide oxide nanoparticles (NPs) dispersed by blending were studied using thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). DSC data proved the occurrence of solvent‐induced crystallization of polymer doped with cerium oxide (ceria). TGA was performed to predict PC flammability properties in composites with 5–15 wt % ceria NPs at various heating rates. Decomposition was represented by first‐order reactions and the Arrhenius equation. A model was formulated for thin samples subject to uniform heat irradiation, which is based on PC softening and decomposition into several products. This is an attempt to predict composite film burning behavior assuming constant heat transmission to samples. [ABSTRACT FROM AUTHOR]

Incorporating enzymes into calcium alginate beads is an effective method to immobilise them and to preserve, at the same time, their catalytic activity. Sodium alginate was mixed with Aspergillus ficuum tannase in aqueous solution, and tannase-loaded calcium alginate beads were prepared using a simple droplet-based microfluidic system. Extensive experimental analysis was carried out to characterise the samples. Microscopic imaging revealed morphological differences between the surfaces of bare alginate matrix and tannase-loaded alginate beads. Thermal analysis allowed assessing the hydration contents of alginate and revealed the presence of tannase entrapped in the loaded beads, which was confirmed by vibrational spectroscopy. X-ray diffraction allowed us to conclude that alginate of tannase-loaded beads is not crystalline, which would make them suitable as carriers for possible controlled release. Moreover, they could be used in food applications to improve tea quality or clarify juices. [ABSTRACT FROM AUTHOR]

We describe our solution to the unusual situation of an inflated, large coronary stent (3.5 mm diameter) which became dislodged from the ostium of the right coronary artery after deployment during a transradial procedure. We discussed tips for retrieval from the radial artery while preserving the access for completion of the procedure. [ABSTRACT FROM AUTHOR]

The enhanced stability of Co nanocrystals (NCs) when they are highly ordered at both nanometer and micrometer scales is reported. For the first time, it is shown that both the crystalline structure of Co nanoparticles (NPs) and their 2D hexagonal organization have a significant impact on the oxidation process rate enabling to produce various types of nanostructures including core-shell NPs. The Co core can be either polycrystalline or hexagonal close-packed (hcp) single-crystalline, whereas the oxide shell is composed either of CoO or of the spinel structrure Co3O4. The present results are evidenced through a careful high-resolution transmission electron microscopy (HRTEM) study and are highly reproducible. [ABSTRACT FROM AUTHOR]

Cangrelor, the first intravenous P2Y12 inhibitor (P2Y12-I), has been approved on the basis of three large RCTs from the CHAMPION program which nevertheless have been criticized for the low bleeding risk of the enrolled patients, the large quote of chronic coronary syndromes, and the use of Clopidogrel as control arm even in the setting of acute coronary syndromes (ACS). We sought to investigate, in the setting of ACS, the comparative performance of Cangrelor in terms of in-hospital ischemic and haemorrhagic outcomes compared with the current gold-standard of oral P2Y12-I. The study retrospectively enrolled 686 consecutive patients admitted to the Divisions of Cardiology of Policlinico of Bari and L. Bonomo Hospital of Andria for ACS and treated with percutaneous coronary intervention. The study population was divided according to the P2Y12-I treatment strategy in two groups: patients given an oral P2Y12-I and patients receiving Cangrelor in the cath lab followed by an oral P2Y12-I. Clinical endpoints included death, ischemic and bleeding events occurring during hospital stay. Cangrelor treated patients presented higher clinical risk profile at presentation and faced higher death rate. However, after PS matching, in-hospital mortality resulted comparable between the groups and Cangrelor use was associated with reduced in-hospital definite stent thrombosis (p = 0.03). Data from our real-world registry highlight that, in the setting of ACS, Cangrelor is prevalently used in patients with very challenging clinical presentations. The adjusted analysis provides for the first time promising data on stent thrombosis reduction associated with Cangrelor use. [ABSTRACT FROM AUTHOR]

A cobalt cementation process in ethanol–watersolvent atdifferent temperatures is presented. A new model is proposed whichtakes into account the depletion of the less electropositive metalby a shrinking core technique. The model comprises a system of twoordinary differential equations whose dependent variables are theconcentration of the cation undergoing cementation and the radiusof the sacrificial metal particles. An analytic solution is obtainedand a comparison between the present model and the traditional oneis proposed. The model is validated by experimental data regressionto investigate the cementation kinetics at different temperatures,and the relevant activation energy suggests the onset of a chemicalcontrol regime for all experimental runs. Finally, the cemented phaseis morphologically and chemically characterized, and the size distributionof the relevant metal aggregates is determined by means of both dynamiclight scattering in solution and atomic force microscopy after dropcasting onto a solid substrate. [ABSTRACT FROM AUTHOR]

Ventricular septal defect (VSD) is a serious complication of myocardial infarction (MI), with its global incidence significantly reduced in recent years due to advances in coronary reperfusion techniques. However, during the COVID-19 pandemic, there was an unexpected rise in the incidence of post-MI VSD, likely driven by delays in seeking treatment. This study retrospectively analyzed 10 cases of post-MI VSD treated at our hospitals from March 2018 to August 2023, comparing incidence rates across pre-pandemic, pandemic, and post-pandemic periods. The findings revealed a notable increase in VSD cases during the pandemic, with six cases occurring in two years, compared to only two cases in each of the pre-pandemic and post-pandemic periods. Despite these fluctuations, surgical intervention remained a crucial and effective treatment, with 60% of patients surviving the 30-day follow-up. The study underscores the impact of delayed treatment on VSD incidence during the pandemic and highlights the critical need for timely medical intervention to manage severe MI complications effectively. [ABSTRACT FROM AUTHOR]

• Cathodic treatment in 0.6 M aqueous H 3 PO 4 :EG 1:1 vol produced pores with diameter ≥1 μm. • Galvanostatic pores (10 mA/cm2) were round as from etching but 3-fold size and 6-fold coverage. • Potentiostatic pores (50 V) were 2-fold size than galvanostatic, and polygonal shape. • Image analysis revealed better uniformity of cathodic pores than etched ones without bias. • Applications of these porous surfaces in the biomedical area are envisaged. We observed exceptionally large pores (1–2 μm diameter) on aluminum electrochemically treated at relatively low voltage bias (50 V) under cathodic polarization. The pore spacing and size did not correlate with the proportionality law of nanoporous aluminum oxide, and appeared at least one order of magnitude higher. We did no inquire the mechanism of pore formation, but verified its reproducibility and investigated the resulting morphology. The pores were more uniformly distributed than those resulting from chemical etching without electrical bias, and appeared almost twofold larger when cathodic treatment was potentiostatic (at 50 V) rather than galvanostatic (at 10 mA/cm2). The obtained surfaces appear promising for extended use as the substrate for living cell cultures, as scaffolds or permanent implant treatment. [ABSTRACT FROM AUTHOR]

A polymer composite based on an innovative filler consisting of microscale powder of nanoporous alumina is modeled. The passing-through nanoscale pores in this system—roughly columnar cylindrical, with diameter of the order of 100 nm—are fully penetrated by the resin, which is not bonded to the inner pore walls by any chemical agent. This system, previously assessed by laboratory experiments, is modeled here for the first time, based on a computational multi-scale hierarchical approach. First, microscale representative volume element (RVE) is modeled in two steps using finite element modeling. Then, the macro-scale RVE is characterized, using a combination of micromechanical rules. The elastic response of the composite is simulated to predict its Young's modulus. This simulation confirms the former experimental results and helps to shed light on the response of the investigated material, which may represent a novel system for use in disparate composite applications. In particular, the nanoporous microfillers composite is compared with a composite material containing the fillers of the same material yet nonporous, bonded to the matrix. It appears that, with respect to this standard concept of three-phase composites, the presence of the nanopores can compensate for the absence of the bonding agent. [ABSTRACT FROM AUTHOR]

Background: The inhibition of PCSK9 lowered LDL cholesterol levels, reducing the risk of cardiovascular events. However, the effect on patients who have undergone surgical myocardial revascularization has not yet been evaluated. Methods: From January 2017 to December 2022, 180 dyslipidemic patients who underwent coronary artery bypass were included in the study. Until December 2019, 100 patients optimized therapy with statin ± ezetimibe (SG). Since January 2020, 80 matched patients added treatment with Evolocumab every 2 weeks (EG). All 180 patients were followed-up at 3 and 12 months, comparing outcomes. Results: The two groups are homogenous. At 3 months and 1 year, a significant decrease in the parameter mean levels of LDL cholesterol and total cholesterol is detected in the Evolocumab group compared to the standard group. No mortality was detected in either group. No complications or drug discontinuation were recorded. In the SG group, five patients (5%) suffered a myocardial infarction during the 1-year follow-up. In the EG group, two patients (2.5%) underwent PTCA due to myocardial infarction. There is no significant difference in overall survival according to the new treatment (p-value = 0.9), and the hazard ratio is equal to 0.94 (95% C.I.: [0.16–5.43]; p-value = 0.9397). Conclusions: The use of Evolocumab, which was started immediately after coronary artery bypass graft surgery, significantly reduced LDL cholesterol and total cholesterol levels compared to statin treatment alone and is completely safe. However, at one year of follow-up, this result did not have impact on the reduction in major clinical events. [ABSTRACT FROM AUTHOR]

Objective: Transcatheter aortic valve implant (TAVI) is the gold standard for the high-surgical-risk group of patients with aortic valve disease and it is an alternative to surgery in patients at intermediate risk. Lethal complications can occur, and many of these are manageable only with emergent conversion to open heart surgery. We retrospectively evaluate the outcome of all patients undergoing TAVI in our departments and the impact of a complete cardiac rescue team to reduce 30-day mortality. Methods: Data from all patients undergoing TAVI between January 2020 and August 2023 in our center were analyzed. An expert complete rescue was present in catheter laboratory. Primary outcomes were in-hospital and at 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. Results: 825 patients were enrolled. The total mortality was 19/825 (2.3%). Eleven of the total patients (1.3%) required emergent conversion to open heart surgery. Among them, eight were alive (73%), with a theoretical decrease of 0.98% in overall mortality. Conclusions: surgical treatment is rare during TAVI. The presence of an expert complete rescue team as support means an increase in survival. Surgery must be used only to restore circulatory and to treat complication while percutaneous approaches should complete the procedure. [ABSTRACT FROM AUTHOR]

The aim of this work is the development of a structured catalyst for the dry reforming of biogas to be used as a pre–reformer in the indirect internal reforming configuration (IIR) of solid oxide fuel cells (SOFCs). The structured catalyst is based on NiCrAl foams coated with ruthenium (nominal loading 3.0 wt%) supported on a CaZr0.85Sm0.15O3−δ (CZS) perovskite oxide. The powder is produced by solution combustion synthesis and deposited on metallic foams by the wash–coating method. Catalytic tests for the dry reforming of methane (DRM) reaction are carried out at 850 °C, 700 °C and 550 °C for an overall 50 h with CH4/CO2 = 1 and p = 1.3 bar at different gas hourly space velocities (GHSVs). The final goal is a proof–of–concept: a laboratory validation of an IIR–SOFC fed by biogas. The carbon amount on spent structured catalysts is evaluated by thermogravimetric analysis and microstructural/compositional investigation. [ABSTRACT FROM AUTHOR]

Abstract: Late thrombosis occurring after bare metal stent (BMS) implantation is a rare complication. However, it is often associated with poor outcome. Mechanisms underlying BMS thrombosis may differ from those underlying drug eluting stent thrombosis. In particular, severe instent restenosis may trigger thrombus formation. This case report describes a very late thrombosis of BMS occurring on an in-stent restenosis. After failure of manual thrombectomy, the case was successfully faced by Excimer Laser Coronary Angioplasty (ELCA). Cases like this may be successfully treated by devices like ELCA combining debulking and thrombus removal capabilities. [ABSTRACT FROM AUTHOR]

We propose the application of morphological, fractal and multifractal analysis to differentiate surface patterns on zirconia-based ceramics after laser treatments. Furthermore, we introduce two new approaches for ceramic surfaces: the Moran correlogram, which complements the spatial autocorrelation analyses, and the Otsu binarization algorithm, which was used to identify the lacunar points in the lacunarity analysis. First, the AFM (Atomic Force Microscope) topographies revealed that samples have significant differences in terms of spatial features. Quantitatively, spatial surface texture parameters indicated that all laser treatments reduced the superficial isotropy of the Zirconia disc. Moran's correlograms revealed a decrease in the short-range correlation in all treated samples. The Minkowski functionals (MFs) indicated a reduction in the amount of matter in the peaks, especially for the sample with Nd-YAG laser treatment. The estimated fractal dimension (FD) pointed out that all laser treatments weakened the surface complexity of the Zirconia disc. On the other hand, clear fingerprints of multifractal behavior in all the samples were detected, where the highest degree of multifractality was computed for the samples with CO2 laser treatment. Finally, our findings suggested that the morphological changes caused by laser treatments on the surfaces of zirconia discs can be monitored and differentiated through the parameters proposed here. [ABSTRACT FROM AUTHOR]

Background Diffuse coronary artery disease treatment still remains a challenge for interventional cardiologists and cardiac surgeons. There are few data on full metal jacket (FMJ) stenting, especially with new-generation drug-eluting stents. We aimed to assess the efficacy and safety of FMJ with new-generation Zotarolimus-eluting stents (n-ZES). Methods and results All patients who underwent FMJ with n-ZES (≥ 60 mm stent length) in eleven Italian interventional centers participating in the Clinical Service® project were included in this analysis. The project population consisted of 120 patients and 122 lesions. Mean age was 67 ± 10 years and 95 (79.2%) patients were male. A chronic total occlusion was present in 34 lesions (27.9%). The number of stents implanted per lesion was 2.9 ± 0.8, and the diameter of the stents was 3.0 ± 0.5 mm. Predilation and post-dilatation were performed in 107 (87.7%) and 92 (75.4%) patients, respectively. At 41 ± 21 month follow-up there were 2 patients with subacute definite stent thrombosis, 6 patients (5.0%) had cardiac death and 5 patients (4.2%) had non-fatal myocardial infarction. Seven patients (5.8%) underwent clinically-driven target lesion revascularization. Fourteen patients (11.7%) had at least one major adverse cardiac event. Conclusion The treatment of diffuse coronary artery disease with FMJ stenting with n-ZES appears to be effective and safe. Late and very-late ST does not seem to be an issue and the rate of restenosis and of major cardiac adverse events after more than 3-year follow-up is rather low. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Previous studies showed differences in platelet reactivity in response to exercise in patients with syndrome X (SX) and those with obstructive coronary artery disease (CAD). In this study, we investigated whether similar differences could be detectable in response to a mental stressful stimulus. Materials and methods: We studied 30 SX patients (60±8 years, 8 men), 20 patients with stable angina and angiographically documented CAD (SA, 66±8 years, 14 men), and 11 patients with unstable angina (UA, 67±8 years, 6 men). A control group of 22 healthy controls (50±7 years, 5 men) was also studied. All subjects underwent a mathematical mental stress test (MST) consisting of rapid consecutive subtractions of number 7 for a period of 5 min. A venous blood sample was collected at baseline and immediately after MST. Platelet reactivity was measured on flowing blood as time necessary to occlude a ring coated with collagen–adenosine diphosphate (ADP; closure time, CT), using the platelet function analyzer (PFA-100) system. Results: At rest, CT was lower in UA patients (87±19 s) compared to controls (109±24 s, p=0.02) and SA patients (105±37 s, p=0.055), and also tended to be lower in SX patients (96±18 s) compared to controls (p=0.07). The CT response to MST differed significantly among groups (p=0.0009). At peak MST, CT did not change in controls (110±27 s, p=0.88), whereas it decreased in SA patients (96±29 s, p=0.003) and tended to decrease in UA patients (82±15 s, p=0.25). In contrast, a significant increase in CT with MST was shown in SX patients (103±21 s, p=0.007). Conclusions: Platelet reactivity is increased by MST in patients with CAD, whereas it paradoxically decreases in SX patients, which may constitute a protective effect against stress-induced events in these patients. [Copyright &y& Elsevier]