5 results on '"Maria Letizia Bacchi"'
Search Results
2. Current era survival of patients with pulmonary arterial hypertension associated with congenital heart disease: a comparison between clinical subgroups
- Author
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Enri Leci, Nazzareno Galiè, Maria Letizia Bacchi Reggiani, Angelo Branzi, Alessandra Manes, Massimiliano Palazzini, Manes A, Palazzini M, Leci E, Bacchi Reggiani ML, Branzi A, and Galiè N
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Adult ,Heart Defects, Congenital ,Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Combination therapy ,Heart disease ,Hypertension, Pulmonary ,CARDIAC HAEMODYNAMICS ,Hemodynamics ,Kaplan-Meier Estimate ,Gastroenterology ,Time-to-Treatment ,Young Adult ,pulmonary arterial hypertension ,Internal medicine ,medicine ,Humans ,Familial Primary Pulmonary Hypertension ,Child ,Referral and Consultation ,Aged ,Retrospective Studies ,Exercise Tolerance ,Lung ,business.industry ,TREATMENT ,Middle Aged ,medicine.disease ,Confidence interval ,Survival Rate ,medicine.anatomical_structure ,Eisenmenger syndrome ,Vascular resistance ,CONGENITAL HEART DISEASE ,Female ,Eisenmenger Complex ,Cardiology and Cardiovascular Medicine ,business - Abstract
AimsThis study compared the clinical, functional, and haemodynamic characteristics and current era survival of subgroups of patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD): Eisenmenger syndrome (ES); PAH-CHD associated with systemic-to-pulmonary shunts (SPs); PAH with small defects (SDs); and PAH after defect correction (CDs).Methods and resultsData from consecutive PAH-CHD patients referred to our centre from 1 January 1998 to 31 May 2011 were collected. A contemporary group of idiopathic PAH patients was utilized for comparison. Treatment was per PAH guidelines, including combination therapy, with approved PAH-specific drugs. Survival was assessed with Kaplan-Meier analysis from the first invasive haemodynamic confirmation of PAH and compared across subgroups by log-rank test. Of 192 patients (mean age 41 ± 17 years; 61% female), 90 had ES (aged 41 ± 16 years); 48 SP (aged 47 ± 18 years); 10 SD (aged 25 ± 21 years); and 44 CD (aged 36 ± 17 years). Patients with ES had the highest baseline pulmonary vascular resistance and the lowest exercise capacity. Seventy-eight per cent were treated with approved PAH-specific drugs, and 44% were treated with combination therapy. Kaplan-Meier survival estimates (95% confidence interval) at 20 years for ES, SP, and CD were 87% (77-93%), 86% (60-96%), and 36% (12-72%, P = 0.0001 vs. ES; P = 0.004 vs. SP), respectively, and at 15 years for SD was 66% (16-91%, P = 0.015 vs. ES; P = 0.016 vs. SP). The survival of the 278 patients with idiopathic PAH appeared to be worse when compared with the PAH-CHD subgroups.ConclusionRelevant clinical, functional, haemodynamic, and survival differences were observed among subgroups. In particular, patients with CD and SD had the worst survival. These findings should be considered when planning medical or interventional treatment strategies in PAH-CHD patients.
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- 2013
3. Predictive value of high sensitivity C-reactive protein in patients with ST-elevation myocardial infarction treated with percutaneous coronary intervention
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Antonio Marzocchi, Simona Silenzi, Maria Letizia Bacchi-Reggiani, Angelo Branzi, Paolo Guastaroba, Francesco Saia, Paolo Ortolani, Nevio Taglieri, Tullio Palmerini, Cinzia Marrozzini, Roberto Grilli, Federica Baldazzi, P.Ortolani, A. Marzocchi, C. Marrozzini, T. Palmerini, F. Saia, N. Taglieri, F. Baldazzi, S. Silenzi, ML. Bacchi Reggiani, P. Guastaroba, R. Grilli, and A. Branzi
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Male ,medicine.medical_specialty ,Transluminal ,medicine.medical_treatment ,Myocardial Infarction ,Infarction ,Percutaneous coronary ,Coronary Angiography ,Sensitivity and Specificity ,Regression Analysi ,Internal medicine ,Humans ,Medicine ,Hospital Mortality ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Adverse effect ,Aged ,biology ,business.industry ,ST elevation ,Angioplasty ,C-reactive protein ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,High-sensitivity C-reactive protein ,C-Reactive Protein ,Treatment Outcome ,Quartile ,Conventional PCI ,Cardiology ,biology.protein ,Regression Analysis ,Female ,Cardiology and Cardiovascular Medicine ,business ,Human - Abstract
Aims To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. Methods and results We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with STEMI onset < 12 h and hs-C-reactive protein determination on admission. Patients were classified into four groups [I (hs-C-reactive protein < 0.48 mg/dL), II (hs-C-reactive protein ≥ 0.48 to < 1.2 mg/dL), III (hs-C-reactive protein ≥ 1.2 to < 3.1 mg/dL), IV (hs-C-reactive protein ≥ 3.1 mg/dL)] according to quartiles of hs-C-reactive protein serum level. The IV quartile hs-C-reactive protein group had a higher incidence of in-hospital mortality and cumulative adverse events. At a mean follow-up of 724 ± 376 days (range 0–1393), the IV quartile hs-C-reactive protein group showed lower estimated survival, lower estimated myocardial infarction-free survival and lower estimated event-free survival. At multivariable analysis hs-C-reactive protein appeared to be an independent predictor of long-term mortality (HR: 1.04, 95% CI: 1.01–1.07, P = 0.003), long-term mortality and re-infarction (HR: 1.03, 95% CI: 1.01–1.06, P = 0.008) and adverse events (HR: 1.03, 95% CI: 1.01–1.05, P = 0.03). Conclusion Evaluation of hs-C-reactive protein on admission in STEMI patients undergoing primary PCI allows reliable risk stratification of these patients.
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- 2007
4. Clinical impact of direct referral to primary percutaneous coronary intervention following pre-hospital diagnosis of ST-elevation myocardial infarction
- Author
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Robin M. T. Cooke, Angelo Branzi, Matteo Aquilina, Maria Letizia Bacchi-Reggiani, Nevio Taglieri, Federica Baldazzi, Simona Silenzi, Paolo Ortolani, Carlo Serantoni, Antonio Marzocchi, Tullio Palmerini, Cinzia Marrozzini, Daniele Grosseto, Francesco Saia, Ortolani P, Marzocchi A, Marrozzini C, Palmerini T, Saia F, Serantoni C, Aquilina M, Silenzi S, Baldazzi F, Grosseto D, Taglieri N, Cooke RM, Bacchi-Reggiani ML, and Branzi A.
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Male ,Emergency Medical Services ,medicine.medical_specialty ,Referral ,medicine.medical_treatment ,Myocardial Infarction ,Internal medicine ,Humans ,Medicine ,Hospital Mortality ,Prospective Studies ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,Referral and Consultation ,Aged ,business.industry ,ST elevation ,Cardiogenic shock ,Percutaneous coronary intervention ,Emergency department ,Middle Aged ,medicine.disease ,Early Diagnosis ,Treatment Outcome ,surgical procedures, operative ,Emergency medicine ,Conventional PCI ,Cardiology ,Female ,Myocardial infarction diagnosis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims Treatment delay is a powerful predictor of survival in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated effectiveness of pre-hospital diagnosis of STEMI with direct referral to PCI, alongside more conventional referral strategies. Methods and results From January 2003 to December 2004, 658 STEMI patients were referred for primary PCI at our intervention laboratory. Three predefined referral routes were compared: (1) for patients within 90 min drive of the PCI centre, pre-hospital diagnosis and direct transportation ( n =166), (2) diagnosis at the interventional hospital emergency department ( n =316), (3) diagnosis at local hospitals before transportation ( n =176). Pre-hospital diagnosis was associated with more than 45 min reduction in treatment delay ( P =0.001). No significant difference in in-hospital mortality was apparent in the overall study population. In the cardiogenic shock subgroup ( n =80), pre-hospital diagnosis was associated with a two-thirds reduction in in-hospital mortality ( P =0.019); mortality was only 6.2% in shock patients who underwent PCI in
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- 2006
5. Randomized comparison between tirofiban and abciximab to promote complete ST-resolution in primary angioplasty: results of the facilitated angioplasty with tirofiban or abciximab (FATA) in ST-elevation myocardial infarction trial
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Antonio, Marzocchi, Antonio, Manari, Giancarlo, Piovaccari, Cinzia, Marrozzini, Sebastiano, Marra, Paolo, Magnavacchi, Pietro, Sangiorgio, Lucia, Marinucci, Nevio, Taglieri, Giovanni, Gordini, Nicola, Binetti, Vincenzo, Guiducci, Nicoletta, Franco, Maria Letizia-Bacchi, Reggiani, Francesco, Saia, Paolo, Guastaroba, Marzocchi A., Manari A., Piovaccari G., Marrozzini C., Marra S., Magnavacchi P., Sangiorgio P., Marinucci L., Taglieri N., Gordini G., Binetti G., Guiducci V., Franco N., Bacchi Reggiani M.L., Saia F., and FATA investigators
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Abciximab ,Myocardial Infarction ,Myocardial Reperfusion ,Coronary Angiography ,Electrocardiography ,Immunoglobulin Fab Fragments ,Internal medicine ,Angioplasty ,medicine ,Humans ,Myocardial infarction ,Prospective Studies ,Angioplasty, Balloon, Coronary ,Dose-Response Relationship, Drug ,business.industry ,ST elevation ,Percutaneous coronary intervention ,Antibodies, Monoclonal ,Drug-Eluting Stents ,Tirofiban ,Middle Aged ,medicine.disease ,Treatment Outcome ,Glycoprotein IIb/IIIa inhibitors ,Anesthesia ,Cardiology ,Platelet aggregation inhibitor ,Tyrosine ,Female ,Cardiology and Cardiovascular Medicine ,business ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
Aims To test the equivalence of high-dose bolus (HDB) tirofiban vs. abciximab during primary percutaneous coronary intervention (PPCI) in terms of ST-segment resolution (STR). Methods and results The FATA trial (Facilitated Angioplasty with Tirofiban or Abciximab) was a prospective, multicentre, open-label trial that enrolled 692 patients with ST-segment elevation myocardial infarction (STEMI) undergoing PPCI. Patients were randomized 1:1 to receive abciximab ( n = 341) or HDB tirofiban ( n = 351). Primary endpoint was the rate of complete (≥70%) STR 90 min after first balloon inflation. Thirty-day incidence of major bleedings, death, re-infarction and new revascularizations was also evaluated. Baseline characteristics of the two groups were well-balanced, with the exception of previous MI rates (tirofiban 6% vs. abciximab 2.6%, P = 0.03). The procedure was successful in 96.7% of the abciximab and in 96.6% of the tirofiban cohort ( P = 0.94). Complete STR was obtained in 67.05% of the tirofiban and 70.45% of the abciximab group (Δ −3.4%, 95% confidence interval −10.35 to +3.56), which falls beyond the predefined Δ ± 10% equivalence boundaries. Rates of secondary endpoints were similar between the two groups. Conclusion This study failed to show the equivalence of HBD of tirofiban and abciximab as adjunctive therapy to PPCI.
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- 2008
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