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1. Carotid artery stenting during endovascular thrombectomy for acute ischemic stroke with tandem occlusion: the Italian Registry of Endovascular Treatment in Acute Stroke

Author

Sallustio, Fabrizio, Pracucci, Giovanni, Cappellari, Manuel, Saia, Valentina, Mascolo, Alfredo Paolo, Marrama, Federico, Gandini, Roberto, Koch, Giacomo, Diomedi, Marina, D’Agostino, Federica, Rocco, Alessandro, Da Ros, Valerio, Wlderk, Andrea, Nezzo, Marco, Argirò, Renato, Morosetti, Daniele, Renieri, Leonardo, Nencini, Patrizia, Vallone, Stefano, Zini, Andrea, Bigliardi, Guido, Pitrone, Antonio, Grillo, Francesco, Bracco, Sandra, Tassi, Rossana, Bergui, Mauro, Naldi, Andrea, Carità, Giuseppe, Casetta, Ilaria, Gasparotti, Roberto, Magoni, Mauro, Simonetti, Luigi, Haznedari, Nicolò, Paolucci, Matteo, Mavilio, Nicola, Malfatto, Laura, Menozzi, Roberto, Genovese, Antonio, Cosottini, Mirco, Orlandi, Giovanni, Comai, Alessio, Franchini, Enrica, Pedicelli, Alessandro, Frisullo, Giovanni, Puglielli, Edoardo, Casalena, Alfonsina, Cester, Giacomo, Baracchini, Claudio, Castellano, Davide, Di Liberto, Alessandra, Ricciardi, Giuseppe Kenneth, Chiumarulo, Luigi, Petruzzellis, Marco, Lafe, Elvis, Persico, Alessandra, Cavasin, Nicola, Critelli, Adriana, Semeraro, Vittorio, Tinelli, Angelica, Giorgianni, Andrea, Carimati, Federico, Auteri, William, Rizzuto, Stefano, Biraschi, Francesco, Nicolini, Ettore, Ferrari, Antonio, Melis, Maurizio, Calia, Stefano, Tassinari, Tiziana, Nuzzi, Nunzio Paolo, Corato, Manuel, Sacco, Simona, Squassina, Guido, Invernizzi, Paolo, Gallesio, Ivan, Ruiz, Luigi, Dui, Giovanni, Carboni, Nicola, Amistà, Pietro, Russo, Monia, Maiore, Mario, Zanda, Bastianina, Craparo, Giuseppe, Mannino, Marina, Inzitari, Domenico, Toni, Danilo, Mangiafico, Salvatore, Gasparotti, R., Inzitari, D., Mangiafico, S., Toni, D., Vallone, S., Zini, A., Bergui, M., Causin, F., Ciccone, A., Nencini, P., Saletti, A., Sallustio, F., Tassi, R., Thyrion, F. Zappoli, Pracucci, G., Saia, V., Gandini, R., Da Ros, V., Greco, L., Morosetti, D., Diomedi, M., Nappini, S., Limbucci, N., Renieri, L., Fainardi, E., Verganti, L., Sacchetti, F., Zelent, G., Bigliardi, G., Dell’Acqua, M. L., Picchetto, L., Vandelli, L., Pentore, R., Maffei, S., Nichelli, P., Longo, M., Pitrone, A., Vinci, S. L., Velo, M., Caragliano, A., Tessitore, A., Bonomo, O., Musolino, R., La Spina, P., Casella, C., Fazio, M. C., Grillo, F., Cotroneo, M., Dell’Aera, C., Francalanza, I., Bracco, S., Cioni, S., Gennari, P., Vallone, I. M., Cerase, A., Martini, G., Stura, G., Daniele, D., Cerrato, P., Naldi, A., Onofrio, M., De Vito, A., Azzini, C., Casetta, I., Mardighian, D., Frigerio, M., Magoni, M., Costa, A., Simonetti, L., Cirillo, L., Taglialatela, F., Isceri, S., Princiotta, C., Dall’Olio, M., Cellerini, M., Gentile, M., Piccolo, L., Migliaccio, L., Brancaleoni, L., Naldi, F., Romoli, M., Zaniboni, A., Ruggiero, M., Sanna, A., Haznedari, N., Commodaro, C., Longoni, M., Biguzzi, S., Cordici, F., Malatesta, E., Castellan, L., Mavilio, N., Salsano, G., Malfatto, L., Finocchi, C., Menozzi, R., Piazza, P., Epifani, E., Andreone, A., Scoditti, U., Castellini, P., Latte, L., Grisendi, I., Cosottini, M., Puglioli, M., Lazzarotti, G., Lauretti, D., Mancuso, M., Giannini, N., Maccarone, M., Orlandi, G., Comai, A., Bonatti, G., Nano, G., Ferro, F., Bonatti, M., Dall’Ora, E., Dossi, R. Currò, Turri, E., Turri, M., Colosimo, C., Pedicelli, A., D’Argento, F., Alexandre, A., Frisullo, G., Di Egidio, V., Puglielli, E. G., Ruggero, L., Assetta, M., Casalena, A., Cester, G., Baracchini, C., Viaro, F., Pieroni, A., Vaudano, G., Comelli, C., Di Maggio, L., Castellano, D., Cavallo, R., Duc, E., Chianale, G., Ciceri, E. F. M., Plebani, M., Augelli, R., Zampieri, P., Grazioli, A., Cappellari, M., Forlivesi, S., Tomelleri, G., Micheletti, N., Chiumarulo, L., Zimatore, D. S., Federico, F., Petruzzelli, M., Zappoli, F., Lafe, E., Sanfilippo, G., Sgreccia, A., Martignoni, A., Cavallini, A., Denaro, F., Persico, A., Cagliari, E., Cavasin, N., Quatrale, R., Critelli, A., Burdi, N., Semeraro, V., Lucarelli, N., Ganimede, M. P., Internò, S., Tinelli, A., Prontera, M. P., Pesare, A., Cotroneo, E., Pampana, E., Ricciardi, F., Gigli, R., Pezzella, F. R., Corsi, F., Giorgianni, A., Baruzzi, F., Pellegrino, C., Terrana, A., Versino, M., Delodovici, M. L., Carimati, F., Cariddi, L. Princiotta, Auteri, W., Di Benedetto, O., Silvagni, U., Perrotta, P., Crispino, E., Petrone, A., Stancati, F., Rizzuto, S., Pugliese, P., Pisani, E., Siniscalchi, A., Gaudiano, C., Pirritano, D., Del Giudice, F., Piano, M., Agostoni, E., Motto, C., Gatti, A., Guccione, A., Tortorella, R., Stecco, A., Guzzardi, G., Del Sette, B., Coppo, L., Baldan, J., Romano, D., Siani, A., Locatelli, G., Saponiero, R., Napolitano, R., De Gregorio, M., Volpe, G., Tenuta, M., Guidetti, G., Biraschi, F., Wulbek, A., Falcou, A., Anzini, A., Mancini, A., De Michele, M., Fausti, S., Di Mascio, M. T., Durastanti, L., Sbardella, E., Mellina, V., Nicolini, E., Comelli, S., Ganau, C., Corraine, S., Fusaro, F., Ferrari, A., Schirru, F., Ledda, V., Secci, S., Melis, M., Piras, V., Moller, J., Padolecchia, R., Allegretti, L., Caldiera, V., Calia, S., Ganci, G., Tassinari, T., Sugo, A., De Nicola, M., Giannoni, M., Bruni, S., Gambelli, E., Provinciali, L., Nuzzi, N. P., Marcheselli, S., Corato, M., Scomazzoni, F., Simionato, F., Roveri, L., Filauri, P., Sacco, S., Orlandi, B., De Santis, F., Tiseo, C., Notturno, F., Ornello, R., Pavia, M., Squassina, G., Cobelli, M., Morassi, M., Magni, E., Invernizzi, P., Pepe, F., Bigni, B., Costa, P., Crabbio, M., Griffini, S., Palmerini, F., Piras, M. P., Gallesio, I., Barbero, S., Ferrandi, D., Dui, G., Fancello, M. C., Zedda, S., Ticca, A., Saddi, M. V., Deiana, G., Rossi, R., Carboni, N., Mela, A., Amistà, P., Russo, M., Iannucci, G., Pinna, V., Di Clemente, L., Santi, M., De Boni, A., De Luca, C., Natrella, M., Fanelli, G., Cristoferi, M., Bottacchi, E., Corso, G., Tosi, P., Sessa, M., Giossi, A., Baietti, Null, Romano, G., Meineri, P., Armentano, A., Versace, P., Arcudi, L., Galvano, G., Petralia, B., Feraco, P., Luppi, G., Giometto, B., Bignamini, V., Piffer, S., Meloni, G. B., Fabio, C., Maiore, M., Pintus, F., Pischedda, A., Manca, A., Mongili, C., Zanda, B., Baule, A., Florio, F., Ciccarese, G., Leone, M., Di Viesti, P., Pappalardo, M. P., Craparo, G., Gallo, C., Monaco, S., Mannino, M., Muto, M., Guarnieri, Gl., Andreone, V., Passalacqua, G., Allegritti, M., Caproni, S., Filizzolo, M., Salmaggi, A., Giordano, A., Marini, C., Frattale, I., Lucente, G., Nozzoli, C., and Lupo, F. A.

Subjects
Stent, Acute stroke, Settore MED/37 - Neuroradiologia, Acute stroke Internal carotid artery diseases Stent Thrombectomy, Neurology (clinical), General Medicine, Settore MED/26, Internal carotid artery diseases, Thrombectomy
Abstract

The management of tandem extracranial internal carotid artery and intracranial large vessel occlusion during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) has been under-investigated. We sought to investigate outcomes of AIS patients with tandem occlusion (TO) treated with carotid artery stenting (CAS) compared to those not treated with CAS (no-CAS) during EVT.We performed a cohort study using data from AIS patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. Outcomes were 3 months' mortality, functional outcome, complete and successful recanalization, any intracranial hemorrhage, parenchymal hematoma and symptomatic intracerebral hemorrhage.Among 466 AIS patients with TO, CAS patients were 122 and no-CAS patients were 226 (118 excluded). After adjustment for unbalanced variables, CAS was associated with a lower rate of 3 months' mortality (OR 0.407, 95% CI 0.171-0.969, p = 0.042). After adjustment for pre-defined variables, CAS was associated with a lower rate of 3 months' mortality (aOR 0.430, 95% CI 0.187-0.989, p = 0.047) and a higher rate of complete recanalization (aOR 1.986, 95% CI 1.121-3.518, p = 0.019), successful recanalization (aOR 2.433, 95% CI 1.263-4.686, p = 0.008) and parenchymal hematoma (aOR 2.876, 95% CI 1.173-7.050, p = 0.021). CAS was associated with lower 3 months mortality (OR 0.373, 95% CI 0.141-0.982, p = 0.046) and higher rates of successful recanalization (OR 2.082, 95% CI 1.099-3.942, p = 0.024) after adjustment for variables associated with 3 months' mortality and successful recanalization, respectively.Among AIS patients with TO, CAS during EVT was associated with a higher rate of successful reperfusion and a lower rate of 3 months' mortality.

Published
2022

2. IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke

Author

Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., Magni E (ORCID:0000-0002-2235-2280), Cappellari, M., Mangiafico, S., Saia, V., Pracucci, G., Nappini, S., Nencini, P., Konda, D., Sallustio, F., Vallone, S., Zini, A., Bracco, S., Tassi, R., Bergui, M., Cerrato, P., Pitrone, A., Grillo, F., Saletti, A., De Vito, A., Gasparotti, Roberto, Magoni, M., Puglielli, E., Casalena, A., Causin, F., Baracchini, C., Castellan, L., Malfatto, L., Menozzi, R., Scoditti, U., Comelli, C., Duc, E., Comai, A., Franchini, E., Cosottini, M., Mancuso, M., Peschillo, S., De Michele, M., Giorgianni, A., Delodovici, M. L., Lafe, E., Denaro, M. F., Burdi, N., Interno, S., Cavasin, N., Critelli, A., Chiumarulo, L., Petruzzellis, M., Doddi, M., Carolei, A., Auteri, W., Petrone, A., Padolecchia, R., Tassinari, T., Pavia, M., Invernizzi, P., Turcato, G., Forlivesi, S., Ciceri, E. F. M., Bonetti, B., Inzitari, D., Toni D., Limbucci N, Consoli, A, Renieri, L, Fainardi, E, Gandini, R, Pampana, E, Diomedi, M, Koch, G, Verganti, L, Sacchetti, F, Zelent, G, Bigliardi, G, Picchetto, L, Vandelli, L, Romano, Dg, Cioni, S, Gennari, P, Cerase, A, Martini, G, Stura, G, Daniele, D, Naldi, A, Papa, R, Vinci, Sl, Bernava, G, Velo, M, Caragliano, A, Tessitore, A, Buonomo, O, Musolino, R, La Spina, P, Casella, C, Carolina Fazio, M, Cotroneo, M, Onofrio, M, Azzini, C, Casetta, I, Mardighian, D, Frigerio, M, Costa, A, Di Egidio, V, Lattanzi, R, Assetta, M, Cester, G, Mavilio, N, Serrati, C, Piazza, P, Epifani, E, Andreone, A, Castellini, P, Latte, L, Grisendi, I, Vaudano, G, Comelli, S, Cavallo, R, Chianale, G, Simonetti, L, Taglialatela, F, Isceri, S, Procaccianti, G, Zaniboni, A, Borghi, A, Bonatti, G, Ferro, F, Bonatti, M, Dall'Ora, E, Currò Dossi, R, Turri, E, Turri, M, Puglioli, M, Lazzarotti, G, Lauretti, D, Giannini, N, Maccarone, M, Orlandi, G, Chiti, A, Guidetti, G, Biraschi, F, Falcou, A, Anzini, A, Mancini, A, Fausti, S, Di Mascio, Mt, Durastanti, L, Sbardella, E, Mellina, V, Baruzzi, F, Pellegrino, C, Terrana, A, Carimati, F, Ruggiero, M, Sanna, A, Passarin, Mg, Colosimo, C, Pedicelli, A, D'Argento, F, Alexandre, A, Frisullo, G, Zappoli, F, Martignoni, A, Cavallini, A, Persico, A, Valvassori, L, Piano, M, Agostoni, E, Motto, C, Gatti, A, Longoni, M, Guccione, A, Tortorella, R, Zampieri, P, Zimatore, D, Grazioli, A, Ricciardi, Gk, Augelli, R, Bovi, P, Tomelleri, G, Micheletti, N, Semeraro, V, Lucarelli, N, Ganimede, M, Tinelli, A, Pia Prontera, M, Pesare, A, Cagliari, E, Quatrale, R, Federico, F, Passalacqua, G, Filauri, P, Orlandi, B, De Santis, F, Gabriele, A, Tiseo, C, Armentano, A, Di Benedetto, O, Silvagni, U, Perrotta, P, Crispino, E, Stancati, F, Rizzuto, S, Pugliese, P, Pisani, E, Siniscalchi, A, Gaudiano, C, Pirritano, D, Del Giudice, F, Calia, S, Ganci, G, Sugo, A, Scomazzoni, F, Simionato, F, Roveri, L, De Nicola, M, Giannoni, M, Bruni, S, Gambelli, E, Provinciali, L, Carriero, A, Coppo, L, Baldan, J, Paolo Nuzzi, N, Marcheselli, S, Corato, M, Cotroneo, E, Ricciardi, F, Gigli, R, Pozzessere, C, Pezzella, Fr, Corsi, F, Squassina, G, Cobelli, M, Morassi, M, Magni, Eugenio, Pepe, F, Bigni, B, Costa, P, Crabbio, M, Griffini, S, Palmerini, F, Piras, Mp, Natrella, M, Fanelli, G, Cristoferi, M, Bottacchi, E, Corso, G, Tosi, P, Amistà, P, Russo, M, Tettoni, S, Gallesio, I, Mascolo, Mc, Meloni, Gb, Fabio, C, Maiore, M, Pintus, F, Pischedda, A, Manca, A, Mongili, C, Zanda, B, Baule, A, Pappalardo, Mp, Craparo, G, Gallo, C, Monaco, S, Mannino, M, Terruso, V, Muto, M, Guarnieri, G, Andreone, V, Dui, G, Ticca, A, Salmaggi, A, Iannucci, G, Pinna, V, Di Clemente, L, Perini, F, De Boni, A, De Luca, C, De Giorgi, F, Corraine, S, Enne, P, Ganau, C, Piras, V., Gasparotti R., and Magni E (ORCID:0000-0002-2235-2280)

Abstract

Background and Purpose - As a reliable scoring system to detect the risk of symptomatic intracerebral hemorrhage after thrombectomy for ischemic stroke is not yet available, we developed a nomogram for predicting symptomatic intracerebral hemorrhage in patients with large vessel occlusion in the anterior circulation who received bridging of thrombectomy with intravenous thrombolysis (training set), and to validate the model by using a cohort of patients treated with direct thrombectomy (test set). Methods - We conducted a cohort study on prospectively collected data from 3714 patients enrolled in the IER (Italian Registry of Endovascular Stroke Treatment in Acute Stroke). Symptomatic intracerebral hemorrhage was defined as any type of intracerebral hemorrhage with increase of ≥4 National Institutes of Health Stroke Scale score points from baseline ≤24 hours or death. Based on multivariate logistic models, the nomogram was generated. We assessed the discriminative performance by using the area under the receiver operating characteristic curve. Results - National Institutes of Health Stroke Scale score, onset-to-end procedure time, age, unsuccessful recanalization, and Careggi collateral score composed the IER-SICH nomogram. After removing Careggi collateral score from the first model, a second model including Alberta Stroke Program Early CT Score was developed. The area under the receiver operating characteristic curve of the IER-SICH nomogram was 0.778 in the training set (n=492) and 0.709 in the test set (n=399). The area under the receiver operating characteristic curve of the second model was 0.733 in the training set (n=988) and 0.685 in the test set (n=779). Conclusions - The IER-SICH nomogram is the first model developed and validated for predicting symptomatic intracerebral hemorrhage after thrombectomy. It may provide indications on early identification of patients for more or less postprocedural intensive management.

Published
2019

3. Do beliefs about the pathogenetic role of amyloid affect the interpretation of amyloid PET in the clinic?

Author

Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Antelmi, L, Pievani, M, Tarallo, A, Muscio, C, Guerra, U, Paghera, B, Padovani, A, Frisoni, G, Zanetti, O, Anzola, G, Bertocchi, M, Chito, E, Galluzzi, S, Geroldi, C, Lussignoli, G, Mattioli, F, Moretti, D, Pizzocaro, C, Borroni, B, Rozzini, L, Prelle, A, Gennuso, M, Villani, D, Raimondi, M, Gentile, S, Bellelli, G, Morandi, A, Turco, R, Bellandi, D, Carbone, P, Abruzzi, L, Bettoni, L, Bianchetti, A, Facchi, E, Di Fazio, I, Turla, M, Cotelli, M, Volta, G, Bigni, B, Bilotti, G, Vollaro, S, Rozzini, R, Boffelli, S, Cappuccio, M, Conti, M, Guizzetti, G, Defanti, C, Mirabile, D, Fascendini, S, Manzoni, L, Salvi, G, Belotti, G, Cavaliere, S, Fiacco, F, Valente, L, Ciccone, A, Lanari, A, Selletti, L, Palmerini, F, Avanzi, S, Vezzadini, G, Boccardi M., Altomare D., Ferrari C., Festari C., Antelmi L., Pievani M., Tarallo A., Muscio C., Guerra U. P., Paghera B., Padovani A., Frisoni G. B., Zanetti O., Anzola G. P., Bertocchi M., Chito E., Galluzzi S., Geroldi C., Lussignoli G., Mattioli F., Moretti D., Pizzocaro C., Borroni B., Rozzini L., Prelle A., Gennuso M., Villani D., Raimondi M. C., Gentile S., Bellelli G., Morandi A., Turco R., Bellandi D., Carbone P., Abruzzi L., Bettoni L., Bianchetti A., Facchi E., Di Fazio I., Turla M., Cotelli M. S., Volta G. D., Bigni B., Bilotti G., Vollaro S., Rozzini R., Boffelli S., Cappuccio M., Conti M. Z., Guizzetti G., Defanti C., Mirabile D., Fascendini S., Manzoni L., Salvi G. P., Belotti G., Cavaliere S., Fiacco F., Valente L., Ciccone A., Lanari A., Selletti L., Palmerini F., Avanzi S., Vezzadini G., Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Antelmi, L, Pievani, M, Tarallo, A, Muscio, C, Guerra, U, Paghera, B, Padovani, A, Frisoni, G, Zanetti, O, Anzola, G, Bertocchi, M, Chito, E, Galluzzi, S, Geroldi, C, Lussignoli, G, Mattioli, F, Moretti, D, Pizzocaro, C, Borroni, B, Rozzini, L, Prelle, A, Gennuso, M, Villani, D, Raimondi, M, Gentile, S, Bellelli, G, Morandi, A, Turco, R, Bellandi, D, Carbone, P, Abruzzi, L, Bettoni, L, Bianchetti, A, Facchi, E, Di Fazio, I, Turla, M, Cotelli, M, Volta, G, Bigni, B, Bilotti, G, Vollaro, S, Rozzini, R, Boffelli, S, Cappuccio, M, Conti, M, Guizzetti, G, Defanti, C, Mirabile, D, Fascendini, S, Manzoni, L, Salvi, G, Belotti, G, Cavaliere, S, Fiacco, F, Valente, L, Ciccone, A, Lanari, A, Selletti, L, Palmerini, F, Avanzi, S, Vezzadini, G, Boccardi M., Altomare D., Ferrari C., Festari C., Antelmi L., Pievani M., Tarallo A., Muscio C., Guerra U. P., Paghera B., Padovani A., Frisoni G. B., Zanetti O., Anzola G. P., Bertocchi M., Chito E., Galluzzi S., Geroldi C., Lussignoli G., Mattioli F., Moretti D., Pizzocaro C., Borroni B., Rozzini L., Prelle A., Gennuso M., Villani D., Raimondi M. C., Gentile S., Bellelli G., Morandi A., Turco R., Bellandi D., Carbone P., Abruzzi L., Bettoni L., Bianchetti A., Facchi E., Di Fazio I., Turla M., Cotelli M. S., Volta G. D., Bigni B., Bilotti G., Vollaro S., Rozzini R., Boffelli S., Cappuccio M., Conti M. Z., Guizzetti G., Defanti C., Mirabile D., Fascendini S., Manzoni L., Salvi G. P., Belotti G., Cavaliere S., Fiacco F., Valente L., Ciccone A., Lanari A., Selletti L., Palmerini F., Avanzi S., and Vezzadini G.

Abstract

Background: Beliefs of dementia experts about the pathogenic role of amyloid in Alzheimer's disease (AD) may affect the use of amyloid positron emission tomography (PET). Objective:To assess the role attributed to amyloid in AD pathogenesis by Italian dementia experts, and whether this modulates the impact of amyloid PET results in their diagnostic workup. Methods: 22 dementia experts rated their beliefs about the pathogenic role of amyloid. Then, we asked them to rate the probability of change in diagnosis based on the result of amyloid PET for 7 case vignettes, depicting patients who initially received a diagnosis based on a comprehensive workup and later received amyloid PET results consistent or inconsistent with the clinical picture. Results: 55% of the experts assigned a dominant role to amyloid, and 32% attributed a similar role to amyloid and tau in AD pathogenesis. The probability of change in diagnosis ranged from 17% (SD = 21.6) for cases with consistent to 51% (SD = 34) for cases with inconsistent PET versus clinical data. Diagnostic change was not biased by the clinicians' beliefs about AD pathogenesis. Conclusions: This work supports an unbiased interpretation of amyloid PET across different beliefs about the pathogenic role of amyloid, and a belief -independent reluctance to change diagnosis in cases where change is expected and recommended. (C) 2015 S. Karger AG, Basel

Published
2016

4. Assessment of the incremental diagnostic value of florbetapir F 18 imaging in patients with cognitive impairment: The incremental diagnostic value of amyloid PET with [18F]-florbetapir (INDIA-FBP) study

Author

Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Guerra, U, Paghera, B, Pizzocaro, C, Lussignoli, G, Geroldi, C, Zanetti, O, Cotelli, M, Turla, M, Borroni, B, Rozzini, L, Mirabile, D, Defanti, C, Gennuso, M, Prelle, A, Gentile, S, Morandi, A, Vollaro, S, Volta, G, Bianchetti, A, Conti, M, Cappuccio, M, Carbone, P, Bellandi, D, Abruzzi, L, Bettoni, L, Villani, D, Raimondi, M, Lanari, A, Ciccone, A, Facchi, E, Di Fazio, I, Rozzini, R, Boffelli, S, Manzoni, L, Salvi, G, Cavaliere, S, Belotti, G, Avanzi, S, Pasqualetti, P, Muscio, C, Padovani, A, Frisoni, G, Antelmi, L, Galluzzi, S, Pievani, M, Redolfi, A, Tarallo, A, Arora, A, Bertocchi, M, Chito, E, Moretti, D, Giubbini, R, Rodella, C, Camoni, L, Massetti, V, Andreoli, M, Bellelli, G, Fascendini, S, Mattioli, F, Turco, R, Vezzadini, G, Raimondi, V, Mondini, S, Zanacchi, E, Grigolo, M, Pezzini, A, Bilotti, G, Bigni, B, Zavarise, P, Ngonga, G, Anzola, G, Turrone, R, Guizzetti, G, Zanetti, M, Boccardi M., Altomare D., Ferrari C., Festari C., Guerra U. P., Paghera B., Pizzocaro C., Lussignoli G., Geroldi C., Zanetti O., Cotelli M. S., Turla M., Borroni B., Rozzini L., Mirabile D., Defanti C., Gennuso M., Prelle A., Gentile S., Morandi A., Vollaro S., Volta G. D., Bianchetti A., Conti M. Z., Cappuccio M., Carbone P., Bellandi D., Abruzzi L., Bettoni L., Villani D., Raimondi M. C., Lanari A., Ciccone A., Facchi E., Di Fazio I., Rozzini R., Boffelli S., Manzoni L., Salvi G. P., Cavaliere S., Belotti G., Avanzi S., Pasqualetti P., Muscio C., Padovani A., Frisoni G. B., Antelmi L., Galluzzi S., Pievani M., Redolfi A., Tarallo A., Arora A., Bertocchi M., Chito E., Moretti D. V., Giubbini R., Rodella C., Camoni L., Massetti V., Andreoli M., Bellelli G., Fascendini S., Mattioli F., Turco R., Vezzadini G., Raimondi V., Mondini S., Zanacchi E. C., Grigolo M., Pezzini A., Bilotti G., Bigni B., Zavarise P., Ngonga G., Anzola G. P., Turrone R., Guizzetti G., Zanetti M., Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Guerra, U, Paghera, B, Pizzocaro, C, Lussignoli, G, Geroldi, C, Zanetti, O, Cotelli, M, Turla, M, Borroni, B, Rozzini, L, Mirabile, D, Defanti, C, Gennuso, M, Prelle, A, Gentile, S, Morandi, A, Vollaro, S, Volta, G, Bianchetti, A, Conti, M, Cappuccio, M, Carbone, P, Bellandi, D, Abruzzi, L, Bettoni, L, Villani, D, Raimondi, M, Lanari, A, Ciccone, A, Facchi, E, Di Fazio, I, Rozzini, R, Boffelli, S, Manzoni, L, Salvi, G, Cavaliere, S, Belotti, G, Avanzi, S, Pasqualetti, P, Muscio, C, Padovani, A, Frisoni, G, Antelmi, L, Galluzzi, S, Pievani, M, Redolfi, A, Tarallo, A, Arora, A, Bertocchi, M, Chito, E, Moretti, D, Giubbini, R, Rodella, C, Camoni, L, Massetti, V, Andreoli, M, Bellelli, G, Fascendini, S, Mattioli, F, Turco, R, Vezzadini, G, Raimondi, V, Mondini, S, Zanacchi, E, Grigolo, M, Pezzini, A, Bilotti, G, Bigni, B, Zavarise, P, Ngonga, G, Anzola, G, Turrone, R, Guizzetti, G, Zanetti, M, Boccardi M., Altomare D., Ferrari C., Festari C., Guerra U. P., Paghera B., Pizzocaro C., Lussignoli G., Geroldi C., Zanetti O., Cotelli M. S., Turla M., Borroni B., Rozzini L., Mirabile D., Defanti C., Gennuso M., Prelle A., Gentile S., Morandi A., Vollaro S., Volta G. D., Bianchetti A., Conti M. Z., Cappuccio M., Carbone P., Bellandi D., Abruzzi L., Bettoni L., Villani D., Raimondi M. C., Lanari A., Ciccone A., Facchi E., Di Fazio I., Rozzini R., Boffelli S., Manzoni L., Salvi G. P., Cavaliere S., Belotti G., Avanzi S., Pasqualetti P., Muscio C., Padovani A., Frisoni G. B., Antelmi L., Galluzzi S., Pievani M., Redolfi A., Tarallo A., Arora A., Bertocchi M., Chito E., Moretti D. V., Giubbini R., Rodella C., Camoni L., Massetti V., Andreoli M., Bellelli G., Fascendini S., Mattioli F., Turco R., Vezzadini G., Raimondi V., Mondini S., Zanacchi E. C., Grigolo M., Pezzini A., Bilotti G., Bigni B., Zavarise P., Ngonga G., Anzola G. P., Turrone R., Guizzetti G., and Zanetti M.

Abstract

IMPORTANCE Cerebral amyloidosis is a key abnormality in Alzheimer disease (AD) and can be detected in vivo with positron emission tomography (PET) ligands. Although amyloid PET has clearly demonstrated analytical validity, its clinical utility is debated. OBJECTIVE To evaluate the incremental diagnostic value of amyloid PET with florbetapir F 18 in addition to the routine clinical diagnostic assessment of patients evaluated for cognitive impairment. DESIGN, SETTING, AND PARTICIPANTS The Incremental Diagnostic Value ofAmyloid PET With [18F]-Florbetapir (INDIA-FBP) Study is a multicenter study involving 18 AD evaluation units from eastern Lombardy, Northern Italy, 228 consecutive adults with cognitive impairmentwere evaluated for AD and other causes of cognitive decline, with a prescan diagnostic confidence of AD between 15%and 85%. Participants underwent routine clinical and instrumental diagnostic assessment. A prescan diagnosiswas made, diagnostic confidencewas estimated, and drug treatmentwas provided. At the time of thisworkup, an amyloid PET/computed tomographic scanwas performed, and the resultwas communicated to physicians afterworkup completion. Physicianswere asked to review the diagnosis, diagnostic confidence, and treatment after the scan. The studywas conducted from August 5, 2013, to December 31, 2014. MAIN OUTCOMES AND MEASURES Primary outcomeswere prescan to postscan changes of diagnosis, diagnostic confidence, and treatment. RESULTS Of the 228 participants, 107 (46%) were male; mean (SD) age was 70.5 (7) years. Diagnostic change occurred in 46 patients (79%) having both a previous diagnosis of AD and an amyloid-negative scan (P < .001) and in 16 (53%) of those with non-AD diagnoses and an amyloid-positive scan (P < .001). Diagnostic confidence in AD diagnosis increased by 15.2%in amyloid-positive (P < .001; effect size Cohen d = 1.04) and decreased by 29.9%in amyloid-negative (P < .001; d = -1.19) scans. Acetylcholinesterase inhibitors and

Published
2016

5. Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic

Author

Boccardi M., Altomare D., Ferrari C., Festari C., Antelmi L., Pievani M., Tarallo A., Muscio C., Guerra U. P., Paghera B., Padovani A., Frisoni G. B., Zanetti O., Anzola G. P., Bertocchi M., Chito E., Galluzzi S., Geroldi C., Lussignoli G., Mattioli F., Moretti D., Pizzocaro C., Borroni B., Rozzini L., Prelle A., Gennuso M., Villani D., Raimondi M. C., Gentile S., Bellelli G., Morandi A., Turco R., Bellandi D., Carbone P., Abruzzi L., Bettoni L., Bianchetti A., Facchi E., Di Fazio I., Turla M., Cotelli M. S., Volta G. D., Bigni B., Bilotti G., Vollaro S., Rozzini R., Boffelli S., Cappuccio M., Conti M. Z., Guizzetti G., Defanti C., Mirabile D., Fascendini S., Manzoni L., Salvi G. P., Belotti G., Cavaliere S., Fiacco F., Valente L., Ciccone A., Lanari A., Selletti L., Palmerini F., Avanzi S., Vezzadini G., Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Antelmi, L, Pievani, M, Tarallo, A, Muscio, C, Guerra, U, Paghera, B, Padovani, A, Frisoni, G, Zanetti, O, Anzola, G, Bertocchi, M, Chito, E, Galluzzi, S, Geroldi, C, Lussignoli, G, Mattioli, F, Moretti, D, Pizzocaro, C, Borroni, B, Rozzini, L, Prelle, A, Gennuso, M, Villani, D, Raimondi, M, Gentile, S, Bellelli, G, Morandi, A, Turco, R, Bellandi, D, Carbone, P, Abruzzi, L, Bettoni, L, Bianchetti, A, Facchi, E, Di Fazio, I, Turla, M, Cotelli, M, Volta, G, Bigni, B, Bilotti, G, Vollaro, S, Rozzini, R, Boffelli, S, Cappuccio, M, Conti, M, Guizzetti, G, Defanti, C, Mirabile, D, Fascendini, S, Manzoni, L, Salvi, G, Belotti, G, Cavaliere, S, Fiacco, F, Valente, L, Ciccone, A, Lanari, A, Selletti, L, Palmerini, F, Avanzi, S, and Vezzadini, G

Subjects
0301 basic medicine, Amyloid, Attitude of Health Personnel, Tau Proteins/metabolism, Amyloid pet, tau Proteins, Pilot Projects, Disease, Affect (psychology), Amyloid/metabolism, Diagnosis, Differential, 03 medical and health sciences, ddc:616.89, Alzheimer's disease pathogenesis, Amyloid positron emission tomography, Differential diagnosis, Incremental diagnostic value, 0302 clinical medicine, Neuroimaging, Positron-Emission Tomography/psychology, Alzheimer Disease, Physicians, Physicians/psychology, mental disorders, Diagnosis, Medicine, Dementia, Humans, business.industry, Alzheimer Disease/diagnosis/diagnostic imaging/metabolism, medicine.disease, eye diseases, 030104 developmental biology, Neurology, Italy, Positron-Emission Tomography, Differential, sense organs, Neurology (clinical), Alzheimer's disease, business, Neuroscience, 030217 neurology & neurosurgery
Abstract

Background: Beliefs of dementia experts about the pathogenic role of amyloid in Alzheimer's disease (AD) may affect the use of amyloid positron emission tomography (PET). Objective: To assess the role attributed to amyloid in AD pathogenesis by Italian dementia experts, and whether this modulates the impact of amyloid PET results in their diagnostic workup. Methods: 22 dementia experts rated their beliefs about the pathogenic role of amyloid. Then, we asked them to rate the probability of change in diagnosis based on the result of amyloid PET for 7 case vignettes, depicting patients who initially received a diagnosis based on a comprehensive workup and later received amyloid PET results consistent or inconsistent with the clinical picture. Results: 55% of the experts assigned a dominant role to amyloid, and 32% attributed a similar role to amyloid and tau in AD pathogenesis. The probability of change in diagnosis ranged from 17% (SD = 21.6) for cases with consistent to 51% (SD = 34) for cases with inconsistent PET versus clinical data. Diagnostic change was not biased by the clinicians' beliefs about AD pathogenesis. Conclusions: This work supports an unbiased interpretation of amyloid PET across different beliefs about the pathogenic role of amyloid, and a belief-independent reluctance to change diagnosis in cases where change is expected and recommended.

Published
2016

7. Assessment of the incremental diagnostic value of florbetapir F 18 imaging in patients with cognitive impairment: The incremental diagnostic value of amyloid PET with [ 18 F]-florbetapir (INDIA-FBP) study

Author

Boccardi, Marina, Altomare, Daniele, Ferrari, Clarissa, Festari, Cristina, Guerra, Ugo Paolo, Paghera, Barbara, Pizzocaro, Claudio, Lussignoli, Giulia, Geroldi, Cristina, Zanetti, Orazio, Cotelli, Maria Sofia, Turla, Marinella, Borroni, Barbara, Rozzini, Luca, Mirabile, Dario, Defanti, Carlo, Gennuso, Michele, Prelle, Alessandro, Gentile, Simona, Morandi, Alessandro, Vollaro, Stefano, Volta, Giorgio Dalla, Bianchetti, Angelo, Conti, Marta Zaffira, Cappuccio, Melania, Carbone, Pasqualina, Bellandi, Daniele, Abruzzi, Luciano, Bettoni, Luigi, Villani, Daniele, Raimondi, Maria Clara, Lanari, Alessia, Ciccone, Alfonso, Facchi, Emanuela, Di Fazio, Ignazio, Rozzini, Renzo, Boffelli, Stefano, Manzoni, Laura, Salvi, Giovanni Pietro, Cavaliere, Sabina, Belotti, Gloria, Avanzi, Stefano, Pasqualetti, Patrizio, Muscio, Cristina, Padovani, Alessandro, Frisoni, Giovanni B., Antelmi, Luigi, Galluzzi, Samantha, Pievani, Michela, Redolfi, Alberto, Tarallo, ANNA ROSA, Arora, Anupa, Bertocchi, Monica, Chitò, Eugenia, Moretti, Davide V., Giubbini, Raffaele, Rodella, Carlo, Camoni, Luca, Massetti, Valentina, Andreoli, Michela, Bellelli, Giuseppe, Fascendini, Sara, Mattioli, Flavia, Turco, Renato, Vezzadini, Giuliana, Raimondi, Vanessa, Mondini, Sara, Zanacchi, Elisa Carolina, Grigolo, Marta, Pezzini, Alessandra, Bilotti, Giacinta, Bigni, Barbara, Zavarise, Paola, Ngonga, Gael, Anzola, Gian Paolo, Turrone, Rosanna, Guizzetti, Gianluca, Zanetti, Marina, Boccardi, Marina, Altomare, Daniele, Ferrari, Clarissa, Festari, Cristina, Frisoni, Giovanni, Boccardi, M, Altomare, D, Ferrari, C, Festari, C, Guerra, U, Paghera, B, Pizzocaro, C, Lussignoli, G, Geroldi, C, Zanetti, O, Cotelli, M, Turla, M, Borroni, B, Rozzini, L, Mirabile, D, Defanti, C, Gennuso, M, Prelle, A, Gentile, S, Morandi, A, Vollaro, S, Volta, G, Bianchetti, A, Conti, M, Cappuccio, M, Carbone, P, Bellandi, D, Abruzzi, L, Bettoni, L, Villani, D, Raimondi, M, Lanari, A, Ciccone, A, Facchi, E, Di Fazio, I, Rozzini, R, Boffelli, S, Manzoni, L, Salvi, G, Cavaliere, S, Belotti, G, Avanzi, S, Pasqualetti, P, Muscio, C, Padovani, A, Frisoni, G, Antelmi, L, Galluzzi, S, Pievani, M, Redolfi, A, Tarallo, A, Arora, A, Bertocchi, M, Chito, E, Moretti, D, Giubbini, R, Rodella, C, Camoni, L, Massetti, V, Andreoli, M, Bellelli, G, Fascendini, S, Mattioli, F, Turco, R, Vezzadini, G, Raimondi, V, Mondini, S, Zanacchi, E, Grigolo, M, Pezzini, A, Bilotti, G, Bigni, B, Zavarise, P, Ngonga, G, Anzola, G, Turrone, R, Guizzetti, G, and Zanetti, M

Subjects
Male, medicine.medical_specialty, Positron-Emission Tomography/methods/standards, Aged, Aged, 80 and over, Alzheimer Disease, Amyloid beta-Peptides, Cognitive Dysfunction, Female, Humans, Male, Positron-Emission Tomography, Predictive Value of Tests, Aniline Compounds, Ethylene Glycols, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, ddc:616.89, 0302 clinical medicine, Alzheimer Disease, Predictive Value of Tests, Medical imaging, 80 and over, Medicine, Humans, Cognitive Dysfunction, Cognitive decline, Cognitive impairment, Amyloid beta-Peptides/metabolism, Aged, Aged, 80 and over, Amyloid beta-Peptides, Aniline Compounds, medicine.diagnostic_test, business.industry, Amyloidosis, Alzheimer Disease/diagnosis/diagnostic imaging/metabolism, Cognitive Dysfunction/diagnosis/diagnostic imaging/metabolism, medicine.disease, aged, aged, 80 and over, alzheimer disease, amyloid beta-peptides, cognitive dysfunction, female, humans, male, positron-emission tomography, predictive value of tests, aniline compounds, ethylene glycols, Surgery, Female, Positron-Emission Tomography, Ethylene Glycols, Neurology (clinical), Positron emission tomography, Predictive value of tests, Radiology, Alzheimer's disease, Abnormality, business, 030217 neurology & neurosurgery
Abstract

IMPORTANCE Cerebral amyloidosis is a key abnormality in Alzheimer disease (AD) and can be detected in vivo with positron emission tomography (PET) ligands. Although amyloid PET has clearly demonstrated analytical validity, its clinical utility is debated. OBJECTIVE To evaluate the incremental diagnostic value of amyloid PET with florbetapir F 18 in addition to the routine clinical diagnostic assessment of patients evaluated for cognitive impairment. DESIGN, SETTING, AND PARTICIPANTS The Incremental Diagnostic Value ofAmyloid PET With [18F]-Florbetapir (INDIA-FBP) Study is a multicenter study involving 18 AD evaluation units from eastern Lombardy, Northern Italy, 228 consecutive adults with cognitive impairmentwere evaluated for AD and other causes of cognitive decline, with a prescan diagnostic confidence of AD between 15%and 85%. Participants underwent routine clinical and instrumental diagnostic assessment. A prescan diagnosiswas made, diagnostic confidencewas estimated, and drug treatmentwas provided. At the time of thisworkup, an amyloid PET/computed tomographic scanwas performed, and the resultwas communicated to physicians afterworkup completion. Physicianswere asked to review the diagnosis, diagnostic confidence, and treatment after the scan. The studywas conducted from August 5, 2013, to December 31, 2014. MAIN OUTCOMES AND MEASURES Primary outcomeswere prescan to postscan changes of diagnosis, diagnostic confidence, and treatment. RESULTS Of the 228 participants, 107 (46%) were male; mean (SD) age was 70.5 (7) years. Diagnostic change occurred in 46 patients (79%) having both a previous diagnosis of AD and an amyloid-negative scan (P < .001) and in 16 (53%) of those with non-AD diagnoses and an amyloid-positive scan (P < .001). Diagnostic confidence in AD diagnosis increased by 15.2%in amyloid-positive (P < .001; effect size Cohen d = 1.04) and decreased by 29.9%in amyloid-negative (P < .001; d = -1.19) scans. Acetylcholinesterase inhibitors and memantine hydrochloride were introduced in 61 (65.6%) patients with positive scan results who had not previously received those drugs, and the use of the drugs was discontinued in 6 (33.3%) patients with negative scan results who were receiving those drugs (P < .001). CONCLUSIONS AND RELEVANCE Amyloid PET in addition to routine assessment in patients with cognitive impairment has a significant effect on diagnosis, diagnostic confidence, and drug treatment. The effect on health outcomes, such as morbidity and mortality, remains to be assessed.

Published
2016

8. Immune and cellular damage biomarkers to predict COVID-19 mortality in hospitalized patients.

Author

Lombardi C, Roca E, Bigni B, Bertozzi B, Ferrandina C, Franzin A, Vivaldi O, Cottini M, D'Alessio A, Del Poggio P, Conte GM, and Berti A

Abstract

Early prediction of COVID-19 in-hospital mortality relies usually on patients' preexisting comorbidities and is rarely reproducible in independent cohorts. We wanted to compare the role of routinely measured biomarkers of immunity, inflammation, and cellular damage with preexisting comorbidities in eight different machine-learning models to predict mortality, and evaluate their performance in an independent population. We recruited and followed-up consecutive adult patients with SARS-Cov-2 infection in two different Italian hospitals. We predicted 60-day mortality in one cohort (development dataset, n = 299 patients, of which 80% was allocated to the development dataset and 20% to the training set) and retested the models in the second cohort (external validation dataset, n = 402). Demographic, clinical, and laboratory features at admission, treatments and disease outcomes were significantly different between the two cohorts. Notably, significant differences were observed for %lymphocytes (p < 0.05), international-normalized-ratio (p < 0.01), platelets, alanine-aminotransferase, creatinine (all p < 0.001). The primary outcome (60-day mortality) was 29.10% (n = 87) in the development dataset, and 39.55% (n = 159) in the external validation dataset. The performance of the 8 tested models on the external validation dataset were similar to that of the holdout test dataset, indicating that the models capture the key predictors of mortality. The shap analysis in both datasets showed that age, immune features (%lymphocytes, platelets) and LDH substantially impacted on all models' predictions, while creatinine and CRP varied among the different models. The model with the better performance was model 8 (60-day mortality AUROC 0.83 ± 0.06 in holdout test set, 0.79 ± 0.02 in external validation dataset). The features that had the greatest impact on this model's prediction were age, LDH, platelets, and %lymphocytes, more than comorbidities or inflammation markers, and these findings were highly consistent in both datasets, likely reflecting the virus effect at the very beginning of the disease., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Author(s).)

Published
2021
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9. Clinical course and outcomes of patients with asthma hospitalized for severe acute respiratory syndrome coronavirus 2 pneumonia: A single-center, retrospective study.

Author

Lombardi C, Roca E, Bigni B, Cottini M, and Passalacqua G

Subjects
Asthma diagnosis, Asthma therapy, COVID-19 etiology, COVID-19 virology, Comorbidity, Disease Management, Disease Susceptibility, Humans, Patient Outcome Assessment, Retrospective Studies, Asthma complications, Asthma epidemiology, COVID-19 complications, COVID-19 epidemiology, SARS-CoV-2
Published
2020
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12. Takotsubo Syndrome Associated with COVID-19.

Author

Roca E, Lombardi C, Campana M, Vivaldi O, Bigni B, Bertozzi B, and Passalacqua G

Abstract

Objective: The availability of public health information for optimised supportive care is critical during the COVID-19 pandemic. We describe the first case of COVID-19 complicated by Takotsubo cardiomyopathy., Materials and Methods: We report the clinical, laboratory and radiological findings of a patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)., Results: The nasopharyngeal swab was positive for SARS-CoV-2 and x-ray images demonstrated pathognomonic pneumonia. The patient developed tachycardia and the echocardiogram confirmed the diagnosis of Takotsubo cardiomyopathy., Conclusions: Doctors should be aware of the need to thoroughly study this new infection in order to understand its underlying mechanisms and related complications., Learning Points: We report the first case of Takotsubo cardiomyopathy associated with COVID-19.We discuss a rare presentation in the current pandemic.COVID-19 can be associated with cardiac complications, even after the onset of pneumonia, and so strict monitoring of these patients is essential., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)

Published
2020
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13. Vascular Risk Factors and Cognition in Parkinson's Disease.

Author

Pilotto A, Turrone R, Liepelt-Scarfone I, Bianchi M, Poli L, Borroni B, Alberici A, Premi E, Formenti A, Bigni B, Cosseddu M, Cottini E, Berg D, and Padovani A

Subjects
Age of Onset, Aged, Attention, Disability Evaluation, Educational Status, Executive Function, Female, Humans, Male, Motor Activity, Neuropsychological Tests, Parkinson Disease diagnosis, Parkinson Disease physiopathology, Parkinson Disease psychology, Prevalence, Risk Factors, Sex Factors, Time Factors, Vascular Diseases physiopathology, Vascular Diseases psychology, Parkinson Disease epidemiology, Vascular Diseases epidemiology
Abstract

Vascular risk factors have been associated with cognitive deficits and incident dementia in the general population, but their role on cognitive dysfunction in Parkinson's disease (PD) is still unclear. The present study addresses the single and cumulative effect of vascular risk factors on cognition in PD patients, taking clinical confounders into account. Standardized neuropsychological assessment was performed in 238 consecutive PD patients. We evaluated the association of single and cumulative vascular risk factors (smoking, diabetes, hypercholesterolemia, hypertension, and heart disease), with the diagnosis of PD normal cognition (PDNC, n = 94), mild cognitive impairment (PD-MCI, n = 111), and dementia (PDD, n = 33). The association between single neuropsychological tests and vascular risk factors was evaluated with covariance analyses adjusted for age at onset, educational levels, gender, disease duration, and motor performance. Age, educational levels, disease duration, and motor function were significantly different between PDNC, PD-MCI, and PDD. Heart disease was the only vascular factor significantly more prevalent in PDD compared with PDNC in adjusted analyses. Performance of tests assessing executive and attention functions were significantly worse in patients with hypertension, heart disease, and/or diabetes (p <  0.05). Heart disease is associated with dementia in PD, suggesting a potential window of intervention. Vascular risk factors act especially on attention and executive functions in PD. Vascular risk stratification may be useful in order to identify PD patients with a greater risk of developing dementia. These findings need to be verified in longitudinal studies.

Published
2016
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