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1. Association of high-risk coronary atherosclerosis at CCTA with clinical and circulating biomarkers: Insight from CAPIRE study

Author

Edoardo Conte, Daniele Andreini, Marco Magnoni, Serge Masson, Saima Mushtaq, Sergio Berti, Mauro Canestrari, Giancarlo Casolo, Domenico Gabrielli, Roberto Latini, Paolo Marraccini, Tiziano Moccetti, Maria Grazia Modena, Gianluca Pontone, Marco Gorini, Aldo P. Maggioni, Attilio Maseri, A. Maseri, D. Andreini, S. Berti, M. Canestrari, G. Casolo, D. Gabrielli, R. Latini, M. Magnoni, P. Marraccini, S. Masson, T. Moccetti, M.G. Modena, G. Pontone, F. Gaspari, S. Ferrari, A. Cannata, N. Stucchi, M. Fois, R. Bernasconi, G. Balconi, T. Vago, T. Letizia, B. Bottazzi, R. Leone, I. Suliman, M. Sommaruga, P. Gremigni, R. Olivieri, L. Pennacchietti, M. Magnacca, M.G. Rossi, E. Pasotti, A. Clemente, S. Mushtaq, E. Mauro, R. Rossi, F. Pigazzani, L. Faggioni, M. Ciardetti, and M. Puppato

Subjects
Male, Computed Tomography Angiography, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Logistic regression, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Risk Factors, Prevalence, Medicine, Prospective Studies, Age Factors, Coronary ct angiography, Middle Aged, Prognosis, Inflammatory biomarkers, Plaque, Atherosclerotic, Serum Amyloid P-Component, C-Reactive Protein, Italy, Cohort, Female, Cardiology and Cardiovascular Medicine, Coronary plaque, Clinical risk factor, medicine.medical_specialty, Cardiac computed tomography, Risk Assessment, 03 medical and health sciences, Sex Factors, Predictive Value of Tests, Diabetes mellitus, Internal medicine, Multidetector Computed Tomography, Humans, Radiology, Nuclear Medicine and imaging, Coronary atherosclerosis, Aged, Glycated Hemoglobin, Inflammation, business.industry, High-risk plaque features, medicine.disease, Cardiovascular prevention, Circulating biomarkers, Cross-Sectional Studies, business, Biomarkers
Abstract

Background High-risk coronary atherosclerosis features evaluated coronary CT angiography (CCTA) were suggested to have a prognostic role. The present study aimed to evaluate the association of circulating biomarkers with high-risk plaque features assessed by CCTA. Methods A consecutive cohort of subjects who underwent CCTA because of suspected CAD was screened for inclusion in the CAPIRE study. Based on risk factors (RF) burden patients were defined as having a low clinical risk (0–1 RF with the exclusion of patients with diabetes mellitus as single RF) or an high clinical risk (≥3 RFs). In all patients, measurement of inflammatory biomarkers and CCTA analysis focused on high-risk plaque features were performed. Univariate and multivariate logistic regression analysis were used to evaluate the relationship between clinical and biological variables with CCTA advanced plaque features. Results 528 patients were enrolled in CAPIRE study. Older age and male sex appeared to be predictors of qualitative high-risk plaque features and associated with the presence of elevated total, non-calcified and low-attenuation plaque volume. Among circulating biomarkers only hs-CRP was found to be associated with qualitative high-risk plaque features (OR 2.02, p = 0.004 and 2.02, p = 0.012 for LAP and RI > 1.1, respectively) with borderline association with LAP-Vol (OR 1.52, p = 0.076); HbA1c and PTX-3 resulted to be significantly associated with quantitative high-risk plaque features (OR 1.71, p = 0.003 and 1.04, p = 0.002 for LAP-Vol, respectively). Conclusions Our results support the association between inflammatory biomarkers (hs-CRP, PTX- 3), HbA1c and high-risk atherosclerotic features detected by CCTA. Male sex and older age are significant predictors of high-risk atherosclerosis.

Published
2021
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2. Long-Term Implications of Atrial Fibrillation in Patients With Degenerative Mitral Regurgitation

Author

Francesco Grigioni, Giovanni Benfari, Jean-Louis Vanoverschelde, Christophe Tribouilloy, Jean-Francois Avierinos, Francesca Bursi, Rakesh M. Suri, Federico Guerra, Agnés Pasquet, Dan Rusinaru, Emanuela Marcelli, Alexis Théron, Andrea Barbieri, Hector Michelena, Siham Lazam, Catherine Szymanski, Vuyisile T. Nkomo, Alessandro Capucci, Prabin Thapa, Maurice Enriquez-Sarano, R. Suri, M.A Clavel, J. Maalouf, H. Michelena, M. Enriquez-Sarano, C. Tribouilloy, F. Trojette, C. Szymanski, D. Rusinaru, G. Touati, J.P. Remadi, F. Guerra, A. Capucci, F. Grigioni, A. Russo, E. Biagini, F. Pasquale, M. Ferlito, C. Rapezzi, C. Savini, G. Marinelli, D. Pacini, G.D. Gargiulo, R. Di Bartolomeo, J. Boulif, C. de Meester, G. El Khoury, B. Gerber, S. Lazam, A. Pasquet, P. Noirhomme, D. Vancraeynest, J-L. Vanoverschelde, J.F. Avierinos, F. Collard, A. Théron, G. Habib, A. Barbieri, F. Bursi, F. Mantovani, R. Lugli, M.G. Modena, G. Boriani, L. Bacchi-Reggiani, Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, University of Balamand [Liban] (UOB), Marseille medical genetics - Centre de génétique médicale de Marseille (MMG), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Grigioni, Francesco, Benfari, Giovanni, Vanoverschelde, Jean-Loui, Tribouilloy, Christophe, Avierinos, Jean-Francoi, Bursi, Francesca, Suri, Rakesh M., Guerra, Federico, Pasquet, Agné, Rusinaru, Dan, Marcelli, Emanuela, Théron, Alexi, Barbieri, Andrea, Michelena, Hector, Lazam, Siham, Szymanski, Catherine, Nkomo, Vuyisile T., Capucci, Alessandro, Thapa, Prabin, Enriquez-Sarano, Maurice, Suri, R., Clavel, M.A., Maalouf, J., Michelena, H., Enriquez-Sarano, M., Tribouilloy, C., Trojette, F., Szymanski, C., Rusinaru, D., Touati, G., Remadi, J.P., Guerra, F., Capucci, A., Grigioni, F., Russo, A., Biagini, E., Pasquale, F., Ferlito, M., Rapezzi, C., Savini, C., Marinelli, G., Pacini, D., Gargiulo, G.D., Di Bartolomeo, R., Boulif, J., de Meester, C., El Khoury, G., Gerber, B., Lazam, S., Pasquet, A., Noirhomme, P., Vancraeynest, D., Vanoverschelde, J.-L., Avierinos, J.F., Collard, F., Théron, A., Habib, G., Barbieri, A., Bursi, F., Mantovani, F., Lugli, R., Modena, M.G., Boriani, G., Bacchi-Reggiani, L., University of Balamand - UOB (LIBAN), UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, and UCL - (SLuc) Service de pathologie cardiovasculaire

Subjects
Male, atrial fibrillation, mitral regurgitation, mitral repair, percutaneous treatment, prognosis, surgery, Aged, Aged, 80 and over, Atrial Fibrillation, Cohort Studies, Female, Humans, Middle Aged, Mitral Valve Insufficiency, Prevalence, Registries, Cardiology and Cardiovascular Medicine, 030204 cardiovascular system & hematology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Sinus rhythm, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Ejection fraction, Mitral repair, Absolute risk reduction, Atrial fibrillation, Prognosis, 3. Good health, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cardiology, medicine.symptom, prognosi, medicine.medical_specialty, Asymptomatic, Article, NO, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, International database, Internal medicine, medicine, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, In patient, Mitral regurgitation, business.industry, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Surgery, business, Percutaneous treatment
Abstract

BACKGROUND: Scientific guidelines consider atrial fibrillation (AF) complicating degenerative mitral regurgitation (DMR) a debated indication for surgery. OBJECTIVES: This study analyzed the prognostic/therapeutic implications of AF at DMR diagnosis and long-term. METHODS: Patients were enrolled in the MIDA (Mitral Regurgitation International Database) registry, which reported the consecutive, multicenter, international experience with DMR due to flail leaflets echocardiographically diagnosed. RESULTS: Among 2,425 patients (age 67 ± 13 years; 71% male, 67% asymptomatic, ejection fraction 64 ± 10%), 1,646 presented at diagnosis with sinus rhythm (SR), 317 with paroxysmal AD, and 462 with persistent AF. Underlying clinical/instrumental characteristics progressively worsened from SR to paroxysmal to persistent AF. During follow-up, paroxysmal and persistent AF were associated with excess mortality (10-year survival in SR and in paroxysmal and persistent AF was 74 ± 1%, 59 ± 3%, and 46 ± 2%, respectively; p < 0.0001), that persisted 20 years post-diagnosis and independently of all baseline characteristics (p values

Published
2019
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3. Title Page / Table of Contents / Preface

Author

Benvindo Justiça, E. Segalés, Gloria Saccani, Evy Bashardi, Andrew N. Nicolaides, Armando Tripodi, T. Fenyvesi, G. Origliani, J. Vermylen, R. Rossi, A. Nemmar, Alexander Koshkaryev, Silvia Navarro, S. Béguin, Francesco Violi, Tiziana Garofano, Antonella Tufano, Uri Seligsohn, Fabrizio Fabris, H.C. Hemker, G. Vilahur, Franco Semprini, R. Abbate, S. Fedi, Saul Yedgar, Sara Morais, C. Fatini, Licia Iacoviello, Irène Juhan-Vague, F. Gensini, Helga Grafenhofer, P. Giesen, S. Coccheri, B. Nemery, P. Carrasco, T. Grimaldi, Jacqueline Conard, G. Fantini, Ida Martinelli, Chiara Melloni, F.R. Rosendaal, Francesco Fallani, Gordon D.O. Lowe, E. Sticchi, Mónica Pereira, Joseph Loscalzo, J.I. Abad, V. Regnault, Juan Carlos Souto, T. Lecompte, Gregory Barshtein, Giovanni Romeo, V.V. Kakkar, Ingrid Pabinger, Ebrahim Shah, Giovanni Di Minno, A. De Fabritiis, F. Sofi, Pilar Medina, Alexandra Estevinho, Matteo Nicola Dario Di Minno, Justo Aznar, E. Conti, Grigoris T. Gerotziafas, George Geroulakos, E. de Smed, Maria Assunta Silvestri, Giuseppe G. Nenci, Fabio M. Pulcinelli, Luisa Lenti, Ismail Elalamy, B. Cosmi, Pierre Morange, Amparo Estellés, Angelo Branzi, Marie-Christine Alessi, Andrew H. Baker, Roberto Catasca, Raymond Verhaeghe, Samuele Nanni, V. Llorente, Francisco España, Andrea Ghiselli, F. Coppi, Domenico Prisco, Manuel Campos, M.F. Hoylaerts, P. Poredoš, Meyer Michel Samama, Stavros K. Kakkos, Giovanni Melandri, José Miguel P. Ferreira de Oliveira, Maura Griffin, David A. Lane, R. AlDieri, Augusto Di Castelnuovo, Serenella Rotondo, L. Badimon, J.J. Badimon, Giovanna Marchetti, Antonella Marcoccia, M.G. Modena, Henrik Sillesen, Joseph Emmerich, Daniela Turchetti, Luigina R. Mollica, Giovanni de Gaetano, Rossella Marcucci, Maria Benedetta Donati, José Manuel Cabeda, Pasquale Pignatelli, Giuseppe Germanò, Pierluigi Tricoci, J. Harenberg, Marie Hélène Horellou, Gianni Belcaro, Antonio Girolami, Bruno Girolami, R. Wagenvoord, Francesco Bernardi, M. Verstraete, P.M. Mannucci, Jean-Noël Fiessinger, I. Jörg, and Irene Pereira

Subjects
medicine.medical_specialty, business.industry, Physiology (medical), medicine, Table of contents, Hematology, Title page, business, Classics, Surgery
Published
2003
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4. Early right ventricular dysfuction in smokers with COPD and reduced diffusion capacity fo caron monoxide (DLco)

Author

Verduri, A, Leuzzi, C, Barbieri, A, Roversi, P, Reggianini, L, Luppi, F, Clini, E, Fabbri, L, Modena, M, Beghe', B, A. Verduri, C Leuzzi, A. Barbieri, P Roversi, L. Reggianini, F. Luppi, E. Clini, L.M. Fabbri, M.G. Modena, B. Beghe', Verduri, A, Leuzzi, C, Barbieri, A, Roversi, P, Reggianini, L, Luppi, F, Clini, E, Fabbri, L, Modena, M, Beghe', B, A. Verduri, C Leuzzi, A. Barbieri, P Roversi, L. Reggianini, F. Luppi, E. Clini, L.M. Fabbri, M.G. Modena, and B. Beghe'

Published
2010

5. Vascular surgery patients: perioperative and long-term risk according to the ACC/AHA guidelines, the additive role of post-operative troponin elevation

Author

Luciano Babuin, Maria Grazia Modena, Andrea Barbieri, Luigi Politi, A Rumolo, Allan S. Jaffe, Mauro Zennaro, Francesca Bursi, Andrea Stella, Mauro Gargiulo, Teresa Grimaldi, F. Bursi, L. Babuin, A. Barbieri, L. Politi, M. Zennaro, T. Grimaldi, A. Rumolo, M. Gargiulo, A. Stella, M.G. Modena, and A.S. Jaffe

Subjects
Adult, Male, medicine.medical_specialty, Adrenergic beta-Antagonists, Cardiology, Myocardial Infarction, Disease-Free Survival, Postoperative Complications, Risk Factors, Internal medicine, Troponin I, medicine, Humans, Myocardial infarction, Prospective Studies, Risk factor, Societies, Medical, Postoperative Care, biology, business.industry, Hazard ratio, Vascular surgery, post-operative troponin elevation, Perioperative, medicine.disease, Prognosis, Troponin, Surgery, Circulatory system, Multivariate Analysis, Practice Guidelines as Topic, biology.protein, Female, Cardiology and Cardiovascular Medicine, business, Vascular Surgical Procedures
Abstract

Aims The objectives of this study are to evaluate the prognostic role of pre-operative stratification in patients undergoing elective major vascular surgery, the timing of adverse outcomes, and the predictive role of troponin (cTn). Methods and results Consecutive vascular surgery candidates (n ¼ 391) were prospectively stratified and treated according to the ACC/AHA guidelines. The patients were categorized into three groups: (1) with coronary revascularization in the past 5 years, (2) with intermediate clinical risk predictors, and (3) with minor or no clinical risk predictors. cTnI was measured post-operatively. By 18 months, 18.7% of subjects had experienced death or acute myocardial infarction (MI) (by the ACC/ESC criteria). The hazard ratio (HR) was 5.21 (95% CI ¼ 2.60–10.43; P , 0.0001) in group 1 and 2.58 (95% CI ¼ 1.27–4.38; P ¼ 0.004) in group 2 when compared with group 3. Most events occurred within 30 days. Elevations of cTnI were associated with adverse outcomes even after multivariable adjustment at long-term (adjusted overall HR ¼ 4.73, 95% CI ¼ 2.92–7.65; P , 0.0001) and at 30 days (adjusted HR ¼ 5.52, 95%CI ¼ 3.23–9.42; P , 0.0001). Conclusion After pre-operative stratification, patients undergoing elective major vascular surgery remain at high risk of MI and death. Events occur mainly early after surgery. cTnI elevations are frequent and independently associated with increased risk. These findings suggest the need for a major re-evaluation of our approach to these patients.

Published
2005

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