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1. Tolerability of vortioxetine compared to selective serotonin reuptake inhibitors in older adults with major depressive disorder (VESPA): a randomised, assessor-blinded and statistician-blinded, multicentre, superiority trial

Author: Ostuzzi, G, Gastaldon, C, Tettamanti, M, Cartabia, M, Monti, I, Aguglia, A, Aguglia, E, Bartoli, F, Callegari, C, Canozzi, A, Carbone, E, Carrà, G, Caruso, R, Cavallotti, S, Chiappini, S, Colasante, F, Compri, B, D'Agostino, A, De Fazio, P, de Filippis, R, Gari, M, Ielmini, M, Ingrosso, G, Mammarella, S, Martinotti, G, Rodolico, A, Roncone, R, Sterzi, E, Tarsitani, L, Tiberto, E, Todini, L, Amaddeo, F, D'Avanzo, B, Barbato, A, Barbui, C, Alessi, M, Avincola, G, Bachi, B, Bernasconi, G, Birgillito, A, Bisso, E, Bonora, S, Calabrese, A, Callovini, T, Canestro, A, Canonico, S, Capogrosso, C, Carosielli, D, Caselli, I, Cavaleri, D, Cavallotto, C, Cesca, M, Chiarenza, C, Cioni, R, Coloccini, S, Cruciata, M, Cumerlato, C, De Filippis, R, De Palma, M, Del Vecchio, S, Della Rocca, B, Di Natale, C, D'Onofrio, E, Espa, I, Fior, G, Gancitano, M, Giordano, B, Giusti, L, Grassi, L, Guzzi, P, Isella, C, Lax, A, Marano, L, Marconi, F, Marella, M, Metelli, A, Michencig, G, Miuli, A, Moncada, A, Morello, P, Moretti, F, Morreale, M, Mosca, A, Nasti, C, Nosé, M, Ogheri, F, Oresti, M, Ornaghi, A, Palpella, D, Pancheri, C, Papola, D, Passeri, S, Pettorusso, M, Piacenti, S, Pinucci, I, Pugliese, V, Purgato, M, Rania, M, Robbi, F, Romito, S, Ronchi, B, Roselli, V, Segura-Garcia, C, Signorelli, M, Simonelli, G, Sociali, A, Sturiale, S, Tambelli, A, Todesco, B, Trabucco, A, Turrini, G, Villa, V, Wiedenmann, F, Zambuto, L, Zanini, E, Zannini, C, Zerbinati, L, Ostuzzi, Giovanni, Gastaldon, Chiara, Tettamanti, Mauro, Cartabia, Massimo, Monti, Igor, Aguglia, Andrea, Aguglia, Eugenio, Bartoli, Francesco, Callegari, Camilla, Canozzi, Andrea, Carbone, Elvira Anna, Carrà, Giuseppe, Caruso, Rosangela, Cavallotti, Simone, Chiappini, Stefania, Colasante, Fabrizio, Compri, Beatrice, D'Agostino, Armando, De Fazio, Pasquale, de Filippis, Renato, Gari, Matteo, Ielmini, Marta, Ingrosso, Gianmarco, Mammarella, Silvia, Martinotti, Giovanni, Rodolico, Alessandro, Roncone, Rita, Sterzi, Enrico, Tarsitani, Lorenzo, Tiberto, Elisa, Todini, Liliana, Amaddeo, Francesco, D'Avanzo, Barbara, Barbato, Angelo, Barbui, Corrado, Alessi, Maria Chiara, Avincola, Gabriele, Bachi, Bianca, Bernasconi, Gianna, Birgillito, Andrea, Bisso, Emanuele, Bonora, Stefano, Calabrese, Angela, Callovini, Tommaso, Canestro, Aurelia, Canonico, Salvo, Capogrosso, Chiara Alessandra, Carbone, Elvira, Carosielli, Doriana, Caselli, Ivano, Cavaleri, Daniele, Cavallotto, Clara, Cesca, Marco, Chiarenza, Cecilia, Cioni, Riccardo Matteo, Coloccini, Sara, Cruciata, Marco, Cumerlato, Claudia, De Filippis, Renato, De Palma, Manuela, Del Vecchio, Sasha, Della Rocca, Bianca, Di Natale, Chiara, D'Onofrio, Ettore, Espa, Irene, Fior, Giulia, Gancitano, Marta, Giordano, Barbara, Giusti, Laura, Grassi, Luigi, Guzzi, Pierluca, Isella, Celeste, Lax, Annamaria, Marano, Leonardo, Marconi, Federico, Marella, Marco, Metelli, Alessia, Michencig, Giulia, Miuli, Andrea, Moncada, Alessandro, Morello, Pietro, Moretti, Federico, Morreale, Marco, Mosca, Alessio, Nasti, Christian, Nosé, Michela, Ogheri, Filippo, Oresti, Margherita, Ornaghi, Alessandra, Palpella, Dario, Pancheri, Corinna, Papola, Davide, Passeri, Silvia, Pettorusso, Mauro, Piacenti, Susanna, Pinucci, Irene, Pugliese, Valentina, Purgato, Marianna, Rania, Marianna, Robbi, Federica, Romito, Samantha, Ronchi, Barbara, Roselli, Valentina, Segura-Garcia, Cristina, Signorelli, Maria Salvina, Simonelli, Gabriele, Sociali, Antonella, Sturiale, Serena, Tambelli, Antonio, Todesco, Beatrice, Trabucco, Alice, Turrini, Giulia, Villa, Veronica, Wiedenmann, Federico, Zambuto, Luca, Zanini, Elisa, Zannini, Chiara, Zerbinati, Luigi, Ostuzzi, G, Gastaldon, C, Tettamanti, M, Cartabia, M, Monti, I, Aguglia, A, Aguglia, E, Bartoli, F, Callegari, C, Canozzi, A, Carbone, E, Carrà, G, Caruso, R, Cavallotti, S, Chiappini, S, Colasante, F, Compri, B, D'Agostino, A, De Fazio, P, de Filippis, R, Gari, M, Ielmini, M, Ingrosso, G, Mammarella, S, Martinotti, G, Rodolico, A, Roncone, R, Sterzi, E, Tarsitani, L, Tiberto, E, Todini, L, Amaddeo, F, D'Avanzo, B, Barbato, A, Barbui, C, Alessi, M, Avincola, G, Bachi, B, Bernasconi, G, Birgillito, A, Bisso, E, Bonora, S, Calabrese, A, Callovini, T, Canestro, A, Canonico, S, Capogrosso, C, Carosielli, D, Caselli, I, Cavaleri, D, Cavallotto, C, Cesca, M, Chiarenza, C, Cioni, R, Coloccini, S, Cruciata, M, Cumerlato, C, De Filippis, R, De Palma, M, Del Vecchio, S, Della Rocca, B, Di Natale, C, D'Onofrio, E, Espa, I, Fior, G, Gancitano, M, Giordano, B, Giusti, L, Grassi, L, Guzzi, P, Isella, C, Lax, A, Marano, L, Marconi, F, Marella, M, Metelli, A, Michencig, G, Miuli, A, Moncada, A, Morello, P, Moretti, F, Morreale, M, Mosca, A, Nasti, C, Nosé, M, Ogheri, F, Oresti, M, Ornaghi, A, Palpella, D, Pancheri, C, Papola, D, Passeri, S, Pettorusso, M, Piacenti, S, Pinucci, I, Pugliese, V, Purgato, M, Rania, M, Robbi, F, Romito, S, Ronchi, B, Roselli, V, Segura-Garcia, C, Signorelli, M, Simonelli, G, Sociali, A, Sturiale, S, Tambelli, A, Todesco, B, Trabucco, A, Turrini, G, Villa, V, Wiedenmann, F, Zambuto, L, Zanini, E, Zannini, C, Zerbinati, L, Ostuzzi, Giovanni, Gastaldon, Chiara, Tettamanti, Mauro, Cartabia, Massimo, Monti, Igor, Aguglia, Andrea, Aguglia, Eugenio, Bartoli, Francesco, Callegari, Camilla, Canozzi, Andrea, Carbone, Elvira Anna, Carrà, Giuseppe, Caruso, Rosangela, Cavallotti, Simone, Chiappini, Stefania, Colasante, Fabrizio, Compri, Beatrice, D'Agostino, Armando, De Fazio, Pasquale, de Filippis, Renato, Gari, Matteo, Ielmini, Marta, Ingrosso, Gianmarco, Mammarella, Silvia, Martinotti, Giovanni, Rodolico, Alessandro, Roncone, Rita, Sterzi, Enrico, Tarsitani, Lorenzo, Tiberto, Elisa, Todini, Liliana, Amaddeo, Francesco, D'Avanzo, Barbara, Barbato, Angelo, Barbui, Corrado, Alessi, Maria Chiara, Avincola, Gabriele, Bachi, Bianca, Bernasconi, Gianna, Birgillito, Andrea, Bisso, Emanuele, Bonora, Stefano, Calabrese, Angela, Callovini, Tommaso, Canestro, Aurelia, Canonico, Salvo, Capogrosso, Chiara Alessandra, Carbone, Elvira, Carosielli, Doriana, Caselli, Ivano, Cavaleri, Daniele, Cavallotto, Clara, Cesca, Marco, Chiarenza, Cecilia, Cioni, Riccardo Matteo, Coloccini, Sara, Cruciata, Marco, Cumerlato, Claudia, De Filippis, Renato, De Palma, Manuela, Del Vecchio, Sasha, Della Rocca, Bianca, Di Natale, Chiara, D'Onofrio, Ettore, Espa, Irene, Fior, Giulia, Gancitano, Marta, Giordano, Barbara, Giusti, Laura, Grassi, Luigi, Guzzi, Pierluca, Isella, Celeste, Lax, Annamaria, Marano, Leonardo, Marconi, Federico, Marella, Marco, Metelli, Alessia, Michencig, Giulia, Miuli, Andrea, Moncada, Alessandro, Morello, Pietro, Moretti, Federico, Morreale, Marco, Mosca, Alessio, Nasti, Christian, Nosé, Michela, Ogheri, Filippo, Oresti, Margherita, Ornaghi, Alessandra, Palpella, Dario, Pancheri, Corinna, Papola, Davide, Passeri, Silvia, Pettorusso, Mauro, Piacenti, Susanna, Pinucci, Irene, Pugliese, Valentina, Purgato, Marianna, Rania, Marianna, Robbi, Federica, Romito, Samantha, Ronchi, Barbara, Roselli, Valentina, Segura-Garcia, Cristina, Signorelli, Maria Salvina, Simonelli, Gabriele, Sociali, Antonella, Sturiale, Serena, Tambelli, Antonio, Todesco, Beatrice, Trabucco, Alice, Turrini, Giulia, Villa, Veronica, Wiedenmann, Federico, Zambuto, Luca, Zanini, Elisa, Zannini, Chiara, and Zerbinati, Luigi
Abstract: Background: Major depressive disorder (MDD) is prevalent and disabling among older adults. Standing on its tolerability profile, vortioxetine might be a promising alternative to selective serotonin reuptake inhibitors (SSRIs) in such a vulnerable population. Methods: We conducted a randomised, assessor- and statistician-blinded, superiority trial including older adults with MDD. The study was conducted between 02/02/2019 and 02/22/2023 in 11 Italian Psychiatric Services. Participants were randomised to vortioxetine or one of the SSRIs, selected according to common practice. Treatment discontinuation due to adverse events after six months was the primary outcome, for which we aimed to detect a 12% difference in favour of vortioxetine. The study was registered in the online repository clinicaltrials.gov (NCT03779789). Findings: The intention-to-treat population included 179 individuals randomised to vortioxetine and 178 to SSRIs. Mean age was 73.7 years (standard deviation 6.1), and 264 participants (69%) were female. Of those on vortioxetine, 78 (44%) discontinued the treatment due to adverse events at six months, compared to 59 (33%) of those on SSRIs (odds ratio 1.56; 95% confidence interval 1.01–2.39). Adjusted and per-protocol analyses confirmed point estimates in favour of SSRIs, but without a significant difference. With the exception of the unadjusted survival analysis showing SSRIs to outperform vortioxetine, secondary outcomes provided results consistent with a lack of substantial safety and tolerability differences between the two arms. Overall, no significant differences emerged in terms of response rates, depressive symptoms and quality of life, while SSRIs outperformed vortioxetine in terms of cognitive performance. Interpretation: As opposed to what was previously hypothesised, vortioxetine did not show a better tolerability profile compared to SSRIs in older adults with MDD in this study. Additionally, hypothetical advantages of vortioxetine on depress
Published: 2024

2. The effect of social media and infodemic on mental health during the COVID-19 pandemic: results from the COMET multicentric trial

Author: Sampogna, G, Di Vincenzo, M, Luciano, M, Della Rocca, B, Albert, U, Carmassi, C, Carra, G, Cirulli, F, Dell'Osso, B, Nanni, M, Pompili, M, Sani, G, Tortorella, A, Volpe, U, Fiorillo, A, Sampogna G., Di Vincenzo M., Luciano M., Della Rocca B., Albert U., Carmassi C., Carra G., Cirulli F., Dell'Osso B., Nanni M. G., Pompili M., Sani G., Tortorella A., Volpe U., Fiorillo A., Sampogna, G, Di Vincenzo, M, Luciano, M, Della Rocca, B, Albert, U, Carmassi, C, Carra, G, Cirulli, F, Dell'Osso, B, Nanni, M, Pompili, M, Sani, G, Tortorella, A, Volpe, U, Fiorillo, A, Sampogna G., Di Vincenzo M., Luciano M., Della Rocca B., Albert U., Carmassi C., Carra G., Cirulli F., Dell'Osso B., Nanni M. G., Pompili M., Sani G., Tortorella A., Volpe U., and Fiorillo A.
Abstract: On January 30, 2020, the World Health Organization (WHO) declared the status of pandemic due to the COVID-19 infection. The initial phases of the pandemic were characterized by uncertainty and public fears. In order to cope with such unexpected conditions, people adopted different coping strategies, including search for information, accessing Internet, and using social media. The present study based on the COMET collaborative research network aims to: (1) assess use of Internet and of social media among the Italian general population; (2) explore differences in web usage between people with pre-existing mental disorders and the general population; (3) identify changes over time in social media usage along the phase 1 of the pandemic; (4) identify the clinical, socio-demographic and contextual predictors of excessive use of social media. A significant increase in time spent on Internet, with an average time of 4.8 ± 0.02 h per day, was found in the global sample of 20,720 participants. Compared with the general population, Internet use was significantly higher in people with pre-existing mental disorders (5.2 ± 0.1 h vs. 4.9 ± 0.02; p < 0.005). According to the multivariate logistic regression model, the risk of excessive use of social media and Internet was significantly higher in people with moderate levels of depressive symptoms (OR: 1.26, CI 95%: 0.99 to 1.59, p < 0.0.005); while protective factors were being students (OR: 0.72, CI 95%: 0.53 to 0.96, p < 0.0029) and living in central Italy (OR: 0.46, CI 95%: 0.23 to 0.90, p < 0.002). The evaluation of social media and Internet use by the general population represents a first step for developing specific protective and supportive interventions for the general population, including practical suggestions on how to safely use Internet and social media.
Published: 2023

3. The impact of COVID-19 pandemic on the healthcare workers mental health

Author: Ferrandino, M., primary, Sollo, V., additional, Di Vincenzo, M., additional, Marafioti, N., additional, Della Rocca, B., additional, Brandi, C., additional, Giallonardo, V., additional, Luciano, M., additional, Sampogna, G., additional, and Fiorillo, A., additional
Published: 2023
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4. SARS-CoV-2 multi-variant rapid detector based on graphene transistor functionalized with an engineered dimeric ACE2 receptor

Author: Romagnoli, A, D'Agostino, M, Pavoni, E, Ardiccioni, C, Motta, S, Crippa, P, Biagetti, G, Notarstefano, V, Rexha, J, Perta, N, Barocci, S, Costabile, B, Colasurdo, G, Caucci, S, Mencarelli, D, Turchetti, C, Farina, M, Pierantoni, L, La Teana, A, Al Hadi, R, Cicconardi, F, Chinappi, M, Trucchi, E, Mancia, F, Menzo, S, Morozzo Della Rocca, B, D'Annessa, I, Di Marino, D, Romagnoli, Alice, D'Agostino, Mattia, Pavoni, Eleonora, Ardiccioni, Chiara, Motta, Stefano, Crippa, Paolo, Biagetti, Giorgio, Notarstefano, Valentina, Rexha, Jesmina, Perta, Nunzio, Barocci, Simone, Costabile, Brianna K, Colasurdo, Gabriele, Caucci, Sara, Mencarelli, Davide, Turchetti, Claudio, Farina, Marco, Pierantoni, Luca, La Teana, Anna, Al Hadi, Richard, Cicconardi, Francesco, Chinappi, Mauro, Trucchi, Emiliano, Mancia, Filippo, Menzo, Stefano, Morozzo Della Rocca, Blasco, D'Annessa, Ilda, Di Marino, Daniele, Romagnoli, A, D'Agostino, M, Pavoni, E, Ardiccioni, C, Motta, S, Crippa, P, Biagetti, G, Notarstefano, V, Rexha, J, Perta, N, Barocci, S, Costabile, B, Colasurdo, G, Caucci, S, Mencarelli, D, Turchetti, C, Farina, M, Pierantoni, L, La Teana, A, Al Hadi, R, Cicconardi, F, Chinappi, M, Trucchi, E, Mancia, F, Menzo, S, Morozzo Della Rocca, B, D'Annessa, I, Di Marino, D, Romagnoli, Alice, D'Agostino, Mattia, Pavoni, Eleonora, Ardiccioni, Chiara, Motta, Stefano, Crippa, Paolo, Biagetti, Giorgio, Notarstefano, Valentina, Rexha, Jesmina, Perta, Nunzio, Barocci, Simone, Costabile, Brianna K, Colasurdo, Gabriele, Caucci, Sara, Mencarelli, Davide, Turchetti, Claudio, Farina, Marco, Pierantoni, Luca, La Teana, Anna, Al Hadi, Richard, Cicconardi, Francesco, Chinappi, Mauro, Trucchi, Emiliano, Mancia, Filippo, Menzo, Stefano, Morozzo Della Rocca, Blasco, D'Annessa, Ilda, and Di Marino, Daniele
Abstract: Reliable point-of-care (POC) rapid tests are crucial to detect infection and contain the spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The emergence of several variants of concern (VOC) can reduce binding affinity to diagnostic antibodies, limiting the efficacy of the currently adopted tests, while showing unaltered or increased affinity for the host receptor, angiotensin converting enzyme 2 (ACE2). We present a graphene field-effect transistor (gFET) biosensor design, which exploits the Spike-ACE2 interaction, the crucial step for SARS-CoV-2 infection. Extensive computational analyses show that a chimeric ACE2-Fragment crystallizable (ACE2-Fc) construct mimics the native receptor dimeric conformation. ACE2-Fc functionalized gFET allows in vitro detection of the trimeric Spike protein, outperforming functionalization with a diagnostic antibody or with the soluble ACE2 portion, resulting in a sensitivity of 20 pg/mL. Our miniaturized POC biosensor successfully detects B.1.610 (pre-VOC), Alpha, Beta, Gamma, Delta, Omicron (i.e., BA.1, BA.2, BA.4, BA.5, BA.2.75 and BQ.1) variants in isolated viruses and patient's clinical nasopharyngeal swabs. The biosensor reached a Limit Of Detection (LOD) of 65 cps/mL in swab specimens of Omicron BA.5. Our approach paves the way for a new and reusable class of highly sensitive, rapid and variant-robust SARS-CoV-2 detection systems.
Published: 2023

5. Effect of affective temperament on illness characteristics of subjects with bipolar disorder and major depressive disorder

Author: Simonetti, Alessio, Luciano, Rita Paola Maria, Sampogna, G., Della Rocca, B., Mancuso, Enrico Maria, De Fazio, P., Di Nicola, Marco, Di Lorenzo, G., Pepe, Maria, Sambataro, F., Signorelli, M. S., Koukopoulos, A. E., Chiaie, R. D., Fiorillo, A., Sani, Gabriele, Simonetti A., Luciano M. (ORCID:0000-0003-4358-0757), Mancuso E. (ORCID:0000-0002-8519-4945), Di Nicola M. (ORCID:0000-0001-7457-0426), Pepe M., Sani G. (ORCID:0000-0002-9767-8752), Simonetti, Alessio, Luciano, Rita Paola Maria, Sampogna, G., Della Rocca, B., Mancuso, Enrico Maria, De Fazio, P., Di Nicola, Marco, Di Lorenzo, G., Pepe, Maria, Sambataro, F., Signorelli, M. S., Koukopoulos, A. E., Chiaie, R. D., Fiorillo, A., Sani, Gabriele, Simonetti A., Luciano M. (ORCID:0000-0003-4358-0757), Mancuso E. (ORCID:0000-0002-8519-4945), Di Nicola M. (ORCID:0000-0001-7457-0426), Pepe M., and Sani G. (ORCID:0000-0002-9767-8752)
Abstract: Background: Affective temperaments represent the stable, biologically determined substrates of mood disorders. The relationship between affective temperaments and bipolar disorder (BD) or major depressive disorder (MDD) has been described. However, the strength of such relationship should be tested while considering other factors influencing the diagnosis of BD/MDD. Literature also lacks a comprehensive description of the interplay between affective temperament and characteristics of mood disorders. The aim of the present study is to address these issues. Methods: This is a multicentric observational study including 7 Italian university sites. Five-hundred-fifty-five euthymic subjects with BD/MDD were enrolled and further divided in those with hyperthymic (Hyper, N = 143), cyclothymic (Cyclo, N = 133), irritable (Irr, N = 49), dysthymic (Dysth, N = 155), and anxious (Anx N = 76) temperaments. Linear, binary, ordinal and logistic regressions were performed to assess the association between affective temperaments and i) diagnosis of BD/MDD; ii) characteristics of illness severity and course. Results: Hyper, Cyclo and Irr were more likely to be associated with BD, together with earlier age of onset and presence of a first-degree relative with BD. Anx and Dysth were more associated with MDD. Differences in association between affective temperaments and characteristics of BD/MDD were observed for hospital admissions, phase-related psychotic symptoms, length and type of depression, comorbidity and pharmacological intake. Limitations: Small sample size, cross-sectional design, recall biases. Conclusion: Specific affective temperaments were associated to certain characteristics of illness severity and course of BD or MDD. Evaluation of affective temperaments might help a deeper understanding of mood disorders.
Published: 2023

6. Qualitative and quantitative modifications of von Willebrand factor in patients with essential thrombocythemia and controlled platelet count

Author: Lancellotti, S., Dragani, A., Ranalli, P., Petrucci, G., Basso, M., Tartaglione, R., Rocca, B., and De Cristofaro, R.
Published: 2015
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7. Effect of low-dose rivaroxaban with low-dose aspirin vs low-dose aspirin on platelet and oxidative biomarkers: a randomized study in diabetes patients with stable peripheral or coronary artery disease

Author: Petrucci, G, primary, Viti, L, additional, Sacco, M, additional, Hatem, D, additional, Lancellotti, S, additional, Rizzi, A, additional, Zaccardi, F, additional, De Cristofaro, R, additional, Pitocco, D, additional, Patrono, C, additional, and Rocca, B, additional
Published: 2022
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8. From the Choice of a Regimen to the Choice of an Intensity: Changing Perspective in the Antithrombotic Therapy of Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention

Author: Rubboli, A., Barbaresi, E., Rocca, B., Rocca B. (ORCID:0000-0001-8304-6423), Rubboli, A., Barbaresi, E., Rocca, B., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: NA
Published: 2020

9. The recovery of platelet cyclooxygenase activity explains interindividual variability in responsiveness to low‐dose aspirin in patients with and without diabetes

Author: ROCCA, B., SANTILLI, F., PITOCCO, D., MUCCI, L., PETRUCCI, G., VITACOLONNA, E., LATTANZIO, S., MATTOSCIO, D., ZACCARDI, F., LIANI, R., VAZZANA, N., DEL PONTE, A., FERRANTE, E., MARTINI, F., CARDILLO, C., MOROSETTI, R., MIRABELLA, M., GHIRLANDA, G., DAVÌ, G., and PATRONO, C.
Published: 2012
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10. Obesity is associated with impaired responsiveness to once-daily low-dose aspirin and in vivo platelet activation

Author: Petrucci, G, Zaccardi, F, Giaretta, A, Cavalca, V, Capristo, E, Cardillo, C, Pitocco, D, Porro, B, Schinzari, F, Toffolo, G, Tremoli, E, Rocca, B, Petrucci G (ORCID:0000-0002-9280-3673), Capristo E (ORCID:0000-0002-5753-3495), Pitocco D (ORCID:0000-0002-6220-686X), Schinzari F, Tremoli E, Rocca B (ORCID:0000-0001-8304-6423), Petrucci, G, Zaccardi, F, Giaretta, A, Cavalca, V, Capristo, E, Cardillo, C, Pitocco, D, Porro, B, Schinzari, F, Toffolo, G, Tremoli, E, Rocca, B, Petrucci G (ORCID:0000-0002-9280-3673), Capristo E (ORCID:0000-0002-5753-3495), Pitocco D (ORCID:0000-0002-6220-686X), Schinzari F, Tremoli E, and Rocca B (ORCID:0000-0001-8304-6423)
Abstract: Background: The prevalence and degree of obesity is rising worldwide, increases cardiovascular risk, modifies body composition and organ function, and potentially affects the pharmacokinetics and/or pharmacodynamics of drugs. Objectives: To investigate the pharmacodynamics of once-daily low-dose aspirin in healthy obese subjects, and to assess whether body weight (BW) and body mass index (BMI) affect the pharmacology of aspirin. Patients/methods: Otherwise healthy, obese (BMI > 30 kg/m2 ) subjects were studied before and after 3-4 weeks of 100-mg once-daily aspirin intake. Aspirin pharmacodynamics were assessed according to serum thromboxane (TX) B2 levels measured at 4 hours, 24 hours (i.e., posologic interval) and 48 hours after the last witnessed intake; age-matched and sex-matched non-obese controls were included. A previously calibrated pharmacokinetic/pharmacodynamic in silico model of aspirin was used to fit serum TXB2 data from obese subjects. At baseline, the major urinary TXA2 and prostacyclin metabolites, urinary isoprostane and plasma inflammatory biomarkers were measured. Results: In 16 obese subjects (aged 47 ± 11 years; BMI of 39.4 ± 5.1 kg/m2 ), residual serum TXB2 values between 4 and 48 hours after aspirin intake were increased 3- to 5-fold as compared with controls. At 24 hours, the residual serum TXB2 level was log-linearly associated with body size over a wide range of BMI and BW values, without any apparent threshold. The in silico model predicted that reduced aspirin bioavailability would be inversely related to body size and rescued by 200 mg of aspirin once daily or 85 mg twice daily. Baseline urinary TXA2 metabolite, isoprostane and plasma C-reactive protein levels were significantly increased in obese subjects. Conclusions: Obesity is associated with impaired aspirin responsiveness, largely because of body size. Impaired inhibition of platelet activation by conventional low-dose aspirin may affect antithrombotic efficacy.
Published: 2019

11. Antithrombotic therapy in diabetes: which, when, and for how long?

Author: Ajjan, R.A., Kietsiriroje, N., Badimon, L., Vilahur, G., Gorog, D.A., Angiolillo, D.J., Russell, D.A., Rocca, B., and Storey, R.F.
Abstract: Cardiovascular disease remains the main cause of mortality in individuals with diabetes mellitus (DM) and also results in significant morbidity. Premature and more aggressive atherosclerotic disease, coupled with an enhanced thrombotic environment, contributes to the high vascular risk in individuals with DM. This prothrombotic milieu is due to increased platelet activity together with impaired fibrinolysis secondary to quantitative and qualitative changes in coagulation factors. However, management strategies to reduce thrombosis risk remain largely similar in individuals with and without DM. The current review covers the latest in the field of antithrombotic management in DM. The role of primary vascular prevention is discussed together with options for secondary prevention following an ischaemic event in different clinical scenarios including coronary, cerebrovascular, and peripheral artery diseases. Antiplatelet therapy combinations as well as combination of antiplatelet and anticoagulant agents are examined in both the acute phase and long term, including management of individuals with sinus rhythm and those with atrial fibrillation. The difficulties in tailoring therapy according to the variable atherothrombotic risk in different individuals are emphasized, in addition to the varying risk within an individual secondary to DM duration, presence of complications and predisposition to bleeding events. This review provides the reader with an up-to-date guide for antithrombotic management of individuals with DM and highlights gaps in knowledge that represent areas for future research, aiming to improve clinical outcome in this high-risk population.
Published: 2021

12. Qualitative and quantitative modifications of von Willebrand factor in essential thrombocythemia: the role of platelets and non-ADAMTS13-dependent proteolytic processing: OR202

Author: Lancellotti, S, Dragani, A, Ranalli, P, Petrucci, G, Basso, M, Tartaglione, R, Rocca, B, and De Cristofaro, R
Published: 2015

13. Aspirin, 110 years later

Author: PATRONO, C. and ROCCA, B.
Published: 2009
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14. Prevention Italy 2021 - An update of the 2018 Consensus document and recommendations for the prevention of cardiovascular disease in Italy

Author: Battistoni, A., Gallo, G., Aragona, C. O., Barchiesi, F., Basolo, A., Bellone, S., Bellotti, P., Bertolotti, M., Bianco, A., Biffi, A., Borghi, C., Cicero, A. F. G., Consoli, A., Corsini, A., Desideri, G., Di Giacinto, B., Fernando, F., Ferri, C., Galiuto, L., Grassi, D., Grassi, G., Icardi, G., Indolfi, C., Lodi, E., Modena, M. G., Muiesan, M. L., Nati, G., Orsi, A., Palermi, S., Parati, G., Passantino, A., Patelli, A., Pelliccia, A., Pengo, M., Filardi, P. P., Perseghin, G., Pirro, M., Pontremoli, R., Rengo, G., Ricotti, R., Rizzoni, D., Rocca, B., Rotella, C., Rubattu, S., Salvetti, G., Sciacqua, A., Serdoz, A., Sirico, F., Squeo, M. R., Tocci, G., Trimarco, B., Vigili de Kreutzenberg, S., Volpe, R., and Volpe, M.
Subjects: Consensus, Italy, Humans, Risk Assessment, Risk Factors, Cardiovascular Diseases
Published: 2021

15. The key contribution of platelet and vascular arachidonic acid metabolism to the pathophysiology of atherothrombosis

Author: Badimon, L, Vilahur, G, Rocca, B, and Patrono, C
Subjects: Platelets, Arachidonic acid, Aspirin, Eicosanoids, lipids (amino acids, peptides, and proteins), Thrombosis, Non-steroidal anti-inflammatory drugs, Haemostasis
Abstract: Arachidonic acid is one of the most abundant and ubiquitous omega-6 polyunsaturated fatty acid, present in esterified form in the membrane phospholipids of all mammalian cells and released from phospholipids by several phospholipases in response to various activating or inhibitory stimuli. Arachidonic acid is the precursor of a large number of enzymatically and non-enzymatically derived, biologically active autacoids, including prostaglandins (PGs), thromboxane (TX) A(2), leukotrienes, and epoxyeicosatetraenoic acids (collectively called eicosanoids), endocannabinoids and isoprostanes, respectively. Eicosanoids are local modulators of the physiological functions and pathophysiological rotes of blood vessels and platelets. For example, the importance of cyctooxygenase (COX)-1-derived TXA(2) from activated platelets in contributing to primary haemostasis and atherothrombosis is demonstrated in animal and human models by the bleeding complications and cardioprotective effects associated with low-dose aspirin, a selective inhibitor of platelet COX-1. The relevance of vascular COX-2-derived prostacyclin (PGI(2)) in endothelial thromboresistance and atheroprotection is clearly shown by animal and human models and by the adverse cardiovascular effects exerted by COX-2 inhibitors in humans. A vast array of arachidonic acid-transforming enzymes, downstream synthases and isomerases, transmembrane receptors, and specificity in their tissue expression make arachidonic acid metabolism a fine-tuning system of vascular health and disease. Its pharmacological regulation is central in human cardiovascular diseases, as demonstrated by biochemical measurements and intervention trials.
Published: 2021

16. Aspirin at 120: Retiring, recombining, or repurposing?

Author: Patrono, Carlo, Rocca, Bianca, Patrono C., Rocca B. (ORCID:0000-0001-8304-6423), Patrono, Carlo, Rocca, Bianca, Patrono C., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: During the past 20 years, we have witnessed the following trends in aspirin usage: (i) a “dropping” trend, characterized by the early discontinuation of low-dose aspirin from dual antiplatelet therapy or triple antithrombotic therapy (oral anticoagulation plus dual antiplatelet therapy in patients with atrial fibrillation) following an acute coronary syndrome or after percutaneous coronary intervention; (ii) a “combinatorial” trend, featuring the addition of a lower dose of a P2Y12 inhibitor or direct oral anticoagulant drug to low-dose aspirin for the long-term treatment of stable patients with atherosclerotic cardiovascular disease; and (iii) a “repurposing” trend, characterized by growing interest in the oncologic community to assess the chemopreventive effect of aspirin against certain types of cancers (particularly of the gastrointestinal tract), both as primary prevention and adjuvant therapy. The aim of this review is to present the mechanistic rationale underlying these trends, discuss the design and findings of trials testing novel treatments or new therapeutic applications of aspirin, and report on the ISTH Congress results on this topic.
Published: 2021

17. How lower doses of direct oral anticoagulants are interpreted in clinical practice: a national survey of the Italian Atherosclerosis, Thrombosis and Vascular Biology (ATVB) Study Group

Author: Rubboli, A., Fresco, C., Paciaroni, M., Rocca, Bianca, Pecora, D., Enea, I., Cuccia, C., Patti, G., Rocca B. (ORCID:0000-0001-8304-6423), Rubboli, A., Fresco, C., Paciaroni, M., Rocca, Bianca, Pecora, D., Enea, I., Cuccia, C., Patti, G., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: AIM: To evaluate the current interpretation of the lower doses of direct oral anticoagulants (DOAC) dabigatran, apixaban, edoxaban and rivaroxaban in nonvalvular atrial fibrillation. METHODS: A questionnaire of 14 statements to which the possible answers were fully agree/partially agree/partially disagree/fully disagree or yes/no was prepared within the board of the Italian Atherosclerosis, Thrombosis and Vascular Biology Study Group and forwarded to individual Italian physicians. RESULTS: A total of 620 complete questionnaires were received from nearly all the Italian regions and physicians of various medical specialists, either enabled or not for the prescription of DOAC. A wide agreement was found as regards the pharmacological, as well as clinical consequences of the administration of the lower dose of factor-Xa inhibitors both in patients with and without clinical and/or laboratory criteria requiring dose reduction. Wide agreement was also found as regards the presence of moderate kidney insufficiency in selecting the dose of DOAC. Instead, more debated were issues regarding the proportionality between dabigatran dose and plasma concentration and selection of dabigatran dose, as well as the role of measuring drug plasma concentration and/or determine the anticoagulant activity of factor-Xa inhibitors when used at the lower dose. CONCLUSION: The interpretation of the lower doses of DOAC in current Italian clinical practice appears largely correct and shared. Because of the persistence of some residual uncertainties, essentially regarding dabigatran, however, continuous educational effort still appears warranted.
Published: 2021

18. Prevention Italy 2021 - An update of the 2018 Consensus document and recommendations for the prevention of cardiovascular disease in Italy [Prevenzione Italia 2021 Un update del Documento di consenso e raccomandazioni per la prevenzione cardiovascolare in Italia]

Author: Battistoni, A, Gallo, G, Aragona, C, Barchiesi, F, Basolo, A, Bellone, S, Bellotti, P, Bertolotti, M, Bianco, A, Biffi, A, Borghi, C, Cicero, A, Consoli, A, Corsini, A, Desideri, G, Di Giacinto, B, Fernando, F, Ferri, C, Galiuto, L, Grassi, D, Grassi, G, Icardi, G, Indolfi, C, Lodi, E, Modena, M, Muiesan, M, Nati, G, Orsi, A, Palermi, S, Parati, G, Passantino, A, Patelli, A, Pelliccia, A, Pengo, M, Filardi, P, Perseghin, G, Pirro, M, Pontremoli, R, Rengo, G, Ricotti, R, Rizzoni, D, Rocca, B, Rotella, C, Rubattu, S, Salvetti, G, Sciacqua, A, Serdoz, A, Sirico, F, Squeo, M, Tocci, G, Trimarco, B, Vigili de Kreutzenberg, S, Volpe, R, Volpe, M, Battistoni, Allegra, Gallo, Giovanna, Aragona, Caterina Oriana, Barchiesi, Fabio, Basolo, Alessio, Bellone, Simonetta, Bellotti, Paolo, Bertolotti, Marco, Bianco, Andrea, Biffi, Alessandro, Borghi, Claudio, Cicero, Arrigo Francesco Giuseppe, Consoli, Agostino, Corsini, Alberto, Desideri, Giovambattista, Di Giacinto, Barbara, Fernando, Fredrik, Ferri, Claudio, Galiuto, Leonarda, Grassi, Davide, Grassi, Guido, Icardi, Giancarlo, Indolfi, Ciro, Lodi, Elisa, Modena, Maria Grazia, Muiesan, Maria Lorenza, Nati, Giulio, Orsi, Andrea, Palermi, Stefano, Parati, Gianfranco, Passantino, Andrea, Patelli, Alessandra, Pelliccia, Antonio, Pengo, Martino, Filardi, Pasquale Perrone, Perseghin, Gianluca, Pirro, Matteo, Pontremoli, Roberto, Rengo, Giuseppe, Ricotti, Roberta, Rizzoni, Damiano, Rocca, Bianca, Rotella, Carlo, Rubattu, Speranza, Salvetti, Guido, Sciacqua, Angela, Serdoz, Andrea, Sirico, Felice, Squeo, Maria Rosaria, Tocci, Giuliano, Trimarco, Bruno, Vigili de Kreutzenberg, Saula, Volpe, Roberto, Volpe, Massimo, Battistoni, A, Gallo, G, Aragona, C, Barchiesi, F, Basolo, A, Bellone, S, Bellotti, P, Bertolotti, M, Bianco, A, Biffi, A, Borghi, C, Cicero, A, Consoli, A, Corsini, A, Desideri, G, Di Giacinto, B, Fernando, F, Ferri, C, Galiuto, L, Grassi, D, Grassi, G, Icardi, G, Indolfi, C, Lodi, E, Modena, M, Muiesan, M, Nati, G, Orsi, A, Palermi, S, Parati, G, Passantino, A, Patelli, A, Pelliccia, A, Pengo, M, Filardi, P, Perseghin, G, Pirro, M, Pontremoli, R, Rengo, G, Ricotti, R, Rizzoni, D, Rocca, B, Rotella, C, Rubattu, S, Salvetti, G, Sciacqua, A, Serdoz, A, Sirico, F, Squeo, M, Tocci, G, Trimarco, B, Vigili de Kreutzenberg, S, Volpe, R, Volpe, M, Battistoni, Allegra, Gallo, Giovanna, Aragona, Caterina Oriana, Barchiesi, Fabio, Basolo, Alessio, Bellone, Simonetta, Bellotti, Paolo, Bertolotti, Marco, Bianco, Andrea, Biffi, Alessandro, Borghi, Claudio, Cicero, Arrigo Francesco Giuseppe, Consoli, Agostino, Corsini, Alberto, Desideri, Giovambattista, Di Giacinto, Barbara, Fernando, Fredrik, Ferri, Claudio, Galiuto, Leonarda, Grassi, Davide, Grassi, Guido, Icardi, Giancarlo, Indolfi, Ciro, Lodi, Elisa, Modena, Maria Grazia, Muiesan, Maria Lorenza, Nati, Giulio, Orsi, Andrea, Palermi, Stefano, Parati, Gianfranco, Passantino, Andrea, Patelli, Alessandra, Pelliccia, Antonio, Pengo, Martino, Filardi, Pasquale Perrone, Perseghin, Gianluca, Pirro, Matteo, Pontremoli, Roberto, Rengo, Giuseppe, Ricotti, Roberta, Rizzoni, Damiano, Rocca, Bianca, Rotella, Carlo, Rubattu, Speranza, Salvetti, Guido, Sciacqua, Angela, Serdoz, Andrea, Sirico, Felice, Squeo, Maria Rosaria, Tocci, Giuliano, Trimarco, Bruno, Vigili de Kreutzenberg, Saula, Volpe, Roberto, and Volpe, Massimo
Published: 2021

19. Prevention of stroke in patients with chronic coronary syndromes or peripheral arterial disease

Author: Parker, W. A. E., Gorog, D. A., Geisler, T., Vilahur, G., Sibbing, D., Rocca, Bianca, Storey, R. F., Rocca B. (ORCID:0000-0001-8304-6423), Parker, W. A. E., Gorog, D. A., Geisler, T., Vilahur, G., Sibbing, D., Rocca, Bianca, Storey, R. F., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: Stroke is a common and devastating condition caused by atherothrombosis, thromboembolism, or haemorrhage. Patients with chronic coronary syndromes (CCS) or peripheral artery disease (PAD) are at increased risk of stroke because of shared pathophysiological mechanisms and risk-factor profiles. A range of pharmacological and non-pharmacological strategies can help to reduce stroke risk in these groups. Antithrombotic therapy reduces the risk of major adverse cardiovascular events, including ischaemic stroke, but increases the incidence of haemorrhagic stroke. Nevertheless, the net clinical benefits mean antithrombotic therapy is recommended in those with CCS or symptomatic PAD. Whilst single antiplatelet therapy is recommended as chronic treatment, dual antiplatelet therapy should be considered for those with CCS with prior myocardial infarction at high ischaemic but low bleeding risk. Similarly, dual antithrombotic therapy with aspirin and very-low-dose rivaroxaban is an alternative in CCS, as well as in symptomatic PAD. Full-dose anticoagulation should always be considered in those with CCS/PAD and atrial fibrillation. Unless ischaemic risk is particularly high, antiplatelet therapy should not generally be added to full-dose anticoagulation. Optimization of blood pressure, low-density lipoprotein levels, glycaemic control, and lifestyle characteristics may also reduce stroke risk. Overall, a multifaceted approach is essential to best prevent stroke in patients with CCS/PAD.
Published: 2021

20. Physical activity and treatment adherence in patients with mental disorders: a randomized controlled trial.

Author: Silvestro, R., Dello Stritto, V., Catapano, P., Di Vincenzo, M., Della Rocca, B., Lapadula, M. V., Toni, C., Bello, R., Luciano, M., Sampogna, G., and Fiorillo, A.
Subjects: PATIENT compliance, PHYSICAL activity, RANDOMIZED controlled trials, QUALITY of life, FUNCTIONAL status
Abstract: Introduction: Lack of adherence to pharmacological treatment is considered a multifactorial phenomenon, remarkably frequent in clinical practice. Non-adherence is associated with increased number of relapses, poor clinical and functional outcomes, and worsening of patient health status, with a resulting increase in healthcare costs, particularly in people with severe mental disorders (SMD). Treatment adherence rates remain extremely low, highlighting the need to develop innovative and integrated strategies; one of these is represented by the promotion of healthy lifestyle behaviours, including regular physical activity. Objectives: The aim of this study is to assess how the rates of treatment adherence vary in patients with SMD after receiving a psychosocial intervention, focusing on the positive relationship between treatment adherence and physical activity. Methods: LIFESTYLE is a randomized controlled trial comparing the efficacy of a structured psychosocial lifestyle intervention involving moderate physical activity exercises over a brief psychoeducational intervention. Levels of physical activity was assessed thorough the IPAQ scale, while treatment adherence was evaluated by the Morisky Medication Adherence Scale (MMAS). Results: The sample includes 401 patients, with a mean duration of illness was 16.3 (±17.8) years. All patients were receiving a pharmacological drug treatment; in particular, 59.6% (N=239) were treated with a second-generation antipsychotic and 54.9% (N=220) with a mood stabilizer. Our results show that moderate physical activity improves rates of treatment adherence. After 6 months, adherence to treatment increased from 35.8% at baseline to 47.6% at baseline in the experimental group, along with improvement in clinical health parameters (reduction in BMI, weight, and metabolic parameters). Another significant inverse correlation was found between adherence and quality of life (Rho di Person: -.140, p<.005). Furthermore, this study indicates that having a diagnosis of major depression, a better cognitive functioning, a shorter duration of illness and contact time with the local mental health centre are factors that positively influence treatment adherence. Remarkably, treatment adherence was not influenced by symptom severity and type of pharmacological treatment. Conclusions: Moderate physical activity can represent a valid strategy to increase treatment adherence in patients with SMD. Therefore, promoting physical activity exercises in our clinical practice may be associated with better outcomes. However, further studies that evaluate patients with acute mental disorders are needed. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]
Published: 2024
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21. The improvement of mental and physical health of people with severe mental disorder: one-year efficacy of a lifestyle experimental intervention.

Author: Carbone, M., Mario, L., Di Vincenzo, M., Della Rocca, B., Toni, C., Cipolla, S., Martinelli, F., Sampogna, G., and Fiorillo, A.
Subjects: PSYCHOPHARMACOLOGY, MENTAL illness, PSYCHOSES, CONTROL (Psychology), MENTAL depression
Abstract: Introduction: Patients with severe mental disorders have a significantly reduced life expectancy than the general population, often resulting from the increased prevalence of cardiovascular and metabolic diseases. Reasons include unhealthy lifestyle behaviours, reduced access to screening programs and adverse effects of many psychotropic drugs. Objectives: Our goal is to assess the efficacy of a psychosocial group intervention promoting healthy lifestyle behaviors compared to a brief psychoeducational group intervention in terms of improvement of severity of psychiatric symptoms and perceived quality of life, and a series of anthropometric and hematological parameters. Methods: This is a multicenter randomized controlled trial. Patients between 18 and 35 years of age with a diagnosis of schizophrenia and other primary psychotic disorders, unipolar depression and bipolar disorder were recruited. Exclusion criteria were inability to perform moderate physical activity, pregnancy and breastfeeding and impaired cognitive functions. Results: 401 patients were recruited and randomly assigned to receive the experimental intervention (LIFESTYLE) or a behavioural control intervention. About 57% of the sample were female, with a mean age of 45.8±11.8, and BMI of 32.5±5.5. All of them were receiving almost one psychotropic drug. At one year, we observed a reduction in HOMA-IR index (from 4.3 ± 5.5 to 3.1 ± 2.9, p<0.01) and triglycerides (from 162.5 ± 78.1 mg/dL to 131.4 ± 76.0 mg/dL, p<0.001), as well as an increase in HDL (from 46.2± 14.6 mg/dL to 50.9±26.7 mg/dL, p<0.05). Moreover, a reduction in the values of BPRS "Affectivity" (from 8.7±3.0 to 7.2±2.5, p<0.001), "Activity" (from 4.7±1.9 to 4.2±1.3, p<0.01) and "Negative Symptoms" subscale (from 7.7±3.1 to 7.0±2.7, p<0.001) was also observed, along with an improvement in perceived quality of life (MANSA total score from 4.0 ± 1.0 to 5.3 ± 0.8, p<0.01). Conclusions: The results support the evidence that the LIFESTYLE intervention has long-lasting positive effects on physical and mental health of people with mental disorders. More efforts need to be done in order to increase the availability of these treatments in routine clinical settings. Disclosure of Interest: None Declared [ABSTRACT FROM AUTHOR]
Published: 2024
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22. Somatization and traumatic events in asylum seekers and refugees resettled in Italy

Author: Tarsitani, L., Todini, L., Roselli, V., Serra, R., Magliocchetti, V., D'Amore, D., della Rocca, B., Pasquini, M., Massetti, P., and Biondi, M.
Subjects: Traumatic events, Perceived social support, Somatization, Forced migration, Stress
Published: 2020

23. Highlights from the 2019 International Aspirin Foundation Scientific Conference, Rome, 28 June 2019: Benefits and risks of antithrombotic therapy for cardiovascular disease prevention

Author: Walker, J., Cattaneo, M., Badimon, L., Agnelli, G., Chan, A.T., Lanas, A., Rocca, B., Rothwell, P., Patrignani, P., Langley, R., Vilahur, G., and Cosentino, F.
Subjects: Cancer Research, Settore BIO/14 - FARMACOLOGIA, aspirin, cardiovascular disease (CVD), benefit, precision medicine, anticoagulant, primary prevention, Conference Report, antithrombotic, antiplatelet, colorectal cancer (CRC), optimizing aspirin dose, secondary prevention, risk, upper gastrointestinal (GI) bleeding, gastroprotectant agents, targeting, diabetes mellitus (DM), Oncology
Abstract: At the 2019 International Aspirin Foundation Scientific Conference ‘Benefits and Risks of Antithrombotic Therapy for Cardiovascular Disease Prevention', held in Rome, Italy, international experts sought to discuss and debate the optimal antithrombotic strategy for the secondary prevention of cardiovascular disease (CVD) and to seek agreement around dosing and target populations for aspirin use in primary disease prevention. Getting the best evidence to support real-life decisions in the clinic can be complex, and individualising management in order to balance both the risks and benefits of different disease prevention strategies appears to be the best approach. It is hoped that future decision-making tools and biomarkers will help direct treatments at those most likely to benefit.
Published: 2020

24. In vivo thromboxane-dependent platelet activation is persistently enhanced in subjects with impaired glucose tolerance

Author: Santilli, F, Zaccardi, F, Liani, R, Petrucci, Giovanna, Simeone, P, Pitocco, Dario, Tripaldi, R, Rizzi, A, Formoso, G, Pontecorvi, Alfredo, Angelucci, E, Pagliaccia, F, Golato, M, De Leva, Francesca, Vitacolonna, E, Rocca, Bianca, Consoli, A, Patrono, Carlo, Petrucci G (ORCID:0000-0002-9280-3673), Pitocco D (ORCID:0000-0002-6220-686X), Pontecorvi A (ORCID:0000-0003-0570-6865), De Leva F, Rocca B (ORCID:0000-0001-8304-6423), Patrono C, Santilli, F, Zaccardi, F, Liani, R, Petrucci, Giovanna, Simeone, P, Pitocco, Dario, Tripaldi, R, Rizzi, A, Formoso, G, Pontecorvi, Alfredo, Angelucci, E, Pagliaccia, F, Golato, M, De Leva, Francesca, Vitacolonna, E, Rocca, Bianca, Consoli, A, Patrono, Carlo, Petrucci G (ORCID:0000-0002-9280-3673), Pitocco D (ORCID:0000-0002-6220-686X), Pontecorvi A (ORCID:0000-0003-0570-6865), De Leva F, Rocca B (ORCID:0000-0001-8304-6423), and Patrono C
Abstract: Background: Impaired glucose tolerance (IGT) is associated with increased cardiovascular morbidity and mortality. Enhanced thromboxane (TX)-dependent platelet activation plays a pivotal role in atherothrombosis and characterizes type 2 diabetes mellitus (DM). Whether this also pertains to IGT is currently unknown. We investigated whether TXA2 -dependent platelet activation, as reflected by 11-dehydro-TXB2 (TXM) urinary excretion, is comparably abnormal in IGT as in DM, is persistent over long-term follow-up, changes as a function of metabolic disease progression, and is influenced by food intake. Methods: We prospectively investigated subjects with IGT (n = 48) and two control groups with DM diagnosed either less than 12 months (n = 60) or 12 months or more (n = 58). Results: Baseline TXM excretion was comparable between subjects with IGT and DM, with no evidence of a circadian variation. During a 36-month follow-up, urinary TXM excretion was stable over time in the DM groups, while tended to increase in subjects with IGT. Increasing urinary TXM excretion over time was observed in the subjects who progressed to diabetes vs nonprogressors. Conclusions: We conclude that TXA2 -dependent platelet activation was at least as high in IGT as in patients with DM and further increased over time, especially in those who progressed to overt diabetes.
Published: 2020

25. Effect of low-dose and standard-dose aspirin on PGE2 biosynthesis among individuals with colorectal adenomas: A randomized clinical trial

Author: Drew, D. A., Schuck, M. M., Magicheva-Gupta, M. V., Stewart, K. O., Gilpin, K. K., Miller, P., Parziale, M. P., Pond, E. N., Takacsi-Nagy, O., Zerjav, D. C., Chin, S. M., Krems, J. M., Meixell, D., Joshi, A. D., Ma, W., Colizzo, F. P., Carolan, P. J., Nishioka, N. S., Staller, K., Richter, J. M., Khalili, H., Gala, M. K., Garber, J. J., Chung, D. C., Yarze, J. C., Zukerberg, L., Petrucci, Giovanna, Rocca, Bianca, Patrono, Carlo, Milne, G. L., Wang, M., Chan, A. T., Petrucci G. (ORCID:0000-0002-9280-3673), Rocca B. (ORCID:0000-0001-8304-6423), Patrono C., Drew, D. A., Schuck, M. M., Magicheva-Gupta, M. V., Stewart, K. O., Gilpin, K. K., Miller, P., Parziale, M. P., Pond, E. N., Takacsi-Nagy, O., Zerjav, D. C., Chin, S. M., Krems, J. M., Meixell, D., Joshi, A. D., Ma, W., Colizzo, F. P., Carolan, P. J., Nishioka, N. S., Staller, K., Richter, J. M., Khalili, H., Gala, M. K., Garber, J. J., Chung, D. C., Yarze, J. C., Zukerberg, L., Petrucci, Giovanna, Rocca, Bianca, Patrono, Carlo, Milne, G. L., Wang, M., Chan, A. T., Petrucci G. (ORCID:0000-0002-9280-3673), Rocca B. (ORCID:0000-0001-8304-6423), and Patrono C.
Abstract: Low-dose aspirin is recommended by the U.S. Preventive Services Task Force for primary prevention of colorectal cancer in certain individuals. However, broader implementation will require improved precision prevention approaches to identify those most likely to benefit. The major urinary metabolite of PGE2, 11a-hydroxy-9,15-dioxo-2,3,4,5-tetranor-prostane-1,20-dioic acid (PGE-M), is a biomarker for colorectal cancer risk, but it is unknown whether PGE-M is modifiable by aspirin in individuals at risk for colorectal cancer. Adults (N 1⁄4 180) who recently underwent adenoma resection and did not regularly use aspirin or NSAIDs were recruited to a double-blind, placebo-controlled, randomized trial of aspirin at 81 or 325 mg/day for 8–12 weeks. The primary outcome was postintervention change in urinary PGE-M as measured by LC/MS. A total of 169 participants provided paired urine samples for analysis. Baseline PGE-M excretion was 15.9 = 14.6 (mean = S.D, ng/mg creatinine). Aspirin significantly reduced PGE-M excretion (=4.7 = 14.8) compared with no decrease (0.8 = 11.8) in the placebo group (P 1⁄4 0.015; mean duration of treatment 1⁄4 68.9 days). Aspirin significantly reduced PGE-M levels in participants receiving either 81 (-15%; P 1⁄4 0.018) or 325 mg/day (-28%; P < 0.0001) compared with placebo. In 40% and 50% of the individuals randomized to 81 or 325 mg/day aspirin, respectively, PGE-M reduction reached a threshold expected to prevent recurrence in 10% of individuals. These results support that aspirin significantly reduces elevated levels of PGE-M in those at increased colorectal cancer risk to levels consistent with lower risk for recurrent neoplasia and underscore the potential utility of PGE-M as a precision chemoprevention biomarker. The ASPIRED trial is registered as NCT02394769.
Published: 2020

26. In vivo thromboxane-dependent platelet activation is persistently enhanced in subjects with impaired glucose tolerance

Author: Santilli, F., Zaccardi, F., Liani, R., Petrucci, Giovanna, Simeone, P., Pitocco, Dario, Tripaldi, R., Rizzi, Alessandro, Formoso, G., Pontecorvi, Alfredo, Angelucci, E., Pagliaccia, F., Golato, M., De Leva, Francesca, Vitacolonna, E., Rocca, Bianca, Consoli, A., Patrono, Carlo, Petrucci G. (ORCID:0000-0002-9280-3673), Pitocco D. (ORCID:0000-0002-6220-686X), Rizzi A., Pontecorvi A. (ORCID:0000-0003-0570-6865), De Leva F., Rocca B. (ORCID:0000-0001-8304-6423), Patrono C., Santilli, F., Zaccardi, F., Liani, R., Petrucci, Giovanna, Simeone, P., Pitocco, Dario, Tripaldi, R., Rizzi, Alessandro, Formoso, G., Pontecorvi, Alfredo, Angelucci, E., Pagliaccia, F., Golato, M., De Leva, Francesca, Vitacolonna, E., Rocca, Bianca, Consoli, A., Patrono, Carlo, Petrucci G. (ORCID:0000-0002-9280-3673), Pitocco D. (ORCID:0000-0002-6220-686X), Rizzi A., Pontecorvi A. (ORCID:0000-0003-0570-6865), De Leva F., Rocca B. (ORCID:0000-0001-8304-6423), and Patrono C.
Abstract: Background: Impaired glucose tolerance (IGT) is associated with increased cardiovascular morbidity and mortality. Enhanced thromboxane (TX)-dependent platelet activation plays a pivotal role in atherothrombosis and characterizes type 2 diabetes mellitus (DM). Whether this also pertains to IGT is currently unknown. We investigated whether TXA2-dependent platelet activation, as reflected by 11-dehydro-TXB2 (TXM) urinary excretion, is comparably abnormal in IGT as in DM, is persistent over long-term follow-up, changes as a function of metabolic disease progression, and is influenced by food intake. Methods: We prospectively investigated subjects with IGT (n = 48) and two control groups with DM diagnosed either less than 12 months (n = 60) or 12 months or more (n = 58). Results: Baseline TXM excretion was comparable between subjects with IGT and DM, with no evidence of a circadian variation. During a 36-month follow-up, urinary TXM excretion was stable over time in the DM groups, while tended to increase in subjects with IGT. Increasing urinary TXM excretion over time was observed in the subjects who progressed to diabetes vs nonprogressors. Conclusions: We conclude that TXA2-dependent platelet activation was at least as high in IGT as in patients with DM and further increased over time, especially in those who progressed to overt diabetes.
Published: 2020

27. Highlights from the 2019 International Aspirin Foundation Scientific Conference, Rome, 28 June 2019: benefits and risks of antithrombotic therapy for cardiovascular disease prevention

Author: Walker, J, Cattaneo, M, Badimon, L, Agnelli, G, Chan, At, Lanas, A, Rocca, Bianca, Rothwell, P, Patrignani, P, Langley, R, Vilahur, G, Cosentino, F, Rocca, B (ORCID:0000-0001-8304-6423), Walker, J, Cattaneo, M, Badimon, L, Agnelli, G, Chan, At, Lanas, A, Rocca, Bianca, Rothwell, P, Patrignani, P, Langley, R, Vilahur, G, Cosentino, F, and Rocca, B (ORCID:0000-0001-8304-6423)
Abstract: At the 2019 International Aspirin Foundation Scientific Conference 'Benefits and Risks of Antithrombotic Therapy for Cardiovascular Disease Prevention', held in Rome, Italy, international experts sought to discuss and debate the optimal antithrombotic strategy for the secondary prevention of cardiovascular disease (CVD) and to seek agreement around dosing and target populations for aspirin use in primary disease prevention. Getting the best evidence to support real-life decisions in the clinic can be complex, and individualising management in order to balance both the risks and benefits of different disease prevention strategies appears to be the best approach. It is hoped that future decision-making tools and biomarkers will help direct treatments at those most likely to benefit.
Published: 2020

28. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD

Author: Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., Huikuri, H. V., Johansson, I., Juni, P., Lettino, M., Marx, N., Mellbin, L. G., Ostgren, C. J., Rocca, Bianca, Roffi, M., Sattar, N., Seferovic, P. M., Sousa-Uva, M., Valensi, P., Wheeler, D. C., Piepoli, M. F., Birkeland, K. I., Adamopoulos, S., Ajjan, R., Avogaro, A., Baigent, C., Brodmann, M., Bueno, H., Ceconi, C., Chioncel, O., Coats, A., Collet, J. -P., Collins, P., Cosyns, B., Di Mario, C., Fisher, M., Fitzsimons, D., Halvorsen, S., Hansen, D., Hoes, A., Holt, R. I. G., Home, P., Katus, H. A., Khunti, K., Komajda, M., Lambrinou, E., Landmesser, U., Lewis, B. S., Linde, C., Lorusso, R., Mach, F., Mueller, C., Neumann, F. -J., Persson, F., Petersen, S. E., Petronio, A. S., Richter, D. J., Rosano, G. M. C., Rossing, P., Ryden, L., Shlyakhto, E., Simpson, I. A., Touyz, R. M., Wijns, W., Wilhelm, M., Williams, B., Windecker, S., Dean, V., Gale, C. P., Hindricks, G., Iung, B., Leclercq, C., Merkely, B., Zelveian, P. H., Scherr, D., Jahangirov, T., Lazareva, I., Shivalkar, B., Naser, N., Gruev, I., Milicic, D., Petrou, P. M., Linhart, A., Hildebrandt, P., Hasan-Ali, H., Marandi, T., Lehto, S., Mansourati, J., Kurashvili, R., Siasos, G., Lengyel, C., Thrainsdottir, I. S., Aronson, D., Di Lenarda, A., Raissova, A., Ibrahimi, P., Abilova, S., Trusinskis, K., Saade, G., Benlamin, H., Petrulioniene, Z., Banu, C., Magri, C. J., David, L., Boskovic, A., Alami, M., Liem, A. H., Bosevski, M., Svingen, G. F. T., Janion, M., Gavina, C., Vinereanu, D., Nedogoda, S., Mancini, T., Ilic, M. D., Fabryova, L., Fras, Z., Jimenez-Navarro, M. F., Norhammar, A., Lehmann, R., Mourali, M. S., Ural, D., Nesukay, E., Chowdhury, T. A., Rocca B. (ORCID:0000-0001-8304-6423), Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., Huikuri, H. V., Johansson, I., Juni, P., Lettino, M., Marx, N., Mellbin, L. G., Ostgren, C. J., Rocca, Bianca, Roffi, M., Sattar, N., Seferovic, P. M., Sousa-Uva, M., Valensi, P., Wheeler, D. C., Piepoli, M. F., Birkeland, K. I., Adamopoulos, S., Ajjan, R., Avogaro, A., Baigent, C., Brodmann, M., Bueno, H., Ceconi, C., Chioncel, O., Coats, A., Collet, J. -P., Collins, P., Cosyns, B., Di Mario, C., Fisher, M., Fitzsimons, D., Halvorsen, S., Hansen, D., Hoes, A., Holt, R. I. G., Home, P., Katus, H. A., Khunti, K., Komajda, M., Lambrinou, E., Landmesser, U., Lewis, B. S., Linde, C., Lorusso, R., Mach, F., Mueller, C., Neumann, F. -J., Persson, F., Petersen, S. E., Petronio, A. S., Richter, D. J., Rosano, G. M. C., Rossing, P., Ryden, L., Shlyakhto, E., Simpson, I. A., Touyz, R. M., Wijns, W., Wilhelm, M., Williams, B., Windecker, S., Dean, V., Gale, C. P., Hindricks, G., Iung, B., Leclercq, C., Merkely, B., Zelveian, P. H., Scherr, D., Jahangirov, T., Lazareva, I., Shivalkar, B., Naser, N., Gruev, I., Milicic, D., Petrou, P. M., Linhart, A., Hildebrandt, P., Hasan-Ali, H., Marandi, T., Lehto, S., Mansourati, J., Kurashvili, R., Siasos, G., Lengyel, C., Thrainsdottir, I. S., Aronson, D., Di Lenarda, A., Raissova, A., Ibrahimi, P., Abilova, S., Trusinskis, K., Saade, G., Benlamin, H., Petrulioniene, Z., Banu, C., Magri, C. J., David, L., Boskovic, A., Alami, M., Liem, A. H., Bosevski, M., Svingen, G. F. T., Janion, M., Gavina, C., Vinereanu, D., Nedogoda, S., Mancini, T., Ilic, M. D., Fabryova, L., Fras, Z., Jimenez-Navarro, M. F., Norhammar, A., Lehmann, R., Mourali, M. S., Ural, D., Nesukay, E., Chowdhury, T. A., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: Guidelines
Published: 2020

29. Incidence and prognostic significance of karyotype abnormalities in de novo primary myelodysplastic syndromes: a study on 331 patients from a single institution

Author: Bernasconi, P, Klersy, C, Boni, M, Cavigliano, P M, Calatroni, S, Giardini, I, Rocca, B, Zappatore, R, Caresana, M, Quarna, J, Lazzarino, M, and Bernasconi, C
Published: 2005
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30. Cyclooxygenase-1, but not -2, is upregulated in NB4 leukemic cells and human primary promyelocytic blasts during differentiation

Author: Rocca, B, Morosetti, R, Habib, A, Maggiano, N, Zassadowski, F, Ciabattoni, G, Chomienne, C, Papp, B, and Ranelletti, F O
Published: 2004
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31. Is FISH a relevant prognostic tool in myelodysplastic syndromes with a normal chromosome pattern on conventional cytogenetics? A study on 57 patients

Author: Bernasconi, P, Cavigliano, P M, Boni, M, Calatroni, S, Klersy, C, Giardini, I, Rocca, B, Crosetto, N, Caresana, M, Lazzarino, M, and Bernasconi, C
Published: 2003
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32. Impact of COX-2 deletion on platelet and megakaryocyte phenotypes: PB 3.29–5

Author: Barbieri, S S, Petrucci, G, Amadio, P, Tarantino, E, Ranelletti, F, Gianellini, S, Rocca, B, Patrono, C, and Tremoli, E
Published: 2013

33. Acute myeloid leukemia (AML) having evolved from essential thrombocythemia (ET): distinctive chromosome abnormalities in patients treated with pipobroman or hydroxyurea

Author: Bernasconi, P, Boni, M, Cavigliano, PM, Calatroni, S, Brusamolino, E, Passamonti, F, Volpe, G, Pistorio, A, Giardini, I, Rocca, B, Caresana, M, Lazzarino, M, and Bernasconi, C
Published: 2002
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34. Thromboxane metabolite excretion is associated with serious vascular events in diabetes mellitus: a sub-study of the ASCEND trial

Author: Rocca, B, primary, Buck, G, additional, Petrucci, G, additional, Parish, S, additional, Pagliaccia, F, additional, Baigent, C, additional, Mafham, M, additional, Bowman, L, additional, Armitage, J, additional, and Patrono, C, additional
Published: 2020
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35. Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds/Leeds Teaching Hospitals NHS Trust, LIGHT Laboratories, Clarendon Way

Author: Cosentino, F., primary, Grant, P. J., additional, Aboyans, V., additional, Bailey, G. J., additional, Ceriello, А., additional, Delgado, V., additional, Federici, M., additional, Filippatos, G., additional, Grobbee, D. E., additional, Hansen, T. В., additional, Huikuri, H. V., additional, Johansson, I., additional, Jüni, P., additional, Lettino, M., additional, Marx, N., additional, Mellbin, L. G., additional, Östgren, C. J., additional, Rocca, B., additional, Roffi, M., additional, Sattar, N., additional, Seferović, P. M., additional, Sousa-Uva, M., additional, Valensi, P., additional, and Wheeler, D. C., additional
Published: 2020
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36. Circulating endothelial progenitor cells and residual in vivo thromboxane biosynthesis in low-dose aspirin-treated polycythemia vera patients: AS-TU-049

Author: Santilli, F, Romano, M, Recchiuti, A, Dragani, A, Falco, A, Lessiani, G, Fioritoni, F, Lattanzio, S, Mattoscio, D, De Cristofaro, R, Rocca, B, and Davì, G
Published: 2009
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37. A new nitrobenzoxadiazole-based GSTP1-1 inhibitor with a previously unheard of mechanism of action and high stability

Author: Fulci, C, Rotili, Dante, De Luca, A, Stella, L, Morozzo Della Rocca, B, Forgione, M, Di Paolo, V, Mai, Antonello, Falconi, M, Quintieri, L, Caccuri, Am, and 7, .
Subjects: Models, Molecular, 0301 basic medicine, TRAF2, Tripeptide, GSTP1, chemistry.chemical_compound, 0302 clinical medicine, Models, Drug Discovery, GSTP1-1, Enzyme Inhibitors, Oxazoles, Ultraviolet, Tumor, Chemistry, General Medicine, Biochemistry, Spectrophotometry, 030220 oncology & carcinogenesis, medicine.symptom, Lead compound, Research Article, Stereochemistry, In silico, NBDHEX, Enzyme-Linked Immunosorbent Assay, Fluorescence, Cell Line, GSH, nitrobenzoxadiazoles, 03 medical and health sciences, Cell Line, Tumor, medicine, Humans, Nitrobenzoxadiazoles, Glutathione S-Transferase pi, Spectrometry, Fluorescence, Spectrophotometry, Ultraviolet, Pharmacology, Drug Discovery3003 Pharmaceutical Science, Settore BIO/10, Spectrometry, lcsh:RM1-950, Molecular, Glutathione, In vitro, 030104 developmental biology, lcsh:Therapeutics. Pharmacology, Mechanism of action
Abstract: Context: The nitrobezoxadiazole derivative NBDHEX is a potent inhibitor of glutathione transferase P1-1 (GSTP1-1) endowed with outstanding anticancer activity in different tumor models. Objective: To characterize by in vitro biochemical and in silico studies the NBDHEX analogues named MC2752 and MC2753. Materials and methods: Synthesis of MC2752 and MC2753, biochemical assays and in silico docking and normal-mode analyses. Results: The presence of a hydrophobic moiety in the side chain of MC2753 confers unique features to this molecule. Unlike its parent drug NBDHEX, MC2753 does not require GSH to trigger the dissociation of the complex between GSTP1-1 and TRAF2, and displays high stability towards the nucleophilic attack of the tripeptide under physiological conditions. Discussion and conclusion: MC2753 may represent a lead compound for the development of novel GSTP1-1 inhibitors not affected in their anticancer action by fluctuations of cellular GSH levels, and characterized by an increased half-life in vivo.
Published: 2017

38. Very-low-dose twice-daily aspirin maintains platelet inhibition and improves haemostasis during dual-antiplatelet therapy for acute coronary syndrome

Author: Parker, W.A.E., Orme, R.C., Hanson, J., Stokes, H.M., Bridge, C.M., Shaw, P.A., Sumaya, W., Thorneycroft, K., Petrucci, G., Porro, B., Judge, H.M., Ajjan, R.A., Rocca, B., and Storey, R.F.
Abstract: Higher aspirin doses may be inferior in ticagrelor-treated acute coronary syndrome (ACS) patients and reducing bleeding risk whilst maintaining antithrombotic benefits could improve outcomes. We characterized the pharmacodynamics of a novel dual-antiplatelet-therapy regimen consisting of very-low-dose twice-daily (BD) aspirin with standard-dose ticagrelor. A total of 20 ticagrelor-treated ACS patients entered a randomized crossover to take aspirin 20 mg BD (12-hourly) during one 14-day period and 75 mg once-daily (OD) in the other. After 14 days of treatment, serum thromboxane (TX)B2 and light-transmittance aggregometry were assessed pre- and 2 h post-morning-dose, bleeding time was measured post-dose, and TXA2 and prostacyclin stable metabolites were measured in urine collected 2 h post-morning-dose. Data are expressed as mean ± SD. After 14 days treatment, serum TXB2 levels were significantly greater 2 h post-dosing with aspirin 20 mg BD vs. 75 mg OD (3.0 ± 3.6 ng/mL vs. 0.8 ± 1.9 ng/mL; p = 0.018) whereas pre-dosing levels were not significantly different (3.5 ± 4.1 ng/mL vs. 2.5 ± 3.1 ng/mL, p = 0.23). 1-mmol/L arachidonic acid-induced platelet aggregation was similarly inhibited by both regimens pre-dose (8.5 ± 14.3% vs. 5.1 ± 3.6%, p = 0.24) and post-dose (8.7 ± 14.2% vs. 6.6 ± 5.3%; p = 0.41). Post-dose bleeding time was shorter with 20 mg BD (680 ± 306 s vs. 834 ± 386 s, p = 0.02). Urinary prostacyclin and TX metabolite excretion were not significantly different. In conclusion, compared to aspirin 75 mg OD, aspirin 20 mg BD provided consistent inhibition of platelet TXA2 release and aggregation, and improved post-dose hemostasis, in ticagrelor-treated ACS patients. Further studies are warranted to assess whether this regimen improves the balance of clinical efficacy and safety.
Published: 2019

39. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy

Author: Regitz-Zagrosek, V, Roos-Hesselink, JW, Bauersachs, J, Blomström-Lundqvist, C, Cífková, R, De Bonis, M, Iung, B, Johnson, MR, Kintscher, U, Kranke, P, Lang, IM, Morais, J, Pieper, PG, Presbitero, P, Price, S, Rosano, GMC, Seeland, U, Simoncini, T, Swan, L, Warnes, CA, Deaton, C, Simpson, IA, Aboyans, V, Agewall, S, Barbato, E, Calda, P, Coca, A, Coman, IM, De Backer, J, Delgado, V, Di Salvo, G, Fitzsimmons, S, Fitzsimons, D, Garbi, M, Gevaert, S, Hindricks, G, Jondeau, G, Kluin, J, Lionis, C, McDonagh, TA, Meier, P, Moons, P, Pantazis, A, Piepoli, MF, Rocca, B, Roffi, M, Rosenkranz, S, Sarkozy, A, Shlyakhto, E, Silversides, CK, Sliwa, K, Sousa-Uva, M, Tamargo, J, Thorne, S, Van de Velde, M, Williams, B, Zamorano, JL, Windecker, S, Bueno, H, Collet, J-P, Dean, V, Gaemperli, O, Jüni, P, Katus, HA, Knuuti, J, Lancellotti, P, Leclercq, C, Ponikowski, P, Richter, DJ, Hammoudi, N, Piruzyan, A, Mascherbauer, J, Samadov, F, Prystrom, A, Pasquet, A, Caluk, J, Gotcheva, N, Skoric, B, Heracleous, H, Vejlstrup, N, Maser, M, Kaaja, RJ, Srbinovska-Kostovska, E, Mounier-Vehier, C, Vakhtangadze, T, Rybak, K, Giannakoulas, G, Kiss, RG, Thrainsdottir, IS, Erwin, RJ, Porter, A, Geraci, G, Ibrahimi, P, Lunegova, O, Mintale, I, Kadri, Z, Benlamin, H, Barysiene, J, Banu, CA, Caruana, M, Gratii, C, Haddour, L, Bouma, BJ, Estensen, M-E, Hoffman, P, Petris, AO, Moiseeva, O, Bertelli, L, Tesic, BV, Dubrava, J, Koželj, M, Prieto-Arévalo, R, Furenäs, E, Schwerzmann, M, Mourali, MS, Ozer, N, Mitchenko, O, Nelson-Piercy, C, Regitz-Zagrosek, V., Roos-Hesselink, J. W., Bauersachs, J., Blomstrom-Lundqvist, C., Cifkova, R., De Bonis, M., Iung, B., Johnson, M. R., Kintscher, U., Kranke, P., Lang, I. M., Morais, J., Pieper, P. G., Presbitero, P., Price, S., Rosano, G. M. C., Seeland, U., Simoncini, T., Swan, L., Warnes, C. A., Regitz-Zagrosek, Vera, Roos-Hesselink, Jolien W, Bauersachs, Johann, Blomström-Lundqvist, Carina, Cífková, Renata, De Bonis, Michele, Iung, Bernard, Johnson, Mark Richard, Kintscher, Ulrich, Kranke, Peter, Lang, Irene Marthe, Morais, Joao, Pieper, Petronella G, Presbitero, Patrizia, Price, Susanna, Rosano, Giuseppe MC, Seeland, Ute, Simoncini, Tommaso, Swan, Lorna, Warnes, Carole A, and Cardiology
Subjects: Counseling, Prenatal Diagnosi, 030204 cardiovascular system & hematology, Guideline, Cardiovascular, 0302 clinical medicine, Pregnancy, Prenatal Diagnosis, 030212 general & internal medicine, 1102 Cardiorespiratory Medicine and Haematology, Societies, Medical, Risk assessment, Advisory Committee, Advisory Committees, Cardiology, Cardiovascular Agents, Europe, Female, Humans, Poland, Pregnancy Complications, Cardiovascular, Practice Guidelines as Topic, valvular heart disease, Cardiovascular disease, Management, Hypertension, Drug therapy, Cardiology and Cardiovascular Medicine, Arrhythmia, Human, medicine.medical_specialty, Settore BIO/14 - FARMACOLOGIA, Cardiomyopathy, Heart failure, Cardiovascular therapy, Pulmonary hypertension, Aortic pathology, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Medical, medicine, Cardiovascular diagnosis, Intensive care medicine, Congenital heart disease, Pharmacology, business.industry, ta3121, medicine.disease, Valvular heart disease, Pregnancy Complications, Cardiovascular System & Hematology, Cardiovascular Agent, Societies, business
Published: 2019

40. Determinants of the interindividual variability in response to antiplatelet drugs

Author: ROCCA, B. and PATRONO, C.
Published: 2005

41. Antithrombotic therapy and revascularisation strategies in people with diabetes and coronary artery disease

Author: Rocca, Bianca, Rubboli, A., Zaccardi, F., Rocca B. (ORCID:0000-0001-8304-6423), Rocca, Bianca, Rubboli, A., Zaccardi, F., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: Background: Diabetes mellitus, largely type 2, affects nearly 10% of the global adult population according to the World Health Organization. Diabetes is an independent risk factor for atherosclerotic cardiovascular diseases, including coronary artery disease. Diabetes patients experience a two to three-fold increased incidence of coronary artery disease, despite improved metabolic control and management of other cardiovascular risk factors. Discussion: Platelet abnormalities and activation as well as reduced antiplatelet drug responsiveness characterise diabetes mellitus. Mechanisms linking diabetes to platelet and vascular abnormalities, atherogenesis and atherosclerotic cardiovascular disease are still only partially known, highlighting the unique complexity of the pro-atherogenic clinical scenario and its treatment. Consistently, a higher residual cardiovascular risk characterises patients with diabetes compared with those without, in spite of improved antiplatelet and antithrombotic treatment combinations. Randomised clinical trials aimed at optimising antiplatelet treatment specifically in patients with diabetes are lacking, both in acute and chronic coronary artery disease settings. Thus, patients with diabetes are treated with regimens validated in studies including only variable proportions of diabetes patients. Myocardial revascularisation appears to confer a comparable relative benefit between diabetes patients and patients without diabetes, and generally coronary artery bypass grafting has a better outcome in diabetes mellitus versus peripheral coronary intervention. New glucose-lowering drugs have been shown to reduce the incidence of major cardiovascular events in secondary prevention. Type 1 diabetes mellitus remains less explored than type 2 in this context. Conclusion: Diabetes-tailored antithrombotic strategies in acute and chronic coronary artery disease remain an unmet clinical need, requiring ad-hoc trials and precision pharmacological strategies
Published: 2019

42. Obesity is associated with in vivo platelet activation and impaired responsiveness to once-daily, low-dose aspirin

Author: Petrucci, Giovanna, Zaccardi, F., Giaretta, A., Cavalca, V., Capristo, Esmeralda, Cardillo, Carmine, Pitocco, Dario, Porro, B., Schinzari, Francesca, Toffolo, G., Tremoli, E., Rocca, Bianca, Petrucci G. (ORCID:0000-0002-9280-3673), Capristo E. (ORCID:0000-0002-5753-3495), cardillo c. (ORCID:0000-0001-5182-3005), Pitocco D. (ORCID:0000-0002-6220-686X), Schinzari F., Rocca B. (ORCID:0000-0001-8304-6423), Petrucci, Giovanna, Zaccardi, F., Giaretta, A., Cavalca, V., Capristo, Esmeralda, Cardillo, Carmine, Pitocco, Dario, Porro, B., Schinzari, Francesca, Toffolo, G., Tremoli, E., Rocca, Bianca, Petrucci G. (ORCID:0000-0002-9280-3673), Capristo E. (ORCID:0000-0002-5753-3495), cardillo c. (ORCID:0000-0001-5182-3005), Pitocco D. (ORCID:0000-0002-6220-686X), Schinzari F., and Rocca B. (ORCID:0000-0001-8304-6423)
Abstract: Obesity is raising worldwide, increases cardiovascular risk, modifies body composition and organ function, and potentially affects drug's pharmacokinetics and/or pharmacodynamics. OBJECTIVES: To investigate pharmacodynamics of once-daily low-dose aspirin in healthy obese subjects and to assess whether body weight (BW) or body mass index (BMI) would affect aspirin pharmacology. PATIENTS/METHODS: Otherwise healthy, obese (BMI>30kg/m2 ) subjects were studied before and after 3-4 weeks of 100mg once-daily aspirin. Aspirin pharmacodynamics was assessed by serum thromboxane (TX)B2 measured at 4, 24 (i.e. posological interval) and 48 hours after the last witnessed intake; age- and sex-matched non-obese controls were included. A previously-calibrated pharmacokinetic/pharmacodynamic in silico model of aspirin was used to fit serum TXB2 data from obese subjects. At baseline the major urinary TXA2 and prostacyclin metabolites, urinary isoprostane and plasma inflammatory biomarkers were measured. RESULTS: In sixteen obese subjects (47±11 years, BMI 39.4±5.1 kg/m2 ), residual serum TXB2 values between 4 and 48 hours post-aspirin were 3 to 5 folds increased compared to controls. At 24 hours, residual serum TXB2 was log-linearly associated with body size over a wide range of BMI and BW values, without any apparent threshold. The in silico model predicted reduced aspirin bioavailability inversely related to body size and rescued by 200 mg once-daily or 85 mg twice-daily. Baseline urinary TXA2 metabolite, isoprostane and plasma C-reactive protein levels were significantly increased in obese subjects. CONCLUSIONS: Obesity is associated with impaired aspirin responsiveness, largely due to body size. Impaired inhibition of platelet activation by conventional low-dose aspirin may affect antithrombotic efficacy.
Published: 2019

43. Antithrombotic therapy and body mass: an expert position paper of the ESC Working Group on Thrombosis

Author: Rocca, B., Fox, K.A., Ajjan, R.A., Andreotti, F., Baigent, C., Collet, J.P., Grove, E.L., Halvorsen, S., Huber, K., Morais, J., Patrono, C., Rubboli, A., Seljeflot, I., Sibbing, D., Siegbahn, A., Berg, J ten, Vilahur, G., Verheugt, F.W.A., Wallentin, L., Weiss, T.W., Wojta, J., Storey, R.F., Rocca, B., Fox, K.A., Ajjan, R.A., Andreotti, F., Baigent, C., Collet, J.P., Grove, E.L., Halvorsen, S., Huber, K., Morais, J., Patrono, C., Rubboli, A., Seljeflot, I., Sibbing, D., Siegbahn, A., Berg, J ten, Vilahur, G., Verheugt, F.W.A., Wallentin, L., Weiss, T.W., Wojta, J., and Storey, R.F.
Abstract: Contains fulltext : 200583.pdf (publisher's version ) (Closed access)
Published: 2018

44. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy

Author: Deaton, C, Simpson, Ia, Aboyans, V, Agewall, S, Barbato, E, Calda, P, Coca, A, Coman, Im, De Backer, J, Delgado, V, Di Salvo, G, Fitzsimmons, S, Fitzsimons, D, Garbi, M, Gevaert, S, Hindricks, G, Jondeau, G, Kluin, J, Lionis, C, Mcdonagh, Ta, Meier, P, Moons, P, Pantazis, A, Piepoli, Mf, Rocca, Bianca, Roffi, M, Rosenkranz, S, Sarkozy, A, Shlyakhto, E, Silversides, Ck, Sliwa, K, Sousa-Uva, M, Tamargo, J, Thorne, S, Van de Velde, M, Williams, B, Zamorano, Jl, Windecker, S, Bueno, H, Collet, Jp, Dean, V, Gaemperli, O, Iung, B, Jüni, P, Katus, Ha, Knuuti, J, Lancellotti, P, Leclercq, C, Ponikowski, P, Richter, Dj, Hammoudi, N, Piruzyan, A, Mascherbauer, J, Samadov, F, Prystrom, A, Pasquet, A, Caluk, J, Gotcheva, N, Skoric, B, Heracleous, H, Vejlstrup, N, Maser, M, Kaaja, Rj, Srbinovska-Kostovska, E, Mounier-Vehier, C, Vakhtangadze, T, Rybak, K, Giannakoulas, G, Kiss, Rg, Thrainsdottir, I, Erwin, Rj, Porter, A, Geraci, G, Ibrahimi, P, Lunegova, O, Mintale, I, Kadri, Z, Benlamin, H, Barysiene, J, Banu, Ca, Caruana, M, Gratii, C, Haddour, L, Bouma, Bj, Estensen, Me, Hoffman, P, Petris, Ao, Moiseeva, O, Bertelli, L, Tesic, Bv, Dubrava, J, Koželj, M, Prieto-Arévalo, R, Furenäs, E, Schwerzmann, M, Mourali, M, Ozer, N, Mitchenko, O, Nelson-Piercy, C., Rocca B (ORCID:0000-0001-8304-6423), Deaton, C, Simpson, Ia, Aboyans, V, Agewall, S, Barbato, E, Calda, P, Coca, A, Coman, Im, De Backer, J, Delgado, V, Di Salvo, G, Fitzsimmons, S, Fitzsimons, D, Garbi, M, Gevaert, S, Hindricks, G, Jondeau, G, Kluin, J, Lionis, C, Mcdonagh, Ta, Meier, P, Moons, P, Pantazis, A, Piepoli, Mf, Rocca, Bianca, Roffi, M, Rosenkranz, S, Sarkozy, A, Shlyakhto, E, Silversides, Ck, Sliwa, K, Sousa-Uva, M, Tamargo, J, Thorne, S, Van de Velde, M, Williams, B, Zamorano, Jl, Windecker, S, Bueno, H, Collet, Jp, Dean, V, Gaemperli, O, Iung, B, Jüni, P, Katus, Ha, Knuuti, J, Lancellotti, P, Leclercq, C, Ponikowski, P, Richter, Dj, Hammoudi, N, Piruzyan, A, Mascherbauer, J, Samadov, F, Prystrom, A, Pasquet, A, Caluk, J, Gotcheva, N, Skoric, B, Heracleous, H, Vejlstrup, N, Maser, M, Kaaja, Rj, Srbinovska-Kostovska, E, Mounier-Vehier, C, Vakhtangadze, T, Rybak, K, Giannakoulas, G, Kiss, Rg, Thrainsdottir, I, Erwin, Rj, Porter, A, Geraci, G, Ibrahimi, P, Lunegova, O, Mintale, I, Kadri, Z, Benlamin, H, Barysiene, J, Banu, Ca, Caruana, M, Gratii, C, Haddour, L, Bouma, Bj, Estensen, Me, Hoffman, P, Petris, Ao, Moiseeva, O, Bertelli, L, Tesic, Bv, Dubrava, J, Koželj, M, Prieto-Arévalo, R, Furenäs, E, Schwerzmann, M, Mourali, M, Ozer, N, Mitchenko, O, Nelson-Piercy, C., and Rocca B (ORCID:0000-0001-8304-6423)
Abstract: Guidelines summarize and evaluate available evidence with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision making of health professionals in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.
Published: 2018

45. A Genome-Wide Association Study of Diabetic Kidney Disease in Subjects With Type 2 Diabetes

Author: van Zuydam, Natalie R, Ahlqvist, Emma, Sandholm, Niina, Deshmukh, Harshal, Rayner, N William, Abdalla, Moustafa, Ladenvall, Clae, Ziemek, Daniel, Fauman, Eric, Robertson, Neil R, Mckeigue, Paul M, Valo, Erkka, Forsblom, Carol, Harjutsalo, Valma, Perna, Annalisa, Rurali, Erica, Marcovecchio, M Loredana, Igo, Robert P, Salem, Rany M, Perico, Norberto, Lajer, Maria, Käräjämäki, Annemari, Imamura, Minako, Kubo, Michiaki, Takahashi, Atsushi, Sim, Xueling, Liu, Jianjun, van Dam, Rob M, Jiang, Guozhi, Tam, Claudia H T, Luk, Andrea O Y, Lee, Heung Man, Lim, Cadmon K P, Szeto, Cheuk Chun, So, Wing Yee, Chan, Juliana C N, Ang, Su Fen, Dorajoo, Rajkumar, Wang, Ling, Clara, Tan Si Hua, Mcknight, Amy-Jayne, Duffy, Seamu, Pezzolesi, Marcus G, Marre, Michel, Gyorgy, Beata, Hadjadj, Samy, Hiraki, Linda T, Ahluwalia, Tarunveer S, Almgren, Peter, Schulz, Christina-Alexandra, Orho-Melander, Marju, Linneberg, Allan, Christensen, Cramer, Witte, Daniel R, Grarup, Niel, Brandslund, Ivan, Melander, Olle, Paterson, Andrew D, Tregouet, David, Maxwell, Alexander P, Lim, Su Chi, Ma, Ronald C W, Tai, E Shyong, Maeda, Shiro, Lyssenko, Valeriya, Tuomi, Tiinamaija, Krolewski, Andrzej S, Rich, Stephen S, Hirschhorn, Joel N, Florez, Jose C, Dunger, David, Pedersen, Oluf, Hansen, Torben, Rossing, Peter, Remuzzi, Giuseppe, Brosnan, Mary Julia, Palmer, Colin N A, Groop, Per-Henrik, Colhoun, Helen M, Groop, Leif C, Mccarthy, Mark, I, Rocca, Bianca, Rocca B (ORCID:0000-0001-8304-6423), van Zuydam, Natalie R, Ahlqvist, Emma, Sandholm, Niina, Deshmukh, Harshal, Rayner, N William, Abdalla, Moustafa, Ladenvall, Clae, Ziemek, Daniel, Fauman, Eric, Robertson, Neil R, Mckeigue, Paul M, Valo, Erkka, Forsblom, Carol, Harjutsalo, Valma, Perna, Annalisa, Rurali, Erica, Marcovecchio, M Loredana, Igo, Robert P, Salem, Rany M, Perico, Norberto, Lajer, Maria, Käräjämäki, Annemari, Imamura, Minako, Kubo, Michiaki, Takahashi, Atsushi, Sim, Xueling, Liu, Jianjun, van Dam, Rob M, Jiang, Guozhi, Tam, Claudia H T, Luk, Andrea O Y, Lee, Heung Man, Lim, Cadmon K P, Szeto, Cheuk Chun, So, Wing Yee, Chan, Juliana C N, Ang, Su Fen, Dorajoo, Rajkumar, Wang, Ling, Clara, Tan Si Hua, Mcknight, Amy-Jayne, Duffy, Seamu, Pezzolesi, Marcus G, Marre, Michel, Gyorgy, Beata, Hadjadj, Samy, Hiraki, Linda T, Ahluwalia, Tarunveer S, Almgren, Peter, Schulz, Christina-Alexandra, Orho-Melander, Marju, Linneberg, Allan, Christensen, Cramer, Witte, Daniel R, Grarup, Niel, Brandslund, Ivan, Melander, Olle, Paterson, Andrew D, Tregouet, David, Maxwell, Alexander P, Lim, Su Chi, Ma, Ronald C W, Tai, E Shyong, Maeda, Shiro, Lyssenko, Valeriya, Tuomi, Tiinamaija, Krolewski, Andrzej S, Rich, Stephen S, Hirschhorn, Joel N, Florez, Jose C, Dunger, David, Pedersen, Oluf, Hansen, Torben, Rossing, Peter, Remuzzi, Giuseppe, Brosnan, Mary Julia, Palmer, Colin N A, Groop, Per-Henrik, Colhoun, Helen M, Groop, Leif C, Mccarthy, Mark, I, Rocca, Bianca, and Rocca B (ORCID:0000-0001-8304-6423)
Abstract: Identification of sequence variants robustly associated with predisposition to diabetic kidney disease (DKD) has the potential to provide insights into the pathophysiological mechanisms responsible. We conducted a genome-wide association study (GWAS) of DKD in type 2 diabetes (T2D) using eight complementary dichotomous and quantitative DKD phenotypes: the principal dichotomous analysis involved 5,717 T2D subjects, 3,345 with DKD. Promising association signals were evaluated in up to 26,827 subjects with T2D (12,710 with DKD). A combined T1D+T2D GWAS was performed using complementary data available for subjects with T1D, which, with replication samples, involved up to 40,340 subjects with diabetes (18,582 with DKD). Analysis of specific DKD phenotypes identified a novel signal near GABRR1 (rs9942471, P = 4.5 × 10-8) associated with microalbuminuria in European T2D case subjects. However, no replication of this signal was observed in Asian subjects with T2D or in the equivalent T1D analysis. There was only limited support, in this substantially enlarged analysis, for association at previously reported DKD signals, except for those at UMOD and PRKAG2, both associated with estimated glomerular filtration rate. We conclude that, despite challenges in addressing phenotypic heterogeneity, access to increased sample sizes will continue to provide more robust inference regarding risk variant discovery for DKD.
Published: 2018

46. The Aspirin Regimens in Essential Thrombocythemia (ARES) phase II randomized trial design: Implementation of the serum thromboxane B(2) assay as an evaluation tool of different aspirin dosing regimens in the clinical setting

Author: De Stefano, Valerio, Rocca, Bianca, Tosetto, A, Soldati, Denise, Petrucci, Giovanna, Beggiato, E, Bertozzi, I, Betti, Silvia, Carli, G, Carpenedo, M, Cattaneo, D, Cavalca, V, Dragani, A, Elli, E, Finazzi, G, Iurlo, A, Lanzarone, G, Lissandrini, L, Palandri, F, Paoli, C, Rambaldi, A, Ranalli, Paola, Randi, Ml, Ricco, A, Rossi, Elena, Ruggeri, M, Specchia, G, Timillero, A, Turnu, L, Vianelli, N, Vannucchi, Am, Rodeghiero, F, Patrono, Carlo, De Stefano V (ORCID:0000-0002-5178-5827), Rocca B (ORCID:0000-0001-8304-6423), Soldati D, Petrucci G (ORCID:0000-0002-9280-3673), Betti S, Ranalli P, Rossi E (ORCID:0000-0002-7572-9379), Patrono C, De Stefano, Valerio, Rocca, Bianca, Tosetto, A, Soldati, Denise, Petrucci, Giovanna, Beggiato, E, Bertozzi, I, Betti, Silvia, Carli, G, Carpenedo, M, Cattaneo, D, Cavalca, V, Dragani, A, Elli, E, Finazzi, G, Iurlo, A, Lanzarone, G, Lissandrini, L, Palandri, F, Paoli, C, Rambaldi, A, Ranalli, Paola, Randi, Ml, Ricco, A, Rossi, Elena, Ruggeri, M, Specchia, G, Timillero, A, Turnu, L, Vianelli, N, Vannucchi, Am, Rodeghiero, F, Patrono, Carlo, De Stefano V (ORCID:0000-0002-5178-5827), Rocca B (ORCID:0000-0001-8304-6423), Soldati D, Petrucci G (ORCID:0000-0002-9280-3673), Betti S, Ranalli P, Rossi E (ORCID:0000-0002-7572-9379), and Patrono C
Abstract: Once-daily (od), low-dose aspirin (75–100 mg) is recommended to reduce the thrombotic risk of patients with essential thrombocytemia (ET). This practice is based on data extrapolated from other high-risk patients and an aspirin trial in polycythemia vera, with the assumption of similar aspirin pharmacodynamics in the two settings. However, the pharmacodynamics of low-dose aspirin is impaired in ET, reflecting accelerated renewal of platelet cyclooxygenase (COX)-1. ARES is a parallel-arm, placebo-controlled, randomized, dose-finding, phase II trial enrolling 300 ET patients to address two main questions. First, whether twice or three times 100 mg aspirin daily dosing is superior to the standard od regimen in inhibiting platelet thromboxane (TX)A2 production, without inhibiting vascular prostacyclin biosynthesis. Second, whether long-term persistence of superior biochemical efficacy can be safely maintained with multiple vs. single dosing aspirin regimen. Considering that the primary study end point is serum TXB2, a surrogate biomarker of clinical efficacy, a preliminary exercise of reproducibility and validation of this biomarker across all the 11 participating centers was implemented. The results of this preliminary phase demonstrate the importance of controlling reproducibility of biomarkers in multicenter trials and the feasibility of using serum TXB2 as a reliable end point for dose-finding studies of novel aspirin regimens.
Published: 2018

47. Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE)

Author: Lip, GYH, Collet, JP, de Caterina, R, Fauchier, L, Lane, DA, Larsen, TB, Marin, F, Morais, J, Narasimhan, C, Olshansky, B, Pierard, L, Potpara, T, Sarrafzadegan, N, Sliwa, K, Varela, G, Vilahur, G, Weiss, T, Boriani, G, Rocca, B, Gorenek, B, Savelieva, I, Sticherling, C, Kudaiberdieva, G, Chao, TF, Violi, F, Nair, M, Zimerman, L, Piccini, J, Storey, R, Halvorsen, S, Gorog, D, Rubboli, A, Chin, A, Scott-Millar, R, and ESC Sci Document Grp
Subjects: Stroke, Mechanical prosthetic heart valves, Anticoagulation, Mitral stenosis, Vitamin K antagonists, Pregnancy, Stroke prevention, Thrombo-embolism, Non-vitamin K antagonist oral anticoagulants, Atrial fibrillation, Valvular heart disease
Abstract: Atrial fibrillation (AF) is a major worldwide public health problem, and AF in association with valvular heart disease (VHD) is also common. However, management strategies for this group of patients have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thrombo-embolic risk also varies according to valve lesion and may also be associated with CHA(2)DS(2)VASc score risk factor components, rather than only the valve disease being causal. Given marked heterogeneity in the definition of valvular and non-valvular AF and variable management strategies, including non-vitamin K antagonist oral anticoagulants (NOACs) in patients with VHD other than prosthetic heart valves or haemodynamically significant mitral valve disease, there is a need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD. To address this topic, a Task Force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group on Thrombosis, with representation from the ESC Working Group on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulacion Cardiaca gamma Electrofisiologia (SOLEACE) with the remit to comprehensively review the published evidence, and to publish a joint consensus document on the management of patients with AF and associated VHD, with up-to-date consensus recommendations for clinical practice for different forms of VHD. This consensus document proposes that the term 'valvular AF' is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional Evaluated Heartvalves, Rheumatic or Artificial (EHRA) categorization in relation to the type of OAC use in patients with AF, as follows: (i) EHRA Type 1 VHD, which refers to AF patients with 'VHD needing therapy with a Vitamin K antagonist (VKA); and (ii) EHRA Type 2 VHD, which refers to AF patients with 'VHD needing therapy with a VKA or a Non-VKA oral anticoagulant (NOAC)', also taking into consideration CHA(2)DS(2)VASc score risk factor components. This consensus document also summarizes current developments in the field, and provides general recommendations for the management of these patients based on the principles of evidence-based medicine.
Published: 2017

48. Antithrombotic Therapy in Atrial Fibrillation Associated with Valvular Heart Disease: Executive Summary of a Joint Consensus Document from the European Heart Rhythm Association (EHRA) and European Society of Cardiology Working Group on Thrombosis, Endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern Africa (CASSA), Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE)

Author: Lip G.Y.H., Collet J.P., De Caterina R., Fauchier L., Lane D.A., Larsen T.B., Marin F., Morais J., Narasimhan C., Olshansky B., Pierard L., Potpara T., Sarrafzadegan N., Sliwa K., Varela G., Vilahur G., Weiss T., Boriani G., and Rocca B.
Subjects: evidence based medicine, oral drug administration, von Willebrand factor, anticoagulant agent, heart atrium appendage, dabigatran, atrial fibrillation, middle income country, expert witness, randomized controlled trial (topic), anticoagulation, medical society, rivaroxaban, fibrinolytic agent, vitamin K group, consensus development, Europe, blood clotting factor 7, priority journal, risk factor, blood clotting factor 9, antivitamin K, mitral valve stenosis, cerebrovascular accident, Asia, CHA2DS2-VASc score, ri, dipyridamole, heart valve replacement, blood clotting, Article, mitral valve repair, blood clotting factor 10, human, antagonists and inhibitors, clopidogrel, prothrombin, anticoagulant therapy, practice guideline, disease association, international normalized ratio, acetylsalicylic acid, thromboembolism, economic aspect, dual antiplatelet therapy, aortic regurgitation, warfarin, valvular heart disease, Africa, cardioembolic stroke
Abstract: Management strategies for patients with atrial fibrillation (AF) in association with valvular heart disease (VHD) have been less informed by randomized trials, which have largely focused on 'non-valvular AF' patients. Thromboembolic risk also varies according to valve lesion and may also be associated with CHA 2 DS 2 -VASc score risk factor components, rather than only the valve disease being causal. Given the need to provide expert recommendations for professionals participating in the care of patients presenting with AF and associated VHD, a task force was convened by the European Heart Rhythm Association (EHRA) and European Society of Cardiology (ESC) Working Group (WG) on Thrombosis, with representation from the ESC WG on Valvular Heart Disease, Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE) with the remit to comprehensively review the published evidence, and to produce a consensus document on the management of patients with AF and associated VHD, with up-to-date consensus statements for clinical practice for different forms of VHD, based on the principles of evidence-based medicine. This is an executive summary of a consensus document which proposes that the term 'valvular AF' is outdated and given that any definition ultimately relates to the evaluated practical use of oral anticoagulation (OAC) type, we propose a functional EHRA (Evaluated Heartvalves, Rheumatic or Artificial) categorization in relation to the type of OAC use in patients with AF, as follows: (1) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 1 VHD, which refers to AF patients with 'VHD needing therapy with a vitamin K antagonist (VKA)' and (2) EHRA (Evaluated Heartvalves, Rheumatic or Artificial) type 2 VHD, which refers to AF patients with 'VHD needing therapy with a VKA or a non-VKA oral anticoagulant also taking into consideration CHA 2 DS 2 -VASc score risk factor components. © 2017 Schattauer.
Published: 2017

49. Management of antithrombotic therapy after bleeding in patients with coronary artery disease and/or atrial fibrillation: expert consensus paper of the European Society of Cardiology Working Group on Thrombosis

Author: Halvorsen, S., Storey, R.F., Rocca, B., Sibbing, D., Grove, E.L., Weiss, T.W., Collet, J.P., Andreotti, F., Gulba, D.C., Lip, G.Y., Husted, S., Vilahur, G., Morais, J., Verheugt, F.W.A., Lanas, A., Salman, R. Al-Shahi, Steg, P.G., Huber, K., Halvorsen, S., Storey, R.F., Rocca, B., Sibbing, D., Grove, E.L., Weiss, T.W., Collet, J.P., Andreotti, F., Gulba, D.C., Lip, G.Y., Husted, S., Vilahur, G., Morais, J., Verheugt, F.W.A., Lanas, A., Salman, R. Al-Shahi, Steg, P.G., and Huber, K.
Abstract: Contains fulltext : 182623.pdf (publisher's version ) (Closed access)
Published: 2017

50. Platelet indices and glucose control in type 1 and type 2 diabetes mellitus: A case-control study

Author: Zaccardi, Francesco, Rocca, Bianca, Rizzi, Alessandro, Ciminello, Angela Maria, Teofili, Luciana, Ghirlanda, Giovanni, De Stefano, Valerio, Pitocco, Dario, Zaccardi, F., Rocca, B. (ORCID:0000-0001-8304-6423), Rizzi, A., Ciminello, A., Teofili, L. (ORCID:0000-0002-7214-1561), Ghirlanda, G., De Stefano, V. (ORCID:0000-0002-5178-5827), Pitocco, D. (ORCID:0000-0002-6220-686X), Zaccardi, Francesco, Rocca, Bianca, Rizzi, Alessandro, Ciminello, Angela Maria, Teofili, Luciana, Ghirlanda, Giovanni, De Stefano, Valerio, Pitocco, Dario, Zaccardi, F., Rocca, B. (ORCID:0000-0001-8304-6423), Rizzi, A., Ciminello, A., Teofili, L. (ORCID:0000-0002-7214-1561), Ghirlanda, G., De Stefano, V. (ORCID:0000-0002-5178-5827), and Pitocco, D. (ORCID:0000-0002-6220-686X)
Abstract: Background and aims: The relationship between platelet indices and glucose control may differ in type 1 (T1DM) and type 2 (T2DM) diabetes. We aimed to investigate differences in mean platelet volume (MPV), platelet count, and platelet mass between patients with T1DM, T2DM, and healthy controls and to explore associations between these platelet indices and glucose control. Methods and results: A total of 691 T1DM and 459 T2DM patients and 943 control subjects (blood donors) were included. HbA1c was measured in all subjects with diabetes and 36 T1DM patients further underwent 24 h-continuous glucose monitoring to estimate short-term glucose control (glucose mean and standard deviation). Adjusting for age and sex, platelet count was higher and MPV lower in both T1DM and T2DM patients vs control subjects, while platelet mass (MPV Ã platelet count) resulted higher only in T2DM. Upon further adjustment for HbA1c, differences in platelet count and mass were respectively 19.5 Ã 109/L (95%CI: 9.8-29.3; p < 0.001) and 101 fL/nL (12-191; p = 0.027) comparing T2DM vs T1DM patients. MPV and platelet count were significantly and differently related in T2DM patients vs both T1DM and control subjects; this difference was maintained also accounting for HbA1c, age, and sex. Platelet mass and the volume-count relationship were significantly related to HbA1c only in T1DM patients. No associations were found between platelet indices and short-term glucose control. Conclusion: By accounting for confounders and glucose control, our data evidenced higher platelet mass and different volume-count kinetics in subjects with T2DM vs T1DM. Long-term glucose control seemed to influence platelet mass and the volume-count relationship only in T1DM subjects. These findings suggest different mechanisms behind platelet formation in T1DM and T2DM patients with long-term glycaemic control being more relevant in T1DM than T2DM.
Published: 2017

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