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4. Rationale and design of the PARTHENOPE trial: A two-by-two factorial comparison of polymer-free vs biodegradable-polymer drug-eluting stents and personalized vs standard duration of dual antiplatelet therapy in all-comers undergoing PCI

Author

Piccolo, Raffaele, Calabrò, Paolo, Varricchio, Attilio, Baldi, Cesare, Napolitano, Giovanni, De Simone, Ciro, Mauro, Ciro, Stabile, Eugenio, Caiazzo, Gianluca, Tesorio, Tullio, Boccalatte, Marco, Tuccillo, Bernardino, Bottiglieri, Giuseppe, Russolillo, Enrico, Di Lorenzo, Emilio, Carrara, Greta, Cassese, Salvatore, Leonardi, Sergio, Biscaglia, Simone, Costa, Francesco, McFadden, Eugene, Heg, Dik, Franzone, Anna, Stefanini, Giulio G., Capodanno, Davide, and Esposito, Giovanni

Published
2023
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5. Pharmacologic Treatment of Pulmonary Hypertension Due to Heart Failure with Preserved Ejection Fraction: Are There More Arrows on Our Bow?

Author

Masarone, Daniele, Valente, Fabio, Verrengia, Marina, Contaldi, Carla, di Palma, Vito, Falco, Luigi, Catapano, Dario, and di Lorenzo, Emilio

Abstract

Pulmonary hypertension (PH) associated with heart failure with preserved ejection fraction (PH-HFpEF) represents a frequent form of PH related to left ventricular dysfunction. The pathophysiology of PH-HFpEF is intricate, and varied and includes vascular, cardiac, and pulmonary factors that contribute synergistically to developing this clinical syndrome. Improved knowledge of the pathophysiology of PH-HFpEF has paved the way for the use of new drugs such as angiotensin receptor neprilysin inhibitors (ARNIs), non-steroidal mineral corticoid receptor antagonist (nsMRA), sodium-glucose cotransporter inhibitors (SGLT2is), levosimendan, and glucagon-like peptide 1 (GLP-1) agonists. ARNIs are a widely used drug for the treatment of PH associated with heart failure with reduced ejection fraction. They have also recently been used in PH-HFpEF patients with hemodynamic benefits that need to be confirmed in future research. Finerenone is an innovative non-steroidal mineralocorticoid receptor antagonist that exhibits notable cardioprotective and renoprotective properties in individuals suffering from chronic diabetic kidney disease. It also enhances outcomes for patients with heart failure, whether they have mildly reduced or preserved ejection fraction. Moreover, in experimental studies, finerenone has been found to lower pulmonary artery pressure, reduce muscularization, and decrease the wall thickness of pulmonary arteries. SGLT2i have revolutionized the treatment of patients with heart failure irrespective of left ventricular ejection fraction, and their treatment is also associated with an improvement in the hemodynamics profile in patients with PH-HFpEF. Levosimendan is a widely used inodilator in the treatment of acute and advanced heart failure. In addition, its use in patients with PH-HFpEF (supported by the positive effects on pulmonary hemodynamics that levosimendan exerts) has recently demonstrated hemodynamic benefit in a small phase 2 study that paved the way for phase 3 studies and the creation of an oral formulation of levosimendan. Finally, GLP1 agonists are a class of drugs that, in preliminary evidence, have shown a positive effect on cardiac hemodynamics, mainly by facilitating left ventricular unloading. These effects, along with the reduction in insulin resistance and weight loss, likely lead to beneficial outcomes for PH-HFpEF patients, especially those with obesity as a comorbidity. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction

Author

Chichareon, Ply, Modolo, Rodrigo, Collet, Carlos, Tenekecioglu, Erhan, Vink, Maarten A., Oh, Pyung Chun, Ahn, Jung-Min, Musto, Carmine, Díaz de la Llera, Luis S., Cho, Young-Seok, Violini, Roberto, Park, Seung-Jung, Suryapranata, Harry, Piek, Jan J., de Winter, Robbert J., Wykrzykowska, Joanna J., Spaulding, Christian, Kang, Woong Chol, Slagboom, Ton, Hofma, Sjoerd H., Wijnbergen, Inge F., Di Lorenzo, Emilio, Pijls, Nico H., Räber, Lorenz, Brugaletta, Salvatore, Sabaté, Manel, Stoll, Hans-Peter, Stone, Gregg W., Windecker, Stephan, Onuma, Yoshinobu, and Serruys, Patrick W.

Published
2019
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11. Impact of hypertension on clinical outcome in STEMI patients undergoing primary angioplasty with BMS or DES: Insights from the DESERT cooperation

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Diaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Published
2014
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12. Impact of Age on Long-Term Outcome After Primary Angioplasty With Bare-Metal or Drug-Eluting Stent (from the DESERT Cooperation)

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Diaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Published
2013
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13. Meta-Analysis Comparing Efficacy and Safety of First Generation Drug-Eluting Stents to Bare-Metal Stents in Patients With Diabetes Mellitus Undergoing Primary Percutaneous Coronary Intervention

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christopher, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Diaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Published
2013
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16. Drug-eluting stents in patients with anterior STEMI undergoing primary angioplasty: a substudy of the DESERT cooperation

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, de la Llera, Luis Salvador Diaz, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Published
2014
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18. Stents liberadores de fármacos frente a stents convencionales en pacientes diabéticos con infarto agudo de miocardio con elevación del segmento ST: un análisis combinado de los datos de pacientes individuales de 7 ensayos aleatorizados

Author

Iijima, Raisuke, Byrne, Robert A., Dibra, Alban, Ndrepepa, Gjin, Spaulding, Christian, Laarman, Gerrit J., Menichelli, Maurizio, Valgimigli, Marco, Di Lorenzo, Emilio, Kaiser, Christoph, Tierala, Ilkka, Mehilli, Julinda, Suttorp, Maarten J., Violini, Roberto, Schömig, Albert, and Kastrati, Adnan

Published
2009
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19. Drug-Eluting Stents Versus Bare-Metal Stents in Diabetic Patients With ST-Segment Elevation Acute Myocardial Infarction: A Pooled Analysis of Individual Patient Data From 7 Randomized Trials

Author

Iijima, Raisuke, Byrne, Robert A., Dibra, Alban, Ndrepepa, Gjin, Spaulding, Christian, Laarman, Gerrit J., Menichelli, Maurizio, Valgimigli, Marco, Di Lorenzo, Emilio, Kaiser, Christoph, Tierala, Ilkka, Mehilli, Julinda, Suttorp, Maarten J., Violini, Roberto, Schömig, Albert, and Kastrati, Adnan

Published
2009
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21. Benefits of drug-eluting stents as compared to bare metal stent in ST-segment elevation myocardial infarction: Four year results of the Paclit Axel or Sirolimus- Eluting stent vs bare metal stent in primary angiOplasty (PASEO) randomized trial

Author

Di Lorenzo, Emilio, Sauro, Rosario, Varricchio, Attilio, Capasso, Michele, Lanzillo, Tonino, Manganelli, Fiore, Mariello, Ciro, Siano, Francesco, Pagliuca, Maria Rosaria, Stanco, Giovanni, Rosato, Giuseppe, and De Luca, Giuseppe

Published
2009
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26. Impact of Diabetes on Long-Term Outcome After Primary Angioplasty: Insights from the DESERT cooperation

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Diaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Published
2013
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28. A new rat model of small vessel stenting

Author

Indolfi, Ciro, Esposito, Giovanni, Stabile, Eugenio, Cavuto, Luigi, Pisani, Alfonso, Coppola, Carmela, Torella, Daniele, Perrino, Cinzia, Di Lorenzo, Emilio, Curcio, Antonio, Palombini, Lucio, and Chiariello, Massimo

Published
2000
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29. Drug-Eluting vs Bare-Metal Stents in Primary Angioplasty: A Pooled Patient-Level Meta-analysis of Randomized Trials

Author

De Luca, Giuseppe, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, van der Hoeven, Bas, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Díaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Cortese, Giuliana, Suryapranata, Harry, and Stone, Gregg W.

Published
2012
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33. Meta-analysis of randomized trials on drug-eluting stents vs. bare-metal stents in patients with acute myocardial infarction

Author

Kastrati, Adnan, Dibra, Alban, Spaulding, Christian, Laarman, Gerrit J., Menichelli, Maurizio, Valgimigli, Marco, Di Lorenzo, Emilio, Kaiser, Christoph, Tierala, Ilkka, Mehilli, Julinda, Seyfarth, Melchior, Varenne, Olivier, Dirksen, Maurits T., Percoco, Gianfranco, Varricchio, Attilio, Pittl, Undine, Syvänne, Mikko, Suttorp, Maarten J., Violini, Roberto, and Schömig, Albert

Published
2007

35. Safety and feasibility of balloon aortic valvuloplasty in non‐TAVI centers: The "BAV for life" experience.

Author

Attisano, Tiziana, Silverio, Angelo, Stabile, Eugenio, Briguori, Carlo, Tuccillo, Bernardino, Scotto Di Uccio, Fortunato, Di Lorenzo, Emilio, Tesorio, Tullio, Giordano, Arturo, Calabrò, Paolo, Cappelli Bigazzi, Maurizio, Golino, Paolo, Scherillo, Marino, Vigorito, Francesco, Quaranta, Gaetano, Esposito, Giovanni, Mauro, Ciro, Musumeci, Giuseppe, Tarantini, Giuseppe, and Galasso, Gennaro

Published
2019
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36. Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation.

Author

Vranckx, Pascal, Frigoli, Enrico, Rothenbühler, Martina, Tomassini, Francesco, Garducci, Stefano, Andò, Giuseppe, Picchi, Andrea, Sganzerla, Paolo, Paggi, Anita, Ugo, Fabrizio, Ausiello, Arturo, Sardella, Gennaro, Franco, Nicoletta, Nazzaro, Marco, Cesare, Nicoletta de, Tosi, Paolo, Falcone, Camillo, Vigna, Carlo, Mazzarotto, Pietro, and Di Lorenzo, Emilio

Abstract

Aims To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 009 femoral) and NSTE-ACS (2196 radial, 2198 femoral). The 30-day co-primary outcomes were major adverse cardiovascular events (MACE), defined as death, myocardial infarction, or stroke, and net adverse clinical events (NACE), defined as MACE or major bleeding In the overall study population, radial access reduced the NACE but not MACE endpoint at the prespecified 0.025 alpha. MACE occurred in 121 (6.1%) STEMI patients with radial access vs. 126 (6.3%) patients with femoral access [rate ratio (RR) = 0.96, 95% CI = 0.75-1.24; P = 0.76] and in 248 (11.3%) NSTE-ACS patients with radial access vs. 303 (13.9%) with femoral access (RR = 0.80, 95% CI = 0.67-0.96; P = 0.016) (Pint = 0.25). NACE occurred in 142 (7.2%) STEMI patients with radial access and in 165 (8.3%) patients with femoral access (RR = 0.86, 95% CI = 0.68-1.08; P = 0.18) and in 268 (12.2%) NSTE-ACS patients with radial access compared with 321 (14.7%) with femoral access (RR = 0.82, 95% CI = 0.69-0.97; P = 0.023) (Pint = 0.76). All-cause mortality and access site-actionable bleeding favoured radial access irrespective of ACS type (Pint = 0.11 and Pint = 0.36, respectively). Conclusion Radial as compared with femoral access provided consistent benefit across the whole spectrum of patients with ACS, without evidence that type of presenting syndrome affected the results of the random access allocation. [ABSTRACT FROM AUTHOR]

Published
2017
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38. Impact of diabetes on the benefits from everolimus-eluting stent as compared to first-generation drug-eluting stent in patients with ST elevation myocardial infarction.

Author

De Luca, Giuseppe, Sauro, Rosario, Capasso, Michele, Lanzillo, Tonino, Manganelli, Fiore, Carbone, Giannignazio, Lanni, Francesca, Pagliuca, Maria Rosaria, Palmieri, Vittorio, Serino, Vincenzo, Rosato, Giuseppe, Suryapranata, Harry, and Di Lorenzo, Emilio

Abstract

Background: Drug-eluting stent has been shown to reduce the risk of repeated revascularization. However, as shown for first-generation drug-eluting stent, they may be counterbalanced by a potential higher risk of stent thrombosis, especially among ST-segment elevation myocardial infarction patients. In addition, diabetes has been shown to be an independent predictor of poor survival and repeated target vessel revascularization. No data have been reported so far on the long-term benefits and safety of new-generation drug-eluting stent in ST-segment elevation myocardial infarction according to diabetes. Therefore, the aim of this study was to evaluate whether diabetes may impact on the benefits from everolimus-eluting stent versus first-generation drug-eluting stent in patients undergoing primary angioplasty. Methods: We combined data from two randomized trials (PaclitAxel or Sirolimus-Eluting Stent vs Bare-Metal Stent in Primary Angioplasty and randomized comparison of everolimus-eluting stents and sirolimus-eluting stents in patients with ST elevation myocardial infarction) including consecutive ST-segment elevation myocardial infarction patients admitted within 12 h of symptom onset undergoing primary angioplasty and stent implantation at a tertiary centre with 24-h primary percutaneous coronary intervention capability. Primary endpoint of this study was major adverse cardiac events at 3-year follow-up. Secondary endpoints were as follows: (1) death, (2) reinfarction, (3) definite or probable ST and (4) target vessel revascularization at 3-year follow-up. No patient was lost to follow-up. Results: Our population is represented by 680 ST-segment elevation myocardial infarction patients treated with drug-eluting stent (180 enrolled in the PaclitAxel or Sirolimus-Eluting Stent vs Bare-Metal Stent in Primary Angioplasty trial, treated with first-generation drug-eluting stent, and 500 patients in the randomized comparison of everolimus-eluting stents and sirolimus-eluting stents in patients with ST elevation myocardial infarction, randomized to everolimus-eluting stent or sirolimus-eluting stent). Diabetes was observed in a total of 178 patients (26.1%) and associated with higher major adverse cardiac events, mortality, reinfarction, stent thrombosis and target vessel revascularization. Similar outcome was observed in terms of overall major adverse cardiac events, mortality, recurrent myocardial infarction, target vessel revascularization, with everolimus-eluting stent as compared to first-generation drug-eluting stent in both diabetic and non-diabetic patients, whereas everolimus-eluting stent was associated with a significantly lower rate of stent thrombosis only in diabetic patients (1.6% vs 9.6%, hazard ratio (95% confidence interval) = 0.15 (0.02−0.98), p = 0.04) whereas no difference was observed in non-diabetic patients. Conclusion: This study shows that among ST-segment elevation myocardial infarction patients undergoing primary angioplasty, diabetes is associated with a significantly worse outcome at 3-year follow-up. A similar outcome was observed between everolimus-eluting stent and first-generation drug-eluting stent in non-diabetic patients, whereas among diabetic patients everolimus-eluting stent was associated with a significant reduction in stent thrombosis. [ABSTRACT FROM AUTHOR]

Published
2015
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40. Long-Term outcome of drug-eluting stents compared with bare metal stents in ST-segment elevation myocardial infarction: results of the paclitaxel- or sirolimus-eluting stent versus bare metal stent in Primary Angioplasty (PASEO) Randomized Trial.

Author

Di Lorenzo E, Sauro R, Varricchio A, Carbone G, Cortese G, Capasso M, Lanzillo T, Manganelli F, Mariello C, Siano F, Pagliuca MR, Stanco G, Rosato G, De Luca G, Di Lorenzo, Emilio, Sauro, Rosario, Varricchio, Attilio, Carbone, Giannignazio, Cortese, Giuliana, and Capasso, Michele

Published
2009
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45. Gender-related differences in outcome after BMS or DES implantation in patients with ST-segment elevation myocardial infarction treated by primary angioplasty: Insights from the DESERT cooperation.

Author

De Luca, Giuseppe, Verdoia, Monica, Dirksen, Maurits T., Spaulding, Christian, Kelbæk, Henning, Schalij, Martin, Thuesen, Leif, Hoeven, Bas van der, Vink, Marteen A., Kaiser, Christoph, Musto, Carmine, Chechi, Tania, Spaziani, Gaia, Diaz de la Llera, Luis Salvador, Pasceri, Vincenzo, Di Lorenzo, Emilio, Violini, Roberto, Suryapranata, Harry, and Stone, Gregg W.

Subjects
*HEALTH outcome assessment, *DRUG-eluting stents, *ARTIFICIAL implants, *MYOCARDIAL infarction, *CARDIAC contraction, *ANGIOPLASTY, *PATIENTS, SEX differences (Biology)
Abstract

Background: Several studies have found that among patients with ST-segment elevation myocardial infarction (STEMI) treated by thrombolysis, female sex is associated with a worse outcome. However, still controversial is the prognostic impact of gender in primary angioplasty, especially in the era of drug-eluting stents (DES). Therefore, the aim of this study was to investigate sex-related differences in clinical outcome in patients with STEMI treated with primary angioplasty with Bare-Metal Stent (BMS) or DES. Methods: Our population is represented by 6298 STEMI patients undergoing primary angioplasty and stent implantation included in the DESERT database. Follow-up data were collected from 3 to 6 years after primary angioplasty. Results: Female gender was observed in 1466 (23.2%) out of 6298 STEMI patients. Women were older (65.3 ± 12.4 vs 59.3 ± 11.4 years, p < 0.001), with higher prevalence of diabetes (18.6% vs 14.5%, p < 0.001), hypertension (52.4% vs 41.4%, p < 0.001), slightly longer ischemia time (272 ± 247 vs 258 ± 220 min, p = 0.06). No difference was observed in terms of angiographic and procedural characteristics. Follow-up data were available at a mean of 1201 ± 441 days. At long-term follow-up female gender was associated with a significantly higher rate of death (11.7% vs 8.5%, HR [95% CI] = 1.45 [1.18–1.78], p < 0.001), while no difference was observed in terms of reinfarction (HR [95% CI] = 1.14 [0.89–1.45], p = 0.3), ST (HR [95% CI] = 1.12 [0.85–1.48], p = 0.4), with similar temporal distribution (acute, subacute, late and very late) between male and female patients, and no difference in TVR (HR [95% CI] = 1.11 [0.95–1.3], p = 0.2, p = 0.2). These results were confirmed in both patients receiving BMS or DES. The impact of female gender on mortality disappeared after correction for baseline confounding factors (HR [95% CI] = 0.88 [0.71–1.09], p = 0.25). Conclusions: This study shows that in patients with STEMI treated by primary angioplasty, female gender is associated with higher mortality rate in comparison with men, and this is mainly due to their higher clinical and angiographic risk profiles. In fact, female sex did not emerge as an independent predictor of mortality. [ABSTRACT FROM AUTHOR]

Published
2013
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