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5 results on '"Niccoli, Giampaolo"'

1. Association of baseline C-reactive protein levels with periprocedural myocardial injury in patients undergoing percutaneous bifurcation intervention: a CACTUS study subanalysis

Author

Niccoli, Giampaolo, Sgueglia, Gregory Angelo, Latib, A, Crea, Filippo, and Colombo, A.

Subjects
Male, Sirolimus, Incidence, Myocardium, Myocardial Infarction, Cardiovascular Agents, Drug-Eluting Stents, Coronary Artery Disease, Middle Aged, Up-Regulation, Necrosis, periprocedural myocardial injury, C-Reactive Protein, Percutaneous Coronary Intervention, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Creatine Kinase, MB Form, Humans, Female, Prospective Studies, bifurcations, Biomarkers, Aged
Abstract

To assess the predictive value of C-reactive protein (CRP) on periprocedural myocardial injury (PMI), evaluated by creatine kinase-myocardial band isoform (CK-MB) elevation in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation for the treatment of coronary bifurcation lesions is actually unknown.Systemic inflammation as assessed by CRP has been associated with averse events after DES implantation. After PCI, the occurrence of PMI is common and has also been associated with worse outcomes. Finally, bifurcations are frequently encountered anatomically complex lesions which the treatment is associated with higher complication rate compared with simple lesions.A total of 96 patients (66 ± 10 years, 70 men) from the Coronary bifurcations: Application of the Crushing Technique Using Sirolimus-eluting stents (CACTUS) trial who had baseline CRP dosage and both baseline and postprocedural CK-MB measurement were included.A complex bifurcation strategy was implemented in 53 (55%) patients, and angiographic success was achieved in all but two (2%) patients. Periprocedural myocardial necrosis (increase of CK-MB between one and three times the upper limit of normal [ULN]) was observed in 12 (13%) patients, and four (4%) patients had PCI-related myocardial infarction (increase of CK-MB more than three times ULN). Notably, progressively higher CRP levels were observed in patients with different increase in CK-MB (P = 0.041). Moreover, CRP1 mg/L significantly predicted CK-MB rise (odds ratio 5.6, 95% confidence interval 1.5-4.3, P = 0.011).In the setting of true coronary bifurcations treated by DES, baseline CRP levels were significantly associated with both the incidence and the extent of PMI.

Published
2012

2. [Clinical value of inflammatory biomarkers after stent implantation]

Author

Niccoli, Giampaolo, Montone, Ra, Ferrante, Giuseppe, Minelli, S, and Crea, Filippo

Subjects
Coronary, Coronary Artery Disease, Risk Assessment, Sensitivity and Specificity, Coronary Restenosis, Drug Therapy, Predictive Value of Tests, Humans, Angioplasty, Balloon, Coronary, Glucocorticoids, Inflammation, Evidence-Based Medicine, Angioplasty, Drug-Eluting Stents, Thrombosis, Prognosis, C-Reactive Protein, Treatment Outcome, Combination, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Biological Markers, Drug Therapy, Combination, Stents, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Balloon, Biomarkers, Platelet Aggregation Inhibitors
Abstract

The introduction of coronary stents into clinical practice has revolutionized the treatment of coronary artery disease. However, in-stent restenosis (ISR) and stent thrombosis represent the main adverse reactions following stent implantation. Along with procedural and technical factors, individual susceptibility, in particular the inflammatory response, play an important role in the development of these complications. C-reactive protein, one of the most extensively studied inflammatory biomarkers, was found to predict the risk of ISR but not of stent thrombosis in bare-metal stent (BMS)-treated patients. On the contrary, C-reactive protein failed to predict the occurrence of ISR in drug-eluting stent (DES)-treated patients, but it appeared to predict the risk of stent thrombosis. Important differences in the pathophysiological mechanisms of adverse reactions to BMS and DES account for the differences in the prognostic value of inflammatory biomarkers. Moreover, DES polymers are responsible for late hypersensitivity allergic reactions that may lead to late ISR and stent thrombosis. Notably, a correct employment of inflammatory biomarkers may become a useful tool for identification and management of high-risk patients. In this review, the evolving role of inflammatory biomarkers in predicting adverse reactions after stent implantation is discussed, underlying therapeutic and clinical consequences for the management of patients receiving a BMS or a DES.

Published
2011

3. Permanent polymer of drug eluting stents increases eosinophil cationic protein levels following percutaneous coronary intervention independently of C-reactive protein.

Author

Niccoli, Giampaolo, Calvieri, Camilla, Minelli, Silvia, Copponi, Giorgia, Montone, Rocco, Imaeva, Asiya, Roberto, Marco, Cosentino, Nicola, and Crea, Filippo

Subjects
*DRUG-eluting stents, *EOSINOPHILS, *BASIC proteins, *C-reactive protein, *BIOMARKERS, *SYMPTOMS
Abstract

Aim : To assess eosinophil cationic protein (ECP) and C-reactive protein (CRP) serum levels at three time points according to different stent types. Methods : 54 patients (age 64 ± 10 years, male 78%), undergoing Bare Metal Stent (BMS) ( n = 11), mammalian Target Of Rapamycin (mTOR)-inhibitor DES ( n = 27) and mTOR-inhibitor bioabsorbable DES (BES) ( n = 16) implantation for stable angina (SA) or non-ST-elevation acute coronary syndromes (NSTE-ACS), were prospectively enrolled. ECP and CRP serum levels were assessed before revascularization, at 1-month and at 1-year after the procedure. Moreover, 21 patients found to have inducible ischemia or angina symptoms at 6 month-stress test underwent 1-year follow-up (FU) angiography. Results : Baseline and 1-month ECP levels were similar among the 3 groups, whilst 1-year ECP was significantly higher in m-TOR-DES [8.61 (6.55–19.77) μg/ml] compared with m-TOR-BES [2.03 (1.78–5.53) μg/ml] and BMS-treated patients [2.23 (1.45–8.95) μg/ml] ( p = 0.02), without significant difference between BES and BMS. CRP was similar among the 3 groups at all time points. 1-year ECP significantly correlated with late loss in patients undergoing FU angiography ( r = 0.64, p = 0.002), while CRP did not ( p = NS). Conclusions : Our finding suggests that mTOR-DES stent type is associated with an increase of ECP levels at 1-year, possibly reflecting a persistent eosinophil activation triggered by permanent polymer. [ABSTRACT FROM AUTHOR]

Published
2014
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4. Eosinophil cationic protein: A new biomarker of coronary atherosclerosis

Author

Niccoli, Giampaolo, Ferrante, Giuseppe, Cosentino, Nicola, Conte, Micaela, Belloni, Flavia, Marino, Marcello, Bacà, Marco, Montone, Rocco Antonio, Sabato, Vito, Schiavino, Domenico, Patriarca, Giampiero, and Crea, Filippo

Subjects
*EOSINOPHILS, *BIOMARKERS, *BASIC proteins, *ATHEROSCLEROTIC plaque, *C-reactive protein, *CORONARY disease, *REGRESSION analysis
Abstract

Abstract: Aims: Coronary atherosclerosis is a chronic inflammatory disease, but different inflammatory biomarkers may reflect different phases of atherosclerotic plaque evolution. We aimed at assessing the role of eosinophil cationic protein (ECP), a sensitive marker of eosinophil activation, and C-reactive protein (CRP) in coronary artery disease (CAD). Methods and results: Consecutive anginal patients with angiographic evidence of CAD [stable angina (SA) or non-ST-elevation acute coronary syndrome (NSTE-ACS)], or with angiographically normal coronary arteries (NCA) were enrolled. The severity of CAD was graded according to Bogaty''s score and coronary lesion morphology was defined as smooth or complex. Baseline ECP and high sensitivity CRP were measured in all patients. Of 198 patients (64±10 years, male 74%), 91 had SA, 57 had NSTE-ACS and 50 had NCA. ECP levels were significantly higher in SA [30μg/L (13.8–46.9), p <0.001] and NSTE-ACS [21.8μg/L (5.5–46.3), p =0.016] compared to NCA [9.7μg/L (6.1–13.6)], without significant difference between SA and NSTE-ACS (p =0.45). CRP levels were significantly higher in NSTE-ACS [2.38mg/L (1.11–11.94)] compared to SA [1.48mg/L (0.82–2.83), p =0.03], and NCA [1.09mg/L (0.8–2.1), p <0.001], without significant difference between SA and NCA (p =0.20). The addition of ECP to main cardiovascular risk factors improved the area under the curve from 0.88 to 0.92, p =0.007 for the angiographic diagnosis of CAD; further addition of CRP increased the area to 0.94, p =0.014. At multiple linear regression analysis ECP levels independently predicted CAD severity (p =0.001), whereas CRP levels independently predicted lesion complexity (p =0.01). Conclusions: Our study shows that ECP is a marker of CAD and that different inflammatory biomarkers reflect different phases of atherosclerotic plaque evolution. [Copyright &y& Elsevier]

Published
2010
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5. CD4+CD28null T lymphocyte frequency, a new marker of cardiovascular risk: relationship with polycystic ovary syndrome phenotypes

Author

Moro, Francesca, Morciano, Andrea, Tropea, Anna, Sagnella, Francesca, Palla, Carola, Scarinci, Elisa, Cosentino, Nicola, Niccoli, Giampaolo, Liuzzo, Giovanna, Crea, Filippo, Lanzone, Antonio, and Apa, Rosanna

Subjects
*CD4 antigen, *T cells, *POLYCYSTIC ovary syndrome, *BIOMARKERS, *CARDIOVASCULAR diseases risk factors, *BODY mass index, *PATHOLOGICAL physiology, *C-reactive protein
Abstract

Objective: To study the frequency of CD4+CD28null T cells, which are aggressive T lymphocytes associated with recurrent coronary instability and type 2 diabetes mellitus, in different polycystic ovary syndrome (PCOS) phenotypes and in age- and body mass index–matched healthy women. Design: Retrospective cohort observational study. Setting: Unit of human reproductive pathophysiology, university hospital. Patient(s): A total of 167 PCOS patients and 102 control subjects. Intervention(s): None. Main Outcome Measure(s): CD4+CD28null T cell frequency, high-sensitive C-reactive protein levels, and other glucose-metabolic parameters. Result(s): CD4+CD28null frequency was significantly higher in all PCOS groups than in control subjects. CD4+CD28null frequency was significantly higher in nonhyperandrogenic phenotype (5.7%, range 3.2–7.1) than in phenotypes with hyperandrogenism (H) + oligoamenorrhea (O) + polycystic ovary (PCO) (3.5%, range 1–5.8), H + O (3%, range 1.8–4.7), and H + PCO (2.63%, range 1.2–4.1). The relative risk of non-H phenotype for PCOS women in the highest quartile for CD4+CD28null frequency compared with PCOS women with the lowest quartile was 3.2 (95% confidence interval 1.9–5.8). Conclusion(s): Cardiovascular risk evaluation should be performed in all PCOS phenotypes. In particular, we demonstrated that the non-H phenotype has potentially increased cardiovascular risk in terms of CD4+CD28null frequency. [ABSTRACT FROM AUTHOR]

Published
2012
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