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1. Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study

Author

De Luca, Leonardo, Leonardi, Sergio, Smecca, Ignazio Maria, Formigli, Dario, Lucci, Donata, Gonzini, Lucio, Tuccillo, Bernardino, Olivari, Zoran, Gulizia, Michele Massimo, Bovenzi, Francesco Maria, De Servi, Stefano, Caporale, R., Cavallini, C., Ceravolo, R., Lupi, A., Musumeci, G., Rakar, S., Maggioni, A. P., Lorimer, A., Orsini, G., Fabbri, Giorgio, Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, Giorgia, Misuraca, G., Manes, M. T., Irace, Lorenzo, Totis, O., Ledda, A., Mauro, C., Boccalatte, M., Iliceto, S., Cacciavillani, L., Savonitto, S., Tortorella, G., Esposito, L., DE ROSA, Paolo, Calabrò, P., Bianchi, R., Napoletano, C., Lalla Piccioni, L., Pavesi, P. C., Boni, Allegra, Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, Paolo, Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Grazioli Gauthier, L., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., Di Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, LAURA CATERINA, Pani, Luisa Anna, Serra, Eleonora, Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, Gabriele, Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Sleiman Helou, J., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, MICHELA MARIA, Caputo, M., Di Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., Di Clemente, D., Felis, S., Castini, D., Rota, C., Casu, Gabriella, Bonano, S., Margheri, M., Ricci Lucchi, G., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Marrara, F., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., Di Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Della Mattia, A., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., Di Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cotti Cometti, V., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., Di Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., Di Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., Di Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Della Casa, S., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., Di Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., and Levantesi, G.

Subjects
Male, Ticagrelor, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Conservative strategy, Population, Acute coronary syndromes, Revascularization, acute coronary syndromes, anticoagulant, antithrombotic therapy, conservative strategy, prasugrel, ticagrelor, aged, coronary care units, female, fibrinolytic agents, follow-up studies, hospital mortality, humans, iItaly, length of stay, male, myocardial revascularization, retrospective studies, survival rate, thrombolytic therapy, practice guidelines as topic, Fibrinolytic Agents, Anticoagulant, Antithrombotic therapy, Prasugrel, Acute Coronary Syndrome, Aged, Coronary Care Units, Female, Follow-Up Studies, Hospital Mortality, Humans, Italy, Length of Stay, Myocardial Revascularization, Retrospective Studies, Survival Rate, Thrombolytic Therapy, Practice Guidelines as Topic, Cardiology and Cardiovascular Medicine, Pharmacology (medical), Internal medicine, Antithrombotic, medicine, education, Survival rate, education.field_of_study, business.industry, Clopidogrel, medicine.disease, Cardiology, business, Fibrinolytic agent, medicine.drug
Abstract

Aims Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Clinical Trial Registration Unique identifier: [NCT02015624][1], . [10.1093/ehjcvp/pvv017][2] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02015624&atom=%2Fehjcardpharm%2F1%2F3%2F168.atom [2]: /lookup/doi/10.1093/ehjcvp/pvv017

Published
2015

2. Antithrombotic strategies in the catheterization laboratory for patients with acute coronary syndromes undergoing percutaneous coronary interventions: insights from the EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units Registry

Author

De Luca, L., Musumeci, G., Leonardi, S., Gonzini, L., Cavallini, C., Calabro, P., Mauro, C., Cacciavillani, L., Savonitto, S., De Servi, S., Caporale, R., Ceravolo, R., Formigli, D., Lupi, A., Rakar, S., Smecca, I. M., Maggioni, A. P., Lucci, D., Lorimer, A., Orsini, G., Fabbri, G., Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, G., Misuraca, G., Manes, M. T., Tuccillo, B., Irace, L., Olivari, Z., Totis, O., Ledda, A., Boccalatte, M., Iliceto, S., Tortorella, G., Esposito, L., De Rosa, P., Bianchi, R., Napoletano, C., Piccioni, L. L., Pavesi, P. C., Bovenzi, F. M., Boni, A., Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, P., Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Gauthier, L. G., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., DI Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, L., Pani, A., Serra, E., Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, G., Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Helou, J. S., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, M., Caputo, M., DI Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., DI Clemente, D., Felis, S., Castini, D., Rota, C., Casu, G., Bonano, S., Margheri, M., Lucchi, G. R., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Santagostino, M., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., De Luca, M., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., DI Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Mattia, A. D., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., DI Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cometti, V. C., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., DI Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., DI Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., DI Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Casa, S. D., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., DI Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., Lupi, G., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., Levantesi, G., de Luca, Leonardo, Musumeci, Giuseppe, Leonardi, Sergio, Gonzini, Lucio, Cavallini, Claudio, Calabrò, Paolo, Mauro, Ciro, Cacciavillani, Luisa, Savonitto, Stefano, de Servi, Stefano, Caporale, Roberto, Ceravolo, Roberto, Formigli, Dario, Lupi, Alessandro, Rakar, Sadir, Smecca, Ivan, Maggioni, Aldo Pietro, Lucci, Donata, Lorimer, Andrea, Orsini, Giampietro, Fabbri, Gianna, Bianchini, Elisa, Abrignani, Maurizio Giuseppe, Bonura, Francesc, Trimarco, Bruno, Galasso, Gennaro, Misuraca, Gianfranco, Manes, Maria Teresa, Tuccillo, Bernardino, and Irace, Luigi.

Subjects
Male, Prasugrel, medicine.medical_treatment, Myocardial Infarction, antithrombotic therapy, 030204 cardiovascular system & hematology, acute coronary syndromes, bivalirudin, heparins, percutaneous coronary intervention, prasugrel, ticagrelor, 0302 clinical medicine, Antithrombotic, 80 and over, Bivalirudin, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Aged, 80 and over, General Medicine, Hirudins, Middle Aged, Recombinant Proteins, Italy, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, medicine.drug, medicine.medical_specialty, Platelet Glycoprotein GPIIb-IIIa Complex, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Acute Coronary Syndrome, Aged, Aspirin, business.industry, Heparin, Percutaneous coronary intervention, Anticoagulants, medicine.disease, Peptide Fragments, Clinical trial, Cross-Sectional Studies, Logistic Models, Conventional PCI, Multivariate Analysis, business
Abstract

Aims In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). Methods EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy. Results Over a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure. Conclusion In our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

Published
2017

3. Comparison of Low-Dose Statin Versus Low-Dose Statin + Armolipid Plus in High-Intensity Statin-Intolerant Patients With a Previous Coronary Event and Percutaneous Coronary Intervention (ADHERENCE Trial)

Author

Campolongo, G, Pelliccia, F, Quattrino, S, Vitale, C, Cacciotti, L, Massaro, R, Volterrani, M, Rosano, G, Marazzi, G., and Giuseppe, Marazzi

Subjects
Male, medicine.medical_specialty, Statin, medicine.drug_class, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Humans, Single-Blind Method, 030212 general & internal medicine, aged, biological products, cholesterol, coronary artery disease, dose-response relationship, drug, drug combinations, drug therapy, combination, female, follow-up studies, humans, hydroxymethylglutaryl-coa reductase inhibitors, male, prospective studies, single-blind method, treatment outcome, dietary supplements, drug tolerance, percutaneous coronary intervention, cardiology and cardiovascular medicine, Prospective Studies, Policosanol, Aged, Biological Products, Dose-Response Relationship, Drug, business.industry, Percutaneous coronary intervention, Drug Tolerance, medicine.disease, Discontinuation, Drug Combinations, Cholesterol, Treatment Outcome, Tolerability, Dietary Supplements, Physical therapy, Cardiology, lipids (amino acids, peptides, and proteins), Drug Therapy, Combination, Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Cardiology and Cardiovascular Medicine, business, medicine.drug, Follow-Up Studies
Abstract

Low-density lipoprotein cholesterol (LDL-C) reduction is associated with a significant decrease in mortality, and statins represent the most effective drugs to achieve this. However, side effects of statins are very common and may lead to treatment discontinuation. Nutraceuticals are a combination of natural components that have shown efficacy in lowering LDL-C concentration when used alone or in association with other agents in patients who are intolerant to high-dose statins. Our aim was to compare the efficacy and tolerability of low-dose statin (LDS) therapy versus combined therapy of LDS plus a nutraceutical combination containing red yeast rice, policosanol, berberine, folic acid, coenzyme Q10 and astaxanthin (Armolipid Plus) in high-risk patients. We performed a randomized (1:1), prospective, parallel group, single-blind trial in which participants had coronary artery disease (n = 100), had undergone percutaneous coronary intervention in the preceding 12 months, were high-dose statin intolerant, and did not achieve ≥50% reduction in LDL-C with LDS treatment alone. After 3 months, patients in the LDS + Armolipid Plus (n = 50) group presented with a significantly greater reduction of LDL-C and total cholesterol (p 0.0001), and 70% of patients in this group achieved the therapeutic target (LDL-C 70 mg/dl), whereas patients in the LDS group did not. Six patients (3 from each group) dropped out due to myalgia. In conclusion, in patients with coronary artery disease and high-dose statin intolerance, the combination of LDS and nutraceuticals represents a valuable therapeutic option.

Published
2017

4. Incidence, determinants and prognostic relevance of dyspnea at admission in patients with Takotsubo syndrome: results from the international multicenter GEIST registry

Author

Luca Arcari, Maria Beatrice Musumeci, Enrica Mariano, Pasquale Caldarola, Federico Guerra, Francesco Romeo, Giuseppina Novo, Ingo Eitel, Luca Cacciotti, Ibrahim Akin, Holger Thiele, Christian Möller, Ibrahim El-Battrawy, Francesco Santoro, Raffaella Semeraro, Natale Daniele Brunetti, Thomas Stiermaier, Massimo Volpe, Luca Rosario Limite, Arcari L., Musumeci M.B., Stiermaier T., El-Battrawy I., Moller C., Guerra F., Novo G., Mariano E., Limite L.R., Cacciotti L., Semeraro R., Volpe M., Romeo F., Caldarola P., Thiele H., Akin I., Brunetti N.D., Eitel I., and Santoro F.

Subjects
Male, 0301 basic medicine, medicine.medical_specialty, Shock, Cardiogenic, Cardiology, lcsh:Medicine, Pulmonary Edema, Article, acute coronary syndrome, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Takotsubo Cardiomyopathy, Internal medicine, medicine, Clinical endpoint, takotsubo syndrome, Humans, Registries, Signs and symptoms, lcsh:Science, Takotsubo syndrome (TTS), chest pain, Aged, Multidisciplinary, Ejection fraction, business.industry, Incidence, Incidence (epidemiology), Cardiogenic shock, Hazard ratio, lcsh:R, Atrial fibrillation, dyspnea, Odds ratio, Middle Aged, Prognosis, medicine.disease, Pulmonary edema, Hospitalization, Dyspnea, 030104 developmental biology, Female, lcsh:Q, business, 030217 neurology & neurosurgery
Abstract

Clinical presentation of Takotsubo syndrome (TTS) may range from acute chest pain to dyspnea: the prognostic role of clinical onset is still controversial. Aim of this study was therefore to investigate the prognostic relevance of dyspnea at presentation in patients with TTS. We analyzed 1,071 TTS patients (median age 72 years, 90% female) enrolled in the international multicenter GEIST registry. Patients were divided according to the presence or absence of dyspnea at hospital admission, as clinically assessed by the accepting physician. The primary endpoint was occurrence of in-hospital complications defined as a composite of pulmonary edema, cardiogenic shock and death. Overall, 316 (30%) patients presented with dyspnea at hospital admission. Diabetes, lower left ventricular ejection fraction and presence of pulmonary disease or atrial fibrillation were independently associated with dyspnea. In-hospital pulmonary edema, cardiogenic shock and death (17% vs. 3%, p

Published
2020

5. Predictive ability of longitudinal changes in PRECISE-DAPT score in patients on dual antiplatelet therapy: The RE-SCORE multicentre prospective registry

Author

Francesco Pelliccia, Vincenzo Pasceri, Tullio Palmerini, Luca Cacciotti, Attilio Placanica, Antonino Granatelli, Giampaolo Niccoli, Felice Gragnano, Filippo Crea, Paolo Calabrò, Gaetano Tanzilli, Giuseppe Marazzi, Carlo Gaudio, Giulio Speciale, Pelliccia, F., Pasceri, V., Marazzi, G., Cacciotti, L., Placanica, A., Gragnano, F., Niccoli, G., Palmerini, T., Tanzilli, G., Speciale, G., Granatelli, A., Calabro, P., Crea, F., and Gaudio, C.

Subjects
medicine.medical_specialty, disease, Epidemiology, business.industry, Dual Anti-Platelet Therapy, DUAL (cognitive architecture), Percutaneous Coronary Intervention, Treatment Outcome, Drug Therapy, Internal medicine, DAPT, guidelines, Combination, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Medicine, Humans, In patient, Drug Therapy, Combination, Registries, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors
Published
2021

6. Usefulness of Low-Dose Statin Plus Ezetimibe and/or Nutraceuticals in Patients With Coronary Artery Disease Intolerant to High-Dose Statin Treatment

Author

Giuseppe Campolongo, Maurizio Volterrani, Giuseppe Marazzi, Francesco Pelliccia, Giuseppe M.C. Rosano, Luca Cacciotti, Rosalba Massaro, Paolo Calabrò, Cristiana Vitale, Marazzi, G., Campolongo, G., Pelliccia, F., Calabro, P., Cacciotti, L., Vitale, C., Massaro, R., Volterrani, M., and Rosano, G.

Subjects
Male, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Gastroenterology, law.invention, Coronary artery disease, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, law, berberine, Single-Blind Method, adherence, 030212 general & internal medicine, Prospective Studies, risk, Anticholesteremic Agents, attainment, Middle Aged, armolipid plus, Cardiology, lipids (amino acids, peptides, and proteins), Drug Therapy, Combination, Female, Cardiology and Cardiovascular Medicine, management, metaanalysis, medicine.drug, medicine.medical_specialty, Statin, medicine.drug_class, 03 medical and health sciences, Percutaneous Coronary Intervention, Ezetimibe, Internal medicine, medicine, Red yeast rice, Humans, Policosanol, combination, therapy, Dose-Response Relationship, Drug, Cholesterol, business.industry, cholesterol, Percutaneous coronary intervention, Cholesterol, LDL, medicine.disease, chemistry, Dietary Supplements, ezetimibe, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

High-dose statin (HDS) therapy is recommended to reduce low-density lipoprotein cholesterol (LDL-C); however, some patients are unable to tolerate the associated side effects. Nutraceuticals have shown efficacy in lowering LDL-C. The aim of this study was to evaluate whether the combination of low-dose statin (LDS) plus ezetimibe (EZE) or LDS plus nutraceutical (Armolipid Plus [ALP] containing red yeast rice, policosanol, and berberine) can lead to a higher proportion of high-risk patients achieving target LDL-C. A secondary objective was to assess the efficacy of triple combination LDS + EZE + ALP in resistant patients (LDL-C >70 mg/dl). A randomized, prospective, parallel-group, single-blind study was conducted in patients with coronary artery disease (n = 100) who had undergone percutaneous coronary intervention in the preceding 12 months, were HDS-intolerant, and were not at LDL-C target (

Published
2019

7. A self-injection acceleration test experiment for the FLAME laser

Author

Giorgio Turchetti, Andrea Rossi, Marco Bellaveglia, S. Fioravanti, G. Gatti, N. Drenska, Alberto Bacci, Luca Serafini, Cristina Vaccarezza, Carlo Benedetti, Tadzio Levato, F. Anelli, Roberto Benocci, Alberto Clozza, S. Gallo, Daniele Filippetto, L. Labate, L. Cultrera, A. Ghigo, P. Valente, Danilo Giulietti, G. Di Pirro, C. A. Cecchetti, C. Vicario, P. Köster, R. Faccini, L. A. Gizzi, L. Cacciotti, Emanuele Pace, Dimitri Batani, V. Lollo, Massimo Ferrario, A. Gamucci, O. Ciricosta, N. Pathak, Antonio Giulietti, Labate, L, Anelli, F, Bacci, A, Batani, D, Bellaveglia, M, Benedetti, C, Benocci, R, Cacciotti, L, Cecchetti, C, Ciricosta, O, Clozza, A, Cultrera, L, Di Pirro, G, Drenska, N, Faccini, R, Ferrario, M, Filippetto, D, Gallo, S, Fioravanti, S, Gamucci, A, Gatti, G, Ghigo, A, Giulietti, A, Giulietti, D, Koster, P, Levato, T, Lollo, V, Pace, E, Pathak, N, Rossi, A, Serafini, L, Turchetti, G, Vaccarezza, C, Valente, P, Vicario, C, and Gizzi, L

Subjects
Physics, Nuclear and High Energy Physics, Radiation, business.industry, Thomson scattering, laser wakefield acceleration, laser-plasma accelerations, thomson scattering, Phase (waves), Laser wakefield acceleration, Electron, Condensed Matter Physics, Plasma acceleration, Laser, law.invention, Acceleration, Optics, law, General Materials Science, Monochromatic color, business, Energy (signal processing), Laser-plasma acceleration
Abstract

A 250-TW laser system (FLAME - Frascati laser for acceleration and multidisciplinary experiments) is now in its commissioning phase in a new laboratory at LNF-INFN in the framework of the PLASMONX (Plasma acceleration and monochromatic X-ray generation) project. The laser will deliver < 25 fs duration pulses with an energy up to 6J, at a 10Hz repetition rate. An ad hoc target area has also been designed and is currently being set up, allowing the first test experiments of electron laser wakefield acceleration to be carried out over the next few months in a safe, radiation-protected environment. An overview of the main features of the laser system and target area is given, along with a survey of the design and set-up of the self-injection test experiment, which is expected to reach the production of sub-GeV electron bunches. © 2010 Taylor and Francis.

Published
2010

8. Comorbidities frequency in Takotsubo syndrome: an international collaborative systematic review including 1109 patients

Author

Patompong Ungprasert, Olivier Morel, Francesco Pelliccia, Rodolfo Citro, Luca Cacciotti, Tetsuro Yoshida, Olivier Lairez, David Antoniucci, Orlando Santana, Eduardo Bossone, Costin N. Ionescu, Juan Carlos Kaski, Guido Parodi, Christos G. Mihos, Jae Kwan Song, Federico Guerra, Nicolas Mansencal, Carlo Gaudio, Andrew W. Teh, Giuseppe Marazzi, Alessandro Capucci, Alberto Valbusa, Maiteder Larrauri-Reyes, Bong Gun Song, Clément Delmas, Franziska Schneck, Holger Nef, Roman Brenner, Andreas Wahl, Pil Hyung Lee, Andres M. Pineda, Cesare Greco, Iván J. Núñez Gil, Giuseppe M.C. Rosano, Ilaria Passaseo, Laboratoire de Biophotonique et Pharmacologie - UMR 7213 (LBP), Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA)), Pelliccia, F, Parodi, G, Greco, C, Antoniucci, D, Brenner, R, Bossone, E, Cacciotti, L, Capucci, A, Citro, R, Delmas, C, Guerra, F, Ionescu, Cn, Lairez, O, Larrauri-Reyes, M, Lee, Ph, Mansencal, N, Marazzi, G, Mihos, Cg, Morel, O, Nef, Hm, Gil, Ijn, Passaseo, I, Pineda, Am, Rosano, G, Santana, O, Schneck, F, Song, Bg, Song, Jk, Teh, Aw, Ungprasert, P, Valbusa, A, Wahl, A, Yoshida, T, Gaudio, C, Kaski, Jc, and Barthel, Ingrid

Subjects
medicine.medical_specialty, [SDV]Life Sciences [q-bio], Cardiovascular risk factors, Cardiomyopathy, Global Health, apical ballooning syndrome, Catecholamines, Risk Factors, Stress, Physiological, Takotsubo Cardiomyopathy, Diabetes mellitus, Internal medicine, medicine, takotsubo syndrome, Humans, medicine (all), ComputingMilieux_MISCELLANEOUS, Acute left ventricular dysfunction, cardiomyopathy, takotsubo cardiomyopathy, Takotsubo syndrome, business.industry, Mean age, General Medicine, medicine.disease, Obesity, 3. Good health, [SDV] Life Sciences [q-bio], Physical therapy, business, Dyslipidemia, Kidney disease
Abstract

Background To identify predisposing factors that can result in the onset of takotsubo syndrome, we performed an international, collaborative systematic review focusing on clinical characteristics and comorbidities of patients with takotsubo syndrome. Methods We searched and reviewed cited references up to August 2013 to identify relevant studies. Corresponding authors of selected studies were contacted and asked to provide additional quantitative details. Data from each study were extracted by 2 independent reviewers. The cumulative prevalence of presenting features and comorbidities was assessed. Nineteen studies whose authors sent the requested information were included in the systematic review, with a total of 1109 patients (951 women; mean age, 59-76 years). Evaluation of risk factors showed that obesity was present in 17% of patients (range, 2%-48%), hypertension in 54% (range, 27%-83%), dyslipidemia in 32% (range, 7%-59%), diabetes in 17% (range, 4%-34%), and smoking in 22% (range, 6%-49%). Emotional stressors preceded takotsubo syndrome in 39% of patients and physical stressors in 35%. The most common comorbidities were psychological disorders (24%; range, 0-49%), pulmonary diseases (15%; range, 0-22%), and malignancies (10%; range, 4%-29%). Other common associated disorders were neurologic diseases (7%; range, 0-22%), chronic kidney disease (7%; range, 2%-27%), and thyroid diseases (6%; range, 0-37%). Conclusions Patients with takotsubo syndrome have a relevant prevalence of cardiovascular risk factors and associated comorbidities. Such of associations needs to be evaluated in further studies.

Published
2014

9. First electrons from the new 220 TW Frascati Laser for Acceleration and Multidisciplinary Experiments (FLAME) at Frascati National Laboratories (LNF)

Author

Danilo Giulietti, R. Di Raddo, R. Faccini, S. Martellotti, Alberto Clozza, P. Chimenti, V. Lollo, O. Cerafogli, C. A. Cecchetti, Antonio Giulietti, Ruggero Ricci, Cristina Vaccarezza, Adolfo Esposito, U. Rotundo, Maria Richetta, A. Gamucci, Dimitri Batani, N. Pathak, M. Pistoni, F. Piastra, S. Fioravanti, Paolo Valente, Roberto Benocci, C. Gatti, L. Labate, L. Cacciotti, Emanuele Pace, Tadzio Levato, M. Calvetti, N. Drenska, G. Di Pirro, L. A. Gizzi, F. Anelli, M. Monteduro, Luigi Pellegrino, Levato, T, Calvetti, M, Anelli, F, Batani, D, Benocci, R, Cacciotti, L, Cecchetti, C, Cerafogli, O, Chimenti, P, Clozza, A, Drenska, N, Esposito, A, Faccini, R, Fioravanti, S, Gamucci, A, Gatti, C, Giulietti, A, Giulietti, D, Labate, L, Lollo, V, Martellotti, S, Monteduro, M, Pace, E, Pathak, N, Pellegrino, L, Piastra, F, Pistoni, M, Di Pirro, G, Di Raddo, R, Rotundo, U, Ricci, R, Richetta, M, Vaccarezza, C, Valente, P, and Gizzi, L

Subjects
Physics, Nuclear and High Energy Physics, business.industry, Settore FIS/01 - Fisica Sperimentale, Pulse duration, Plasma, Electron, Laser, radio-protection, laser plasma acceleration, law.invention, Pulse (physics), Acceleration, Optics, Nuclear magnetic resonance, law, Electromagnetic shielding, Laser plasma acceleration Radio-protection, Optical radiation, business, Instrumentation
Abstract

A new era of laser based plasma accelerators is emerging following the commissioning of many high power laser facilities around the world. Extremely short (tens of fs) laser pulses with energy of multi-joules level are available at these newly built facilities. Here we describe the new 220 TW FLAME facility. In particular we discuss the laser system general layout, the main measurements on the laser pulse parameters, the underground target area. Finally we give an overview of the first results of the Self-Injection Test Experiment (SITE), obtained at a low laser energy. This initial low laser energy experimental campaign was necessary for the validation of the radio-protection shielding (Esposito, 2011 [1]) we discuss here. With respect to our preliminary configuration, with a pulse duration of 30 fs and a focusing optic of F/15, we discuss here the minimum laser energy requirements for electron acceleration and the forward transmitted optical radiation. (C) 2012 Elsevier B.V. All rights reserved.

Published
2013

10. Development of a Multi-GeV spectrometer for laser-plasma experiment at FLAME

Author

S. Martellotti, Pasquale Londrillo, Giorgio Turchetti, G. Gatti, N. Drenska, Carlo Benedetti, Daniele Filippetto, Massimo Ferrario, G. Di Pirro, A. Ghigo, Alberto Bacci, N. Pathak, Andrea Rossi, Cristina Vaccarezza, Dimitri Batani, L. Cacciotti, Emanuele Pace, Danilo Giulietti, Francesco Tani, Luca Serafini, Roberto Benocci, C. A. Cecchetti, S. Fioravanti, L. Labate, Petra Koester, Tadzio Levato, Marco Bellaveglia, L. Cultrera, Antonio Giulietti, Paolo Valente, Alessandro Gallo, R. Faccini, F. Anelli, Alberto Clozza, L. A. Gizzi, V. Lollo, A. Gamucci, Valente, P, Anelli, F, Bacci, A, Batani, D, Bellaveglia, M, Benocci, R, Benedetti, C, Cacciotti, L, Cecchetti, C, Clozza, A, Cultrera, L, Di Pirro, G, Drenska, N, Faccini, R, Ferrario, M, Filippetto, D, Fioravanti, S, Gallo, A, Gamucci, A, Gatti, G, Ghigo, A, Giulietti, A, Giulietti, D, Gizzi, L, Koester, P, Labate, L, Levato, T, Lollo, V, Londrillo, P, Martellotti, S, Pace, E, Pathak, N, Rossi, A, Tani, F, Serafini, L, Turchetti, G, and Vaccarezza, C

Subjects
Nuclear and High Energy Physics, Electron, fibers, Laserplasma, Spectrometer, law.invention, spectrometer, laser-plasma, laserplasma, scintillation, electron, detector, Nuclear physics, Acceleration, Optics, law, Fiber, Instrumentation, Scintillation, Physics, business.industry, Detector, Plasma, Laser, Orders of magnitude (time), Cathode ray, Physics::Accelerator Physics, business, Beam (structure)
Abstract

The advance in laser-plasma acceleration techniques pushes the regime of the resulting accelerated particles to higher energies and intensities. In particular, the upcoming experiments with the 250 TW laser at the FLAME facility of the INFN Laboratori Nazionali di Frascati, will enter the GeV regime with more than 100 pC of electrons. At the current status of understanding of the acceleration mechanism, relatively large angular and energy spreads are expected. There is therefore the need for developing a device capable to measure the energy of electrons over three orders of magnitude (few MeV to few GeV), with still unknown angular divergences. Within the PlasmonX experiment at FLAME, a spectrometer is being constructed to perform these measurements. It is made of an electro-magnet and a screen made of scintillating fibers for the measurement of the trajectories of the particles. The large range of operation, the huge number of particles and the need to focus the divergence, present challenges in the design and construction of such a device. We present the design considerations for this spectrometer that lead to the use of scintillating fibers, multichannel photo-multipliers and a multiplexing electronics, a combination which is innovative in the field. We also present the experimental results obtained with a high intensity electron beam performed on a prototype at the LNF beam test facility. (C) 2011 Elsevier B.V. All rights reserved.

Published
2011

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