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1. The Italian SurveY on carDiac rEhabilitation - 2008 (ISYDE-2008): a snapshot of current cardiac rehabilitation programmes and provides in Italy Part 2: ISYDE-2008 investigators and directory of italian cardiac rehabilitation centers

Author

Tramarin R., De Feo S., Ambrosetti M., Griffo R., Maslowsky F., Vaghi P., Riccio C., Carlon R., Castello A., Ferratini M., Schweiger C., Chieffo C., Diaco T., Ciglia C., Lapolla A., Pietropaolo F., Furgi G., Martin G., Semprini P., Avallone A., Bertoli D., Belardinelli R., Soffiantino F., Scrutinio D., Maxia P., Coco R., Giustarini C., Anniboletti P., Favretto G., Calisi P., Chiavetta C., Guarracini L., Marcellini G., Iannopollo M., Borrello G., Matta M., Peccerillo N., Boncompagni F., Amici A., Feraco E., Pulitano G., Tripodi E., Capomolla S., Golino P., Parrilli G., Di Patria A., Di Gioia C., Miceli D., Perrotta S., Rubino A., Aulitto V., Riccio G., Codec L., Coruzzi P., Violi E., Nardini M., Urbinati S., Dcruz S., Piepoli M., Fucili A., Cerulli M., Roberto B., Balestra G., Tuniz D., Gori P., Marini R., Morgera T., Di Mario F., Volterrani M., Galati A., Salustri A., Jesi A.P., Lacch A., Loperfido F., Corsiglia L., Pantaleo P., Gigli G., Marchesi D., Febo O., Cobelli F., Malinverni C., Jones N., Anzà C., Frizzelli R., Gei P., Acquistapace F., Carugo S., Malfatto G., Meloni C., Giordano A., Schizzarotto A., Zanettini R., Bosco R., Aglieri S., Caprioli G., Cuocina N., Salvetti S., Savonelli C., Corda G., Meinecke C., Castiglioni, Pierfranco R., Giani P., Robustelli F., Gullace G., Passoni F., Barelli M.V., Richichi I., Rossi A., Politi, Persico M., Alessandrini F., Giannuzzi P., Mazzucco G., Bosimini E., Riva G., Massobrio N., Gondoni L., Aina F., Ingignoli B., Cal M.V., Carpagnano A., Costante A., Villella M., La Rosa C., Sannia L., Barbanto P., Rametta R., Albanese D., Circo A., Raciti R., Scarnato L., Dispensa F., La Spina L., Stuto A., Vasco C., Gibiino S., Gabriele M., Dispensieri C., Carini V., Provvidenza M., Scalzini A., Macchi C., Vannucci M., Iacopetti L., Cordoni M., Gabriele F., Pitscheider W., Bettini R., Girardini D., Mandorla S., Anniboletti F., Patriarchi F., Baroni P.L., Bordin F., Biondi P., Bellotto F., Zanocco A., Ponchia A., Mantovani E., Li Greci E., Celegon L., Baracchi S., Pizzolato G., Peroni L., Apolloni E., Guarniero M., Roncon L., VIGORITO, CARLO, Tramarin, R., De Feo, S., Ambrosetti, M., Griffo, R., Maslowsky, F., Vaghi, P., Riccio, C., Carlon, R., Castello, A., Ferratini, M., Schweiger, C., Chieffo, C., Vigorito, Carlo, Diaco, T., Ciglia, C., Lapolla, A., Pietropaolo, F., Furgi, G., Martin, G., Semprini, P., Avallone, A., Bertoli, D., Belardinelli, R., Soffiantino, F., Scrutinio, D., Maxia, P., Coco, R., Giustarini, C., Anniboletti, P., Favretto, G., Calisi, P., Chiavetta, C., Guarracini, L., Marcellini, G., Iannopollo, M., Borrello, G., Matta, M., Peccerillo, N., Boncompagni, F., Amici, A., Feraco, E., Pulitano, G., Tripodi, E., Capomolla, S., Golino, P., Parrilli, G., Di Patria, A., Di Gioia, C., Miceli, D., Perrotta, S., Rubino, A., Aulitto, V., Riccio, G., Codec, L., Coruzzi, P., Violi, E., Nardini, M., Urbinati, S., Dcruz, S., Piepoli, M., Fucili, A., Cerulli, M., Roberto, B., Balestra, G., Tuniz, D., Gori, P., Marini, R., Morgera, T., Di Mario, F., Volterrani, M., Galati, A., Salustri, A., Jesi, A. P., Lacch, A., Loperfido, F., Corsiglia, L., Pantaleo, P., Gigli, G., Marchesi, D., Febo, O., Cobelli, F., Malinverni, C., Jones, N., Anzà, C., Frizzelli, R., Gei, P., Acquistapace, F., Carugo, S., Malfatto, G., Meloni, C., Giordano, A., Schizzarotto, A., Zanettini, R., Bosco, R., Aglieri, S., Caprioli, G., Cuocina, N., Salvetti, S., Savonelli, C., Corda, G., Meinecke, C., Castiglioni, Pierfranco, R., Giani, P., Robustelli, F., Gullace, G., Passoni, F., Barelli, M. V., Richichi, I., Rossi, A., Politi, Persico, M., Alessandrini, F., Giannuzzi, P., Mazzucco, G., Bosimini, E., Riva, G., Massobrio, N., Gondoni, L., Aina, F., Ingignoli, B., Cal, M. V., Carpagnano, A., Costante, A., Villella, M., La Rosa, C., Sannia, L., Barbanto, P., Rametta, R., Albanese, D., Circo, A., Raciti, R., Scarnato, L., Dispensa, F., La Spina, L., Stuto, A., Vasco, C., Gibiino, S., Gabriele, M., Dispensieri, C., Carini, V., Provvidenza, M., Scalzini, A., Macchi, C., Vannucci, M., Iacopetti, L., Cordoni, M., Gabriele, F., Pitscheider, W., Bettini, R., Girardini, D., Mandorla, S., Anniboletti, F., Patriarchi, F., Baroni, P. L., Bordin, F., Biondi, P., Bellotto, F., Zanocco, A., Ponchia, A., Mantovani, E., Li Greci, E., Celegon, L., Baracchi, S., Pizzolato, G., Peroni, L., Apolloni, E., Guarniero, M., and Roncon, L.

Subjects
Pulmonary and Respiratory Medicine, Studio ISYDE, medicine.medical_specialty, Time Factors, Cardiologia Riabilitativa, medicine.medical_treatment, lcsh:Medicine, Directory, Rehabilitation Centers, Risk profile, medicine, Directories as Topic, Internet, Cardiac Rehabilitation, Rehabilitation, business.industry, Core component, Prevenzione Secondaria, lcsh:R, Health Surveys, Government Programs, Italy, Cardiovascular Diseases, Physical therapy, Snapshot (computer storage), Cardiology and Cardiovascular Medicine, business
Abstract

From January 28th to February 10th, 2008 the Italian Society of Cardiac Rehabilitation and Prevention (GICR) conducted a national web-based survey aimed to provide specific and updated information on organization and core components of cardiac rehabilitation (CR) in Italy, and to describe, both in residential and out-patient settings, indications for CR, clinical characteristics of referred patients, risk profile, performed diagnostic procedures, exercise and educational programme, treatments and arrangements for the follow-up [1, 2]. The ISYDE-2008 is a multicenter, longitudinal, prospective observation study whose design was previously described [1, 2].

Published
2016

2. ICAROS (Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization): temporary report of the first prospective, longitudinal registry of the cardiac rehabilitation network GICR/IACPR

Author

Griffo R, Temporelli PL, Fattirolli F, Ambrosetti M, Tramarin R, Vestri AR, De Feo S, Tavazzi L, ICAROS, VIGORITO, CARLO, Griffo, R, Temporelli, Pl, Fattirolli, F, Ambrosetti, M, Tramarin, R, Vestri, Ar, De Feo, S, Tavazzi, L, Vigorito, Carlo, and Icaros

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, medicine.medical_treatment, Health Behavior, MEDLINE, lcsh:Medicine, Revascularization, recommended lifestyle targets, Percutaneous Coronary Intervention, Risk Factors, Secondary Prevention, Humans, Medicine, Registries, Coronary Artery Bypass, Medical prescription, Risk factor, Life Style, Secondary prevention, Rehabilitation, drug prescription, business.industry, lcsh:R, Percutaneous coronary intervention, lifestyle intervention, Cardiovascular Prevention and Rehabilitation, treatment adherence, cardiac rehabilitation, Italy, Cardiovascular Diseases, Emergency medicine, Conventional PCI, Physical therapy, Patient Compliance, revascularization, Cardiology and Cardiovascular Medicine, business
Abstract

The Italian survey on CardiAc RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS) was a multicenter, prospective, longitudinal survey carried out by the Italian Association on Cardiovascular Prevention and Rehabilitation (GICR/IACPR) in patients on completion of a CR program after coronary artery by pass grafting (CABG) and percutaneous coronary intervention (PCI). The aim was to evaluate in the short and medium term: i) the cardioprotective drug prescription, modification and adherence; ii) the achievement and maintenance of recommended lifestyle targets and risk factor control and their association with cardiovascular events; iii) the predictors of non-adherence to therapy and lifestyle recommendations. The ICAROS results offers a portrait of the “real world” of clinical practice concerning patients after CABG and PCI, and stresses the need to improve secondary prevention care after the index event: many patients after revascularization leave the acute wards without an optimal prescription of preventive medication but the prescription of cardiopreventive drugs and risk factors control is excellent after completion of a CR program. Following CR, the maintenance of evidence-based drugs and lifestyle adherence at one year is fairly good as far as the target goals of secondary prevention are concerned, but to investigate the influence of CR on long term outcome longer term studies are required. Last, but not least, ICAROS shows that some characteristics (PCI as index event, living alone, poor eating habits or smoking in young age, and old age, in particular with comorbidities) may identify patients with poor behavioral modification in the medium term follow-up and in these patients further support may be warranted. In conclusion, participation in CR results in excellent treatment after revascularization, as well as a good lifestyle and medication adherence at 1 year and provides further confirmation of the the benefit of secondary prevention.

Published
2015

3. Prognostic significance of serum uric acid in outpatients with chronic heart failure is complex and related to body mass index: Data from the IN-CHF Registry

Author

Baldasseroni, S, Urso, R, Maggioni, Ap, Orso, F, Fabbri, G, Marchionni, N, Tavazzi, L, the IN CHF Investigators: Mezzani, A, Bielli, M, Milanese, G, Ugliengo, G, Pozzi, R, Rabajoli, F, Bosimini, E, Begliuomini, G, Ferrari, A, Barzizza, F, Valsecchi, F, Dadda, F, Faggiano, P, Castiglioni, G, Gibelli, G, Turelli, Al, Belluschi, R, Bianchi, C, Emanuelli, C, Gramenzi, S, Foti, S, Agnelli, D, Mascioli, G, Cazzani, E, Zanelli, E, Domenighini, D, Castelli, C, Moroni, E, Gara, E, Guzzetti, S, Muzzupappa, S, Turiel, M, Cappiello, E, Sandrone, G, Recalcati, F, Valenti, D, Achilli, F, Vincenzi, A, Rusconi, F, Palvarini, M, Ghio, S, Fontana, A, Giusti, A, Scelsi, L, Sebastiani, R, Ceresa, M, Nassiacos, D, Meloni, S, Nicoli, T, Bandini, P, Pedretti, R, Paolucci, M, Amati, L, Ravetta, M, Morandi, F, Provasoli, S, Bertolini, A, Imperiale, D, Agen, W, Planca, E, Quorso, P, Ferro, A, Pedrolli, C, Russo, P, Tarantini, L, Candelpergher, G, Cannarozzo, Pp, De Cian, F, Agnoli, A, Stefanini, Mg, Cacciavillani, L, Boffa, Gm, Mario, L, Renosto, G, Stritoni, P, Varotto, L, Penzo, M, Perini, G, Giuliano, G, Barducci, E, Piazza, R, Albanese, Mc, Fresco, C, Picco, F, Venturini, P, Camerini, A, Griffo, R, Derchi, G, Delfino, L, Pizzorno, L, Mazzantini, S, Torre, F, Orlandi, S, Bertoli, D, Gentile, A, Naccarella, F, Gatti, M, Coluccini, M, Morgagni, G, Alfano, G, Reggianini, L, Sansoni, S, Serra, W, Passerini, F, Del Corso, P, Rusconi, L, Marzaloni, M, Mezzetti, M, Gambarati, Gp, Mariani, Pr, Volterrani, C, Venturi, F, Zambald, G, Casolo, G, Moschi, G, Geri Brandinelli, A, Miracapillo, G, Boni, A, Italiani, G, Vergoni, W, Paci, Am, Lattanzi, F, Reisenhofer, B, Severini, D, Taddei, T, Dalle Luche, A, Comella, A, Gasperini, U, Cocchieri, M, Alunni, G, Bosi, E, Panciarola, R, Maragoni, G, Bardelli, G, Testarmata, P, Pasetti, L, Budini, A, Gabrilelli, D, Coderoni, B, Midi, P, Romaniello, C, Del Sindaco, D, Leggio, F, Terranova, A, Pulignano, G, Pozzar, F, Ansalone, G, Magris, B, Giannantoni, P, Cacciatore, G, Bottero, G, Scaffidi, G, Valtorta, C, Salustri, A, Amadeo, F, Barbato, G, Aspromonte, N, Baldo, V, Baldo, E, Frattaroli, C, Mariani, A, Di Marco, G, Levantesi, G, Potena, Ap, Colonna, N, Montano, A, Sensale, P, Maiolica, O, Somelli, A, Napolitano, F, Provvisiero, P, Bottiglieri, P, Ciriello, N, Angelini, E, Andriulo, C, De Santis, F, Cocco, F, Zecca, A, Pennetta, A, Mariello, F, Magliari, F, De Giorgi, A, Callerame, M, Santoro, V, Pede, S, Renna, A, De Donno, O, De Lorenzi, E, Polimeni, G, Russo, Va, Mangia, R, Truncellito, L, Cariello, Fp, Affinita, M, Perticone, F, Cloro, C, Borelli, D, Matta, M, Lopresti, D, Misuraca, G, Caporale, R, Chiappetta, P, Tripodi, E, Tassone, F, Salituri, S, Errigo, C, Meringolo, G, Donnangelo, L, Canonico, G, Coco, R, Franco, M, Coglitore, A, Donato, A, Di Tano, G, Cento, Domenico, DE GREGORIO, Cesare, Mongiovı, M, Schillaci, Am, Mirto, Ij, Clemenza, F, Ingrillı, F, Cavallaro, A, Aloisi, B, Ledda, G, Rizzo, C, Porcu, M, Salis, S, Pistis, L, Pili, G, Piras, S, Maoddi, I, and Uras, F.

Subjects
Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Hyperuricemia, Models, Biological, Severity of Illness Index, Body Mass Index, chemistry.chemical_compound, Thinness, Internal medicine, Severity of illness, Ambulatory Care, Humans, Medicine, Registries, Mortality, Survival analysis, Aged, Retrospective Studies, Aged, 80 and over, Heart Failure, Nutrition and Dietetics, business.industry, Hazard ratio, Middle Aged, Prognosis, medicine.disease, Survival Analysis, Confidence interval, Uric Acid, Surgery, Italy, chemistry, Heart failure, Cardiology, Uric acid, Female, Cardiology and Cardiovascular Medicine, business, Body mass index
Abstract

In the field of cardiovascular diseases, elevated levels of serum uric acid (UA) reflect a marked activation of the xanthine oxidase pathway with increase in free radicals production; it is often associated with an inflammatory state, oxygen consumption and endothelial dysfunction. All these associations have been also confirmed in heart failure (HF) but the pathophysiological role of UA in this setting is not well understood. The aim of this study was to evaluate the prognostic role of UA in outpatients enrolled in the Italian Registry of Congestive Heart Failure (IN-CHF).All patients met the European Society of Cardiology (ESC) criteria for diagnosis of HF. We considered patients with complete clinical data and UA level available at the baseline and at 1-year follow-up. The study population was composed of 877 patients aged 63 ± 12 years. One-year mortality was 10.8% and dead patients had a higher level of UA than survivors (7.1 mg dl⁻¹ vs 6.6 mg dl⁻¹, p0.0207). In multivariable full model of analysis, UA did not result in an independent predictor of death in overall population, but only in patients with low body mass index (BMI) (≤22 kg m⁻²) (hazard ratio (HR): 2.38, 95% confidence interval (CI) 1.36-4.18). In this subgroup, a statistically significant gradual relationship between UA and survival was detected starting from values higher than 8 mg dl⁻¹.Elevated level of UA is not an independent predictor of mortality in chronic HF, but it markedly worsens outcome if associated with low level of BMI. This association is likely an indicator of chronic inflammatory and catabolic state.

Published
2012

4. Effective secondary prevention through cardiac rehabilitation after coronary revascularization and predictors of poor adherence to lifestyle modification and medication. Results of the ICAROS Survey

Author

Griffo R, Ambrosetti M, Tramarin R, Fattirolli F, Temporelli PL, Vestri AR, De Feo S, Tavazzi L, ICAROS investigators, VIGORITO, CARLO, Griffo, R, Ambrosetti, M, Tramarin, R, Fattirolli, F, Temporelli, Pl, Vestri, Ar, De Feo, S, Tavazzi, L, Vigorito, Carlo, and Icaros, Investigators

Subjects
Male, Lifestyle intervention, medicine.medical_specialty, medicine.medical_treatment, Cardiac rehabilitation, Logistic regression, Revascularization, Coronary artery bypass surgery, Percutaneous coronary intervention, Treatment adherence, Predictive Value of Tests, Internal medicine, medicine, Secondary Prevention, Humans, cardiovascular diseases, Longitudinal Studies, Prospective Studies, Registries, Aged, Secondary prevention, Rehabilitation, business.industry, Cardiovascular Agents, Middle Aged, Coronary revascularization, Cross-Sectional Studies, Treatment Outcome, Italy, Cardiovascular Diseases, Conventional PCI, Physical therapy, Patient Compliance, Female, Cardiology and Cardiovascular Medicine, business, Risk Reduction Behavior, Follow-Up Studies
Abstract

Background and aim: Secondary prevention is a priority after coronary revascularization. We investigate the impact of a cardiac rehabilitation (CR) program on lifestyle, risk factors and medication modifications and analyze predictors of poor behavioral changes and events in patients after coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). Methods: Multicenter (n = 62), prospective, longitudinal survey in post-CABG or -PCI consecutive patients after a comprehensive CR program. Cardiac risk factors, lifestyle habits, medication and 1 year cardiovascular events were collected. Logistic regression analyzed the association between risk factors, events and predictors of non-adherence to treatment and lifestyle. Results: At 1 year, of the 1262 patients (66 ± 10 years, CABG 69%, PCI 31%), 94% were taking antiplatelet agents (vs. 91.8% at CR admission and 91.7% at CR discharge, p = ns), 87% statins (vs. 67.5%, p

Published
2013

5. Precipitating factors and decision-making processes of short-term worsening heart failure despite 'optimal' treatment (from the IN-CHF Registry)

Author

Opasich, C., Rapezzi, C., Lucci, D., Gorini, M., Pozzar, F., Zanelli, E., Tavazzi, L., Mezzani, Maggioni A. P. AND THE IN CHF Investigators: A., Bielli, M., Milanese, U., Ugliengo, G., Pozzi, R., Rabajoli, F., Bosimini, E., Valsecchi, M. G., Dadda, F., Faggiano, P., Castiglioni, G., Gibelli, G., Turelli, A. L., Belluschi, R., Bianchi, C., Emanuelli, C., Gramenzi, S., Foti, G., Agnelli, D., Volterrani, M., Moroni, E., Gara, E., Turiel, A., Recalcati, F., Valenti, D., Rusconi, F., Palvarini, M., Giusti, A., Inserra, C., Nassiacos, D., Meloni, S., Nicoli, T., Bandini, P., Moizi, M., Pedretti, R., Paolucci, M., Amati, L., Ravetta, M., Morandi, F., Provasoli, S., Planca, E., Quorso, P., Ferro, A., Pedrolli, C., Riggi, L., Tarantini, L., Candelpergher, G., Berton, G., Stefanini, M. G., Cacciavillani, L., Boffa, G. M., Mario, L., Renosto, G., Stritoni, P., Perini, G., Bonadiman, C., Varotto, L., Penzo, M., Giuliano, G., Marini, R., Barducci), E., Humar, F., Albanese, M. C., Fresco, C., Camerini, A., Griffo, R., Derchi, G., Vengo, P., Fazzini, L., Pizzorno, L., Bertoli, D., Morgagni, G., Bruno, G., Iori, E., Melandri, F., Cionini, F., Reggianini, L., Passerini, F., Del Corso, P., Rusconi, L., Marzaloni, M., Mezzetti, M., Gambarati, G. P., Mariani, P. R., Volterrani, C., Venturi, F., Zambaldi, G., Geri Brandinelli, A., Taddei, T., Dalle Luche, A., Arcuri, G., Giannini, R., Gasperini, U., Alunni, G., Bosi, E., Cocchieri, M., Severini, D., Maragoni, G., C. Ferroni, G. Saccomanno, Pasetti, L., Budini, A., Manfrin, M., Coderoni, B., Mori, A., Midi, P., D. Del Sindaco, F. Leggio, Terranova, A., Pulignano, G., Cacciatore, G., Menichelli, M., Ansalone, G., Magris, B., Scaffidi, G., Valtorta, C., Salustri, A., Amaddeo, F., Barbato, G., Aspromonte, N., Renzi, M., Mantini, L., Frattaroli, C., Mariani, A., Di Marco, G., Levantesi, G., Colonna, N., Montano, A., Di Maggio, O., Toscano, G., Capuano, V., Scherillo, M., Sensale, P., Rullo, V., Maurea, N., Miceli, D., Somelli, A., Napolitano, F., Provvisiero, P., Di Muro, M. R., Bottiglieri, P., Rufolo, F., Ciriello, N., Angelini, E., Andriulo, C., De Santis, F., Cocco, F., Zecca, A., Pennetta, A., Mariello, F., Magliari, F., De Giorgi, A., Santoro, V., Pede, S., Renna, A., De Donno, O., De Lorenzi, E., Polimeni, G., Russo, V. A., Mangia, R., Cariello, F. P., Affinita, M., Perticone, F., Cloro, C., Misuraca, G., Caporale, R., Chiappetta, P., Tripodi, E., Tassone, F., Salituri, S., Errigo, C., Meringolo, G., Donnangelo, L., Canonico, G., Coco, R., Franco, M., Coglitore, A., Donato, A., Di Tano, G., Cento, D., DE GREGORIO, Cesare, Mongiovì, M., Schillaci, A. M., Mirto, U., Clemenza, F., Ingrillì, F., Aloisi, B., Porcu, M., Pili, G., and Piras, S.

Subjects
Male, medicine.medical_specialty, Heart disease, Decision Making, Risk Factors, Internal medicine, Heart rate, Humans, Medicine, Decompensation, Prospective Studies, Registries, Practice Patterns, Physicians', Intensive care medicine, Prospective cohort study, Aged, Heart Failure, business.industry, Atrial fibrillation, Middle Aged, Prognosis, medicine.disease, Blood pressure, Heart failure, Multivariate Analysis, Emergency medicine, Ambulatory, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

This study sought to prospectively assess which factors were related to short-term worsening heart failure (HF) leading to or not to hospital admission, in long-term outpatients followed by cardiologists. The subsequent decision-making process was also analyzed. The study population consisted of 2,701 outpatients enrolled in the registry of the Italian Network on Congestive Heart Failure (IN-CHF) and followed by 133 cardiology centers (19% of all existing Italian cardiology centers). Clinical and follow-up data were collected by local trained clinicians; 215 patients (8%) had short-term decompensation (on average 2 months after the index outpatient visit). Multivariate analysis showed that previous hospitalization, long duration of symptoms, ischemic etiology, atrial fibrillation, higher functional class (New York Heart Association classification III to IV), higher heart rate, and low systolic blood pressure were independently associated with HF destabilization. Poor compliance (21%) and infection (12%) were the most frequent precipitating factors, but a precipitating factor was not identified in 40% of the patients. Poor compliance was more common in women, but no other clinical characteristics emerged as being related with a specific precipitating factor. Fifty-seven percent of the patients with a short-term recurrence of worsening HF required hospital admission; infusion treatment with inotropes and/or vasodilators was necessary in 19% of them. Long-term therapy was changed in 48% of the patients. Thus, in ambulatory HF patients, short-term worsening HF can be predicted according to the clinical characteristics on an outpatient basis. Nearly 1/3 of precipitating factors can be prevented. Patient education and avoidance of inappropriate treatment may reduce the number of relapses.

Published
2001

6. Age-dependent prognostic significance of atrial fibrillation in outpatients with chronic heart failure: data from the Italian Network on Congestive Heart Failure Registry

Author

Baldasseroni, S, Orso, F, Fabbri, G, De Bernardi, A, Cirrincione, V, Gonzini, L, Fumagalli, S, Marchionni, N, Midi, P, Maggioni, Ap, Mezzani, A, Bielli, M, Milanese, U, Ugliengo, G, Pozzi, R, Rabajoli, F, Bosimini, E, Begliuomini, G, Ferrari, A, Barzizza, F, Valsecchi, Mg, Dadda, F, Faggiano, P, Castiglioni, G, Gibelli, G, Turelli, Al, Belluschi, R, Bianchi, C, Emanuelli, C, Gramenzi, S, Foti, G, Agnelli, D, Mascioli, G, Cazzani, E, Zanelli, E, Domenighini, D, Castelli, C, Moroni, E, Gara, E, Guzzetti, S, Muzzupappa, S, Turiel, M, Cappiello, E, Sandrone, G, Recalcati, F, Valenti, D, Achilli, F, Vincenzi, A, Rusconi, F, Palvarini, M, Ghio, S, Fontana, A, Giusti, A, Scelsi, L, Sebastiani, R, Ceresa, M, Nassiacos, D, Meloni, S, Nicoli, T, Bandini, P, Pedretti, R, Paolucci, M, Amati, L, Ravetta, M, Morandi, F, Provasoli, S, Bertolini, A, Imperiale, D, Agen, W, Planca, E, Quorso, P, Ferro, A, Pedrolli, C, Russo, P, Tarantini, L, Candelpergher, G, Cannarozzo, Pp, De Cian, F, Agnoli, A, Stefanini, Mg, Cacciavillani, L, Boffa, Gm, Mario, L, Renosto, G, Stritoni, P, Varotto, L, Penzo, M, Perini, G, Giuliano, G, Barducci, E, Piazza, R, Albanese, Mc, Fresco, C, Picco, F, Venturini, P, Camerini, A, Griffo, R, Derchi, G, Delfino, L, Pizzorno, L, Mazzantini, S, Torre, F, Orlandi, S, Bertoli, D, Gentile, A, Naccarella, F, Gatti, M, Coluccini, M, Morgagni, G, Alfano, G, Reggianini, L, Sansoni, S, Serra, W, Passerini, F, Del Corso, P, Rusconi, L, Marzaloni, M, Mezzetti, M, Gambarati, Gp, Mariani, Pr, Volterrani, C, Venturi, F, Zambaldi, G, Casolo, G, Moschi, G, Geri Brandinelli, A, Miracapillo, G, Boni, A, Italiani, G, Vergoni, W, Paci, Am, Lattanzi, F, Reisenhofer, B, Severini, D, Taddei, T, Dalle Luche, A, Comella, A, Gasperini, U, Cocchieri, M, Alunni, G, Bosi, E, Panciarola, R, Maragoni, G, Bardelli, G, Testarmata, P, Pasetti, L, Budini, A, Gabrilelli, D, Coderoni, B, Romaniello, C, Del Sindaco, D, Leggio, F, Terranova, A, Pulignano, G, Pozzar, F, Ansalone, G, Magris, B, Giannantoni, P, Cacciatore, G, Bottero, G, Scaffidi, G, Valtorta, C, Salustri, A, Amaddeo, F, Barbato, G, Aspromonte, N, Baldo, V, Baldo, E, Frattaroli, C, Mariani, A, Di Marco, G, Levantesi, G, Potena, Ap, Colonna, N, Montano, A, Sensale, P, Maiolica, P, Somelli, A, Napolitano, F, Provvisiero, P, Bottiglieri, P, Ciriello, N, Angelini, E, Andriulo, C, De Santis, F, Cocco, F, Zecca, A, Pennetta, A, Mariello, F, Magliari, F, De Giorgi, A, Callerame, M, Santoro, V, Pede, S, Renna, A, De Donno, O, De Lorenzi, E, Polimeni, G, Russo, Va, Mangia, R, Truncellito, L, Cariello, Fp, Affinita, M, Perticone, F, Cloro, C, Borelli, D, Matta, M, Lopresti, D, Misuraca, G, Caporale, R, Chiappetta, P, Tripodi, E, Tassone, F, Salituri, S, Errigo, C, Meringolo, G, Donnangelo, L, Canonico, G, Coco, R, Franco, M, Coglitore, A, Donato, A, Di Tano, G, Cento, D, DE GREGORIO, Cesare, Mongiovì, M, Schillaci, Am, Mirto, U, Clemenza, F, Ingrillì, F, Cavallaro, A, Aloisi, B, Ledda, G, Rizzo, C, Porcu, M, Salis, S, Pistis, L, Pili, G, Piras, S, Maoddi, I, and Uras, F.

Subjects
Male, medicine.medical_specialty, Adrenergic beta-Antagonists, Age dependent, Angiotensin-Converting Enzyme Inhibitors, VENTRICULAR SYSTOLIC DYSFUNCTION, POPULATION-BASED COHORT, Age Distribution, Older patients, Internal medicine, Atrial Fibrillation, Outpatients, medicine, Humans, Pharmacology (medical), Registries, Aged, Heart Failure, business.industry, Network on, Anticoagulants, Atrial fibrillation, Middle Aged, medicine.disease, Prognosis, Death, Sudden, Cardiac, Italy, Heart failure, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Anti-Arrhythmia Agents
Abstract

Objectives: The role of atrial fibrillation (AF) in older patients with heart failure (HF) is controversial because many variables seem to influence their outcome. We investigated the predictivity of AF in 3 age groups of outpatients with HF. Methods: We analyzed 8,178 outpatients enrolled in the Italian Network on Congestive Heart Failure Registry with HF diagnosed according to the European Society of Cardiology criteria. A trained cardiologist established the diagnosis of AF and HF at the entry visit at each center. We stratified the population into 3 age groups, as follows: group A, ≤65 years; group B, 66–75 years, and group C, >75 years. Results: Group A was composed of 4,261 patients, 683 with AF (16.0%); in group B there were 2,651 patients, 638 with AF (24.1%), and group C was composed of 1,266 patients, 412 with AF (32.5%). The 1-year mortality rate was higher in AF patients in all groups. In a multivariate model, AF remained an independent risk factor for death in groups A and B, but not in group C [group A: hazard ratio (HR) 1.42, 95% confidence interval (CI) 1.10–1.81; group B: HR 1.29, 95% CI 1.00–1.67; group C: HR 1.05, 95% CI 0.78–1.43]. Conclusion: The prevalence of AF increased with age and was associated with a higher mortality rate. However, AF independently predicted all-cause mortality only in patients aged ≤75 years.

Published
2010

7. Global Secondary Prevention Strategies to Limit Event Recurrence After Myocardial Infarction

Author

Giannuzzi P., Temporelli P.L., Marchioli R., Maggioni A.P., Balestroni G., Ceci V., Chieffo C., Gattone M., Griffo R., Schweiger C., Tavazzi L., Urbinati S., Valagussa F., Vanuzzo D., Girardini D., Francesconi G., Vona M., Santoni R., Sarno C., Calisi P., Forzoni M., Boncompagni L., Tabouret G., Canci U., Rosato G., Stanco G., Gullace G., Carbone C., Gavazzi A., Mazzoleni D., Pinelli G., Frizzelli R., Tortelli O., Pantaleoni A., Mantovani E., Pettinati G., Storti G., Riccio C., Scrutinio D., Passantino A., Guiducci D., Zobbi G., Vanaria D., Barbanti P., Carini V., Coco R., Borrello G., Mazza M.L., Chiesa F., Sansoni C., Morbelli E., Rossi L., Ciglia C., Di Giovanni P., Cocchieri M., Dò V., Trudu A., Albonic D., Bendinelli S., Iori E., Balestra G., Giacometti N., Coppetti S., Priori S., Masotti G., Fattirolli F., Meniconi L., Paolucci P., Malinverni C., Quarenghi F., Fontanelli A., Marini R., Mandorla S., Provvidenza M., Giordano A., De Giuli F., Odoguardi L., Barsotti S., Moccetti T., Molteni A., Mauri F., Lecchi G., Bettini R., Bertoldi A., Zanettini R., Centeleghe P., Corallo S., Rainoldi M.L., Ferratini M., Tavanelli M., Leonetti G., Malfatto G., Pascotto P., Zanocco A., Buchberger R., Masaro G., Cobelli F., Sala L., Musca G., Cauteruccio M.A., Giallauria F., Mininni N., Morra P., Castello A., Sarullo F.M., Castelli D., Tramarin R., De Salvo M., Porcellati C., Giovagnoni F., Anniboletti P.F., Calisti M.G., Vergoni W., Iacopetti L., Zelaschi F., D'Cruz S., Lopizzo A., Caiazza M., Gigli G., Pastine J., Pulitanò G., Ruggeri A., Piovaccari G., Semprini P., Zavatteri G., Diaco T., Lumia F., Tamiz A.M., Oliva G., Galati A., Picelli A., Picelli F., Bosco R., Marcellini G., Zanchè E., Martin G., Masutti S., Milani L., Pizzolato G.M., Occhi G., Partesana N., Baldi N., Polimeni G., Furgi G., Nicolino A., Bevilacqua R., Ingignoli B., Massobrio N., Avogliero G., Pedretti R., Vaninetti R., Donnangelo L., Chiatto M., Gori P., Garbin R., RICCARDI, GABRIELE, VIGORITO, CARLO, Giannuzzi, P., Temporelli, P. L., Marchioli, R., Maggioni, A. P., Balestroni, G., Ceci, V., Chieffo, C., Gattone, M., Griffo, R., Schweiger, C., Tavazzi, L., Urbinati, S., Valagussa, F., Vanuzzo, D., Girardini, D., Francesconi, G., Vona, M., Santoni, R., Sarno, C., Calisi, P., Forzoni, M., Boncompagni, L., Tabouret, G., Canci, U., Rosato, G., Stanco, G., Gullace, G., Carbone, C., Gavazzi, A., Mazzoleni, D., Pinelli, G., Frizzelli, R., Tortelli, O., Pantaleoni, A., Mantovani, E., Pettinati, G., Storti, G., Riccio, C., Scrutinio, D., Passantino, A., Guiducci, D., Zobbi, G., Vanaria, D., Barbanti, P., Carini, V., Coco, R., Borrello, G., Mazza, M. L., Chiesa, F., Sansoni, C., Morbelli, E., Rossi, L., Ciglia, C., Di Giovanni, P., Cocchieri, M., Dò, V., Trudu, A., Albonic, D., Bendinelli, S., Iori, E., Balestra, G., Giacometti, N., Coppetti, S., Priori, S., Masotti, G., Fattirolli, F., Meniconi, L., Paolucci, P., Malinverni, C., Quarenghi, F., Fontanelli, A., Marini, R., Mandorla, S., Provvidenza, M., Giordano, A., De Giuli, F., Odoguardi, L., Barsotti, S., Moccetti, T., Molteni, A., Mauri, F., Lecchi, G., Bettini, R., Bertoldi, A., Zanettini, R., Centeleghe, P., Corallo, S., Rainoldi, M. L., Ferratini, M., Tavanelli, M., Leonetti, G., Malfatto, G., Pascotto, P., Zanocco, A., Buchberger, R., Masaro, G., Cobelli, F., Riccardi, Gabriele, Sala, L., Musca, G., Cauteruccio, M. A., Vigorito, Carlo, Giallauria, F., Mininni, N., Morra, P., Castello, A., Sarullo, F. M., Castelli, D., Tramarin, R., De Salvo, M., Porcellati, C., Giovagnoni, F., Anniboletti, P. F., Calisti, M. G., Vergoni, W., Iacopetti, L., Zelaschi, F., D'Cruz, S., Lopizzo, A., Caiazza, M., Gigli, G., Pastine, J., Pulitanò, G., Ruggeri, A., Piovaccari, G., Semprini, P., Zavatteri, G., Diaco, T., Lumia, F., Tamiz, A. M., Oliva, G., Galati, A., Picelli, A., Picelli, F., Bosco, R., Marcellini, G., Zanchè, E., Martin, G., Masutti, S., Milani, L., Pizzolato, G. M., Occhi, G., Partesana, N., Baldi, N., Polimeni, G., Furgi, G., Nicolino, A., Bevilacqua, R., Ingignoli, B., Massobrio, N., Avogliero, G., Pedretti, R., Vaninetti, R., Donnangelo, L., Chiatto, M., Gori, P., and Garbin, R.

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, GOSPEL, Angina Pectoris, law.invention, Angina, Randomized controlled trial, law, Internal medicine, Myocardial Revascularization, Secondary Prevention, Internal Medicine, medicine, Clinical endpoint, Humans, Myocardial infarction, Life Style, Stroke, Heart Failure, Cardiac Rehabilitation, business.industry, Surrogate endpoint, Hazard ratio, Middle Aged, medicine.disease, Heart failure, Physical therapy, Female, business, Stress, Psychological
Abstract

Background Secondary prevention is not adequately implemented after myocardial infarction (MI). We assessed the effect on quality of care and prognosis of a long-term, relatively intensive rehabilitation strategy after MI. Methods We conducted a multicenter, randomized controlled trial in patients following standard post-MI cardiac rehabilitation, comparing a long-term, reinforced, multifactorial educational and behavioral intervention with usual care. A total of 3241 patients with recent MI were randomized to a 3-year multifactorial continued educational and behavioral program (intervention group; n = 1620) or usual care (control group; n = 1621). The combination of cardiovascular (CV) mortality, nonfatal MI, nonfatal stroke, and hospitalization for angina pectoris, heart failure, or urgent revascularization procedure was the primary end point. Other end points were major CV events, major cardiac and cerebrovascular events, lifestyle habits, and drug prescriptions. Results End point events occurred in 556 patients (17.2%). Compared with usual care, the intensive intervention did not decrease the primary end point significantly (16.1% vs 18.2%; hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.74-1.04). However, the intensive intervention decreased several secondary end points: CV mortality plus nonfatal MI and stroke (3.2% vs 4.8%; HR, 0.67; 95% CI, 0.47-0.95), cardiac death plus nonfatal myocardial infarction (2.5% vs 4.0%; HR, 0.64; 95% CI, 0.43-0.94), and nonfatal MI (1.4% vs 2.7%; HR, 0.52; 95% CI, 0.31-0.86). A marked improvement in lifestyle habits (ie, exercise, diet, psychosocial stress, less deterioration of body weight control) and in prescription of drugs for secondary prevention was seen in the intervention group. Conclusion The GOSPEL Study is the first trial to our knowledge to demonstrate that a multifactorial, continued reinforced intervention up to 3 years after rehabilitation following MI is effective in decreasing the risk of several important CV outcomes, particularly nonfatal MI, although the overall effect is small. Trial Registration ClinicalTrials.gov Identifier:NCT00421876

Published
2008

8. The Italian survey on cardiac rehabilitation - 2008 (ISYDE-2008). Part 3. National availability and organization of cardiac rehabilitation facilities. Official report of the Italian association for cardiovascular prevention, rehabilitation and epidemiology (IACPR-GICR)

Author

Tramarin R., Ambrosetti M., De Feo S., Piepoli M., Riccio C., Griffo R., Carlon R., Castello A., Ferratini M., Schweiger C., Chieffo C., Diaco T., Ciglia C., Lapolla A., Pietropaolo F., Furgi G., Martin G., Semprini P., Avallone A., Bertoli D., Belardinelli R., Soffiantino F., Scrutinio D., Maxia P., Coco R., Giustarini C., Anniboletti P., Favretto G., Vaghi P., Calisi P., Chiavetta C., VIGORITO, CARLO, Tramarin, R., Ambrosetti, M., De Feo, S., Piepoli, M., Riccio, C., Griffo, R., Carlon, R., Castello, A., Ferratini, M., Schweiger, C., Chieffo, C., Vigorito, Carlo, Diaco, T., Ciglia, C., Lapolla, A., Pietropaolo, F., Furgi, G., Martin, G., Semprini, P., Avallone, A., Bertoli, D., Belardinelli, R., Soffiantino, F., Scrutinio, D., Maxia, P., Coco, R., Giustarini, C., Anniboletti, P., Favretto, G., Vaghi, P., Calisi, P., and Chiavetta, C.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, Cardiologia Riabilitativa, medicine.medical_treatment, attrezzature, Staffing, lcsh:Medicine, Ambulatory Care Facilities, Rehabilitation Centers, Health Services Accessibility, Age Distribution, Ambulatory care, Health care, Epidemiology, medicine, Humans, ISYDE 2008, strutture, Geriatrics, Rehabilitation, Cardiac Rehabilitation, business.industry, lcsh:R, Coronary Care Units, organization, medicine.disease, Long-term care, Italy, Cardiovascular Diseases, staffing, Health Care Surveys, Workforce, Physical therapy, program, Medical emergency, provision, Cardiology and Cardiovascular Medicine, business
Abstract

From January 28th to February 10th 2008, the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (IACPR-GICR) conducted the ISYDE- 2008 study, the primary aim of which was to take a detailed snapshot of cardiac rehabilitation (CR) provision in Italy – in terms of number and distribution of facilities, staffing levels, organization and setting – and compare the actual CR provision with the recommendations of national guidelines for CR and secondary prevention. The secondary aim was to describe the patient population currently being referred to CR and the components of the programs offered. Out of 190 cardiac rehabilitation centers existing in Italy in 2008, 165 (87%) took part in the study. On a national basis, there is one CR unit every 299,977 inhabitants: in northern Italy there is one CR unit every 263,578 inhabitants, while in central and southern Italy there is one every 384,034 and 434,170 inhabitants, respectively. The majority of CR units are located in public hospitals (59%), the remainder in privately owned health care organizations (41%). Fifty-nine percent are located in hospitals providing both acute and rehabilitation care, 32% are in specifically dedicated rehabilitation structures, while 8% operate in the context of residential long term care for chronic conditions. Almost three-quarters of CR units currently operating are linked to dedicated cardiology divisions (74%), 5% are linked to physical medicine and rehabilitation divisions, 2% to internal medicine, and 19% to cardiac surgery and other divisions. Inhospital care is provided by 62.4% of the centers; outpatient care is provided on a day-hospital basis by 10.9% of facilities and on an ambulatory basis by 20%. The CR units are led in 86% of cases by a cardiologist and in only 14% of cases by specialists in internal medicine, geriatrics, physical medicine and rehabilitation, pneumology or other disciplines. In terms of staffing, each cardiac rehabilitation unit has 4.0±2.7 dedicated physicians (range 1-16, mode 2), 10.1±8.0 nurses, 3.3±2.5 physiotherapists (range 0 – 20; 16% of services have no physiotherapist in the rehabilitation team), 1.5±0.8 psychologists, and a dietitian (present in 62% of CR units). Phase II CR programs are available in 67.9% of cases in residential (inpatient) and in 30.9% of cases in outpatient (day-hospital and ambulatory) settings. Phase III programs are offered by 56.4% of the centers in ambulatory outpatient regime, and on an at home basis by 4.8% with telecare supervision, 7.3% without. Long term secondary prevention follow up programs are provided by 42.4% of CR services.

9. A low pulse pressure is an independent predictor of mortality in heart failure: Data from a large nationwide cardiology database (IN-CHF registry)

Author

Schillaci, Giuseppe, Di Luzio, Silvia, Coluccini, Mario, Gonzini, Lucio, Porcu, Maurizio, Pozzar, Francesco, Maggioni, Aldo P, Investigators, Mezzani, A, Bielli, M, Milanese, U, Ugliengo, G, Pozzi, R, Rabajoli, F, Bosimini, E, Begliuomini, G, Ferrari, A, Barzizza, F, Valsecchi, Mg, Dadda, F, Faggiano, P, Castiglioni, G, Gibelli, G, Turelli, Al, Belluschi, R, Bianchi, C, Emanuelli, C, Gramenzi, S, Foti, G, Agnelli, D, Mascioli, G, Cazzani, E, Zanelli, E, Domenighini, D, Castelli, C, Moroni, E, Gara, S, Guzzetti, S, Muzzupappa, S, Turiel, M, Cappiello, E, Sandrone, G, Recalcati, F, Valenti, D, Achilli, F, Vincenzi, A, Rusconi, F, Palvarini, M, Ghio, S, Fontana, A, Giusti, A, Scelsi, L, Sebastiani, R, Ceresa, M, Nassiacos, D, Meloni, S, Nicoli, T, Bandini, P, Pedretti, R, Paolucci, M, Amati, L, Ravetta, M, Morandi, F, Provasoli, S, Bertolini, A, Imperiale, D, Agen, W, Planca, E, Quorso, P, Ferro, A, Pedrolli, C, Russo, P, Tarantini, L, Candelpergher, G, Cannarozzo, Pp, De Cian, F, Agnoli, A, Stefanini, Mg, Cacciavillani, L, Boffa, Gm, Mario, L, Renosto, G, Stritoni, P, Varotto, L, Penzo, M, Perini, G, Giuliano, G, Barducci, E, Piazza, R, Albanese, Mc, Fresco, C, Picco, F, Venturini, P, Camerini, A, Griffo, R, Derchi, G, Delfino, L, Pizzorno, L, Mazzantini, S, Torre, F, Orlandi, S, Bertoli, D, Gentile, A, Naccarella, F, Gatti, M, Coluccini, M, Morgagni, G, Alfano, G, Reggianini, L, Sansoni, S, Serra, W, Passerini, F, Del Corso, P, Rusconi, L, Marzaloni, M, Mezzetti, M, Gambarati, Gp, Mariani, Pr, Volterrani, C, Venturi, F, Zambaldi, G, Casolo, G, Moschi, G, Geri Brandinelli, G, Miracapillo, G, Boni, A, Italiani, G, Vergoni, W, Paci, Ap, Lattanzi, F, Reisenhofer, B, Severini, D, Taddei, T, Dalle Luche, A, Comella, A, Gasperini, U, Cocchieri, M, Alunni, G, Bosi, E, Panciarola, R, Maragoni, G, Bardelli, G, Testarmata, P, Pasetti, L, Budini, A, Gabrielli, D, Coderoni, B, Midi, P, Romaniello, C, Del Sindaco, D, Leggio, F, Terranova, A, Pulignano, G, Pozzar, P, Ansalone, G, Magris, B, Giannantoni, P, Cacciatore, G, Bottero, G, Scaffidi, G, Valtorta, C, Salustri, A, Amaddeo, F, Barbato, G, Aspromonte, N, Baldo, V, Baldo, E, Frattaroli, C, Mariani, A, Di Marco, G, Levantesi, G, Potena, Ap, Colonna, N, Montano, A, Sensale, P, Maiolica, O, Somelli, A, Napolitano, F, Provvisiero, P, Bottiglieri, P, Ciriello, N, Angelini, E, Andriulo, C, De Santis, F, Cocco, F, Pennetta, A, Mariello, F, Magliari, F, De Giorgi, A, Callerame, M, Santoro, V, Pede, S, Renna, A, De Donno, O, De Lorenzi, E, Polimeni, V, Russo, Va, Mangia, R, Truncellito, L, Cariello, Fp, Affinita, M, Perticone, F, Cloro, C, Borelli, D, Matta, M, Lopresti, D, Misuraca, A, Caporale, R, Chiappetta, P, Tripodi, E, Tassone, F, Salituri, S, Errigo, C, Meringolo, G, Donnangelo, L, Canonico, G, Coco, R, Franco, M, Coglitore, A, Donato, A, Di Tano, G, Cento, D, DE GREGORIO, Cesare, Mongiovì, M, Schillaci, Am, Mirto, U, Clemenza, F, Ingrillì, F, Cavallaro, A, Aloisi, B, Ledda, G, Rizzo, C, Porcu, M, Salis, S, Pistis, L, Pili, G, Piras, S, Maoddi, I, and Uras, F.

Subjects
Adult, Male, medicine.medical_specialty, Blood Pressure, Independent predictor, Low pulse pressure, Predictive Value of Tests, Internal medicine, Humans, Medicine, Aged, Female, Follow-Up Studies, Heart Failure, Italy, Middle Aged, Pulse, Registries, Stroke Volume, business.industry, medicine.disease, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

A high pulse pressure (PP) predicts cardiovascular mortality in hypertension and in the elderly. We analyzed the data from the Italian Network of Congestive Heart Failure Registry to test the prognostic role of PP in patients with heart failure.A total of 8660 patients with heart failure (mean age 64 +/- 12 years, 73% male) were divided into four groups according to their PP (40, 40-49, 50-59, andor = 60 mmHg), and followed prospectively.After 1 year, 995 patients (11.5%) died. Both the mean arterial pressure and systolic blood pressure were found to be inversely associated with mortality at univariate and multivariate analyses. An inverse univariate relation was observed between PP and all-cause mortality. An excess mortality risk in the lowest PP group (odds ratio 1.40, 95% confidence interval 1.09-1.79 vs the highest PP group) was confirmed in a multivariate analysis which took into account the effect of several other variables, including mean arterial pressure. Similar findings were obtained for cardiovascular mortality. When we replaced systolic blood pressure with mean arterial pressure in the model, PP did not retain its independent prognostic role, possibly because of the high co-linearity between these two variables (r = 0.87).For any given level of mean arterial pressure, a low PP is an independent predictor of all-cause and cardiovascular death in patients with heart failure. The association may be partly related to the strong influence of low systolic blood pressure on mortality. Different pathophysiological mechanisms may underlie the opposite prognostic significance of PP in hypertension and heart failure.

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10. ANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy

Author

Claudio Cricelli, Roberto Ferrari, Marino Scherillo, Gerardo Medea, Alberico L. Catapano, Giovanni Battista Zito, Mauro Campanini, Maurizio Averna, Simona Giampaoli, Andrea Di Lenarda, Francesco Rossi, Giuseppe Musumeci, Pompilio Faggiano, Attilio Maseri, Leonardo Bolognese, Enzo Bonora, Giorgio Cantelli Forti, Pasquale Perrone Filardi, Aldo P. Maggioni, Marcello Arca, Damiano Parretti, Gualtiero Ricciardi, Carmine Riccio, Raffaele Griffo, Maria Pia Ruggieri, Ferruccio Ceriotti, Enrico Pusineri, Michele Massimo Gulizia, Francesco Perticone, Furio Colivicchi, Francesco Romeo, Antonio Vittorio Panno, Nicoletta Musacchio, Federico Nardi, Maurizio Giuseppe Abrignani, Alessandro Mugelli, Marcello Ciaccio, Maria Stella Graziani, Gulizia, M., Colivicchi, F., Ricciardi, G., Giampaoli, S., Maggioni, A., Averna, M., Graziani, M., Ceriotti, F., Mugelli, A., Rossi, F., Medea, G., Parretti, D., Abrignani, M., Arca, M., Perrone Filardi, P., Perticone, F., Catapano, A., Griffo, R., Nardi, F., Riccio, C., Di Lenarda, A., Scherillo, M., Musacchio, N., Panno, A., Zito, G., Campanini, M., Bolognese, L., Faggiano, P., Musumeci, G., Pusineri, E., Ciaccio, M., Bonora, E., Cantelli Forti, G., Ruggieri, M., Cricelli, C., Romeo, F., Ferrari, R., Maseri, A., Gulizia, Mm, Colivicchi, F, Ricciardi, G, Giampaoli, S, Maggioni, Ap, Averna, M, Graziani, M, Ceriotti, F, Mugelli, A, Rossi, F, Medea, G, Parretti, D, Abrignani, Mg, Arca, M, Perrone Filardi, P, Perticone, F, Catapano, A, Griffo, R, Nardi, F, Riccio, C, Di Lenarda, A, Scherillo, M, Musacchio, N, Panno, Av, Zito, G, Campanini, M, Bolognese, L, Faggiano, Pm, Musumeci, M, Pusineri, E, Ciaccio, M, Bonora, E, Cantelli Forti, G, Ruggieri, Mp, Cricelli, C, Romeo, F, Ferrari, R, and Maseri, A

Subjects
medicine.medical_specialty, Settore MED/09 - Medicina Interna, PCSK9 inhibitor, MEDLINE, 030204 cardiovascular system & hematology, NO, atherosclerosis, diagnostic and therapeutic pathways, hypercholesterolaemia, PCSK9 inhibitors, statins, sustainable health care, Diagnostic and therapeutic pathways, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Ezetimibe, Internal medicine, Diabetes mellitus, medicine, 030212 general & internal medicine, Intensive care medicine, Risk management, Cause of death, Hypercholesterolaemia, business.industry, Atherosclerotic cardiovascular disease, Cholesterol, Sustainable health care, Statins, Diagnostic and therapeutic pathway, Statin, High Cholesterol Levels, Articles, medicine.disease, Atherosclerosis, chemistry, Atherosclerosi, Cardiology, lipids (amino acids, peptides, and proteins), Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Atherosclerotic cardiovascular disease still represents the leading cause of death in western countries. A wealth of scientific evidence demonstrates that increased blood cholesterol levels have a major impact on the outbreak and progression of atherosclerotic plaques. Moreover, several cholesterol-lowering pharmacological agents, including statins and ezetimibe, have proven effective in improving clinical outcomes. This document is focused on the clinical management of hypercholesterolemia and has been conceived by 16 Italian medical associations with the support of the Italian National Institute of Health. The authors have considered with particular attention the role of hypercholesterolemia in the genesis of atherosclerotic cardiovascular disease. Besides, the implications of high cholesterol levels in the definition of the individual cardiovascular risk profile have been carefully analyzed, while all available therapeutic options for blood cholesterol reduction and cardiovascular risk mitigation have been considered. Finally, this document outlines the diagnostic and therapeutic pathways for the clinical management of patients with hypercholesterolemia.

Published
2017

11. Quality of work experience after angioplasty or heart surgery: a monocentric cohort study

Author

Gaia Savioli, Massimo Miglioretti, Andrea Gragnano, Giacomo Baiardo, Luca Corsiglia, Raffaele Griffo, Miglioretti, M, Gragnano, A, Baiardo, G, Savioli, G, Corsiglia, L, and Griffo, R

Subjects
Adult, Male, Rehabilitation hospital, medicine.medical_specialty, Job involvement, Return to work, medicine.medical_treatment, Workload, 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Angioplasty, medicine, Humans, Prospective Studies, Cardiac Surgical Procedures, Depression (differential diagnoses), Quality of work life, Rehabilitation, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, Cardiovascular disease, 030210 environmental & occupational health, Surgery, Italy, Job satisfaction, Anxiety, Female, medicine.symptom, business, Cohort study
Abstract

The study evaluated work experience changes and its determinants after return to work (RTW) in angioplasty or heart surgery patients. During a 1-year period (2014) in a Rehabilitation Hospital in northwestern Italy, we approached 253 patients (19.3% of inpatients). 199 patients consented to complete a survey on job characteristics, job satisfaction, job involvement, illness perception, depression, anxiety, adherence to therapy, and sociodemographic characteristics. The data were analysed with paired sample t tests and random intercept regression models. 156 patients completed both the baseline and the 6-month follow-up assessments. After 6 months, 137 (88%) patients return to work (86% male, M age = 51.9 ± 8.1). The patients predominantly underwent angioplasty/bypass (46%) or valve replacement/repair (38%). Work hours (WO), job satisfaction (JS), and job involvement (JI) significantly decreased after RTW (WO: t (132) = 2.07, p

Published
2017

12. Cardiac Prevention and Rehabilitation '3.0': From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR)

Author

Cesare Greco, Gian Francesco Mureddu, Oreste Febo, Maria Teresa La Rovere, Francesco Giallauria, Marco Ambrosetti, Carmine Riccio, Manuela Iannucci, Pompilio Faggiano, Silvia Brazzo, Nicolò Dasseni, Simonetta Scalvini, Antonio Mazza, Raffaele Griffo, Ugo Corrà, Elisabetta Angelino, Giuseppe Favretto, Roberto F.E. Pedretti, Mario Mallardo, Pier Luigi Temporelli, Marina Ferrari, Massimo Piepoli, Luigi Tavazzi, Francesco Fattirolli, Pedretti, RFE(1), Fattirolli, F, Griffo, R, Ambrosetti, M, Angelino, E, Brazzo, S, Corrà, U, Dasseni, N, Faggiano, P, Favretto, G, Febo, O, Ferrari, M, Giallauria, F, Greco, C, Iannucci, M, La Rovere, Mt, Mallardo, M, Mazza, A, Piepoli, M, Riccio, C, Scalvini, S, Tavazzi, L, Temporelli, Pl, and Mureddu, Gf.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Heart Diseases, medicine.medical_treatment, Psychological intervention, Cardiac rehabilitation, lcsh:Medicine, Subspecialty, Phase (combat), Quality of life (healthcare), Health care, Humans, Medicine, Intensive care medicine, Societies, Medical, Secondary prevention, Rehabilitation, business.industry, lcsh:R, Prognosis, Italy, Cardiovascular Diseases, Acute Disease, Chronic Disease, Quality of Life, Position paper, Cardiology and Cardiovascular Medicine, business, secondary prevention
Abstract

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Once centered on the acute phase, aimed primarily at short-term survival, the healthcare of cardiac patients now increasingly involves the chronic phase where the challenge is to guarantee continuity and quality of care in the medium and long-term. The aim of the present position paper is to provide the state-of-the-art of CR in Italy, discussing its trengths and weaknesses as well as future perspectives.

Published
2018

13. Cardiac rehabilitation in chronic heart failure

Author

Francesco, Giallauria, Francesco, Fattirolli, Roberto, Tramarin, Marco, Ambrosetti, Raffaele, Griffo, Carmine, Riccio, Carlo, Vigorito, Loris, Roncon, Giallauria, Francesco, Fattirolli, F, Tramarin, R, Ambrosetti, M, Griffo, R, Riccio, C, and Vigorito, Carlo.

Subjects
Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Comorbidity, Risk Assessment, Ventricular Function, Left, Risk Factors, Odds Ratio, medicine, Humans, Prospective Studies, Myocardial infarction, Prospective cohort study, Aged, Aged, 80 and over, Heart Failure, Chi-Square Distribution, Rehabilitation, business.industry, Stroke Volume, General Medicine, Odds ratio, Stroke volume, Length of Stay, Middle Aged, medicine.disease, Patient Discharge, chronic heart failure, cardiac rehabilitation, Logistic Models, Treatment Outcome, Italy, Health Care Surveys, Heart failure, Chronic Disease, Multivariate Analysis, cardiovascular system, Physical therapy, Female, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

BACKGROUND: Using data from the Italian SurveY on carDiac rEhabilitation (ISYDE-2008), this study provides insight into the level of implementation of cardiac rehabilitation in patients with chronic heart failure (CHF). METHODS: Data from 165 Italian cardiac rehabilitation units were collected online from 28 January to 10 February 2008. RESULTS: The study cohort consisted of 2281 patients (66.9 ± 11.8 years): 285 (71.3 ± 12.2 years, 66% male) CHF patients and 1996 (66.3 ± 11.6 years, 74% male) non-CHF patients. Compared with non-CHF, CHF patients were older, showed more comorbidity, had lower left ventricular (LV) ejection fraction and reduced access to functional evaluation, underwent more complications during cardiac rehabilitation, and had longer length of in-hospital stay. CHF patients were also more likely to be transferred to ICU (9 versus 3%, P

Published
2014

14. Experimental results on the effectiveness of microwave treatment of phoenix canariensis palm infested by Rhynchophorus ferrugineus

Author

Gaetano Panariello, R. Griffo, Fulvio Schettino, Daniele Pinchera, Emilio Caprio, Annamaria Greco, Rita Massa, Marco Donald Migliore, Massa, Rita, Greco, A., Caprio, Emilio, Panariello, G., Migliore, M. D., Pinchera, D., Schettino, F., and Griffo, R.

Subjects
microwave pest control, Phoenix canariensis palm, Red Palm Weevil, biology, business.industry, Pest control, High effectiveness, biology.organism_classification, Electromagnetic heating, Microwave applications, Rhynchophorus, Horticulture, Phoenix canariensis, microwave pest control, Phoenix canariensis palm, Mediterranean area, Environmental science, Red Palm Weevil, business, Palm
Abstract

High power microwave applications can be considered an attractive and eco-compatibile solution for contrasting the diffusion of Rhynchophorus ferrugineus, one of the major threats to palm in the Mediterranean area. In this work we present the results of a research activity aimed to obtain by palm dielectric heating temperatures that are lethal for the insect without damaging the plant tissues. Laboratory and semi-field tests showed an high effectiveness of the techniques.

Published
2015

15. Does the return to work have a negative impact on the lifestyle of cardiovascular patients? Comments on the ICAROS results

Author

Massimo Miglioretti, Marco Ambrosetti, Roberto Tramarin, Annarita Vestri, Andrea Gragnano, Raffaele Griffo, Miglioretti, M, Gragnano, A, Griffo, R, Ambrosetti, M, Tramarin, R, and Vestri, A

Subjects
Male, Gerontology, medicine.medical_specialty, Logistic regression, Odds, healthy lifestyle, Humans, Medicine, Life Style, Depression (differential diagnoses), cardiac rehabilitation, cardiovascular patients, return to work, Job strain, business.industry, Odds ratio, Middle Aged, M-PSI/06 - PSICOLOGIA DEL LAVORO E DELLE ORGANIZZAZIONI, Cardiac rehabilitation, Cardiovascular patients, Healthy lifestyle, Return to work, Physical therapy, Absenteeism, Patient Compliance, Female, Job satisfaction, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

Dear Editor,Although cardiovascular disease (CVD) is most prevalent in theelderly, it often affects patients in their productive years prior toretirement age (65–70 years) [1]. In this case, almost always,medical and rehabilitative support has the objective to promotethe return to work (RTW) [2]. Previous studies have focused onvariables that can affect a more rapid and satisfactory RTW, andthese studies concluded that the RTW after CVD is a complex andmultidimensional process that is more influenced by psychosocialfactors (e.g., depression, work strain, job satisfaction, and workplacejustice) than by the patient's clinical status (e.g., left ventricularejection fraction) [3,4]. The RTW after a cardiovascular event is noteasy [5], and observational studies have reported that workers withCVD show increased rates of absenteeism and disability periodscompared with workers without CVD [6]. There is an abundance ofscientific literature demonstrating that lifestyle interventions inpatients with CAD can reduce the risk of new events, improve thesurvival and the quality of life [7,8]. Nevertheless, the influence ofwork on healthy lifestyle is relatively unknown and adverse jobconditions, characterized by high job strain, might increase thelikelihood of co-occurring health risk behaviors [9].Wethusanalyzed the data collected with the Italian survey on CardiacRehabilitation and Secondary prevention after cardiac revascular-ization (ICAROS) to verify patient adherence to a healthy lifestyle.ICAROS has already been described elsewhere [8,10].Inbrief,itisaprospective, longitudinal, multicenter registry with on-line datacollection that evaluates the achievement and maintenance ofrecommended lifestyle targets and risk control after completing acomprehensive inpatient or outpatient cardiac rehabilitation pro-gram aftercardiac revascularization. The lifestyle data collectionwasperformed by trained investigators at discharge from the CardiacRehabilitation program, as well as 6 months and 1 year later, using abrief questionnaire that analyzed smoking habits (smoking vs. nosmoking), diet (the consumption frequency of vegetables, fruit, fish,olive oil and cheese/butter was evaluated to obtain a Mediterraneandiet score, which was then categorized into good or bad diet), andphysical activity (never/rarely vs. ≥30 min/session of moderateintensity exercise per 3 times/week) [8,10]. The ethical committeefor each center approved the protocol, and informed consent wasobtained from each patient. To obtain a balanced sample for thisresearch,accordingtothecurrentincreasein meanretirementageinItaly, we extracted only working age patients (b70) from the ICAROSdatabase, and we divided them into two groups: workers and non-workers before CVD. Using these categories, we selected 789 of 1272patients; demographic and lifestyle profiles of the study populationsare reported in Table 1.Inoursample,thenumberofworkingpeopledecreasedovertime.Atthe moment of the index event workers were 51.5% of the studypopulation:6and12 monthsaftertheendofthesupervisedCRprogrampatient with a profitable work were 47 and 38.9%, respectively. Thus,9.6% of those that were working before CVD did not return to work6 months after discharge, and 17.3% of those that returned to work lefttheir jobs within the first 12 months after discharge.We performed 3 logistic regressions to assess the influence ofwork on smoking behavior, dietary habits and physical activity,controlling for the effects of time after discharge, other lifestylehabits, intervention type, age and sex (Table 2 ).The logistic regressionused to predict smoking behavior revealedthat the odds for smoking was 1.84 (95% CI = 1.13–2.99) timesgreater for workers compared with non-workers. Nevertheless, sex(male odds ratio (OR) = 2.75; 95% CI = 1.25–6.03) and, weakly, age(OR = 0.97; 95% CI = 0.94–0.99) also affected smoking behavior.The return to work did not have an effect on dietary habits andphysical activity. However, our data suggested that these lifestylebehaviors were linked. Indeed, bad dietary habits increased theprobability of smoking (OR = 1.81; 95% CI = 1.23–2.66), smokingbehavior decreased the probability of adopting a healthy diet(OR = 0.62; 95% CI = 0.39–1.00) and adopting a healthy dietincreased the probability of being physically active (≥3times/week), with an odds ratio of 1.98 (95% CI = 1.56–2.40).Our data highlighted three important aspects related to thereturn to work and lifestyle modification that, to the best of ourknowledge, were previously unexplored. First, a considerable groupof CVD patients returned to work but then, within the first yeardecided to retire; second, patients that returned to work had anincreased risk of not quitting. Finally patients with a defectivecontrol of one lifestyle risk factors are at higher risk for adoption ofan additional unhealthy lifestyle. Because the return to work for CVDpatients is psychologically stressful [4,6], it might be postulated thatsome patients decide to retire and that other patients resumesmoking after the RTW as a result of maladaptive coping strategies.In conclusion, this ancillary analysis of ICAROS highlights theimportance of considering in patients with CAD not only the RTWbut also their level of functioning once they are back at work [10].Inparticular, one question raised here is whether it is possible tobalance work life with a healthy lifestyle or if the RTW leads tosmoking and other unhealthy behaviors. From this perspective, wethink that our data open an interesting field of research and a newrole for cardiac rehabilitation.

Published
2014

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