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1. Spontaneous coronary artery dissection: Overview of pathophysiology

Author

Domenico Gabrielli, Stefania Angela Di Fusco, Furio Colivicchi, Annamaria Iorio, Luigi Pollarolo, Roberta Rossini, Fortunato Scotto di Uccio, Michele Massimo Gulizia, Fabiana Lucà, and Filippo Zilio

Subjects
medicine.medical_specialty, Acute coronary syndrome, business.industry, Coronary Vessel Anomalies, 030204 cardiovascular system & hematology, Coronary Angiography, medicine.disease, Research findings, Pathophysiology, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Vascular Diseases, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Intensive care medicine, Artery dissection, Scad, business
Abstract

The growing use of imaging examinations has led to increased detection of spontaneous coronary artery dissection (SCAD) as a non-atherosclerotic cause of acute coronary syndrome (ACS). Since a greater awareness of pathophysiologic mechanisms has relevant implications in clinical practice, we aim to provide an update to current knowledge of SCAD pathophysiology. We discuss the most common conditions associated with SCAD, including predisposing factors and triggers, and focus on potential mechanisms leading to SCAD development. Furthermore, we report the main genetic research findings that have shed further light on SCAD pathophysiology. Finally, we summarize practical considerations in SCAD management based on pathophysiologic insights.

Published
2022
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2. How to keep the cath-lab of a COVID-free hub center during the pandemic in a hub and spoke cardiology network: a single center's experience

Author

Michele Dallago, Filippo Zilio, Simone Muraglia, Marco Borghesi, Roberto Bonmassari, Daniel Todaro, and Giuseppe Braito

Subjects
medicine.medical_specialty, Acute coronary syndrome, Cath lab, SARS-CoV-2, business.industry, Cardiology, COVID-19, Crash, Chest pain, Single Center, medicine.disease, Internal medicine, Intensive care, Pandemic, Health care, medicine, Humans, ST Elevation Myocardial Infarction, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Pandemics
Abstract

BACKGROUND: north of Italy has been one of the most affected area in the world by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). The healthcare system has been overwhelmed by the huge number of patients in need of mechanical ventilation or intensive care, resulting in a delay of treatment of patients with acute coronary syndrome (ACS), due to a crash in STEMI networks and closure of a certain number of hub centers, and to a delay in patients' seeking for medical evaluation for chest pain or angina-equivalent symptoms. METHODS: in the Trentino region, a mountainous area with about 500,000 inhabitants, very close to Lombardy that was the epicenter of the pandemic in Italy, to avoid these dramatic consequences, we developed a new protocol tailored to our specificity to keep our institution, and above all the cath-lab, clean from the SARS-CoV-2 infection, to ensure full operativity for cardiologic emergencies. RESULTS: Applying this protocol during the two months of the peak of the infection in Italy no one of the staff members of the cath-lab, the ICCU or the cardiology ward tested positive to nasal swab for SARS-CoV-2 and the same result was obtained for all the patients admitted to our units. CONCLUSIONS: our real world experience shows that during the COVID-19 pandemic, quick activation of an appropriate protocol defining specific pathways for patients with a medical urgency is effective in minimizing healthcare personnel exposure and to preserve full operativity of the hub centers. This issue will be of a crucial importance, now that we are facing the second wave of the pandemic.

Published
2022
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3. Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI

Author

Giuseppe De Luca, Pierre Deharo, Pierfrancesco Agostoni, Gabriele Gabrielli, Francisco Bosa Ojeda, Ylitalo Antti, Lisette Okkels Jensen, Bor Wilbert, Luigi Vignali, Fortunato Scotto Di Uccio, Dariusz Dudek, Marco Boccalatte, Monica Verdoia, Edouard Benit, Gianni Casella, Heidi Lehtola, Alessandra Scoccia, Tim Kinnaird, Massimo Siviglia, Raul Moreno, Vladimir Ganyukov, Arpad Lux, Mika Laine, Adrian P. Banning, Santiago Camacho-Freiere, Guido Parodi, José Moreu, Michał Kidawa, Miha Cercek, Victor Becerra, Stephane Manzo, Elvin Kedhi, Marija Vavlukis, Filippo Zilio, Ciro De Simone, Nikola Bakraceski, Xavier Carrillo, Giuseppe Uccello, Maurizio Menichelli, Gerard Rourai Ferrer, Dimitrios Alexopoulos, Benjamin Faurie, Jurriën M. ten Berg, Lucia Marinucci, Juan Sanchis Forés, Giovanni Amoroso, Sébastien Levesque, Bernardo Tuccillo, Enrico Fabris, Peter Ludman, Rui Campante Teles, Wojtek Wojakowski, Leonardo Spedicato, Lucian Calmac, Yves Cottin, Maurits T. Dirksen, Petr Kala, Thomas W Johnson, Xacobe Flores Rios, Gianluca Caiazzo, Clemens van Birgelen, Francesco Versaci, Alexander Ijsselmuiden, Luca Donazzan, Kees-Jan Royaards, Adriaan O. Kraaijeveld, Alejandro Gutierrez Barrios, Gennaro Galasso, Vincenzo Guiducci, Julinda Mehilli, Giuseppe Cirrincione, Andrea Santucci, Giuliana Cortese, José Luis Díez Gil, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Periklis Davlouros, Tomas Kovarnik, Arturo García-Touchard, Pieter C. Smits, De Luca, G., Verdoia, M., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., van Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., Lux, A., Kovarnik, T., Davlouros, P., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Alexopulos, D., Moreno, R., Kedhi, E., Uccello, G., Faurie, B., Gutierrez Barrios, A., Di Uccio, F. S., Wilbert, B., Smits, P., Cortese, G., Parodi, G., Dudek, D., banning, adrian/0000-0002-2842-7861, GUIDUCCI, VINCENZO/0000-0002-0833-2785, vavlukis, marija/0000-0002-4479-6691, Bor, Willem L/0000-0002-3253-5961, DAVLOUROS, PERIKLIS/0000-0002-1439-1992, Uccello, Giuseppe/0000-0002-6163-8468, Kidawa, Michal/0000-0002-5000-6561, [De Luca, Giuseppe] Univ Piemonte Orientale, Div Cardiol, Azienda Osped Univ Maggiore Carita, Novara, Italy, [Verdoia, Monica] Osped Inferm Biella, ASL Biella, Div Cardiol, Biella, Italy, [Cercek, Miha] Univ Med Ctr, Ctr Intens Internal Med, Ljubljana, Slovenia, [Jensen, Lisette Okkels] Odense Univ Hosp, Div Cardiol, Odense, Denmark, [Vavlukis, Marija] Ss Cyril & Methodius Univ, Med Fac, Univ Clin Cardiol, Skopje, North Macedonia, [Calmac, Lucian] Clin Emergency Hosp Bucharest, Bucharest, Romania, [Johnson, Tom] Univ Hosp Bristol NHSFT, Bristol Heart Inst, Div Cardiol, Bristol, Avon, England, [Johnson, Tom] Univ Bristol, Bristol, Avon, England, [Ferrer, Gerard Rourai] Hosp Univ Bellvitge, Heart Dis Inst, Intervent Cardiol Unit, Barcelona, Spain, [Ganyukov, Vladimir] State Res Inst Complex Issues Cardiovasc Dis, Div Cardiol, Kemerovo, Russia, [Wojakowski, Wojtek] Med Univ Silezia, Div Cardiol, Katowice, Poland, [Kinnaird, Tim] Univ Hosp Wales, Div Cardiol, Cardiff, Wales, [van Birgelen, Clemens] Thoraxctr Twente, Dept Cardiol, Med Spectrum Twente, Enschede, Netherlands, [Cottin, Yves] Univ Hosp, Div Cardiol, Dijon, France, [IJsselmuiden, Alexander] Amphia Hosp, Div Cardiol, Breda, Netherlands, [Tuccillo, Bernardo] Osped Mare, Div Cardiol, Naples, Italy, [Di Uccio, Fortunato Scotto] Osped Mare, Div Cardiol, Naples, Italy, [Versaci, Francesco] Osped Santa Maria Goretti, Div Cardiol, Latina, Italy, [Royaards, Kees-Jan] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Smits, Pieter] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Ten Berg, Jurrien] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Wilbert, Bor] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Laine, Mika] Helsinki Univ Cent Hosp, Div Cardiol, Helsinki, Finland, [Dirksen, Maurits] Northwest Clin, Div Cardiol, Alkmaar, Netherlands, [Siviglia, Massimo] Osped Riuniti Reggio Calabria, Div Cardiol, Reggio Di Calabria, Italy, [Casella, Gianni] Osped Maggiore Bologna, Div Cardiol, Bologna, Italy, [Kala, Petr] Masaryk Univ, Univ Hosp Brno, Med Fac, Brno, Czech Republic, [Diez Gil, Jose Luis] H Univ & Politecn La Fe, Valencia, Spain, [Banning, Adrian] John Radcliffe Hosp, Oxford, England, [Becerra, Victor] Hosp Clin Univ Virgen Victoria, Malaga, Spain, [De Simone, Ciro] Clin Villa Fiori, Div Cardiol, Acerra, Italy, [Santucci, Andrea] Osped Santa Maria Misericordia, Perugia, Italy, [Carrillo, Xavier] Hosp Germans Triasi Pujol, Badalona, Spain, [Scoccia, Alessandra] Osped St Anna, Div Cardiol, Ferrara, Italy, [Amoroso, Giovanni] Onze Lieve Vrouwe Gasthuis OLVG, Amsterdam, Netherlands, [Lux, Arpad] Mastricht Univ, Med Ctr, Maastricht, Netherlands, [Kovarnik, Tomas] Charles Univ Hosp, Prague, Czech Republic, [Davlouros, Periklis] Patras Univ Hosp, Invas Cardiol & Congenital Heart Dis, Patras, Greece, [Mehilli, Julinda] Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Munich, Germany, [Gabrielli, Gabriele] Azienda Osped Univ, Intervent Cardiol Unit, Osped Riuniti, Ancona, Italy, [Rios, Xacobe Flores] Complexo Hosp Univ La Coruna, La Coruna, Spain, [Bakraceski, Nikola] Ctr Cardiovasc Dis, Ohrid, North Macedonia, [Levesque, Sebastien] CHU Poitiers, Univ Hosp, Poitiers, France, [Cirrincione, Giuseppe] Osped Civ Arnas, Div Cardiol, Palermo, Italy, [Guiducci, Vincenzo] AUSL IRCCS, Reggio Emilia, Italy, [Kidawa, Michal] Med Univ Lodz, Cent Hosp, Lodz, Poland, [Spedicato, Leonardo] Osped Santa Maria Misericordia, Div Cardiol, Udine, Italy, [Marinucci, Lucia] Osped Riuniti Marche Nord, Div Cardiol, Azienda Osped, Pesaro, Italy, [Ludman, Peter] Univ Hosp Birmingham, Birmingham, W Midlands, England, [Zilio, Filippo] Osped Santa Chiara, Trento, Italy, [Galasso, Gennaro] Osped San Giovanni Dio Ruggi Aragona, Div Cardiol, Salerno, Italy, [Fabris, Enrico] Univ Ospedali Riuniti, Azienda Osped, Trieste, Italy, [Menichelli, Maurizio] Osped F Spaziani, Div Cardiol, Frosinone, Italy, [Garcia-Touchard, Arturo] Hosp Puerta Hierro, Div Cardiol, Majadahonda, Spain, [Manzo, Stephane] Paris 07 Univ, CHU Lariboisiere, AP HP, Div Cardiol,INSERM,UMRS 942, Paris, France, [Caiazzo, Gianluca] Osped G Moscati, Div Cardiol, Aversa, Italy, [Moreu, Jose] Complejo Hosp Toledo, Div Cardiol, Toledo, Spain, [Sanchis Fores, Juan] Hosp Clin Univ Valencia, Div Cardiol, Valencia, Spain, [Donazzan, Luca] Osped S Maurizio Bolzano, Div Cardiol, Bolzano, Italy, [Vignali, Luigi] Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy, [Teles, Rui] Hosp Santa Cruz, Div Cardiol, CHLO Carnaxide, Lisbon, Portugal, [Benit, Edouard] Jessa Ziekenhuis, Div Cardiol, Hasselt, Belgium, [Agostoni, Pierfrancesco] Ziekenhuis Netwerk Antwerpen ZNA Middelheim, Div Cardiol, Antwerp, Belgium, [Bosa Ojeda, Francisco] Hosp Univ Canarias, Div Cardiol, Santa Cruz De Tenerife, Spain, [Lehtola, Heidi] Oulu Univ Hosp, Div Cardiol, Oulu, Finland, [Camacho-Freiere, Santiago] Juan Ramon Jimenez Hosp, Div Cardiol, Huelva, Spain, [Kraaijeveld, Adriaan] UMC Utrecht, Div Cardiol, Utrecht, Netherlands, [Antti, Ylitalo] Univ Hosp, Heart Ctr, Div Cardiol, Turku, Finland, [Boccalatte, Marco] Osped Santa Maria Grazie, Div Cardiol, Pozzuoli, Italy, [Deharo, Pierre] Aix Marseille Univ, CHU Timone, Div Cardiol, Marseille, France, [Lozano Martinez-Luengas, Inigo] Hosp Cabuenes, Div Cardiol, Gijon, Spain, [Scheller, Bruno] Univ Saarland, Div Cardiol Clin & Expt Intervent Cardiol, Homburg, Germany, [Alexopoulos, Dimitrios] Attikon Univ Hosp, Div Cardiol, Athens, Greece, [Moreno, Raul] Hosp Paz, Div Cardiol, Madrid, Spain, [Kedhi, Elvin] St Jan Hosp, Div Cardiol, Brugge, Belgium, [Uccello, Giuseppe] Osped A Manzoni Lecco, Div Cardiol, Lecce, Italy, [Faurie, Benjamin] Grp Hosp Mutualiste Grenoble, Div Cardiol, Grenoble, France, [Gutierrez Barrios, Alejandro] Hosp Puerta Mar, Div Cardiol, Cadiz, Spain, [Cortese, Giuliana] Univ Padua, Dept Stat Sci, Padua, Italy, [Parodi, Guido] Azienda Osped Univ Sassari, Sassari, Italy, [Dudek, Dariusz] Jagiellonian Univ Med Coll, Inst Cardiol, Krakow, Poland, RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Male, Internationality, medical decision-making, medicine.medical_treatment, 030204 cardiovascular system & hematology, Rate ratio, COVID-19 (coronavirus), Settore MED/06, 0302 clinical medicine, Pandemic, Percutaneous Coronary Intervention/statistics & numerical data, Medicine, Viral, 030212 general & internal medicine, Myocardial infarction, Registries, Acute myocardial-infarction, Original Investigation, STEMI, ST-segment elevation myocardial infarction, Middle Aged, 3. Good health, Europe, fibrinolysis, Female, COVID-19, primary angioplasty, STEMI, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Coronavirus Infections, Pandemics, Pneumonia, Viral, Cardiology and Cardiovascular Medicine, Editorial Comment, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Primary angioplasty, IRR, incidence rate ratio, Europe/epidemiology, 03 medical and health sciences, Betacoronavirus, cardiovascular diseases, Mortality, PCI, percutaneous coronary intervention, DES, drug-eluting stent(s), business.industry, ST Elevation Myocardial Infarction/mortality, PPCI, primary PCI, SARS-CoV-2, MORTALITY, Percutaneous coronary intervention, Retrospective cohort study, Pneumonia, medicine.disease, Confidence interval, ST-segment elevation myocardial infarction, CI, confidence interval, Emergency medicine, COVID-19, STEMI, primary angioplasty, ACS, acute coronary syndrome, business
Abstract

Background The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. Objectives The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of “at-risk” patient cohorts for failure to present or delays to treatment. Methods This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. Results A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p, Central Illustration

Published
2020
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4. Renin-Angiotensin System inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID Pandemic

Author

Giuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uguz, Dinaldo C Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan LOH, Lucian Calmac, Gerard Roura Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M. Becerra-Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Arpad Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, Carlos E Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohammed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Monica Verdoia, De Luca, Giuseppe, Nardin, Matteo, Algowhary, Magdy, Uguz, Berat, Oliveira, Dinaldo C, Ganyukov, Vladimir, Zimbakov, Zan, Cercek, Miha, Jensen, Lisette Okkel, Loh, Poay Huan, Calmac, Lucian, Roura Ferrer, Gerard, Quadros, Alexandre, Milewski, Marek, Scotto di Uccio, Fortunato, von Birgelen, Clemen, Versaci, Francesco, Ten Berg, Jurrien, Casella, Gianni, Lung, Aaron Wong Sung, Kala, Petr, Díez Gil, José Lui, Carrillo, Xavier, Dirksen, Maurit, Becerra-Munoz, Victor M, Lee, Michael Kang-Yin, Juzar, Dafsah Arifa, de Moura Joaquim, Rodrigo, Paladino, Roberto, Milicic, Davor, Davlouros, Perikli, Bakraceski, Nikola, Zilio, Filippo, Donazzan, Luca, Kraaijeveld, Adriaan, Galasso, Gennaro, Lux, Arpad, Marinucci, Lucia, Guiducci, Vincenzo, Menichelli, Maurizio, Scoccia, Alessandra, Yamac, Aylin Hatice, Mert, Kadir Ugur, Flores Rios, Xacobe, Kovarnik, Toma, Kidawa, Michal, Moreu, Josè, Flavien, Vincent, Fabris, Enrico, Martínez-Luengas, Iñigo Lozano, Boccalatte, Marco, Bosa Ojeda, Francisco, Arellano-Serrano, Carlo, Caiazzo, Gianluca, Cirrincione, Giuseppe, Kao, Hsien-Li, Sanchis Forés, Juan, Vignali, Luigi, Pereira, Helder, Manzo, Stephane, Ordoñez, Santiago, Arat Özkan, Alev, Scheller, Bruno, Lehtola, Heidi, Teles, Rui, Mantis, Christo, Antti, Ylitalo, Brum Silveira, João António, Zoni, Rodrigo, Bessonov, Ivan, Savonitto, Stefano, Kochiadakis, George, Alexopulos, Dimitrio, Uribe, Carlos E, Kanakakis, John, Faurie, Benjamin, Gabrielli, Gabriele, Gutierrez Barrios, Alejandro, Bachini, Juan Pablo, Rocha, Alex, Tam, Frankie Chor-Cheung, Rodriguez, Alfredo, Lukito, Antonia Anna, Saint-Joy, Veauthyelau, Pessah, Gustavo, Tuccillo, Andrea, Cortese, Giuliana, Parodi, Guido, Bouraghda, Mohammed Abed, Kedhi, Elvin, Lamelas, Pablo, Suryapranata, Harry, Verdoia, Monica, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM), and Centro de Estudos de Doenças Crónicas (CEDOC)

Subjects
Renin-angiotensin system inhibitors, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, COVID-19, 030204 cardiovascular system & hematology, STEMI, RC648-665, Diseases of the endocrine glands. Clinical endocrinology, Article, Renin-angiotensin system inhibitor, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Text mining, SDG 3 - Good Health and Well-being, 030220 oncology & carcinogenesis, Internal medicine, Pandemic, Renin–angiotensin system, Internal Medicine, Cardiology, Medicine, business
Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment.Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients.Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p < 0.0001), consistently both in 2019 and in 2010.Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both pre-admission chronic RASI therapy and in-hospital RASI did not negatively affected patients' survival during the hospitalization, neither increased the risk of SARS-CoV2 infection.Trial registration number: NCT04412655.

Published
2021
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5. Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Author

Pierre Deharo, Pieter C. Smits, Giuseppe De Luca, Luigi Vignali, Clemens von Birgelen, Michał Kidawa, Lucia Marinucci, Gabriele Gabrielli, Miha Cercek, Francisco Bosa Ojeda, Bernardo Tuccillo, Lisette Okkels Jensen, Gennaro Galasso, Vincenzo Guiducci, Pierfrancesco Agostoni, Monica Verdoia, Edouard Benit, Ewout Bruwiere, Massimo Siviglia, Maurizio Menichelli, Heidi Lehtola, Stephane Manzo, Benjamin Faurie, Filippo Zilio, Gerard Rourai Ferrer, José Moreu, Guido Parodi, Ylitalo Antti, Rui Campante Teles, Giovanni Amoroso, Jurriën M. ten Berg, Sébastien Levesque, Bor Wilbert, Fortunato Scotto Di Uccio, Maurits T. Dirksen, Raul Moreno, Kees Jan Royaards, Xavier Carrillo, Giuseppe Uccello, Alejandro Gutierrez Barrios, Lucian Calmac, Victor Becerra, Petr Kala, Thomas W Johnson, Wojtek Wojakowski, Marija Vavlukis, Leonardo Spedicato, Adriaan O. Kraaijeveld, Francesco Versaci, Marco Boccalatte, Xacobe Flores Rios, Alessandra Scoccia, Arnoud W J van 't Hof, Efthymia Varytimiadi, Peter Ludman, José Luis Díez Gil, Tomas Kovarnik, Gianni Casella, Tim Kinnaird, Adrian P. Banning, Vladimir Ganyukov, Arturo García-Touchard, Marek Milewski, Ciro De Simone, Nikola Bakraceski, Julinda Mehilli, Giuseppe Cirrincione, Grigorios Tsigkas, Juan Sanchis Forés, Andrea Santucci, Elvin Kedhi, Gianluca Caiazzo, Luca Donazzan, Alexander Ijsselmuiden, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Enrico Fabris, Mika Laine, Yves Cottin, Niels Debel, Santiago Camacho-Freiere, Health Technology & Services Research, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Debel, N., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., von Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., van't Hof, A. W., Kovarnik, T., Tsigkas, G., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Ojeda, F. B., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Varytimiadi, E., Moreno, R., Uccello, G., Faurie, B., Gutierrez Barrios, A., Milewski, M., Bruwiere, E., Smits, P., Wilbert, B., Di Uccio, F. S., Parodi, G., Kedhi, E., Verdoia, M., vavlukis, marija/0000-0002-4479-6691, banning, adrian/0000-0002-2842-7861, Agostoni, Pierfrancesco/0000-0002-1505-9369, Jensen, Lisette Okkels/0000-0002-4838-2429, Cercek, Miha/0000-0001-6193-0349, Milewski, Marek/0000-0001-5459-9125, Johnson, Thomas/0000-0003-4638-601X, and Calmac, Lucian/0000-0002-3031-8023

Subjects
Registrie, ST Elevation Myocardial Infarction/diagnosis, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, SARS-CoV-2, ST segment elevation myocardial infarction, 0302 clinical medicine, Retrospective Studie, Registries, 030212 general & internal medicine, Myocardial infarction, skin and connective tissue diseases, THROMBUS ASPIRATION, Percutaneous Coronary Intervention/adverse effects, Thrombosis(please add them), education.field_of_study, Thrombosis, 3. Good health, Treatment Outcome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Humans, Reperfusion, Retrospective Studies, COVID-19, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction, Population, Article, 03 medical and health sciences, Internal medicine, medicine, cardiovascular diseases, Platelet activation, education, METAANALYSIS, business.industry, MORTALITY, ELEVATION MYOCARDIAL-INFARCTION, Percutaneous coronary intervention, Retrospective cohort study, medicine.disease, body regions, 3121 General medicine, internal medicine and other clinical medicine, Heart failure, Conventional PCI, business
Abstract

Background and aims SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p, Graphical abstract Image 1

Published
2021
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6. Impact of renin-angiotensin system inhibitors on mortality during the COVID Pandemic among STEMI patients undergoing mechanical reperfusion : Insight from an international STEMI registry

Author

Lisette Okkels Jensen, Gianni Casella, Vladimir Ganyukov, José Moreu, Stephane Manzo, Giuseppe De Luca, Elvin Kedhi, Juan Sanchis Forés, Alejandro Gutierrez Barrios, Raul Moreno, Adriaan O. Kraaijeveld, Mika Laine, Xavier Carrillo, Nikola Bakraceski, Montserrat Gracida Blancas, Giuseppe Uccello, Michał Kidawa, Miha Cercek, Gabriele Gabrielli, Andrea Santucci, Maurizio Menichelli, Iñigo Lozano Martínez-Luengas, Giuliana Cortese, Gianluca Caiazzo, Pierfrancesco Agostoni, Benjamin Faurie, Dimitrios Alexopulos, Bruno Scheller, Monica Verdoia, Giovanni Amoroso, Sébastien Levesque, Xacobe Flores Rios, Lucian Calmac, Wojtek Wojakowski, Lucia Marinucci, Periklis Davlouros, Petr Kala, Heidi Lehtola, Gennaro Galasso, Vincenzo Guiducci, Bor Wilbert, Tomas Kovarnik, Thomas W Johnson, Gabriella Visconti, Victor Becerra, Luca Donazzan, Filippo Zilio, Francisco Bosa Ojeda, Jurriën M. ten Berg, Bernabé López Ledesma, Arpad Lux, Tim Berkout, Luigi Vignali, Alessandra Scoccia, Enrico Fabris, Rui Campante Teles, Maurits T. Dirksen, Oliver Bushljetikj, Roberto Padalino, Alexander Ijsselmuiden, Guido Parodi, Santiago Camacho-Freiere, Francesco Versaci, Ylitalo Antti, Fortunato Scotto Di Uccio, Bernardo Tuccillo, Clemens von Birgelen, HUS Abdominal Center, and Kardiologian yksikkö

Subjects
0301 basic medicine, Male, medicine.medical_treatment, THERAPY, Percutaneous coronary intervention, Renin-Angiotensin System, 0302 clinical medicine, Pandemic, Renin-Angiotensin System inhibitors, Myocardial infarction, Registries, education.field_of_study, General Medicine, Middle Aged, Prognosis, 3. Good health, Hospitalization, WUHAN, 317 Pharmacy, 030220 oncology & carcinogenesis, Original Article, Female, Lower mortality, RECEPTOR BLOCKERS, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Population, Myocardial Reperfusion, RM1-950, CHINA, 03 medical and health sciences, MORBIDITY, LEFT-VENTRICULAR DYSFUNCTION, Internal medicine, Renin–angiotensin system, medicine, Mortalitat, Humans, In patient, Mortality, education, Pandemics, Antihypertensive Agents, Aged, Pharmacology, business.industry, SARS-CoV-2, COVID-19, medicine.disease, COVID-19 Drug Treatment, ST-segment elevation myocardial infarction, 030104 developmental biology, MYOCARDIAL-INFARCTION, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction, Therapeutics. Pharmacology, 3111 Biomedicine, business
Abstract

Background: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study. Methods: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission. Results: Our population is represented by 6095 patients, of whom 3654 admitted in 2019 and 2441 in 2020. No difference in the prevalence of SARSCoV2 infection was observed according to RASI therapy at admission (2.5% vs 2.1%, p = 0.5), which was associated with a significantly lower mortality (adjusted OR [95% CI]=0.68 [0.51 & ndash;0.90], P = 0.006), confirmed in the analysis restricted to 2020 (adjusted OR [95% CI]=0.5[0.33 & ndash;0.74], P = 0.001). Among the 5388 patients in whom data on in-hospital medication were available, in-hospital RASI therapy was associated with a significantly lower mortality (2.1% vs 16.7%, OR [95% CI]=0.11 [0.084 & ndash;0.14], p < 0.0001), confirmed after adjustment in both periods. Among the 62 SARSCoV-2 positive patients, RASI therapy, both at admission or in-hospital, showed no prognostic effect. Conclusions: This is the first study to investigate the impact of RASI therapy on the prognosis and SARSCoV2 infection of STEMI patients undergoing PPCI during the COVID-19 pandemic. Both pre-admission and in-hospital RASI were associated with lower mortality. Among SARSCoV2-positive patients, both chronic and in-hospital RASI therapy showed no impact on survival.

Published
2021
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7. Cardiac arrest complicating cardiogenic shock: from pathophysiological insights to Impella-assisted cardiopulmonary resuscitation in a pheochromocytoma-induced Takotsubo cardiomyopathy—a case report

Author

Roberto Bonmassari, Simone Muraglia, and Filippo Zilio

Subjects
medicine.medical_specialty, Cardiac assist devices, medicine.medical_treatment, Cardiomyopathy, Pheochromocytoma, 030204 cardiovascular system & hematology, Return of spontaneous circulation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Case report, medicine, Extracorporeal membrane oxygenation, AcademicSubjects/MED00200, 030212 general & internal medicine, Cardiopulmonary resuscitation, Cardiogenic shock, Impella, business.industry, Cardiac arrest, medicine.disease, Ventricular assist device, Cardiology, Coronary perfusion pressure, Takotsubo cardiomyopathy, Cardiology and Cardiovascular Medicine, business
Abstract

Background A ‘catecholamine storm’ in a case of pheochromocytoma can lead to a transient left ventricular dysfunction similar to Takotsubo cardiomyopathy. A cardiogenic shock can thus develop, with high left ventricular end-diastolic pressure and a reduction in coronary perfusion pressure. This scenario can ultimately lead to a cardiac arrest, in which unloading the left ventricle with a peripheral left ventricular assist device (Impella®) could help in achieving the return of spontaneous circulation (ROSC). Case summary A patient affected by Takotsubo cardiomyopathy caused by a pheochromocytoma presented with cardiogenic shock that finally evolved into refractory cardiac arrest. Cardiopulmonary resuscitation was performed but ROSC was achieved only after Impella® placement. Discussion In the clinical scenario of Takotsubo cardiomyopathy due to pheochromocytoma, when cardiogenic shock develops treatment is difficult because exogenous catecholamines, required to maintain organ perfusion, could exacerbate hypertension and deteriorate the cardiomyopathy. Moreover, as the coronary perfusion pressure is critically reduced, refractory cardiac arrest could develop. Although veno-arterial extra-corporeal membrane oxygenation (va-ECMO) has been advocated as the treatment of choice for in-hospital refractory cardiac arrest, in the presence of left ventricular overload a device like Impella®, which carries fewer complications as compared to ECMO, could be effective in obtaining the ROSC by unloading the left ventricle.

Published
2021
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8. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry

Author

Gianluca Caiazzo, Giuseppe De Luca, Sébastien Levesque, Victor Becerra, Filippo Zilio, Gabriele Gabrielli, Xacobe Flores Rios, José Moreu, Tomas Kovarnik, Wojtek Wojakowski, Juan Sanchis Forés, Luca Donazzan, Dimitrios Alexopoulos, Gerard Rourai Ferrer, Luigi Vignali, Alessandra Scoccia, Giuseppe Uccello, Lucia Marinucci, Marco Boccalatte, Lisette Okkels Jensen, Enrico Fabris, Michał Kidawa, Miha Cercek, Ylitalo Antti, Stephane Manzo, Lucian Calmac, Gennaro Galasso, Vincenzo Guiducci, Iñigo Lozano Martínez-Luengas, Petr Kala, Elvin Kedhi, Bruno Scheller, Monica Verdoia, Bor Wilbert, Maurizio Menichelli, Benjamin Faurie, Thomas W Johnson, Alejandro Gutierrez Barrios, José Luis Díez Gil, Giuliana Cortese, Clemens von Birgelen, Guido Parodi, Raul Moreno, Francesco Versaci, Arpad Lux, Santiago Camacho-Freiere, Xavier Carrill, Periklis Davlouros, Mika Laine, Adriaan O. Kraaijeveld, Heidi Lehtola, Jurriën M. ten Berg, Gianni Casella, Vladimir Ganyukov, Ciro De Simone, Nikola Bakraceski, Rui Campante Teles, Maurits T. Dirksen, Francisco Bosa Ojeda, Marija Vavlukis, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, [De Luca,G, Verdoia,M] Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy. giuseppe.deluca@med.uniupo.it. [Cercek,M] Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia. [Jensen,LO] Division of Cardiology, Odense Universitets Hospital, Odense, Danemark. [Vavlukis,M] University Clinic for Cardiology, Medical Faculty, Ss' Cyril and Methodius University, Skopje, North Macedonia. [Calmac,L] Clinic Emergency Hospital of Bucharest, Bucharest, Romania. [Johnson,T] Division of Cardiology, Bristol Heart Institute, University Hospitals Bristol, NHSFT & University of Bristol, Bristol, UK. [Roura i Ferrer,G] Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. [Ganyukov,V] 8Division of Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. [Wojakowski,W] Division of Cardiology, Medical University of Silezia, Katowice, Poland. [von Birgelen,C] Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands. [Versaci,F] Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy. [Ten Berg,J] Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. [Laine,L] Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. [Dirksen,M] Division of Cardiology, Northwest Clinic, Alkmaar, The Netherlands. [Casella,G] Division of Cardiology, Ospedale Maggiore, Bologna, Italy. [Kala,P] University Hospital Brno, Medical Faculty of Masaryk University Brno, Brno, Czech Republic. [Díez Gil,JL] H. Universitario y Politécnico La Fe, Valencia, Spain. [Becerra,V] Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. [De Simone,C] Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy. [Carrill,X] Hospital Germans Triasi Pujol, Badalona, Spain. [Scoccia,A] Division of Cardiology, Ospedale 'Sant'Anna', Ferrara, Italy. [Lux,A] Maastricht University Medical Center, Maastricht, The Netherlands. [Kovarnik,T] University Hospital Prague, Prague, Czech Republic. [Davlouros,P] Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece. [Gabrielli,G] Interventional Cardiology Unit, Azienda Ospedaliero Universitaria 'Ospedali Riuniti', Ancona, Italy. [Flores Rios,X] Complexo Hospitaliero Universitario La Coruna, La Coruna, Spain. [Bakraceski,N] Center for Cardiovascular Diseases, Ohrid, North Macedonia. [Levesque,S] Center Hospitalier, Universitaire de Poitiers, University Hospital, Poitiers, France. [Guiducci,V] AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy. [Kidawa,M] Central Hospital of Medical University of Lodz, Łódź, Poland. [Marinucci,L] Division of Cardiology, AziendaOspedaliera 'Ospedali Riuniti Marche Nord', Pesaro, Italy. [Zilio,F] Ospedale Santa Chiara di Trento, Trento, Italy. [Galasso,G] Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy. [Fabris,E] Azienda Ospedaliero - Universitaria Ospedali Riuniti Trieste, Trieste, Italy. [Menichelli,M] Division of Cardiology, Ospedale 'F. Spaziani, Frosinone, Italy. [Manzo,S] Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, Paris, France. [Caiazzo,G] Division of Cardiology, Ospedale 'G Moscati', Aversa, Italy. [Moreu,J] Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain. [Sanchis Forés,J] Division of Cardiology, Hospital Clinico Universitario de Valencia, Valencia, Spain. [Donazzan,L] Division of Cardiology, Ospedale 'S. Maurizio' Bolzano Ospedale 'S. Maurizio', Bolzano, Italy. [Vignali,L] Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy. [Teles,R] Division of Cardiology, Hospital de Santa Cruz, CHLO - Carnaxide, Carnaxide, Portugal. [Bosa Ojeda,F] Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. [Lehtola,H] Division of Cardiology, Oulu University Hospital, Oulu, Finland. [Camacho‑Freiere,S] Division of Cardiology, Juan Ramon Jimenez Hospital, Huelva, Spain. [Kraaijeveld,A] Division of Cardiology, UMC Utrecht, Utrecht, The Netherlands. [Antti,Y] Division of Cardiology, Heart Centre Turku, Turku, Finland. [Boccalatte,M] Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Italy. [Lozano Martínez‑Luengas,I] Division of Cardiology, Hospital Cabueñes, Gijon, Spain. [Scheller,B] Division of Cardiology, Clinical and Experimental Interventional Cardiology, University of Saarland, Saarbrücken, Germany. [Alexopoulos,D] Division of Cardiology, Attikon University Hospital, Athens, Greece. [Faurie,B] Division of Cardiology, Ospedale 'A. Manzoni' Lecco, Lecco, Italy. [Gutierrez Barrios,A] Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France. [Wilbert,B] Division of Cardiology, Hospital Puerta del Mar, Cadiz, Spain. [Cortese,G] Department of Statistical Sciences, University of Padova, Padova, Italy. [Moreno,R] Division of Cardiology, Hospital la Paz, Madrid, Spain. [Parodi,G] Azienda Ospedaliero-Universitaria Sassari, Sassari, Italy. [Kedhi,E] Division of Cardiology, St-Jan Hospital, Brugge, Belgium. [Verdoia,M] Division of Cardiology, Ospedale degli Infermi, ASL Biella, Ponderano, Italy., HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Roura i Ferrer, G., Ganyukov, V., Wojakowski, W., von Birgelen, C., Versaci, F., Ten Berg, J., Laine, M., Dirksen, M., Casella, G., Kala, P., Diez Gil, J. L., Becerra, V., De Simone, C., Carrill, X., Scoccia, A., Lux, A., Kovarnik, T., Davlouros, P., Gabrielli, G., Flores Rios, X., Bakraceski, N., Levesque, S., Guiducci, V., Kidawa, M., Marinucci, L., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Manzo, S., Caiazzo, G., Moreu, J., Sanchis Fores, J., Donazzan, L., Vignali, L., Teles, R., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Martinez-Luengas, I. L., Scheller, B., Alexopoulos, D., Uccello, G., Faurie, B., Gutierrez Barrios, A., Wilbert, B., Cortese, G., Moreno, R., Parodi, G., Kedhi, E., and Verdoia, M.

Subjects
Registrie, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Infarto del miocardio con elevación del ST, Time Factors, COVID-19/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, Rate ratio, Geographical Locations::Geographic Locations::Europe::Europe, Eastern [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Time-to-Treatment/trends, 0302 clinical medicine, Retrospective Studie, Risk Factors, Síndrome coronario agudo, 030212 general & internal medicine, Myocardial infarction, Hospital Mortality, Registries, Diabetes Mellitus/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Time-to-Treatment [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Original Investigation, Percutaneous Coronary Intervention/adverse effects, Aged, COVID-19, Diabetes Mellitus, Europe, Female, Humans, Hypertension, Middle Aged, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Time-to-Treatment, Treatment Outcome, Hospital Mortality/trends, Health Care::Health Services Administration::Organization and Administration::Records as Topic::Registries [Medical Subject Headings], education.field_of_study, Incidence (epidemiology), Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention [Medical Subject Headings], Diabetes Mellitu, Intervención coronaria percutánea, 3. Good health, surgical procedures, operative, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, ACUTE MYOCARDIAL-INFARCTION, Time Factor, Population, Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Europe/epidemiology, Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings], 03 medical and health sciences, Hypertension/epidemiology, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, education, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Pandemia, Pandemic, Diseases::Endocrine System Diseases::Diabetes Mellitus [Medical Subject Headings], ST Elevation Myocardial Infarction/mortality, business.industry, Risk Factor, MORTALITY, Percutaneous coronary intervention, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Retrospective cohort study, medicine.disease, Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [Medical Subject Headings], lcsh:RC666-701, 3121 General medicine, internal medicine and other clinical medicine, Reperfusion, Conventional PCI, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality [Medical Subject Headings], business
Abstract

Background It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes–ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. Methods The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. Results A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73–0.85, p p p Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. Conclusions The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. Trial registration number: NCT 04412655.

Published
2020
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9. Sex differences in clinical and angiographic characteristics in spontaneous coronary artery dissection

Author

Alberto Menotti, Michele Dallago, Simone Muraglia, Filippo Zilio, Daniel Todaro, Roberto Bonmassari, Marco Borghesi, Giuseppe Braito, and Fabiola Morat

Subjects
Male, Acute coronary syndrome, medicine.medical_specialty, Sex Characteristics, business.industry, Coronary Vessel Anomalies, Dissection, Cardiovascular risk factors, medicine.disease, Coronary Angiography, Internal medicine, medicine, Cardiology, Molecular Medicine, Humans, Female, Cardiology and Cardiovascular Medicine, Artery dissection, business, Scad
Abstract

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome, mostly in women; however, differences between the sexes should be investigated. Materials & methods: Hundred consecutive patients affected by SCAD were identified; coronary lesions were classified according to the most recent classification and clinical and angiographic data of men and women were compared. Results: Men were significantly younger than women, with more cardiovascular risk factors. Lesions were prevalently classified as type 2A, type 2B or type 1; an angiographic pattern compatible with the presence of an intimal tear (types 1 and 1/2) was more represented in males. Conclusion: Sex-related differences in clinical and angiographic characteristics could help in shedding light on mechanisms that contribute to SCAD.

Published
2020

10. Pathophysiology and management of recreational drug-related acute coronary syndrome: ANMCO position statement

Author

Furio Colivicchi, Michele Massimo Gulizia, Fabiana Lucà, Marco Flori, Fortunato Scotto di Uccio, Luigi Pollarolo, Domenico Gabrielli, Stefania Angela Di Fusco, Annamaria Iorio, Giuseppe Galati, Francesco Ciccirillo, Nadia Ingianni, Marco Malvezzi Caracciolo D'Aquino, Roberta Rossini, and Filippo Zilio

Subjects
medicine.medical_specialty, Acute coronary syndrome, Recreational Drug, MEDLINE, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Coronary Circulation, Epidemiology, medicine, Humans, 030212 general & internal medicine, Acute Coronary Syndrome, Intensive care medicine, business.industry, Illicit Drugs, Disease Management, General Medicine, medicine.disease, Recreational drug use, Coronary Vessels, Pathophysiology, Substance abuse, Cardiology and Cardiovascular Medicine, business
Abstract

Recreational drug use may cause coronary artery disease through several mechanisms. An increasing number of young patients with drug-related acute coronary syndrome have been reported over recent years. The present position statement reports the most recent epidemiological data on acute coronary syndrome in the setting of drug abuse, describes the main pathophysiological mechanisms underlying coronary artery disease and acute events in these patients, and provides practical recommendations on management and an overview of prognosis.

Published
2020

11. Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome

Author

Fabrizio D'Ascenzo, Ugo Limbruno, Massimo Fineschi, Andrea Picchi, Antonio Maria Leone, Filippo Zilio, Stefano Rigattieri, Paolo Calabria, Matteo Cameli, Enrico Cerrato, Alberto Cresti, and Marco Ferlini

Subjects
Male, Target lesion, medicine.medical_specialty, Acute coronary syndrome, Time Factors, medicine.medical_treatment, Coronary revascularization, Fractional flow reserve, Acute Coronary Syndrome, Aged, Coronary Angiography, Female, Follow-Up Studies, Fractional Flow Reserve, Myocardial, Humans, Middle Aged, Myocardial Revascularization, Prognosis, Retrospective Studies, Severity of Illness Index, Cardiology and Cardiovascular Medicine, 030204 cardiovascular system & hematology, Revascularization, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Clinical endpoint, Myocardial, 030212 general & internal medicine, Myocardial infarction, business.industry, medicine.disease, Stenosis, Cardiology, business
Abstract

Objective Revascularization of functionally non-significant stenoses in patients with stable coronary artery disease can safely be deferred as rate of adverse cardiovascular events is low. It is not clear whether fractional flow reserve (FFR) is just as accurate in acute coronary syndromes (ACS). The aim of this study is to assess the outcome of coronary lesions whose revascularization was deferred based on negative FFR values in subjects with ACS. Methods Patients with acute coronary syndrome and showing at least one coronary stenosis whose revascularization was deferred based on FFR value >0.80 were included in the study. The primary endpoint of the study was the rate of target lesion failure (TLF), a composite of cardiac events (cardiac death, myocardial infarction and any coronary revascularization) related to the initially deferred stenosis at three-year follow-up. Results A total of 319 patients (237 male), mean age 68 [59–74] years and 355 coronary lesions with deferred revascularization based on negative FFR values (0.88±0.05) were selected. The rate of TLF was 6% at 1-year, 9% at 2-year and 12% at 3-year follow-up. TLF was driven by a new acute coronary syndrome in 75% of cases. The median time interval from FFR assessment to TLF was 457 [138–868] days. Conclusions In patients with acute coronary syndrome, the rate of TLF of the initially deferred coronary stenoses is 12% at 3-year follow-up and TLF occurred because of a new ACS in three quarters of cases.

Published
2017
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12. Pharmacological therapy for the prevention of cardiovascular events in patients with myocardial infarction with non-obstructed coronary arteries (MINOCA): Insights from a multicentre national registry

Author

Denise Zaffalon, Roberto Bonmassari, Monica Verdoia, Giuseppe De Luca, Alessia Bonci, Juan Carlos Kaski, Andrea Boscutti, Francesco Cassadonte, Fabio Infusino, Federico Guerra, Massimo Mancone, Stefano Coiro, Alessandro Capucci, Francesco Fedele, Giuseppe Ambrosio, Francesco Bianco, Antonio Dello Russo, Giuseppe Ciliberti, Isabella Tritto, Marco Merlo, Rocco Gioscia, Sabina Gallina, Gianfranco Sinagra, Filippo Zilio, Marco Vatrano, Giulia Stronati, Ciliberti, G., Verdoia, M., Merlo, M., Zilio, F., Vatrano, M., Bianco, F., Mancone, M., Zaffalon, D., Bonci, A., Boscutti, A., Infusino, F., Coiro, S., Stronati, G., Tritto, I., Gioscia, R., Dello Russo, A., Fedele, F., Gallina, S., Cassadonte, F., Ambrosio, G., Bonmassari, R., De Luca, G., Sinagra, G., Capucci, A., Kaski, J. C., and Guerra, F.

Subjects
Registrie, Acute coronary syndrome, medicine.medical_specialty, Prognosi, Acute coronary syndromes, Acute myocardial infarction, MINOCA, Pharmacological therapy, Prognosis, Aged, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Cohort Studies, Female, Humans, Italy, Registries, Retrospective Studies, Coronary Vessels, Myocardial Infarction, 030204 cardiovascular system & hematology, acute coronary syndromes, acute myocardial infarction, pharmacological therapy, prognosis, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Internal medicine, medicine, Clinical endpoint, 030212 general & internal medicine, Myocardial infarction, Stroke, Coronary Vessel, Aspirin, business.industry, Angiotensin Receptor Antagonist, Angiotensin-Converting Enzyme Inhibitor, Retrospective cohort study, medicine.disease, Heart failure, Cohort Studie, Cardiology and Cardiovascular Medicine, business, Human, Cohort study, medicine.drug
Abstract

Aims To assess the effect of pharmacological therapy on long-term prognosis of patients with MINOCA. Methods and results In this retrospective multicentre cohort study involving 9 Hub Hospitals across Italy we enrolled consecutive patients 18 years and older with diagnosis of MINOCA discharged from 1st March 2012 to 31st March 2018. Data on baseline characteristics and pharmacological therapy at discharge (ACEI/ARB, angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists; ASA, acetylsalicylic acid; beta-blockers; CCB, calcium-channel blockers; DAPT, dual anti-platelet therapy; statins), were collected systematically. The primary endpoint (PE) of the study was a composite of all cause death or acute myocardial infarction or acute coronary syndrome or heart failure leading to hospitalization or stroke. A total of 621 patients were included (mean [SD] age 65.1 [13.9] years; 344 [55.4%] female), of whom 106 (17.1%) experienced PE, including 27 patients (4.3%) who died. Multivariable analysis, after correction for all baseline differences, showed a significant association between pharmacological therapy at discharge and an increased risk of PE for aspirin (HR[95%CI] = 2.47[1.05–5.78], adjusted p = 0.04), whereas beta-blockers were associated with a significant benefit (HR[95%CI] = 0.49 [0.31–0.79], adjusted p = 0.02). Conclusion The use of beta-blockers was significantly associated to a less frequent occurrence of adverse outcomes at long-term follow-up among patients with MINOCA, whereas ASA displayed a potentially harmful impact on prognosis. The findings in the study may be relevant for the design of future studies which should take into account possible heterogeneity among MINOCA patients.

Published
2020

13. A Combination of Drug-Eluting Stents and Bioresorbable Vascular Scaffolds in the Treatment of Multivessel Coronary Artery Disease

Author

Massimo Napodano, Filippo Zilio, and Ahmed Al-Mamary

Subjects
medicine.medical_specialty, coronary stenosis, medicine.medical_treatment, lcsh:Medicine, Coronary stenosis, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, case report, 030212 general & internal medicine, Myocardial infarction, cardiovascular diseases, italy, business.industry, percutaneous coronary intervention, lcsh:R, Percutaneous coronary intervention, drug-eluting stents, General Medicine, ultrasonography, medicine.disease, Optimal management, Case report, Drug-eluting stents, Italy, Ultrasonography, Apposition, medicine.anatomical_structure, myocardial infarction, Cardiology, cardiovascular system, Radiology, business, Artery
Abstract

Optimal management of multivessel coronary artery disease can be complex. We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction. Coronary angiography showed diffuse multiple sub-occlusive lesions of the proximal and distal left coronary vessels involving a long segment of the vessel. On intravascular ultrasonography (IVUS), the left main artery was moderately diseased with critically stenotic and calcified branch ostia . A successful percutaneous coronary intervention using the T-stenting and small protrusion technique with two drug-eluting stents (DES) was performed on the left main artery and its main branches. Two bioresorbable vascular scaffolds were also deployed in overlap at the mid to distal segments of the left anterior descending artery and overlapping a previous DES at the proximal segment. The full expansion and apposition of the struts and scaffolds to the vessel wall without residual stenosis was confirmed by IVUS. Keywords: Drug-Eluting Stents; Percutaneous Coronary Intervention; Ultrasonography; Coronary Stenosis; Myocardial Infarction; Case Report; Italy.

Published
2016

14. Out-of-hospital cardiac arrest after acute cocaine intoxication associated with Brugada ECG patterns: Insights into physiopathologic mechanisms and implications for therapy

Author

A Dorigo, Alessandro Zorzi, Rossella Snenghi, Filippo Zilio, R El Mazloum, Domenico Corrado, Massimo Montisci, and Roberta Montisci

Subjects
medicine.medical_specialty, business.industry, medicine, Cocaine intoxication, Cardiology and Cardiovascular Medicine, medicine.disease, Intensive care medicine, business, Out of hospital cardiac arrest
Published
2015
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15. Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

Author

Massimo Mancone, Gennaro Sardella, Maurizio D'Amico, Claudio Moretti, Géraud Souteyrand, P. Omede, Mario Iannaccone, Andrea Picchi, Massimo Fineschi, Nicolas Amabile, Enrico Cerrato, Fabrizio D'Ascenzo, Pascal Motreff, Ugo Limbruno, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Filippo Zilio, Fabrizio Ugo, Giampaolo Niccoli, Francesco Colombo, Roberto Garbo, Marco Ferlini, Alberto Cresti, Ovidio De Filippo, Stefano Rigattieri, Umberto Barbero, Antonio Maria Leone, Corrado Tamburino, Salvatore Colangelo, Antonio Montefusco, Universita della Tuscia, Istituto di Genio Rurale, Hôpital nord, St Etienne, CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Dipartimento de Matematica [Milano], Università degli Studi di Milano [Milano] (UNIMI), Groupe d'anthropologie scolastique/Equipe CRH (GAS-CRH), École des hautes études en sciences sociales (EHESS)-Centre National de la Recherche Scientifique (CNRS), Università degli studi della Tuscia [Viterbo], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), and Università degli Studi di Milano = University of Milan (UNIMI)

Subjects
Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Subgroup analysis, Fractional flow reserve, 030204 cardiovascular system & hematology, Culprit, acute coronary syndrome, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Humans, Prospective Studies, Registries, 030212 general & internal medicine, Propensity Score, fractional flow reserve, medicine (all), ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, optical coherence tomography, Unstable angina, business.industry, Percutaneous coronary intervention, Middle Aged, medicine.disease, Drug eluting stent, Optical coherence tomography, Cardiology and Cardiovascular Medicine, 3. Good health, Fractional Flow Reserve, Myocardial, Drug-eluting stent, Conventional PCI, Cardiology, Female, drug eluting stent, cardiology and cardiovascular medicine, business, Tomography, Optical Coherence, Follow-Up Studies
Abstract

To compare in patients with ACS (acute coronary syndromes) a PCI (percutaneous coronary intervention) approach based on FFR (fractional flow reserve) vs. one based on OCT (optical coherence tomography).Consecutive patients admitted for ACS and treated with a PCI approach based on OCT or on FFR (recruited in two different studies) were compared and matched with propensity score analysis. Target Lesion revascularization (TLR) was the primary end point, while major adverse cardiovascular events [MACEs defined as the composite of death from cardiac causes, non-fatal MI, clinically driven target vessel revascularization (TVR), or re-hospitalization due to unstable angina] were the secondary ones. Sub-group analysis was performed for patients with FFR/OCT performed on culprit lesions and not. 285 patients were enrolled in the OCT-guided group and 335 in the FFR-guided group, 197 for each being selected after propensity score. After 25months (range: 7-39months), OCT-guided group were exposed to lower incidence of TLR (4.1% vs. 14.2% p0.01) compared with FFR-guided group without impact on MACEs (14.2% vs. 14.2%, p=1) or all-cause death (3.6% vs. 1.1%, p=0.34). At Kaplan-Maier curve analysis for MACEs OCT-guided and FFR-guided groups showed similar outcomes (HR 1.19, CI 0.65-2.2, p=0.54). Subgroup analysis on culprit and not culprit vessel demonstrated consistent results.An OCT based approach in ACS patients offers a reduction in TLR when compared to a PCI-FFR driven. These findings should be confirmed in randomized controlled trial.

Published
2017
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16. Impact of the presence and amount of myocardial fibrosis by cardiac magnetic resonance on arrhythmic outcome and sudden cardiac death in nonischemic dilated cardiomyopathy

Author

Diego Miotto, Sabino Iliceto, Luisa Cacciavillani, Domenico Corrado, Federico Migliore, Alessandro Zorzi, Manuel De Lazzari, Filippo Zilio, Francesco Corbetti, Chiara Calore, Gaetano Thiene, Cristina Basso, Francesco Tona, Giuseppe Tarantini, Benedetta Giorgi, Martina Perazzolo Marra, and Giulia Vettor

Subjects
Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Magnetic Resonance Imaging, Cine, Ventricular tachycardia, Ventricular Function, Left, Sudden cardiac death, Predictive Value of Tests, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, cardiovascular diseases, Aged, Ejection fraction, business.industry, Incidence, Myocardium, Hazard ratio, Dilated cardiomyopathy, Middle Aged, Prognosis, medicine.disease, Fibrosis, Defibrillators, Implantable, Survival Rate, Death, Sudden, Cardiac, Treatment Outcome, Italy, Heart failure, Ventricular fibrillation, Tachycardia, Ventricular, Cardiology, Female, Myocardial fibrosis, Cardiology and Cardiovascular Medicine, business
Abstract

Current risk stratification for sudden cardiac death (SCD) in nonischemic dilated cardiomyopathy (NIDC) relies on left ventricular (LV) dysfunction, a poor marker of ventricular electrical instability. Contrast-enhanced cardiac magnetic resonance has the ability to accurately identify and quantify ventricular myocardial fibrosis (late gadolinium enhancement [LGE]).To evaluate the impact of the presence and amount of myocardial fibrosis on arrhythmogenic risk prediction in NIDC.One hundred thirty-seven consecutive patients with angiographically proven NIDC were enrolled for this study. All patients were followed up for a combined arrhythmic end point including sustained ventricular tachycardia (VT), appropriate implantable cardioverter-defibrillator (ICD) intervention, ventricular fibrillation (VF), and SCD.LV-LGE was identified in 76 (55.5%) patients. During a median follow-up of 3 years, the combined arrhythmic end point occurred in 22 (16.1%) patients: 8 (5.8%) sustained VT, 9 (6.6%) appropriate ICD intervention, either against VF (n = 5; 3.6%) or VT (n = 4; 2.9%), 3 (2.2%) aborted SCD, and 2 (1.5%) died suddenly. Kaplan-Meier analysis revealed a significant correlation between the LV-LGE presence (not the amount and distribution) and malignant arrhythmic events (P.001). In univariate Cox regression analysis, LV-LGE (hazard ratio [HR] 4.17; 95% confidence interval [CI] 1.56-11.2; P = .005) and left bundle branch block (HR 2.43; 95% CI 1.01-5.41; P = .048) were found to be associated with arrhythmias. In multivariable analysis, the presence of LGE was the only independent predictor of arrhythmias (HR 3.8; 95% CI 1.3-10.4; P = .01).LV-LGE is a powerful and independent predictor of malignant arrhythmic prognosis, while its amount and distribution do not provide additional prognostic value. Contrast-enhanced cardiac magnetic resonance may contribute to identify candidates for ICD therapy not fulfilling the current criteria based on left ventricular ejection fraction.

Published
2014
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17. Development and Validation of a Distal Embolization Risk Score During Primary Angioplasty in ST-Elevation Myocardial Infarction

Author

Massimo Napodano, Sabino Iliceto, Anna Chiara Frigo, Anna Carrer, Giuseppe Tarantini, Ahmed Hussien Hussien Al Mamary, Filippo Zilio, Gilberto Dariol, Chiara Fraccaro, and Gianpiero D'Amico

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Embolism, Myocardial Infarction, Logistic regression, Coronary Angiography, Risk Assessment, Aged, Cohort Studies, Electrocardiography, Female, Humans, Logistic Models, Middle Aged, Percutaneous Coronary Intervention, Random Allocation, Registries, Reproducibility of Results, Risk Factors, Stents, Cardiology and Cardiovascular Medicine, Medicine (all), Internal medicine, medicine, Myocardial infarction, Framingham Risk Score, business.industry, Percutaneous coronary intervention, Thrombolysis, medicine.disease, Cohort, Cardiology, Risk assessment, business, Cohort study
Abstract

This study aims to develop and validate a new angiographic risk score to predict the risk of distal embolization (DE) during primary percutaneous coronary intervention (p-PCI) for ST-elevation myocardial infarction. Study included data from 1,200 patients who underwent p-PCI. The cohort was randomly split into a derivation cohort (n = 814) and a validation cohort (n = 386). Logistic regression was used to examine the relation between risk factors and the occurrence of DE. To each covariate in the model was assigned an integer score based on the regression coefficients. Variables included in the risk score, according to multivariable analysis, were occlusion pattern of infarct-related artery, Thrombolysis In Myocardial Infarction Thrombus Score 2 to 4, reference vessel diameter ≥3.5 mm, and lesion length >20 mm. To each variable was assigned a 0- to +2-point score according to the strength of the statistical association. Rates of DE in low-, intermediate-, and high-risk groups were 5.6%, 15.8%, and 40% in the derivation cohort (p for trend

Published
2015

18. TCT-850 Building of a network for the management of out of hospital cardiac arrest: experience of an italian mountainous region

Author

Giuseppe Braito, Simone Muraglia, Roberto Bonmassari, Alberto Menotti, Filippo Zilio, Francesca Tedoldi, and Michele Dallago

Subjects
medicine.medical_specialty, business.industry, Public health, Medicine, Medical emergency, Cardiology and Cardiovascular Medicine, business, medicine.disease, Out of hospital cardiac arrest
Published
2016
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19. CLINICAL ASSESSMENT OF NO-REFLOW IN HUMANS: COMPARISON BETWEEN CARDIAC MAGNETIC RESONANCE AND ANGIOGRAPHY

Author

Sabino Iliceto, Francesco Corbetti, Cristina Basso, A. Marzari, Giuseppe Tarantini, Manuel De Lazzari, Veronica Spadotto, Martina Perazzolo Marra, Luisa Cacciavillani, and Filippo Zilio

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Angiography, Medicine, Radiology, Cardiac magnetic resonance, business, Cardiology and Cardiovascular Medicine
Published
2010
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