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8 results on '"Montefusco, Antonio"'

1. Impact of Kissing Balloon in Patients Treated With Ultrathin Stents for Left Main Lesions and Bifurcations

Author

Gaido, Luca, D’ascenzo, Fabrizio, Imori, Yoichi, Wojakowski, Wojciech, Saglietto, Andrea, Figini, Filippo, Mattesini, Alessio, Trabattoni, Daniela, Rognoni, Andrea, Tomassini, Francesco, Bernardi, Alessandro, Ryan, Nicola, Muscoli, Saverio, Helft, Gerard, de Filippo, Ovidio, Parma, Radoslaw, de Luca, Leonardo, Ugo, Fabrizio, Cerrato, Enrico, Montefusco, Antonio, Pennacchi, Mauro, Wańha, Wojciech, Smolka, Grzegorz, de Lio, Giulia, Bruno, Francesco, Huczek, Zenon, Boccuzzi, Giacomo, Cortese, Bernardo, Capodanno, Davide, Omedè, Pierluigi, Mancone, Massimo, Nuñez-Gil, Ivan, Romeo, Francesco, Varbella, Ferdiando, Rinaldi, Mauro, Escaned, Javier, Conrotto, Federico, Burzotta, Francesco, Chieffo, Alaide, Perl, Leor, D’amico, Maurizio, Di Mario, Carlo, Sheiban, Imad, Gagnor, Andrea, Giammaria, Massimo, de Ferrari, Gaetano Maria, Maria Vittoria Hospital [Turin], Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino, Nippon Medical School [Tokyo, Japon], Medical University of Silesia (SUM), Careggi University Hospital [Florence, Italie], Università degli Studi di Milano = University of Milan (UNIMI), University Hospital 'Maggiore della Carità' [Novara, Italy], Ospedale di Rivoli [Rivoli, Italy] (OR), San Luigi Gonzaga University Hospital [Turin, Italy] (SLGUH Orbassano), Ospedale San Giovanni Bosco [Turin, Italy] (OSGB), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos [Madrid, Spain] (IdISSC), Università degli Studi di Roma Tor Vergata [Roma], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Università degli studi di Torino = University of Turin (UNITO), Medical University of Warsaw - Poland, Ospedale San Giovanni Evangelista [Rome, Italy] (OSGE), Clinica San Carlo [Milan, Italy] (CSC), AOU Policlinico Vittorio-Emanuele [Catania, Italia], Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma] (Unicatt), IRCCS San Raffaele Scientific Institute [Milan, Italie], Rabin Medical Center [Tel Aviv, Israël], Clinica Pederzoli [Peschiera del Garda, Italy] (CP), and Lesnik, Philippe

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], percutaneous coronary intervention, drug-eluting stents, thrombosis, coronary artery disease
Abstract

Background: There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. Methods: All patients undergoing left main or bifurcations percutaneous coronary intervention enrolled in the RAIN registry (Very Thin Stents for Patients With MAIN or BiF in Real Life: The RAIN, a Multicenter Study) evaluating ultrathin stents were included. Major adverse cardiac event (a composite of all-cause death, myocardial infarction, target lesion revascularization, and stent thrombosis) was the primary end point, while its components, along with target vessel revascularization, were the secondary end points. The main analysis was performed comparing patients with and without FKI after adjustment with inverse probability of treatment weighting. Subgroup analyses were performed according to FKI (short [

Published
2020
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2. Real-World Data of Prasugrel vs. Ticagrelor in Acute Myocardial Infarction: Results from the RENAMI Registry.

Author

De Filippo, Ovidio, Cortese, Martina, D´Ascenzo, Fabrizio, Raposeiras-Roubin, Sergio, Abu-Assi, Emad, Kinnaird, Tim, Ariza-Solé, Albert, Manzano-Fernández, Sergio, Templin, Christian, Velicki, Lazar, Xanthopoulou, Ioanna, Cerrato, Enrico, Rognoni, Andrea, Boccuzzi, Giacomo, Montefusco, Antonio, Montabone, Andrea, Taha, Salma, Durante, Alessandro, Gili, Sebastiano, and Magnani, Giulia

Subjects
NONSTEROIDAL anti-inflammatory agents, TREATMENT of acute coronary syndrome, ADENOSINE triphosphatase, ANTICOAGULANTS, EVALUATION of medical care, MYOCARDIAL infarction, PATIENT safety, TREATMENT effectiveness, ACQUISITION of data, PERCUTANEOUS coronary intervention, EVALUATION, THERAPEUTICS
Abstract

Background: Limited data are available concerning differences in clinical outcomes for real-life patients treated with ticagrelor versus prasugrel after percutaneous coronary intervention (PCI). Objective: Our objective was to determine and compare the efficacy and safety of ticagrelor and prasugrel in a real-world population. Methods: RENAMI was a retrospective, observational registry including the data and outcomes of consecutive patients with acute coronary syndrome (ACS) who underwent primary PCI and were discharged with dual antiplatelet therapy (DAPT) between January 2012 and January 2016. The mean follow-up period was 17 ± 9 months. In total, 11 university hospitals from six European countries participated. After propensity-score matching, there were no substantial differences in the baseline clinical and interventional features. All patients were treated with acetylsalicylic acid plus prasugrel 10 mg once daily or acetylsalicylic acid plus ticagrelor 90 mg twice daily. Mean duration of DAPT was 12.04 ± 3.4 months with prasugrel and 11.90 ± 4.1 months with ticagrelor (p = 0.47). The primary and secondary endpoints were long-term net adverse clinical events (NACE) and major adverse cardiovascular events (MACE), respectively, along with their single components. Subgroup analysis for freedom from NACE and MACE was performed according to length of DAPT and clinical presentation [ST-elevation myocardial infarction (STEMI)-ACS versus non-ST-elevation myocardial infarction (NSTEMI)-ACS]. Results: In total, 4424 patients (2725 ticagrelor, 1699 prasugrel) were enrolled. After propensity-score matching, 1290 patients in each cohort were included in the analysis. At 12 months, the incidence of both NACE and MACE was lower with prasugrel (NACE: 5.3% vs. 8.5% [p = 0.001]; MACE: 5% vs. 8.1% [p = 0.001]) mainly driven by a reduction in recurrent myocardial infarction (MI) (2.4 vs. 4.0%; p = 0.029) and a lower rate of Bleeding Academic Research Consortium (BARC) 3–5 bleeding (1.5 vs. 2.9%; p = 0.011). The benefit of prasugrel was confirmed for patients with NSTEMI and for those discharged with a DAPT regimen of ≤ 12 months. Only a trend in the reduction of NACE and MACE was noted for STEMI or for those treated with longer DAPT. Conclusions: Comparison of these drugs suggested that prasugrel is safer and more efficacious than ticagrelor in combination with aspirin after NSTEMI but not STEMI. No differences were found for events occurring after 12 months. The nonrandomized design of the present research means further studies are required to support these findings. [ABSTRACT FROM AUTHOR]

Published
2019
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3. Efficacy and Safety of Available Protocols for Aspirin Hypersensitivity for Patients Undergoing Percutaneous Coronary Intervention.

Author

Bianco, Matteo, Bernardi, Alessandro, D'Ascenzo, Fabrizio, Cerrato, Enrico, Omedè, Pierluigi, Montefusco, Antonio, DiNicolantonio, James J., Zoccai, Giuseppe Biondi, Varbella, Ferdinando, Carini, Giovanni, Moretti, Claudio, Pozzi, Roberto, and Gaita, Fiorenzo

Abstract

Background--The most suitable approach for patients with aspirin hypersensitivity undergoing percutaneous coronary intervention remains to be assessed. Methods and Results-- Pubmed, Google Scholar, and Cochrane were systematically searched for papers describing protocols about aspirin hypersensitivity in the percutaneous coronary intervention setting. Discharge from hospital with aspirin was the primary end point, whereas rates of adverse reactions being a secondary outcome. An online international survey was performed to critically analyze rates of aspirin hypersensitivity and its medical and interventional management. Eleven studies with 283 patients were included. An endovenous desensitization protocol was performed on one of them, with high efficacy rate (98%) and a low adverse reaction rate when compared with oral administration. No significant differences were reported among the oral protocols in terms of efficacy (less versus more fractionated [95.8% {95.4%- 96.2%} versus 95.9% {95.2-96.5%}]), whereas higher incidence of rash and angioedema were reported for protocols with <6 doses escalation (2.6% [1.1%-4.1%] versus 2.6% [1.9%-3.2%]). In the survey, we collected answer from 86 physician of the 100 interviewed. Fifty-six percent of them managed aspirin hypersensitivity changing the therapeutic regimen (eg, clopidogrel monotherapy and indobufen). Despite the previous safety data, desensitization protocols were adopted by only 42% of surveyed cardiologist. Conclusions--Available protocols for aspirin hypersensitivity are effective and safe, representing a feasible approach for patients needing dual antiplatelet therapy. [ABSTRACT FROM AUTHOR]

Published
2016
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5. Daily risk of adverse outcomes in patients undergoing complex lesions revascularization: A subgroup analysis from the RAIN-CARDIOGROUP VII study (veRy thin stents for patients with left mAIn or bifurcatioN in real life).

Author

Biolè, Carloalberto, Huczek, Zenon, Nuñez-Gil, Ivan, Boccuzzi, Giacomo, Autelli, Michele, Montefusco, Antonio, Trabattoni, Daniela, Ryan, Nicola, Venuti, Giuseppe, Imori, Yoichi, Takano, Hitoshi, Matsuda, Junya, Shimizu, Wataru, Muscoli, Saverio, Montabone, Andrea, Wojakowski, Wojciech, Rognoni, Andrea, Helft, Gerard, Gallo, Diego, and Parma, Radoslaw

Subjects
*PERCUTANEOUS coronary intervention, *ACUTE coronary syndrome, *SUBGROUP analysis (Experimental design), *CORONARY disease, *MYOCARDIAL revascularization, *DRUG-eluting stents
Abstract

Percutaneous coronary intervention (PCI) for complex lesions, including unprotected left main (ULM) and bifurcations, is gaining a relevant role in treating coronary artery disease with good outcomes, also thanks to new generation stents. The daily risk of adverse cardiovascular events and their temporal distribution after these procedures is not known. All consecutive patients presenting with a critical lesion of ULM or bifurcation treated with very thin struts stents, enrolled in the RAIN-Cardiogroup VII study, were analyzed. The daily risk of major acute cardiovascular events (MACE), target lesion revascularization (TLR) and stent thrombosis (ST) and their temporal distribution in the first year of follow-up was the primary endpoint. Differences among subgroups (ULM, patient presentation, kind of stent polymer) were the secondary endpoint. 2745 patients were included, mean age 68 ± 11 years, 33.3% diabetics, 54.5% had an acute coronary syndrome (ACS); 88.5% of treated lesions were bifurcations, 27.2% ULM. Average daily risk was 0.022% for MACE, 0.005% for TLR and 0.004% for ST, in the first year. Bimodal distribution of adverse events, especially TLR, with an early peak in the first 50 days and a late one after 150 days, was observed. Patients with ULM presented a significantly higher daily risk of events, and ACS patients presented higher MACE risk. No difference emerged according to the type of stent polymer. The daily risk of adverse events in the first year after complex PCI in our study is acceptably low. PCI on ULM carries a higher risk of complications. • PCI for complex lesions with new stents carries a low daily risk of adverse events. • Daily risks are 0.022% for MACE, 0.005% for TLR and 0.004% for ST in the first year. • Daily risks of TLR and ST show a bimodal distribution. • PCI on ULM carries a higher risk of complications. • Stent polymer is not associated with a difference in the daily risk of events. [ABSTRACT FROM AUTHOR]

Published
2019
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6. Radial Versus Femoral Access for the Treatment of Left Main Lesion in the Era of Second-Generation Drug-Eluting Stents

Author

Sebastiano Gili, Hiroyoshi Kawamoto, Marco Pavani, Pierluigi Omedè, Claudio Moretti, Giuseppe Biondi Zoccai, Antonio Colombo, Maurizio D'Amico, Fabrizio D'Ascenzo, Roberto di Summa, Alaide Chieffo, Fabrizio Ugo, Fiorenzo Gaita, Ferdinando Varbella, Giacomo Boccuzzi, Francesco Tomassini, Antonio Montefusco, Federico Conrotto, Roberto Garbo, Javier Escaned, Enrico Cerrato, Gili, Sebastiano, D'Ascenzo, Fabrizio, Di Summa, Roberto, Conrotto, Federico, Cerrato, Enrico, Chieffo, Alaide, Boccuzzi, Giacomo, Montefusco, Antonio, Ugo, Fabrizio, Omedã©, Pierluigi, Kawamoto, Hiroyoshi, Tomassini, Francesco, Pavani, Marco, Varbella, Ferdinando, Garbo, Roberto, D'Amico, Maurizio, Biondi Zoccai, Giuseppe, Moretti, Claudio, Escaned, Javier, Colombo, Antonio, and Gaita, Fiorenzo

Subjects
Registrie, Male, medicine.medical_specialty, Acute coronary syndrome, Percutaneous, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Prosthesis Design, Follow-Up Studie, Catheterization, Peripheral, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Retrospective Studie, Internal medicine, medicine.artery, Catheterization, Peripheral, Drug-Eluting Stent, medicine, Humans, Registries, 030212 general & internal medicine, Myocardial infarction, Radial artery, Coronary Vessel, Aged, Retrospective Studies, Coronary Vessels, Female, Femoral Artery, Follow-Up Studies, Radial Artery, Treatment Outcome, Drug-Eluting Stents, Cardiology and Cardiovascular Medicine, business.industry, Percutaneous coronary intervention, Retrospective cohort study, medicine.disease, Surgery, Propensity score matching, Cardiology, business, Human
Abstract

Transradial access (TRA) is often avoided in favor of the transfemoral access (TFA) during percutaneous coronary interventions of the unprotected left main coronary artery (ULM), due to technical and safety concerns. The aim of this study was to compare the performance of TRA and TFA in the treatment of ULM with second-generation drug-eluting stents. Consecutive patients who underwent percutaneous coronary intervention on ULM with second-generation drug-eluting stents were retrospectively enrolled in the multicenter Failure in Left Main Study With 2nd Generation Stents (FAILS 2) registry. Patients were stratified according to the arterial access. The choice between TRA and TFA was left to each operator's preferences. Bleedings during index hospitalization were the primary end point. Secondary end points were major adverse cardiovascular events (a composite of death, reinfarction, and target lesion revascularization), the single components of major adverse cardiovascular events at follow-up and stent thrombosis. Propensity score matching was executed to account for possible confounding. Overall, 1,247 patients were enrolled (23.2% [289] of female gender, mean age 70.2 ± 10.2 years). Diagnosis at presentation was stable angina in 603 (48.7%) cases, non–ST-segment elevation acute coronary syndrome in 465 (37.3%), ST-segment elevation myocardial infarction in 117 (9.5%). Mean follow-up was 726 ± 654 days. After propensity score with matching, 354 patients were included. The primary end point was significantly reduced in patients treated with TRA (2.0% vs 4.0%, p = 0.042), whereas no differences emerged pertaining the secondary end points, including target lesion revascularization and reinfarction. In conclusion, TRA may reduce in-hospital bleedings in patients undergoing percutaneous treatment of the ULM, without increasing the rate of adverse cardiovascular events at follow-up, and may therefore be safely used in the treatment of the ULM.

Published
2017
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7. Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents–Cardiogroup III Study)

Author

Claudio Moretti, Alaide Chieffo, Maurizio D'Amico, Javier Escaned, Giuseppe Biondi-Zoccai, Giacomo Boccuzzi, Roberto di Summa, Ferdinando Varbella, Fabrizio D'Ascenzo, Fabrizio Ugo, Roberto Garbo, Marco Pavani, Sara Rettegno, Antonio Colombo, Fiorenzo Gaita, Federico Conrotto, Hyroishi Kawamoto, Enrico Cerrato, Antonio Montefusco, Pierluigi Omedè, D'Ascenzo, Fabrizio, Chieffo, Alaide, Cerrato, Enrico, Ugo, Fabrizio, Pavani, Marco, Kawamoto, Hyroishi, Di Summa, Roberto, Varbella, Ferdinando, Boccuzzi, Giacomo, Omedã, Pierluigi, Rettegno, Sara, Garbo, Roberto, Conrotto, Federico, Montefusco, Antonio, Biondi zoccai, Giuseppe, D'Amico, Maurizio, Moretti, Claudio, Escaned, Javier, Gaita, Fiorenzo, and Colombo, Antonio

Subjects
Male, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Coronary artery disease, 0302 clinical medicine, Restenosis, Coronary Restenosi, Retrospective Studie, Cause of Death, Intravascular ultrasound, Aged, Coronary Restenosis, Female, Humans, Incidence, Percutaneous Coronary Intervention, Prognosis, Retreatment, Retrospective Studies, Tomography, Optical Coherence, Treatment Outcome, Ultrasonography, Interventional, Drug-Eluting Stents, Cardiology and Cardiovascular Medicine, Drug-Eluting Stent, 030212 general & internal medicine, Myocardial infarction, Tomography, Ultrasonography, Cause of death, Interventional, medicine.diagnostic_test, Hazard ratio, Cardiology, Human, medicine.medical_specialty, Prognosi, Revascularization, 03 medical and health sciences, Internal medicine, medicine, business.industry, Percutaneous coronary intervention, medicine.disease, Optical Coherence, business
Abstract

Incidence, predictors, and impact on prognosis of target lesion revascularization (TLR) for patients treated with second-generation drug-eluting stents (DESs) on unprotected left main (ULM) remain to be defined. The present study is a multicenter study including patients treated with a second-generation DES on ULM from June 2007 to January 2015. Rate of TLR was the primary end point. All cause death, myocardial infarction, target vessel revascularization, and stent thrombosis were the secondary end points. A total of 1,270 patients were enrolled: after a follow-up of 650 days (230 to 1,170), 47 (3.7%) of them underwent a re–percutaneous coronary intervention TLR on the left main, 22 during a planned angiographic follow-up. Extent of coronary artery disease was similar among groups (median value of Syntax of 27 ± 10 vs 26 ± 9, p = 0.45), as localization of the lesion in the ULM. Of patients reporting with TLR on ULM, 56% presented with a focal restenosis, 33% diffuse and 10% proliferative. At multivariate analysis, insulin-dependent diabetes mellitus increased risk of TLR (hazard ratio [HR] 2.0: 1.1 to 3.6, p = 0.04), whereas use of intravascular ultrasound resulted protective (HR 0.5: 0.3 to 0.9, p = 0.02). At follow-up, rates of cardiovascular death did not differ among the 2 groups (4% vs 4%, p = 0.95). At multivariate analysis, TLR on LM did not increase risk of all cause death (HR 0.4: 0.1 to 1.6, p = 0.22), whereas cardiogenic shock and III tertile of Syntax portended a worse prognosis (HR 4.5: 2.1 to 10.2, p = 0.01 and HR 1.4: 1.1 to 1.6, p = 0.03, respectively). In conclusion, repeated revascularization after implantation of second-generation DES on ULM represents an unfrequent event, being increased in insulin-dependent patients and reduced by intravascular ultrasound. Impact on prognosis remains neutral, being related to clinical presentation and extent of coronary artery disease.

Published
2017
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8. Self-expandable sirolimus-eluting stents compared to second-generation drug-eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS-2 registries

Author

Corrado Tamburino, Arnaldo Poli, Francesco Tomassini, Antonio Colombo, Alaide Chieffo, Sebastiano Gili, Paolo Sganzerla, Gioel Gabrio Secco, Luigi Emilio Pastormerlo, Antonio Montefusco, Fabrizio D'Ascenzo, Fiorenzo Gaita, Kuan Leong Yew, Gennaro Sardella, Bernardo Cortese, Massimo Mancone, Annamaria Nicolino, Plinio Cirillo, Andreas Baumbach, Grzegorz Smolka, Roberto di Summa, Fabrizio Ugo, Wojciech Wańha, Javier Escaned, Montefusco, Antonio, D'Ascenzo, Fabrizio, Gili, Sebastiano, Smolka, Grzegorz, Chieffo, Alaide, Baumbach, Andrea, Escaned, Javier, Sganzerla, Paolo, Tomassini, Francesco, Secco, Gioel Gabrio, Ugo, Fabrizio, Tamburino, Corrado, Nicolino, Annamaria, Mancone, Massimo, Poli, Arnaldo, Yew, Kuan-Leong, Cirillo, Plinio, Wanha, Wojciech, Pastormerlo, Luigi Emilio, di Summa, Roberto, Sardella, Gennaro, Colombo, Antonio, Gaita, Fiorenzo, and Cortese, Bernardo

Subjects
Radiology, Nuclear Medicine and Imaging, medicine.medical_treatment, 030204 cardiovascular system & hematology, time factors, 0302 clinical medicine, alloys, cardiovascular agents, self expandable metallic stents, Nuclear Medicine and Imaging, middle aged, 80 and over, risk factors, 030212 general & internal medicine, Myocardial infarction, second-generation drug-eluting stent, humans, media_common, Aged, 80 and over, risk assessment, drug-eluting stents, General Medicine, aged, retrospective studies, female, sirolimus, Cardiology, Radiology, Cardiology and Cardiovascular Medicine, coronary artery disease, medicine.drug, Drug, medicine.medical_specialty, Randomization, media_common.quotation_subject, 03 medical and health sciences, male, Internal medicine, medicine, percutaneous coronary intervention, self-expandable stent, unprotected left main, cardiovascular diseases, Unstable angina, business.industry, prosthesis design, registries, Percutaneous coronary intervention, medicine.disease, comparative effectiveness research, Sirolimus, Propensity score matching, treatment outcome, aged, 80 and over, business, Mace
Abstract

OBJECTIVES: To compare the effectiveness and safety of self-expandable, sirolimus-eluting Stentys stents (SES) and second-generation drug-eluting stents (DES-II) for the treatment of the unprotected left main (ULM). BACKGROUND: SES may provide a valuable option to treat distal ULM, particularly when significant caliber gaps with side branches are observed. METHODS: Patients from the multicenter SPARTA (clinicaltrials.gov: NCT02784405) and FAILS2 registries were included. Propensity-score with matching was performed to account for the lack of randomization. Primary end-point was the rate of major adverse cardiovascular events (MACE, a composite of all cause death, myocardial infarction, target lesion revascularization [TLR], unstable angina and definite stent thrombosis [ST]). Single components of MACE were the secondary end-points. RESULTS: Overall, 151 patients treated with SES and 1270 with DES-II were included; no differences in MACE rate at 250 days were observed (9.8% vs. 11.5%, P = 0.54). After propensity score with matching, 129 patients treated with SES and 258 with DES-II, of which about a third of female gender, were compared. After a follow-up of 250 days, MACE rate did not differ between the two groups (9.9% vs. 8.5%, P = 0.66), as well as the rate of ULM TLR (1.6% vs. 3.1%, P = 0.36) and definite ST (0.8% vs. 1.2%, P = 0.78). These results were consistent also when controlling for the treatment with provisional vs. 2-stents strategies for the ULM bifurcation. CONCLUSION: SES use for ULM treatment was associated with a similar MACE rate compared to DES-II at an intermediate-term follow-up. SES might represent a potential option in this setting.

Published
2019

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