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51. The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification

Author

Matteo Bertini, Alberto Monello, Marco Toselli, Francesco Giannini, Mario Iannaccone, Davide Vignale, Alessandra Scoccia, Tommaso Nannini, Francesca Besana, Gianluca Campo, Luigi Vignali, Anna Palmisano, Antonio Esposito, Giuseppe Sangiorgi, Chiara Gnasso, Davide Ippolito, Daniele Andreini, Riccardo Leone, Pietro Sergio, Piergiorgio Turchio, Antonio Mangieri, Arif A Khokhar, Valeria Nicoletti, Gianluigi Patelli, Paolo Giacomo Vaudano, Antonio Colombo, Alberto Cereda, G Pontone, Claudio Rapezzi, Aldo P. Maggioni, Gianmarco Iannopollo, Nicola Sverzellati, Marco Loffi, Giacomo Bellani, Gabriele Tumminello, Cereda, A, Toselli, M, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Mangieri, A, Khokhar, A, Campo, G, Scoccia, A, Bertini, M, Loffi, M, Sergio, P, Andreini, D, Pontone, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Vignali, L, Sverzellati, N, Iannaccone, M, Vaudano, P, Sangiorgi, G, Turchio, P, Monello, A, Tumminello, G, Maggioni, A, Rapezzi, C, Colombo, A, Giannini, F, and Esposito, A

Subjects
Cardiovascular calcifications, Male, Aging, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Context (language use), Aorta, Thoracic, 030204 cardiovascular system & hematology, Sex bia, Sars-CoV2, NO, Settore MED/11, 03 medical and health sciences, 0302 clinical medicine, Cardiovascular calcification, Internal medicine, medicine.artery, Lung CT, Medicine, Thoracic aorta, Humans, 030212 general & internal medicine, Vascular Calcification, Aged, Aged, 80 and over, Sex bias, business.industry, SARS-CoV-2, Mortality rate, COVID-19, medicine.disease, Sex bias, Sars-CoV2, Lung CT, Cardiovascular calcifcations, COVID-19, Coronary Calcium Score, Pneumonia, Coronary artery calcification, RNA, Viral, Cardiovascular calcifcations, Female, Original Article, Geriatrics and Gerontology, business
Abstract

Recent clinical and demographical studies on COVID-19 patients have demonstrated that men experience worse outcomes than women. However, in most cases, the data were not stratified according to gender, limiting the understanding of the real impact of gender on outcomes. This study aimed to evaluate the disaggregated in-hospital outcomes and explore the possible interactions between gender and cardiovascular calcifications. Data was derived from the sCORE-COVID-19 registry, an Italian multicentre registry that enrolled COVID-19 patients who had undergone a chest computer tomography scan on admission. A total of 1683 hospitalized patients (mean age 67±14 years) were included. Men had a higher prevalence of cardiovascular comorbidities, a higher pneumonia extension, more coronary calcifications (63% vs.50.9%, p3, pp=0.001), but the death event tended to occur earlier in women (15±7 vs. 8±7 days, p= 0.07). Non-survivors had a higher coronary, thoracic aorta, and aortic valve calcium score. Female sex, a known independent predictor of a favorable outcome in SARS-CoV2 infection, was not protective in women with a coronary calcification volume greater than 100 mm3. There were significant differences in cardiovascular comorbidities and vascular calcifications between men and women with SARS-CoV2 pneumonia. The differences in outcomes can be at least partially explained by the different cardiovascular profiles. However, women with poor outcomes had the same coronary calcific burden as men. The presumed favorable female sex bias in COVID-19 must therefore be reviewed in the context of comorbidities, especially cardiovascular ones.

Published
2021

52. The impact of periprocedural myocardial infarction on mortality in older adults with non-ST-segment elevation acute coronary syndrome

Author

Alessandra Scoccia, Andrea Rubboli, Simone Biscaglia, Roberta Campana, Giovanni Grazzi, Gianluca Campo, Paolo Cimaglia, Cristina Morelli, Filippo Maria Verardi, Andrea Erriquez, Roberto Ferrari, Gianni Mazzoni, Rita Pavasini, Elisabetta Tonet, Laura Sofia Cardelli, Matteo Tebaldi, Elisa Maietti, and Stefano Volpato

Subjects
Male, periprocedural myocardial infarction, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Socio-culturale, Perioperative Care, acute coronary syndrome, Internal medicine, medicine, Clinical endpoint, Humans, ST segment, Myocardial infarction, Non-ST Elevated Myocardial Infarction, Health Education, Aged, Frailty, Hand Strength, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, physical performance, General Medicine, Physical Functional Performance, Prognosis, medicine.disease, mortality, older patients, Confidence interval, Exercise Therapy, Outcome and Process Assessment, Health Care, Italy, Heart Disease Risk Factors, Conventional PCI, Cohort, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Aims The prognostic implication of periprocedural myocardial infarction (MI) in older patients has been less investigated. The aim of this study is to assess the relationship between large periprocedural MI and long-term mortality in older patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary intervention (PCI). Methods This is a pooled analysis of older NSTEACS patients who were included in the FRASER and HULK studies. Periprocedural MI was defined in agreement with the Society for Cardiovascular Angiography and Interventions definition. The primary outcome was all-cause mortality. The secondary outcome was cardiovascular mortality. The predictors of periprocedural MI and the relationship with scales of physical performance, namely Short Physical Performance Battery and grip strength, were also investigated. Results The study included 586 patients. Overall, periprocedural MI occurred in 24 (4.1%) patients. After a median follow-up of 1023 (740-1446) days, the primary endpoint occurred in 94 (16%) patients. After multivariable analysis, periprocedural MI emerged as an independent predictor of all-cause mortality (hazard risk 4.30, 95% confidence interval 2.27-8.12). This finding was consistent for cardiovascular mortality (hazard risk 7.45, 95% confidence interval 3.56-15.67). SYNTAX score, multivessel PCI and total stent length were independent predictors of large periprocedural MI. At hospital discharge, patients suffering from periprocedural MI showed poor values of Short Physical Performance Battery and grip strength as compared with others. Conclusion In a cohort of older NSTEACS patients undergoing PCI, large periprocedural MI occurred in around 4% of patients and was associated with long-term occurrence of all-cause and cardiovascular mortality. Clinical trial registration ClinicalTrials.gov: NCT02324660 and NCT03021044.

Published
2021

53. Lipid Plaque Burden in NSTE-ACS patients with or without COPD: insights from the SCAP trial

Author

Rita Pavasini, Simone Biscaglia, Giulia Passarini, Andrea Erriquez, Alessandra Scoccia, Rossella Ruggiero, Paolo Cimaglia, Salvatore Brugaletta, Matteo Serenelli, Gianluca Campo, Sean P. Madden, Davide Bernucci, Matteo Tebaldi, and Elisa Maietti

Subjects
Spirometry, medicine.medical_specialty, Acute coronary syndrome, Non-ST-elevated acute coronary syndrome, Coronary Artery Disease, Culprit, NO, Pulmonary Disease, Chronic Obstructive, Internal medicine, Clinical endpoint, medicine, Humans, Acute Coronary Syndrome, Adverse effect, Lipid core burden index, COPD, medicine.diagnostic_test, business.industry, Chronic obstructive pulmonary disease, medicine.disease, Lipids, Pathophysiology, Plaque, Atherosclerotic, Cardiology, Synergy Between PCI with Taxus and Cardiac Surgery (SYNTAX) score, business, Cardiology and Cardiovascular Medicine, Nste acs, Chronic obstructive pulmonary disease, Non-ST-elevated acute coronary syndrome, Near infrared spectroscopy, Lipid core burden index, Synergy Between PCI with Taxus and Cardiac Surgery (SYNTAX) score, Near infrared spectroscopy
Abstract

BACKGROUND COPD patients have higher recurrence of adverse events and worse prognosis after acute coronary syndrome (ACS). The underlying pathophysiological mechanism is not fully elucidated. METHODS In screening for COPD in ACS (SCAP) trial (NCT02324660), ACS patients with smoking habit underwent a predischarge screening procedure to detect undiagnosed chronic obstructive pulmonary disease (UCOPD) confirmed with spirometry at 60 days. Patients were then categorized as UCOPD or no-COPD. In 65 NSTE-ACS patients, we performed near infrared spectroscopy (NIRS) in the culprit and at least one non-culprit vessel (151 vessels overall), and we calculated the SYNTAX I score. Primary endpoint was max lipid core burden index (LCBI) 4 mm. Secondary endpoints were SYNTAX score I and vessel LCBI. RESULTS Max LCBI 4 mm and vessel LCBI were significantly higher in the UCOPD compared to the no-COPD group (UCOPD 388±122, no-COPD 264±131, p

Published
2021

54. Coronary and total thoracic calcium scores predict mortality and provides pathophysiologic insights in COVID-19 patients

Author

Giovanni Landoni, Andrea Biagi, Nicola Sverzellati, Roberto Ferrari, Fabio Anastasio, Gianluigi Patelli, Claudia Costa, Piergiorgio Turchio, Arif A. Khokhar, Alessandra Scoccia, Pietro Andrea Bonaffini, Cristiano Spreafico, Camillo Talei Franzesi, Gianni Casella, Edda Boccia, Antonio Esposito, Marco Toselli, Aldo P. Maggioni, Elisabetta Mancini, Chiara Gnasso, Luigi Vignali, Alessandro Sticchi, Elisa Scarnecchia, Antonio Colombo, Giacomo Bellani, Gianluca Pontone, Alberto Cereda, Caterina Chiara De Carlini, Marco Manfrini, Francesco Ponticelli, Stefano Maggiolini, Anna Palmisano, Claudio Rapezzi, Marco Loffi, Alberto Pacielli, Francesca Besana, Michele Senni, Lucio Baffoni, Sandro Sironi, Evgeny Fominskiy, Gianmarco Iannopollo, Francesco De Cobelli, Daniele Andreini, Giorgio Benatti, Paolo Giacomo Vaudano, Francesco Giannini, Gian Battista Danzi, Chiara Micossi, Alberto Monello, Tommaso Nannini, Massimiliano Sperandio, Carlo Tacchetti, Mario Iannaccone, Davide Vignale, Attilio Iacovoni, Riccardo Leone, Davide Ippolito, Gianluca Campo, Francesco Paolo Lombardo, Elisabetta Cesini, Valeria Nicoletti, Margherita Muri, Iljia Gardi, Giannini, F., Toselli, M., Palmisano, A., Cereda, A., Vignale, D., Leone, R., Nicoletti, V., Gnasso, C., Monello, A., Manfrini, M., Khokhar, A., Sticchi, A., Biagi, A., Turchio, P., Tacchetti, C., Landoni, G., Boccia, E., Campo, G., Scoccia, A., Ponticelli, F., Danzi, G. B., Loffi, M., Muri, M., Pontone, G., Andreini, D., Mancini, E. M., Casella, G., Iannopollo, G., Nannini, T., Ippolito, D., Bellani, G., Franzesi, C. T., Patelli, G., Besana, F., Costa, C., Vignali, L., Benatti, G., Sverzellati, N., Scarnecchia, E., Lombardo, F. P., Anastasio, F., Iannaccone, M., Vaudano, P. G., Pacielli, A., Baffoni, L., Gardi, I., Cesini, E., Sperandio, M., Micossi, C., De Carlini, C. C., Spreafico, C., Maggiolini, S., Bonaffini, P. A., Iacovoni, A., Sironi, S., Senni, M., Fominskiy, E., De Cobelli, F., Maggioni, A. P., Rapezzi, C., Ferrari, R., Colombo, A., Esposito, A., Giannini, F, Toselli, M, Palmisano, A, Cereda, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Manfrini, M, Khokhar, A, Sticchi, A, Biagi, A, Turchio, P, Tacchetti, C, Landoni, G, Boccia, E, Campo, G, Scoccia, A, Ponticelli, F, Danzi, G, Loffi, M, Muri, M, Pontone, G, Andreini, D, Mancini, E, Casella, G, Iannopollo, G, Nannini, T, Ippolito, D, Bellani, G, Franzesi, C, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Sverzellati, N, Scarnecchia, E, Lombardo, F, Anastasio, F, Iannaccone, M, Vaudano, P, Pacielli, A, Baffoni, L, Gardi, I, Cesini, E, Sperandio, M, Micossi, C, De Carlini, C, Spreafico, C, Maggiolini, S, Bonaffini, P, Iacovoni, A, Sironi, S, Senni, M, Fominskiy, E, De Cobelli, F, Maggioni, A, Rapezzi, C, Ferrari, R, Colombo, A, and Esposito, A

Subjects
Aortic valve, Male, Computed Tomography Angiography, Aorta, Thoracic, 030204 cardiovascular system & hematology, Severity of Illness Index, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Thoracic aorta, Aged, 80 and over, Middle Aged, Coronary Vessels, Pathophysiology, Calcium score, In-hospital mortality, medicine.anatomical_structure, Italy, Aortic Valve, Cardiology, Aortic valve, Calcification, Calcium score, Coronary artery, COVID-19, Thoracic aorta, In-hospital mortality, Female, Cardiology and Cardiovascular Medicine, Artery, Research Paper, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Aortic Diseases, chemistry.chemical_element, Calcium, Coronary artery, NO, Calcification, 03 medical and health sciences, Predictive Value of Tests, medicine.artery, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Vascular Calcification, Aged, Retrospective Studies, business.industry, SARS-CoV-2, COVID-19, medicine.disease, Pneumonia, chemistry, business
Abstract

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread worldwide determining dramatic impacts on healthcare systems. Early identification of high-risk parameters is required in order to provide the best therapeutic approach. Coronary, thoracic aorta and aortic valve calcium can be measured from a non-gated chest computer tomography (CT) and are validated predictors of cardiovascular events and all-cause mortality. However, their prognostic role in acute systemic inflammatory diseases, such as COVID-19, has not been investigated. OBJECTIVES: The aim was to evaluate the association of coronary artery calcium and total thoracic calcium on in-hospital mortality in COVID-19 patients. METHODS: 1093 consecutive patients from 16 Italian hospitals with a positive swab for COVID-19 and an admission chest CT for pneumonia severity assessment were included. At CT, coronary, aortic valve and thoracic aorta calcium were qualitatively and quantitatively evaluated separately and combined together (total thoracic calcium) by a central Core-lab blinded to patients' outcomes. RESULTS: Non-survivors compared to survivors had higher coronary artery [Agatston (467.76 ​± ​570.92 vs 206.80 ​± ​424.13 ​mm2, p ​

Published
2021

55. Impact of clinical and subclinical coronary artery disease as assessed by coronary artery calcium in COVID-19

Author

Arif A. Khokhar, Alberto Pacielli, Francesco Ponticelli, Marco Toselli, Gianmarco Iannopollo, Alberto Monello, Davide Ippolito, Antonio Colombo, Alessandro Sticchi, Antonio Esposito, Anna Palmisano, Luigi Vignali, Gianluca Campo, Pietro Andrea Bonaffini, Valeria Nicoletti, Caterina Chiara De Carlini, Daniele Andreini, Claudia Costa, Riccardo Leone, Giorgio Benatti, Giacomo Bellani, Marco Loffi, Andrea Biagi, Carlo Tacchetti, Fabio Anastasio, Elisa Scarnecchia, Chiara Gnasso, Alessandra Scoccia, Stefano Maggiolini, Gian Battista Danzi, Roberto Ferrari, Francesca Besana, Gianluigi Patelli, Claudio Rapezzi, Mario Iannaccone, Davide Vignale, Michele Senni, Gianluca Pontone, Guglielmo Gallone, Francesco Giannini, Gianni Casella, Alberto Cereda, Paolo Giacomo Vaudano, Scoccia, A, Gallone, G, Cereda, A, Palmisano, A, Vignale, D, Leone, R, Nicoletti, V, Gnasso, C, Monello, A, Khokhar, A, Sticchi, A, Biagi, A, Tacchetti, C, Campo, G, Rapezzi, C, Ponticelli, F, Danzi, G, Loffi, M, Pontone, G, Andreini, D, Casella, G, Iannopollo, G, Ippolito, D, Bellani, G, Patelli, G, Besana, F, Costa, C, Vignali, L, Benatti, G, Iannaccone, M, Vaudano, P, Pacielli, A, De Carlini, C, Maggiolini, S, Bonaffini, P, Senni, M, Scarnecchia, E, Anastasio, F, Colombo, A, Ferrari, R, Esposito, A, Giannini, F, Toselli, M, Scoccia, A., Gallone, G., Cereda, A., Palmisano, A., Vignale, D., Leone, R., Nicoletti, V., Gnasso, C., Monello, A., Khokhar, A., Sticchi, A., Biagi, A., Tacchetti, C., Campo, G., Rapezzi, C., Ponticelli, F., Danzi, G. B., Loffi, M., Pontone, G., Andreini, D., Casella, G., Iannopollo, G., Ippolito, D., Bellani, G., Patelli, G., Besana, F., Costa, C., Vignali, L., Benatti, G., Iannaccone, M., Vaudano, P. G., Pacielli, A., De Carlini, C. C., Maggiolini, S., Bonaffini, P. A., Senni, M., Scarnecchia, E., Anastasio, F., Colombo, A., Ferrari, R., Esposito, A., Giannini, F., and Toselli, M.

Subjects
0301 basic medicine, Male, medicine.medical_specialty, coronary artery calcifications, Coronary Artery Disease, Coronary artery calcification, 030204 cardiovascular system & hematology, Coronary Angiography, Agatston score, Coronary artery disease, Article, NO, COVID-19, Coronary artery disease, Atherosclerosis, Agatston score, Coronary artery calcifications, Calcium score, In-hospital mortality, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Risk Factors, Internal medicine, Coronary artery calcifications, Clinical endpoint, Medicine, Humans, Myocardial infarction, cardiovascular diseases, Coronary atherosclerosis, Subclinical infection, Aged, Retrospective Studies, business.industry, SARS-CoV-2, Hazard ratio, COVID-19, Middle Aged, medicine.disease, Atherosclerosis, Coronary Vessels, Calcium score, In-hospital mortality, 030104 developmental biology, Atherosclerosi, Cardiology, Calcium, atherosclerosis, Cardiology and Cardiovascular Medicine, business
Abstract

Background and aims The potential impact of coronary atherosclerosis, as detected by coronary artery calcium, on clinical outcomes in COVID-19 patients remains unsettled. We aimed to evaluate the prognostic impact of clinical and subclinical coronary artery disease (CAD), as assessed by coronary artery calcium score (CAC), in a large, unselected population of hospitalized COVID-19 patients undergoing non-gated chest computed tomography (CT) for clinical practice. Methods SARS-CoV 2 positive patients from the multicenter (16 Italian hospitals), retrospective observational SCORE COVID-19 (calcium score for COVID-19 Risk Evaluation) registry were stratified in three groups: (a) “clinical CAD” (prior revascularization history), (b) “subclinical CAD” (CAC >0), (c) “No CAD” (CAC=0). Primary endpoint was in-hospital mortality and the secondary endpoint was a composite of myocardial infarction and cerebrovascular accident (MI/CVA). Results Amongst 1625 patients (male 67.2%, median age 69 [interquartile range 58-77] years), 31%, 57.8% and 11.1% had no, subclinical and clinical CAD, respectively. Increasing rates of in-hospital mortality (11.3% vs. 27.3% vs. 39.8%, p400, respectively, p, Graphical abstract Image 1

Published
2021

56. Corrigendum to 'Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database' [Int J Cardiol. 2020 Oct 15; 317: 103–110. PMID: 32360652] (International Journal of Cardiology (2020) 317 (103–110), (S0167527320312663), (10.1016/j.ijcard.2020.04.079))

Author

Rosa Raimondo, P. Perrone Filardi, Enrico Perna, Rocco Lagioia, Piero Gentile, Alessandra Scoccia, Alice Bonomi, Elisabetta Salvioni, Paola Gugliandolo, Andrea Passantino, Piergiuseppe Agostoni, Chiara Minà, Ugo Corrà, Massimo F Piepoli, C. Cavaliere, Luca Arcari, Angela Beatrice Scardovi, Giuseppe Limongelli, Maria Frigerio, Maurizio Bussotti, Federica Re, Stefania Paolillo, Damiano Magrì, Roberto Badagliacca, Massimo Mapelli, Gaia Cattadori, Michele Correale, Gianfranco Sinagra, Nicola Cosentino, Carlo Vignati, Sergio Caravita, Rita Gravino, Paola Gargiulo, Gianfranco Parati, Francesco Clemenza, Paolillo, S., Salvioni, E., Perrone Filardi, P., Bonomi, A., Sinagra, G., Gentile, P., Gargiulo, P., Scoccia, A., Cosentino, N., Gugliandolo, P., Badagliacca, R., Lagioia, R., Correale, M., Frigerio, M., Perna, E., Piepoli, M., Re, F., Raimondo, R., Mina, C., Clemenza, F., Bussotti, M., Limongelli, G., Gravino, R., Passantino, A., Magri, D., Parati, G., Caravita, S., Scardovi, A. B., Arcari, L., Vignati, C., Mapelli, M., Cattadori, G., Cavaliere, C., Corra, U., and Agostoni, P.

Subjects
MECKI score database, medicine.medical_specialty, Ejection fraction, business.industry, MEDLINE, heart failure, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, medicine.disease, prognostic, diabetes mellitus, reduced ejection fraction, Term (time), Heart failure, Diabetes mellitus, Internal medicine, Cardiology, medicine, Cardiology and Cardiovascular Medicine, business, Glycemic
Abstract

The authors regret that the Author Dr. Bussotti Maurizio appears with the following affiliation: Unità Operativa Cardiologia Riabilitativa, Multimedica IRCCS, Milano, Italy. But that was a mistake, the right affiliation of Dr. Bussotti Maurizio is instead: Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy. The authors kindly ask you to correct this affiliation also with all abstracting partners as PubMed. The authors would like to apologise for any inconvenience caused. DOI of original article: .

Published
2021

57. 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

59. Ticagrelor Increases SIRT1 and HES1 mRNA Levels in Peripheral Blood Cells from Patients with Stable Coronary Artery Disease and Chronic Obstructive Pulmonary Disease

Author

Alessandra Scoccia, Roberto Ferrari, Paola Rizzo, Luisa Marracino, Rita Pavasini, Gianluca Campo, Fernanda Martini, Ilaria Bononi, Laura Sofia Cardelli, Francesco Vieceli Dalla Sega, Anna Piredda, Valeria Martino, Francesca Fortini, Marco Manfrini, Giorgio Aquila, and Antonio Pannuti

Subjects
0301 basic medicine, medicine.medical_treatment, 030204 cardiovascular system & hematology, Pharmacology, Systemic inflammation, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), Ticagrelor, chronic obstructive pulmonary disease (copd), Catalysis, NO, ticagrelor, lcsh:Chemistry, Inorganic Chemistry, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, P2Y12, SIRT1, medicine, Physical and Theoretical Chemistry, Endothelial dysfunction, lcsh:QH301-705.5, Molecular Biology, Spectroscopy, Notch signaling, business.industry, Organic Chemistry, FOXP3, Percutaneous coronary intervention, General Medicine, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), Ticagrelor, Clopidogrel, Notch signaling, SIRT1, Clopidogrel, medicine.disease, Computer Science Applications, 030104 developmental biology, lcsh:Biology (General), lcsh:QD1-999, coronary artery disease (cad), medicine.symptom, business, Ticagrelor, medicine.drug
Abstract

Ticagrelor is a powerful P2Y12 inhibitor with pleiotropic effects in the cardiovascular system. Consistently, we have reported that in patients with stable coronary artery disease (CAD) and concomitant chronic obstructive pulmonary disease (COPD) who underwent percutaneous coronary intervention (PCI), 1-month treatment with ticagrelor was superior in improving biological markers of endothelial function, compared with clopidogrel. The objective of this study was to investigate the mechanisms underlying these beneficial effects of ticagrelor by conducting molecular analyses of RNA isolated from peripheral blood cells of these patients. We determined mRNAs levels of markers of inflammation and oxidative stress, such as ROR&gamma, t (T helper 17 cells marker), FoxP3 (regulatory T cells marker), NLRP3, ICAM1, SIRT1, Notch ligands JAG1 and DLL4, and HES1, a Notch target gene. We found that 1-month treatment with ticagrelor, but not clopidogrel, led to increased levels of SIRT1 and HES1 mRNAs. In patients treated with ticagrelor or clopidogrel, we observed a negative correlation among changes in both SIRT1 and HES1 mRNA and serum levels of Epidermal Growth Factor (EGF), a marker of endothelial dysfunction found to be reduced by ticagrelor treatment in our previous study. In conclusion, we report that in stable CAD/COPD patients ticagrelor positively regulates HES1 and SIRT1, two genes playing a protective role in the context of inflammation and oxidative stress. Our observations confirm and expand previous studies showing that the beneficial effects of ticagrelor in stable CAD/COPD patients may be, at least in part, mediated by its capacity to reduce systemic inflammation and oxidative stress.

Published
2020
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60. Ticagrelor Increases

Author

Giorgio, Aquila, Francesco, Vieceli Dalla Sega, Luisa, Marracino, Rita, Pavasini, Laura Sofia, Cardelli, Anna, Piredda, Alessandra, Scoccia, Valeria, Martino, Francesca, Fortini, Ilaria, Bononi, Fernanda, Martini, Marco, Manfrini, Antonio, Pannuti, Roberto, Ferrari, Paola, Rizzo, and Gianluca, Campo

Subjects
Ticagrelor, Blood Cells, Epidermal Growth Factor, Receptors, Notch, Coronary Artery Disease, Article, Clopidogrel, Pulmonary Disease, Chronic Obstructive, SIRT1, Sirtuin 1, coronary artery disease (CAD), Human Umbilical Vein Endothelial Cells, Humans, Transcription Factor HES-1, RNA, Messenger, chronic obstructive pulmonary disease (COPD), Cells, Cultured, Platelet Aggregation Inhibitors, Notch signaling, Signal Transduction
Abstract

Ticagrelor is a powerful P2Y12 inhibitor with pleiotropic effects in the cardiovascular system. Consistently, we have reported that in patients with stable coronary artery disease (CAD) and concomitant chronic obstructive pulmonary disease (COPD) who underwent percutaneous coronary intervention (PCI), 1-month treatment with ticagrelor was superior in improving biological markers of endothelial function, compared with clopidogrel. The objective of this study was to investigate the mechanisms underlying these beneficial effects of ticagrelor by conducting molecular analyses of RNA isolated from peripheral blood cells of these patients. We determined mRNAs levels of markers of inflammation and oxidative stress, such as RORγt (T helper 17 cells marker), FoxP3 (regulatory T cells marker), NLRP3, ICAM1, SIRT1, Notch ligands JAG1 and DLL4, and HES1, a Notch target gene. We found that 1-month treatment with ticagrelor, but not clopidogrel, led to increased levels of SIRT1 and HES1 mRNAs. In patients treated with ticagrelor or clopidogrel, we observed a negative correlation among changes in both SIRT1 and HES1 mRNA and serum levels of Epidermal Growth Factor (EGF), a marker of endothelial dysfunction found to be reduced by ticagrelor treatment in our previous study. In conclusion, we report that in stable CAD/COPD patients ticagrelor positively regulates HES1 and SIRT1, two genes playing a protective role in the context of inflammation and oxidative stress. Our observations confirm and expand previous studies showing that the beneficial effects of ticagrelor in stable CAD/COPD patients may be, at least in part, mediated by its capacity to reduce systemic inflammation and oxidative stress.

Published
2020

62. Comparison of quantitative flow ratio, Pd/Pa and diastolic hyperemia-free ratio versus fractional flow reserve in non-culprit lesion of patients with non ST-segment elevation myocardial infarction

Author

Matteo, Tebaldi, Simone, Biscaglia, Andrea, Erriquez, Carlo, Penzo, Carlo, Tumscitz, Alessandra, Scoccia, Giorgio, Quadri, Giorgio, Sacchetta, Anna, Folla, Giuseppe, Vadalà, Luca, Fileti, and Gianluca, Campo

Subjects
angiography-derived index, Coronary Stenosis, Reproducibility of Results, angiography-derived index, functional evaluation, non hyperemic pressure ratio, Coronary Angiography, Coronary Vessels, Severity of Illness Index, NO, Fractional Flow Reserve, Myocardial, Treatment Outcome, Predictive Value of Tests, functional evaluation, non hyperemic pressure ratio, Humans, Non-ST Elevated Myocardial Infarction
Abstract

To investigate the correlation between quantitative flow ratio (QFR), Pd/Pa, diastolic hyperemia-free ratio (DFR) and fractional flow reserve (FFR, gold standard) in non-culprit lesion (NCL) of patients with non ST-segment elevation myocardial infarction (NSTEMI).The non-hyperemic pressure ratio (NHPR) and the angiography-based indexes have been developed to overcome the limitation of the use of the FFR.Between January and December 2019, 184 NCL from 116 NSTEMI patients underwent physiologic assessment and were included in the study. NCLs were investigated with QFR, Pd/Pa, DFR, and FFR. Mean values of QFR, Pd/Pa, DFR and FFR were 0.85 ± 0.10, 0.92 ± 0.07, 0.93 ± 0.05 and 0.84 ± 0.07, respectively.DFR and FFR showed a good correlation (r = 0.76). Bland and Altman plot showed a mean difference of 0.080. DFR Diagnostic accuracy was 88%. The area under the ROC curve (AUC) for DFR was 0.946 (95%CI 0.90-0.97, p = .0001). Similar findings were reported for Pd/Pa (r = 0.73; mean difference 0.095, diagnostic accuracy 84%, AUC 0.909 [95%CI 0.85-0.94, p = .0001]) and QFR (r = 0.68; mean difference 0.01; diagnostic accuracy 88%, AUC 0.964 [95% CI 0.91-0.98, p = .0001]). FFR, QFR, Pd/Pa and DFR identified 31%, 32%, 30% and 32% potentially flow-limiting lesions, respectively.In NSTEMI patients, QFR, Pd/Pa and DFR showed equivalence as compared to gold standard FFR in the discrimination of non-culprit lesions requiring revascularization.

Published
2020

63. Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database

Author

Stefania, Paolillo, Elisabetta, Salvioni, Pasquale, Perrone Filardi, Alice, Bonomi, Gianfranco, Sinagra, Piero, Gentile, Paola, Gargiulo, Alessandra, Scoccia, Nicola, Cosentino, Paola, Gugliandolo, Roberto, Badagliacca, Rocco, Lagioia, Michele, Correale, Maria, Frigerio, Enrico, Perna, Massimo, Piepoli, Federica, Re, Rosa, Raimondo, Chiara, Minà, Francesco, Clemenza, Maurizio, Bussotti, Giuseppe, Limongelli, Rita, Gravino, Andrea, Passantino, Damiano, Magrì, Gianfranco, Parati, Sergio, Caravita, Angela B, Scardovi, Luca, Arcari, Carlo, Vignati, Massimo, Mapelli, Gaia, Cattadori, Carlo, Cavaliere, Ugo, Corrà, Piergiuseppe, Agostoni, Paolillo, S, Salvioni, E, Perrone Filardi, P, Bonomi, A, Sinagra, G, Gentile, P, Gargiulo, P, Scoccia, A, Cosentino, N, Gugliandolo, P, Badagliacca, R, Lagioia, R, Correale, M, Frigerio, M, Perna, E, Piepoli, M, Re, F, Raimondo, R, Minà, C, Clemenza, F, Bussotti, M, Limongelli, G, Gravino, R, Passantino, A, Magrì, D, Parati, G, Caravita, S, Scardovi, Ab, Arcari, L, Vignati, C, Mapelli, M, Cattadori, G, Cavaliere, C, Corrà, U, Agostoni, P, Paolillo, S., Salvioni, E., Perrone Filardi, P., Bonomi, A., Sinagra, G., Gentile, P., Gargiulo, P., Scoccia, A., Cosentino, N., Gugliandolo, P., Badagliacca, R., Lagioia, R., Correale, M., Frigerio, M., Perna, E., Piepoli, M., Re, F., Raimondo, R., Mina, C., Clemenza, F., Bussotti, M., Limongelli, G., Gravino, R., Passantino, A., Magri, D., Parati, G., Caravita, S., Scardovi, A. B., Arcari, L., Vignati, C., Mapelli, M., Cattadori, G., Cavaliere, C., Corra, U., and Agostoni, P.

Subjects
Diabetes mellitu, Diabetes mellitus, Glycated hemoglobin, Humans, Stroke Volume, Heart failure, Prognosis, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Glycemic Control, diabetes mellitus, glycated hemoglobin, heart failure, prognosis, glycemic control, humans, kidney, stroke volume, Kidney
Abstract

Background: The prognostic role of diabetes mellitus (DM) in heart failure (HF) patients is undefined, since DM is outweighed by several DM-related variables when confounders are considered. We determined the prognostic role of DM, treatment, and glycemic control in a real-life HF population. Methods: 3927 HF patients included in the Metabolic Exercise Cardiac Kidney Index (MECKI) score database were evaluated with a median follow-up of 3.66 years (IQR 1.70–6.67). Data analysis considered survival between DM (n = 897) vs. non-DM (n = 3030) patients, and, in diabetics, between insulin (n = 304), oral antidiabetics (n = 479), and dietary only (n = 88) treatments. The role of glycemic control was evaluated grouping DM patients according to glycated hemoglobin (HbA1c): 8% (n = 149). All analyses were performed also adjusting for ejection fraction, renal function, hemoglobin, sodium, exercise peak oxygen uptake, and ventilation/carbon dioxide relationship slope. Study primary endpoint was the composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Secondary endpoints were cardiovascular and all causes death. Results: For all endpoints, upon adjustment for confounders, DM status and insulin treatment or dietary regimen were not significantly associated with adverse long-term prognosis compared to non-DM and oral antidiabetic treated patients, respectively. A worse prognosis was observed in HbA1c >8% patients (Log-Rank p < 0.001), even after correction for confounding factors. All results were replicated by hazard ratio analysis. Conclusion: In HF patients, DM, insulin treatment and dietary regimen are not adverse outcome predictors. The only condition related to long-term prognosis, considering potential confounders, is poor glycemic control.

Published
2020

64. CRT-600.02 Procedural Performance of Ultrathin, Biodegradable-Polymer-Coated Stents Versus Durable-Polymer-Coated Stents Based on Intracoronary Imaging

Author

Annemieke C. Ziedses des Plantes, Tara Neleman, Maria N. Tovar Forero, Leon Visser, Alessandra Scoccia, Frederik T.W. Groenland, Jurgen M.R. Ligthart, Eric Boersma, Rutger-Jan Nuis, Wijnand den Dekker, Jeroen Wilschut, Roberto Diletti, Felix Zijlstra, Nicolas M. Van Mieghem, and Joost Daemen

Subjects
Cardiology and Cardiovascular Medicine
Published
2022

66. TCT-395 Diagnostic Performance of 3D Quantitative Coronary Angiography Vessel FFR With Diastolic Pressure Ratio: A Pooled Analysis of the FAST EXTEND and FAST II Studies

Author

Kaneshka Masdjedi, Mariusz Tomaniak, Jurgen Ligthart, Tara Neleman, Alessandra Scoccia, Joost Daemen, Frederik Groenland, Ernest Spitzer, and Nicolas M. Van Mieghem

Subjects
Coronary angiography, medicine.medical_specialty, Blood pressure, Pooled analysis, business.industry, Internal medicine, medicine, Cardiology, Cardiology and Cardiovascular Medicine, business
Published
2021

67. TCT-479 Percutaneous Suture-Based Closure of Patent Foramen Ovale: Initial Results of a Multicenter Experience in a Highly Selected Population

Author

Alessandra Scoccia, Antonio Colombo, Alessandra Laricchia, Alfonso Ielasi, Gabriele Maliandi, Monica Barki, Antonio Mangieri, Francesco Giannini, and Maurizio Tespili

Subjects
education.field_of_study, medicine.medical_specialty, Percutaneous, business.industry, Population, Closure (topology), medicine.disease, Surgery, Suture (anatomy), Patent foramen ovale, medicine, Cardiology and Cardiovascular Medicine, education, business
Published
2021

68. Type III coronary perforation during chronic total occlusion percutaneous coronary interventions treated with Cyanoacrylate glue embolization: case report and review of the technique

Author

Carlo Tumscitz, Valerio Lanzillotti, Lucia Pirani, Alessandra Scoccia, Francesco Gallo, and Annamaria Di Cesare

Subjects
medicine.medical_specialty, Percutaneous, Cyanoacrylate, law, business.industry, Perforation (oil well), medicine, Glue embolization, business, Total occlusion, Surgery, law.invention
Published
2019

69. Qualitative and quantitative evaluation of a new wearable device for ECG and respiratory Holter monitoring

Author

Alessandra Scoccia, Alessandra Leonardi, Andrea Aliverti, Dario Ossola, Carlo Vignati, Carolina Lombardi, Flavia Nicoli, Rudy Rigoni, Massimo Mapelli, Piergiuseppe Agostoni, Antonio Sarmento, Stefania Paolillo, Sarmento, A., Vignati, C., Paolillo, S., Lombardi, C., Scoccia, A., Nicoli, F., Mapelli, M., Leonardi, A., Ossola, D., Rigoni, R., Agostoni, P., Aliverti, A., Sarmento, A, Vignati, C, Paolillo, S, Lombardi, C, Scoccia, A, Nicoli, F, Mapelli, M, Leonardi, A, Ossola, D, Rigoni, R, Agostoni, P, and Aliverti, A

Subjects
Apnea, ECG monitoring, Respiratory monitoring, wearable device, Male, medicine.medical_specialty, Respiratory rate, wearable device, Respiratory physiology, Respiratory monitoring, 030204 cardiovascular system & hematology, Clothing, 03 medical and health sciences, QRS complex, Wearable Electronic Devices, 0302 clinical medicine, Heart Rate, Internal medicine, Medicine, ST segment, Humans, Tidal volume, Aged, Aged, 80 and over, Cross-Sectional Studie, Respiratory Mechanic, business.industry, Cardiorespiratory fitness, Middle Aged, Cross-Sectional Studies, 030228 respiratory system, Breathing, Cardiology, Respiratory Mechanics, Electrocardiography, Ambulatory, Female, Wearable Electronic Device, Cardiology and Cardiovascular Medicine, business, Human
Abstract

Background Recent advances in wearable technology make continuous cardiorespiratory monitoring possible, with potential applications in assessment of cardiopulmonary patients, healthy subjects and athletes. The aim of the present study was to qualitatively and quantitatively evaluate a new wearable device (Learn Inspire Free Entertain = L.I.F.E.) by embedding in a compression shirt a 12‑lead ECG system and 5 respiratory sensors. Methods Thirty cardiorespiratory patients and ten healthy subjects were studied for 24 h during their usual life activities. In 8 healthy subjects, simultaneous measurements of the device and of an ergo-spirometer were performed during different levels of ventilation in five different body positions. The quality of ECG signals in terms of measurability of heart rate, P wave, QRS complex and ST segment, was analyzed by four expert cardiologists/respiratory physiologists using an arbitrary 1–5 scale. The sum of the respiratory signals was used to calculate the respiratory rate, inspiratory time and relative changes of tidal volume. These parameters were compared to ergo-spirometer measurements. Results Median quality value was >3 for heart rate, QRS complex, ST segment and P wave (except in L3, aVL, aVF, V1 and V2 leads). Median quality of respiratory traces was >4 in patients and between 3 and 4 in healthy subjects. The respiratory monitoring of respiratory rate and inspiratory time was accurate in all body positions. Tidal volumes were underestimated due to a high level of ventilation. Conclusions The L.I.F.E. device provides an accurate continuous monitoring of cardiorespiratory signals during the 24 h both in normal subjects and cardiorespiratory patients.

Published
2018

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