139 results on '"Guardigli G"'
Search Results
52. Italian Multicenter Study on a Single Lead VDD Pacing System Using a Narrow Atrial Dipole Spacing
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ANTONIOLI, G.E., primary, ANSANI, L., additional, BARBIERI, D., additional, GUARDIGLI, G., additional, PERCOCO, G.F., additional, and TOSELLI, T., additional
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- 1992
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53. AV Delay and Exercise Stress Tests: Behavior in Normal Subjects
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BARBIERI, D., primary, PERCOCO, G.F., additional, TOSELLI, T., additional, GUARDIGLI, G., additional, ANSANI, L., additional, and ANTONIOLI, G.E., additional
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- 1990
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54. A New Single Lead VDD Pacing System
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PERCOCO, G.F., primary, ANSANI, L., additional, BARBIERI, D., additional, GUARDIGLI, G., additional, TOSELLI, T., additional, AUDOGLIO, R., additional, and ANTONIOLI, G.E., additional
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- 1990
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55. Tumor necrosis factor-alpha receptor 1 is a major predictor of mortality and new-onset heart failure in patients with acute myocardial infarction: the Cytokine-Activation and Long-Term Prognosis in Myocardial Infarction (C-ALPHA) Study.
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Valgimigli M, Ceconi C, Malagutti P, Merli E, Soukhomovskaia O, Francolini G, Cicchitelli G, Olivares A, Parrinello G, Percoco G, Guardigli G, Mele D, Pirani R, and Ferrari R
- Published
- 2005
56. Serum from patients with acute coronary syndromes displays a proapoptotic effect on human endothelial cells: a possible link to pan-coronary syndromes.
- Author
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Valgimigli M, Agnoletti L, Curello S, Comini L, Francolini G, Mastrorilli F, Merli E, Pirani R, Guardigli G, Grigolato PG, Ferrari R, Valgimigli, Marco, Agnoletti, Laura, Curello, Salvatore, Comini, Laura, Francolini, Gloria, Mastrorilli, Francesca, Merli, Elisa, Pirani, Roberto, and Guardigli, Gabriele
- Published
- 2003
57. Analysis of azide-insensitive Ca2+-dependent ATPase activity in atrial specimens from patients with coronary or valvular heart disease
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Guardigli G, Pasquale Bernardi, Santi Spampinato, Cavazza M, Carlo Ventura, Claudio Marcello Caldarera, and Luciana Bastagli
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Azides ,medicine.medical_specialty ,ATPase ,Heart Valve Diseases ,Coronary Disease ,Calcium-Transporting ATPases ,General Biochemistry, Genetics and Molecular Biology ,chemistry.chemical_compound ,Myofibrils ,Internal medicine ,medicine ,Humans ,Heart Atria ,cardiovascular diseases ,Coronary Artery Bypass ,General Pharmacology, Toxicology and Pharmaceutics ,chemistry.chemical_classification ,Atrium (architecture) ,biology ,business.industry ,Myocardium ,valvular heart disease ,General Medicine ,medicine.disease ,Kinetics ,Endocrinology ,Enzyme ,chemistry ,Heart failure ,Concomitant ,cardiovascular system ,biology.protein ,Cardiology ,Azide ,Myofibril ,business - Abstract
The activity of the azide-insensitive Ca 2+ -dependent ATPase (highly enriched in myofibrillar ATPase activity) was studied in specimens of both right and left atria which were taken from patients with ischemic and/or valvular heart disease during coronary by pass and/ or valvular substitution. A significantly lower enzymatic activity was found in atrial specimens from patients with left ventricular heart failure in comparison to the atrial fragments obtained from the patients with normal heart function. Such an inhibition reflected a significant increase in the Km of the enzyme for ATP and was associated with a concomitant reduction in Vmax, both more evident in the left atrial fragments. Moreover, tissue homogenates of atrial specimens from failing hearts exhibited a lower protein SH group content when compared to the atrial homogenates from the heart with normal left ventricular heart function.
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- 1987
58. Efficacy of angiotensin-converting enzyme inhibitors in secondary prevention,L'utilità degli inibitori dell'enzima di conversione dell'angiotensina nella prevenzione secondaria
- Author
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Claudio Ceconi, Mastrorilli, F., Squasi, P. A., Gaitani, S., Guardigli, G., and Ferrari, R.
59. Analysis of azide-insensitive Ca2+-dependent ATPase activity in atrial specimens from patients with coronary or valvular heart disease
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Ventura, C., primary, Bastagli, L., additional, Spampinato, S., additional, Guardigli, G., additional, Cavazza, M., additional, Bernardi, P., additional, and Caldarera, C.M., additional
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- 1987
- Full Text
- View/download PDF
60. Expression of major histocompatibility complex class II antigens on bile duct epithelium in patients with hepatic graft-versus-host disease after bone marrow transplantation
- Author
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Miglio, F., primary, Pignatelli, M., additional, Mazzeo, V., additional, Baraldini, M., additional, Stefanini, G.F., additional, Guardigli, G., additional, Bandini, G., additional, Ricci, P., additional, Tura, S., additional, and Gasbarrini, G., additional
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- 1987
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61. Time and frequency domain analysis of atrial iegms. A tool to discriminate supraventricular arrhythmias.
- Author
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Antonioli, GE., Toselli, T., Audoglio, R., Guardigli, G., and Tarjan, P.P.
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- 2000
62. Analysis of azide-insensitive Ca 2+-dependent ATPase activity in atrial specimens from patients with coronary or valvular heart disease
- Author
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Ventura, C., Bastagli, L., Spampinato, S., Guardigli, G., Cavazza, M., Bernardi, P., and Caldarera, C.M.
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- 1987
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63. Induction of hormesis in plants by urban trace metal pollution
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Gaia Mattarello, Mihaela Odajiu, Annalisa Tassoni, Mirko Salinitro, Giorgia Guardigli, Salinitro M., Mattarello G., Guardigli G., Odajiu M., and Tassoni A.
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Chromium ,Cardamine hirsuta ,Hormesi ,Plant Roots ,Soil ,Hydroponics ,Stellaria media ,Soil Pollutant ,Soil Pollutants ,Poa annua ,Trace metal ,Biomass ,Photosynthesis ,media_common ,Multidisciplinary ,biology ,Metal ,Plants ,Citie ,Biodegradation, Environmental ,Metals ,Medicine ,Plant Shoots ,Cadmium ,Environmental Monitoring ,Pollution ,Science ,media_common.quotation_subject ,Plant Shoot ,Plant Development ,Article ,food ,Hormesis ,Metals, Heavy ,Cities ,Trace Element ,Hydroponic ,Abiotic ,Plant Root ,Plant ,biology.organism_classification ,food.food ,Trace Elements ,Environmental sciences ,Agronomy ,Lead ,Plant stress responses ,Annual plant ,Plant sciences - Abstract
Hormesis is a dose–response phenomenon observed in numerous living organisms, caused by low levels of a large number of stressors, among which metal ions. In cities, metal levels are usually below toxicity limits for most plant species, however, it is of primary importance to understand whether urban metal pollution can threaten plant survival, or, conversely, be beneficial by triggering hormesis. The effects of Cd, Cr and Pb urban concentrations were tested in hydroponics on three annual plants, Cardamine hirsuta L., Poa annua L. and Stellaria media (L.) Vill., commonly growing in cities. Results highlighted for the first time that average urban trace metal concentrations do not hinder plant growth but cause instead hormesis, leading to a considerable increase in plant performance (e.g., two to five-fold higher shoot biomass with Cd and Cr). The present findings, show that city habitats are more suitable for plants than previously assumed, and that what is generally considered to be detrimental to plants, such as trace metals, could instead be exactly the plus factor allowing urban plants to thrive.
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- 2021
64. Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry
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George Ntaios, Menno V. Huisman, Hans-Christoph Diener, Jonathan L. Halperin, Christine Teutsch, Sabrina Marler, Venkatesh K. Gurusamy, Milla Thompson, Gregory Y.H. Lip, Brian Olshansky, Dzifa Wosornu Abban, Nasser Abdul, Atilio Marcelo Abud, Fran Adams, Srinivas Addala, Pedro Adragão, Walter Ageno, Rajesh Aggarwal, Sergio Agosti, Piergiuseppe Agostoni, Francisco Aguilar, Julio Aguilar Linares, Luis Aguinaga, Jameel Ahmed, Allessandro Aiello, Paul Ainsworth, Jorge Roberto Aiub, Raed Al-Dallow, Lisa Alderson, Jorge Antonio Aldrete Velasco, Dimitrios Alexopoulos, Fernando Alfonso Manterola, Pareed Aliyar, David Alonso, Fernando Augusto Alves da Costa, José Amado, Walid Amara, Mathieu Amelot, Nima Amjadi, Fabrizio Ammirati, Marianna Andrade, Nabil Andrawis, Giorgio Annoni, Gerardo Ansalone, M.Kevin Ariani, Juan Carlos Arias, Sébastien Armero, Chander Arora, Muhammad Shakil Aslam, M. Asselman, Philippe Audouin, Charles Augenbraun, S. Aydin, Ivaneta Ayryanova, Emad Aziz, Luciano Marcelo Backes, E. Badings, Ermentina Bagni, Seth H. Baker, Richard Bala, Antonio Baldi, Shigenobu Bando, Subhash Banerjee, Alan Bank, Gonzalo Barón Esquivias, Craig Barr, Maria Bartlett, Vanja Basic Kes, Giovanni Baula, Steffen Behrens, Alan Bell, Raffaella Benedetti, Juan Benezet Mazuecos, Bouziane Benhalima, Jutta Bergler-Klein, Jean-Baptiste Berneau, Richard A. Bernstein, Percy Berrospi, Sergio Berti, Andrea Berz, Elizabeth Best, Paulo Bettencourt, Robert Betzu, Ravi Bhagwat, Luna Bhatta, Francesco Biscione, Giovanni BISIGNANI, Toby Black, Michael J. Bloch, Stephen Bloom, Edwin Blumberg, Mario Bo, Ellen Bøhmer, Andreas Bollmann, Maria Grazia Bongiorni, Giuseppe Boriani, D.J. Boswijk, Jochen Bott, Edo Bottacchi, Marica Bracic Kalan, Drew Bradman, Donald Brautigam, Nicolas Breton, P.J.A.M. Brouwers, Kevin Browne, Jordi Bruguera Cortada, A. Bruni, Claude Brunschwig, Hervé Buathier, Aurélie Buhl, John Bullinga, Jose Walter Cabrera, Alberto Caccavo, Shanglang Cai, Sarah Caine, Leonardo Calò, Valeria Calvi, Mauricio Camarillo Sánchez, Rui Candeias, Vincenzo Capuano, Alessandro Capucci, Ronald Caputo, Tatiana Cárdenas Rizo, Francisco Cardona, Francisco Carlos da Costa Darrieux, Yan Carlos Duarte Vera, Antonio Carolei, Susana Carreño, Paula Carvalho, Susanna Cary, Gavino Casu, Claudio Cavallini, Guillaume Cayla, Aldo Celentano, Tae-Joon Cha, Kwang Soo Cha, Jei Keon Chae, Kathrine Chalamidas, Krishnan Challappa, Sunil Prakash Chand, Harinath Chandrashekar, Ludovic Chartier, Kausik Chatterjee, Carlos Antero Chavez Ayala, Aamir Cheema, Amjad Cheema, Lin Chen, Shih-Ann Chen, Jyh Hong Chen, Fu-Tien Chiang, Francesco Chiarella, Lin Chih-Chan, Yong Keun Cho, Jong-Il Choi, Dong Ju Choi, Guy Chouinard, Danny Hoi-Fan Chow, Dimitrios Chrysos, Galina Chumakova, Eduardo Julián José Roberto Chuquiure Valenzuela, Nicoleta Cindea Nica, David J. Cislowski, Anthony Clay, Piers Clifford, Andrew Cohen, Michael Cohen, Serge Cohen, Furio Colivicchi, Ronan Collins, Paolo Colonna, Steve Compton, Derek Connolly, Alberto Conti, Gabriel Contreras Buenostro, Gregg Coodley, Martin Cooper, Julian Coronel, Giovanni Corso, Juan Cosín Sales, Yves Cottin, John Covalesky, Aurel Cracan, Filippo Crea, Peter Crean, James Crenshaw, Tina Cullen, Harald Darius, Patrick Dary, Olivier Dascotte, Ira Dauber, Vicente Davalos, Ruth Davies, Gershan Davis, Jean-Marc Davy, Mark Dayer, Marzia De Biasio, Silvana De Bonis, Raffaele De Caterina, Teresiano De Franceschi, J.R. de Groot, José De Horta, Axel De La Briolle, Gilberto de la Pena Topete, Angelo Amato Vicenzo de Paola, Weimar de Souza, A. de Veer, Luc De Wolf, Eric Decoulx, Sasalu Deepak, Pascal Defaye, Freddy Del-Carpio Munoz, Diana Delic Brkljacic, N. Joseph Deumite, Silvia Di Legge, Igor Diemberger, Denise Dietz, Pedro Dionísio, Qiang Dong, Fabio Rossi dos Santos, Elena Dotcheva, Rami Doukky, Anthony D'Souza, Simon Dubrey, Xavier Ducrocq, Dmitry Dupljakov, Mauricio Duque, Dipankar Dutta, Nathalie Duvilla, A. Duygun, Rainer Dziewas, Charles B. Eaton, William Eaves, L.A. Ebels-Tuinbeek, Clifford Ehrlich, Sabine Eichinger-Hasenauer, Steven J. Eisenberg, Adnan El Jabali, Mahfouz El Shahawy, Mauro Esteves Hernandes, Ana Etxeberria Izal, Rudolph Evonich, Oksana Evseeva, Andrey Ezhov, Raed Fahmy, Quan Fang, Ramin Farsad, Laurent Fauchier, Stefano Favale, Maxime Fayard, Jose Luis Fedele, Francesco Fedele, Olga Fedorishina, Steven R. Fera, Luis Gustavo Gomes Ferreira, Jorge Ferreira, Claudio Ferri, Anna Ferrier, Hugo Ferro, Alexandra Finsen, Brian First, Stuart Fischer, Catarina Fonseca, Luísa Fonseca Almeida, Steven Forman, Brad Frandsen, William French, Keith Friedman, Athena Friese, Ana Gabriela Fruntelata, Shigeru Fujii, Stefano Fumagalli, Marta Fundamenski, Yutaka Furukawa, Matthias Gabelmann, Nashwa Gabra, Niels Gadsbøll, Michel Galinier, Anders Gammelgaard, Priya Ganeshkumar, Christopher Gans, Antonio Garcia Quintana, Olivier Gartenlaub, Achille Gaspardone, Conrad Genz, Frédéric Georger, Jean-Louis Georges, Steven Georgeson, Evaldas Giedrimas, Mariusz Gierba, Ignacio Gil Ortega, Eve Gillespie, Alberto Giniger, Michael C. Giudici, Alexandros Gkotsis, Taya V. Glotzer, Joachim Gmehling, Jacek Gniot, Peter Goethals, Seth Goldbarg, Ronald Goldberg, Britta Goldmann, Sergey Golitsyn, Silvia Gómez, Juan Gomez Mesa, Vicente Bertomeu Gonzalez, Jesus Antonio Gonzalez Hermosillo, Víctor Manuel González López, Hervé Gorka, Charles Gornick, Diana Gorog, Venkat Gottipaty, Pascal Goube, Ioannis Goudevenos, Brett Graham, G. Stephen Greer, Uwe Gremmler, Paul G. Grena, Martin Grond, Edoardo Gronda, Gerian Grönefeld, Xiang Gu, Ivett Guadalupe Torres Torres, Gabriele Guardigli, Carolina Guevara, Alexandre Guignier, Michele Gulizia, Michael Gumbley, Albrecht Günther, Andrew Ha, Georgios Hahalis, Joseph Hakas, Christian Hall, Bing Han, Seongwook Han, Joe Hargrove, David Hargroves, Kenneth B. Harris, Tetsuya Haruna, Emil Hayek, Jeff Healey, Steven Hearne, Michael Heffernan, Geir Heggelund, J.A. Heijmeriks, Maarten Hemels, I. Hendriks, Sam Henein, Sung-Ho Her, Paul Hermany, Jorge Eduardo Hernández Del Río, Yorihiko Higashino, Michael Hill, Tetsuo Hisadome, Eiji Hishida, Etienne Hoffer, Matthew Hoghton, Kui Hong, Suk keun Hong, Stevie Horbach, Masataka Horiuchi, Yinglong Hou, Jeff Hsing, Chi-Hung Huang, David Huckins, null kathy Hughes, A. Huizinga, E.L. Hulsman, Kuo-Chun Hung, Gyo-Seung Hwang, Margaret Ikpoh, Davide Imberti, Hüseyin Ince, Ciro Indolfi, Shujiro Inoue, Didier Irles, Harukazu Iseki, C. Noah Israel, Bruce Iteld, Venkat Iyer, Ewart Jackson-Voyzey, Naseem Jaffrani, Frank Jäger, Martin James, Sung-Won Jang, Nicolas Jaramillo, Nabil Jarmukli, Robert J. Jeanfreau, Ronald D. Jenkins, Carlos Jerjes Sánchez, Javier Jimenez, Robert Jobe, Tomas Joen-Jakobsen, Nicholas Jones, Jose Carlos Moura Jorge, Bernard Jouve, Byung Chun Jung, Kyung Tae Jung, Werner Jung, Mikhail Kachkovskiy, Krystallenia Kafkala, Larisa Kalinina, Bernd Kallmünzer, Farzan Kamali, Takehiro Kamo, Priit Kampus, Hisham Kashou, Andreas Kastrup, Apostolos Katsivas, Elizabeth Kaufman, Kazuya Kawai, Kenji Kawajiri, John F. Kazmierski, P. Keeling, José Francisco Kerr Saraiva, Galina Ketova, AJIT Singh Khaira, Aleksey Khripun, Doo-Il Kim, Young Hoon Kim, Nam Ho Kim, Dae Kyeong Kim, Jeong Su Kim, June Soo Kim, Ki Seok Kim, Jin bae Kim, Elena Kinova, Alexander Klein, James J. Kmetzo, G. Larsen Kneller, Aleksandar Knezevic, Su Mei Angela Koh, Shunichi Koide, Anastasios Kollias, J.A. Kooistra, Jay Koons, Martin Koschutnik, William J. Kostis, Dragan Kovacic, Jacek Kowalczyk, Natalya Koziolova, Peter Kraft, Johannes A. Kragten, Mori Krantz, Lars Krause, B.J. Krenning, F. Krikke, Z. Kromhout, Waldemar Krysiak, Priya Kumar, Thomas Kümler, Malte Kuniss, Jen-Yuan Kuo, Achim Küppers, Karla Kurrelmeyer, Choong Hwan Kwak, Bénédicte Laboulle, Arthur Labovitz, Wen Ter Lai, Andy Lam, Yat Yin Lam, Fernando Lanas Zanetti, Charles Landau, Giancarlo Landini, Estêvão Lanna Figueiredo, Torben Larsen, Karine Lavandier, Jessica LeBlanc, Moon Hyoung Lee, Chang-Hoon Lee, John Lehman, Ana Leitão, Nicolas Lellouche, Malgorzata Lelonek, Radoslaw Lenarczyk, T. Lenderink, Salvador León González, Peter Leong-Sit, Matthias Leschke, Nicolas Ley, Zhanquan Li, Xiaodong Li, Weihua Li, Xiaoming Li, Christhoh Lichy, Ira Lieber, Ramon Horacio Limon Rodriguez, Hailong Lin, Feng Liu, Hengliang Liu, Guillermo Llamas Esperon, Nassip Llerena Navarro, Eric Lo, Sergiy Lokshyn, Amador López, José Luís López-Sendón, Adalberto Menezes Lorga Filho, Richard S. Lorraine, Carlos Alberto Luengas, Robert Luke, Ming Luo, Steven Lupovitch, Philippe Lyrer, Changsheng Ma, Genshan Ma, Irene Madariaga, Koji Maeno, Dominique Magnin, Gustavo Maid, Sumeet K. Mainigi, Konstantinos Makaritsis, Rohit Malhotra, Rickey Manning, Athanasios Manolis, Helard Andres Manrique Hurtado, Ioannis Mantas, Fernando Manzur Jattin, Vicky Maqueda, Niccolo Marchionni, Francisco Marin Ortuno, Antonio Martín Santana, Jorge Martinez, Petra Maskova, Norberto Matadamas Hernandez, Katsuhiro Matsuda, Tillmann Maurer, Ciro Mauro, Erik May, Nolan Mayer, John McClure, Terry McCormack, William McGarity, Hugh McIntyre, Brent McLaurin, Feliz Alvaro Medina Palomino, Francesco Melandri, Hiroshi Meno, Dhananjai Menzies, Marco Mercader, Christian Meyer, Beat j. Meyer, Jacek Miarka, Frank Mibach, Dominik Michalski, Patrik Michel, Rami Mihail Chreih, Ghiath Mikdadi, Milan Mikus, Davor Milicic, Constantin Militaru, Sedi Minaie, Bogdan Minescu, Iveta Mintale, Tristan Mirault, Michael J. Mirro, Dinesh Mistry, Nicoleta Violeta Miu, Naomasa Miyamoto, Tiziano Moccetti, Akber Mohammed, Azlisham Mohd Nor, Michael Mollerus, Giulio Molon, Sergio Mondillo, Patrícia Moniz, Lluis Mont, Vicente Montagud, Oscar Montaña, Cristina Monti, Luciano Moretti, Kiyoo Mori, Andrew Moriarty, Jacek Morka, Luigi Moschini, Nikitas Moschos, Andreas Mügge, Thomas J. Mulhearn, Carmen Muresan, Michela Muriago, Wlodzimierz Musial, Carl W. Musser, Francesco Musumeci, Thuraia Nageh, Hidemitsu Nakagawa, Yuichiro Nakamura, Toru Nakayama, Gi-Byoung Nam, Michele Nanna, Indira Natarajan, Hemal M. Nayak, Stefan Naydenov, Jurica Nazli, Alexandru Cristian Nechita, Libor Nechvatal, Sandra Adela Negron, James Neiman, Fernando Carvalho Neuenschwander, David Neves, Anna Neykova, Ricardo Nicolás Miguel, George Nijmeh, Alexey Nizov, Rodrigo Noronha Campos, Janko Nossan, Tatiana Novikova, Ewa Nowalany-Kozielska, Emmanuel Nsah, Juan Carlos Nunez Fragoso, Svetlana Nurgalieva, Dieter Nuyens, Ole Nyvad, Manuel Odin de Los Rios Ibarra, Philip O'Donnell, Martin O'Donnell, Seil Oh, Yong Seog Oh, Dongjin Oh, Gilles O'Hara, Kostas Oikonomou, Claudia Olivares, Richard Oliver, Rafael Olvera Ruiz, Christoforos Olympios, null Anna omaszuk-Kazberuk, Joaquín Osca Asensi, null eena Padayattil jose, Francisco Gerardo Padilla Padilla, Victoria Padilla Rios, Giuseppe Pajes, A. Shekhar Pandey, Gaetano Paparella, F. Paris, Hyung Wook Park, Jong Sung Park, Fragkiskos Parthenakis, Enrico Passamonti, Rajesh J. Patel, Jaydutt Patel, Mehool Patel, Janice Patrick, Ricardo Pavón Jimenez, Analía Paz, Vittorio Pengo, William Pentz, Beatriz Pérez, Alma Minerva Pérez Ríos, Alejandro Pérez-Cabezas, Richard Perlman, Viktor Persic, Francesco Perticone, Terri K. Peters, Sanjiv Petkar, Luis Felipe Pezo, Christian Pflücke, David N. Pham, Roland T. Phillips, Stephen Phlaum, Denis Pieters, Julien Pineau, Arnold Pinter, Fausto Pinto, R. Pisters, Nediljko Pivac, Darko Pocanic, Cristian Podoleanu, Alessandro Politano, Zdravka Poljakovic, Stewart Pollock, Jose Polo Garcéa, Holger Poppert, Maurizio Porcu, Antonio Pose Reino, Neeraj Prasad, Dalton Bertolim Précoma, Alessandro Prelle, John Prodafikas, Konstantin Protasov, Maurice Pye, Zhaohui Qiu, Jean-Michel Quedillac, Dimitar Raev, Carlos Antonio Raffo Grado, Sidiqullah Rahimi, Arturo Raisaro, Bhola Rama, Ricardo Ramos, Maria Ranieri, Nuno Raposo, Eric Rashba, Ursula Rauch-Kroehnert, Ramakota Reddy, Giulia Renda, Shabbir Reza, Luigi Ria, Dimitrios Richter, Hans Rickli, Werner Rieker, Tomas Ripolil Vera, Luiz Eduardo Ritt, Douglas Roberts, Ignacio Rodriguez Briones, Aldo Edwin Rodriguez Escudero, Carlos Rodríguez Pascual, Mark Roman, Francesco Romeo, E. Ronner, Jean-Francois Roux, Nadezda Rozkova, Miroslav Rubacek, Frank Rubalcava, Andrea M. Russo, Matthieu Pierre Rutgers, Karin Rybak, Samir Said, Tamotsu Sakamoto, Abraham Salacata, Adrien Salem, Rafael Salguero Bodes, Marco A. Saltzman, Alessandro Salvioni, Gregorio Sanchez Vallejo, Marcelo Sanmartín Fernández, Wladmir Faustino Saporito, Kesari Sarikonda, Taishi Sasaoka, Hamdi Sati, Irina Savelieva, Pierre-Jean Scala, Peter Schellinger, Carlos Scherr, Lisa Schmitz, Karl-Heinz Schmitz, Bettina Schmitz, Teresa Schnabel, Steffen Schnupp, Peter Schoeniger, Norbert Schön, Peter Schwimmbeck, Clare Seamark, Greg Searles, Karl-Heinz Seidl, Barry Seidman, Jaroslaw Sek, Lakshmanan Sekaran, Carlo SERRATI, Neerav Shah, Vinay Shah, Anil Shah, Shujahat Shah, Vijay Kumar Sharma, Louise Shaw, Khalid H. Sheikh, Naruhito Shimizu, Hideki Shimomura, Dong-Gu Shin, Eun-Seok Shin, Junya Shite, Gerolamo Sibilio, Frank Silver, Iveta Sime, Tim A. Simmers, Narendra Singh, Peter Siostrzonek, Didier Smadja, David W. Smith, Marcelo Snitman, Dario Sobral Filho, Hassan Soda, Carl Sofley, Adam Sokal, Yannie Soo Oi Yan, Rodolfo Sotolongo, Olga Ferreira de Souza, Jon Arne Sparby, Jindrich Spinar, David Sprigings, Alex C. Spyropoulos, Dimitrios Stakos, Clemens Steinwender, George Stergiou, Ian Stiell, Marcus Stoddard, Anastas Stoikov, Witold Streb, Ioannis Styliadis, Guohai Su, Xi Su, Wanda Sudnik, Kai Sukles, Xiaofei Sun, H. Swart, Janko Szavits-Nossan, Jens Taggeselle, Yuichiro Takagi, Amrit Pal Singh Takhar, Angelika Tamm, Katsumi Tanaka, Tanyanan Tanawuttiwat, Sherman Tang, Aylmer Tang, Giovanni Tarsi, Tiziana Tassinari, Ashis Tayal, Muzahir Tayebjee, J.M. ten Berg, Dan Tesloianu, Salem H.K. The, Dierk Thomas, Serge Timsit, Tetsuya Tobaru, Andrzej R. Tomasik, Mikhail Torosoff, Emmanuel Touze, Elina Trendafilova, W. Kevin Tsai, Hung Fat Tse, Hiroshi Tsutsui, Tian Ming Tu, Ype Tuininga, Minang Turakhia, Samir Turk, Wayne Tcurner, Arnljot Tveit, Richard Tytus, C. Valadão, P.F.M.M. van Bergen, Philippe van de Borne, B.J. van den Berg, C. van der Zwaan, M. Van Eck, Peter Vanacker, Dimo Vasilev, Vasileios Vasilikos, Maxim Vasilyev, Srikar Veerareddy, Mario Vega Miño, Asok Venkataraman, Paolo Verdecchia, Francesco Versaci, Ernst Günter Vester, Hubert Vial, Jason Victory, Alejandro Villamil, Marc Vincent, Anthony Vlastaris, Jürgen vom Dahl, Kishor Vora, Robert B. Vranian, Paul Wakefield, Ningfu Wang, Mingsheng Wang, Xinhua Wang, Feng Wang, Tian Wang, Alberta L. Warner, Kouki Watanabe, Jeanne Wei, Christian Weimar, Stanislav Weiner, Renate Weinrich, Ming-Shien Wen, Marcus Wiemer, Preben Wiggers, Andreas Wilke, David Williams, Marcus L. Williams, Bernhard Witzenbichler, Brian Wong, Ka Sing Lawrence Wong, Beata Wozakowska-Kaplon, Shulin Wu, Richard C. Wu, Silke Wunderlich, Nell Wyatt, John (Jack) Wylie, Yong Xu, Xiangdong Xu, Hiroki Yamanoue, Takeshi Yamashita, Ping Yen Bryan Yan, Tianlun Yang, Jing Yao, Kuo-Ho Yeh, Wei Hsian Yin, Yoto Yotov, Ralf Zahn, Stuart Zarich, Sergei Zenin, Elisabeth Louise Zeuthen, Huanyi Zhang, Donghui Zhang, Xingwei Zhang, Ping Zhang, Jun Zhang, Shui Ping Zhao, Yujie Zhao, Zhichen Zhao, Yang Zheng, Jing Zhou, Sergio Zimmermann, Andrea Zini, Steven Zizzo, Wenxia Zong, L Steven Zukerman, Cardiology, ACS - Heart failure & arrhythmias, Ntaios G., Huisman M.V., Diener H.-C., Halperin J.L., Teutsch C., Marler S., Gurusamy V.K., Thompson M., Lip G.Y.H., Olshansky B., Abban D.W., Abdul N., Abud A.M., Adams F., Addala S., Adragao P., Ageno W., Aggarwal R., Agosti S., Agostoni P., Aguilar F., Linares J.A., Aguinaga L., Ahmed J., Aiello A., Ainsworth P., Aiub J.R., Al-Dallow R., Alderson L., Aldrete Velasco J.A., Alexopoulos D., Manterola F.A., Aliyar P., Alonso D., Alves da Costa F.A., Amado J., Amara W., Amelot 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Oral ,medicine.medical_specialty ,anticoagulants ,Vitamin K ,medicine.drug_class ,Medizin ,Administration, Oral ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,Antithrombotic treatment ,0302 clinical medicine ,Randomized controlled trial ,law ,Risk Factors ,Internal medicine ,Antithrombotic ,medicine ,non-vitamin-K antagonist oral anticoagulant ,Diseases of the circulatory (Cardiovascular) system ,Humans ,SAMe-TT2R2 ,In patient ,atrial fibrillation ,030212 general & internal medicine ,Prospective Studies ,Registries ,Medical prescription ,business.industry ,Anticoagulant ,non-vitamin-K antagonist oral ,Atrial fibrillation ,medicine.disease ,non-vitamin-K antagonist oral anticoagulants ,Clinical trial ,Stroke ,Treatment Outcome ,SAMe-TT ,RC666-701 ,2 ,R ,vitamin-K-antagonist oral anticoagulants ,Administration ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,SAMe-TT R ,Cardiology and Cardiovascular Medicine ,business - Abstract
CA extern - Weitere Nicht-UDE-Autoren sind nicht genannt. Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007. © 2020 Hellenic Society of Cardiology
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- 2021
65. Effects of alirocumab on cardiovascular and metabolic outcomes after acute coronary syndrome in patients with or without diabetes: a prespecified analysis of the ODYSSEY OUTCOMES randomised controlled trial
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Kausik K Ray, Helen M Colhoun, Michael Szarek, Marie Baccara-Dinet, Deepak L Bhatt, Vera A Bittner, Andrzej J Budaj, Rafael Diaz, Shaun G Goodman, Corinne Hanotin, Robert A Harrington, J Wouter Jukema, Virginie Loizeau, Renato D Lopes, Angèle Moryusef, Jan Murin, Robert Pordy, Arsen D Ristic, Matthew T Roe, José Tuñón, Harvey D White, Andreas M Zeiher, Gregory G Schwartz, Philippe Gabriel Steg, Gregory G. Schwartz, Ph. Gabriel Steg, Deepak L. Bhatt, Vera A. Bittner, Shaun G. Goodman, Robert A. Harrington, J. Wouter Jukema, Harvey D. White, Andreas M. Zeiher, Pierluigi Tricoci, Matthew T. Roe, Kenneth W. Mahaffey, Jay M. Edelberg, Guillaume Lecorps, William J. Sasiela, Jean-François Tamby, Philip E. Aylward, Heinz Drexel, Peter Sinnaeve, Mirza Dilic, Renato D. Lopes, Nina N. Gotcheva, Juan-Carlos Prieto, Huo Yong, Patricio López-Jaramillo, Ivan Pećin, Zeljko Reiner, Petr Ostadal, Margus Viigimaa, Markku S. Nieminen, Vakhtang Chumburidze, Nikolaus Marx, Nicolas Danchin, Evangelos Liberopoulos, Pablo Carlos Montenegro Valdovinos, Hung-Fat Tse, Robert Gabor Kiss, Denis Xavier, Doron Zahger, Marco Valgimigli, Takeshi Kimura, Hyo Soo Kim, Sang-Hyun Kim, Andrejs Erglis, Aleksandras Laucevicius, Sasko Kedev, Khalid Yusoff, Gabriel Arturo Ramos López, Marco Alings, Sigrun Halvorsen, Roger M. Correa Flores, Andrzej Budaj, Joao Morais, Maria Dorobantu, Yuri Karpov, Arsen D. Ristic, Terrance Chua, Zlatko Fras, Anthony J. Dalby, H. Asita de Silva, Emil Hagström, Ulf Landmesser, Chern-En Chiang, Piyamitr Sritara, Sema Guneri, Alexander Parkhomenko, Kausik K. Ray, Patrick M. Moriarty, Robert Vogel, Bernard Chaitman, Sheryl F. Kelsey, Anders G. Olsson, Jean-Lucien Rouleau, Maarten L. Simoons, Karen Alexander, Chiara Meloni, Robert Rosenson, Eric J.G. Sijbrands, John H. Alexander, Luciana Armaganijan, Akshay Bagai, Maria Cecilia Bahit, J. Matthew Brennan, Shaun Clifton, Adam D. 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Negron Miguel, S, Sanabria Perez, E, Carrion Chambilla, J, Chavez Ayala, C, Castillo Leon, R, Vargas Gonzales, R, Hernandez Zuniga, J, Camacho Cosavalente, L, Bravo Mannucci, J, Heredia Landeo, J, Llerena Navarro, N, Roldan Concha, Y, Rodriguez Chavez, V, Anchante Hernandez, H, Zea Nunez, C, Mogrovejo Ramos, W, Ferrolino, A, Sy, R, Tirador, L, Matiga, G, Coching, R, Bernan, A, Rogelio, G, Morales, D, Tan, E, Sulit, D, Wlodarczak, A, Jaworska, K, Skonieczny, G, Pawlowicz, L, Wojewoda, P, Busz-Papiez, B, Bednarski, J, Goch, A, Staneta, P, Dulak, E, Saminski, K, Krasowski, W, Sudnik, W, Zurakowski, A, Skorski, M, Miklaszewicz, B, Kubica, J, Andrzej Lipko, J, Kostarska-Srokosz, E, Piepiorka, M, Drzewiecka, A, Stasiewski, A, Blicharski, T, Bystryk, L, Szpajer, M, Korol, M, Czerski, T, Mirek-Bryniarska, E, Gniot, J, Lubinski, A, Gorny, J, Franek, E, Raczak, G, Szwed, H, Monteiro, P, Mesquita Bastos, J, Pereira, H, Martins, D, Seixo, F, Mendonca, C, Botelho, A, Caetano, F, Minescu, B, Istratoaie, O, Tesloianu, D, Cristian, G, Dumitrescu, S, Podoleanu, C, Constantinescu, M, Bengus, C, Militaru, C, Rosu, D, Parepa, I, Matei, A, Alexandru, T, Malis, M, Coman, I, Stanescu-Cioranu, R, Dimulescu, D, Shvarts, Y, Orlikova, O, Kobalava, Z, Barbarash, O, Markov, V, Lyamina, N, Gordienko, A, Zrazhevsky, K, Vishnevsky, A, Gurevich, V, Stryuk, R, Lomakin, N, Bokarev, I, Khlevchuk, T, Shalaev, S, Khaisheva, L, Chizhov, P, Viktorova, I, Osokina, N, Shchekotov, V, Akatova, E, Chumakova, G, Libov, I, Voevoda, M, Tretyakova, T, Baranov, E, Shustov, S, Yakushin, S, Gordeev, I, Khasanov, N, Reshetko, O, Sotnikova, T, Molchanova, O, Nikolaev, K, Gapon, L, Baranova, E, Shogenov, Z, Kosmachova, E, Povzun, A, Egorova, L, Tyrenko, V, Ivanov, I, Ilya, M, Kanorsky, S, Simic, D, Ivanovic, N, Davidovic, G, Tasic, N, Asanin, M, Stojic, S, Apostolovic, S, Ilic, S, Putnikovic Tosic, B, Stankovic, A, Arandjelovic, A, Radovanovic, S, Todic, B, Balinovac, J, Dincic, D, Seferovic, P, Karadzic, A, Dodic, S, Dimkovic, S, Jakimov, T, Poh, K, Ong, H, Tang I-Shing, J, Micko, K, Nociar, J, Pella, D, Fulop, P, Hranai, M, Palka, J, Mazur, J, Majercak, I, Dzupina, A, Fazekas, F, Gonsorcik, J, Bugan, V, Selecky, J, Kamensky, G, Strbova, J, Smik, R, Dukat, A, Zuran, I, Poklukar, J, Cernic Suligoj, N, Cevc, M, Cyster, H, Ranjith, N, Corbett, C, Bayat, J, Makotoko, E, du Toit Theron, H, Kapp, I, de V Basson, M, Lottering, H, Van Aswegen, D, Van Zyl, L, Sebastian, P, Pillay, T, Saaiman, J, Commerford, P, Cassimjee, S, Riaz, G, Ebrahim, I, Sarvan, M, Mynhardt, J, Reuter, H, Moodley, R, Vida, M, Cequier Fillat, A, Bodi Peris, V, Fuentes Jimenez, F, Marin, F, Cruz Fernandez, J, Hidalgo Urbano, R, Gil-Extremera, B, Toledo, P, Worner Diz, F, Garcia-Dorado, D, Iniguez, A, Gonzalez-Juanatey, J, Fernandez Portales, J, Civeira Murillo, F, Matas Pericas, L, Zamorano, J, De Mora Martin, M, Bruguera Cortada, J, Alonso Martin, J, Serrano Antolin, J, De Berrazueta Fernandez, J, Vazquez de Prada, J, Diaz Fernandez, J, Garcia Lledo, J, Cosin Sales, J, Botas Rodriguez, J, Gusi Tragant, G, Benedicto, A, Gonzalez-Juanatey, C, Camprubi Potau, M, Plaza Perez, I, De La Tassa, C, Loma-Osorio Rincon, P, Balaguer Recena, J, Escudier, J, Payeras, A, Alonso Orcajo, N, Valdivielso, P, Constantine, G, Haniffa, R, Tissera, N, Amarasekera, S, Ponnamperuma, C, Fernando, N, Fernando, K, Jayawardena, J, Wijeyasingam, S, Ranasinghe, G, Ekanayaka, R, Mendis, S, Senaratne, V, Mayurathan, G, Sirisena, T, Rajapaksha, A, Herath, J, Amarasena, N, Berglund, S, Rasmanis, G, Vedin, O, Witt, N, Mourtzinis, G, Nicol, P, Hansen, O, Romeo, S, Agergaard Jensen, S, Torstensson, I, Ahremark, U, Sundelin, T, Moccetti, T, Muller, C, Mach, F, Binde, R, Tsai, W, Ueng, K, Lai, W, Liu, M, Hwang, J, Yin, W, Hsieh, I, Hsieh, M, Kuo, J, Huang, T, Fang, C, Kaewsuwanna, P, Soonfuang, W, Jintapakorn, W, Sukonthasarn, A, Wongpraparut, N, Sastravaha, K, Sansanayudh, N, Kehasukcharoen, W, Piyayotai, D, Chotnoparatpat, P, Camsari, A, Kultursay, H, Mutlu, B, Ersanli, M, Demirtas, M, Kirma, C, Ural, E, Koldas, L, Karpenko, O, Prokhorov, A, Vakaluyk, I, Myshanych, H, Reshotko, D, Batushkin, V, Rudenko, L, Kovalskyi, I, Kushnir, M, Tseluyko, V, Mostovoy, Y, Stanislavchuk, M, Kyiak, Y, Karpenko, Y, Malynovsky, Y, Klantsa, A, Kutniy, O, Amosova, E, Tashchuk, V, Leshchuk, O, Rishko, M, Kopytsya, M, Yagensky, A, Vatutin, M, Bagriy, A, Barna, O, Ushakov, O, Dzyak, G, Goloborodko, B, Rudenko, A, Zheleznyy, V, Trevelyan, J, Zaman, A, Lee, K, Moriarty, A, Aggarwal, R, Clifford, P, Wong, Y, Iqbal, S, Subkovas, E, Braganza, D, Sarkar, D, Storey, R, Griffiths, H, Mcclure, S, Muthusamy, R, Smith, S, Kurian, J, Levy, T, Barr, C, Kadr, H, Gerber, R, Simaitis, A, Soran, H, Mathur, A, Brodison, A, Ayaz, M, Cheema, M, Oliver, R, Thackray, S, Mudawi, T, Rahman, G, Sultan, A, Sharman, D, Sprigings, D, Butler, R, Wilkinson, P, Lip, G, Halcox, J, Gallagher, S, Ossei-Gerning, N, Vardi, G, Baldari, D, Brabham, D, Treasure II, C, Dahl, C, Palmer, B, Wiseman, A, Puri, S, Mohart, A, Ince, C, Flores, E, Wright, S, Cheng, S, Rosenberg, M, Rogers, W, Kosinski, E, Forgosh, L, Waltman, J, Khan, M, Shoukfeh, M, Dagher, G, Cambier, P, Lieber, I, Kumar, P, East, C, Krichmar, P, Hasan, M, White, L, Knickelbine, T, Haldis, T, Gillespie, E, Amidon, T, Suh, D, Arif, I, Abdallah, M, Akhter, F, Carlson, E, D'Urso, M, El-Ahdab, F, Nelson, W, Moriarty, K, Harris, B, Cohen, S, Carter, L, Doty, D, Sabatino, K, Haddad, T, Malik, A, Rao, S, Mulkay, A, Jovin, I, Klancke, K, Malhotra, V, Devarapalli, S, Koren, M, Chandna, H, Dodds III, G, Goraya, T, Bengston, J, Janik, M, Moran, J, Sumner, A, Kobayashi, J, Davis, W, Yazdani, S, Pasquini, J, Thakkar, M, Vedere, A, Leimbach, W, Rider, J, Fenton, S, Singh, N, Shah, A, Janosik, D, Pepine, C, Berman, B, Gelormini, J, Daniels, C, Richard, K, Keating, F, Kondo, N, Shetty, S, Levite, H, Waider, W, Takata, T, Abu-Fadel, M, Shah, V, Izzo, M, Kumar, A, Hattler, B, Do, R, Link, C, Bortnick, A, Kinzfogl III, G, Ghitis, A, Larry, J, Teufel, E, Kuhlman, P, Mclaurin, B, Zhang, W, Thew, S, Abbas, J, White, M, Islam, O, Subherwal, S, Ranadive, N, Vakili, B, Gring, C, Henderson, D, Schuchard, T, Farhat, N, Kline, G, Mahal, S, Whitaker, J, Speirs, S, Andersen, R, Daboul, N, Horwitz, P, Zahr, F, Ponce, G, Jafar, Z, Mcgarvey, J, Panchal, V, Voyce, S, Blok, T, Sheldon, W, Azizad, M, Schmalfuss, C, Picone, M, Pederson, R, Herzog, W, Friedman, K, Lindsey, J, Nowins, R, Timothy, E, Leonard, P, Lepor, N, El Shahawy, M, Weintraub, H, Irimpen, A, Alonso, A, May, W, Christopher, D, Galski, T, Chu, A, Mody, F, Ramin, E, Hodes, Z, Rossi, J, Rose, G, Fairlamb, J, Lambert, C, Raisinghani, A, Abbate, A, Vetrovec, G, King, M, Carey, C, Gerber, J, Younis, L, Vidovich, M, Knutson, T, Friedman, D, Chaleff, F, Loussararian, A, Rozeman, P, Kimmelstiel, C, Kuvin, J, Silver, K, Foster, M, Tonnessen, G, Espinoza, A, Amlani, M, Wali, A, Malozzi, C, Jong, G, Massey, C, Wattanakit, K, O'Donnell, P, Singal, D, Jaffrani, N, Banuru, S, Fisher, D, Xenakis, M, Perlmutter, N, Bhagwat, R, Strader, J, Blonder, R, Akyea-Djamson, A, Labroo, A, Marais, H, Claxton, E, Weiss, R, Kathryn, R, Berk, M, Joshi, P, Khera, A, Khaira, A, Kumkumian, G, Lupovitch, S, Purow, J, Welka, S, Hoffman, D, Fischer, S, Soroka, E, Eagerton, D, Pancholy, S, Ray, M, Erenrich, N, Farrar, M, Pollock, S, French, W, Diamantis, S, Guy, D, Gimple, L, Neustel, M, Schwartz, S, Pereira, E, Albert, S, Spriggs, D, Strain, J, Mittal, S, Vo, A, Chane, M, Hall, J, Vijay, N, Lotun, K, Lester, F, Nahhas, A, Pope, T, Nager, P, Vohra, R, Sharma, M, Bashir, R, Ahmed, H, Berlowitz, M, Fishberg, R, Barrucco, R, Yang, E, Radin, M, Sporn, D, Stapleton, D, Eisenberg, S, Landzberg, J, Mcgough, M, Turk, S, Schwartz, M, Sundram, P, Jain, D, Zainea, M, Bayron, C, Karlsberg, R, Dohad, S, Lui, H, Keen, W, Westerhausen, D, Khurana, S, Agarwal, H, Birchem, J, Penny, W, Chang, M, Murphy, S, Henry, J, Schifferdecker, B, Gilbert, J, Chalavarya, G, Eaton, C, Schmedtje, J, Christenson, S, Dotani, I, Denham, D, Macdonell, A, Gibson, P, Rahman, A, Al Joundi, T, Assi, N, Conrad, G, Kotha, P, Love, M, Giesler, G, Rubenstein, H, Gamil, D, Akright, L, Krawczyk, J, Cobler, J, Wells, T, Welker, J, Foster, R, Gilmore, R, Anderson, J, Jacoby, D, Gardner, G, Dandillaya, R, Vora, K, Kostis, J, Hunter, J, Laxson, D, Ball, E, Egydio, F, Kawakami, A, Oliveira, J, Wozniak, J, Matthews, A, Ratky, C, Valiris, J, Berdan, L, Hepditch, A, Quintero, K, Rorick, T, Westbrook, M, Pascual, A, Rovito, C, Bezault, M, Drouet, E, Simon, T, Alsweiler, C, Luyten, A, Butters, J, Griffith, L, Shaw, M, Grunberg, L, Islam, S, Bregeault, M, Bougon, N, Faustino, D, Fontecave, S, Murphy, J, Verrier, M, Agnetti, V, Andersen, D, Badreddine, E, Bekkouche, M, Bouancheau, C, Brigui, I, Brocklehurst, M, Cianciarulo, J, Devaul, D, Domokos, S, Gache, C, Gobillot, C, Guillou, S, Healy, J, Heath, M, Jaiwal, G, Javierre, C, Labeirie, J, Monier, M, Morales, U, Mrabti, A, Mthombeni, B, Okan, B, Smith, L, Sheller, J, Sopena, S, Pellan, V, Benbernou, F, Bengrait, N, Lamoureux, M, Kralova, K, Scemama, M, Bejuit, R, Coulange, A, Berthou, C, Repincay, J, Lorenzato, C, Etienne, A, Gouet, V, Normand, M, Ourliac, A, Rondel, C, Adamo, A, Beltran, P, Barraud, P, Dubois-Gache, H, Halle, B, Metwally, L, Mourgues, M, Sotty, M, Vincendet, M, Cotruta, R, Chengyue, Z, Fournie-Lloret, D, Morrello, C, Perthuis, A, Picault, P, Zobouyan, I, Dempsey, M, Mcclanahan, M, ODYSSEY OUTCOMES Comm Investigato, and Ege Üniversitesi
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Male ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,STATIN THERAPY ,blood-glucose ,Endocrinology, Diabetes and Metabolism ,GUIDELINES ,PCSK9 ,0302 clinical medicine ,Endocrinology ,GENETIC-VARIANTS ,Cardiovascular Disease ,Diabetes Complication ,Aged Antibodies, Monoclonal, Humanized / therapeutic use* Cardiovascular Diseases / blood Cardiovascular Diseases / prevention & control* Diabetes Complications / blood Diabetes Complications / prevention & control* Female Humans Male Middle Aged Substances ,Clinical endpoint ,Medicine ,guidelines ,030212 general & internal medicine ,Prediabetes ,Myocardial infarction ,myocardial-infarction ,genetic-variants ,statin therapy ,risk ,pcsk9 ,association ,liraglutide ,evolocumab ,RISK ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,BLOOD-GLUCOSE ,ASSOCIATION ,Middle Aged ,Cardiovascular Diseases ,Female ,Life Sciences & Biomedicine ,Human ,medicine.medical_specialty ,Acute coronary syndrome ,PCSK9 inhibitor ,acute coronary syndrome ,lipoprotein(a) ,low-density lipoprotein cholesterol ,030209 endocrinology & metabolism ,Antibodies, Monoclonal, Humanized ,Diabetes Complications ,Endocrinology & Metabolism ,03 medical and health sciences ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,Humans ,Aged ,Alirocumab ,diabetes, PCSK9, hyperlipidemia ,Science & Technology ,ODYSSEY OUTCOMES Committees and Investigators ,business.industry ,Unstable angina ,EVOLOCUMAB ,medicine.disease ,MYOCARDIAL-INFARCTION ,LIRAGLUTIDE ,Human medicine ,business - Abstract
Doi, Yasuji/0000-0002-8368-0827; galvani, marcello/0000-0001-5897-667X; Gislason, Gunnar H/0000-0002-0548-402X; Taskinen, Marja-Riitta/0000-0002-6229-3588; Sherwood, Matthew/0000-0002-4305-5883; Malynovsky, Yaroslav V/0000-0002-9118-1104; Viktorova, vic-inna@mail.ru I.A./0000-0001-8728-2722; bastos, jose/0000-0002-9526-3123; Yang, Eric H/0000-0003-4889-7454; Rudenko, Anatoliy Viktorovich/0000-0003-1099-1613; Novotny, Vojtech/0000-0003-3521-9945; Nikolaev, Konstantin/0000-0003-4601-6203; Reshetko, Olga/0000-0003-3107-7636; Leonardi, Sergio/0000-0002-4800-6132; Muenzel, Thomas/0000-0001-5503-4150; Ushakov, Alexei V/0000-0002-7020-4442; Tse, Hung Fat/0000-0002-9578-7808; Podoleanu, Cristian/0000-0001-9987-2519; Raffel, Owen C/0000-0001-5470-7050; Khasanov, Niiaz/0000-0002-7760-0763; Chumakova, Galina A/0000-0002-2810-6531; Ersanli, Murat/0000-0003-1847-3087; cornel, jan hein/0000-0002-1006-2112; Abbate, Antonio/0000-0002-1930-785X; Racca, Vittorio/0000-0002-4465-3789; Urina-Triana, Miguel A/0000-0001-6003-4622; Rasputina, Lesia/0000-0003-1230-4039; Racca, Vittorio/0000-0002-4465-3789; Reis, Gilmar/0000-0002-4847-1034; Sandhu, Manjinder/0000-0003-2538-2079; Keskin, Kudret/0000-0002-9049-1530; PAREPA, IRINEL/0000-0002-7571-9015; Manakshe, Gajendra/0000-0002-4983-4271; Nicolau, Jose C/0000-0002-9680-3689; Strelnieks, Aldis/0000-0003-3493-2562; Budaj, Andrzej/0000-0002-6395-2098; Marin, Francisco/0000-0001-7246-7708; Wongpraparut, Nattawut/0000-0002-1541-3313; Yuan, Zuyi/0000-0002-4141-0298; Jeong, Myung Ho/0000-0003-2424-810X; Mostovoy, Yuriy/0000-0002-7041-1230; Pepine, Carl/0000-0002-6011-681X; Lopez-Jaramillo, Patricio/0000-0002-9122-8742; Garcia-Lledo, Alberto/0000-0002-8986-2584; Tesloianu, Nicolae-Dan/0000-0002-1007-3022; Kosmacheva, Elena/0000-0001-8600-0199; Kunz Sebba Barroso Souza, Weimar/0000-0002-1265-1930; Katz, Amos/0000-0003-0422-934X; Tunon, Jose/0000-0002-1373-0999; Acevedo, Monica/0000-0002-7989-6633; Hove, Jens/0000-0002-5600-5623; Yakushin, Sergey/0000-0001-7202-742X; Gonzalez Juanatey, Jose Ramon/0000-0001-9681-3388; Lyamina, Nadezhda/0000-0001-6939-3234; Aylward, Philip/0000-0002-5358-8552; Apostolovic, Svetlana/0000-0001-9015-297X; Airaksinen, Juhani/0000-0002-0193-568X; Nahhas, Prof. Dr. Ahmed/0000-0002-2887-8187; Barbarash, Olga/0000-0002-4642-3610, WOS: 000475553300016, PubMed: 31272931, Background After acute coronary syndrome, diabetes conveys an excess risk of ischaemic cardiovascular events. A reduction in mean LDL cholesterol to 1.4-1.8 mmol/L with ezetimibe or statins reduces cardiovascular events in patients with an acute coronary syndrome and diabetes. However, the efficacy and safety of further reduction in LDL cholesterol with an inhibitor of proprotein convertase subtilisin/kexin type 9 (PCSK9) after acute coronary syndrome is unknown. We aimed to explore this issue in a prespecified analysis of the ODYSSEY OUTCOMES trial of the PCSK9 inhibitor alirocumab, assessing its effects on cardiovascular outcomes by baseline glycaemic status, while also assessing its effects on glycaemic measures including risk of new-onset diabetes. Methods ODYSSEY OUTCOMES was a randomised, double-blind, placebo-controlled trial, done at 1315 sites in 57 countries, that compared alirocumab with placebo in patients who had been admitted to hospital with an acute coronary syndrome (myocardial infarction or unstable angina) 1-12 months before randomisation and who had raised concentrations of atherogenic lipoproteins despite use of high-intensity statins. Patients were randomly assigned (1: 1) to receive alirocumab or placebo every 2 weeks; randomisation was stratified by country and was done centrally with an interactive voice-response or web-response system. Alirocumab was titrated to target LDL cholesterol concentrations of 0.65-1.30 mmol/L. in this prespecified analysis, we investigated the effect of alirocumab on cardiovascular events by glycaemic status at baseline (diabetes, prediabetes, or normoglycaemia)-defined on the basis of patient history, review of medical records, or baseline HbA(1c) or fasting serum glucose-and risk of new-onset diabetes among those without diabetes at baseline. the primary endpoint was a composite of death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischaemic stroke, or unstable angina requiring hospital admission. ODYSSEY OUTCOMES is registered with ClinicalTrials. gov, number NCT01663402. Findings At study baseline, 5444 patients (28.8%) had diabetes, 8246 (43.6%) had prediabetes, and 5234 (27.7%) had normoglycaemia. There were no significant differences across glycaemic categories in median LDL cholesterol at baseline (2.20-2.28 mmol/L), after 4 months' treatment with alirocumab (0.80 mmol/L), or after 4 months' treatment with placebo (2.25-2.28 mmol/L). in the placebo group, the incidence of the primary endpoint over a median of 2.8 years was greater in patients with diabetes (16.4%) than in those with prediabetes (9.2%) or normoglycaemia (8.5%); hazard ratio (HR) for diabetes versus normoglycaemia 2.09 (95% CI 1.78-2.46, p, Sanofi; Regeneron Pharmaceuticals, Sanofi and Regeneron Pharmaceuticals.
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- 2019
66. A COVID-19 specific multiparametric and ECG-based score for the prediction of in-hospital mortality: ELCOVID score.
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Zuin M, Ferrari R, Guardigli G, Malagù M, Vitali F, Zucchetti O, D'Aniello E, Di Ienno L, Gibiino F, Cimaglia P, Grosseto D, Corzani A, Galvani M, Ortolani P, Rubboli A, Tortorici G, Casella G, Sassone B, Navazio A, Rossi L, Aschieri D, Mezzanotte R, Manfrini M, and Bertini M
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- Humans, Female, Male, Aged, Italy epidemiology, Prospective Studies, Aged, 80 and over, Risk Assessment methods, Severity of Illness Index, Middle Aged, COVID-19 mortality, COVID-19 diagnosis, COVID-19 physiopathology, COVID-19 complications, Hospital Mortality, Electrocardiography methods
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We aimed to develop and validate a COVID-19 specific scoring system, also including some ECG features, to predict all-cause in-hospital mortality at admission. Patients were retrieved from the ELCOVID study (ClinicalTrials.gov identifier: NCT04367129), a prospective, multicenter Italian study enrolling COVID-19 patients between May to September 2020. For the model validation, we randomly selected two-thirds of participants to create a derivation dataset and we used the remaining one-third of participants as the validation set. Over the study period, 1014 hospitalized COVID-19 patients (mean age 74 years, 61% males) met the inclusion criteria and were included in this analysis. During a median follow-up of 12 (IQR 7-22) days, 359 (35%) patients died. Age (HR 2.25 [95%CI 1.72-2.94], p < 0.001), delirium (HR 2.03 [2.14-3.61], p = 0.012), platelets (HR 0.91 [0.83-0.98], p = 0.018), D-dimer level (HR 1.18 [1.01-1.31], p = 0.002), signs of right ventricular strain (RVS) (HR 1.47 [1.02-2.13], p = 0.039) and ECG signs of previous myocardial necrosis (HR 2.28 [1.23-4.21], p = 0.009) were independently associated to in-hospital all-cause mortality. The derived risk-scoring system, namely EL COVID score, showed a moderate discriminatory capacity and good calibration. A cut-off score of ≥ 4 had a sensitivity of 78.4% and 65.2% specificity in predicting all-cause in-hospital mortality. ELCOVID score represents a valid, reliable, sensitive, and inexpensive scoring system that can be used for the prognostication of COVID-19 patients at admission and may allow the earlier identification of patients having a higher mortality risk who may be benefit from more aggressive treatments and closer monitoring., (© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
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- 2024
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67. Immune Checkpoint Inhibitors-Associated Myocarditis: Diagnosis, Treatment and Current Status on Rechallenge.
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Frascaro F, Bianchi N, Sanguettoli F, Marchini F, Meossi S, Zanarelli L, Tonet E, Serenelli M, Guardigli G, Campo G, Calabrò L, and Pavasini R
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Immune checkpoint molecules like cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death 1 (PD-1) or its ligand, programmed cell death ligand 1 (PD-L1), play a critical role in regulating the immune response, and immune checkpoint inhibitors (ICIs) targeting these checkpoints have shown clinical efficacy in cancer treatment; however, their use is associated with immune-related adverse events (irAEs), including cardiac complications. The prevalence of cardiac irAEs, particularly myocarditis, is relatively low, but they can become a severe and potentially life-threatening condition, usually occurring shortly after initiating ICI treatment; moreover, diagnosing ICI-related myocarditis can be challenging. Diagnostic tools include serum cardiac biomarkers, electrocardiography (ECG), echocardiography, cardiac magnetic resonance (CMR) and endomyocardial biopsy (EMB). The treatment of ICI-induced myocarditis involves high-dose corticosteroids, which have been shown to reduce the risk of major adverse cardiac events (MACE). In refractory cases, second-line immunosuppressive drugs may be considered, although their effectiveness is based on limited data. The mortality rates of ICI-induced myocarditis, particularly in severe cases, are high (38-46%). Therapy rechallenge after myocarditis is associated with a risk of recurrence and severe complications. The decision to rechallenge should be made on a case-by-case basis, involving a multidisciplinary team of cardiologists and oncologists. Further research and guidance are needed to optimize the management of cancer patients who have experienced such complications, evaluating the risks and benefits of therapy rechallenge. The purpose of this review is to summarize the available evidence on cardiovascular complications from ICI therapy, with a particular focus on myocarditis and, specifically, the rechallenge of immunotherapy after a cardiac adverse event.
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- 2023
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68. Safety and efficacy of new-generation coronary bioresorbable scaffolds.
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Ruggiero R, Pompei G, Tonet E, Vitali F, Guardigli G, Campo G, and Pavasini R
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- Humans, Absorbable Implants, Treatment Outcome, Coronary Artery Disease surgery, Drug-Eluting Stents adverse effects
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Introduction: The concept of bioresorbable scaffolds (BRS) was born with the aim to reduce the rate of late and very late cardiac events related to drug-eluting stents. However, first-generation BRS failed to prove their short-term safety and efficacy. Based on data derived from early investigations, new-generation BRS have been developed and tested in preliminary studies. The present review's focus was to summarize the mechanical characteristics of these new scaffolds and the clinical evidence of their safety and efficacy., Evidence Acquisition: This systematic review was performed following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). PUBMED, Google Scholar, and Biomed central databases were analyzed. Only papers published in English and in peer-reviewed journals were selected to summarize current evidence about new generation BRS, with CE mark approval. Overall, 23 studies were included., Evidence Synthesis: Data obtained from selected studies assessing the safety and efficacy of new generation BRS are encouraging. This is thanks to the progressive development of scaffolds with a different backbone structure and struts thickness that guarantee higher radial strength, flexibility, and resistance to fracture. These characteristics led to low rates of major adverse cardiac events and device-oriented composite endpoint at follow-up., Conclusions: New-generation BRS have a good safety profile in stable patients with simple lesions, supported by a meticulous implantation technique. The first studies were performed on a small population with short-term follow-up, therefore new randomized clinical trials and registries are needed to expand the preliminary findings.
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- 2023
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69. [Epicardial adipose tissue: a novel cardiovascular risk factor].
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Micillo M, Cossu A, Pompei G, Cocco M, Boccadoro A, De Raffele M, Pavasini R, Passarini G, Fortunato V, Guardigli G, and Tonet E
- Subjects
- Humans, Risk Factors, Heart, Heart Disease Risk Factors, Cardiovascular Diseases etiology, Heart Failure etiology
- Abstract
Epicardial adipose tissue (EAT) has various metabolic functions aiming at heart protection. When abnormal, it is related to atherosclerotic plaque development and adverse cardiovascular outcome. Additionally, in recent years, several studies have demonstrated its role in other settings such as atrial fibrillation and heart failure with preserved ejection fraction. Future studies should aim to assess diagnostic role of EAT and the effect of medical therapy on EAT volume and attenuation.
- Published
- 2023
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- View/download PDF
70. Cardiovascular prevention: sometimes dreams can come true.
- Author
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Ferrari R, Cimaglia P, Cantone A, Serenelli M, and Guardigli G
- Abstract
Cardiovascular disease (CVD) is a chronic condition driven by the complex interaction of different risk factors including genetics, lifestyle, environment, etc. which, differently from other pathologies, can be prevented. Treatment of CVD has been inconceivably successful but now it seems that it has reached a plateau suggesting that prevention is the way forward. However, the COVID-19 pandemic has spotted all the limits of the actual health system regarding territorial and, particularly, of preventive medicine. To this end, recently, the SCORE2 risk prediction algorithms, a contemporary model to estimate 10 years risk of CVD in Europe and the new guidelines on prevention have been released. The present review article describes a dream: how prevention of CVD should be addressed in the future. New concepts and paradigms like early genetically personalized and imaging driven risk factors, cardiac risk cartography, measurements of the exposome, estimation of costs of a delayed outcome vs. healthy lifespan, are all addressed. We highlight the importance of technologies and the concept of being engaged in a 'healthy' and not just 'sick' system as it is today. The concept of 'clearing house' with a 'care health team' instead of a 'heart team' is described. Finally, we articulate the four points necessary for the dream to come true., Competing Interests: Conflict of interest: R.F. reports having received research grants and personal fees from Novartis and Servier personal fees from Merck Serono, Boehringer Ingelheim, Sunpharma, Lupin, Doc Generici, Pfizer, Spa Prodotti Antibiotici outside the submitted work. He is a director of Art Research and Science S.r.l (A.R.S.1). P.C. has no conflict of interest to disclose. A.C. has no conflict of interest to disclose. M.S. has no conflict of interest to disclose. G.G. has no conflict of interest to disclose., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2023
- Full Text
- View/download PDF
71. Cardiovascular prevention: sometimes dreams can come true.
- Author
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Ferrari R, Cimaglia P, Rapezzi C, Tavazzi L, and Guardigli G
- Abstract
Cardiovascular disease (CVD) is a chronic condition driven by the complex interaction of different risk factors including genetics, lifestyle, environment, etc. which, differently from other pathologies, can be prevented. Treatment of CVD has been inconceivably successful but now it seems that it has reached a plateau suggesting that prevention is the way forward. However, the COVID-19 pandemic has spotted all the limits of the actual health system regarding territorial and, particularly, of preventive medicine. To this end, recently, the SCORE2 risk prediction algorithms, a contemporary model to estimate 10-years risk of CVD in Europe and the new guidelines on prevention have been released. The present review article describes a dream: how prevention of CVD should be addressed in the future. New concepts and paradigms like early genetically personalized and imaging driven risk factors, cardiac risk cartography, measurements of the exposome, estimation of costs of a delayed outcome vs. healthy lifespan, are all addressed. We highlight the importance of technologies and the concept of being engaged in a ' healthy ' and not just ' sick ' system as it is today. The concept of ' clearing house ' with a ' healthcare team ' instead of a ' heart team ' is described. Finally, we articulate the four points necessary for the dream to come true., Competing Interests: Conflict of interest: R.F. reports having received research grants and personal fees from Novartis and Servier personal fees from Merck Serono, Boehringer Ingelheim, Sunpharma, Lupin, Doc Generici, Pfizer, Spa Prodotti Antibiotici outside the submitted work. He is a director of Art Research and Science S.r.l (A.R.S.1). P.C. has no conflict of interest to disclose. C.R. reports grants and personal fees from Pfizer, personal fees from Sanofi, personal fees from Novartis, personal fees from Alnylam Pharmaceuticals, outside the submitted work. L.T. reports personal fees from SERVIER, personal fees from CVIE THERAPEUTICS outside the submitted work. G.G. has no conflict of interest to disclose., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.)
- Published
- 2022
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72. The future of cardiovascular prevention: between fiction and reality.
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Guardigli G, Cimaglia P, Rapezzi C, Tavazzi L, and Ferrari R
- Subjects
- Humans, Heart, Cardiovascular System
- Abstract
Competing Interests: Conflict of interest: Gabriele Guardigli reports no conflict of interest; Paolo Cimaglia reports no conflict of interest; Claudio Rapezzi has received personal fees from PFIZER INSTITUTIONAL GRANTS, NOVARTIS, ALNYLAM, AKCEA, SANOFI; Luigi Tavazzi reports personal fees from SERVIER, personal fees from CVIE THERAPEUTICS outside the submitted work; Roberto Ferrari has received research grants and personal fees from Novartis and Servier, personal fees from Merck Serono, Boehringer Ingelheim, Sunpharma, Lupin, Doc Generici, Pfizer, Spa Prodotti Antibiotici. He is a director of Art Research and Science S.r.l (A.R.S.1).
- Published
- 2022
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73. Three-Dimensional Electro-Anatomical Mapping and Myocardial Work Performance during Spontaneous Rhythm, His Bundle Pacing and Right Ventricular Pacing: The EMPATHY Study.
- Author
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Malagù M, Vitali F, Massafra RF, Cardelli LS, Pavasini R, Guardigli G, Rapezzi C, and Bertini M
- Abstract
Background: His bundle pacing (HBP) has emerged as an alternative site to right ventricular pacing (RVP) with encouraging outcomes. To date, no study has investigated the systematic approach of three-dimensional electroanatomic mapping (3D-EAM) to guide HBP implantation and to evaluate myocardial activation timing. Furthermore, studies reporting a comprehensive assessment of the ventricular function, using myocardial work (MW) evaluation are lacking., Objectives: (1) To evaluate the systematic use of the 3D-EAM as a guide to HBP; (2) to assess the electrical and mechanical activations with high-density mapping, comparing spontaneous ventricular activation (SVA), HBP and RVP; (3) to assess the myocardial function through speckle-tracking echocardiography (STE) and MW analysis in SVA, HBP and RVP., Methods: 3D-EAM was performed in consecutive patients undergoing HBP implantation with a low use of fluoroscopy. All patients were systematically evaluated with high-density mapping, MW and STE., Results: Fifteen patients were enrolled, of whom three had an implant failure (20%). RV activation time was not statistically different between SVA and HBP (103 vs. 104 ms, p = 0.969) but was significantly higher in RVP (133 ms, p = 0.011 vs. SVA and p = 0.001 vs HBP). Global constructive work was significantly lower during RVP (1191 mmHg%) than during SVA and HBP (1648 and 1505 mmHg%, p = 0.011 and p = 0.008, respectively) and did not differ between SVA and HBP ( p = 0.075)., Conclusions: 3D-EAM and MW evaluation showed that HBP was comparable to the physiological SVA in terms of activation time and cardiac performance. Compared to both SVA and HBP, RVP was associated with a worse activation timing and ventricular efficiency.
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- 2022
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74. [Use of multimodality imaging for the diagnosis of aortic stenosis].
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Cantone A, Guardigli G, and Passarini G
- Subjects
- Aortic Valve, Humans, Multimodal Imaging methods, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Transcatheter Aortic Valve Replacement
- Published
- 2022
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75. [Screening for atrial fibrillation in the general population: experience from a cardiovascular risk campaign in the Emilia-Romagna Region].
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Di Pasquale G, Cardelli LS, Canovi L, Dal Passo B, Frascaro F, Zanarelli L, Guardigli G, Campo G, Aschieri D, Vignali L, Navazio A, Rubboli A, Ortolani P, Galvani M, Ni M, Piovaccari G, Tortorici G, Urbinati S, Tondi S, Sassone B, Tortorella G, De Palma R, Casella G, and Boriani G
- Subjects
- Female, Heart Disease Risk Factors, Humans, Male, Risk Assessment, Risk Factors, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, Cardiovascular Diseases complications, Stroke prevention & control, Thromboembolism complications
- Abstract
Background: Atrial fibrillation (AF) is a major cause of cerebral ischemia, and its early detection may impact on health. Both invasive and non-invasive devices can be used for the diagnosis of AF. The aim of our study was to estimate the prevalence of AF using a single-lead ECG device (MyDiagnostickTM) on an adult, asymptomatic population during a screening campaign., Methods: A total of 2547 subjects underwent AF screening., Results: The device detected an arrhythmia in 42 subjects (1.65%), and AF was confirmed on 12-lead ECG in 14 (0.55%) of them. The prevalence of confirmed AF increased in subjects over 65 years of age (1.21%) or with a CHA2DS2-VASc score ≥2 in males or ≥3 in females (1.33%). Furthermore, heart failure (odds ratio [OR] 8.62, 95% confidence interval [CI] 1.87-39.6, p=0.006) and diabetes (OR 4.55, 95% CI 1.25-16.5, p=0.021) significantly increased the risk of AF., Conclusions: During a screening campaign, the diagnosis of AF increases when subjects with a high thromboembolic risk are selected.
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- 2022
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76. Procalcitonin Predicts Bacterial Infection, but Not Long-Term Occurrence of Adverse Events in Patients with Acute Coronary Syndrome.
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Pavasini R, Fabbri G, Marchini F, Bianchi N, Deserio MA, Sanguettoli F, Verardi FM, Segala D, Pompei G, Tonet E, Serenelli M, Caglioni S, Guardigli G, Campo G, and Cultrera R
- Abstract
This study compiles data to determine if procalcitonin (PCT) values may predict both the risk of bacterial infection and potentially negative long-term outcomes in patients with acute coronary syndromes (ACS). All patients with a diagnosis of ACS that had PCT levels assessed during the first 24 h of hospitalization were enrolled in this study. The primary outcome was to detect the presence of bacterial infection defined as the occurrence of fever and at least one positive blood or urinary culture with clinical signs of infection. The secondary outcome was to monitor the occurrence after 1 year of the composite outcome of all-cause mortality, stroke and myocardial infarction. Overall, 569 patients were enrolled (mean age 69.37 ± 14 years, 30% females). Of these, 44 (8%) met the criteria for bacterial infection. After multivariate analysis, PCT and SBP were found to be independent predictors of bacterial infections (OR for PCT above the cut-off 2.67, 95% CI 1.09-6.53, p = 0.032 and OR for SBP 0.98, 95% CI 0.97-0.99, p = 0.043). After 1 year, the composite outcome of all-cause death, MI and stroke occurred in 104 patients (18%). PCT was not found to be an independent predictor of these outcomes. In conclusion, when assessing ACS, we found that testing for PCT levels during hospital admissions procedures was a good predictor of bacterial infections but not of all-cause mortality, stroke, or myocardial infarction. Clinicaltrial.org identifier: NCT02438085.
- Published
- 2022
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77. Induction of hormesis in plants by urban trace metal pollution.
- Author
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Salinitro M, Mattarello G, Guardigli G, Odajiu M, and Tassoni A
- Subjects
- Biodegradation, Environmental, Cadmium chemistry, Chromium chemistry, Cities, Hydroponics, Lead, Metals, Photosynthesis, Plant Development drug effects, Plant Roots, Plant Shoots, Soil, Biomass, Environmental Monitoring methods, Hormesis drug effects, Metals, Heavy analysis, Plants drug effects, Soil Pollutants analysis, Trace Elements pharmacology
- Abstract
Hormesis is a dose-response phenomenon observed in numerous living organisms, caused by low levels of a large number of stressors, among which metal ions. In cities, metal levels are usually below toxicity limits for most plant species, however, it is of primary importance to understand whether urban metal pollution can threaten plant survival, or, conversely, be beneficial by triggering hormesis. The effects of Cd, Cr and Pb urban concentrations were tested in hydroponics on three annual plants, Cardamine hirsuta L., Poa annua L. and Stellaria media (L.) Vill., commonly growing in cities. Results highlighted for the first time that average urban trace metal concentrations do not hinder plant growth but cause instead hormesis, leading to a considerable increase in plant performance (e.g., two to five-fold higher shoot biomass with Cd and Cr). The present findings, show that city habitats are more suitable for plants than previously assumed, and that what is generally considered to be detrimental to plants, such as trace metals, could instead be exactly the plus factor allowing urban plants to thrive., (© 2021. The Author(s).)
- Published
- 2021
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78. In- and out-of-hospital mortality for myocardial infarction during the first wave of the COVID-19 pandemic in Emilia-Romagna, Italy: A population-based observational study.
- Author
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Campo G, Fortuna D, Berti E, De Palma R, Pasquale GD, Galvani M, Navazio A, Piovaccari G, Rubboli A, Guardigli G, Galiè N, Boriani G, Tondi S, Ardissino D, Piepoli M, Banchelli F, Santarelli A, and Casella G
- Abstract
Background: The COVID-19 pandemic has put several healthcare systems under severe pressure. The present analysis investigates how the first wave of the COVID-19 pandemic affected the myocardial infarction (MI) network of Emilia-Romagna (Italy)., Methods: Based on Emilia-Romagna mortality registry and administrative data from all the hospitals from January 2017 to June 2020, we analysed: i) temporal trend in MI hospital admissions; ii) characteristics, management, and 30-day mortality of MI patients; iii) out-of-hospital mortality for cardiac cause., Findings: Admissions for MI declined on February 22, 2020 (IRR -19.5%, 95%CI from -8.4% to -29.3%, p = 0.001), and further on March 5, 2020 (IRR -21.6%, 95%CI from -9.0% to -32.5%, p = 0.001). The return to pre-COVID-19 MI-related admission levels was observed from May 13, 2020 (IRR 34.3%, 95%CI 20.0%-50.2%, p <0.001). As compared to those before the pandemic, MI patients admitted during and after the first wave were younger and with fewer risk factors. The 30-day mortality remained in line with that expected based on previous years (ratio observed/expected was 0.96, 95%CI 0.84-1.08). MI patients positive for SARS-CoV-2 were few (1.5%) but showed poor prognosis (around 5-fold increase in 30-day mortality). In 2020, the number of out-of-hospital cardiac deaths was significantly higher (ratio observed/expected 1.17, 95%CI 1.08-1.27). The peak was reached in April., Interpretation: In Emilia-Romagna, MI hospitalizations significantly decreased during the first wave of the COVID-19 pandemic. Management and outcomes of hospitalized MI patients remained unchanged, except for those with SARS-CoV-2 infection. A concomitant increase in the out-of-hospital cardiac mortality was observed., Funding: None., Competing Interests: The Authors have nothing to disclose., (© 2021 The Author(s).)
- Published
- 2021
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79. Electrocardiographic features of 431 consecutive, critically ill COVID-19 patients: an insight into the mechanisms of cardiac involvement.
- Author
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Bertini M, Ferrari R, Guardigli G, Malagù M, Vitali F, Zucchetti O, D'Aniello E, Volta CA, Cimaglia P, Piovaccari G, Corzani A, Galvani M, Ortolani P, Rubboli A, Tortorici G, Casella G, Sassone B, Navazio A, Rossi L, Aschieri D, and Rapezzi C
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, COVID-19 epidemiology, Cross-Sectional Studies, Female, Hospitalization statistics & numerical data, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Respiration, Artificial, Retrospective Studies, SARS-CoV-2, Arrhythmias, Cardiac physiopathology, Arrhythmias, Cardiac virology, COVID-19 complications, Critical Illness, Electrocardiography
- Abstract
Aims: Our aim was to describe the electrocardiographic features of critical COVID-19 patients., Methods and Results: We carried out a multicentric, cross-sectional, retrospective analysis of 431 consecutive COVID-19 patients hospitalized between 10 March and 14 April 2020 who died or were treated with invasive mechanical ventilation. This project is registered on ClinicalTrials.gov (identifier: NCT04367129). Standard ECG was recorded at hospital admission. ECG was abnormal in 93% of the patients. Atrial fibrillation/flutter was detected in 22% of the patients. ECG signs suggesting acute right ventricular pressure overload (RVPO) were detected in 30% of the patients. In particular, 43 (10%) patients had the S1Q3T3 pattern, 38 (9%) had incomplete right bundle branch block (RBBB), and 49 (11%) had complete RBBB. ECG signs of acute RVPO were not statistically different between patients with (n = 104) or without (n=327) invasive mechanical ventilation during ECG recording (36% vs. 28%, P = 0.10). Non-specific repolarization abnormalities and low QRS voltage in peripheral leads were present in 176 (41%) and 23 (5%), respectively. In four patients showing ST-segment elevation, acute myocardial infarction was confirmed with coronary angiography. No ST-T abnormalities suggestive of acute myocarditis were detected. In the subgroup of 110 patients where high-sensitivity troponin I was available, ECG features were not statistically different when stratified for above or below the 5 times upper reference limit value., Conclusions: The ECG is abnormal in almost all critically ill COVID-19 patients and shows a large spectrum of abnormalities, with signs of acute RVPO in 30% of the patients. Rapid and simple identification of these cases with ECG at hospital admission can facilitate classification of the patients and provide pathophysiological insights., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2020
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80. [Appropriateness criteria for the management of lipid-lowering therapy with alirocumab in high cardiovascular risk patients. The opinion of a multidisciplinary group of Italian experts].
- Author
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Lettino M, Zambon A, Musumeci G, Arca M, Bilato C, Brunetti ND, Calabrò P, Casu G, Chiarella F, Faggiano P, Ferlini M, Guardigli G, Imbalzano E, Indolfi C, Marcucci R, Menozzi A, Mureddu GF, Filardi PP, Pirro M, Pisciotta L, Scherillo M, Suppressa P, Uguccioni M, Varbella F, Gentile L, Rapezzi C, and Averna M
- Subjects
- Atherosclerosis drug therapy, Cholesterol, LDL, Consensus, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Italy, Risk Assessment, Risk Factors, Antibodies, Monoclonal, Humanized therapeutic use, Anticholesteremic Agents therapeutic use, Cardiovascular Diseases complications, Cardiovascular Diseases prevention & control, Hypercholesterolemia drug therapy
- Abstract
High levels of LDL cholesterol (LDL-C) represent a causal factor for cardiovascular diseases on an atherosclerotic basis, with a direct correlation between these and mortality or cardiovascular events, such that the reduction of both is associated proportionally and linearly with the reduction of LDL-C.Statins and ezetimibe are used for LDL-C lowering but may not be sufficient to achieve the targets defined by the ESC/EAS guidelines, which recommend use of PCSK9 inhibitors for further LDL-C reduction in patients not at goal.This project submitted 86 clinical scenarios to a group of experts, cardiologists, internists and lipidologists, collecting their opinion on the appropriateness of different behaviors and decisions. We used the RAND/UCLA method of assessing the appropriateness of clinical interventions, validated to combine the best scientific evidence available with expert judgment. To this end, the benefit-risk ratio was evaluated in the proposed clinical scenarios. Each indication was classified as "appropriate", "uncertain" or "inappropriate" based on the average score given by the participants.This document presents the results of a consensus process that led to the development of recommendations for the management of clinical scenarios on the treatment of patients with dyslipidemia, which cannot always be solved with scientific evidence alone.
- Published
- 2020
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81. Ferrara VI.
- Author
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Ferrari R, Guardigli G, and Cimaglia P
- Published
- 2018
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82. Ferrara II.
- Author
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Ferrari R and Guardigli G
- Published
- 2017
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83. Reperfusion Damage - A Story of Success, Failure, and Hope.
- Author
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Ferrari R, Balla C, Malagù M, Guardigli G, Morciano G, Bertini M, Biscaglia S, and Campo G
- Subjects
- Animals, Humans, Myocardial Ischemia pathology, Myocardial Reperfusion adverse effects, Time Factors, Ventricular Function, Left, Myocardial Ischemia therapy, Myocardial Reperfusion Injury prevention & control
- Abstract
Tissue salvage of severely ischemic myocardium requires timely reperfusion by thrombolysis, angioplasty, or bypass. However, recovery of left ventricular function is rare. It may be absent or, even worse, reperfusion can induce further damage. Laboratory studies have shown convincingly that reperfusion can increase injury over and above that attributable to the pre-existing ischemia, precipitating arrhythmias, suppressing the recovery of contractile function ("stunning") and possibly even causing cell death in potentially salvable ischemic tissue. The mechanisms of reperfusion injury have been widely studied and, in the laboratory, it can be attenuated or prevented. Disappointingly, this is not the case in the clinic, particularly after thrombolysis or primary angioplasty. In contrast, excellent results have been achieved by surgeons by means of cardioplegia and hypothermia. For the interventionist, the issue is more complex as, contrary to cardiac surgery where the cardioplegia can be applied before ischemia and the heart can be stopped, during an angioplasty the heart still has to beat to support the circulation. We analyze in detail all these issues.
- Published
- 2017
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84. Secondary prevention of CAD with ACE inhibitors: a struggle between life and death of the endothelium.
- Author
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Ferrari R, Guardigli G, and Ceconi C
- Subjects
- Angiotensin II drug effects, Angiotensin II metabolism, Apoptosis drug effects, Atherosclerosis complications, Atherosclerosis metabolism, Bradykinin drug effects, Bradykinin metabolism, Cardiotonic Agents therapeutic use, Coronary Artery Disease etiology, Coronary Artery Disease physiopathology, Disease Progression, Endothelial Cells pathology, Endothelial Cells physiology, Endothelium, Vascular pathology, Endothelium, Vascular physiology, Endothelium, Vascular physiopathology, Heart Failure etiology, Heart Failure physiopathology, Humans, Hypertension etiology, Hypertension physiopathology, Peptidyl-Dipeptidase A drug effects, Peptidyl-Dipeptidase A metabolism, Perindopril therapeutic use, Plaque, Atherosclerotic etiology, Plaque, Atherosclerotic pathology, Plaque, Atherosclerotic physiopathology, Plaque, Atherosclerotic prevention & control, Randomized Controlled Trials as Topic, Stem Cells physiology, Acute Coronary Syndrome prevention & control, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Coronary Artery Disease therapy, Endothelial Cells drug effects, Endothelium, Vascular drug effects, Heart Failure therapy, Hypertension therapy, Secondary Prevention
- Abstract
Angiotensin-converting enzyme (ACE) inhibitors improve outcomes in patients with coronary artery disease (CAD), heart failure, and hypertension. This short review examines clinical evidence for such effects and the underlying mechanism of action. One potential mode of action for ACE inhibitors in CAD is blood pressure reduction. However, recent data suggest that the effects of ACE inhibitors on the endothelium may also be relevant in attenuating the progression of atherosclerosis. In CAD, chronic overexpression of tissue ACE disrupts the angiotensin II/bradykinin balance with a net result of endothelial dysfunction, mainly due to an increased rate of apoptosis. An imbalance between endothelial apoptosis (death) and its renewal from the bone marrow (life) causes discontinuity of the endothelial layer, favoring the initiation and progression of a biochemical sequence that leads to atherosclerosis, plaque rupture, and eventually acute coronary syndromes. There is clinical and experimental evidence that ACE inhibition improves the life and death cycle of the endothelium. By restoring the bradykinin/angiotensin II balance, ACE inhibition reduces the rate of endothelial apoptosis and experimental results suggest that ACE inhibition can also improve the production and mobilization of endothelial progenitor cells from bone marrow. We report our experience in this context with perindopril.
- Published
- 2010
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85. A modern fairy tale.
- Author
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Ferrari R, Guardigli G, and Tavazzi L
- Subjects
- Cardiovascular Diseases etiology, Cardiovascular Diseases mortality, Diet adverse effects, Diet, Mediterranean, Exercise, Health Knowledge, Attitudes, Practice, Health Promotion, Humans, Italy, Life Expectancy, Risk Assessment, Risk Factors, Cardiovascular Diseases prevention & control, Life Style, Preventive Health Services, Risk Reduction Behavior
- Published
- 2009
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86. [Beyond dyssynchrony: what are the factors determining the response to cardiac resynchronization therapy?].
- Author
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Mele D, Toselli T, Dal Monte A, Guardigli G, Ceconi C, and Ferrari R
- Subjects
- Aged, Decision Trees, Female, Heart Failure complications, Heart Failure etiology, Heart Failure physiopathology, Humans, Male, Heart Failure therapy, Pacemaker, Artificial
- Abstract
Although cardiac resynchronization therapy is currently used for treatment of refractory heart failure in patients with low ejection fraction and cardiac dyssynchrony, there is a substantial number of non-responders. This indicates that, in addition to cardiac dyssynchrony, there are other factors affecting response to cardiac resynchronization therapy. Pre-implant identification of these factors appears of crucial importance in order to finalize the resynchronization treatment to those patients who have the highest probability of a positive response. In this review the main non-dyssynchrony determinants of response to cardiac resynchronization therapy are presented and discussed.
- Published
- 2008
87. Factor XIIIA-V34L and factor XIIIB-H95R gene variants: effects on survival in myocardial infarction patients.
- Author
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Gemmati D, Federici F, Campo G, Tognazzo S, Serino ML, De Mattei M, Valgimigli M, Malagutti P, Guardigli G, Ferraresi P, Bernardi F, Ferrari R, Scapoli GL, and Catozzi L
- Subjects
- Aged, Alleles, Cohort Studies, Female, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction pathology, Polymerase Chain Reaction, Time Factors, Factor XIII genetics, Factor XIIIa genetics, Genetic Variation, Myocardial Infarction mortality
- Abstract
It has been demonstrated recently that coagulation factor XIII (FXIII) plays an extraordinary role in myocardial healing after infarction, improving survival in a mouse model. Common FXIII gene variants (i.e. FXIIIA-V34L and FXIIIB-H95R) significantly influence the molecular activity. To evaluate whether there is a relationship between the two FXIII gene variants and survival in patients after myocardial infarction (MI), V34L and H95R were PCR-genotyped in a cohort of 560 MI cases and follow-up was monitored. Cases with ST-segment elevation MI (STEMI) were 416 (74.3%) and 374 of these were treated with primary percutaneous coronary intervention (PCI) (89.9%). The remaining 144 patients showed non-ST-segment elevation MI (NSTEMI) at enrollment. The combined endpoint was the occurrence of death, re-infarction, and heart failure. Kaplan-Meier analysis at one year yielded an overall rate for adverse events of 24.5% with a lower incidence in the L34-carriers (28.8% vs 17.1%; log-rank, P = 0.00025), similar to that of the 416 STEMI (23.8%) being (28.0% and 16.9%; VV34- and L34-carriers respectively; log-rank, P = 0.001). Primary PCI-group had a slight lower incidence (22.9%) of adverse events (26.8% and 17.1%; VV34- and L34-carriers respectively; log-rank, P = 0.009). During hospitalization, 506 patients received PCI (374 primary PCI and 132 elective PCI). Significance was conserved also in the overall PCI-group (28.6% and 17.8%; VV34- and L34-carriers respectively; log-rank, P = 0.001). Similar findings were observed at 30 days follow-up. Cases carrying both FXIII variants had improved survival rate (log-rank, P = 0.019). On the other hand, minor bleeding complications were found increased in L34-carriers (P = 0.0001) whereas major bleeding complications were not. Finally, more direct evidence on the role of FXIII molecule on survival might come from the fact that despite significant FXIII antigen reductions observed in cases after MI, regardless the FXIII genotype considered, L34-carriers kept almost normal FXIII activity (VV34- vs L34-carriers; P < 0.001). We conclude that FXIII L34-allele improves survival after MI in all the groups analyzed, possibly through its higher activity associated with assumable positive effects on myocardial healing and recovered functions. Genetically determined higher FXIII activity might influence post-MI outcome. This paves the way for using FXIII molecules to improve myocardial healing, recovery of functions, and survival after infarction.
- Published
- 2007
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88. Tirofiban: a critical reappraisal of the clinical use, recent developments and future perspectives.
- Author
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Valgimigli M, Campo G, Percoco G, Pellegrino L, Guardigli G, and Ferrari R
- Abstract
Platelet activation and aggregation has been shown to be heightened in the setting of acute coronary syndromes and to be an independent predictor of adverse events. Blocking platelet aggregation with medical therapy (aspirin, clopidogrel, glycoprotein [GP]IIb/IIIa antagonists) has been demonstrated to be of unequivocal benefit. GPIIb/IIIa is a platelet-specific adhesion receptor that mediates the formation of platelet aggregates. Tirofiban is a small, synthetic, nonpeptide, competitive GPIIb/IIIa antagonist with high specificity and affinity for the GPIIb/IIIa receptor. The Platelet Receptor Inhibition for ischemic Syndrome Management (PRISM) and Platelet Receptor Inhibition for ischemic Syndrome Management in Patients Limited by Unstable signs and Symptoms (PRISM-PLUS) studies found that tirofiban, administered in the upstream setting - based on an infusion of a 30-min bolus - reduced the incidence of major adverse cardiovascular events in patients with non-ST segment elevation acute coronary syndromes, compared with heparin alone. Accordingly, the use of tirofiban in this setting has become a class I indication in the US and European guidelines. A 3-min bolus was also developed to allow the use of tirofiban directly in the catheterization laboratory. However, the do Tirofiban And ReoPro Give Similar Efficacy Trial (TARGET) study has demonstrated clinical inferiority of tirofiban versus abciximab due to suboptimal platelet inhibition soon after administration of 10 microg/kg bolus. To achieve an inhibition of platelet aggregation of more than 90% in the first hour after treatment, a new bolus of tirofiban was identified (10-25 microg/kg). The first case-control and randomized studies based on this new regimen have shown that this dosage was safe and effective in reducing the incidence of adverse events in patients treated with percutaneous coronary intervention. Several Phase II and III studies are ongoing to extend these preliminary findings.
- Published
- 2006
- Full Text
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89. [Efficacy of angiotensin-converting enzyme inhibitors in secondary prevention].
- Author
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Ceconi C, Mastrorilli F, Squasi PA, Gaitani S, Guardigli G, and Ferrari R
- Subjects
- Angiotensin-Converting Enzyme Inhibitors administration & dosage, Angiotensin-Converting Enzyme Inhibitors pharmacology, Cardiovascular Diseases mortality, Follow-Up Studies, Forecasting, Heart Failure drug therapy, Humans, Multicenter Studies as Topic, Myocardial Infarction drug therapy, Myocardial Ischemia prevention & control, Prospective Studies, Randomized Controlled Trials as Topic, Renin-Angiotensin System drug effects, Risk, Risk Factors, Time Factors, Ventricular Dysfunction drug therapy, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Cardiovascular Diseases drug therapy, Cardiovascular Diseases prevention & control
- Abstract
This paper reports the rationale for the cardiovascular protective effects of angiotensin-converting enzyme (ACE) inhibitors and reviews the overall results of recent randomized clinical trials. ACE-inhibitors prevent degradation of bradykinin, exert anti-ischemic action, inhibit thrombosis and platelet aggregation, are antiatherogenic, improve endothelial function and vessel remodeling, and have anti-inflammatory properties. Previous trials have shown that ACE-inhibitors reduce cardiovascular events in patients with heart failure or ventricular dysfunction. These findings have recently been extended to patients with lower risk profile, no evidence of heart failure and in secondary prevention using lipophilic ACE-inhibitors with high affinity for tissue ACE, i.e. those most likely to have high antiatherosclerotic efficacy. The central role of long-acting lipophilic ACE-inhibitors for cardiovascular protection has been clearly established and they should now be considered as a routine treatment for secondary prevention in the same way as aspirin, beta-blockers and statins.
- Published
- 2005
90. [Radiofrequency ablation of atrial fibrillation in 2005: where are we now?].
- Author
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Pratola C, Baldo E, Notarstefano P, Toselli T, Guardigli G, and Ferrari R
- Subjects
- Humans, Italy, Retrospective Studies, Atrial Fibrillation surgery, Catheter Ablation methods, Catheter Ablation trends
- Published
- 2005
91. Tirofiban and sirolimus-eluting stent vs abciximab and bare-metal stent for acute myocardial infarction: a randomized trial.
- Author
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Valgimigli M, Percoco G, Malagutti P, Campo G, Ferrari F, Barbieri D, Cicchitelli G, McFadden EP, Merlini F, Ansani L, Guardigli G, Bettini A, Parrinello G, Boersma E, and Ferrari R
- Subjects
- Abciximab, Aged, Angioplasty, Balloon, Coronary, Drug Delivery Systems, Female, Humans, Male, Middle Aged, Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors, Single-Blind Method, Tirofiban, Antibodies, Monoclonal therapeutic use, Immunoglobulin Fab Fragments therapeutic use, Immunosuppressive Agents administration & dosage, Myocardial Infarction therapy, Platelet Aggregation Inhibitors therapeutic use, Sirolimus administration & dosage, Stents, Tyrosine analogs & derivatives, Tyrosine therapeutic use
- Abstract
Context: Bare-metal stenting with abciximab pretreatment is currently considered a reasonable reperfusion strategy for acute ST-segment elevation myocardial infarction (STEMI). Sirolimus-eluting stents significantly reduce the need for target-vessel revascularization (TVR) vs bare-metal stents but substantially increase procedural costs. At current European list prices, the use of tirofiban instead of abciximab would absorb the difference in cost between stenting with sirolimus-eluting vs bare-metal stents., Objective: To evaluate the clinical and angiographic impact of single high-dose bolus tirofiban plus sirolimus-eluting stenting vs abciximab plus bare-metal stenting in patients with STEMI., Design, Setting, and Patients: Prospective, single-blind, randomized controlled study (Single High Dose Bolus Tirofiban and Sirolimus Eluting Stent vs Abciximab and Bare Metal Stent in Myocardial Infarction [STRATEGY]) of 175 patients (median age, 63 [interquartile range, 55-72] years) presenting to a single referral center in Italy with STEMI or presumed new left bundle-branch block and randomized between March 6, 2003, and April 23, 2004., Intervention: Single high-dose bolus tirofiban regimen plus sirolimus-eluting stenting (n = 87) vs standard-dose abciximab plus bare-metal stenting (n = 88)., Main Outcome Measures: The primary end point was a composite of death, nonfatal myocardial infarction, stroke, or binary restenosis at 8 months. Secondary outcomes included freedom, at day 30 and month 8, from major cardiac or cerebrovascular adverse events (composite of death, reinfarction, stroke, and repeat TVR)., Results: Cumulatively, 14 of 74 patients (19%; 95% confidence interval [CI], 10%-28%) in the tirofiban plus sirolimus-eluting stent group and 37 of 74 patients (50%; 95% CI, 44%-56%) in the abciximab plus bare-metal stent group reached the primary end point (hazard ratio, 0.33; 95% CI, 0.18-0.60; P<.001 [P<.001 by Fischer exact test]). The cumulative incidence of death, reinfarction, stroke, or TVR was significantly lower in the tirofiban plus sirolimus-eluting stent group (18%) vs the abciximab plus bare-metal stent group (32%) (hazard ratio, 0.53; 95% CI, 0.28-0.92; P = .04), predominantly reflecting a reduction in the need for TVR. Binary restenosis was present in 6 of 67 (9%; 95% CI, 2%-16%) and 24 of 66 (36%; 95% CI, 26%-46%) patients in the tirofiban plus sirolimus-eluting stent and abciximab plus bare-metal stent groups, respectively (P = .002)., Conclusion: Tirofiban-supported sirolimus-eluting stenting of infarcted arteries holds promise for improving outcomes while limiting health care expenditure in patients with myocardial infarction undergoing primary intervention.
- Published
- 2005
- Full Text
- View/download PDF
92. The additive value of tirofiban administered with the high-dose bolus in the prevention of ischemic complications during high-risk coronary angioplasty: the ADVANCE Trial.
- Author
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Valgimigli M, Percoco G, Barbieri D, Ferrari F, Guardigli G, Parrinello G, Soukhomovskaia O, and Ferrari R
- Subjects
- Acute Disease, Aged, Anticoagulants administration & dosage, Biomarkers blood, Coronary Stenosis epidemiology, Coronary Stenosis therapy, Creatine Kinase blood, Creatine Kinase, MB Form, Dose-Response Relationship, Drug, Double-Blind Method, Female, Heparin administration & dosage, Humans, Intraoperative Complications epidemiology, Isoenzymes blood, Male, Middle Aged, Myocardial Ischemia epidemiology, Prevalence, Risk Factors, Syndrome, Tirofiban, Treatment Outcome, Troponin I blood, Angioplasty, Balloon, Coronary, Intraoperative Complications etiology, Intraoperative Complications prevention & control, Myocardial Ischemia etiology, Myocardial Ischemia prevention & control, Platelet Aggregation Inhibitors administration & dosage, Tyrosine administration & dosage, Tyrosine analogs & derivatives
- Abstract
Objectives: We sought to determine the safety and efficacy of high-dose bolus (HDB) tirofiban in high-risk patients undergoing percutaneous coronary intervention (PCI)., Background: The use of HDB tirofiban in the catheterization laboratory is controversial. In particular, in patients with acute coronary syndromes undergoing PCI, there is no evidence that tirofiban administered in the catheterization laboratory is superior to heparin alone. This finding probably reflects the suboptimal platelet inhibition when tirofiban is employed at RESTORE (Randomized Efficacy Study of Tirofiban for Outcomes and Restenosis) regimen., Methods: A total of 202 patients (mean age 69 +/- 8 years; 137 males [68%]) undergoing high-risk PCI, pretreated with thienopyridines, were consecutively randomized to HDB tirofiban (25 microg/kg/3 min, and infusion of 0.15 microg/kg/min for 24 to 48 h) or placebo immediately before the procedure and then followed for a median time of 185 days (range 45 to 324 days) for the occurrence of the primary composite end point of death, myocardial infarction, target vessel revascularization (TVR), and bailout use of glycoprotein (GP) IIb/IIIa inhibitors., Results: The cumulative incidence of the primary end point was 35% and 20% in placebo and HDB tirofiban groups, respectively (hazard ratio 0.51, 95% confidence interval 0.29 to 0.88; p = 0.01). This difference was mainly due to the reduction of myocardial infarction and bailout use of GP IIb/IIIa inhibitors, with no significant effect on TVR or death. The safety profile did not differ between tirofiban and placebo., Conclusions: The use of tirofiban, when administered at HDB, is safe and significantly reduces the incidence of ischemic/thrombotic complications during high-risk PCI.
- Published
- 2004
- Full Text
- View/download PDF
93. Assessment of left ventricular volume and function by integration of simplified 3D echocardiography, tissue harmonic imaging and automated extraction of endocardial borders.
- Author
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Mele D, Teoli R, Cittanti C, Pasanisi G, Guardigli G, Levine RA, and Ferrari R
- Subjects
- Algorithms, Female, Humans, Image Processing, Computer-Assisted, Least-Squares Analysis, Male, Middle Aged, Observer Variation, Reproducibility of Results, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left physiopathology, Echocardiography, Three-Dimensional, Ventricular Dysfunction, Left diagnostic imaging
- Abstract
Background: Quantitative three-dimensional echocardiography (3DEcho) of left ventricle (LV) is still limited because of the need for manually tracing endocardial borders: this can increase observer variability depending on the quality of fundamental (FUND) 2D images. We tested the combination of a simplified 3DEcho technique for LV reconstruction with automated endocardial border detection (Digital Echo Quantification, DEQ) and tissue harmonic imaging (THI) for enhancement of endocardium-cavity interface., Methods: Twenty-five consecutive patients with ischaemic heart disease and dilated or distorted LV underwent 3DEcho and gated-SPECT nuclear examinations evaluating: (a) end-diastolic and end-systolic volumes (EDV, ESV); (b) ejection fraction (EF); (c) volume/time curve (VTC). Thereafter, 3DEcho was applied to 47 patients with acute myocardial infarction (AMI) at pre-discharge and 6 months to evaluate remodelling., Results: Integrated 3DEcho values in THI modality were obtained in 84% of patients and correlated well with nuclear data for EDV (r = 0.95, mean difference = -2.2 +/- 15.8 ml), ESV (r = 0.98, mean difference = -3.5 +/- 10.2 ml), and EF (r = 0.82, mean difference = 0.6 +/- 6.4%; all mean differences NS vs. 0), with an interobserver variability of 4.9, 5.7 and 8.2% for EDV, ESV and EF respectively. Automated VTC by 3DEcho in THI modality reproduced well that obtained by nuclear technique (r = 0.96) and allowed recognition of LV remodelling in 36% of patients at 6 months. Integrated 3DEcho values in FUND modality were obtained only in 52% of patients and showed much higher errors and interobserver variability., Conclusions: THI permits accurate 3D reconstruction of LV borders detected by DEQ, allowing automated VTC throughout the cardiac cycle as well as study of LV remodelling.
- Published
- 2004
- Full Text
- View/download PDF
94. High-dose bolus tirofiban and sirolimus eluting stent versus abiciximab and bare metal stent in acute myocardial infarction (STRATEGY) study--protocol design and demography of the first 100 patients.
- Author
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Valgimigli M, Percoco G, Cicchitelli G, Ferrari F, Barbieri D, Ansani L, Guardigli G, Parrinello G, Malagutti P, Soukhomovskaia O, Bettini A, Campo G, and Ferrari R
- Subjects
- Abciximab, Antibodies, Monoclonal economics, Clinical Protocols, Coronary Restenosis prevention & control, Drug Implants administration & dosage, Drug Implants economics, Drug Implants therapeutic use, Drug Therapy, Combination, Electrocardiography, Female, Forecasting, Humans, Immunoglobulin Fab Fragments economics, Injections, Italy, Male, Middle Aged, Myocardial Infarction diagnosis, Platelet Aggregation drug effects, Sirolimus administration & dosage, Sirolimus economics, Stents economics, Time Factors, Tirofiban, Treatment Outcome, Tyrosine economics, Antibodies, Monoclonal therapeutic use, Immunoglobulin Fab Fragments therapeutic use, Myocardial Infarction drug therapy, Sirolimus therapeutic use, Stents statistics & numerical data, Tyrosine administration & dosage, Tyrosine analogs & derivatives, Tyrosine therapeutic use
- Abstract
Background: Primary bare metal stenting and abciximab infusion are currently considered the best available reperfusion strategy for acute ST-segment elevation myocardial infarction (STEMI). Sirolimus eluting stents (SES), compared to bare metal stent (BMS), greatly reduce the incidence of binary restenosis and target vessel revascularisation (TVR), but their use on a routine basis results in a significant increase in medical costs. With current European list prices, the use of tirofiban instead of abciximab would save enough money to absorb the difference between SES and BMS., Aim: To assess whether in patients with STEMI the combination of SES with high dose bolus (HDB) tirofiban results in a similar incidence of major cardiovascular events (MACE) but in a lower binary restenosis rate after six months compared to BMS and abciximab., Methods and Results: 160 patients are required to satisfy the primary composite end-point, including MACE and binary restenosis. The study is ongoing: the current paper focuses on the methodology and demography of the first 100 patients so far enrolled. Patients randomised to HDB tirofiban (n = 50, mean age: 62 +/- 12, 40 males) and abciximab (n = 50, mean age: 63 +/- 12, 38 males) do not differ for medical history, presentation profile, medications at discharge, angiographic profile and creatine-kinase MB-fraction at peak., Conclusions: The results of the trial will be available by the end of 2004: they will be crucial for the cardiologists to know whether the gold standard for AMI treatment should be reconsidered after the introduction of SES into the clinical practice.
- Published
- 2004
- Full Text
- View/download PDF
95. Improved recognition of dysfunctioning myocardial segments by longitudinal strain rate versus velocity in patients with myocardial infarction.
- Author
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Mele D, Pasanisi G, Heimdal A, Cittanti C, Guardigli G, Levine RA, Sutherland G, and Ferrari R
- Subjects
- Aged, Coronary Circulation physiology, Evoked Potentials, Visual, Feasibility Studies, Female, Humans, Image Enhancement, Male, Middle Aged, Myocardial Infarction diagnostic imaging, Myocardial Infarction epidemiology, Observer Variation, Sensitivity and Specificity, Blood Flow Velocity physiology, Echocardiography, Doppler, Color, Myocardial Contraction physiology, Myocardial Infarction physiopathology
- Abstract
Doppler tissue imaging (DTI) can measure myocardial velocities but velocities alone cannot distinguish active from passive wall motion, whereas this is possible by strain rate (SR) imaging (SRI). We evaluated the accuracy of SRI for recognition of abnormal regional systolic function compared with DTI, B-mode echocardiography, and anatomic M-mode in 24 patients with myocardial infarction who underwent gated stress Tc 99m sestamibi scan. Sensitivity and specificity for recognition of infarct segments were 91% and 84% for visual SRI, 63% and 73% for visual DTI, 78% and 71% for B-mode echocardiography, and 87% and 77% for anatomic M-mode, respectively. Peak SRs correlated with wall-motion assessment by B-mode echocardiography better than peak velocities (P =.66 vs.10), with less overlap between groups. Therefore, SRI improves evaluation of regional wall motion compared with DTI and conventional ultrasound techniques in patients with myocardial infarction, mainly because it identifies segments that are moving passively but not shortening normally.
- Published
- 2004
- Full Text
- View/download PDF
96. Clinical feasibility of low energy internal atrial cardioversion with a three-electrode configuration in patients with unsuccessful conventional configurations.
- Author
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Benedini G, Gardini A, Toselli T, Antonioli G, Guardigli G, Saccomanno G, and Marini M
- Subjects
- Aged, Electrodes, Feasibility Studies, Female, Humans, Male, Middle Aged, Atrial Fibrillation therapy, Electric Countershock methods
- Abstract
Low energy internal cardioversion is a safe and highly effective method for atrial fibrillation termination. We will describe 6 patients in whom the conventional 2-electrode systems with the defibrillation leads positioned in the right atrium and in the coronary sinus or left pulmonary artery failed to terminate the arrhythmia despite the use of maximal available energies. A 3-electrode configuration including right atrium, coronary sinus and left pulmonary artery was used in order to encompass as much atrial mass as possible between the cathode and the anode. The atrial fibrillation was successfully interrupted in 4 out of 6 patients. The creation of a 3-electrode configuration may be a further technical expedient in order to increase the success rate of internal cardioversion when usual manoeuvres like lead repositioning, reversion of polarity, or addition of antiarrhythmic drugs are ineffective.
- Published
- 2000
- Full Text
- View/download PDF
97. AV delay optimization and management of DDD paced patients with dilated cardiomyopathy.
- Author
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Guardigli G, Ansani L, Percoco GF, Toselli T, Spisani P, Braggion G, and Antonioli GE
- Subjects
- Aged, Blood Flow Velocity, Cardiomyopathy, Dilated diagnostic imaging, Cardiomyopathy, Dilated physiopathology, Echocardiography, Doppler, Heart Failure diagnostic imaging, Heart Failure physiopathology, Heart Failure therapy, Heart Rate, Humans, Male, Middle Aged, Stroke Volume, Cardiac Pacing, Artificial, Cardiomyopathy, Dilated therapy
- Abstract
Ten DDD paced patients, suffering from dilated cardiomyopathy in the NYHA functional classes III or IV were studied by means of Doppler echocardiography at different programmed values of atrioventricular (AV) delay (200, 150, 120, 100, and 80 msec). The following variables were evaluated: LV diameter, ejection fraction, mitral and aortic flow velocity integrals, and stroke volume. During VDD pacing, a resting AV delay associated with the best diastolic filling and systolic function was identified and programmed individually. Shortening of the AV delay to about 100 msec was associated with a gradual and progressive improvement. Further decrease caused an impairment of systolic function. The patients were clinically and hemodynamically reevaluated after 2 months of follow-up. A reduction of NYHA class and an improvement of LV function were consistently found. The reported data suggest that programming of an optimal AV delay may improve myocardial function in DDD paced patients with congestive heart failure. This result may be the consequence of an optimization of left ventricular filling and a better use of the Frank-Starling law.
- Published
- 1994
- Full Text
- View/download PDF
98. Long-term reliability of single lead atrial synchronous pacing systems using closely spaced atrial dipoles: five-year experience.
- Author
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Ansani L, Percoco GF, Guardigli G, Toselli T, and Antonioli GE
- Subjects
- Aged, Aged, 80 and over, Electrocardiography, Equipment Failure, Female, Follow-Up Studies, Heart Block physiopathology, Heart Block therapy, Humans, Male, Middle Aged, Pacemaker, Artificial adverse effects
- Abstract
To assess the long-term capability of single atrioventricular (AV) lead VDD pacing systems using close atrial dipoles to assure reliable atrial guided pacing, the safety and efficacy of 86 VDD units implanted in 73 patients at a single center since November 1988 was reviewed. All patients suffered from advanced AV block with normal sinoatrial function. Sixty five patients received a LEM/CCS Twinal 30/30S system, four patients received a Vitatron-Saphir system, and four patients received a Medtronic Thera VDR 8348 system. All patients underwent provocative tests in search of myopotential interference, and Holter recordings; in a group of patients who underwent pacemaker replacement a comparison was made between implant and replacement measurements. The mean follow-up duration was 27.3 months. A high percentage of successfully VDD paced patients and a low incidence of pacemaker malfunction, regularly solved by pacemaker reprogramming, was reported. Atrial signal amplitudes comparable to those measured at implant were found at replacement in all patients. These data support the long-term reliability of single AV lead VDD pacing systems with closely spaced atrial dipoles, as well as stable atrial sensing by floating bipolar atrial electrodes and effective atrial synchronous ventricular pacing over time.
- Published
- 1994
- Full Text
- View/download PDF
99. Direct and autonomically mediated effects of oral quinidine on RR/QT relation after an abrupt increase in heart rate.
- Author
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Cappato R, Alboni P, Codecà L, Guardigli G, Toselli T, and Antonioli GE
- Subjects
- Administration, Oral, Adult, Aged, Atropine pharmacology, Autonomic Nervous System drug effects, Cardiac Pacing, Artificial, Electrophysiology, Female, Heart Rate physiology, Humans, Linear Models, Male, Middle Aged, Propranolol pharmacology, Ventricular Function, Arrhythmias, Cardiac physiopathology, Electrocardiography drug effects, Heart Ventricles drug effects, Quinidine pharmacology
- Abstract
Objectives: This study evaluates the direct and autonomically mediated effects of oral quinidine on ventricular repolarization in humans., Background: Interactions between quinidine-related vagolytic properties and autonomic modulation on ventricular repolarization are unknown. The relative role of the two components, if present, might improve our understanding of the therapeutic and proarrhythmic mechanisms of quinidine on the ventricular tissue., Methods: Rate-related changes in the QT interval were investigated after an abrupt increase in heart rate in 15 patients during atrial pacing. In the control study, the QT interval was measured at six paced cycle lengths (600, 540, 500, 460, 430 and 400 ms) both in the basal state and after autonomic blockade (intravenous propranolol, 0.2 mg/kg, and intravenous atropine, 0.04 mg/kg); oral quinidine was then administered at a daily dosage of 1,200 mg for 3 to 4 days, after which the QT duration was reassessed using the same method in a second study., Results: During the control study, the mean slope of the regression curve estimating the correlation between pacing cycle length and QT duration was significantly lower after autonomic blockade (0.14 +/- 0.05) than in the basal state (0.27 +/- 0.10, p < 0.05). Quinidine exhibited a prominent but opposite effect on the mean slope of the regression curves in basal conditions (from 0.27 +/- 0.10 to 0.20 +/- 0.07, p < 0.05) and after withdrawal of autonomic modulation (from 0.14 +/- 0.05 to 0.19 +/- 0.05, p < 0.05), thus annulling the differences observed between the two states in the control study., Conclusions: A quinidine-induced increase in QT duration as cycle length is prolonged is consistent with a reverse use dependence effect on ventricular repolarization. This effect is not evident in the basal state owing to interaction of quinidine-related vagolytic effect with the autonomic tone. Reverse use dependence and vagolytic activity on ventricular tissue indicate two potentially undesirable effects that could play a role in the lack of efficacy or proarrhythmic effect of quinidine.
- Published
- 1993
- Full Text
- View/download PDF
100. Changes in prostaglandin renal synthesis in cardiovascular disease.
- Author
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Fontana F, Guardigli G, Ruffini M, Chiarella M, Spagnolo N, de Collibus C, Bastagli L, and Bernardi P
- Subjects
- Humans, Cardiovascular Diseases metabolism, Kidney metabolism, Prostaglandins biosynthesis
- Abstract
We investigated the factors able to stimulate (hormones, drugs, fluid volume changes and prostaglandin precursors) or inhibit (NSAIDs) renal prostaglandin synthesis. We then assessed the effects of NSAIDs on: A) the efficacy of certain drugs (furosemide, ACE-inhibitors), whose action is mediated by a stimulation of prostaglandin synthesis; B) the physiopathology of cardiovascular diseases such as myocardial infarction and heart failure, in which renal and circulatory output is reduced; C) arterial hypertension.
- Published
- 1989
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