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151. Heart failure in COVID-19: the multicentre, multinational PCHF-COVICAV registry

Author

Sokolski, M., Trenson, S., Sokolska, J. M., D'Amario, D., Meyer, P., Poku, N. K., Biering-Sorensen, T., Hojbjerg Lassen, M. C., Skaarup, K. G., Barge-Caballero, E., Pouleur, A. -C., Stolfo, D., Sinagra, G., Ablasser, K., Muster, V., Rainer, P. P., Wallner, M., Chiodini, A., Heiniger, P. S., Mikulicic, F., Schwaiger, J., Winnik, S., Cakmak, H. A., Gaudenzi, M., Mapelli, M., Mattavelli, I., Paul, M., Cabac-Pogorevici, I., Bouleti, C., Lilliu, M., Minoia, C., Dauw, J., Costa, J., Celik, A., Mewton, N., Montenegro, C. E. L., Matsue, Y., Loncar, G., Marchel, M., Bechlioulis, A., Michalis, L., Dorr, M., Prihadi, E., Schoenrath, F., Messroghli, D. R., Mullens, W., Lund, L. H., Rosano, G. M. C., Ponikowski, P., Ruschitzka, F., Flammer, A. J., D'Amario D., Sokolski, M., Trenson, S., Sokolska, J. M., D'Amario, D., Meyer, P., Poku, N. K., Biering-Sorensen, T., Hojbjerg Lassen, M. C., Skaarup, K. G., Barge-Caballero, E., Pouleur, A. -C., Stolfo, D., Sinagra, G., Ablasser, K., Muster, V., Rainer, P. P., Wallner, M., Chiodini, A., Heiniger, P. S., Mikulicic, F., Schwaiger, J., Winnik, S., Cakmak, H. A., Gaudenzi, M., Mapelli, M., Mattavelli, I., Paul, M., Cabac-Pogorevici, I., Bouleti, C., Lilliu, M., Minoia, C., Dauw, J., Costa, J., Celik, A., Mewton, N., Montenegro, C. E. L., Matsue, Y., Loncar, G., Marchel, M., Bechlioulis, A., Michalis, L., Dorr, M., Prihadi, E., Schoenrath, F., Messroghli, D. R., Mullens, W., Lund, L. H., Rosano, G. M. C., Ponikowski, P., Ruschitzka, F., Flammer, A. J., and D'Amario D.

Abstract

Aims: We assessed the outcome of hospitalized coronavirus disease 2019 (COVID-19) patients with heart failure (HF) compared with patients with other cardiovascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia). We further wanted to determine the incidence of HF events and its consequences in these patient populations. Methods and results: International retrospective Postgraduate Course in Heart Failure registry for patients hospitalized with COVID-19 and CArdioVascular disease and/or risk factors (arterial hypertension, diabetes, or dyslipidaemia) was performed in 28 centres from 15 countries (PCHF-COVICAV). The primary endpoint was in-hospital mortality. Of 1974 patients hospitalized with COVID-19, 1282 had cardiovascular disease and/or risk factors (median age: 72 [interquartile range: 62–81] years, 58% male), with HF being present in 256 [20%] patients. Overall in-hospital mortality was 25% (n = 323/1282 deaths). In-hospital mortality was higher in patients with a history of HF (36%, n = 92) compared with non-HF patients (23%, n = 231, odds ratio [OR] 1.93 [95% confidence interval: 1.44–2.59], P < 0.001). After adjusting, HF remained associated with in-hospital mortality (OR 1.45 [95% confidence interval: 1.01–2.06], P = 0.041). Importantly, 186 of 1282 [15%] patients had an acute HF event during hospitalization (76 [40%] with de novo HF), which was associated with higher in-hospital mortality (89 [48%] vs. 220 [23%]) than in patients without HF event (OR 3.10 [2.24–4.29], P < 0.001). Conclusions: Hospitalized COVID-19 patients with HF are at increased risk for in-hospital death. In-hospital worsening of HF or acute HF de novo are common and associated with a further increase in in-hospital mortality.

Published
2021

152. Cardiovascular risk management in type 2 diabetes mellitus: a joint position paper of the Italian Cardiology (SIC) and Italian Diabetes (SID) Societies

Author

Avogaro, A, Barillà, F, Cavalot, F, Consoli, A, Federici, M, Mancone, M, Paolillo, S, Pedrinelli, R, Perseghin, G, Filardi, P, Scicali, R, Sinagra, G, Spaccarotella, C, Indolfi, C, Purrello, F, Avogaro, Angelo, Barillà, Francesco, Cavalot, Franco, Consoli, Agostino, Federici, Massimo, Mancone, Massimo, Paolillo, Stefania, Pedrinelli, Roberto, Perseghin, Gianluca, Filardi, Pasquale Perrone, Scicali, Roberto, Sinagra, Gianfranco, Spaccarotella, Carmen, Indolfi, Ciro, Purrello, Francesco, Avogaro, A, Barillà, F, Cavalot, F, Consoli, A, Federici, M, Mancone, M, Paolillo, S, Pedrinelli, R, Perseghin, G, Filardi, P, Scicali, R, Sinagra, G, Spaccarotella, C, Indolfi, C, Purrello, F, Avogaro, Angelo, Barillà, Francesco, Cavalot, Franco, Consoli, Agostino, Federici, Massimo, Mancone, Massimo, Paolillo, Stefania, Pedrinelli, Roberto, Perseghin, Gianluca, Filardi, Pasquale Perrone, Scicali, Roberto, Sinagra, Gianfranco, Spaccarotella, Carmen, Indolfi, Ciro, and Purrello, Francesco

Abstract

Aim: This review represents a joint effort of the Italian Societies of Cardiology (SIC) and Diabetes (SID) to define the state of the art in a field of great clinical and scientific interest which is experiencing a moment of major cultural advancements, the cardiovascular risk management in type 2 diabetes mellitus. Data synthesis: Consists of six chapters that examine various aspects of pathophysiology, diagnosis and therapy which in recent months have seen numerous scientific innovations and several clinical studies that require extensive sharing. Conclusions: The continuous evolution of our knowledge in this field confirms the great cultural vitality of these two cultural spheres, which requires, under the leadership of the scientific Societies, an ever greater and effective collaboration.

Published
2021

159. Consulenza cardiologica e gestione perioperatoria del paziente cardiopatico. Protocollo dell’Azienda Sanitaria Universitaria Integrata di Trieste – Anno 2019

Author

Massa, L., Mascaretti, L. G., Ratti, C., Zecchin, M., Perkan, A., Fabris, E., Vitrella, G., Fabro, M., Luzzati, R., Di Lenarda, A., Pelusi, L., Bergamini, P. R., Sinagra, G., Massa, L., Mascaretti, L. G., Ratti, C., Zecchin, M., Perkan, A., Fabris, E., Vitrella, G., Fabro, M., Luzzati, R., Di Lenarda, A., Pelusi, L., Bergamini, P. R., and Sinagra, G.

Subjects
Invasive procedure, Endocarditis, Antiplatelet therapy, Cardiac implantable electronic device, Anticoagulant, Anticoagulants, Invasive procedures, Cardiovascular risk, Direct oral anticoagulants, Cardiac implantable electronic devices, Surgery, Endocarditi, Direct oral anticoagulant
Abstract

La gestione dei pazienti con nota o sospetta cardiopatia, che sono ricoverati o che devono essere sottoposti ad intervento chirurgico non cardiaco o ad una procedura invasiva, è molto complessa, sia per le comorbilità spesso presenti, sia per le molteplici terapie assunte, sia perché spesso sono portatori di dispositivi cardiaci impiantabili. Scopo di questo documento è di fornire indicazioni e standardizzare i comportamenti dei vari medici nella gestione dei pazienti cardiopatici o sospetti tali, al fine di (a) gestire le acuzie cardiologiche con timing e accuratezza adeguati, e (b) definire il rischio cardiologico nel singolo paziente con tempi ed indicazioni appropriate, permettendogli di affrontare la procedura chirurgica o invasiva con il rischio più basso correlato alla presenza della cardiopatia.

Published
2019

160. Documento di consenso ANMCO/FADOI/SIAARTI/SIC/SIMG/SIMI/SIMEU: Il percorso clinico-diagnostico e terapeutico del paziente con scompenso cardiaco acuto dal domicilio alla dimissione dal Pronto Soccorso/ Dipartimento di Emergenza-Accettazione

Author

Mortara, A., Gabrielli, D., Pugliese, F. R., Corcione, A., Perticone, F., Fontanella, A., Mercuro, G., Cricelli, C., Iacoviello, M., D'Ambrosio, G., Guarracino, F., Modesti, P. A., Vescovo, G., De Maria, R., Iacovoni, A., Macera, F., Palmieri, V., Pasqualucci, D., Battistoni, I., Alunni, G., Aspromonte, N., Caldarola, P., Campanini, M., Caporale, R., Casolo, G., Cipriani, M., Di Tano, G., Domenicucci, S., Murrone, A., Nardi, F., Navazio, A., Oliva, F., Parretti, D., Urbinati, S., Valente, S., Valeriano, V., Zuin, G., Metra, M., Sinagra, G., Gulizia, M. M., Di Lenarda, A., Mortara, A., Gabrielli, D., Pugliese, F. R., Corcione, A., Perticone, F., Fontanella, A., Mercuro, G., Cricelli, C., Iacoviello, M., D'Ambrosio, G., Guarracino, F., Modesti, P. A., Vescovo, G., De Maria, R., Iacovoni, A., Macera, F., Palmieri, V., Pasqualucci, D., Battistoni, I., Alunni, G., Aspromonte, N., Caldarola, P., Campanini, M., Caporale, R., Casolo, G., Cipriani, M., Di Tano, G., Domenicucci, S., Murrone, A., Nardi, F., Navazio, A., Oliva, F., Parretti, D., Urbinati, S., Valente, S., Valeriano, V., Zuin, G., Metra, M., Sinagra, G., Gulizia, M. M., and Di Lenarda, A.

Subjects
Heart Failure, Patient Transfer, Emergency Service, Care pathway, Emergency department, Acute heart failure, Patient Discharge, Hospital, Italy, Acute Disease, Practice Guidelines as Topic, Critical Pathways, Care transitions, Hospital discharge, Emergency Service, Hospital, Humans, Care transition, Human
Abstract

Lo scompenso cardiaco (SC) acuto impegna le strutture ospedaliere in tutto il mondo e, a confronto con altre patologie cardiache acute come le sindromi coronariche, determina esiti a distanza marcatamente sfavorevoli: il tasso di mortalità o riospedalizzazione a 3 mesi è pari al 33%, la mortalità ad 1 anno dal ricovero varia tra 25% e 50%. Un fattore critico nella gestione dello SC acuto è rappresentato dalla molteplicità di professionisti sanitari coinvolti nel percorso diagnostico-terapeutico di questa sindrome, medici di medicina generale, medici di emergenza, cardiologi, internisti, anestesisti-rianimatori, e quindi dalla necessità di integrare conoscenze e competenze diverse e di convergere su obiettivi assistenziali in grado di migliorare gli esiti clinici. Questo documento di consenso origina dal lavoro congiunto delle Società Scientifiche espressione delle diverse figure professionali coinvolte nell’assistenza ai pazienti con SC acuto e ha condiviso strategie e percorsi volti a garantire sia livelli assistenziali di qualità che esiti migliori. Il documento dettaglia l’intero percorso del paziente con SC acuto dall’esordio dei sintomi a domicilio, dalla diagnosi, gestione domiciliare o invio in Pronto Soccorso/Dipartimento di Emergenza-Accettazione (PS/DEA), modalità di trasporto, terapia precoce, attraverso i percorsi clinici strumentali per la diagnosi in PS/DEA e il trattamento, la stratificazione del rischio e la dimissione del paziente in degenza ordinaria o a domicilio. Si analizza il possibile ruolo del “fast-track” cardiologico, dell’Osservazione Breve Intensiva e la presa in carico dell’assistenza territoriale attraverso la medicina generale e l’ambulatorio specialistico per la cura dello SC. Il crescente carico assistenziale e le complesse problematiche generate dallo SC acuto non possono trovare adeguata soluzione al di fuori di un approccio integrato multidisciplinare che ponga efficacemente in rete le strutture di emergenza con le unità di degenza intensiva e ordinaria e con il contesto delle cure territoriali. Il documento, grazie all’apporto delle più qualificate Società Scientifiche, persegue questo obiettivo proponendo un percorso strutturato, condiviso ed applicabile, in grado di contribuire ad una gestione del problema omogenea sul territorio nazionale.

Published
2019

161. Insufficienza tricuspidale e indicazioni al trattamento

Author

Vitrella G., Fabris E., Gatti G., Falco L., Rakar S., Perkan A., Sinagra G., Vitrella, G., Fabris, E., Gatti, G., Falco, L., Rakar, S., Perkan, A., and Sinagra, G.

Subjects
Cardiac Catheterization, Prognosi, Humans, Tricuspid regurgitation, Cardiac catheterization, Aged, Prognosis, Severity of Illness Index, Tricuspid Valve Insufficiency, Human
Abstract

Tricuspid regurgitation is a frequent valvular heart disease, particularly in the elderly and in association with other left-sided heart diseases. It has an adverse prognostic impact, with progressively increasing mortality as the degree of regurgitation increases. Isolated or combined (with mitral and/or aortic) surgery remains the treatment of choice, provided operative risk is acceptable. Several transcatheter treatment techniques, currently in early clinical or preclinical study phase, could provide alternative treatment options for patients with high surgical risk.

Published
2019

162. Acute heart failure congestion and perfusion status – impact of the clinical classification on in-hospital and long-term outcomes; insights from the ESC-EORP-HFA Heart Failure Long-Term Registry

Author

Chioncel, O., Mebazaa, A., Maggioni, A. P., Harjola, V. -P., Rosano, G., Laroche, C., Piepoli, M. F., Crespo-Leiro, M. G., Lainscak, M., Ponikowski, P., Filippatos, G., Ruschitzka, F., Seferovic, P., Coats, A. J. S., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., J. -F., Ly, Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Genis, A. B., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., Gunes, H., Chioncel, O., Mebazaa, A., Maggioni, A. P., Harjola, V. -P., Rosano, G., Laroche, C., Piepoli, M. F., Crespo-Leiro, M. G., Lainscak, M., Ponikowski, P., Filippatos, G., Ruschitzka, F., Seferovic, P., Coats, A. J. S., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Dayem, T. K. A., Farag, N., Halawa, S. I., Hamid, M. A., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Nagy, A. C., Halmosi, R., Elber, J., Alony, I., Shotan, A., Fuhrmann, A. V., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Dessalvi, C. C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Galifi, M. A., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Zanolla, L., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Soska, K. W., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Leszek, P., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Aguiar, C. T., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Guimaraes, T. O., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Correia, A. S., Peres, M., Marta, L., da Silva, G. F., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Cordeiro, A. F., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Lazic, J. S., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Ilic, M. D., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Adic, N. C., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Murin, J., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Iskra, M. S., Ravnikar, T., Suligoj, N. C., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Vrckovnik, M. P., Kladnik, M., Pusnik, C. S., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Anguita, M. J. F., Page, J. C. G., Martinez, F. M. S., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Fernandez, S. L., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Cerdena, I. L., Baldomero, I. F. H., Padron, A. L., Rosillo, S. O., Gonzalez-Gallarza, R. D., Montanes, O. S., Manjavacas, A. M. I., Conde, A. C., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Cubero, J. S., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Subias, P. E., Hernandez, M. V., Cano, M. J. R., Sanchez, M. A. G., Jimenez, J. F. D., Garrido-Lestache, E. B., Pinilla, J. M. G., de la Villa, B. G., Sahuquillo, A., Marques, R. B., Calvo, F. T., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Molina, B. D., Orus, J., Gonzalo, F. E., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Valero, D. B., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Diaz, J. L., Platero, A. R., Arias, J. C., Blasco-Peiro, T., Julve, M. S., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., and Gunes, H.

Subjects
Adult, Male, Registry, medicine.medical_specialty, New York Heart Association Class, Acute heart failure, Congestion, Forrester classification, Outcomes, Perfusion, Acute Disease, Aged, Blood Pressure, Coronary Circulation, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Humans, Long-Term Care, Middle Aged, Registries, Risk Factors, Treatment Outcome, Hospitalization, 030204 cardiovascular system & hematology, Lower risk, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Long term outcomes, Medicine, Outcome, business.industry, Hazard ratio, acute heart failure, congestion, forrester classification, outcomes, perfusion, registry, acute disease, adult, aged, blood pressure, coronary circulation, female, follow-up studies, heart failure, hospital mortality, humans, long-term care, male, middle aged, registries, risk factors, treatment outcome, hospitalization, medicine.disease, Confidence interval, 3. Good health, Heart failure, Emergency medicine, Cardiology and Cardiovascular Medicine, business
Abstract

[Abstract] Aims: Classification of acute heart failure (AHF) patients into four clinical profiles defined by evidence of congestion and perfusion is advocated by the 2016 European Society of Cardiology (ESC)guidelines. Based on the ESC-EORP-HFA Heart Failure Long-Term Registry, we compared differences in baseline characteristics, in-hospital management and outcomes among congestion/perfusion profiles using this classification. Methods and results: We included 7865 AHF patients classified at admission as: 'dry-warm' (9.9%), 'wet-warm' (69.9%), 'wet-cold' (19.8%) and 'dry-cold' (0.4%). These groups differed significantly in terms of baseline characteristics, in-hospital management and outcomes. In-hospital mortality was 2.0% in 'dry-warm', 3.8% in 'wet-warm', 9.1% in 'dry-cold' and 12.1% in 'wet-cold' patients. Based on clinical classification at admission, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: 'wet-warm' vs. 'dry-warm' 1.78 (1.43-2.21) and 'wet-cold' vs. 'wet-warm' 1.33 (1.19-1.48). For profiles resulting from discharge classification, the adjusted hazard ratios (95% confidence interval) for 1-year mortality were: 'wet-warm' vs. 'dry-warm' 1.46 (1.31-1.63) and 'wet-cold' vs. 'wet-warm' 2.20 (1.89-2.56). Among patients discharged alive, 30.9% had residual congestion, and these patients had higher 1-year mortality compared to patients discharged without congestion (28.0 vs. 18.5%). Tricuspid regurgitation, diabetes, anaemia and high New York Heart Association class were independently associated with higher risk of congestion at discharge, while beta-blockers at admission, de novo heart failure, or any cardiovascular procedure during hospitalization were associated with lower risk of residual congestion. Conclusion: Classification based on congestion/perfusion status provides clinically relevant information at hospital admission and discharge. A better understanding of the clinical course of the two entities could play an important role towards the implementation of targeted strategies that may improve outcomes.

Published
2019

163. Iperpotassiemia nello scompenso cardiaco: nuove soluzioni per un vecchio problema

Author

Romani, S., Porcari, A., Fabris, E., Sinagra, G., Romani, S., Porcari, A., Fabris, E., and Sinagra, G.

Subjects
Heart failure, Hyperkalemia, Patiromer, Renin-angiotensin system, ZS-9 compound, Decision Trees, Heart Failure, Humans, Polymers, Silicates, Treatment Outcome, Decision Tree, Silicate, Polymer, Human
Abstract

Il potassio è il principale ione intracellulare e la sua omeostasi è finemente regolata dall’apparato renale e gastrointestinale. L’insufficienza renale e l’iperpotassiemia sono condizioni di comune riscontro nei pazienti con scompenso cardiaco, risultato di una complessa interazione tra cuore e rene (es. sindrome cardio-renale) e degli effetti collaterali dei farmaci comunemente impiegati per il trattamento della malattia cardiaca (es. inibitori del sistema renina-angiotensina-aldosterone). Sebbene l’iperpotassiemia incrementi il rischio di disturbi di conduzione ed aritmie minacciose per la vita, il suo significato prognostico nello scompenso cardiaco è incerto. L’iperpotassiemia e la progressione del danno renale costituiscono i principali limiti all’introduzione e alla titolazione delle terapie eziologiche dello scompenso cardiaco. L’ingresso in commercio di nuovi farmaci per la prevenzione e il trattamento cronico dell’iperpotassiemia permette di introdurre e modulare la terapia anti-neurormonale in pazienti con scompenso cardiaco altrimenti esclusi per i livelli di potassio sierico eccessivamente elevati. Questa rassegna tratta gli aspetti fisiopatologici ed epidemiologico-prognostici dell’iperpotassiemia, offrendo, inoltre, un’analisi sulle possibili strategie di trattamento della disionia nello scompenso cardiaco.

Published
2019

164. Sacubitril/valsartan eligibility and outcomes in the ESC-EORP-HFA Heart Failure Long-Term Registry: bridging between European Medicines Agency/Food and Drug Administration label, the PARADIGM-HF trial, ESC guidelines, and real world

Author

Kapelios C. J., Lainscak M., Savarese G., Laroche C., Seferovic P., Ruschitzka F., Coats A., Anker S. D., Crespo-Leiro M. G., Filippatos G., Piepoli M. F., Rosano G., Zanolla L., Aguiar C., Murin J., Leszek P., McDonagh T., Maggioni A. P., Lund L. H., Auer J., Ablasser K., Fruhwald F., Dolze T., Brandner K., Gstrein S., Poelzl G., Moertl D., Reiter S., Podczeck-Schweighofer A., Muslibegovic A., Vasilj M., Fazlibegovic E., Cesko M., Zelenika D., Palic B., Pravdic D., Cuk D., Vitlianova K., Katova T., Velikov T., Kurteva T., Gatzov P., Kamenova D., Antova M., Sirakova V., Krejci J., Mikolaskova M., Spinar J., Krupicka J., Malek F., Hegarova M., Lazarova M., Monhart Z., Hassanein M., Sobhy M., El Messiry F., El Shazly A. H., Elrakshy Y., Youssef A., Moneim A. A., Noamany M., Reda A., Abdel Dayem T. K., Farag N., Ibrahim Halawa S., Abdel Hamid M., Said K., Saleh A., Ebeid H., Hanna R., Aziz R., Louis O., Enen M. A., Ibrahim B. S., Nasr G., Elbahry A., Sobhy H., Ashmawy M., Gouda M., Aboleineen W., Bernard Y., Luporsi P., Meneveau N., Pillot M., Morel M., Seronde M. -F., Schiele F., Briand F., Delahaye F., Damy T., Eicher J. -C., de Groote P., Fertin M., Lamblin N., Isnard R., Lefol C., Thevenin S., Hagege A., Jondeau G., Logeart D., Le Marcis V., Ly J. -F., Coisne D., Lequeux B., Le Moal V., Mascle S., Lotton P., Behar N., Donal E., Thebault C., Ridard C., Reynaud A., Basquin A., Bauer F., Codjia R., Galinier M., Tourikis P., Stavroula M., Tousoulis D., Stefanadis C., Chrysohoou C., Kotrogiannis I., Matzaraki V., Dimitroula T., Karavidas A., Tsitsinakis G., Kapelios C., Nanas J., Kampouri H., Nana E., Kaldara E., Eugenidou A., Vardas P., Saloustros I., Patrianakos A., Tsaknakis T., Evangelou S., Nikoloulis N., Tziourganou H., Tsaroucha A., Papadopoulou A., Douras A., Polgar L., Merkely B., Kosztin A., Nyolczas N., Csaba Nagy A., Halmosi R., Elber J., Alony I., Shotan A., Vazan Fuhrmann A., Amir O., Romano S., Marcon S., Penco M., Di Mauro M., Lemme E., Carubelli V., Rovetta R., Metra M., Bulgari M., Quinzani F., Lombardi C., Bosi S., Schiavina G., Squeri A., Barbieri A., Di Tano G., Pirelli S., Ferrari R., Fucili A., Passero T., Musio S., Di Biase M., Correale M., Salvemini G., Brognoli S., Zanelli E., Giordano A., Agostoni P., Italiano G., Salvioni E., Copelli S., Modena M. G., Reggianini L., Valenti C., Olaru A., Bandino S., Deidda M., Mercuro G., Cadeddu Dessalvi C., Marino P. N., Di Ruocco M. V., Sartori C., Piccinino C., Parrinello G., Licata G., Torres D., Giambanco S., Busalacchi S., Arrotti S., Novo S., Inciardi R. M., Pieri P., Chirco P. R., Ausilia Galifi M., Teresi G., Buccheri D., Minacapelli A., Veniani M., Frisinghelli A., Priori S. G., Cattaneo S., Opasich C., Gualco A., Pagliaro M., Mancone M., Fedele F., Cinque A., Vellini M., Scarfo I., Romeo F., Ferraiuolo F., Sergi D., Anselmi M., Melandri F., Leci E., Iori E., Bovolo V., Pidello S., Frea S., Bergerone S., Botta M., Canavosio F. G., Gaita F., Merlo M., Cinquetti M., Sinagra G., Ramani F., Fabris E., Stolfo D., Artico J., Miani D., Fresco C., Daneluzzi C., Proclemer A., Cicoira M., Marchese G., Torelli F., Vassanelli C., Voronina N., Erglis A., Tamakauskas V., Smalinskas V., Karaliute R., Petraskiene I., Kazakauskaite E., Rumbinaite E., Kavoliuniene A., Vysniauskas V., Brazyte-Ramanauskiene R., Petraskiene D., Stankala S., Switala P., Juszczyk Z., Sinkiewicz W., Gilewski W., Pietrzak J., Orzel T., Kasztelowicz P., Kardaszewicz P., Lazorko-Piega M., Gabryel J., Mosakowska K., Bellwon J., Rynkiewicz A., Raczak G., Lewicka E., Dabrowska-Kugacka A., Bartkowiak R., Sosnowska-Pasiarska B., Wozakowska-Kaplon B., Krzeminski A., Zabojszcz M., Mirek-Bryniarska E., Grzegorzko A., Bury K., Nessler J., Zalewski J., Furman A., Broncel M., Poliwczak A., Bala A., Zycinski P., Rudzinska M., Jankowski L., Kasprzak J. D., Michalak L., Wojtczak Soska K., Drozdz J., Huziuk I., Retwinski A., Flis P., Weglarz J., Bodys A., Grajek S., Kaluzna-Oleksy M., Straburzynska-Migaj E., Dankowski R., Szymanowska K., Grabia J., Szyszka A., Nowicka A., Samcik M., Wolniewicz L., Baczynska K., Komorowska K., Poprawa I., Komorowska E., Sajnaga D., Zolbach A., Dudzik-Plocica A., Abdulkarim A. -F., Lauko-Rachocka A., Kaminski L., Kostka A., Cichy A., Ruszkowski P., Splawski M., Fitas G., Szymczyk A., Serwicka A., Fiega A., Zysko D., Krysiak W., Szabowski S., Skorek E., Pruszczyk P., Bienias P., Ciurzynski M., Welnicki M., Mamcarz A., Folga A., Zielinski T., Rywik T., Sobieszczanska-Malek M., Piotrowska M., Kozar-Kaminska K., Komuda K., Wisniewska J., Tarnowska A., Balsam P., Marchel M., Opolski G., Kaplon-Cieslicka A., Gil R. J., Mozenska O., Byczkowska K., Gil K., Pawlak A., Michalek A., Krzesinski P., Piotrowicz K., Uzieblo-Zyczkowska B., Stanczyk A., Skrobowski A., Ponikowski P., Jankowska E., Rozentryt P., Polonski L., Gadula-Gacek E., Nowalany-Kozielska E., Kuczaj A., Kalarus Z., Szulik M., Przybylska K., Klys J., Prokop-Lewicka G., Kleinrok A., Tavares Aguiar C., Ventosa A., Pereira S., Faria R., Chin J., De Jesus I., Santos R., Silva P., Moreno N., Queiros C., Lourenco C., Pereira A., Castro A., Andrade A., Oliveira Guimaraes T., Martins S., Placido R., Lima G., Brito D., Francisco A. R., Cardiga R., Proenca M., Araujo I., Marques F., Fonseca C., Moura B., Leite S., Campelo M., Silva-Cardoso J., Rodrigues J., Rangel I., Martins E., Sofia Correia A., Peres M., Marta L., Ferreira da Silva G., Severino D., Durao D., Leao S., Magalhaes P., Moreira I., Filipa Cordeiro A., Ferreira C., Araujo C., Ferreira A., Baptista A., Radoi M., Bicescu G., Vinereanu D., Sinescu C. -J., Macarie C., Popescu R., Daha I., Dan G. -A., Stanescu C., Dan A., Craiu E., Nechita E., Aursulesei V., Christodorescu R., Otasevic P., Seferovic P. M., Simeunovic D., Ristic A. D., Celic V., Pavlovic-Kleut M., Suzic Lazic J., Stojcevski B., Pencic B., Stevanovic A., Andric A., Iric-Cupic V., Jovic M., Davidovic G., Milanov S., Mitic V., Atanaskovic V., Antic S., Pavlovic M., Stanojevic D., Stoickov V., Ilic S., Deljanin Ilic M., Petrovic D., Stojsic S., Kecojevic S., Dodic S., Cemerlic Adic N., Cankovic M., Stojiljkovic J., Mihajlovic B., Radin A., Radovanovic S., Krotin M., Klabnik A., Goncalvesova E., Pernicky M., Kovar F., Kmec J., Semjanova H., Strasek M., Savnik Iskra M., Ravnikar T., Cernic Suligoj N., Komel J., Fras Z., Jug B., Glavic T., Losic R., Bombek M., Krajnc I., Krunic B., Horvat S., Kovac D., Rajtman D., Cencic V., Letonja M., Winkler R., Valentincic M., Melihen-Bartolic C., Bartolic A., Pusnik Vrckovnik M., Kladnik M., Slemenik Pusnik C., Marolt A., Klen J., Drnovsek B., Leskovar B., Fernandez Anguita M. J., Gallego Page J. C., Salmeron Martinez F. M., Andres J., Bayes-Genis A., Mirabet S., Mendez A., Garcia-Cosio L., Roig E., Leon V., Gonzalez-Costello J., Muntane G., Garay A., Alcade-Martinez V., Lopez Fernandez S., Rivera-Lopez R., Puga-Martinez M., Fernandez-Alvarez M., Serrano-Martinez J. L., Crespo-Leiro M., Grille-Cancela Z., Marzoa-Rivas R., Blanco-Canosa P., Paniagua-Martin M. J., Barge-Caballero E., Laynez Cerdena I., Famara Hernandez Baldomero I., Lara Padron A., Ofelia Rosillo S., Dalmau Gonzalez-Gallarza R., Salvador Montanes O., Iniesta Manjavacas A. M., Castro Conde A., Araujo A., Soria T., Garcia-Pavia P., Gomez-Bueno M., Cobo-Marcos M., Alonso-Pulpon L., Segovia Cubero J., Sayago I., Gonzalez-Segovia A., Briceno A., Escribano Subias P., Vicente Hernandez M., Ruiz Cano M. J., Gomez Sanchez M. A., Delgado Jimenez J. F., Barrios Garrido-Lestache E., Garcia Pinilla J. M., Garcia de la Villa B., Sahuquillo A., Bravo Marques R., Torres Calvo F., Perez-Martinez M. T., Gracia-Rodenas M. R., Garrido-Bravo I. P., Pastor-Perez F., Pascual-Figal D. A., Diaz Molina B., Orus J., Epelde Gonzalo F., Bertomeu V., Valero R., Martinez-Abellan R., Quiles J., Rodrigez-Ortega J. A., Mateo I., ElAmrani A., Fernandez-Vivancos C., Bierge Valero D., Almenar-Bonet L., Sanchez-Lazaro I. J., Marques-Sule E., Facila-Rubio L., Perez-Silvestre J., Garcia-Gonzalez P., Ridocci-Soriano F., Garcia-Escriva D., Pellicer-Cabo A., de la Fuente Galan L., Lopez Diaz J., Recio Platero A., Arias J. C., Blasco-Peiro T., Sanz Julve M., Sanchez-Insa E., Aured-Guallar C., Portoles-Ocampo A., Melin M., Hagglund E., Stenberg A., Lindahl I. -M., Asserlund B., Olsson L., Dahlstrom U., Afzelius M., Karlstrom P., Tengvall L., Wiklund P. -A., Olsson B., Kalayci S., Temizhan A., Cavusoglu Y., Gencer E., Yilmaz M. B., Gunes H., Kapelios, C. J., Lainscak, M., Savarese, G., Laroche, C., Seferovic, P., Ruschitzka, F., Coats, A., Anker, S. D., Crespo-Leiro, M. G., Filippatos, G., Piepoli, M. F., Rosano, G., Zanolla, L., Aguiar, C., Murin, J., Leszek, P., Mcdonagh, T., Maggioni, A. P., Lund, L. H., Auer, J., Ablasser, K., Fruhwald, F., Dolze, T., Brandner, K., Gstrein, S., Poelzl, G., Moertl, D., Reiter, S., Podczeck-Schweighofer, A., Muslibegovic, A., Vasilj, M., Fazlibegovic, E., Cesko, M., Zelenika, D., Palic, B., Pravdic, D., Cuk, D., Vitlianova, K., Katova, T., Velikov, T., Kurteva, T., Gatzov, P., Kamenova, D., Antova, M., Sirakova, V., Krejci, J., Mikolaskova, M., Spinar, J., Krupicka, J., Malek, F., Hegarova, M., Lazarova, M., Monhart, Z., Hassanein, M., Sobhy, M., El Messiry, F., El Shazly, A. H., Elrakshy, Y., Youssef, A., Moneim, A. A., Noamany, M., Reda, A., Abdel Dayem, T. K., Farag, N., Ibrahim Halawa, S., Abdel Hamid, M., Said, K., Saleh, A., Ebeid, H., Hanna, R., Aziz, R., Louis, O., Enen, M. A., Ibrahim, B. S., Nasr, G., Elbahry, A., Sobhy, H., Ashmawy, M., Gouda, M., Aboleineen, W., Bernard, Y., Luporsi, P., Meneveau, N., Pillot, M., Morel, M., Seronde, M. -F., Schiele, F., Briand, F., Delahaye, F., Damy, T., Eicher, J. -C., de Groote, P., Fertin, M., Lamblin, N., Isnard, R., Lefol, C., Thevenin, S., Hagege, A., Jondeau, G., Logeart, D., Le Marcis, V., Ly, J. -F., Coisne, D., Lequeux, B., Le Moal, V., Mascle, S., Lotton, P., Behar, N., Donal, E., Thebault, C., Ridard, C., Reynaud, A., Basquin, A., Bauer, F., Codjia, R., Galinier, M., Tourikis, P., Stavroula, M., Tousoulis, D., Stefanadis, C., Chrysohoou, C., Kotrogiannis, I., Matzaraki, V., Dimitroula, T., Karavidas, A., Tsitsinakis, G., Kapelios, C., Nanas, J., Kampouri, H., Nana, E., Kaldara, E., Eugenidou, A., Vardas, P., Saloustros, I., Patrianakos, A., Tsaknakis, T., Evangelou, S., Nikoloulis, N., Tziourganou, H., Tsaroucha, A., Papadopoulou, A., Douras, A., Polgar, L., Merkely, B., Kosztin, A., Nyolczas, N., Csaba Nagy, A., Halmosi, R., Elber, J., Alony, I., Shotan, A., Vazan Fuhrmann, A., Amir, O., Romano, S., Marcon, S., Penco, M., Di Mauro, M., Lemme, E., Carubelli, V., Rovetta, R., Metra, M., Bulgari, M., Quinzani, F., Lombardi, C., Bosi, S., Schiavina, G., Squeri, A., Barbieri, A., Di Tano, G., Pirelli, S., Ferrari, R., Fucili, A., Passero, T., Musio, S., Di Biase, M., Correale, M., Salvemini, G., Brognoli, S., Zanelli, E., Giordano, A., Agostoni, P., Italiano, G., Salvioni, E., Copelli, S., Modena, M. G., Reggianini, L., Valenti, C., Olaru, A., Bandino, S., Deidda, M., Mercuro, G., Cadeddu Dessalvi, C., Marino, P. N., Di Ruocco, M. V., Sartori, C., Piccinino, C., Parrinello, G., Licata, G., Torres, D., Giambanco, S., Busalacchi, S., Arrotti, S., Novo, S., Inciardi, R. M., Pieri, P., Chirco, P. R., Ausilia Galifi, M., Teresi, G., Buccheri, D., Minacapelli, A., Veniani, M., Frisinghelli, A., Priori, S. G., Cattaneo, S., Opasich, C., Gualco, A., Pagliaro, M., Mancone, M., Fedele, F., Cinque, A., Vellini, M., Scarfo, I., Romeo, F., Ferraiuolo, F., Sergi, D., Anselmi, M., Melandri, F., Leci, E., Iori, E., Bovolo, V., Pidello, S., Frea, S., Bergerone, S., Botta, M., Canavosio, F. G., Gaita, F., Merlo, M., Cinquetti, M., Sinagra, G., Ramani, F., Fabris, E., Stolfo, D., Artico, J., Miani, D., Fresco, C., Daneluzzi, C., Proclemer, A., Cicoira, M., Marchese, G., Torelli, F., Vassanelli, C., Voronina, N., Erglis, A., Tamakauskas, V., Smalinskas, V., Karaliute, R., Petraskiene, I., Kazakauskaite, E., Rumbinaite, E., Kavoliuniene, A., Vysniauskas, V., Brazyte-Ramanauskiene, R., Petraskiene, D., Stankala, S., Switala, P., Juszczyk, Z., Sinkiewicz, W., Gilewski, W., Pietrzak, J., Orzel, T., Kasztelowicz, P., Kardaszewicz, P., Lazorko-Piega, M., Gabryel, J., Mosakowska, K., Bellwon, J., Rynkiewicz, A., Raczak, G., Lewicka, E., Dabrowska-Kugacka, A., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Zabojszcz, M., Mirek-Bryniarska, E., Grzegorzko, A., Bury, K., Nessler, J., Zalewski, J., Furman, A., Broncel, M., Poliwczak, A., Bala, A., Zycinski, P., Rudzinska, M., Jankowski, L., Kasprzak, J. D., Michalak, L., Wojtczak Soska, K., Drozdz, J., Huziuk, I., Retwinski, A., Flis, P., Weglarz, J., Bodys, A., Grajek, S., Kaluzna-Oleksy, M., Straburzynska-Migaj, E., Dankowski, R., Szymanowska, K., Grabia, J., Szyszka, A., Nowicka, A., Samcik, M., Wolniewicz, L., Baczynska, K., Komorowska, K., Poprawa, I., Komorowska, E., Sajnaga, D., Zolbach, A., Dudzik-Plocica, A., Abdulkarim, A. -F., Lauko-Rachocka, A., Kaminski, L., Kostka, A., Cichy, A., Ruszkowski, P., Splawski, M., Fitas, G., Szymczyk, A., Serwicka, A., Fiega, A., Zysko, D., Krysiak, W., Szabowski, S., Skorek, E., Pruszczyk, P., Bienias, P., Ciurzynski, M., Welnicki, M., Mamcarz, A., Folga, A., Zielinski, T., Rywik, T., Sobieszczanska-Malek, M., Piotrowska, M., Kozar-Kaminska, K., Komuda, K., Wisniewska, J., Tarnowska, A., Balsam, P., Marchel, M., Opolski, G., Kaplon-Cieslicka, A., Gil, R. J., Mozenska, O., Byczkowska, K., Gil, K., Pawlak, A., Michalek, A., Krzesinski, P., Piotrowicz, K., Uzieblo-Zyczkowska, B., Stanczyk, A., Skrobowski, A., Ponikowski, P., Jankowska, E., Rozentryt, P., Polonski, L., Gadula-Gacek, E., Nowalany-Kozielska, E., Kuczaj, A., Kalarus, Z., Szulik, M., Przybylska, K., Klys, J., Prokop-Lewicka, G., Kleinrok, A., Tavares Aguiar, C., Ventosa, A., Pereira, S., Faria, R., Chin, J., De Jesus, I., Santos, R., Silva, P., Moreno, N., Queiros, C., Lourenco, C., Pereira, A., Castro, A., Andrade, A., Oliveira Guimaraes, T., Martins, S., Placido, R., Lima, G., Brito, D., Francisco, A. R., Cardiga, R., Proenca, M., Araujo, I., Marques, F., Fonseca, C., Moura, B., Leite, S., Campelo, M., Silva-Cardoso, J., Rodrigues, J., Rangel, I., Martins, E., Sofia Correia, A., Peres, M., Marta, L., Ferreira da Silva, G., Severino, D., Durao, D., Leao, S., Magalhaes, P., Moreira, I., Filipa Cordeiro, A., Ferreira, C., Araujo, C., Ferreira, A., Baptista, A., Radoi, M., Bicescu, G., Vinereanu, D., Sinescu, C. -J., Macarie, C., Popescu, R., Daha, I., Dan, G. -A., Stanescu, C., Dan, A., Craiu, E., Nechita, E., Aursulesei, V., Christodorescu, R., Otasevic, P., Seferovic, P. M., Simeunovic, D., Ristic, A. D., Celic, V., Pavlovic-Kleut, M., Suzic Lazic, J., Stojcevski, B., Pencic, B., Stevanovic, A., Andric, A., Iric-Cupic, V., Jovic, M., Davidovic, G., Milanov, S., Mitic, V., Atanaskovic, V., Antic, S., Pavlovic, M., Stanojevic, D., Stoickov, V., Ilic, S., Deljanin Ilic, M., Petrovic, D., Stojsic, S., Kecojevic, S., Dodic, S., Cemerlic Adic, N., Cankovic, M., Stojiljkovic, J., Mihajlovic, B., Radin, A., Radovanovic, S., Krotin, M., Klabnik, A., Goncalvesova, E., Pernicky, M., Kovar, F., Kmec, J., Semjanova, H., Strasek, M., Savnik Iskra, M., Ravnikar, T., Cernic Suligoj, N., Komel, J., Fras, Z., Jug, B., Glavic, T., Losic, R., Bombek, M., Krajnc, I., Krunic, B., Horvat, S., Kovac, D., Rajtman, D., Cencic, V., Letonja, M., Winkler, R., Valentincic, M., Melihen-Bartolic, C., Bartolic, A., Pusnik Vrckovnik, M., Kladnik, M., Slemenik Pusnik, C., Marolt, A., Klen, J., Drnovsek, B., Leskovar, B., Fernandez Anguita, M. J., Gallego Page, J. C., Salmeron Martinez, F. M., Andres, J., Bayes-Genis, A., Mirabet, S., Mendez, A., Garcia-Cosio, L., Roig, E., Leon, V., Gonzalez-Costello, J., Muntane, G., Garay, A., Alcade-Martinez, V., Lopez Fernandez, S., Rivera-Lopez, R., Puga-Martinez, M., Fernandez-Alvarez, M., Serrano-Martinez, J. L., Crespo-Leiro, M., Grille-Cancela, Z., Marzoa-Rivas, R., Blanco-Canosa, P., Paniagua-Martin, M. J., Barge-Caballero, E., Laynez Cerdena, I., Famara Hernandez Baldomero, I., Lara Padron, A., Ofelia Rosillo, S., Dalmau Gonzalez-Gallarza, R., Salvador Montanes, O., Iniesta Manjavacas, A. M., Castro Conde, A., Araujo, A., Soria, T., Garcia-Pavia, P., Gomez-Bueno, M., Cobo-Marcos, M., Alonso-Pulpon, L., Segovia Cubero, J., Sayago, I., Gonzalez-Segovia, A., Briceno, A., Escribano Subias, P., Vicente Hernandez, M., Ruiz Cano, M. J., Gomez Sanchez, M. A., Delgado Jimenez, J. F., Barrios Garrido-Lestache, E., Garcia Pinilla, J. M., Garcia de la Villa, B., Sahuquillo, A., Bravo Marques, R., Torres Calvo, F., Perez-Martinez, M. T., Gracia-Rodenas, M. R., Garrido-Bravo, I. P., Pastor-Perez, F., Pascual-Figal, D. A., Diaz Molina, B., Orus, J., Epelde Gonzalo, F., Bertomeu, V., Valero, R., Martinez-Abellan, R., Quiles, J., Rodrigez-Ortega, J. A., Mateo, I., Elamrani, A., Fernandez-Vivancos, C., Bierge Valero, D., Almenar-Bonet, L., Sanchez-Lazaro, I. J., Marques-Sule, E., Facila-Rubio, L., Perez-Silvestre, J., Garcia-Gonzalez, P., Ridocci-Soriano, F., Garcia-Escriva, D., Pellicer-Cabo, A., de la Fuente Galan, L., Lopez Diaz, J., Recio Platero, A., Arias, J. C., Blasco-Peiro, T., Sanz Julve, M., Sanchez-Insa, E., Aured-Guallar, C., Portoles-Ocampo, A., Melin, M., Hagglund, E., Stenberg, A., Lindahl, I. -M., Asserlund, B., Olsson, L., Dahlstrom, U., Afzelius, M., Karlstrom, P., Tengvall, L., Wiklund, P. -A., Olsson, B., Kalayci, S., Temizhan, A., Cavusoglu, Y., Gencer, E., Yilmaz, M. B., and Gunes, H.

Subjects
medicine.medical_specialty, Registry, Prognosi, Tetrazoles, 030204 cardiovascular system & hematology, Angiotensin receptor, Sacubitril, 03 medical and health sciences, Angiotensin Receptor Antagonists, 0302 clinical medicine, Internal medicine, medicine, neprilysin inhibitor, Humans, LCZ696, Enalapril, Registries, Sacubitril/valsartan, New York Heart Association Class I, Heart Failure, Angiotensin receptor–neprilysin inhibitor, Eligibility, Ejection fraction, business.industry, United States Food and Drug Administration, Aminobutyrates, Biphenyl Compounds, Stroke Volume, Guideline, Prognosis, Neprilysin, United States, Valsartan, medicine.disease, 3. Good health, Drug Combinations, Heart failure, Cardiology and Cardiovascular Medicine, business, angiotensin receptor–neprilysin inhibitor, eligibility, lcz696, prognosis, registry, sacubitril/valsartan, aminobutyrates, angiotensin receptor antagonists, humans, neprilysin, registries, stroke volume, tetrazoles, united states, united states food and drug administration, valsartan, heart failure, Sacubitril, Valsartan, medicine.drug
Abstract

Aims To assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM-HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes. Methods and results Outpatients with HFrEF in the ESC-EORP-HFA Long-Term Heart Failure (HF-LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM-HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM-HF and guideline criteria, respectively. Absent PARADIGM-HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub-optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%) and sub-optimal pharmacotherapy (82%); absent label criteria were absence of symptoms (New York Heart Association class I). When a daily requirement of ACEi/ARB >= 10mg enalapril (instead of >= 20 mg) was used, eligibility rose from 12% to 28% based on both PARADIGM-HF and guidelines. One-year heart failure hospitalization was higher (12% and 17% vs. 12%) and all-cause mortality lower (5.3% and 6.5% vs. 7.7%) in registry eligible patients compared to the enalapril arm of PARADIGM-HF. Conclusions Among outpatients with HFrEF in the ESC-EORP-HFA HF-LT Registry, 84% met label criteria, while only 12% and 28% met PARADIGM-HF and guideline criteria for LCZ696 if requiring >= 20 mg and >= 10mg enalapril, respectively. Registry patients eligible for LCZ696 had greater heart failure hospitalization but lower mortality rates than the PARADIGM-HF enalapril group.

Published
2019

172. Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial

Author

Cardinale, D, Ciceri, F, Latini, R, Franzosi, M, Sandri, M, Civelli, M, Cucchi, G, Menatti, E, Mangiavacchi, M, Cavina, R, Barbieri, E, Gori, S, Colombo, A, Curigliano, G, Salvatici, M, Rizzo, A, Ghisoni, F, Bianchi, A, Falci, C, Aquilina, M, Rocca, A, Monopoli, A, Milandri, C, Rossetti, G, Bregni, M, Malossi, A, Nassiacos, D, Verusio, C, Giordano, M, Staszewsky, L, Barlera, S, Nicolis, E, Magnoli, M, Masson, S, Cipolla, C, Curigliano, Sicuro, M, Rossetti, Maggioni, A, Labianca, R, Tettamanti, M, Senni, M, Finzi, A, Grosso, F, Vago, T, Gramenzi, S, Balconi, G, Bernasconi, R, Buratti, M, Ojeda-Fernandez, M, Vasami, A, Thiebat, B, Bare, C, Corzani, A, Coccolo, F, Colecchia, S, Pellegrini, C, Appio, L, Caico, I, Mesenzani, O, Campana, C, Gilardoni, M, Scognamiglio, G, Corrado, G, Battagin, D, De Rosa, F, Carpino, C, Palazzo, S, Giannessi, P, Zipoli, G, Pastori, P, Callegari, S, Sesenna, C, Fodor, C, Guiducci, D, Mazza, R, Turazza, F, Vallerio, P, Marbello, L, Sala, E, Fragasso, G, Trinca, S, Farolfi, A, Andreis, D, Lanzoni, L, Marchetti, F, Mioranza, E, Banzato, A, Re, F, Gaibazzi, N, Gullo, M, Turina, M, Gervasi, E, Giaroli, F, Barco, B, Bertolini, A, Sinagra, G, Aleksova, A, Guglielmi, A, Pinotti, G, Gueli, R, Mongiardi, C, Vallini, I, Cardinale D., Ciceri F., Latini R., Franzosi M. G., Sandri M. T., Civelli M., Cucchi G., Menatti E., Mangiavacchi M., Cavina R., Barbieri E., Gori S., Colombo A., Curigliano G., Salvatici M., Rizzo A., Ghisoni F., Bianchi A., Falci C., Aquilina M., Rocca A., Monopoli A., Milandri C., Rossetti G., Bregni M., Malossi A., Nassiacos D., Verusio C., Giordano M., Staszewsky L., Barlera S., Nicolis E. B., Magnoli M., Masson S., Cipolla C. M., Sicuro M., Maggioni A. P., Labianca R., Tettamanti M., Senni M., Finzi A., Grosso F., Vago T., Gramenzi S., Balconi G., Bernasconi R., Nicolis E., Buratti M. G., Ojeda-Fernandez M. L., Vasami A., Thiebat B., Bare C., Corzani A., Coccolo F., Colecchia S., Pellegrini C., Appio L., Caico I., Mesenzani O., Campana C., Gilardoni M., Scognamiglio G., Corrado G., Battagin D., De Rosa F., Carpino C., Palazzo S., Giannessi P. G., Zipoli G., Pastori P., Callegari S., Sesenna C., Fodor C., Guiducci D., Mazza R., Turazza F. M., Vallerio P., Marbello L., Sala E., Fragasso G., Trinca S., Farolfi A., Andreis D., Lanzoni L., Marchetti F., Mioranza E., Banzato A., Re F., Gaibazzi N., Gullo M., Turina M. C., Gervasi E., Giaroli F., Barco B., Bertolini A., Sinagra G., Aleksova A., Guglielmi A., Pinotti G., Gueli R., Mongiardi C., Vallini I., Cardinale, D, Ciceri, F, Latini, R, Franzosi, M, Sandri, M, Civelli, M, Cucchi, G, Menatti, E, Mangiavacchi, M, Cavina, R, Barbieri, E, Gori, S, Colombo, A, Curigliano, G, Salvatici, M, Rizzo, A, Ghisoni, F, Bianchi, A, Falci, C, Aquilina, M, Rocca, A, Monopoli, A, Milandri, C, Rossetti, G, Bregni, M, Malossi, A, Nassiacos, D, Verusio, C, Giordano, M, Staszewsky, L, Barlera, S, Nicolis, E, Magnoli, M, Masson, S, Cipolla, C, Curigliano, Sicuro, M, Rossetti, Maggioni, A, Labianca, R, Tettamanti, M, Senni, M, Finzi, A, Grosso, F, Vago, T, Gramenzi, S, Balconi, G, Bernasconi, R, Buratti, M, Ojeda-Fernandez, M, Vasami, A, Thiebat, B, Bare, C, Corzani, A, Coccolo, F, Colecchia, S, Pellegrini, C, Appio, L, Caico, I, Mesenzani, O, Campana, C, Gilardoni, M, Scognamiglio, G, Corrado, G, Battagin, D, De Rosa, F, Carpino, C, Palazzo, S, Giannessi, P, Zipoli, G, Pastori, P, Callegari, S, Sesenna, C, Fodor, C, Guiducci, D, Mazza, R, Turazza, F, Vallerio, P, Marbello, L, Sala, E, Fragasso, G, Trinca, S, Farolfi, A, Andreis, D, Lanzoni, L, Marchetti, F, Mioranza, E, Banzato, A, Re, F, Gaibazzi, N, Gullo, M, Turina, M, Gervasi, E, Giaroli, F, Barco, B, Bertolini, A, Sinagra, G, Aleksova, A, Guglielmi, A, Pinotti, G, Gueli, R, Mongiardi, C, Vallini, I, Cardinale D., Ciceri F., Latini R., Franzosi M. G., Sandri M. T., Civelli M., Cucchi G., Menatti E., Mangiavacchi M., Cavina R., Barbieri E., Gori S., Colombo A., Curigliano G., Salvatici M., Rizzo A., Ghisoni F., Bianchi A., Falci C., Aquilina M., Rocca A., Monopoli A., Milandri C., Rossetti G., Bregni M., Malossi A., Nassiacos D., Verusio C., Giordano M., Staszewsky L., Barlera S., Nicolis E. B., Magnoli M., Masson S., Cipolla C. M., Sicuro M., Maggioni A. P., Labianca R., Tettamanti M., Senni M., Finzi A., Grosso F., Vago T., Gramenzi S., Balconi G., Bernasconi R., Nicolis E., Buratti M. G., Ojeda-Fernandez M. L., Vasami A., Thiebat B., Bare C., Corzani A., Coccolo F., Colecchia S., Pellegrini C., Appio L., Caico I., Mesenzani O., Campana C., Gilardoni M., Scognamiglio G., Corrado G., Battagin D., De Rosa F., Carpino C., Palazzo S., Giannessi P. G., Zipoli G., Pastori P., Callegari S., Sesenna C., Fodor C., Guiducci D., Mazza R., Turazza F. M., Vallerio P., Marbello L., Sala E., Fragasso G., Trinca S., Farolfi A., Andreis D., Lanzoni L., Marchetti F., Mioranza E., Banzato A., Re F., Gaibazzi N., Gullo M., Turina M. C., Gervasi E., Giaroli F., Barco B., Bertolini A., Sinagra G., Aleksova A., Guglielmi A., Pinotti G., Gueli R., Mongiardi C., and Vallini I.

Abstract

Background: Troponin changes over time have been suggested to allow for an early diagnosis of cardiac injury ensuing cancer chemotherapy; cancer patients with troponin elevation may benefit of therapy with enalapril. It is unknown whether a preventive treatment with enalapril may further increase the benefit. Methods: The International CardioOncology Society-one trial (ICOS-ONE) was a controlled, open-label trial conducted in 21 Italian hospitals. Patients were randomly assigned to two strategies: enalapril in all patients started before chemotherapy (CT; ‘prevention’ arm), and enalapril started only in patients with an increase in troponin during or after CT (‘troponin-triggered’ arm). Troponin was assayed locally in 2596 blood samples, before and after each anthracycline-containing CT cycle and at each study visit; electrocardiogram and echocardiogram were done at baseline, and at 1, 3, 6 and 12-month follow-up. Primary outcome was the incidence of troponin elevation above the threshold. Findings: Of the 273 patients, 88% were women, mean age 51 ± 12 years. The majority (76%) had breast cancer, 3% had a history of hypertension and 4% were diabetic. Epirubicin and doxorubicin were most commonly prescribed, with median cumulative doses of 360 [270–360] and 240 [240–240] mg/m2, respectively. The incidence of troponin elevation was 23% in the prevention and 26% in the troponin-triggered group (p = 0.50). Three patients (1.1%) -two in the prevention, one in the troponin-triggered group-developed cardiotoxicity, defined as 10% point reduction of LV ejection fraction, with values lower than 50%. Interpretation: Low cumulative doses of anthracyclines in adult patients with low cardiovascular risk can raise troponins, without differences between the two strategies of giving enalapril. Considering a benefit of enalapril in the prevention of LV dysfunction, a troponin-triggered strategy may be more convenient.

Published
2018

173. Prevalence and prognostic impact of non-cardiac co-morbidities in heart failure outpatients with preserved and reduced ejection fraction: a community-based study

Author

Iorio, A, Senni, M, Barbati, G, Greene, S, Poli, S, Zambon, E, Di Nora, C, Cioffi, G, Tarantini, L, Gavazzi, A, Sinagra, G, Di Lenarda, A, Iorio A, Senni M, Barbati G, Greene SJ, Poli S, Zambon E, Di Nora C, Cioffi G, Tarantini L, Gavazzi A, Sinagra G, Di Lenarda A, Iorio, A, Senni, M, Barbati, G, Greene, S, Poli, S, Zambon, E, Di Nora, C, Cioffi, G, Tarantini, L, Gavazzi, A, Sinagra, G, Di Lenarda, A, Iorio A, Senni M, Barbati G, Greene SJ, Poli S, Zambon E, Di Nora C, Cioffi G, Tarantini L, Gavazzi A, Sinagra G, and Di Lenarda A

Abstract

Aim: To assess adverse outcomes attributable to non-cardiac co-morbidities and to compare their effects by left ventricular ejection fraction (LVEF) group [LVEF <50% (heart failure with reduced ejection fraction, HFrEF), LVEF ≥50% (heart failure with preserved ejection fraction, HFpEF)] in a contemporary, unselected chronic heart failure population. Methods and results: This community-based cohort enrolled patients from October 2009 to December 2013. Adjusted hazard ratio (HR) and the population attributable fraction (PAF) were used to compare the contribution of 15 non-cardiac co-morbidities to adverse outcome. Overall, 2314 patients (mean age 77 ±10 years, 57% men) were recruited [n = 941 (41%) HFrEF, n = 1373 (59%) HFpEF]. Non-cardiac co-morbidity rates were similarly high, except for obesity and hypertension which were more prevalent in HFpEF. At a median follow-up of 31 (interquartile range 16–41) months, 472 (20%) patients died. Adjusted mortality rates were not significantly different between the HFrEF and HFpEF groups. After adjustment, an increasing number of non-cardiac co-morbidities was associated with a higher risk for all-cause mortality [HR 1.25; 95% confidence interval (CI) 1.10–1.26; P < 0.001], all-cause hospitalization (HR 1.17; 95% CI 1.12–1.23; P < 0.001), heart failure hospitalization (HR 1.28; 95% CI 1.19–1.38; P < 0.001), non-cardiovascular hospitalization (HR 1.16; 95% CI 1.11–1.22; P < 0.001). The co-morbidities contributing to high PAF were: anaemia, chronic kidney disease, chronic obstructive pulmonary disease, diabetes mellitus, and peripheral artery disease. These findings were similar for HFrEF and HFpEF. Interaction analysis yielded similar results. Conclusions: In a contemporary community population with chronic heart failure, non-cardiac co-morbidities confer a similar contribution to outcomes in HFrEF and HFpEF. These observations suggest that quality improvement initiatives aimed at optimizing co-morbidities may be

Published
2018

176. Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

Author

Kapelios, C.J. Laroche, C. Crespo-Leiro, M.G. Anker, S.D. Coats, A.J.S. Díaz-Molina, B. Filippatos, G. Lainscak, M. Maggioni, A.P. McDonagh, T. Mebazaa, A. Metra, M. Moura, B. Mullens, W. Piepoli, M.F. Rosano, G.M.C. Ruschitzka, F. Seferovic, P.M. Lund, L.H. Gale, C.P. Beleslin, B. Budaj, A. Chioncel, O. Dagres, N. Danchin, N. Erlinge, D. Emberson, J. Glikson, M. Gray, A. Kayikcioglu, M. Maggioni, A. Nagy, K.V. Nedoshivin, A. Petronio, A.-S. Roos-Hesselink, J. Wallentin, L. Zeymer, U. Anker, S. Mebazaa, A. Coats, A. Filippatos, G. Ferrari, R. Maggioni, A.P. Goda, A. Diez, M. Fernandez, A. Fruhwald, F. Gatzov, P. Kurlianskaya, A. Hullin, R. Christodoulides, T. Hradec, J. Nielsen, O.W. Nedjar, R. Uuetoa, T. Jimenez, J.F.D. Harjola, V.-P. Logeart, D. Tousoulis, D. Milicic, D. Merkely, B. Amir, O. Shotan, A. Shafie, D. Mirrakhimov, E. Kavoliuniene, A. Erglis, A. Otljanska, M. Kostovska, E.S. DeMarco, D.C. Drozdz, J. Fonseca, C. Chioncel, O. Dekleva, M. Dahlstrom, U. Lainscak, M. Goncalvesova, E. Estrago, V. Bajraktari, G. Auer, J. Ablasser, K. Fruhwald, F. Dolze, T. Brandner, K. Gstrein, S. Poelzl, G. Moertl, D. Reiter, S. Muslibegovic, A. Vasilj, M. Fazlibegovic, E. Cesko, M. Zelenika, D. Palic, B. Pravdic, D. Cuk, D. Vitlianova, K. Katova, T. Kurteva, T. Gatzov, P. Kamenova, D. Antova, M. Krejci, J. Spinar, J. Krupicka, J. Malek, F. Hegarova, M. Lazarova, M. Monhart, Z. Hassanein, M. El Messiry, F. El Shazly, A.H. Elrakshy, Y. Youssef, A. Moneim, A.A. Noamany, M. Dayem, T.K.A. Farag, N. Halawa, S.I. Hamid, M.A. Saleh, A. Ebeid, H. Hanna, R. Louis, O. Enen, M.A. Ibrahim, B.S. Nasr, G. Elbahry, A. Sobhy, H. Ashmawy, M. Gouda, M. Aboleineen, W. Bernard, Y. Meneveau, N. Pillot, M. Morel, M. Seronde, M.-F. Schiele, F. Briand, F. Delahaye, F. Damy, T. Eicher, J.-C. de Groote, P. Fertin, M. Lamblin, N. Isnard, R. Thevenin, S. Hagege, A. Logeart, D. Le Marcis, V. Ly, J.-F. Coisne, D. Lequeux, B. Le Moal, V. Mascle, S. Lotton, P. Behar, N. Donal, E. Ridard, C. Reynaud, A. Basquin, A. Bauer, F. Codjia, R. Galinier, M. Tourikis, P. Stavroula, M. Stefanadis, C. Chrysohoou, C. Kotrogiannis, I. Matzaraki, V. Karavidas, A. Tsitsinakis, G. Kapelios, C. Nanas, J. Kampouri, H. Nana, E. Kaldara, E. Eugenidou, A. Vardas, P. Saloustros, I. Tsaknakis, T. Evangelou, S. Tziourganou, H. Tsaroucha, A. Papadopoulou, A. Douras, A. Polgar, L. Kosztin, A. Nyolczas, N. Nagy, A.C. Halmosi, R. Elber, J. Shotan, A. Fuhrmann, A.V. Amir, O. Romano, S. Marcon, S. Penco, M. Di Mauro, M. Lemme, E. Carubelli, V. Rovetta, R. Bulgari, M. Quinzani, F. Bosi, S. Schiavina, G. Squeri, A. Di Tano, G. Pirelli, S. Ferrari, R. Fucili, A. Passero, T. Musio, S. Di Biase, M. Correale, M. Salvemini, G. Brognoli, S. Zanelli, E. Giordano, A. Agostoni, P. Salvioni, E. Copelli, S. Modena, M.G. Valenti, C. Olaru, A. Bandino, S. Deidda, M. Mercuro, G. Marino, P.N. Di Ruocco, M.V. Piccinino, C. Parrinello, G. Licata, G. Torres, D. Giambanco, S. Busalacchi, S. Arrotti, S. Novo, S. Inciardi, R.M. Pieri, P. Galifi, M.A. Teresi, G. Buccheri, D. Minacapelli, A. Veniani, M. Frisinghelli, A. Priori, S.G. Cattaneo, S. Opasich, C. Gualco, A. Pagliaro, M. Mancone, M. Fedele, F. Cinque, A. Vellini, M. Scarfo, I. Romeo, F. Ferraiuolo, F. Sergi, D. Anselmi, M. Melandri, F. Leci, E. Iori, E. Bovolo, V. Frea, S. Bergerone, S. Botta, M. Canavosio, F.G. Gaita, F. Merlo, M. Cinquetti, M. Sinagra, G. Ramani, F. Fabris, E. Artico, J. Miani, D. Fresco, C. Daneluzzi, C. Proclemer, A. Cicoira, M. Zanolla, L. Marchese, G. Torelli, F. Vassanelli, C. Voronina, N. Tamakauskas, V. Smalinskas, V. Karaliute, R. Petraskiene, I. Rumbinaite, E. Kavoliuniene, A. Brazyte-Ramanauskiene, R. Petraskiene, D. Sinkiewicz, W. Gilewski, W. Pietrzak, J. Orzel, T. Kardaszewicz, P. Lazorko-Piega, M. Mosakowska, K. Bellwon, J. Rynkiewicz, A. Raczak, G. Lewicka, E. Dabrowska-Kugacka, A. Bartkowiak, R. Wozakowska-Kaplon, B. Krzeminski, A. Zabojszcz, M. Grzegorzko, A. Bury, K. Nessler, J. Zalewski, J. Furman, A. Poliwczak, A. Bala, A. Zycinski, P. Rudzinska, M. Jankowski, L. Kasprzak, J.D. Michalak, L. Soska, K.W. Drozdz, J. Huziuk, I. Flis, P. Weglarz, J. Bodys, A. Grajek, S. Straburzynska-Migaj, E. Dankowski, R. Szymanowska, K. Szyszka, A. Nowicka, A. Samcik, M. Wolniewicz, L. Komorowska, K. Poprawa, I. Komorowska, E. Sajnaga, D. Zolbach, A. Abdulkarim, A.-F. Lauko-Rachocka, A. Kaminski, L. Kostka, A. Cichy, A. Ruszkowski, P. Splawski, M. Fitas, G. Szymczyk, A. Serwicka, A. Fiega, A. Zysko, D. Krysiak, W. Szabowski, S. Skorek, E. Pruszczyk, P. Bienias, P. Ciurzynski, M. Welnicki, M. Mamcarz, A. Folga, A. Zielinski, T. Rywik, T. Leszek, P. Sobieszczanska-Malek, M. Kozar-Kaminska, K. Komuda, K. Wisniewska, J. Tarnowska, A. Marchel, M. Opolski, G. Kaplon-Cieslicka, A. Gil, R.J. Mozenska, O. Gil, K. Pawlak, A. Michalek, A. Krzesinski, P. Piotrowicz, K. Stanczyk, A. Skrobowski, A. Ponikowski, P. Jankowska, E. Rozentryt, P. Polonski, L. Nowalany-Kozielska, E. Kuczaj, A. Kalarus, Z. Szulik, M. Klys, J. Prokop-Lewicka, G. Kleinrok, A. TavaresAguiar, C. Ventosa, A. Pereira, S. Faria, R. Chin, J. DeJesus, I. Santos, R. Silva, P. Moreno, N. Lourenço, C. Pereira, A. Castro, A. Andrade, A. OliveiraGuimaraes, T. Martins, S. Placido, R. Lima, G. Brito, D. Francisco, A.R. Proenca, M. Araujo, I. Marques, F. Fonseca, C. Moura, B. Campelo, M. Silva-Cardoso, J. Rodrigues, J. Rangel, I. Martins, E. Peres, M. Marta, L. Severino, D. Durao, D. Leao, S. Magalhaes, P. Moreira, I. Ferreira, C. Araujo, C. Ferreira, A. Baptista, A. Radoi, M. Bicescu, G. Vinereanu, D. Sinescu, C.-J. Macarie, C. Popescu, R. Daha, I. Dan, G.-A. Stanescu, C. Dan, A. Craiu, E. Nechita, E. Christodorescu, R. Otasevic, P. Seferovic, P.M. Simeunovic, D. Ristic, A.D. Celic, V. Pavlovic-Kleut, M. Stojcevski, B. Pencic, B. Stevanovic, A. Andric, A. Simić, D. Ašanin, M. Iric-Cupic, V. Jovic, M. Milanov, S. Mitic, V. Atanaskovic, V. Antic, S. Pavlovic, M. Stanojevic, D. Stoickov, V. Ilic, S. DeljaninIlic, M. Petrovic, D. Stojsic, S. Kecojevic, S. Dodic, S. Adic, N.C. Cankovic, M. Stojiljkovic, J. Mihajlovic, B. Radin, A. Radovanovic, S. Krotin, M. Klabnik, A. Pernicky, M. Murin, J. Kovar, F. Kmec, J. Strasek, M. Iskra, M.S. Ravnikar, T. Suligoj, N.C. Fras, Z. Jug, B. Glavic, T. Losic, R. Bombek, M. Krunic, B. Horvat, S. Kovac, D. Rajtman, D. Letonja, M. Winkler, R. Melihen-Bartolic, C. Bartolic, A. Kladnik, M. Pusnik, C.S. Marolt, A. Klen, J. Drnovsek, B. Leskovar, B. Anguita, M.J.F. GallegoPage, J.C. Martinez, F.M.S. Andres, J. Bayes-Genis, A. Mirabet, S. Mendez, A. Garcia-Cosio, L. Leon, V. Gonzalez-Costello, J. Muntane, G. Garay, A. Alcade-Martinez, V. Fernandez, S.L. Rivera-Lopez, R. Fernandez-Alvarez, M. Serrano-Martinez, J.L. Grille-Cancela, Z. Marzoa-Rivas, R. Paniagua-Martin, M.J. Barge-Caballero, E. Gonzalez-Gallarza, R.D. SalvadorMontanes, O. Manjavacas, A.M.I. Conde, A.C. Araujo, A. Soria, T. Gomez-Bueno, M. Cobo-Marcos, M. Alonso-Pulpon, L. SegoviaCubero, J. Sayago, I. Gonzalez-Segovia, A. Briceno, A. Subias, P.E. Cano, M.J.R. Sanchez, M.A.G. Jimenez, J.F.D. Pinilla, J.M.G. de la Villa, B.G. Sahuquillo, A. Marques, R.B. Calvo, F.T. Perez-Martinez, M.T. Garrido-Bravo, I.P. Pastor-Perez, F. Pascual-Figal, D.A. Molina, B.D. Orus, J. Gonzalo, F.E. Bertomeu, V. Valero, R. Martinez-Abellan, R. Quiles, J. Mateo, I. ElAmrani, A. Fernandez-Vivancos, C. Valero, D.B. Almenar-Bonet, L. Sanchez-Lazaro, I.J. Marques-Sule, E. Facila-Rubio, L. Perez-Silvestre, J. Garcia-Gonzalez, P. Garcia-Escriva, D. Pellicer-Cabo, A. de laFuente Galan, L. Diaz, J.L. Platero, A.R. Arias, J.C. Blasco-Peiro, T. Julve, M.S. Sanchez-Insa, E. Portoles-Ocampo, A. Melin, M. Hägglund Lindahl, I.-M. Asserlund, B. Olsson, L. Dahlström, U. Afzelius, M. Karlström, P. Tengvall, L. Olsson, B. Kalayci, S. Cavusoglu, Y. Gencer, E. Yilmaz, M.B. Gunes, H.

Abstract

Aims: Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results: We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66 ± 13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62,. 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion: Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease. © 2020 European Society of Cardiology

Published
2020

177. Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Author

Lainšcak, M. Milinkovic, I. Polovina, M. Crespo-Leiro, M.G. Lund, L.H. Anker, S.D. Laroche, C. Ferrari, R. Coats, A.J.S. McDonagh, T. Filippatos, G. Maggioni, A.P. Piepoli, M.F. Rosano, G.M.C. Ruschitzka, F. Simic, D. Ašanin, M. Eicher, J.-C. Yilmaz, M.B. Seferovic, P.M. Gale, C.P. Chair, G.B. Branko Beleslin, R.S. Andrzej Budaj, P.L. Chioncel, R.O. Nikolaos Dagres, D.E. Nicolas Danchin, F.R. David Erlinge, S.E. Jonathan Emberson, G.B. Michael Glikson, I.L. Alastair Gray, G.B. Meral Kayikcioglu, T.R. Aldo Maggioni, I.T. Klaudia Vivien Nagy, H.U. Aleksandr Nedoshivin, R.U. Anna-Sonia Petronio, I.T. Jolien Roos-Hesselink, N.L. Lars Wallentin, S.E. Uwe Zeymer, D.E. Mebazaa, A. Coats, A. A. Goda, A.L. M. Diez, A.R. A. Fernandez, A.R. F. Fruhwald, A.T. Fazlibegovic, E. P. Gatzov, B.G. A. Kurlianskaya, B.Y. R. Hullin, C.H. T. Christodoulides, C.Y. J. Hradec, C.Z. O. Wendelboe Nielsen, D.K. R. Nedjar, D.Z. T. Uuetoa, E.E. M. Hassanein, E.G. J. F. Delgado Jimenez, E.S. V-P. Harjola, F.I. D. Logeart, F.R. V. Chumburidze, G.E. D. Tousoulis, G.R. D. Milicic, H.R. B. Merkely, H.U. O'Donoghue IE, E. O. Amir, I.L. A. Shotan, I.L. D. Shafie, I.R. M. Metra, I.T. A. Matsumori, J.P. E. Mirrakhimov, K.G. A. Kavoliuniene, L.T. A. Erglis, L.V. Vataman, E. M. Otljanska, M.K. E. Srbinovska Kostovska, M.K. D. Cassar DeMarco, M.T. J. Drozdz, P.L. Fonseca, C. M. Dekleva, R.S. E. Shkolnik, R.U. U. Dahlstrom, S.E. M. Lainscak, S.I. E. Goncalvesova, S.K. A. Temizhan, T.R. V. Estrago, U.Y. G. Bajraktari, X.K. Auer, J. Ablasser, K. Fruhwald, F. Dolze, T. Brandner, K. Gstrein, S. Poelzl, G. Moertl, D. Reiter, S. Podczeck-Schweighofer, A. Muslibegovic, A. Vasilj, M. Cesko, M. Zelenika, D. Palic, B. Pravdic, D. Cuk, D. Vitlianova, K. Katova, T. Velikov, T. Kurteva, T. Gatzov, P. Kamenova, D. Antova, M. Sirakova, V. Krejci, J. Mikolaskova, M. Spinar, J. Krupicka, J. Malek, F. Hegarova, M. Lazarova, M. Monhart, Z. Hassanein, M. Sobhy, M. El Messiry, F. El Shazly, A.H. Elrakshy, Y. Youssef, A. Moneim, A.A. Noamany, M. Reda, A. Dayem, T.K.A. Farag, N. Halawa, S.I. Hamid, M.A. Said, K. Saleh, A. Ebeid, H. Hanna, R. Aziz, R. Louis, O. Enen, M.A. Ibrahim, B.S. Nasr, G. Elbahry, A. Sobhy, H. Ashmawy, M. Gouda, M. Aboleineen, W. Bernard, Y. Luporsi, P. Meneveau, N. Pillot, M. Morel, M. Seronde, M.-F. Schiele, F. Briand, F. Delahaye, F. Damy, T. de Groote, P. Fertin, M. Lamblin, N. Isnard, R. Lefol, C. Thevenin, S. Hagege, A. Jondeau, G. Logeart, D. Le Marcis, V. Ly, J.-F. Coisne, D. Lequeux, B. Le Moal, V. Mascle, S. Lotton, P. Behar, N. Donal, E. Thebault, C. Ridard, C. Reynaud, A. Basquin, A. Bauer, F. Codjia, R. Galinier, M. Tourikis, P. Stavroula, M. Tousoulis, D. Stefanadis, C. Chrysohoou, C. Kotrogiannis, I. Matzaraki, V. Dimitroula, T. Karavidas, A. Tsitsinakis, G. Kapelios, C. Nanas, J. Kampouri, H. Nana, E. Kaldara, E. Eugenidou, A. Vardas, P. Saloustros, I. Patrianakos, A. Tsaknakis, T. Evangelou, S. Nikoloulis, N. Tziourganou, H. Tsaroucha, A. Papadopoulou, A. Douras, A. Polgar, L. Merkely, B. Kosztin, A. Nyolczas, N. Nagy, A.C. Halmosi, R. Elber, J. Alony, I. Shotan, A. Fuhrmann, A.V. Amir, O. Romano, S. Marcon, S. Penco, M. Di Mauro, M. Lemme, E. Carubelli, V. Rovetta, R. Metra, M. Bulgari, M. Quinzani, F. Lombardi, C. Bosi, S. Schiavina, G. Squeri, A. Barbieri, A. Di Tano, G. Pirelli, S. Fucili, A. Passero, T. Musio, S. Di Biase, M. Correale, M. Salvemini, G. Brognoli, S. Zanelli, E. Giordano, A. Agostoni, P. Italiano, G. Salvioni, E. Copelli, S. Modena, M.G. Reggianini, L. Valenti, C. Olaru, A. Bandino, S. Deidda, M. Mercuro, G. Dessalvi, C.C. Marino, P.N. Di Ruocco, M.V. Sartori, C. Piccinino, C. Parrinello, G. Licata, G. Torres, D. Giambanco, S. Busalacchi, S. Arrotti, S. Novo, S. Inciardi, R.M. Pieri, P. Chirco, P.R. Galifi, M.A. Teresi, G. Buccheri, D. Minacapelli, A. Veniani, M. Frisinghelli, A. Priori, S.G. Cattaneo, S. Opasich, C. Gualco, A. Pagliaro, M. Mancone, M. Fedele, F. Cinque, A. Vellini, M. Scarfo, I. Romeo, F. Ferraiuolo, F. Sergi, D. Anselmi, M. Melandri, F. Leci, E. Iori, E. Bovolo, V. Pidello, S. Frea, S. Bergerone, S. Botta, M. Canavosio, F.G. Gaita, F. Merlo, M. Cinquetti, M. Sinagra, G. Ramani, F. Fabris, E. Stolfo, D. Artico, J. Miani, D. Fresco, C. Daneluzzi, C. Proclemer, A. Cicoira, M. Zanolla, L. Marchese, G. Torelli, F. Vassanelli, C. Voronina, N. Erglis, A. Tamakauskas, V. Smalinskas, V. Karaliute, R. Petraskiene, I. Kazakauskaite, E. Rumbinaite, E. Kavoliuniene, A. Vysniauskas, V. Brazyte-Ramanauskiene, R. Petraskiene, D. Stankala, S. Switala, P. Juszczyk, Z. Sinkiewicz, W. Gilewski, W. Pietrzak, J. Orzel, T. Kasztelowicz, P. Kardaszewicz, P. Lazorko-Piega, M. Gabryel, J. Mosakowska, K. Bellwon, J. Rynkiewicz, A. Raczak, G. Lewicka, E. Dabrowska-Kugacka, A. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Zabojszcz, M. Mirek-Bryniarska, E. Grzegorzko, A. Bury, K. Nessler, J. Zalewski, J. Furman, A. Broncel, M. Poliwczak, A. Bala, A. Zycinski, P. Rudzinska, M. Jankowski, L. Kasprzak, J.D. Michalak, L. Soska, K.W. Drozdz, J. Huziuk, I. Retwinski, A. Flis, P. Weglarz, J. Bodys, A. Grajek, S. Kaluzna-Oleksy, M. Straburzynska-Migaj, E. Dankowski, R. Szymanowska, K. Grabia, J. Szyszka, A. Nowicka, A. Samcik, M. Wolniewicz, L. Baczynska, K. Komorowska, K. Poprawa, I. Komorowska, E. Sajnaga, D. Zolbach, A. Dudzik-Plocica, A. Abdulkarim, A.-F. Lauko-Rachocka, A. Kaminski, L. Kostka, A. Cichy, A. Ruszkowski, P. Splawski, M. Fitas, G. Szymczyk, A. Serwicka, A. Fiega, A. Zysko, D. Krysiak, W. Szabowski, S. Skorek, E. Pruszczyk, P. Bienias, P. Ciurzynski, M. Welnicki, M. Mamcarz, A. Folga, A. Zielinski, T. Rywik, T. Leszek, P. Sobieszczanska-Malek, M. Piotrowska, M. Kozar-Kaminska, K. Komuda, K. Wisniewska, J. Tarnowska, A. Balsam, P. Marchel, M. Opolski, G. Kaplon-Cieslicka, A. Gil, R.J. Mozenska, O. Byczkowska, K. Gil, K. Pawlak, A. Michalek, A. Krzesinski, P. Piotrowicz, K. Uzieblo-Zyczkowska, B. Stanczyk, A. Skrobowski, A. Ponikowski, P. Jankowska, E. Rozentryt, P. Polonski, L. Gadula-Gacek, E. Nowalany-Kozielska, E. Kuczaj, A. Kalarus, Z. Szulik, M. Przybylska, K. Klys, J. Prokop-Lewicka, G. Kleinrok, A. Aguiar, C.T. Ventosa, A. Pereira, S. Faria, R. Chin, J. De Jesus, I. Santos, R. Silva, P. Moreno, N. Queirós, C. Lourenço, C. Pereira, A. Castro, A. Andrade, A. Guimaraes, T.O. Martins, S. Placido, R. Lima, G. Brito, D. Francisco, A.R. Cardiga, R. Proenca, M. Araujo, I. Marques, F. Moura, B. Leite, S. Campelo, M. Silva-Cardoso, J. Rodrigues, J. Rangel, I. Martins, E. Correia, A.S. Peres, M. Marta, L. da Silva, G.F. Severino, D. Durao, D. Leao, S. Magalhaes, P. Moreira, I. Cordeiro, A.F. Ferreira, C. Araujo, C. Ferreira, A. Baptista, A. Radoi, M. Bicescu, G. Vinereanu, D. Sinescu, C.-J. Macarie, C. Popescu, R. Daha, I. Dan, G.-A. Stanescu, C. Dan, A. Craiu, E. Nechita, E. Aursulesei, V. Christodorescu, R. Otasevic, P. Simeunovic, D. Ristic, A.D. Celic, V. Pavlovic-Kleut, M. Lazic, J.S. Stojcevski, B. Pencic, B. Stevanovic, A. Andric, A. Iric-Cupic, V. Jovic, M. Davidovic, G. Milanov, S. Mitic, V. Atanaskovic, V. Antic, S. Pavlovic, M. Stanojevic, D. Stoickov, V. Ilic, S. Ilic, M.D. Petrovic, D. Stojsic, S. Kecojevic, S. Dodic, S. Adic, N.C. Cankovic, M. Stojiljkovic, J. Mihajlovic, B. Radin, A. Radovanovic, S. Krotin, M. Klabnik, A. Goncalvesova, E. Pernicky, M. Murin, J. Kovar, F. Kmec, J. Semjanova, H. Strasek, M. Iskra, M.S. Ravnikar, T. Suligoj, N.C. Komel, J. Fras, Z. Jug, B. Glavic, T. Losic, R. Bombek, M. Krajnc, I. Krunic, B. Horvat, S. Kovac, D. Rajtman, D. Cencic, V. Letonja, M. Winkler, R. Valentincic, M. Melihen-Bartolic, C. Bartolic, A. Vrckovnik, M.P. Kladnik, M. Pusnik, C.S. Marolt, A. Klen, J. Drnovsek, B. Leskovar, B. Anguita, M.J.F. Page, J.C.G. Martinez, F.M.S. Andres, J. Bayes-Genis, A. Mirabet, S. Mendez, A. Garcia-Cosio, L. Roig, E. Leon, V. Gonzalez-Costello, J. Muntane, G. Garay, A. Alcade-Martinez, V. Fernandez, S.L. Rivera-Lopez, R. Puga-Martinez, M. Fernandez-Alvarez, M. Serrano-Martinez, J.L. Grille-Cancela, Z. Marzoa-Rivas, R. Blanco-Canosa, P. Paniagua-Martin, M.J. Barge-Caballero, E. Cerdena, I.L. Baldomero, I.F.H. Padron, A.L. Rosillo, S.O. Gonzalez-Gallarza, R.D. Montanes, O.S. Manjavacas, A.M.I. Conde, A.C. Araujo, A. Soria, T. Garcia-Pavia, P. Gomez-Bueno, M. Cobo-Marcos, M. Alonso-Pulpon, L. Cubero, J.S. Sayago, I. Gonzalez-Segovia, A. Briceno, A. Subias, P.E. Hernandez, M.V. Cano, M.J.R. Sanchez, M.A.G. Jimenez, J.F.D. Garrido-Lestache, E.B. Pinilla, J.M.G. de la Villa, B.G. Sahuquillo, A. Marques, R.B. Calvo, F.T. Perez-Martinez, M.T. Gracia-Rodenas, M.R. Garrido-Bravo, I.P. Pastor-Perez, F. Pascual-Figal, D.A. Molina, B.D. Orus, J. Gonzalo, F.E. Bertomeu, V. Valero, R. Martinez-Abellan, R. Quiles, J. Rodrigez-Ortega, J.A. Mateo, I. ElAmrani, A. Fernandez-Vivancos, C. Valero, D.B. Almenar-Bonet, L. Sanchez-Lazaro, I.J. Marques-Sule, E. Facila-Rubio, L. Perez-Silvestre, J. Garcia-Gonzalez, P. Ridocci-Soriano, F. Garcia-Escriva, D. Pellicer-Cabo, A. de la Fuente Galan, L. Diaz, J.L. Platero, A.R. Arias, J.C. Blasco-Peiro, T. Julve, M.S. Sanchez-Insa, E. Aured-Guallar, C. Portoles-Ocampo, A. Melin, M. Hägglund, E. Stenberg, A. Lindahl, I.-M. Asserlund, B. Olsson, L. Dahlström, U. Afzelius, M. Karlström, P. Tengvall, L. Wiklund, P.-A. Olsson, B. Kalayci, S. Temizhan, A. Cavusoglu, Y. Gencer, E. Gunes, H. the European Society of Cardiology Heart Failure Long-Term Registry Investigators Group

Abstract

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P ≤ 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P = 0.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P 75 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF ≤45%. © 2019 The Authors. European Journal of Heart Failure © 2019 European Society of Cardiology

Published
2020

178. Unravelling the interplay between hyperkalaemia, renin–angiotensin–aldosterone inhibitor use and clinical outcomes. Data from 9222 chronic heart failure patients of the ESC-HFA-EORP Heart Failure Long-Term Registry

Author

Rossignol, P. Lainscak, M. Crespo-Leiro, M.G. Laroche, C. Piepoli, M.F. Filippatos, G. Rosano, G.M.C. Savarese, G. Anker, S.D. Seferovic, P.M. Ruschitzka, F. Coats, A.J.S. Mebazaa, A. McDonagh, T. Sahuquillo, A. Penco, M. Maggioni, A.P. Lund, L.H. Christopher Peter Gale, G.B. Branko Beleslin, R.S. Andrzej Budaj, P.L. Ovidiu Chioncel, R.O. Nikolaos Dagres, D.E. Nicolas Danchin, F.R. David Erlinge, S.E. Jonathan Emberson, G.B. Michael Glikson, I.L. Alastair Gray, G.B. Meral Kayikcioglu, T.R. Aldo Maggioni, I.T. Klaudia Vivien Nagy, H.U. Aleksandr Nedoshivin, R.U. Anna-Sonia Petronio, I.T. Jolien Roos-Hesselink, N.L. Lars Wallentin, S.E. Uwe Zeymer, D.E. Anker, S. Mebazaa, A. Coats, A. Filippatos, G. Ferrari, R. Maggioni, A.P. Goda, A. Diez, M. Fernandez, A. Fruhwald, F. Fazlibegovic, E. Gatzov, P. Kurlianskaya, A. Hullin, R. Christodoulides, T. Hradec, J. Nielsen, O.W. Nedjar, R. Uuetoa, T. Hassanein, M. Jimenez, J.F.D. Harjola, V.P. Logeart, D. Chumburidze, V. Tousoulis, D. Milicic, D. Merkely, B. O'Donoghue, E. Amir, O. Shotan, A. Shafie, D. Metra, M. Matsumori, A. Mirrakhimov, E. Kavoliuniene, A. Erglis, A. Vataman, E. Otljanska, M. Kostovska, E.S. DeMarco, D.C. Drozdz, J. Fonseca, C. Chioncel, O. Dekleva, M. Shkolnik, E. Dahlstrom, U. Lainscak, M. Goncalvesova, E. Temizhan, A. Estrago, V. Bajraktari, G. Auer, J. Ablasser, K. Fruhwald, F. Dolze, T. Brandner, K. Gstrein, S. Poelzl, G. Moertl, D. Reiter, S. Podczeck-Schweighofer, A. Muslibegovic, A. Vasilj, M. Fazlibegovic, E. Cesko, M. Zelenika, D. Palic, B. Pravdic, D. Cuk, D. Vitlianova, K. Katova, T. Velikov, T. Kurteva, T. Gatzov, P. Kamenova, D. Antova, M. Sirakova, V. Krejci, J. Mikolaskova, M. Spinar, J. Krupicka, J. Malek, F. Hegarova, M. Lazarova, M. Monhart, Z. Hassanein, M. Sobhy, M. El Messiry, F. El Shazly, A.H. Elrakshy, Y. Youssef, A. Moneim, A.A. Noamany, M. Reda, A. Dayem, T.K.A. Farag, N. Halawa, S.I. Hamid, M.A. Said, K. Saleh, A. Ebeid, H. Hanna, R. Aziz, R. Louis, O. Enen, M.A. Ibrahim, B.S. Nasr, G. Elbahry, A. Sobhy, H. Ashmawy, M. Gouda, M. Aboleineen, W. Bernard, Y. Luporsi, P. Meneveau, N. Pillot, M. Morel, M. Seronde, M.-F. Schiele, F. Briand, F. Delahaye, F. Damy, T. Eicher, J.-C. de Groote, P. Fertin, M. Lamblin, N. Isnard, R. Lefol, C. Thevenin, S. Hagege, A. Jondeau, G. Logeart, D. Le Marcis, V. Ly, J.-F. Coisne, D. Lequeux, B. Le Moal, V. Mascle, S. Lotton, P. Behar, N. Donal, E. Thebault, C. Ridard, C. Reynaud, A. Basquin, A. Bauer, F. Codjia, R. Galinier, M. Tourikis, P. Stavroula, M. Tousoulis, D. Stefanadis, C. Chrysohoou, C. Kotrogiannis, I. Matzaraki, V. Dimitroula, T. Karavidas, A. Tsitsinakis, G. Kapelios, C. Nanas, J. Kampouri, H. Nana, E. Kaldara, E. Eugenidou, A. Vardas, P. Saloustros, I. Patrianakos, A. Tsaknakis, T. Evangelou, S. Nikoloulis, N. Tziourganou, H. Tsaroucha, A. Papadopoulou, A. Douras, A. Polgar, L. Kosztin, A. Nyolczas, N. Nagy, A.C. Halmosi, R. Elber, J. Alony, I. Shotan, A. Fuhrmann, A.V. Amir, O. Romano, S. Marcon, S. Penco, M. Di Mauro, M. Lemme, E. Carubelli, V. Rovetta, R. Bulgari, M. Quinzani, F. Lombardi, C. Bosi, S. Schiavina, G. Squeri, A. Barbieri, A. Di Tano, G. Pirelli, S. Ferrari, R. Fucili, A. Passero, T. Musio, S. Di Biase, M. Correale, M. Salvemini, G. Brognoli, S. Zanelli, E. Giordano, A. Agostoni, P. Italiano, G. Salvioni, E. Copelli, S. Modena, M.G. Reggianini, L. Valenti, C. Olaru, A. Bandino, S. Deidda, M. Mercuro, G. Dessalvi, C.C. Marino, P.N. Di Ruocco, M.V. Sartori, C. Piccinino, C. Parrinello, G. Licata, G. Torres, D. Giambanco, S. Busalacchi, S. Arrotti, S. Novo, S. Inciardi, R.M. Pieri, P. Chirco, P.R. Galifi, M.A. Teresi, G. Buccheri, D. Minacapelli, A. Veniani, M. Frisinghelli, A. Priori, S.G. Cattaneo, S. Opasich, C. Gualco, A. Pagliaro, M. Mancone, M. Fedele, F. Cinque, A. Vellini, M. Scarfo, I. Romeo, F. Ferraiuolo, F. Sergi, D. Anselmi, M. Melandri, F. Leci, E. Iori, E. Bovolo, V. Pidello, S. Frea, S. Bergerone, S. Botta, M. Canavosio, F.G. Gaita, F. Merlo, M. Cinquetti, M. Sinagra, G. Ramani, F. Fabris, E. Stolfo, D. Artico, J. Miani, D. Fresco, C. Daneluzzi, C. Proclemer, A. Cicoira, M. Zanolla, L. Marchese, G. Torelli, F. Vassanelli, C. Voronina, N. Tamakauskas, V. Smalinskas, V. Karaliute, R. Petraskiene, I. Kazakauskaite, E. Rumbinaite, E. Kavoliuniene, A. Vysniauskas, V. Brazyte-Ramanauskiene, R. Petraskiene, D. Stankala, S. Switala, P. Juszczyk, Z. Sinkiewicz, W. Gilewski, W. Pietrzak, J. Orzel, T. Kasztelowicz, P. Kardaszewicz, P. Lazorko-Piega, M. Gabryel, J. Mosakowska, K. Bellwon, J. Rynkiewicz, A. Raczak, G. Lewicka, E. Dabrowska-Kugacka, A. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Zabojszcz, M. Mirek-Bryniarska, E. Grzegorzko, A. Bury, K. Nessler, J. Zalewski, J. Furman, A. Broncel, M. Poliwczak, A. Bala, A. Zycinski, P. Rudzinska, M. Jankowski, L. Kasprzak, J.D. Michalak, L. Soska, K.W. Drozdz, J. Huziuk, I. Retwinski, A. Flis, P. Weglarz, J. Bodys, A. Grajek, S. Kaluzna-Oleksy, M. Straburzynska-Migaj, E. Dankowski, R. Szymanowska, K. Grabia, J. Szyszka, A. Nowicka, A. Samcik, M. Wolniewicz, L. Baczynska, K. Komorowska, K. Poprawa, I. Komorowska, E. Sajnaga, D. Zolbach, A. Dudzik-Plocica, A. Abdulkarim, A.-F. Lauko-Rachocka, A. Kaminski, L. Kostka, A. Cichy, A. Ruszkowski, P. Splawski, M. Fitas, G. Szymczyk, A. Serwicka, A. Fiega, A. Zysko, D. Krysiak, W. Szabowski, S. Skorek, E. Pruszczyk, P. Bienias, P. Ciurzynski, M. Welnicki, M. Mamcarz, A. Folga, A. Zielinski, T. Rywik, T. Leszek, P. Sobieszczanska-Malek, M. Piotrowska, M. Kozar-Kaminska, K. Komuda, K. Wisniewska, J. Tarnowska, A. Balsam, P. Marchel, M. Opolski, G. Kaplon-Cieslicka, A. Gil, R.J. Mozenska, O. Byczkowska, K. Gil, K. Pawlak, A. Michalek, A. Krzesinski, P. Piotrowicz, K. Uzieblo-Zyczkowska, B. Stanczyk, A. Skrobowski, A. Ponikowski, P. Jankowska, E. Rozentryt, P. Polonski, L. Gadula-Gacek, E. Nowalany-Kozielska, E. Kuczaj, A. Kalarus, Z. Szulik, M. Przybylska, K. Klys, J. Prokop-Lewicka, G. Kleinrok, A. Aguiar, C.T. Ventosa, A. Pereira, S. Faria, R. Chin, J. De Jesus, I. Santos, R. Silva, P. Moreno, N. Queirós, C. Lourenço, C. Pereira, A. Castro, A. Andrade, A. Guimaraes, T.O. Martins, S. Placido, R. Lima, G. Brito, D. Francisco, A.R. Cardiga, R. Proenca, M. Araujo, I. Marques, F. Fonseca, C. Moura, B. Leite, S. Campelo, M. Silva-Cardoso, J. Rodrigues, J. Rangel, I. Martins, E. Correia, A.S. Peres, M. Marta, L. da Silva, G.F. Severino, D. Durao, D. Leao, S. Magalhaes, P. Moreira, I. Cordeiro, A.F. Ferreira, C. Araujo, C. Ferreira, A. Baptista, A. Radoi, M. Bicescu, G. Vinereanu, D. Sinescu, C.-J. Macarie, C. Popescu, R. Daha, I. Dan, G.-A. Stanescu, C. Dan, A. Craiu, E. Nechita, E. Aursulesei, V. Christodorescu, R. Otasevic, P. Seferovic, P.M. Simeunovic, D. Ristic, A.D. Celic, V. Pavlovic-Kleut, M. Lazic, J.S. Stojcevski, B. Pencic, B. Stevanovic, A. Andric, A. Simić, D. Ašanin, M. Iric-Cupic, V. Jovic, M. Davidovic, G. Milanov, S. Mitic, V. Atanaskovic, V. Antic, S. Pavlovic, M. Stanojevic, D. Stoickov, V. Ilic, S. Ilic, M.D. Petrovic, D. Stojsic, S. Kecojevic, S. Dodic, S. Adic, N.C. Cankovic, M. Stojiljkovic, J. Mihajlovic, B. Radin, A. Radovanovic, S. Krotin, M. Klabnik, A. Goncalvesova, E. Pernicky, M. Murin, J. Kovar, F. Kmec, J. Semjanova, H. Strasek, M. Iskra, M.S. Ravnikar, T. Suligoj, N.C. Komel, J. Fras, Z. Jug, B. Glavic, T. Losic, R. Bombek, M. Krajnc, I. Krunic, B. Horvat, S. Kovac, D. Rajtman, D. Cencic, V. Letonja, M. Winkler, R. Valentincic, M. Melihen-Bartolic, C. Bartolic, A. Vrckovnik, M.P. Kladnik, M. Pusnik, C.S. Marolt, A. Klen, J. Drnovsek, B. Leskovar, B. Anguita, M.J.F. Page, J.C.G. Martinez, F.M.S. Andres, J. Bayes-Genis, A. Mirabet, S. Mendez, A. Garcia-Cosio, L. Roig, E. Leon, V. Gonzalez-Costello, J. Muntane, G. Garay, A. Alcade-Martinez, V. Fernandez, S.L. Rivera-Lopez, R. Puga-Martinez, M. Fernandez-Alvarez, M. Serrano-Martinez, J.L. Grille-Cancela, Z. Marzoa-Rivas, R. Blanco-Canosa, P. Paniagua-Martin, M.J. Barge-Caballero, E. Cerdena, I.L. Baldomero, I.F.H. Padron, A.L. Rosillo, S.O. Gonzalez-Gallarza, R.D. Montanes, O.S. Manjavacas, A.M.I. Conde, A.C. Araujo, A. Soria, T. Garcia-Pavia, P. Gomez-Bueno, M. Cobo-Marcos, M. Alonso-Pulpon, L. Cubero, J.S. Sayago, I. Gonzalez-Segovia, A. Briceno, A. Subias, P.E. Hernandez, M.V. Cano, M.J.R. Sanchez, M.A.G. Jimenez, J.F.D. Garrido-Lestache, E.B. Pinilla, J.M.G. de la Villa, B.G. Sahuquillo, A. Marques, R.B. Calvo, F.T. Perez-Martinez, M.T. Gracia-Rodenas, M.R. Garrido-Bravo, I.P. Pastor-Perez, F. Pascual-Figal, D.A. Molina, B.D. Orus, J. Gonzalo, F.E. Bertomeu, V. Valero, R. Martinez-Abellan, R. Quiles, J. Rodrigez-Ortega, J.A. Mateo, I. ElAmrani, A. Fernandez-Vivancos, C. Valero, D.B. Almenar-Bonet, L. Sanchez-Lazaro, I.J. Marques-Sule, E. Facila-Rubio, L. Perez-Silvestre, J. Garcia-Gonzalez, P. Ridocci-Soriano, F. Garcia-Escriva, D. Pellicer-Cabo, A. de la Fuente Galan, L. Diaz, J.L. Platero, A.R. Arias, J.C. Blasco-Peiro, T. Julve, M.S. Sanchez-Insa, E. Aured-Guallar, C. Portoles-Ocampo, A. Melin, M. Hägglund, E. Stenberg, A. Lindahl, I.-M. Asserlund, B. Olsson, L. Dahlström, U. Afzelius, M. Karlström, P. Tengvall, L. Olsson, B. Kalayci, S. Temizhan, A. Cavusoglu, Y. Gencer, E. Yilmaz, M.B. Gunes, H.

Subjects
cardiovascular diseases
Abstract

Aims: We assessed the interplay between hyperkalaemia (HK) and renin–angiotensin–aldosterone system inhibitor (RAASi) use, dose and discontinuation, and their association with all-cause or cardiovascular death in patients with chronic heart failure (HF). We hypothesized that HK-associated increased death may be related to RAASi withdrawal. Methods and results: The ESC-HFA-EORP Heart Failure Long-Term Registry was used. Among 9222 outpatients (HF with reduced ejection fraction: 60.6%, HF with mid-range ejection fraction: 22.9%, HF with preserved ejection fraction: 16.5%) from 31 countries, 16.6% had HK (≥5.0 mmol/L) at baseline. Angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) was used in 88.3%, a mineralocorticoid receptor antagonist (MRA) in 58.7%, or a combination in 53.2%; of these, at ≥50% of target dose in ACEi: 61.8%; ARB: 64.7%; and MRA: 90.3%. At a median follow-up of 12.2 months, there were 789 deaths (8.6%). Both hypokalaemia and HK were independently. associated with higher mortality, and ACEi/ARB prescription at baseline with lower mortality. MRA prescription was not retained in the model. In multivariable analyses, HK at baseline was independently associated with MRA non-prescription at baseline and subsequent discontinuation. When considering subsequent discontinuation of RAASi (instead of baseline use), HK was no longer found associated with all-cause deaths. Importantly, all RAASi (ACEi, ARB, or MRA) discontinuations were strongly associated with mortality. Conclusions: In HF, hyper- and hypokalaemia were associated with mortality. However, when adjusting for RAASi discontinuation, HK was no longer associated with mortality, suggesting that HK may be a risk marker for RAASi discontinuation rather than a risk factor for worse outcomes. © 2020 European Society of Cardiology

Published
2020

179. Multi-ancestry GWAS of the electrocardiographic PR interval identifies 202 loci underlying cardiac conduction

Author

Ntalla, I. (Ioanna), Weng, L.-C., Cartwright, J.H. (James H.), Hall, A.W. (Amelia Weber), Sveinbjornsson, G. (Gardar), Tucker, N.R. (Nathan R.), Choi, S.H. (Seung Hoan), Chaffin, M.D. (Mark D.), Roselli, C. (Carolina), Barnes, M.J. (Michael), Mifsud, B. (Borbala), Warren, H.R. (Helen R.), Hayward, C. (Caroline), Marten, J. (Jonathan), Cranley, J.J. (James J.), Concas, M.P. (Maria Pina), Gasparini, P. (Paolo), Boutin, T. (Thibaud), Kolcic, I. (Ivana), Polasek, O. (Ozren), Rudan, I. (Igor), Araujo, N.M. (Nathalia M.), Lima-Costa, M.F. (Maria Fernanda), Ribeiro, A.L. (Antonio), Souza, R.P. (Renan P.), Tarazona-Santos, E. (Eduardo), Giedraitis, V. (Vilmantas), Ingelsson, E. (Erik), Mahajan, A. (Anubha), Morris, A.P. (Andrew), Del Greco M, F. (Fabiola), Foco, L. (Luisa), Gögele, M. (Martin), Hicks, A.A. (Andrew A.), Cook, J.P. (James P.), Kao, W.H.L. (Wen), Lindgren, C.M. (Cecilia M.), Sundström, J. (Johan), Nelson, C.P. (Christopher P.), Riaz, M.B. (Muhammad B.), Samani, N.J. (Nilesh), Sinagra, G. (Gianfranco), Ulivi, S. (Shelia), Kähönen, M. (Mika), Mishra, P.P. (Pashupati P.), Mononen, N. (Nina), Nikus, K. (Kjell), Caulfield, M. (Mark), Dominiczak, A. (Anna), Padmanabhan, S. (Sandosh), Montasser, M.E. (May E.), O’Connell, J.R. (Jeff R.), Ryan, K. (Kathleen), Shuldiner, A.R. (Alan R.), Aeschbacher, S. (Stefanie), Conen, D. (David), Risch, L. (Lorenz), Thériault, S. (Sébastien), Hutri-Kähönen, N. (Nina), Lehtimäki, T. (Terho), Lyytikäinen, L.-P. (Leo-Pekka), Raitakari, O. (Olli), Barnes, C.L.K. (Catriona L. K.), Campbell, H. (Harry), Joshi, P.K. (Peter), Wilson, J.F. (James), Isaacs, A.J. (Aaron), Kors, J.A. (Jan), Duijn, C.M. (Cornelia) van, Huang, P.L. (Paul L.), Gudnason, V. (Vilmundur), Harris, T.B. (Tamara B.), Launer, L.J. (Lenore), Smith, A.V. (Albert), Bottinger, E.P. (Erwin), Loos, R.J.F. (Ruth), Nadkarni, G. (Girish), Preuss, M. (Michael), Correa, D.D., Mei, H. (Hao), Meitinger, T. (Thomas), Müller-Nurasyid, M. (Martina), Peters, A. (Annette), Waldenberger, M. (Melanie), Mangino, M. (Massimo), Spector, T.D. (Timothy), Rienstra, S.A., van de Vegte, Y.J. (Yordi J.), Harst, P. (Pim) van der, Verweij, N. (Niek), Kääb, S. (Stefan), Schramm, K. (Katharina), Sinner, M.F. (Moritz), Strauch, K. (Konstantin), Cutler, M.J. (Michael J.), Fatkin, D. (Diane), London, B. (Barry), Olesen, M.S. (Morten S.), Roden, D.M. (Dan M.), Benjamin Shoemaker, M. (M.), Gustav Smith, J. (J.), Biggs, M.L. (M.), Bis, J.C. (Joshua), Brody, J.A. (Jennifer A.), Psaty, B.M. (Bruce), Rice, K.M. (Kenneth), Sotoodehnia, N. (Nona), Grandi, A. (Alessandro) de, Fuchsberger, C. (Christian), Penninx, B.W.J.H., Pramstaller, P.P. (Peter Paul), Ford, I. (Ian), Jukema, J.W. (Jan Wouter), Macfarlane, P.W. (Peter W.), Trompet, S. (Stella), Dörr, M. (Marcus), Felix, S.B. (Stephan B.), Völker, U. (Uwe), Weiss, S. (Stefan), Havulinna, A.S. (Aki), Jula, A. (Antti), Sääksjärvi, K. (K.), Salomaa, V. (Veikko), Guo, X. (Xiuqing), Heckbert, S.R. (Susan), Lin, H.J. (Henry J.), Rotter, J.I. (Jerome I.), Taylor, K.D. (Kent), Yao, J. (Jie), Mutsert, R. (Reneé) de, Maan, A.C. (Arie C.), Mook-Kanamori, D.O. (Dennis O.), Noordam, R. (Raymond), Cucca, F. (Francesco), Ding, J. (Jun), Lakatta, E. (Edward), Qian, Y. (Yong), Tarasov, K.V. (Kirill V.), Levy, D. (Daniel), Lin, H. (Honghuang), Newton-Cheh, C. (Christopher), Lunetta, K.L. (Kathryn), Murray, A.D. (Alison D.), Porteous, D.J. (David J.), Smith, B.H. (Blair), Stricker, B.H.Ch. (Bruno), Uitterlinden, A.G. (André), Berg, M.E. (Marten) van den, Haessler, J. (Jeff), Jackson, R.D. (Rebecca), Kooperberg, C. (Charles), Peters, U. (Ulrike), Reiner, A.P. (Alexander P.), Whitsel, E.A. (Eric), Alonso, A. (Alvaro), Arking, D.E. (Dan E.), Boerwinkle, E.A. (Eric), Ehret, G.B. (Georg B.), Soliman, E.Z. (Elsayed Z.), Avery, C.L., Gogarten, S.M., Kerr, K.F. (Kathleen), Laurie, C.C. (Cathy C.), Seyerle, A.A. (Amanda A.), Stilp, A. (Adrienne), Assa, S. (Solmaz), Abdullah Said, M. (M.), Yldau van der Ende, M. (M.), Lambiase, P.D. (Pier), Orini, M. (Michele), Ramirez, J. (Julia), Van Duijvenboden, S. (Stefan), Arnar, D.O. (David O.), Gudbjartsson, D.F. (Daniel), Holm, H. (Hilma), Sulem, P. (Patrick), Thorleifsson, G. (Gudmar), Thorolfsdottir, R.B. (Rosa B.), Thorsteinsdottir, U. (Unnur), Benjamin, E.J. (Emelia J.), Tinker, A. (Andrew), Zwart, J-A. (John-Anker), Ellinor, P.T. (Patrick), Jamshidi, Y. (Yalda), Lubitz, S.A. (Steven), Munroe, P. (Patricia), Ntalla, I. (Ioanna), Weng, L.-C., Cartwright, J.H. (James H.), Hall, A.W. (Amelia Weber), Sveinbjornsson, G. (Gardar), Tucker, N.R. (Nathan R.), Choi, S.H. (Seung Hoan), Chaffin, M.D. (Mark D.), Roselli, C. (Carolina), Barnes, M.J. (Michael), Mifsud, B. (Borbala), Warren, H.R. (Helen R.), Hayward, C. (Caroline), Marten, J. (Jonathan), Cranley, J.J. (James J.), Concas, M.P. (Maria Pina), Gasparini, P. (Paolo), Boutin, T. (Thibaud), Kolcic, I. (Ivana), Polasek, O. (Ozren), Rudan, I. (Igor), Araujo, N.M. (Nathalia M.), Lima-Costa, M.F. (Maria Fernanda), Ribeiro, A.L. (Antonio), Souza, R.P. (Renan P.), Tarazona-Santos, E. (Eduardo), Giedraitis, V. (Vilmantas), Ingelsson, E. (Erik), Mahajan, A. (Anubha), Morris, A.P. (Andrew), Del Greco M, F. (Fabiola), Foco, L. (Luisa), Gögele, M. (Martin), Hicks, A.A. (Andrew A.), Cook, J.P. (James P.), Kao, W.H.L. (Wen), Lindgren, C.M. (Cecilia M.), Sundström, J. (Johan), Nelson, C.P. (Christopher P.), Riaz, M.B. (Muhammad B.), Samani, N.J. (Nilesh), Sinagra, G. (Gianfranco), Ulivi, S. (Shelia), Kähönen, M. (Mika), Mishra, P.P. (Pashupati P.), Mononen, N. (Nina), Nikus, K. (Kjell), Caulfield, M. (Mark), Dominiczak, A. (Anna), Padmanabhan, S. (Sandosh), Montasser, M.E. (May E.), O’Connell, J.R. (Jeff R.), Ryan, K. (Kathleen), Shuldiner, A.R. (Alan R.), Aeschbacher, S. (Stefanie), Conen, D. (David), Risch, L. (Lorenz), Thériault, S. (Sébastien), Hutri-Kähönen, N. (Nina), Lehtimäki, T. (Terho), Lyytikäinen, L.-P. (Leo-Pekka), Raitakari, O. (Olli), Barnes, C.L.K. (Catriona L. K.), Campbell, H. (Harry), Joshi, P.K. (Peter), Wilson, J.F. (James), Isaacs, A.J. (Aaron), Kors, J.A. (Jan), Duijn, C.M. (Cornelia) van, Huang, P.L. (Paul L.), Gudnason, V. (Vilmundur), Harris, T.B. (Tamara B.), Launer, L.J. (Lenore), Smith, A.V. (Albert), Bottinger, E.P. (Erwin), Loos, R.J.F. (Ruth), Nadkarni, G. (Girish), Preuss, M. (Michael), Correa, D.D., Mei, H. (Hao), Meitinger, T. (Thomas), Müller-Nurasyid, M. (Martina), Peters, A. (Annette), Waldenberger, M. (Melanie), Mangino, M. (Massimo), Spector, T.D. (Timothy), Rienstra, S.A., van de Vegte, Y.J. (Yordi J.), Harst, P. (Pim) van der, Verweij, N. (Niek), Kääb, S. (Stefan), Schramm, K. (Katharina), Sinner, M.F. (Moritz), Strauch, K. (Konstantin), Cutler, M.J. (Michael J.), Fatkin, D. (Diane), London, B. (Barry), Olesen, M.S. (Morten S.), Roden, D.M. (Dan M.), Benjamin Shoemaker, M. (M.), Gustav Smith, J. (J.), Biggs, M.L. (M.), Bis, J.C. (Joshua), Brody, J.A. (Jennifer A.), Psaty, B.M. (Bruce), Rice, K.M. (Kenneth), Sotoodehnia, N. (Nona), Grandi, A. (Alessandro) de, Fuchsberger, C. (Christian), Penninx, B.W.J.H., Pramstaller, P.P. (Peter Paul), Ford, I. (Ian), Jukema, J.W. (Jan Wouter), Macfarlane, P.W. (Peter W.), Trompet, S. (Stella), Dörr, M. (Marcus), Felix, S.B. (Stephan B.), Völker, U. (Uwe), Weiss, S. (Stefan), Havulinna, A.S. (Aki), Jula, A. (Antti), Sääksjärvi, K. (K.), Salomaa, V. (Veikko), Guo, X. (Xiuqing), Heckbert, S.R. (Susan), Lin, H.J. (Henry J.), Rotter, J.I. (Jerome I.), Taylor, K.D. (Kent), Yao, J. (Jie), Mutsert, R. (Reneé) de, Maan, A.C. (Arie C.), Mook-Kanamori, D.O. (Dennis O.), Noordam, R. (Raymond), Cucca, F. (Francesco), Ding, J. (Jun), Lakatta, E. (Edward), Qian, Y. (Yong), Tarasov, K.V. (Kirill V.), Levy, D. (Daniel), Lin, H. (Honghuang), Newton-Cheh, C. (Christopher), Lunetta, K.L. (Kathryn), Murray, A.D. (Alison D.), Porteous, D.J. (David J.), Smith, B.H. (Blair), Stricker, B.H.Ch. (Bruno), Uitterlinden, A.G. (André), Berg, M.E. (Marten) van den, Haessler, J. (Jeff), Jackson, R.D. (Rebecca), Kooperberg, C. (Charles), Peters, U. (Ulrike), Reiner, A.P. (Alexander P.), Whitsel, E.A. (Eric), Alonso, A. (Alvaro), Arking, D.E. (Dan E.), Boerwinkle, E.A. (Eric), Ehret, G.B. (Georg B.), Soliman, E.Z. (Elsayed Z.), Avery, C.L., Gogarten, S.M., Kerr, K.F. (Kathleen), Laurie, C.C. (Cathy C.), Seyerle, A.A. (Amanda A.), Stilp, A. (Adrienne), Assa, S. (Solmaz), Abdullah Said, M. (M.), Yldau van der Ende, M. (M.), Lambiase, P.D. (Pier), Orini, M. (Michele), Ramirez, J. (Julia), Van Duijvenboden, S. (Stefan), Arnar, D.O. (David O.), Gudbjartsson, D.F. (Daniel), Holm, H. (Hilma), Sulem, P. (Patrick), Thorleifsson, G. (Gudmar), Thorolfsdottir, R.B. (Rosa B.), Thorsteinsdottir, U. (Unnur), Benjamin, E.J. (Emelia J.), Tinker, A. (Andrew), Zwart, J-A. (John-Anker), Ellinor, P.T. (Patrick), Jamshidi, Y. (Yalda), Lubitz, S.A. (Steven), and Munroe, P. (Patricia)

Abstract

The electrocardiographic PR interval reflects atrioventricular conduction, and is associated with conduction abnormalities, pacemaker implantation, atrial fibrillation (AF), and cardiovascular mortality. Here we report a multi-ancestry (N = 293,051) genome-wide association meta-analysis for the PR interval, discovering 202 loci of which 141 have not previously been reported. Variants at identified loci increase the percentage of heritability explained, from 33.5% to 62.6%. We observe enrichment for cardiac muscle developmental/contractile and cytoskeletal genes, highlighting key regulation processes for atrioventricular conduction. Additionally, 8 loci not previously reported harbor genes underlying inherited arrhythmic syndromes and/or cardiomyopathies suggesting a role for these genes in cardiovascular pathology in the general population. We show that polygenic predisposition to PR interval duration is an endophenotype for cardiovascular disease, including distal conduc

Published
2020
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180. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

Author

De Rosa, Miriam Stefania, Spaccarotella, C., Basso, C., Calabro, M. P., Curcio, A., Filardi, P. P., Mancone, M., Mercuro, G., Muscoli, S., Nodari, S., Pedrinelli, R., Sinagra, G., Indolfi, C., Angelini, F., Barilla, F., Bartorelli, A., Benedetto, F., Bernabo, P., Bolognese, L., Briani, M., Cacciavillani, L., Calabrese, Anna Chiara, Calabro, P., Caliendo, L., Calo, L., Casella, Gioietta, Casu, G., Cavallini, C., Ciampi, Q., Ciccone, M., Comito, M., Corrada, E., Crea, Filippo, D'Andrea, A., D'Urbano, M., De Caterina, R., De Ferrari, G., De Ponti, R., Della Mattia, A., Di Mario, Clara, Donnazzan, L., Esposito, Gianfranco, Fedele, F., Ferraro, A., Galasso, G., Galie, N., Gnecchi, M., Golino, P., Golia, B., Guarini, P., Leonardi, S., Locuratolo, N., Luzza, F., Manganiello, V., Francesca Marchetti, M., Marenzi, Giancarlo, Margonato, A., Meloni, L., Metra, M., Milo, Anna Maria, Mongiardo, A., Monzo, L., Morisco, C., Novo, G., Pancaldi, S., Parollo, M., Paterno, G., Patti, G., Priori, S., Ravera, A., Giuseppe Rebuzzi, A., Rossi, M., Scherillo, M., Semprini, F., Senni, M., Sibilio, G., Siviglia, M., Tamburino, C., Tortorici, G., Versace, F., Villari, B., Volpe, M., De Rosa S. (ORCID:0000-0002-8869-155X), Calabrese A., Casella G., Crea F. (ORCID:0000-0001-9404-8846), DI Mario C., Esposito G., Marenzi G., Milo M., De Rosa, Miriam Stefania, Spaccarotella, C., Basso, C., Calabro, M. P., Curcio, A., Filardi, P. P., Mancone, M., Mercuro, G., Muscoli, S., Nodari, S., Pedrinelli, R., Sinagra, G., Indolfi, C., Angelini, F., Barilla, F., Bartorelli, A., Benedetto, F., Bernabo, P., Bolognese, L., Briani, M., Cacciavillani, L., Calabrese, Anna Chiara, Calabro, P., Caliendo, L., Calo, L., Casella, Gioietta, Casu, G., Cavallini, C., Ciampi, Q., Ciccone, M., Comito, M., Corrada, E., Crea, Filippo, D'Andrea, A., D'Urbano, M., De Caterina, R., De Ferrari, G., De Ponti, R., Della Mattia, A., Di Mario, Clara, Donnazzan, L., Esposito, Gianfranco, Fedele, F., Ferraro, A., Galasso, G., Galie, N., Gnecchi, M., Golino, P., Golia, B., Guarini, P., Leonardi, S., Locuratolo, N., Luzza, F., Manganiello, V., Francesca Marchetti, M., Marenzi, Giancarlo, Margonato, A., Meloni, L., Metra, M., Milo, Anna Maria, Mongiardo, A., Monzo, L., Morisco, C., Novo, G., Pancaldi, S., Parollo, M., Paterno, G., Patti, G., Priori, S., Ravera, A., Giuseppe Rebuzzi, A., Rossi, M., Scherillo, M., Semprini, F., Senni, M., Sibilio, G., Siviglia, M., Tamburino, C., Tortorici, G., Versace, F., Villari, B., Volpe, M., De Rosa S. (ORCID:0000-0002-8869-155X), Calabrese A., Casella G., Crea F. (ORCID:0000-0001-9404-8846), DI Mario C., Esposito G., Marenzi G., and Milo M.

Abstract

Aims: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). Methods and Results: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). Conclusion: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.

Published
2020

184. Impact on clinical outcomes of right ventricular response to percutaneous correction of secondary mitral regurgitation

Author

Caiffa, T, primary, Castrichini, M, additional, Biagini, E, additional, De Luca, A, additional, Compagnone, M, additional, Berardini, A, additional, Merlo, M, additional, Fabris, E, additional, Vitrella, G, additional, Pinamonti, B, additional, Korcova, R, additional, Barbati, G, additional, Saia, F, additional, Stolfo, D, additional, and Sinagra, G, additional

Published
2021
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200. The late-onset dilated cardiomyopathy

Author

Cannata, A, primary, Merlo, M, additional, Manca, P, additional, Dal Ferro, M, additional, Paldino, A, additional, Artico, J, additional, Gentile, P, additional, Jirikowic, J, additional, Todd, E, additional, Salcedo, E, additional, Graw, S, additional, McDonagh, T, additional, Taylor, M, additional, Mestroni, L, additional, and Sinagra, G, additional

Published
2020
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