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1. Effects on the incidence of cardiovascular events of the addition of pioglitazone versus sulfonylureas in patients with type 2 diabetes inadequately controlled with metformin (TOSCA.IT): a randomised, multicentre trial

Author

Vaccaro, Olga, Masulli, Maria, Nicolucci, Antonio, Maggioni, Aldo Pietro, Sesti, Giorgio, Mocarelli, Paolo, Lucisano, Giuseppe, Sacco, Michele, Signorini, Stefano, Cappellini, Fabrizio, Riccardi, Gabriele, Boemi, Massimo, D'Angelo, Federica, Giansanti, Roberto, Tanase, Laura, Lanari, Luigi, Testa, Ivano, Ricci, Lucia, Pancani, Francesca, Ranchelli, Anna, Vagheggi, Paolo, Scatona, Alessia, Fontana, Lucia, Giorgino, Francesco, Laviola, Luigi, Tarantino, Lucia, Ippolito, Claudia, Gigantelli, Vittoria, Manicone, Mariangela, Conte, Eleonora, Trevisan, Roberto, Scaranna, Cristiana, Rota, Rossella, Corsi, Anna, Dodesini, Alessandro R., Reggiani, Giulio Marchesini, Montesi, Luca, Mazzella, Natalia, Forlani, Gabriele, Caselli, Chiara, Di Luzio, Raffaella, Mazzotti, Arianna, Aiello, Antimo, Barrea, Angelina, Musto, Antonio, D'Amico, Fiorentina, Squatrito, Sebastiano, Sinagra, Tiziana, Longhitano, Sara, Trowpea, Vanessa, Sparti, Maria, Italia, Salvatore, Lisi, Enrico, Grasso, Giuseppe, Pezzino, Vincenzo, Insalaco, Federica, Gnasso, Agostino, Carallo, Claudio, Scicchitano, Caterina, De Franceschi, Maria Serena, Santini, Costanza, Calbucci, Giovanni, Ripani, Raffaella, Corsi, Laura, Cuneo, Giacomo, Corsi, Simona, Giorda, Carlo B., Romeo, Francesco, Lesina, Annalisa, Comoglio, Marco, Bonetto, Caterina, Robusto, Anna, Nada, Elisa, Asprino, Vincenzo, Cetraro, Rosa, Impieri, Michelina, Lucchese, Giuseppe, Donnarumma, Giovanna, Tizio, Biagio, Clemente, Gennaro, Lenza, Lazzaro, Paraggio, Pia, Tomasi, Franco, Zamboni, Chiara, Dozio, Nicoletta, Scalambra, Egle, Mannucci, Edoardo, Lamanna, Caterina, Cignarelli, Mauro, Macchia, Olga La, Fariello, Stefania, Sorrentino, Maria Rosaria, Franzetti, Ivano, Radin, Raffaella, Cordera, Renzo, Annunziata, Francesca, Bonabello, Laura Affinito, Durante, Arianna, Dolcino, Mara, Gallo, Fiorenza, Mazzucchelli, Chiara, Aleo, Anna, Melga, Pierluigi, Briatore, Lucia, Maggi, Davide, Storace, Daniela, Cecoli, Francesca, Antenucci, Daniela, D'Ugo, Ercole, Pupillo, Mario, Baldassarre, Maria Pompea Antonia, Salvati, Filippo, Minnucci, Anita, De Luca, Angelo, Zugaro, Antonella, Santarelli, Livia, Bosco, Angela, Petrella, Vittorio, La Verghetta, Grazia Giovanna, Iannarelli, Rossella, De Gregorio, Antonella, D'Andrea, Settimio, Giuliani, Anna Elisa, Polidoro, w Lorella, Sperandio, Alessandra, Sciarretta, Filomena, Pezzella, Alfonso, Buzzetti, Raffaella, Carlone, Angela, Potenziani, Stella, Venditti, Chiara, Foffi, Chiara, Carbone, Salvatore, Cipolloni, Laura, Moretti, Chiara, Leto, Gaetano, Serra, Rosalia, Petrachi, Francesca, Romano, Isabella, Di Cianni, Graziano, Lacaria, Emilia, Russo, Laura, Goretti, Chiara, Sannino, Claudia, Gregori, Giovanna, Dolci, Maria, Bruselli, Laura, Mori, Mary L., Baccetti, Fabio, Del Freo, Maria, Di Benedetto, Antonino, Cucinotta, Domenico, Giunta, Loretta, Ruffo, Maria Concetta, Cannizzaro, Desiree, Pintaudi, Basilio, Perrone, Giovanni, Pata, Pietro, Ragonese, Francesco, Lettina, Gabriele, Mancuso, Teresa, Coppolino, Aldo, Piatti, Pier Marco, Monti, Lucilla, Stuccillo, Michela, Lucotti, Pietro, Setola, Manuela, Crippa, Giulia Valentina, Loi, Cinzia, Oldani, Matteo, Bottalico, Maria Luisa, Pellegata, Beatrice, Bonomo, Matteo, Menicatti, Laura Silvia Maria, Resi, Veronica, Bertuzzi, Federico, Disoteo, Eugenia Olga, Pizzi, Gianluigi, Rivellese, Angela Albarosa, Annuzzi, Giovanni, Capaldo, Brunella, Nappo, Rossella, Auciello, Stefania Michela, Turco, Anna Amelia, Costagliola, Lucia, Iovine, Ciro, Corte, Giuseppina Della, Vallefuoco, Pasquale, Nappi, Francesca, Vitale, Marilena, Cocozza, Sara, Ciano, Ornella, Massimino, Elena, Garofalo, Nadia, Avogaro, Angelo, Vedovato, Monica, Guarneri, Gabriella, Lapolla, Annunziata, Fedele, Domenico, Sartore, Giovanni, Chilelli, Nino Cristiano, Burlina, Silvia, Bonsembiante, Barbara, Giordano, Carla, Galluzzo, Aldo, Torregrossa, Vittoria, Dall'Aglio, Elisabetta, Mancastroppa, Giovanni, Arsenio, Leone, Cioni, Federico, Caronna, Silvana, Papi, Matteo, Babini, Massimiliano, Perriello, Gabriele, Santeusanio, Fausto, Calagreti, Gioia, Timi, Alessia, Tantucci, Alice, Marino, Cecilia, Consoli, Agostino, Ginestra, Federica, Di Biagio, Rosamaria, Taraborelli, Merilda, Del Prato, Stefano, Miccoli, Roberto, Bianchi, Cristina, Garofolo, Monia, Politi, Konstantina Savina, Penno, Giuseppe, Zavaroni, Donatella, Livraga, Stefania, Calzoni, Fabio, Mancastroppa, Giovanni Luigi Francesco, Anichini, Roberto, Corsini, Elisa, Tedeschi, Anna, Gaglianò, Maria Sole, Ippolito, Giulio, Salutini, Elisabetta, Citro, Giuseppe, Cervellino, Francesco, Natale, Maria, Salvatore, Vita, Zampino, Armando, Sinisi, Rosa, Calabrese, Maria, Arcangeli, Adolfo, Zogheri, Alessia, Guizzotti, Sandra, Longo, Rossella, Di Bartolo, Paolo, Pellicano, Francesca, Scolozzi, Patrizia, Termine, Simona, Luberto, Alessandra, Ballardini, Giorgio, Babini, Anna Carla, Trojani, Cristina, Mazzuca, Paolo, Bruglia, Matteo, Ciamei, Monica, Genghini, Silvia, Zannoni, Chiara, Pugliese, Giuseppe, Vitale, Martina, Rangel, Graziela, Salvi, Laura, Zappaterreno, Alessandra, Cordone, Samantha, Simonelli, Paola, Meggiorini, Marilla, Frasheri, Aurora, Di Pippo, Clelia, Maglio, Cristina, Mazzitelli, Giulia, Lauro, Davide, Rinaldi, Maria Elena, Galli, Angelica, Romano, Maria, D'Angelo, Paola, Leotta, Sergio, Suraci, Concetta, De Cosmo, Salvatore, Bacci, Simonetta, Palena, Antonio Pio, Genovese, Stefano, Mancino, Monica, Rondinelli, Maurizio, Capone, Filippo, Calabretto, Elisabetta, Bulgheroni, Monica, Bucciarelli, Loredana, Dotta, Francesco, Ceccarelli, Elena, Fondelli, Cecilia, Santacroce, Clorinda, Guarino, Elisa, Nigi, Laura, Lalli, Carlo, Di Vizia, Giovanni, Scarponi, Maura, Montani, Valeria, Di Bernardino, Paolo, Romagni, Paola, Dolcetti, Katia, Cannarsa, Emanuela, Forte, Elisa, Tamburo, Lucilla, Fornengo, Paolo, Perin, Paolo Cavallo, Prinzis, Tania, Gruden, Gabriella, Bruno, Graziella, Zucco, Chiara, Perotta, Massimo, Marena, Saverio, Monsignore, Simona, Panero, Francesco, Ponzi, Fulvia, Bossi, Antonio Carlo, Carpinteri, Rita, Casagrande, Maria Linda, Coletti, Maria Francesca, Balini, Annalisa, Filopanti, Marcello, Madaschi, Sara, Pulcina, Anna, Grimaldi, Franco, Tonutti, Laura, Venturini, Giorgio, Agus, Sandra, Pagnutti, Stefania, Guidotti, Francesca, Cavarape, Alessandro, Bonora, Enzo, Cigolini, Massimo, Pichiri, Isabella, Brangani, Corinna, Fainelli, Giulia, Tomasetto, Elena, Zoppini, Giacomo, Galletti, Anna, Perrone, Dominica, Capra, Claudio, Bianchini, Francesca, Ceseri, Martina, Di Nardo, Barbara, Sasso, Elisa, Bartolomei, Barbara, Suliman, Irina, Fabbri, Gianna, Romano, Geremia, Maturo, Nicola, Nunziata, Giuseppe, Capobianco, Giuseppe, De Simone, Giuseppina, Villa, Valeria, Rota, Giuseppe, Pentangelo, Carmine, Carbonara, Ornella, Caiazzo, Gennaro, Cutolo, Michele, Sorrentino, Tommasina, Mastrilli, Valeria, Amelia, Umberto, Masi, Stefano, Corigliano, Gerardo, Gaeta, Iole, Armentano, Vincenzo, Calatola, Pasqualino, Capuano, Gelsomina, Angiulli, Bruno, Auletta, Pasquale, Petraroli, Ettore, Iodice, Cinzia E., Agrusta, Mariano, Maggioni, Aldo P, Rivellese, Angela A, Giorda, Carlo B, La Macchia, Olga, Bossi, Antonio C, and di Bartolo, Paolo

Published
2017
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4. IDegLira for the Real-World Treatment of Type 2 Diabetes in Italy: Protocol and Interim Results from the REX Observational Study.

Author

Fadini, Gian Paolo, Buzzetti, Raffaella, Fittipaldi, Maria Rosa, D'Incau, Ferruccio, Da Porto, Andrea, Girelli, Angela, Simoni, Lucia, Lastoria, Giusi, Consoli, Agostino, REX study group, Iazzetta, Nicolangelo, Di Giovanni, Giuseppe, Carbonara, Ornella, Aragiusto, Concetta, Carleo, Diego, Da Rosa, Nicoletta, Martedì, Emilia, Landolfi, Luigi, Marracino, Marta, and Tortora, Anna

Subjects
TYPE 2 diabetes, DIABETIC nephropathies, GLYCEMIC control, INSULIN therapy, SCIENTIFIC observation, WEIGHT gain
Abstract

Introduction: IDegLira was shown to maintain glycemic control while reducing risk of hypoglycemia and body weight gain. The REX study was designed to generate real-world evidence on the use of IDegLira in Italian clinical practice in two different subgroups of patients, those switching to IDegLira from a basal insulin-supported oral therapy (BOT group) and those from a basal plus bolus insulin regimen (BB group). Methods: Adult patients with T2D diagnosed for at least 12 months and having started IDegLira 2–3 months prior to enrolment, coming from a BOT or BB regimen, were enrolled in this multicenter observational prospective cohort study conducted in 28 Italian centers. This paper presents the methodological framework of the REX study and provides the interim analysis results describing the patients' baseline characteristics and the clinical reasons for IDegLira treatment initiation. Results: Of the 360 patients enrolled in the REX study, 331 were considered eligible for this interim analysis, 76.4% in the BOT and 23.6% in the BB group. Mean (SD) HbA1c was 8.5% (1.4) in the BOT and 8.2% (1.7) in the BB group. The most common T2D complications were diabetic macroangiopathy and diabetic nephropathy in both groups. The median (interquartile range) insulin daily dose before IDegLira was 15.0 (10.0–20.0) units in the BOT group and 42 (30.0–52.0) in the BB group. Oral antidiabetics were taken by 98% and 51.3% of patients, respectively. The main reason for switching to IDegLira was the inadequate glycemic control in the BOT group (86% of patients), and the intent to simplify the treatment in the BB group (66.7%). Conclusions: IdegLira is initiated after BOT in inadequately controlled patients to improve glycemic control, whereas in BB patients it is used to simplify the therapeutic regimen. Final results of the REX study will shed light on patients' outcomes after IdegLira treatment under routine clinical care. [ABSTRACT FROM AUTHOR]

Published
2022
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5. Glucose metabolism and coronary heart disease in patients with normal glucose tolerance

Author

Sasso, Ferdinando C., Carbonara, Ornella, Nasti, Rodolfo, Campana, Biagio, Torella, Roberto, Cozzolino, Domenico, Marfella, Raffaele, Torella, Michele, and Nappi, Giannantonio

Subjects
Coronary heart disease -- Care and treatment, Coronary heart disease -- Research, Glucose metabolism -- Research, Glucose metabolism -- Health aspects
Abstract

The glucose metabolism in patients with normal glucose tolerance (NGT) and coronary heart disease (CHD) is investigated. The results conclude that for patients with NGT and different extents of atherosclerotic disease, postload glycemia and HbA level are not equally distributed but are significantly higher in those with more severe diseases.

Published
2004

6. Increased Activity of the Ubiquitin-Proteasome System in Patients With Symptomatic Carotid Disease Is Associated With Enhanced Inflammation and May Destabilize the Atherosclerotic Plaque: Effects of Rosiglitazone Treatment

Author

Marfella, Raffaele, D’Amico, Michele, Di Filippo, Clara, Baldi, Alfonso, Siniscalchi, Mario, Sasso, Ferndinando Carlo, Portoghese, Michele, Carbonara, Ornella, Crescenzi, Basilio, Sangiuolo, Paolo, Nicoletti, Giovanni Francesco, Rossiello, Raffaele, Ferraraccio, Franca, Cacciapuoti, Federico, Verza, Mario, Coppola, Ludovico, Rossi, Francesco, and Paolisso, Giuseppe

Published
2006
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7. Peri-Procedural Tight Glycemic Control during Early Percutaneous Coronary Intervention Is Associated with a Lower Rate of In-Stent Restenosis in Patients with Acute ST-Elevation Myocardial Infarction

Author

Marfella, Raffaele, Sasso, Ferdinando Carlo, Siniscalchi, Mario, Paolisso, Pasquale, Rizzo, Maria Rosaria, Ferraro, Fausto, Stabile, Eugenio, Sorropago, Giovanni, Calabrò, Paolo, Carbonara, Ornella, Cinquegrana, Giorgio, Piscione, Federico, Ruocco, Antonio, DʼAndrea, Davide, Rapacciuolo, Antonio, Petronella, Pasquale, Bresciani, Alessandro, Rubino, Paolo, Mauro, Ciro, and Paolisso, Giuseppe

Published
2012

10. The Ubiquitin-Proteasome System and Inflammatory Activity in Diabetic Atherosclerotic Plaques: Effects of Rosiglitazone Treatment

Author

Marfella, Raffaele, DʼAmico, Michele, Esposito, Katherine, Baldi, Alfonso, Di Filippo, Clara, Siniscalchi, Mario, Sasso, Ferndinando Carlo, Portoghese, Michele, Cirillo, Francesca, Cacciapuoti, Federico, Carbonara, Ornella, Crescenzi, Basilio, Baldi, Feliciano, Ceriello, Antonio, Nicoletti, Giovanni Francesco, DʼAndrea, Francesco, Verza, Mario, Coppola, Ludovico, Rossi, Francesco, and Giugliano, Dario

Published
2006

17. Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy:a multicenter prospective 8 years follow up study

Author

Sasso, Ferdinando Carlo, Lascar, Nadia, Ascione, Antonella, Carbonara, Ornella, de Nicola, Luca, Minutolo, Roberto, Salvatore, Teresa, Rizzo, Maria Rosaria, Cirillo, Plinio, Paolisso, Giuseppe, Marfella, Raffaele, and on behalf of NID-2 study group

Subjects
cardiovascular diseases
Abstract

Background: Although numerous studies and metanalysis have shown the beneficial effect of statin therapy in CVD secondary prevention, there is still controversy such the use of statins for primary CVD prevention in patients with DM. The purpose of this study was to evaluate the occurrence of total major adverse cardio-vascular events (MACE) in a cohort of patients with type 2 diabetes complicated by nephropathy treated with statins, in order to verify real life effect of statin on CVD primary prevention. Methods: We conducted an observational prospective multicenter study on 564 patients with type 2 diabetic nephropathy free of cardiovascular disease attending 21 national outpatient diabetes clinics and followed them up for 8 years. 169 of them were treated with statins (group A) while 395 were not on statins (group B). Results: Notably, none of the patients was treated with a high-intensity statin therapy according to last ADA position statement. Total MACE occurred in 32 patients from group A and in 68 patients from group B. Fatal MACE occurred in 13 patients from group A and in 30 from group B; nonfatal MACE occurred in 19 patients from group A and in 38 patients from group B. The analysis of the Kaplan-Meier survival curves showed a not statistically significant difference in the incidence of total (p 0.758), fatal (p 0.474) and nonfatal (p 0.812) MACE between the two groups. HbA1c only showed a significant difference in the incidence of MACE between the two groups (HR 1.201, CI 1.041-1.387, p 0.012). Conclusions: These findings suggest that, in a real clinical setting, moderate-intensity statin treatment is ineffective in cardiovascular primary prevention for patients with diabetic nephropathy.

Published
2016

18. Lack of effect of aspirin in primary CV prevention in type 2 diabetic patients with nephropathy: results from 8 years follow-up of NID-2 study

Author

Sasso, Ferdinando Carlo, primary, Marfella, Raffaele, additional, Pagano, Antonio, additional, Porta, Giovanni, additional, Signoriello, Giuseppe, additional, Lascar, Nadia, additional, Minutolo, Roberto, additional, Carbonara, Ornella, additional, Persico, Marcello, additional, Piscione, Federico, additional, De Nicola, Luca, additional, Torella, Roberto, additional, and Paolisso, Giuseppe, additional

Published
2014
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19. Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study.

Author

Sasso, Ferdinando Carlo, Lascar, Nadia, Ascione, Antonella, Carbonara, Ornella, De Nicola, Luca, Minutolo, Roberto, Salvatore, Teresa, Rizzo, Maria Rosaria, Cirillo, Plinio, Paolisso, Giuseppe, and Marfella, Raffaele

Subjects
STATINS (Cardiovascular agents), CARDIOVASCULAR disease prevention, PEOPLE with diabetes, KIDNEY diseases, DIABETIC nephropathies, DRUG side effects
Abstract

Background: Although numerous studies and metanalysis have shown the beneficial effect of statin therapy in CVD secondary prevention, there is still controversy such the use of statins for primary CVD prevention in patients with DM. The purpose of this study was to evaluate the occurrence of total major adverse cardio-vascular events (MACE) in a cohort of patients with type 2 diabetes complicated by nephropathy treated with statins, in order to verify real life effect of statin on CVD primary prevention. Methods: We conducted an observational prospective multicenter study on 564 patients with type 2 diabetic nephropathy free of cardiovascular disease attending 21 national outpatient diabetes clinics and followed them up for 8 years. 169 of them were treated with statins (group A) while 395 were not on statins (group B). Results: Notably, none of the patients was treated with a high-intensity statin therapy according to last ADA position statement. Total MACE occurred in 32 patients from group A and in 68 patients from group B. Fatal MACE occurred in 13 patients from group A and in 30 from group B; nonfatal MACE occurred in 19 patients from group A and in 38 patients from group B. The analysis of the Kaplan-Meier survival curves showed a not statistically significant difference in the incidence of total (p 0.758), fatal (p 0.474) and nonfatal (p 0.812) MACE between the two groups. HbA1c only showed a significant difference in the incidence of MACE between the two groups (HR 1.201, CI 1.041-1.387, p 0.012). Conclusions: These findings suggest that, in a real clinical setting, moderate-intensity statin treatment is ineffective in cardiovascular primary prevention for patients with diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Published
2016
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20. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

Author

Marfella, Raffaele, primary, Sasso, Ferdinando Carlo, additional, Rizzo, Maria Rosaria, additional, Paolisso, Pasquale, additional, Barbieri, Michelangela, additional, Padovano, Vincenzo, additional, Carbonara, Ornella, additional, Gualdiero, Pasquale, additional, Petronella, Pasquale, additional, Ferraraccio, Franca, additional, Petrella, Antonello, additional, Canonico, Raffaele, additional, Campitiello, Ferdinando, additional, Della Corte, Angela, additional, Paolisso, Giuseppe, additional, and Canonico, Silvestro, additional

Published
2012
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21. Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk

Author

Nasti, Rodolfo, primary, Carbonara, Ornella, additional, di Santo Stefano, Maria L Mangoni, additional, Auriemma, Roberta, additional, Esposito, Sabato, additional, Picardi, Giuseppe, additional, Lascar, Nadia, additional, Pagano, Antonio, additional, Ruggiero, Roberto, additional, Torella, Roberto, additional, and Sasso, Ferdinando C, additional

Published
2011
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25. Management of cardiovascular risk factors in advanced type 2 diabetic nephropathy: a comparative analysis in nephrology, diabetology and primary care settings

Author

Minutolo, Roberto, primary, Sasso, Ferdinando C, additional, Chiodini, Paolo, additional, Cianciaruso, Bruno, additional, Carbonara, Ornella, additional, Zamboli, Pasquale, additional, Tirino, Giuseppina, additional, Pota, Andrea, additional, Torella, Roberto, additional, Conte, Giuseppe, additional, and Nicola, Luca De, additional

Published
2006
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26. Increased Vascular Endothelial Growth Factor Expression But Impaired Vascular Endothelial Growth Factor Receptor Signaling in the Myocardium of Type 2 Diabetic Patients With Chronic Coronary Heart Disease

Author

Sasso, Ferdinando Carlo, primary, Torella, Daniele, additional, Carbonara, Ornella, additional, Ellison, Georgina M., additional, Torella, Michele, additional, Scardone, Michelangelo, additional, Marra, Claudio, additional, Nasti, Rodolfo, additional, Marfella, Raffaele, additional, Cozzolino, Domenico, additional, Indolfi, Ciro, additional, Cotrufo, Maurizio, additional, Torella, Roberto, additional, and Salvatore, Teresa, additional

Published
2005
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27. Effects of insulin-glucose infusion on left ventricular function at rest and during dynamic exercise in healthy subjects and noninsulin dependent diabetic patients

Author

Sasso, Ferdinando Carlo, primary, Carbonara, Ornella, additional, Cozzolino, Domenico, additional, Rambaldi, Pierfrancesco, additional, Mansi, Luigi, additional, Torella, Daniele, additional, Gentile, Sandro, additional, Turco, Salvatore, additional, Torella, Roberto, additional, and Salvatore, Teresa, additional

Published
2000
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28. Coronary artery disease is detectable by multi-slice computed tomography in most asymptomatic type 2 diabetic patients at high cardiovascular risk.

Author

Nasti, Rodolfo, Carbonara, Ornella, di Santo Stefano, Maria L Mangoni, Auriemma, Roberta, Esposito, Sabato, Picardi, Giuseppe, Lascar, Nadia, Pagano, Antonio, Ruggiero, Roberto, Torella, Roberto, and Sasso, Ferdinando C

Abstract

Objective: Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography.Methods: In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥50% lumen narrowing), patients were sent to conventional coronary angiography (CCA).Results: Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥75% and were submitted to the revascularisation procedure.Conclusion: MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy. [ABSTRACT FROM PUBLISHER]

Published
2012
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29. Dipeptidyl Peptidase 4 Inhibition May Facilitate Healing of Chronic Foot Ulcers in Patients with Type 2 Diabetes

Author

Marfella, Raffaele, Carlo Sasso, Ferdinando, Rosaria Rizzo, Maria, Paolisso, Pasquale, Barbieri, Michelangela, Padovano, Vincenzo, Carbonara, Ornella, Gualdiero, Pasquale, Petronella, Pasquale, Ferraraccio, Franca, Petrella, Antonello, Canonico, Raffaele, Campitiello, Ferdinando, Della Corte, Angela, Paolisso, Giuseppe, and Canonico, Silvestro

Abstract

The pathophysiology of chronic diabetic ulcers is complex and still incompletely understood, both micro- and macroangiopathy strongly contribute to the development and delayed healing of diabetic wounds, through an impaired tissue feeding and response to ischemia. With adequate treatment, some ulcers may last only weeks; however, many ulcers are difficult to treat and may last months, in certain cases years; 19–35% of ulcers are reported as nonhealing. As no efficient therapy is available, it is a high priority to develop new strategies for treatment of this devastating complication. Because experimental and pathological studies suggest that incretin hormone glucagon-like peptide-1 may improves VEGF generation and promote the upregulation of HIF-1α through a reduction of oxidative stress, the study evaluated the effect of the augmentation of GLP-1, by inhibitors of the dipeptidyl peptidase-4, such as vildagliptin, on angiogenesis process and wound healing in diabetic chronic ulcers. Although elucidation of the pathophysiologic importance of these aspects awaits further confirmations, the present study evidences an additional aspect of how DPP-4 inhibition might contribute to improved ulcer outcome.

Published
2012
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30. Peri-procedural tight glycemic control during early percutaneous coronary intervention is associated with a lower rate of in-stent restenosis in patients with acute ST-elevation myocardial infarction

Author

Maria Rosaria Rizzo, Ciro Mauro, Giorgio Cinquegrana, Fausto Ferraro, Federico Piscione, Ferdinando Carlo Sasso, Ornella Carbonara, Giovanni Sorropago, Paolo Rubino, Pasquale Paolisso, Giuseppe Paolisso, Paolo Calabrò, Pasquale Petronella, Antonio Rapacciuolo, Davide D’Andrea, Mario Siniscalchi, Alessandro Bresciani, Eugenio Stabile, Raffaele Marfella, Antonio Ruocco, Marfella, Raffaele, Sasso, Ferdinando Carlo, Siniscalchi, Mario, Paolisso, Pasquale, Rizzo, Maria Rosaria, Ferraro, Fausto, Stabile, Eugenio, Sorropago, Giovanni, Calabro', Paolo, Carbonara, Ornella, Cinquegrana, Giorgio, Piscione, Federico, Ruocco, Antonio, D'Andrea, Davide, Rapacciuolo, Antonio, Petronella, Pasquale, Bresciani, Alessandro, Rubino, Paolo, Mauro, Ciro, Paolisso, Giuseppe, Marfella, R, Sasso, Fc, Siniscalchi, M, Paolisso, P, Rizzo, Mr, Ferraro, F, Sorropago, G, Calabrò, P, Carbonara, O, Cinquegrana, G, Piscione, F, Ruocco, A, D'Andrea, D, Petronella, P, Bresciani, A, Rubino, P, Mauro, C, and Paolisso, G.

Subjects
Blood Glucose, medicine.medical_specialty, Acute ST-Elevation Myocardial Infarction, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Myocardial Infarction, Glycemic Control, Coronary Angiography, Biochemistry, Coronary Restenosis, Electrocardiography, Endocrinology, Restenosis, Coronary Restenosi, Angioplasty, Internal medicine, medicine, Stent, Humans, cardiovascular diseases, Myocardial infarction, Prospective Studies, Angioplasty, Balloon, Coronary, Glycemic, Glycated Hemoglobin, Hemoglobin A, Glycosylated, In-Stent Restenosi, biology, business.industry, Insulin, C-reactive protein, Biochemistry (medical), Percutaneous coronary intervention, medicine.disease, Prospective Studie, Conventional PCI, Cardiology, biology.protein, Early Percutaneous Coronary Intervention, Stents, business, Human
Abstract

We examined the effects of peri-procedural intensive glycemic control (IGC) during early percutaneous coronary intervention (PCI) on restenosis rate in hyperglycemic patients with ST-segment elevation myocardial infarction (STEMI).A total of 165 hyperglycemic patients (glucose ≥ 140 mg/dl) with first STEMI undergoing PCI were studied. Patients were randomized to IGC for almost 24 h after PCI (n = 82; glucose, 80-140 mg/dl) followed by multidose sc insulin during the hospital stay or conventional glycemic control (CGC; n = 83; glucose, 180-200 mg/dl) followed by conventional therapy. Coronary angiography was performed at study entry and at 6-month follow-up. Blood samples for glycemia, hemoglobin A1c, inflammatory markers (C-reactive protein and TNF-α), monocyte chemoattractant-protein-1, and oxidative stress (nitrotyrosine) were collected immediately before and 24 h, 30 and 180 d after PCI.After insulin infusion, mean plasma glucose during the peri-procedural period was greater in the CGC group than in the IGC group (CGC, 191 ± 15 mg/dl; IGC, 145 ± 35 mg/dl; P0.001). After the insulin infusion period, the levels of markers of oxidative stress (nitrotyrosine), inflammation (C-reactive protein, TNF-α), and monocyte chemoattractant-protein-1 were significantly higher in CGC patients compared with IGC patients. Moreover, ICG during PCI reduces restenosis by half (48 and 24%) at 6 months. During follow-up, there was no difference in mortality rates, glucose, inflammatory and oxidative stress markers among the groups. In-stent restenosis was positively associated with mean plasma glucose levels as well as oxidative stress and inflammatory markers during the insulin infusion period.In hyperglycemic patients with STEMI, optimal peri-procedural glycemic control by reducing oxidative stress and inflammation may improve the outcome after PCI.

Published
2012

31. Cardiovascular risk factors and disease management in type 2 diabetic patients with diabetic nephropathy

Author

Giuseppe Conte, Ferdinando Carlo Sasso, Ornella Carbonara, Rodolfo Nasti, Roberto Torella, Luca De Nicola, Teresa Salvatore, Roberto Minutolo, Sasso, Ferdinando Carlo, DE NICOLA, Luca, Carbonara, Ornella, Nasti, Rodolfo, Minutolo, Roberto, Salvatore, Teresa, Conte, Giuseppe, and Torella, Roberto

Subjects
sodium intake and anemia, Adult, Male, medicine.medical_specialty, Anemia, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, Diabetic nephropathy, Risk Factors, Diabetes mellitus, Internal medicine, Chronic renal failure, diabetic nephopathy, Internal Medicine, medicine, Prevalence, Albuminuria, Humans, Diabetic Nephropathies, Risk factor, Aged, Advanced and Specialized Nursing, cardiorenal risk factor, business.industry, Middle Aged, medicine.disease, Surgery, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Italy, Cardiovascular Diseases, Hypertension, Microalbuminuria, Female, business, Kidney disease
Abstract

OBJECTIVE—The purpose of this study was to assess the prevalence of cardiorenal risk factors, their management in a routine clinical setting, and the actual achievement of international guideline targets in a large cohort of type 2 diabetic patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS—A multicentric cross-sectional study was performed in the Campania region in Italy to evaluate cardiorenal risk factors and their management in light of international guidelines. Overall, 28,550 diabetic patients were screened in the 21 participating centers; 847 (348 male and 449 female) patients with type 2 diabetes and a clinical diagnosis of diabetic nephropathy were recruited. RESULTS—Of these subjects, 749 had microalbuminuria and 98 had macroalbuminuria. Targets for blood pressure, HbA1c, LDL cholesterol, HDL cholesterol, and triglycerides were reached in, respectively, 17.5, 32.3, 30.7, 47, and 55.2% of the patients. Chronic renal failure (glomerular filtration rate CONCLUSIONS—This is the first study to investigate a large cohort of type 2 diabetic patients with early and moderate diabetic nephropathy strictu sensu. Notably, impaired renal function can be often diagnosed in these patients even in the presence of microalbuminuria. Thus, clinical diagnosis of diabetic nephopathy allows us to identify a group of patients at very high cardiorenal risk, for whom care is really difficult. We suggest that a correct diagnosis of diabetic nephropathy should always be made and that sodium intake and anemia should be routinely evaluated in these patients.

Published
2006

32. Moderate-intensity statin therapy seems ineffective in primary cardiovascular prevention in patients with type 2 diabetes complicated by nephropathy. A multicenter prospective 8 years follow up study

Author

Giuseppe Paolisso, Ornella Carbonara, Teresa Salvatore, Raffaele Marfella, Antonella Ascione, Plinio Cirillo, Nadia Lascar, Luca De Nicola, Maria Rosaria Rizzo, Ferdinando Carlo Sasso, Roberto Minutolo, Sasso, Ferdinando Carlo, Lascar, Nadia, Ascione, Antonella, Carbonara, Ornella, DE NICOLA, Luca, Minutolo, Roberto, Salvatore, Teresa, Rizzo, Maria Rosaria, Cirillo, Plinio, Paolisso, Giuseppe, Marfella, Raffaele, and De Nicola, Luca

Subjects
Male, Time Factors, Endocrinology, Diabetes and Metabolism, Kaplan-Meier Estimate, Type 2 diabetes, 030204 cardiovascular system & hematology, Diabete, Diabetic nephropathy, 0302 clinical medicine, Risk Factors, Ambulatory Care, Diabetic Nephropathies, Prospective Studies, 030212 general & internal medicine, Original Investigation, Primary prevention, Incidence (epidemiology), Diabetes, Middle Aged, CVD, Treatment Outcome, Italy, Cardiovascular Diseases, Cohort, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Statin, medicine.drug_class, Drug Administration Schedule, Nephropathy, 03 medical and health sciences, Internal medicine, Diabetes mellitus, medicine, Humans, cardiovascular diseases, Aged, Proportional Hazards Models, Glycated Hemoglobin, business.industry, medicine.disease, Diabetes Mellitus, Type 2, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, Biomarkers, Mace, Follow-Up Studies
Abstract

Background Although numerous studies and metanalysis have shown the beneficial effect of statin therapy in CVD secondary prevention, there is still controversy such the use of statins for primary CVD prevention in patients with DM. The purpose of this study was to evaluate the occurrence of total major adverse cardio-vascular events (MACE) in a cohort of patients with type 2 diabetes complicated by nephropathy treated with statins, in order to verify real life effect of statin on CVD primary prevention. Methods We conducted an observational prospective multicenter study on 564 patients with type 2 diabetic nephropathy free of cardiovascular disease attending 21 national outpatient diabetes clinics and followed them up for 8 years. 169 of them were treated with statins (group A) while 395 were not on statins (group B). Results Notably, none of the patients was treated with a high-intensity statin therapy according to last ADA position statement. Total MACE occurred in 32 patients from group A and in 68 patients from group B. Fatal MACE occurred in 13 patients from group A and in 30 from group B; nonfatal MACE occurred in 19 patients from group A and in 38 patients from group B. The analysis of the Kaplan–Meier survival curves showed a not statistically significant difference in the incidence of total (p 0.758), fatal (p 0.474) and nonfatal (p 0.812) MACE between the two groups. HbA1c only showed a significant difference in the incidence of MACE between the two groups (HR 1.201, CI 1.041–1.387, p 0.012). Conclusions These findings suggest that, in a real clinical setting, moderate-intensity statin treatment is ineffective in cardiovascular primary prevention for patients with diabetic nephropathy. Trial registration ClinicalTrials.gov Identifier NCT00535925. Date of registration: September 24, 2007, retrospectively registered

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