101 results on '"Corrada, E."'
Search Results
2. Corrigendum to “Impact of hemoglobin levels at admission on outcomes among elderly patients with acute coronary syndrome treated with low-dose Prasugrel or clopidogrel: A sub-study of the ELDERLY ACS 2 trial” [Int J Cardiol. 2022 Dec 15;369:5-11]
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De Luca, G., primary, Verdoia, M., additional, Morici, N., additional, Ferri, L.A., additional, Piatti, L., additional, Grosseto, D., additional, Bossi, I., additional, Sganzerla, P., additional, Tortorella, G., additional, Cacucci, M., additional, Ferrario, M., additional, Murena, E., additional, Tondi, S., additional, Toso, A., additional, Bongioanni, S., additional, Ravera, A., additional, Corrada, E., additional, Mariani, M., additional, Di Ascenzo, L., additional, Petronio, A.S., additional, Cavallini, C., additional, Vitrella, G., additional, Antonicelli, R., additional, Cesana, B.M., additional, De Luca, L., additional, Ottani, F., additional, Moffa, N., additional, Savonitto, S., additional, and De Servi, S., additional
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- 2023
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3. 24h SCAI stage reclassification to predict outcome. Insights from the prospective Altshock-2 registry
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Morici, N, primary, Frea, S, additional, Ditali, V, additional, Briani, M, additional, Bertaina, M, additional, Ravera, A, additional, Sorini Dini, C, additional, Moltrasio, M, additional, Saia, F, additional, Corrada, E, additional, De Ferrari, G M, additional, Garatti, L, additional, Colombo, C, additional, Tavazzi, G, additional, and Pappalardo, F, additional
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- 2022
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4. Right ventricular adaptation to isolated temporary left ventricular support for cardiogenic shock
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Cozzi, O F, primary, Bertoldi, L F B, additional, Reimers, B R, additional, Corrada, E C, additional, Condorelli, G C, additional, Bauersachs, J B, additional, and Schaefer, A S, additional
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- 2022
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5. A prospective registry to get insights into profile, management and outcome of cardiogenic shock patients
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Morici, N, primary, Frea, S, additional, Bertaina, M, additional, Iannacone, M, additional, Sacco, A, additional, Villanova, L, additional, Corrada, E, additional, Valente, S, additional, De Ferrari, G M, additional, Ravera, A, additional, Moltrasio, M, additional, Sionis, A, additional, Kapur, N, additional, Pappalardo, F, additional, and Tavazzi, G M, additional
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- 2022
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6. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
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De Rosa, S, Spaccarotella, C, Basso, C, Calabro, M, Curcio, A, Filardi, 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, A, Calabro, P, Caliendo, L, Calo, L, Casella, G, Casu, G, Cavallini, C, Ciampi, Q, Ciccone, M, Comito, M, Corrada, E, Crea, F, D'Andrea, A, D'Urbano, M, De Caterina, R, De Ferrari, G, De Ponti, R, Della Mattia, A, DI Mario, C, Donnazzan, L, Esposito, G, 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, G, Margonato, A, Meloni, L, Metra, M, Milo, M, 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., 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 A., Calabro P., Caliendo L., Calo L., Casella G., Casu G., Cavallini C., Ciampi Q., Ciccone M., Comito M., Corrada E., Crea F., D'Andrea A., D'Urbano M., De Caterina R., De Ferrari G., De Ponti R., Della Mattia A., DI Mario C., Donnazzan L., Esposito G., 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 G., Margonato A., Meloni L., Metra M., Milo M., 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, Spaccarotella, C, Basso, C, Calabro, M, Curcio, A, Filardi, 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, A, Calabro, P, Caliendo, L, Calo, L, Casella, G, Casu, G, Cavallini, C, Ciampi, Q, Ciccone, M, Comito, M, Corrada, E, Crea, F, D'Andrea, A, D'Urbano, M, De Caterina, R, De Ferrari, G, De Ponti, R, Della Mattia, A, DI Mario, C, Donnazzan, L, Esposito, G, 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, G, Margonato, A, Meloni, L, Metra, M, Milo, M, 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., 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 A., Calabro P., Caliendo L., Calo L., Casella G., Casu G., Cavallini C., Ciampi Q., Ciccone M., Comito M., Corrada E., Crea F., D'Andrea A., D'Urbano M., De Caterina R., De Ferrari G., De Ponti R., Della Mattia A., DI Mario C., Donnazzan L., Esposito G., 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 G., Margonato A., Meloni L., Metra M., Milo M., 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., and Volpe 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.
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- 2020
7. Variable effect of P2Y12 inhibition on platelet thrombus volume in flowing blood
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MENDOLICCHIO, G.L., ZAVALLONI, D., BACCI, M., CORRADA, E., MARCONI, M., LODIGIANI, C., PRESBITERO, P., ROTA, L., and RUGGERI, Z.M.
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- 2011
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8. Outcomes of Elderly Patients with ST-Elevation or Non-ST-Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
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Morici, N, Savonitto, S, Ferri, L, Grosseto, D, Bossi, I, Sganzerla, P, Tortorella, G, Cacucci, M, Ferrario, M, Crimi, G, Murena, E, Tondi, S, Toso, A, Gandolfo, N, Ravera, A, Corrada, E, Mariani, M, Di Ascenzo, L, Petronio, A, Cavallini, C, Vitrella, G, Antonicelli, R, Piscione, F, Rogacka, R, Antolini, L, Alicandro, G, La Vecchia, C, Piatti, L, De Servi, S, Morici N., Savonitto S., Ferri L. A., Grosseto D., Bossi I., Sganzerla P., Tortorella G., Cacucci M., Ferrario M., Crimi G., Murena E., Tondi S., Toso A., Gandolfo N., Ravera A., Corrada E., Mariani M., Di Ascenzo L., Petronio A. S., Cavallini C., Vitrella G., Antonicelli R., Piscione F., Rogacka R., Antolini L., Alicandro G., La Vecchia C., Piatti L., De Servi S., Morici, N, Savonitto, S, Ferri, L, Grosseto, D, Bossi, I, Sganzerla, P, Tortorella, G, Cacucci, M, Ferrario, M, Crimi, G, Murena, E, Tondi, S, Toso, A, Gandolfo, N, Ravera, A, Corrada, E, Mariani, M, Di Ascenzo, L, Petronio, A, Cavallini, C, Vitrella, G, Antonicelli, R, Piscione, F, Rogacka, R, Antolini, L, Alicandro, G, La Vecchia, C, Piatti, L, De Servi, S, Morici N., Savonitto S., Ferri L. A., Grosseto D., Bossi I., Sganzerla P., Tortorella G., Cacucci M., Ferrario M., Crimi G., Murena E., Tondi S., Toso A., Gandolfo N., Ravera A., Corrada E., Mariani M., Di Ascenzo L., Petronio A. S., Cavallini C., Vitrella G., Antonicelli R., Piscione F., Rogacka R., Antolini L., Alicandro G., La Vecchia C., Piatti L., and De Servi S.
- Abstract
Introduction: Acute coronary syndromes (ACS) have been classified according to the finding of ST-segment elevation on the presenting electrocardiogram, with different treatment strategies and practice guidelines. However, a comparative description of the clinical characteristics and outcomes of acute coronary syndrome elderly patients undergoing percutaneous coronary intervention during index admission has not been published so far. Methods: Retrospective cohort study of patients enrolled in the Elderly ACS-2 multicenter randomized trial. Main outcome measures were crude cumulative incidence and cause-specific hazard ratio (cHR) of cardiovascular death, noncardiovascular death, reinfarction, and stroke. Results: Of 1443 ACS patients aged >75 years (median age 80 years, interquartile range 77-84), 41% were classified as ST-elevation myocardial infarction (STEMI), and 59% had non-ST-elevation ACS (NSTEACS) (48% NSTEMI and 11% unstable angina). As compared with those with NSTEACS, STEMI patients had more favorable baseline risk factors, fewer prior cardiovascular events, and less severe coronary disease, but lower ejection fraction (45% vs 50%, P <.001). At a median follow-up of 12 months, 51 (8.6%) STEMI patients had died, vs 39 (4.6%) NSTEACS patients. After adjusting for sex, age, and previous myocardial infarction, the hazard among the STEMI group was significantly higher for cardiovascular death (cHR 1.85; 95% confidence interval [CI], 1.02-3.36), noncardiovascular death (cHR 2.10; 95% CI, 1.01-4.38), and stroke (cHR 4.8; 95% CI, 1.7-13.7). Conclusions: Despite more favorable baseline characteristics, elderly STEMI patients have worse survival and a higher risk of stroke compared with NSTEACS patients after percutaneous coronary intervention.
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- 2019
9. G-CSF for Extensive STEMI: Results from the STEM-AMI OUTCOME CMR Substudy
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Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, Pompilio, G, Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito G., Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., Pompilio G., Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, Pompilio, G, Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito G., Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., and Pompilio G.
- Abstract
Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-Term. Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. Methods and Results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-To-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/m2 in the change of indexed LV end-systolic volume in favor of G-CSF group (P=0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only (P=0.04). Mor
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- 2019
10. G-CSF for Extensive STEMI
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Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito Giovanni, Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., Pompilio G., Achilli, F., Pontone, G., Bassetti, B., Squadroni, L., Campodonico, J., Corrada, E., Facchini, C., Mircoli, L., Esposito, Giovanni, Scarpa, D., Pidello, S., Righetti, S., Di Gennaro, F., Guglielmo, M., Muscogiuri, G., Baggiano, A., Limido, A., Lenatti, L., Di Tano, G., Malafronte, C., Soffici, F., Ceseri, M., Maggiolini, S., Colombo, G. I., and Pompilio, G.
- Subjects
left ventricular remodeling ,Male ,Ventricular Remodeling ,Heart Ventricles ,percutaneous coronary intervention ,Stroke Volume ,Organ Size ,Middle Aged ,Myocardial Contraction ,myocardial infarction ,standard of care ,Granulocyte Colony-Stimulating Factor ,Humans ,ST Elevation Myocardial Infarction ,Female ,Single-Blind Method ,Prospective Studies ,Aged - Abstract
In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term.The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain.Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/mEarly administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment-elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain.URL: https://www.clinicaltrials.gov. Unique identifier: NCT01969890.
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- 2019
11. How do cardiologists select patients for dual antiplatelet therapy continuation beyond 1 year after a myocardial infarction? Insights from the EYESHOT Post-MI Study
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De Luca L., Colivicchi F., Meessen J., Uguccioni M., Piscione F., Bernabo P., Lardieri G., Granatelli A., Gabrielli D., Gulizia M. M., Silverio A., Benvenga R. M., Mascia F., Fusco A., Cicala S., Oltrona Visconti L., Marinoni B., Canosi U., Cirillo P., Trimarco B., Ziviello F., Grosseto D., Menozzi M., Mezzena D., Mauro C., Sasso A., Bellis A., Calabro P., Gragnano F., Cesaro A., Venturelli V., Porretta V., Borrelli N., Indolfi C., De Rosa S., Torella D., Morici N., Molfese M., Della Rovere F., Caiffa T., Moretto G., Grippo G., Di Vincenzo E., Lucisano L., Pennacchi M., Geraci G., Sanfilippo N., Ledda A., Di Lenarda A., Cherubini A., Russo G., Piemonte F., Di Donato A., Carraturo A., Villari B., Ciampi Q., Contaldi C., Pacher V., Corrada E., Cattani D., Nassiacos D., Meloni S., Barco B., Bonmassari R., Bertoldi A., Tedoldi F., Cannone M., Valenti G., Musci R. L., Caldarola P., Locuratolo N., Sublimi Saponetti L., Gentili L., Maiandi C., Caputo M., Capparuccia C. A., Tonella T., Massari F. M., Lupi A., Tessitori M., Montano M., Scaglione A., Torri A., Tortorella G., Navazio A., Cemin R., Latina L., Briguglia D., Marino R., Scalvini S., Zanelli E., Paganini V., Riboni G., Leiballi E., Della Mattia A., Imperadore F., Tespili M., Santangelo G., Parravicini U., Dellavesa P., Testa R., Venturini E., Feola M., Testa M., Crisci V., Tramontana M., Robiglio L., Varbella F., Meynet I., Galati A., Maddaluna A., Bilato C., Loddo I., Licciardello G., Cassaniti L., Scherillo M., Formigli D., Marullo L., Chianese L., Paolillo C., De Santis A. P. A., Brunetti N. D., Bottigliero D., Della Bona R., Giannico M. B., Tramarin R., Lucibello S., Perna G. P., Marini M., Colavita A. R., Raziliop A., Francese G. M., Mariani M., Collauto F., D'Urbano M., Naio R., Ando G., Saporito F., Assanelli E. M., Cabiati A., Crivaro A., Alberti S., Marchese I., Nejat T., Refice S., Raino R., Aiello A., Cristinziani G. R., Barilla F., Iorio R., Mascelli G., Tartaglione S. N., Di Chiara G., D'Andrea D., Antonicelli R., Malatesta G., Di Mario C., Mattesini A., Tramontana L., Conti S., Sommariva L., Celestini A., Amico F., Giubilato S., Amico A. F., De Filippis M., Pasini G. F., Triggiani M., Ferrara V., Cappetti S., Carugo S., Lucreziotti S., Persico M., Gizzi G., Cipolla T., Caronia A., Buia E., Pastori P., Scarpignato M., Biscottini E., Poletti F., Vimercati C., Pirola R., Barbieri E., Dugo C., De Cesare N., De Benedictis M. L., Ruggeri A., Campana C., Bonura S., Vigna C., Marchese N., Partesana N. G., Bandini P., Farinola G., Santoro D., Cassadonte F., Calabro F., Sansoni M., Abrignani M. G., Bonura F., Benvenuto M., Liso A., Passero T., Mori I., Pozzoni B., Prati F., Finocchiaro M. L., Tufano N., Miserrafiti B., Lacquaniti V., Del Piccolo F., Mohamad B., Spinnler M. T., Bovolo V., Rebulla E., Pieri M., Paloscia L., Di Clemente D., Mazzucco G., Micanti A., Peci P., Ornago O., Proietti F., Michisanti M., Reverzani A., Donatini A., Costa P., Russo S., Franceschini Grisolia E., Mario L., Di Palma F., Dell'Aquila F., Maestroni A., Caico S. I., De Caro G., Attianese L., Perotti S., Cotti Cometti V., Astengo D., Guerri E., Cianflone D., Maranta F., Esposito N., Malvezzi Caracciolo D'Aquino M., Caliendo L., Ricci C., Ceruso C. P., Lanteri S., Serdoz R., Bruno E., De Matteis C., Campagnuolo C., Ammirati M. A., Corrado V. M., Amado Eleas M. A., Fattore L., Ippoliti C., Turiano G., Piergentili C., Chiarella F., Capogrosso P., Perotti M., Di Marco S., Sibilio G., Di Lorenzo L., Aurelio A., Ramondo A. B., Zanna D., Cernetti C., Napolitano G., Negroni S., Alessandri N., Rigo F., Giusti F., Casu G., Vicentini A., Calculli G., Fera M. S., Lettica G. V., Vagheggini G., Piti A., Porfidia A., Di Leo A., Ravera A., Ciotta E., Sacca S., Silvestri O., Isidori S., Natali P., Anselmi M., Testa L., Antonelli A., Tavasci E., Furgi G., Lavorgna A., Gasparetto N., Bisceglia T., De Luca, L., Colivicchi, F., Meessen, J., Uguccioni, M., Piscione, F., Bernabo, P., Lardieri, G., Granatelli, A., Gabrielli, D., Gulizia, M. M., Silverio, A., Benvenga, R. M., Mascia, F., Fusco, A., Cicala, S., Oltrona Visconti, L., Marinoni, B., Canosi, U., Cirillo, P., Trimarco, B., Ziviello, F., Grosseto, D., Menozzi, M., Mezzena, D., Mauro, C., Sasso, A., Bellis, A., Calabro, P., Gragnano, F., Cesaro, A., Venturelli, V., Porretta, V., Borrelli, N., Indolfi, C., De Rosa, S., Torella, D., Morici, N., Molfese, M., Della Rovere, F., Caiffa, T., Moretto, G., Grippo, G., Di Vincenzo, E., Lucisano, L., Pennacchi, M., Geraci, G., Sanfilippo, N., Ledda, A., Di Lenarda, A., Cherubini, A., Russo, G., Piemonte, F., Di Donato, A., Carraturo, A., Villari, B., Ciampi, Q., Contaldi, C., Pacher, V., Corrada, E., Cattani, D., Nassiacos, D., Meloni, S., Barco, B., Bonmassari, R., Bertoldi, A., Tedoldi, F., Cannone, M., Valenti, G., Musci, R. L., Caldarola, P., Locuratolo, N., Sublimi Saponetti, L., Gentili, L., Maiandi, C., Caputo, M., Capparuccia, C. A., Tonella, T., Massari, F. M., Lupi, A., Tessitori, M., Montano, M., Scaglione, A., Torri, A., Tortorella, G., Navazio, A., Cemin, R., Latina, L., Briguglia, D., Marino, R., Scalvini, S., Zanelli, E., Paganini, V., Riboni, G., Leiballi, E., Della Mattia, A., Imperadore, F., Tespili, M., Santangelo, G., Parravicini, U., Dellavesa, P., Testa, R., Venturini, E., Feola, M., Testa, M., Crisci, V., Tramontana, M., Robiglio, L., Varbella, F., Meynet, I., Galati, A., Maddaluna, A., Bilato, C., Loddo, I., Licciardello, G., Cassaniti, L., Scherillo, M., Formigli, D., Marullo, L., Chianese, L., Paolillo, C., De Santis, A. P. A., Brunetti, N. D., Bottigliero, D., Della Bona, R., Giannico, M. B., Tramarin, R., Lucibello, S., Perna, G. P., Marini, M., Colavita, A. R., Francese, G. M., Mariani, M., Collauto, F., D'Urbano, M., Naio, R., Ando, G., Saporito, F., Assanelli, E. M., Cabiati, A., Crivaro, A., Alberti, S., Marchese, I., Nejat, T., Refice, S., Aiello, A., Cristinziani, G. R., Barilla, F., Iorio, R., Mascelli, G., Tartaglione, S. N., Di Chiara, G., D'Andrea, D., Antonicelli, R., Malatesta, G., Di Mario, C., Mattesini, A., Tramontana, L., Conti, S., Sommariva, L., Celestini, A., Amico, F., Giubilato, S., Amico, A. F., De Filippis, M., Pasini, G. F., Triggiani, M., Ferrara, V., Cappetti, S., Carugo, S., Lucreziotti, S., Persico, M., Gizzi, G., Cipolla, T., Caronia, A., Buia, E., Pastori, P., Scarpignato, M., Biscottini, E., Poletti, F., Vimercati, C., Pirola, R., Barbieri, E., Dugo, C., De Cesare, N., De Benedictis, M. L., Ruggeri, A., Campana, C., Bonura, S., Vigna, C., Marchese, N., Partesana, N. G., Bandini, P., Farinola, G., Santoro, D., Cassadonte, F., Calabro, F., Sansoni, M., Abrignani, M. G., Bonura, F., Benvenuto, M., Liso, A., Passero, T., Mori, I., Pozzoni, B., Prati, F., Finocchiaro, M. L., Tufano, N., Miserrafiti, B., Lacquaniti, V., Del Piccolo, F., Mohamad, B., Spinnler, M. T., Bovolo, V., Rebulla, E., Pieri, M., Paloscia, L., Di Clemente, D., Mazzucco, G., Micanti, A., Peci, P., Ornago, O., Proietti, F., Michisanti, M., Reverzani, A., Donatini, A., Costa, P., Russo, S., Franceschini Grisolia, E., Mario, L., Di Palma, F., Dell'Aquila, F., Maestroni, A., Caico, S. I., De Caro, G., Attianese, L., Perotti, S., Cotti Cometti, V., Astengo, D., Guerri, E., Cianflone, D., Maranta, F., Esposito, N., Malvezzi Caracciolo D'Aquino, M., Caliendo, L., Ricci, C., Ceruso, C. P., Lanteri, S., Serdoz, R., Bruno, E., De Matteis, C., Campagnuolo, C., Ammirati, M. A., Corrado, V. M., Amado Eleas, M. A., Fattore, L., Ippoliti, C., Turiano, G., Piergentili, C., Chiarella, F., Capogrosso, P., Perotti, M., Di Marco, S., Sibilio, G., Di Lorenzo, L., Aurelio, A., Ramondo, A. B., Zanna, D., Cernetti, C., Napolitano, G., Negroni, S., Alessandri, N., Rigo, F., Giusti, F., Casu, G., Vicentini, A., Calculli, G., Fera, M. S., Lettica, G. V., Vagheggini, G., Piti, A., Porfidia, A., Di Leo, A., Ravera, A., Ciotta, E., Sacca, S., Silvestri, O., Isidori, S., Natali, P., Anselmi, M., Testa, L., Antonelli, A., Tavasci, E., Furgi, G., Lavorgna, A., Gasparetto, N., Bisceglia, T., Raziliop, A., and Raino, R.
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Male ,Multivariate analysis ,Time Factors ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Cardiologists ,post‐MI ,030212 general & internal medicine ,Myocardial infarction ,Prospective Studies ,Registries ,intervention ,risk ,Dual Anti-Platelet Therapy ,focused update ,ticagrelor keywords plus:coronary-artery-disease ,Atrial fibrillation ,General Medicine ,clopidogrel ,dual antiplatelet therapy ,percutaneous coronary intervention ,post-mi ,secondary prevention ,dapt score ,duration ,management ,Middle Aged ,Clopidogrel ,Treatment Outcome ,Female ,Cardiology and Cardiovascular Medicine ,Ticagrelor ,Human ,medicine.drug ,medicine.medical_specialty ,animal structures ,Time Factor ,Clinical Investigations ,Cardiologist ,Drug Administration Schedule ,Follow-Up Studie ,ticagrelor ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,cardiovascular diseases ,Aged ,Aspirin ,post-MI ,Follow-Up Studies ,Platelet Aggregation Inhibitors ,Patient Selection ,business.industry ,Platelet Aggregation Inhibitor ,Percutaneous coronary intervention ,medicine.disease ,Prospective Studie ,Conventional PCI ,Observational study ,business - Abstract
Background Current guidelines suggest to consider dual antiplatelet therapy (DAPT) continuation for longer than 12 months in selected patients with myocardial infarction (MI). Hypothesis We sought to assess the criteria used by cardiologists in daily practice to select patients with a history of MI eligible for DAPT continuation beyond 1 year. Methods We analyzed data from the EYESHOT Post-MI, a prospective, observational, nationwide study aimed to evaluate the management of patients presenting to cardiologists 1 to 3 years from the last MI event. Results Out of the 1633 post-MI patients enrolled in the study between March and December 2017, 557 (34.1%) were on DAPT at the time of enrolment, and 450 (27.6%) were prescribed DAPT after cardiologist assessment. At multivariate analyses, a percutaneous coronary intervention (PCI) with multiple stents and the presence of peripheral artery disease (PAD) resulted as independent predictors of DAPT continuation, while atrial fibrillation was the only independent predictor of DAPT interruption for patients both at the second and the third year from MI at enrolment and the time of discharge/end of the visit. Conclusions Risk scores recommended by current guidelines for guiding decisions on DAPT duration are underused and misused in clinical practice. A PCI with multiple stents and a history of PAD resulted as the clinical variables more frequently associated with DAPT continuation beyond 1 year from the index MI.
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- 2019
12. Healthcare professionals’ knowledge on cardiopulmonary resuscitation correlated with return of spontaneous circulation rates after in-hospital cardiac arrests: A multicentric study between university hospitals in 12 European countries
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Kourek, C. Greif, R. Georgiopoulos, G. Castrén, M. Böttiger, B. Mongardon, N. Hinkelbein, J. Carmona-Jiménez, F. Scapigliati, A. Marchel, M. Bárczy, G. Van de Velde, M. Koutun, J. Corrada, E. Scheffer, G.J. Dougenis, D. Xanthos, T.
- Abstract
Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%. Aims: The purpose of this study was to assess healthcare professionals’ knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest. Methods and results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support (P=0.005) while Belgium hospitals scored highest on advanced life support (P
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- 2020
13. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
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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.
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- 2020
14. Agitation and delirium in intensive cardiac care unit. A multicenter prospective registry
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Moltrasio, M, primary, Sacco, A, additional, Corrada, E, additional, Poletti, F, additional, Cosentino, N, additional, Campodonico, J, additional, and Marenzi, G, additional
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- 2020
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15. Vasopressors and inotropes in cardiogenic shock: Is there room for 'adrenaline resuscitation'?
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Morici, N, Stucchi, M, Sacco, A, Bottiroli, M, Oliva, F, Carugo, S, Castini, D, Catena, E, Cipriani, M, Corrada, E, Frigerio, M, Gagliardone, M, Garascia, A, Gentile, F, Mafrici, A, Milazzo, F, Negrini, M, Pappalardo, F, Russo, C, Senni, M, Seregni, R, Morici N., Stucchi M., Sacco A., Bottiroli M. A., Oliva F., Carugo S., Castini D., Catena E., Cipriani M., Corrada E., Frigerio M., Gagliardone M. P., Garascia A., Gentile F., Mafrici A., Milazzo F., Negrini M., Pappalardo F., Russo C., Senni M., Seregni R. G., Morici, N, Stucchi, M, Sacco, A, Bottiroli, M, Oliva, F, Carugo, S, Castini, D, Catena, E, Cipriani, M, Corrada, E, Frigerio, M, Gagliardone, M, Garascia, A, Gentile, F, Mafrici, A, Milazzo, F, Negrini, M, Pappalardo, F, Russo, C, Senni, M, Seregni, R, Morici N., Stucchi M., Sacco A., Bottiroli M. A., Oliva F., Carugo S., Castini D., Catena E., Cipriani M., Corrada E., Frigerio M., Gagliardone M. P., Garascia A., Gentile F., Mafrici A., Milazzo F., Negrini M., Pappalardo F., Russo C., Senni M., and Seregni R. G.
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- 2016
16. Vorapaxar in the secondary prevention of atherothrombotic events
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- Abstract
BACKGROUND:Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.METHODS:We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.5 mg daily) or matching placebo and followed them for a median of 30 months. The primary efficacy end point was the composite of death from cardiovascular causes, myocardial infarction, or stroke. After 2 years, the data and safety monitoring board recommended discontinuation of the study treatment in patients with a history of stroke owing to the risk of intracranial hemorrhage.RESULTS:At 3 years, the primary end point had occurred in 1028 patients (9.3%) in the vorapaxar group and in 1176 patients (10.5%) in the placebo group (hazard ratio for the vorapaxar group, 0.87; 95% confidence interval [CI], 0.80 to 0.94; P
- Published
- 2012
17. Varespladib and cardiovascular events in patients with an acute coronary syndrome: the VISTA-16 randomized clinical trial
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Nicholls, Stephen J., Kastelein, John J. P., Schwartz, Gregory G., Bash, Dianna, Rosenson, Robert S., Cavender, Matthew A., Brennan, Danielle M., Koenig, Wolfgang, Jukema, J. Wouter, Nambi, Vijay, Wright, R. Scott, Menon, Venu, Lincoff, A. Michael, Nissen, Hennekens C, Steven E., Brown, Wv, Demets, D, Pfeffer, M, Roleau, J, Abraham, J, Gebel, J, Huff, C, Katzan, I, Shishehbor, M, Rassi, A, Uchino, K, Vest, A, Zishiri, E, Heckman, Mj, Balog, C, Dart, A, Amerena, J, Prasad, C, Farshid, A, Gunalingam, B, Thompson, P, Collins, N, Arstall, M, van Gaal, W, Aroney, C, Mahar, L, Youssef, G, Horowitz, J, Anand, D, Rodes-Cabau, J, Polasek, P, Lai, C, Huynh, T, Hubacek, J, Kokis, A, Paradis, Jm, Mukherjee, A, Senaratne, M, Constance, C, Gosselin, G, Lavi, S, Parker, J, Zadra, R, Abramson, B, Della-Siega, A, Spinar, J, Pudil, R, Motovska, Z, Maly, M, Hutyra, M, Pleva, L, Mayer, O, Semenka, J, Klimovic, T, Horak, D, Cervinka, P, Klimsa, Z, Hulinsky, V, Reichert, P, Monhart, Z, Rotterova, H, Kobulia, B, Shaburishvili, T, Mamatsashvili, M, Chapidze, G, Chumburidze, V, Megreladze, I, Khintibidze, I, Leithäuser, B, Voehringer, Hf, Wachter, R, Nogai, K, Lapp, H, Haltern, G, Gielen, S, Dorsel, T, Möllmann, H, Stellbrink, C, Hengstenberg, C, Dengler, T, Heuer, H, Kreuzer, J, Leschke, M, Mudra, H, Werner, N, Braun-Dullaeus, R, Rosenberg, M, Frey, N, Koenig, W, Strasser, R, Genth-Zotz, S, Kiss, R, Nagy, A, Kovacs, Z, Csapo, K, Edes, I, Sereg, M, Vertes, A, Ronaszeki, A, Kancz, S, Benczur, B, Polgar, P, Muller, G, Simonyi, G, Dezsi, C, Merkely, B, Dinnyes, J, Lupkovics, G, Kahali, D, Banker, D, Trivedi, S, Rajput, R, Premchand, R, Dani, S, Vadaganelli, P, Gupta, S, Chandra, S, Fulwani, M, Chawla, K, Parikh, K, Prati, F, Speciale, G, Valgimigli, M, Suriano, P, Sangiorgi, G, Fineschi, M, Merenda, R, Marenzi, G, Berti, S, Corrada, E, Cuccia, C, Testa, R, Moretti, L, Mennuni, M, Biasucci, Lm, Lioy, E, Auguadro, C, Magagnini, E, Fedele, F, Piscione, F, Azar, R, Trip, Md, Liem, A, den Hartoog, M, Lenderink, T, van de Wetering ML, Lok, D, Oei, F, Tans, Jg, Ilmer, B, Keijzers, M, Monraats, P, Kedhi, E, Breedveld, Rw, Herrman, J, van Wijk, L, Ronner, E, Nierop, P, Bosschaert, M, Hermans, W, Doevendans, P, Troquay, R, van der Heijden, R, Veen, G, Bokern, Mj, Bronzwaer, Pn, Kie, Sh, Den Hartog, F, Elliott, J, Wilkins, G, Hart, H, Devlin, G, Harding, S, Ponikowski, P, Madej, A, Kochmanski, M, Witkowski, A, Pluta, W, Bronisz, M, Kornacewicz-Jach, Z, Wysokinski, A, Ujda, M, Drozdz, J, Derlaga, B, Gessek, J, Dabrowski, M, Miekus, P, Kozlowski, A, Gniot, J, Musial, W, Dobrzycki, S, Rynkiewicz, A, Psuja, P, Rekosz, J, Drzewiecki, A, Kuznetsov, V, Gordeev, I, Goloshchekin, B, Markov, V, Barbarich, V, Belenky, D, Mikhin, V, Volkova, E, Timofeev, A, Ermoshkina, L, Barbarash, O, Klein, G, Libis, R, Vishnevsky, A, Linev, K, Khaisheva, L, Ruda, M, Dovgalevskiy, Y, Shvarts, Y, Zateyshchikov, D, Kostenko, V, Shalnev, V, Simanenkov, V, Arkhipov, M, Ovcharenko, E, Guseva, G, Akhunova, S, Ortiz, Ai, Navarro, Mj, Romero, Aj, Goya, Il, Peñaranda, As, Cendon, Aa, Rubio, Am, Zubiri, Jj, Soriano, Fr, Sanz, Rr, Genís, Ab, Lago, Vn, Fernández, Jd, Romo, Ai, Franco, Sn, Martin, Ih, Montero, Js, Martin Mde, M, González, Mj, Antolin, Jm, Areses, El, Miranda, Jm, Alonso-Pulpón, L, Esquivias, Gb, Jarne, Ef, Cortés, Jm, Pérez, Mb, Gormaz, Cl, Alegret, Jm, Nava, Js, Ingelmo, Jm, Urbano, Rh, Sanmartín, M, Katerenchuk, O, Vakaliuk, I, Karpenko, O, Prokhorov, O, Koval, O, Faynyk, A, Kopytsya, M, Karpenko, Y, Kraiz, I, Feskov, O, Rudenko, L, Kozhukhov, S, Goloborodko, B, Rivera, E, Broadwater, S, Crowley, S, Vijay, N, Goswami, R, Ferrier, L, Blanchard, A, Mccullum, K, Chernick, R, Bertolet, B, Battaglia, J, Richardson, J, Lochridge, S, Lieberman, S, Amkieh, A, Cavender, Jb, Denning, S, Treasure, C, Kmetzo, J, Stillabower, M, Brilakis, E, Schwartz, G, Acheatel, R, Kukuy, E, Ashchi, M, Skelding, K, Martin, L, Gillespie, E, French, W, Pollock, S, Polk, D, Black, R, Drenning, D, Anderson, J, Sanz, M, Korban, E, Wiley, M, Rezkalla, S, Minisi, A, Shah, A, Silverman, P, Amlani, M, Eaton, G, Brown, A, Jay, D, Loussararian, A, Lamas, G, Lauer, M, Williams, J, Asfour, A, Runquist, L, Robertson, R, Blonder, R, Davies, C, Downes, T, Chronos, N, Marso, S, Haldis, T, Eich, D, Ahmed, M, East, C, Macdonald, L, Seigel, P, White, M, Camp, A, Kleiman, N, Burtt, D, Strain, J, Go, B, Henry, P, Sultan, P, Delafontaine, P, Kashou, H, Lambert, C, Movahed, M, Saucedo, J, Thadani, U, Chandrashekhar, Y, Lu, D, Chandna, H, Mann, J, Ramaswamy, G, Browne, K, Janik, M, Cannon, K, Tolerico, P., Berni, Andrea, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, and Cardiology
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Male ,Indoles ,Acetates ,Acute Coronary Syndrome ,Aged ,Angina, Unstable ,Atherosclerosis ,Double-Blind Method ,Early Termination of Clinical Trials ,Female ,Heptanoic Acids ,Humans ,Middle Aged ,Phospholipases A ,Phospholipases A2, Secretory ,Pyrroles ,Risk ,Stroke ,Survival Analysis ,Treatment Outcome ,Myocardial Infarction ,law.invention ,chemistry.chemical_compound ,Randomized controlled trial ,law ,Atorvastatin ,Clinical endpoint ,Medicine (all) ,General Medicine ,Angina ,Keto Acids ,medicine.medical_specialty ,Acute coronary syndrome ,Placebo ,Unstable ,Internal medicine ,Multicenter trial ,medicine ,Atorvastatin Calcium ,Unstable angina ,business.industry ,Secretory ,medicine.disease ,Interim analysis ,Surgery ,Phospholipases A2 ,chemistry ,Varespladib ,business - Abstract
Importance Secretory phospholipase A 2 (sPLA 2 ) generates bioactive phospholipid products implicated in atherosclerosis. The sPLA 2 inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown. Objective To determine the effects of sPLA 2 inhibition with varespladib on cardiovascular outcomes. Design, Setting, and Participants A double-blind, randomized, multicenter trial at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America of 5145 patients randomized within 96 hours of presentation of an acute coronary syndrome (ACS) to either varespladib (n = 2572) or placebo (n = 2573) with enrollment between June 1, 2010, and March 7, 2012 (study termination on March 9, 2012). Interventions Participants were randomized to receive varespladib (500 mg) or placebo daily for 16 weeks, in addition to atorvastatin and other established therapies. Main Outcomes and Measures The primary efficacy measure was a composite of cardiovascular mortality, nonfatal myocardial infarction (MI), nonfatal stroke, or unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated. Results At a prespecified interim analysis, including 212 primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1%) treated with varespladib compared with 109 patients (5.1%) treated with placebo (hazard ratio [HR], 1.25; 95% CI, 0.97-1.61; log-rank P = .08). Varespladib was associated with a greater risk of MI (78 [3.4%] vs 47 [2.2%]; HR, 1.66; 95% CI, 1.16-2.39; log-rank P = .005). The composite secondary end point of cardiovascular mortality, MI, and stroke was observed in 107 patients (4.6%) in the varespladib group and 79 patients (3.8%) in the placebo group (HR, 1.36; 95% CI, 1.02-1.82; P = .04). Conclusions and Relevance In patients with recent ACS, varespladib did not reduce the risk of recurrent cardiovascular events and significantly increased the risk of MI. The sPLA 2 inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS. Trial Registration clinicaltrials.gov Identifier:NCT01130246
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- 2014
18. Thrombin-receptor antagonist vorapaxar in acute coronary syndromes
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Tricoci, P, Huang, Z, Held, C, Moliterno, Dj, Armstrong, Pw, Van de Werf, F, White, Hd, Aylward, Pe, Wallentin, L, Chen, E, Lokhnygina, Y, Pei, J, Leonardi, S, Rorick, Tl, Kilian, Am, Jennings, Lh, Ambrosio, G, Bode, C, Cequier, A, Cornel, Jh, Diaz, R, Erkan, A, Huber, K, Hudson, Mp, Jiang, L, Jukema, Jw, Lewis, Bs, Lincoff, Am, Montalescot, G, Nicolau, Jc, Ogawa, H, Pfisterer, M, Prieto, Jc, Ruzyllo, W, Sinnaeve, Pr, Storey, Rf, Valgimigli, M, Whellan, Dj, Widimsky, P, Strony, J, Harrington, Ra, Mahaffey, Kw, Huo, Y, Lixin, J, Isaza, D, Grande, P, Laine, M, Wong, L, Ofner, P, Yamaguchi, T, Park, Sj, Nordrehaug, Je, Providencia, L, Cheem, Th, Dalby, A, Betriu, A, Chen, Mf, Verheugt, F, Frye, Rl, Hochman, J, Steg, Pg, Bailey, Kr, Easton, Jd, Lincoff, A, Underwood, Fd, Wrestler, J, Larson, D, Vandyne, B, Kilian, A, Harmelin-Kadouri, R, Layton, L, Lipka, L, Petrauskas, S, Qidwai, M, Sorochuck, C, Temple, T, Mason, D, Sydlowski, D, Gallagher, B, Villasin, A, Beernaert, A, Douglas, S, Garrett, J, Wiering, J, Adriaenssens, T, Ganame, J, Hulselmans, M, Katz, Jn, Kayaert, P, La Gerche, A, Onsea, K, Zalewski, J, Johnson, A, O'Briant, J, Smith, M, Akerblom, A, Armaganijan, L, Bertolami, A, Brennan, M, da Ponte Nacif SA, de Campos Gonzaga, C, Dequadros, A, Déry, Jp, Dev, S, Ducrocq, G, Eapen, Zp, Echenique, L, Eggers, K, Garcia, H, Guimaraes, Hp, Hagstrom, E, Hanet, C, James, S, Jonelid, B, Kolls, Bj, Leiria, T, Leite, R, Lombardi, C, Lopes, Rd, Malagutti, P, Mathews, R, Mehta, Rh, Melloni, C, Piccini, Jp, Rodriques Soares, P, Roe, Mt, Shah, Br, Stashenko, G, Szczech, La, Truffa, A, Varenhorst, C, Vranckx, P, Williams, J, Kilaru, R, White, Ja, Binkowitz, B, He, W, Ramos, Ms, Hasbani, E, Farras, Ha, Luz del Valle, L, Zapata, G, Centeno, Ep, Hominal, M, Beloscar, J, Panno, M, Berli, M, Carlevaro, O, Wasserman, T, Lembo, L, Diez, F, Bettinotti, M, Allall, O, Macin, S, Hii, C, Bett, N, Aroney, C, Roberts-Thomson, P, Arstall, M, Horowitz, J, Prasan, A, Farshid, A, Rankin, J, Duffy, S, Sinhal, A, Hendricks, R, Waites, J, Hill, A, French, J, Adams, M, Soward, A, Dick, R, Jepson, N, Nelson, G, Thompson, P, Neunteufl, T, Pachinger, O, Leisch, F, Siostrzonek, P, Roithinger, F, Pieske, B, Weber, H, Eber, B, Zenker, G, Sinnaeve, P, Roosen, J, Vervoort, G, Coussement, P, Striekwold, H, Boland, J, Van Dorpe, A, Dujardin, K, Mertens, D, Vanneste, L, Celen, H, Lesseliers, H, Vrolix, M, Leone, A, De Maeseneire, S, Hellemans, S, Silva, Fa, Franken, M, Moraes JB Jr, Mora, R, Michalaros, Y, Perin, M, Guimaraes, Ae, da Silva DG, Mattos, Ma, Alves AR Jr, Hernandes, Me, Golin, V, da Silva SA, Ardito, W, Dery, Jp, Mukherjee, A, Tanguay, Jf, Kornder, J, Lutchmedial, S, Degrace, M, Klinke, P, Constance, C, Nogareda, G, Wong, G, Macdonald, P, Senaratne, M, Rupka, D, Halperin, F, Ramanathan, K, Natarajan, M, Lai, C, Brossoit, R, Tymchak, W, Rose, B, Dupuis, R, Mansour, S, Bata, I, Zadra, R, Turek, M, Madan, M, Le May, M, Leon, L, Perez, L, Yovaniniz, P, Pedemonte, O, Campos, P, Pincetti, C, Sepulveda, P, Li, W, Zhao, R, Li, Z, Yang, Y, Chen, J, Li, H, Jiang, Y, Li, D, Qu, P, Sun, Y, Zheng, Y, Zhou, C, Zhang, F, Wei, M, Wang, D, Lemus, J, Fernandez, Rl, Jaramillo, C, Ochoa, J, Velez, S, Cano, N, Lutz, J, Botero, R, Jaramillo, M, Saaib, J, Sanchez, G, Hernandez, H, Mendoza, F, Rizcala, A, Urina, M, Polasek, R, Motovska, Z, Zemanek, D, Ostransky, J, Kettner, J, Spinar, J, Groch, L, Ramik, C, Stumar, J, Linhart, A, Pleva, L, Niedobova, E, Macha, J, Vojacek, J, Stipal, R, Galatius, S, Eggert, S, Mickley, H, Egstrup, K, Pedersen, O, Hvilsted, L, Sykulski, R, Skagen, K, Dodt, K, Klarlund, K, Husted, S, Jensen, G, Melchior, T, Sjoel, A, Steffensen, Fh, Airaksinen, Ke, Laukkanen, Ja, Syvanne, Ms, Kotila, Mj, Mikael, K, Naveri, Hk, Hekkala, Am, Mustonen, Jn, Halkosaari, M, Ohlmann, P, Khalife, K, Dibon, O, Hirsch, Jl, Furber, A, Nguyen-Khac, Jo, Delarche, N, Probst, V, Lim, P, Bayet, G, Dauphin, R, Levai, L, Galinier, M, Belhassane, A, Wiedemann, Jy, Fouche, R, Coisne, D, Henry, P, Schiele, F, Boueri, Z, Vaquette, B, Davy, Jm, Cottin, Y, D'Houdain, F, Danchin, N, Cassat, C, Messner, P, Elbaz, M, Coste, P, Zemour, G, Maupas, E, Feldman, L, Soto, Fx, Ferrari, E, Haltern, G, Heuer, H, Genth-Zotz, S, Loges, C, Stellbrink, C, Terres, W, Ferrar, M, Zeymer, U, Brachmann, J, Mudra, H, Vohringer, Hf, vom Dah, J, Kreuzer, J, Hill, S, Kleinertz, K, Kadel, C, Appel, Kf, Nienabe, C, Behrens, S, Frantz, S, Mehrhof, F, Krings, P, Hengstenberg, C, Lueders, S, Hanefel, C, Krulls-Munch, J, Dorse, T, Leschke, M, Nogai, K, Butter, C, Darius, H, Fichtlscherer, Hp, Schmitt, C, Kasisk, Hp, Dorr, M, Fran, N, Jereczek, M, Wiemer, M, Nickenig, G, Boudriot, E, Werner, G, Altila, T, Strasser, R, Baldus, S, Desaga, M, Buerke, M, Land, S, Schunkert, H, Schulze, Ho, Holmer, S, Sohn, Hy, Burkhardt, W, Lauer, B, Schwimmbeck, P, Schoeller, R, Lapp, H, Gross, M, Kindermann, I, Schuster, P, Yu, Cm, Lee, S, Merkely, B, Apro, D, Lupkovics, G, Edes, I, Ungi, I, Piroth, Z, Csapo, K, Dezsi, Ca, Herczeg, B, Sereg, M, Butnaru, A, Lewis, B, Rosenschein, U, Mosseri, M, Turgeman, Y, Pollak, A, Shotan, A, Hammerman, H, Rozenman, Y, Gottlieb, S, Atar, S, Weiss, A, Marmor, A, Iakobishvili, Z, Mascia, F, De Cesare, N, Piovaccari, G, Ceravolo, R, Fiscella, A, Salvioni, A, Silvestri, O, Moretti, L, Severi, S, Carmina, Mg, De Caterina, R, Fattore, L, Terrosu, P, Trimarco, B, Ardissino, D, Uguccioni, L, Auguadro, C, Gregorio, G, De Ferrari, G, Testa, R, Evola, R, De Servi, S, Sganzerla, P, Vassanelli, C, Brunelli, C, Scherillo, M, Tamburino, C, Limido, A, Luzza, F, Percoco, Gf, Sinagra, G, Volpe, M, Crea, F, Fedele, F, Rasetti, G, Cinelli, F, Merlini, P, Sisto, F, Biancoli, S, Fresco, C, Corrada, E, Casolo, G, Santini, M, D'Alessandro, B, Antoniucci, D, Tuccillo, B, Assennato, P, Puccioni, E, Pasquetto, G, Perna, Gp, Morgagni, G, Takizawa, K, Kato, K, Oshima, S, Yagi, M, Asai, T, Kamiya, H, Hirokami, M, Sakota, S, Sueyoshi, A, Shimomura, H, Hashimoto, T, Miyahara, M, Matsumura, T, Nakao, K, Kakuta, T, Nakamura, S, Nishi, Y, Kawajiri, K, Nagai, Y, Takahashi, A, Ikari, Y, Hara, K, Koga, T, Fujii, K, Tobaru, T, Tsunoda, R, Uchiyama, T, Hirayama, H, Fujimoto, K, Sakurai, S, Tanigawa, T, Ohno, M, Yamamoto, E, Ikuta, S, Kato, A, Kikuta, K, Takami, A, Chong, Wp, Ong, Tk, Yusof, A, Maskon, O, Kahar, A, Breedveld, Rw, Bendermacher, Pe, Hamer, Bj, Oude Ophuis AJ, Nierop, Pr, Westendorp, Ic, Beijerbacht, Hp, Herrman, Jp, van 't Hof AW, Troquay, Rp, van der Meer, P, Peters, Rh, van Rossum, P, Liem, A, Pieterse, Mg, van Eck JW, van der Zwaan, C, Pasupati, S, Elliott, J, Tisch, J, Hart, H, Luke, R, Scott, D, Ternouth, I, White, H, Hamer, A, Harding, S, Wilkins, G, O'Meeghan, T, Harrison, N, Nilsen, D, Thalamus, J, Aaberge, L, Brunvand, H, Lutterbey, G, Omland, Tm, Eritsland, J, Wiseth, R, Aase, O, Campos, C, Horna, M, Toce, L, Salazar, M, Przewlocki, T, Ponikowski, P, Kasprzak, J, Kopaczewski, J, Musial, W, Mazurek, W, Kawecka-Jaszcz, K, Pluta, W, Dobrzycki, S, Loboz-Grudzien, K, Lewczuk, J, Karwowski, D, Grajek, S, Dudek, D, Trusz-Gluza, M, Kornacewicz-Jach, Z, Gil, R, Ferreira, J, Gavina, C, Ferreira, R, Martins, D, Garcia-Rinaldi, R, Ufret, R, Vazquez-Tanus, J, Banchs, H, Wong, A, Tan, Hc, Guerra, M, Ebrahim, I, Roux, J, Blomerus, P, Saaiman, A, Corbett, C, Pillay, T, Freeman, V, Horak, A, Zambakides, C, Burgess, L, Yoon, Jh, Ahn, Th, Gwon, Hc, Seong, Iw, Kim, Hs, Jeong, Mh, Kim, Yd, Chae, Sc, Hernandez, Jm, Pique, M, Fernandez Portales, J, Paz, Ma, Lopez Palop, R, Iniguez, A, Diaz Fernandez, J, Alvarez, P, Sanz, E, Heras, M, Sala, J, Goicolea, J, Cruz Fernandez, J, Serra, A, Fernandez Ortiz, A, Calle, G, Barriales, V, Albarran, A, Curos, A, Molano Casimiro FJ, Suarez, Ma, Franco, Sn, Bayon, J, Suarez, J, Belchi, J, Moreu, J, San Martin, M, Melgares Moreno, R, Aguirre Salcedo, J, Gonzalez Juanatey JR, Martinez Romero, P, Galache Osuna JG, Albertsson, P, Diderholm, E, Lycksell, M, Rasmanis, G, Swahn, E, Cherfan, P, Christensen, K, Lundman, P, Larson, Le, Vasko, P, Pripp, Cm, Johansson, A, Moccetti, T, Corti, R, Pieper, M, Mach, F, Eberli, F, Jeger, R, Rickli, H, Vogt, P, Windecker, S, Wu, Cj, Kao, Hl, Charng, Mj, Chang, Kc, Chen, Zc, Tsa, Cd, Shyu, Kg, Lai, Wt, Hsieh, Ic, Hou, Jy, Yeh, Hi, Ueng, Kc, Yin, Wh, Timurkaynak, T, Yigit, Z, Yilmaz, M, Boyaci, A, Sahin, M, Goktekin, O, Bozkurt, E, Ercan, E, Yildirir, A, Muthusamy, R, Keeling, P, Levy, T, Zaman, A, Cohen, A, Gorog, D, Baumbach, A, Oldroyd, K, Kadr, H, Tait, G, Bellenger, N, Davis, G, Shakespeare, C, Senior, R, Bruce, D, Uren, N, Trouton, T, Ahsan, A, Hamed, A, Malik, I, Sarma, J, Millar-Craig, M, Robson, H, Kennon, S, Sprigings, D, Brodie, B, Kang, Gs, Thomas, G, Cheng, Sc, Espinoza, A, Kassas, S, Jafar, Z, Kumar, P, Izzo, M, Wiseman, A, Chandna, H, Felten, W, D'Urso, M, Gudipati, Cr, Coram, R, Gill, S, Bengtson, J, Chang, M, Raisinghani, A, Blankenship, J, Harbor, Wf, Kraft, P, Ashraf, R, Chambers, J, Albirini, A, Malik, A, Ziada, K, Slepian, M, Taussig, A, Vernon, H, Jetty, P, Islam, Ma, Canaday, D, Martin, T, Burchenal, Jj, Gencheff, N, Nygaard, T, Panchal, V, Merritt, R, Abrahams, L, Lambert, C, Reyes, P, Leimbach, W, Chhabra, A, Caputo, R, Imburgia, M, Erickson, B, Kleiman, N, Hunter, J, Dehning, M, Graham, B, Strain, J, White, Jk, Mcgarvey, J Jr, Henderson, D, Treasure, C 2nd, Mirro, M, Pancholy, S, Helmy, T, Westerhausen, D, Dib, N, Penny, W, Kim, H, Degregorio, M, Jay, D, Kmonicek, J, Berlowitz, M, Starling, M, Langevin, E, Nelson, R, Singer, A, Siachos, A, Gibson, G, Parrott, C, Held, J, Puleo, P, Wolford, T, Omar, B, Brilakis, E, Lewis, S, Heller, L, Brener, S, Addo, T, Lieberman, S, Eisenberg, D, Feldman, R, Waksman, R, Waltman, J, Schulman, S, Bounds, C, Voyce, S, Batchelor, W, Dobies, D, Pasnoori, V, Chandrashekhar, Y, Vetrovec, G, Azrin, M, Spriggs, D, Hirsch, C, Smucker, M, Chetcuti, S, Stella, R, Levite, H, Shoukfeh, M, Vidovich, M, Saucedo, J, Fintel, D, Low, R, Gellman, J, Ahsan, C, Unks, Dm, Tolleson, T, Ceccoli, H, Aggarwal, K, Bhaktaram, V, Olson, C, Decaro, M, Kaluski, E, Mehta, V, Puma, J, Singh, V, Fulmer, J, Lewis, D, Khadra, S, Staniloae, C, East, M, Sundram, Ps, Anderson, J, Wasserman, H, Guy, D, Brill, D, Kruse, K, Ebrahimi, R, Nguyen, T, Keating, F, Srivastava, R, Wassmer, P, Todd, J 3rd, Stein, M, Hamzeh, I, Laxson, D, Hodson, R, Puri, S, Vijayaraghavan, K, Gazmuri, R, Chu, A, Vijay, N, Rabinowitz, A, Block, T, Agarwal, H, Martin, J, Zetterlund, P, Fortuin, D, Macdonell, A 3rd, Zouzoulas, S, Chepuri, V, Schmalfuss, C, Karve, M, Aviles, R, Lieberman, E, Amlani, M, Murphy, S, Shapiro, T, Herzog, E, Ariani, K, Bhagwat, R, Hockstad, E, Kai, W, Saririan, M, Roth, R, Weiland, F, Atassi, K, Harjai, K, Muhlestein, J, Marsh, R, Shokooh, S, Nahhas, A, Labroo, A, Mayor, M, Koshy, S, Tariq, M, Rayos, G, Jones, S, Klugherz, B, Dewey, R, Rashid, Hu, Wohns, D, Feiring, A, Bowles, M, Rohrbeck, S, Monroe, Vs, De Gottlieb, A, Gumm, D, Brown, C 3rd, Chang, D, Kalaria, V, Minisi, A, Joumaa, M, Josephson, R, Kleczka, J, Silver, K, Coleman, P, Brachfeld, C, Saltiel, F, Reiner, J, Carell, E, Hanovich, G, Rosenberg, M, Das, G, Blick, D, and Universitat de Barcelona
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Male ,Pyridines ,medicine.medical_treatment ,Kaplan-Meier Estimate ,law.invention ,Lactones ,Randomized controlled trial ,law ,Thrombin receptor antagonist ,clopidogrel ,placebo ,thienopyridine derivative ,vorapaxar ,antithrombocytic agent ,lactone ,proteinase activated receptor 1 ,pyridine derivative ,Coronary Artery Bypass ,Vorapaxar ,Cardiovascular diseases [NCEBP 14] ,Drugs ,General Medicine ,Middle Aged ,Combined Modality Therapy ,Cardiovascular diseases ,Cardiovascular Diseases ,Cardiology ,Platelet aggregation inhibitor ,Drug Therapy, Combination ,Female ,Plaquetes sanguínies ,Intracranial Hemorrhages ,Major bleeding ,Medicaments ,medicine.drug ,medicine.medical_specialty ,Acute coronary syndrome ,Bypass cardiopulmonary ,Hemorrhage ,Pharmacotherapy ,Blood platelets ,Double-Blind Method ,Angioplasty ,Internal medicine ,medicine ,Humans ,Receptor, PAR-1 ,Acute Coronary Syndrome ,Aged ,business.industry ,Malalties cardiovasculars ,medicine.disease ,Surgery ,Bypass cardiopulmonar ,business ,Platelet Aggregation Inhibitors ,Follow-Up Studies - Abstract
Item does not contain fulltext BACKGROUND: Vorapaxar is a new oral protease-activated-receptor 1 (PAR-1) antagonist that inhibits thrombin-induced platelet activation. METHODS: In this multinational, double-blind, randomized trial, we compared vorapaxar with placebo in 12,944 patients who had acute coronary syndromes without ST-segment elevation. The primary end point was a composite of death from cardiovascular causes, myocardial infarction, stroke, recurrent ischemia with rehospitalization, or urgent coronary revascularization. RESULTS: Follow-up in the trial was terminated early after a safety review. After a median follow-up of 502 days (interquartile range, 349 to 667), the primary end point occurred in 1031 of 6473 patients receiving vorapaxar versus 1102 of 6471 patients receiving placebo (Kaplan-Meier 2-year rate, 18.5% vs. 19.9%; hazard ratio, 0.92; 95% confidence interval [CI], 0.85 to 1.01; P=0.07). A composite of death from cardiovascular causes, myocardial infarction, or stroke occurred in 822 patients in the vorapaxar group versus 910 in the placebo group (14.7% and 16.4%, respectively; hazard ratio, 0.89; 95% CI, 0.81 to 0.98; P=0.02). Rates of moderate and severe bleeding were 7.2% in the vorapaxar group and 5.2% in the placebo group (hazard ratio, 1.35; 95% CI, 1.16 to 1.58; P
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- 2012
19. Le reti dell’emergenza in cardiologia : l’esperienza lombarda
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Grieco, N., Corrada, E., Sesana, G., Fontana, G., Lombardi, F., Ieva, Francesca, Marzegalli, M., and Paganoni, ANNA MARIA
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- 2008
20. Eisenmenger syndrome complicated by pulmonary artery dissection
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Aldrovandi, A., primary, Monti, L., additional, Corrada, E., additional, Profili, M., additional, and Presbitero, P., additional
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- 2007
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21. Dipyridamole thallium-201 imaging very early after uncomplicated acute myocardial infarction in patients treated with thrombolytic therapy
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Pirelli, S., primary, Moreo, A., additional, Piccalo', G., additional, Corato, A., additional, Sara, R., additional, Danzi, G. B., additional, Corrada, E., additional, Massa, D., additional, and De vita, C., additional
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- 1997
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22. Sex-specific benefits of sirolimus-eluting stent on long-term outcomes in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: Insights from the Multicenter Evaluation of Single High-Dose Bolus...
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Ferrante G, Presbitero P, Corrada E, Campo G, Bolognese L, Vassanelli C, Colangelo S, De Cesare N, E Rodriguez A, Bramucci E, Moreno R, Piva T, Sheiban I, Pasquetto G, Prati F, Nazzaro MS, Ferrari R, and Valgimigli M
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- 2012
23. Exercise testing and dipyridamole echocardiography test before and 48 h after successful coronary angioplasty: prognostic implications.
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Massa, D., Pirelli, S., Gara, E., Faletra, F., Alberti, A., Piccalò, G., Corrada, E., Mafrici, A., Formentini, A., and Campolo, L.
- Abstract
The purpose of the present study was to determine the value of exercise testing (ET) and dipyridamole echocardiography test (DET) in the early functional evaluation after a successful coronary angioplasty (PTCA) and in the prediction of angina recurrence.52 patients underwent ET and DET before and 48 h after a successful PTCA. During a 6–12 month follow-up period they all underwent clinical evaluation. Before PTCA, ET was positive in 49 of 52 patients (94%) and new asynergies were detected by DETin 47 of 52 patients (90%). 48 h after PTCA 23 patients (44%) had positive ET results and 10 had a positive DET response. During the follow-up, 17 patients experienced recurrence of angina. Positive predictive value (PPV) for angina recurrence of ET and DET performed early after the PTCA were, respectively, 57 and 80%. The PPV of ET increased to 88% when electrocardiographic (ECG) positivisy was accompanied by angina. Negative predictive values of ET and DET were, respectively, 86% and 79%. Early after PTCA, exercise ECG positivity was not predictive of symptom recurrence while ECG positivily associated with angina revealed a high PPV, similar to that of DET. [ABSTRACT FROM PUBLISHER]
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- 1989
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24. Dipyridamole–thallium 201 scintigraphy in the early post-infarction period: (Safety and accuracy in predicting the extent of coronary disease and future recurrence of angina in patients suffering from their first mycocardial infarction).
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PIRELLI, S., INGLESE, E., SUPPA, M., CORRADA, E., and CAMPOLO, L.
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To evaluate the safety and usefulness of myocardial thallium-201 scintigraphy after intravenous dipyridamole during the early post-infarction period, 35 patients under 60 years of age and with recent first transmural uncomplicated myocardial infarction (27 inferior, 8 anterior) were examined between the 5 and 13 day of hospilization. Although four patients experienced angina and transient ischemic ST depression during the test, there were no serious complications. Patients were followed for a mean period of 11.4±6.3 months after hospital dicharge. None of the patients experienced recurrent infarction and there were no cardiac deaths. In 11 patients there were reversible prefusion defects in areas different from those of myocardial infarction. Of these patients, seven (one with infarct vessel stenosis only and six with multivessel coronary disease) developed angina during the follow-up: five underwent coronary surgery because of severe angina refractory to full medical theraphy. Out of the 24 patients without reversible perfusion defects, only two (with multivessel coronary disease) showed typical angina sysmptoms. The presence of redistribution on thallium scans was significantly more frequent in patients who developed a recurrence of angina over a period of 11.4±6.3 months of follow-up (p<0.0005). Thus dipyridamole–thallium 201 scintigraphy is a safe, non-invasive stress test which may be used early following uncomplicated myocardial infarction in order to indentify patients at risk for the recurrence of angina. [ABSTRACT FROM PUBLISHER]
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- 1988
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25. The effects on exercise tolerance of a new transdermal therapeutic system containing nitroglycerine, in patients with stable angina pectoris.
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Carù, B., Pirelli, S., Ferratini, M., Gasparini, M., Cattafi, G., Corrada, E., and Pollavini, P.
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In two randomized, double blind, placebo-controlled, within patient, studies, the effects of 4 doses of a new transdermal therapeutic system containing nitroglycerin (TTS-NTG) were studied in a total of 15 patients with stable exercise-induced angina pectoris. A single 24-hour application of TTS-NTG 10 cm2, TTS-NTG 20 cm2 and TTS placebo (1st study: 6 patients) and of TTS-NTG 40 cm2 TTS-NTG 80 cm2 and TTS placebo (2nd study: 9 patients) was applied on 3 different days, and a symptom-limited cycloergometric exercise test was performed 3, 12 (only in the 2nd study) and 24 hours after the application of each treatment.In comparison with placebo, the doses tested in the 1st study induced, at the 3rd hour post-dosing, a decrease in standing systolic blood pressure and an improvement in exercise tolerance which, however, were not statistically significant while the effects at the 24th hour were similar to those of placebo. In the 2nd study, in comparison with placebo, both TTS-NTG doses induced, 3 hours post-dosing, a significant decrease in both lying and standing systolic (P < 0·01) blood pressure at rest, and a significant (P < 0·01) improvement in exercise tolerance throughout the 24 hours of application.It is concluded that, in patients with exercise-induced angina pectoris due to coronary artery disease, a single application of TTS-NTG 40 cm2 or 80 cm2 results in a 24-hour increase in exercise tolerance. [ABSTRACT FROM PUBLISHER]
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- 1988
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26. Predictors of mortality in patients undergoing percutaneous aortic valve implantation
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Panico, C., Pagnotta, P., Mennuni, M., Corrada, E., Barbaro, C., Rossi, M., Lisignoli, L., Zavalloni, V., Parenti, D., Belli, G., Gabriele Gasparini, and Presbitero, P.
27. [Angioplasty in patients with multivessel coronary disease. Indication criteria and short- and medium-term results]
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Campolo L, Mafrici A, Corrada E, Gian Battista Danzi, Formentini A, and Pirelli S
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Adult ,Male ,Time Factors ,Evaluation Studies as Topic ,Recurrence ,Humans ,Coronary Disease ,Female ,Middle Aged ,Angioplasty, Balloon ,Aged ,Follow-Up Studies
28. The Milano network for acute coronary syndromes and emergency services
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Grieco, N., Sesana, G., Corrada, E., Francesca Ieva, Paganoni, A. M., and Marzegalli, M.
29. Cardiac death and heart failure following primary angioplasty in extensive myocardial infarction: Incremental prognostic value of clinical, functional and angiographic data
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Corrada, E., Bigi, R., paola colombo, Bossi, I., Biase, A. M., Mafrici, A., Parodi, O., and Klugmann, S.
30. THE CRUCIAL ROLE OF THE HEART VALVE TEAM IN THE MANAGEMENT OF A COMPLEX CASE OF MULTIVALVULAR DISEASE
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Cannata, F., Mauro Chiarito, Panico, C., Pagnotta, P., Gasparini, M., Bragato, R., Corrada, E., and Pini, D.
31. Admission glycemia and markers of inflammation are independent outcome predictors in primary PCI in non-diabetic patients
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Corrada, E., Alessio Cappelleri, Belli, G., Genovese, S., Barbaro, C., Gasparini, G., Pagnotta, P., Rossi, M., Zavalloni, D., and Presbitero, P.
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Blood Glucose ,Inflammation ,Male ,Patient Admission ,Predictive Value of Tests ,Myocardial Infarction ,Humans ,Female ,Angioplasty, Balloon, Coronary ,Middle Aged ,Prognosis ,Aged - Abstract
To assess the prognostic value of admission plasma glucose (APG) respect to clinical variables and inflammatory markers in a selected population of non-diabetic patients with ST elevation myocardial infarction (STEMI) treated with primary angioplasty (primary coronary intervention, PCI).A total of 188 consecutive non-diabetic STEMI patients undergoing primary PCI were divided into four quartiles based on APG (117, 117-140, 141-170,170 mg/dL). Combined end-point of major adverse cardiac events (MACE) was defined as death, acute heart failure, re-infarction, unstable angina or inducible ischemia.Event-free survival from MACE was significantly (P0.001) correlated with APG quartiles and decrease from the lowest to the highest: 6 months event-free survival was 89.3%, 77.4%, 59.1%, 42.5%. Patients with higher APG were characterized by a significantly higher Killip class (P0.001), higher serum creatinine (P0.05) on admission, and a lower rate of thrombolysis in myocardial infarction (TIMI) 3 flow after PCI (P0.05). Multivariate analysis showed APG170 mg/dL (hazard ratio [HR] 2.39, 95% confidence interval [CI] 1.24 to 4.65, P0.01), admission high-sensitivity C-reactive protein level (HR 1.19, 95% CI 1.07 to 1.31, P0.001), white blood cells count (HR 1.07, 95% CI 1.00 to 1.14, P0.04) and heart rate (HR 1.02, 95% CI 1.00 to 1.04, P0.02) to be independent predictors of MACE.Admission glycemia and inflammatory markers are independent predictors of MACE in the mid-term follow-up in non-diabetic STEMI treated with primary PCI. Further investigations are needed to study the pathogenesis of stress hyperglycaemia, interactions with mechanisms of inflammation and whether early and aggressive treatment with insulin may influence outcome of primary PCI.
32. The crucial role of the heart valve team in the management of a complex case of multivalvular disease and heart failure
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Francesco Cannata, Chiarito, M., Panico, C., Pagliaro, B., Ardino, L., Torracca, L., Gasparini, M., Pagnotta, P., Corrada, E., Reimers, B., Condorelli, G., and Pini, D.
33. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era
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De Rosa, Salvatore, Spaccarotella, Carmen, Basso, Cristina, Calabrò, Maria Pia, Curcio, Antonio, Filardi, Pasquale Perrone, Mancone, Massimo, Mercuro, Giuseppe, Muscoli, Saverio, Nodari, Savina, Pedrinelli, Roberto, Sinagra, Gianfranco, Indolfi, Ciro, Angelini, Filippo, Barillà, Francesco, Bartorelli, Antonio, Benedetto, Francesco, Bernabò, Paola, Bolognese, Leonardo, Briani, Martina, Cacciavillani, Luisa, Calabrese, Alice, Calabrò, Paolo, Caliendo, Luigi, Calò, Leonardo, Casella, Gianni, Casu, Gavino, Cavallini, Claudio, Ciampi, Quirino, Ciccone, Marco, Comito, Michele, Corrada, Elena, Crea, Filippo, D’Andrea, Antonello, D’Urbano, Maurizio, De Caterina, Raffaele, De Ferrari, Gaetano, De Ponti, Roberto, Della Mattia, Alessio, Di Mario, Carlo, Donazzan, Luca, Esposito, Giovanni, Fedele, Francesco, Ferraro, Alessandro, Galasso, Gennaro, Galiè, Nazzareno, Gnecchi, Massimiliano, Golino, Paolo, Golia, Bruno, Guarini, Pasquale, Leonardi, Sergio, Locuratolo, Nicola, Luzza, Francesco, Manganiello, Vincenzo, Francesca Marchetti, Maria, Marenzi, Giancarlo, Margonato, Alberto, Meloni, Luigi, Metra, Marco, Milo, Marco, Mongiardo, Annalisa, Monzo, Luca, Morisco, Carmine, Novo, Giuseppina, Pancaldi, Stefano, Parollo, Matteo, Paternò, Giovanni, Patti, Giuseppe, Priori, Silvia, Ravera, Amelia, Giuseppe Rebuzzi, Antonio, Rossi, Massimo, Scherillo, Marino, Semprini, Franco, Senni, Michele, Sibilio, Gerolamo, Siviglia, Massimo, Tamburino, Corrado, Tortorici, Gianfranco, Versace, Francesco, Villari, Bruno, Volpe, Massimo, De Rosa S., 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 A., Calabro P., Caliendo L., Calo L., Casella G., Casu G., Cavallini C., Ciampi Q., Ciccone M., Comito M., Corrada E., Crea F., D'Andrea A., D'Urbano M., De Caterina R., De Ferrari G., De Ponti R., Della Mattia A., DI Mario C., Donnazzan L., Esposito G., 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 G., Margonato A., Meloni L., Metra M., Milo M., 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., 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, A., Calabro, P., Caliendo, L., Calo, L., Casella, G., Casu, G., Cavallini, C., Ciampi, Q., Ciccone, M., Comito, M., Corrada, E., Crea, F., D'Andrea, A., D'Urbano, M., De Caterina, R., De Ferrari, G., De Ponti, R., Della Mattia, A., DI Mario, C., Donnazzan, L., Esposito, G., 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, G., Margonato, A., Meloni, L., Metra, M., Milo, M., 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, Spaccarotella, C, Basso, C, Calabro, M, Curcio, A, Filardi, 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, A, Calabro, P, Caliendo, L, Calo, L, Casella, G, Casu, G, Cavallini, C, Ciampi, Q, Ciccone, M, Comito, M, Corrada, E, Crea, F, D'Andrea, A, D'Urbano, M, De Caterina, R, De Ferrari, G, De Ponti, R, Della Mattia, A, DI Mario, C, Donnazzan, L, Esposito, G, 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, G, Margonato, A, Meloni, L, Metra, M, Milo, M, 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, Salvatore, Spaccarotella, Carmen, Basso, Cristina, Calabrò, Maria Pia, Curcio, Antonio, Filardi, Pasquale Perrone, Mancone, Massimo, Mercuro, Giuseppe, Muscoli, Saverio, Nodari, Savina, Pedrinelli, Roberto, Sinagra, Gianfranco, and Indolfi, Ciro
- Subjects
Male ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Settore MED/11 ,0302 clinical medicine ,Acute myocardial infarction, Cardiac care units, STEMI, Aged, Aged, 80 and over, COVID-19, Female, Hospitalization, Humans, Italy, Male, Middle Aged, SARS-CoV-2, Betacoronavirus, Coronavirus Infections, Myocardial Infarction, Pandemics, Pneumonia, Viral ,Case fatality rate ,80 and over ,Medicine ,030212 general & internal medicine ,Myocardial infarction ,Viral ,Aged, 80 and over ,Acute myocardial infarction ,Cardiac care units ,COVID-19 ,SARS-CoV2 ,STEMI ,Aged ,Female ,Hospitalization ,Humans ,Italy ,Middle Aged ,Betacoronavirus ,Coronavirus Infections ,Pandemics ,Pneumonia, Viral ,Cardiology and Cardiovascular Medicine ,Human ,medicine.medical_specialty ,Fast Track Clinical Research ,03 medical and health sciences ,Cardiac care unit ,cardiovascular diseases ,Betacoronaviru ,Pandemic ,business.industry ,Coronavirus Infection ,SARS-CoV-2 ,Pneumonia ,medicine.disease ,acute myocardial infarction ,cardiac care units ,Confidence interval ,Relative risk ,Emergency medicine ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Myocardial infarction complications ,Observational study ,Myocardial infarction diagnosis ,business ,Complication - 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
34. Rosiglitazone plus metformin to prevent type 2 diabetes mellitus.
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Ferrante G, Zavalloni D, Corrada E, and Presbitero P
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- 2010
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35. G-CSF for Extensive STEMI
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Cristina Malafronte, Andrea Baggiano, Marco Guglielmo, Stefano Pidello, Gualtiero I. Colombo, Filiberto Di Gennaro, Jeness Campodonico, Alberto Limido, Luca Mircoli, Giuseppe Muscogiuri, Gianluca Pontone, Martina Ceseri, Stefano Righetti, Federica Soffici, Laura Lenatti, Daniele Scarpa, Stefano Maggiolini, Elena Corrada, Camilla Facchini, Giuseppe Di Tano, Beatrice Bassetti, Lidia Squadroni, Felice Achilli, Giulio Pompilio, Giovanni Esposito, Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, and Pompilio, G
- Subjects
Oncology ,medicine.medical_specialty ,Prasugrel ,Physiology ,medicine.medical_treatment ,Phases of clinical research ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Myocardial infarction ,left ventricular remodeling ,business.industry ,percutaneous coronary intervention ,Percutaneous coronary intervention ,medicine.disease ,Clopidogrel ,Granulocyte colony-stimulating factor ,myocardial infarction ,standard of care ,granulocyte colony-stimulating factor ,Stem cell ,Cardiology and Cardiovascular Medicine ,business ,Ticagrelor ,medicine.drug - Abstract
Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment–elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term. Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment–elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. Methods and Results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment–elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC ( P =0.01); concurrently, there was a significant between-group difference of 6.7 mL/m 2 in the change of indexed LV end-systolic volume in favor of G-CSF group ( P =0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only ( P =0.04). Moreover, over time improvement of global longitudinal strain was 2.4% higher in G-CSF patients versus SOC ( P =0.04). Global circumferential strain significantly improved in G-CSF group only ( P =0.006). Conclusions: Early administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment–elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01969890.
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- 2019
36. Outcomes of Elderly Patients with ST-Elevation or Non-ST-Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention
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Daniele Grosseto, Nuccia Morici, Roberto Antonicelli, Paolo Sganzerla, Stefano Savonitto, Gabriele Crimi, Leonardo Di Ascenzo, Elderly Acs Investigators, Carlo La Vecchia, Matteo Mariani, Luigi Piatti, Michele Cacucci, Stefano Tondi, Gianfranco Alicandro, Amelia Ravera, Giovanni Tortorella, A. Sonia Petronio, Ernesto Murena, Elena Corrada, Irene Bossi, Claudio Cavallini, Giancarlo Vitrella, Maurizio Ferrario, Renata Rogacka, Nicola Gandolfo, Laura Antolini, Stefano De Servi, Federico Piscione, Anna Toso, Luca A. Ferri, Morici, N, Savonitto, S, Ferri, L, Grosseto, D, Bossi, I, Sganzerla, P, Tortorella, G, Cacucci, M, Ferrario, M, Crimi, G, Murena, E, Tondi, S, Toso, A, Gandolfo, N, Ravera, A, Corrada, E, Mariani, M, Di Ascenzo, L, Petronio, A, Cavallini, C, Vitrella, G, Antonicelli, R, Piscione, F, Rogacka, R, Antolini, L, Alicandro, G, La Vecchia, C, Piatti, L, and De Servi, S
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Male ,Acute coronary syndrome ,medicine.medical_specialty ,medicine.medical_treatment ,Myocardial Infarction ,030204 cardiovascular system & hematology ,Cohort Studies ,Electrocardiography ,03 medical and health sciences ,Elderly ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Acute coronary syndrome, Elderly, Myocardial infarction, Acute Coronary Syndrome, Aged, Aged, 80 and over, Cohort Studies, Female, Humans, Male, Myocardial Infarction, Percutaneous Coronary Intervention, Retrospective Studies, Stroke, Treatment Outcome, Treatment Outcome, Electrocardiography ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Acute Coronary Syndrome ,Stroke ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Unstable angina ,ST elevation ,Hazard ratio ,Percutaneous coronary intervention ,Retrospective cohort study ,General Medicine ,medicine.disease ,Treatment Outcome ,Cardiology ,Female ,business - Abstract
Introduction: Acute coronary syndromes (ACS) have been classified according to the finding of ST-segment elevation on the presenting electrocardiogram, with different treatment strategies and practice guidelines. However, a comparative description of the clinical characteristics and outcomes of acute coronary syndrome elderly patients undergoing percutaneous coronary intervention during index admission has not been published so far. Methods: Retrospective cohort study of patients enrolled in the Elderly ACS-2 multicenter randomized trial. Main outcome measures were crude cumulative incidence and cause-specific hazard ratio (cHR) of cardiovascular death, noncardiovascular death, reinfarction, and stroke. Results: Of 1443 ACS patients aged >75 years (median age 80 years, interquartile range 77-84), 41% were classified as ST-elevation myocardial infarction (STEMI), and 59% had non-ST-elevation ACS (NSTEACS) (48% NSTEMI and 11% unstable angina). As compared with those with NSTEACS, STEMI patients had more favorable baseline risk factors, fewer prior cardiovascular events, and less severe coronary disease, but lower ejection fraction (45% vs 50%, P
- Published
- 2019
37. Vasopressors and inotropes in cardiogenic shock: is there room for 'adrenaline resuscitation'?
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Morici, Nuccia, Stucchi, Miriam, Sacco, Alice, Bottiroli, Maurizio A., Oliva, Fabrizio, Carugo, Stefano, Castini, Diego, Catena, Emanuele, Cipriani, Manlio, Corrada, Elena, Frigerio, Maria, Gagliardone, Maria Pia, Garascia, Andrea, Gentile, Francesco, Mafrici, Antonio, Milazzo, Filippo, Negrini, Marco, Pappalardo, Federico, Russo, Claudio, Senni, Michele, Seregni, Romano Giuseppe, Morici, N, Stucchi, M, Sacco, A, Bottiroli, M, Oliva, F, Carugo, S, Castini, D, Catena, E, Cipriani, M, Corrada, E, Frigerio, M, Gagliardone, M, Garascia, A, Gentile, F, Mafrici, A, Milazzo, F, Negrini, M, Pappalardo, F, Russo, C, Senni, M, Seregni, R, Morici, Nuccia, Stucchi, Miriam, Sacco, Alice, Bottiroli, Maurizio A., Oliva, Fabrizio, Carugo, Stefano, Castini, Diego, Catena, Emanuele, Cipriani, Manlio, Corrada, Elena, Frigerio, Maria, Gagliardone, Maria Pia, Garascia, Andrea, Gentile, Francesco, Mafrici, Antonio, Milazzo, Filippo, Negrini, Marco, Pappalardo, Federico, Russo, Claudio, Senni, Michele, and Seregni, Romano Giuseppe
- Subjects
Inotrope ,medicine.medical_specialty ,Resuscitation ,Letter ,resuscitation ,blood vessel reactivity ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,medication therapy management ,03 medical and health sciences ,0302 clinical medicine ,medicine ,In patient ,human ,kidney function ,Intensive care medicine ,business.industry ,Cardiogenic shock ,cardiogenic shock ,030208 emergency & critical care medicine ,medicine.disease ,mortality ,vasodilatation ,priority journal ,business - Abstract
We read with interest the paper of Tarvasmaki et al. [1] regarding the role of inotropes and vasopressors in patients with cardiogenic shock. The authors should be congratulated for their effort of prospectively collecting a huge amount of data in one of the most challenging settings. However, too much emphasis seems to be placed on the authors’ conclusions, especially taking into account some of the study’s limitations.
- Published
- 2016
38. GLP-1-ra and heart failure-related outcomes in patients with and without history of heart failure: an updated systematic review and meta-analysis.
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Villaschi A, Ferrante G, Cannata F, Pini D, Pagnesi M, Corrada E, Reimers B, Mehran R, Federici M, Savarese G, Metra M, Condorelli G, Stefanini GG, and Chiarito M
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- Humans, Hospitalization statistics & numerical data, Randomized Controlled Trials as Topic, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Hypoglycemic Agents therapeutic use, Treatment Outcome, Heart Failure epidemiology, Glucagon-Like Peptide-1 Receptor agonists
- Abstract
Aims: Glucagon-like peptide-1 receptor agonists (GLP1-ra) have shown to reduce cardiovascular (CV) events in patients with diabetes, including heart failure (HF) hospitalizations. However, whether such benefit consistently occurs in patients with history of HF remains uncertain. We performed a systematic review and meta-analysis to assess the impact of GLP1-ra on CV outcomes in patients with and without HF history., Methods and Results: All randomized, placebo-controlled trials evaluating GLP1-ra and reporting CV outcomes stratified by HF history were searched in Pubmed from inception to November 12th, 2023. The primary outcome was HF hospitalizations. Secondary outcomes included CV death, the composite of CV death and hospitalizations for HF, and major adverse cardiovascular events (MACE). Hazard ratio (HR) and 95% confidence interval (CIs) were used as effect estimates and calculated with a random-effects model. 68,653 patients (GLP1-ra = 34,301, placebo = 34,352) from 10 trials were included. GLP1-ra reduced HF hospitalization (no HF: HR = 0.79, 95% CI 0.63-0.98; HF: HR = 1.00, 95% CI 0.82-1.24, p
interaction = 0.12), CV death (no HF: HR = 0.81, 95% CI 0.71-0.92; HF: HR = 0.97, 95% CI 0.81-1.15, pinteraction = 0.11), and the composite of HF hospitalizations and CV death (no HF: HR = 0.80, 95% CI 0.72-0.89; HF: HR = 1.00 95% CI 0.88-1.15, pinteraction = 0.010) only in patients without history of HF, despite a significant interaction between HF history and treatment effect was detected only for the latter. MACE were reduced in both subgroups without significant interaction between HF history and treatment effect (no HF: HR = 0.86, 95% CI 0.78-0.96; HF: HR = 0.83, 95% CI 0.72-0.95, pinteraction = 0.69)., Conclusion: GLP1-ra do not decrease HF-hospitalization risk, despite a potential benefit in patients without history of HF, but are effective in reducing ischemic events irrespective of the presence of HF. PROSPERO-registered (CRD42022371264)., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)- Published
- 2024
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39. Differences between cardiogenic shock related to acute decompensated heart failure and acute myocardial infarction.
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Bertaina M, Morici N, Frea S, Garatti L, Briani M, Sorini C, Villanova L, Corrada E, Sacco A, Moltrasio M, Ravera A, Tedeschi M, Bertoldi L, Lettino M, Saia F, Corsini A, Camporotondo R, Colombo CNJ, Bertolin S, Rota M, Oliva F, Iannaccone M, Valente S, Pagnesi M, Metra M, Sionis A, Marini M, De Ferrari GM, Kapur NK, Pappalardo F, and Tavazzi G
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- Humans, Shock, Cardiogenic etiology, Shock, Cardiogenic therapy, Prospective Studies, Myocardial Infarction therapy, Heart Failure complications, Heart Failure therapy, ST Elevation Myocardial Infarction complications
- Abstract
Aims: The present analysis from the multicentre prospective Altshock-2 registry aims to better define clinical features, in-hospital course, and management of cardiogenic shock complicating acutely decompensated heart failure (ADHF-CS) as compared with that complicating acute myocardial infarction (AMI-CS)., Methods and Results: All patients with AMI-CS or ADHF-CS enrolled in the Altshock-2 registry between March 2020 and February 2022 were selected. The primary objective was the characterization of ADHF-CS patients as compared with AMI-CS. In-hospital length of stay and mortality were secondary endpoints. One-hundred-ninety of the 238 CS patients enrolled in the aforementioned period were considered for the present analysis: 101 AMI-CS (80% ST-elevated myocardial infarction and 20% non-ST-elevated myocardial infarction) and 89 ADHF-CS. As compared with AMI-CS, ADHF-CS patients were younger [63 (IQR 59-76) vs. 67 (IQR 54-73) years, P = 0.01], but presented with higher creatinine [1.6 (IQR 1.0-2.6) vs. 1.2 (IQR 1.0-1.4) mg/dL, P < 0.001], bilirubin [1.3 (IQR 0.9-2.3) vs. 0.6 (IQR 0.4-1.1) mg/dL, P = 0.01], and central venous pressure values [14 mmHg (IQR 8-12) vs. 10 mmHg (IQR 7-14),P = 0.01]. Norepinephrine was the most common catecholamine used in AMI-CS (79.3%), whereas epinephrine was used more commonly in ADHF-CS (65.5%); 75.8% vs. 46.6% received a temporary mechanical support in AMI-CS and ADHF-CS, respectively (P < 0.001). Length of hospital stay was longer in the latter [28 (IQR 13-48) vs. 17 (IQR 9-29) days, P = 0.001]. Heart replacement therapies were more frequently used in the ADHF-CS group (heart transplantation 13.5% vs. 0% and left ventricular assist device 11% vs. 2%, P < 0.01 and 0.01, respectively). In-hospital mortality was 41.1% (38.6% AMI-CS vs. 43.8% ADHF-CS, P = 0.5)., Conclusions: ADHF-CS is characterized by a higher prevalence of end-organ and biventricular dysfunction at presentation, a longer hospital length of stay, and higher need of heart replacement therapies when compared with AMI-CS. In-hospital mortality was similar between the two aetiologies. Our data warrant development of new management protocols focused on CS aetiology., (© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
- Published
- 2023
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40. SCAI stage reclassification at 24 h predicts outcome of cardiogenic shock: Insights from the Altshock-2 registry.
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Morici N, Frea S, Bertaina M, Sacco A, Corrada E, Dini CS, Briani M, Tedeschi M, Saia F, Colombo C, Rota M, Oliva F, Iannaccone M, De Ferrari GM, Sionis A, Kapur NK, Tavazzi G, and Pappalardo F
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- Humans, Prospective Studies, Treatment Outcome, Registries, Hospital Mortality, Shock, Cardiogenic diagnosis, Shock, Cardiogenic therapy, Shock, Cardiogenic etiology, Angiography adverse effects
- Abstract
Background: Cardiogenic shock (CS) includes several phenotypes with heterogenous hemodynamic features. Timely prognostication is warranted to identify patients requiring treatment escalation. We explored the association of the updated Society for Cardiovascular Angiography and Interventions (SCAI) stages classification with in-hospital mortality using a prospective national registry., Methods: Between March 2020 and February 2022 the Altshock-2 Registry has included 237 patients with CS of all etiologies at 11 Italian Centers. Patients were classified according to their admission SCAI stage (assigned prospectively and independently updated according to the recently released version). In-hospital mortality was evaluated for association with both admission and 24-h SCAI stages., Results: The overall in-hospital mortality was 38%. Of the 237 patients included and staged according to the updated SCAI classification, 20 (8%) had SCAI shock stage B, 131 (55%) SCAI stage C, 61 (26%) SCAI stage D and 25 (11%) SCAI stage E. In-hospital mortality stratified according to the SCAI classification at 24 h was 18% for patients in SCAI stage B, 27% for SCAI stage C, 63% for SCAI stage D and 100% for SCAI stage E. Both the revised SCAI stages on admission and at 24 h were associated with in-hospital mortality, but the classification potential slightly increased at 24-h. After adjusting for age, sex, lactate level, eGFR, CVP, inotropic score and mechanical circulatory support [MCS], SCAI classification at 24 h was an independent predictor of in-hospital mortality., Conclusions: In the Altshock-2 registry the utility of SCAI shock stages to identify risk of in-hospital mortality increased at 24 h after admission. Escalation of treatment (either pharmacological or with MCS) should be tailored to achieve prompt clinical improvement within the first 24 h after admission. Registration: http://www., Clinicaltrials: gov; Unique identifier: NCT04295252., (© 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
- Published
- 2023
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41. Impact of hemoglobin levels at admission on outcomes among elderly patients with acute coronary syndrome treated with low-dose Prasugrel or clopidogrel: A sub-study of the ELDERLY ACS 2 trial.
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De Luca G, Verdoia M, Morici N, Ferri LA, Piatti L, Grosseto D, Bossi I, Sganzerla P, Tortorella G, Cacucci M, Ferrario M, Murena E, Tondi S, Toso A, Bongioanni S, Ravera A, Corrada E, Mariani M, Di Ascenzo L, Petronio AS, Cavallini C, Vitrella G, Antonicelli R, Cesana BM, De Luca L, Ottani F, Moffa N, Savonitto S, and De Servi S
- Subjects
- Aged, Clopidogrel, Hemorrhage epidemiology, Hospitalization, Humans, Platelet Aggregation Inhibitors, Prasugrel Hydrochloride, Treatment Outcome, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome drug therapy, Percutaneous Coronary Intervention adverse effects
- Abstract
Hemoglobin (Hb) levels have emerged as a useful tool for risk stratification and the prediction of outcome after myocardial infarction. We aimed at evaluating the prognostic impact of this parameter among patients in advanced age, where the larger prevalence of anemia and the higher rate of comorbidities could directly impact on the cardiovascular risk., Methods: All the patients in the ELDERLY-2 trial, were included in this analysis and stratified according to the values of hemoglobin at admission. The primary endpoint of this study was cardiovascular mortality within one year. The secondary endpoints were all-cause mortality, MI, Bleeding Academic Research Consortium (BARC) type 2-3 or 5 bleeding, any stroke, re-hospitalization for cardiovascular event or stent thrombosis (probable or definite) within 12 months after index admission., Results: We included in our analysis 1364 patients, divided in quartiles of Hb values (<12.2; 12.2-13.39; 13.44-14.49; ≥ 4.5 g/dl). At a mean follow- up of 330.4 ± 99.9 days cardiovascular mortality was increased in patients with lower Hb (HR[95%CI] = 0.76 [0.59-0.97], p = 0.03). Results were no more significant after correction for baseline differences (adjusted HR[95%CI] = 1.22 [0.41-3.6], p = 0.16). Similar results were observed for overall mortality. At subgroup analysis, (according to Hb median values) a significant interaction was observed only with the type of antiplatelet therapy, but not with major high-risk subsets of patients., Conclusions: Among elderly patients with acute coronary syndrome managed invasively, lower hemoglobin at admission is associated with higher cardiovascular and all-cause mortality and major ischemic events, mainly explained by the higher risk profile., (Copyright © 2022 Elsevier B.V. All rights reserved.)
- Published
- 2022
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42. Association of Sex with Outcome in Elderly Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention.
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De Rosa R, Morici N, De Luca G, De Luca L, Ferri LA, Piatti L, Tortorella G, Grosseto D, Franco N, Misuraca L, Sganzerla P, Cacucci M, Antonicelli R, Cavallini C, Lenatti L, Leuzzi C, Murena E, Ravera A, Ferrario M, Corrada E, Colombo D, Prati F, Piscione F, Petronio AS, Galasso G, De Servi S, and Savonitto S
- Subjects
- Aged, Female, Humans, Hypertension epidemiology, Italy epidemiology, Male, Mortality, Overweight epidemiology, Prognosis, Risk Factors, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction epidemiology, Severity of Illness Index, Acute Coronary Syndrome diagnosis, Acute Coronary Syndrome mortality, Acute Coronary Syndrome surgery, Percutaneous Coronary Intervention methods, Percutaneous Coronary Intervention statistics & numerical data, Risk Assessment methods, Risk Assessment statistics & numerical data, Sex Factors
- Abstract
Background: Worse outcomes have been reported for women, compared with men, after an acute coronary syndrome (ACS). Whether this difference persists in elderly patients undergoing similar invasive treatment has not been studied. We investigated sex-related differences in 1-year outcome of elderly acute coronary syndrome patients treated by percutaneous coronary intervention (PCI)., Methods: Patients 75 years and older successfully treated with PCI were selected among those enrolled in 3 Italian multicenter studies. Cox regression analysis was used to assess the independent predictive value of sex on outcome at 12-month follow-up., Results: A total of 2035 patients (44% women) were included. Women were older and most likely to present with ST-elevation myocardial infarction (STEMI), diabetes, hypertension, and renal dysfunction; men were more frequently overweight, with multivessel coronary disease, prior myocardial infarction, and revascularizations. Overall, no sex disparity was found about all-cause (8.3% vs 7%, P = .305) and cardiovascular mortality (5.7% vs 4.1%, P = .113). Higher cardiovascular mortality was observed in women after STEMI (8.8%) vs 5%, P = .041), but not after non ST-elevation-ACS (3.5% vs 3.7%, P = .999). A sensitivity analysis excluding patients with prior coronary events (N = 1324, 48% women) showed a significantly higher cardiovascular death in women (5.4% vs 2.9%, P = .025). After adjustment for baseline clinical variables, female sex did not predict adverse outcome., Conclusions: Elderly men and women with ACS show different clinical presentation and baseline risk profile. After successful PCI, unadjusted 1-year cardiovascular mortality was significantly higher in women with STEMI and in those with a first coronary event. However, female sex did not predict cardiovascular mortality after adjustment for the different baseline variables., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
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43. Clinical Challenges in an Unusual Setting: ST-Elevation in a Patient Suffering From Graft Versus Host Disease, Between Thrombosis and Coronary Spasm.
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Liccardo G, Corrada E, Bertoldi L, Briani M, Sanz-Sanchez J, Chiarito M, Mariotti J, de Philippis C, Santoro A, Reimers B, and Regazzoli D
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- Arrhythmias, Cardiac, Electrocardiography, Humans, Spasm, Coronary Thrombosis diagnostic imaging, Coronary Thrombosis etiology, Graft vs Host Disease, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction etiology, Thrombosis diagnostic imaging, Thrombosis etiology
- Abstract
Competing Interests: Declaration of competing interest All authors have no relationships relevant to the contents of this paper to disclose and received no funding for the research.
- Published
- 2021
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44. Early intra-aortic balloon pump in acute decompensated heart failure complicated by cardiogenic shock: Rationale and design of the randomized Altshock-2 trial.
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Morici N, Marini C, Sacco A, Tavazzi G, Cipriani M, Oliva F, Rota M, De Ferrari GM, Campolo J, Frigerio G, Valente S, Leonardi S, Corrada E, Bottiroli M, Grosseto D, Cacciavillani L, Frigerio M, and Pappalardo F
- Subjects
- Humans, Acute Disease, Cardiovascular Agents therapeutic use, Prospective Studies, Renal Replacement Therapy, Sample Size, Time Factors, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Heart Failure complications, Heart Failure drug therapy, Heart Failure surgery, Heart-Assist Devices, Intra-Aortic Balloon Pumping, Shock, Cardiogenic complications, Shock, Cardiogenic drug therapy, Shock, Cardiogenic surgery
- Abstract
Background: Cardiogenic shock (CS) is a systemic disorder associated with dismal short-term prognosis. Given its time-dependent nature, mechanical circulatory support may improve survival. Intra-aortic balloon pump (IABP) had gained widespread use because of the easiness to implant and the low rate of complications; however, a randomized trial failed to demonstrate benefit on mortality in the setting of acute myocardial infarction. Acute decompensated heart failure with cardiogenic shock (ADHF-CS) represents a growing resource-intensive scenario with scant data and indications on the best management. However, a few data suggest a potential benefit of IABP in this setting. We present the design of a study aimed at addressing this research gap., Methods and Design: The Altshock-2 trial is a prospective, randomized, multicenter, open-label study with blinded adjudicated evaluation of outcomes. Patients with ADHF-CS will be randomized to early IABP implantation or to vasoactive treatments. The primary end point will be 60 days patients' survival or successful bridge to heart replacement therapy. The key secondary end point will be 60-day overall survival; 60-day need for renal replacement therapy; in-hospital maximum inotropic score, maximum duration of inotropic/vasopressor therapy, and maximum sequential organ failure assessment score. Safety end points will be in-hospital occurrence of bleeding events (Bleeding Academic Research Consortium >3), vascular access complications and systemic (noncerebral) embolism. The sample size for the study is 200 patients., Implications: The Altshock-2 trial will provide evidence on whether IABP should be implanted early in ADHF-CS patients to improve their clinical outcomes., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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45. [Percutaneous mitral valve repair in acute mitral regurgitation].
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Cannata F, Sanz-Sánchez J, Cozzi O, Briani M, Bertoldi L, Fazzari F, Ferrante G, Corrada E, Bragato RM, Stefanini GG, Pagnotta PG, Reimers B, and Regazzoli D
- Subjects
- Aged, 80 and over, Female, Humans, Mitral Valve diagnostic imaging, Mitral Valve surgery, Treatment Outcome, Cardiac Surgical Procedures, Heart Valve Prosthesis Implantation, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery
- Abstract
Acute mitral regurgitation is a life-threatening pathology. Nowadays, percutaneous mitral valve repair with the MitraClip device offers, in selected patients, a safe and effective therapeutic alternative to open surgery. Hereby, we report the case of an 82-year-old woman with lateral ST-elevation myocardial infarction determining severe acute mitral regurgitation, who was treated with an urgent MitraClip procedure. Moreover, we discuss echocardiographic assessment of acute mitral regurgitation and we review available literature and possible management of this complex scenario.
- Published
- 2021
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46. Timing of Oral P2Y 12 Inhibitor Administration in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.
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Tarantini G, Mojoli M, Varbella F, Caporale R, Rigattieri S, Andò G, Cirillo P, Pierini S, Santarelli A, Sganzerla P, Cacciavillani L, Babuin L, De Cesare N, Limbruno U, Massoni A, Rognoni A, Pavan D, Belloni F, Cernetti C, Favero L, Saia F, Fovino LN, Masiero G, Roncon L, Gasparetto V, Ferlini M, Ronco F, Rossini R, Canova P, Trabattoni D, Russo A, Guiducci V, Penzo C, Tarantino F, Mauro C, Corrada E, Esposito G, Marchese A, Berti S, Martinato M, Azzolina D, Gregori D, Angiolillo DJ, and Musumeci G
- Subjects
- Acute Coronary Syndrome complications, Acute Coronary Syndrome diagnostic imaging, Aged, Coronary Angiography, Female, Humans, Male, Middle Aged, Non-ST Elevated Myocardial Infarction etiology, Acute Coronary Syndrome therapy, Non-ST Elevated Myocardial Infarction prevention & control, Platelet Aggregation Inhibitors administration & dosage, Prasugrel Hydrochloride administration & dosage, Purinergic P2Y Receptor Antagonists administration & dosage, Ticagrelor administration & dosage
- Abstract
Background: Although oral P2Y
12 inhibitors are key in the management of patients with non-ST-segment elevation acute coronary syndrome, the optimal timing of their administration is not well defined., Objectives: The purpose of this study was to compare downstream and upstream oral P2Y12 inhibitors administration strategies in patients with non-ST-segment elevation acute coronary syndrome undergoing invasive treatment., Methods: We performed a randomized, adaptive, open-label, multicenter clinical trial. Patients were randomly assigned to receive pre-treatment with ticagrelor before angiography (upstream group) or no pre-treatment (downstream group). Patients in the downstream group undergoing percutaneous coronary intervention were further randomized to receive ticagrelor or prasugrel. The primary hypothesis was the superiority of the downstream versus the upstream strategy on the combination of efficacy and safety events (net clinical benefit)., Results: We randomized 1,449 patients to downstream or upstream oral P2Y12 inhibitor administration. A pre-specified stopping rule for futility at interim analysis led the trial to be stopped. The rate of the primary endpoint, a composite of death due to vascular causes; nonfatal myocardial infarction or nonfatal stroke; and Bleeding Academic Research Consortium type 3, 4, and 5 bleeding through day 30, did not differ significantly between the downstream and upstream groups (percent absolute risk reduction: -0.46; 95% repeated confidence interval: -2.90 to 1.90). These results were confirmed among patients undergoing percutaneous coronary intervention (72% of population) and regardless of the timing of coronary angiography (within or after 24 h from enrollment)., Conclusions: Downstream and upstream oral P2Y12 inhibitor administration strategies were associated with low incidence of ischemic and bleeding events and minimal numeric difference of event rates between treatment groups. These findings led to premature interruption of the trial and suggest the unlikelihood of enhanced efficacy of 1 strategy over the other. (Downstream Versus Upstream Strategy for the Administration of P2Y12 Receptor Blockers In Non-ST Elevated Acute Coronary Syndromes With Initial Invasive Indication [DUBIUS]; NCT02618837)., Competing Interests: Author Relationship With Industry This work was funded by the Italian Society of Interventional Cardiology (SICI-GISE). Dr. Tarantini has received Speakers Bureau fees from AstraZeneca, Daiichi-Sankyo, and Eli Lilly. Dr. Mojoli has received individual payments for participating on the Advisory Boards of The Medicines Company and Abbott Vascular; and has been a speaker at scientific congresses from AstraZeneca, Daiichi-Sankyo, Chiesi Farmaceutici, and Servier; and his institution has received an unconditioned research grant from Chiesi Farmaceutici. Dr. Varbella has received consulting fees/honoraria from AstraZeneca, Daiichi-Sankyo, Bayer, Pfizer, Boehringer Ingelheim, Servier, Amgen, Sanofi, Piam, Alvi Medica, Teleflex, and Stenty. Dr. Caporale has received an Advisory Board fee from AstraZeneca. Dr. Rigattieri has received a consulting fee from AstraZeneca; and has received a Speakers Bureau fee from Eli Lilly. Dr. Andò has received individual payments as a consultant, for serving on the Advisory Board, or as a speaker at scientific congresses from AstraZeneca, Daiichi-Sankyo, Chiesi Farmaceutici, Pfizer–Bristol Myers Squibb, Boehringer Ingelheim, and Biosensors. Dr. Saia has received Speakers Bureau fees from AstraZeneca and Daiichi-Sankyo. Dr. Ferlini has received individual payment as a consultant, for serving on the Advisory Board, or as a speaker at scientific congresses from AstraZeneca, Chiesi Farmaceutici, Bayer, Biosensors, Sanofi, and Boehringer Ingelheim. Dr. Angiolillo has received consulting fees or honoraria as an individual from Abbott, Amgen, Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol Myers Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, PLx Pharma, Pfizer, Sanofi, and The Medicines Company; has received payment as an individual for participation in review activities from CeloNova and St. Jude Medical; and has received institutional payments for grants from Amgen, AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli-Lilly, Gilead, Idorsia, Janssen, Matsutani Chemical Industry Co., Merck, Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie Foundation. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2020 American College of Cardiology Foundation. All rights reserved.)- Published
- 2020
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47. Early detection of elevated cardiac biomarkers to optimise risk stratification in patients with COVID-19.
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Stefanini GG, Chiarito M, Ferrante G, Cannata F, Azzolini E, Viggiani G, De Marco A, Briani M, Bocciolone M, Bragato R, Corrada E, Gasparini GL, Marconi M, Monti L, Pagnotta PA, Panico C, Pini D, Regazzoli D, My I, Kallikourdis M, Ciccarelli M, Badalamenti S, Aghemo A, Reimers B, and Condorelli G
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, COVID-19, Coronavirus Infections complications, Early Diagnosis, Female, Hospitalization, Humans, Italy, Male, Middle Aged, Pandemics, Pneumonia, Viral complications, Predictive Value of Tests, Retrospective Studies, Risk Assessment, SARS-CoV-2, Betacoronavirus, Cardiovascular Diseases epidemiology, Coronavirus Infections blood, Coronavirus Infections mortality, Natriuretic Peptide, Brain blood, Pneumonia, Viral blood, Pneumonia, Viral mortality, Troponin I blood
- Abstract
Objective: Risk stratification is crucial to optimise treatment strategies in patients with COVID-19. We aimed to evaluate the impact on mortality of an early assessment of cardiac biomarkers in patients with COVID-19., Methods: Humanitas Clinical and Research Hospital (Rozzano-Milan, Lombardy, Italy) is a tertiary centre that has been converted to the management of COVID-19. Patients with confirmed COVID-19 were entered in a dedicated database for cohort observational analyses. Outcomes were stratified according to elevated levels (ie, above the upper level of normal) of high-sensitivity cardiac troponin I (hs-TnI), B-type natriuretic peptide (BNP) or both measured within 24 hours after hospital admission. The primary outcome was all-cause mortality., Results: A total of 397 consecutive patients with COVID-19 were included up to 1 April 2020. At the time of hospital admission, 208 patients (52.4%) had normal values for cardiac biomarkers, 90 (22.7%) had elevated both hs-TnI and BNP, 59 (14.9%) had elevated only BNP and 40 (10.1%) had elevated only hs-TnI. The rate of mortality was higher in patients with elevated hs-TnI (22.5%, OR 4.35, 95% CI 1.72 to 11.04), BNP (33.9%, OR 7.37, 95% CI 3.53 to 16.75) or both (55.6%, OR 18.75, 95% CI 9.32 to 37.71) as compared with those without elevated cardiac biomarkers (6.25%). A multivariate analysis identified concomitant elevation of both hs-TnI and BNP as a strong independent predictor of all-cause mortality (OR 3.24, 95% CI 1.06 to 9.93)., Conclusions: An early detection of elevated hs-TnI and BNP predicts mortality in patients with COVID-19. Cardiac biomarkers should be systematically assessed in patients with COVID-19 at the time of hospital admission in order to optimise risk stratification., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2020
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48. Impact of diabetes on clinical outcome among elderly patients with acute coronary syndrome treated with percutaneous coronary intervention: insights from the ELDERLY ACS 2 trial.
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De Luca G, Verdoia M, Savonitto S, Piatti L, Grosseto D, Morici N, Bossi I, Sganzerla P, Tortorella G, Cacucci M, Murena E, Toso A, Bongioanni S, Ravera A, Corrada E, Mariani M, Di Ascenzo L, Petronio AS, Cavallini C, Vitrella G, Antonicelli R, Rogacka R, and De Servi S
- Subjects
- Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome mortality, Age Factors, Aged, Aged, 80 and over, Comorbidity, Coronary Thrombosis epidemiology, Diabetes Mellitus diagnosis, Diabetes Mellitus mortality, Female, Health Status, Hemorrhage epidemiology, Humans, Italy epidemiology, Male, Non-ST Elevated Myocardial Infarction diagnostic imaging, Non-ST Elevated Myocardial Infarction mortality, Recurrence, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction mortality, Stents, Time Factors, Treatment Outcome, Acute Coronary Syndrome therapy, Diabetes Mellitus epidemiology, Non-ST Elevated Myocardial Infarction therapy, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention instrumentation, Percutaneous Coronary Intervention mortality, ST Elevation Myocardial Infarction therapy
- Abstract
Background: Despite recent improvements in percutaneous coronary revascularization and antithrombotic therapies for the treatment of acute coronary syndromes, the outcome is still unsatisfactory in high-risk patients, such as the elderly and patients with diabetes. The aim of the current study was to investigate the prognostic impact of diabetes on clinical outcome among patients included in the Elderly-ACS 2 trial, a randomized, open-label, blinded endpoint study carried out at 32 centers in Italy., Methods: Our population is represented by 1443 patients included in the Elderly-ACS 2 trial. Diabetes was defined as known history of diabetes at admission. The primary endpoint of this analysis was cardiovascular mortality, while secondary endpoints were all-cause death, recurrent myocardial infarction, Bleeding Academic Research Consortium type 2 or 3 bleeding, and rehospitalization for cardiovascular event or stent thrombosis within 12 months after index admission., Results: Diabetes was present in 419 (29%) out of 1443 patients. Diabetic status was significantly associated with major cardiovascular risk factors and history of previous coronary disease, presentation with non-ST segment elevation myocardial infarction (P = 0.01) more extensive coronary disease (P = 0.02), more advanced Killip class at presentation (P = 0.003), use at admission of statins (P = 0.004) and diuretics at discharge (P < 0.001). Median follow-up was 367 days (interquartile range: 337-378 days). Diabetic status was associated with an absolute increase in the rate of cardiovascular mortality as compared with patients without diabetes [5.5 vs. 3.3%, hazard ratio (HR) 1.7 (0.99-2.8), P = 0.054], particularly among those treated with clopidogrel [HR (95% confidence interval (CI)) = 1.89 (0.93-3.87), P = 0.08]. However, this difference disappeared after correction for baseline differences [Adjusted HR (95% CI) 1.1(0.4-2.9), P = 0.86]. Similar findings were observed for other secondary endpoints, except for bleeding complications, significantly more frequent in diabetic patients [HR (95% CI) 2.02 (1.14-3.6), P = 0.02; adjusted HR (95% CI) = 2.1 (1.01-4.3), P = 0.05]. No significant interaction was observed between type of dual antiplatelet therapy, diabetic status and outcome., Conclusion: Among elderly patients with acute coronary syndromes, diabetic status was associated with higher rates of comorbidities, more severe cardiovascular risk profile and major bleeding complications fully accounting for the absolute increase in mortality. In fact, diabetes mellitus did not emerge as an independent predictor of survival in advanced age.
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- 2020
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49. Healthcare professionals' knowledge on cardiopulmonary resuscitation correlated with return of spontaneous circulation rates after in-hospital cardiac arrests: A multicentric study between university hospitals in 12 European countries.
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Kourek C, Greif R, Georgiopoulos G, Castrén M, Böttiger B, Mongardon N, Hinkelbein J, Carmona-Jiménez F, Scapigliati A, Marchel M, Bárczy G, Van de Velde M, Koutun J, Corrada E, Scheffer GJ, Dougenis D, and Xanthos T
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- Adolescent, Adult, Belgium, Delivery of Health Care statistics & numerical data, Female, Finland, France, Germany, Greece, Hospital Mortality, Humans, Hungary, Italy, Male, Middle Aged, Netherlands, Odds Ratio, Poland, Return of Spontaneous Circulation physiology, Slovakia, Spain, Switzerland, Young Adult, Cardiopulmonary Resuscitation methods, Clinical Competence, Health Knowledge, Attitudes, Practice, Health Personnel, Heart Arrest mortality, Heart Arrest therapy, Hospitals, University statistics & numerical data
- Abstract
Background: In-hospital cardiac arrest is a major cause of death in European countries, and survival of patients remains low ranging from 20% to 25%., Aims: The purpose of this study was to assess healthcare professionals' knowledge on cardiopulmonary resuscitation among university hospitals in 12 European countries and correlate it with the return of spontaneous circulation rates of their patients after in-hospital cardiac arrest., Methods and Results: A total of 570 healthcare professionals from cardiology, anaesthesiology and intensive care medicine departments of European university hospitals in Italy, Poland, Hungary, Belgium, Spain, Slovakia, Germany, Finland, The Netherlands, Switzerland, France and Greece completed a questionnaire. The questionnaire consisted of 12 questions based on epidemiology data and cardiopulmonary resuscitation training and 26 multiple choice questions on cardiopulmonary resuscitation knowledge. Hospitals in Switzerland scored highest on basic life support ( P =0.005) while Belgium hospitals scored highest on advanced life support ( P <0.001) and total score in cardiopulmonary resuscitation knowledge ( P =0.01). The Swiss hospitals scored highest in cardiopulmonary resuscitation training ( P <0.001). Correlation between cardiopulmonary resuscitation knowledge and return of spontaneous circulation rates of patients with in-hospital cardiac arrest demonstrated that each additional correct answer on the advanced life support score results in a further increase in return of spontaneous circulation rates (odds ratio 3.94; 95% confidence interval 2.78 to 5.57; P <0.001)., Conclusion: Differences in knowledge about resuscitation and course attendance were found between university hospitals in 12 European countries. Education in cardiopulmonary resuscitation is considered to be vital for patients' return of spontaneous circulation rates after in-hospital cardiac arrest. A higher level of knowledge in advanced life support results in higher return of spontaneous circulation rates.
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- 2020
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50. Impact of body mass index on clinical outcome among elderly patients with acute coronary syndrome treated with percutaneous coronary intervention: Insights from the ELDERLY ACS 2 trial.
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De Luca G, Verdoia M, Savonitto S, Ferri LA, Piatti L, Grosseto D, Morici N, Bossi I, Sganzerla P, Tortorella G, Cacucci M, Ferrario M, Murena E, Sibilio G, Tondi S, Toso A, Bongioanni S, Ravera A, Corrada E, Mariani M, Di Ascenzo L, Petronio AS, Cavallini C, Vitrella G, Antonicelli R, Rogacka R, and De Servi S
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- Acute Coronary Syndrome diagnostic imaging, Acute Coronary Syndrome mortality, Age Factors, Aged, Aged, 80 and over, Cause of Death, Clopidogrel adverse effects, Comorbidity, Female, Frail Elderly, Geriatric Assessment, Hemorrhage chemically induced, Hemorrhage mortality, Humans, Italy, Male, Non-ST Elevated Myocardial Infarction diagnostic imaging, Non-ST Elevated Myocardial Infarction mortality, Platelet Aggregation Inhibitors adverse effects, Prasugrel Hydrochloride adverse effects, Recurrence, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction diagnostic imaging, ST Elevation Myocardial Infarction mortality, Time Factors, Treatment Outcome, Acute Coronary Syndrome therapy, Body Mass Index, Clopidogrel administration & dosage, Non-ST Elevated Myocardial Infarction therapy, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Platelet Aggregation Inhibitors administration & dosage, Prasugrel Hydrochloride administration & dosage, ST Elevation Myocardial Infarction therapy
- Abstract
Background and Aim: Elderly patients are at increased risk of hemorrhagic and thrombotic complications after an acute coronary syndrome (ACS). Frailty, comorbidities and low body weight have emerged as conditioning the prognostic impact of dual antiplatelet therapy (DAPT). The aim of the present study was to investigate the prognostic impact of body mass index (BMI) on clinical outcome among patients included in the Elderly-ACS 2 trial, a randomized, open-label, blinded endpoint study comparing low-dose (5 mg) prasugrel vs clopidogrel among elderly patients with ACS., Methods and Results: Our population is represented by 1408 patients enrolled in the Elderly-ACS 2 trial. BMI was calculated at admission. The primary endpoint of this analysis was cardiovascular (CV) mortality. Secondary endpoints were all-cause death, recurrent MI, Bleeding Academic Research Consortium (BARC) type 2 or 3 bleeding, and re-hospitalization for cardiovascular reasons or stent thrombosis within 12 months after index admission. Patients were grouped according to median values of BMI (
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- 2020
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