40 results on '"F. Turazza"'
Search Results
2. C33 AN UNEXPECTED CARDIOGENIC SHOCK
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E Leiballi, C Lestuzzi, E Viel, A Riccio, M Valente, F Turazza, R Pecoraro, and D Pavan
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Cardiology and Cardiovascular Medicine - Abstract
Background Chemotherapy regime based on 5–fluorouracil (5–FU) are frequently administered in the treatment of gastro–intestinal malignancies, especially colorectal carcinomas. A potential severe side effect of 5–FU is cardiotoxicity with often presents with chest pain related to coronary vasospasm. More serious cardiotoxicity, including dilated cardiomyopathy, ventricular arrhythmia and sudden cardiac death has also reported in the literature. Case report. We present a 40–years–old man with stage IV colon adenocarcinoma with metastases. The patient had no history, or risk factors, of cardiac disease. The patient was started on palliative chemotherapy with FOLFOXIRI (Leucovorin/Irinotecan/Fluorouracil). Approximately 24 h into receiving the first infusional dose of 5–FU the patient developed progressive chest pain. Electrocardiography (ECG) revealed sinus tachycardia without repolarization changes. Cardiac biomarkers indicated a moderate elevated troponin (430–580 ng/L). Echocardiogram revealed severely reduced left ventricular function with an ejection fraction (EF) of 23%. Subsequently, the patient developed a hemodynamic instability treated with noradrenaline and dobutamine, but the patient remained in cardiogenic shock. The patient was transferred to cardiac surgery for ECMO placement. Despite ECMO placement the patient was hemodinamically unstable, it was necessary to position also IMPELLA and IABP. The improvement was very slow and the ventricular function returned to normal after 5 days. A subsequent cardiac MRI showed delayed enhancement with diffuse subepicardial distribution (non–ischaemic pattern). Conclusion Our case emphasizes the importance of early recognition of this rare complication and prompt cessation of 5–FU, as cardiac dysfunction in this context is potentially reversible. The precise mechanism remains unclear, but several mechanisms have been proposed including coronary vasospasm, direct toxicity to the myocardium, endothelial dysfunction. It should be noted that these mechanisms were elucidated though animal modeling, case reports, and small clinical studies.
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- 2023
3. Tendencias actuales en el tratamiento de las fracturas de rodilla en niños y adolescentes
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JJ Masquijo, F Turazza, and AM Paccola
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General Medicine - Published
- 2022
4. Current trends in the treatment of knee fractures in children and adolescents
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A M, Paccola, F, Turazza, and J J, Masquijo
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Adolescent ,Knee Fractures ,Humans ,Child - Abstract
Fractures about the knee are common in children and adolescents. Characteristics of the growing skeleton make children susceptible to specific fractures that do not occur in adults. Understanding the relevant anatomy, pathophysiology, diagnosis, and treatment options are important to decrease the risk of complications. The aim of this article is to discuss the current trends in diagnosis and treatment of tibial eminence, tibial tuberosity sleeve, and osteochondral fractures in children and adolescents.Las fracturas en el área de la rodilla son frecuentes en los niños y adolescentes. Las características del esqueleto en crecimiento hacen que los niños sean susceptibles de sufrir fracturas específicas que no se producen en los adultos. La comprensión de la anatomía, la fisiopatología, el diagnóstico y las opciones de tratamiento pertinentes son importantes para disminuir el riesgo de complicaciones. El objetivo de este artículo es discutir las tendencias actuales en el diagnóstico y el tratamiento de las fracturas de eminencia tibial, manguito de tuberosidad tibial y osteocondrales en niños y adolescentes.
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- 2022
5. P173 THERAPEUTIC MANAGEMENT OF FLUOROPYRIMIDINE CARDIOTOXICITY: AN ANECDOTAL CASE
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A Paccone, I Bisceglia, C Lestuzzi, D Fiscella, M Canale, F Turazza, G Russo, G Gallucci, M Camilli, V Quagliariello, C Maurea, and N Maurea
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Cardiology and Cardiovascular Medicine - Abstract
Background Fluoropirimidine represents one of the staple treatment of metastatic colorectal cancer; chemoterapy–based cardiotoxicity is unfortunately habitual in clinical practice. Raltitrexed could represent a valid alterantive to 5–FU in patients with cardiovascular comorbidities or in which 5–FU Has not been tolerated. Case Report Our patient is a 73 years–old woman, who underwent left colon surgical resection due to subocclusion; a whola body staging was not performed. After surgery, patient underwent CT scan,i n which multiple liver, lung and peritoneal metastases were identified. Biomolecular profiling assessment was perfomed (RAS, BRAF Wild type, DPYD*6 heterozigosis mutation). On January 2020, patient began FOLFIRI + PANITUMUMAB scheme as first line treatment (total cycles perfomed: 15). On January 2021, PD was detected though restaging imaging, and patient was subsequently treated with FOLFOX + BEvacizumab as second line. After 5 cycles, patient developed dyspnoea and palpitation; EKG was performed depicting Atrial fibrillation with heart rate: 73bpm, preserved biventricular systolic function and increased BNP and NT–pro–BNP serum concentration. According to patient’s high thromboembolic risk, oral anticoagulation (NOAC) was administered and multidisciplinary discussion was scheduled. NAO were preferred to Vitamin K antagonists due to drug–drug interactions; the treatment–of–choice was Apixaban 2.5 mg bis in die. Given the fact that aforementioned condition could have been attributed to 5–FU cardiologic toxicity, Raltitrexed was administered in lieu thereof 5–FU once synusal rythm was restored (TOMOX scheme). Bevacizumab administration was restored after a longer waiting (ca 2 months); the patient uderwent systematic and serial cardiologic assessment through clinical and EKG consults. Conclusion Our case report depicts the undelayable necessity of a Multidisciplinar collaboration in which oncologists and cardiologists could propose personalized treatment strategies which ensure correct antitumoral activities without significant and life–threatening toxicities.
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- 2023
6. P424 MEDIASTINAL ROUND CELL SARCOMA WITH PULMONARY ARTERY STENOSIS: CLINICAL USEFULNESS OF CARDIAC MRI IN CARDIO–ONCOLOGY
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M Canale, I Bisceglia, G Gallucci, F Turazza, M Camilli, G Russo, C Lestuzzi, A Paccone, D Fiscella, N Maurea, C Bucciarelli Ducci, G Baldi, G Casolo, and A Camerini
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Cardiology and Cardiovascular Medicine - Abstract
Case description: a previously healthy 26–year–old man presented with dyspnea on exertion and dry cough. CT scan revealed a large mediastinal mass with displacement of great vessels and trachea and pericardial effusion. Cardiac MRI showed the huge mediastinal mass, literally leaning on the heart with signs of compression of the pulmonary artery (Figure 1) with the typical D–shape of inter ventricular septum. Pericardial effusion did not compress the RV due to high intraventricular pressure. At baseline echo the mass simulated pulmonary artery stenosis as a consequence of pulmonary artery “ab extrinseco” compression. Surgical biopsy showed Ewing sarcoma lately redefined into undifferentiated round cell sarcoma so the patient started chemotherapy with VAI (vincristine, adriblastine, and ifosfamide) x6 followed by maintenance etoposide and ifosfamide (no anthraciclines for risk of cardiac toxicity). After induction phase MRI showed a partial response to treatment; mediastinal mass further reduced at the end of maintenance (Figure 2). Pericardial effusion disappeared and peak velocity of pulmonary artery went back to normal level at echo. Our patient underwent surgery with en–block removal of mediastinal mass with pericardium and anonymous vein and partial pulmonary upper left lobe resection with R0 resection. Pathology report confirmed an undifferentiated round cell sarcoma (possible embryonal origin, FISH analysis for EWS/FUS genes and 12p negative). Adjuvant mediastinal radiotherapy was delivered. The patient is alive without disease recurrence at one–year follow–up. Conclusions cardiac MR offer great tissue characterization (differential diagnosis between malignant and benign masses) inside/outside the heart. CMR is non–invasive/non radiation and ideal technique for surgery indication and follow–up imaging.
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- 2023
7. P420 A CANCER PATIENT WITH PULMONARY THROMBOEMBOLISM: IS IT RIGHT TO APPLY THE CRITERIA FOR DOSE REDUCTION IN THESE PATIENTS?
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G Russo, A Guglielmi, A Cherubini, G Faganello, I Bisceglia, M Canale, M Camilli, D Fiscella, A Paccone, G Gallucci, F Turazza, C Lestuzzi, C Cappelletto, C Mazzone, M Bollini, E Grande, A Ius, L Mattei, and A Di Lenarda
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Cardiology and Cardiovascular Medicine - Abstract
A 78 years old woman presented in our cardio–oncology out–patient clinic to renew apixaban treatment plan. In her medical history she was a former smoker, with a chronic kidney disease in IIIb stadium according to KDIGOI guidelines with a creatinine of 1,54 mg/dl, GFR according CKD 32 ml/min/1.73m2 and according Cockcroft e Gault 28 ml/min/1.73m2. In 2010, she had a right lobe pulmonary cancer diagnosis treated in neo–adjuvant with gemcitabine. After chemotherapy, she underwent surgical lobectomy. During hospitalization she had a deep venous thrombosis complicated by pulmonary thromboembolism, heparin sc was given with resolution of the clinical picture. In 2012 she had a recurrence of pulmonary thromboembolism. Heparin and warfarin in a second time was given. In 2016 for cancer disease progression, she underwent various oncological treatments and she found a stability disease with osimertinib and stereotaxic radiotherapy. Warfarin was switched to apixaban low–doses for low weight and chronic kidney disease. In 2021 in osimertinib therapy, cancer was under control. She was continuing low–dose apixaban. One year later, a CT scan demonstrated a disease progression and inferior cava venous thrombosis. A cardiac evaluation in our unit was required: patients was asymptomatic. EKG and Echocardiogram were normal. Apixaban low dose was changed to edoxaban 30 mg. There was a complete vein recanalization. Unfortunately, patient died after 8 months for cancer. It is important, in the direct oral anticoagulation therapy in cancer patient, to consider not only the indication for dose reduction known by the registration studies but also cancer and therapy factors.
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- 2023
8. P126 RADIOTHERAPY AND THE HEART: IN SEARCH OF ARIANNA‘S THREAD
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B Irma, A Federico, M Raffaella, M Camilli, M Canale, G Russo, F Turazza, F De Felice, S Matera, and D Cartoni
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Cardiology and Cardiovascular Medicine - Abstract
Background Radiation therapy (RT) is widely diffused in the treatment of cancer; but it could lead to various negative consequences on the cardiovascular system, even several years after treatment end. They include also valvular heart diseases, arrythmias, coronary artery diseases, heart failure, pericardial diseases, systemic and pulmonary artery diseases. We report an interesting case about RT cardiotoxicity different manifestation occurred in the same patient. Case report: 79 years old patient, history of previous testicular seminoma when he was 54 years old (1997), treated through surgery and RT with betatron (total body cobalt). In 2008 aortic valve replacement with mechanical prothesis; in 2017 first hospitalization for heart failure during atrial fibrillation. In subsequent years, recurring episodes of atrial fibrillation (2 unsuccessful attempts at electrical cardioversion), and heart failure exacerbations with mild reduced ejection fraction, treated through medical therapy improvement. At follow–up echocardiogram (03/19) finding of ejection fraction mild reduced (45%), right sections increased in volumes, tricuspid valve moderate regurgitation. In January 2022, at the last cardiac check–up, he reported worsening dyspnoeic symptoms, and occasional episodes of retrosternal pain in last months. It was performed Coro–TC observing a 60% stenosis at distal tract of right coronary; in addition, patient underwent a transoesophageal echocardiogram which documented further reduction in left ventricle ejection fraction, and worsening tricuspid regurgitation to a severe degree, with anulus dilatation and partial failure of leaflets coaptation, which appeared fibro–elastic; inferior vena cava ectasia, Paps 40–45 mmHg circa. Holter–ECG showed atrial fibrillation for all 24 hours, plus 2000 BEV. The case was discussed in Heart Team, and an indication was placed for Triclip intervention. Discussion Nowadays great achievements of anticancer therapies improved patients’ survival, consequently increased the number of anticancer therapies complications; therefore, an accurate cardiac screening for early diagnosis and effective treatment of CV adverse effects is necessary. Several distinct factors contribute to determine the onset cardiotoxicity insurgence, such as the type of cancer, its anatomical localization; radiation techniques applied, total and fractional radiation doses; patient’s age and his comorbidity and risk factors for cardiovascular diseases.
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- 2023
9. P544The importance of contractile reserve when assessing asymptomatic patients with aortic stenosisP545Determinants of secondary mitral regurgitation in patients with aortic stenosis and preserved ejection fractionP546Exercise physiology in patients with mitral annular calcificationP547Evaluation of left atrial strain in patients with rheumatic mitral stenosisP548Impact of mitral regurgitation on impaired alveolar-capillary membrane diffusion in heart failure with reduced ejection fractionP549Edge-to-edge-repair in patients with dilated cardiomyopathy and secondary mitral regurgitation: acute effect on annular geometryP550Changes in the management of functional mitral regurgitation in the last 8 years in a tertiary referral hospitalP551Percutaneous closure of periprosthetic paravalvular leaks under echocardiographic guidance: establishing an alternative to reoperation?P552Clinical profile and predictors of mortality in infective endocarditis with neurologic complicationsP553TAVI, arterial stiffness and ventricular-arterial couplingP554Low contrast media CT angiography prior to transcatheter aortic valve implantation procedureP555Hemodynamic and prognostic impact of permanent pacemaker implantation following transcatheter aortic valve implantationP556Impact of transfemoral aortic valve implantation or surgical aortic valve replacement on right ventricular function in the early postprocedural phaseP557Effects of atrial fibrillation in patients undergoing mitral valve repair with the mitraclip system:one-year outcomes from the GRASP registryP558Who will not benefit from cardioversionP559Is there residual mechanical dysynchrony after initial IEGM optimization in cardiac resynchronization patients?P560Left ventricular reverse remodeling in dilated cardiomyopathy- maintained subclinical myocardial systolic and diastolic dysfunctionP561Improvement of left ventricular ejection fraction is correlated with serum markers of extracellular matrix fibrosis in dilated cardiomyopathyP5622D-radial strain as a novel tool to identify pre-clinical hypertrophic cardiomyopathy mutation carriersP563Long term vigorous exercise is well tolerated in hypertrophic cardiomyopathyP564Left atrial volume and not diameter is the main determinant of atrial fibrillation in patients with hypertrophic cardiomyopathyP565Assessment of papillary muscle mass, apical displacement and mitral valve function in children and young adults with hypertrophic cardiomyopathy using three dimensional echocardiographyP566Combining tissue Doppler-derived Tei index and two-dimensional speckle tracking imaging derived longitudinal strain to predict outcome of patients with light-chain cardiac amyloidosisP567Left and right ventricular dysfunction in patients submitted to chemotherapy with anthracyclines - predictive value of myocardial deformation imagingP568Echocardiography outcome monitoring of hypertensive patients with diastolic dysfunction under doxorubicin therapy
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AL. Pop-Moldovan, AC. Gomes, D. Liu, N. Joseph, M. Rosca, LA. Dejgaard, G. Santambrogio, S. Wisniowska-Smialek, S M R Amorim, J. Ljubas Macek, M. Leitman, AM. Caggegi, A. Mas-Stachurska, M. Drakopoulou, A. Annoni, E. Sciatti, M. Braga, AI. Azevedo, M. Ruiz Ortiz, L. Faber, D. Fina, FA. Castro, G. Pressman, JM. Bantu-Bimbi, JJ. Van Zalen, S. Badiani, L. Hart, A. Marshall, N. Patel, G. Lloyd, L. Jahjah, D. Schulze, T. Tran, T. Pepersack, JL. Vandenbossche, P. Unger, Y. Topilsky, E. Donal, O. Azevedo, M. Lourenco, M. Fernandes, I. Oliveira, A. Lourenco, G. Santos, V. Labate, A. Gasperetti, PL. Laforgia, F. Bandera, E. Alfonzetti, M. Guazzi, W. Scholtz, A. Graw, N. Bogunovic, Z. Dimitriadis, S. Scholtz, J. Boergermann, J. Gummert, D. Horstkotte, D. Mesa, M. Delgado, G. Gutierrez Ballesteros, C. Aristizabal Duque, J. Fernandez Cabeza, E. Duran, C. Ferreiro, J. Sanchez Fernandez, J. Suarez De Lezo, P. Braga, A. Rodrigues, L. Santos, B. Melica, J. Ribeiro, F. Sampaio, R. Fontes-Carvalho, A. Dias, V. Gama Ribeiro, H. Nascimento, L. Flores, V. Ribeiro, F. Melao, C. Sousa, F. Macedo, P. Dias, MJ. Maciel, E. Vizzardi, I. Bonadei, F. Platto, M. Metra, A. Formenti, ME. Mancini, G. Pontone, D. Andreini, L. Fusini, M. Muratori, S. Mushtaq, M. Guglielmo, M. Pepi, K. Toutouzas, K. Stathogiannis, A. Michelongona, G. Latsios, A. Synetos, G. Trantalis, S. Sideris, G. Lazaros, D. Tousoulis, M. Cladellas, M. Ble, B. Vaquerizo, N. Farre, L. Molina, M. Gomez, R. Millan, J. Marti, S. Scandura, P. Capranzano, S. Mangiafico, G. Ronsivalle, M. Chiaranda', S. Giaquinta, A. Popolo Rubbio, S. Farruggio, S. Buccheri, S. Imme', G. Castania, ME. Di Salvo, D. Capodanno, C. Tamburino, V. Tyomkin, E. Peleg, T. Fuchs, Z. Gabara, Z. Vered, V. Reskovic Luksic, M. Pasalic, B. Pezo Nikolic, M. Brestovac, J. Separovic Hanzevacki, J. Rodrigues, M. Campelo, B. Moura, E. Martins, J. Silva-Cardoso, P. Rubis, L. Khachatryan, A. Karabinowska, P. Faltyn, E. Dziewiecka, B. Biernacka-Fijalkowska, A. Lesniak-Sobelga, M. Kostkiewicz, P. Podolec, A. Peritore, P. Vallerio, F. Spano', L. Occhi, R. Facchetti, E. Manfredini, F. Turazza, A. Moreo, C. Giannattasio, TF. Haland, OH. Lie, M. Ribe, IS. Leren, T. Edvardsen, KH. Haugaa, L. Mandes, A. Calin, CC. Beladan, R. Enache, A. Mateescu, C. Baicus, C. Ginghina, BA. Popescu, L. Li, M. Craft, L. Mill, C. Erickson, S. Kutty, K. Hu, S. Herrmann, M. Cikes, G. Ertl, F. Weidemann, S. Stoerk, P. Nordbeck, LR. Lopes, M. Correia, AG. Ferreira, H. Mansinho, H. Pereira, M. Trofenciuc, DA. Darabantiu, M. Puschita, and RM. Christodorescu
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Aortic valve ,medicine.medical_specialty ,Ejection fraction ,business.industry ,Diastole ,General Medicine ,medicine.disease ,Asymptomatic ,Stenosis ,medicine.anatomical_structure ,Internal medicine ,Aortic valve stenosis ,medicine ,Cardiology ,Stress Echocardiography ,Radiology, Nuclear Medicine and imaging ,Systole ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing. We therefore examined echocardiographic predictors of exercise ability during cardiopulmonary exercise testing.24 asymptomatic patients with moderate to severe or severe aortic stenosis and preserved ejection fraction underwent stress echocardiography with simultaneous cardiopulmonary exercise testing. The primary assessment of exercise ability was the VO2peak and OUES. Echocardiography was measured at rest and during maximal exercise (defined as RER > 1)OUES and VO2peak showed a poor relationship with conventional parameters of severity including peak and mean gradients, AVA and dimensionless index, resting systolic function (by EF and TDI). During exercise systolic augmentation had a good relationship with exercise ability but the exercise mean gradient and exercise LVEF did not.Longitudinal systolic function and particularly systolic augmentation is the strongest predictor of exercise ability when compared to conventional measures of severity.VO2peakOUESS' exerciseRho=0.69 (p=0.001)R= 0.71 (p=0.001)S' restRho=0.52 (p=0.01)R= 0.44 (p=ns)Rest AV max VRho= 0.09 (p=ns)R= -0.08 (p=ns)Rest AV mean PGRho= 0.34 (p=ns)R=-0.10 (p=ns)Exercise AV max VRho=0.43 (p=0.05)R=0.23 (p=ns)Exercise AVmean PGRho= 0.51 (p=0.001)R=0.26 (p=ns)Rest AVARho=0.40 (p=ns)Rho=0.46 (p=0.04)Dimensionless indexRho=0.15 (p=ns)R=0.13 (p=ns)LVEF restRho=-0.18 (p=ns)R=-0.32 (p=ns)LVEF exerciseRho=0.18 (p=ns)R=0.17 (p=ns)S' - systolic velocity; V - velocity; AV - aortic valve; AVA- aortic valve area; LVEF - left ventricular ejection fraction.
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- 2016
10. Prognostic Impact of Diabetes and Prediabetes on Survival Outcomes in Patients With Chronic Heart Failure: A Post-Hoc Analysis of the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca-Heart Failure) Trial
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Marco Dauriz, Giovanni Targher, Pier Luigi Temporelli, Donata Lucci, Lucio Gonzini, Gian Luigi Nicolosi, Roberto Marchioli, Gianni Tognoni, Roberto Latini, Franco Cosmi, Luigi Tavazzi, Aldo Pietro Maggioni, Simona Barlera, Maria Grazia Franzosi, Aldo P. Maggioni, Maurizio Porcu, Salim Yusuf, Fulvio Camerini, Jay N. Cohn, Adriano Decarli, Bertram Pitt, Peter Sleight, Philip A. Poole‐Wilson, Enrico Geraci, Marino Scherillo, Gianna Fabbri, Barbara Bartolomei, Daniele Bertoli, Franco Cobelli, Claudio Fresco, Antonietta Ledda, Giacomo Levantesi, Cristina Opasich, Franco Rusconi, Gianfranco Sinagra, Fabio Turazza, Alberto Volpi, Martina Ceseri, Gianluca Alongi, Antonio Atzori, Filippo Bambi, Desiree Bastarolo, Francesca Bianchini, Iacopo Cangioli, Vittoriana Canu, Concetta Caporusso, Gabriele Cenni, Laura Cintelli, Michele Cocchio, Alessia Confente, Eva Fenicia, Giorgio Friso, Marco Gianfriddo, Gianluca Grilli, Beatrice Lazzaro, Giuseppe Lonardo, Alessia Luise, Rachele Nota, Mariaelena Orlando, Rosaria Petrolo, Chiara Pierattini, Valeria Pierota, Alessandro Provenzani, Velia Quartuccio, Anna Ragno, Chiara Serio, Alvise Spolaor, Arianna Tafi, Elisa Tellaroli, Stefano Ghio, Elisa Ghizzardi, Serge Masson, Lella Crociati, Maria Teresa La Rovere, Ugo Corrà, Andrea Finzi, Marco Gorini, Valentina Milani, Giampietro Orsini, Elisa Bianchini, Silvia Cabiddu, Ilaria Cangioli, Laura Cipressa, Maria Lucia Cipressa, Giuseppina Di Bitetto, Barbara Ferri, Luisa Galbiati, Andrea Lorimer, Carla Pera, Paola Priami, Antonella Vasamì, T. Moccetti, M.G. Rossi, E. Pasotti, F. Vaghi, P. Roncarolo, M.T. Zunino, F. Matta, E. Actis Perinetto, F. Gaita, G. Azzaro, M. Zanetta, A.M. Paino, U. Parravicini, D. Vegis, R. Conte, P. Ferraro, A. De Bernardi, S. Morelloni, M. Fagnani, P. Greco Lucchina, L. Montagna, E. Bellone, D. Sappè, F. Ferraro, M. Delucchi, S.G. Reynaud, M. Dore, A. La Brocca, N. Massobrio, L. Bo, R. Trinchero, M. Imazio, G. Brocchi, A. Nejrotti, L. Rissone, S. Gabasio, C. Zocchi, S. Randazzo, A. Crenna, P. Giannuzzi, E. Bonanomi, A. Mezzani, M. De Marchi, G. Begliuomini, C.A. Gianonatti, A. Gavazzi, A. Grosu, L. Dei Cas, S. Nodari, P. Garyfallidis, A. Bertoletti, C. Bonifazi, S. Arisi, F. Mascaro, M. Fraccarollo, S. Dell'Orto, M. Sfolcini, F. Bortolini, D. Raccagni, A. Turelli, M. Santarone, E. Miglierina, L. Sormani, R. Jemoli, F. Tettamanti, S. Pirelli, C. Bianchi, S. Verde, M. Mariani, V. Ziacchi, A. Ferrazza, A. Russo, M. Bortolotti, G.F. Pasini, A. Volpi, K.N. Jones, D. Cuzzucrea, G. Gullace, C. Carbone, A. Granata, S. De Servi, G. Del Rosso, C. Inserra, E. Renaldini, C. Zappa, M. Moretti, R. Zanini, M. Ferrari, E. Moroni, A. Cei, C. Lissi, E. Dovico, C. Fiorentini, P. Palermo, B. Brusoni, M. Negrini, J. Heyman, G.B. Danzi, A. Finzi, M. Frigerio, F. Turazza, L. Beretta, A. Sachero, F. Casazza, L. Squadroni, F. Lombardi, L. Marano, A. Margonato, G. Fragasso, O.C. Febo, E. Aiolfi, F. Olmetti, A. Grieco, V. Antonazzo, G. Specchia, A. Mortara, F. Robustelli, M.G. Songini, C. Schweiger, A. Frisinghelli, M. Palvarini, C. Campana, L. Scelsi, N. Ajmone Marsan, F. Cobelli, A. Gualco, C. Opasich, S. De Feo, R. Mazzucco, M.A. Iannone, T. Diaco, D. Zaniboni, G. Milanesi, D. Nassiacos, S. Meloni, P. Giani, T. Nicoli, C. Malinverni, A. Gusmini, L. Pozzoni, G. Bisiani, P. Margaroli, A. Schizzarotto, A. Daverio, G. Occhi, N. Partesana, P. Bandini, M.G. Rosella, S. Giustiniani, G. Cucchi, R. Pedretti, R. Raimondo, R. Vaninetti, A. Fedele, I. Ghezzi, E. Rezzonico, J.A. Salerno Uriarte, F. Morandi, F. Salvucci, C. Valenti, G. Graziano, M. Romanò, C. Cimminiello, I. Mangone, M. Lombardo, P. Quorso, G. Marinoni, M. Breghi, M. Erckert, A. Dienstl, G. Mirante Marini, C. Stefenelli, G. Cioffi, E. Buczkowska, A. Bonanome, F. Bazzanini, L. Parissenti, C. Serafini, G. Catania, L. Tarantini, G. Rigatelli, S. Boni, A. Pasini, E. Masini, A.A. Zampiero, M. Zanchetta, L. Franceschetto, P. Delise, C. Marcon, A. Sacchetta, L. Borgese, L. Artusi, P. Casolino, F. Corbara, A. Banzato, M. Barbiero, M.P. Aldegheri, R. Bazzucco, G. Crivellenti, A. Raviele, C. Zanella, P. Pascotto, P. Sarto, S. Milan, E. Barbieri, P. Girardi, W. Dalla Villa, J. Dalle Mule, M.L. Di Sipio, R. Cazzin, D. Milan, P. Zonzin, M. Carraro, R. Rossi, E. Carbonieri, I. Rossi, P. Stritoni, P. Meneghetti, G. Risica, P.L. Tenderini, C. Vassanelli, L. Zanolla, G. Perini, G. Brighetti, R. Chiozza, G. Giuliano, R. Gortan, R. Cesanelli, G.L. Nicolosi, R. Piazza, L. Mos, O. Vriz, D. Pavan, G. Pascottini, E. Alberti, M. Werren, L. Solinas, G. Sinagra, F. Longaro, P. Fioretti, M.C. Albanese, D. Miani, R. Gianrossi, A. Pende, P. Rubartelli, O. Magaia, S. Domenicucci, D. Caruso, A.S. Faraguti, L. Magliani, F. Miccoli, G. Guglielmino, D. Bertoli, A. Cantarelli, S. Orlandi, A. Vallebona, A. Pozzati, G. Brega, L.G. Pancaldi, R. Vandelli, S. Urbinati, M.G. Poci, M. Zoli, G.M. Costa, U. Guiducci, G. Zobbi, F. Tartagni, A. Tisselli, A. Gentili, P. Pieri, E. Cagnetta, S. Bendinelli, A. Barbieri, R. Conti, R. Ferrari, F. Merlini, A. Fucili, P. Moruzzi, E. Buia, M. Galvani, D. Ferrini, G. Baggioni, P. Yiannacopulu, G. Canè, A. Bonfiglioli, R. Zandomeneghi, L. Brugioni, A. Giannini, R. Di Ruvo, M. Giuliani, L. Rusconi, P. Del Corso, G. Piovaccari, F. Bologna, P. Venturi, F. Melandri, E. Bagni, L. Bolognese, R. Perticucci, A. Zuppiroli, M. Nannini, N. Consoli, P. Petrone, C. Pipitò, L. Colombi, D. Bernardi, P.R. Mariani, R. Testa, F. Mazzinghi, F. Cosmi, D. Cosmi, A. Zipoli, A. Cecchi, G. Castelli, M. Ciaccheri, F. Mori, F. Pieri, P. Valoti, D. Chiarantini, G.M. Santoro, C. Minneci, F. Marchi, M. Milli, G. Zambaldi, A.A. Brandinelli Geri, M. Cipriani, M. Alessandri, S. Severi, S. Stefanelli, A. Comella, R. Poddighe, A. Digiorgio, M. Carluccio, S. Berti, A. Rizza, V. Bonatti, V. Molendi, A. Brancato, N. D'Aprile, G. Giappichini, S. Del Vecchio, G. Mantini, F. De Tommasi, G. Meucci, M. Cordoni, S. Bechi, L. Barsotti, P. Baldini, M. Romei, G. Scopelliti, G. Lauri, F. Pestelli, F. Furiozzi, M. Cocchieri, D. Severini, F. Patriarchi, P. Chiocchi, M. Buccolieri, S. Martinelli, A. Wee, F. Angelici, M. Bernardinangeli, G. Proietti, B. Biscottini, R. Panciarola, L. Marinacci, G.P. Perna, D. Gabrielli, A. Moraca, L. Moretti, L. Partemi, G. Gregori, R. Amici, G. Patteri, P. Capone, E. Savini, G.L. Morgagni, L. Paccaloni, F. Pezzuoli, S. Carincola, S. Papi, S. De Crescentini, P. Gerardi, P. Midi, E. Gallenzi, G. Pajes, C. Mancone, V. Di Spirito, M. Di Gennaro, S. Calcagno, S. Toscano, S. Antonicoli, F. Carta, G. Giorgi, F. Comito, E. Daniele, O. Ciarla, P.G. Gelfo, A. Acquaviva, D. Testa, G. Testa, F.A. Pagliaro, F. Russo, F. Vetta, I. Marchese, G. Di Sciascio, A. D'Ambrosio, F. Leggio, D. Del Sindaco, A. Lacchè, A. Avallone, M.P. Risa, P. Azzolini, E. Baldo, E. Giovannini, G. Pulignano, C. Tondo, E. Picchio, E. ani, P. Tanzi, F. Pozzar, F. Farnetti, M. Azzarito, M. Santini, A. Varveri, G. Ferraiuolo, C. Valtorta, A. Gaspardone, G. Barbato, V. Ceci, N. Aspromonte, F. Bellocci, C. Colizzi, F. Fedele, F.I. Perez, A. Galati, A. Rossetti, A. Mainella, D. etta, C. Matteucci, G. Busi, A. De Angelis, G. Farina, A. Granatelli, F. Leone, F. Frasca, R. Di Giovambattista, G. Castellani, G. Massaro, G. Mastrogiuseppe, A. Vacri, F. De Sanctis, M. Cioli, S. Di Luzio, C. Napoletano, L.L. Piccioni, G. De Simone, A. Ottaviano, V. Mazza, C. Spedaliere, D. Staniscia, E. Calgione, G. De Marco, T. Chiacchio, T. Di Napoli, S. Romanzi, G. Salvatore, P. Golino, A. Palermo, F. Mascia, A. Vetrano, A. Vinciguerra, L. Caliendo, R. Longobardi, G. De Caro, R. Di Nola, F. Piemonte, D. Prinzi, P. De Rosa, V. De Rosa, F. Riello, V. Capuano, G. Vecchio, M. Landi, S. Amato, M. Garofalo, M. D'Avino, P. Sensale, O. Maiolica, R. Santoro, P. Caso, D. Miceli, N. Maurea, U. Bianchi, C. Crispo, M. Chiariello, P. Perrone Filardi, L. Russo, N. Capuano, G. Ungaro, G. Vergara, F. Scafuro, G. D'Angelo, C. Campaniello, P. Bottiglieri, A. Volpe, R. Battista, L. De Risi, G. Cardillo, G. Sibilio, A.P. Marino, F. Silvestri, P. Predotti, A. Iervoglini, C. De Matteis, P. Sarnicola, M.M. Matarazzo, S. Baldi, V. Iuliano, C. Astarita, P. Cuccaro, A. Liguori, G. Liguori, G. Gregorio, L. Petraglia, G. Antonelli, G. Amodio, I. De Luca, D. Traversa, G. Franchini, M.L. Lenti, D. Cavallari, C. D'Agostino, G. Scalera, C.M. Altamura, M. Russo, A.R. Mascolo, G. Pettinati, S.A. Ciricugno, D. Scrutinio, A. Passantino, D. Mastrangelo, A. Di Masi, R. De Carne, M. Cannone, F. Dibiase, M. Pensato, F. Loliva, F. Trapani, I. Panettieri, L. Leone, M. Di Biase, M. Carrone, V. Gallone, F. Cocco, M. Costantini, C. Tritto, F. Cavalieri, L. Stella, F. Magliari, M. Callerame, A. De Giorgi, L. Pellegrino, M. Correra, V. Portulano, G.L. Nisi, G. Grassi, E. Cristallo, D. De Laura, C. Salerno, R. Fanelli, M. Villella, S. Pede, A. Renna, E. De Lorenzi, L. Urso, V. Lenti, A. Peluso, N. Baldi, G. Polimeni, P. Palma, R. Lauletta, E. Tagliamonte, T. Cirillo, B. Silvestri, G. Centonze, B. D'Alessandro, L. Truncellito, D. Mecca, M.A. Petruzzi, R.O.M. Coviello, A. Lopizzo, M. telli, S. Barbuzzi, S. Gubelli, G. Germinario, N. Cosentino, A. Mingrone, R. Vico, G. Borrello, M.L. Mazza, R. Cimino, D. Galasso, F. Cassadonte, U. Talarico, F. Perticone, S. Cassano, F. Catapano, S. Calemme, E. Feraco, C. Cloro, G. Misuraca, R. Caporale, L. Vigna, V. Spagnuolo, F. De Rosa, G. Spadafora, G. Zampaglione, R. Russo, F.A. Schipani, A.F. Ferragina, D. Stranieri, G. Musca, C. Carpino, P. Bencardino, F. Raimondo, D. Musacchio, G. Pulitanò, A. Ruggeri, A. Provenzano, S. Salituri, M. Musolino, S. Calandruccio, A. Marrari, E. Tripodi, R. Scali, L. Anastasio, A. Arone, P. Aragona, L. Donnangelo, M.G.A. Comito, F. Bilotta, I. Vaccaro, R. Rametta, V. Ventura, A. Bonvegna, A. Alì, C. Cinnirella, M. Raineri, F. Pompeo, N. Cascio Ingurgio, V. Carini, R. Coco, G. Giunta, G. Leonardi, V. Randazzo, V. Di Blasi, C. Tamburino, G. Russo, S. Mangiameli, R. Cardillo, D. Castelli, V. Inserra, A. Arena, M.M. Gulizia, S. Raciti, G. Rapisarda, R. Romano, P. Prestifilippo, G.B. Braschi, G. Ledda, R. Terrazzino, M. De Caro, G. Scilabra, B. agnino, R. Grassi, G. Di Tano, G.F. Scimone, L. Vasquez, C. Coppolino, A. Casale, M. Castelli, G. D'Urso, E. D'Antonio, L. Lo Presti, E. Badalamenti, P. Conti, N. Sanfilippo, V. Cirrincione, M.T. Cinà, G. Cusimano, A. Taormina, P. Giuliano, A. Bajardi, V. Mandalà, A. Canonico, G. Geraci, F.P. Sabella, F. Enia, A.M. Floresta, I. Lo Cascio, D. Gumina, A. Cavallaro, G. Piccione, R. Ferrante, M. Blandino, M.S. Iudicello, E. Mossuti, G. Romano, L. Lombardo, P. Monastra, D. Di Vincenzo, M. Porcu, P. Orrù, F. Muscas, G. Giardina, M. Corda, G. Locci, A. Podda, M. Ledda, P. Siddi, C. Lai, G. Pili, G. Mercuro, G. Mureddu, A. Ganau, G. Meloni, G. Poddighe, G. Sanna, Dauriz, Marco, Targher, Giovanni, Temporelli, Pier Luigi, Lucci, Donata, Gonzini, Lucio, Nicolosi, Gian Luigi, Marchioli, Roberto, Tognoni, Gianni, Latini, Roberto, Cosmi, Franco, Tavazzi, Luigi, Maggioni, Aldo Pietro, on behalf of the GISSI-HF, Investigator, Margonato, Alberto, Moccetti, T., Rossi, M. G., Pasotti, E., Vaghi, F., Roncarolo, P., Zunino, M. T., Matta, F., Actis Perinetto, E., Gaita, F., Azzaro, G., Zanetta, M., Paino, A. M., Parravicini, U., Vegis, D., Conte, R., Ferraro, P., De Bernardi, A., Morelloni, S., Fagnani, M., Greco Lucchina, P., Montagna, L., Bellone, E., Sappè, D., Ferraro, F., Delucchi, M., Reynaud, S. G., Dore, M., La Brocca, A., Massobrio, N., Bo, L., Trinchero, R., Imazio, M., Brocchi, G., Nejrotti, A., Rissone, L., Gabasio, S., Zocchi, C., Randazzo, S., Crenna, A., Giannuzzi, P., Bonanomi, E., Mezzani, A., De Marchi, M., Begliuomini, G., Gianonatti, C. A., Gavazzi, A., Grosu, A., Dei Cas, L., Nodari, S., Garyfallidis, P., Bertoletti, A., Bonifazi, C., Arisi, S., Mascaro, F., Fraccarollo, M., Dell'Orto, S., Sfolcini, M., Bortolini, F., Raccagni, D., Turelli, A., Santarone, M., Miglierina, E., Sormani, L., Jemoli, R., Tettamanti, F., Pirelli, S., Bianchi, C., Verde, S., Mariani, M., Ziacchi, V., Ferrazza, A., Russo, A., Bortolotti, M., Pasini, G. F., Volpi, A., Jones, K. N., Cuzzucrea, D., Gullace, G., Carbone, C., Granata, A., De Servi, S., Del Rosso, G., Inserra, C., Renaldini, E., Zappa, C., Moretti, M., Zanini, R., Ferrari, M., Moroni, E., Cei, A., Lissi, C., Dovico, E., Fiorentini, C., Palermo, P., Brusoni, B., Negrini, M., Heyman, J., Danzi, G. 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L., Paccaloni, L., Pezzuoli, F., Carincola, S., Papi, S., De Crescentini, S., Gerardi, P., Midi, P., Gallenzi, E., Pajes, G., Mancone, C., Di Spirito, V., Di Gennaro, M., Calcagno, S., Toscano, S., Antonicoli, S., Carta, F., Giorgi, G., Comito, F., Daniele, E., Ciarla, O., Gelfo, P. G., Acquaviva, A., Testa, D., Testa, G., Pagliaro, F. A., Russo, F., Vetta, F., Marchese, I., Di Sciascio, G., D'Ambrosio, A., Leggio, F., Del Sindaco, D., Lacchè, A., Avallone, A., Risa, M. P., Azzolini, P., Baldo, E., Giovannini, E., Pulignano, G., Tondo, C., Picchio, E., Biffani, E., Tanzi, P., Pozzar, F., Farnetti, F., Azzarito, M., Santini, M., Varveri, A., Ferraiuolo, G., Valtorta, C., Gaspardone, A., Barbato, G., Ceci, V., Aspromonte, N., Bellocci, F., Colizzi, C., Fedele, F., Perez, F. I., Galati, A., Rossetti, A., Mainella, A., Ciuffetta, D., Matteucci, C., Busi, G., De Angelis, A., Farina, G., Granatelli, A., Leone, F., Frasca, F., Di Giovambattista, R., Castellani, G., Massaro, G., Mastrogiuseppe, G., Vacri, A., De Sanctis, F., Cioli, M., Di Luzio, S., Napoletano, C., Piccioni, L. L., De Simone, G., Ottaviano, A., Mazza, V., Spedaliere, C., Staniscia, D., Calgione, E., De Marco, G., Chiacchio, T., Di Napoli, T., Romanzi, S., Salvatore, G., Golino, P., Palermo, A., Mascia, F., Vetrano, A., Vinciguerra, A., Caliendo, L., Longobardi, R., De Caro, G., Di Nola, R., Piemonte, F., Prinzi, D., De Rosa, P., De Rosa, V., Riello, F., Capuano, V., Vecchio, G., Landi, M., Amato, S., Garofalo, M., D'Avino, M., Sensale, P., Maiolica, O., Santoro, R., Caso, P., Miceli, D., Maurea, N., Bianchi, U., Crispo, C., Chiariello, M., Perrone Filardi, P., Russo, L., Capuano, N., Ungaro, G., Vergara, G., Scafuro, F., D'Angelo, G., Campaniello, C., Bottiglieri, P., Volpe, A., Battista, R., De Risi, L., Cardillo, G., Sibilio, G., Marino, A. P., Silvestri, F., Predotti, P., Iervoglini, A., De Matteis, C., Sarnicola, P., Matarazzo, M. 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F., Stranieri, D., Musca, G., Carpino, C., Bencardino, P., Raimondo, F., Musacchio, D., Pulitanò, G., Ruggeri, A., Provenzano, A., Salituri, S., Musolino, M., Calandruccio, S., Marrari, A., Tripodi, E., Scali, R., Anastasio, L., Arone, A., Aragona, P., Donnangelo, L., Comito, M. G. A., Bilotta, F., Vaccaro, I., Rametta, R., Ventura, V., Bonvegna, A., Alì, A., Cinnirella, C., Raineri, M., Pompeo, F., Cascio Ingurgio, N., Carini, V., Coco, R., Giunta, G., Leonardi, G., Randazzo, V., Di Blasi, V., Tamburino, C., Russo, G., Mangiameli, S., Cardillo, R., Castelli, D., Inserra, V., Arena, A., Gulizia, M. M., Raciti, S., Rapisarda, G., Romano, R., Prestifilippo, P., Braschi, G. B., Ledda, G., Terrazzino, R., De Caro, M., Scilabra, G., Graffagnino, B., Grassi, R., Di Tano, G., Scimone, G. F., Vasquez, L., Coppolino, C., Casale, A., Castelli, M., D'Urso, G., D'Antonio, E., Lo Presti, L., Badalamenti, E., Conti, P., Sanfilippo, N., Cirrincione, V., Cinà, M. T., Cusimano, G., Taormina, A., Giuliano, P., Bajardi, A., Mandalà, V., Canonico, A., Geraci, G., Sabella, F. P., Enia, F., Floresta, A. M., Lo Cascio, I., Gumina, D., Cavallaro, A., Piccione, G., Ferrante, R., Blandino, M., Iudicello, M. S., Mossuti, E., Romano, G., Lombardo, L., Monastra, P., Di Vincenzo, D., Porcu, M., Orrù, P., Muscas, F., Giardina, G., Corda, M., Locci, G., Podda, A., Ledda, M., Siddi, P., Lai, C., Pili, G., Mercuro, G., Mureddu, G., Ganau, A., Meloni, G., Poddighe, G., Sanna, G., Barlera, Simona, Franzosi, Maria Grazia, Porcu, Maurizio, Yusuf, Salim, Camerini, Fulvio, Cohn, Jay N., Decarli, Adriano, Pitt, Bertram, Sleight, Peter, Poole-Wilson, Philip A., Geraci, Enrico, Scherillo, Marino, Fabbri, Gianna, Bartolomei, Barbara, Bertoli, Daniele, Cobelli, Franco, Fresco, Claudio, Ledda, Antonietta, Levantesi, Giacomo, Opasich, Cristina, Rusconi, Franco, Sinagra, Gianfranco, Turazza, Fabio, Volpi, Alberto, Ceseri, Martina, Alongi, Gianluca, Atzori, Antonio, Bambi, Filippo, Bastarolo, Desiree, Bianchini, Francesca, Cangioli, Iacopo, Canu, Vittoriana, Caporusso, Concetta, Cenni, Gabriele, Cintelli, Laura, Cocchio, Michele, Confente, Alessia, Fenicia, Eva, Friso, Giorgio, Gianfriddo, Marco, Grilli, Gianluca, Lazzaro, Beatrice, Lonardo, Giuseppe, Luise, Alessia, Nota, Rachele, Orlando, Mariaelena, Petrolo, Rosaria, Pierattini, Chiara, Pierota, Valeria, Provenzani, Alessandro, Quartuccio, Velia, Ragno, Anna, Serio, Chiara, Spolaor, Alvise, Tafi, Arianna, Tellaroli, Elisa, Ghio, Stefano, Ghizzardi, Elisa, Masson, Serge, Crociati, Lella, La Rovere, Maria Teresa, Corrà, Ugo, Di Giulio, Paola, Finzi, Andrea, Gorini, Marco, Milani, Valentina, Orsini, Giampietro, Bianchini, Elisa, Cabiddu, Silvia, Cangioli, Ilaria, Cipressa, Laura, Cipressa, Maria Lucia, Di Bitetto, Giuseppina, Ferri, Barbara, Galbiati, Luisa, Lorimer, Andrea, Pera, Carla, Priami, Paola, and Vasamì, Antonella
- Subjects
Blood Glucose ,Male ,Glycated Hemoglobin A ,heart failure ,Kaplan-Meier Estimate ,prediabetes ,030204 cardiovascular system & hematology ,time factors ,Settore MED/11 ,cause of death ,0302 clinical medicine ,Glycemic control ,prediabetic state ,Cause of Death ,italy ,middle aged ,Prevalence ,80 and over ,double-blind method ,blood glucose ,risk factors ,030212 general & internal medicine ,Prediabetes ,Rosuvastatin Calcium ,humans ,rosuvastatin calcium ,Cause of death ,Original Research ,Metabolic Syndrome ,Aged, 80 and over ,adult ,Chronic heart failure ,Diabetes mellitus ,Heart failure ,Mortality ,Cardiology and Cardiovascular Medicine ,Hazard ratio ,chronic heart failure ,diabetes mellitus ,glycemic control ,mortality ,Treatment Outcome ,Adolescent ,Biomarkers ,Chronic Disease ,Diabetes Mellitus ,Fatty Acids, Omega-3 ,Double-Blind Method ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Hospitalization ,Heart Failure ,Italy ,Prediabetic State ,Risk Assessment ,Proportional Hazards Models ,Risk Factors ,Time Factors ,risk assessment ,Middle Aged ,kaplan-meier estimate ,aged ,female ,Prediabete ,young adult ,Female ,omega-3 ,Human ,hospitalization ,Adult ,medicine.medical_specialty ,Diabetes mellitu ,proportional hazards models ,Time Factor ,hydroxymethylglutaryl-coa reductase inhibitors ,prevalence ,fatty acids ,03 medical and health sciences ,Young Adult ,male ,Internal medicine ,Post-hoc analysis ,glycated hemoglobin a ,medicine ,Intensive care medicine ,Aged ,Glycated Hemoglobin ,Proportional hazards model ,business.industry ,Risk Factor ,biomarkers ,Biomarker ,medicine.disease ,Clinical trial ,adolescent ,Proportional Hazards Model ,treatment outcome ,aged, 80 and over ,chronic disease ,fatty acids, omega-3 ,cardiology and cardiovascular medicine ,Hydroxymethylglutaryl-CoA Reductase Inhibitor ,business - Abstract
Background The independent prognostic impact of diabetes mellitus ( DM ) and prediabetes mellitus (pre‐ DM ) on survival outcomes in patients with chronic heart failure has been investigated in observational registries and randomized, clinical trials, but the results have been often inconclusive or conflicting. We examined the independent prognostic impact of DM and pre‐ DM on survival outcomes in the GISSI ‐HF (Gruppo Italiano per lo Studio della Sopravvivenza nella Insufficienza Cardiaca‐Heart Failure) trial. Methods and Results We assessed the risk of all‐cause death and the composite of all‐cause death or cardiovascular hospitalization over a median follow‐up period of 3.9 years among the 6935 chronic heart failure participants of the GISSI ‐ HF trial, who were stratified by presence of DM (n=2852), pre‐ DM (n=2013), and non‐ DM (n=2070) at baseline. Compared with non‐ DM patients, those with DM had remarkably higher incidence rates of all‐cause death (34.5% versus 24.6%) and the composite end point (63.6% versus 54.7%). Conversely, both event rates were similar between non‐ DM patients and those with pre‐ DM . Cox regression analysis showed that DM , but not pre‐ DM , was associated with an increased risk of all‐cause death (adjusted hazard ratio, 1.43; 95% CI , 1.28–1.60) and of the composite end point (adjusted hazard ratio, 1.23; 95% CI , 1.13–1.32), independently of established risk factors. In the DM subgroup, higher hemoglobin A1c was also independently associated with increased risk of both study outcomes (all‐cause death: adjusted hazard ratio, 1.21; 95% CI , 1.02–1.43; and composite end point: adjusted hazard ratio, 1.14; 95% CI , 1.01–1.29, respectively). Conclusions Presence of DM was independently associated with poor long‐term survival outcomes in patients with chronic heart failure. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 00336336.
- Published
- 2017
11. 24Hour modulation of peripheral and central blood pressure heart rate and arterial stiffness in heart transplant hypertensive individuals
- Author
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M. Varrenti, P. Meani, L. Giupponi, P. Vallerio, E. Ferrari, M. Stucchi, A. Maloberti, J. Bruno, F. Turazza, G. Parati, M. Frigerio, C. Giannattasio., Varrenti, M, Meani, P, Giupponi, L, Vallerio, P, Ferrari, E, Stucchi, M, Maloberti, A, Bruno, J, Turazza, F, Parati, G, Frigerio, M, and Giannattasio, C
- Subjects
peripheral and central blood pressure, heart transplant - Published
- 2015
12. 24Hour modulation of peripheral and central blood pressure heart rate and arterial stiffness in heart transplant hypertensive individuals
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Varrenti, M, Meani, P, Giupponi, L, Vallerio, P, Ferrari, E, Stucchi, M, Maloberti, A, Bruno, J, Turazza, F, Parati, G, Frigerio, M, Giannattasio, C, M. Varrenti, P. Meani, L. Giupponi, P. Vallerio, E. Ferrari, M. Stucchi, A. Maloberti, J. Bruno, F. Turazza, G. Parati, M. Frigerio, C. Giannattasio., Varrenti, M, Meani, P, Giupponi, L, Vallerio, P, Ferrari, E, Stucchi, M, Maloberti, A, Bruno, J, Turazza, F, Parati, G, Frigerio, M, Giannattasio, C, M. Varrenti, P. Meani, L. Giupponi, P. Vallerio, E. Ferrari, M. Stucchi, A. Maloberti, J. Bruno, F. Turazza, G. Parati, M. Frigerio, and C. Giannattasio.
- Published
- 2015
13. P5.9 LACK OF RECOVERY IN NOCTURNAL DECLINE OF HEART RATE AND BLOOD PRESSURE AFTER HEART TRASPLANTATION
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L. Bonacchini, Siegfried Wassertheurer, Paolo Meani, M. Frigerio, Gianfranco Parati, Marisa Varrenti, V. Riva, Alessandro Maloberti, L. Giupponi, Cristina Giannattasio, and F. Turazza
- Subjects
medicine.medical_specialty ,business.industry ,Specialties of internal medicine ,General Medicine ,Nocturnal ,Blood pressure ,RC581-951 ,RC666-701 ,Internal medicine ,Heart rate ,medicine ,Cardiology ,Diseases of the circulatory (Cardiovascular) system ,business - Published
- 2014
14. Epidemiologic variables and outcome of 1972 young patients with acute myocardial infarction. Data from the GISSI-2 database. Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2)
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T, Moccetti, R, Malacrida, E, Pasotti, F, Sessa, M, Genoni, S, Barlera, F, Turazza, and A P, Maggioni
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Male ,Physical Exertion ,Smoking ,Age Factors ,Myocardial Infarction ,Blood Pressure ,Middle Aged ,Prognosis ,Body Mass Index ,Cholesterol ,Logistic Models ,Sex Factors ,Treatment Outcome ,Italy ,Predictive Value of Tests ,Risk Factors ,Multivariate Analysis ,Income ,Educational Status ,Humans ,Female ,Hospital Mortality ,Aged - Abstract
Acute myocardial infarction in younger patients is uncommon, occurring mainly in men. The recent introduction of thrombolysis improved survival, left ventricular function, and infarct size.To evaluate characteristics and clinical outcome of the patients younger than 50 years randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico study. All patients received a thrombolytic treatment.The 11483 patients were divided into 3 age subgroups: younger than 50 years (17.2%), between 50 and 70 years (60.2%), and older than 70 years (22.6%). All relations between variables were first determined by an unadjusted analysis. An adjusted analysis was performed by multiple logistic regression models for in-hospital and 6-month mortality.While older patients had a significantly higher rate of a history of hypercholesterolemia, diabetes, and hypertension, smoking and a positive family history were significantly more frequent in younger patients. Total in-hospital and 6-month mortality were significantly lower in patients younger than 50 years (2.7% and 1.2%, respectively) than in patients between 50 and 70 years old (6.9% and 2.7%) and those older than 70 years (21.1% and 8.4%). After multivariate analysis, the predictive value of age was confirmed.Our findings, based on a large group of patients who received thrombolytic treatment, suggest that younger age is a significant independent indicator of a favorable prognosis after acute myocardial infarction.
- Published
- 1997
15. Angiotensin-converting enzyme inhibition in myocardial infarction--Part 2: Clinical issues and controversies
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V F, Huckell, V, Bernstein, R, Crowell, G R, Dagenais, L A, Higginson, S, Isserow, P, Laramée, P, Liu, J L, McCans, R C, Orchard, R, Prewitt, B P, Quinn, M, Samson, F, Turazza, J W, Warnica, and A, Wielgosz
- Subjects
Clinical Trials as Topic ,Death, Sudden, Cardiac ,Risk Factors ,Cost-Benefit Analysis ,Patient Selection ,Myocardial Infarction ,Humans ,Angiotensin-Converting Enzyme Inhibitors - Abstract
Over the past 10 years, several clinical studies have concluded that, in patients already receiving conventional therapies, angiotensin-converting enzyme (ACE) inhibitors further reduce the risk of death following myocardial infarction (MI). Post-MI ACE inhibitors have proven to be effective as long term therapy in high risk patients as well as when used for much shorter periods in a broad patient population. However, while considerable mortality data have been collected, the effects of ACE inhibitors post-MI on other cardiovascular outcomes have not been as well documented. In addition, a number of issues regarding the most effective use of these agents remain unresolved. This paper, the second of two parts, focuses on the clinical issues and controversies surrounding the use of ACE inhibitors following acute MI. The effects of ACE inhibitors on the outcomes of sudden death, nonsudden death, recurrent angina, mitral regurgitation and left ventricular dysfunction are reviewed and potential mechanisms of action are proposed. In addition, ACE inhibitor therapy is discussed in terms of patient selection criteria, choice of agent, optimal dosing regimen, concomitant use of other therapies and relative costs of treatment. Finally, potential mechanisms of action of ACE inhibitors are proposed for each of the outcomes examined.
- Published
- 1997
16. Angiotensin-converting enzyme inhibition in myocardial infarction--Part 1: Clinical data
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V F, Huckell, V, Bernstein, J A, Cairns, R, Crowell, G R, Dagenais, L A, Higginson, S, Isserow, P, Laramée, P, Liu, J L, McCans, R C, Orchard, R, Prewitt, B P, Quinn, M, Samson, F, Turazza, J W, Warnica, and A, Wielgosz
- Subjects
Clinical Trials as Topic ,Risk Factors ,Myocardial Infarction ,Humans ,Angiotensin-Converting Enzyme Inhibitors - Abstract
There is an increasing body of clinical trial evidence to support the use of angiotensin-converting enzyme (ACE) inhibitors in the management of patients following myocardial infarction (MI). Enthusiasm for the use of ACE inhibitors in the acute phase of MI had previously been tempered by the adverse results of an early trial. However, exciting new information is available from several large, randomized studies that has not only quelled those initial concerns but also attests to the efficacy of using this class of medication in the first 24 h after an acute MI. A Canadian National Opinion Leader Symposium was held in November 1995 to review the results of the major ACE inhibitor clinical trials and to discuss key issues and controversies surrounding their use in acute MI. The focus of this paper, the first of two parts, is on the results of the major ACE inhibitor clinical trials.
- Published
- 1997
17. Tarsal Coalition: Surgical Management in the Young Athlete.
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Masquijo J and Turazza F
- Abstract
Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)
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- 2024
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18. [ANMCO Position paper in collaboration with ITACARE-P: Cardio-oncology rehabilitation. Are we ready?]
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Bisceglia I, Venturini E, Canale ML, Ambrosetti M, Riccio C, Giallauria F, Gallucci G, Abrignani MG, Russo G, Lestuzzi C, Mistrulli R, De Luca G, Turazza F, Mureddu GF, Di Fusco SA, Lucà F, De Luca L, Camerini A, Halasz G, Camilli M, Quagliariello V, Maurea N, Fattirolli F, Gulizia MM, Gabrielli D, Grimaldi M, Colivicchi F, and Oliva F
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- Humans, Cardio-Oncology, Quality of Life, Cancer Survivors, Cardiologists, Cardiovascular Diseases prevention & control
- Abstract
Cardio-oncology rehabilitation (CORE) is not only an essential component of cancer rehabilitation, but also a pillar of preventive cardio-oncology. CORE is a comprehensive model based on a multitargeted approach and its efficacy has been widely documented; when compared to an "exercise only" program, comprehensive CORE demonstrates a better outcome. It involves nutritional counseling, psychological support and cardiovascular risk assessment, and it is directed to a very demanding population with a heavy burden of cardiovascular diseases driven by physical inactivity, cancer therapy-induced metabolic derangements and cancer therapy-related cardiovascular toxicities. Despite its usefulness, CORE is still underused in cancer patients and we are still at the dawning of remote models of rehabilitation (telerehabilitation). Not all cardio-oncology rehabilitation is created equal: a careful screening procedure to identify patients who will benefit the most from CORE and a multidisciplinary customized approach are mandatory to achieve a better outcome for cancer survivors throughout their cancer journey.The aim of this position paper is to provide an updated review of CORE not only for cardiologists dealing with this peculiar patient population, but also for oncologists, primary care providers, patients and caregivers. This multidisciplinary team should help cancer patients to maintain a healthy and active life before, during and after cancer treatment, in order to improve quality of life and to fight health inequities.
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- 2024
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19. [Anterior tibialis tendon transfer for the treatment of dynamic supination in patients with clubfoot. Analysis of clinical outcomes and complications].
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Turazza F, Sanchez E, Allende V, and Masquijo JJ
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- Child, Humans, Tendon Transfer methods, Supination, Treatment Outcome, Foot, Casts, Surgical, Recurrence, Clubfoot surgery
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Introduction: our aim was to evaluate the clinical outcomes and complications of anterior tibialis tendon transfer (ATTT) in children with dynamic supination after clubfoot treatment., Material and Methods: children with dynamic supination after initial treatment with Ponseti method or surgery who underwent ATTT between 2008 and 2020 were included for evaluation. Demographic data, previous treatment, associated procedures and fixation method were analyzed. Functional results were evaluated with the grading system described by Thompson. Complications and their treatment were analyzed., Results: a total of 39 patients (57 feet) were analyzed. 70% received previous treatment with Ponseti method, 19.3% underwent surgical posteromedial release, and 10.7% another type of surgical treatment. 88% of cases required associated procedures including Achilles tendon lengthening or tenotomy, plantar fasciotomy, tibial osteotomy, lateral column shortening, posterior release. The predominant type of fixation was the pull-out button method (96.5%). The average follow-up was 31.5 months. According to the Thompson grading system, 52 patients presented good results, two fair and three poor. 98.2% of the feet showed active contraction of the transferred tibialis anterior tendon. There were four complications: plantar irritation, synovial cyst in the dorsum of the foot and deep infection. Two feet required unplanned surgery., Conclusion: anterior tibialis tendon transfer is an effective technique to correct residual dynamic supination in patients with clubfoot.
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- 2023
20. Causes of death in women with breast cancer: a risks and rates study on a population-based cohort.
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Contiero P, Boffi R, Borgini A, Fabiano S, Tittarelli A, Mian M, Vittadello F, Epifani S, Ardizzone A, Cirilli C, Boschetti L, Marguati S, Cascone G, Tumino R, Fanetti AC, Giumelli P, Candela G, Scuderi T, Castelli M, Bongiorno S, Barigelletti G, Perotti V, Veronese C, Turazza F, Crivaro M, and Tagliabue G
- Abstract
Introduction: The increasing survival of patients with breast cancer has prompted the assessment of mortality due to all causes of death in these patients. We estimated the absolute risks of death from different causes, useful for health-care planning and clinical prediction, as well as cause-specific hazards, useful for hypothesis generation on etiology and risk factors., Materials and Methods: Using data from population-based cancer registries we performed a retrospective study on a cohort of women diagnosed with primary breast cancer. We carried out a competing-cause analysis computing cumulative incidence functions (CIFs) and cause-specific hazards (CSHs) in the whole cohort, separately by age, stage and registry area., Results: The study cohort comprised 12,742 women followed up for six years. Breast cancer showed the highest CIF, 13.71%, and cardiovascular disease was the second leading cause of death with a CIF of 3.60%. The contribution of breast cancer deaths to the CIF for all causes varied widely by age class: 89.25% in women diagnosed at age <50 years, 72.94% in women diagnosed at age 50-69 and 48.25% in women diagnosed at age ≥70. Greater CIF variations were observed according to stage: the contribution of causes other than breast cancer to CIF for all causes was 73.4% in women with stage I disease, 42.9% in stage II-III and only 13.2% in stage IV. CSH computation revealed temporal variations: in women diagnosed at age ≥70 the CSH for breast cancer was equaled by that for cardiovascular disease and "other diseases" in the sixth year following diagnosis, and an early peak for breast cancer was identified in the first year following diagnosis. Among women aged 50-69 we identified an early peak for breast cancer followed by a further peak near the second year of follow-up. Comparison by geographic area highlighted conspicuous variations: the highest CIF for cardiovascular disease was more than 70% higher than the lowest, while for breast cancer the highest CIF doubled the lowest., Conclusion: The integrated interpretation of absolute risks and hazards suggests the need for multidisciplinary surveillance and prevention using community-based, holistic and well-coordinated survivorship care models., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Contiero, Boffi, Borgini, Fabiano, Tittarelli, Mian, Vittadello, Epifani, Ardizzone, Cirilli, Boschetti, Marguati, Cascone, Tumino, Fanetti, Giumelli, Candela, Scuderi, Castelli, Bongiorno, Barigelletti, Perotti, Veronese, Turazza, Crivaro, Tagliabue and the MAPACA Working Group.)
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- 2023
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21. Ultrasound evaluation of the femoral trochlea in newborns: incidence of trochlear dysplasia and associated risk factors.
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Masquijo J, Bruno A, Warde A, Mónico C, and Turazza F
- Abstract
This study aimed to describe the femoral groove morphology using ultrasound in children under 6 months, estimate the incidence of trochlear dysplasia, and evaluate associated risk factors. A prospective study included 298 patients who underwent universal ultrasound screening for hip dysplasia [developmental dysplasia of the hip (DDH)] and knee ultrasound. Measurements of sulcus angle (SA), trochlear depth (TD), and trochlear facet asymmetry (TFA) were analyzed. Trochlear dysplasia was considered present if the ASO was ≥159°. Reproducibility was assessed using the intraclass correlation coefficient (ICC) in 60 knees. Logistic regression adjusted for confounders, presenting odds ratios (OR) and 95% confidence intervals (CI). Significance was set at P < 0.05. Analysis included 596 knees (298 patients). Females accounted for 51% of patients, with 7% having breech presentation, 4.4% DDH, 6.4% family history of DDH, and 5% family history of patellofemoral instability. ICC showed excellent agreement for SA and TD, but poor for TFA. Trochlear dysplasia incidence was 3% (9/298; 67% bilateral). Median (IQR) values were 147.5 (144.0-150.5) for SA, 2.4 (2.2-2.8) for TD, and 1.1 (1.0, 1.1) for TFA. Breech presentation (OR, 9.68; 95% CI 1.92-48.71, P = 0.006) and concomitant DDH (OR 6.29, 95% CI 1.04-37.78, P = 0.044) were associated with trochlear dysplasia. Ultrasound effectively evaluates femoral groove morphology and diagnoses trochlear dysplasia in newborns. Trochlear dysplasia incidence was 3%, with a 10-fold higher risk in breech presentation and 6-fold higher risk in concomitant DDH. Standardized screening and timely treatment protocols should be further investigated. Level of evidence: Diagnostic Level II., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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22. [Cardio-oncogeriatrics: ANMCO position paper on cardio-oncology management of elderly patients].
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Bisceglia I, Canale ML, Camilli M, Gallucci G, Laudisio A, Lestuzzi C, Russo G, Turazza F, Fiscella D, Paccone A, Maurea N, Parrini I, Di Fusco SA, Lucà F, Mistrulli R, Zuccalà G, Gulizia MM, Gabrielli D, Oliva F, and Colivicchi F
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- Humans, Aged, Medical Oncology, Geriatric Assessment, Cardiotoxicity complications, Neoplasms therapy, Neoplasms complications, Cardiovascular Diseases chemically induced, Cardiovascular Diseases therapy
- Abstract
Geriatric patients are an increasing population and cancer treatment in this population is a challenging and unsolved issue. Ageing is characterized by low-grade inflammation (inflamm-ageing), an important driver for age-related diseases such as cardiovascular diseases and cancer. These chronic conditions share pathophysiological bases, risk factors and may coexist. The burden of comorbidities lowers the threshold for cardiotoxic effects of oncologic treatments. Geriatric assessment is helpful in identifying the peculiar vulnerabilities of this complex population, but a multidisciplinary approach (with oncologists and cardio-oncologists) is needed to improve the appropriateness of care. In this ANMCO position paper, we define the role of cardio-oncologists in the different scenarios of older cancer patients (active cancer, long-term survivors), the importance of geriatric assessment, the unmet needs of survivors and the complexity of comorbidity management.
- Published
- 2022
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23. Corrigendum: Portrait of Italian Cardio-Oncology: Results of a Nationwide Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Survey.
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Canale ML, Turazza F, Lestuzzi C, Parrini I, Camerini A, Russo G, Colivicchi F, Gabrielli D, Gulizia MM, Oliva S, Tarantini L, Maurea N, Rigacci L, Petrolati S, Casolo G, and Bisceglia I
- Abstract
[This corrects the article DOI: 10.3389/fcvm.2021.677544.]., (Copyright © 2022 Canale, Turazza, Lestuzzi, Parrini, Camerini, Russo, Colivicchi, Gabrielli, Gulizia, Oliva, Tarantini, Maurea, Rigacci, Petrolati, Casolo and Bisceglia.)
- Published
- 2022
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24. Current trends in the treatment of knee fractures in children and adolescents.
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Paccola AM, Turazza F, and Masquijo JJ
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- Child, Humans, Adolescent, Knee Fractures
- Abstract
Fractures about the knee are common in children and adolescents. Characteristics of the growing skeleton make children susceptible to specific fractures that do not occur in adults. Understanding the relevant anatomy, pathophysiology, diagnosis, and treatment options are important to decrease the risk of complications. The aim of this article is to discuss the current trends in diagnosis and treatment of tibial eminence, tibial tuberosity sleeve, and osteochondral fractures in children and adolescents.
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- 2022
25. Cardiologic Long-Term Follow-Up of Patients Treated With Chest Radiotherapy: When and How?
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Lestuzzi C, Mascarin M, Coassin E, Canale ML, and Turazza F
- Abstract
Introduction: Radiotherapy may cause valvular (VHD), pericardial, coronary artery disease (CAD), left ventricular dysfunction (LVD), arrhythmias. The risk of radiation induced heart disease (RIHD) increases over time. The current guidelines suggest a screening for RIHD every 5 years in the long-term survivors who had been treated by chest RT. Methods: We reviewed the clinical and instrumental data of 106 patients diagnosed with RIHD. In one group (Group A: 69 patients) RIHD was diagnosed in an asymptomatic phase through a screening with ECG, echocardiogram and stress test. A second group (37 patients) was seen when RIHD was symptomatic. We compared the characteristics of the two groups at the time of RT, of RIHD detection and at last follow-up. Results: Overall, 64 patients (60%) had CAD (associated to other RIHD in 18); 39 (36.7%) had LVD (isolated in 20); 24 (22.6%) had VHD (isolated in 10 cases). The interval between the last negative test and the diagnosis of moderate or severe RIHD was <5 years in 26 patients, and <4 years in 18. In group A, 63% of the patients with CAD had silent ischemia. The two groups did not differ with regard to type of tumor, cardiovascular risk factors, use of anthracycline-based chemotherapy, age at RT treatment, radiation dose and interval between RT and toxicity detection. The mean time from RT and RIHD was 16 years in group A and 15 in group B. Interventional therapy at RIHD diagnosis was more frequent in group B (54 vs. 30%, p < 0.05). At last follow-up, 27 patients had died (12 of cancer, 9 of cardiac causes, 6 of other causes); mean ejection fraction was 60% in group A and 50% in group B ( p < 0.01). Patients with ejection fraction ≤ 50% were 14.5% in group A and 40% in group B ( p < 0.01). Conclusions: Clinically relevant RIHD become evident at a mean interval of 16 years after RT. The most frequent clinical manifestations are CAD and LVD. RIHD diagnosis in asymptomatic patients may preserve their cardiac function with timely interventions. We suggest -after 10 years from radiotherapy- a screening every 2-3 years., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Lestuzzi, Mascarin, Coassin, Canale and Turazza.)
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- 2021
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26. Portrait of Italian Cardio-Oncology: Results of a Nationwide Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO) Survey.
- Author
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Canale ML, Turazza F, Lestuzzi C, Parrini I, Camerini A, Russo G, Colivicchi F, Gabrielli D, Gulizia MM, Oliva S, Tarantini L, Maurea N, Rigacci L, Petrolati S, Casolo G, and Bisceglia I
- Abstract
Aims: Cardio-oncology has achieved a pivotal role in science, but real world data on its clinical impact are still limited. Methods: A questionnaire was sent out to all cardio-oncology services across Italy ( n = 120). The questionnaire was made up of 28 questions divided into four blocks: (A) general information on hospitals and service, (B) the inner organization of cardio-oncology and its relationships with out-of-hospital cardiologists and general practitioners, (C) educational needs and referral guidelines, and (D) activities/specific workload. Results: Ninety-six out of 120 (80%) completed the questionnaire; 9.4% were cancer centers while 90.6% were general hospitals. A cardio-oncology team was present in 56% of the cancer centers and in 20% only of general hospitals, and a cardio-oncology pathway was active in 55% of cancer centers and in just 14% of the general hospitals. Relationships with out-of-hospital cardiologists and general practitioners were lacking. The guidelines of reference were ESC and ANMCO/AIOM. Patients receiving anthracycline chemotherapy underwent scheduled monitoring by means of echocardiography in 58% of cases. Routine use of cardiac damage biomarkers was overall low, ranging from 22 to 33% while the use of global longitudinal strain reached 44%. Conclusions: Italian cardio-oncology showed a growing influence on clinical practice but still has room for improvement. Cardio-oncology teams are still scarce, and the application of dedicated paths is poor. The need for specific training has been highlighted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Canale, Turazza, Lestuzzi, Parrini, Camerini, Russo, Colivicchi, Gabrielli, Gulizia, Oliva, Tarantini, Maurea, Rigacci, Petrolati, Casolo and Bisceglia.)
- Published
- 2021
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27. Could two-dimensional radial strain be considered as a novel tool to identify pre-clinical hypertrophic cardiomyopathy mutation carriers?
- Author
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Santambrogio GM, Maloberti A, Vallerio P, Peritore A, Spanò F, Occhi L, Musca F, Belli O, De Chiara B, Casadei F, Facchetti R, Turazza F, Manfredini E, Giannattasio C, and Moreo A
- Subjects
- Adolescent, Adult, Aged, Cardiac Myosins genetics, Cardiomyopathy, Hypertrophic genetics, Cardiomyopathy, Hypertrophic physiopathology, Carrier Proteins genetics, Case-Control Studies, DNA Mutational Analysis, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Mutation, Myosin Heavy Chains genetics, Phenotype, Predictive Value of Tests, Reproducibility of Results, Troponin T genetics, Young Adult, Cardiomyopathy, Hypertrophic diagnostic imaging, Echocardiography, Ventricular Function, Left
- Abstract
Treatment of overt form of hypertrophic cardiomyopathy (HCM) is often unsuccessful. Efforts are focused on a possible early identification in order to prevent or delaying the development of hypertrophy. Our aim was to find an echocardiographic marker able to distinguish mutation carriers without left ventricular hypertrophy (LVH) from healthy subjects. We evaluated 28 patients, members of eight families. Three types of mutation were recognized: MYBPC3 (five families), MYH7 (two families) and TNNT2 (one family). According to genetic (G) and phenotypic (Ph) features, patients were divided in three groups: Group A (10 patients), mutation carriers with LVH (G+/Ph+); Group B (9 patients), mutation carriers without LVH (G+/Ph-); Group C (9 patients), healthy subjects (G-/Ph-). Echocardiography examination was performed acquiring standard 2D, DTI and 2D-strain imaging. Global longitudinal strain (GLS) and global radial strain (GRS) at basal and mid-level were measured. GRS was significantly different between group B and C at basal level (32.18% ± 9.6 vs. 44.59% ± 12.67 respectively; p-value < 0.0001). In basal posterior and basal inferior segments this difference was particularly evident. ROC curves showed for both the involved segments good AUCs (0.931 and 0.861 for basal posterior and inferior GRS respectively) with the best predictive cut-off for basal posterior GRS at 43.65%, while it was 38.4% for basal inferior GRS. Conversely, GLS values were similar in the three group. 2D longitudinal strain is a valid technique to study HCM. Radial strain and particularly basal posterior and inferior segmental reduction could be able to identify mutation carriers in a pre-clinical phase of disease.
- Published
- 2019
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28. [Psychological evaluation and support in patients with left ventricular assist devices: preliminary data at 6-month follow-up].
- Author
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Voltolini A, Minotti A, Verde A, Cipriani M, Garascia A, Turazza F, Macera F, Perna E, Russo CF, Fumagalli E, and Frigerio M
- Subjects
- Adult, Aged, Female, Follow-Up Studies, Heart Diseases psychology, Humans, Life Expectancy, Male, Middle Aged, Patient Compliance, Surveys and Questionnaires, Time Factors, Heart Diseases therapy, Heart-Assist Devices psychology, Quality of Life
- Abstract
Background: Heart disease has an impact on patient's identity and self-perception. Taking into account the wide literature about psychological aspects before and after heart transplant, it clearly emerges that there is a lack of data and results for patients up to implantation of ventricular assist devices (VAD). The aim of the present study was to explore quality of life and factors correlated with psychological adjustment in patients supported with VAD., Methods: From February 2013 to August 2014, 18 patients (17 male, mean age 57 years) under clinical evaluation before and after VAD implantation were enrolled. During interviews, patients were assessed with EuroQoL-5D questionnaire to monitor improvement of quality of life before implantation and at 3 and 6 months; critical issues, needs and point of views of patients have been described., Results: A significant improvement in the quality of life score was observed at 3 (score 38 [interquartile range 30-40] vs 75 [60-80], p<0.05) and 6 months (38 [30-40] vs 70 [60-80], p<0.05). Overall, patients' psychological state investigated by the test showed a clear and positive trend. All patients need to empower through complete information about the device, related risks and life expectancy. Interdisciplinary approach improved compliance with therapy., Conclusions: Successful treatment and efficient psychological care are closely related to assessment and continuous clinical support. This approach ensures a better selection of patients and improves their compliance. Further data are needed to support our preliminary observations and to explore long-term quality of life.
- Published
- 2016
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29. Heart transplantation: 25 years' single-centre experience.
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Bruschi G, Colombo T, Oliva F, Botta L, Morici N, Cannata A, Vittori C, Turazza F, Garascia A, Pedrazzini G, Frigerio M, and Martinelli L
- Subjects
- Adolescent, Adult, Age Distribution, Age Factors, Aged, Blood Transfusion statistics & numerical data, Cardio-Renal Syndrome epidemiology, Cause of Death, Child, Coronary Artery Disease mortality, Female, Graft Rejection epidemiology, Graft Survival, Hospital Mortality, Humans, Immunosuppressive Agents therapeutic use, Infections epidemiology, Italy epidemiology, Kaplan-Meier Estimate, Length of Stay statistics & numerical data, Lymphoproliferative Disorders mortality, Male, Middle Aged, Multivariate Analysis, Neoplasms mortality, Operative Time, Percutaneous Coronary Intervention statistics & numerical data, Reoperation statistics & numerical data, Respiration, Artificial statistics & numerical data, Sex Distribution, Survival Analysis, Young Adult, Heart Transplantation statistics & numerical data
- Abstract
Objectives: Heart transplantation (HTx) is still one of the most effective therapies for end-stage heart disease for patients with no other medical or surgical therapy. We report the results of our 25-year orthotropic HTx single-centre experience., Methods: From November 1985, 905 orthotopic heart transplants have been performed at our centre. We exclude from the present analysis 13 patients who underwent re-transplantation and 14 pediatric cases (age at HTx <15 years)., Results: The present study collected the data of 878 primary adult orthotopic HTx performed at our centre. Mean age at HTx was of 49.6 ± 11.6 years. Mean donor age was 36.9 ± 14.8 years. Hospital mortality was 11.6% (102 patients), early graft failure was the principal cause of death (58 patients) followed by infections (18 cases) and acute rejection (7 patients). Overall actuarial survival was 78.1% at 5 years and 63.8% and 47.5%, respectively, at 10 and 15 years from HTx. Mean survival was 10.74 years; 257 late deaths were reported (33.1%); main causes were neoplasm in 83 patients, and cardiac causes included coronary allograft vasculopathy in 78 patients. Freedom from any infection at 5, 10 and 15 years was 52.2, 44.1 and 40.1%, respectively. Freedom from rejection at 5 years was 36.2%, with 493 patients experiencing at last one episode of rejection, the majority occurring during the first 2 months after transplantation. The long-term survival of HTx recipients is limited in large part by the development of coronary artery vasculopathy and malignancies. In our experience freedom from coronary allograft vasculopathy at 10 years was 66.9%, and 85 patients underwent percutaneous coronary revascularization. In our study population, 44 patients experienced posttransplant lymphoproliferative disorder and 91 patients experienced a solid neoplasm, mean survival free from neoplasm was 12.23 years., Conclusion: Over the past four decades the field of HTx has evolved considerably, with improvements in surgical techniques and postoperative patients' care. A careful patient selection and treatment of candidates for transplantation as well as accurate clinical follow-up combined with real multidisciplinary teamwork that involved different heart failure specialists, allowed us to obtain our excellent long-term results.
- Published
- 2013
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30. Combined heart and kidney transplantation: long-term analysis of renal function and major adverse events at 20 years.
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Bruschi G, Botta L, Colombo T, Busnach G, Pedrazzini G, Cannata A, Trunfio S, Macera F, Turazza F, Oliva F, Sansalone CV, Paino R, Frigerio M, and Martinelli L
- Subjects
- Adult, Female, Follow-Up Studies, Graft Rejection, Heart Diseases complications, Heart Failure complications, Heart Failure surgery, Heart Transplantation pathology, Humans, Hypertension complications, Hypertension surgery, Kidney Diseases complications, Kidney Failure, Chronic complications, Kidney Failure, Chronic surgery, Kidney Transplantation pathology, Male, Middle Aged, Patient Selection, Tissue Donors, Treatment Outcome, Heart Diseases surgery, Heart Transplantation statistics & numerical data, Kidney Diseases surgery, Kidney Transplantation statistics & numerical data
- Abstract
Background: Combined heart-kidney transplantation (HKTx) is an accepted therapeutic option for patients with end-stage heart disease associated with severely impaired renal function. We report our long-term follow-up with this combined procedure., Patients and Methods: Between April 1989 to November 2009, nine patients underwent combined simultaneous (HKTx) at our center. Seven patients were males (mean age 45.2 +/- 10.12 years); seven patients were on dialysis at the time of transplantation., Results: Surgical procedures were uneventful in all patients. One patient died in the intensive care unit 41 days after transplantation. During long-term follow-up, three patients died: one due to infection and multiorgan failure 148 months after HKTx, one due to a lung neoplasm after 6 years, and one, a cerebral stroke at 34 months after transplantation. Only one patient experience renal allograft failure secondary to hypertension and cyclosporine nephrotoxicity at 10 years after HKTx with the need for renal replacement therapy. Last estimated glomerular filtration rates of all other patients was 61.3 +/- 17.4 mL/min., Conclusions: In selected patients, with coexisting end-stage cardiac and renal failure, combined HKTx with an allograft from the same donor proved to give satisfactory short- and long-term results, with a low incidence of both cardiac and renal allograft complications., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
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31. Percutaneous coronary interventions in cardiac allograft vasculopathy: a single-center experience.
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Colombo P, Bruschi G, Sacco A, Oreglia J, De Marco F, Colombo T, Botta L, Macera F, Turazza F, Frigerio M, Martinelli L, and Klugmann S
- Subjects
- Adolescent, Adult, Biopsy, Cardiac Catheterization, Coronary Angiography, Coronary Disease diagnostic imaging, Coronary Disease etiology, Coronary Disease pathology, Drug Therapy, Combination, Female, Heart Transplantation immunology, Heart Transplantation mortality, Heart Transplantation pathology, Humans, Immunosuppressive Agents, Male, Middle Aged, Palliative Care, Reoperation statistics & numerical data, Retrospective Studies, Survival Rate, Transplantation, Homologous pathology, Vascular Diseases diagnostic imaging, Vascular Diseases etiology, Vascular Diseases pathology, Angioplasty, Balloon, Coronary methods, Coronary Disease surgery, Heart Transplantation adverse effects, Vascular Diseases therapy
- Abstract
Objective: Cardiac allograft vasculopathy represents an accelerated form of obstructive coronary disease. It is the main cause of late death following heart transplantation. Percutaneous coronary intervention is considered a palliative procedure due to high restenosis rates. The aim of this study was to review our experience with percutaneous coronary interventions using stents in cardiac transplant recipients., Methods: The present analysis included all primary adult heart transplanted patients who had been discharged from the hospital after transplantation, had a clinical follow-up of 12 months and underwent percutaneous coronary intervention (PCI)., Results: Seventy heart transplanted patients underwent percutaneous revascularization. Our analysis comprised 85 first-vessel procedures resulting in treatment of 135 lesions. The mean time from heart transplantation to first intervention was 9.3 +/- 4.8 years. Primary success was obtained in 96% lesions; at least 1 recurrent stenosis event occurred in 16 patients with primarily successful PCI. Lesions treated with drug-eluting stents experienced recurrent stenosis in 16% of cases. During a mean follow-up after PCI of 45.2 +/- 41.7 months, 27 deaths (19 cardiac) and 1 late re-transplantation occurred after PCI., Conclusion: In cardiac transplant recipients, percutaneous coronary intervention with stents can be performed safely with high rates of primary success. Restenosis rates were higher compared with coronary interventions in native coronary arteries. Drug-eluting stents seemed to favorably impact restenosis compared with bare-metal stents. The clinical benefit from percutaneous coronary intervention may be reduced due to disease progression in untreated coronary segments., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)
- Published
- 2010
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32. Blood glutathione as independent marker of lipid peroxidation in heart failure.
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Campolo J, De Maria R, Caruso R, Accinni R, Turazza F, Parolini M, Roubina E, De Chiara B, Cighetti G, Frigerio M, Vitali E, and Parodi O
- Subjects
- Adult, Ascorbic Acid blood, Biomarkers blood, Female, Humans, Logistic Models, Male, Malondialdehyde blood, Middle Aged, Multivariate Analysis, Risk Factors, alpha-Tocopherol blood, Glutathione blood, Heart Failure blood, Lipid Peroxidation
- Abstract
Background: Aminothiols have a critical function as intracellular redox buffers and constitute furthermore an important extracellular redox system. Lipid peroxidation is increased in chronic heart failure (CHF), but the contribution of each thiol to oxidative stress in this syndrome has not been evaluated., Aim: To assess the correlation between blood and plasma concentrations of aminothiols and lipid peroxidation as marker of oxidative stress in CHF patients., Methods: Blood reduced glutathione (GSH), plasma total and reduced cysteine, cysteinylglycine, homocysteine, GSH, alpha-tocopherol, ascorbic acid, and free malondialdehyde (MDA) were assessed in samples obtained from 26 CHF heart transplant candidates and 26 age- and gender-matched controls with atherosclerotic risk factors and no history of cardiovascular disease. Results are expressed as median and interquartile range (I-III)., Results: MDA levels were significantly higher in CHF patients than in controls [1.03 (0.56-1.60) microM vs. 0.70 (0.40-0.83) microM, p=0.006]. Blood reduced GSH concentrations were significantly higher [662 (327-867) microM vs. 416 (248-571) microM, p=0.016], while alpha-tocopherol levels were significantly lower [15 (13-19) microM vs. 21 (17-32) microM, p=0.001] in CHF patients than in controls. By multivariate logistic regression analysis, the only independent predictors of lipid peroxidation, as expressed by MDA levels > or = 1.00 microM, were increased blood GSH concentrations (OR 1.003 per unit, 95% CI 1.001 to 1.006, p=0.008), ischemic (OR 20, 95% CI 2.6 to 155, p=0.004) and non ischemic CHF etiology (OR 11, 95% CI 1.3 to 99, p=0.026)., Conclusions: Abnormalities in intracellular GSH cycling are associated to increased lipid peroxidation in CHF.
- Published
- 2007
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33. [Mechanical assist devices in advanced heart failure. Indications and perspectives].
- Author
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Colombo T, Russo C, Lanfranconi M, Bruschi G, Garatti A, Milazzo F, Catena E, Oliva F, Turazza F, Frigerio M, and Vitali E
- Subjects
- Heart Transplantation, Humans, Patient Selection, Heart Failure surgery, Heart-Assist Devices standards, Heart-Assist Devices trends
- Abstract
Congestive heart failure is recognized as a major public health issue and is the leading cause of death in western countries. Heart transplantation currently remains the gold standard option for end-stage heart failure patients. Heart transplantation is also one of the most limited therapies, not only with regard to the lack of donor hearts but also because of the surgical limitations inherent to the clinical aspects of this severely ill patient population. Mechanical circulatory support systems have been developed as effective adjuvant therapeutic options in these terminally ill patients. Over the past two decades, mechanical circulatory support devices have steadily evolved in the clinical management of end-stage heart failure, and have emerged as a standard of care for the treatment of acute and chronic heart failure refractory to conventional medical therapy. Future blood pumps should be smaller and totally implantable, as well as more efficient, biocompatible, and reliable.
- Published
- 2006
34. Blood glutathione as a marker of cardiac allograft vasculopathy in heart transplant recipients.
- Author
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De Chiara B, Bigi R, Campolo J, Parolini M, Turazza F, Masciocco G, Frigerio M, Fiorentini C, and Parodi O
- Subjects
- Biomarkers blood, Humans, Male, Oxidation-Reduction, Transplantation, Homologous, Vascular Diseases etiology, Glutathione blood, Heart Transplantation adverse effects, Heart Transplantation methods, Vascular Diseases blood
- Abstract
Background: Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx). Between immunologic and non-immunologic factors, reactive oxygen species generation has been proposed as pathogenetic mechanism. This study was aimed at evaluating redox status in HTx recipients and verifying whether it could be independently associated with CAV., Methods: Fifty-five consecutive male HTx recipients, median [interquartile range] age 60 yr [50, 64], underwent angiography 67 months [21, 97] after HTx to assess CAV, defined as significant stenosis in >or=1 epicardial vessel or any distal vessel attenuation. All patients underwent blood sampling 89 months [67, 119] after HTx for biochemical (glucose, creatinine, total and LDL cholesterol, and cyclosporin levels) and redox evaluation [plasma reduced and total homocysteine, cysteine, cysteinylglycine, glutathione, blood reduced glutathione (GSH(bl)) and vitamin E]. Univariate Odds Ratios (OR) with 95% confidence interval (95% CI, highest vs. lowest quartile) were estimated on the basis of a logistic regression analysis between clinical, conventional biochemical and redox data. Only the significant variables at univariate entered into multivariate analysis., Results: CAV was documented in 15 (27%) patients. Univariate analysis showed that time from HTx to angiography (OR 3.97, 95% CI 1.15-14, p = 0.03) and GSH(bl) (OR 0.31, 95% CI: 0.14-0.70, p = 0.005) were significantly associated with CAV. However, multivariate analysis revealed GSH(bl) as the only independent predictor of CAV (OR 0.31, 95% CI: 0.13-0.74, p = 0.008)., Conclusions: In HTx recipients reduced levels of GSH(bl) are independently associated with CAV. Given its potent intracellular scavenger properties, GSH(bl) may serve as a marker of antioxidant defence consumption, favouring CAV development.
- Published
- 2005
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35. Usefulness of chronotropic incompetence to dipyridamole in predicting myocardial perfusion defects in heart transplant recipients.
- Author
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De Chiara B, Bigi R, Devoto E, Cavenaghi G, Turazza F, Sara R, Colombo T, Frigerio M, and Parodi O
- Subjects
- Case-Control Studies, Coronary Disease diagnostic imaging, Electrocardiography, Female, Humans, Logistic Models, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Tomography, Emission-Computed, Single-Photon, Coronary Disease diagnosis, Dipyridamole, Heart Rate drug effects, Heart Transplantation diagnostic imaging, Technetium Tc 99m Sestamibi, Vasodilator Agents
- Abstract
The aim of this report was to assess the relation between heart rate response to dipyridamole infusion and perfusion defects at quantitative sestamibi single-photon emission computed tomographic imaging. We demonstrated in 166 heart transplant recipients that chronotropic incompetence to dipyridamole is the only significant and independent predictor of perfusion defects.
- Published
- 2003
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36. Epidemiologic variables and outcome of 1972 young patients with acute myocardial infarction. Data from the GISSI-2 database. Investigators of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2).
- Author
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Moccetti T, Malacrida R, Pasotti E, Sessa F, Genoni M, Barlera S, Turazza F, and Maggioni AP
- Subjects
- Age Factors, Aged, Blood Pressure, Body Mass Index, Cholesterol blood, Educational Status, Female, Hospital Mortality, Humans, Income, Italy epidemiology, Logistic Models, Male, Middle Aged, Multivariate Analysis, Myocardial Infarction blood, Myocardial Infarction mortality, Myocardial Infarction therapy, Physical Exertion, Predictive Value of Tests, Prognosis, Risk Factors, Sex Factors, Smoking, Treatment Outcome, Myocardial Infarction epidemiology
- Abstract
Background: Acute myocardial infarction in younger patients is uncommon, occurring mainly in men. The recent introduction of thrombolysis improved survival, left ventricular function, and infarct size., Objective: To evaluate characteristics and clinical outcome of the patients younger than 50 years randomized in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico study. All patients received a thrombolytic treatment., Methods: The 11483 patients were divided into 3 age subgroups: younger than 50 years (17.2%), between 50 and 70 years (60.2%), and older than 70 years (22.6%). All relations between variables were first determined by an unadjusted analysis. An adjusted analysis was performed by multiple logistic regression models for in-hospital and 6-month mortality., Results: While older patients had a significantly higher rate of a history of hypercholesterolemia, diabetes, and hypertension, smoking and a positive family history were significantly more frequent in younger patients. Total in-hospital and 6-month mortality were significantly lower in patients younger than 50 years (2.7% and 1.2%, respectively) than in patients between 50 and 70 years old (6.9% and 2.7%) and those older than 70 years (21.1% and 8.4%). After multivariate analysis, the predictive value of age was confirmed., Conclusions: Our findings, based on a large group of patients who received thrombolytic treatment, suggest that younger age is a significant independent indicator of a favorable prognosis after acute myocardial infarction.
- Published
- 1997
37. Angiotensin-converting enzyme inhibition in myocardial infarction--Part 2: Clinical issues and controversies.
- Author
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Huckell VF, Bernstein V, Crowell R, Dagenais GR, Higginson LA, Isserow S, Laramée P, Liu P, McCans JL, Orchard RC, Prewitt R, Quinn BP, Samson M, Turazza F, Warnica JW, and Wielgosz A
- Subjects
- Angiotensin-Converting Enzyme Inhibitors economics, Clinical Trials as Topic, Cost-Benefit Analysis, Death, Sudden, Cardiac prevention & control, Humans, Myocardial Infarction economics, Myocardial Infarction mortality, Patient Selection, Risk Factors, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Myocardial Infarction drug therapy
- Abstract
Over the past 10 years, several clinical studies have concluded that, in patients already receiving conventional therapies, angiotensin-converting enzyme (ACE) inhibitors further reduce the risk of death following myocardial infarction (MI). Post-MI ACE inhibitors have proven to be effective as long term therapy in high risk patients as well as when used for much shorter periods in a broad patient population. However, while considerable mortality data have been collected, the effects of ACE inhibitors post-MI on other cardiovascular outcomes have not been as well documented. In addition, a number of issues regarding the most effective use of these agents remain unresolved. This paper, the second of two parts, focuses on the clinical issues and controversies surrounding the use of ACE inhibitors following acute MI. The effects of ACE inhibitors on the outcomes of sudden death, nonsudden death, recurrent angina, mitral regurgitation and left ventricular dysfunction are reviewed and potential mechanisms of action are proposed. In addition, ACE inhibitor therapy is discussed in terms of patient selection criteria, choice of agent, optimal dosing regimen, concomitant use of other therapies and relative costs of treatment. Finally, potential mechanisms of action of ACE inhibitors are proposed for each of the outcomes examined.
- Published
- 1997
38. Angiotensin-converting enzyme inhibition in myocardial infarction--Part 1: Clinical data.
- Author
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Huckell VF, Bernstein V, Cairns JA, Crowell R, Dagenais GR, Higginson LA, Isserow S, Laramée P, Liu P, McCans JL, Orchard RC, Prewitt R, Quinn BP, Samson M, Turazza F, Warnica JW, and Wielgosz A
- Subjects
- Clinical Trials as Topic, Humans, Myocardial Infarction mortality, Risk Factors, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Myocardial Infarction drug therapy
- Abstract
There is an increasing body of clinical trial evidence to support the use of angiotensin-converting enzyme (ACE) inhibitors in the management of patients following myocardial infarction (MI). Enthusiasm for the use of ACE inhibitors in the acute phase of MI had previously been tempered by the adverse results of an early trial. However, exciting new information is available from several large, randomized studies that has not only quelled those initial concerns but also attests to the efficacy of using this class of medication in the first 24 h after an acute MI. A Canadian National Opinion Leader Symposium was held in November 1995 to review the results of the major ACE inhibitor clinical trials and to discuss key issues and controversies surrounding their use in acute MI. The focus of this paper, the first of two parts, is on the results of the major ACE inhibitor clinical trials.
- Published
- 1997
39. [Sepsis and endocarditis: two rare complications following pacemaker implantation. Description of a case and review of the literature].
- Author
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Vecchi MR, Media R, Lazzaroni A, Azzollini M, Turazza F, Mantovani G, and Pappalettera M
- Subjects
- Bacteremia complications, Endocarditis, Bacterial complications, Female, Humans, Middle Aged, Staphylococcal Infections complications, Bacteremia etiology, Endocarditis, Bacterial etiology, Pacemaker, Artificial adverse effects, Staphylococcal Infections etiology
- Abstract
A case of Staphylococcus aureus tricuspid valve endocarditis in a patient with permanent transvenous VVI pacemaker and recurrent febrile episodes is described. Medical treatment was not effective, and only with surgical removal of the lead was the infection successfully treated.
- Published
- 1992
40. GISSI trials in acute myocardial infarction. Rationale, design, and results.
- Author
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Maggioni AP, Franzosi MG, Fresco C, Turazza F, and Tognoni G
- Subjects
- Clinical Trials as Topic, Humans, Multicenter Studies as Topic, Myocardial Infarction drug therapy, Thrombolytic Therapy
- Abstract
The first Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto (GISSI) study showed striking evidence of the effectiveness and safety of intravenous thrombolytic treatment in acute myocardial infarction (MI). Since publication in The Lancet, the original report has become a reference work for every paper which deals with thrombolysis. In addition to GISSI's scientific value, these studies applied formal research to routine clinical practice outside of referral centers. Nearly all Italian CCUs took part in the GISSI projects, so that the results provide a profile of the patient who seeks care for acute MI in Italy. This wide data base allowed GISSI investigators to look into some relevant clinical events, eg, primary ventricular fibrillation, stroke, and in-hospital reinfarction. The GISSI-2 trial followed the GISSI-1 philosophy. The package of treatments recommended after extensive discussion with all the investigators (beta-blocker, aspirin, nitrates) was widely adopted. Now, only five years after the start of the GISSI-1, the overall mortality of Italian patients with acute MI has decreased from 13.0 percent to about 9 percent, and the number of patients with acute MI arriving in hospital within 1 h of the onset of symptoms has increased 50 percent. It is the wish of the GISSI investigators that this approach to treating acute MI will be regarded and acknowledged as their major contribution to the problem.
- Published
- 1990
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