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4. Effects of stress hyperglycemia on acute myocardial infarction: role of inflammatory immune process in functional cardiac outcome

Author

MARFELLA, Raffaele, SINISCALCHI M, ESPOSITO, Katherine, SELLITTO A, DE FANIS U, ROMANO, Ciro Pasquale, PORTOGHESE M, SICILIANO S, NAPPO F, SASSO, Ferdinando Carlo, MININNI N, CACCIAPUOTI, Federico, LUCIVERO, Giacomo, GIUNTA, Riccardo, VERZA M, GIUGLIANO, Dario, Marfella, Raffaele, Siniscalchi, M, Esposito, Katherine, Sellitto, A, DE FANIS, U, Romano, Ciro Pasquale, Portoghese, M, Siciliano, S, Nappo, F, Sasso, Ferdinando Carlo, Mininni, N, Cacciapuoti, Federico, Lucivero, Giacomo, Giunta, Riccardo, Verza, M, and Giugliano, Dario

Subjects
Blood Glucose, Male, Receptors, IgG, CD4-CD8 Ratio, Interleukin-18, Myocardial Infarction, HLA-DR Antigens, Middle Aged, Antigens, Differentiation, CD56 Antigen, C-Reactive Protein, Antigens, CD, Echocardiography, Stress, Physiological, Hyperglycemia, Humans, CTLA-4 Antigen, Female, Biomarkers, T-Lymphocytes, Cytotoxic
Abstract

OBJECTIVE— Stresshyperglycemiahasbeenassociatedwithincreasedmortalityinpatients with myocardial infarction (MI). We examined the association between plasma glucose levels, circulating inflammatory markers, T-cell activation, and functional cardiac outcome in patients with first MI. RESEARCH DESIGN AND METHODS — Echocardiographic parameters, circulating levels of interleukin-18 (IL-18), C-reactive protein (CPR), and the percent of CD16-CD56, CD4/CD8, CD152, and HLA-DR expression were investigated in 108 patients with acute MI on admission to the emergency ward. RESULTS — Our review found that 31 new hyperglycemic patients (glycemia 7 mmol/l) had higher infarct segment length (P 0.05) and myocardial performance index (P 0.02) and reduced transmitral Doppler flow (P 0.05), pulmonary flow analysis (P 0.02), and ejection fraction (P 0.05) compared with 36 hyperglycemic diabetic patients and 41 normoglycemic patients. Plasma IL-18 and CRP were higher in the hyperglycemic than in the normoglycemic patients (P 0.005), with the highest values in patients with new hyperglycemia (P 0.05). Hyperglycemic patients had a higher percent of CD16/CD56 cells and CD4/CD8 ratio (P 0.01), whereas they had lower CD152 expression (which has a negative regulatory function in T-cell activation) compared with normoglycemic patients (P 0.001). CONCLUSIONS— DuringMI,hyperglycemiaisassociatedwithincreasedlevelsofinflamma- tory markers, enhanced expression of cytotoxic T-cells, and reduced expression of T-cells, which are implicated in limiting the immune process. An increased inflammatory immune process seems a likely mechanism linking acute hyperglycemia to poor cardiac outcome in MI patients.

Published
2003

5. Effects of stress hyperglicemia on acute myocardial infarction

Author

MARFELLA R, SINISCALCHI M, ESPOSITO, Katherine, SELLITTO A, DE FANIS U, ROMANO, Ciro Pasquale, PORTOGHESE M, SICILIANO S, NAPPO F, SASSO, Ferdinando Carlo, MININNI N, CACCIAPUOTI, Federico, LUCIVERO, Giacomo, GIUNTA, Riccardo, VERZA M, GIUGLIANO, Dario, Marfella, R, Siniscalchi, M, Esposito, Katherine, Sellitto, A, DE FANIS, U, Romano, Ciro Pasquale, Portoghese, M, Siciliano, S, Nappo, F, Sasso, Ferdinando Carlo, Mininni, N, Cacciapuoti, Federico, Lucivero, Giacomo, Giunta, Riccardo, Verza, M, and Giugliano, Dario

Published
2003

7. Effects of different training protocols on left ventricular myocardial function in competitive athletes: a Doppler tissue imaging study

Author

D Andrea, A., Caso, P., Severino, S., Galderisi, M., Sarubbi, B., Giuseppe LImongelli, Cice, G., D Andrea, L., Scherillo, M., Mininni, N., Calabrò, R., D'Andrea, Antonello, Caso, Pio, Severino, Sergio, Galderisi, Maurizio, Sarubbi, Berardo, Limongelli, Giuseppe, Cice, Gennaro, D'Andrea, Luigi, Scherillo, Marino, Mininni, Nicola, Calabrò, Raffaele, D'Andrea, A, Caso, P, Severino, S, Galderisi, M, Sarubbi, B, Cice, G, D'Andrea, L, Scherillo, M, Mininni, N, and Calabro', Raffaele

Subjects
Adult, Echocardiography, Doppler, Pulsed, Male, Humans, Female, Hypertrophy, Left Ventricular, Adaptation, Physiological, Exercise, Swimming, Ventricular Function, Left, Echocardiography, Doppler, Color, Human
Abstract

The aim of the study was to analyze the differences in myocardial function in case of left ventricular (LV) hypertrophy induced by either endurance or strength training in top-level athletes.Standard Doppler echo and pulsed Doppler tissue imaging (DTI) of the interventricular septum and of the LV inferior wall were performed in 26 competitive endurance athletes (long-distance swimmers) (group A) and in 20 strength-trained athletes (short-distance swimmers) (group B). By means of DTI, the following parameters of myocardial function were assessed: the systolic peak velocities (Sm), the pre-contraction time, the contraction time, the early (Em) and late (Am) diastolic velocities, the Em/Am ratio and the relaxation time.The two groups were comparable for age and sex, but at rest group B showed a higher heart rate, systolic blood pressure and body surface area. The LV mass index and fractional shortening did not significantly differ between the two groups. However, group B showed an increased sum of the wall thicknesses (septum + posterior wall) (p0.001) and of the relative wall thickness, while the LV stroke volume and LV end-diastolic diameter (p0.001) were greater in group A. All transmitral Doppler indexes were higher in group A, with an increased E/A ratio. DTI analysis showed, in group A, a higher Em and Em/Am ratio as well as a longer relaxation time both at the septal and at the inferior wall levels, with comparable Sm, pre-contraction and contraction times. Distinct multiple linear regression models revealed an independent positive association between the inferior peak Em velocity and the LV end-diastolic diameter (p0.001) in group A, and an independent direct correlation of the inferior peak Sm velocity with the sum of the wall thicknesses (p0.001) and with the end-systolic stress in group B.The early diastolic myocardial function is positively influenced by the preload increase in group A, while an increased afterload and LV wall thickness in group B mainly seem to induce an enhancement of the regional myocardial systolic function.

Published
2002

10. Right ventricular myocardial diastolic dysfunction in different kinds of cardiac hypertrophy: analysis by pulsed Doppler tissue imaging

Author

Maurizio Galderisi, Severino, S., Caso, P., Cicala, S., Petrocelli, A., Simone, L., Mininni, N., Divitiis, O., Galderisi, Maurizio, Severino, S, Caso, P, Cicala, S, Petrocelli, A, De Simone, L, Mininni, N, and de Divitiis, O.

Subjects
Adult, Male, Hypertrophy, Right Ventricular, Ventricular Dysfunction, Right, Predictive Value of Test, Cardiomyopathy, Hypertrophic, Middle Aged, Echocardiography, Doppler, Color, Heart Ventricle, Ultrasonography, Doppler, Pulsed, Heart Septum, Female, Hypertrophy, Left Ventricular, Blood Flow Velocity, Human
Abstract

Right ventricular (RV) chamber involvement has been demonstrated in hypertrophic cardiomyopathy (HCM) as well as in hypertensive left ventricular hypertrophy (LVH) but little is known about RV myocardial dysfunction occurring in these two pathologies. The aim of this study was to compare Doppler tissue imaging (DTI) of the right ventricle in HCM and LVH in relation to DTI of the left ventricle and Doppler standard of the RV and left ventricular (LV) inflow.

Published
2001

11. [Inhibitors of the platelet's receptor GPIIb/IIIA. Progress in the treatment of acute myocardial ischemia and future trends]

Author

CACCIAPUOTI, Federico, SINISCALCHI M, ESPOSITO, Katherine, SELLITTO A, DE FANIS U, ROMANO C, PORTOGHESE M, SICILIANO S, NAPPO F, SASSO, Ferdinando Carlo, MININNI N, CACCIAPUOTI F, LUCIVERO G, GIUNTA, Riccardo, VERZA M, GIUGLIANO, Dario, Cacciapuoti, Federico, Siniscalchi, M, Esposito, Katherine, Sellitto, A, DE FANIS, U, Romano, C, Portoghese, M, Siciliano, S, Nappo, F, Sasso, Ferdinando Carlo, Mininni, N, Cacciapuoti, F, Lucivero, G, Giunta, Riccardo, Verza, M, and Giugliano, Dario

Subjects
Myocardial Ischemia, Humans, Platelet Glycoprotein GPIIb-IIIa Complex, Forecasting
Abstract

The possible mechanisms inducing acute coronary obstruction starting from the atherosclerotic plaque are illustrated. The effects of the inhibitors of the platelet's receptor GPIIb/IIIa and the results of the main trials performed using these inhibitors are reported. Finally, the results obtained immediately before their employment in the coronary angioplasty with or without stent's implantation are also reported. The first applications in acute ischemic stroke appear to be favourable too.

Published
2001

12. [Surgical treatment and interventional therapy in cerebral ischemia]

Author

CACCIAPUOTI, Federico, SINISCALCHI M, ESPOSITO, Katherine, SELLITTO A, DE FANIS U, ROMANO C, PORTOGHESE M, SICILIANO S, NAPPO F, SASSO, Ferdinando Carlo, MININNI N, CACCIAPUOTI F, LUCIVERO G, GIUNTA, Riccardo, VERZA M, GIUGLIANO, Dario, Cacciapuoti, Federico, Siniscalchi, M, Esposito, Katherine, Sellitto, A, DE FANIS, U, Romano, C, Portoghese, M, Siciliano, S, Nappo, F, Sasso, Ferdinando Carlo, Mininni, N, Cacciapuoti, F, Lucivero, G, Giunta, Riccardo, Verza, M, and Giugliano, Dario

Subjects
Cerebral Revascularization, Elective Surgical Procedures, Humans, Emergencies, Neurosurgical Procedures, Brain Ischemia
Abstract

The aim of this review was to evaluate the possibility of correcting cerebral ischemia (including both extracranial varieties) using elective as well as emergency surgery in order to avoid the onset of acute cerebral ischemia. The study included patients suffering from cerebral ischemia with a thromboembolic etiology. The author describe the emergency surgical procedures currently used in embolic forms affecting the extracranial vessels and percutaneous transluminal angioplasty (PTA) which is confined solely to extracranial vessels at present. In the authors' opinion, this method (with or without the application of one or more stents) will soon represent the routine method of cerebral revascularisation in the near future. The authors review the results currently obtained using extracranial PTA in the main brain surgery centres worldwide, the most frequent complications and the problems still to be resolved. In conclusion, it is useful to use interventional procedures to treat both extracranial and intracranial lesions in order to significantly reduce mortality from acute cerebral ischemia and its functional sequelae.

Published
2000

16. Global Secondary Prevention Strategies to Limit Event Recurrence After Myocardial Infarction

Author

Giannuzzi P., Temporelli P.L., Marchioli R., Maggioni A.P., Balestroni G., Ceci V., Chieffo C., Gattone M., Griffo R., Schweiger C., Tavazzi L., Urbinati S., Valagussa F., Vanuzzo D., Girardini D., Francesconi G., Vona M., Santoni R., Sarno C., Calisi P., Forzoni M., Boncompagni L., Tabouret G., Canci U., Rosato G., Stanco G., Gullace G., Carbone C., Gavazzi A., Mazzoleni D., Pinelli G., Frizzelli R., Tortelli O., Pantaleoni A., Mantovani E., Pettinati G., Storti G., Riccio C., Scrutinio D., Passantino A., Guiducci D., Zobbi G., Vanaria D., Barbanti P., Carini V., Coco R., Borrello G., Mazza M.L., Chiesa F., Sansoni C., Morbelli E., Rossi L., Ciglia C., Di Giovanni P., Cocchieri M., Dò V., Trudu A., Albonic D., Bendinelli S., Iori E., Balestra G., Giacometti N., Coppetti S., Priori S., Masotti G., Fattirolli F., Meniconi L., Paolucci P., Malinverni C., Quarenghi F., Fontanelli A., Marini R., Mandorla S., Provvidenza M., Giordano A., De Giuli F., Odoguardi L., Barsotti S., Moccetti T., Molteni A., Mauri F., Lecchi G., Bettini R., Bertoldi A., Zanettini R., Centeleghe P., Corallo S., Rainoldi M.L., Ferratini M., Tavanelli M., Leonetti G., Malfatto G., Pascotto P., Zanocco A., Buchberger R., Masaro G., Cobelli F., Sala L., Musca G., Cauteruccio M.A., Giallauria F., Mininni N., Morra P., Castello A., Sarullo F.M., Castelli D., Tramarin R., De Salvo M., Porcellati C., Giovagnoni F., Anniboletti P.F., Calisti M.G., Vergoni W., Iacopetti L., Zelaschi F., D'Cruz S., Lopizzo A., Caiazza M., Gigli G., Pastine J., Pulitanò G., Ruggeri A., Piovaccari G., Semprini P., Zavatteri G., Diaco T., Lumia F., Tamiz A.M., Oliva G., Galati A., Picelli A., Picelli F., Bosco R., Marcellini G., Zanchè E., Martin G., Masutti S., Milani L., Pizzolato G.M., Occhi G., Partesana N., Baldi N., Polimeni G., Furgi G., Nicolino A., Bevilacqua R., Ingignoli B., Massobrio N., Avogliero G., Pedretti R., Vaninetti R., Donnangelo L., Chiatto M., Gori P., Garbin R., RICCARDI, GABRIELE, VIGORITO, CARLO, Giannuzzi, P., Temporelli, P. L., Marchioli, R., Maggioni, A. P., Balestroni, G., Ceci, V., Chieffo, C., Gattone, M., Griffo, R., Schweiger, C., Tavazzi, L., Urbinati, S., Valagussa, F., Vanuzzo, D., Girardini, D., Francesconi, G., Vona, M., Santoni, R., Sarno, C., Calisi, P., Forzoni, M., Boncompagni, L., Tabouret, G., Canci, U., Rosato, G., Stanco, G., Gullace, G., Carbone, C., Gavazzi, A., Mazzoleni, D., Pinelli, G., Frizzelli, R., Tortelli, O., Pantaleoni, A., Mantovani, E., Pettinati, G., Storti, G., Riccio, C., Scrutinio, D., Passantino, A., Guiducci, D., Zobbi, G., Vanaria, D., Barbanti, P., Carini, V., Coco, R., Borrello, G., Mazza, M. L., Chiesa, F., Sansoni, C., Morbelli, E., Rossi, L., Ciglia, C., Di Giovanni, P., Cocchieri, M., Dò, V., Trudu, A., Albonic, D., Bendinelli, S., Iori, E., Balestra, G., Giacometti, N., Coppetti, S., Priori, S., Masotti, G., Fattirolli, F., Meniconi, L., Paolucci, P., Malinverni, C., Quarenghi, F., Fontanelli, A., Marini, R., Mandorla, S., Provvidenza, M., Giordano, A., De Giuli, F., Odoguardi, L., Barsotti, S., Moccetti, T., Molteni, A., Mauri, F., Lecchi, G., Bettini, R., Bertoldi, A., Zanettini, R., Centeleghe, P., Corallo, S., Rainoldi, M. L., Ferratini, M., Tavanelli, M., Leonetti, G., Malfatto, G., Pascotto, P., Zanocco, A., Buchberger, R., Masaro, G., Cobelli, F., Riccardi, Gabriele, Sala, L., Musca, G., Cauteruccio, M. A., Vigorito, Carlo, Giallauria, F., Mininni, N., Morra, P., Castello, A., Sarullo, F. M., Castelli, D., Tramarin, R., De Salvo, M., Porcellati, C., Giovagnoni, F., Anniboletti, P. F., Calisti, M. G., Vergoni, W., Iacopetti, L., Zelaschi, F., D'Cruz, S., Lopizzo, A., Caiazza, M., Gigli, G., Pastine, J., Pulitanò, G., Ruggeri, A., Piovaccari, G., Semprini, P., Zavatteri, G., Diaco, T., Lumia, F., Tamiz, A. M., Oliva, G., Galati, A., Picelli, A., Picelli, F., Bosco, R., Marcellini, G., Zanchè, E., Martin, G., Masutti, S., Milani, L., Pizzolato, G. M., Occhi, G., Partesana, N., Baldi, N., Polimeni, G., Furgi, G., Nicolino, A., Bevilacqua, R., Ingignoli, B., Massobrio, N., Avogliero, G., Pedretti, R., Vaninetti, R., Donnangelo, L., Chiatto, M., Gori, P., and Garbin, R.

Subjects
Male, medicine.medical_specialty, Myocardial Infarction, GOSPEL, Angina Pectoris, law.invention, Angina, Randomized controlled trial, law, Internal medicine, Myocardial Revascularization, Secondary Prevention, Internal Medicine, medicine, Clinical endpoint, Humans, Myocardial infarction, Life Style, Stroke, Heart Failure, Cardiac Rehabilitation, business.industry, Surrogate endpoint, Hazard ratio, Middle Aged, medicine.disease, Heart failure, Physical therapy, Female, business, Stress, Psychological
Abstract

Background Secondary prevention is not adequately implemented after myocardial infarction (MI). We assessed the effect on quality of care and prognosis of a long-term, relatively intensive rehabilitation strategy after MI. Methods We conducted a multicenter, randomized controlled trial in patients following standard post-MI cardiac rehabilitation, comparing a long-term, reinforced, multifactorial educational and behavioral intervention with usual care. A total of 3241 patients with recent MI were randomized to a 3-year multifactorial continued educational and behavioral program (intervention group; n = 1620) or usual care (control group; n = 1621). The combination of cardiovascular (CV) mortality, nonfatal MI, nonfatal stroke, and hospitalization for angina pectoris, heart failure, or urgent revascularization procedure was the primary end point. Other end points were major CV events, major cardiac and cerebrovascular events, lifestyle habits, and drug prescriptions. Results End point events occurred in 556 patients (17.2%). Compared with usual care, the intensive intervention did not decrease the primary end point significantly (16.1% vs 18.2%; hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.74-1.04). However, the intensive intervention decreased several secondary end points: CV mortality plus nonfatal MI and stroke (3.2% vs 4.8%; HR, 0.67; 95% CI, 0.47-0.95), cardiac death plus nonfatal myocardial infarction (2.5% vs 4.0%; HR, 0.64; 95% CI, 0.43-0.94), and nonfatal MI (1.4% vs 2.7%; HR, 0.52; 95% CI, 0.31-0.86). A marked improvement in lifestyle habits (ie, exercise, diet, psychosocial stress, less deterioration of body weight control) and in prescription of drugs for secondary prevention was seen in the intervention group. Conclusion The GOSPEL Study is the first trial to our knowledge to demonstrate that a multifactorial, continued reinforced intervention up to 3 years after rehabilitation following MI is effective in decreasing the risk of several important CV outcomes, particularly nonfatal MI, although the overall effect is small. Trial Registration ClinicalTrials.gov Identifier:NCT00421876

Published
2008
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17. PREAMI: Perindopril and remodelling in elderly with acute myocardial infarction: Study rationale and design

Author

Battaglia, A., Ferraro, L., Lo Monaco, M., Palumbo, A., Mariani, M., Biadi, O., Boccalatte, A., Polimeno, S., Rosa, V., Liguori, L., Cuomo, S., Boccanelli, A., Morosetti, P., D Angelo, G., Bottiglieri, P., Brunelli, C., Spallarossa, P., Rolandi, A., Rossettini, Pf, Campa, P., Francesco BARILLA', Biase, L., Biscosi, C., Zampino, D., Capponi, E., Buccolieri, M., Gattobigio, R., Capucci, A., Passerini, F., Piepoli, M., Castello, A., Chiariello, M., Betocchi, S., Ciampi, Q., Losi, M., Corsini, G., Melorio, S., Dalle Mule, J., Mazzella, M., Cristinziani, Gr, Mario, L., Luca, I., Fusco, F., Del Salvatore, B., Sorino, M., Delise, P., Mozzato, Mg, Bilardo, G., Coro, L., Fantinel, M., Zasso, A., Fedele, F., Di Donato, D., Romano, S., Pascale, F., Giasi, M., Ciarcia, L., Lizzardo, A., Mastursi, M., Giordano, A., Benigno, M., Zanelli, E., Campana, M., Giovannini, E., Lacche, A., Pulignano, G., Giuffrida, G., Montana, G., Licciardello, G., L Abbate, A., Carpeggiani, C., Morales, A., Leghissa, R., Mandorla, S., Del Pinto, M., Borgioni, C., Mininni, N., Petrillo, Me, Moretti, G., Bonaglia, M., Zoni, A., Piscicelli, C., Orlandi, M., Panciroli, C., Oddone, A., Caizzi, V., Tartarini, G., Lattanzi, F., Reisenhofer, B., Pascotto, P., Zanocco, A., Dabizzi, Rp, Bini, L., Mondanelli, D., Frascarelli, F., Pitscheider, W., Erlicher, A., Rauhe, W., Bonsante, E., Polimeni, M., Catananti, F., Guerrisi, G., Magnani, B., Rapezzi, C., Ferlito, M., Amati, S., Di Leo, L., Manzo, M., Baldi, C., Cristofaro, M., Citro, R., Raviele, A., Turiano, G., Zuin, G., Rengo, F., Furgi, G., Papa, A., Rotiroti, D., Rosato, G., Siano, F., Pagliuca, MR, Rovelli, G., Heyman, J., Locati, I., Sanguinetti, M., Tomassini, F., Mantovani, R., Sanna, A., Marras, L., Crabu, E., Locci, G., Moio, N., Scilla, C., Tavazzi, L., Magrini, G., Bersano, C., Laudisa, Ml, Trimarco, B., Argenziano, L., Silvestri, S., Valagussa, F., Ciro, E., Cantu, E., Trocino, G., Rossillo, A., Valagussa, L., Finocchi, G., Benvenuto, Gm, Bonanno, C., Ometto, R., Risica, G., Gualandi, G., Facchin, L., Tenderini, P., Nicolosi, Gl, Burelli, C., Macor, F., Bellone, E., Laiso, D., Carvalho, P., Peila, C., Fagiano, A., Gardiol, S., Ganci, B., Presutto, P., Fontanelli, A., Morgera, T., Scarpino, L., Barbuzzi, S., Capogrosso, V., Terrosu, Pf, Contini, Gm, Sabino, G., Pes, R., Uneddu, F., Mecca, D., Tommaso, I., Rusconi, C., Brunazzi, Mc, Codeluppi, P., Pasqualini, M., Gorni, R., Negrelli, M., Paparoni, S., Core, A., Pecce, P., Petrella, L., Zennaro, Rg, Garuti, W., Alfano, G., Bacca, F., Petrucci, G., Paci, Am, Bigalli, G., Mangiameli, S., Gulizia, M., Cardillo, R., Ferrari, G., Tettamanti, F., Butti, E., Picchione, N., Sulla, A., Stroder, P., Perna, Gp, Ricci, S., Generali, Ca, Adornato, E., Ghisio, A., Tidu, M., Ferrari, R., Mele, D., Cicchitelli, G., Merli, E., Russa, O., Azcarate, Jma, Gonzales, Pz, Vilchez, F., Alonso, Lfi, Montero, Jmm, Zarzosa, Cd, Martin, Es, Ros, Jo, Martinez, Mh, Palau, Vm, Carranza, Mst, Mayor, Djlb, Cocina, Eg, Valderrama, Jc, Jimenez, Rp, Pardo, Jam, Cortada, Jb, Lorente, Lj, Guerrero, Jjg, Martinez, A., Coronado, Jlb, Casado, Rs, Cendon, Aa, Cokkinos, D., Maounis, T., Karatasakis, G., Kremastinos, D., Iliodromitis, S., Karatzas, D., Georgiadis, M., Paraskevaidis, I., Toutouzas, P., Antoniadis, P., Angeli, C., Vadas, P., Kaleboubas, M., Stamatelopoulos, S., Nanas, I., Kanakakis, A., Dalianis, A., Zacharoulis, A., Fotiadis, I., Pyrgakis, V., Liata, O., Mazen, B., Kardaras, F., Kardara, D., Krokos, V., Sioras, H., Fousas, S., Stefanidis, A., Papadopoulos, G., Papadopoulos, C., Papagiannis, I., Karidas, I., Zobolos, S., Preami, Investigators, A., Battaglia, L., Ferraro, M. L., Monaco, A., Palumbo, M., Mariani, O., Biadi, A., Boccalatte, S., Polimeno, V. D., Rosa, L., Liguori, S., Cuomo, A., Boccanelli, P., Morosetti, G., D'Angelo, P., Bottiglieri, C., Brunelli, P., Spallarossa, A., Rolandi, P. F., Rossettini, P., Campa, F., Barilla, L. D., Biase, C., Biscosi, D., Zampino, E., Capponi, M., Buccolieri, R., Gattobigio, A., Capucci, F., Passerini, M., Piepoli, A., Castello, M., Chiariello, Betocchi, Sandro, Q., Ciampi, Losi, MARIA ANGELA, G., Corsini, S., Melorio, J. D., Mule, M., Mazzella, G. R., Cristinziani, L., Mario, I. D., Luca, F., Fusco, B. D., Salvatore, M., Sorino, P., Delise, M. G., Mozzato, G., Bilardo, L., Coro', M., Fantinel, A., Zasso, F., Fedele, D. D., Donato, S., Romano, F. D., Pascale, M., Giasi, L., Ciarcia, A., Lizzardo, M., Mastursi, A., Giordano, M., Benigno, E., Zanelli, M., Campana, E., Giovannini, A., Lacche, G., Pulignano, G., Giuffrida, G., Montana, G., Licciardello, A., L'Abbate, C., Carpeggiani, A., Morale, R., Leghissa, S., Mandorla, M. D., Pinto, C., Borgioni, N., Mininni, M. E., Petrillo, G., Moretti, M., Bonaglia, A., Zoni, C., Piscicelli, M., Orlandi, C., Panciroli, A., Oddone, V., Caizzi, G., Tartarini, F., Lattanzi, B., Reisenhofer, P., Pascotto, A., Zanocco, R. P., Dabizzi, L., Bini, D., Mondanelli, F., Frascarelli, W., Pitscheider, A., Erlicher, W., Rauhe, E., Bonsante, M., Polimeni, F., Catananti, G., Guerrisi, B., Magnani, C., Rapezzi, M., Ferlito, S., Amati, L. D., Leo, M., Manzo, C., Baldi, M. D., Cristofaro, R., Citro, A., Raviele, G., Turiano, G., Zuin, F., Rengo, G., Furgi, A., Papa, D., Rotiroti, G., Rosato, F., Siano, M. R., Pagliuca, G., Rovelli, J., Heyman, I., Locati, M., Sanguinetti, F., Tomassini, R., Mantovani, A., Sanna, L., Marra, E., Crabu, G., Locci, N., Moio, C., Scilla, L., Tavazzi, G., Magrini, C., Bersano, M. L., Laudisa, Trimarco, Bruno, L., Argenziano, S., Silvestri, F., Valagussa, E., Ciro, E., Cantu, G., Trocino, A., Rossillo, L., Valagussa, G., Finocchi, G. M., Benvenuto, C., Bonanno, R., Ometto, G., Risica, G., Gualandi, L., Facchin, P., Tenderini, G. L., Nicolosi, C., Burelli, F., Macor, E., Bellone, D., Laiso, P., Carvalho, C., Peila, A., Fagiano, S., Gardiol, B., Ganci, P., Presutto, A., Fontanelli, T., Morgera, L., Scarpino, S., Barbuzzi, V., Capogrosso, P. F., Terrosu, G. M., Contini, G., Sabino, R., Pe, F., Uneddu, D., Mecca, I. D., Tommaso, C., Rusconi, M. C., Brunazzi, P., Codeluppi, M., Pasqualini, R., Gorni, M., Negrelli, S., Paparoni, A., Core, P., Pecce, L., Petrella, R. G., Zennaro, W., Garuti, G., Alfano, F., Bacca, G., Petrucci, A. M., Paci, G., Bigalli, S., Mangiameli, M., Gulizia, R., Cardillo, G., Ferrari, F., Tettamanti, E., Butti, N., Picchione, A., Sulla, P., Stroder, G. P., Perna, S., Ricci, C. A., Generali, E., Adornato, A., Ghisio, M., Tidu, R., Ferrari, D., Mele, G., Cicchitelli, E., Merli, O., Russa, J. M., A., P. Z., Gonzale, F., Vilchez, L. F. I., J. M. M., C. D., Zarzosa, E. S., Martin, J. O., De, M. H., Martinez, V. M., Palau, M. S. T., D. J. L., E. G., Cocina, J. C., Valderrama, R. P., Jimenez, J. A., M., J. B., Cortada, L. J., Lorente, J. J., G., A., Martinez, J. L., B., R. S., Casado, A. A., Cendon, D., Cokkino, T., Maouni, G., Karatasaki, D., Kremastino, S., Iliodromiti, D., Karatza, M., Georgiadi, I., Paraskevaidi, P., Toutouza, P., Antoniadi, C., Angeli, P., Vada, M., Kalebouba, S., Stamatelopoulo, I., Nana, A., Kanakaki, A., Daliani, A., Zacharouli, I., Fotiadi, V., Pyrgaki, O., Liata, B., Mazen, F., Kardara, D., Kardara, V., Kroko, H., Siora, S., Fousa, A., Stefanidi, G., Papadopoulo, C., Papadopoulo, I., Papagianni, I., Karida, and S., Zobolos

Subjects
Male, Ventricular Remodeling, Myocardial Infarction, Angiotensin-Converting Enzyme Inhibitors, Electrocardiography, ace inhibitors, elderly, heart rate variability, left ventricular remodeling, myocardial infarction, perindopril, Double-Blind Method, Echocardiography, Research Design, Perindopril, Electrocardiography, Ambulatory, Humans, Female, Aged
Abstract

Angiotensin-converting enzyme (ACE) inhibitors reduce mortality, the development of remodeling, left ventricular (LV) dysfunction, and ischemic events, both when administered alone as long-term treatment in patients with impaired LV function and/or heart failure (HF) and as short-term treatment, early after acute myocardial infarction (AMI) and/or HF. The few data available on the use of ACE inhibitors in the elderly after AMI are conflicting. Nothing is known about the effects of ACE inhibitors in elderly postinfarction patients with preserved LV function: these patients have a remarkable medium- to long-term mortality and HF incidence after infarction. The aim of this study is to evaluate, in patients with AMI agedor =65 years, the effects of Perindopril on the combined outcome of death, hospitalization for HF, and heart remodeling, considered to be aor =8% increase in LV end-diastolic volume (LVEDV). Secondary objectives include the same factors listed in the primary end points but considered separately. In addition, safety of the drug, ventricular remodeling, and adaptation are being evaluated. A total of 1100 patients with AMI (first episode or reinfarction), agedor =65 years, and preserved or only moderately depressed LV (LV ejection fractionor =40%), are to be enrolled and randomly assigned to treatment (8 mg for 12 months of Perindopril or placebo, in double-blind conditions). Clinical assessment is performed at fixed times, and periodic evaluations of (1) ventricular shape, dimensions, and function by quantitative 2-D echocardiography, and (2) heart rate variability and arrhythmias by ambulatory electrocardiographic monitoring are anticipated. The results and conclusions will be available by 2002 year.

Published
2000

18. MEDICAL SCIENCE. GISSI-2: A factorial randomised trial of alteplase versus streptokinase and heparin versus no heparin among 12 490 patients with acute myocardial infarction

Author

Feruglio, G. A., Lotto, A., Rovelli, F., Solinas, P., Tavazzi, L., Tognoni, G., De Vita, C., Franzosi, M. G., Maggiom, A. P., Mauri, F., Volpi, A., Selvini, A., Donato, L., Garattmi, S., Loi, U., Sirchia, G., Ambrosioni, E., Camerini, F., Campolo, L., Donati, M. B., Ferrari, M., Farchi, G., Geraci, E., Mannucci, P. M., Marubini, E., Neri Semeri, G. G., Peto, R., Prati, P. L., Specchia, G., Vecchio, C., Visani, L., Yusuf, S., Mezzanotte, G., Santoro, E., Bruno, M., Cappello, T., Coppini, A., Fincati, F., Mantovani, G., Pangrazzi, J., Pogna, M., Turazza, F. M., Ansehni, M., Barbonaglia, L., Bigi, R., Cavalli, A., Frigerio, M., Giordano, A., Gualtierotti, C., Torta, D., Vinci, P., Bossi, M., Furlanello, F., Braito, E., Giulia, V., Palmieri, M., Majoimo, P., Pinelli, G., Papi, L., Nardelli, A., Capestro, F., Rossi, A., Ricci, D., Mininni, N., Bianco, G., Barbuzzi, S., Plastina, F., Di Giovanna, F., Mereu, D., Giordano, F., Barlotti, R., Loparco, G., Boscarino, S., Ruggeri, G., Anastasi, R., Paciaroni, E., Tomassini, P. F., Purcaro, A., Francesconi, M., Figliolia, S., Tesse, S., Devoti, G., Giometti, R., Teoni, P., Burali, A., Zucconelli, V., Iervoglini, A., Amabili, S., Caratti, C. A., Zola, G., Ferraguto, P., Sagci, G., Rotiroti, D., Genovese, M., Da€™amato, N., Taurino, L., Colonna, L., Bovenzi, F., Messina, D., Sarcina, G., Compostella, L., Cucchini, F., Malacrida, R., Gradel, C., Bridda, A., Pellegrini, P., Acone, L., Bruno, A., Tespili, M., Guaghurrii, G., Casari, A., Bobba, F., Scaramuzzino, G., Berardi, C., De Castro, U., Fulvi, M., Lintner, W., Erlicher, A., Pitscheider, W., Scola Gagliardi, R., Bonizzato, G., Roggero, C., Perrini, A., Tsialtas, D., Straneo, U., Storelli, A., Verrienti, A., Albonico, B., Corradi, L., De Petra, V., Villani, C., Maxia, P., Bianco, A., Crabu, E., Centamore, G., Di Stefano, G., Vancheri, F., Amico, C., Baldini, F., Santopuoli, G., Pantaleoni, A., Contessotto, F., Terlizzi, R., Turchi, E., Teglio, V., Pignatti, F., Aletto, C., Gozzelino, G., Pettinati, G., De Santis, F., Correale, E., Romano, S., Perrotta, R., Tritto, C., May, L., Achilli, G., Suzzi, G., Cemetti, C., Longobardi, R., Somma, G., Palumbo, C., Gallone, P., Sorrentino, F., Dato, A., Della Monica, R., Pagano, L., Alberti, A., Orselli, L., Negrini, M., De Ponti, C., Acito, P., Capelletti, D., Bortolini, F., Coppola, V., Ciglia, C., De Cesare, M., De Lio, U., Maiolino, P., Giannini, R., Niccolini, A., Marinoni, C., Guasconi, C., Sonnino, S., Pagliei, M., Ferrari, G., Politi, A., Galli, M., De Rinaldis, G., Calcagnile, A., Bendinelli, S., Lusetti, L., Mollaioli, M., Cosmi, F., Venneri, N., Feraco, E., Lauro, A., Catelli, P., Poluzzi, C., Distante, S., Pedroni, P., Zampaglione, G., Lumare, R., Bruna, C., De Benedictis, N., Ziacchi, V., Lomanto, B., Riva, D., Bertocchi, P., Tirella, G., Tessitori, M., Bini, A., Peruzzi, F., Maresta, A., Pirazzini, L., Gaggi, S., Frausini, G., Malacame, C., Codeca, L., Cappato, R., Andreoli, L., Bastoni, L. A., Pucci, P., Sarro, F., Vergassola, R., Barchielli, M., De Matteis, D., Carrone, M., Liberati, R., Meniconi, L., Radogna, M., Tallone, M., Ieri, A., Ferreri, A., Guidali, P., Canziani, R., Mariello, F., Minelli, C., Muzio, L., Rota Baldini, M., Lupi, G., Cecchi, A., Giuliano, G., Bellotti, S., Livi, S., Corti, E., Rossi, P., Delfino, R., Iannetti, M., Pastorini, C., Pennesi, A., Di Giacinto, N., Bertolo, L., Slomp, L., Cresti, A., Svetoni, N., Distefano, S., Veneri, L., Moretti, S., Palermo, R., Giovanelli, N., Parchi, C., Dethomads, M., Paparella, N., Carrino, C., Aquaro, G., Idone, P., Marsili, P., Sideri, F., Valerio, A., Tullio, D., Ragazzini, G., Gramenzi, S., De Pasquale, B., Gelfo, P. G., Rosselli, P., De Marchi, E., Greco, M. R., Fazio, A. M., Savoia, M. T., Gerosa, C., Barbiero, M., Barbaresi, F., Volta, G., Da€™urbano, M., Passoni, F., Parola, G., Lanzini, A., Baldini, U., Del Bene, P., Orlandi, M., Oddone, A., Lazzari, M., Ballerini, B., Bozzi, L., Moccetti, T., Bemasconi, E., Sanguinetti, M., Tognoli, T., Bardelli, G., Maggi, A., Turato, R., Piva, M., Izzo, A., Tantalo, L., Rizzi, A., Scilabra, G., Varvaro, F., Colombo, G., Grieco, A., Dovico, E., Belluzzi, F., Casellato, F., Lecchi, G., Maugeri Sacci, C., Consolo, A., Piccolo, E., Zuin, G., Zappa, C., Sanna, G. P., Dossena, M. G., Corsini, C., Lettino, M., Marconi, M., Mafrici, A., Leonardi, G., Moreo, A., Seregni, R., Pastine, I., Casazza, F., Regalia, F., Maggiolini, S., Benenati, P. M., Rigo, R., Pascotto, P., Zanocco, A., Artusi, L., Cappelli, C., Bernardi, C., Pahnieri, M., Zilio, G., Sandri, R., Neri, G., Valagussa, F., Osculati, G., Cira, A., Da€™aniello, L., Piantadosi, F. R., Improta, M., Severino, S., Bisconti, C., Mostacci, M., Randon, L., Boschello, M., Allegri, M., Freggiaro, V., Mureddu, V., Soro, F., Marras, E., Marchi, S. M., De Luca, C., Manetta, M., Dalla Volta, S., Maddalena, F., Donzelli, M., Vitrano, M. G., Canonico, A., Ledda, A., Bellomare, D., Carrubba, A., Da€™antonio, E., Scardulla, C., Raineri, A., Traina, M., La Calce, C., Cirincione, V., Montanar, F., Strizzolo, L., Di Gregorio, D., Mantini, L., Chiriatti, G., Gazzola, U., Rosi, A., Mellini, M., Piazza, R., Micheli, G., Bechi, S., Martines, C., Marchese, D., Bigalli, A., Davini, P., Boem, A., Del Citerna, F., Giomi, A., Codeluppi, P., Negrelli, M., Brieda, M., Charmet, P. A., Petrella, A., Bardazzi, L., Bianco, G. A., Marco, A., Licitra, R., Lettica, G. V., Tumiotto, G., Bosi, S., Spitali, G., Casali, G., Bottoni, N., Parenti, G. F., Triulzi, E., Brighi, F., Benati, A., De Sanctis, A., Mene, A., Pesaresi, A., Bologna, F., Lumia, F., Barbato, G., Milazzotto, F., Proietti, F., Angrisani, G., Azzolini, P., Coppola, E., Trani, Carlo, Masini, V., Rocchi, M., Borgia, M. C., Luciani, C., Vitucci, N. C., Giuliani, P., Tugnoli, F., Vetta, C., Altieri, T., Gimigliano, F., Striano, U., Salituri, S., Zanazzi, G., Zonzin, P., Bugatti, U., Ravera, B., Allemano, P., Reynaud, S., Sanson, A., Milani, L., De Simone, M. V., Villella, A., Grazzini, M., Amidei, S., Ansehni, L., Benza, G., Tagliamonte, A., Messina, V., Etro, M. D., Vivaldi, F., Cortese, R., Ibba, G. V., Sannia, L., Pedrazzini, F., Gazzotti, G. L., Pizzuti, A., Antonielli, E., Becchi, G., Filice, A., Salmoiraghi, A., Caramanno, G., Caporicci, D., Brun, M., Ferrario, G., Giani, P., Ronconi, G., Douglas, S., Bianchi, C., Cucchi, G., Marieni, M., Marcellini, G., Speca, G., Beato, E., Serabni, N., Bazzucchi, M., Coronelli, R., Rossi, L., Basso, G., Presbitero, P., Bevilacqua, R., Pallisco, O., Di Leo, M., Golzio, P. G., Parigi, A., Belli, R., Trinchero, R., Gaschino, G., Barenghi, M., Poggio, G. L., Braschi, G. B., Sciacca, R., Sammartano, A., Braito, G., Cuzzato, V., Frigo, G., Perissinono, F., Galati, A., Accogli, M., Morgera, T., Barbieri, L., Slavich, G. A., Fresco, C., Cuda, A., Liguori, A., Cozzi, A., Caico, S., Alberio, M., Di Marco, G., De Vito, G., Valente, S., Zagatti, G., Zardini, P., Nidasio, G. P., Girardi, P., Mazzini, C., Nava, S., Achilli, A., Bisogno, A., Pasotti, C., Ballestra, A. M., and Giustarini, C.

Subjects
Aspirin, medicine.medical_specialty, business.industry, Streptokinase, acute myocardial infarction, General Medicine, Heparin, medicine.disease, Atenolol, Surgery, Anistreplase, Anesthesia, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine, Myocardial infarction, business, Stroke, medicine.drug, Killip class
Abstract

A multicentre, randomised, open trial with a 2 x 2 factorial design was conducted to compare the benefits and risks of two thrombolytic agents, streptokinase (SK, 1·5 MU infused intravenously over 30-60 min) and alteplase (tPA, 100 mg infused intravenously over 3 h) in patients with acute myocardial infarction admitted to coronary care units within 6 h from onset of symptoms. The patients were also randomised to receive heparin (12 500 U subcutaneously twice daily until discharge from hospital, starting 12 h after beginning the tPA or SK infusion) or usual therapy. All patients without specific contraindications were given atenolol (5-10 mg iv) and aspirin (300-325 mg a day). The end-point of the study was the combined estimate of death plus severe left ventricular damage. 12 490 patients were randomised to four treatment groups (SK alone, SK plus heparin, tPA alone, tPA plus heparin). No specific differences between the two thrombolytic agents were detected as regards the combined end-point (tPA 23·1%; SK 22·5%; relative risk 1·04, 95% Cl 0·95-1·13), nor after the addition of heparin to the aspirin treatment (hep 22·7%, no hep 22·9%; RR 0·99, 95% Cl 0·91-1·08). The outcome of patients allocated to the four treatment groups was similar with respect to baseline risk factors such as age, Killip class, hours from onset of symptoms, and site and type of infarct. The rates of major in-hospital cardiac complications (reinfarction, post-infarction angina) were also similar. The incidence of major bleeds was significantly higher in SK and heparin treated patients (respectively, tPA 0·5%, SK 1·0%, RR 0·57, 95% Cl 0·38-0·85; hep 1·0%, no hep 0·6%, RR 1·64, 95% Cl 1·09-2·45), whereas the overall incidence of stroke was similar in all groups. SK and tPA appear equally effective and safe for use in routine conditions of care, in all infarct patients who have no contraindications, with or without post-thrombolytic heparin treatment. The 8·8% hospital mortality of the study population (compared with approximately 13% in the control cohort of the GISSI-1 trial) indicates the beneficial impact of the proven acute treatments for AMI.

Published
1990

30. Prognostic value of supine bicycle exercise stress echocardiography in patients with known or suspected coronary artery disease.

Author

D'Andrea A, Severino S, Caso P, Liccardo B, Forni A, Fusco A, Piccolo RL, Scherillo M, Mininni N, and Calabró R

Abstract

AIMS: To assess the prognostic significance of supine bicycle exercise stress echocardiography (ESE) for cardiac events, and the ESE additional role compared to other traditional clinical and echo variables, in patients with proven or suspected coronary artery disease (CAD). METHODS AND RESULTS: Clinical status and long-term outcome were assessed in 607 patients, for a mean period of 49.9 +/- 12.5 months. ESE was performed for the diagnosis of suspected CAD in 267 patients, and for the risk stratification in 340 patients. At baseline, the mean value of WMSI was 1.22 +/- 0.36, and the mean left ventricular ejection fraction was 58.2 +/- 10.9%. The ESE was positive for ischemia in 210 patients (34.9%), while the ECG was suggestive for ischemia in 157 patients. At peak effort, the mean WMSI was 1.38 +/- 0.46. Low work load was achieved by 158 patients (26.1%). During the follow-up period there were 222 events, including 48 cardiac deaths and 34 acute non-fatal myocardial infarction. By multivariable model, cigarette smoking, peak WMSI, positive ESE for ischemia and low work load were the only independent predictors of cardiac death. The cumulative 5-year mean survival rate according to ESE response was 95.9% in patients with negative ESE, and 81.7% in positive ESE (p < 0.00001). CONCLUSIONS: In patients with known or suspected CAD able to perform a physical stress, bicycle ESE is able to stratify patients at higher risk of cardiac events. The final report of an ESE performed for prognostic purpose should include both the assessment of induced dyssinergy and the evaluation of indexes of the extent and the severity of myocardial ischemia. [ABSTRACT FROM AUTHOR]

Published
2005

31. Atrial myocardial deformation properties predict maintenance of sinus rhythm after external cardioversion of recent-onset lone atrial fibrillation: a color Doppler myocardial imaging and transthoracic and transesophageal echocardiographic study.

Author

Di Salvo G, Caso P, Lo Piccolo R, Fusco A, Martiniello AR, Russo MG, D'Onofrio A, Severino S, Calabró P, Pacileo G, Mininni N, Calabró R, Di Salvo, Giovanni, Caso, Pio, Lo Piccolo, Rosalia, Fusco, Angela, Martiniello, Alfonso R, Russo, Maria G, D'Onofrio, Antonio, and Severino, Sergio

Published
2005

33. Prognostic value of pharmacological stress echocardiography in diabetic patients.

Author

D'Andrea, A, Severino, S, Caso, P, De Simone, L, Liccardo, B, Forni, A, Pascotto, M, Di Salvo, G, Scherillo, M, Mininni, N, and Calabrò, R

Subjects
STRESS echocardiography, PEOPLE with diabetes, CORONARY disease, MYOCARDIAL infarction, UNIVARIATE analysis, ISCHEMIA, PATIENTS
Abstract

Our study was undertaken to assess the prognostic significance of pharmacological stress echocardiography in 325 diabetic patients. Pharmacological stress echocardiography was performed for diagnosis of coronary artery disease in 128 patients, and for risk stratification in 197 patients. Follow-up was 34 months. Cardiac-related death and non-fatal myocardial infarction were considered hard events. During the follow-up period, there were 38 deaths and 23 acute non-fatal myocardial infarctions. By univariate analysis, a pharmacological stress echocardiography positive response for ischaemia indicated an increased risk of cardiovascular death. However, by multivariate analysis, advanced age and peak ejection fraction <40% were the only independent predictors of cardiac death. The same peak ejection fraction (EF) <40%, rest wall motion score index and previous myocardial infarction were independent predictors of hard events. After dividing the population into two subgroups on the basis of EF at rest, only a peak EF <40% and a pharmacological stress echocardiography positive test were powerful independent predictors of cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Published
2003
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34. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione.

Author

Marchioli R, Barzi F, Bomba E, Chieffo C, Di Gregorio D, Di Mascio R, Franzosi MG, Geraci E, Levantesi G, Maggioni AP, Mantini L, Marfisi RM, Mastrogiuseppe G, Mininni N, Nicolosi GL, Santini M, Schweiger C, Tavazzi L, Tognoni G, and Tucci C

Published
2002

35. Assessment of absolute risk of death after myocardial infarction by use of multiple-risk-factor assessment equations; GISSI-Prevenzione mortality risk chart.

Author

Marchioli, R, Avanzini, F, Barzi, F, Chieffo, C, Di Castelnuovo, A, Franzosi, M.G, Geraci, E, Maggioni, A.P, Marfisi, R.M, Mininni, N, Nicolosi, G.L, Santini, M, Schweiger, C, Tavazzi, L, Tognoni, G, and Valagussa on behalf of GISSI-Prevenzione Investigators, F

Abstract

Aims To present and discuss a comprehensive and ready to use prediction model of risk of death after myocardial infarction based on the very recently concluded follow-up of the large GISSI-Prevenzione cohort and on the integrated evaluation of different categories of risk factors: those that are non-modifiable, and those related to lifestyles, co-morbidity, background, and other conventional clinical complications produced by the index myocardial infarction.Methods The 11–324 men and women recruited in the study within 3 months from their index myocardial infarction have been followed-up to 4 years. The following risk factors have been used in a Cox proportional hazards model: non-modifiable risk factors: age and sex; complications after myocardial infarction: indicators of left ventricular dysfunction (signs or symptoms of acute left ventricular failure during hospitalization, ejection fraction, NYHA class and extent of ventricular asynergy at echocardiography), indicators of electrical instability (number of premature ventricular beats per hour, sustained or repetitive arrhythmias during 24-h Holter monitoring), indicators of residual ischaemia (spontaneous angina pectoris after myocardial infarction, Canadian Angina Classification class, and exercise testing results); cardiovascular risk factors: smoking habits, history of diabetes mellitus and arterial hypertension, systolic and diastolic blood pressure, blood total and HDL cholesterol, triglycerides, fibrinogen, leukocytes count, intermittent claudication, and heart rate. Multiple regression modelling was assessed by receiver operating characteristic (ROC) analysis. Generalizability of the models was assessed through cross validation and bootstrapping techniques.Population and Results During the 4 years of follow-up, a total of 1071 patients died. Age and left ventricular dysfunction were the most relevant predictors of death. Because of pharmacological treatments, total blood cholesterol, triglycerides, and blood pressure values were not significantly associated with prognosis. Sex-specific prediction equations were formulated to predict risk of death according to age, simple indicators of left ventricular dysfunction, electrical instability, and residual ischaemia along with the following cardiovascular risk factors: smoking habits, history of diabetes mellitus and arterial hypertension, blood HDL cholesterol, fibrinogen, leukocyte count, intermittent claudication, and heart rate. The predictive models produced on the basis of information available in the routine conditions of clinical care after myocardial infarction provide ready to use and highly discriminant criteria to guide secondary prevention strategies.Conclusions and Implications Besides documenting what should be the preferred and practicable focus of clinical attention for today's patients, the experience of GISSI-Prevenzione suggests that periodically and prospectively collected databases on naturalistic' cohorts could be an important option for updating and verifying the impact of guidelines, which should incorporate the different components of the complex profile of cardiovascular risk. The GISSI Prevenzione risk function is a simple tool to predict risk of death and to improve clinical management of subjects with recent myocardial infarction. The use of predictive risk algorithms can favour the shift from medical logic, based on the treatment of single risk factors, to one centred on the patient as a whole as well as the tailoring of medical interventions according to patients' overall risk. [ABSTRACT FROM PUBLISHER]

Published
2001
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36. Involvement of Right Ventricle in Left Ventricular Hypertrophic Cardiomyopathy: Analysis by Pulsed Doppler Tissue Imaging.

Author

Severino, S., Caso, P., Cicala, S., Galderisi, M., de Simone, L., D'Andrea, A., D'errico, A., and Mininni, N.

Subjects
RIGHT heart ventricle, LEFT heart ventricle, HYPERTROPHIC cardiomyopathy, DOPPLER echocardiography, DIASTOLE (Cardiac cycle)
Abstract

Aims: This study uses pulsed Doppler tissue imaging to analyse right ventricular myocardial function and its interaction with left ventricle in hypertrophic cardiomyopathy involving ventricular septum.Methods and Results: Thirty-four patients with septal hypertrophic cardiomyopathy and 30 normal subjects, comparable for sex, age, body mass index and heart rate, underwent complete standard Doppler echocardiography and pulsed Doppler tissue imaging of both posterior septum and right ventricular free wall, calculating myocardial velocities and both systolic and diastolic time intervals. Except for peak velocity A, the other Doppler tricuspid inflow measurements were significantly impaired in hypertrophic cardiomyopathy, without changes of tricuspid annular systolic excursion. Right ventricular Doppler tissue imaging showed longer right ventricular myocardial relaxation time in hypertrophic cardiomyopathy than in controls (P<0·00001), without a significant difference from other myocardial diastolic and systolic measurements. In the overall population, Doppler measurements of right and left ventricular inflow were not significantly associated, while (with the exception of myocardial deceleration time) all the other myocardial systolic and diastolic measurements derived by tissue imaging were directly related to the homologous septal myocardial indexes. In addition, a significant inverse relation was found between septal wall thickness and myocardial relaxation index (right–left myocardial relaxation time/right ventricular relaxation time×100).Conclusions: This study shows the usefulness of pulsed Doppler tissue imaging to detect impairment of right ventricular myocardial function and to provide evidence about ventricular interaction in forms of hypertrophic cardiomyopathy which involve interventricular septum. [ABSTRACT FROM AUTHOR]

Published
2000
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37. [Balloon occlusion aortography in the angiographic study of pulmonary atresia with interventricular defect]

Author

VIOLINI R, MININNI N, DE LEVA F, MARSICO L, ALBORINO A, MARSICO F., CALABRO', Raffaele, Violini, R, Calabro', Raffaele, Mininni, N, DE LEVA, F, Marsico, L, Alborino, A, and Marsico, F.

Subjects
Heart Defects, Congenital, Heart Septal Defects, Ventricular, Pulmonary Valve, Infant, Newborn, Humans, Infant, Aortography
Abstract

Balloon aortography is a new technique for the angiographic study of pulmonary atresia with ventricular septal defect. A Swan-Ganz angiographic catheter is employed, whose balloon is inflated to stop blood flow in the descending aorta, thus ensuring the opacification of the pulmonary circulation. By this method we have studied 18 patients. Anatomic details of the pulmonary arterial circulation were obtained in all. No complications occurred. Balloon aortography is a simple and safe technique for the routine study of patients with pulmonary atresia and ventricular septal defect, whereas selective injection in collateral arteries or pulmonary veins, which carries more risk and is more complex, should be adopted only in selected cases.

Published
1983

38. [The vectorcardiogram of Fallot's tetralogy in the first two years of life. Qualitative and quantitative analysis (author's transl)]

Author

MARSICO F, ALBORINO A, MININNI N., CALABRO', Raffaele, Marsico, F, Calabro', Raffaele, Alborino, A, and Mininni, N.

Subjects
Male, Age Factors, Infant, Newborn, Tetralogy of Fallot, Vectorcardiography, Humans, Infant, Female
Abstract

36 patients, less than two years old, affected by Fallot's tetralogy were studied by vectorcardiography. The configuration of the QRS loop in the three orthogonal planes, the voltage of the 0.10 sec spatial vector, RMSV and LMSV vectors, and their azimuth and elevation were evaluated. Such data have been correlated to arterial oxygen saturation. Qualitative analysis showed a clockwise or figure eight QRS loop on the H and F planes in the great majority of cases; and only in a counterclockwise loop on the H plane was the suspicion of an arterial oxygen saturation greater than 85% especially in cases older than two months. The terminal forces of the QRS loop on the H plane were always directed under the O point, Whereas in the valvular pulmonary stenosis, terminal forces are generally superior to the O point. Quantitative analysis demonstrated the constant increase of the RMSV and the direct relationship of the LMSV to arterial oxygen saturation, and so it was the principal parameter for evaluation of the left ventricular volume and the size of pulmonary flow and the degree of pulmonary stenosis. The relationship between the azimuth of 0.01 sec spatial vector to O2 saturation was highly significant, showing a progressive anterior development of the former, as the latter increased.

Published
1976

39. [Balloon catheter atrial septostomy via the umbilical vein]

Author

CALABRO', Raffaele, MININNI N., Calabro', Raffaele, and Mininni, N.

Subjects
Cardiac Catheterization, Umbilical Veins, Heart Septum, Infant, Newborn, Humans, Heart Septal Defects, Atrial
Abstract

The feasibility of atrial septostomy through the ombelical vein is discussed. The advantages and the pitfalls of this technique are examined. On the basis of our experience with 8 cases thus treated in the last year, it is concluded that a careful use of this technique in patients under six days of age is indicated.

Published
1979

40. Noninvasive Assessment of Left and Right Internal Mammary Artery Graft Patency with High-Frequency Transthoracic Echocardiography

Author

De Simone, L., Caso, P., Severino, S., Scherillo, M., D'Andrea, A., Varricchio, A., Violini, R., and Mininni, N.

Abstract

Objectives: The aim of this study was (1) to visualize internal mammary artery grafts (IMAG) on coronary artery by transthoracic echocardiography and (2) to assess the patency of the grafts. Methods: Twenty-three patients (21 men, 56 +/- 6 years) with previous coronary artery bypass grafting were studied at baseline and after they underwent low-dose dipyridamole infusion. The parameters obtained were systolic (SPV) and diastolic (DPV) peak velocities and their ratio (DPV/SPV); the dipyridamole infusion to baseline ratio of DPV was an index of IMAG blood flow reserve (FR). Two groups of patients were selected at baseline: group A, (n = 12) with a DPV/SPV >1, and group B (n = 11), with a DPV/SPV <1. Results: The IMAG was identified in all patients. Intraluminal flow signals obtained with pulsed wave Doppler showed a biphasic pattern (1 systolic and 1 diastolic wave). After dipyridamole infusion was administered, flow velocities increased in 11 of 12 patients in group A and in 5 of 11 patients in group B. In group A the DPV/SPV increased from 1.79 +/- 0.47 to 1.8 +/- 0.43 (P = not significant), and the FR was 1.8 +/- 0.4. In group B the DPV/SPV increased from 0.46 +/- 0.05 to 0.5 +/- 0.09 (P = not significant), and the FR was 1.3 +/- 0.41. Coronary angiography showed the graft patency in all patients in group A and in 5 patients in group B with increased flow velocity after dipyridamole infusion. In the identification of graft stenosis at baseline, DPV/SPV showed 100% sensibility and 58% specificity, and FR showed 92% sensibility and 84% specificity. Conclusion: Doppler echocardiographic evaluation of the IMAG is a simple noninvasive method to assess the functional impairment of the vessel. (J Am Soc Echocardiogr 1999;12:841-9.)

Published
1999
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41. Diagnostic value of transesophageal echocardiography in the assessment of congenitally corrected transposition of the great arteries in adult patients

Author

Caso, P., Ascione, L., Lange, A., Palka, P., Mininni, N., and Sutherland, G.R.

Abstract

This study was designed to evaluate the relative diagnostic values of transthoracic (TTE) and transesophageal (TEE) echocardiography in the assessment of congenitally corrected transposition of the great arteries in adult patients. Twelve patients (mean age 29 years, range 21 to 39 years) with congenitally corrected transposition of the great arteries underwent both TTE and TEE examinations to assess this complex cardiac lesion. Of the 12 patients evaluated, situs solitus and inversus were present in 8 and in 4 patients, respectively. TTE correctly identified atrial situs in only 10 patients, whereas TEE, directly evaluating the morphologic features of either appendage, correctly determined situs in every patient. In all 11 patients with intact inlet ventricular septum, the spatial relationship between the septal leaflets of atrioventricular valves was correctly evaluated by both techniques. However, the chordal attachments of both valves were clearly elucidated by TEE in all patients, whereas TTE could obtain images of these in only three patients. TTE was able to evaluate the discordant connection between the right ventricle and the anterior vessel (aorta) in 10 patients, whereas the connection between the left ventricle and the posterior vessel was clearly shown only in 7 patients. Transesophageal longitudinal planes better elucidated these two discordances in all patients irrespective of the position of the heart in the chest and atrial situs. Four patients had an associated ventricular septal defect (inlet defect in one, perimembranous in two, and muscular in one); the inlet defect was unrestrictive and could be easily detected by either imaging technique, whereas the membranous was detected by TTE and by the horizontal transesophageal planes; the muscular defect was recognized only by TTE. Three patients had an associated pulmonary stenosis; Doppler transthoracic echocardiography showed a left outflow peak gradient of 100 mm Hg in two patients and of 80 mm Hg in one but failed to adequately assess the morphologic features of the stenosis, whose features were clearly visualized by transesophageal longitudinal planes in all patients. In conclusion, in our experience TEE is superior to transthoracic imaging in studying congenitally corrected transposition of the great arteries in adult patients; the horizontal plane is best suited to the evaluation of atrial situs and the atrioventricular junction, whereas the longitudinal plane is most valuable in the study of the morphologic features of the ventriculoarterial connections. These findings should be equally applicable to multiplane transesophageal studies. (Am Heart J 1998;135:43-50.)

Published
1998
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43. Regional diastolic function in normotensive versus hypertensive subjects: Comparison using Doppler myocardial imaging

Author

Caso, P., Maurizio Galderisi, Cioppa, C., Severino, S., Simone, L., Izzo, A., Liberate, C., Divitiis, O., Mininni, N., Caso, P, Galderisi, Maurizio, Cioppa, C, Severino, S, De Simone, L, Izzo, A, Liberato, C, de Divitiis, O, and Mininni, N.

Subjects
Male, Echocardiography, Doppler, Pulsed, Analysis of Variance, Diastole, Heart Rate, Systole, Data Interpretation, Statistical, Hypertension, Ventricular Function, Blood Pressure, Middle Aged, Human
Abstract

Pulsed Doppler myocardial imaging (DMI) is a new technique that makes it possible to obtain an on-line quantitative assessment of wall motion in different myocardial segments through sample-volume placement. Therefore, this tool is suitable for identifying changes in regional diastolic function in uncomplicated arterial hypertension. In this study, we examined standard Doppler-derived indexes of global left ventricular diastolic function and regional diastolic parameters obtained by pulse-wave DMI in a population of hypertensive patients, comparing them with the indexes found in a control group of normotensive subjects.

44. Surgery of rheumatic mitral stenosis: Comparison of different techniques

Author

Ismeno, G., Renzulli, A., Feo, M., Alessandro Della Corte, Mauro, C., Romano, G., Mininni, N., Cotrufo, M., Ismeno, G, Renzulli, A, DE FEO, Marisa, DELLA CORTE, Alessandro, Mauro, C, Romano, G, Mininni, N, and Cotrufo, M.

Subjects
Adult, Male, Reoperation, Analysis of Variance, Rheumatic Heart Disease, Length of Stay, Middle Aged, Perioperative Care, Survival Rate, Heart Valve Prosthesis, Quality of Life, Humans, Mitral Valve, Mitral Valve Stenosis, Female, Hospital Mortality, Cardiac Surgical Procedures, Aged, Ultrasonography
Abstract

The breakthrough of percutaneous transvenous mitral commissurotomy (PTMC) has dramatically changed the indications for the surgical treatment of rheumatic mitral stenosis over the last decade. No recent studies comparing long-term results of PTMC, open mitral commissurotomy (OMC) and mitral valve replacement (MVR) with bileaflet prostheses are available in medical literature.Between January 1991 and December 1997, 313 patients with pure and isolated rheumatic stenosis were treated in our department. One hundred and eleven patients underwent PTMC, 82 OMC and 120 MVR. There was no statistical difference (p0.05) between the mortality rates of the three groups of patients. No cases of hospital mortality were observed in the patients who underwent PTMC and OMC, whereas two patients (1.6%) died within 30 days after MVR. Seven year actuarial survival results are: 95.41+/-2(SE)% (PTMC), 98.05+/-1% (OMC) and 92.82+/-33% (MVR) (p=NS). Freedom from embolism was 98.78+/-1% in PTMC, 98.78+/-1% in OMC and 92.52+/-2% in MVR (p0.05); freedom from reoperation was 88.43+/-8% in PTMC, 96.35%+/-2% in OMC and 97.72+/-1% in MVR (p0.05). The mean NYHA class at the end of follow-up was lower in OMC (1.14+/-0.3) versus PTMC (1.39+/-0.6) and MVR (1.41+/-0.71) (p=0.001).Even though conservative techniques are the first option to consider in treating mitral valve stenosis, valve replacement with bileaflet prostheses no longer represents a limiting factor to survival and quality of life.

46. DETERMINANTS OF 6-MONTH MORTALITY IN SURVIVORS OF MYOCARDIAL-INFARCTION AFTER THROMBOLYSIS - RESULTS OF THE GISSI-2 DATA-BASE

Author

VOLPI A, DEVITA C, FRANZOSI MG, GERACI E, MAGGIONI AP, MAURI F, NEGRI E, SANTORO E, TAVAZZI L, TOGNONI G, FERUGLIO GA, LOTTO A, ROVELLI F, SOLINAS P, BRUNO M, CAPPELLO T, COPPINI A, FINCATI F, MANTOVANI G, PANGRAZZI J, POGNA M, TURAZZA FM, ANSELMI M, BARBONAGLIA L, BIGI R, CAVALLI A, FRIGERIO M, GIORDANO A, GUALTIEROTTI C, TORTA D, CAROLA R, GIORDANO F, BARLOTTI R, LOPARCO G, VIGLINO GL, RUGGERI G, GIAMUNDO L, DANESI A, PACIARONI E, GAMBINI C, URBANO G, PURCARO A, FRANCESCONI M, FIGLIOLIA S, CANNONE M, ANTOLINI R, DEVOTI G, CRISTALLINI P, PORCIELLO PI, TEONI P, BURALI A, ZUCCONELLI V, DEMATTEIS C, IERVOGLINI A, SCATASTA M, AMABILI S, CARATTI CA, ZOLA G, FERRAGUTO P, SALICI G, CENTARO A, ROTIROTI D, GENOVESE M, GINEVRINO P, DAMATO N, ALTAMURA CM, COLONNA L, CASTELLANETA G, BOVENZI F, MESSINA D, GALANTINO A, CAMPOREALE N, CUCCHINI F, CAMPOSTELLA L, MALACRIDA R, GENONI M, PELLEGRINI P, BRIDDA A, RIGGI L, ACONE L, MOSCATIELLO G, BRUNO A, INVERNIZZI G, TESPILI M, GUAGLIUMI G, CASARI A, ALBANO T, TOMASSINI B, DIBIASE G, SCARAMUZZINO G, RUGGERO S, BRACCHETTI D, DECASTRO U, FULVI M, BRAITO E, ERLICHER A, OBERLECHNER W, GAGLIARDI RS, BIGHIGNOLI L, BONIZZATO G, RIZZI GM, SCAZZINA L, PERRINI A, STRANEO G, STRANEO U, SCIRE A, VERRIENTI A, GUADALUPI M, STORELLI A, ZUCCA L, DABUSTI M, ALBONICO B, DEPETRA V, TABACCHI GC, SCERVINO R, MEREU D, MAXIA P, BIANCO A, CRABU E, MANGIAMELI S, CENTAMORE G, MALFITANO D, AMICO C, VANCHERI F, SANTOPUOLI G, BALDINI F, PANTALEONI A, CONTESSOTTO F, TERLIZZI R, MERIGHI A, TURCHI E, TEGLIO V, PIGNATTI F, PEZZANA A, GOZZOLINO G, GIGLIO M, PETTINATI G, IEVA M, CIRICUGNO S, CORREALE E, ROMANO S, DIFUCCIA A, CASTELLANO B, NATALE A, CERNETTI C, CELEGON L, CANDELPERGHER G, ARIENZO F, RUSSO F, DEVIVO L, MAY L, ACHILLI G, BLASI A, SORRENTINO F, DATO A, GALLONE P, PALUMBO C, DELLAMONICA R, PAGANO L, ALBERTI A, ORSELLI L, DEPONTI C, PARMIGIANI ML, FERRARI M, ACITO P, BUSI F, DELLAVITTORIA G, BELLET C, BORTOLINI F, ROSSI A, CORONA C, BONDI S, NICCOLINI D, GAMBERI G, ARCURI G, MAIOLINO P, CARROZZA A, DELIO U, CAPRETTI G, MARINONI C, GUASCONI C, SONNINO S, PAGLIEI M, FERRARI G, LOMBARDI R, AGNELLI D, DERINALDIS G, CALCAGNILE A, SIGNORELLI S, BENDINELLI S, LUSETTI L, MOLLAIOLI M, COSMI F, PLASTINA F, VENNERI N, FERACO E, CATELLI P, POLUZZI C, DISTANTE S, BIANCHI C, COPPETTI S, ZAMPAGLIONE G, GATTO C, ZURLO R, USLENGHI E, MARGARIA F, MILANESE U, LOMANTO B, ZIACCHI V, RIVA D, BERTOCCHI P, TIRELLA G, DAULERIO M, SAURO G, BINI A, MAZZONI V, POGGI P, MARESTA A, JACOPI F, PATRONCINI A, PUPITA F, GAGGI S, FRAUSINI G, ANTONIOLI GE, MALACARNE C, CODECA L, CAPPATO R, ANDREOLI L, VARACCA S, BUIO E, FAZZINI PF, PUCCI P, SARRO F, VERGASSOLA R, BARCHIELLI M, DEMATTEIS D, CARRONE M, BRUNOZZI LT, MENICONI L, LIBERATI R, RADOGNA M, TALLONE M, CONTE R, IERI A, ZIPOLI A, SANSONI M, CANZIANI R, GUIDALI P, CRISTALLO E, MARIELLO F, MUZIO L, BENVENUTO MR, BALDINI MR, VECCHIO C, CHIARELLA F, FALCIDIENO M, CECCHI A, GIULIANO G, SEU V, PERUGINI P, TOSELLI A, BASSO F, CORTI E, ROSSI P, DELFINO R, CAPONNETTO S, GNECCO G, GHIGLIOTTI G, PENNESI A, LOMBARDI G, RUGGIERI A, BERTOLO L, SLOMP L, LANZETTA T, MAZZARONE L, CRESTI A, BELLODI G, ZUARINI AM, VENERI L, PARCHI C, GIOVANELLI N, NEGRONI S, DETHOMATIS M, BARGHINI A, MARINO E, RICCI D, LEMME P, DIGIACOMO U, AQUARO G, RONZANI G, OTTELLO B, VONTI V, MORETTI S, PALERMO R, MARSILI P, SIDERI F, RAGAZZINI G, GRAMENZI S, BATTISTINI S, DIODATO T, VALERIO A, TUCCI C, DEPASQUALE B, GELFO PG, BERTULLA A, BOLLINI R, DEMARCHI E, BACCA F, DEGIORGI V, LOCATELLI V, SAVOIA MT, FERRACINI C, BARBARESI F, COTOGNI A, FRANCO G, PASSONI F, DURBANO M, MORETTI G, PEROTTI S, CAPRETTI M, DELBENE P, CASCONE M, BALDINI U, ORLANDI M, ODDONE A, CAIZZI V, MASINI G, LAZZARI M, BALLERINI B, BOZZI L, MOCETTI T, BERTOLINI A, PASOTTI E, SANGUINETTI M, MANTOVANI R, TOGNOLI T, MAGGI A, TUSA M, CAMERONI E, GUERRA GP, REGGIANI A, REDAELLI S, GIUSTI S, TANTALO L, RIZZI A, DIGIOVANNI N, GUZZO V, GABRIELE M, COLOMBO G, ALBERZONI A, SALVIOLI G, GALFETTI F, DOVICO E, BELLUZZI F, GOLA E, CASELLATO F, LECCHI G, CONSOLO F, SACCA CB, CONSOLO A, PICCOLO E, GASPARINI G, MASSA D, BELLI C, DOSSENA MG, CORSINI C, SANNA GP, AZZOLLINI M, TRUAZZA F, NADOR F, DEMARTINI M, BOZZI G, SEREGNI R, PASTINE I, MORPURGO M, CASAZZA F, REGALIA F, MAGGIOLINI S, RIGO R, PANCALDI S, POZZETTI D, PASCOTTO P, FRANCESCHI L, DAINESE F, MELINI L, CAPPELLI C, BERNARDI C, PALMIERI M, BORGIONI L, ZILIO G, SANDRI R, ALITTO F, MASARO G, VALAGUSSA F, SCHIAVINA R, RAVESI D, DANIELLO L, PIANTADOSI FR, BARRA P, ROMEO D, MININNI N, SEVERINO S, MOSTACCI M, CASTELLARI M, BANDA D, ROLANDI R, VILLA WD, CARBONE V, ALLEGRI M, FASCIOLO L, PITTALIS M, MUREDDU V, SORO F, DELEDDA MG, MARRAS E, MARCHI SM, DELUCA C, MANETTA M, VOLTA SD, SPERANDEO V, DONZELLI M, VITRANO MG, PITROLO F, LAMONICA S, BELLANCA G, MESSINA G, MIRTO U, RAINERI A, TRAINA M, DIBENEDETTO A, RIBAUDO E, DIFRANCESCO M, RONCHITELLI R, CARONE M, DIGREGORIO D, DIPAOLO G, PASQUALE M, COREA L, COCCHIERI M, ALUNNI G, PAPI L, CHIRIATTI G, LUPETTI M, GAZZOLA U, ARRUZZOLI S, VILLANI GQ, MELLINI M, MADRUZZA L, PIAZZA R, MICHELI G, FRANCHINI C, BECHI S, MARTINES C, MARCHESE D, GABBIA G, BIGALLI A, CIUTI M, CABANI E, DELCITERNA F, ALFIERI A, CHITI M, LONGHINI J, CODELUPPI P, NEGRELLI M, ZANUTTINI D, NICOLOSI GL, MARTIN G, PETRELLA A, BARDAZZI L, BIANCO GA, CELLAMARE G, GIANNELLI F, LICITRA G, LICITRA R, LETTICA GV, TUMIOTTO G, BELLANTI G, BOSI S, CASALI G, MONDUCCI I, BARONE A, PARENTI F, HEYMAN J, COZZI E, BALDACCI G, BACCOS D, BRIGHI F, DESANCTIS A, BOCK R, ROSSI F, AMATI P, SEMPRINI P, NARDELLI A, BOTTERO G, VARTOLO C, MILAZZOTTO F, DICROCE G, DIMARIO F, ANGRISANI G, AZZOLINI P, NEJA CP, MANZOLI U, ROSSI E, TRANI C, MASINI V, SEBASTIANI F, TOPAI M, BORGIA MC, LUCIANI C, FERRI F, DEPAOLA D, CAPURSO S, TUGNOLI F, VETTA C, ALTIERI T, BORZI M, VISCOMI A, STRIANO U, SALITURI S, ZONZIN P, FIORENCIS R, BADIN A, RAVERA B, BALDI C, SILVESTRI F, ALLEMANO P, REYNAUD S, SANSON A, MILANI L, DESIMONE MV, RUSSO A, VILLELLA A, GRAZINI M, AMIDEI S, ANSELMI L, PICCANICOLINO R, MASCELLI G, TAGLIAMONTE A, MESSINA V, TEDESCHI C, BOSSI M, BISIOLI M, TACCHI G, PAGNI G, VIVALDI F, IBBA GV, SANNIA L, PEDRAZZINI F, BAGNI E, FABII S, ALVINO A, ANTONIELLI E, DORONZO B, MARTINENGO E, BECCHI G, SALMOIRAGHI A, DIGIOVANNA F, CARAMANNO G, CAPORICCI D, BRUN M, GIANI P, FERRARIO G, PECI P, RONCONI G, SKOUSE D, GIUSTINIANI S, CUCCHI GF, TAVASCI E, SILVERII A, MARCELLINI G, SPECA G, STANISCIA D, CIMINO A, SERAFINI N, DEBONIS P, CERRUTI P, BAZZUCCHI M, DALPRA F, SPEROTTO C, MOLE GD, BARBANO G, POMARI F, GASCHINO G, PARIGI A, GANDOLFO N, RONDONI F, BRUSCA A, DILEO M, GOLZIO PG, ABRATE M, SCLAVO MG, ROCCI R, POGGIO G, GIANI S, CUZZUCREA D, BRASCHI GB, SCIACCA R, SAMMARTANO A, FURLANELLO F, BRAITO G, CUZZATO V, TOTIS O, FAURETTO F, LEO F, GALATI A, PALMA P, CAMERINI F, MORGERA T, BARBIERI L, SLAVICK GA, FRESCO C, CUDA A, SARNICOLA P, ARZILLO P, BINAGHI G, MACCHI G, CALVERI G, DIMARCO G, LEVANTESI G, PANERAI C, CATURELLI G, FACCHIN L, SARTORE G, ZARDINI P, MARINO P, CARBONIERI E, NAVA S, MAZZINI C, NAVA R, SERRA N, SASSARA M, NICROSINI F, GANDOLFI P, BERGOGNONI G, BALLESTRA AM, VIOLO C, VOLPI A, DEVITA C, FRANZOSI MG, GERACI E, MAGGIONI AP, MAURI F, NEGRI E, SANTORO E, TAVAZZI L, TOGNONI G, FERUGLIO GA, LOTTO A, ROVELLI F, SOLINAS P, BRUNO M, CAPPELLO T, COPPINI A, FINCATI F, MANTOVANI G, PANGRAZZI J, POGNA M, TURAZZA FM, ANSELMI M, BARBONAGLIA L, BIGI R, CAVALLI A, FRIGERIO M, GIORDANO A, GUALTIEROTTI C, TORTA D, CAROLA R, GIORDANO F, BARLOTTI R, LOPARCO G, VIGLINO GL, RUGGERI G, GIAMUNDO L, DANESI A, PACIARONI E, GAMBINI C, URBANO G, PURCARO A, FRANCESCONI M, FIGLIOLIA S, CANNONE M, ANTOLINI R, DEVOTI G, CRISTALLINI P, PORCIELLO PI, TEONI P, BURALI A, ZUCCONELLI V, DEMATTEIS C, IERVOGLINI A, SCATASTA M, AMABILI S, CARATTI CA, ZOLA G, FERRAGUTO P, SALICI G, CENTARO A, ROTIROTI D, GENOVESE M, GINEVRINO P, DAMATO N, ALTAMURA CM, COLONNA L, CASTELLANETA G, BOVENZI F, MESSINA D, GALANTINO A, CAMPOREALE N, CUCCHINI F, CAMPOSTELLA L, MALACRIDA R, GENONI M, PELLEGRINI P, BRIDDA A, RIGGI L, ACONE L, MOSCATIELLO G, BRUNO A, INVERNIZZI G, TESPILI M, GUAGLIUMI G, CASARI A, ALBANO T, TOMASSINI B, DIBIASE G, SCARAMUZZINO G, RUGGERO S, BRACCHETTI D, DECASTRO U, FULVI M, BRAITO E, ERLICHER A, OBERLECHNER W, GAGLIARDI RS, BIGHIGNOLI L, BONIZZATO G, RIZZI GM, SCAZZINA L, PERRINI A, STRANEO G, STRANEO U, SCIRE A, VERRIENTI A, GUADALUPI M, STORELLI A, ZUCCA L, DABUSTI M, ALBONICO B, DEPETRA V, TABACCHI GC, SCERVINO R, MEREU D, MAXIA P, BIANCO A, CRABU E, MANGIAMELI S, CENTAMORE G, MALFITANO D, AMICO C, VANCHERI F, SANTOPUOLI G, BALDINI F, PANTALEONI A, CONTESSOTTO F, TERLIZZI R, MERIGHI A, TURCHI E, TEGLIO V, PIGNATTI F, PEZZANA A, GOZZOLINO G, GIGLIO M, PETTINATI G, IEVA M, CIRICUGNO S, CORREALE E, ROMANO S, DIFUCCIA A, CASTELLANO B, NATALE A, CERNETTI C, CELEGON L, CANDELPERGHER G, ARIENZO F, RUSSO F, DEVIVO L, MAY L, ACHILLI G, BLASI A, SORRENTINO F, DATO A, GALLONE P, PALUMBO C, DELLAMONICA R, PAGANO L, ALBERTI A, ORSELLI L, DEPONTI C, PARMIGIANI ML, FERRARI M, ACITO P, BUSI F, DELLAVITTORIA G, BELLET C, BORTOLINI F, ROSSI A, CORONA C, BONDI S, NICCOLINI D, GAMBERI G, ARCURI G, MAIOLINO P, CARROZZA A, DELIO U, CAPRETTI G, MARINONI C, GUASCONI C, SONNINO S, PAGLIEI M, FERRARI G, LOMBARDI R, AGNELLI D, DERINALDIS G, CALCAGNILE A, SIGNORELLI S, BENDINELLI S, LUSETTI L, MOLLAIOLI M, COSMI F, PLASTINA F, VENNERI N, FERACO E, CATELLI P, POLUZZI C, DISTANTE S, BIANCHI C, COPPETTI S, ZAMPAGLIONE G, GATTO C, ZURLO R, USLENGHI E, MARGARIA F, MILANESE U, LOMANTO B, ZIACCHI V, RIVA D, BERTOCCHI P, TIRELLA G, DAULERIO M, SAURO G, BINI A, MAZZONI V, POGGI P, MARESTA A, JACOPI F, PATRONCINI A, PUPITA F, GAGGI S, FRAUSINI G, ANTONIOLI GE, MALACARNE C, CODECA L, CAPPATO R, ANDREOLI L, VARACCA S, BUIO E, FAZZINI PF, PUCCI P, SARRO F, VERGASSOLA R, BARCHIELLI M, DEMATTEIS D, CARRONE M, BRUNOZZI LT, MENICONI L, LIBERATI R, RADOGNA M, TALLONE M, CONTE R, IERI A, ZIPOLI A, SANSONI M, CANZIANI R, GUIDALI P, CRISTALLO E, MARIELLO F, MUZIO L, BENVENUTO MR, BALDINI MR, VECCHIO C, CHIARELLA F, FALCIDIENO M, CECCHI A, GIULIANO G, SEU V, PERUGINI P, TOSELLI A, BASSO F, CORTI E, ROSSI P, DELFINO R, CAPONNETTO S, GNECCO G, GHIGLIOTTI G, PENNESI A, LOMBARDI G, RUGGIERI A, BERTOLO L, SLOMP L, LANZETTA T, MAZZARONE L, CRESTI A, BELLODI G, ZUARINI AM, VENERI L, PARCHI C, GIOVANELLI N, NEGRONI S, DETHOMATIS M, BARGHINI A, MARINO E, RICCI D, LEMME P, DIGIACOMO U, AQUARO G, RONZANI G, OTTELLO B, VONTI V, MORETTI S, PALERMO R, MARSILI P, SIDERI F, RAGAZZINI G, GRAMENZI S, BATTISTINI S, DIODATO T, VALERIO A, TUCCI C, DEPASQUALE B, GELFO PG, BERTULLA A, BOLLINI R, DEMARCHI E, BACCA F, DEGIORGI V, LOCATELLI V, SAVOIA MT, FERRACINI C, BARBARESI F, COTOGNI A, FRANCO G, PASSONI F, DURBANO M, MORETTI G, PEROTTI S, CAPRETTI M, DELBENE P, CASCONE M, BALDINI U, ORLANDI M, ODDONE A, CAIZZI V, MASINI G, LAZZARI M, BALLERINI B, BOZZI L, MOCETTI T, BERTOLINI A, PASOTTI E, SANGUINETTI M, MANTOVANI R, TOGNOLI T, MAGGI A, TUSA M, CAMERONI E, GUERRA GP, REGGIANI A, REDAELLI S, GIUSTI S, TANTALO L, RIZZI A, DIGIOVANNI N, GUZZO V, GABRIELE M, COLOMBO G, ALBERZONI A, SALVIOLI G, GALFETTI F, DOVICO E, BELLUZZI F, GOLA E, CASELLATO F, LECCHI G, CONSOLO F, SACCA CB, CONSOLO A, PICCOLO E, GASPARINI G, MASSA D, BELLI C, DOSSENA MG, CORSINI C, SANNA GP, AZZOLLINI M, TRUAZZA F, NADOR F, DEMARTINI M, BOZZI G, SEREGNI R, PASTINE I, MORPURGO M, CASAZZA F, REGALIA F, MAGGIOLINI S, RIGO R, PANCALDI S, POZZETTI D, PASCOTTO P, FRANCESCHI L, DAINESE F, MELINI L, CAPPELLI C, BERNARDI C, PALMIERI M, BORGIONI L, ZILIO G, SANDRI R, ALITTO F, MASARO G, VALAGUSSA F, SCHIAVINA R, RAVESI D, DANIELLO L, PIANTADOSI FR, BARRA P, ROMEO D, MININNI N, SEVERINO S, MOSTACCI M, CASTELLARI M, BANDA D, ROLANDI R, VILLA WD, CARBONE V, ALLEGRI M, FASCIOLO L, PITTALIS M, MUREDDU V, SORO F, DELEDDA MG, MARRAS E, MARCHI SM, DELUCA C, MANETTA M, VOLTA SD, SPERANDEO V, DONZELLI M, VITRANO MG, PITROLO F, LAMONICA S, BELLANCA G, MESSINA G, MIRTO U, RAINERI A, TRAINA M, DIBENEDETTO A, RIBAUDO E, DIFRANCESCO M, RONCHITELLI R, CARONE M, DIGREGORIO D, DIPAOLO G, PASQUALE M, COREA L, COCCHIERI M, ALUNNI G, PAPI L, CHIRIATTI G, LUPETTI M, GAZZOLA U, ARRUZZOLI S, VILLANI GQ, MELLINI M, MADRUZZA L, PIAZZA R, MICHELI G, FRANCHINI C, BECHI S, MARTINES C, MARCHESE D, GABBIA G, BIGALLI A, CIUTI M, CABANI E, DELCITERNA F, ALFIERI A, CHITI M, LONGHINI J, CODELUPPI P, NEGRELLI M, ZANUTTINI D, NICOLOSI GL, MARTIN G, PETRELLA A, BARDAZZI L, BIANCO GA, CELLAMARE G, GIANNELLI F, LICITRA G, LICITRA R, LETTICA GV, TUMIOTTO G, BELLANTI G, BOSI S, CASALI G, MONDUCCI I, BARONE A, PARENTI F, HEYMAN J, COZZI E, BALDACCI G, BACCOS D, BRIGHI F, DESANCTIS A, BOCK R, ROSSI F, AMATI P, SEMPRINI P, NARDELLI A, BOTTERO G, VARTOLO C, MILAZZOTTO F, DICROCE G, DIMARIO F, ANGRISANI G, AZZOLINI P, NEJA CP, MANZOLI U, ROSSI E, TRANI C, MASINI V, SEBASTIANI F, TOPAI M, BORGIA MC, LUCIANI C, FERRI F, DEPAOLA D, CAPURSO S, TUGNOLI F, VETTA C, ALTIERI T, BORZI M, VISCOMI A, STRIANO U, SALITURI S, ZONZIN P, FIORENCIS R, BADIN A, RAVERA B, BALDI C, SILVESTRI F, ALLEMANO P, REYNAUD S, SANSON A, MILANI L, DESIMONE MV, RUSSO A, VILLELLA A, GRAZINI M, AMIDEI S, ANSELMI L, PICCANICOLINO R, MASCELLI G, TAGLIAMONTE A, MESSINA V, TEDESCHI C, BOSSI M, BISIOLI M, TACCHI G, PAGNI G, VIVALDI F, IBBA GV, SANNIA L, PEDRAZZINI F, BAGNI E, FABII S, ALVINO A, ANTONIELLI E, DORONZO B, MARTINENGO E, BECCHI G, SALMOIRAGHI A, DIGIOVANNA F, CARAMANNO G, CAPORICCI D, BRUN M, GIANI P, FERRARIO G, PECI P, RONCONI G, SKOUSE D, GIUSTINIANI S, CUCCHI GF, TAVASCI E, SILVERII A, MARCELLINI G, SPECA G, STANISCIA D, CIMINO A, SERAFINI N, DEBONIS P, CERRUTI P, BAZZUCCHI M, DALPRA F, SPEROTTO C, MOLE GD, BARBANO G, POMARI F, GASCHINO G, PARIGI A, GANDOLFO N, RONDONI F, BRUSCA A, DILEO M, GOLZIO PG, ABRATE M, SCLAVO MG, ROCCI R, POGGIO G, GIANI S, CUZZUCREA D, BRASCHI GB, SCIACCA R, SAMMARTANO A, FURLANELLO F, BRAITO G, CUZZATO V, TOTIS O, FAURETTO F, LEO F, GALATI A, PALMA P, CAMERINI F, MORGERA T, BARBIERI L, SLAVICK GA, FRESCO C, CUDA A, SARNICOLA P, ARZILLO P, BINAGHI G, MACCHI G, CALVERI G, DIMARCO G, LEVANTESI G, PANERAI C, CATURELLI G, FACCHIN L, SARTORE G, ZARDINI P, MARINO P, CARBONIERI E, NAVA S, MAZZINI C, NAVA R, SERRA N, SASSARA M, NICROSINI F, GANDOLFI P, BERGOGNONI G, BALLESTRA AM, and VIOLO C

Subjects
cardiovascular diseases
Abstract

Background. Current knowledge of risk assessment in survivors of myocardial infarction is largely based on data gathered before the advent of thrombolysis. It must be determined whether and to what extent available information and proposed criteria of prognostication are applicable in the thrombolytic era. Methods and Results. We reassessed risk prediction in the 10 219 survivors of myocardial infarction with follow-up data available (ie, 98% of the total) who had been enrolled in the GISSI-2 trial, relying on a set of prespecified variables. The 3.5% 6-month all-cause mortality rate of these patients compared with the higher value of 4.6% found in the corresponding GISSI-1 cohort, originally allocated to streptokinase therapy, indicates a 24% reduction in postdischarge 6-month mortality. On multivariate analysis (Cox model), the following variables were predictors of 6-month all-cause mortality: ineligibility for exercise test for both cardiac (relative risk [RR], 3.30; 95% confidence interval [CI], 2.36-4.62) and noncardiac reasons (RR, 3.28; 95% CI, 2.23-4.72), early left ventricular failure (RR, 2.41; 95% Cl, 1.87-3.09), echocardiographic evidence of recovery phase left ventricular dysfunction (RR, 2.30; 95% CI, 1.78-2.98), advanced (more than 70 years) age (RR, 1.81; 95% Cl, 1.43 -2.30), electrical instability (ie, frequent and/or complex ventricular arrhythmias) (RR, 1.70; 95% Cl, 1.32-2.19), late left ventricular failure (RR, 1.54; 95% Cl, 1.17-2.03), previous myocardial infarction (RR, 1.47; 95% CI, 1.14-1.89), and a history of treated hypertension (RR, 1.32; 95% Cl, 1.05-1.65). Early post-myocardial infarction angina, a positive exercise test, female sex, history of angina, history of insulin-dependent diabetes, and anterior site of myocardial infarction were not risk predictors. On further multivariate analysis, performed on 8315 patients with the echocardiographic indicator of left ventricular dysfunction available, only previous myocardial infarction was not retained as an independent risk predictor. Conclusions. A decline in 6-month mortality of myocardial infarction survivors, seen within 6 hours of symptom onset, has been observed in recent years. Ineligibility for exercise test, early left ventricular failure, and recovery-phase left ventricular dysfunction are the most powerful (RR, >2) predictors of 6-month mortality among patients recovering from myocardial infarction after thrombolysis. Qualitative variables reflecting residual myocardial ischemia do not appear to be risk predictors. The lack of an independent adverse influence of early post-myocardial infarction angina on 6-month survival represents a major difference between this study and those of the prethrombolytic era.

47. The clopidogrel in unstable angina to prevent Recurrent Events (CURE) trial programme - Rationale, design and baseline characteristics including a meta-analysis of the effects of thienopyridines in vascular disease

Author

Yusuf, S., Mehta, S., Anand, S., Avezum, A., Awan, N., Bertrand, M., Blumenthal, M., Bouthier, J., Budaj, A., Ceremuzynski, L., Chrolavicius, S., Col, J., Commerford, P., Diaz, R., Flather, M., Fox, K., Franzosi, Mg, Gaudin, C., Gersh, B., Grossman, W., Halon, D., Hess, T., Hunt, D., Joyner, C., Karatzas, N., Keltai, M., Khurmi, N., Kopecky, S., Lewis, B., Maggioni, A., Malmberg, K., Moccetti, T., Morais, J., Paolasso, E., Peters, R., Piegas, L., Pipilis, A., Ramos-Corrales, Ma, Rupprecht, Hj, Ryden, L., Sitkei, E., Sotty, M., Tognoni, G., Valentin, V., Varigos, J., Widimsky, P., Wittlinger, T., Pogue, J., Copland, I., Cracknell, B., Demers, C., Eikelboom, J., Hall, K., Keys, J., Mcqueen, M., Montague, P., Morris, B., Ounpuu, S., Wright, C., Yacyshyn, V., Zhao, F., Lewis, Bs, Commerford, Pj, Wyse, G., Cairns, J., Hart, R., Hirsh, J., Gent, M., Ryan, T., Wittes, J., Auger, P., Basart, Dcg, Chan, Y., Raedt, H., Den Hartoog, M., Galli, M., Garcia-Guerrero, Jj, Marquis, Jf, Mauri, F., Mayosi, B., Natarajan, M., Nieminen, M., Norris, J., Panju, A., Peters, Rj, Renkin, J., Rihal, C., Szymanski, P., Wasek, W., Allende, G., Bono, Jo, Caccavo, A., Fernandez, Aa, Fuselli, Jj, Gambarte, Aj, Guerrero, Raa, Hasbani, Eg, Liprandi, As, Marzetti, E., Mon, G., Nordaby, R., Nul, D., Quijano, G., Salvati, A., San Martin, E., Sokn, F., Torre, H., Trivi, M., Tuero, E., Amerena, J., Bailey, N., Bett, Jhn, Buncle, A., Careless, D., Desilva, S., Ewart, A., Fitzpatrick, D., Garrahy, P., Gunawardane, K., Hamer, A., Hill, A., Jackson, B., Lane, G., Nelson, G., Owensby, D., Rees, D., Rosen, D., Sampson, J., Singh, B., Taylor, R., Thomson, A., Walsh, W., Watson, B., Glogar, H., Steinbach, K., Geutjens, L., Ledune, J., Lescot, C., Popeye, R., Vermeulen, J., Abrantes, Ja, Baruzzi, Ac, Bassan, R., Bodanese, Lc, Carvalho, Ac, Mario Coutinho, Albuquerque, Dc, Dutra, O., Esteves, Jp, Leaes, Pe, Marino, Rl, Neto, Jam, Nicolau, Jc, Rabelo, A., Timerman, A., Xavier, Ss, Bata, I., Bhargava, Rk, Bogaty, P., Bolduc, P., Boyne, T., Chan, Yk, D Astous, M., Davies, T., Dhingra, S., Desjardins, L., Douglas, Jg, Fortin, C., Fung, A., Gangbar, E., Gebhardt, V., Gervais, Pb, Giannoccaro, Jp, Gossard, D., Gosselin, G., Grandmont, D., Grover, A., Gupta, M., Hiscock, Jg, Hynd, Jwh, Hussain, M., Iless, A., Kitching, A., Kostuk, W., Kouz, S., Kwok, K., Lee, H., Lefkowitz, C., Lenis, J., Lubelsky, B., Ma, P., May, B., Mercier, M., Montigny, M., Morris, A., Nawaz, S., Pallie, S., Parekh, P., Pesant, Y., Pilon, C., Pistawka, K., Rajakumar, Arj, Rebane, T., Ricci, J., Ruel, M., Schuld, R., Starra, R., Sussex, B., Talbot, P., Theroux, P., Venkatesh, G., Weeks, As, Winkler, Lh, Wisenberg, G., Woo, K., Yu, E., Zadra, R., Bocek, P., Branny, M., Cepelak, V., Drapalik, V., Gregor, P., Groch, L., Jansky, P., Kalslerova, M., Starek, A., Svitil, P., Vaclavicek, A., Husted, S., Rasmussen, Lh, Nielsen, Hk, Hamalainen, T., Majamas-Voltti, K., Mustonen, J., Peuhkurinen, K., Raasakka, T., Ylitalo, A., Adam, Mc, Agraou, B., Amat, G., Bessede, G., Boulenc, Jm, Boureux, C., Dambrine, P., Decoulx, E., Delarche, N., Desjoyaux, E., D Hautefeuille, B., Dubois-Rande, Jl, Fadel, N., Fouche, R., Fournier, P., Haftel, Y., Kahn, Jc, Ketelers, Jy, Lallemant, R., Lang, M., Lelguen, C., Leroy, F., Montalescot, G., Poulard, Je, Richard, M., Wittenberg, O., Beythien, Rd, Dippold, Wg, Harenberg, J., Hasslacher, C., Hauptmann, Ke, Hempel, G., Horacek, T., Kaulhausen, A., Kohler, B., Kurz, C., Lengfelder, W., Liebau, G., Loos, U., Neuss, H., Ochs, Hr, Pollock, B., Post, G., Reismann, K., Sauer, M., Schmidt, A., Schmitt, H., Schuster, P., Trenkwalder, P., Uebis, R., Leitner, Er, Vossbeck, G., Christakos, S., Karidis, K., Kelesidis, K., Papadopoulos, K., Tirologos, A., Tsaknakis, T., Gesztesi, T., Herczeg, B., Janosi, A., Kalo, E., Karpati, P., Mesko, E., Mezofi, M., Poor, F., Regos, L., Rudas, L., Soltesz, P., Szaboki, F., Timar, S., Valyi, P., Zamolyi, K., Daly, Km, Meany, Bt, Sugrue, D., Caspi, A., David, D., Marmor, A., Nazzal, D., Omary, M., Reisin, L., Rosenfeld, T., Shasha, S., Vered, Z., Zimlichman, R., Bellet, C., Bernardi, D., Branzi, A., Ceci, V., Celegon, L., Cernigliaro, C., Corsini, G., Croce, A., Caterina, R., Servi, S., Di Biase, G., Di Chiara, A., Di Pasquale, G., Filorizzo, G., Fiorentini, C., Ignone, G., Lombardi, F., Mafrici, A., Margonato, A., Maurea, N., Meneghetti, P., Meniconi, L., Mennuni, M., Mininni, N., Murrone, A., Notaristefan, A., Pettinati, G., Pinelli, G., Rossi, R., Sanna, A., Scabbia, E., Terrosu, P., Trinchero, R., Ruiz, Ra, Diaz, Ac, Santamaria, Ih, Pons, Jll, Diaz, Cjs, Castro, Jat, Morales, Ev, Bronzwaer, Pna, Haan, Hpj, Grosfeld, Mjw, Heijmeriks, Ja, Jochemsen, Gm, Klomps, Hc, Landsaat, Pm, Michels, Hr, Peters, Jrm, Beek, Gj, Hiejden, R., Verheul, Ja, Viergever, Ep, Audeau, M., Bopitiya, U., Hills, M., Ikram, H., Erikssen, J., Morstel, T., Vik-Mo, H., Haerem, Jw, Achremczyk, P., Banasiak, W., Burduk, P., Danielewicz, H., Demczuk, M., Dworzanski, W., Frycz, J., Gessek, J., Gorny, J., Janik, K., Jedrzejowski, A., Kawka-Urbanek, T., Kozlowski, A., Krasowski, W., Maciejewicz, J., Majcher, Z., Malinowski, S., Marczyk, T., Miekus, P., Ogorek, M., Piepiorka, M., Religa, K., Reszka, Z., Smielak-Korombel, W., Susol, D., Szpajer, M., Ujda, M., Waszyrowski, T., Zebrowski, A., Zielinski, Z., Cardoso, P., Carrageta, M., Correia, A., Cunha, D., Ferreira, L., Ferreira, R., Ribeiro, Vg, Tuna, Jl, Gomes, Mv, Aboo, A., Bobak, L., Brown, B., Cassim, S., King, J., Manga, P., Maritz, F., Marx, Jd, Mekel, J., Myburgh, Dp, Routier, R., Orcajo, Na, Asin, E., Colomina, F., Del Nogal, F., Echanove, I., Ferriz, J., Alcantara, Ag, Guerrero, Jjg, Juanatey, Jrg, Jodar, L., Lekuona, I., Miralles, L., Llorian, Ar, Rovira, A., San Jose, Jm, Valle, V., Abdon, Nj, Bartholdson, B., Fredholm, O., Kristensson, Be, Messner, T., Moller, Bh, Rasmanis, G., Stjerna, A., Strandberg, Le, Tolhagen, K., Caduff, B., Christen, S., Gallino, A., Haller, A., Noseda, G., Schmidt, D., Weber, A., Allen, M., Allison, W., Berk, M., Blankenship, D., Browne, K., Bryg, Rj, Caputo, C., Carr, K., Chandrashekhar, Y., Chelliah, N., Courtney, Dl, Deedwania, P., Detrano, R., Dixon, Ew, Dzwonczyk, T., Egbujiobi, L., Erenrich, Nh, Frazier, R., Funai, J., Gammon, Rs, Geer, Vr, Ghali, J., Goldberg, Mc, Goldman, S., Grainer, S., Grewal, G., Hanley, P., Haronian, H., Hermany, R., Karlsberg, R., Kesselbrenner, M., Krantzler, J., Lader, Ew, Lakkis, N., Levites, R., Lewis, Wr, Losordo, Dw, Magorien, R., Minisi, A., Minor, St, Newton, Cm, Nisar, A., Pacheco, Tr, Papuchis, G., Promisloff, S., Puma, J., Rokey, R., Sacco, J., Saeian, K., Schlesinger, R., Sharma, Sc, Shettigar, R., Smith, K., Thadani, U., Thomas, I., Urban, Pl, Vallenkaran, G., Whitaker, J., Yellen, Lg, Zarich, S., Zaroff, J., Adgey, Yja, Brack, M., Bridges, A., Cohen, A., Currie, P., Dwight, Jf, Findlay, I., Foale, R., Gemmill, J., Goodfellow, J., Gray, Ke, Holdright, D., Jennings, K., Keeling, P., Ludman, P., Murphy, C., Oliver, Rm, Rodrigues, E., Smith, Rh, Sprigings, D., Stephens, J., Swan, J., Timmis, A., Vincent, R., Yusuf, S, Mehta, S, Anand, S, Avezum, A, Awan, N, Bertrand, M, Blumenthal, M, Bouthier, J, Budaj, A, Ceremuzynski, L, Chrolavicius, S, Col, J, Commerford, P, Diaz, R, Flather, M, Fox, K, Franzosi, Mg, Gaudin, C, Gersh, B, Grossman, W, Halon, D, Hess, T, Hunt, D, Joyner, C, Karatzas, N, Keltai, M, Khurmi, N, Kopecky, S, Lewis, B, Maggioni, A, Malmberg, K, Moccetti, T, Morais, J, Paolasso, E, Peters, R, Piegas, L, Pipilis, A, Ramos Corrales, Ma, Rupprecht, Hj, Ryden, L, Sitkei, E, Sotty, M, Tognoni, G, Valentin, V, Varigos, J, Widimsky, P, Wittlinger, T, Pogue, J, Copland, I, Cracknell, B, Demers, C, Eikelboom, J, Hall, K, Keys, J, Mcqueen, M, Montague, P, Morris, B, Ounpuu, S, Wright, C, Yacyshyn, V, Zhao, F, Commerford, Pj, Wyse, G, Cairns, J, Hart, R, Hirsh, J, Gent, M, Ryan, T, Wittes, J, Auger, P, Basart, Dcg, Chan, Y, De Raedt, H, den Hartoog, M, Galli, M, Garcia Guerrero, Jj, Marquis, Jf, Mauri, F, Mayosi, B, Natarajan, M, Nieminen, M, Norris, J, Panju, A, Peters, Rj, Renkin, J, Rihal, C, Szymanski, P, Wasek, W, Allende, G, Bono, Jo, Caccavo, A, Fernandez, Aa, Fuselli, Jj, Gambarte, Aj, Guerrero, Raa, Hasbani, Eg, Liprandi, A, Marzetti, E, Mon, G, Nordaby, R, Nul, D, Quijano, G, Salvati, A, San Martin, E, Sokn, F, Torre, H, Trivi, M, Tuero, E, Amerena, J, Bailey, N, Bett, Jhn, Buncle, A, Careless, D, Desilva, S, Ewart, A, Fitzpatrick, D, Garrahy, P, Gunawardane, K, Hamer, A, Hill, A, Jackson, B, Lane, G, Nelson, G, Owensby, D, Rees, D, Rosen, D, Sampson, J, Singh, B, Taylor, R, Thomson, A, Walsh, W, Watson, B, Glogar, H, Steinbach, K, Geutjens, L, Ledune, J, Lescot, C, Popeye, R, Vermeulen, J, Abrantes, Ja, Baruzzi, Ac, Bassan, R, Bodanese, Lc, Carvalho, Ac, Coutinho, M, de Albuquerque, Dc, Dutra, O, Esteves, Jp, Leaes, Pe, Marino, Rl, Neto, Jam, Nicolau, Jc, Rabelo, A, Timerman, A, Xavier, S, Bata, I, Bhargava, Rk, Bogaty, P, Bolduc, P, Boyne, T, Chan, Yk, D'Astous, M, Davies, T, Dhingra, S, Desjardins, L, Douglas, Jg, Fortin, C, Fung, A, Gangbar, E, Gebhardt, V, Gervais, Pb, Giannoccaro, Jp, Gossard, D, Gosselin, G, Grandmont, D, Grover, A, Gupta, M, Hiscock, Jg, Hynd, Jwh, Hussain, M, Iless, A, Kitching, A, Kostuk, W, Kouz, S, Kwok, K, Lee, H, Lefkowitz, C, Lenis, J, Lubelsky, B, Ma, P, May, B, Mercier, M, Montigny, M, Morris, A, Nawaz, S, Pallie, S, Parekh, P, Pesant, Y, Pilon, C, Pistawka, K, Rajakumar, Arj, Rebane, T, Ricci, J, Ruel, M, Schuld, R, Starra, R, Sussex, B, Talbot, P, Theroux, P, Venkatesh, G, Weeks, A, Winkler, Lh, Wisenberg, G, Woo, K, Yu, E, Zadra, R, Bocek, P, Branny, M, Cepelak, V, Drapalik, V, Gregor, P, Groch, L, Jansky, P, Kalslerova, M, Starek, A, Svitil, P, Vaclavicek, A, Husted, S, Rasmussen, Lh, Nielsen, Hk, Hamalainen, T, Majamas Voltti, K, Mustonen, J, Peuhkurinen, K, Raasakka, T, Ylitalo, A, Adam, Mc, Agraou, B, Amat, G, Bessede, G, Boulenc, Jm, Boureux, C, Dambrine, P, Decoulx, E, Delarche, N, Desjoyaux, E, D'Hautefeuille, B, Dubois Rande, Jl, Fadel, N, Fouche, R, Fournier, P, Haftel, Y, Kahn, Jc, Ketelers, Jy, Lallemant, R, Lang, M, Lelguen, C, Leroy, F, Montalescot, G, Poulard, Je, Richard, M, Wittenberg, O, Beythien, Rd, Dippold, Wg, Harenberg, J, Hasslacher, C, Hauptmann, Ke, Hempel, G, Horacek, T, Kaulhausen, A, Kohler, B, Kurz, C, Lengfelder, W, Liebau, G, Loos, U, Neuss, H, Ochs, Hr, Pollock, B, Post, G, Reismann, K, Sauer, M, Schmidt, A, Schmitt, H, Schuster, P, Trenkwalder, P, Uebis, R, von Leitner, Er, Vossbeck, G, Christakos, S, Karidis, K, Kelesidis, K, Papadopoulos, K, Tirologos, A, Tsaknakis, T, Gesztesi, T, Herczeg, B, Janosi, A, Kalo, E, Karpati, P, Mesko, E, Mezofi, M, Poor, F, Regos, L, Rudas, L, Soltesz, P, Szaboki, F, Timar, S, Valyi, P, Zamolyi, K, Daly, Km, Meany, Bt, Sugrue, D, Caspi, A, David, D, Marmor, A, Nazzal, D, Omary, M, Reisin, L, Rosenfeld, T, Shasha, S, Vered, Z, Zimlichman, R, Bellet, C, Bernardi, D, Branzi, A, Ceci, V, Celegon, L, Cernigliaro, C, Corsini, G, Croce, A, De Caterina, R, De Servi, S, Di Biase, G, Di Chiara, A, Di Pasquale, G, Filorizzo, G, Fiorentini, C, Ignone, G, Lombardi, F, Mafrici, A, Margonato, Alberto, Maurea, N, Meneghetti, P, Meniconi, L, Mennuni, M, Mininni, N, Murrone, A, Notaristefan, A, Pettinati, G, Pinelli, G, Rossi, R, Sanna, A, Scabbia, E, Terrosu, P, Trinchero, R, Ruiz, Ra, Diaz, Ac, Santamaria, Ih, Pons, Jll, Diaz, Cj, Castro, Jat, Morales, Ev, Bronzwaer, Pna, de Haan, Hpj, Grosfeld, Mjw, Heijmeriks, Ja, Jochemsen, Gm, Klomps, Hc, Landsaat, Pm, Michels, Hr, Peters, Jrm, van Beek, Gj, van der Hiejden, R, Verheul, Ja, Viergever, Ep, Audeau, M, Bopitiya, U, Hills, M, Ikram, H, Erikssen, J, Morstel, T, Vik Mo, H, Haerem, Jw, Achremczyk, P, Banasiak, W, Burduk, P, Danielewicz, H, Demczuk, M, Dworzanski, W, Frycz, J, Gessek, J, Gorny, J, Janik, K, Jedrzejowski, A, Kawka Urbanek, T, Kozlowski, A, Krasowski, W, Maciejewicz, J, Majcher, Z, Malinowski, S, Marczyk, T, Miekus, P, Ogorek, M, Piepiorka, M, Religa, K, Reszka, Z, Smielak Korombel, W, Susol, D, Szpajer, M, Ujda, M, Waszyrowski, T, Zebrowski, A, Zielinski, Z, Cardoso, P, Carrageta, M, Correia, A, Cunha, D, Ferreira, L, Ferreira, R, Ribeiro, Vg, Tuna, Jl, Gomes, Mv, Aboo, A, Bobak, L, Brown, B, Cassim, S, King, J, Manga, P, Maritz, F, Marx, Jd, Mekel, J, Myburgh, Dp, Routier, R, Orcajo, Na, Asin, E, Colomina, F, del Nogal, F, Echanove, I, Ferriz, J, Alcantara, Ag, Guerrero, Jjg, Juanatey, Jrg, Jodar, L, Lekuona, I, Miralles, L, Llorian, Ar, Rovira, A, San Jose, Jm, Valle, V, Abdon, Nj, Bartholdson, B, Fredholm, O, Kristensson, Be, Messner, T, Moller, Bh, Rasmanis, G, Stjerna, A, Strandberg, Le, Tolhagen, K, Caduff, B, Christen, S, Gallino, A, Haller, A, Noseda, G, Schmidt, D, Weber, A, Allen, M, Allison, W, Berk, M, Blankenship, D, Browne, K, Bryg, Rj, Caputo, C, Carr, K, Chandrashekhar, Y, Chelliah, N, Courtney, Dl, Deedwania, P, Detrano, R, Dixon, Ew, Dzwonczyk, T, Egbujiobi, L, Erenrich, Nh, Frazier, R, Funai, J, Gammon, R, Geer, Vr, Ghali, J, Goldberg, Mc, Goldman, S, Grainer, S, Grewal, G, Hanley, P, Haronian, H, Hermany, R, Karlsberg, R, Kesselbrenner, M, Krantzler, J, Lader, Ew, Lakkis, N, Levites, R, Lewis, Wr, Losordo, Dw, Magorien, R, Minisi, A, Minor, St, Newton, Cm, Nisar, A, Pacheco, Tr, Papuchis, G, Promisloff, S, Puma, J, Rokey, R, Sacco, J, Saeian, K, Schlesinger, R, Sharma, Sc, Shettigar, R, Smith, K, Thadani, U, Thomas, I, Urban, Pl, Vallenkaran, G, Whitaker, J, Yellen, Lg, Zarich, S, Zaroff, J, Adgey, Yja, Brack, M, Bridges, A, Cohen, A, Currie, P, Dwight, Jf, Findlay, I, Foale, R, Gemmill, J, Goodfellow, J, Gray, Ke, Holdright, D, Jennings, K, Keeling, P, Ludman, P, Murphy, C, Oliver, Rm, Rodrigues, E, Smith, Rh, Sprigings, D, Stephens, J, Swan, J, Timmis, A, and Vincent, R.

Abstract

Background Other than aspirin, there are few oral antithrombotic treatments with proven efficacy in patients with acute coronary syndrome. In this report, we present the rationale, design and baseline characteristics of the Clopidogrel in Unstable angina to prevent Recurrent ischaemic Events (CURE) trial, which includes a meta-analysis of the effects of thienopyridines in patients with vascular disease. Methods and Results Combined data from randomized trials of thienopyrindines in patients with atherosclerotic disease demonstrated a 29% reduction in vascular events when compared with placebo/control (n=2392) (OR 0.71, 95% CI 0.58-0.86, P=0.0006) and a 10% reduction in vascular events when compared with aspirin (n=22 254) (OR 0.91, 95% Cl 0.84-0.99, P=0.039). Similarly, randomized trials of aspirin plus thienopyridines in patients undergoing intracoronary stenting, demonstrated marked benefit of aspirin plus ticlopidine in reducing death or myocardial infarction compared with aspirin alone (OR 0.23, 95% CI 0.11-0.49, P=0.0001) or aspirin plus warfarin (OR 0.51, 95% CI 0.33-0.78, P=0.002). Whether these benefits extend to the much larger population of patients with acute coronary syndrome is unknown. CURE is an international, randomized, double-blind trial, in which patients with acute coronary syndrome will be randomized to receive either a bolus dose of clopidogrel (300 mg) followed by 75 mg per day for 3-12 months, or matching placebo. Both groups will receive aspirin. The co-primary efficacy end-points of CURE are: (1) the composite of cardiovascular death, myocardial infarction or stroke; and (2) the composite of cardiovascular death, myocardial infarction, stroke or refractory ischaemia. CURE will recruit approximately 12 500 patients with acute coronary syndrome (from 28 countries) and its power to detect moderate treatment benefits will be in the region of 80-90%, while maintaining an overall type I error (a) of 0.05. The baseline characteristics of the study population are consistent with at least a moderate risk group of patients with acute coronary syndrome. Conclusions Randomized trials of thienopyridines in patients with vascular disease demonstrate that thienopyridines are effective in reducing vascular events when compared with placebo/control or aspirin, as well as when used in combination with aspirin in patients undergoing intracoronary stent implantation. The CURE trial is a large international study to determine if acute and longterm treatment with the combination of clopidogrel and aspirin is superior to aspirin alone in patients with acute coronary syndrome. (C) 2000 The European Society of Cardiology. RI Nicolau, Jose/E-1487-2012

48. Noninvasive assessment of left and right internal mammary artery graft patency using transthoracic color Doppler echocardiography

Author

Simone, L., Caso, P., Severino, S., Cicala, S., Maurizio Galderisi, Renzulli, A., Bonzani, G., Scherillo, M., Mininni, N., Cotrufo, M., De Simone, Luigi, Caso, Pio, Severino, Sergio, Cicala, Silvana, Galderisi, Maurizio, Renzulli, Attilio, Bonzani, Giulio, Scherillo, Marino, Mininni, Nicola, and Cotrufo, Maurizio

Subjects
Male, Observer Variation, Systole, Coronary Artery Bypa, Statistics as Topic, Graft Occlusion, Vascular, Reproducibility of Result, Dipyridamole, Middle Aged, Coronary Angiography, Severity of Illness Index, Echocardiography, Doppler, Color, Treatment Outcome, Diastole, Echocardiography, Vasodilator Agent, Infusions, Intra-Arterial, Mammary Arterie, Female, Multivariate Analysi, Blood Flow Velocity, Vascular Patency, Human
Abstract

The aim of this study was to evaluate the patency of left and right internal mammary artery grafts respectively on the left anterior descending and right coronary artery by noninvasive transthoracic color Doppler echocardiography.

49. GISSI-3 - EFFECTS OF LISINOPRIL AND TRANSDERMAL GLYCERYL TRINITRATE SINGLY AND TOGETHER ON 6-WEEK MORTALITY AND VENTRICULAR-FUNCTION AFTER ACUTE MYOCARDIAL-INFARCTION

Author

Devita, C., Fazzini, P. F., Geraci, E., Tavazzi, L., Tognoni, G., Vecchio, C., Boeri, R., Damico, G., Loi, U., Marubini, E., Pagliaro, L., Rovelli, F., Franzosi, M. G., Latini, R., Maggioni, A. P., Mauri, F., Volpi, A., Barlera, S., Negri, E., Nicolis, E., Santoro, E., Santoro, L., Bonfanti, E., Capello, T., Casati, A., Corato, A., Gardinale, E., Negrini, M., Nobili, A., Staszewsky, L., Tavanelli, M., Torta, D., Gambelli, G., Moroni, L., Pellanda, J. J., Pietropaolo, F., Balli, E., Barbieri, A., Bechi, S., Carrone, M., Catanzaro, M., Fasciolo, L., Fresco, C., Ghiani, A., Iacuitti, G., Ledda, A., Levantesi, G., Pasini, P., Peci, P., Pizzetti, F., Sagone, A., Turazza, F., Villella, A., Villella, M., Braggio, N., Disertori, M., Frezzati, S., Garattini, S., Marino, P., Maseri, A., Mazzotta, G., Nicolosi, G., Pirelli, S., Sanna, G. P., Valagussa, F., Dargie, H. J., Peto, R., Pocock, S., Sleight, P., Yusuf, S., Giordano, F., Varlese, A., Loparco, G., Iberti, V., Giamundo, L., Anastasi, R., Paciaroni, E., Raffaeli, S., Purcaro, A., Ciampani, N., Rita, E., Cuccaroni, G., Baldinelli, A., Altieri, A., Giornetti, R., Azzaro, G., Ferraguto, P., Salici, G., Laconi, E., Tiburzi, F. M., Bernardi, D., Lunardi, M., Colonna, L., Bovenzi, F., Amodio, F., Sarcina, G., Carpagnano, A., Matera, A., Malacrida, R., Rigotti, R., Dallemule, J., Debiasi, A., Bridda, A., Invernizzi, G., Piti, A., Colombo, L., Tomassini, B., Biasia, R., Solda, P., Scaramuzzino, G., Mirri, A., Bracchetti, D., Decastro, U., Lintner, W., Erlicher, A., Gronda, M., Devecchi, P., Gagliardi, R. S., Battistoni, N., Storelli, A., Guadalupi, M., Nadovezza, S., Zuffiano, D., Depetra, V., Scervino, R., Tabacchi, G., Dessalvi, F., Scorcu, G., Giardina, G., Raffo, M., Boi, W., Cammalleri, G., Gruttadauria, G., Baldini, F., Paolone, P., Pantaleoni, A., Contessotto, F., Deconti, F., Pignatti, F., Frignani, A., Ivaldi, M., Aletto, C., Pettinati, G., Ciricugno, A., Muscella, A., Correale, E., Romano, S., Dandrea, D., Murena, E., Longobardi, R., Dimartino, N., Paolini, E., Gaddi, P., Calvelli, C., Dulcetti, F., Galassi, A., Coco, R., Coppola, A., Centamore, G., Calabrese, G., Sgalambro, G., Circo, A., Raciti, S., Dellamonica, R., Malinconico, M., Deponti, C., Parmigiani, M. L., Bellet, C., Bortolini, F., Buffoli, L., Tiberi, A., Ferrari, A., Rossi, A., Ciglia, C., Dicenso, M., Mangiarotti, E., Ornaghi, M., Do, V., Spapperi, D., Maiolino, P., Delio, U., Carrozza, A., Marinoni, C., Guasconi, C., Sandro Sonnino, Pagliei, M., Ferrari, G., Politi, A., Delazzaro, M., Rinaldis, G., Calcagnile, A., Lusetti, L., Bendinelli, S., Mollaioli, M., Cosmi, F., Plastina, F., Misuraca, G., Serafini, O., Venneri, N., Catelli, P., Poluzzi, C., Bergamaschi, G., Fadin, M. B., Dechiara, F., Zampaglione, G., Elia, M., Racca, E., Meinardi, F., Casasso, F., Bertocchi, P., Donzelli, W., Pessina, S., Tirella, G., Sauro, G., Tessitori, M., Bini, A., Bartoletti, A., Agnelli, D., Zagami, A., Andreoli, L., Bastoni, L., Pucci, P., Santini, A., Buonamici, P. G., Filice, M., Badolati, S., Zerauchek, M., Dematteis, D., Maulucci, G., Dantuono, C., Liberti, R., Menicono, L., Mattoli, A., Tallone, M., Divita, G., Manca, G., Licci, E., Canziani, R., Guidali, P., Rancan, E., Mariello, F., Pennetta, A., Minelli, C., Baldini, M. R., Cazzani, E., Romano, M., Bellotti, P., Camerini, A., Davi, R., Piazza, R., Musso, G., Rossi, P., Giacchero, C., Seu, V., Toselli, A., Digiacinto, N., Dicio, G., Spanghero, M., Cresti, A., Svetoni, N., Bruno, G., Distefano, S., Giovanelli, N., Fini, M., Dethomatis, M., Pandini, R., Carrino, C., Giammaria, M., Pistelli, P., Ronzani, G., Ottello, B., Melappioni, A., Zappelli, L., Marsili, P., Scimia, A., Ragazzini, G., Gramenzi, S., Motto, A., Tullio, D., Tucci, D., Rosselli, P., Gaggioli, G., Bollini, R., Fazio, A. M., Russo, R., Bossi, M., Savoia, M., Valsecchi, M. A., Barbaresi, F., Barbiero, M., Bonofiglio, C., Gemelli, M., Bonaglia, M., Bossoni, E., Lanzini, A., Delbene, P., Cascone, M., Orlandi, M., Oddone, A., Sallazzo, V., Panuccio, D., Cane, G., Moccetti, T., Pasotti, E., Tognoli, T., Caravita, L., Maggi, A., Bardelli, G. C., Tusa, M., Maggi, G., Guerra, G. P., Reggiani, A., Izzo, A., Colombo, G., Foti, F., Consolo, F., Arrigo, F., Sacca, A. M., Mafrici, A., Alberti, A., Belli, C., Dossena, M. G., Spinola, A., Casiraghi, M. G., Azzollini, M., Pozzoni, L., Salmoirago, E., Massironi, L., Sala, R., Bressi, R., Rigo, R., Cappelli, S., Malavasi, V., Pascotto, P., Pasqual, A. S., Sarto, P., Sani, F., Tosoni, D., Spinnler, M. T., Persico, D., Orsi, R., Lugliengo, V., Parolini, V., Zilio, G., Sandri, R., Neri, G., Alitto, F., Petri, D., Cusa, E. N., Mazzitelli, L., Piantadosi, F. R., Daniello, L., Polimeno, S., Mininni, N., Greco, R., Bisconti, C., Cucchiari, C., Dallavilla, W., Randon, L., Allegri, M., Marchi, S. M., Sanna, E., Deluca, C., Manetta, M., Dallavolta, S., Maddalena, F., Donzelli, M., Pulisano, U., Dimaria, B., Celona, G., Marchi, S., Vivirito, A., Carrubba, A., Lamalfa, R. G., Schicchi, R., Bellanca, G., Battaglia, A., Cirrincione, V., Ribaudo, E., Strizzolo, L., Carone, M., Digregorio, D., Mantini, L., Corea, L., Cocchieri, M., Notaristefano, A., Catanese, C., Faleburle, M., Sgarbi, E., Cesaroni, P., Baldini, P. M., Papi, L., Lavarini, L., Lorenzini, M., Tarditi, V., Menara, N., Conti, M., Ferro, M., Gianotti, A., Crivello, R., Micheli, G., Conti, U., Cabani, E., Davini, P., Delciterna, F., Giomi, A., Alfieri, A., Chiti, M., Codeluppi, P., Smerieri, O., Dinapoli, T., Capozzoli, M. R., Topi, P. L., Paperini, L., Topi, A., Zanuttini, D., Nicolosi, G. L., Visentin, P., Charmet, P. A., Petrella, A., Bardazzi, L., Nassi, F., Bianco, G. A., Cellammare, G., Licitra, R., Cintolo, C., Spadola, V., Guarrella, L., Casali, G., Monducci, I., Zobbi, G., Guiducci, U., Cerri, P., Violi, E., Rovelli, G., Triulzi, E., Rusconi, L., Sabattini, R., Desanctis, A., Bock, R., Orazi, S., Palmieri, M., Rossi, F., Pesaresi, A., Cioppi, F., Palamara, A., Mancini, P., Ferraiuolo, G., Azzolini, P., Neja, C. P., Risa, M. P., Borgia, M. C., Borgia, C., Zanchi, E., Risa, A. L., Colace, F., Tozzi, Q., Jesi, A. P., Tassoni, G., Vitucci, N. C., Lironcurti, C., Altieri, T., Viscomi, A., Striano, U., Salituri, S., Tarantino, F., Girardini, D., Zonzin, P., Roncon, L., Ferrarese, E., Ravera, B., Bugatti, U., Padula, G., Gigantino, A., Allemano, P., Reynaud, S., Fanelli, R., Derito, V., Croce, A., Galli, M., Bertoli, D., Vivaldi, F., Pedrazzini, F., Barani, R., Dileo, M., Doronzo, B., Gambarati, G. P., Zobbi, M., Caramanno, G., Craparo, F. G., Giani, P., Antongiovanni, G. B., Grasso, V., Mossuti, E., Rosella, M. G., Skouse, D., Giustiniani, S., Cucchi, G., Conti, E., Fagagnini, L., Pardi, L., Core, A., Staniscia, D., Serafini, N., Cerruti, P., Bazzucchi, M., Petrucci, G., Trinchero, R., Cecchi, E., Demarie, D., Brusasco, G., Gandolfo, N., Saviolo, R., Bergerone, S., Bergandi, G., Barbieri, D., Mina, E., Biondo, G. B., Ledda, G., Trapani, G., Frigo, G., Benettin, A., Galati, A., Accogli, M., Feruglio, G. A., Gianfagna, P., Prelli, L., Giamperi, M., Gheller, G., Cudali, A., Liguori, G., Dimarco, G., Bottari, E., Valente, S., Giglioli, C., Ramoscello, G., Rizzi, G. M., Pellinghelli, G., Perrini, A., Deluca, F., Savelli, S., Capezzuto, A., Gandolfi, P., Bergognoni, G., Ballestra, A. M., and Violo, C.

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