Search

Your search keyword '"Malafronte C."' showing total 24 results
Start Over Author "Malafronte C."
24 results on '"Malafronte C."'

1. G-CSF for Extensive STEMI: Results from the STEM-AMI OUTCOME CMR Substudy

Author

Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, Pompilio, G, Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito G., Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., Pompilio G., Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, Pompilio, G, Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito G., Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., and Pompilio G.

Abstract

Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-Term. Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. Methods and Results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-To-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/m2 in the change of indexed LV end-systolic volume in favor of G-CSF group (P=0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only (P=0.04). Mor

Published
2019

2. Two cases with Fundus albipunctatus due to mutations in RPE65 gene

Author

Di Lorio V, Brunetti-Pierri R, Karali M, Calzolaio F, Malafronte C, De Benedictis A, Banfi S, Testa F, Simonelli F, Di Lorio, V, Brunetti-Pierri, R, Karali, M, Calzolaio, F, Malafronte, C, De Benedictis, A, Banfi, S, Testa, F, and Simonelli, F

Subjects
genetic structures, sense organs, eye diseases
Abstract

Purpose : Mutations in RPE65 have been primarily associated with Leber Congenital Amaurosis (LCA) and Early Onset Retinitis Pigmentosa (EORP). To extend the phenotypic spectrum associated with genetic defects in this gene, we report two cases of Fundus albipunctatus, a type of Congenital Stationary Night Blindness (CSNB), that harbor biallelic pathogenic variants in RPE65. Methods : Two unrelated Caucasian pediatric patients, born to non-consanguineous parents, underwent a complete ophthalmological assessment. Detailed physical examinations were performed to exclude systemic disease. Genetic analysis was performed by targeted Next Generation Sequencing (clinical exome). Results : An 11-year-old girl presented with night blindness from early childhood and a 15-year-old girl reported night blindness and narrowing of visual field from childhood. Both patients displayed the same clinical findings. Best corrected visual acuity was 20/20 in both eyes. Fundus examination revealed numerous white-yellow dots scattered in the mid periphery of the retina. OCT examination showed normal retinal structure, thickness and photoreceptor layer. Fundus autofluorescence displayed normal autofluorescence at the posterior pole with focal areas of hypoautofluorescence at the middle retinal periphery. Goldmann visual field showed mild reduction of visual field. Full field electroretinography (ERG) showed scotopic responses below the noise level and normal photopic responses with electronegative ERG findings. Genetic analysis identified, in the first patient, the younger one, two missense likely pathogenic variants (p.Arg347His, p.Tyr368His) in RPE65. Segregation analysis in the unaffected parents confirmed their presence in trans. While, in the other patient biallelic pathogenic variants (p.Glu254Asp, p.Leu328Phe) were identified in RPE65. Conclusions : Our study extends the phenotypic spectrum of the retinal dystrophies associated with biallelic variants in RPE65 ranging from LCA to CNSB. The findings indicate that patients harboring mutations in RPE65 gene can present different phenotypes and a careful clinical evaluation is indispensable for the selection/prioritisation of patients that can benefit from available therapeutic options.

Published
2020

3. G-CSF for Extensive STEMI

Author

Achilli F., Pontone G., Bassetti B., Squadroni L., Campodonico J., Corrada E., Facchini C., Mircoli L., Esposito Giovanni, Scarpa D., Pidello S., Righetti S., Di Gennaro F., Guglielmo M., Muscogiuri G., Baggiano A., Limido A., Lenatti L., Di Tano G., Malafronte C., Soffici F., Ceseri M., Maggiolini S., Colombo G. I., Pompilio G., Achilli, F., Pontone, G., Bassetti, B., Squadroni, L., Campodonico, J., Corrada, E., Facchini, C., Mircoli, L., Esposito, Giovanni, Scarpa, D., Pidello, S., Righetti, S., Di Gennaro, F., Guglielmo, M., Muscogiuri, G., Baggiano, A., Limido, A., Lenatti, L., Di Tano, G., Malafronte, C., Soffici, F., Ceseri, M., Maggiolini, S., Colombo, G. I., and Pompilio, G.

Subjects
left ventricular remodeling, Male, Ventricular Remodeling, Heart Ventricles, percutaneous coronary intervention, Stroke Volume, Organ Size, Middle Aged, Myocardial Contraction, myocardial infarction, standard of care, Granulocyte Colony-Stimulating Factor, Humans, ST Elevation Myocardial Infarction, Female, Single-Blind Method, Prospective Studies, Aged
Abstract

In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term.The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain.Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/mEarly administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment-elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain.URL: https://www.clinicaltrials.gov. Unique identifier: NCT01969890.

Published
2019

4. Effects of extracorporeal cardiopulmonary resuscitation on neurological and cardiac outcome after ischaemic refractory cardiac arrest

Author

Cesana, F, Avalli, L, Garatti, L, Coppo, A, Righetti, S, Calchera, I, Scanziani, E, Cozzolino, P, Malafronte, C, Mauro, A, Soffici, F, Sulmina, E, Bozzon, V, Maggioni, E, Foti, G, Achilli, F, Cesana F., Avalli L., Garatti L., Coppo A., Righetti S., Calchera I., Scanziani E., Cozzolino P., Malafronte C., Mauro A., Soffici F., Sulmina E., Bozzon V., Maggioni E., Foti G., Achilli F., Cesana, F, Avalli, L, Garatti, L, Coppo, A, Righetti, S, Calchera, I, Scanziani, E, Cozzolino, P, Malafronte, C, Mauro, A, Soffici, F, Sulmina, E, Bozzon, V, Maggioni, E, Foti, G, Achilli, F, Cesana F., Avalli L., Garatti L., Coppo A., Righetti S., Calchera I., Scanziani E., Cozzolino P., Malafronte C., Mauro A., Soffici F., Sulmina E., Bozzon V., Maggioni E., Foti G., and Achilli F.

Abstract

BACKGROUND: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation.METHODS: We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011-2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months).RESULTS: Patients in the extracorporeal cardiopulmonary resuscitation group ( n=63, 43%) were younger (59±9 vs 63±8 year-old, p=0.02) with lower incidence of atherosclerosis risk factors than those with conventional cardiopulmonary resuscitation. In the extracorporeal cardiopulmonary resuscitation group, left ventricular ejection fraction was lower than conventional cardiopulmonary resuscitation at early echocardiography (19±16% vs 37±11 p<0.01). Survivors in both groups showed similar left ventricular ejection fraction 15 days and 4-6 months after cardiac arrest (46±8% vs 49±10, 47±11% vs 45±13%, p not significant for both), despite a major extent and duration of cardiac ischaemia in extracorporeal cardiopulmonary resuscitation patients. At multivariate analysis, the total cardiac arrest time was the only independent predictor of survival.CONCLUSIONS: Extracorporeal cardiopulmonary resuscitation patients are younger and have less comorbidities than conventional cardiopulmonary resuscitation, but they have worse survival and lower earl

Published
2018

9. Poster Session 5: Saturday 10 December 2011, 08:30-12:30 * Location: Poster Area

Author

Gong, L., primary, Ye, Z., additional, Zeng, Z., additional, Xia, M., additional, Zhong, Y., additional, Yao, Y., additional, Lee, E., additional, Ionescu, A., additional, Dwivedi, G., additional, Mahadevan, G., additional, Jiminez, D., additional, Frenneaux, M., additional, Steeds, R., additional, Moore, C., additional, Samad, Z., additional, Jackson, K., additional, Castellucci, J., additional, Kisslo, J., additional, Von Ramm, O., additional, D'ascenzi, F., additional, Zaca', V., additional, Cameli, M., additional, Lisi, M., additional, Natali, B., additional, Malandrino, A., additional, Mondillo, S., additional, Barbier, P., additional, Guerrini, U., additional, Franzosi, M., additional, Castiglioni, L., additional, Nobili, E., additional, Colazzo, F., additional, Li Causi, T., additional, Sironi, L., additional, Tremoli, E., additional, Clausen, H., additional, Macdonald, S., additional, Basaggianis, C., additional, Newton, J., additional, Bennati, E., additional, Reccia, R., additional, Bigio, E., additional, Maccherini, M., additional, Chiavarelli, M., additional, Henein, M., additional, Floria, M., additional, Jamart, J., additional, Arsenescu Georgescu, C., additional, Mantovani, F., additional, Barbieri, A., additional, Bursi, F., additional, Valenti, C., additional, Quaglia, M., additional, Modena, M., additional, Kutty, S., additional, Gribben, P., additional, Padiyath, A., additional, Polak, A., additional, Scott, C., additional, Waiss, M., additional, Danford, D., additional, Bech-Hanssen, O., additional, Selimovic, N., additional, Rundqvist, B., additional, Schmiedel, L., additional, Hohmann, C., additional, Katzke, S., additional, Haacke, K., additional, Rauwolf, T., additional, Strasser, R., additional, Tumasyan, L. R., additional, Adamyan, K., additional, Kosmala, W., additional, Derzhko, R., additional, Przewlocka-Kosmala, M., additional, Mysiak, A., additional, Stachowska, B., additional, Jedrzejuk, D., additional, Bednarek-Tupikowska, G., additional, Chrzanowski, L., additional, Kasprzak, J., additional, Wojciechowska, C., additional, Wita, K., additional, Busz-Papiez, B., additional, Gasior, Z., additional, Mizia-Stec, K., additional, Kukulski, T., additional, Gosciniak, P., additional, Sinkiewicz, W., additional, Moelmen, H., additional, Stoylen, A., additional, Thorstensen, A., additional, Torp, H., additional, Dalen, H., additional, Groves, A., additional, Nicholson, G., additional, Lopez, L., additional, Goh, C.-W., additional, Ahn, H., additional, Byun, Y., additional, Kim, J., additional, Park, J., additional, Lee, J., additional, Kim, B., additional, Rhee, K., additional, Kim, K., additional, Yoon, H., additional, Hong, Y., additional, Park, H., additional, Ahn, Y., additional, Jeong, M., additional, Cho, J., additional, Kang, J., additional, Grapsa, J., additional, Dawson, D., additional, Karfopoulos, K., additional, Jakaj, G., additional, Punjabi, P., additional, Nihoyannopoulos, P., additional, Ruisanchez Villar, C., additional, Lerena Saenz, P., additional, Gonzalez Vilchez, F., additional, Gonzalez Fernandez, C., additional, Zurbano Goni, F., additional, Cifrian Martinez, J., additional, Mons Lera, R., additional, Ruano Calvo, J., additional, Martin Duran, R., additional, Vazquez De Prada Tiffe, J., additional, Pietrzak, R., additional, Werner, B., additional, Voillot, D., additional, Huttin, O., additional, Zinzius, P., additional, Schwartz, J., additional, Sellal, J., additional, Lemoine, S., additional, Christophe, C., additional, Popovic, B., additional, Juilliere, Y., additional, Selton-Suty, C., additional, Ishii, K., additional, Furukawa, A., additional, Nagai, T., additional, Kataoka, K., additional, Seino, Y., additional, Shimada, K., additional, Yoshikawa, J., additional, Tekkesin, A., additional, Yildirimturk, O., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Aytekin, S., additional, Jaroch, J., additional, Loboz-Grudzien, K., additional, Bociaga, Z., additional, Kowalska, A., additional, Kruszynska, E., additional, Wilczynska, M., additional, Dudek, K., additional, Kakihara, R., additional, Naruse, C., additional, Hironaka, H., additional, Tsuzuku, T., additional, Cucchini, U., additional, Muraru, D., additional, Badano, L., additional, Solda', E., additional, Tuveri, M., additional, Al Nono, O., additional, Sarais, C., additional, Iliceto, S., additional, Santos, L., additional, Cortez-Dias, N., additional, Ribeiro, S., additional, Goncalves, S., additional, Jorge, C., additional, Carrilho-Ferreira, P., additional, Silva, D., additional, Silva-Marques, J., additional, Lopes, M., additional, Diogo, A., additional, Hristova, K., additional, Vassilev, D., additional, Pavlov, P., additional, Katova, T., additional, Simova, I., additional, Kostova, V., additional, Esposito, R., additional, Santoro, A., additional, Schiano Lomoriello, V., additional, Raia, R., additional, De Palma, D., additional, Dores, E., additional, De Simone, G., additional, Galderisi, M., additional, Zaborska, B., additional, Makowska, E., additional, Pilichowska, E., additional, Maciejewski, P., additional, Bednarz, B., additional, Wasek, W., additional, Stec, S., additional, Budaj, A., additional, Spinelli, L., additional, Morisco, C., additional, Assante Di Panzillo, E., additional, Crispo, S., additional, Di Marino, S., additional, Trimarco, B., additional, Farina, F., additional, Innelli, P., additional, Rapacciuolo, A., additional, Polgar, B., additional, Banyai, F., additional, Rokusz, L., additional, Tomcsanyi, I., additional, Vaszily, M., additional, Nieszner, E., additional, Borsanyi, T., additional, Kerecsen, G., additional, Preda, I., additional, Kiss, R. G., additional, Bull, S., additional, Suttie, J., additional, Augustine, D., additional, Francis, J., additional, Karamitsos, T., additional, Becher, H., additional, Prendergast, B., additional, Neubauer, S., additional, Myerson, S., additional, Lodge, F., additional, Broyd, C., additional, Milton, P., additional, Mikhail, G., additional, Mayet, J., additional, Davies, J., additional, Francis, D., additional, Clavel, M.-A., additional, Ennezat, P.-V., additional, Marechaux, S., additional, Dumesnil, J., additional, Bellouin, A., additional, Bergeron, S., additional, Meimoun, P., additional, Le Tourneau, T., additional, Pasquet, A., additional, Pibarot, P., additional, Herrmann, S., additional, Stoerk, S., additional, Niemann, M., additional, Hu, K., additional, Voelker, W., additional, Ertl, G., additional, Weidemann, F., additional, Aytekin, V., additional, Kogoj, P., additional, Ambrozic, J., additional, Bunc, M., additional, Di Salvo, G., additional, Rea, A., additional, Castaldi, B., additional, Gala, S., additional, D'aiello, A., additional, Mormile, A., additional, Pisacane, F., additional, Pacileo, G., additional, Russo, M., additional, Calabro, R., additional, Nguyen, L., additional, Ricksten, S.-E., additional, Jeppsson, A., additional, Schersten, H., additional, Boerlage-Van Dijk, K., additional, Yong, Z., additional, Bouma, B., additional, Koch, K., additional, Vis, M., additional, Piek, J., additional, Baan, J., additional, Scandura, S., additional, Ussia, G., additional, Caggegi, A., additional, Cammalleri, V., additional, Sarkar, K., additional, Mangiafico, S., additional, Chiaranda', M., additional, Imme', S., additional, Pistritto, A., additional, Tamburino, C., additional, Ring, L., additional, Nair, S., additional, Wells, F., additional, Shapiro, L., additional, Rusk, R., additional, Rana, B., additional, Madrid Marcano, G., additional, Solis Martin, J., additional, Gonzalez Mansilla, A., additional, Bravo, L., additional, Menarguez Palanca, C., additional, Munoz, P., additional, Bouza, E., additional, Yotti, R., additional, Bermejo Thomas, J., additional, Fernandez Aviles, F., additional, Tamayo, T., additional, Denes, M., additional, Balint, O., additional, Csepregi, A., additional, Csillik, A., additional, Erdei, T., additional, Temesvari, A., additional, Fernandez-Pastor, J., additional, Linde-Estrella, A., additional, Cabrera-Bueno, F., additional, Pena-Hernandez, J., additional, Barrera-Cordero, A., additional, Alzueta-Rodriguez, F., additional, De Teresa-Galvan, E., additional, Merlo, M., additional, Pinamonti, M., additional, Finocchiaro, G., additional, Pyxaras, S., additional, Barbati, G., additional, Buiatti, A., additional, Dilenarda, A., additional, Sinagra, G., additional, Kuperstein, R., additional, Freimark, D., additional, Hirsch, S., additional, Feinberg, M., additional, Arad, M., additional, Mitroi, C., additional, Garcia Lunar, I., additional, Monivas Palomero, V., additional, Mingo Santos, S., additional, Beltran Correas, P., additional, Gonzalez Lopez, E., additional, Garcia Pavia, P., additional, Gonzalez Mirelis, J., additional, Cavero Gibanel, M., additional, Alonso Pulpon, L., additional, Pinamonti, B., additional, Zaidi, A., additional, Ghani, S., additional, Sheikh, N., additional, Gati, S., additional, Howes, R., additional, Sharma, R., additional, Sharma, S., additional, Calcagnino, M., additional, O'mahony, C., additional, Coats, C., additional, Cardona, M., additional, Garcia, A., additional, Murphy, E., additional, Lachmann, R., additional, Mehta, A., additional, Hughes, D., additional, Elliott, P., additional, Di Bella, G., additional, Madaffari, A., additional, Donato, R., additional, Mazzeo, A., additional, Casale, M., additional, Zito, C., additional, Vita, G., additional, Carerj, S., additional, Marek, D., additional, Indrakova, J., additional, Rusinakova, Z., additional, Skala, T., additional, Kocianova, E., additional, Taborsky, M., additional, Musca, F., additional, De Chiara, B., additional, Belli, O., additional, Cataldo, S., additional, Brunati, C., additional, Colussi, G., additional, Quattrocchi, G., additional, Santambrogio, G., additional, Spano, F., additional, Moreo, A., additional, Rustad, L., additional, Nytroen, K., additional, Gullestad, L., additional, Amundsen, B., additional, Aakhus, S., additional, Maroz-Vadalazhskaya, N., additional, Shumavetc, V., additional, Kurganovich, S., additional, Seljun, Y., additional, Ostrovskiy, A., additional, Ostrovskiy, Y., additional, Segers, P., additional, Orda, A., additional, Karolko, B., additional, Driessen, M. M. P., additional, Eising, J. B., additional, Uiterwaal, C., additional, Van Der Ent, C. K., additional, Meijboom, F. J., additional, Shang, Q., additional, Tam, L., additional, Sun, J., additional, Sanderson, J., additional, Zhang, Q., additional, Li, E., additional, Yu, C., additional, Arroyo Ucar, E., additional, De La Rosa Hernandez, A., additional, Hernandez Garcia, C., additional, Jorge Perez, P., additional, Lacalzada Almeida, J., additional, Jimenez Rivera, J., additional, Duque Garcia, A., additional, Barragan Acea, A., additional, Laynez Cerdena, I., additional, Kaldararova, M., additional, Simkova, I., additional, Pacak, J., additional, Tittel, P., additional, Masura, J., additional, Tadic, M., additional, Ivanovic, B., additional, Zlatanovic, M., additional, Damjanov, N., additional, Maggiolini, S., additional, Gentile, G., additional, Bozzano, A., additional, Suraci, S., additional, Meles, E., additional, Carbone, C., additional, Tempesta, A., additional, Malafronte, C., additional, Piatti, L., additional, Achilli, F., additional, Luijendijk, P., additional, Stevens, A., additional, De Bruin-Bon, H., additional, Vriend, J., additional, Van Den Brink, R., additional, Vliegen, H., additional, Mulder, B., additional, Chow, V., additional, Ng, A., additional, Chung, T., additional, Kritharides, L., additional, Iancu, M., additional, Serban, M., additional, Craciunescu, I., additional, Hodo, A., additional, Ghiorghiu, I., additional, Popescu, B., additional, Ginghina, C., additional, Styczynski, G., additional, Szmigielski, C. A., additional, Kaczynska, A., additional, Leszczynski, J., additional, Rosinski, G., additional, Kuch-Wocial, A., additional, Slavich, M., additional, Ancona, M., additional, Fisicaro, A., additional, Oppizzi, M., additional, Marone, E., additional, Bertoglio, L., additional, Melissano, G., additional, Margonato, A., additional, Chiesa, R., additional, Agricola, E., additional, Mohammed, M., additional, Cusma-Piccione, M., additional, Piluso, S., additional, Arcidiaco, S., additional, Nava, R., additional, Giuffre, R., additional, Ciraci, L., additional, Ferro, M., additional, Uusitalo, V., additional, Luotolahti, M., additional, Pietila, M., additional, Wendelin-Saarenhovi, M., additional, Hartiala, J., additional, Saraste, M., additional, Knuuti, J., additional, Saraste, A., additional, Kochanowski, J., additional, Scislo, P., additional, Piatkowski, R., additional, Grabowski, M., additional, Marchel, M., additional, Roik, M., additional, Kosior, D., additional, Opolski, G., additional, Bartko, P. E., additional, Graf, S., additional, Khorsand, A., additional, Rosenhek, R., additional, Burwash, I., additional, Beanlands, R., additional, Baumgartner, H., additional, Mundigler, G., additional, Kudrnova, S., additional, Apor, A., additional, Huttl, H., additional, Mori, F., additional, Santoro, G., additional, Oddo, A., additional, Rosso, G., additional, Meucci, F., additional, Pieri, F., additional, Squillantini, G., additional, Gensini, G., additional, Postula, M., additional, Park, D.-G., additional, Hong, J.-Y., additional, Kim, S.-E., additional, Lee, J.-H., additional, Han, K.-R., additional, Oh, D.-J., additional, Dal Bianco, L., additional, Beraldo, M., additional, Peluso, D., additional, Al Mamary, A., additional, Aggeli, C., additional, Felekos, I., additional, Poulidakis, E., additional, Pietri, P., additional, Roussakis, G., additional, Siasos, G., additional, Stefanadis, C., additional, Hoshiba, H., additional, Miyasaka, C., additional, Sato, H., additional, Yamanaka, A., additional, Lilli, A., additional, Baratto, M., additional, Magnacca, M., additional, Comella, A., additional, Poddighe, R., additional, Talini, E., additional, Canale, M., additional, Chioccioli, M., additional, Del Meglio, J., additional, Casolo, G., additional, Kuznetsov, V. A., additional, Melnikov, N. N., additional, Krinochkin, D. V., additional, Calin, A., additional, Enache, R., additional, Beladan, C., additional, Rosca, M., additional, Lupascu, L., additional, Purcarea, F., additional, Calin, C., additional, Gurzun, M., additional, Dulgheru, R., additional, Ciobanu, A., additional, Magda, S., additional, Mihaila, S., additional, Rimbas, R., additional, Margulescu, A., additional, Cinteza, M., additional, Vinereanu, D., additional, Sumin, A. N., additional, Arhipov, O., additional, Yoon, J., additional, Moon, J., additional, Rim, S., additional, Nyktari, E., additional, Patrianakos, A., additional, Solidakis, G., additional, Psathakis, E., additional, Parthenakis, F., additional, Vardas, P., additional, Kordybach, M., additional, Kowalski, M., additional, Kowalik, E., additional, Hoffman, P., additional, Nagy, K. V., additional, Kutyifa, V., additional, Edes, E., additional, Merkely, B., additional, Gerlach, A., additional, Rost, C., additional, Schmid, M., additional, Rost, M., additional, Flachskampf, F., additional, Daniel, W., additional, Breithardt, O., additional, Altekin, E., additional, Karakas, S., additional, Yanikoglu, A., additional, Er, A., additional, Baktir, A., additional, Demir, I., additional, Deger, N., additional, Klitsie, L., additional, Hazekamp, M., additional, Roest, A., additional, Van Der Hulst, A., additional, Gesink- Van Der Veer, B., additional, Kuipers, I., additional, Blom, N., additional, Ten Harkel, A., additional, Farsalinos, K., additional, Tsiapras, D., additional, Kyrzopoulos, S., additional, Avramidou, E., additional, Vasilopoulou, D., additional, Voudris, V., additional, Florianczyk, T., additional, Kalinowski, M., additional, Szulik, M., additional, Streb, W., additional, Rybus-Kalinowska, B., additional, Sliwinska, A., additional, Stabryla, J., additional, Kukla, M., additional, Nowak, J., additional, Kalarus, Z., additional, Florescu, M., additional, Mihalcea, D., additional, Magda, L., additional, Suran, B., additional, Enescu, O., additional, Mincu, R., additional, Salerno, G., additional, Scognamiglio, G., additional, D'andrea, A., additional, Dinardo, G., additional, Gravino, R., additional, Sarubbi, B., additional, Disalvo, G., additional, Liao, J.-N., additional, Sung, S., additional, Chen, C., additional, Park, S., additional, Shin, S., additional, Kim, M., additional, Shim, S., additional, Helvacioglu, F., additional, Ulusoy, O., additional, Duran, C., additional, Kirschner, R., additional, Simor, T., additional, Ambrosio, G., additional, Tran, T., additional, Raman, S., additional, Vidal Perez, R. C., additional, Carreras, F., additional, Leta, R., additional, Pujadas, S., additional, Barros, A., additional, Hidalgo, A., additional, Alomar, X., additional, Pons-Llado, G., additional, Olofsson, M., additional, Boman, K., additional, Ledakowicz-Polak, A., additional, Polak, L., additional, Zielinska, M., additional, Fontana, A., additional, Schirone, V., additional, Mauro, A., additional, Zambon, A., additional, Giannattasio, C., additional, Trocino, G., additional, Dekleva, M., additional, Dungen, H., additional, Inkrot, S., additional, Gelbrich, G., additional, Suzic Lazic, J., additional, Kleut, M., additional, Markovic Nikolic, N., additional, Waagstein, F., additional, Khoor, S., additional, Balogh, N., additional, Simon, I., additional, Fugedi, K., additional, Kovacs, I., additional, Khoor, M., additional, Florian, G., additional, Kocsis, A., additional, Szuszai, T., additional, O'driscoll, J., additional, Saha, A., additional, Smith, R., additional, Gupta, S., additional, Lenkey, Z., additional, Gaszner, B., additional, Illyes, M., additional, Sarszegi, Z., additional, Horvath, I. G., additional, Magyari, B., additional, Molnar, F., additional, Cziraki, A., additional, Elnoamany, M. F., additional, Badran, H., additional, Ebraheem, H., additional, Reda, A., additional, and Elsheekh, N., additional

Published
2011
Full Text
View/download PDF

10. Granulocyte colony-stimulating factor attenuates left ventricular remodelling after acute anterior STEMI: results of the single-blind, randomized, placebo-controlled multicentre STem cEll Mobilization in Acute Myocardial Infarction (STEM-AMI) Trial.

Author

Achilli F, Malafronte C, Lenatti L, Gentile F, Dadone V, Gibelli G, Maggiolini S, Squadroni L, Di Leo C, Burba I, Pesce M, Mircoli L, Capogrossi MC, Di Lelio A, Camisasca P, Morabito A, Colombo G, Pompilio G, STEM-AMI Investigators, and Achilli, Felice

Abstract

Aims: The aim of this study was to assess the effect of granulocyte colony-stimulating factor (G-CSF) on left ventricular (LV) function and volumes in patients with anterior ST-elevation myocardial infarction (STEMI) and depressed LV ejection fraction (EF). Methods and Results: Sixty consecutive patients with anterior STEMI, undergoing primary angioplasty percutaneous coronary intervention (PCI), with symptom-to-reperfusion time of 2-12 h and EF ≤45% after PCI, were randomized to G-CSF 5 μg/kg b.i.d. subcutaneously (n = 24) or placebo (n = 25) for 5 days, starting <12 h after PCI. The primary endpoint was an increase from baseline to 6 months of 5% in left ventricular ejection fraction (LVEF), as measured by magnetic resonance imaging (MRI). Co-primary endpoint was a ≥20 mL difference in end-diastolic volume (EDV). Infarct size and perfusion were evaluated with late gadolinium enhancement (LGE) and gated (99m)Technetium Sestamibi single-photon emission computed tomography (SPECT). Left ventricular EDV and end-systolic volume (ESV) increased from baseline to 6 months in the placebo group (81.7 ± 24.4 to 94.4 ± 26.0 mL/m(2), P < 0.00005 and 45.2 ± 20.0 to 53.2 ± 23.8 mL/m(2), P = 0.016) but were unchanged in the G-CSF group (82.2 ± 20.3 to 85.7 ± 23.7 mL/m(2), P = 0.40 and 46.0 ± 18.2 to 48.4 ± 20.8 mL/m(2), P = 0.338). There were no significant differences in EF or perfusion between groups. A significant reduction in transmural LGE segments was seen at 6 months in the G-CSF vs. placebo groups (4.38 ± 2.9 to 3.3 ± 2.6, P = 0.04 and 4.2 ± 2.6 to 3.6 ± 2.7, P = 0.301, respectively). Significantly more placebo patients had a change in left ventricular end-diastolic volume abovethe median (9.3 mL/m(2)) when reperfusion time exceeded 180 min (median time-to-reperfusion) (P = 0.0123). Severe adverse events were similar between groups. Conclusion: Early G-CSF administration attenuates ventricular remodelling in patients with anterior STEMI and EF ≤45% after successful PCI. [ABSTRACT FROM AUTHOR]

Published
2010
Full Text
View/download PDF

12. G-CSF for Extensive STEMI

Author

Cristina Malafronte, Andrea Baggiano, Marco Guglielmo, Stefano Pidello, Gualtiero I. Colombo, Filiberto Di Gennaro, Jeness Campodonico, Alberto Limido, Luca Mircoli, Giuseppe Muscogiuri, Gianluca Pontone, Martina Ceseri, Stefano Righetti, Federica Soffici, Laura Lenatti, Daniele Scarpa, Stefano Maggiolini, Elena Corrada, Camilla Facchini, Giuseppe Di Tano, Beatrice Bassetti, Lidia Squadroni, Felice Achilli, Giulio Pompilio, Giovanni Esposito, Achilli, F, Pontone, G, Bassetti, B, Squadroni, L, Campodonico, J, Corrada, E, Facchini, C, Mircoli, L, Esposito, G, Scarpa, D, Pidello, S, Righetti, S, Di Gennaro, F, Guglielmo, M, Muscogiuri, G, Baggiano, A, Limido, A, Lenatti, L, Di Tano, G, Malafronte, C, Soffici, F, Ceseri, M, Maggiolini, S, Colombo, G, and Pompilio, G

Subjects
Oncology, medicine.medical_specialty, Prasugrel, Physiology, medicine.medical_treatment, Phases of clinical research, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, 030212 general & internal medicine, Myocardial infarction, left ventricular remodeling, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, medicine.disease, Clopidogrel, Granulocyte colony-stimulating factor, myocardial infarction, standard of care, granulocyte colony-stimulating factor, Stem cell, Cardiology and Cardiovascular Medicine, business, Ticagrelor, medicine.drug
Abstract

Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment–elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-term. Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment–elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. Methods and Results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment–elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-to-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC ( P =0.01); concurrently, there was a significant between-group difference of 6.7 mL/m 2 in the change of indexed LV end-systolic volume in favor of G-CSF group ( P =0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only ( P =0.04). Moreover, over time improvement of global longitudinal strain was 2.4% higher in G-CSF patients versus SOC ( P =0.04). Global circumferential strain significantly improved in G-CSF group only ( P =0.006). Conclusions: Early administration of G-CSF exerted a beneficial effect on top of SOC in patients with LV dysfunction after extensive ST-segment–elevation myocardial infarction in terms of global systolic function, adverse remodeling, scar size, and myocardial strain. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01969890.

Published
2019

13. Effects of extracorporeal cardiopulmonary resuscitation on neurological and cardiac outcome after ischaemic refractory cardiac arrest

Author

Cristina Malafronte, Francesca Cesana, P Cozzolino, Andrea Mauro, Anna Coppo, Giuseppe Foti, Elena Maggioni, Laura Garatti, Stefano Righetti, Federica Soffici, Felice Achilli, Leonello Avalli, Elisabetta Scanziani, Endrit Sulmina, Veronica Bozzon, I. Calchera, Cesana, F, Avalli, L, Garatti, L, Coppo, A, Righetti, S, Calchera, I, Scanziani, E, Cozzolino, P, Malafronte, C, Mauro, A, Soffici, F, Sulmina, E, Bozzon, V, Maggioni, E, Foti, G, and Achilli, F

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, ischemic cardiac arrest, medicine.medical_treatment, Ischemia, 030204 cardiovascular system & hematology, Return of spontaneous circulation, Coronary Angiography, Critical Care and Intensive Care Medicine, cardiac arrest outcome, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Refractory, Risk Factors, Retrospective Studie, Internal medicine, medicine, Extracorporeal membrane oxygenation, Humans, Extracorporeal cardiopulmonary resuscitation, Cardiopulmonary resuscitation, Retrospective Studies, Aged, business.industry, Risk Factor, 030208 emergency & critical care medicine, General Medicine, extracorporeal membrane oxygenation, Middle Aged, medicine.disease, Refractory cardiac arrest, Cardiopulmonary Resuscitation, Heart Arrest, Survival Rate, extracorporeal-cardiopulmonary resuscitation, Treatment Outcome, Coronary Occlusion, Italy, Coronary occlusion, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Clinical death, Human
Abstract

Background: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation. Methods: We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011–2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months). Results: Patients in the extracorporeal cardiopulmonary resuscitation group ( n=63, 43%) were younger (59±9 vs 63±8 year-old, p=0.02) with lower incidence of atherosclerosis risk factors than those with conventional cardiopulmonary resuscitation. In the extracorporeal cardiopulmonary resuscitation group, left ventricular ejection fraction was lower than conventional cardiopulmonary resuscitation at early echocardiography (19±16% vs 37±11 pConclusions: Extracorporeal cardiopulmonary resuscitation patients are younger and have less comorbidities than conventional cardiopulmonary resuscitation, but they have worse survival and lower early left ventricular ejection fraction. Survivors after extracorporeal cardiopulmonary resuscitation have a neurological outcome and recovery of heart function comparable to subjects with return of spontaneous circulation. Total cardiac arrest time is the only predictor of survival after cardiopulmonary resuscitation in both groups.

Published
2017

15. The hidden hypothesis: A disseminated tuberculosis case.

Author

Foresti S, Perego MR, Carugati M, Casati A, Malafronte C, Manzoni M, Badolato R, Gori A, and Achilli F

Subjects
Aged, Bayes Theorem, Humans, Male, Mycobacterium tuberculosis isolation & purification, Pericarditis, Tuberculous diagnosis, Tuberculosis diagnosis
Abstract

Case Presentation: 77-year-old former smoker admitted because of fatigue and abdominal distention. Past medical history positive for two previous hospitalizations for pericardial and pleural effusions (no diagnosis achieved). At admission erythrocyte sedimentation rate was 122mm per hour. Baseline investigations revealed ascitic, pleural and pericardial effusion. Effusions were tapped: neoplastic cells and acid-fast bacilli (AFB) were not identified, aerobic and mycobacterial culture resulted negative. QuantiFERON TB-Gold test was negative. Total body PET-CT and autoimmunity panel were negative. A neoplastic process was considered the most likely explanation. Before signing off the patient to comfort care, a reassessment was performed and an exposure to tuberculosis during childhood was documented. Because of constrictive pericarditis, pericardiectomy was performed: histologic examination showed chronic pericardial inflammation without granulomas, but Ziehl-Neelsen stain identified AFB and PCR was positive for Mycobacterium tuberculosis complex. Patient was started on anti-TB therapy with resolution of the effusions in the following months. Genes associated with defects in innate immunity were sequences and dentritic cells were studied, but no alterations were identified., Discussion: A Bayesian approach to clinical decision making should be recommended. Interpretation of diagnostic tests should take into account the imperfect diagnostic performance of the majority of these tests. Further studies to investigate genetic susceptibility to tuberculosis are needed., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2019
Full Text
View/download PDF

16. Effects of extracorporeal cardiopulmonary resuscitation on neurological and cardiac outcome after ischaemic refractory cardiac arrest.

Author

Cesana F, Avalli L, Garatti L, Coppo A, Righetti S, Calchera I, Scanziani E, Cozzolino P, Malafronte C, Mauro A, Soffici F, Sulmina E, Bozzon V, Maggioni E, Foti G, and Achilli F

Subjects
Adolescent, Adult, Aged, Coronary Angiography, Coronary Occlusion diagnosis, Female, Heart Arrest etiology, Heart Arrest mortality, Humans, Italy epidemiology, Male, Middle Aged, Retrospective Studies, Risk Factors, Survival Rate trends, Treatment Outcome, Young Adult, Cardiopulmonary Resuscitation methods, Coronary Occlusion complications, Extracorporeal Membrane Oxygenation methods, Heart Arrest therapy
Abstract

Background: Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation., Methods: We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011-2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months)., Results: Patients in the extracorporeal cardiopulmonary resuscitation group ( n=63, 43%) were younger (59±9 vs 63±8 year-old, p=0.02) with lower incidence of atherosclerosis risk factors than those with conventional cardiopulmonary resuscitation. In the extracorporeal cardiopulmonary resuscitation group, left ventricular ejection fraction was lower than conventional cardiopulmonary resuscitation at early echocardiography (19±16% vs 37±11 p<0.01). Survivors in both groups showed similar left ventricular ejection fraction 15 days and 4-6 months after cardiac arrest (46±8% vs 49±10, 47±11% vs 45±13%, p not significant for both), despite a major extent and duration of cardiac ischaemia in extracorporeal cardiopulmonary resuscitation patients. At multivariate analysis, the total cardiac arrest time was the only independent predictor of survival., Conclusions: Extracorporeal cardiopulmonary resuscitation patients are younger and have less comorbidities than conventional cardiopulmonary resuscitation, but they have worse survival and lower early left ventricular ejection fraction. Survivors after extracorporeal cardiopulmonary resuscitation have a neurological outcome and recovery of heart function comparable to subjects with return of spontaneous circulation. Total cardiac arrest time is the only predictor of survival after cardiopulmonary resuscitation in both groups.

Published
2018
Full Text
View/download PDF

17. BM ageing: Implication for cell therapy with EPCs.

Author

Rurali E, Bassetti B, Perrucci GL, Zanobini M, Malafronte C, Achilli F, and Gambini E

Subjects
Aging pathology, Animals, Bone Marrow pathology, Cardiovascular Diseases pathology, Endothelial Progenitor Cells pathology, Humans, Aging metabolism, Bone Marrow metabolism, Cardiovascular Diseases metabolism, Cardiovascular Diseases therapy, Cell- and Tissue-Based Therapy, Endothelial Progenitor Cells metabolism
Abstract

The bone marrow (BM) is a well-recognized source of stem/progenitor cells for cell therapy in cardiovascular diseases (CVDs). Preclinical and clinical studies suggest that endothelial progenitor cells (EPCs) contribute to reparative process of vascular endothelium and participate in angiogenesis. As for all organs and cells across the lifespan, BM and EPCs are negatively impacted by ageing due to microenvironment modifications and EPC progressive dysfunctions. The encouraging results in terms of neovascularization observed in young animals after EPC administration were mitigated in aged patients treated for ischemic CVDs. The limited efficacy of EPC-based therapy in clinical setting might be ascribed at least partly to ageing. In this review, we comprehensively discussed the age-related changes of BM and EPCs and their implication for cardiovascular cell-therapies. Finally, we examined alternative approaches under investigation to enhance EPC potency., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2016
Full Text
View/download PDF

18. Granulocyte-colony stimulating factor for large anterior ST-elevation myocardial infarction: rationale and design of the prospective randomized phase III STEM-AMI OUTCOME trial.

Author

Achilli F, Malafronte C, Cesana F, Maggiolini S, Mauro C, De Ferrari GM, Lenatti L, Tespili M, Pasqualini P, Gentile F, Capogrossi MC, Maggioni A, Maseri A, Pontone G, Colombo GI, and Pompilio G

Subjects
Aged, Coronary Angiography, Female, Follow-Up Studies, Humans, Injections, Intra-Arterial, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction physiopathology, Prospective Studies, Time Factors, Treatment Outcome, Ventricular Function, Left, Ventricular Remodeling, Electrocardiography, Granulocyte Colony-Stimulating Factor administration & dosage, Myocardial Infarction therapy, Percutaneous Coronary Intervention methods
Abstract

Background: Granulocyte-colony stimulating factor (G-CSF) has been clinically tested in ST-elevation myocardial infarction (STEMI) with mixed results. Our 3-year follow-up data from STEM-AMI trial documented a sustained benefit of G-CSF on adverse ventricular remodeling after large anterior STEMI, when administered early and at a high-dose in patients with left ventricular (LV) dysfunction. The Aim of the present trial is to establish whether G-CSF improves hard clinical long-term outcomes., Methods: The STEM-AMI OUTCOME is a prospective, multicenter, randomized, open-label, phase III trial. It will include 1,530 patients with anterior STEMI undergoing primary percutaneous coronary intervention 2 to 24 hours after symptoms onset and with LV ejection fraction ≤45% after successful reperfusion. Patients will be randomized 1:1 to G-CSF and/or standard treatment. The primary end point is a reduced occurrence of all-cause death, recurrence of myocardial infarction, or hospitalization due to heart failure in G-CSF-treated patients. Left ventricular remodeling will be assessed via cardiac ultrasound and a substudy with cardiac magnetic resonance will be carried out in 120 subjects. Accrual and follow-up periods will last 3 and 2 years, respectively., Conclusions: The STEM-AMI OUTCOME study is designed to be a rigorous controlled phase III trial with adequate statistical power to conclusively assess efficacy of G-CSF treatment in STEMI., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Published
2015
Full Text
View/download PDF

19. G-CSF treatment for STEMI: final 3-year follow-up of the randomised placebo-controlled STEM-AMI trial.

Author

Achilli F, Malafronte C, Maggiolini S, Lenatti L, Squadroni L, Gibelli G, Capogrossi MC, Dadone V, Gentile F, Bassetti B, Di Gennaro F, Camisasca P, Calchera I, Valagussa L, Colombo GI, and Pompilio G

Subjects
Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction physiopathology, Prospective Studies, Time Factors, Ventricular Dysfunction, Left etiology, Granulocyte Colony-Stimulating Factor therapeutic use, Myocardial Infarction complications, Myocardial Infarction therapy, Ventricular Dysfunction, Left prevention & control, Ventricular Remodeling
Abstract

Objective: To assess whether granulocyte colony-stimulating factor (G-CSF) treatment induces a sustained benefit on adverse remodelling in patients with large anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction after successful reperfusion., Methods: The STEM-AMI Trial was a prospective, placebo-controlled, multicentre study. Sixty consecutive patients with a first anterior STEMI, who underwent primary percutaneous coronary intervention 2-12 h after symptom onset, with LV ejection fraction (LVEF) ≤45% measured by echocardiography within 12 h after successful revascularisation (TIMI flow score ≥2), were randomised 1:1 to G-CSF (5 µg/Kg body weight b.i.d.) or placebo. Clinical events and Major Adverse Cardiac and Cerebrovascular Event (MACCE) were monitored, and LVEF, LV end-diastolic (LVEDV) and end-systolic (LVESV) volumes, and infarct size were evaluated by MRI at the final 3-year follow-up., Results: Fifty-four patients completed the study, of whom 35 with MRI. No significant differences were found in mortality and MACCE between G-CSF and placebo-treated groups. The 3-year infarct size was not different between groups, whereas LVEDV was significantly lower in G-CSF (n=20) than in placebo (n=15) patients (170.1±8.1 vs 197.2±8.9 mL, respectively; p=0.033 at analysis of covariance). A significant inverse correlation was detected in G-CSF patients between the number of circulating CD34 cells at 30 days after reperfusion and the 3-year absolute and indexed LVEDV (ρ=-0.71, 95% CI -0.90 to -0.30, and ρ=-0.62, -0.86 to -0.14, respectively), or their change over time (r=-0.59, -0.85 to -0.11, and r=-0.55, -0.83 to -0.06, respectively)., Conclusions: G-CSF therapy may be beneficial in attenuating ventricular remodelling subsequent to a large anterior STEMI in the long term. No differences have been detected in clinical outcome.

Published
2014
Full Text
View/download PDF

20. [From the coronary care unit to the intensive cardiac care unit: the evolution of the Cardiovascular Department of a tertiary center].

Author

Ferri L, Farina A, Lenatti L, Malafronte C, Ruffa F, Piatti L, Maggiolini S, Lorenzi G, Gamba A, Catena E, and Achilli F

Subjects
Aged, Female, Hospital Departments, Humans, Male, Retrospective Studies, Coronary Care Units, Intensive Care Units, Myocardial Infarction therapy
Abstract

Background: Substantial changes have occurred over time in the diagnoses, procedures and characteristics of patients admitted to coronary care units (CCU). Following the introduction of cardiac surgery activity in our hospital in December 2009, the aim of this study was to evaluate the changes in activity, processes of care and outcomes of patients consecutively admitted to our CCU after the reorganization of the Cardiovascular Department., Methods: All 1674 consecutive patients admitted to the CCU from January 2009 to December 2010 were enrolled in this retrospective registry., Results: In 2010, the number of patients referred from other hospitals or wards significantly increased (from 17.2% to 28.3%; p<0.001). Significant was also the increase of patients with ST-elevation myocardial infarction (n=190 to n=230, p<0.001), shock (n=20 to n=50, p<0.001), pulmonary edema (n=47 to n=64, p<0.05), cardiac arrest (n=2 to n=8, p<0.05), aortic dissection (n=0 to n=12; p<0.001). Conversely, the number of patients admitted for acute coronary syndromes without ST-segment elevation and GRACE risk score <140 significantly decreased (n=169 to n=52, p<0.001). In parallel, a significant increase in the use of intra-aortic balloon pump (2.0% to 5.6%, p<0.001), continuous hemofiltration (0.3% to 3.1%, p>0.001), non-invasive ventilation (5.6% to 10.5%, p<0.001) and mechanical ventilation (0% to 4.1%, p<0.001) was observed. Intensive care devices were more frequently used in the subgroups affected by shock, acute coronary syndromes without ST-segment elevation and GRACE risk score >200, and heart failure. Interestingly, despite the increase in high-risk clinical conditions the intra-CCU mortality did not change (3.1 vs 2.9%)., Conclusions: Patients admitted to the CCU have high-risk acute clinical conditions. A model based on the sharing of cardiological, cardiac anesthesiological and surgical expertise is effective in increasing admission appropriateness and improving standards of care in a short period of time.

Published
2012
Full Text
View/download PDF

21. Capecitabine-induced cardiotoxicity: when to suspect? How to manage? A case report.

Author

Farina A, Malafronte C, Valsecchi MA, and Achilli F

Subjects
Angina Pectoris drug therapy, Angina Pectoris physiopathology, Capecitabine, Chemotherapy, Adjuvant, Colonic Neoplasms secondary, Colonic Neoplasms surgery, Coronary Angiography, Coronary Vasospasm drug therapy, Coronary Vasospasm physiopathology, Deoxycytidine adverse effects, Diltiazem therapeutic use, Electrocardiography, Fluorouracil adverse effects, Heart Rate drug effects, Humans, Male, Middle Aged, Tachycardia, Ventricular drug therapy, Tachycardia, Ventricular physiopathology, Vasodilator Agents therapeutic use, Angina Pectoris chemically induced, Antimetabolites, Antineoplastic adverse effects, Colonic Neoplasms drug therapy, Coronary Vasospasm chemically induced, Deoxycytidine analogs & derivatives, Fluorouracil analogs & derivatives, Tachycardia, Ventricular chemically induced
Abstract

We present a case of capecitabine-induced cardiac toxicity manifested by chest pain, ST-segment elevation and ventricular tachycardia. Symptoms and ECG alterations were completely reversible after withdrawal of the drug. Coronary angiography demonstrated the absence of epicardial coronary spasm. We suggest cardiac monitoring with ECG Holter and effort ECG during the first days of drug administration. Prompt evaluation of chest pain in this setting is of paramount importance.

Published
2009
Full Text
View/download PDF

22. Stem cells mobilization in acute myocardial infarction (stem-AMI trial): preliminary data of a perspective, randomized, single blind trial.

Author

Malafronte C and Achilli F

Subjects
Aged, Coronary Angiography, Data Interpretation, Statistical, Echocardiography, Echocardiography, Doppler, Electrocardiography, Electrocardiography, Ambulatory, Female, Follow-Up Studies, Heart Failure, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Time Factors, Tomography, Emission-Computed, Single-Photon, Angioplasty, Balloon, Coronary, Granulocyte Colony-Stimulating Factor administration & dosage, Hematopoietic Stem Cell Mobilization, Myocardial Infarction therapy, Ventricular Function, Left
Abstract

Aim: Clinical trials demonstrated that granulocyte colony-stimulating factor (G-CSF) administration seems to be safe in patients with acute myocardial infarction but the results about the effectiveness are not so encouraging. The main problem is to distinguish the effects that early revascularization and regenerative therapy have on left ventricular (LV) function. The purpose of our perspective randomized trial is to evaluate the efficacy of G-CSF administration, assessed by improvement of LV ejection fraction by cardiac magnetic resonance imaging (MRI), in patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention (PCI) and with evidence of LV dysfunction., Methods: Fifty consecutive patients with first anterior ST-elevation myocardial infarction (STEMI), undergoing primary PCI, with symptom to balloon >2 and <12 hours and ejection fraction (EF) =or<45%, are randomized to 150 microg/m2 G-CSF bis in die subcutaneously (from day 0 to day 4) in addition to standard care. Patients are submitted to echocardiography, Holter monitoring, gated single photon emission computed tomography (SPECT) and MRI at baseline and at 6 months of follow up. Coronary angiogram is repeated at 6 months to evaluate in-stent restenosis., Results: From July 2006 until August 2007, 13 consecutive patients were enrolled and 5 of them were assigned to G-CSF administration. All patients underwent PCI and stenting of left anterior descending artery. Mean baseline EF evaluated by echocardiography, SPECT and MRI was respectively 36%, 33% and 38%. No adverse events were observed during G-CSF administration. The mean white blood cells count, in the treatment arm, was 36.1 x 10(9)/L +/- 2.90 on day 5., Conclusion: Preliminary data of our study do not support any conclusive result. However, the characteristics of our population could allow us to distinguish the effects that revascularization and regenerative therapy have on LV function in patients with acute myocardial infarction.

Published
2007

23. Tako-tsubo: a transitory impairment of microcirculation? A case report.

Author

Malafronte C, Farina A, Tempesta A, Lobiati E, Galbiati R, Cantù E, Piatti L, Florimonte L, Maffioli L, and Achilli F

Subjects
Aged, Coronary Angiography, Coronary Stenosis diagnosis, Diagnosis, Differential, Echocardiography, Stress, Electrocardiography, Female, Follow-Up Studies, Humans, Radionuclide Ventriculography, Tomography, Emission-Computed, Single-Photon, Ventricular Dysfunction, Left diagnosis, Coronary Stenosis etiology, Ventricular Dysfunction, Left complications
Abstract

The tako-tsubo syndrome, or transient left ventricular apical ballooning, has been widely described in Japan as a cardiomyopathy which resembles acute myocardial infarction on presentation, but characterized by a normal coronary tree and a favorable outcome. Conversely few series have been described in Europe and etiology and mechanism are still unknown. We describe the case of a 74-year-old Italian woman with tako-tsubo cardiomyopathy, one of the first Italian cases reported to our knowledge. In the acute phase, echocardiography and ventriculography showed the typical mid-apical systolic left ventricular dysfunction, with an angiographically normal coronary tree. A few days after, technetium-99m single-photon emission computed tomography disclosed a large mid-apical perfusion defect and dobutamine stress echocardiography showed a typical "biphasic" response. Three months later, all of these tests normalized with normal left ventricular function. In conclusion, the results of functional tests, during the acute and subacute phases, suggest that, in the absence of evident coronary spasm, a transitory reduction of the coronary reserve played a role in the pathogenesis. In the absence of epicardial coronary obstruction this could be due to a transient microcircle dysfunction, and may be attributed to a spasm followed by impaired vasodilation capability.

Published
2005

24. Cardiac arrhythmias due to severe hypokalemia in a patient with classic Bartter disease.

Author

Malafronte C, Borsa N, Tedeschi S, Syrèn ML, Stucchi S, Bianchetti MG, Achilli F, and Bettinelli A

Subjects
Female, Humans, Infant, Severity of Illness Index, Arrhythmias, Cardiac etiology, Bartter Syndrome complications, Hypokalemia complications
Abstract

We report a young girl with classic Bartter disease (type III) with severe hypokalemia (< or = 2.0 mmol/l) who developed a prolonged heart rate-corrected QT interval of 510 ms (upper reference 430 ms) and ST segment depression in all leads. Holter electrocardiography was performed (with a plasma potassium level of 2.0 mmol/l) and it disclosed a stable sinus rhythm, a prolonged correct QT interval, more-evident ST segment depression during an increase in heart rate, a few single premature ventricular complexes, and nocturnal conduction abnormalities such as second-degree atrioventricular block 2:1. In the light of these results, the treatment was modified by increasing indomethacin from 1.5 to 3 mg/kg per day and adding spironolactone at a dose of 5 mg/kg per day. After 10 days, plasma potassium levels increased to 2.7 mmol/l and electrocardiographic abnormalities regressed. No other cardiac abnormalities were noted when the serum potassium was maintained > 2.5 mmol/l. In conclusion, this case report supports the link between arrhythmic events and chronic renal hypokalemic alkalosis in renal tubular disorders. We highlight the importance of standardizing the use of rest electrocardiography and 24-h Holter monitoring to diagnose arrhythmic events in children with severe hypokalemic renal disorders, especially in those with a plasma potassium < 2.5 mmol/l. The importance of beginning early medical treatment, to improve plasma potassium levels and reverse cardiac abnormalities, is emphasized.

Published
2004
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results