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19 results on '"Noussan, Patrizia"'

1. Secondary prevention and follow-up of patients with ACS and not-at-target LDL: An Italian real-world retro-prospective analysis by the INERTIA group

Author

Del Pinto, Maurizio, Amico, Francesco, Brunetti, Natale, Caldarola, Pasquale, Carugo, Stefano, Cavallini, Claudio, D'Andrea, Antonello, Fedele, Francesco, Mauro, Ciro, Noussan, Patrizia, Paloscia, Leonardo, Prati, Francesco, Tarzia, Pierpaolo, Tespili, Maurizio, Barbieri, Lucia, Basso, Pierangelo, Buono, Andrea, D'Alleva, Alberto, Giubilato, Simona, Iannacone, Mario, Ferrante, Fabio, Granata, Giuseppina, Ieva, Riccardo, Madrid, Alfredo, Mallus, Maria Teresa, and Tagliamonte, Ercole

Published
2023
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2. Comparison of ECMO vs ECpella in Patients With Non-Post-Pericardiotomy Cardiogenic Shock: An Updated Meta-Analysis

Author

Iannaccone, Mario, primary, Venuti, Giuseppe, additional, di Simone, Emanuela, additional, De Filippo, Ovidio, additional, Bertaina, Maurizio, additional, Colangelo, Salvatore, additional, Boccuzzi, Giacomo, additional, de Piero, Maria Elena, additional, Attisani, Matteo, additional, Barbero, Umberto, additional, Zanini, Paola, additional, Livigni, Sergio, additional, Noussan, Patrizia, additional, D'Ascenzo, Fabrizio, additional, de Ferrari, Gaetano Maria, additional, Porto, Italo, additional, and Truesdell, Alexander G., additional

Published
2022
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3. Prognostic implications of pulmonary artery catheter monitoring in patients with cardiogenic shock: A systematic review and meta-analysis of observational studies

Author

Bertaina, Maurizio, primary, Galluzzo, Alessandro, additional, Rossello, Xavier, additional, Sbarra, Pierluigi, additional, Petitti, Elisabetta, additional, Prever, Silvia Brach, additional, Boccuzzi, Giacomo, additional, D'Ascenzo, Fabrizio, additional, Frea, Simone, additional, Pidello, Stefano, additional, Morici, Nuccia, additional, Sacco, Alice, additional, Oliva, Fabrizio, additional, Valente, Serafina, additional, De Ferrari, Gaetano Maria, additional, Ugo, Fabrizio, additional, Rametta, Francesco, additional, Attisani, Matteo, additional, Zanini, Paola, additional, Noussan, Patrizia, additional, and Iannaccone, Mario, additional

Published
2022
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4. Pulmonary Artery Catheter Monitoring in Patients with Cardiogenic Shock: Time for a Reappraisal?

Author

Bertaina, Maurizio, primary, Galluzzo, Alessandro, additional, Morici, Nuccia, additional, Sacco, Alice, additional, Oliva, Fabrizio, additional, Valente, Serafina, additional, D’Ascenzo, Fabrizio, additional, Frea, Simone, additional, Sbarra, Pierluigi, additional, Petitti, Elisabetta, additional, Brach Prever, Silvia, additional, Boccuzzi, Giacomo, additional, Zanini, Paola, additional, Attisani, Matteo, additional, Rametta, Francesco, additional, De Ferrari, Gaetano Maria, additional, Noussan, Patrizia, additional, and Iannaccone, Mario, additional

Published
2022
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5. Short term outcomes of Impella circulatory support for high‐risk percutaneous coronary intervention a systematic review and meta‐analysis

Author

Elia, Edoardo, primary, Iannaccone, Mario, additional, D'Ascenzo, Fabrizio, additional, Gallone, Guglielmo, additional, Colombo, Francesco, additional, Albani, Stefano, additional, Attisani, Matteo, additional, Rinaldi, Mauro, additional, Boccuzzi, Giacomo, additional, Conrotto, Federico, additional, Noussan, Patrizia, additional, and De Ferrari, Gaetano Maria, additional

Published
2021
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6. Long-term clinical follow-up of the multicentre, randomized study to test immunosuppressive therapy with oral prednisone for the prevention of restenosis after percutaneous coronary interventions: Cortisone plus BMS or DES veRsus BMS alone to EliminAte Restenosis (CEREA-DES)

Author

Ribichini, Flavio, Tomai, Fabrizio, Pesarini, Gabriele, Zivelonghi, Carlo, Rognoni, Andrea, De Luca, Giuseppe, Boccuzzi, Giacomo, Presbitero, Patrizia, Ferrero, Valeria, Ghini, Anna S., Marino, Paolo, Vassanelli, Corrado, Ribichini, Flavio, Ferrero, Valeria, Pesarini, Gabriele, Dal Dosso, Silvia, Vassanelli, Corrado, Tanguay, Jean-Francois, Tomai, Fabrizio, Presbitero, Patrizia, Minelli, Massimo, Marino, Paolo, Anselmi, M., Abukarsh, R., Cima, A., Ferrara, A., Ferrero, V., Menegatti, G., Molinari, G., Pesarini, G., Ribichini, F., Spartà, D., Altamura, L., Aurigemma, C., Beraldi, M., Corvo, P., De Luca, L., De Persio, G., Ghini, A.S., Pastori, F., Pellanda, J., Petrolini, A, Skossyreva, O., Tomai. Ospedale, F., Ospedale, S., Bosco, Giovanni, Boccuzzi, G., Colangelo, S., Garbo, R., Minelli, M., Noussan, P., Belli, G., Presbitero, P., Rossi, M., Soregaroli, D., Zavalloni, D., De Luca, G., Franchi, E., Leverone, M., Rognoni, A., Brunelleschi, Sandra, Feola, Mauro, Trinità, Ospedale S., Menegatti, Giuliana, Noussan, Patrizia, Giovanni, Ospedale San, Zanolla, Luisa, and Magnani, Corrado

Published
2013
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7. Risk factors for primary ventricular fibrillation during a first myocardial infarction: Clinical findings from PREDESTINATION (PRimary vEntricular fibrillation and suDden dEath during firST myocardIal iNfArcTION)

Author

De Ferrari, Gaetano M., primary, Dusi, Veronica, additional, Ruffinazzi, Marta, additional, Masiello, Lucrezia C., additional, Ruffino, Enrico, additional, Cacciavillani, Luisa, additional, Noussan, Patrizia, additional, Zacà, Valerio, additional, Sanna, Tommaso, additional, Lazzarotti, Marina L., additional, Usmiani, Tullio, additional, Gnecchi, Massimiliano, additional, Parati, Gianfranco, additional, Crotti, Lia, additional, and Schwartz, Peter J., additional

Published
2020
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11. Diagnostic accuracy of functional, imaging and biochemical tests for patients presenting with chest pain to the emergency department: A systematic review and meta-analysis

Author

Iannaccone, Mario, primary, Gili, Sebastiano, additional, De Filippo, Ovidio, additional, D’Amico, Salvatore, additional, Gagliardi, Marco, additional, Bertaina, Maurizio, additional, Mazzilli, Silvia, additional, Rettegno, Sara, additional, Bongiovanni, Federica, additional, Gatti, Paolo, additional, Ugo, Fabrizio, additional, Boccuzzi, Giacomo G, additional, Colangelo, Salvatore, additional, Prato, Silvia, additional, Moretti, Claudio, additional, D’Amico, Maurizio, additional, Noussan, Patrizia, additional, Garbo, Roberto, additional, Hildick-Smith, David, additional, Gaita, Fiorenzo, additional, and D’Ascenzo, Fabrizio, additional

Published
2018
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13. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy

Author

Iannaccone, Mario, primary, D’Ascenzo, Fabrizio, additional, Vadalà, Paolo, additional, Wilton, Stephen B, additional, Noussan, Patrizia, additional, Colombo, Francesco, additional, Raposeiras Roubín, Sergio, additional, Abu Assi, Emad, additional, González-Juanatey, José Ramón, additional, Simao Henriques, Jose Paulo, additional, Saucedo, Jorge, additional, Kikkert, Wouter J, additional, Nuñez-Gil, Iván, additional, Ariza-Sole, Albert, additional, Song, Xian-tao, additional, Alexopoulos, Dimitrios, additional, Liebetrau, Christoph, additional, Kawaji, Tetsuma, additional, Moretti, Claudio, additional, Garbo, Roberto, additional, Huczek, Zenon, additional, Nie, Shao-Ping, additional, Fujii, Toshiharu, additional, Correia, Luis CL, additional, Kawashiri, Masa-aki, additional, García Acuña, José María, additional, Southern, Danielle, additional, Alfonso, Emilio, additional, Terol, Belén, additional, Garay, Alberto, additional, Zhang, Dongfeng, additional, Chen, Yalei, additional, Xanthopoulou, Ioanna, additional, Osman, Neriman, additional, Möllmann, Helge, additional, Shiomi, Hiroki, additional, Giordana, Francesca, additional, Kowara, Michal, additional, Filipiak, Krzysztof, additional, Wang, Xiao, additional, Yan, Yan, additional, Fan, Jing-Yao, additional, Ikari, Yuji, additional, Nakahashi, Takuya, additional, Sakata, Kenji, additional, Gaita, Fiorenzo, additional, Yamagishi, Masakazu, additional, Kalpak, Oliver, additional, and Kedev, Sasko, additional

Published
2017
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14. Diagnostic accuracy of functional, imaging and biochemical tests for patients presenting with chest pain to the emergency department: A systematic review and meta-analysis

Author

Iannaccone, Mario, Gili, Sebastiano, De Filippo, Ovidio, D’Amico, Salvatore, Gagliardi, Marco, Bertaina, Maurizio, Mazzilli, Silvia, Rettegno, Sara, Bongiovanni, Federica, Gatti, Paolo, Ugo, Fabrizio, Boccuzzi, Giacomo G, Colangelo, Salvatore, Prato, Silvia, Moretti, Claudio, D’Amico, Maurizio, Noussan, Patrizia, Garbo, Roberto, Hildick-Smith, David, Gaita, Fiorenzo, and D’Ascenzo, Fabrizio

Abstract

Background: Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined.Methods: Medline, Cochrane Library CENTRAL, EMBASE and Biomed Central were systematically screened (start date 1 September 2016, end date 1 December 2016). Prospective studies (observational or randomised controlled trial) comparing functional/imaging or biochemical tests for patients presenting with chest pain to the emergency department were included.Results: Overall, 77 studies were included, for a total of 49,541 patients (mean age 59.9 years). Fast and six-hour highly sensitive troponin T protocols did not show significant differences in their ability to detect acute coronary syndromes, as they reported a sensitivity and specificity of 0.89 (95% confidence interval 0.79–0.94) and 0.84 (0.74–0.9) vs 0.89 (0.78–0.94) and 0.83 (0.70–0.92), respectively. The addition of copeptin to troponin increased sensitivity and reduced specificity, without improving diagnostic accuracy. The diagnostic value of non-invasive tests for patients without troponin increase was tested. Coronary computed tomography showed the highest level of diagnostic accuracy (sensitivity 0.93 (0.81–0.98) and specificity 0.90 (0.93–0.94)), along with myocardial perfusion scintigraphy (sensitivity 0.85 (0.77–0.91) and specificity 0.92 (0.83–0.96)). Stress echography was inferior to coronary computed tomography but non-inferior to myocardial perfusion scintigraphy, while exercise testing showed the lower level of diagnostic accuracy.Conclusions: Fast and six-hour highly sensitive troponin T protocols provide an overall similar level of diagnostic accuracy to detect acute coronary syndrome. Among the non-invasive ischaemia tests for patients without troponin increase, coronary computed tomography and myocardial perfusion scintigraphy showed the highest sensitivity and specificity.

Published
2019
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15. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy

Author

Iannaccone, Mario, D’Ascenzo, Fabrizio, Vadalà, Paolo, Wilton, Stephen B, Noussan, Patrizia, Colombo, Francesco, Raposeiras Roubín, Sergio, Abu Assi, Emad, González-Juanatey, José Ramón, Simao Henriques, Jose Paulo, Saucedo, Jorge, Kikkert, Wouter J, Nuñez-Gil, Iván, Ariza-Sole, Albert, Song, Xian-tao, Alexopoulos, Dimitrios, Liebetrau, Christoph, Kawaji, Tetsuma, Moretti, Claudio, Garbo, Roberto, Huczek, Zenon, Nie, Shao-Ping, Fujii, Toshiharu, Correia, Luis CL, Kawashiri, Masa-aki, García Acuña, José María, Southern, Danielle, Alfonso, Emilio, Terol, Belén, Garay, Alberto, Zhang, Dongfeng, Chen, Yalei, Xanthopoulou, Ioanna, Osman, Neriman, Möllmann, Helge, Shiomi, Hiroki, Giordana, Francesca, Kowara, Michal, Filipiak, Krzysztof, Wang, Xiao, Yan, Yan, Fan, Jing-Yao, Ikari, Yuji, Nakahashi, Takuya, Sakata, Kenji, Gaita, Fiorenzo, Yamagishi, Masakazu, Kalpak, Oliver, and Kedev, Sasko

Abstract

Background: The prevalence and outcome of patients with cancer that experience acute coronary syndrome (ACS) have to be determined.Methods and results: The BleeMACS project is a multicentre observational registry enrolling patients with acute coronary syndrome undergoing percutaneous coronary intervention worldwide in 15 hospitals. The primary endpoint was a composite event of death and re-infarction after one year of follow-up. Bleedings were the secondary endpoint. 15,401 patients were enrolled, 926 (6.4%) in the cancer group and 14,475 (93.6%) in the group of patients without cancer. Patients with cancer were older (70.8±10.3 vs. 62.8±12.1 years, P<0.001) with more severe comorbidities and presented more frequently with non-ST-segment elevation myocardial infarction compared with patients without cancer. After one year, patients with cancer more often experienced the composite endpoint (15.2% vs. 5.3%, P<0.001) and bleedings (6.5% vs. 3%, P<0.001). At multiple regression analysis the presence of cancer was the strongest independent predictor for the primary endpoint (hazard ratio (HR) 2.1, 1.8–2.5, P<0.001) and bleedings (HR 1.5, 1.1–2.1, P=0.015). Despite patients with cancer generally being undertreated, beta-blockers (relative risk (RR) 0.6, 0.4–0.9, P=0.05), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (RR 0.5, 0.3–0.8, P=0.02), statins (RR 0.3, 0.2–0.5, P<0.001) and dual antiplatelet therapy (RR 0.5, 0.3–0.9, P=0.05) were shown to be protective factors, while proton pump inhibitors (RR 1, 0.6–1.5, P=0.9) were neutral.Conclusion: Cancer has a non-negligible prevalence in patients with acute coronary syndrome undergoing percutaneous coronary intervention, with a major risk of cardiovascular events and bleedings. Moreover, these patients are often undertreated from clinical despite medical therapy seems to be protective. Registration:The BleeMACS project (NCT02466854).

Published
2018
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17. Zofenopril and ramipril and acetylsalicylic acid in postmyocardial infarction patients with left ventricular systolic dysfunction: a retrospective analysis in hypertensive patients of the SMILE-4 study

Author

Borghi, Claudio, Ambrosioni, Ettore, Omboni, Stefano, Cicero, Arrigo F. G., Bacchelli, Stefano, Esposti, Daniela D., Vinereanu, Dragos, Ambrosio, Giuseppe, Zava, Dario, SMILE-4 Working Party: Dimitrios Alexopolulus, Mario Garcia Alvés, Aurora Andrade, Marco Agrusta, Antonio Barsotti, Serena Bergerone, Luigi Caliendo, Pio Caso, Antonio Castello, Domenico Cianflone, Tommaso Cipolla, Gaetano De Ferrari, Giuseppe De Nittis, Livio Dei Cas, Paolo Di Pasquale, Rosario Evola, Luciano Fattore, Raffaele Ferrante, Antonio Fiscella, Achille Gaspardone, Giuseppe Ielasi, Niccol ‘o Marchionni, Giancarlo Marenzi, Filippo Marte, Federico Miccoli, Patrizia Noussan, Ioannis Nanas, Salvatore Novo, Mario Orlandi, Giancarlo Piovaccari, Maurizio Porcu, Patrizia Presbitero, Antonio Raviele, Emiliano Renaldini, Jorge Uriarte Salerno, Giovanni Storti, Corrado Tamburino, Pierfranco Terrosu, Roberto Testa, Rita Trinchero, Bernardino Tuccillo, Ludovico Vasquez, Giovanni Quinto Villani, Claudio, Borghi, Ettore, Ambrosioni, Stefano, Omboni, Arrigo F. G., Cicero, Stefano, Bacchelli, Daniela D., Esposti, Dragos, Vinereanu, Giuseppe, Ambrosio, Dario, Zava, Working Party: Dimitrios Alexopolulus, SMILE-4, Garcia Alvés, Mario, Andrade, Aurora, Agrusta, Marco, Barsotti, Antonio, Bergerone, Serena, Caliendo, Luigi, Caso, Pio, Castello, Antonio, Cianflone, Domenico, Cipolla, Tommaso, De Ferrari, Gaetano, De Nittis, Giuseppe, Dei Cas, Livio, Di Pasquale, Paolo, Evola, Rosario, Fattore, Luciano, Ferrante, Raffaele, Fiscella, Antonio, Gaspardone, Achille, Ielasi, Giuseppe, ‘o Marchionni, Niccol, Marenzi, Giancarlo, Marte, Filippo, Miccoli, Federico, Noussan, Patrizia, Nanas, Ioanni, Novo, Salvatore, Orlandi, Mario, Piovaccari, Giancarlo, Porcu, Maurizio, Presbitero, Patrizia, Raviele, Antonio, Renaldini, Emiliano, Uriarte Salerno, Jorge, Storti, Giovanni, Tamburino, Corrado, Terrosu, Pierfranco, Testa, Roberto, Trinchero, Rita, Tuccillo, Bernardino, Vasquez, Ludovico, Quinto Villani, Giovanni, Claudio Borghi, Ettore Ambrosioni, Stefano Omboni, Arrigo F.G. Cicero, Stefano Bacchelli, Daniela D. Esposti, Dragos Vinereanu, Giuseppe Ambrosio, Dario Zava, and on behalf of the SMILE-4 Working Party

Subjects
Male, Captopril, Physiology, Myocardial Infarction, Infarction, Blood Pressure, law.invention, chemistry.chemical_compound, Ventricular Dysfunction, Left, Randomized controlled trial, Ramipril, Retrospective Studie, law, Retrospective analysis, zofenopril, Myocardial infarction, Randomized Controlled Trials as Topic, left ventricular dysfunction, Middle Aged, humanities, Zofenopril, Europe, Antihypertensive Agent, angiotensin-converting enzyme inhibitor, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, Human, medicine.drug, arterial hypertension, medicine.medical_specialty, acute myocardial infarction, Internal medicine, Internal Medicine, medicine, Humans, cardiovascular diseases, Risk factor, Antihypertensive Agents, Aged, Retrospective Studies, Aspirin, business.industry, Platelet Aggregation Inhibitor, Retrospective cohort study, acetylsalicylic acid, medicine.disease, chemistry, business, Platelet Aggregation Inhibitors
Abstract

BACKGROUND: Antecedent hypertension represents a risk factor for adverse outcomes in survivors of acute myocardial infarction (AMI). Prognosis of such patients might be greatly improved by drugs enhancing blood pressure control. In the present retrospective analysis of the randomized, double-blind, parallel-group, SMILE-4 study we compared the efficacy of zofenopril 60 mg and acetylsalicylic acid (ASA) 100 mg versus ramipril 10 mg and ASA in patients with AMI complicated by left ventricular dysfunction, classified according to a history of hypertension. METHODS: The primary study end-point was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Hypertension was defined according to medical history and current blood pressure values at entry and could be determined in 682 of 716 patients of the intention-to-treat analysis. RESULTS: One hundred and fifty-seven patients (23%) were normotensives and 525 (77%) hypertensives. In the normotensive population the primary end-point occurred in 19 of 76 zofenopril-treated patients (25%) and in 23 of 81 ramipril-treated patients (28%) [odds ratio (95% confidence interval): 0.84 (0.41-1.71), P = 0.631]. In the hypertensive population, major cardiovascular outcomes were reported in 84 of 273 zofenopril-treated patients (31%) and in 99 of 252 ramipril-treated patients (39%), with a 31% significantly (P = 0.041) lower risk with zofenopril [0.69 (0.48-0.99)]. The superiority of zofenopril versus ramipril was particularly evident in patients with isolated systolic hypertension [n = 131, 0.48 (0.23-0.99), P = 0.045]. CONCLUSION: This retrospective analysis of the SMILE-4 study confirmed the good efficacy of zofenopril and ASA in the prevention of long-term cardiovascular outcomes also in the subgroup of patients with hypertension.

Published
2013

18. Diagnostic accuracy of functional, imaging and biochemical tests for patients presenting with chest pain to the emergency department: A systematic review and meta-analysis.

Author

Iannaccone M, Gili S, De Filippo O, D'Amico S, Gagliardi M, Bertaina M, Mazzilli S, Rettegno S, Bongiovanni F, Gatti P, Ugo F, Boccuzzi GG, Colangelo S, Prato S, Moretti C, D'Amico M, Noussan P, Garbo R, Hildick-Smith D, Gaita F, and D'Ascenzo F

Subjects
Acute Coronary Syndrome diagnostic imaging, Biomarkers blood, Chest Pain diagnostic imaging, Echocardiography, Stress methods, Emergency Service, Hospital, Exercise Test methods, Female, Glycopeptides blood, Humans, Male, Middle Aged, Prospective Studies, Radionuclide Imaging methods, Sensitivity and Specificity, Troponin T blood, Acute Coronary Syndrome blood, Chest Pain blood, Coronary Vessels diagnostic imaging, Myocardial Perfusion Imaging methods, Tomography, X-Ray Computed methods
Abstract

Background: Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined., Methods: Medline, Cochrane Library CENTRAL, EMBASE and Biomed Central were systematically screened (start date 1 September 2016, end date 1 December 2016). Prospective studies (observational or randomised controlled trial) comparing functional/imaging or biochemical tests for patients presenting with chest pain to the emergency department were included., Results: Overall, 77 studies were included, for a total of 49,541 patients (mean age 59.9 years). Fast and six-hour highly sensitive troponin T protocols did not show significant differences in their ability to detect acute coronary syndromes, as they reported a sensitivity and specificity of 0.89 (95% confidence interval 0.79-0.94) and 0.84 (0.74-0.9) vs 0.89 (0.78-0.94) and 0.83 (0.70-0.92), respectively. The addition of copeptin to troponin increased sensitivity and reduced specificity, without improving diagnostic accuracy. The diagnostic value of non-invasive tests for patients without troponin increase was tested. Coronary computed tomography showed the highest level of diagnostic accuracy (sensitivity 0.93 (0.81-0.98) and specificity 0.90 (0.93-0.94)), along with myocardial perfusion scintigraphy (sensitivity 0.85 (0.77-0.91) and specificity 0.92 (0.83-0.96)). Stress echography was inferior to coronary computed tomography but non-inferior to myocardial perfusion scintigraphy, while exercise testing showed the lower level of diagnostic accuracy., Conclusions: Fast and six-hour highly sensitive troponin T protocols provide an overall similar level of diagnostic accuracy to detect acute coronary syndrome. Among the non-invasive ischaemia tests for patients without troponin increase, coronary computed tomography and myocardial perfusion scintigraphy showed the highest sensitivity and specificity.

Published
2019
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19. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy.

Author

Iannaccone M, D'Ascenzo F, Vadalà P, Wilton SB, Noussan P, Colombo F, Raposeiras Roubín S, Abu Assi E, González-Juanatey JR, Simao Henriques JP, Saucedo J, Kikkert WJ, Nuñez-Gil I, Ariza-Sole A, Song XT, Alexopoulos D, Liebetrau C, Kawaji T, Moretti C, Garbo R, Huczek Z, Nie SP, Fujii T, Correia LC, Kawashiri MA, García Acuña JM, Southern D, Alfonso E, Terol B, Garay A, Zhang D, Chen Y, Xanthopoulou I, Osman N, Möllmann H, Shiomi H, Giordana F, Kowara M, Filipiak K, Wang X, Yan Y, Fan JY, Ikari Y, Nakahashi T, Sakata K, Gaita F, Yamagishi M, Kalpak O, and Kedev S

Subjects
Acute Coronary Syndrome complications, Acute Coronary Syndrome surgery, Aged, Asia epidemiology, Europe epidemiology, Female, Humans, Male, Middle Aged, Neoplasms complications, North America epidemiology, Prevalence, South America epidemiology, Survival Rate trends, Treatment Outcome, Acute Coronary Syndrome epidemiology, Neoplasms epidemiology, Percutaneous Coronary Intervention, Postoperative Complications epidemiology, Registries, Risk Assessment
Abstract

Background: The prevalence and outcome of patients with cancer that experience acute coronary syndrome (ACS) have to be determined., Methods and Results: The BleeMACS project is a multicentre observational registry enrolling patients with acute coronary syndrome undergoing percutaneous coronary intervention worldwide in 15 hospitals. The primary endpoint was a composite event of death and re-infarction after one year of follow-up. Bleedings were the secondary endpoint. 15,401 patients were enrolled, 926 (6.4%) in the cancer group and 14,475 (93.6%) in the group of patients without cancer. Patients with cancer were older (70.8±10.3 vs. 62.8±12.1 years, P<0.001) with more severe comorbidities and presented more frequently with non-ST-segment elevation myocardial infarction compared with patients without cancer. After one year, patients with cancer more often experienced the composite endpoint (15.2% vs. 5.3%, P<0.001) and bleedings (6.5% vs. 3%, P<0.001). At multiple regression analysis the presence of cancer was the strongest independent predictor for the primary endpoint (hazard ratio (HR) 2.1, 1.8-2.5, P<0.001) and bleedings (HR 1.5, 1.1-2.1, P=0.015). Despite patients with cancer generally being undertreated, beta-blockers (relative risk (RR) 0.6, 0.4-0.9, P=0.05), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (RR 0.5, 0.3-0.8, P=0.02), statins (RR 0.3, 0.2-0.5, P<0.001) and dual antiplatelet therapy (RR 0.5, 0.3-0.9, P=0.05) were shown to be protective factors, while proton pump inhibitors (RR 1, 0.6-1.5, P=0.9) were neutral., Conclusion: Cancer has a non-negligible prevalence in patients with acute coronary syndrome undergoing percutaneous coronary intervention, with a major risk of cardiovascular events and bleedings. Moreover, these patients are often undertreated from clinical despite medical therapy seems to be protective. Registration:The BleeMACS project (NCT02466854).

Published
2018
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