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Piccolo R, Gioia GD, Niglio T, D’Anna C, Rosa RD, Strisciuglio T, Bevilacqua M, Piscione F, Cirillo P, Galasso G. Pharmacotherapeutic Considerations for the Use of Prasugrel and Ticagrelor to Reduce Stent Thrombosis in Patients With Acute Coronary Syndrome. Angiology 2012; 65:130-6. [DOI: 10.1177/0003319712467530] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the improvement in stent technology, stent thrombosis (ST), a potentially catastrophic event, still occurs. Among several risk factors for ST, high on-treatment platelet reactivity to clopidogrel has been demonstrated to play a role, occurring in about one-third of the patients. In order to overcome this limitation, prasugrel and ticagrelor, newer P2Y12 inhibitors, have been developed and approved for clinical use. Two large clinical trials, TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet inhibitioN with prasugrel-thrombolysis in myocardial infarction (TRITON-TIMI) 38 and Study of Platelet Inhibition and Patient Outcomes (PLATO), evaluated these drugs in patients with acute coronary syndrome (ACS), showing a significant improvement in efficacy end points (including a prominent reduction in ST occurrence) compared to clopidogrel. In contrast, the TRILOGY ACS trial found no benefit with prasugrel compared to clopidogrel in patients with medically treated ACS. The aim of this review is to consider decision-making strategies between prasugrel and ticagrelor in daily clinical practice.
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Citro R, Giudice R, Mirra M, Bottiglieri G, Bossone E, Di Benedetto G, Piscione F. Tako-tsubo syndrome soon after caesarean delivery: two case reports. Int J Cardiol 2012; 161:e48-9. [DOI: 10.1016/j.ijcard.2012.04.073] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/08/2012] [Indexed: 10/28/2022]
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103
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Campanile A, Sozzi F, Consonni D, Piscione F, Sganzerla P, Indolfi C, Stabile A, Migliorini A, Ferraresi R, Boccuzzi G, Danzi GB. TCT-459 Long-Term Outcome in Patients with ST-Elevation Myocardial Infarction and Infarct-Related Coronary Artery Ectasia treated with Primary Percutaneous Coronary Intervention. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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104
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Savonitto S, Cavallini C, Petronio AS, Murena E, Antonicelli R, Sacco A, Steffenino G, Bonechi F, Mossuti E, Manari A, Tolaro S, Toso A, Daniotti A, Piscione F, Morici N, Cesana BM, Jori MC, De Servi S. Early Aggressive Versus Initially Conservative Treatment in Elderly Patients With Non–ST-Segment Elevation Acute Coronary Syndrome. JACC Cardiovasc Interv 2012; 5:906-16. [DOI: 10.1016/j.jcin.2012.06.008] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 05/29/2012] [Accepted: 06/07/2012] [Indexed: 01/12/2023]
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105
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Marfella R, Sasso FC, Siniscalchi M, Paolisso P, Rizzo MR, Ferraro F, Stabile E, Sorropago G, Calabrò P, Carbonara O, Cinquegrana G, Piscione F, Ruocco A, D'Andrea D, Rapacciuolo A, Petronella P, Bresciani A, Rubino P, Mauro C, Paolisso G. Peri-procedural tight glycemic control during early percutaneous coronary intervention is associated with a lower rate of in-stent restenosis in patients with acute ST-elevation myocardial infarction. J Clin Endocrinol Metab 2012; 97:2862-71. [PMID: 22639289 DOI: 10.1210/jc.2012-1364] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE We examined the effects of peri-procedural intensive glycemic control (IGC) during early percutaneous coronary intervention (PCI) on restenosis rate in hyperglycemic patients with ST-segment elevation myocardial infarction (STEMI). RESEARCH DESIGN AND METHODS A total of 165 hyperglycemic patients (glucose ≥ 140 mg/dl) with first STEMI undergoing PCI were studied. Patients were randomized to IGC for almost 24 h after PCI (n = 82; glucose, 80-140 mg/dl) followed by multidose sc insulin during the hospital stay or conventional glycemic control (CGC; n = 83; glucose, 180-200 mg/dl) followed by conventional therapy. Coronary angiography was performed at study entry and at 6-month follow-up. Blood samples for glycemia, hemoglobin A1c, inflammatory markers (C-reactive protein and TNF-α), monocyte chemoattractant-protein-1, and oxidative stress (nitrotyrosine) were collected immediately before and 24 h, 30 and 180 d after PCI. RESULTS After insulin infusion, mean plasma glucose during the peri-procedural period was greater in the CGC group than in the IGC group (CGC, 191 ± 15 mg/dl; IGC, 145 ± 35 mg/dl; P < 0.001). After the insulin infusion period, the levels of markers of oxidative stress (nitrotyrosine), inflammation (C-reactive protein, TNF-α), and monocyte chemoattractant-protein-1 were significantly higher in CGC patients compared with IGC patients. Moreover, ICG during PCI reduces restenosis by half (48 and 24%) at 6 months. During follow-up, there was no difference in mortality rates, glucose, inflammatory and oxidative stress markers among the groups. In-stent restenosis was positively associated with mean plasma glucose levels as well as oxidative stress and inflammatory markers during the insulin infusion period. CONCLUSIONS In hyperglycemic patients with STEMI, optimal peri-procedural glycemic control by reducing oxidative stress and inflammation may improve the outcome after PCI.
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Giugliano G, Di Serafino L, Perrino C, Schiano V, Laurenzano E, Cassese S, De Laurentis M, Schiattarella GG, Brevetti L, Sannino A, Gargiulo G, Franzone A, Indolfi C, Piscione F, Trimarco B, Esposito G. Effects of successful percutaneous lower extremity revascularization on cardiovascular outcome in patients with peripheral arterial disease. Int J Cardiol 2012; 167:2566-71. [PMID: 22790191 DOI: 10.1016/j.ijcard.2012.06.055] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 06/11/2012] [Accepted: 06/16/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lower extremity peripheral arterial disease (LE-PAD) reduces walking capacity and is associated with an increased cardiovascular risk. Endovascular revascularization of LE-PAD improves walking performance and quality of life. In the present study, we determined whether successful lower limbs revascularization also impacts cardiovascular outcome in LE-PAD patients. METHODS 479 consecutive LE-PAD patients at stage II of Fontaine's classification, with ankle/brachial index ≤ 0.90 and one or more stenosis >50% in at least one leg artery, were enrolled in the study. According to the Trans-Atlantic Inter Society Consensus II recommendations, 264 (55.1%) underwent percutaneous lower extremity angioplasty (PTA group), while 215 (44.9%) were managed with conservative therapy (MT group). The incidence of major cardiovascular events (including cardiovascular death, myocardial infarction, ischemic stroke, coronary and carotid revascularizations) was prospectively analyzed by Kaplan-Meier curves. Crude and adjusted HRs (95% CI) of developing a cardiovascular event were calculated by Cox analysis. RESULTS No baseline differences were observed among the groups, except for a lower maximum walking distance in the PTA group. During a median follow-up of 21 months (12.0-29.0), the incidence of cardiovascular events was markedly lower in PTA compared to MT patients (6.4% vs. 16.3%; p=0.003), and patients in the MT group showed a 4.1-fold increased cardiovascular risk compared to patients in the PTA group, after adjustment for potential confounders (95% CI 1.22-13.57, p=0.023). CONCLUSIONS This study shows that successful revascularization of LE-PAD patients affected by intermittent claudication, in addition to improving functional status, reduces the occurrence of future major cardiovascular events.
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Galasso G, Piccolo R, Cassese S, Esposito G, Cirillo P, Leosco D, Rapacciuolo A, Sirico D, De Biase C, Niglio T, Piscione F. Unrestricted use of endeavor resolute zotarolimus-eluting stent in daily clinical practice: a prospective registry. THE JOURNAL OF INVASIVE CARDIOLOGY 2012; 24:251-255. [PMID: 22684376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND To evaluate the safety and efficacy of unrestricted Endeavor Resolute zotarolimus-eluting stent (ZES) use. Furthermore, we sought to evaluate clinical outcomes associated with on- and off-label use of Resolute ZES. METHODS The current study was a prospective, single-center registry. The primary endpoint was major adverse cardiac events (MACE), defined as the composite of death, myocardial infarction (MI), and target-vessel revascularization (TVR). Secondary endpoints were death, MI, TVR, and stent thrombosis (ST). RESULTS A total of 370 patients were prospectively enrolled. Off-label Resolute ZES use was performed in 311 patients (84%). At a mean follow-up of 17.3 ± 6 months, MACE occurred in 31 patients (8.5%), death in 15 (4.1%), MI in 10 (2.7%), and TVR in 19 (5.2%). Definite, probable, and possible ST occurred in 9 patients (2.5%). Off-label Resolute ZES implantation, as compared to on-label use, was not associated with an increased risk of MACE (9.4% vs 3.4%; P=.13), death (4.9% vs 0%; P=.14), MI (3.3% vs 0%; P=.38), and TVR (5.5% vs 3.4%; P=.75). On multivariable analysis, previous revascularization (P=.008), but not off-label Resolute ZES implantation (P=.07), was associated with MACE. CONCLUSIONS In daily clinical practice, Resolute ZES was mostly implanted in patients with off-label indications and associated with a relatively low rate of MACE and TVR.
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Piccolo R, Cassese S, Galasso G, Niglio T, De Rosa R, De Biase C, Piscione F. Long-term clinical outcomes following sirolimus-eluting stent implantation in patients with acute myocardial infarction. A meta-analysis of randomized trials. Clin Res Cardiol 2012; 101:885-93. [PMID: 22588843 DOI: 10.1007/s00392-012-0472-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 04/26/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to perform a meta-analysis of randomized trials, evaluating the long-term outcomes of sirolimus-eluting stents (SES) versus bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND Despite short-term outcomes of patients with STEMI undergoing primary percutaneous coronary intervention indicate a benefit of SES in terms of reintervention, several concerns remain on the long-term safety and efficacy of SES. METHODS A systematic literature search of electronic resources, through October 2011, was performed using specific search terms. Included trials were randomized studies comparing SES to BMS in STEMI patients, with a follow-up ≥3 years. RESULTS Seven trials were included, with a total of 2,364 patients. At a median follow-up of 3 years, SES significantly reduced the risk of target-vessel revascularization when compared with BMS [odds ratio (OR), 0.44; 95 % confidence interval (CI), 0.34-0.57; p < 0.0001], without increasing the risk of mortality (OR 0.78; 95 % CI, 0.57-1.08; p = 0.14), reinfarction (OR 0.91; 95 % CI, 0.61-1.35, p = 0.64) and early to late stent thrombosis (OR 0.77; 95 % CI, 0.49-1.20; p = 0.25). However after the first year, SES did not further reduce target-vessel revascularization (OR 1.06; 95 % CI, 0.64-1.74; p = 0.83) and increased the risk of very late stent thrombosis (OR 2.81; 95 % CI, 1.33-5.92; p = 0.007). CONCLUSIONS At long-term follow-up, SES compared to BMS use in STEMI patients reduces the risk of target-vessel revascularization, without increasing the risk of death and reinfarction. However, the strong SES efficacy is counterbalanced by a significant risk of very late stent thrombosis.
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Biondi-Zoccai G, Valgimigli M, Margheri M, Marzocchi A, Lettieri C, Stabile A, Petronio AS, Binetti G, Bolognese L, Bellone P, Sardella G, Contarini M, Sheiban I, Marra S, Piscione F, Romeo F, Colombo A, Sangiorgi G. Assessing the role of eptifibatide in patients with diffuse coronary disease undergoing drug-eluting stenting: the INtegrilin plus STenting to Avoid myocardial Necrosis Trial. Am Heart J 2012; 163:835.e1-7. [PMID: 22607870 DOI: 10.1016/j.ahj.2012.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 02/05/2012] [Indexed: 02/05/2023]
Abstract
BACKGROUND The optimal antiplatelet regimen in elective patients undergoing complex percutaneous coronary interventions (PCIs) is uncertain. We aimed to assess the impact of glycoprotein IIb/IIIa (GpIIb/IIIa) inhibition with eptifibatide in clinically stable subjects with diffuse coronary lesions. METHODS Patients with stable coronary artery disease undergoing PCI by means of implantation of >33 mm of drug-eluting stent were single-blindedly randomized to heparin plus eptifibatide versus heparin alone. The primary end point was the rate of abnormal post-PCI creatine kinase-MB mass values. Secondary end points were major adverse cardiovascular events (MACEs) (ie, cardiac death, myocardial infarction, or urgent revascularization) and MACE plus bailout GpIIb/IIIa inhibitor use. RESULTS The study was stopped for slow enrollment and funding issues after including a total of 91 patients: 44 were randomized to heparin plus eptifibatide, and 47, to heparin alone. Analysis for the primary end point showed a trend toward lower rates of abnormal post-PCI creatine kinase-MB mass values in the heparin-plus-eptifibatide group (18 [41%]) versus the heparin-alone group (26 [55%], relative risk 0.74 [95% CI 0.48-1.15], P = .169). Similar nonstatistically significant trends were found for rates of MACE, their components, or MACE plus bailout GpIIb/IIIa inhibitors (all P > .05). Notably, heparin plus eptifibatide proved remarkably safe because major bleedings or minor bleeding was uncommon and nonsignificantly different in both groups (all P > .05). CONCLUSIONS Given its lack of statistical power, the INSTANT study cannot definitively provide evidence against or in favor of routine eptifibatide administration in stable patients undergoing implantation of multiple drug-eluting stent for diffuse coronary disease. However, the favorable trend evident for the primary end point warrants further larger randomized studies.
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Galasso G, Niglio T, De Luca S, De Biase C, Parisi V, Piscione F. Impact of bivalirudin and Genous stent in patients with acute myeloid leukemia undergoing emergency percutaneous coronary angioplasty for acute coronary syndrome [corrected]. Leukemia 2012; 26:2300-1. [PMID: 22466223 DOI: 10.1038/leu.2012.93] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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111
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Contaldi C, Losi MA, Rapacciuolo A, Prastaro M, Lombardi R, Parisi V, Parrella LS, Di Nardo C, Giamundo A, Puglia R, Esposito G, Piscione F, Betocchi S. Percutaneous treatment of patients with heart diseases: selection, guidance and follow-up. A review. Cardiovasc Ultrasound 2012; 10:16. [PMID: 22452829 PMCID: PMC3364155 DOI: 10.1186/1476-7120-10-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 03/27/2012] [Indexed: 01/30/2023] Open
Abstract
Aortic stenosis and mitral regurgitation, patent foramen ovale, interatrial septal defect, atrial fibrillation and perivalvular leak, are now amenable to percutaneous treatment. These percutaneous procedures require the use of Transthoracic (TTE), Transesophageal (TEE) and/or Intracardiac echocardiography (ICE). This paper provides an overview of the different percutaneous interventions, trying to provide a systematic and comprehensive approach for selection, guidance and follow-up of patients undergoing these procedures, illustrating the key role of 2D echocardiography.
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Cassese S, Esposito G, Mauro C, Varbella F, Carraturo A, Montinaro A, Cirillo P, Galasso G, Rapacciuolo A, Piscione F. MGUard versus bAre-metal stents plus manual thRombectomy in ST-elevation myocarDial infarction pAtieNts-(GUARDIAN) trial: study design and rationale. Catheter Cardiovasc Interv 2012; 79:1118-26. [PMID: 22105879 DOI: 10.1002/ccd.23405] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2011] [Accepted: 10/02/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND Distal embolization may decrease coronary and myocardial reperfusion after percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI). In this setting, manual thrombectomy (MT) resulted in better perfusion and clinical outcomes when compared with "conventional" PCI (direct stenting or stenting after predilation). MGuard net protective stent (MGS, Inspire-MD, Tel-Aviv, Israel) is a new bare-metal stent (BMS) with a polyethylene theraphthalate mesh coverage anchored to the external surface of the struts aiming to minimize distal embolization during PCI. PURPOSE We intend to determine whether MGS implantation is comparable with a strategy of MT pretreatment followed by BMS deployment. STUDY DESIGN The MGUard versus bAre-metal stents plus manual thRombectomy in ST-elevation myocarDial Infarction pAtieNts (GUARDIAN) is a multicentre, prospective, randomized, noninferiority, open-label trial with a planned inclusion of 556 STEMI patients. Patients are assigned to treatment with MGS or MT pretreatment followed by BMS implantation in the infarct-related artery. All patients are treated medically according to current international guidelines. Randomization is performed before coronary angiography. The primary endpoint is complete (≥ 70%) ST-segment resolution at 60 min after PCI. Secondary endpoints are thrombolysis in myocardial infarction (TIMI) coronary flow grade ≥ 2, corrected TIMI frame count <23, myocardial blush grade of the infarct related area ≥ 2, and major adverse cardiac events rate at 30-day, 6-month, and 1-year follow-up. A cardiac magnetic resonance imaging substudy is planned to investigate microvascular obstruction and infarct size area reduction, at prespecified time-points, among 80 consecutive patients enrolled. CONCLUSIONS If MGS implantation is noninferior to a strategy of MT pretreatment followed by BMS deployment, it will lend support to the use of this treatment as another possible option for STEMI patients undergoing PCI.
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Madan M, Tan M, Halvorsen S, Westernout CM, Cantor W, May MRL, Borgia F, Piscione F, Mario CD, Scheller B, Armstrong P, Fernandez-Aviles F, Sanchez PL, Graham J, Yan A, Goodman S. TIMING OF ANGIOGRAPHY AND CLINICAL OUTCOMES AFTER FIBRINOLYSIS: A PATIENT-LEVEL ANALYSIS OF RANDOMIZED EARLY INVASIVE CLINICAL TRIALS. J Am Coll Cardiol 2012. [DOI: 10.1016/s0735-1097(12)60354-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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114
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De Rosa R, Piccolo R, Cassese S, Petretta A, D'Andrea C, D'Anna C, Piscione F, Chiariello M. Coronary flow reserve evaluation: basics, techniques and clinical applications. Minerva Cardioangiol 2011; 59:569-580. [PMID: 19946255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Coronary flow reserve is a useful physiologic parameter providing information on coronary stenoses severity. To date, the gold standard to evaluate coronary flow reserve consists of fractional flow reserve (FFR) measurement, assessed with a pressure-wire. The FFR has a high lesion specificity, due to insensitivity to patient hemodynamic status and to coronary microvascular resistance; it shows low inter- and intraindividual variability and a well-defined, bound cut-off range values (0.75-0.80). Several reports confirmed that FFR has high reproducibility and feasibility in patients with either single- or multi-vessel coronary artery disease, or with both stable and instable coronary artery disease and that is significantly associated with patient outcome. More recently, the FFR has been used as a sensitive marker of successful percutaneous coronary intervention, since postprocedural FFR value strongly predicts patients event-free survival rate after angioplasty. Moreover, it has been demonstrated that abnormal FFR ratios can be also associated with diffused atherosclerotic coronary artery disease in the absence of unique angiographically detectable stenoses requiring revascularization. There are strong evidences supporting that the FFR provides crucial functional information that could be related with morphological endovascular ultrasound findings, with the possibility to achieve same information in a cheaper, easier and more available manner. This review will focus on the current available literature regarding coronary flow reserve quantification and its clinical validation, suggesting and highlighting its current and future clinical applications.
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Cirillo P, Golino P, Piscione F, Cimmino G, Petrillo G, Abbate G, De Palma R. Transcoronary Th-17 lymphocytes and acute coronary syndromes: new evidence from the crime scene? Int J Cardiol 2011; 153:215-6. [DOI: 10.1016/j.ijcard.2011.09.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 09/17/2011] [Indexed: 11/30/2022]
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116
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Cirillo P, Iannelli G, Piscione F. Endovascular treatment of residual type A aortic dissection preserving patency of supra-aortic vessels by implantation of the Djumbodis® system. No more surgery for the aortic arch? THE JOURNAL OF INVASIVE CARDIOLOGY 2011; 23:E251-E253. [PMID: 22045088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A persistent distal false lumen perfusion--residual type A aortic dissection--is found in 50% to 100% of patients following ascending aorta replacement. Complications of persistent or newly developed dissection of the distal aorta are often fatal and require reoperation, leading to a higher morbidity and mortality rate for these patients than with primary surgery. Thus, many efforts have been done to treat this aortic disease by an endovascular approach. Unfortunately, patency of the supra-aortic vessel still remains an unresolved issue. The present report describes the case of a patient with a residual type A aortic dissection persisting after ascending aorta replacement, successfully treated by implantation of a new endovascular device, the Djumbodis® Dissection System, a bare stent with sufficiently large mesh to join the dissected layers without occluding main vital branches such as supra-aortic arteries.
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Sasso FC, Furbatto F, Carbonara O, Nasti R, Morra S, Torella R, Piscione F. Prevalence of diabetes in patients with nonacute CAD. Acta Diabetol 2011; 48:247-8. [PMID: 21347730 DOI: 10.1007/s00592-011-0263-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 01/30/2011] [Indexed: 11/29/2022]
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118
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Graham J, Cantor W, Tan M, Yan A, Le May M, Jolly S, Piscione F, Di Mario C, Scheller B, Armstrong P, Madan M, Halvorsen S, Fernandez-Aviles F, Goodman S. 718 Radial versus femoral access for percutaneous coronary intervention in ST-elevation myocardial infarction patients treated with fibrinolysis: A patient-level meta-analysis of the randomized early routine invasive clinical trials. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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119
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Cassese S, Cirillo P, Dellegrottaglie S, Piscione F, Chiariello M. Acquired left coronary artery fistula draining to the cardiac vein system after acute myocardial infarction revealed by CT scan. Clin Imaging 2011; 35:395-7. [PMID: 21872131 DOI: 10.1016/j.clinimag.2010.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 08/11/2010] [Indexed: 11/19/2022]
Abstract
Coronary artery fistula (CAF) is a congenital condition characterized by a pathological communication between a coronary artery and a systemic vein or one of the cardiac chambers. Iatrogenic CAFs were reported to develop secondary to the rupture of coronary aneurysm. Instances of acquired CAF draining into the cardiac chambers have been described after acute myocardial infarction. Angiography is the gold standard in diagnosing CAF. We describe the case of a patient who developed a fistula draining into the middle cardiac vein on the posterior interventricular sulcus, after acute myocardial infarction, revealed by CT scan.
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Esposito G, Cassese S, Gargiulo G, Sannino A, Schiattarella GG, Piscione F, Chiariello M. Balancing hemorrhagic and thrombotic complications in a patient with a very late paclitaxel-eluting stent thrombosis: a clinical case report. J Cardiovasc Med (Hagerstown) 2011; 12:366-9. [PMID: 20407382 DOI: 10.2459/jcm.0b013e328337583a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Stent thrombosis is a rare but potentially fatal complication of percutaneous treatment of coronary disease. Its occurrence after placement of drug eluting stents (DES) has raised concerns, as this event may occur very late after stent implantation. Here, we report a case of very late stent thrombosis (VLST) experienced 1462 days after DES deployment in a patient with challenging clinical status, requiring counterbalancing hemorrhagic and thrombotic risk factors.
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Cassese S, Piccolo R, Galasso G, Piscione F. Everolimus- versus first generation drug-eluting stents: the never-ending story of searching for a winner in the "limus family". Int J Cardiol 2011; 150:212. [PMID: 21640408 DOI: 10.1016/j.ijcard.2011.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 05/13/2011] [Indexed: 10/18/2022]
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Galasso G, De Rosa R, Piscione F, Iaccarino G, Vosa C, Sorriento D, Piccolo R, Rapacciuolo A, Walsh K, Chiariello M. Myocardial expression of FOXO3a-Atrogin-1 pathway in human heart failure. Eur J Heart Fail 2011; 12:1290-6. [PMID: 21098579 DOI: 10.1093/eurjhf/hfq102] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Several studies have shown that muscle mass loss is an important pathogenic issue in heart failure (HF). Atrogin-1 is a F-box protein selectively expressed in cardiac and skeletal muscle tissue, which plays a pivotal role in muscle wasting regulation. The aim of this study was to investigate the expression of Atrogin-1 and the molecular pathway involved in Atrogin-1 regulation in human HF. METHODS AND RESULTS Cardiac tissue from patients with HF (HF group: n=10) or with normal left ventricular function (control group: n=9) was studied by western blot and real time-PCR analysis. Linear regression analysis between patients left ventricular ejection fraction (LVEF) and Atrogin1 or its regulator Forkhead box O 3a (Foxo3a) myocardial expression was performed to test correlations between protein expression and LVEF. Western blot analysis revealed that the myocardial expression of Atrogin-1 in the HF group was 2.5-fold increased compared with controls (P=0.007). Accordingly, Atrogin-1 mRNA was 1.5 higher than in controls (P=0.003). The expression of Foxo3a and its up-stream regulator AKT were also measured. Western blot analysis demonstrated in the HF group a 2.56-fold reduction of AKT phosphorylation and a 3.32-fold increase of Foxo3a as compared with controls (P=0.002 and P=0.001, respectively). Finally, linear regression showed a significant relationship between Foxo3a or Atrogin-1 expression and LVEF (R=0.976, P<0.0001 and R=0.895, P=0.003, respectively). CONCLUSION Our results suggest that in human HF, the activity of AKT decreases, with activation of Foxo3a and induction of Atrogin-1, thereby leading to a molecular state that favours heart muscle loss and left ventricular dysfunction.
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Iannelli G, Di Tommaso L, Cirillo P, Smimmo R, Piscione F, Vosa C. Treatment of Residual Type A Aortic Dissection With Implantation of the Djumbodis System: Is Purely Endovascular Treatment Becoming a Reality? J Endovasc Ther 2011; 18:368-73. [DOI: 10.1583/11-3397.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Petrillo G, Cirillo P, Prastaro M, D'Ascoli GL, Piscione F. Percutaneous approach to treatment of coronary disease in a patient with uremic cardiomyopathy. World J Cardiol 2011; 3:117-20. [PMID: 21526049 PMCID: PMC3082735 DOI: 10.4330/wjc.v3.i4.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Revised: 04/04/2011] [Accepted: 04/11/2011] [Indexed: 02/06/2023] Open
Abstract
Uremic cardiomyopathy is chronic ischemic left ventricular dysfunction characterized by heart failure, myocardial ischemia, hypotension in dialysis and arrhythmia. This nosologic entity represents a leading cause of morbidity and mortality among patients with end-stage renal disease receiving long-term hemodialysis. It is intuitive that revascularization in the presence of coronary artery disease in these patients represents an effective option for improving their prognosis. Although the surgical option seems to be followed by the best clinical outcome, some patients refuse this option and others are not good candidates for surgery. The present report describes the case of a patient affected by uremic cardiomyopathy and severe coronary artery disease in whom revascularization with percutaneous coronary angioplasty was followed by a significant improvement in quality of life.
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Borgia F, Di Serafino L, Sannino A, Gargiulo G, Schiattarella GG, De Laurentis M, Scudiero L, Perrino C, Piscione F, Esposito G, Chiariello M. AngioJet rheolytic thrombectomy for acute superficial femoral artery stent or femoropopliteal by-pass thrombosis. Monaldi Arch Chest Dis 2011; 74:76-81. [PMID: 21275230 DOI: 10.4081/monaldi.2010.271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Thrombosis of superficial femoral artery (SFA) nitinol stents or polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts after discontinuation of antiplatelet therapy is an emergent clinical challenge of acute limb ischemia (ALI), requiring immediate percutaneous intervention. Currently, there is no evidence-based approach for the management of such complications. We describe the cases of two patients presenting with ALI due to nitinol stent thrombosis after discontinuation of antiplatelet therapy and the case of a patient presenting with ALI due to PTFE femoropopliteal graft thrombosis in which limb salvage was obtained by AngioJet rheolytic thrombectomy and re-stenting. In both cases, the thrombus was successfully removed using the Possis AngioJet mechanical thrombectomy catheter and percutaneous transluminal angioplasty (PTA) was performed to recanalize two femoropopliteal nitinol stents and a femoropopliteal PTFE graft. In both cases, optimal angiographic result was obtained. To the best of our knowledge, these are the first three cases reporting the use of the AngioJet rheolytic thrombectomy in ALI due to stent or graft thrombosis. Taken together, these cases suggest that AngioJet rheolytic thrombectomy might represent a novel effective strategy in the percutaneous treatment of stent or graft thrombosis determining ALI.
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Petrillo G, Cirillo P, Leosco D, Maresca F, Piscione F, Chiariello M. Percutaneous coronary intervention in a patient with acute non-ST-elevation myocardial infarction and haemophilia A: a 'genous' experience. Haemophilia 2011; 17:e245-6. [PMID: 20609013 DOI: 10.1111/j.1365-2516.2010.02355.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Marrone C, Galasso G, Piccolo R, de Leva F, Paladini R, Piscione F, Santoro G. Antiplatelet versus anticoagulation therapy after extracardiac conduit Fontan: a systematic review and meta-analysis. Pediatr Cardiol 2011; 32:32-9. [PMID: 20967441 DOI: 10.1007/s00246-010-9808-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 09/18/2010] [Indexed: 12/01/2022]
Abstract
The benefits of prophylactic anticoagulation or antiplatelet therapy for patients undergoing extracardiac conduit (ECC) Fontan procedure still are a matter of debate. Through a systematic review and meta-analysis, this study aimed to determine the incidence of thromboembolism among patients undergoing ECC Fontan who received anticoagulation or antiplatelet therapy. Until February 2010, MEDLINE studies describing the incidence of thromboembolic events after ECC Fontan were reviewed. Information on type of drugs and clinical outcome was extracted. The 20 studies analyzed involved 1,075 patients: 220 (20.4%) in the antiplatelet group and 855 (79.5%) in the anticoagulation group. The mean follow-up period ranged from 2 to 144 months. The overall thromboembolism rate was 5.2% (95% confidence interval [CI], 3.8-7%; I(2) = 0%; p(het) = 0.32). The effect of different therapeutic strategies on the occurrence of thromboembolic and bleeding events was analyzed. Interestingly, the anticoagulation therapy compared with the antiplatelet therapy was not associated with a significant reduction in the incidence of overall thromboembolic complications (5% vs 4.5%, respectively; I(2) = 0%; p(het) = 0.80). Only two cases of bleeding were observed among patients receiving anticoagulant therapy at the time of the event. For patients undergoing ECC Fontan, the rate of thromboembolic and bleeding events associated with antiplatelet therapy is similar to that associated with anticoagulation therapy.
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Pabari PA, Kyriacou A, Moraldo M, Unsworth B, Baruah R, Sutaria N, Hughes A, Mayet J, Francis DP, Uejima T, Loboz K, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evangelista A, Leftheriotis G, Fraser AG, Kiotsekoglou A, Govindan M, Govind SC, Saha SK, Camm AJ, Azcarate PM, Castano S, Rodriguez-Manero M, Arraiza M, Levy B, Barba J, Rabago G, Bastarrika G, Nemes A, Takacs R, Varkonyi T, Gavaller H, Baczko I, Forster T, Wittmann T, Papp JG, Lengyel C, Varro A, Tumasyan LR, Adamyan KG, Savu O, Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Versiero M, Galderisi M, Esposito R, Rapacciuolo A, Esposito G, Raia R, Morgillo T, Piscione F, De Simone G, Oraby MA, Maklady FA, Mohamed EM, Eraki AZ, Zaliaduonyte-Peksiene D, Tamuleviciute E, Janenaite J, Marcinkeviciene J, Mizariene V, Bucyte S, Vaskelyte J, Trifunovic D, Nedeljkovic I, Popovic D, Ostojic M, Vujisic-Tesic B, Petrovic M, Stankovic S, Sobic-Saranovic D, Banovic M, Dikic-Djordjevic A, Savino K, Lilli A, Grikstaite E, Giglio V, Bordoni E, Maragoni G, Cavallini C, Ambrosio G, Nedeljkovic I, Ostojic M, Vujisic-Tesic B, Jakovljevic B, Petrovic M, Trifunovic D, Beleslin B, Nedeljkovic M, Banovic M, Petrovic O, Moral S, Rodriguez-Palomares J, Descalzo M, Marti G, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Garcia-Dorado D, Schnell F, Donal E, Thebault C, Bernard A, Corbineau H, Le Breton H, Kochanowski J, Scislo P, Piatkowski R, Roik M, Marchel M, Kosior D, Opolski G, Lesniak-Sobelga AM, Wicher-Muniak E, Kostkiewicz M, Olszowska M, Suchon E, Klimeczek P, Banys P, Pasowicz M, Tracz W, Podolec P, Moral S, Rodriguez-Palomares J, Descalzo M, Pineda V, Mahia P, Gutierrez L, Gonzalez-Alujas T, Laynez A, Evangelista A, Garcia-Dorado D, Hoefsten DE, Loegstrup BB, Norager B, Moller JE, Flyvbjerg A, Egstrup K, Streb W, Szulik M, Nowak J, Markowicz-Pawlus E, Duszanska A, Sedkowska A, Kalarus Z, Kukulski T, Spinelli L, Morisco C, Assante Di Panzillo E, Buono F, Crispo S, Trimarco B, Oraby MA, Hawary AA, Nasr GM, Fawzy MM, Faber L, Scholtz W, Boergermann J, Wiemer M, Kleikamp G, Bogunovic N, Dimitriadis Z, Gummert J, Hering D, Horstkotte D, Luca' F, Gelsomino S, Lorusso R, Caciolli S, Carella R, Bille' G, De Cicco G, Pazzagli V, Gensini GF, Borowiec A, Dabrowski R, Janas J, Kraska A, Firek B, Kowalik I, Szwed H, Marcus KA, De Korte CL, Feuth T, Thijssen JM, Kapusta L, Dahl J, Videbaek L, Poulsen MK, Pellikka PA, Veien K, Andersen LI, Haghfelt T, Moller JE, Haberka M, Mizia - Stec K, Adamczyk T, Mizia M, Chmiel A, Pysz P, Sosnowski M, Gasior Z, Trusz - Gluza M, Tendera M, Niklewski T, Wilczek K, Chodor P, Podolecki T, Frycz-Kurek A, Kukulski T, Kalarus Z, Zembala M, Yurdakul S, Yildirimturk O, Tayyareci Y, Memic K, Demiroglu ICC, Aytekin S, Garcia Alonso CJ, Ferrer Sistach E, Delgado L, Lopez Ayerbe J, Vallejo Camazon N, Gual Capllonch F, Espriu Simon M, Ruyra X, Caballero Parrilla A, Bayes Genis A, Lecuyer L, Berrebi A, Florens E, Noghin M, Huerre C, Achouh P, Zegdi R, Fabiani JN, De Chiara B, Moreo A, Musca F, De Marco F, Lobiati E, Belli O, Mauri F, Klugmann S, Caballero A, Vallejo N, Gonzalez Guardia A, Nunez Aragon R, Bosch C, Lopez Ayerbe J, Ferrer E, Pedro Botet ML, Gual F, Bayes Genis A, Cusma-Piccione M, Zito C, Oreto G, Giuffre R, Todaro MC, Barbaro CM, Lanteri S, Longordo C, Salvia J, Carerj S, Bensaid A, Gallet R, Fougeres E, Lim P, Nahum J, Deux JF, Gueret P, Teiger E, Dubois-Rande JL, Monin JL, Yurdakul S, Tayyareci Y, Yildirimturk O, Behramoglu F, Colakoglu Z, Aytekin V, Demiroglu C, Aytekin S, Gargani L, Poggianti E, Bucalo R, Rizzo M, Agrusta F, Landi P, Sicari R, Picano E, Sutandar A, Siswanto BB, Irmalita I, Harimurti G, Hayashi SY, Nascimento MM, Lindholm B, Lind B, Seeberger A, Nowak J, Pachaly MA, Riella MC, Bjallmark A, Brodin LA, Poanta L, Porojan M, Dumitrascu DL, Ikonomidis I, Tzortzis S, Lekakis J, Kremastinos DT, Paraskevaidis I, Andreadou I, Nikolaou M, Katsibri P, Anastasiou-Nana M, Maceira Gonzalez AM, Ripoll C, Cosin-Sales J, Igual B, Salazar J, Belloch V, Cosin-Aguilar J, Pennell DJ, Masaki M, Pulido JN, Yuasa T, Gillespie S, Afessa B, Brown DR, Mankad SV, Oh JK, Gurghean AL, Mihailescu AM, Tudor I, Homentcovschi C, Muraru M, Bruckner IV, Correia CE, Rodrigues B, Moreira D, Santos LF, Gama P, Dionisio O, Cabral C, Santos O, Bombardini T, Gherardi S, Arpesella G, Valente S, Calamai I, Pasanisi E, Sansoni S, Picano E, Szymanski P, Dobrowolski P, Lipczynska M, Klisiewicz A, Hoffman P, Stepowski D, Kurtz B, Grezis-Soulie G, Savoure A, Anselme F, Bauer F, Castillo J, Herszkowicz N, Ferreira C, Goscinska A, Mizia-Stec K, Gasior Z, Mizia M, Haberka M, Chmiel A, Poborski W, Azevedo O, Quelhas I, Guardado J, Fernandes M, Miranda CS, Gaspar P, Lourenco A, Medeiros R, Almeida J, L Bennani S, Algalarrondo V, Dinanian S, Guiader J, Juin C, Adams D, Slama MS, Onaindia JJ, Quintana O, Velasco S, Astigarraga E, Cacicedo A, Gonzalez J, Rodriguez I, Sadaba M, Eneriz M, Laraudogoitia Zaldumbide E, Nunez-Gil I, Luaces M, Zamorano J, Garcia Rubira JC, Vivas D, Ibanez B, Marcos Alberca P, Fernandez Golfin C, Alonso J, Macaya C, Silva Marques J, Almeida AG, Carvalho V, Jorge C, Silva D, Gato Varela M, Martins S, Brito D, Lopes MG, Tripodi E, Miserrafiti B, Montemurro V, Scali R, Tripodi P, Marchel M, Kochanowski J, Piatkowski R, Scislo P, Winkler A, Madej A, Hausmanowa-Petrusewicz I, Opolski G, Fijalkowski M, Koprowski A, Jaguszewski M, Galaska R, Taszner M, Rynkiewicz A, Citro R, Rigo F, Provenza G, Ciampi Q, Patella MM, D'andrea A, Antonini-Canterin F, Vriz O, Astarita C, Bossone E, Heggemann F, Walter TH, Kaelsch TH, Sueselbeck T, Papavassiliu TH, Borggrefe M, Haghi D, Monk-Hansen T, Have Dall C, Bisgaard Christensen S, Snoer M, Gustafsson F, Rasmusen H, Prescott E, Finocchiaro G, Pinamonti B, Merlo M, Barbati G, Di Lenarda A, Bussani R, Sinagra G, Butz T, Faber L, Lang CN, Meissner A, Plehn G, Yeni H, Langer C, Horstkotte D, Trappe HJ, Gu X, Gu XY, He YH, Li ZA, Han JC, Chen J, Gaudron P, Niemann M, Herrmann S, Hu K, Bijnens B, Hillenbrand H, Beer M, Ertl G, Weidemann F, Mazzone A, Mariani M, Foffa I, Vianello A, Del Ry S, Bevilacqua S, Andreassi MG, Glauber M, Berti S, Kochanowski J, Scislo P, Piatkowski R, Grabowski M, Roik M, Postula M, Marchel M, Kosior D, Opolski G, Dragulescu A, Van Arsdell G, Al-Radi O, Caldarone C, Mertens L, Lee KJ, Unsworth B, Casula RP, Yadav H, Baruah R, Cherian A, Sutaria N, Hughes AD, Mayet J, Francis DP, Vitarelli A, D'orazio S, Nguyen BL, Iorio G, Battaglia D, Caranci F, Padella V, Capotosto L, Alessandroni L, Barilla F, Cardin C, Hascoet S, Saudron M, Caudron G, Arnaudis B, Acar P, Sun MM, Shu XH, Pan CZ, Fang XY, Kong DH, Fang F, Zhang Q, Chan YS, Xie JM, Yip WK, Lam YY, Sanderson JE, Yu CM, Rosca M, O' Connor K, Romano G, Magne J, Calin A, Popescu BA, Muraru D, Pierard L, Ginghina C, Lancellotti P, Roushdy A, Elfiky I, El Shahid G, Elfiky A, El Sayed M, Wierzbowska-Drabik K, Chrzanowski L, Kapusta A, Plonska-Goscinak E, Krzeminska-Pakula M, Kurpesa M, Rechcinski T, Trzos E, Kasprzak JD, Ersboll MK, Valeur N, Mogensen UM, Andersen M, Moller JE, Hassager C, Sogaard P, Kober LV, Kloeckner M, Hayat D, Nahum J, Dussault C, Lellouche N, Elbaz N, Dubois-Rande JL, Gueret P, Lim P, Demopoulos A, Hatzigeorgiou G, Leontiades E, Motsi A, Karatasakis G, Athanassopoulos G, Zycinski P, Chrzanowski L, Wierzbowska-Drabik K, Kasprzak J, Vazquez Alvarez MC, Medrano Lopez C, Camino Lopez M, Granja S, Zunzunegui Martinez JL, Maroto Alvaro E, Tsai WC, Chen JY, Liu YW, Lin CC, Tsai LM, Silva Marques J, Gomes DC, Robalo Martins S, Gois MR, Ribeiro S, Nunes Diogo A, Almeida AG, Lopes MG, Zito C, Sengupta P, Di Bella G, Cusma-Piccione M, Oreto G, Caracciolo G, Longordo C, Lentini S, Carerj S, Kinova E, Zlatareva N, Goudev A, Papagiannis N, Mpouki M, Papagianni A, Vorria M, Mpenetos G, Lytra D, Papadopoulou E, Sgourakis P, Malakos J, Kyriazis J, Saha SK, Kodali V, Toole R, Govind SC, Kiotsekoglou A, Gopal AS, Celutkiene J, Rudys A, Grabauskiene V, Glaveckaite S, Sadauskiene E, Lileikiene Z, Bickauskaite N, Ciburiene E, Skorniakov V, Laucevicius A, Attenhofer Jost CH, Pfyffer M, Lindquist R, Santos JLF, Coelho ORC, Mady CM, Picard MHP, Salemi VMC, Funk L, Butz T, Lang CN, Prull MW, Plehn G, Yeni H, Meissner A, Trappe HJ, Tsai WC, Liu YW, Shih JY, Lin CC, Huang YY, Tsai LM, Lancellotti P, Donal E, Magne J, O'connor K, Moonen M, Pierard LA, Cozma DC, Mornos C, Ionac A, Petrescu L, Dragulescu D, Dan R, Popescu I, Dragulescu SI, Von Lueder TG, Hodt A, Gjerdalen GF, Andersen TE, Solberg EE, Steine K, Savu O, Van Mieghem T, Dekoninck P, Gucciardo L, Jurcut R, Giusca S, Popescu BA, Ginghina C, Deprest J, Voigt JU, Rostek M, Pikto-Pietkiewicz W, Dluzniewski M, Antoniewicz A, Poletajew S, Borowka A, Pasierski T, Malyutina SK, Ryabikov M, Ragino J, Ryabikov A, Sitia S, Tomasoni L, Atzeni F, Gianturco L, Sarzi-Puttini P, De Gennaro Colonna V, Turiel M, Uejima T, Loboz K, Vriz O, Polombo C, Carerj S, Hughes A, Vinereanu D, Gutierrez FR, Lefhtheriotis G, Fraser AG, Hurst RT, Nelson MR, Mookadam F, Thota V, Emani U, Al Harthi M, Stepanek J, Cha S, Lester SJ, Ho EMM, Hemeryck L, Hall M, Scott K, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Santos L, Cortez-Dias N, Silva D, Silva Marques J, Ribeiro S, Goncalves S, Almeida Ribeiro M, Robalo Martins S, Bordalo E Sa A, Lopes MG, Teske AJ, D'Hooge J, Claus P, Rademakers F, Voigt JU, Magnino C, Marcos-Alberca P, Milan A, Nunez-Gil I, Almeria C, Caniadas V, Rodrigo JL, Perez De Isla L, Macaya C, Zamorano JL, Gustafsson U, Larsson M, Bjallmark A, Lindqvist P, Brodin L, Waldenstrom A, Roosens B, Hernot S, Droogmans S, Van Camp G, Lahoutte T, Lancellotti P, Cosyns B, Ho EMM, Scott K, Hemeryck L, Hall M, Bennett K, Mahmud A, Daly C, King G, Murphy RT, Brown AS, Rao CM, Aguglia D, Casciola G, Imbesi C, Marvelli A, Sgro M, Benedetto D, Tripepi R, Zoccali C, Benedetto FA, Muraru D, Badano LP, Cardillo M, Del Mestre L, Gianfagna P, Proclemer A, Tschernich HD, Mora B, Base E, Weber U, Dumfarth J, Mukherjee C, Skaltsiotis HS, Kaladaridis AK, Bramos DB, Kottis GK, Antoniou AA, Agrios IA, Takos DT, Vasiladiotis NV, Pamboucas KP, Toumanidis STT, Shim A, Kasprzak JD, Lipec P, Michalski B, Wozniakowski B, Stefanczyk L, Rotkiewicz A, Cameli M, Lisi M, Padeletti M, Bigio E, Bernazzali S, Tsoulpas C, Maccherini M, Henein M, Mondillo S, Garcia Lunar I, Mingo Santos S, Monivas Palomero V, Mitroi C, Beltran Correas P, Ruiz Bautista L, Muniz Lozano A, Gonzalez Gonzalez M, Pabari PA, Stegemann B, Willson K, Kyriacou A, Moraldo M, Mayet J, Hughes A, Francis DP, Zeppellini R, Iavernaro A, Zadro M, Carasi M, De Domenico R, Rigo T, Artuso E, Erente G, Ramondo A, Le TT, Huang FQ, Gu Y, Tan RS. Poster session II * Thursday 9 December 2010, 14:00-18:00. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010. [DOI: 10.1093/ejechocard/jeq138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Piscione F, Piccolo R, Cassese S. Direct stenting should be attempted by default whenever possible. BRITISH HEART JOURNAL 2010. [DOI: 10.1136/hrt.2010.202309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schiano Lomoriello V, Galderisi M, Rapacciuolo A, Santoro A, Maresca G, Ferrara LA, Piscione F, de Simone G. Serial speckle tracking and successful post-STEMI percutaneous coronary intervention: incremental value versus visual wall motion analysis. J Cardiovasc Med (Hagerstown) 2010; 11:768-71. [DOI: 10.2459/jcm.0b013e3283356f22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Cirillo P, Petrillo G, D’Ascoli GL, Piscione F, Chiariello M. Successful use of the Cardiva Boomerang™ vascular closure device to close a brachial artery puncture site after emergency PTCA. Heart Vessels 2010; 25:565-8. [DOI: 10.1007/s00380-010-0003-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 11/26/2009] [Indexed: 11/28/2022]
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Galasso G, Santulli G, Piscione F, De Rosa R, Trimarco V, Piccolo R, Cassese S, Iaccarino G, Trimarco B, Chiariello M. The GPIIIA PlA2 polymorphism is associated with an increased risk of cardiovascular adverse events. BMC Cardiovasc Disord 2010; 10:41. [PMID: 20846430 PMCID: PMC2954874 DOI: 10.1186/1471-2261-10-41] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 09/16/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The clinical impact of PlA2 polymorphism has been investigated in several diseases, but the definition of its specific role on thrombotic cardiovascular complications has been challenging. We aimed to explore the effect of PlA2 polymorphism on outcome in patients with atherosclerosis. METHODS We studied 400 consecutive patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention. A replication study was conducted in 74 hypertensive patients with cerebrovascular events while a group of 100 healthy subjects was included as control population. PlA genotype was determined by PCR-RFLP on genomic DNA from peripheral blood cells. Major adverse cardiac events (MACE), were considered as end points, and recorded at a mean follow up of 24 ± 4.3 months. RESULTS The frequencies of PlA2 polymorphism was similar between groups and genotype distribution was in Hardy-Weinberg equilibrium. In patients with CAD, the presence of PlA2 allele was associated with higher incidence of cardiac death (13.1% vs. 1.5%, p = 0.0001), myocardial infarction (10.7% vs. 2.6%, p = 0.004) and needs of new revascularization (34.8% vs. 17.7%, p = 0.010). Accordingly, the Kaplan-Meier analysis for event free survival in patients harboring the PlA2 allele showed worse long-term outcome for these patients (p = 0.015). Cox regression analysis identified the presence of PlA2 as an independent predictor of cardiac death (OR: 9.594, 95% CI: 2.6 to 35.3, p = 0.002) and overall MACE (OR: 1.829, 95% CI: 1.054 to 3.176, p = 0.032). In the replication study, the PlA2 polymorphism increased the risk of stroke (OR: 4.1, 95% CI: 1.63-12.4, p = 0.02) over TIA and was identified as an independent risk factor for stroke (B:-1.39; Wald: 7.15; p = 0.001). CONCLUSIONS Our study demonstrates that in patients with severe atherosclerosis the presence of PlA2 allele is associated with thrombotic cardiovascular complications.
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Piscione F, Piccolo R, Cassese S, Galasso G, De Rosa R, D'Andrea C, Chiariello M. Effect of drug-eluting stents in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention: a meta-analysis of randomised trials and an adjusted indirect comparison. EUROINTERVENTION 2010; 5:853-60. [PMID: 20142203 DOI: 10.4244/eijv5i7a143] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS The role of drug-eluting stent (DES) remains an unsettled issue in patients with ST-segment elevation myocardial infarction (STEMI). Therefore, we performed a meta-analysis of randomised trials to evaluate the clinical outcome of DES as compared with bare-metal stent (BMS) after percutaneous coronary intervention (PCI). METHODS AND RESULTS We undertook a literature search until July 2009. Thirteen clinical trials met inclusion criteria, with 7,244 patients enrolled. Up to 1-year, patients treated with DES as compared with BMS experienced less target-vessel revascularisation (TVR) (5.11% versus 11.19% respectively, p<0.00001) and recurrent myocardial infarction rates (3.03% versus 3.70% respectively, p=0.02). In addition, no significant differences were found in terms of cardiac death (2.80% versus 3.52%, p=0.21) and stent thrombosis (2.65% versus 2.76%, p=0.37). Using the adjusted indirect comparison, a significant difference between sirolimus- and paclitaxel-eluting stent was found when TVR was evaluated (OR [95% CI] =0.59 [0.40-0.89], p=0.01), without differences in other clinical outcomes. CONCLUSIONS In patients undergoing PCI for STEMI, treatment with DES is associated with decreased TVR and myocardial infarction rates, without increasing cardiac death or stent thrombosis occurrence. Sirolimus-eluting stent is associated with a greater TVR reduction as compared to paclitaxel-eluting stent.
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Borgia F, Goodman SG, Halvorsen S, Cantor WJ, Piscione F, Le May MR, Fernández-Avilés F, Sánchez PL, Dimopoulos K, Scheller B, Armstrong PW, Di Mario C. Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis. Eur Heart J 2010; 31:2156-69. [PMID: 20601393 DOI: 10.1093/eurheartj/ehq204] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIMS Multiple trials in patients with ST-segment elevation myocardial infarction (STEMI) compared early routine percutaneous coronary intervention (PCI) after successful fibrinolysis vs. standard therapy limiting PCI only to patients without evidence of reperfusion (rescue PCI). These trials suggest that all patients receiving fibrinolysis should receive mechanical revascularization within 24 h from initial hospitalization. However, individual trials could not demonstrate a significant reduction in 'hard' endpoints such as death and reinfarction. We performed a meta-analysis of randomized controlled trials to define the benefits of early PCI after fibrinolysis over standard therapy on clinical and safety endpoints in STEMI. METHODS AND RESULTS We identified seven eligible trials, enrolling a total of 2961 patients. No difference was found in the incidence of death at 30 days between the two strategies. Early PCI after successful fibrinolysis reduced the rate of reinfarction (OR: 0.55, 95% CI: 0.36-0.82; P = 0.003), the combined endpoint death/reinfarction (OR: 0.65, 95% CI: 0.49-0.88; P = 0.004) and recurrent ischaemia (OR: 0.25, 95% CI: 0.13-0.49; P < 0.001) at 30-day follow-up. These advantages were achieved without a significant increase in major bleeding (OR: 0.93, 96% CI: 0.67-1.34; P = 0.70) or stroke (OR: 0.63, 95% CI: 0.31-1.26; P = 0.21). The benefits of a routine invasive strategy over standard therapy were maintained at 6-12 months, with persistent significant reduction in the endpoints reinfarction (OR: 0.64, 95% CI: 0.40-0.98; P = 0.01) and combined death/reinfarction (OR: 0.71, 95% CI: 0.52-0.97; P = 0.03). CONCLUSION Early routine PCI after fibrinolysis in STEMI patients significantly reduced reinfarction and recurrent ischaemia at 1 month, with no significant increase in adverse bleeding events compared to standard therapy. Benefits of early PCI persist at 6-12 month follow-up.
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Dimova I, Hlushchuk R, Makanya A, Djonov V, Theurl M, Schgoer W, Albrecht K, Beer A, Patsch JR, Schratzberger P, Mahata S, Kirchmair R, Didie M, Christalla P, Rau T, Eschenhagen T, Schumacher U, Lin Q, Zenke M, Zimmmermann W, Hoch M, Fischer P, Stapel B, Missol-Kolka E, Erschow S, Scherr M, Drexler H, Hilfiker-Kleiner D, Diebold I, Petry A, Kennel P, Djordjevic T, Hess J, Goerlach A, Castellano J, Aledo R, Sendra J, Costales P, Badimon L, Llorente-Cortes V, Dworatzek E, Mahmoodzadeh S, Regitz-Zagrosek V, Posa A, Varga C, Berko A, Veszelka M, Szablics P, Vari B, Pavo I, Laszlo F, Brandenburger M, Wenzel J, Bogdan R, Richardt D, Reppel M, Hescheler J, Terlau H, Dendorfer A, Heijman J, Rudy Y, Westra R, Volders P, Rasmusson R, Bondarenko V, Ertas Gokhan MD, Ural Ertan MD, Karaoz Erdal PHD, Aksoy Ayca PHD, Kilic Teoman MD, Kozdag Guliz MD, Vural Ahmet MD, Ural Dilek MD, Poulet C, Christ T, Wettwer E, Ravens U, Van Der Pouw Kraan C, Schirmer S, Fledderus J, Moerland P, Leyen T, Piek J, Van Royen N, Horrevoets A, Fleissner F, Jazbutyte V, Fiedler J, Galuppo P, Mayr M, Ertl G, Bauersachs J, Thum T, Protze S, Bussek A, Ravens U, Li F, Hoo R, Lam K, Xu A, Westenbrink B, Maass A, Sillje H, Van Veldhuisen D, Van Gilst W, De Boer R, Biesmans L, Bito V, Driessen R, Holemans P, Subramanian P, Lenaerts I, Huysmans C, Sipido K, Mourouzis I, Pantos C, Galanopoulos G, Gavra M, Perimenis P, Spanou D, Cokkinos D, Karshovska E, Berezin A, Panasenko T, Euler G, Partsch S, Harjung C, Heger J, Bogdanova A, Mihov D, Mocharla P, Yakushev S, Megens R, Vogel J, Gassmann M, Tavakoli R, Johansen D, Sanden E, Xi C, Sundset R, Ytrehus K, Bliksoen M, Rutkovskiy A, Akhtar S, Mariero L, Vaage I, Stenslokken K, Pisarenko O, Shulzhenko V, Studneva I, Serebryakova L, Tskitishvili O, Pelogeykina Y, Timoshin A, Heyll K, Vanin A, Ziberna L, Lunder M, Drevensek G, Passamonti S, Gorza L, Ravara B, Scapin C, Vitadello M, Zigrino F, Jansen Y, Gerosa G, Gwathmey J, Del Monte F, Vilahur G, Juan-Babot O, Onate B, Casani L, Badimon L, Lemoine S, Calmettes G, Weber C, Jaspard-Vinassa B, Duplaa C, Couffinhal T, Diolez P, Dos Santos P, Fusco A, Santulli G, Cipolletta E, Sorriento D, Cervero P, Schober A, Trimarco B, Feliciello A, Iaccarino G, Loganathan S, Barnucz E, Korkmaz S, Hirschberg K, Karck M, Szabo G, Kozichova K, Zafeiriou M, Hlavackova M, Neckar J, Kolar F, Novakova O, Novak F, Kusmic C, Matteucci M, Pelosi G, Vesentini N, Barsanti C, Noack C, Trivella M, Abraham N, L'abbate A, Muntean D, Mirica S, Duicu O, Raducan A, Hancu M, Fira-Mladinescu O, Ordodi V, Renger A, Voelkl J, Haubner B, Neely G, Moriell C, Seidl S, Pachinger O, Penninger J, Metzler B, Dietz R, Zelarayan L, Bergmann M, Meln I, Malashicheva A, Anisimov S, Kalinina N, Sysoeva V, Zaritskey A, Barbuti A, Scavone A, Mazzocchi N, Crespi A, Capilupo D, Difrancesco D, Qian L, Shim W, Gu Y, Mohammed S, Wong P, Noack C, Renger A, Zafiriou M, Dietz R, Schaeffer H, Bergmann M, Zelarayan L, Kovacs P, Simon J, Christ T, Wettwer E, Varro A, Ravens U, Athias P, Wolf J, Bouchot O, Vandroux D, Mathe A, De Carvalho A, Laurent G, Rainer P, Huber M, Edelmann F, Stojakovic T, Trantina-Yates A, Trauner M, Pieske B, Von Lewinski D, De Jong A, Maass A, Oberdorf-Maass S, Van Gelder I, Lin Y, Li J, Wang F, He Y, Li X, Xu H, Yang X, Coppini R, Ferrantini C, Ferrara C, Rossi A, Mugelli A, Poggesi C, Cerbai E, Rozmaritsa N, Voigt N, Christ T, Wettwer E, Dobrev D, Ravens U, Kienitz MC, Zoidl G, Bender K, Pott L, Kohajda Z, Kristof A, Kovacs P, Virag L, Varro A, Jost N, Voigt N, Trafford A, Ravens U, Dobrev D, Prnjavorac B, Mujaric E, Jukic J, Abduzaimovic K, Brack K, Patel V, Coote J, Ng G, Wilders R, Van Ginneken A, Verkerk A, Brack K, Coote J, Ng G, Xaplanteris P, Vlachopoulos C, Baou K, Vassiliadou C, Dima I, Ioakeimidis N, Stefanadis C, Ruifrok W, Qian C, Sillje H, Van Goor H, Van Veldhuisen D, Van Gilst W, De Boer R, Schmidt K, Kaiser F, Erdmann J, De Wit C, Barnett O, Kyyak Y, Cesana F, Boffi L, Mauri T, Alloni M, Betelli M, Nava S, Giannattasio C, Mancia G, Vilskersts R, Kuka J, Svalbe B, Liepinsh E, Dambrova M, Zakrzewicz A, Maroski J, Vorderwuelbecke B, Fiedorowicz K, Da Silva-Azevedo L, Pries A, Gryglewska B, Necki M, Zelawski M, Grodzicki T, Scoditti E, Massaro M, Carluccio M, Distante A, Storelli C, De Caterina R, Kocgirli O, Valcaccia S, Dao V, Suvorava T, Kumpf S, Floeren M, Oppermann M, Kojda G, Leo C, Ziogas J, Favaloro J, Woodman O, Goettsch W, Marton A, Goettsch C, Morawietz H, Khalifa E, Ashour Z, Dao V, Floeren M, Kumpf S, Suvorava T, Kojda G, Rupprecht V, Scalera F, Martens-Lobenhoffer J, Bode-Boeger S, Li W, Kwan Y, Leung G, Patella F, Mercatanti A, Pitto L, Rainaldi G, Tsimafeyeu I, Tishova Y, Wynn N, Kalinchenko S, Clemente Lorenzo M, Grande M, Barriocanal F, Aparicio M, Martin A, Hernandez J, Lopez Novoa J, Martin Luengo C, Kurlianskaya A, Denisevich T, Leo C, Ziogas J, Favaloro J, Woodman O, Barth N, Loot A, Fleming I, Wang Y, Gabrielsen A, Ripa R, Jorgensen E, Kastrup J, Arderiu G, Pena E, Badimon L, Kobus K, Czyszek J, Kozlowska-Wiechowska A, Milkiewicz P, Milkiewicz M, Madonna R, Montebello E, Geng Y, De Caterina R, Chin-Dusting J, Michell D, Skilton M, Dixon J, Dart A, Moore X, Hlushchuk R, Ehrbar M, Reichmuth P, Heinimann N, Djonov V, Hewing B, Stangl V, Stangl K, Laule M, Baumann G, Ludwig A, Widmer-Teske R, Mueller A, Stieger P, Tillmanns H, Braun-Dullaeus R, Sedding D, Troidl K, Eller L, Benli I, Apfelbeck H, Schierling W, Troidl C, Schaper W, Schmitz-Rixen T, Hinkel R, Trenkwalder T, Pfosser A, Globisch F, Stachel G, Lebherz C, Bock-Marquette I, Kupatt C, Seyler C, Duthil-Straub E, Zitron E, Scholz E, Thomas D, Gierten J, Karle C, Fink R, Padro T, Lugano R, Garcia-Arguinzonis M, Badimon L, Schuchardt M, Pruefer J, Toelle M, Pruefer N, Jankowski V, Jankowski J, Zidek W, Van Der Giet M, Pena E, Arderiu G, Badimon L, Fransen P, Van Hove C, Michiels C, Van Langen J, Bult H, Quarck R, Wynants M, Alfaro-Moreno E, Rosario Sepulveda M, Wuytack F, Van Raemdonck D, Meyns B, Delcroix M, Christofi F, Wijetunge S, Sever P, Hughes A, Ohanian J, Forman S, Ohanian V, Wijetunge S, Hughes A, Gibbons C, Ohanian J, Ohanian V, Costales P, Aledo R, Vernia S, Das A, Shah V, Casado M, Badimon L, Llorente-Cortes V, Fransen P, Van Hove C, Van Langen J, Bult H, Bielenberg W, Daniel J, Tillmanns H, Sedding D, Daniel JM, Hersemeyer K, Schmidt-Woell T, Kaetzel D, Tillmans H, Sedding D, Kanse S, Tuncay E, Kandilci H, Zeydanli E, Sozmen N, Akman D, Yildirim S, Turan B, Nagy N, Acsai K, Farkas A, Papp J, Varro A, Toth A, Viero C, Mason S, Williams A, Marston S, Stuckey D, Dyer E, Song W, El Kadri M, Hart G, Hussain M, Faltinova A, Gaburjakova J, Urbanikova L, Hajduk M, Tomaskova B, Antalik M, Zahradnikova A, Steinwascher P, Jaquet K, Muegge A, Ferrantini C, Coppini R, Wang G, Zhang M, Cerbai E, Tesi C, Poggesi C, Ter Keurs H, Kettlewell S, Smith G, Workman A, Acsai K, Lenaerts I, Holemans P, Sokolow S, Schurmans S, Herchuelz A, Sipido K, Antoons G, Wehrens X, Li N, Respress JR, De Almeida A, Van Oort R, Bussek A, Lohmann H, Christ T, Wettwer E, Ravens U, Saes M, Muegge A, Jaquet K, Messer A, Copeland O, Leung M, Marston S, Matthes F, Steinbrecher J, Salinas-Riester G, Opitz L, Hasenfuss G, Lehnart S, Caracciolo G, Eleid M, Carerj S, Chandrasekaran K, Khandheria B, Sengupta P, Riaz I, Tyng L, Dou Y, Seymour A, Dyer C, Griffin S, Haswell S, Greenman J, Yasushige S, Amorim P, Nguyen T, Schwarzer M, Mohr F, Doenst T, Popin Sanja S, Lalosevic D, Capo I, Momcilov Popin T, Astvatsatryan A, Senan M, Astvatsatryan A, Senan M, Shafieian G, Goncalves N, Falcao-Pires I, Henriques-Coelho T, Moreira-Goncalves D, Leite-Moreira A, Bronze Carvalho L, Azevedo J, Andrade M, Arroja I, Relvas M, Morais G, Seabra M, Aleixo A, Winter J, Brack K, Ng G, Zabunova M, Mintale I, Lurina D, Narbute I, Zakke I, Erglis A, Astvatsatryan A, Senan M, Marcinkevics Z, Kusnere S, Abolins A, Aivars J, Rubins U, Nassar Y, Monsef D, Hamed G, Abdelshafy S, Chen L, Wu Y, Wang J, Cheng C, Sternak M, Khomich T, Jakubowski A, Szafarz M, Szczepanski W, Mateuszuk L, Szymura-Oleksiak J, Chlopicki S, Sulicka J, Strach M, Kierzkowska I, Surdacki A, Mikolajczyk T, Balwierz W, Guzik T, Grodzicki T, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Rogoza A, Shakur R, Metcalfe S, Bradley J, Demyanets S, Kaun C, Kastl S, Pfaffenberger S, Huk I, Maurer G, Huber K, Wojta J, Eriksson O, Aberg M, Siegbahn A, Prnjavorac B, Niccoli G, Sgueglia G, Conte M, Giubilato S, Cosentino N, Ferrante G, Crea F, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Ilisei D, Leon M, Mitu F, Kyriakakis E, Philippova M, Cavallari M, Bochkov V, Biedermann B, De Libero G, Erne P, Resink T, Titov V, Bakogiannis C, Antoniades C, Tousoulis D, Demosthenous M, Psarros C, Sfyras N, Channon K, Stefanadis C, Del Turco S, Navarra T, Basta G, De Caterina R, Carnicelli V, Frascarelli S, Zucchi R, Kostareva A, Malashicheva A, Sjoberg G, Gudkova A, Semernin E, Shlyakhto E, Sejersen T, Cucu N, Anton M, Stambuli D, Botezatu A, Arsene C, Lupeanu E, Anton G, Beer A, Theurl M, Schgoer W, Albrecht K, Patsch J, Huber E, Schratzberger P, Kirchmair R, Lande C, Cecchettini A, Tedeschi L, Trivella M, Citti L, Chen B, Ma Y, Yang Y, Ma X, Liu F, Hasanzad M, Rejali L, Fathi M, Minassian A, Mohammad Hassani R, Najafi A, Sarzaeem M, Sezavar S, Akhmedov A, Klingenberg R, Yonekawa K, Lohmann C, Gay S, Maier W, Neithard M, Luescher T, Xie X, Ma Y, Yang Y, Fu Z, Li X, Ma X, Liu F, Chen B, Kevorkov A, Verduci L, Mercatanti A, Cremisi F, Pitto L, Wonnerth A, Katsaros K, Zorn G, Kaun C, Weiss T, Huber K, Maurer G, Wojta J, De Rosa R, Galasso G, Piscione F, Santulli G, Iaccarino G, Piccolo R, Luciano R, Chiariello M, Szymanski M, Schoemaker R, Van Veldhuisen D, Van Gilst W, Hillege H, Rizzo S, Basso C, Thiene G, Valente M, Rickelt S, Franke W, Bartoloni G, Bianca S, Giurato E, Barone C, Ettore G, Bianca I, Eftekhari P, Wallukat G, Bekel A, Heinrich F, Fu M, Briedert M, Briand J, Roegel J, Rizzo S, Pilichou K, Basso C, Thiene G, Korkmaz S, Radovits T, Pali S, Hirschberg K, Zoellner S, Loganathan S, Karck M, Szabo G, Bartoloni G, Pucci A, Pantaleo J, Martino S, Pelosi G, Matteucci M, Kusmic C, Vesentini N, Piccolomini F, Viglione F, Trivella M, L'abbate A, Slavikova J, Chottova Dvorakova M, Kummer W, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Akbarzadeh Najar R, Ghaderian S, Tabatabaei Panah A, Vakili H, Rezaei Farimani A, Rezaie G, Beigi Harchegani A, Falcao-Pires I, Hamdani N, Gavina C, Van Der Velden J, Niessen H, Stienen G, Leite-Moreira A, Paulus W, Goncalves N, Falcao-Pires I, Moura C, Lamego I, Eloy C, Niessen H, Areias J, Leite-Moreira A, Bonda T, Dziemidowicz M, Hirnle T, Dmitruk I, Kaminski K, Musial W, Winnicka M, Villar A, Merino D, Ares M, Pilar F, Valdizan E, Hurle M, Nistal J, Vera V, Toelle M, Van Der Giet M, Zidek W, Jankowski J, Astvatsatryan A, Senan M, Karuppasamy P, Chaubey S, Dew T, Sherwood R, Desai J, John L, Marber M, Kunst G, Cipolletta E, Santulli G, Attanasio A, Del Giudice C, Campiglia P, Illario M, Iaccarino G, Berezin A, Koretskaya E, Bishop E, Fearon I, Heger J, Warga B, Abdallah Y, Meyering B, Schlueter K, Piper H, Euler G, Lavorgna A, Cecchetti S, Rio T, Coluzzi G, Carrozza C, Conti E, Crea F, Andreotti F, Berezin A, Glavatskiy A, Uz O, Kardesoglu E, Yiginer O, Bas S, Ipcioglu O, Ozmen N, Aparci M, Cingozbay B, Ivanes F, Hillaert M, Susen S, Mouquet F, Doevendans P, Jude B, Montalescot G, Van Belle E, Leon M, Ilisei D, Mitu F, Castellani C, Angelini A, De Boer O, Van Der Loos C, Gerosa G, Thiene G, Van Der Wal A, Dumitriu I, Baruah P, Kaski J, Maytham O, D Smith J, Rose M, Cappelletti A, Pessina A, Mazzavillani M, Calori G, Margonato A, De Rosa R, Galasso G, Piscione F, Cassese S, Piccolo R, Luciano R, D'anna C, Chiariello M, Niccoli G, Ferrante G, Leo A, Giubilato S, Silenzi A, Baca' M, Biasucci L, Crea F, Baller D, Gleichmann U, Holzinger J, Bitter T, Horstkotte D, Bakogiannis C, Antoniades C, Antonopoulos A, Tousoulis D, Miliou A, Triantafyllou C, Channon K, Stefanadis C, Masson W, Siniawski D, Sorroche P, Casanas L, Scordo W, Krauss J, Cagide A, Schuchardt M, Toelle M, Huang T, Wiedon A, Van Der Giet M, Chin-Dusting J, Lee S, Walker K, Dart A, O'dea K, Skilton M, Perez Berbel P, Arrarte Esteban V, Garcia Valentin M, Sola Villalpando M, Lopez Vaquero C, Caballero L, Quintanilla Tello M, Sogorb Garri F, Duerr G, Elhafi N, Bostani T, Swieny L, Kolobara E, Welz A, Roell W, Dewald O, Kaludercic N, Takimoto E, Nagayama T, Chen K, Shih J, Kass D, Di Lisa F, Paolocci N, Vinet L, Pezet M, Briec F, Previlon M, Rouet-Benzineb P, Hivonnait A, Charpentier F, Mercadier J, Villar A, Cobo M, Llano M, Montalvo C, Exposito V, Nistal J, Hurle M, Ruifrok W, Meems L. Saturday, 17 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Piscione F, Danzi GB, Cassese S, Esposito G, Cirillo P, Galasso G, Rapacciuolo A, Leosco D, Briguori C, Varbella F, Tuccillo B, Chiariello M. Multicentre experience with MGuard net protective stent in ST-elevation myocardial infarction: safety, feasibility, and impact on myocardial reperfusion. Catheter Cardiovasc Interv 2010; 75:715-21. [PMID: 19937780 DOI: 10.1002/ccd.22292] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To report, for the first time, angiographic and ECG results as well as in-hospital and 1-month clinical follow-up, after MGuard net protective stent (Inspire-MD, Tel-Aviv, Israel-MGS) implantation in consecutive, not randomized, STEMI patients undergoing primary or rescue PCI. BACKGROUND Distal embolization may decrease coronary and myocardial reperfusion after percutaneous coronary intervention (PCI), in ST-elevation myocardial infarction (STEMI) setting. METHODS One-hundred consecutive patients underwent PCI, with MGS deployment for STEMI, in five different high-volume PCI centres. Sixteen patients presented cardiogenic shock at admission. RESULTS All patients underwent successful procedures: mean TIMI flow grade and mean corrected TIMI frame count-cTFC(n)-improved from baseline values to 2.85 +/- 0.40 and to 17.20 +/- 10.51, respectively, with a mean difference in cTFC(n) between baseline and postprocedure of 46.88 +/- 31.86. High-myocardial blush grade (90% MBG 3; 10% MBG 2) was also achieved in all patients. Sixty minutes post-PCI, a high rate (90%) of complete (>or=70%) ST-segment resolution was achieved. At in-hospital follow-up, seven deaths occurred: noteworthy, 5 of 16 patients with cardiogenic shock at admission died. After hospital discharge, no Major Adverse Cardiac Events have been reported up to 30-day follow-up. CONCLUSIONS MGS might represent a safe and feasible option for PCI in STEMI patients, providing high perfusional and ECG improvement. Further randomized trials comparing this strategy with the conventional one are needed in the near future to assess the impact on clinical practice of this strategy.
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Piscione F, Cassese S. "Pro-healing" coronary stent before undeferrable major non-cardiac surgery. Heart 2010; 96:715; author reply 715. [PMID: 20424156 DOI: 10.1136/hrt.2009.188698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Piscione F, Piccolo R, Cassese S, Galasso G, D'Andrea C, De Rosa R, Chiariello M. Is direct stenting superior to stenting with predilation in patients treated with percutaneous coronary intervention? results from a meta-analysis of 24 randomised controlled trials. Heart 2010; 96:588-94. [DOI: 10.1136/hrt.2009.183277] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Esposito G, Franzone A, Cassese S, Schiattarella GG, Capretti G, Pironti G, Di Serafino L, Perrino C, Piscione F, Chiariello M. Endovascular repair for isolated iliac artery aneurysms: case report and review of the current literature. J Cardiovasc Med (Hagerstown) 2010; 10:861-5. [PMID: 19543108 DOI: 10.2459/jcm.0b013e32832e1904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
For a long time, open surgical repair has been considered the preferred management option for the exclusion of isolated iliac artery aneurysms.The development of transluminally placed endovascular stent grafts, which have been studied extensively for aneurysm exclusion in the abdominal and thoracic aorta, provided a less invasive approach for exclusion of iliac artery aneurysms as compared with surgical reconstruction or open surgical graft placement.Here we report a case of concomitant bilateral common and internal iliac artery aneurysms excluded successfully with multiple stent-grafting deployment with extension to the external iliac arteries and without coil embolization requirements.
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Piscione F, Cantor WJ, Fernandez-Aviles F, Halvorsen S, Le-May M, Armstrong PW, Bruno S, Goodman SG, Dimopoulos K, Borgia F, Di Mario C. EARLY PCI AFTER THROMBOLYSIS VERSUS STANDARD THERAPY IN STEMI PATIENTS: A CUMULATIVE META-ANALYSIS. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)60982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Piscione F, Cassese S, Galasso G, Rapacciuolo A, De Rosa R, Piccolo R, D'Andrea C, Chiariello M. Coronary stenting early before non-cardiac surgery: is the endothelial progenitor cell capturing coronary stent a solution? Minerva Cardioangiol 2010; 58:147-152. [PMID: 20145601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The authors report, for the first time, immediate and mid-term outcome of early antiplatelet therapy discontinuation followed by uneventful non-cardiac surgery and endovascular aortic repair, few days after successful deployment of an endothelial progenitor cell capturing coronary stent, in three consecutive patients.
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142
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Rengo G, Galasso G, Vitale DF, Furgi G, Zincarelli C, Golino L, Femminella GD, Piscione F, Rengo F, Leosco D. An active lifestyle prior to coronary surgery is associated with improved survival in elderly patients. J Gerontol A Biol Sci Med Sci 2010; 65:758-63. [PMID: 20106960 DOI: 10.1093/gerona/glp216] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An active lifestyle is associated with a reduced cardiovascular risk in middle-aged as well as in elderly patients. In the present study, we investigated the association between physical activity habits of elderly participants prior to coronary artery bypass grafting (CABG) and survival free from both all-cause and cardiac death. METHODS AND RESULTS Study population consisted of 587 elderly patients (>or=70 years) CABG patients stratified, according to the Physical Activity Scale for the Elderly (PASE), into less active (low PASE) and exercised (high PASE) groups. At follow-up (mean: 44.3 +/- 21.0 months), 33 (37.1%) of 89 total deaths occurred for cardiac causes. Sixty-month survival rate was 65% and 96% for low-PASE and high-PASE groups, respectively (log rank = 49.460, p < .0001). Cox survival analysis indicated a significant (p < .0001) nonlinear association between PASE score increments and improved survival with the most evident differences in the lowest score categories. A robust association was also found between low PASE score and increased cardiac-related mortality (p < .0001). CONCLUSIONS Our data indicate that a more active lifestyle is significantly associated with improved survival in elderly CABG patients. The nonlinearity of the relation suggests that more sedentary patients could have the most benefit on survival by increasing their exercise lifestyle habits. The improved outcome is explained by both cardiac and overall mortality reduction.
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143
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Rapacciuolo A, D'andrea C, Maresca G, di Pietro E, Piscione F, Chiariello M. Multiple MGuard stent implantation to treat massive right coronary artery dissection during primary coronary angioplasty. J Cardiovasc Med (Hagerstown) 2010; 12:356-60. [PMID: 20093945 DOI: 10.2459/jcm.0b013e328334092d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Here we report a case of a 79-year-old woman with inferior myocardial infarction, transferred to our cath lab to perform a primary percutaneous coronary intervention (PPCI). During the procedure, a massive dissection complicated the thrombotic lesion of the right coronary artery (RCA). In this case, we decided to use the MGuard stent to treat both the large dissection and the thrombotic lesion. MGuard stent is a combination of a coronary stent merged with an embolic protection device. After multiple MGuard stent implantation we obtained a complete resolution of the coronary dissection obtaining a patent RCA with normal antegrade flow.
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144
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D'Andrea C, Esposito G, Piscione F, Chiariello M. Tirofiban administration and percutaneous coronary intervention with stenting of saphenous vein graft thrombosis. J Cardiovasc Med (Hagerstown) 2009; 10:875-8. [DOI: 10.2459/jcm.0b013e32832e669a] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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145
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Piscione F, Piccolo R, Cassese S, Galasso G, Chiariello M. Clinical impact of sirolimus-eluting stent in ST-segment elevation myocardial infarction: a meta-analysis of randomized clinical trials. Catheter Cardiovasc Interv 2009; 74:323-32. [PMID: 19360858 DOI: 10.1002/ccd.22017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To evaluate outcome of patients undergoing sirolimus-eluting stent (SES) as compared to bare-metal stent (BMS) implantation during primary angioplasty for ST-segment elevation myocardial infarction (STEMI). BACKGROUND The role of SES in primary percutaneous coronary intervention setting is still debated. METHODS We searched Medline, EMBASE, CENTRAL, scientific session abstracts, and relevant Websites for studies in any language, from the inception of each database until October 2008. Only randomized clinical trials with a mean follow-up period >6 months and sample size >100 patients were included. Primary endpoint for efficacy was target-vessel revascularization (TVR) and primary endpoint for safety was stent thrombosis. Secondary endpoints were cardiac death and recurrent myocardial infarction (MI). RESULTS Six trials were included in the meta-analysis, including 2,381 patients (1,192 randomized to SES and 1,189 to BMS). Up to 12-month follow-up, TVR was significantly lower in patients treated with SES as compared to patients treated with BMS (4.53% vs. 12.53%, respectively; odds ratio [OR] 0.33; 95% confidence interval [CI] 0.24-0.46; P < 0.00001). There were no significant differences in the incidence of stent thrombosis (3.02% vs. 3.70%, OR = 0.81 [95% CI, 0.52-1.27], P = 0.81), cardiac death (2.77% vs. 3.28%, OR = 0.84 [95% CI, 0.52-1.35], P = 0.47), and recurrent MI (2.94% vs. 4.04%, OR = 0.71 [95% CI, 0.45-1.11], P = 0.13) between the two groups. CONCLUSION SES significantly reduces TVR rates as compared to BMS in STEMI patients up to 1 year follow-up. Further studies with larger population and longer follow-up time are needed to confirm our findings.
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Cirillo P, De Rosa S, Di Palma V, De Rosa R, Maietta P, Piscione F, Chiariello M. Different vascular response to concurrent implantation of sirolimus- and zotarolimus-eluting stents in the same vessel. Heart Vessels 2009; 24:313-6. [DOI: 10.1007/s00380-008-1134-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 11/25/2008] [Indexed: 11/25/2022]
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147
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Furbatto F, Esposito G, Piccolo R, Franzone A, Capretti G, Piscione F, Chiariello M. Coronary angioplasty with stenting for acute coronary syndrome in patients with isolated single coronary artery: a report of two cases. J Cardiovasc Med (Hagerstown) 2009; 10:550-3. [DOI: 10.2459/jcm.0b013e32832b962e] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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148
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Santulli G, Ciccarelli M, Palumbo G, Campanile A, Galasso G, Ziaco B, Altobelli GG, Cimini V, Piscione F, D'Andrea LD, Pedone C, Trimarco B, Iaccarino G. In vivo properties of the proangiogenic peptide QK. J Transl Med 2009; 7:41. [PMID: 19505323 PMCID: PMC2702279 DOI: 10.1186/1479-5876-7-41] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 06/08/2009] [Indexed: 01/01/2023] Open
Abstract
The main regulator of neovascularization is Vascular Endothelial Growth Factor (VEGF). We recently demonstrated that QK, a de novo engineered VEGF mimicking peptide, shares in vitro the same biological properties of VEGF, inducing capillary formation and organization. On these grounds, the aim of this study is to evaluate in vivo the effects of this small peptide. Therefore, on Wistar Kyoto rats, we evaluated vasomotor responses to VEGF and QK in common carotid rings. Also, we assessed the effects of QK in three different models of angiogenesis: ischemic hindlimb, wound healing and Matrigel plugs. QK and VEGF present similar endothelium-dependent vasodilatation. Moreover, the ability of QK to induce neovascularization was confirmed us by digital angiographies, dyed beads dilution and histological analysis in the ischemic hindlimb as well as by histology in wounds and Matrigel plugs. Our findings show the proangiogenic properties of QK, suggesting that also in vivo this peptide resembles the full VEGF protein. These data open to new fields of investigation on the mechanisms of activation of VEGF receptors, offering clinical implications for treatment of pathophysiological conditions such as chronic ischemia.
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Rapacciuolo A, Losi MA, Borgia F, De Angelis MC, Esposito F, Cavallaro M, De Rosa R, Piscione F, Chiariello M. Transcatheter closure of patent ductus arteriosus reverses left ventricular dysfunction in a septuagenarian. J Cardiovasc Med (Hagerstown) 2009; 10:344-8. [PMID: 19430347 DOI: 10.2459/jcm.0b013e3283276f30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A 70-year-old man was admitted because of a 6-month history of progressive dyspnoea on exertion. The medical history showed that he suffered from patent ductus arteriosus (PDA) that was closed at 35 years of age by surgical ligation. Subsequently, up to year 1992, no evidence of residual left-to-right shunt was found. When he first came to our attention, we performed an echocardiographic test evidencing left ventricular dilation and contractile dysfunction and a recurrence of PDA. To exclude other possible causes of congestive heart failure, we performed several tests, including a coronary angiogram that showed coronary atherosclerosis without significant lesions. The haemodynamic study confirmed that the PDA was associated with a mild pulmonary hypertension with a QP: QS of 2: 1. The patient did not report any cardiovascular risk factor. Therefore, we concluded that PDA was responsible for congestive heart failure in this patient. We performed percutaneous closure of PDA, which was able to reverse left ventricular dilation and dysfunction, improving the patient's symptoms, at 1 month as well as 4 months after the interventional procedure. Although this kind of device is frequently used in the paediatric population, adult patients may present different challenges in proper management, such as poor visualization, calcification and pulmonary hypertension. In the description of the case reported here, we show that a PDA can present as congestive heart failure in the elderly. Percutaneous closure can be very effective in ameliorating left ventricular performance as well as symptoms.
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Piscione F, Piccolo R, De Rosa R, Chiariello M. [Assessment of quality of life in patients with peripheral arterial disease: a problem left ahead]. GIORNALE ITALIANO DI CARDIOLOGIA (2006) 2009; 10:216-224. [PMID: 19475875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Peripheral arterial disease is a common clinical condition and represents a manifestation of systemic atherosclerosis. It has been demonstrated that peripheral arterial disease impairs significantly quality of life, and thus its improvement has become an important goal of therapy, particularly in symptomatic patients. In addition, the impact of this disease on quality of life is not adequately described by physical examination findings and common clinical data, such as the ankle-brachial index. Thus, to properly understand the clinical evolution of peripheral arterial disease and its treatment, it is useful to integrate clinical outcome measures with data derived from the patient's point of view in order to avoid that procedural success is evaluated only in terms of appropriate use of the available technical tools and of a good angiographic result without taking into account its consequences on daily future life of patients. It would therefore be necessary that the caregivers involved in the evaluation and treatment of patients with peripheral arterial disease are able to use and interpret the validated instruments for quality of life assessment. Among therapeutic strategies, percutaneous transluminal angioplasty is emerging as a suitable option to improve both clinical outcome and quality of life, even though it cannot contrast the progression of atherosclerotic disease. In this article we review major generic and specific instruments to assess patient-reported quality of life. Moreover, we describe the impact of peripheral arterial disease and its endovascular treatment on quality of life.
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