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Bertaina M, Morici N, Frea S, Garatti L, Briani M, Sorini C, Villanova L, Corrada E, Sacco A, Moltrasio M, Ravera A, Tedeschi M, Bertoldi L, Lettino M, Saia F, Corsini A, Camporotondo R, Colombo CNJ, Bertolin S, Rota M, Oliva F, Iannaccone M, Valente S, Pagnesi M, Metra M, Sionis A, Marini M, De Ferrari GM, Kapur NK, Pappalardo F, Tavazzi G. Differences between cardiogenic shock related to acute decompensated heart failure and acute myocardial infarction. ESC Heart Fail 2023; 10:3472-3482. [PMID: 37723131 PMCID: PMC10682868 DOI: 10.1002/ehf2.14510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 04/13/2023] [Accepted: 08/08/2023] [Indexed: 09/20/2023] Open
Abstract
AIMS The present analysis from the multicentre prospective Altshock-2 registry aims to better define clinical features, in-hospital course, and management of cardiogenic shock complicating acutely decompensated heart failure (ADHF-CS) as compared with that complicating acute myocardial infarction (AMI-CS). METHODS AND RESULTS All patients with AMI-CS or ADHF-CS enrolled in the Altshock-2 registry between March 2020 and February 2022 were selected. The primary objective was the characterization of ADHF-CS patients as compared with AMI-CS. In-hospital length of stay and mortality were secondary endpoints. One-hundred-ninety of the 238 CS patients enrolled in the aforementioned period were considered for the present analysis: 101 AMI-CS (80% ST-elevated myocardial infarction and 20% non-ST-elevated myocardial infarction) and 89 ADHF-CS. As compared with AMI-CS, ADHF-CS patients were younger [63 (IQR 59-76) vs. 67 (IQR 54-73) years, P = 0.01], but presented with higher creatinine [1.6 (IQR 1.0-2.6) vs. 1.2 (IQR 1.0-1.4) mg/dL, P < 0.001], bilirubin [1.3 (IQR 0.9-2.3) vs. 0.6 (IQR 0.4-1.1) mg/dL, P = 0.01], and central venous pressure values [14 mmHg (IQR 8-12) vs. 10 mmHg (IQR 7-14),P = 0.01]. Norepinephrine was the most common catecholamine used in AMI-CS (79.3%), whereas epinephrine was used more commonly in ADHF-CS (65.5%); 75.8% vs. 46.6% received a temporary mechanical support in AMI-CS and ADHF-CS, respectively (P < 0.001). Length of hospital stay was longer in the latter [28 (IQR 13-48) vs. 17 (IQR 9-29) days, P = 0.001]. Heart replacement therapies were more frequently used in the ADHF-CS group (heart transplantation 13.5% vs. 0% and left ventricular assist device 11% vs. 2%, P < 0.01 and 0.01, respectively). In-hospital mortality was 41.1% (38.6% AMI-CS vs. 43.8% ADHF-CS, P = 0.5). CONCLUSIONS ADHF-CS is characterized by a higher prevalence of end-organ and biventricular dysfunction at presentation, a longer hospital length of stay, and higher need of heart replacement therapies when compared with AMI-CS. In-hospital mortality was similar between the two aetiologies. Our data warrant development of new management protocols focused on CS aetiology.
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Affiliation(s)
- Maurizio Bertaina
- Division of CardiologySan Giovanni Bosco Hospital, ASL Città di TorinoTurinItaly
| | - Nuccia Morici
- IRCCS S. Maria Nascente—Fondazione Don Carlo Gnocchi ONLUSMilanItaly
| | - Simone Frea
- Intensive Cardiac Care UnitCittà della Salute e della Scienza di TorinoTurinItaly
| | - Laura Garatti
- Cardiology Department and De Gasperis Cardio CenterASST Grande Ospedale Metropolitano NiguardaMilanItaly
| | | | - Carlotta Sorini
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaSienaItaly
| | - Luca Villanova
- Cardiology Department and De Gasperis Cardio CenterASST Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Elena Corrada
- Humanitas Research Hospital, IRCCS RozzanoMilanItaly
| | - Alice Sacco
- Cardiology Department and De Gasperis Cardio CenterASST Grande Ospedale Metropolitano NiguardaMilanItaly
| | | | - Amelia Ravera
- Cardiology Department, Intensive Care UnitS. Giovanni Di Dio e Ruggi D'Aragona HospitalSalernoItaly
| | - Michele Tedeschi
- Cardiology Department, Intensive Care UnitS. Giovanni Di Dio e Ruggi D'Aragona HospitalSalernoItaly
| | | | | | - Francesco Saia
- Cardiology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Anna Corsini
- Cardiology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Rita Camporotondo
- Intensive Cardiac Care UnitFondazione Policlinico San Matteo Hospital IRCCSPaviaItaly
| | | | - Stephanie Bertolin
- Cardiothoracic and Vascular Anesthesia and Intensive CareAO SS. Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | - Matteo Rota
- Units of Biostatistics and Biomathematics and Bioinformatics, Department of Molecular and Translational MedicineUniversity of BresciaBresciaItaly
| | - Fabrizio Oliva
- Cardiology Department and De Gasperis Cardio CenterASST Grande Ospedale Metropolitano NiguardaMilanItaly
| | - Mario Iannaccone
- Division of CardiologySan Giovanni Bosco Hospital, ASL Città di TorinoTurinItaly
| | - Serafina Valente
- Division of Cardiology, Department of Medical BiotechnologiesUniversity of SienaSienaItaly
| | - Matteo Pagnesi
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public HealthUniversity of Brescia, Cardiothoracic Department, Civil HospitalsBresciaItaly
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public HealthUniversity of Brescia, Cardiothoracic Department, Civil HospitalsBresciaItaly
| | - Alessandro Sionis
- Intensive Cardiac Care Unit, Cardiology DepartmentHospital de la Santa Creu i Sant PauBarcelonaSpain
| | - Marco Marini
- Division of Cardiology and ICCU, Department of Cardiovascular SciencesOspedali RiunitiAnconaItaly
| | - Gaetano Maria De Ferrari
- Intensive Cardiac Care UnitCittà della Salute e della Scienza di TorinoTurinItaly
- Department of Medical SciencesUniversity of TorinoTurinItaly
| | | | - Federico Pappalardo
- Cardiothoracic and Vascular Anesthesia and Intensive CareAO SS. Antonio e Biagio e Cesare ArrigoAlessandriaItaly
| | - Guido Tavazzi
- Department of Clinical‐Surgical, Diagnostic and Paediatric SciencesUniversity of Pavia ItalyPaviaItaly
- Anesthesia and Intensive CareFondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione IPaviaItaly
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Jofra T, Galvani G, Cosorich I, De Giorgi L, Annoni A, Vecchione A, Sorini C, Falcone M, Fousteri G. Experimental colitis in IL-10-deficient mice ameliorates in the absence of PTPN22. Clin Exp Immunol 2019; 197:263-275. [PMID: 31194881 DOI: 10.1111/cei.13339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2019] [Indexed: 02/06/2023] Open
Abstract
Interleukin (IL)-10 plays a key role in controlling intestinal inflammation. IL-10-deficient mice and patients with mutations in IL-10 or its receptor, IL-10R, show increased susceptibility to inflammatory bowel diseases (IBD). Protein tyrosine phosphatase, non-receptor type 22 (PTPN22) controls immune cell activation and the equilibrium between regulatory and effector T cells, playing an important role in controlling immune homoeostasis of the gut. Here, we examined the role of PTPN22 in intestinal inflammation of IL-10-deficient (IL-10-/- ) mice. We crossed IL-10-/- mice with PTPN22-/- mice to generate PTPN22-/- IL-10-/- double knock-out mice and induced colitis with dextran sodium sulphate (DSS). In line with previous reports, DSS-induced acute and chronic colitis was exacerbated in IL-10-/- mice compared to wild-type (WT) controls. However, PTPN22-/- IL-10-/- double knock-out mice developed milder disease compared to IL-10-/- mice. IL-17-promoting innate cytokines and T helper type 17 (Th17) cells were markedly increased in PTPN22-/- IL-10-/- mice, but did not provide a protctive function. CXCL1/KC was also increased in PTPN22-/- IL-10-/- mice, but therapeutic injection of CXCL1/KC in IL-10-/- mice did not ameliorate colitis. These results show that PTPN22 promotes intestinal inflammation in IL-10-deficient mice, suggesting that therapeutic targeting of PTPN22 might be beneficial in patients with IBD and mutations in IL-10 and IL-10R.
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Affiliation(s)
- T Jofra
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Galvani
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I Cosorich
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L De Giorgi
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Annoni
- San Raffaele Telethon Institute for Gene Therapy, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Vecchione
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - C Sorini
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Falcone
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - G Fousteri
- Division of Immunology Transplantation and Infectious Diseases (DITID), Diabetes Research Institute (DRI), IRCCS San Raffaele Scientific Institute, Milan, Italy
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Frattola D, Sorini C, Aliverti V, Losa M. An in vivo method to assess the local tolerability of intranasally administered drugs. Arch Toxicol Suppl 1991; 14:272-5. [PMID: 1805747 DOI: 10.1007/978-3-642-74936-0_58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- D Frattola
- ISF-Laboratories for Biomedical Research, Trezzano s/N, Milan, Italy
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