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Di Serafino L, Turturo M, Larosa C, Scalamogna M, Cirillo P, Vito Alessandro A, Lanzone S, Bartolomucci F, Granata R, Rea FS, Piccolo R, Franzone A, Gargiulo G, Spaccarotella CAM, Stabile E, Esposito G. A comparison between radial artery compression devices for patent hemostasis after transradial percutaneous interventions. J Invasive Cardiol 2024. [PMID: 38422529 DOI: 10.25270/jic/23.00302] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Patent hemostasis (PH) is essential for preventing radial artery occlusion (RAO) after trans-radial procedures; however, it remains unclear how it should be obtained. The aim of this multicenter randomized study was to evaluate whether the use of an adjustable device (AD), inflated with a pre-determined amount of air (AoA), was more effective than a non-adjustable device (non-AD) for achieving PH, thereby reducing the incidence of RAO. METHODS We enrolled a total of 480 patients undergoing transradial procedure at 3 Italian institutions. Before the procedure, a modified Reverse Barbeau Test (mRBT) was performed in all patients to evaluate the AoA to be eventually inflated in the AD. After the procedure, patients were randomized into 2 groups: (1) AD Group, using TR-Band (Terumo) inflated with the pre-determined AoA; and 2) non-AD Group, using RadiStop (Abbott). An RBT was performed during compression to demonstrate the achievement of PH, as well as 24 hours later to evaluate the occurrence of RAO. RESULTS PH was more often obtained in the AD Group compared with the non-AD Group (90% vs 64%, respectively, P less than .001), with no difference in terms of bleedings. RAO occurred more often in the non-AD Group compared with the AD Group (10% vs 3%, respectively, P less than .001). Of note, mRBT was effective at guiding AD inflation and identifying high-risk patients in whom PH was more difficult to obtain. CONCLUSIONS The use of AD, filled with a predetermined AoA, allowed PH significantly more often compared with non-AD, providing a significantly reduced incidence of RAO.
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Affiliation(s)
- Luigi Di Serafino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
| | | | | | - Maria Scalamogna
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Plinio Cirillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | | | | | - Riccardo Granata
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Francesco Saverio Rea
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Raffaele Piccolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Anna Franzone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppe Gargiulo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | | | - Eugenio Stabile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; Division of Cardiology, San Carlo Hospital, Potenza, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Nasso G, Larosa C, Bartolomucci F, Brigiani MS, Contegiacomo G, Demola MA, Vignaroli W, Tripoli A, Girasoli C, Lisco R, Trivigno M, Tunzi RM, Loizzo T, Hila D, Franchino R, Amodeo V, Ventra S, Diaferia G, Schinco G, Agrò FE, Zingaro M, Rosa I, Lorusso R, Del Prete A, Santarpino G, Speziale G. Safety and Efficacy of PCSK9 Inhibitors in Patients with Acute Coronary Syndrome Who Underwent Coronary Artery Bypass Grafts: A Comparative Retrospective Analysis. J Clin Med 2024; 13:907. [PMID: 38337601 PMCID: PMC10856256 DOI: 10.3390/jcm13030907] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024] Open
Abstract
Background. The in-hospital reduction in low-density lipoprotein cholesterol (LDL-C) levels following acute coronary syndrome (ACS) is recommended in the current clinical guidelines. However, the efficacy of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors in those patients undergoing coronary artery bypass graft (CABG) has never been demonstrated. Methods. From January 2022 to July 2023, we retrospectively analyzed 74 ACS patients characterized by higher LDL-C levels than guideline targets and who underwent coronary bypass surgery. In the first period (January 2022-January 2023), the patients increased their statin dosage and/or added Ezetimibe (Group STEZE, 43 patients). At a later time (February 2023-July 2023), the patients received not only statins and Ezetimibe but also Evolocumab 140 mg every 2 weeks starting as early as possible (Group STEVO, 31 patients). After one and three months post-discharge, the patients underwent clinical and laboratory controls with an evaluation of the efficacy lipid measurements and every adverse event. Results. The two groups did not differ in terms of preoperative risk factors and Euroscore II (STEVO: 2.14 ± 0.75 vs. STEZE: 2.05 ± 0.6, p = 0.29). Also, there was no difference between the groups in terms of ACS (ST-, Instable angina, or NSTE) and time of symptoms onset regarding total cholesterol, LDL-C, and HDL-C trends from the preprocedural period to 3-month follow-up, but there was a more significant reduction in LDL-C and total cholesterol in the STEVO group (p = 0.01 and p = 0.04, respectively) and no difference in HDL-C rise (p = 0.12). No deaths were reported. In three STEZE group patients, angina recurrence posed the need for percutaneous re-revascularization. No STEVO patients developed significant adverse events. The statistical difference in these serious events, 7% in STEZE vs. 0% in STEVO, was not significant (p = 0.26). Conclusions. Evolocumab initiated "as soon as possible" in ACS patients submitted to CABG with high-intensity statin therapy and Ezetimibe was well tolerated and resulted in a substantial and significant reduction in LDL-C levels at discharge, 1 month, and 3 months. This result is associated with a reduction but without a statistical difference between groups.
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Affiliation(s)
- Giuseppe Nasso
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Claudio Larosa
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (C.L.); (F.B.); (M.Z.); (I.R.)
| | - Francesco Bartolomucci
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (C.L.); (F.B.); (M.Z.); (I.R.)
| | - Mario Siro Brigiani
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Gaetano Contegiacomo
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Maria Antonietta Demola
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Walter Vignaroli
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Alessandra Tripoli
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Cataldo Girasoli
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Rosanna Lisco
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Marialisa Trivigno
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Roberto Michele Tunzi
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Tommaso Loizzo
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Dritan Hila
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Rosalba Franchino
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Vincenzo Amodeo
- Department of Cardiology, Hospital of Polistena, 89024 Polistena, Italy;
| | - Simone Ventra
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
| | - Giuseppe Diaferia
- Department of Cardiology, “M. Di Miccoli” Hospital, 70051 Barletta, Italy;
| | - Giacomo Schinco
- Health Management, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy;
| | - Felice Eugenio Agrò
- Department of Anesthesiology, University Campus Bio Medico, 00128 Rome, Italy;
| | - Maddalena Zingaro
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (C.L.); (F.B.); (M.Z.); (I.R.)
| | - Isabella Rosa
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (C.L.); (F.B.); (M.Z.); (I.R.)
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University, 6229 Maastricht, The Netherlands;
| | - Armando Del Prete
- Department of Cardiology, Santa Maria Goretti Hospital, 04100 Latina, Italy;
| | - Giuseppe Santarpino
- Department of Clinical and Experimental Medicine, Magna Graecia University, 88100 Catanzaro, Italy;
- Department of Cardiac Surgery, Città di Lecce Hospital, GVM Care & Research, 73100 Lecce, Italy
| | - Giuseppe Speziale
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (M.S.B.); (G.C.); (M.A.D.); (W.V.); (A.T.); (C.G.); (R.L.); (M.T.); (R.M.T.); (T.L.); (D.H.); (R.F.); (S.V.); (G.S.)
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Nasso G, Vignaroli W, Contegiacomo G, Marchese A, Fattouch K, D’Alessandro P, Brigiani MS, Vitobello V, Triggiani V, Demola MA, Tonioni S, Paparella D, Sechi S, Bonifazi R, Santarpino G, Resta F, Bartolomucci F, Lorusso R, Larosa C, Valenti G, Tito A, Moscarelli M, Margari V, Fiore F, Condello I, Speziale G. Emergent Conversion to Open Heart Surgery during Transcatheter Aortic Valve Implantation: The Presence of a Rescue Team Improves Outcomes. J Clin Med 2023; 12:7705. [PMID: 38137774 PMCID: PMC10743555 DOI: 10.3390/jcm12247705] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE Transcatheter aortic valve implant (TAVI) is the gold standard for the high-surgical-risk group of patients with aortic valve disease and it is an alternative to surgery in patients at intermediate risk. Lethal complications can occur, and many of these are manageable only with emergent conversion to open heart surgery. We retrospectively evaluate the outcome of all patients undergoing TAVI in our departments and the impact of a complete cardiac rescue team to reduce 30-day mortality. METHODS Data from all patients undergoing TAVI between January 2020 and August 2023 in our center were analyzed. An expert complete rescue was present in catheter laboratory. Primary outcomes were in-hospital and at 30-day mortality and evaluation of all cases needed for emergent conversion to open heart surgery. RESULTS 825 patients were enrolled. The total mortality was 19/825 (2.3%). Eleven of the total patients (1.3%) required emergent conversion to open heart surgery. Among them, eight were alive (73%), with a theoretical decrease of 0.98% in overall mortality. CONCLUSIONS surgical treatment is rare during TAVI. The presence of an expert complete rescue team as support means an increase in survival. Surgery must be used only to restore circulatory and to treat complication while percutaneous approaches should complete the procedure.
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Affiliation(s)
- Giuseppe Nasso
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Walter Vignaroli
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
- Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy; (K.F.); (S.T.); (S.S.)
| | - Gaetano Contegiacomo
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Alfredo Marchese
- Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy; (A.M.); (F.R.); (A.T.); (V.M.)
| | - Khalil Fattouch
- Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy; (K.F.); (S.T.); (S.S.)
| | - Pasquale D’Alessandro
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Mario Siro Brigiani
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Vincenza Vitobello
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Vera Triggiani
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Maria Antonietta Demola
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Stefano Tonioni
- Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy; (K.F.); (S.T.); (S.S.)
| | - Domenico Paparella
- Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy; (A.M.); (F.R.); (A.T.); (V.M.)
| | - Stefano Sechi
- Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy; (K.F.); (S.T.); (S.S.)
| | - Raffaele Bonifazi
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Giuseppe Santarpino
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Fabrizio Resta
- Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy; (A.M.); (F.R.); (A.T.); (V.M.)
| | - Francesco Bartolomucci
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (F.B.); (C.L.); (G.V.)
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), 6229 HX Maastricht, The Netherlands;
| | - Claudio Larosa
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (F.B.); (C.L.); (G.V.)
| | - Giovanni Valenti
- Department of Cardiology, Hospital of Andria, 76123 Andria, Italy; (F.B.); (C.L.); (G.V.)
| | - Antonio Tito
- Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy; (A.M.); (F.R.); (A.T.); (V.M.)
| | - Marco Moscarelli
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Vito Margari
- Department of Cardiac Surgery, Santa Maria Hospital, GVM Care & Research, 70124 Bari, Italy; (A.M.); (F.R.); (A.T.); (V.M.)
| | - Flavio Fiore
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Ignazio Condello
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
| | - Giuseppe Speziale
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, 70124 Bari, Italy; (W.V.); (G.C.); (P.D.); (M.S.B.); (V.V.); (V.T.); (M.A.D.); (R.B.); (G.S.); (M.M.); (F.F.); (I.C.); (G.S.)
- Department of Cardiac Surgery, San Carlo di Nancy, GVM Care & Research, 00165 Roma, Italy; (K.F.); (S.T.); (S.S.)
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Nasso G, Condello I, D'Abramo M, De Luca A, Larosa C, Valenti G, Bartolomucci F, Di Bari N, Sechi S, Diaferia G, De Rosis MG, Amodeo V, Melina G, Speziale G, Vignaroli W. Infective Endocarditis After Percutaneous Device Closure of Atrial Septal Defects: Incidence, Diagnosis, and Treatment. Case Report and Literature Review. Surg Technol Int 2023; 43:sti43/1740. [PMID: 38011012 DOI: 10.52198/23.sti.43.cv1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Infective endocarditis (IE) on atrial septal defect (ASD) closure devices, while extremely rare, has been reported to be more frequent early after the procedure. We describe a case of late IE after percutaneous closure of patent foramen ovale (PFO). We also performed a literature review on this subject. We reviewed a total of 42,365 patients who were treated with percutaneous devices: 13,916 for ostium secundum (OS) (32%), 24,726 for PFO (58%) and 3,723 for OS+PFO (8%). Among these patients, we identified 50 cases of IE after atrial septal defect device closure (0.001%). In contrast to previous reports, nearly 66% of IE in this setting occurred late, after at least 6 months from the procedure (33/50 patients). A statistical analysis clearly showed that the mean time from the procedure to IE increased in the last five years, probably associated with a change in antiplatelet therapy after ASD closure. Management of IE on an ASD occluder should always be discussed in the setting of a multidisciplinary heart team that includes a cardiologist, cardiac surgeon, and anesthetist. While surgical strategies gave excellent results, conservative management might be considered in cases of small IE vegetations and for patients in good general condition. However, in these cases, the patient must be closely observed with repeated blood and instrumental tests.
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Affiliation(s)
- Giuseppe Nasso
- GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy
| | - Ignazio Condello
- GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy
| | - Mizar D'Abramo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Angelo De Luca
- Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | | | | | | | - Nicola Di Bari
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Sechi
- GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy
| | | | | | | | - Giovanni Melina
- Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Giuseppe Speziale
- GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
- Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy
- GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy
| | - Walter Vignaroli
- GVM Care < Research, Department of Cardiovascular Surgery, Anthea Hospital, Bari, Italy
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
- Department of Clinical and Molecular Medicine, Cardiac Surgery Unit, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
- Azienda Ospedaliera BAT, Bonomo Hospital, Andria, Italy
- GVM Care < Research, Department of Cardiovascular Surgery, San Carlo di Nancy, Rome, Italy
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Nasso G, Speziale G, Bartolomucci F, Valenti G, Larosa C, Borrello F, Amodeo V, Fiore F, Condello I. Cardiopulmonary Bypass Settings for the Prevention of Early Hypotension During CABG. Surg Technol Int 2023; 43:sti43/1727. [PMID: 37851306 DOI: 10.52198/23.sti.43.cv1727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
BACKGROUND Vasoplegic syndrome is a form of vasodilatory shock that can occur before, during or after cardiopulmonary bypass (CPB). We introduce a strategy to reduce the incidence of early hypotension phenomena during Coronary Artery Bypass Graft (CABG) procedures. MATERIALS AND METHODS In this prospective cohort study, 100 patients underwent elective CABG with two perioperative CPB settings. The study group (50 patients) was managed with retrograde autologous priming (RAP), 3-minute stepwise for the institution of CPB, and pulsatile flow (PP). The control group (50 patients) was managed without RAP, with the rapid initiation of CPB, and non-pulsatile (NP) flow. The primary endpoints were MAP (mmHg), number of hypotensive phenomena (MAP < 50 mmHg for > 30 sec), the venous return volume on CPB (ml), the cardiac index (L/min/m2), hemoglobin (g/dL), indexed oxygen delivery (DO2i, ml/min/m2), the systemic vascular resistance index (SVRI, dynes s m2/cm5), number of 1-ml boluses of a vasoactive substance (norepinephrine), the positive fluid balance (ml), and the number of red blood cell units for transfusion. RESULTS During CPB, the mean values in the study and control groups were as follows: MAP, 68± 7 vs 56 ± 7 (p-value, 0.0019); hypotensive phenomena, 3 ± 1 vs 8 ±2 (p-value, 0.019); venous return volume, 840±79 vs 1129 ±123 (p-value, 0.0017); cardiac index, 2.4 ± 0.4 vs 2.7 ±0.2 (p-value, 0.0023); hemoglobin, 9.13 ± 0.29 vs 7.8± 0.23 (p-value, 0.0001); DO2i, 301± 12 vs 276±23 (p-value, 0.0011); SVRI, 1879 ±280 vs 2210 ±140 (p-value, 0.0017); norepinephrine, 1±2 vs 8 ±3 (p-value, 0.0023); positive fluid balance, 750 ±212 vs 1450 ±220 (p-value, 0.005); and total number of red blood cell units for transfusion, 16 ±4.2 vs 27 ± 5.3 (p-value, 0.008). CONCLUSIONS In this prospective cohort study, during CPB, the study group showed a better preservation of MAP, SVRI, and DO2i, and a reduction of vasoconstrictor use in a CPB setting with the RAP technique, 3-minute stepwise for the initiation of CPB and pulsatile pump flow, compared to the control group. Further studies are needed to validate this perioperative approach to CPB.
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Affiliation(s)
- Giuseppe Nasso
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy
| | - Giuseppe Speziale
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy
| | | | | | | | - Francesco Borrello
- Division of Cardiology and Intensive Care Unit, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Vincenzo Amodeo
- Department of Cardiology, Ospedale Santa Maria degli Ungheresi, Polistena, Italy
| | - Flavio Fiore
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy
| | - Ignazio Condello
- Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy
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Pepe M, Carulli E, Larosa C, Napoli G, Nestola PL, Carella MC, Giordano S, Tritto R, Bartolomucci F, Cirillo P, Zoccai GB, Giordano A, Ciccone MM. Comparative effectiveness of Cangrelor in patients with acute coronary syndrome undergoing percutaneous coronary intervention: an observational investigation from the M.O.Ca. registry. Sci Rep 2023; 13:10685. [PMID: 37393369 PMCID: PMC10314899 DOI: 10.1038/s41598-023-37084-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/19/2022] [Accepted: 06/15/2023] [Indexed: 07/03/2023] Open
Abstract
Cangrelor, the first intravenous P2Y12 inhibitor (P2Y12-I), has been approved on the basis of three large RCTs from the CHAMPION program which nevertheless have been criticized for the low bleeding risk of the enrolled patients, the large quote of chronic coronary syndromes, and the use of Clopidogrel as control arm even in the setting of acute coronary syndromes (ACS). We sought to investigate, in the setting of ACS, the comparative performance of Cangrelor in terms of in-hospital ischemic and haemorrhagic outcomes compared with the current gold-standard of oral P2Y12-I. The study retrospectively enrolled 686 consecutive patients admitted to the Divisions of Cardiology of Policlinico of Bari and L. Bonomo Hospital of Andria for ACS and treated with percutaneous coronary intervention. The study population was divided according to the P2Y12-I treatment strategy in two groups: patients given an oral P2Y12-I and patients receiving Cangrelor in the cath lab followed by an oral P2Y12-I. Clinical endpoints included death, ischemic and bleeding events occurring during hospital stay. Cangrelor treated patients presented higher clinical risk profile at presentation and faced higher death rate. However, after PS matching, in-hospital mortality resulted comparable between the groups and Cangrelor use was associated with reduced in-hospital definite stent thrombosis (p = 0.03). Data from our real-world registry highlight that, in the setting of ACS, Cangrelor is prevalently used in patients with very challenging clinical presentations. The adjusted analysis provides for the first time promising data on stent thrombosis reduction associated with Cangrelor use.
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Affiliation(s)
- Martino Pepe
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy.
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Polyclinic of Bari, P.zza Giulio Cesare 11, 70124, Bari, Italy.
| | - Eugenio Carulli
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
| | - Claudio Larosa
- Division of Cardiology, Lorenzo Bonomo Hospital, Andria, Italy
| | - Gianluigi Napoli
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
| | - Palma Luisa Nestola
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
| | - Maria Cristina Carella
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
| | - Salvatore Giordano
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Rocco Tritto
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
| | | | - Plinio Cirillo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Giuseppe Biondi Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
- Mediterranea Cardiocentro, Naples, Italy
| | - Arturo Giordano
- Invasive Cardiology Unit, "Pineta Grande" Hospital, Castel Volturno, Caserta, Italy
| | - Marco Matteo Ciccone
- Division of Cardiology, Department of Interdisciplinary Medicine (D.I.M.), University of Bari "Aldo Moro", Bari, Italy
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Condello I, Nasso G, Larosa C. Cardiopulmonary Bypass Techniques and Postoperative Nadir Hemoglobin in Cardiac Surgery. Ann Thorac Surg 2021; 114:1526-1527. [PMID: 34736926 DOI: 10.1016/j.athoracsur.2021.09.052] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Ignazio Condello
- Department of Cardiac Surgery, GVM Care and Research, Perfusion Service, Anthea Hospital, Via Camillo Rosalba 35/37, Bari 70124, Italy.
| | - Giuseppe Nasso
- Department of Cardiac Surgery, GVM Care and Research, Perfusion Service, Anthea Hospital, Via Camillo Rosalba 35/37, Bari 70124, Italy
| | - Claudio Larosa
- Department of Cardiology, Azienda Sanitaria Localedella provincia di Barletta Andria Trani, Andria, Italy
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Larosa C, Saldābola R, Zicāns J, Merijs Meri R, Eggenhöffner R, Converti A. Prediction of Thermal Behavior of Polycarbonate/Cerium Oxide Composite Films. Chem Eng Technol 2021. [DOI: 10.1002/ceat.202100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Claudio Larosa
- Pole of Chemical Engineering Department of Civil, Chemical and Environmental Engineering via Opera Pia 15 16145 Genoa Italy
| | - Rūta Saldābola
- Riga Technical University Faculty of Material Science and Applied Chemistry Institute of Polymer Materials 3 Paula Valdena Street 1048 Riga Latvia
| | - Jānis Zicāns
- Riga Technical University Faculty of Material Science and Applied Chemistry Institute of Polymer Materials 3 Paula Valdena Street 1048 Riga Latvia
| | - Remo Merijs Meri
- Riga Technical University Faculty of Material Science and Applied Chemistry Institute of Polymer Materials 3 Paula Valdena Street 1048 Riga Latvia
| | - Roberto Eggenhöffner
- University of Genoa Department of Surgical Science and Integrate Diagnostic Corso Europa 30 16145 Genoa Italy
- Istituto Nazionale Biostrutture e Biosistemi – Consorzio Interuniversitario Viale delle Medaglie d'Oro 305 00136 Rome Italy
| | - Attilio Converti
- Pole of Chemical Engineering Department of Civil, Chemical and Environmental Engineering via Opera Pia 15 16145 Genoa Italy
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Pepe M, Larosa C, Cirillo P, Carulli E, Forleo C, Nestola PL, Ercolano V, D'Alessandro P, Giordano A, Biondi-Zoccai G, Moscarelli M, Palmiotto AI, Esposito G, Favale S. Clinical use of cangrelor: a real world multicenter experience from South Italy Insights from the M.O.Ca. registry. Panminerva Med 2021; 64:9-16. [PMID: 34060281 DOI: 10.23736/s0031-0808.21.04437-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Dual antiplatelet therapy (DAPT) with acetylsalicylic acid and oral P2Y12 inhibitor (P2Y12-I) represents the standard of care for patients with acute coronary syndromes (ACS) or with chronic coronary syndromes (CCS) treated with percutaneous coronary intervention (PCI). Cangrelor, the first intravenous P2Y12-I, is deemed to overcome the drawbacks of the oral administration; nevertheless real world data on this new drug are scanty. We sought to investigate routine clinical use of cangrelor in four interventional centers of Italy. METHODS We enrolled 241 consecutive patients (196 ACS, 45 CCS) treated with cangrelor during PCI. Drug administration modalities and in-hospital clinical outcomes were evaluated. A subanalysis in patients selected on the basis of the CHAMPION Phoenix trial inclusion/exclusion criteria (CHAMPION-like subpopulation) was also performed. RESULTS Cangrelor was mainly utilized in ACS patients, who presented poorer clinical conditions and higher bleeding risk. Cangrelor was given only in P2Y12-I naïve patients; switch to clopidogrel was always done at the end of the infusion, while ticagrelor or prasugrel were prevalently given 30 minutes before. In-hospital mortality was 10.0% and GUSTO moderate/severe bleeding was 2.5%. Bleeding data showed nevertheless to be in line with the CHAMPION Phoenix results in the "CHAMPION-like" subpopulation. CONCLUSIONS Cangrelor was predominantly used in ACS with modalities substantially in accord with the label indications. Poor clinical outcomes are due to the prevalent utilization in highly challenging clinical settings, nevertheless the rate of bleeding and stent thrombosis are in line with the randomized trials if analyzed in a subpopulation of comparable risk profile.
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Affiliation(s)
- Martino Pepe
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Bari, Italy -
| | - Claudio Larosa
- Division of Cardiology, Lorenzo Bonomo Hospital, Andria, Italy
| | - Plinio Cirillo
- Division of Cardiology, Department of Advanced Biomedical Sciences, School of Medicine, Federico II University, Naples, Italy
| | - Eugenio Carulli
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Bari, Italy
| | - Cinzia Forleo
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Bari, Italy
| | - Palma L Nestola
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Bari, Italy
| | - Vincenzo Ercolano
- Division of Cardiology, Department of Advanced Biomedical Sciences, School of Medicine, Federico II University, Naples, Italy
| | | | - Arturo Giordano
- Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Marco Moscarelli
- Cardiothoracic and Vascular Department, Maria Cecilia Hospital GVM Care & Research, Cotignola, Ravenna, Italy
| | | | - Giovanni Esposito
- Division of Cardiology, Department of Advanced Biomedical Sciences, School of Medicine, Federico II University, Naples, Italy
| | - Stefano Favale
- Cardiovascular Diseases Section, Cardiothoracic Department (DAI), University of Bari, Bari, Italy
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Larosa C, Talu S, Reverberi AP, Salerno M. Microporous morphology of cathodic electrolytic treated aluminum imaged by atomic force microscopy. Materials Letters 2020. [DOI: 10.1016/j.matlet.2020.128593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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De Marzo V, Parisi R, Caruso M, D'Amario D, Annibali G, Manganiello V, Vergallo R, Donahue M, Cialdella P, Ielasi A, Misuraca L, Altamura L, Cortese B, Larosa C, Canepa M, Porto I. Hard Events AfteR Orsiro Sirolimus-Eluting Stent (HEROES) in STEMI: A Multicenter Registry. J Invasive Cardiol 2020; 32:E331-E337. [PMID: 33221731] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To evaluate the safety and efficacy of the Orsiro sirolimus-eluting stent (Biotronik) in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (pPCI). Specific drug-eluting stent (DES) platforms might influence pPCI success rate in the mid-to-long term. Orsiro, a hybrid sirolimus DES with thin struts and a biodegradable polymer, may potentially cause less stent malapposition, stent-induced inflammation, and mechanical damage, improving clinical outcomes. METHODS We retrospectively enrolled all patients who received 1 or more Orsiro DES in the target vessel of pPCI at 9 Italian centers from January 2012 to March 2016. The primary endpoint was a device-oriented composite endpoint (DOCE) of cardiac death, any myocardial infarction clearly attributable to the intervention culprit vessel (TVMI), and ischemic-driven target-lesion revascularization (ID-TLR) at 1-year follow-up. Secondary endpoints were: (1) DOCE at 6-month and 3-year follow-up; (2) any definite/probable stent thrombosis; and (3) any major bleeding. RESULTS The study cohort comprised 353 patients. At 1-year follow-up, we observed a 3.7% cumulative incidence of DOCE, consisting of 11 cardiac deaths (3.1%), 2 TVMIs (0.6%), and 2 ID-TLRs (0.6%). There was only 1 definite stent thrombosis (0.3%) and 8 bleedings (2.4%). Kaplan-Meier analysis showed DOCE-free survival rates of 96.6% at 6 months, 96.3% at 1 year, and 93.8% at 3 years. CONCLUSIONS Our findings support the real-world safety and efficacy of the Orsiro stent for pPCI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Italo Porto
- University of Genoa, Cardiovascular Unit, Department of Internal Medicine and Specialties (DIMI) Viale Benedetto XV, 10, 16132 Genoa, Italy.
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Navarese EP, Frediani L, Kandzari DE, Caiazzo G, Cenname AM, Cortese B, Piva T, Muçaj A, Tumscitz C, Paparoni F, Larosa C, Bisceglia T, Menozzi M, Gurbel PA, Kubica J. Efficacy and safety of intracoronary epinephrine versus conventional treatments alone in STEMI patients with refractory coronary no‐reflow during primary PCI: The RESTORE observational study. Catheter Cardiovasc Interv 2020; 97:602-611. [DOI: 10.1002/ccd.29113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 06/07/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Eliano P. Navarese
- Department of Cardiology, Collegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
- SIRIO MEDICINE Network Bydgoszcz Poland
- Faculty of Medicine University of Alberta Edmonton Canada
| | - Lara Frediani
- Department of Cardiology Livorno Hospital, Azienda Usl Toscana Nord‐Ovest, Ospedali Riuniti di Livorno Livorno Italy
| | | | | | | | | | - Tommaso Piva
- Department of Cardiologic Azienda Ospedaliero Universitaria "Ospedali Riuniti" Ancona Italy
| | - Andi Muçaj
- Department of Cardiologic Azienda Ospedaliero Universitaria "Ospedali Riuniti" Ancona Italy
| | | | | | - Claudio Larosa
- Department of Cardiology Azienda Ospedaliera Bonomo Andria Italy
| | - Teodoro Bisceglia
- Department of Cardiology Santa Maria della Misericordia Hospital Udine Italy
| | | | - Paul A. Gurbel
- Sinai Center form Thrombosis Research Sinai Hospital of Baltimore Baltimore Maryland USA
| | - Jacek Kubica
- Department of Cardiology, Collegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
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Larosa C, Salerno M, de Lima JS, Merijs Meri R, da Silva MF, de Carvalho LB, Converti A. Characterisation of bare and tannase-loaded calcium alginate beads by microscopic, thermogravimetric, FTIR and XRD analyses. Int J Biol Macromol 2018; 115:900-906. [DOI: 10.1016/j.ijbiomac.2018.04.138] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 01/13/2023]
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Larosa C, Patra N, Salerno M, Mikac L, Merijs Meri R, Ivanda M. Preparation and characterization of polycarbonate/multiwalled carbon nanotube nanocomposites. Beilstein J Nanotechnol 2017; 8:2026-2031. [PMID: 29046850 PMCID: PMC5629402 DOI: 10.3762/bjnano.8.203] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 09/04/2017] [Indexed: 06/07/2023]
Abstract
A polymer nanocomposite was produced by ultrasonic-assisted dispersion of multiwalled carbon nanotubes (MWCNTs) in a polycarbonate matrix using p-xylene and dichloromethane as the solvents. The filler loading was varied from 1 to 3 wt % in order to examine the effect of MWCNTs on the structure and properties of the composites. The nanocomposites were characterized by DSC, DTA, TGA, UV-vis, FTIR and Raman spectroscopy to evaluate the changes induced by the filler in the polymer matrix. UV-vis, FTIR and Raman spectroscopy measurements confirmed the presence of the dispersed phase in the composite films, while TGA and DSC analysis of the nanocomposites revealed enhanced thermal stability and decreased crystallinity, respectively, as compared to the neat polymer. The proposed composites can find application in a number of everyday products where polycarbonate is the base polymer.
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Affiliation(s)
- Claudio Larosa
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, via Opera Pia 15, 16145 Genoa, Italy
| | - Niranjan Patra
- Department of Mechanical Engineering, University of Wyoming, 82071 Laramie, USA
| | - Marco Salerno
- Materials Characterization Facility, Istituto Italiano di Tecnologia, via Morego 30, 16163 Genoa, Italy
| | - Lara Mikac
- Rudjer Bošković Institute, Center of Excellence for Advanced Materials and Sensing Devices, Bijenička 54, 10000 Zagreb, Croatia
| | - Remo Merijs Meri
- Department of Polymer Materials, Riga Technical University, Azenes Str. 14/24, Riga LV-1048, Latvia
| | - Mile Ivanda
- Rudjer Bošković Institute, Center of Excellence for Advanced Materials and Sensing Devices, Bijenička 54, 10000 Zagreb, Croatia
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Bartolomucci F, Tito A, Navarese EP, Iacovelli F, Mele M, Larosa C, Ciccone MM, Cassese M, Pepe M. STEMI and NSTEMI ACS in a 30-Year-Old Patient: An Extremely Rare Complication of a Left Atrial Myxoma. Heart Surg Forum 2017; 20:E116-E118. [PMID: 28671868 DOI: 10.1532/hsf.1607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 11/23/2016] [Accepted: 06/14/2017] [Indexed: 11/20/2022]
Abstract
Primary cardiac tumors are a rare entity whose incidence in the general population ranges from 0.0017% to 0.28%. Myxomas represent nearly half of all primary benign cardiac tumors and they prevalently affect female patients. Embolic manifestation is rare with a reported incidence of 0.06%.We present the case of a 30-year-old male patient with acute anterolateral infarction caused by total occlusion of the left anterior descending artery as a consequence of a left atrial myxoma embolization. Urgent surgical resection of the mass didn't avoid early recurrence of atrial myxoma, whose second presentation was again myocardial infarction.This case alerts physicians to "unusual" myocardial infarction patients, when atherosclerotic pathogenesis appears unlikely. In these cases early echocardiographic evaluation should be mandatory and atrial myxoma should be considered among the possible causes. Complete surgical resection is the only effective therapeutic option to improve prognosis; the chance of tumor recurrence should dictate careful research for additional myxomas during surgery and stricter follow-up planning.
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Affiliation(s)
| | - Antonio Tito
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Eliano Pio Navarese
- Department of Internal Medicine, Division of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University, Düsseldorf, Germany Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE research network, Düsseldorf, Germany
| | - Fortunato Iacovelli
- Interventional Cardiology Service, “Montevergine” Clinic, Mercogliano, Italy; Division of Cardiology, Department of Advanced Biomedical Sciences, University of Napoli “Federico II”, Napoli, Italy
| | - Marco Mele
- Coronary Care Unit-Cardiology Unit, Teresa Masselli Mascia Hospital, San Severo (FG), Italy
| | - Claudio Larosa
- Division of Cardiology, L. Bonomo Hospital, Andria (BT), Italy
| | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy
| | - Mauro Cassese
- Department of Cardiovascular Surgery, Casa Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Martino Pepe
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, School of Medicine, Policlinico, Bari, Italy
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Durante A, Foglia Manzillo G, Burzotta F, Trani C, Aurigemma C, Summaria F, Patrizi R, Talarico GP, Latib A, Figini F, Romagnoli E, De Vita M, Fantoni C, My L, Larosa C, Manzoli A, Turturo M, Berni A, Corrado G. Long term follow-up of "full metal jacket" of de novo coronary lesions with new generation Zotarolimus-eluting stents. Int J Cardiol 2016; 221:1008-12. [PMID: 27441483 DOI: 10.1016/j.ijcard.2016.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 06/24/2016] [Accepted: 07/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Diffuse coronary artery disease treatment still remains a challenge for interventional cardiologists and cardiac surgeons. There are few data on full metal jacket (FMJ) stenting, especially with new-generation drug-eluting stents. We aimed to assess the efficacy and safety of FMJ with new-generation Zotarolimus-eluting stents (n-ZES). METHODS AND RESULTS All patients who underwent FMJ with n-ZES (≥60mm stent length) in eleven Italian interventional centers participating in the Clinical Service® project were included in this analysis. The project population consisted of 120 patients and 122 lesions. Mean age was 67±10years and 95 (79.2%) patients were male. A chronic total occlusion was present in 34 lesions (27.9%). The number of stents implanted per lesion was 2.9±0.8, and the diameter of the stents was 3.0±0.5mm. Predilation and post-dilatation were performed in 107 (87.7%) and 92 (75.4%) patients, respectively. At 41±21month follow-up there were 2 patients with subacute definite stent thrombosis, 6 patients (5.0%) had cardiac death and 5 patients (4.2%) had non-fatal myocardial infarction. Seven patients (5.8%) underwent clinically-driven target lesion revascularization. Fourteen patients (11.7%) had at least one major adverse cardiac event. CONCLUSION The treatment of diffuse coronary artery disease with FMJ stenting with n-ZES appears to be effective and safe. Late and very-late ST does not seem to be an issue and the rate of restenosis and of major cardiac adverse events after more than 3-year follow-up is rather low.
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Affiliation(s)
- Alessandro Durante
- Unità Operativa Complessa di Cardiologia, Ospedale Valduce, Como, Italy.
| | | | - Francesco Burzotta
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Carlo Trani
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cristina Aurigemma
- Dipartimento Cardiovascolare, Università Cattolica del Sacro Cuore, Roma, Italy
| | | | | | | | - Azeem Latib
- Unità Di Emodinamica e Cardiologia Interventistica, Ospedale San Raffaele, Milan, Italy
| | - Filippo Figini
- Unità Di Emodinamica e Cardiologia Interventistica, Ospedale San Raffaele, Milan, Italy
| | - Enrico Romagnoli
- Unità di Emodinamica e Cardiologia Interventistica - Ospedale di Belcolle, Viterbo, Italy
| | - Mariarosaria De Vita
- Unità Operativa Di Cardiologia, Azienda Ospedaliera Morgagni Pierantoni, Forlì, Italy
| | - Cecilia Fantoni
- Unità Operativa Di Cardiologia, Istituto Clinico Humanitas Mater Domini, Castellanza, Italy
| | - Luigi My
- Unità di Cardiologia, Casa di Cura Villa Verde, Taranto, Italy
| | - Claudio Larosa
- Unità Di Cardiologia, Ospedale Lorenzo Bonomo, Andria, Italy
| | - Alessandro Manzoli
- Unità di Emodinamica e Cardiologia Interventistica, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Maurizio Turturo
- UOC Cardiologia, Presidio Ospedaliero Di Venere, Bari Carbonara, Italy
| | - Andrea Berni
- UOC Cardiologia, Azienda Ospedaliera Sant'Andrea, Roma, Italy
| | - Giovanni Corrado
- Unità Operativa Complessa di Cardiologia, Ospedale Valduce, Como, Italy
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Bragazzi NL, Gasparini R, Amicizia D, Panatto D, Larosa C. Porous Alumina as a Promising Biomaterial for Public Health. Adv Protein Chem Struct Biol 2015; 101:213-29. [PMID: 26572980 DOI: 10.1016/bs.apcsb.2015.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Porous aluminum is a nanostructured material characterized by unique properties, such as chemical stability, regular uniformity, dense hexagonal porous lattice with high aspect ratio nanopores, excellent mechanical strength, and biocompatibility. This overview examines how the structure and properties of porous alumina can be exploited in the field of public health. Porous alumina can be employed for fabricating membranes and filters for bioremediation, water ultrafiltration, and microfiltration/nanofiltration, being a promising technique for having clean and fresh water, which is essential for human health. Porous alumina-based nanobiosensor coated with specific antibodies or peptides seem to be a useful tool to detect and remove pathogens both in food and in water, as well as for environmental monitoring. Further, these applications, being low-energy demanding and cost-effective, are particularly valuable in resource-limited settings and contexts, and can be employed as point of use devices in developing countries, where there is an urgent need of hygiene and safety assurance.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), Via Antonio Pastore 1, University of Genoa, Genoa, Italy
| | - Roberto Gasparini
- Department of Health Sciences (DISSAL), Via Antonio Pastore 1, University of Genoa, Genoa, Italy.
| | - Daniela Amicizia
- Department of Health Sciences (DISSAL), Via Antonio Pastore 1, University of Genoa, Genoa, Italy
| | - Donatella Panatto
- Department of Health Sciences (DISSAL), Via Antonio Pastore 1, University of Genoa, Genoa, Italy
| | - Claudio Larosa
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy
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Burzotta F, Summaria F, Latib A, De Vita M, Fantoni C, Benedetto S, Turturo M, Larosa C, Manzoli A, Trani C. Prospective multicentre clinical performance evaluation of second and third generation zotarolimus-eluting stents to treat patients with bifurcated coronary lesions. Catheter Cardiovasc Interv 2015; 87:15-22. [PMID: 25914397 DOI: 10.1002/ccd.25954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/15/2015] [Indexed: 11/07/2022]
Abstract
AIM To assess the "real world" clinical outcome of patients with bifurcated lesions undergoing percutaneous coronary intervention with implantation of second and third generations of zotarolimus-eluting stent. METHODS AND RESULTS Nine Italian centres participated in a prospective multicentre clinical project evaluating the outcome of patients receiving zotarolimus-eluting Resolute stent and Resolute Integrity stents. Patients with bifurcated lesions entered this evaluation. Clinical characteristics and angiographic and procedural details were prospectively recorded. Clinical outcome was prospectively assessed to evaluate the occurrence of major adverse cardiac events (MACE). A total of 577 patients were enrolled. The target lesion was distal left main in 11.1% and left anterior descending artery in 52.8%, and 30.3% of lesions were Medina 1,1,1. At a mean follow-up time of 27.0 ± 13.5 months, the survival free from MACE was 91.8%. Survival free from MACE was similar in patients grouped according to different bifurcated lesion complexity. On the contrary, patients receiving a single stent had better survival free from MACE as compared with those with double stent (P = 0.005). At multivariable analysis, double stenting (but not bifurcated lesion complexity) was found to be a significant predictor of MACE (hazard ratio, 2.52; 95% confidence interval, 1.28-4.94; P = 0.007). Of note, patients receiving the second stent as a bail-out had worse survival free from MACE compared with those who received it as a planned technique (P = 0.045). CONCLUSION The treatment of patients with bifurcated lesions with second and third generation zotarolimus-eluting stents is associated with good long-term clinical outcomes. Clinical outcome seems to be independent of lesion complexity, but may be influenced by the stenting technique (single or double stenting as well as elective or bail-out double stenting). © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Francesco Burzotta
- Cardiovascular Department, Catholic University of Sacred Heart, Rome, Italy
| | | | - Azeem Latib
- Unità Di Emodinamica E Cardiologia Interventistica, Istituto Scientifico Universitario San Raffaele, Milan, Italy
| | - Maria De Vita
- Unità Operativa Di Cardiologia, Azienda Ospedaliera Morgagni Pierantoni, Forlì, Italy
| | - Cecilia Fantoni
- Unità Operativa Di Cardiologia, Istituto Clinico Humanitas Mater Domini, Castellanza, Italy
| | - Stefano Benedetto
- S.S.C, Emodinamica, Ente Ospedaliero Ospedali Galliera, Genova, Italy
| | - Maurizio Turturo
- UOC Cardiologia, Presidio Ospedaliero Di Venere, Bari Carbonara, Italy
| | - Claudio Larosa
- Unità Di Cardiologia, Ospedale Lorenzo Bonomo, Andria, Italy
| | - Alessandro Manzoli
- Emodinamica E Cardiologia Interventistica, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | - Carlo Trani
- Cardiovascular Department, Catholic University of Sacred Heart, Rome, Italy
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Porto I, Larosa C, Rosa I, Burzotta F, Trani C. Successful transradial removal of an inflated coronary stent dislodged from the right coronary ostium. Cardiovasc Revasc Med 2014; 15:432-5. [PMID: 24929473 DOI: 10.1016/j.carrev.2014.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Revised: 04/22/2014] [Accepted: 05/01/2014] [Indexed: 12/01/2022]
Abstract
We describe our solution to the unusual situation of an inflated, large coronary stent (3.5 mm diameter) which became dislodged from the ostium of the right coronary artery after deployment during a transradial procedure. We discussed tips for retrieval from the radial artery while preserving the access for completion of the procedure.
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Affiliation(s)
- Italo Porto
- Cardiovascular and Neurologic Department, San Donato Hospital, Arezzo, Italy.
| | | | | | | | - Carlo Trani
- Catholic University of the Sacred Heart, Rome, Italy
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Ielasi A, Latib A, Burzotta F, Summaria F, De Vita M, Anzuini A, Larosa C, Della Rovere F, Lanzone S, manzoli A, Giovannelli F, Colombo A. TCT-210 Clinical Outcomes Following Resolute Zotarolimus-eluting Stent Implantation in Diabetic versus Non-Diabetic Patients Suitable for Percutaneous Coronary Revascularization: Insights From a Multicenter Italian Registry. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nicolini C, Correia TB, Stura E, Larosa C, Spera R, Pechkova E. Atomic force microscopy and anodic porous allumina of nucleic acid programmable protein arrays. Recent Pat Biotechnol 2013; 7:112-121. [PMID: 23848275 DOI: 10.2174/18722083113079990003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 01/29/2013] [Accepted: 02/13/2013] [Indexed: 06/02/2023]
Abstract
The methodological aspects are here presented for the NAPPA (Nucleic Acid Programmable Protein Arrays) characterization by atomic force microscopy and anodic porous alumina. Anodic Porous Alumina represents also an advanced on chip laboratory for gene expression contained in an engineered plasmid vector. The results obtained with CdK2, CDKN1A, p53 and Jun test genes expressed on NAPPA and the future developments are discussed in terms of our pertinent and recent Patents and of their possibility to overcome some limitations of present fluorescence detection in probing protein-protein interaction in both basic sciences and clinical studies.
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Affiliation(s)
- Claudio Nicolini
- Nanoworld Institute President, Bergamo, Biophysics Eminent Chair University of Genova, Italy.
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Larosa C, Salerno M, Nanni P, Reverberi AP. Cobalt Cementation in an Ethanol–Water System: Kinetics and Morphology of Metal Aggregates. Ind Eng Chem Res 2012. [DOI: 10.1021/ie300918y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Claudio Larosa
- DICheP, Department of Chemical
Engineering and Process, University of Genova, via Opera Pia 15, 16145 Genova, Italy
- Faculty of Physics, Alexandru Ioan Cuza University, Bulevardul Carol I, No.11, 700506
Iasi, Romania
| | - Marco Salerno
- IIT, Italian Institute of Technology, via Morego 30, 16163 Genova, Italy
| | - Paolo Nanni
- DICheP, Department of Chemical
Engineering and Process, University of Genova, via Opera Pia 15, 16145 Genova, Italy
| | - Andrea P. Reverberi
- DCCI, Department of Chemistry
and Industrial Chemistry, University of Genova, via Dodecaneso 32, 16146 Genova, Italy
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Porto I, Belloni F, Niccoli G, Larosa C, Leone AM, Burzotta F, Trani C, De Maria GL, Hamilton-Craig C, Crea F. Filter no-reflow during percutaneous coronary intervention of saphenous vein grafts: incidence, predictors and effect of the type of protection device. EUROINTERVENTION 2011; 7:955-61. [DOI: 10.4244/eijv7i8a151] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Salerno M, Giacomelli L, Larosa C. Biomaterials for the programming of cell growth in oral tissues: The possible role of APA. Bioinformation 2011; 5:291-3. [PMID: 21364837 PMCID: PMC3043349 DOI: 10.6026/97320630005291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2010] [Accepted: 09/14/2010] [Indexed: 11/26/2022] Open
Abstract
Examples of programmed tissue response after the interaction of cells with biomaterials are a hot topic in current dental research. We propose here the use
of anodic porous alumina (APA) for the programming of cell growth in oral tissues. In particular, APA may trigger cell growth by the controlled release
of specific growth factors and/or ions. Moreover, APA may be used as a scaffold to promote generation of new tissue, due to the high interconnectivity of
pores and the high surface roughness displayed by this material.
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Affiliation(s)
- Marco Salerno
- Italian Institute of Technology, via Morego 30, I-16163 Bolzaneto (Genova), Italy
- Marco Salerno: Phone: 0039-010-71781444; Fax: 0039-010-72032
| | - Luca Giacomelli
- Tirrenian Stomatologic Institute, via Aurelia 335, I-55041 Lido di Camaiore (Lucca), Italy
| | - Claudio Larosa
- National Research Center, via De Marini 6, I-16149 Genova, Italy
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Larosa C, Ricco A, Cosentino N, Marino M, Mongiardo R, Niccoli G. A case of very late thrombosis of bare metal stent successfully treated with Excimer Laser Coronary Angioplasty. Int J Cardiol 2010; 145:e60-e63. [DOI: 10.1016/j.ijcard.2008.12.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Accepted: 12/14/2008] [Indexed: 11/26/2022]
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Sharp AS, Latib A, Ielasi A, Larosa C, Godino C, Saolini M, Magni V, Gerber RT, Montorfano M, Carlino M, Michev I, Chieffo A, Colombo A. Long-Term Follow-Up on a Large Cohort of “Full-Metal Jacket” Percutaneous Coronary Intervention Procedures. Circ Cardiovasc Interv 2009; 2:416-22. [PMID: 20031751 DOI: 10.1161/circinterventions.109.886945] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Limited long-term data exist on patients who have undergone drug-eluting stenting of very long lesions (requiring ≥60 mm of continuous stent) in native coronary arteries (“full-metal jacket”).
Methods and Results—
We examined consecutive procedures taking place between March 2002 and 2007 at 2 high-volume centers in Milan, Italy. Exclusion criteria were percutaneous coronary intervention for restenosis, percutaneous coronary intervention to a bypass graft, or percutaneous coronary intervention for acute ST-elevation myocardial infarction (MI). We identified 658 full-metal jacket lesions in 617 patients. Average age of the cohort was 62.0�10.6; 32.8% were diabetic, 51.5% had a previous MI, and 33.4% had undergone a previous percutaneous transluminal coronary angioplasty. Mean ejection fraction was 52.1�10.4%. The lesion was a chronic total occlusion in 33.0%. Median duration of clinical follow-up was 39 months (interquartile range, 28 to 50). Six-month follow-up was achieved in 97% of patients; 2-year follow-up was achieved in 91%. All-cause mortality rate was 7.3%; cardiac death rate was 3.6%. Non–procedure-related MI rates were 3.5%. Target lesion revascularization rates were 23.4%. There were 17 cases of Academic Research Consortium–defined definite or probable stent thrombosis (2.6%): 5 acute, 2 subacute, 6 late, and 4 very late. Ten of the 17 cases occurred while the patient was receiving dual antiplatelet therapy; 4 of the 17 after premature termination of 1 or both antiplatelets, and 3 of the 17 occurred while the patient was receiving single-antiplatelet therapy, after having completed the prescribed course of dual antiplatelet therapy.
Conclusion—
When very long lesions (≥60 mm) were treated using overlapping drug-eluting stents, 23.4% required a further procedure for restenosis at 3-year follow-up. However, MI, stent thrombosis, and cardiac mortality rates were relatively low.
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Affiliation(s)
- Andrew S.P. Sharp
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Azeem Latib
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Alfonso Ielasi
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Claudio Larosa
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Cosmo Godino
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Marta Saolini
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Valeria Magni
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Robert T. Gerber
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Matteo Montorfano
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Mauro Carlino
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Iassen Michev
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Alaide Chieffo
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
| | - Antonio Colombo
- From the San Raffaele Scientific Institute and EMO-GVM Centro Cuore, Columbus Hospital, Milan, Italy; (A.S.P.S., A.L., A.I., C.L., C.G., M.S., V.M., R.T.G., M.M., M.C., I.M., A.C., A.C.) and Imperial College Healthcare NHS Trust, St Mary’s Hospital, London, United Kingdom (A.S.P.S.)
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Affiliation(s)
- Claudio Larosa
- Nanoworld Institute – CIRSDNNOB and Biophysics Division, University of Genova, Corso Europa 30, 16132 Genoa, Italy; E-Mails: (C.L.); (E.S.); (R.E.)
| | - Enrico Stura
- Nanoworld Institute – CIRSDNNOB and Biophysics Division, University of Genova, Corso Europa 30, 16132 Genoa, Italy; E-Mails: (C.L.); (E.S.); (R.E.)
- Fondazione El.B.A., Piazza SS Apostoli 66, 00100 Roma, Italy
| | - Roberto Eggenhöffner
- Nanoworld Institute – CIRSDNNOB and Biophysics Division, University of Genova, Corso Europa 30, 16132 Genoa, Italy; E-Mails: (C.L.); (E.S.); (R.E.)
| | - Claudio Nicolini
- Nanoworld Institute – CIRSDNNOB and Biophysics Division, University of Genova, Corso Europa 30, 16132 Genoa, Italy; E-Mails: (C.L.); (E.S.); (R.E.)
- Fondazione El.B.A., Piazza SS Apostoli 66, 00100 Roma, Italy
- Author to whom correspondence should be addressed; E-Mail: ; Tel. +39-010-353-38217; Fax: +39-010-353-38215
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Porto I, Larosa C, Niccoli G, Leone AM, Burzotta F, Testa L, Van Gaal W, Lanza GA, Crea F. Nonconventional use of coronary guidewires for ECG recording and emergency pacing. J Cardiovasc Med (Hagerstown) 2008; 9:1222-8. [DOI: 10.2459/jcm.0b013e32830fe706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Larosa C, Sgueglia GA, Sestito A, Infusino F, Niccoli G, Lamendola P, Mariani L, Santangeli P, Lombardo A, Crea F, Lanza GA. Predictors of impaired heart rate variability and clinical outcome in patients with acute myocardial infarction treated by primary angioplasty. J Cardiovasc Med (Hagerstown) 2008; 9:76-80. [PMID: 18268424 DOI: 10.2459/jcm.0b013e3280c56d56] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the determinants and prognostic value of heart rate variability (HRV) in acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention (PCI). METHODS We studied 64 patients with AMI (58.4 +/- 10 years, 56 men), treated by PCI within 12 h of symptom onset. Patients underwent 24-h electrocardiographic Holter recording before discharge. HRV was measured in the time- and frequency-domain. Cardiac events were assessed at 6 months. RESULTS At univariate analysis, Thrombolysis in Myocardial Infarction (TIMI) flow grade < 3 was significantly predictive of reduced frequency-domain variables. On multivariate analysis, diabetes and pre-PCI time > 6 h were the strongest predictors of depressed HRV, with peak creatine kinase myocardial-type and lower left ventricular ejection fraction being also variably correlated with impaired HRV. At 6-month follow-up, seven patients (10.1%) had cardiac events (one AMI, six revascularization procedures). A low standard deviation of RR intervals was a significant predictor of events (P = 0.009), although only age was associated with the endpoint (P = 0.05) on multivariate analysis. CONCLUSIONS Our study shows that, in AMI patients treated by primary PCI, a delay in coronary revascularization and AMI extension are key factors for determining depressed HRV.
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Affiliation(s)
- Claudio Larosa
- Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
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Santangeli P, Lamendola P, Larosa C, Lombardo A, Sestito A, Infusino F, Sgueglia GA, Mariani L, Marinaccio L, Lanza GA, Crea F. Effect of primary coronary intervention on heart rate variability and left ventricular function in patients with acute myocardial infarction. Minerva Cardioangiol 2007; 55:703-710. [PMID: 18091639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM Several studies showed that primary percutaneous coronary interventions (PCI) have a favourable impact on left ventricular remodeling and heart rate variability (HRV) both at short- and long-term follow-up in patients suffering an acute myocardial infarction (AMI). However, no previous study investigated the relationship between left ventricular remodeling and changes in HRV during follow-up in AMI patients treated by primary PCI. METHODS We studied 28 patients with AMI (57+/-8 years, 27 men), treated by PCI within 12 hours of symptom onset. Patients underwent a 24-hour ECG Holter recording and left ventricular ejection fraction (LVEF) echocardiographic assessment before discharge, and at 1-month and 6-month follow-up. HRV was measured in the time- and frequency-domain. RESULTS A significant improvement of both time- and frequency-domain HRV variables was observed at 1-month and at 6-month follow-up with the most significant changes being found for standard deviation of normal-normal beat intervals (SDNN) in the time-domain (95.5+/-26.1 ms vs 125.5+/-29.8 ms vs 142.8+/-28.8 ms, respectively; P<0.001) and for very low frequency (VLF) amplitude in the frequency-domain (36.7+/-9.8 ms vs 44.1+/-11.1 vs 48.9+/-12.2 ms, respectively; P<0.001). In contrast, compared to basal values, LVEF was substantially unchanged at 1-month and 6-month follow-up (48.8+/-8.5% vs 50.8+/-10% vs 49.6+/-9%, respectively; P=0.25). At 6-month follow-up 11 patients showed an improvement of >or= 5% of LVEF, whereas 17 patients did not show any improvement of LVEF. HRV variables significantly improved in a similar way in these two subgroups both at 1-month and at 6-month follow-up. CONCLUSION Our data demonstrate that, in AMI patients treated by primary PCI, HRV improves over time, independent of changes in LVEF. The clinical implications of these findings deserve to be addressed in future studies.
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Affiliation(s)
- P Santangeli
- Department of Cardiology, Sacro Cuore Catholic University, Rome, Italy
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Infusino F, Lanza GA, Larosa C, Sgueglia GA, Marinaccio L, Lamendola P, Mariani L, Santangeli P, Sestito A, Crea F. Exercise-induced ST-segment elevation in patients with a recent acute myocardial infarction treated by primary percutaneous coronary intervention. Ann Noninvasive Electrocardiol 2007; 12:349-53. [PMID: 17970960 DOI: 10.1111/j.1542-474x.2007.00184.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To get insight in the mechanism of exercise-induced ST-segment elevation (STE) in patients with Q/QS waves at the electrocardiogram (ECG). METHODS We performed exercise stress test in 13 patients with anterior acute myocardial infarction treated by successful primary percutaneous coronary intervention (PCI). RESULTS Compared to rest, an additional STE > or = 1 mm in one or more precordial ECG leads during exercise occurred in nine patients (69%), in the absence of symptoms. CONCLUSIONS In acute myocardial infarction (MI) patients, treated by primary PCI and showing optimal coronary blood flow restoration at angiography, STE can still be induced by exercise in Q/QS wave ECG leads. This finding lends further support to the theory that exercise-induced STE in this clinical context is unlikely to represent by itself transient myocardial ischemia or viability.
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Affiliation(s)
- Fabio Infusino
- Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Larosa C, Infusino F, Sgueglia GA, Aurigemma C, Sestito A, Lombardo A, Niccoli G, Crea F, Lanza GA. Effect of primary percutaneous coronary intervention versus thrombolysis on ventricular arrhythmias and heart rate variability in acute myocardial infarction. Ital Heart J 2005; 6:629-33. [PMID: 16161495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Several studies showed that thrombolysis reduces ventricular arrhythmias and improves heart rate variability (HRV) in patients with acute myocardial infarction (AMI). Primary percutaneous coronary intervention (PCI) has recently become the treatment of choice for AMI, but it is still unknown whether it has favorable effects on these prognostic variables. METHODS We studied a group of 44 consecutive AMI patients (39 males, 5 females, mean age 59 +/- 9 years) submitted to primary PCI and 93 consecutive AMI patients (80 males, 13 females, mean age 61.0 +/- 11 years) treated with thrombolytic therapy within 6 hours of symptom onset. All patients underwent 24-hour Holter recording before discharge. RESULTS The number of premature ventricular beats and the prevalence of non-sustained ventricular tachycardia in the 24 hours were lower in the PCI group (162 +/- 474 and 9%, respectively) than in the thrombolysed group (334 +/- 1730 and 14%, respectively), but the difference did not achieve statistical significance (p = 0.62 and p = 0.58, respectively). There were also no significant differences in HRV variables between the two groups, although a lower proportion of PCI patients tended to have bottom quartile values of HRV variables. The favorable trend for arrhythmias and HRV in PCI patients, however, seemed to be related to a worse basal clinical profile of thrombolysed patients, including a higher prevalence of previous AMI (14 vs 2%, p = 0.065), diabetes (27 vs 18%, p = 0.14) and, in particular, a lower use of beta-blockers (35 vs 93%, p < 0.001). CONCLUSIONS In this study, we failed to show any significant benefit of primary PCI compared to thrombolysis on ventricular arrhythmias and HRV in patients with ST-segment elevation AMI. The clinical implications of these findings deserve investigation in future studies.
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Affiliation(s)
- Claudio Larosa
- Institute of Cardiology, Catholic University, Rome, Italy
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Sestito A, Maccallini A, Sgueglia GA, Infusino F, Larosa C, Aurigemma C, Crea F, Lanza GA. Platelet reactivity in response to mental stress in syndrome X and in stable or unstable coronary artery disease. Thromb Res 2004; 116:25-31. [PMID: 15850605 DOI: 10.1016/j.thromres.2004.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Revised: 10/02/2004] [Accepted: 10/03/2004] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Previous studies showed differences in platelet reactivity in response to exercise in patients with syndrome X (SX) and those with obstructive coronary artery disease (CAD). In this study, we investigated whether similar differences could be detectable in response to a mental stressful stimulus. MATERIALS AND METHODS We studied 30 SX patients (60+/-8 years, 8 men), 20 patients with stable angina and angiographically documented CAD (SA, 66+/-8 years, 14 men), and 11 patients with unstable angina (UA, 67+/-8 years, 6 men). A control group of 22 healthy controls (50+/-7 years, 5 men) was also studied. All subjects underwent a mathematical mental stress test (MST) consisting of rapid consecutive subtractions of number 7 for a period of 5 min. A venous blood sample was collected at baseline and immediately after MST. Platelet reactivity was measured on flowing blood as time necessary to occlude a ring coated with collagen-adenosine diphosphate (ADP; closure time, CT), using the platelet function analyzer (PFA-100) system. RESULTS At rest, CT was lower in UA patients (87+/-19 s) compared to controls (109+/-24 s, p=0.02) and SA patients (105+/-37 s, p=0.055), and also tended to be lower in SX patients (96+/-18 s) compared to controls (p=0.07). The CT response to MST differed significantly among groups (p=0.0009). At peak MST, CT did not change in controls (110+/-27 s, p=0.88), whereas it decreased in SA patients (96+/-29 s, p=0.003) and tended to decrease in UA patients (82+/-15 s, p=0.25). In contrast, a significant increase in CT with MST was shown in SX patients (103+/-21 s, p=0.007). CONCLUSIONS Platelet reactivity is increased by MST in patients with CAD, whereas it paradoxically decreases in SX patients, which may constitute a protective effect against stress-induced events in these patients.
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Affiliation(s)
- Alfonso Sestito
- Istituto di Cardiologia, Università Cattolica del S. Cuore, L.go A. Gemelli, 8 00168-Roma, Italy
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Sestito A, Sgueglia G, Infusino F, Larosa C, Zecchi P, Crea F, Lanza G. P-437 Heart rate turbulence in coronary artery disease and in ventricular arrhythmias but normal heart. Europace 2003. [DOI: 10.1016/eupace/4.supplement_2.b169-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- A. Sestito
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - G.A. Sgueglia
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - F. Infusino
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - C. Larosa
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - P. Zecchi
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - F. Crea
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
| | - G.A. Lanza
- Istituto di Cardiologia, Università Cattolica Del Sacro Cuore
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Roma, Italia
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Worrell TW, Crisp E, Larosa C. Electromyographic reliability and analysis of selected lower extremity muscles during lateral step-up conditions. J Athl Train 1998; 33:156-62. [PMID: 16558504 PMCID: PMC1320404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To determine 1) the electromyographic (EMG) reliability within and between testing sessions; 2) the effect of sex on the EMG activity of the vastus medialis oblique (VMO), vastus lateralis (VL), hamstring (HS), and gluteus maximus (GM) and VMO:VL ratios during maximal voluntary isometric contraction (MVIC) and lateral step-up (LSU) conditions; and 3) the muscle recruitment and VMO:VL ratios during MVIC and LSU conditions. DESIGN AND SETTING Subjects participated in a familiarization session and two testing sessions in which they performed a 20.32-cm (8-in) LSU with and without resistance while the EMG activity was monitored for the VMO, VL, HS, and GM muscles. SUBJECTS Nineteen subjects performed LSUs holding 25% body weight (Group 25%), and 13 subjects performed LSUs holding 10% body weight (Group 10%). There were 32 subjects total: 19 males and 13 females. MEASUREMENTS Statistical analyses included a two-way analysis of variance (ANOVA) to compare sex and testing conditions for percentage of MVIC and VMO:VL ratios; three-way repeated-measures ANOVA to compare muscle, resistance, and session factors for percentage of MVIC; and a two-way repeated-measures ANOVA to compare conditions and session factors for VMO:VL ratios. These analyses were performed for both groups. RESULTS Reliability results revealed good intrasession and poor intersession intraclass correlation coefficients. No difference existed in muscle recruitment or VMO:VL ratios between males and females for either group. The three-way ANOVA revealed a significant two-way interaction (muscle x resistance) for both groups. Post hoc testing revealed the following EMG recruitment patterns: VMO > HS, GM, VL;VL > HS, GM; HS = GM for both groups. For Group 25%, the two-way ANOVA revealed greater VMO:VL ratios during MVIC for session one than for LSU. CONCLUSIONS Intrasession reliability was higher than intersession reliability, but similar conclusions were reached concerning muscle recruitment in both testing situations. No sex differences existed in recruitment patterns. The LSU requires greater VMO and VL recruitment than HS and GM recruitment. In addition, VMO:VL ratios varied tremendously in a group of asymptomatic subjects, which challenges the theory of a "normal" VMO:VL ratio of 1:1 in asymptomatic subjects.
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Affiliation(s)
- T W Worrell
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN 46227
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Iqbal MP, Rothenberg SP, Larosa C. Immunologic heterogeneity of dihydrofolate reductase from methotrexate sensitive and resistant L1210 leukemia cells. Proc Soc Exp Biol Med 1985; 180:98-102. [PMID: 2412235 DOI: 10.3181/00379727-180-42149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Dihydrofolate reductase from L1210 leukemia cells which are sensitive and resistant to methotrexate has the same physical and kinetic properties and immunoreactivity with a guinea pig antiserum raised to the enzyme purified from the methotrexate resistant strain. However, a chicken antiserum to dihydrofolate reductase from methotrexate sensitive L1210 cells has greater affinity for the homologous enzyme than for the enzyme from the MTX resistant cells indicating that there is some antigenic difference in these molecules.
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