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Sacco A, Pagnesi M, Frea S, Briani M, Dini CS, Bertaina M, Marini M, Trombara F, Villanova L, Ravera A, Tavazzi G, Pappalardo F, Morici N, Potena L. Transitioning to Palliative Care in an Italian Cardiac Intensive Care Unit Network. Am J Crit Care 2024; 33:145-148. [PMID: 38424013 DOI: 10.4037/ajcc2024535] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Recent data indicate that end-of-life management for patients affected by acute decompensated heart failure in cardiac intensive care units is aggressive, with late or no engagement of palliative care teams. OBJECTIVE To assess current palliative care and end-of-life practices in a contemporary Italian multicenter registry of patients with cardiogenic shock due to acute decompensated heart failure. METHODS A survey-based approach was used to collect data on palliative care and end-of-life management practices. The AltShock-2 registry enrolled patients with cardiogenic shock from 12 participating centers. A subset of 153 patients with cardiogenic shock due to acute decompensated heart failure enrolled between March 2020 and March 2023 was analyzed, with a focus on early engagement of palliative care teams and deactivation of implantable cardioverter-defibrillators (ICDs). RESULTS "Do not resuscitate" orders were documented in patient records in only 5 of 12 centers (42%). Palliative care teams were engaged for 21 of 153 enrolled patients (13.7%). Among the 51 patients with ICDs, 6 of 17 patients who died (35%) had defibrillator deactivation. Of the 17 patients who died, 13 died in the hospital and 4 died within 6 months after discharge; 1 patient had ICD deactivation supported by palliative care services at home. CONCLUSIONS Therapy-limiting practices, including ICD deactivation, are not routine in the Italian centers participating in this study. The results emphasize the importance of integrating palliative care as a simultaneous process with intensive care to address the unmet needs of these patients and their families.
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Affiliation(s)
- Alice Sacco
- Alice Sacco is a physician, Cardiac Intensive Care Unit, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Matteo Pagnesi
- Matteo Pagnesi is a physician, Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Simone Frea
- Simone Frea is a physician, Intensive Cardiac Care Unit, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Martina Briani
- Martina Briani is a physician, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy
| | - Carlotta Sorini Dini
- Carlotta Sorini Dini is a physician, Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Maurizio Bertaina
- Maurizio Bertaina is a physician, Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Marco Marini
- Marco Marini is a physician, Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, Ancona, Italy
| | - Filippo Trombara
- Filippo Trombara is a physician, Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Luca Villanova
- Luca Villanova is a physician, Cardiac Intensive Care Unit, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Amelia Ravera
- Amelia Ravera is a physician, Department of Cardiology, "San Giovanni di Dio e Ruggi D'Aragona" Hopital-University, Salerno, Italy
| | - Guido Tavazzi
- Guido Tavazzi is a physician, Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia Italy Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione I, Pavia, Italy
| | - Federico Pappalardo
- Federico Pappalardo is a physician, Cardiothoracic and Vascular Anesthesia and Intensive Care, Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Nuccia Morici
- Nuccia Morici is a physician, IRCCS S. Maria Nascente-Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Luciano Potena
- Luciano Potena is a physician, Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
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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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De Filippo O, D'Ascenzo F, Iannaccone M, Bertaina M, Leone A, Borzillo I, Ravetti E, Solano A, Pagliassotto I, Nebiolo M, Bruno F, Giacobbe F, Muscoli S, Monticone S, Brizzi MF, Biondi Zoccai G, De Ferrari GM. Safety and efficacy of bempedoic acid: a systematic review and meta-analysis of randomised controlled trials. Cardiovasc Diabetol 2023; 22:324. [PMID: 38017541 PMCID: PMC10685600 DOI: 10.1186/s12933-023-02022-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/10/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND AIMS Bempedoic Acid (BA) is a novel Lipid-Lowering Therapy (LLT). We performed a systematic review and meta-analysis to assess the efficacy and safety of BA in patients with hypercholesterolemia. METHODS PubMed, Scopus, and Cochrane library databases were searched for randomised controlled trials evaluating the efficacy and/or safety of BA compared with placebo. Trials investigating dosages other than 180 mg/die were excluded. Major adverse cardiovascular events (MACE) were the primary efficacy endpoint. LDL-cholesterol reduction was the primary laboratory endpoint. Pre-specified safety endpoints included muscle-related adverse events, new-onset diabetes, and gout. The protocol was registered on PROSPERO (temporary ID:399,867). RESULTS Study search identified 275 deduplicated results. 11 studies, encompassing 18,315 patients (9854 on BA vs 8461 on placebo/no treatment) were included. BA was associated with a reduced risk of MACE (OR 0.86, 95% CI 0.79-0.95), myocardial infarction (OR 0.76, 95% CI 0.64-0.88) and unstable angina (OR 0.69, 95% CI 0.54-0.88) compared to control, over a median follow up of 87 (15-162) weeks. BA was associated with a reduction of LDL-Cholesterol (mean difference [MD]-22.42,95% CI - 24.02% to - 20.82%), total cholesterol (- 16.50%,95% - 19.21% to - 13.79%), Apo-B lipoprotein (- 19.55%, - 22.68% to - 16.42%) and high-sensitivity CRP (- 27.83%, - 31.71% to - 23.96%) at 12 weeks. BA was associated with a higher risk of gout (OR 1.55, 95% CI 1.27-1.90) as compared with placebo. Efficacy on laboratory endpoints was confirmed, with a variable extent, across patients on statin or ezetimibe background therapy. CONCLUSIONS The improved cholesterol control achieved with BA translates into a reduced risk of MACE, including myocardial infarction and coronary revascularisation. The drug has a satisfactory safety profile except for an increased risk of gout.
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Affiliation(s)
- Ovidio De Filippo
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy.
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy.
| | - Mario Iannaccone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città Di Torino, Turin, Italy
| | - Maurizio Bertaina
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città Di Torino, Turin, Italy
| | - Attilio Leone
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Irene Borzillo
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Emanuele Ravetti
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Andrea Solano
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Ilaria Pagliassotto
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Marco Nebiolo
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Francesco Bruno
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
| | - Federico Giacobbe
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Saverio Muscoli
- Division of Cardiology, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - Silvia Monticone
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
| | - Maria Felice Brizzi
- Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giuseppe Biondi Zoccai
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, "Città Della Salute e Della Scienza" Hospital, Turin, Italy
- Department of Medical Sciences, University of Turin, Corso Bramante 88, 10126, Turin, Italy
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Iannaccone M, Bertaina M, Morici N, Chieffo A. Impact of sex in cardiogenic shock outcomes: Still not seeing it coming? Int J Cardiol 2023:S0167-5273(23)00591-0. [PMID: 37088324 DOI: 10.1016/j.ijcard.2023.04.037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Mario Iannaccone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy.
| | - Maurizio Bertaina
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy
| | - Nuccia Morici
- IRCCS S. Maria Nascente - Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Alaide Chieffo
- Vita-Salute San Raffaele University, Milan, Italy; Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Marcelli L, Bolmgren K, Barghini D, Battisti M, Blaksley C, Blin S, Belov A, Bertaina M, Bianciotto M, Bisconti F, Cambiè G, Capel F, Casolino M, Churilo I, Crisconio M, Taille CDL, Ebisuzaki T, Eser J, Fenu F, Franceschi M, Fuglesang C, Golzio A, Gorodetzky P, Kasuga H, Kajino F, Klimov P, Kuznetsov V, Manfrin M, Mascetti G, Marszal W, Miyamoto H, Murashov A, Napolitano T, Ohmori H, Olinto A, Parizot E, Picozza P, Piotrowski L, Plebaniak Z, Prevot G, Reali E, Romoli G, Ricci M, Sakaki N, Shinozaki K, Szabelski J, Takizawa Y, Vagelli V, Valentini G, Vrabel M, Wiencke L. Dataset of night-time emissions of the Earth in the near UV range (290-430 nm), with 6.3 km resolution in the latitude range -51.6<L<+51.6 degrees, acquired on board the International Space Station with the Mini-EUSO detector. Data Brief 2023; 48:109105. [PMID: 37095754 PMCID: PMC10121388 DOI: 10.1016/j.dib.2023.109105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
The data presented in this article are related to the research paper entitled "Observation of night-time emissions of the Earth in the near UV range from the International Space Station with the Mini-EUSO detector" (Remote Sensing of Environment, Volume 284, January 2023, 113336, https://doi.org/10.1016/j.rse.2022.113336). The data have been acquired with the Mini-EUSO detector, an UV telescope operating in the range 290-430 nm and located inside the International Space Station. The detector was launched in August 2019, and it has started operations from the nadir-facing UV-transparent window in the Russian Zvezda module in October 2019. The data presented here refer to 32 sessions acquired between 2019-11-19 and 2021-05-06. The instrument consists of a Fresnel-lens optical system and a focal surface composed of 36 multi-anode photomultiplier tubes, each with 64 channels, for a total of 2304 channels with single photon counting sensitivity. The telescope, with a square field-of-view of 44°, has a spatial resolution on the Earth surface of 6.3 km and saves triggered transient phenomena with a temporal resolution of 2.5 µs and 320 µs. The telescope also operates in continuous acquisition at a 40.96 ms scale. In this article, large-area night-time UV maps obtained processing the 40.96 ms data, taking averages over regions of some specific geographical areas (e.g., Europe, North America) and over the entire globe, are presented. Data are binned into 0.1° × 0.1° or 0.05° × 0.05° cells (depending on the scale of the map) over the Earth's surface. Raw data are made available in the form of tables (latitude, longitude, counts) and .kmz files (containing the .png images). These are - to the best of our knowledge - the highest sensitivity data in this wavelength range and can be of use to various disciplines.
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6
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Morici N, Frea S, Bertaina M, Sacco A, Corrada E, Dini CS, Briani M, Tedeschi M, Saia F, Colombo C, Rota M, Oliva F, Iannaccone M, De Ferrari GM, Sionis A, Kapur NK, Tavazzi G, Pappalardo F. SCAI stage reclassification at 24 h predicts outcome of cardiogenic shock: Insights from the Altshock-2 registry. Catheter Cardiovasc Interv 2023; 101:22-32. [PMID: 36378673 PMCID: PMC10100478 DOI: 10.1002/ccd.30484] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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: 07/15/2022] [Revised: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiogenic shock (CS) includes several phenotypes with heterogenous hemodynamic features. Timely prognostication is warranted to identify patients requiring treatment escalation. We explored the association of the updated Society for Cardiovascular Angiography and Interventions (SCAI) stages classification with in-hospital mortality using a prospective national registry. METHODS Between March 2020 and February 2022 the Altshock-2 Registry has included 237 patients with CS of all etiologies at 11 Italian Centers. Patients were classified according to their admission SCAI stage (assigned prospectively and independently updated according to the recently released version). In-hospital mortality was evaluated for association with both admission and 24-h SCAI stages. RESULTS The overall in-hospital mortality was 38%. Of the 237 patients included and staged according to the updated SCAI classification, 20 (8%) had SCAI shock stage B, 131 (55%) SCAI stage C, 61 (26%) SCAI stage D and 25 (11%) SCAI stage E. In-hospital mortality stratified according to the SCAI classification at 24 h was 18% for patients in SCAI stage B, 27% for SCAI stage C, 63% for SCAI stage D and 100% for SCAI stage E. Both the revised SCAI stages on admission and at 24 h were associated with in-hospital mortality, but the classification potential slightly increased at 24-h. After adjusting for age, sex, lactate level, eGFR, CVP, inotropic score and mechanical circulatory support [MCS], SCAI classification at 24 h was an independent predictor of in-hospital mortality. CONCLUSIONS In the Altshock-2 registry the utility of SCAI shock stages to identify risk of in-hospital mortality increased at 24 h after admission. Escalation of treatment (either pharmacological or with MCS) should be tailored to achieve prompt clinical improvement within the first 24 h after admission. Registration: http://www. CLINICALTRIALS gov; Unique identifier: NCT04295252.
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Affiliation(s)
- Nuccia Morici
- IRCCS S. Maria Nascente - Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Simone Frea
- Intensive Cardiac Care Unit, Città della Salute e della Scienza di Torino, Torino, Italy
| | - Maurizio Bertaina
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy
| | - Alice Sacco
- Cardiology Department and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elena Corrada
- Humanitas Research Hospital IRCCS Rozzano, Milan, Italy
| | - Carlotta Sorini Dini
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
| | | | - Michele Tedeschi
- Cardiology Department, Intensive Care Unit, S. Giovanni Di Dio e Ruggi D'Aragona Hospital, Salerno, Italy
| | - Francesco Saia
- Cardiology Unit, Cardio-Thoraco-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Costanza Colombo
- Intensive Cardiac Care Unit, Fondazione Policlinico San Matteo Hospital IRCCS, Pavia, Italy
| | - Matteo Rota
- Department of Molecular and Translational Medicine, Units of Biostatistics and Biomathematics and Bioinformatics, University of Brescia, Brescia, Italy
| | - Fabrizio Oliva
- Cardiology Department and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Mario Iannaccone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Torino, Italy
| | - Gaetano M De Ferrari
- Intensive Cardiac Care Unit, Città della Salute e della Scienza di Torino, Torino, Italy.,Department of Medical Sciences, University of Torino, Torino, Italy
| | - Alessandro Sionis
- Intensive Cardiac Care Unit, Cardiology Department, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Navin K Kapur
- The CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA
| | - Guido Tavazzi
- Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia Italy.,Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione I, Pavia, Italy
| | - Federico Pappalardo
- Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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7
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Morici N, Frea S, Bertaina M, Iannacone M, Sacco A, Villanova L, Corrada E, Valente S, De Ferrari GM, Ravera A, Moltrasio M, Sionis A, Kapur N, Pappalardo F, Tavazzi GM. A prospective registry to get insights into profile, management and outcome of cardiogenic shock patients. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1503] [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: 11/13/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) is the most severe form of acute heart failure, characterized by life-threatening end-organ hypoperfusion resulting from a low cardiac output state. Data on epidemiology of CS has been mostly drawn from registries focusing on acute myocardial infarction (AMI). However, recent evidence in a contemporary cohort in North America has shown that more than two thirds of all CS cases were related to causes other than AMI and that these patients had outcomes at least as poor as patients with AMICS.
Purpose
To provide data on profile, management, outcome, and evolution over time of CS patients admitted to ICCU/ICU and to compare them between patients with AMICS and acute decompensated heart failure (ADHF-CS).
Methods
The Altshock-2 Registry is a multicenter national prospective data collection, part of the Italian Altshock-2 program. Recruitment started on 2 March 2020 with 11 Italian Centers contributing to patients' enrolment. A total of 238 patients were hospitalized with confirmed diagnosis of CS between March 2020 and February 2022 in a multicenter national initiative. The mean age of this patient population was 64 years (interquartile range [IQR] 54–74) and 76% were male. Ninety-seven patients (41%) were admitted for AMICS, whereas 84 patients (35.3%) had ADHF-CS; 57 patients (24%) had other causes. As compared to AMICS patients, those admitted for ADHF-CS were younger, but with a higher burden of comorbidities (renal, liver, thyroid disease, atrial fibrillation, anemia), pre-existing decreased ejection fraction and a higher number of chronic drugs. Patients with ADHF-CS had a prevalent cardio-metabolic phenotype upon admission with prevalent congestion. Mechanical ventilation was more commonly used in patients with AMICS, compared to ADHF-CS, along with an increased inotropic score. Conversely, sodium nitroprusside was used in about sixty percent of patients with ADHF-CS. Sixty percent of the included population received a temporary mechanical circulatory support (MCS) device, which was intra-aortic balloon pump (IABP) in the eighty percent of the supported patients. Pulmonary artery catheter was used for monitoring only in the 18% of the included patients whereas an extensive echocardiographic approach was applied. Twenty-one patients (25%) underwent heart replacement therapy in the ADHF-CS patients versus 2 (2%) in the AMICS. Thirty-day mortality occurred in 32 patients (33%) in the AMICS group versus 23 (27%) in the ADHF-CS group (p=0.41).
Conclusions
Different diagnostic approaches and uses of mechanical circulatory support devises and inotropes are implemented in transatlantic settings. Uniform definitions and more homogenous protocols tailored on CS etiologies and clinical and biochemical phenotypes are needed in prospective initiatives in order to effectively compared results and outcome.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Morici
- Don Gnocchi Foundation - IRCCS Centro S. Maria Nascente , Milan , Italy
| | - S Frea
- Hospital Citta Della Salute e della Scienza di Torino , Turin , Italy
| | - M Bertaina
- Torino North Emergency San Giovanni Bosco , Turin , Italy
| | - M Iannacone
- Torino North Emergency San Giovanni Bosco , Turin , Italy
| | - A Sacco
- Niguarda Ca Granda Hospital , Milan , Italy
| | | | - E Corrada
- Humanitas Research Hospital , Milan , Italy
| | | | - G M De Ferrari
- Hospital Citta Della Salute e della Scienza di Torino , Turin , Italy
| | - A Ravera
- San Giovanni di Dio and Ruggi d'Aragona University Hospital , Salerno , Italy
| | | | - A Sionis
- Hospital de la Santa Creu i Sant Pau , Barcelona , Spain
| | - N Kapur
- Tufts Medical Center, Inc. , Boston , United States of America
| | - F Pappalardo
- SS. Antonio E Biagio E Cesare Arrigo Hopital , Alessandria , Italy
| | - G M Tavazzi
- Policlinic Foundation San Matteo IRCCS , Pavia , Italy
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8
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Morici N, Frea S, Ditali V, Briani M, Bertaina M, Ravera A, Sorini Dini C, Moltrasio M, Saia F, Corrada E, De Ferrari GM, Garatti L, Colombo C, Tavazzi G, Pappalardo F. 24h SCAI stage reclassification to predict outcome. Insights from the prospective Altshock-2 registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1501] [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: 11/13/2022] Open
Abstract
Abstract
Background
Cardiogenic shock (CS) includes several phenotypes of congestion or hypoperfusion with heterogenous hemodynamic features. Timely prognostication with scoring tools is warranted to identify patients requiring escalation to mechanical circulatory support (MCS) and to avoid futility.
Purpose
Accordingly, we explored the role of the updated Society for Cardiovascular Angiography and Interventions (SCAI) stages classification on in-hospital mortality using a prospective national registry.
Methods
The Altshock-2 Registry includes 237 patients with CS of all etiologies enrolled between March 2020 and February 2022 in 11 Italian Centers. Patients were classified according to the admission SCAI stages (assigned prospectively and independently updated according to the most recently released version); 24-hour re-assessment was prospectively performed in 201 patients. In-hospital mortality was evaluated for association with admission and 24 hours SCAI stages adjusted for the most relevant clinical covariates.
Results
Of the 237 patients included, 20 (8.4%) had SCAI shock stage B, 132 (55.8%) SCAI stage C, 60 (25.3) SCAI stage D and 25 (10.5%) SCAI stage E. Patients in stage B had the worst reclassification at 24-hours, with 42% of them showing worsened status and only 8% improving. In-hospital mortality was 38%. The revised SCAI stages at baseline were not independently associated with in-hospital mortality, whereas the SCAI classification at 24-h correctly and independently predicted mortality (the rate of in-hospital death was 18% for patients in SCAI shock stage B, 27% for SCAI shock stage C, 64% for SCAI shock stage D, 100% for SCAI shock stage E). At the multivariate analysis (adjusted for age, gender, eGFR, inotropic score and MCS) only SCAI classification at 24-hour evaluation was an independent predictor of in-hospital mortality (OR and 95% CI were, respectively, 3.32, 0.36–30.63, p=0.290 for SCAI stage C and 13.07, 1.69–146.3 for SCAI stage D, with E perfectly predicting because all patients died).
Conclusions
The revised SCAI stage classification may improve prognostication only at 24-hour evaluation. Aggressive treatment (either pharmacological or with MCS escalation) should be tailored in order to achieve prompt clinical improvement within the first 24-hours; refractory SCAI stage E at 24 hours portends dismal prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Morici
- Don Gnocchi Foundation - IRCCS Centro S. Maria Nascente , Milan , Italy
| | - S Frea
- Hospital Citta Della Salute e della Scienza di Torino , Turin , Italy
| | - V Ditali
- Niguarda Ca Granda Hospital , Milan , Italy
| | - M Briani
- Humanitas Research Hospital IRCCS Rozzano , Milan , Italy
| | - M Bertaina
- San Giovanni Bosco Hospital , Turin , Italy
| | - A Ravera
- San Giovanni di Dio and Ruggi d'Aragona University Hospital , Salerno , Italy
| | | | - M Moltrasio
- Monzino Cardiology Center, IRCCS , Milan , Italy
| | - F Saia
- University Hospital of Bologna S. Orsola-Malpighi Polyclinic , Bologna , Italy
| | - E Corrada
- Humanitas Research Hospital IRCCS Rozzano , Milan , Italy
| | - G M De Ferrari
- Hospital Citta Della Salute e della Scienza di Torino , Turin , Italy
| | - L Garatti
- Niguarda Ca Granda Hospital , Milan , Italy
| | - C Colombo
- Policlinic Foundation San Matteo IRCCS , Pavia , Italy
| | - G Tavazzi
- Policlinic Foundation San Matteo IRCCS , Pavia , Italy
| | - F Pappalardo
- Antonio E Biagio E C.Arrigo Healthcare Centre , Alessandria , Italy
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9
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Gallone G, Elia E, Bruno F, Angelini F, Franchin L, Bocchino PP, Piroli F, Annone U, Montabone A, Marengo G, Bertaina M, De Filippo O, Baldetti L, Palmisano A, Serafini A, Esposito A, Depaoli A, D’ascenzo F, Fonio P, De Ferrari GM. Impacto de los tratamientos hipolipemiantes en los resultados cardiovasculares según la puntuación de calcio coronario. Revisión sistemática y metanálisis. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.07.017] [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: 11/25/2022]
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10
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Gallone G, Elia E, Bruno F, Angelini F, Franchin L, Bocchino PP, Piroli F, Annone U, Montabone A, Marengo G, Bertaina M, De Filippo O, Baldetti L, Palmisano A, Serafini A, Esposito A, Depaoli A, D'ascenzo F, Fonio P, De Ferrari GM. Impact of lipid-lowering therapies on cardiovascular outcomes according to coronary artery calcium score. A systematic review and meta-analysis. Rev Esp Cardiol (Engl Ed) 2022; 75:506-514. [PMID: 34483065 DOI: 10.1016/j.rec.2021.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION AND OBJECTIVES Coronary artery calcium (CAC) score improves the accuracy of risk stratification for atherosclerotic cardiovascular disease (ASCVD) events compared with traditional cardiovascular risk factors. We evaluated the interaction of coronary atherosclerotic burden as determined by the CAC score with the prognostic benefit of lipid-lowering therapies in the primary prevention setting. METHODS We reviewed the MEDLINE, EMBASE, and Cochrane databases for studies including individuals without a previous ASCVD event who underwent CAC score assessment and for whom lipid-lowering therapy status stratified by CAC values was available. The primary outcome was ASCVD. The pooled effect of lipid-lowering therapy on outcomes stratified by CAC groups (0, 1-100,> 100) was evaluated using a random effects model. RESULTS Five studies (1 randomized, 2 prospective cohort, 2 retrospective) were included encompassing 35 640 individuals (female 38.1%) with a median age of 62.2 [range, 49.6-68.9] years, low-density lipoprotein cholesterol level of 128 (114-146) mg/dL, and follow-up of 4.3 (2.3-11.1) years. ASCVD occurrence increased steadily across growing CAC strata, both in patients with and without lipid-lowering therapy. Comparing patients with (34.9%) and without (65.1%) treatment exposure, lipid-lowering therapy was associated with reduced occurrence of ASCVD in patients with CAC> 100 (OR, 0.70; 95%CI, 0.53-0.92), but not in patients with CAC 1-100 or CAC 0. Results were consistent when only adjusted data were pooled. CONCLUSIONS Among individuals without a previous ASCVD, a CAC score> 100 identifies individuals most likely to benefit from lipid-lowering therapy, while undetectable CAC suggests no treatment benefit.
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Affiliation(s)
- Guglielmo Gallone
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy.
| | - Edoardo Elia
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Francesco Bruno
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Filippo Angelini
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Luca Franchin
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Pier Paolo Bocchino
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Francesco Piroli
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Umberto Annone
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Andrea Montabone
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Giorgio Marengo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Maurizio Bertaina
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Luca Baldetti
- Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Palmisano
- Department of Radiology and Experimental Imaging Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Antonio Esposito
- Department of Radiology and Experimental Imaging Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Depaoli
- Department of Radiology, Città della Salute e della Scienza, Torino, Italy
| | - Fabrizio D'ascenzo
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Paolo Fonio
- Department of Radiology, Città della Salute e della Scienza, Torino, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Torino, Italy
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11
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Bertaina M, Galluzzo A, Morici N, Sacco A, Oliva F, Valente S, D’Ascenzo F, Frea S, Sbarra P, Petitti E, Brach Prever S, Boccuzzi G, Zanini P, Attisani M, Rametta F, De Ferrari GM, Noussan P, Iannaccone M. Pulmonary Artery Catheter Monitoring in Patients with Cardiogenic Shock: Time for a Reappraisal? Card Fail Rev 2022; 8:e15. [PMID: 35541286 PMCID: PMC9069264 DOI: 10.15420/cfr.2021.32] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/19/2022] [Indexed: 12/20/2022] Open
Abstract
Cardiogenic shock represents one of the most dramatic scenarios to deal with in intensive cardiology care and is burdened by substantial short-term mortality. An integrated approach, including timely diagnosis and phenotyping, along with a well-established shock team and management protocol, may improve survival. The use of the Swan-Ganz catheter could play a pivotal role in various phases of cardiogenic shock management, encompassing diagnosis and haemodynamic characterisation to treatment selection, titration and weaning. Moreover, it is essential in the evaluation of patients who might be candidates for long-term heart-replacement strategies. This review provides a historical background on the use of the Swan-Ganz catheter in the intensive care unit and an analysis of the available evidence in terms of potential prognostic implications in this setting.
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Affiliation(s)
- Maurizio Bertaina
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | | | - Nuccia Morici
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; IRCCS S Maria Nascente – Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Alice Sacco
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabrizio Oliva
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Serafina Valente
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Simone Frea
- Division of Cardiology, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Pierluigi Sbarra
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Elisabetta Petitti
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Silvia Brach Prever
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Giacomo Boccuzzi
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Paola Zanini
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Matteo Attisani
- Department of Cardiac Surgery, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | | | - Gaetano Maria De Ferrari
- Division of Cardiology, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Patrizia Noussan
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Mario Iannaccone
- Department of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
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12
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Bertaina M, Galluzzo A, Rossello X, Sbarra P, Petitti E, Prever SB, Boccuzzi G, D'Ascenzo F, Frea S, Pidello S, Morici N, Sacco A, Oliva F, Valente S, De Ferrari GM, Ugo F, Rametta F, Attisani M, Zanini P, Noussan P, Iannaccone M. Prognostic implications of pulmonary artery catheter monitoring in patients with cardiogenic shock: A systematic review and meta-analysis of observational studies. J Crit Care 2022; 69:154024. [PMID: 35344825 DOI: 10.1016/j.jcrc.2022.154024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 08/08/2021] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE To investigate the impact of pulmonary artery catheter (PAC) monitoring on survival of cardiogenic shock(CS), in the light of the controversies in available evidence. MATERIALS AND METHODS MEDLINE, EMBASE, Cochrane library and Web of Science were systematically screened to identify most relevant studies on patients with CS comparing PAC use to non-use during hospital stay. Short-term mortality was the primary endpoint and the use of Mechanical Circulatory Support (MCS) devices was the secondary one. RESULTS Six observational studies including 1,166,762 patients were selected. The most frequent etiology of CS was post-myocardial infarction (75% [95% CI 55-89%] in PAC-group and 81%[95% CI 47-95%] in non-PAC group). Overall, PAC was used in 33%(95% CI 24-44%) of cases. Pooling data adjusted for confounders, a significant association between the PAC-group and a reduction in short-term mortality emerged when compared to the non-PAC group (36%[95% CI 27-45%] vs 47%[95% CI 35-59%];AdjustedOR 0.71, 95% CI 0.59-0.87, p < 0.01). MCS use was significantly higher in PAC vs non-PAC group (59% [95% CI 54-65%]) vs 48% [95% CI 43-53%]);OR 1.60 [95% CI 1.27-2.02, p < 0.01]). CONCLUSIONS PAC was associated with lower incidence of short-term mortality in CS pooling adjusted observational studies. Prospective studies are needed to confirm our hypothesis and better clarify the mechanisms of this potential prognostic benefit.
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Affiliation(s)
- Maurizio Bertaina
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy.
| | | | - Xavier Rossello
- Cardiology Department, Institut d'Investigació Sanitària Illes Balears, Hospital Universitari Son Espases, Palma, Spain
| | - Pierluigi Sbarra
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy
| | | | | | - Giacomo Boccuzzi
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, Molinette Hospital, University of Turin, Italy
| | - Simone Frea
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, Molinette Hospital, University of Turin, Italy
| | - Stefano Pidello
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, Molinette Hospital, University of Turin, Italy
| | - Nuccia Morici
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; IRCCS S. Maria Nascente, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
| | - Alice Sacco
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Fabrizio Oliva
- Intensive Cardiac Care Unit and De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Serafina Valente
- Department of Cardiovascular Diseases, University of Siena, Siena, Italy
| | - Gaetano Maria De Ferrari
- Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza, Molinette Hospital, University of Turin, Italy
| | - Fabrizio Ugo
- Department of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
| | | | - Matteo Attisani
- Department of Cardiovascular and Thoracic Surgery, Città della Salute e della Scienza, Molinette Hospital, University of Turin, Italy; Department of cardiovascular surgery, San Giovanni Bosco Hospital, Turin, Italy
| | - Paola Zanini
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy
| | - Patrizia Noussan
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy
| | - Mario Iannaccone
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Italy
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13
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Adams JH, Ahmad S, Allard D, Anzalone A, Bacholle S, Barrillon P, Bayer J, Bertaina M, Bisconti F, Blaksley C, Blin-Bondil S, Bobík P, Cafagna F, Campana D, Capel F, Casolino M, Cassardo C, Catalano C, Cremonini R, Dagoret-Campagne S, Danto P, del Peral L, de la Taille C, Díaz Damian A, Dupieux M, Ebersoldt A, Ebisuzaki T, Eser J, Evrard J, Fenu F, Ferrarese S, Fornaro C, Fouka M, Gorodetzky P, Guarino F, Guzman A, Hachisu Y, Haungs A, Judd E, Jung A, Karczmarczyk J, Kawasaki Y, Klimov PA, Kuznetsov E, Mackovjak S, Manfrin M, Marcelli L, Medina-Tanco G, Mercier K, Merino A, Mernik T, Miyamoto H, Morales de los Ríos JA, Moretto C, Mot B, Neronov A, Ohmori H, Olinto AV, Osteria G, Panico B, Parizot E, Paul T, Picozza P, Piotrowski LW, Plebaniak Z, Pliego S, Prat P, Prévôt G, Prieto H, Putis M, Rabanal J, Ricci M, Rojas J, Rodríguez Frías MD, Roudil G, Sáez Cano G, Sahnoun Z, Sakaki N, Sanchez JC, Santangelo A, Sarazin F, Scotti V, Shinozaki K, Silva H, Soriano JF, Suino G, Szabelski J, Toscano S, Tabone I, Takizawa Y, von Ballmoos P, Wiencke L, Wille M, Zotov M. A Review of the EUSO-Balloon Pathfinder for the JEM-EUSO Program. Space Sci Rev 2022; 218:3. [PMID: 35153338 PMCID: PMC8807436 DOI: 10.1007/s11214-022-00870-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 12/31/2021] [Indexed: 06/14/2023]
Abstract
EUSO-Balloon is a pathfinder for JEM-EUSO, the mission concept of a spaceborne observatory which is designed to observe Ultra-High Energy Cosmic Ray (UHECR)-induced Extensive Air Showers (EAS) by detecting their UltraViolet (UV) light tracks "from above." On August 25, 2014, EUSO-Balloon was launched from Timmins Stratospheric Balloon Base (Ontario, Canada) by the balloon division of the French Space Agency CNES. After reaching a floating altitude of 38 km, EUSO-Balloon imaged the UV light in the wavelength range ∼290-500 nm for more than 5 hours using the key technologies of JEM-EUSO. The flight allowed a good understanding of the performance of the detector to be developed, giving insights into possible improvements to be applied to future missions. A detailed measurement of the photoelectron counts in different atmospheric and ground conditions was achieved. By means of the simulation of the instrument response and by assuming atmospheric models, the absolute intensity of diffuse light was estimated. The instrument detected hundreds of laser tracks with similar characteristics to EASs shot by a helicopter flying underneath. These are the first recorded laser tracks measured from a fluorescence detector looking down on the atmosphere. The reconstruction of the direction of the laser tracks was performed. In this work, a review of the main results obtained by EUSO-Balloon is presented as well as implications for future space-based observations of UHECRs.
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Affiliation(s)
- J. H. Adams
- University of Alabama in Huntsville, Huntsville, USA
| | - S. Ahmad
- Omega, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - D. Allard
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - A. Anzalone
- INAF - Istituto di Astrofisica Spaziale e Fisica Cosmica di Palermo, Palermo, Italy
- Istituto Nazionale di Fisica Nucleare - Sezione di Catania, Catania, Italy
| | - S. Bacholle
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - P. Barrillon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - J. Bayer
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - M. Bertaina
- Istituto Nazionale di Fisica Nucleare - Sezione di Torino, Torino, Italy
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - F. Bisconti
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - C. Blaksley
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - S. Blin-Bondil
- Omega, Ecole Polytechnique, CNRS/IN2P3, Palaiseau, France
| | - P. Bobík
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - F. Cafagna
- Istituto Nazionale di Fisica Nucleare - Sezione di Bari, Bari, Italy
| | - D. Campana
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
| | - F. Capel
- KTH Royal Institute of Technology, Stockholm, Sweden
| | - M. Casolino
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
| | - C. Cassardo
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - C. Catalano
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - R. Cremonini
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - P. Danto
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | | | | | | | - M. Dupieux
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - A. Ebersoldt
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - J. Eser
- Colorado School of Mines, Golden, USA
| | - J. Evrard
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | - F. Fenu
- Istituto Nazionale di Fisica Nucleare - Sezione di Torino, Torino, Italy
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - S. Ferrarese
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - M. Fouka
- Center of Research in Astronomy, Astrophysics, and Geophysics, Algiers, Algeria
| | - P. Gorodetzky
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - F. Guarino
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - A. Guzman
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - Y. Hachisu
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | - A. Haungs
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - E. Judd
- Space Sciences Laboratory, University of California, Berkeley, CA USA
| | - A. Jung
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | | | | | - P. A. Klimov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow, Russia
| | - E. Kuznetsov
- University of Alabama in Huntsville, Huntsville, USA
| | - S. Mackovjak
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - M. Manfrin
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - L. Marcelli
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
| | - G. Medina-Tanco
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - K. Mercier
- CNES, 18 avenue Edouard Belin, Toulouse, France
| | | | - T. Mernik
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | - H. Miyamoto
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | - C. Moretto
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - B. Mot
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | - A. Neronov
- ISDC Data Centre for Astrophysics, Versoix, Switzerland
| | - H. Ohmori
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | | | - G. Osteria
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
| | - B. Panico
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - E. Parizot
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - T. Paul
- Lehman College, City University of New York, New York, USA
| | - P. Picozza
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma Tor Vergata, Roma, Italy
- Dipartimento di Fisica, Universitá di Roma Tor Vergata, Roma, Italy
| | | | - Z. Plebaniak
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- National Centre for Nuclear Research, Lodz, Poland
| | - S. Pliego
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - P. Prat
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - G. Prévôt
- APC, Univ. Paris Diderot, CNRS/IN2P3, CEA/Irfu, Obs de Paris, Paris, France
| | - H. Prieto
- Universidad de Alcalá, Madrid, Spain
| | - M. Putis
- Institute of Experimental Physics, Slovak Academy of Sciences, Košice, Slovakia
| | - J. Rabanal
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France
| | - M. Ricci
- Istituto Nazionale di Fisica Nucleare, Laboratori Nazionali di Frascati, Frascati, Italy
| | - J. Rojas
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - G. Roudil
- IRAP, Université de Toulouse, CNRS, Toulouse, France
| | | | - Z. Sahnoun
- Center of Research in Astronomy, Astrophysics, and Geophysics, Algiers, Algeria
| | - N. Sakaki
- RIKEN, 2-1 Hirosawa, Wako, Saitama Japan
| | - J. C. Sanchez
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - A. Santangelo
- Institute for Astronomy and Astrophysics, University of Tübingen, Tübingen, Germany
| | | | - V. Scotti
- Istituto Nazionale di Fisica Nucleare - Sezione di Napoli, Naples, Italy
- Dipartimento di Scienze Fisiche, Universitá di Napoli Federico II, Naples, Italy
| | - K. Shinozaki
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
- National Centre for Nuclear Research, Lodz, Poland
| | - H. Silva
- Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - G. Suino
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | - J. Szabelski
- National Centre for Nuclear Research, Lodz, Poland
| | - S. Toscano
- ISDC Data Centre for Astrophysics, Versoix, Switzerland
| | - I. Tabone
- Dipartimento di Fisica, Universitá di Torino, Torino, Italy
| | | | | | | | - M. Wille
- ECAP, University of Erlangen-Nuremberg, Erlangen, Germany
| | - M. Zotov
- Skobeltsyn Institute of Nuclear Physics, Lomonosov Moscow State University, Moscow, Russia
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14
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Iannaccone M, Venuti G, di Simone E, De Filippo O, Bertaina M, Colangelo S, Boccuzzi G, de Piero ME, Attisani M, Barbero U, Zanini P, Livigni S, Noussan P, D'Ascenzo F, de Ferrari GM, Porto I, Truesdell AG. Comparison of ECMO vs ECpella in patients with non post-pericardiotomy cardiogenic shock: An updated meta-analysis. Cardiovasc Revasc Med 2021; 40:134-141. [PMID: 34654655 DOI: 10.1016/j.carrev.2021.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 07/18/2021] [Revised: 09/12/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The impact of Impella and ECMO (ECPELLA) in cardiogenic shock (CS) remains to be defined. The aim of this meta-analysis is to evaluate the benefit of ECPELLA compared to VA-ECMO in patients with non post-pericardiotomy CS. METHODS All studies reporting short term outcomes of ECpella or VA ECMO in non post-pericardiotomy CS were included. The primary endpoint was 30-day mortality. Vascular and bleeding complications and LVAD implantation/heart transplant within 30-days were assessed as secondary outcomes. RESULTS Of 407 studies identified, 13 observational studies (13,682 patients, 13,270 with ECMO and 412 with ECpella) were included in this analysis. 30-day mortality was 55.8% (51.6-59.9) in the VA-ECMO group and 58.3% (53.5-63.0) in the ECpella group. At meta-regression analysis the implantation of IABP did not affect mortality in the ECMO group. The rate of major bleeding in patients on VA-ECMO and ECpella support were 21.3% (16.9-26.5) and 33.1% (25.9-41.2) respectively, while the rates of the composite outcome of LVAD implantation and heart transplantation within 30-days in patients on VA-ECMO and ECpella support were 14.4% (9.0-22.2) and 10.8%. When directly compared in 3 studies, ECpella showed a positive effect on 30-day mortality compared to ECMO (OR: 1.81: 1.039-3.159). CONCLUSION Our data suggest that ECpella may reduce 30-day mortality and increase left ventricle recovery, despite increased of bleeding rates.
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Affiliation(s)
- Mario Iannaccone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy.
| | | | - Emanuela di Simone
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Ovidio De Filippo
- Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy
| | - Maurizio Bertaina
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Salvatore Colangelo
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Giacomo Boccuzzi
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Maria Elena de Piero
- Department of Anesthesiology and Intensive Care, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Matteo Attisani
- Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy
| | | | - Paola Zanini
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Sergio Livigni
- Department of Anesthesiology and Intensive Care, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Patrizia Noussan
- Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Città della Scienza e della Salute, University of Turin, Turin, Italy
| | | | - Italo Porto
- Cardiovascular Disease Unit, IRCCS Policlinic Hospital San Martino, Genova, Italy
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15
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Bertaina M, Nuñez-Gil IJ, Franchin L, Fernández Rozas I, Arroyo-Espliguero R, Viana-Llamas MC, Romero R, Maroun Eid C, Uribarri A, Becerra-Muñoz VM, Huang J, Alfonso E, Marmol-Mosquera F, Ugo F, Cerrato E, Fernandez-Presa L, Raposeiras Roubin S, Feltes Guzman G, Gonzalez A, Abumayyaleh M, Fernandez-Ortiz A, Macaya C, Estrada V. Non-invasive ventilation for SARS-CoV-2 acute respiratory failure: a subanalysis from the HOPE COVID-19 registry. Emerg Med J 2021; 38:359-365. [PMID: 33727235 PMCID: PMC7970657 DOI: 10.1136/emermed-2020-210411] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The COVID-19 pandemic has seriously challenged worldwide healthcare systems and limited intensive care facilities, leading to physicians considering the use of non-invasive ventilation (NIV) for managing SARS-CoV-2-related acute respiratory failure (ARF). METHODS We conducted an interim analysis of the international, multicentre HOPE COVID-19 registry including patients admitted for a confirmed or highly suspected SARS-CoV-2 infection until 18 April 2020. Those treated with NIV were considered. The primary endpoint was a composite of death or need for intubation. The components of the composite endpoint were the secondary outcomes. Unadjusted and adjusted predictors of the primary endpoint within those initially treated with NIV were investigated. RESULTS 1933 patients who were included in the registry during the study period had data on oxygen support type. Among them, 390 patients (20%) were treated with NIV. Compared with those receiving other non-invasive oxygen strategy, patients receiving NIV showed significantly worse clinical and laboratory signs of ARF at presentation. Of the 390 patients treated with NIV, 173 patients (44.4%) met the composite endpoint. In-hospital death was the main determinant (147, 37.7%), while 62 patients (15.9%) needed invasive ventilation. Those requiring invasive ventilation had the lowest survival rate (41.9%). After adjustment, age (adjusted OR (adj(OR)) for 5-year increase: 1.37, 95% CI 1.15 to 1.63, p<0.001), hypertension (adj(OR) 2.95, 95% CI 1.14 to 7.61, p=0.03), room air O2 saturation <92% at presentation (adj(OR) 3.05, 95% CI 1.28 to 7.28, p=0.01), lymphocytopenia (adj(OR) 3.55, 95% CI 1.16 to 10.85, p=0.03) and in-hospital use of antibiotic therapy (adj(OR) 4.91, 95% CI 1.69 to 14.26, p=0.003) were independently associated with the composite endpoint. CONCLUSION NIV was used in a significant proportion of patients within our cohort, and more than half of these patients survived without the need for intubation. NIV may represent a viable strategy particularly in case of overcrowded and limited intensive care resources, but prompt identification of failure is mandatory to avoid harm. Further studies are required to better clarify our hypothesis. TRIAL REGISTRATION NUMBERS NCT04334291/EUPAS34399.
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Affiliation(s)
- Maurizio Bertaina
- Department of Cardiology, San Giovanni Bosco Hospital, Turin, Piemonte, Italy
- Emergency Medicine Department, Martini Hospital Centre, Torino, Piemonte, Italy
| | - Ivan J Nuñez-Gil
- Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Community of Madrid, Spain
| | - Luca Franchin
- Emergency Medicine Department, Martini Hospital Centre, Torino, Piemonte, Italy
- Division of Cardiology, Cardiovascular and Thoracic Department, University Hospital Città della Salute e della Scienza, Turin, Italy
| | | | - Ramón Arroyo-Espliguero
- Department of Cardiology, General University Hospital of Guadalajara, Guadalajara, Castilla-La Mancha, Spain
| | - María C Viana-Llamas
- Department of Cardiology, General University Hospital of Guadalajara, Guadalajara, Castilla-La Mancha, Spain
| | - Rodolfo Romero
- Servicio de Urgencias, Getafe University Hospital, Getafe, Community of Madrid, Spain
| | | | - Aitor Uribarri
- Division of Cardiology, Valladolid University Clinical Hospital, Valladolid, Castilla y León, Spain
| | | | - Jia Huang
- Department of Critical Care Medicine, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Emilio Alfonso
- Division of Cardiology, Institute of Cardiology and Cardiovascular Surgery, Havana, Cuba
| | - Fernando Marmol-Mosquera
- Internal Medicine Department, Hospital General del norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | - Fabrizio Ugo
- Division of Cardiology, Sant'Andrea di Vercelli Hospital, Vercelli, Piedmont, Italy
| | - Enrico Cerrato
- Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | | | | | - Gisela Feltes Guzman
- Division of Cardiology, Hospital Nuestra Señora de América Madrid, Madrid, Spain
| | - Adelina Gonzalez
- Infanta Sofia University Hospital, San Sebastian de los Reyes, Community of Madrid, Spain
| | | | | | - Carlos Macaya
- Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Community of Madrid, Spain
| | - Vicente Estrada
- Cardiovascular Institute, Hospital Clinico San Carlos, Madrid, Community of Madrid, Spain
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16
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Núñez-Gil IJ, Fernández-Ortiz A, Maroud Eid C, Huang J, Romero R, Becerra-Muñoz VM, Uribarri A, Feltes G, Trabatoni D, Fernandez-Rozas I, Viana-Llamas MC, Pepe M, Cerrato E, Bertaina M, Capel Astrua T, Alfonso E, Castro-Mejía AF, Raposeiras-Roubin S, D'Ascenzo F, Espejo Paeres C, Signes-Costa J, Bardaji A, Fernandez-Pérez C, Marin F, Fabregat-Andres O, Akin I, Estrada V, Macaya C. Underlying heart diseases and acute COVID-19 outcomes. Cardiol J 2020; 28:202-214. [PMID: 33346365 DOI: 10.5603/cj.a2020.0183] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 07/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The presence of any underlying heart condition could influence outcomes during the coronavirus disease 2019 (COVID-19). METHODS The registry HOPE-COVID-19 (Health Outcome Predictive Evaluation for COVID-19, NCT04334291) is an international ambispective study, enrolling COVID-19 patients discharged from hospital, dead or alive. RESULTS HOPE enrolled 2798 patients from 35 centers in 7 countries. Median age was 67 years (IQR: 53.0-78.0), and most were male (59.5%). A relevant heart disease was present in 682 (24%) cases. These were older, more frequently male, with higher overall burden of cardiovascular risk factors (hypertension, dyslipidemia, diabetes mellitus, smoking habit, obesity) and other comorbidities such renal failure, lung, cerebrovascular disease and oncologic antecedents (p < 0.01, for all). The heart cohort received more corticoids (28.9% vs. 20.4%, p < 0.001), antibiotics, but less hydroxychloroquine, antivirals or tocilizumab. Considering the epidemiologic profile, a previous heart condition was independently related with shortterm mortality in the Cox multivariate analysis (1.62; 95% CI 1.29-2.03; p < 0.001). Moreover, heart patients needed more respiratory, circulatory support, and presented more in-hospital events, such heart failure, renal failure, respiratory insufficiency, sepsis, systemic infammatory response syndrome and clinically relevant bleedings (all, p < 0.001), and mortality (39.7% vs. 15.5%; p < 0.001). CONCLUSIONS An underlying heart disease is an adverse prognostic factor for patients suffering COVID-19. Its presence could be related with different clinical drug management and would benefit from maintaining treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers during in-hospital stay.
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Affiliation(s)
- Iván J Núñez-Gil
- Hospital Clinico San Carlos, Prof Martin Lagos, sn, 28040 Madrid, Spain.
| | | | | | - Jia Huang
- The Second People's Hospital of Shenzhen, Shenzhen, China
| | | | - Victor Manuel Becerra-Muñoz
- Unidad de Gestión Clínica Área del Corazón, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga (UMA), Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Málaga, Spain
| | - Aitor Uribarri
- Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | | | | | - Martino Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari
| | - Enrico Cerrato
- San Luigi Gonzaga University Hospital, Rivoli, Turin. Italy
| | | | | | - Emilio Alfonso
- Instituto de Cardiología y Cirugía Cardiovascular, Havana, Cuba
| | | | | | | | | | - Jaime Signes-Costa
- Hospital Clínico Universitario, Incliva, Universidad de Valencia, Valencia, Spain
| | | | | | - Francisco Marin
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Ibrahim Akin
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - Vicente Estrada
- Hospital Clinico San Carlos, Prof Martin Lagos, sn, 28040 Madrid, Spain
| | - Carlos Macaya
- Hospital Clinico San Carlos, Prof Martin Lagos, sn, 28040 Madrid, Spain
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17
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Boretto P, Bruno F, Bertaina M, Bocchino P, Galluzzo A, Gatti P, Peyracchia M, De Ferrari G. Prognostic implication of sodium nitroprusside vasodilator test in pulmonary hypertension and left heart disease: insights from PUSHON registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2284] [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: 11/14/2022] Open
Abstract
Abstract
Background
Definition of combined post and pre-capillary pulmonary hypertension (Cpc-PH) is controversial, despite involving up to 25% of patients with heart failure with reduced ejection fraction (HFrEF). The 2019 World Symposium on PH focused on conflicting results and potential misleading interpretation of mean transpulmonary gradient (TPG) and diastolic transpulmonary gradient (DPG) in predicting outcomes in type 2 PH patients. A new Cpc-PH definition has been proposed, basing on pulmonary arterial wedge pressure (PAWP) >15 mmHg and pulmonary vascular resistance (PVR) >3 WU. In this setting, the role of vasodilator challenge has marginally been explored.
Purpose
This study aims to investigate whether vasodilator test increases prognostic accuracy in PH-LHD comparing to PVR and TPG.
Methods
125 patients with a first diagnosis of PH-LHD were selected within the PUlmonary hypertenSion in rigHt heart catheterization (PUSHON) registry. All patients underwent right heart catheterization and sodium nitroprusside vasodilator infusion. Hemodynamic response was defined as decrease of mean pulmonary arterial pressure (mPAP) <25 mmHg with maintenance of systemic systolic arterial pressure >85 mmHg. Primary endpoint was a composite of cardiac death, heart transplantation and urgent LVAD implant at 2 years.
Results
34 (27%) patients were sodium nitroprusside responders. Normalization of mPAP during acute vasodilator challenge was associated with higher event-free survival at 2 years (HR 2.46, 95% C.I. 1.29–4.69, p=0.006). Responders to nitroprusside showed lower baseline pressure regimens in pulmonary artery (sPAP 56.4±12.9 vs 63.2±12.4 mmHg, p=0.009; mPAP 38.1±6.9 vs 44.7±8.8 mmHg, p=0.001) and lower Wedge Pressure (25.1±6.6 vs 29.8±6.6 mmHg, p=0.001). Also, patients with positive vasodilator test showed better right ventricular function expressed by TAPSE (17.2±4.3 vs 15.4±3.8 mm, p=0.05) and higher EF (34.6±15.3% vs 28.1±13.1%, p=0.023). Interestingly, nitroprusside responders exhibited lower DPG (−0.11±5.30 vs 2.04±5.21 p=0.04). At multivariate analysis PVR and TPG ≥12 mmHg fail to independently predict primary endpoint, while positive vasodilator response was independently associated with better outcome (OR 0.22, 95% C.I. 0.09–0.52, p=0.001). The same results were confirmed in the Cpc-PH subgroup (OR 0.54, 95% C.I. 0.08–0.78, p=0.018).
Conclusions
Nitroprusside vasodilator response was associated with a higher event-free survival at 2 years follow-up in our cohort of patients with PH-LHD. Larger studies with prospective hemodynamic evaluations are needed to support our hypothesis.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - F Bruno
- University of Turin, Torino, Italy
| | | | | | | | - P Gatti
- University of Turin, Torino, Italy
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18
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Galluzzo A, Bertaina M, Frea S. Urinary sodium evaluation: the missing target for diuretic treatment optimization in acute heart failure patients? Letter regarding the article ‘Clinical importance of urinary sodium excretion in acute heart failure’. Eur J Heart Fail 2020; 22:1933. [DOI: 10.1002/ejhf.1814] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 03/15/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Alessandro Galluzzo
- Division of Cardiology Sant'Andrea Hospital Vercelli Italy
- Division of Cardiology Città della Salute e della Scienza University Hospital of Turin Turin Italy
| | - Maurizio Bertaina
- Division of Cardiology Città della Salute e della Scienza University Hospital of Turin Turin Italy
| | - Simone Frea
- Division of Cardiology Città della Salute e della Scienza University Hospital of Turin Turin Italy
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19
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D'Ascenzo F, Bertaina M, Fioravanti F, Bongiovanni F, Raposeiras-Roubin S, Abu-Assi E, Kinnaird T, Ariza-Solé A, Manzano-Fernández S, Templin C, Velicki L, Xanthopoulou I, Cerrato E, Rognoni A, Boccuzzi G, Omedè P, Montabone A, Taha S, Durante A, Gili S, Magnani G, Autelli M, Grosso A, Blanco PF, Garay A, Quadri G, Varbella F, Queija BC, Paz RC, Fernández MC, Pousa IM, Gallo D, Morbiducci U, Dominguez-Rodriguez A, Valdés M, Cequier A, Alexopoulos D, Iñiguez-Romo A, Gaita F, Rinaldi M, Lüscher TF. Long versus short dual antiplatelet therapy in acute coronary syndrome patients treated with prasugrel or ticagrelor and coronary revascularization: Insights from the RENAMI registry. Eur J Prev Cardiol 2020; 27:696-705. [DOI: 10.1177/2047487319836327] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 08/30/2023]
Abstract
Introduction The benefits of short versus long-term dual antiplatelet therapy (DAPT) based on the third generation P2Y12 antagonists prasugrel or ticagrelor, in patients with acute coronary syndromes treated with percutaneous coronary intervention remain to be clearly defined due to current evidences limited to patients treated with clopidogrel. Methods All acute coronary syndrome patients from the REgistry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) undergoing percutaneous coronary intervention and treated with aspirin, prasugrel or ticagrelor were stratified according to DAPT duration, that is, shorter than 12 months (D1 group), 12 months (D2 group) and longer than 12 months (D3 group). The three groups were compared before and after propensity score matching. Net adverse clinical events (NACEs), defined as a combination of major adverse cardiac events (MACEs) and major bleedings (including therefore all cause death, myocardial infarction and Bleeding Academic Research Consortium (BARC) 3–5 bleeding), were the primary end points, MACEs (a composite of all cause death and myocardial infarction) the secondary one. Single components of NACEs were co-secondary end points, along with BARC 2–5 bleeding, cardiovascular death and stent thrombosis. Results A total of 4424 patients from the RENAMI registry with available data on DAPT duration were included in the model. After propensity score matching, 628 patients from each group were selected. After 20 months of follow up, DAPT for 12 months and DAPT for longer than 12 months significantly reduced the risk of NACE (D1 11.6% vs. D2 6.7% vs. D3 7.2%, p = 0.003) and MACE (10% vs. 6.2% vs. 2.4%, p < 0.001) compared with DAPT for less than 12 months. These differences were driven by a reduced risk of all cause death (7.8% vs. 1.3% vs. 1.6%, p < 0.001), cardiovascular death (5.1% vs. 1.0% vs. 1.2%, p < 0.0001) and recurrent myocardial infarction (8.3% vs. 5.2% vs. 3.5%, p = 0.002). NACEs were lower with longer DAPT despite a higher risk of BARC 2–5 bleedings (4.6% vs. 5.7% vs. 6.2%, p = 0.04) and a trend towards a higher risk of BARC 3–5 bleedings (2.4% vs. 3.3% vs. 3.9%, p = 0.06). These results were not consistent for female patients and those older than 75 years old, due to an increased risk of bleedings which exceeded the reduction in myocardial infarction. Conclusion In unselected real world acute coronary syndrome patients treated with percutaneous coronary intervention, DAPT with prasugrel or ticagrelor prolonged beyond 12 months markedly reduces fatal and non-fatal ischaemic events, offsetting the increased risk deriving from the higher bleeding risk. On the contrary, patients >75 years old and female ones showed a less favourable risk–benefit ratio for longer DAPT due to excess of bleedings.
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Affiliation(s)
- Fabrizio D'Ascenzo
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Maurizio Bertaina
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Francesco Fioravanti
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Federica Bongiovanni
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | | | - Emad Abu-Assi
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | - Tim Kinnaird
- Cardiology Department, University Hospital of Wales, Cardiff, UK
| | - Albert Ariza-Solé
- Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain
| | | | - Christian Templin
- University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland
| | - Lazar Velicki
- Medical faculty, University of Novi Sad, Novi Sad, Serbia and Institute of cardiovascular diseases Vojvodina, Sremska Kamenica, Serbia
| | | | - Enrico Cerrato
- Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli (Torino), Italy
| | - Andrea Rognoni
- Catheterization Laboratory, Maggiore della Carità Hospital, Novara, Italy
| | | | - Pierluigi Omedè
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | | | - Salma Taha
- Department of Cardiology, Faculty of Medicine, Assiut University, Egypt
| | | | - Sebastiano Gili
- University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland
| | - Giulia Magnani
- University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland
| | - Michele Autelli
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Alberto Grosso
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Pedro Flores Blanco
- Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain
| | - Alberto Garay
- Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain
| | - Giorgio Quadri
- Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli (Torino), Italy
| | - Ferdinando Varbella
- Interventional Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli (Torino), Italy
| | | | - Rafael Cobas Paz
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | | | - Isabel Muñoz Pousa
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | - Diego Gallo
- PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy
| | - Umberto Morbiducci
- PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy
| | | | - Mariano Valdés
- Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain
| | - Angel Cequier
- Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain
| | | | | | - Fiorenzo Gaita
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Mauro Rinaldi
- Department of Cardiology, Department of Medical Sciences, University of Torino, Italy
| | - Thomas F Lüscher
- Royal Brompton and Harefield Hospitals Trust and Imperial College, London, UK
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D'Ascenzo F, Gili S, Bertaina M, Iannaccone M, Cammann VL, Di Vece D, Kato K, Saglietto A, Szawan KA, Frangieh AH, Boffini B, Annaratone M, Sarcon A, Levinson RA, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuß G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun‐Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, El‐Battrawy I, Akin I, Borggrefe M, Horowitz JD, Kozel M, Tousek P, Widimský P, Gilyarova E, Shilova A, Gilyarov M, Biondi‐Zoccai G, Winchester DE, Ukena C, Neuhaus M, Bax JJ, Prasad A, Di Mario C, Böhm M, Gasparini M, Ruschitzka F, Bossone E, Citro R, Rinaldi M, De Ferrari GM, Lüscher T, Ghadri JR, Templin C. Impact of aspirin on takotsubo syndrome: a propensity score‐based analysis of the InterTAK Registry. Eur J Heart Fail 2020; 22:330-337. [PMID: 31863563 DOI: 10.1002/ejhf.1698] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 03/16/2018] [Revised: 11/04/2019] [Accepted: 11/07/2019] [Indexed: 02/05/2023] Open
Affiliation(s)
- Fabrizio D'Ascenzo
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della ScienzaUniversity of Turin Turin Italy
| | | | - Maurizio Bertaina
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della ScienzaUniversity of Turin Turin Italy
| | - Mario Iannaccone
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della ScienzaUniversity of Turin Turin Italy
| | - Victoria L. Cammann
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Davide Di Vece
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Ken Kato
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Andrea Saglietto
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della ScienzaUniversity of Turin Turin Italy
| | - Konrad A. Szawan
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Antonio H. Frangieh
- Deutsches Herzzentrum MünchenTechnische Universität München Munich Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Munich Germany
| | | | | | - Annahita Sarcon
- Section of Cardiac Electrophysiology, Department of MedicineUniversity of California‐San Francisco San Francisco CA USA
| | - Rena A. Levinson
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
- Division of Biological SciencesUniversity of California San Diego San Diego CA USA
| | - Jennifer Franke
- Department of CardiologyHeidelberg University Hospital Heidelberg Germany
| | - L. Christian Napp
- Department of Cardiology and AngiologyHannover Medical School Hannover Germany
| | - Milosz Jaguszewski
- First Department of CardiologyMedical University of Gdansk Gdansk Poland
| | - Michel Noutsias
- Department of Internal Medicine III, Division of Cardiology, Angiology and Intensive Medical CareUniversity Hospital Halle, Martin‐Luther‐University Halle Halle Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology 1University Medical Center Mainz Mainz Germany
| | - Maike Knorr
- Center for Cardiology, Cardiology 1University Medical Center Mainz Mainz Germany
| | - Susanne Heiner
- Center for Cardiology, Cardiology 1University Medical Center Mainz Mainz Germany
| | - Hugo A. Katus
- Department of CardiologyHeidelberg University Hospital Heidelberg Germany
| | | | - Heribert Schunkert
- Deutsches Herzzentrum MünchenTechnische Universität München Munich Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Munich Germany
| | - Holger Thiele
- Department of Internal Medicine/CardiologyHeart Center Leipzig – University Hospital Leipzig Germany
| | - Johann Bauersachs
- Department of Cardiology and AngiologyHannover Medical School Hannover Germany
| | - Carsten Tschöpe
- Department of CardiologyCharité, Campus Rudolf Virchow Berlin Germany
| | - Burkert M. Pieske
- Department of CardiologyCharité, Campus Rudolf Virchow Berlin Germany
| | | | - Guido Michels
- Department of Internal Medicine IIIHeart Center University of Cologne Cologne Germany
| | - Roman Pfister
- Department of Internal Medicine IIIHeart Center University of Cologne Cologne Germany
| | | | - Claudius Jacobshagen
- Clinic for Cardiology and PneumologyGeorg August University Goettingen Goettingen Germany
| | - Gerd Hasenfuß
- Clinic for Cardiology and PneumologyGeorg August University Goettingen Goettingen Germany
| | - Mahir Karakas
- Department of General and Interventional CardiologyUniversity Heart Center Hamburg Hamburg Germany
- DZHK (German Centre for Cardiovascular Research), partner site Hamburg/Kiel/Luebeck Hamburg Germany
| | - Wolfgang Koenig
- Deutsches Herzzentrum MünchenTechnische Universität München Munich Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance Munich Germany
| | - Wolfgang Rottbauer
- Department of Internal Medicine II – CardiologyUniversity of Ulm, Medical Center Ulm Germany
| | - Samir M. Said
- Internal Medicine/Cardiology, Angiology, and PneumologyMagdeburg University Magdeburg Germany
| | | | - Adrian Banning
- Department of Cardiology, John Radcliffe HospitalOxford University Hospitals Oxford UK
| | - Florim Cuculi
- Department of CardiologyKantonsspital Lucerne Lucerne Switzerland
| | - Richard Kobza
- Department of CardiologyKantonsspital Lucerne Lucerne Switzerland
| | - Thomas A. Fischer
- Department of CardiologyKantonsspital Winterthur Winterthur Switzerland
| | - Tuija Vasankari
- Heart CenterTurku University Hospital and University of Turku Turku Finland
| | | | - Grzegorz Opolski
- Department of CardiologyMedical University of Warsaw Warsaw Poland
| | - Rafal Dworakowski
- Department of Cardiology, Kings College HospitalKings Health Partners London UK
| | - Philip MacCarthy
- Department of Cardiology, Kings College HospitalKings Health Partners London UK
| | - Christoph Kaiser
- Department of CardiologyUniversity Hospital Basel Basel Switzerland
| | - Stefan Osswald
- Department of CardiologyUniversity Hospital Basel Basel Switzerland
| | - Leonarda Galiuto
- Fondazione Policlinico Universitario A. Gemelli, IRCCSUniversità Cattolica del Sacro Cuore Rome Italy
| | - Filippo Crea
- Fondazione Policlinico Universitario A. Gemelli, IRCCSUniversità Cattolica del Sacro Cuore Rome Italy
| | - Wolfgang Dichtl
- University Hospital for Internal Medicine III (Cardiology and Angiology)Medical University Innsbruck Innsbruck Austria
| | - Wolfgang M. Franz
- University Hospital for Internal Medicine III (Cardiology and Angiology)Medical University Innsbruck Innsbruck Austria
| | - Klaus Empen
- Department of Internal Medicine BUniversity Medicine Greifswald Greifswald Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald Greifswald Germany
| | - Stephan B. Felix
- Department of Internal Medicine BUniversity Medicine Greifswald Greifswald Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald Greifswald Germany
| | - Clément Delmas
- Department of Cardiology and Cardiac Imaging CenterUniversity Hospital of Rangueil Toulouse France
| | - Olivier Lairez
- Department of Cardiology and Cardiac Imaging CenterUniversity Hospital of Rangueil Toulouse France
| | - Ibrahim El‐Battrawy
- First Department of Medicine, Faculty of MedicineUniversity Medical Centre Mannheim (UMM) University of Heidelberg Mannheim Germany
- DZHK (German Center for Cardiovascular Research), partner site, Heidelberg‐Mannheim Mannheim Germany
| | - Ibrahim Akin
- First Department of Medicine, Faculty of MedicineUniversity Medical Centre Mannheim (UMM) University of Heidelberg Mannheim Germany
- DZHK (German Center for Cardiovascular Research), partner site, Heidelberg‐Mannheim Mannheim Germany
| | - Martin Borggrefe
- First Department of Medicine, Faculty of MedicineUniversity Medical Centre Mannheim (UMM) University of Heidelberg Mannheim Germany
- DZHK (German Center for Cardiovascular Research), partner site, Heidelberg‐Mannheim Mannheim Germany
| | - John D. Horowitz
- Department of Cardiology, Basil Hetzel Institute, Queen Elizabeth HospitalUniversity of Adelaide Adelaide Australia
| | - Martin Kozel
- Cardiocenter, Third Faculty of MedicineCharles University in Prague and University Hospital Královské Vinohrady Prague Czech Republic
| | - Petr Tousek
- Cardiocenter, Third Faculty of MedicineCharles University in Prague and University Hospital Královské Vinohrady Prague Czech Republic
| | - Petr Widimský
- Cardiocenter, Third Faculty of MedicineCharles University in Prague and University Hospital Královské Vinohrady Prague Czech Republic
| | - Ekaterina Gilyarova
- Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov Moscow Russia
| | - Alexandra Shilova
- Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov Moscow Russia
| | - Mikhail Gilyarov
- Intensive Coronary Care Unit, Moscow City Hospital # 1 named after N. Pirogov Moscow Russia
| | - Giuseppe Biondi‐Zoccai
- Department of Medico‐Surgical Sciences and BiotechnologiesSapienza University of Rome Latina Italy
| | - David E. Winchester
- Department of Medicine, College of MedicineUniversity of Florida Gainesville FL USA
| | - Christian Ukena
- Klinik für Innere Medizin IIIUniversitätsklinikum des Saarlandes Homburg Germany
| | - Michael Neuhaus
- Department of CardiologyKantonsspital Frauenfeld Frauenfeld Switzerland
| | - Jeroen J. Bax
- Department of CardiologyLeiden University Medical Centre Leiden The Netherlands
| | - Abhiram Prasad
- Division of Cardiovascular Diseases Mayo Clinic Rochester MN USA
| | - Carlo Di Mario
- Structural Interventional CardiologyUniversity Hospital Careggi Florence Italy
| | - Michael Böhm
- Klinik für Innere Medizin IIIUniversitätsklinikum des Saarlandes Homburg Germany
| | - Mauro Gasparini
- Department of Mathematical SciencesPolitecnico di Torino Turin Italy
| | - Frank Ruschitzka
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Eduardo Bossone
- Division of Cardiology‘Antonio Cardarelli’ Hospital Naples Italy
| | - Rodolfo Citro
- Heart DepartmentUniversity Hospital ‘San Giovanni di Dio e Ruggi d'Aragona’ Salerno Italy
| | - Mauro Rinaldi
- Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della ScienzaUniversity of Turin Turin Italy
| | - Gaetano Maria De Ferrari
- Department of Molecular Medicine University of Pavia, and Cardiac Intensive Care Unit and Laboratories for Experimental CardiologyIRCCS Fondazione Policlinico San Matteo Pavia Italy
| | - Thomas Lüscher
- Center for Molecular Cardiology, Schlieren CampusUniversity of Zurich Zurich Switzerland
- Royal Brompton and Harefield Hospitals Trust and Imperial College London UK
| | - Jelena R. Ghadri
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
| | - Christian Templin
- Department of Cardiology, University Heart CenterUniversity Hospital Zurich Zurich Switzerland
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Bertaina M, Galluzzo A, D'Ascenzo F, Conrotto F, Grosso Marra W, Frea S, Alunni G, Crimi G, Moretti C, Montefusco A, D'Amico M, Perl L, Rinaldi M, Giustetto C, De Ferrari GM. Prognostic impact of MitraClip in patients with left ventricular dysfunction and functional mitral valve regurgitation: A comprehensive meta-analysis of RCTs and adjusted observational studies. Int J Cardiol 2019; 290:70-76. [DOI: 10.1016/j.ijcard.2019.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/14/2019] [Accepted: 05/05/2019] [Indexed: 11/29/2022]
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Kang D, Apel W, Arteaga-Velázquez J, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Daumiller K, de Souza V, Di Pierro F, Doll P, Engel R, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huber D, Huege T, Kampert KH, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Palmieri N, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. Recent results from the KASCADE-Grande data analysis. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920804005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
KASCADE, together with its extension KASCADE-Grande measured individual air showers of cosmic rays in the primary energy range of 100 TeV to 1 EeV. The data collection was fully completed at the end of 2013 and the experiment was dismantled. However, the data analysis is still in progress. Recently, we published a new result on upper limits to the flux of ultra-high energy gamma rays, which set constraints on some fundamental astrophysical models. We also use the data to investigate the validity of the new hadronic interactions models like SIBYLL version 2.3c or EPOS-LHC. In addition, we updated and improved the webbased platform of the KASCADE Cosmic Ray Data Centre (KCDC), where now the data from KASCADE and KASCADE-Grande of more than 20 years measurements is available, including corresponding Monte-Carlo simulated events based on three different hadronic interaction models. In this contribution, recent results from KASCADE-Grande and the update of KCDC is briefly discussed.
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Arteaga-Velázquez J, Rivera-Rangel D, Apel W, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Daumiller K, de Souza V, Di Pierro F, Doll P, Engel R, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huege T, Kampert K, Kang D, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. Study of themuon content of high-energy air showers with KASCADE-Grande. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920806003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In this work, we report measurements on the muon content (Eth > 230 MeV) of extensive air showers (EAS) induced by cosmic rays with primary energy from 10 PeV up to 1 EeV performed with the KASCADE-Grande experiment. The measurements are confronted with SIBYLL 2.3. The results are focused on the dependence of the total muon number and the lateral density distribution of muons in EAS on the zenith angle and the total number of charged particles in the shower. We also present updated results of a detailed study of the attenuation length of shower muons, which reveal a deviation between the measured data and the predictions of the post-LHC hadronic interaction models SIBYLL 2.3, QGSJET-II-04 and EPOS-LHC.
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Chiavassa A, Apel W, Arteaga-Velázquez J, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Cossavella F, Daumiller K, de Souza V, Di Pierro F, Doll P, Engel R, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huber D, Huege T, Kampert KH, Kang D, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Palmieri N, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. Summary of the main results of the KASCADE and KASCADE-Grande experiments. EPJ Web Conf 2019. [DOI: 10.1051/epjconf/201920803002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The KASCADE and KASCADE-Grande experiments operated in KIT-Campus North, Karlsruhe (Germany) from 1993 to 2012. The two experiments studied primary cosmic rays in the energy range from 1014 eV to 1018 eV, investigating the change of slope of the spectrum detected at 2 - 4 × 1015 eV, the so called knee. We briefly review the performance of the experiments and then the main results obtained in the operation of both experiments: the test of hadronic interaction models, the all particle primary spectrum, the elemental composition of primary cosmic rays (with the first claim of a knee-like feature of the heavy primaries spectrum) and the search for large scale anisotropies.
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Bertaina M, Ferraro I, Omedè P, Conrotto F, Saint-Hilary G, Cavender MA, Claessen BE, Henriques JP, Frea S, Usmiani T, Grosso Marra W, Pennone M, Moretti C, D'Amico M, D'Ascenzo F. Meta-Analysis Comparing Complete or Culprit Only Revascularization in Patients With Multivessel Disease Presenting With Cardiogenic Shock. Am J Cardiol 2018; 122:1661-1669. [PMID: 30220420 DOI: 10.1016/j.amjcard.2018.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/30/2018] [Accepted: 08/07/2018] [Indexed: 12/31/2022]
Abstract
The optimal strategy for patients with an acute myocardial infarction (MI) and multivessel (MV) coronary artery disease complicated by cardiogenic shock (CS) remains unknown. We conducted a meta-analysis of all randomized controlled trials and observational studies that reported adjusted effect measures to evaluate the association of MV-PCI (percutaneous coronary intervention), compared with culprit only (C)-PCI, with cardiovascular events in patients admitted for CS and MV disease. We identified 12 studies (n = 1 randomized controlled trials, n = 11 observational) that included 7,417 patients (n = 1,809 treated with MV-PCI and n = 5,608 with C-PCI). When compared with C-PCI, MV-PCI was not associated with an increased risk of short-term death (odds ratio [OR] 1.14, 95% confidence interval [CI] 0.87 to 1.48, p = 0.35 and adjusted OR [ORadj] 1.00, 95% CI 0.70 to 1.43, p = 1.00). In-hospital and/or short-term mortality tended to be higher with MV-PCI, when compared with C-PCI, for CS patients needing dialysis (ß 0.12, 95% CI from 0.049 to 0.198; p= 0.001), whereas MV-PCI was associated with lower in-hospital and/or short-term mortality in patients with an anterior MI (ß -0.022, 95% CI -0.03 to -0.01; p <0.001). MV-PCI strategy was associated with a more frequent need for dialysis or contrast-induced nephropathy after revascularization (OR 1.36, 95% CI 1.06 to 1.75, p = 0.02). In conclusion, MV-PCI seems not to increase risk of death during short- or long-term follow-up when compared with C-PCI in patients admitted for MV coronary artery disease and MI complicated by CS. Furthermore, it appears a more favorable strategy in patients with anterior MI, whereas the increased risk for AKI and its negative prognostic impact should be considered in decision-making process. Further studies are needed to confirm our hypothesis on in these subpopulations of CS patients.
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Cavallero E, Bertaina M, Cerrato E, D'Ascenzo F. Reply to: Cardiac protection by remote ischemic preconditioning in patients with diabetes status. Int J Cardiol 2018; 267:56. [PMID: 29957263 DOI: 10.1016/j.ijcard.2018.05.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/02/2018] [Accepted: 05/25/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Erika Cavallero
- Division of Cardiology, SS. Annunziata Hospital, Savigliano (CN), Italy
| | - Maurizio Bertaina
- Division of Cardiology, University Hospital San Luigi Gonzaga, Orbassano, (Turin), Italy; Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy
| | - Enrico Cerrato
- Division of Cardiology, University Hospital San Luigi Gonzaga, Orbassano, (Turin), Italy; Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
| | - Fabrizio D'Ascenzo
- Division of Cardiology, University Hospital San Luigi Gonzaga, Orbassano, (Turin), Italy; Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy
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Bertaina M, De Filippo O, Iannaccone M, Colombo A, Stone G, Serruys P, Mancone M, Omedè P, Conrotto F, Pennone M, Kimura T, Kawamoto H, Zoccai GB, Sheiban I, Templin C, Benedetto U, Cavalcante R, D’Amico M, Gaudino M, Moretti C, Gaita F, D’Ascenzo F. Percutaneous coronary intervention or coronary artery bypass graft in left main coronary artery disease. J Cardiovasc Med (Hagerstown) 2018; 19:554-563. [PMID: 30095584 DOI: 10.2459/jcm.0000000000000703] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Conrotto F, Bertaina M, Raposeiras-Roubin S, Kinnaird T, Ariza-Solé A, Manzano-Fernández S, Templin C, Velicki L, Xanthopoulou I, Cerrato E, Rognoni A, Boccuzzi G, Omedè P, Montabone A, Taha S, Durante A, Gili S, Magnani G, Autelli M, Grosso A, Flores Blanco P, Garay A, Quadri G, Varbella F, Caneiro Queija B, Cobas Paz R, Cespón Fernández M, Muñoz Pousa I, Gallo D, Morbiducci U, Dominguez-Rodriguez A, Valdés M, Cequier A, Alexopoulos D, Iñiguez-Romo A, Gaita F, Abu-Assi E, D’Ascenzo F. Prasugrel or ticagrelor in patients with acute coronary syndrome and diabetes: a propensity matched substudy of RENAMI. European Heart Journal: Acute Cardiovascular Care 2018; 8:536-542. [DOI: 10.1177/2048872618802783] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Introduction: The safety and efficacy of prasugrel and ticagrelor in patients with diabetes mellitus presenting with acute coronary syndrome and treated with percutaneous coronary intervention remain to be assessed. Methods: All diabetes patients admitted for acute coronary syndrome and enrolled in the REgistry of New Antiplatelets in patients with Myocardial Infarction (RENAMI) were compared before and after propensity score matching. Net adverse cardiovascular events (composite of death, stroke, myocardial infarction and BARC 3–5 bleedings) and major adverse cardiovascular events (composite of death, stroke and myocardial infarction) were the co-primary endpoints. Single components of primary endpoints were secondary endpoints. Results: Among 4424 patients enrolled in RENAMI, 462 and 862 diabetes patients treated with prasugrel and ticagrelor, respectively, were considered. After propensity score matching, 386 patients from each group were selected. At 19±5 months, major adverse cardiovascular events and net adverse cardiovascular events were similar in the prasugrel and ticagrelor groups (5.4% vs. 3.4%, P=0.16 and 6.7% vs. 4.1%, P=0.11, respectively). Ticagrelor was associated with a lower risk of death and BARC 2–5 bleeding when compared to prasugrel (2.8% vs. 0.8%, P=0.031 and 6.0% vs. 2.6%, P=0.02, respectively) and a clear but not significant trend for a reduction of BARC 3–5 bleeding (2.3% vs. 0.8%, P=0.08). There were no significant differences in myocardial infarction recurrence and stent thrombosis. Conclusion: Diabetes patients admitted for acute coronary syndrome seem to benefit equally in terms of major adverse cardiovascular events from ticagrelor or prasugrel use. Ticagrelor was associated with a significant reduction in all-cause death and bleedings, without differences in recurrent ischaemic events, which should be confirmed in dedicated randomised controlled trials.
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Affiliation(s)
| | | | | | - Tim Kinnaird
- Cardiology Department, University Hospital of Wales, Cardiff, UK
| | - Albert Ariza-Solé
- Department of Cardiology, University Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Christian Templin
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Lazar Velicki
- Department of Cardiology, Institute of Cardiovascular Diseases, Vojvodina, Serbia
| | | | - Enrico Cerrato
- Interventional Unit, San Luigi Gonzaga University Hospital, San Luigi, Italy
| | - Andrea Rognoni
- Catheterization Laboratory, Maggiore della Carità Hospital, Novara, Italy
| | | | | | | | - Salma Taha
- Department of Cardiology, Assiut University, Assiut, Egypt
| | | | - Sebastiano Gili
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Giulia Magnani
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | | | - Alberto Grosso
- Department of Cardiology, University of Turin, Turin, Italy
| | - Pedro Flores Blanco
- Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain
| | - Alberto Garay
- Department of Cardiology, University Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Giorgio Quadri
- Interventional Unit, San Luigi Gonzaga University Hospital, San Luigi, Italy
| | - Ferdinando Varbella
- Interventional Unit, San Luigi Gonzaga University Hospital, San Luigi, Italy
| | | | - Rafael Cobas Paz
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | | | - Isabel Muñoz Pousa
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
| | - Diego Gallo
- PolitoBIOMed Lab, Politecnico di Torino, Turin, Italy
| | | | | | - Mariano Valdés
- Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain
| | - Angel Cequier
- Department of Cardiology, University Hospital de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Fiorenzo Gaita
- Department of Cardiology, University of Turin, Turin, Italy
| | - Emad Abu-Assi
- Department of Cardiology, University Hospital Álvaro Cunqueiro, Vigo, Spain
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Omedè P, Bertaina M, Cerrato E, Rubio L, Nuñez-Gil I, Gili S, Taha S, Macaya C, Escaned J, D'Ascenzo F. Radial and femoral access for interventional fellows performing diagnostic coronary angiographies: the LEARN-Cardiogroup II, a prospective multicenter study. J Cardiovasc Med (Hagerstown) 2018; 19:650-654. [PMID: 30222662 DOI: 10.2459/jcm.0000000000000716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Safety and efficacy of radial and femoral access for coronary angiography performed by cardiology fellows remain to be evaluated. METHODS In this multicenter prospective study, cardiology fellows selected the access site (among femoral, right and left radial artery) for coronary angiography. All bleeding events related to the access site and all complications (a composite of all bleedings and artery occlusion) were the co-primary safety end points. Success for each access site, procedural and radiological times and single components of primary outcome were the secondary ones. RESULTS Overall, 201 patients were enrolled. Fellows chose right radial, left radial or femoral access in 164 (82%), 20 (10%) and 17 (8%) cases, respectively. All-cause bleedings were lower in radial cohort (4 vs. 19%; P = 0.001) mainly driven by minor bleedings (4 vs. 18%, P = 0.012). Also, overall complications were less frequent with the radial approach (18 vs. 30%, P = 0.03) and radial artery occlusion did not differ between right vs. left side (4 vs. 5%, P = 0.76). Procedural time (minutes) was similar between radial and femoral site (23 ± 9 vs. 22 ± 10, P = 0.91), as well as time of X-ray exposure (6 ± 3 vs. 4 ± 2, P = 0.11), DAP (Gy/cm: 17 ± 11 vs. 18 ± 12, P = 0.74) and amount of contrast medium (ml: 106 ± 81 vs. 84 ± 43, P = 0.89). Success for access was significantly higher with radial artery (89 vs. 71%, P = 0.004). CONCLUSION Radial artery is the most exploited access by cardiologist fellows, leading to reduction in minor bleedings and higher success compared with femoral access. No differences in procedural time and radiation exposures were recorded.
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Affiliation(s)
| | | | - Enrico Cerrato
- Division of Cardiology, 'AOU San Luigi e Centro di Emodinamica unità interaziendale', San Luigi- Rivoli, Italy
| | - Lolo Rubio
- Division of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Ivan Nuñez-Gil
- Division of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | | | - Salma Taha
- Division of Cardiology, Assiut University Hospital, Assiut, Egypt
| | - Carlos Macaya
- Division of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Javier Escaned
- Division of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
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Fioravanti F, Bertaina M, D'Ascenzo F, Bongiovanni F, Raposeiras-Roubin S, Abu-Assi E, Kinnaird T, Ariza-Sole A, Manzano-Fernandez S, Templin C, Velicki L, Xanthopoulou I, Cerrato E, Rognoni A, Luscher TF. P3178Long vs. short dual antiplatelet therapy in ACS patients treated with prasugrel or ticagrelor and coronary revascularization: a propensity score analysis from the RENAMI registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3178] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Fioravanti
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Department of Cardiology, Turin, Italy
| | - M Bertaina
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Department of Cardiology, Turin, Italy
| | - F D'Ascenzo
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Department of Cardiology, Turin, Italy
| | - F Bongiovanni
- Hospital Molinette of the University Hospital S. Giovanni Battista/City University Hosp of Health an, Department of Cardiology, Turin, Italy
| | | | - E Abu-Assi
- Hospital of Meixoeiro, Department of Cardiology, Vigo, Spain
| | - T Kinnaird
- University Hospital of Wales, Cardiology Department, Cardiff, United Kingdom
| | - A Ariza-Sole
- University Hospital of Bellvitge, Department of Cardiology, Barcelona, Spain
| | - S Manzano-Fernandez
- Hospital Clínico Univeristario Virgen de la Arrixaca, Department of Cardiology, Murcia, Spain
| | - C Templin
- Royal Brompton Hospital, Department of Cardiology, London, United Kingdom
| | - L Velicki
- Institute of cardiovascular Diseases, Vojvodina, Serbia
| | | | - E Cerrato
- University Hospital of Bellvitge, Department of Cardiology, Barcelona, Spain
| | - A Rognoni
- Hospital Maggiore Della Carita, Novara, Italy
| | - T F Luscher
- Royal Brompton Hospital, Department of Cardiology, London, United Kingdom
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Iannaccone M, Gili S, De Filippo O, D'Amico S, Gagliardi M, Bertaina M, Mazzilli S, Rettegno S, Bongiovanni F, Gatti P, Ugo F, Boccuzzi GG, Colangelo S, Prato S, Moretti C, D'Amico M, Noussan P, Garbo R, Hildick-Smith D, Gaita F, D'Ascenzo F. Diagnostic accuracy of functional, imaging and biochemical tests for patients presenting with chest pain to the emergency department: A systematic review and meta-analysis. Eur Heart J Acute Cardiovasc Care 2018; 8:412-420. [PMID: 29350536 DOI: 10.1177/2048872617754275] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined. METHODS Medline, Cochrane Library CENTRAL, EMBASE and Biomed Central were systematically screened (start date 1 September 2016, end date 1 December 2016). Prospective studies (observational or randomised controlled trial) comparing functional/imaging or biochemical tests for patients presenting with chest pain to the emergency department were included. RESULTS Overall, 77 studies were included, for a total of 49,541 patients (mean age 59.9 years). Fast and six-hour highly sensitive troponin T protocols did not show significant differences in their ability to detect acute coronary syndromes, as they reported a sensitivity and specificity of 0.89 (95% confidence interval 0.79-0.94) and 0.84 (0.74-0.9) vs 0.89 (0.78-0.94) and 0.83 (0.70-0.92), respectively. The addition of copeptin to troponin increased sensitivity and reduced specificity, without improving diagnostic accuracy. The diagnostic value of non-invasive tests for patients without troponin increase was tested. Coronary computed tomography showed the highest level of diagnostic accuracy (sensitivity 0.93 (0.81-0.98) and specificity 0.90 (0.93-0.94)), along with myocardial perfusion scintigraphy (sensitivity 0.85 (0.77-0.91) and specificity 0.92 (0.83-0.96)). Stress echography was inferior to coronary computed tomography but non-inferior to myocardial perfusion scintigraphy, while exercise testing showed the lower level of diagnostic accuracy. CONCLUSIONS Fast and six-hour highly sensitive troponin T protocols provide an overall similar level of diagnostic accuracy to detect acute coronary syndrome. Among the non-invasive ischaemia tests for patients without troponin increase, coronary computed tomography and myocardial perfusion scintigraphy showed the highest sensitivity and specificity.
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Affiliation(s)
- Mario Iannaccone
- 1 Division of Cardiology, University of Turin, Italy.,2 Division of Cardiology, S.G. Bosco Hospital, Italy
| | | | | | | | | | | | | | - Sara Rettegno
- 1 Division of Cardiology, University of Turin, Italy
| | | | - Paolo Gatti
- 1 Division of Cardiology, University of Turin, Italy
| | - Fabrizio Ugo
- 2 Division of Cardiology, S.G. Bosco Hospital, Italy
| | | | | | - Silvia Prato
- 2 Division of Cardiology, S.G. Bosco Hospital, Italy
| | | | | | | | - Roberto Garbo
- 2 Division of Cardiology, S.G. Bosco Hospital, Italy
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Arteaga-Velázquez J, Rivera-Rangel D, Apel W, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Daumiller K, Souza VD, Pierro FD, Doll P, Engel R, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huege T, Kampert K, Kang D, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. Tests of the SIBYLL 2.3 high-energy hadronic interaction model using the KASCADE-Grande muon data. EPJ Web of Conferences 2018. [DOI: 10.1051/epjconf/201817207003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The KASCADE-Grande observatory was a ground-based air shower array dedicated to study the energy and composition of cosmic rays in the energy interval E = 1 PeV –1 EeV. The experiment consisted of different detector systems which allowed the simultaneous measurement of distinct components of air showers (EAS), such as the muon content. In this contribution, we study the total muon number and the lateral density distribution of muons in EAS detected by KASCADE-Grande as a function of the zenith angle and the total number of charged particles. The attenuation length of the muon content of EAS is also measured. The results are compared with the predictions of the SIBYLL 2.3 high-energy hadronic interaction model.
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D'Ascenzo F, Iannaccone M, Saint-Hilary G, Bertaina M, Schulz-Schüpke S, Wahn Lee C, Chieffo A, Helft G, Gili S, Barbero U, Biondi Zoccai G, Moretti C, Ugo F, D'Amico M, Garbo R, Stone G, Rettegno S, Omedè P, Conrotto F, Templin C, Colombo A, Park SJ, Kastrati A, Hildick-Smith D, Gasparini M, Gaita F. Impact of design of coronary stents and length of dual antiplatelet therapies on ischaemic and bleeding events: a network meta-analysis of 64 randomized controlled trials and 102 735 patients. Eur Heart J 2017; 38:3160-3172. [PMID: 29020300 DOI: 10.1093/eurheartj/ehx437] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [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: 11/15/2016] [Accepted: 07/13/2017] [Indexed: 02/05/2023] Open
Affiliation(s)
- Fabrizio D'Ascenzo
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Mario Iannaccone
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
- Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154 Turin, Italy
| | - Gaelle Saint-Hilary
- Department of Mathematical Sciences "G. L. Lagrange", Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Maurizio Bertaina
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Stefanie Schulz-Schüpke
- Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München Lazarettstrasse 36, Munich 80636, Germany
| | - Cheol Wahn Lee
- Department of Cardiology, The Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina Milano, 60, 20132 Milan, Italy
| | - Gerard Helft
- Department of Cardiology, Cardiology Institute, Pitié-Salpêtrière Hospital, UPMC, APHP, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - Sebastiano Gili
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Umberto Barbero
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Giuseppe Biondi Zoccai
- Department of Cardiology, La Sapienza, Piazzale Aldo Moro, 5, 00185 Rome, Italy
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso Della Repubblica 79, 04100 Latina, Italy
- Department of AngioCardioNeurology, IRCCS Neuromed, Via Atinense, 18, 86077 Pozzilli, Italy
| | - Claudio Moretti
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Fabrizio Ugo
- Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154 Turin, Italy
| | - Maurizio D'Amico
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Roberto Garbo
- Department of Cardiology, San Giovanni Bosco Hospital, Piazza del Donatore di Sangue 3, 10154 Turin, Italy
| | - Gregg Stone
- Department of Cardiology, Columbia University Medical Center, USA Cardiovascular Research Foundation, 161 Ft. Washington Ave. Herbert Irving Pavilion 6th Floor, New York, NY 10032 212.305.7060, USA
| | - Sara Rettegno
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Pierluigi Omedè
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Federico Conrotto
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
| | - Christian Templin
- Department of Cardiology, University Heart Center, University Hospital Zurich, Rämistrasse 100, 8091 Zürich, Switzerland
| | - Antonio Colombo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Via Olgettina Milano, 60, 20132 Milan, Italy
| | - Seung-Jung Park
- Department of Cardiology, The Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
| | - Adnan Kastrati
- Department of Cardiology, Deutsches Herzzentrum München, Technische Universität München Lazarettstrasse 36, Munich 80636, Germany
| | - David Hildick-Smith
- Department of Cardiology, Sussex Cardiac Centre, Barry Building, Eastern Rd, Brighton BN2 5BE, UK
| | - Mauro Gasparini
- Department of Mathematical Sciences "G. L. Lagrange", Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Fiorenzo Gaita
- Department of Cardiology, Città Della Salute e della Scienza Hospital, Corso Bramante 88/90, 10126 Turin, Italy
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Bertaina M, D'Ascenzo F, Iannaccone M, Frangieh A, Gaita F, Templin C. 3113Is aspirin needed after Takotsubo syndrome?: a propensity score sub-analysis of inter-tak registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bertaina M, D'Ascenzo F, Iannaccone M, D'Amico M, Moretti C, Gaita F. Angiographic Follow-Up in Patients With Coronary Artery Disease: Is There a Window to Be Definitively Closed? JACC Cardiovasc Interv 2017; 10:843-844. [PMID: 28427606 DOI: 10.1016/j.jcin.2017.01.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 01/27/2017] [Accepted: 01/28/2017] [Indexed: 11/28/2022]
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D’Ascenzo F, De Filippo O, Bertaina M, Iannaccone M, Gaita F. “You don’t need a weather man to know which way the wind blows”: understanding differences and applications in clinical practice of randomized controlled trials on unprotected left main. Ann Transl Med 2017; 5:77. [DOI: 10.21037/atm.2017.01.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Haungs A, Apel W, Arteaga-Velázquez J, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Daumiller K, Souza VD, Pierro FD, Doll P, Engel R, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Heck D, Hörandel J, Huege T, Kampert KH, Kang D, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. KASCADE-Grande: Composition studies in the view of the post-LHC hadronic interaction models. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201714513001] [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: 11/14/2022] Open
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Iannaccone M, D'Ascenzo F, Frangieh AH, Niccoli G, Ugo F, Boccuzzi G, Bertaina M, Mancone M, Montefusco A, Amabile N, Sardella G, Motreff P, Toutouzas K, Colombo F, Garbo R, Biondi-Zoccai G, Tamburino C, Omedè P, Moretti C, D'amico M, Souteyrand G, Meieir P, Lüscher TF, Gaita F, Templin C. Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry. Catheter Cardiovasc Interv 2016; 90:E46-E52. [PMID: 28029210 DOI: 10.1002/ccd.26880] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 06/27/2016] [Revised: 11/07/2016] [Accepted: 11/13/2016] [Indexed: 02/05/2023]
Abstract
AIM To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome). METHODS AND RESULTS FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT-guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching. The number stents useds was the primary outcome, while the incidence of MACE (a composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) was the secondary endpoint. A total of 285 patients OCT-guided and 1,547 angiography guided patients were enrolled, resulting in 270 for each cohort after propensity score with matching. Two stents were used in 12% versus 34%; 3 stents in 8% versus 38% of the patients (P < 0.001). After a follow up of 700 days (450-890), there was no difference in myocardial infarction (6% vs. 6%, P = 0.86), while MACE (11% vs. 16%, P = 0.06), target vessel revascularization (2% vs. 4%, P = 0.15) and stent thrombosis rates (0% vs. 2.7%, P = 0.26) were numerically lower for the OCT-guided cohort but none of these endpoints did reach statistical significance. CONCLUSIONS An OCT-guided approach reduced the number of stents used, number of patients treated with more than one stent, while there was no statistically significant difference in clinical endpoints while most of them were numerically lower, including stent thrombosis rates. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Mario Iannaccone
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Fabrizio D'Ascenzo
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Antonio H Frangieh
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland
| | - Giampaolo Niccoli
- Division of Cardiology, Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Fabrizio Ugo
- Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy
| | | | - Maurizio Bertaina
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Massimo Mancone
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Antonio Montefusco
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Nicolas Amabile
- Cardiology Department, Institut Mutualiste Montsouris, Paris, France
| | - Gennaro Sardella
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Pascal Motreff
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France
| | - Konstantinos Toutouzas
- First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece
| | | | - Roberto Garbo
- Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy
| | - Giuseppe Biondi-Zoccai
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy and University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland
| | - Corrado Tamburino
- Division of Cardiology, Cardio-thoracic-vascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Pierluigi Omedè
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Claudio Moretti
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Maurizio D'amico
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Geraud Souteyrand
- Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France
| | - Pascal Meieir
- Division of Cardiology, University of Geneva, Geneva, Switzerland
| | - Thomas F Lüscher
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland
| | - Fiorenzo Gaita
- "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy
| | - Christian Templin
- Department of Cardiology, Zurich University Hospital, Zurich, Switzerland
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Iannaccone M, Meynet I, Omedè P, D'Ascenzo F, Taha S, Bertaina M, Colaci C, Marangoni L, Ribezzo M, Boffini M, Rinaldi M, Moretti C, Gaita F. Relationship between ventricular pressure and coronary artery disease in asymptomatic adult heart transplant recipients. J Cardiovasc Med (Hagerstown) 2016; 18:410-414. [PMID: 26999619 DOI: 10.2459/jcm.0000000000000320] [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] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The association between data of right heart catheterization and cardiac allograft vasculopathy (CAV) in adult heart transplant (HTx) recipients remains to be determined. METHODS AND RESULTS This is an observational, retrospective study, including all consecutive asymptomatic HTx patients undergoing routine right and left catheterization. The independent predictive power of pulmonary capillary wedge pressure (PCWP) to predict CAV (classified according to working formulation of a standardized nomenclature for CAV-2010) was the primary end point. Seventy-one patients were included, with a mean time from HTx to procedure of 19 ± 25 months. At coronary angiography first degree of CAV was found in eight patients (11.2%), second degree of CAV in two patients (2.8%), and third in two (2.8%). PCWP values were significantly higher in patients with CAV compared with patients without CAV (17.5 ± 7.5 vs. 10.4 ± 5.6, P < 0.001) and values of 15 mmHg or greater had an AUC of 0.71 (0.48-0.92), with a sensitivity of 71% and a specificity of 73% in predicting CAV, with an independent relationship confirmed at logistic regression analysis (odds ratio 1.28, IC 1.06-1.53; P = 0.008). CONCLUSION A significantly elevated PCWP at the time of the diagnosis of transplant coronary artery disease may be considered as an early marker of CAV, especially in asymptomatic HTx recipients.
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Affiliation(s)
- Mario Iannaccone
- Division of Cardiology, 'Città della Salute e della Scienza', Ospedale S.G. Battista -- Molinette, University of Turin, Turin, Italy
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Moretti C, D'Ascenzo F, Omedè P, Sciuto F, Presutti DG, Di Cuia M, Colaci C, Giusto F, Ballocca F, Cerrato E, Colombo F, Gonella A, Giordana F, Longo G, Vilardi I, Bertaina M, Orlando A, Andrini R, Ferrando A, DiNicolantonio JJ, Zoccai GB, Sheiban I, Gaita F. Thirty-day readmission rates after PCI in a metropolitan center in Europe: incidence and impact on prognosis. J Cardiovasc Med (Hagerstown) 2016; 16:238-45. [PMID: 25111771 DOI: 10.2459/jcm.0000000000000136] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Thirty-day readmission rates after percutaneous coronary intervention (PCI) have been related to adverse prognosis, and represent one of the most investigated indicators of quality of care. These data, however, derive from non-European centers evaluating all-cause readmissions, without stratification for diagnosis. METHODS All consecutive patients undergoing PCI at our center from January 2009 to December 2011 were enrolled. Thirty-day readmissions related to postinfarction angina, myocardial infarction, unstable angina or heart failure were defined as acute coronary syndrome (ACS) or heart failure rehospitalizations. Major cardiac adverse event (MACE) was the primary outcome, and its single components (death, myocardial infarction and repeated revascularization) the secondary ones. RESULTS A total of 1192 patients were included; among them, 53 (4.7%) were readmitted within 30 days, and 25 (2.1%) were classified as ACS/heart failure related. During hospitalization, patients with ACS/heart failure readmissions were more likely to suffer a periprocedural myocardial infarction (22 vs. 4%; P = 0.012), and to undergo PCI at 30 days (52 vs. 0.5%; P < 0.001). Logistic regression analysis indicated that periprocedural myocardial infarction represented the only independent predictor of an ACS/heart failure readmission [odds ratio (OR) 4.5; 1.1-16.8; P = 0.047]. After a median follow-up of 787 days (434-1027; first and third quartiles), patients with a 30-day ACS/heart failure readmission experienced higher rates of MACE, all-cause death and myocardial infarction (64 vs. 21%, P < 0.001; 28 vs. 6%, P = 0.017; and 20 vs. 2.7%, P < 0.001, respectively). Cox multivariate analysis indicated that ACS/heart failure 30-day readmissions were independently related to an increased risk of all-cause death (OR 3.3; 1.1-8.8; P = 0.02), differently from 30-day non-ACS/heart failure readmissions (OR 3.1; 0.7-12.9; P = 0.12). CONCLUSION Thirty-day readmissions after PCI in an Italian center are infrequent, and only those patients with ACS/heart failure show a detrimental impact on prognosis who have periprocedural myocardial infarction as the only independent predictor.
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Affiliation(s)
- Claudio Moretti
- aDivision of Cardiology, Department of Internal Medicine, Città Della Salute e Della Scienza bCSI-Piemonte - Direzione Salute - Area Trattamento Dati cSC Programmazione e Controllo di Gestione, Turin, Italy dWegmans Pharmacy, Ithaca, New York, USA
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Moretti C, Iqbal J, Murray S, Bertaina M, Parviz Y, Fenning S, Quadri G, Gunn J, D’Ascenzo F, Marra S, Moiraghi C, Riccardini F, Veglio F, Gaita F, Denvir M. Prospective assessment of a palliative care tool to predict one-year mortality in patients with acute coronary syndrome. European Heart Journal: Acute Cardiovascular Care 2016; 6:272-279. [DOI: 10.1177/2048872616633841] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
| | - Javaid Iqbal
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, UK
| | | | | | - Yasir Parviz
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, UK
| | | | | | - Julian Gunn
- South Yorkshire Cardiothoracic Centre, Northern General Hospital, UK
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Moretti C, Quadri G, D'Ascenzo F, Bertaina M, Giusto F, Marra S, Moiraghi C, Scaglione L, Torchio M, Montrucchio G, Bo M, Porta M, Cavallo Perin P, Marinone C, Riccardini F, Iqbal J, Omedè P, Bergerone S, Veglio F, Gaita F. THE STORM (acute coronary Syndrome in paTients end Of life and Risk assesMent) study. Emerg Med J 2015; 33:10-6. [DOI: 10.1136/emermed-2014-204114] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 04/01/2015] [Indexed: 12/11/2022]
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Bertaina M, Bowaire A, Cambursano S, Caruso R, Contino G, Cotto G, Crivello F, Forza R, Guardone N, Manfrin M, Mignone M, Mulas R, Suino G, Tibaldi P. EUSO@TurLab: An experimental replica of ISS orbits. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20158903003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Łuczak P, Apel W, Arteaga-Velázquez J, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Curcio C, Daumiller K, Souza VD, Pierro FD, Doll P, Engel R, Engler J, Fuchs B, Fuhrmann D, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huber D, Huege T, Kampert KH, Kang D, Klages H, Link K, Ludwig M, Mathes H, Mayer H, Melissas M, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Palmieri N, Petcu M, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. The 〈 ln A 〉 study with the Muon tracking detector in the KASCADE-Grande experiment – comparison of hadronic interaction models. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20159913001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arteaga-Velázquez J, Apel W, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Cossavella F, Daumiller K, Souza VD, Pierro FD, Doll P, Engel R, Engler J, Fuchs B, Fuhrmann D, Gherghel-Lascu A, Gils H, Glasstetter R, Grupen C, Haungs A, Heck D, Hörandel J, Huber D, Huege T, Kampert KH, Kang D, Klages H, Link K, Łuczak P, Mathes H, Mayer H, Milke J, Mitrica B, Morello C, Oehlschläger J, Ostapchenko S, Palmieri N, Petcu M, Pierog T, Rebel H, Roth M, Schieler H, Schoo S, Schröder F, Sima O, Toma G, Trinchero G, Ulrich H, Weindl A, Wochele J, Zabierowski J. Confronting the EPOS-LHC model predictions on the charged particle and muon attenuation lengths of EAS with the measurements of the KASCADE-Grande observatory. EPJ Web of Conferences 2015. [DOI: 10.1051/epjconf/20159912002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Smída R, Werner F, Engel R, Arteaga-Velázquez JC, Bekk K, Bertaina M, Blümer J, Bozdog H, Brancus IM, Chiavassa A, Cossavella F, Di Pierro F, Doll P, Fuchs B, Fuhrmann D, Grupen C, Haungs A, Heck D, Hörandel JR, Huber D, Huege T, Kampert KH, Kang D, Klages H, Kleifges M, Krömer O, Link K, Luczak P, Ludwig M, Mathes HJ, Mathys S, Mayer HJ, Melissas M, Morello C, Neunteufel P, Oehlschläger J, Palmieri N, Pekala J, Pierog T, Rautenberg J, Rebel H, Riegel M, Roth M, Salamida F, Schieler H, Schoo S, Schröder FG, Sima O, Stasielak J, Toma G, Trinchero GC, Unger M, Weber M, Weindl A, Wilczyński H, Will M, Wochele J, Zabierowski J. First Experimental Characterization of Microwave Emission from Cosmic Ray Air Showers. Phys Rev Lett 2014; 113:221101. [PMID: 25494064 DOI: 10.1103/physrevlett.113.221101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Indexed: 06/04/2023]
Abstract
We report the first direct measurement of the overall characteristics of microwave radio emission from extensive air showers. Using a trigger provided by the KASCADE-Grande air shower array, the signals of the microwave antennas of the Cosmic-Ray Observation via Microwave Emission experiment have been read out and searched for signatures of radio emission by high-energy air showers in the GHz frequency range. Microwave signals have been detected for more than 30 showers with energies above 3×10^{16} eV. The observations presented in this Letter are consistent with a mainly forward-directed and polarized emission process in the GHz frequency range. The measurements show that microwave radiation offers a new means of studying air showers at E≥10^{17} eV.
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Affiliation(s)
- R Smída
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - F Werner
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - R Engel
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | | | - K Bekk
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Bertaina
- Università di Torino and Sezione INFN, 10125 Torino, Italy
| | - J Blümer
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - H Bozdog
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - I M Brancus
- National Institute of Physics and Nuclear Engineering, 76900 Bucharest, Romania
| | - A Chiavassa
- Università di Torino and Sezione INFN, 10125 Torino, Italy
| | - F Cossavella
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - F Di Pierro
- Università di Torino and Sezione INFN, 10125 Torino, Italy
| | - P Doll
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - B Fuchs
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - D Fuhrmann
- Bergische Universität Wuppertal, 42097 Wuppertal, Germany
| | - C Grupen
- Department of Physics, Siegen University, 57072 Germany
| | - A Haungs
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - D Heck
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J R Hörandel
- Department of Astrophysics, Radboud University Nijmegen, 6500 The Netherlands
| | - D Huber
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - T Huege
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - K-H Kampert
- Bergische Universität Wuppertal, 42097 Wuppertal, Germany
| | - D Kang
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - H Klages
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Kleifges
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - O Krömer
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - K Link
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - P Luczak
- Department of Astrophysics, National Centre for Nuclear Research, 90-950 Łódź, Poland
| | - M Ludwig
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - H J Mathes
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - S Mathys
- Bergische Universität Wuppertal, 42097 Wuppertal, Germany
| | - H J Mayer
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Melissas
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - C Morello
- Osservatorio Astrofisico di Torino, INAF 10133, Torino, Italy
| | - P Neunteufel
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J Oehlschläger
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - N Palmieri
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J Pekala
- Institute of Nuclear Physics PAN, 31-342 Krakow, Poland
| | - T Pierog
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J Rautenberg
- Bergische Universität Wuppertal, 42097 Wuppertal, Germany
| | - H Rebel
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Riegel
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Roth
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - F Salamida
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - H Schieler
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - S Schoo
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - F G Schröder
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - O Sima
- Department of Physics, University of Bucharest, 76900 Bucharest, Romania
| | - J Stasielak
- Institute of Nuclear Physics PAN, 31-342 Krakow, Poland
| | - G Toma
- National Institute of Physics and Nuclear Engineering, 76900 Bucharest, Romania
| | - G C Trinchero
- Osservatorio Astrofisico di Torino, INAF 10133, Torino, Italy
| | - M Unger
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - M Weber
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - A Weindl
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - H Wilczyński
- Institute of Nuclear Physics PAN, 31-342 Krakow, Poland
| | - M Will
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J Wochele
- Karlsruhe Institute of Technology (KIT), 76021 Karlsruhe, Germany
| | - J Zabierowski
- Department of Astrophysics, National Centre for Nuclear Research, 90-950 Łódź, Poland
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Apel W, Arteaga-Velazquez J, Bähren L, Bekk K, Bertaina M, Biermann P, Blümer J, Bozdog H, Brancus I, Cantoni E, Chiavassa A, Daumiller K, de Souza V, Di Pierro F, Doll P, Engel R, Falcke H, Fuchs B, Fuhrmann D, Gemmeke H, Grupen C, Haungs A, Heck D, Hörandel J, Horneffer A, Huber D, Huege T, Isar P, Kampert KH, Kang D, Krömer O, Kuijpers J, Link K, Łuczak P, Ludwig M, Mathes H, Melissas M, Morello C, Oehlschläger J, Palmieri N, Pierog T, Rautenberg J, Rebel H, Roth M, Rühle C, Saftoiu A, Schieler H, Schmidt A, Schröder F, Sima O, Toma G, Trinchero G, Weindl A, Wochele J, Zabierowski J, Zensus J. Reconstruction of the energy and depth of maximum of cosmic-ray air showers from LOPES radio measurements. Int J Clin Exp Med 2014. [DOI: 10.1103/physrevd.90.062001] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Gili S, D'Ascenzo F, Moretti C, Omedè P, Vilardi I, Bertaina M, Biondi Zoccai G, Sheiban I, Stone GW, Gaita F. Impact on prognosis of periprocedural myocardial infarction after percutaneous coronary intervention. J Interv Cardiol 2014; 27:482-90. [PMID: 25175019 DOI: 10.1111/joic.12143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Different definitions of periprocedural myocardial infarction (MI) after percutaneous coronary intervention (PCI) have been provided, but their impact on prognosis remains to be determined. METHODS Procedural data from consecutive patients undergoing PCI from 2009 to 2011 were revised to adjudicate diagnosis of periprocedural MI according to CK-MB increase (>3 × URL and >5 × URL), to troponin increase (>3 × 99th percentile URL and >5 × 99th percentile URL) and to recent 2012 Task Force and Society for Cardiovascular Angiography and Interventions (SCAI) definitions. Major adverse cardiovascular events (MACE) was the primary end-point. RESULTS Seven hundred twelve patients were enrolled; after 771 days, 115 (16.7%) patients experienced MACE. One hundred ninety patients were diagnosed with a periprocedural MI defined as elevation of troponin >5 × 99th percentile of URL. When adjudicating 2012 Task Force definition on these patients, 46 were excluded and 1.4% of them experienced a MACE and 0.3% died, while among 144 with periprocedural MI, 2.9% reported a MACE and 1.3% died. After appraisal of SCAI definition, 176 patients were excluded, 3.8% of them with a MACE and 1.4% died, and for those with periprocedural MI, 0.5% experienced a MACE and 0.1% died. Similar low performance was appraised after reclassification of patients from more than 3 of upper limit of CK-MB and of troponin. At multivariate analysis, none of these definitions related to adverse events. CONCLUSION Periprocedural MI represents a frequent complication for patients undergoing PCI. All present definitions share a still not satisfactory discrimination between patients with and without adverse events at follow-up, stressing the need for more accurate definitions.
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Affiliation(s)
- Sebastiano Gili
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy
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Moretti C, Omedè P, Presutti DG, D’Ascenzo F, De Simone V, Colaci C, Bertaina M, Vilardi I, Gaita F. Shaping an ectatic coronary artery: Stentys implantation. Int J Cardiol 2014; 171:459-61. [DOI: 10.1016/j.ijcard.2013.11.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/20/2013] [Accepted: 11/23/2013] [Indexed: 10/25/2022]
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Šmída R, Baur S, Bertaina M, Blümer J, Chiavassa A, Engel R, Haungs A, Huege T, Kampert KH, Klages H, Kleifges M, Krömer O, Ludwig M, Mathys S, Neunteufel P, Pekala J, Rautenberg J, Riegel M, Roth M, Salamida F, Schieler H, Stasielak J, Unger M, Weber M, Werner F, Wilczyński H, Wochele J. Observation of microwave emission from extensive air showers with CROME. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20135308010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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