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Lucà F, Pavan D, Gulizia MM, Manes MT, Abrignani MG, Benedetto FA, Bisceglia I, Brigido S, Caldarola P, Calvanese R, Canale ML, Caretta G, Ceravolo R, Chieffo A, Chimenti C, Cornara S, Cutolo A, Di Fusco SA, Di Matteo I, Di Nora C, Fattirolli F, Favilli S, Francese GM, Gelsomino S, Geraci G, Giubilato S, Ingianni N, Iorio A, Lanni F, Montalto A, Nardi F, Navazio A, Nesti M, Parrini I, Pilleri A, Pozzi A, Rao CM, Riccio C, Rossini R, Scicchitano P, Valente S, Zuccalà G, Gabrielli D, Grimaldi M, Colivicchi F, Oliva F. [Gender discrepancy: time to implement gender-based clinical management]. G Ital Cardiol (Rome) 2024; 25:126-139. [PMID: 38270370 DOI: 10.1714/4187.41763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
It is well established that gender strongly influences cardiovascular risk factors, playing a crucial role in cardiovascular prevention, clinical pathways, diagnostic approach and treatment. Beyond the sex, which is a biological factor, gender entails a socio-cultural condition that impacts access and quality of care due to structural and institutional barriers. However, despite its great importance, this issue has not been adequately covered. Indeed sex and gender differences scarcely impact the clinical approach, creating a lot of disparities in care and outcomes of patients. Therefore, it becomes essential to increase the awareness of the importance of sex and gender influences on cardiovascular diseases. Moreover, new strategies for reducing disparities should be developed. Importantly, these differences should be taken into account in guideline recommendations. In this regard, it is crucial to include a greater number of women in clinical trials, since they are currently underrepresented. Furthermore, more women should be involved as member of international boards in order to develop recommendations and guidelines with more attention to this important topic.The aim of this ANMCO position paper is to shed light on gender differences concerning many cardiovascular drugs in order to encourage a more personalized therapeutic approach.
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Affiliation(s)
- Fabiana Lucà
- Divisione di Cardiologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria
| | - Daniela Pavan
- Dipartimento Cardio-Cerebro-Riabilitativo, Azienda Sanitaria Friuli Occidentale, Pordenone
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | | | | | | | - Irma Bisceglia
- Servizi Cardiologici Integrati, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | | | | | | | - Giorgio Caretta
- S.C. Cardiologia, Ospedale Sant'Andrea, La Spezia, ASL5 Liguria
| | - Roberto Ceravolo
- U.O. Cardiologia e UTIC, Ospedale Giovanni Paolo II, Lamezia Terme (CZ)
| | - Alaide Chieffo
- Emodinamica-Cardiologia Interventistica, IRCCS Ospedale San Raffaele, Milano
| | - Cristina Chimenti
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, Azienda Ospedaliera Policlinico Umberto I, Sapienza Università di Roma, Roma
| | - Stefano Cornara
- S.C. Cardiologia Levante, P.O. Levante - Ospedale San Paolo, Savona
| | - Ada Cutolo
- U.O.C. Cardiologia, Ospedale dell'Angelo, Venezia-Mestre
| | - Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Presidio Ospedaliero San Filippo Neri - ASL Roma 1, Roma
| | - Irene Di Matteo
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Concetta Di Nora
- S.O.C. Cardiochirurgia, A.O.U. Santa Maria della Misericordia, Udine
| | - Francesco Fattirolli
- Dipartimento di Medicina Sperimentale e Clinica, Università degli Studi, Firenze
| | - Silvia Favilli
- S.O.C. Cardiologia Pediatrica e della Transizione, IRCSS Azienda Ospedaliero-Universitaria Meyer, Firenze
| | - Giuseppina Maura Francese
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Sandro Gelsomino
- Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht - CARIM, University of Maastricht, Maastricht, Olanda
| | - Giovanna Geraci
- U.O. Cardiologia, P.O. Sant'Antonio Abate, ASP Trapani, Erice (TP)
| | - Simona Giubilato
- U.O.C. Cardiologia con UTIC ed Emodinamica, Azienda Ospedaliera Cannizzaro, Catania
| | | | - Annamaria Iorio
- U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | | | - Andrea Montalto
- U.O. Cardiochirurgia, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Federico Nardi
- Dipartimento di Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Alessandro Navazio
- S.O.C. Cardiologia Ospedaliera, Presidio Ospedaliero Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Reggio Emilia
| | - Martina Nesti
- Dipartimento Cardiologico e Neurologico, Ospedale San Donato, Arezzo
| | | | - Annarita Pilleri
- S.S.D. Consulenza e Valutazione Cardiologica, Azienda di Rilievo Nazionale e Alta Specializzazione "G. Brotzu", Cagliari
| | - Andrea Pozzi
- U.O.C. Cardiologia 1, Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo
| | - Carmelo Massimiliano Rao
- Divisione di Cardiologia, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria
| | - Carmine Riccio
- U.O.S.D. Follow-up del Paziente Post-Acuto, Dipartimento Cardio-Vascolare, AORN Sant'Anna e San Sebastiano, Caserta
| | - Roberta Rossini
- S.C. Cardiologia, Azienda Ospedaliera S. Croce e Carle, Cuneo
| | | | - Serafina Valente
- Cardiologia Clinico-Chirurgica (UTIC), A.O.U. Senese, Ospedale Santa Maria alle Scotte, Siena
| | - Giuseppe Zuccalà
- Dipartimento di Geriatria, Centro di Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore e IRCCS Fondazione Policlinico A. Gemelli, Roma
| | - Domenico Gabrielli
- U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma - Fondazione per il Tuo cuore - Heart Care Foundation, Firenze
| | - Massimo Grimaldi
- U.O.C. Cardiologia-UTIC, Ospedale Miulli, Acquaviva delle Fonti (BA)
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Presidio Ospedaliero San Filippo Neri - ASL Roma 1, Roma
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
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2
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Brigido S, Manes MT, Ingianni N, Lanni F, Cutolo A, La Rovere MT, Pavan D. [Gender cardiology: focus on clinical and pathophysiological peculiarities in women with long COVID syndrome]. G Ital Cardiol (Rome) 2024; 25:6-13. [PMID: 38140991 DOI: 10.1714/4165.41585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Long COVID is a clinical syndrome characterized by the persistence or development of symptoms due to COVID-19 at least 12 weeks after initial infection. More than 200 different symptoms have been ascribed to long COVID, the most common being fatigue, shortness of breath, and muscle weakness. Women have a three-fold higher risk of being diagnosed with long COVID, and the symptoms more often described are persistent weakness, chest pain, altered smell and taste, palpitations or muscle pain, as well as neurological, gastrointestinal and rheumatologic symptoms. Long COVID features are influenced by immune function, endothelial dysfunction and sex hormones. Moreover, it leads to systemic dysfunction, so various therapeutic strategies have been explored and still different trials are ongoing, mainly regarding anticoagulation and immuno-modulators. Nowadays the most quoted interventions are focused rehabilitation programs and pharmacological selected treatments in specifical cases. The aim of this review will be focusing the clinical and pathophysiological sex-related peculiarities to understand the different long COVID phenotypes and possibly address a better tailored approach and treatment.
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Affiliation(s)
| | | | | | | | - Ada Cutolo
- U.O.C. Cardiologia, Ospedale dell'Angelo, Venezia-Mestre
| | - Maria Teresa La Rovere
- Dipartimento di Cardiologia, Istituti Clinici Scientifici Maugeri IRCCS, Montescano (PV)
| | - Daniela Pavan
- Dipartimento Cardio-cerebro-riabilitativo, Azienda Sanitaria Friuli Occidentale, Pordenone
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Zilio F, Di Fusco SA, Flori M, Malvezzi Caracciolo D'Aquino M, Pollarolo L, Ingianni N, Lucà F, Riccio C, Gulizia MM, Gabrielli D, Oliva F, Colivicchi F. Physical activity and the heart: from well-established cardiovascular benefits to possible adverse effects. Trends Cardiovasc Med 2024; 34:18-25. [PMID: 35738324 DOI: 10.1016/j.tcm.2022.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/15/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 12/12/2022]
Abstract
The favorable effects of physical activity on the cardiovascular system have been well described in scientific literature. Physical activity reduces cardiovascular morbidity and mortality in both healthy subjects and in patients with cardiovascular disease. However, different intensity levels of physical activity have a different impact on the cardiovascular system. Some data support the hypothesis of a "physical activity paradox": repetitive exposure to vigorous physical activity may induce biological effects that counteract the benefits of moderate intensity levels of physical activity. In this review, we report the main effects of acute and chronic physical activity on the cardiovascular system and we summarize the biochemical mechanisms that may explain these effects.
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Affiliation(s)
- Filippo Zilio
- Department of Cardiology, Santa Chiara Hospital, APSS, Trento Italy.
| | | | - Marco Flori
- Cardiology Unit, Presidio Ospedaliero Unico Urbino, Urbino, Italy
| | | | - Luigi Pollarolo
- Cardiology Unit, Santo Spirito Hospital, Casale Monferrato, Italy
| | - Nadia Ingianni
- Cardiologo ASP Trapani Distretti Marsala e Castelvetrano, Marsala, Italy
| | - Fabiana Lucà
- Division of Cardiology, Big Metropolitan Hospital, Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Carmine Riccio
- UOSD "Follow up del paziente post acuto", Dipartimento Cardiovascolare, Azienda Ospedaliera Sant'Anna e San Sebastiano, Caserta, Italy
| | - Michele Massimo Gulizia
- Cardiology Division, Garibaldi-Nesima Hospital, Catania, Italy; ANMCO Heart Care Foundation, Florence, Italy
| | - Domenico Gabrielli
- Cardiology/CCU Unit, Cardiovascular Department, San Camillo Hospital, Rome, Italy
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, Rome, Italy
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4
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Giubilato S, Lucà F, Abrignani MG, Gatto L, Rao CM, Ingianni N, Amico F, Rossini R, Caretta G, Cornara S, Di Matteo I, Di Nora C, Favilli S, Pilleri A, Pozzi A, Temporelli PL, Zuin M, Amico AF, Riccio C, Grimaldi M, Colivicchi F, Oliva F, Gulizia MM. Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention. J Clin Med 2023; 12:5989. [PMID: 37762932 PMCID: PMC10531720 DOI: 10.3390/jcm12185989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Chronic coronary syndrome (CCS), which encompasses a broad spectrum of clinical presentations of coronary artery disease (CAD), is the leading cause of morbidity and mortality worldwide. Recent guidelines for the management of CCS emphasize the dynamic nature of the CAD process, replacing the term "stable" with "chronic", as this disease is never truly "stable". Despite significant advances in the treatment of CAD, patients with CCS remain at an elevated risk of major cardiovascular events (MACE) due to the so-called residual cardiovascular risk. Several pathogenetic pathways (thrombotic, inflammatory, metabolic, and procedural) may distinctly contribute to the residual risk in individual patients and represent a potential target for newer preventive treatments. Identifying the level and type of residual cardiovascular risk is essential for selecting the most appropriate diagnostic tests and follow-up procedures. In addition, new management strategies and healthcare models could further support available treatments and lead to important prognostic benefits. This review aims to provide an overview of the diagnostic and therapeutic challenges in the management of patients with CCS and to promote more effective multidisciplinary care.
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Affiliation(s)
- Simona Giubilato
- Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Fabiana Lucà
- Cardiology Department, Grande Ospedale Metropolitano, AO Bianchi Melacrino Morelli, 89129 Reggio Calabria, Italy; (F.L.); (C.M.R.)
| | | | - Laura Gatto
- Cardiology Department, San Giovanni Addolorata Hospital, 00184 Rome, Italy
| | - Carmelo Massimiliano Rao
- Cardiology Department, Grande Ospedale Metropolitano, AO Bianchi Melacrino Morelli, 89129 Reggio Calabria, Italy; (F.L.); (C.M.R.)
| | - Nadia Ingianni
- ASP Trapani Cardiologist Marsala Castelvetrano Districts, 91022 Castelvetrano, Italy;
| | - Francesco Amico
- Cardiology Department, Cannizzaro Hospital, 95126 Catania, Italy;
| | - Roberta Rossini
- Cardiology Unit, Ospedale Santa Croce e Carle, 12100 Cuneo, Italy;
| | - Giorgio Caretta
- Sant’Andrea Hospital, ASL 5 Regione Liguria, 19124 La Spezia, Italy;
| | - Stefano Cornara
- Arrhytmia Unit, Division of Cardiology, Ospedale San Paolo, Azienda Sanitaria Locale 2, 17100 Savona, Italy;
| | - Irene Di Matteo
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milan, Italy; (I.D.M.); (F.O.)
| | - Concetta Di Nora
- Department of Cardiothoracic Science, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, Italy;
| | - Silvia Favilli
- Department of Pediatric Cardiology, Meyer Hospital, 50139 Florence, Italy;
| | - Anna Pilleri
- Cardiology Unit, Brotzu Hospital, 09121 Cagliari, Italy;
| | - Andrea Pozzi
- Cardiology Department, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy;
| | - Pier Luigi Temporelli
- Division of Cardiac Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, 28013 Gattico-Veruno, Italy;
| | - Marco Zuin
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy;
- Department of Cardiology, West Vicenza Hospital, 136071 Arzignano, Italy
| | - Antonio Francesco Amico
- CCU-Cardiology Unit, Ospedale San Giuseppe da Copertino Hospital, Copertino, 73043 Lecce, Italy
| | - Carmine Riccio
- Cardiovascular Department, Sant’Anna e San Sebastiano Hospital, 81100 Caserta, Italy;
| | - Massimo Grimaldi
- Department of Cardiology, General Regional Hospital “F. Miulli”, 70021 Bari, Italy;
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, 00135 Rome, Italy;
| | - Fabrizio Oliva
- De Gasperis Cardio Center, Niguarda Hospital, 20162 Milan, Italy; (I.D.M.); (F.O.)
| | - Michele Massimo Gulizia
- Cardiology Department, Garibaldi Nesima Hospital, 95122 Catania, Italy;
- Heart Care Foundation, 50121 Florence, Italy
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Francese GM, Aspromonte N, Valente S, Geraci G, Pavan D, Bisceglia I, Caforio ALP, Colavita AR, Cutolo A, De Angelis MC, Di Fusco SA, Enea I, Fiscella D, Frongillo D, Gil Ad V, Giubilato S, Giuffrida C, Ingianni N, Lucà F, Marcantoni L, Martinis F, Marzullo R, Masciocco G, Parrini I, Rakar S, Resta M, Riva L, Rossini R, Russo D, Russo G, Russo MG, Scardovi AB, De Luca L, Gabrielli D, Gulizia MM, Oliva F, Colivicchi F. [ANMCO Position paper: Cardiovascular disease in women - prevention, diagnosis, treatment and organization of care]. G Ital Cardiol (Rome) 2022; 23:775-792. [PMID: 36169129 DOI: 10.1714/3881.38644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cardiovascular diseases are still the main cause of death among women despite the improvements in treatment and prognosis achieved in the last 30 years of research. The determinant factors and causes have not been completely identified but the role of "gender" is now recognized. It is well known that women tend to develop cardiovascular disease at an older age than men, and have a high probability of manifesting atypical symptoms not often recognized. Other factors may also co-exist in women, which may favor the onset of specific cardiac diseases such as those with a sex-specific etiology (differential effects of estrogens, pregnancy pathologies, etc.) and those with a different gender expression of specific and prevalent risk factors, inflammatory and autoimmune diseases and cancer. Whether the gender differences observed in cardiovascular outcomes are influenced by real biological differences remains a matter of debate.This ANMCO position paper aims at providing the state of the research on this topic, with particular attention to the diagnostic aspects and to care organization.
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Affiliation(s)
- Giuseppina Maura Francese
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Nadia Aspromonte
- U.O.S. Scompenso Cardiaco, Dipartimento di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma
| | - Serafina Valente
- Cardiologia Clinico-Chirurgica (UTIC), Ospedale Santa Maria alle Scotte, A.O.U. Senese, Siena
| | - Giovanna Geraci
- U.O.C. Cardiologia-UTIC ed Emodinamica, P.O. "V. Cervello", Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo
| | - Daniela Pavan
- S.O.C. Cardiologia, Ospedale di San Vito al Tagliamento, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento (PN)
| | - Irma Bisceglia
- Servizi Cardiologici Integrati, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma
| | | | | | - Ada Cutolo
- U.O. Cardiologia, Ospedale dell'Angelo, Venezia-Mestre, Azienda ULSS 3 Serenissima
| | - Maria Carmen De Angelis
- U.O.C. Cardiologia-UTIC-Emodinamica-Elettrofisiologia-Elettrostimolazione, Ospedale del Mare, Napoli
| | - Stefania Angela Di Fusco
- U.O.C. Cardiologia Clinica e Riabilitativa, Presidio Ospedaliero San Filippo Neri, Roma, ASL Roma 1
| | - Iolanda Enea
- U.O.C. Medicina e Chirurgia d'Urgenza, A.O.R.N. Sant'Anna e San Sebastiano, Caserta
| | - Damiana Fiscella
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania
| | - Doriana Frongillo
- U.O.C. Cardiologia, Ospedale San Sebastiano Martire, Frascati (RM), ASL Roma 6
| | - Vered Gil Ad
- U.O. Cardiologia, Ospedale Policlinico San Martino, Genova
| | - Simona Giubilato
- U.O.C. Cardiologia con UTIC ed Emodinamica, Azienda Ospedaliera Cannizzaro, Catania
| | - Clea Giuffrida
- Psicologa e Psicoterapeuta Cognitivo Comportamentale, Catania
| | - Nadia Ingianni
- U.O.C. di Cardiologia e UTIC, P.O. Sant'Antonio Abate, Erice (TP), ASP Trapani
| | - Fabiana Lucà
- Cardiologia-UTIC, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria
| | - Lina Marcantoni
- U.O.C. Cardiologia, Ospedale Santa Maria della Misericordia, Rovigo, ULSS 5 Polesana
| | - Flavia Martinis
- S.O.C. Cardiologia, Ospedale di San Vito al Tagliamento, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento (PN)
| | - Raffaella Marzullo
- U.O.C. Cardiologia Pediatrica, Università della Campania "L. Vanvitelli", Ospedale Monaldi, Napoli
| | - Gabriella Masciocco
- Cardiologia 2-Insufficienza Cardiaca e Trapianti, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Iris Parrini
- Dipartimento di Cardiologia, Ospedale Mauriziano, Torino
| | - Serena Rakar
- S.C. Cardiologia, Dipartimento CardioToracoVascolare, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste
| | | | - Letizia Riva
- U.O.C. Cardiologia, Ospedale Maggiore, Azienda USL di Bologna, Bologna
| | | | | | - Giulia Russo
- S.C. Cardiovascolare e Medicina dello Sport, Dipartimento Cardiotoracovascolare, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste
| | - Maria Giovanna Russo
- U.O.C. Cardiologia Pediatrica, Università della Campania "L. Vanvitelli", Ospedale Monaldi, Napoli
| | | | - Leonardo De Luca
- U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Domenico Gabrielli
- U.O.C. Cardiologia, Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliera San Camillo Forlanini, Roma
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania - Fondazione per il Tuo cuore - Heart Care Foundation, Firenze
| | - Fabrizio Oliva
- Cardiologia 1-Emodinamica, Dipartimento Cardiotoracovascolare "A. De Gasperis", ASST Grande Ospedale Metropolitano Niguarda, Milano
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, Presidio Ospedaliero San Filippo Neri, Roma, ASL Roma 1
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Di Fusco SA, Rossini R, Flori M, Pollarolo L, Ingianni N, Malvezzi Caracciolo D'Aquino M, Galati G, Zilio F, Iorio A, Scotto di Uccio F, Lucà F, Gulizia MM, Ciccirillo F, Gabrielli D, Colivicchi F. Pathophysiology and management of recreational drug-related acute coronary syndrome: ANMCO position statement. J Cardiovasc Med (Hagerstown) 2021; 22:79-89. [PMID: 32858637 DOI: 10.2459/jcm.0000000000001091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/05/2022]
Abstract
Recreational drug use may cause coronary artery disease through several mechanisms. An increasing number of young patients with drug-related acute coronary syndrome have been reported over recent years. The present position statement reports the most recent epidemiological data on acute coronary syndrome in the setting of drug abuse, describes the main pathophysiological mechanisms underlying coronary artery disease and acute events in these patients, and provides practical recommendations on management and an overview of prognosis.
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Affiliation(s)
| | - Roberta Rossini
- U.O.C. Cardiologia, Azienda Ospedaliera Santa Croce e Carle, Cuneo
| | - Marco Flori
- U.O.C. Cardiologia, Presidio Ospedaliero Unico Urbino (PU)
| | - Luigi Pollarolo
- U.O.C Cardiologia, Ospedale Santo Spirito, Casale Monferrato (AL)
| | - Nadia Ingianni
- U.O.C. Cardiologia, Presidio Ospedaliero Paolo Borsellino, Marsala (TP)
| | | | - Giuseppe Galati
- Divisione di Cardiologia, IRCCS Ospedale San Raffaele, Milan
| | | | - Annamaria Iorio
- U.S.C. Cardiologia 2, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo
| | | | - Fabiana Lucà
- U.O.C. Cardiologia, A.O. Bianchi Melacrino Morelli, Reggio Calabria
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione 'Garibaldi', Catania
- Presidente Fondazione per il Tuo cuore, Firenze - Heart Care Foundation Onlus, Florence
| | | | - Domenico Gabrielli
- U.O.C Cardiologia, Ospedale Civile Augusto Murri, Area Vasta 4 Fermo, ASUR Marche, Fermo (AN), Italy
| | - Furio Colivicchi
- U.O.C. Cardiologia Clinica e Riabilitativa, P.O San Filippo Neri - ASL Roma1, Rome
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7
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Lucà F, Cipolletta L, Di Fusco SA, Rao CM, Ingianni N, Iorio A, Francese GM, Gelsomino S, Zecchin M, Gabrielli D, Gulizia MM. A practical guide to pacemaker follow-up. Minerva Cardioangiol 2020; 67:433-438. [PMID: 31637899 DOI: 10.23736/s0026-4725.19.04843-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Fabiana Lucà
- Unit of Intensive Therapy, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy - .,Unit of Interventional Cardiology, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy -
| | - Laura Cipolletta
- Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti di Ancona University Hospital, Ancona, Italy
| | - Stefania A Di Fusco
- Unit of Cardiology, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy.,Unit of Intensive Therapy, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
| | - Carmelo M Rao
- Unit of Intensive Therapy, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy.,Unit of Interventional Cardiology, Bianchi Melacrino Morelli Hospital, Reggio Calabria, Italy
| | - Nadia Ingianni
- Unit of Cardiology, Paolo Borsellino Hospital, ASP Trapani, Marsala, Italy.,Unit of Intensive Therapy, Paolo Borsellino Hospital, ASP Trapani, Marsala, Italy
| | - Annamaria Iorio
- Unit of Cardiology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giuseppina M Francese
- Unit of Cardiology, Garibaldi-Nesima Hospital, Azienda di Rilevo Nazionale e Alta Specialità, Catania, Italy
| | - Sandro Gelsomino
- Cardiothoracic Department, Maastricht University Hospital, Maastricht, the Netherlands
| | - Massimo Zecchin
- Unit of Cardiology, Ospedali Riuniti University Hospital, Trieste, Italy
| | | | - Michele M Gulizia
- Unit of Cardiology, Garibaldi-Nesima Hospital, Azienda di Rilevo Nazionale e Alta Specialità, Catania, Italy.,Fondazione per il Tuo Cuore, Florence, Italy
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Lucà F, Cipolletta L, Di Fusco SA, Iorio A, Pozzi A, Rao CM, Ingianni N, Benvenuto M, Madeo A, Fiscella D, Benedetto D, Francese GM, Gelsomino S, Zecchin M, Gabrielli D, Gulizia MM. Remote monitoring: Doomed to let down or an attractive promise? Int J Cardiol Heart Vasc 2019; 24:100380. [PMID: 31193998 PMCID: PMC6545403 DOI: 10.1016/j.ijcha.2019.100380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 11/25/2022]
Abstract
Device interrogation and management are time consuming, representing a relevant burden for pacing centers. In several situations, patients' management requires additional follow up visits. Remote Monitoring (RM) allows an optimal recall management and a rapid diagnosis of device or lead failure, without the need of additional in office visits. Further it allows a significant delay reduction between the adverse event and the reaction to the alarm, shortening the time needed to make a clinical decision. A role in risk-predicting patient-related outcomes has also been shown. RM permits detection of the arrhythmia from 1 to 5 months in advance compared to in-office visits. Importantly, by using specific algorithms with multiparametric analysis, RM has been studied as a potential instrument to identify early patients on risk of worsening HF using specific algorithms. Although the use of RM in HF setting remains controversial, it has been proposed to improve HF clinical outcomes and survival in clinical trials. In this sense, RM success could require a standardization of process within a management model, that may involve different health care professionals. In this review, we examine recent advances of RM providing an update of this tool through different clinical scenarios.
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Key Words
- AHRE, Atrial High Rate Episodes
- ARTESIA, Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation
- ASSERT, ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and atrial fibrillation Reduction atrial pacing Trial
- Atrial fibrillation
- CHAMPION, CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients
- CIED, Cardiac Implantable Electronic Devices
- COMPAS, COMPArative follow-up Schedule with home monitoring
- CONNECT, Clinical Evaluation of Remote Notification to Reduce Time to Clinical Decision
- CRT, Cardiac Resynchronization Therapy
- ECOST, Effectiveness and Cost of ICDs Follow-up Schedule with Telecardiology
- EHRA, European Heart Rhythm Association
- EVOLVO, Evolution of Management Strategies of Heart Failure Patients With Implantable Defibrillators
- Heart failure
- ICD, Implantable Cardioverter Defibrillator
- IMPACT, Combined Use of BIOTRONIK Home Monitoring and Predefined Anticoagulation to Reduce Stroke Risk
- IN-TIME, Influence of Home Monitoring on the Clinical Status of Heart Failure Patients With an Impaired Left Ventricular Function
- ISHNE, International Society for Holter and Noninvasive Electrocardiology
- Implantable devices
- MORE-CARE, MOnitoring Resynchronization dEvices and CARdiac patiEnts
- MULTISENSE HF, Multisensor Chronic Evaluation in Ambulatory Heart Failure Patients
- MoniC, Model Project Monitor Centre
- NOAH, Non–vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes
- NYHA, New York Heart Association
- OPTILINK-HF, Optimization of Heart Failure Management Using Medtronic OptiVol Fluid Status Monitoring and CareLink Network
- PARTNERS HF, Program to Access and Review Trending Information and Evaluate Correlation to Symptoms in Patients With Heart Failure
- PMK, Pacemaker
- REFORM Trial, Remote Follow-Up for ICD-Therapy in Patients Meeting MADIT II Criteria
- RM, Remote Monitoring
- RM-HF, REmote Monitoring: an evaluation of implantable devices for management of Heart Failure patients
- Remote telemonitoring
- SELENE, Selection of potential predictors of worsening Heart Failure
- TARIFF, Evaluation Registry for Remote Follow-up
- TRUST, Lumos-T Safely Reduces Routine Office Device Follow-up
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Affiliation(s)
- Fabiana Lucà
- UTIC e Cardiologia Interventistica, Azienda Ospedaliera “Bianchi Melacrino Morelli”, Reggio Calabria, Italy
- Corresponding author.
| | - Laura Cipolletta
- Dipartimento di Scienze Cardiovascolari, Clinica di Cardiologia, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Italy
| | | | - Annamaria Iorio
- UO di Cardiologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Pozzi
- UO di Cardiologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Carmelo Massimiliano Rao
- UTIC e Cardiologia Interventistica, Azienda Ospedaliera “Bianchi Melacrino Morelli”, Reggio Calabria, Italy
| | - Nadia Ingianni
- UOC Cardiologia e UTIC, P.O. Paolo Borsellino, ASP Trapani, Marsala, Italy
| | | | - Andrea Madeo
- UOC Cardiologia, Ospedale di Castrovillari, Cosenza, Italy
| | - Damiana Fiscella
- UOC Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilevo Nazionale e Alta Specialità, Catania, Italy
| | | | - Giuseppina Maura Francese
- UOC Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilevo Nazionale e Alta Specialità, Catania, Italy
| | - Sandro Gelsomino
- Cardiothoracic Department, Maastricht University Hospital, Maastricht, the Netherlands
| | - Massimo Zecchin
- U.O. Cardiologia, Azienda Ospedaliero Universitaria “Ospedali Riuniti”, Trieste, Italy
| | | | - Michele Massimo Gulizia
- UOC Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilevo Nazionale e Alta Specialità, Catania, Italy
- Fondazione per il Tuo Cuore, Italy
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