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3 results on '"Daniele Maselli"'

1. Prognostic Impact of Multiple Prior Percutaneous Coronary Interventions in Patients Undergoing Coronary Artery Bypass Grafting

Author

Fausto Biancari, Magnus Dalén, Vito G. Ruggieri, Till Demal, Giuseppe Gatti, Francesco Onorati, Giuseppe Faggian, Antonino S. Rubino, Daniele Maselli, Riccardo Gherli, Antonio Salsano, Matteo Saccocci, Giuseppe Santarpino, Francesco Nicolini, Tuomas Tauriainen, Marisa De Feo, Juhani Airaksinen, Stefano Rosato, Andrea Perrotti, and Giovanni Mariscalco

Subjects
coronary artery bypass grafting, percutaneous coronary intervention, previous PCI, prior PCI, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background Multiple percutaneous coronary interventions (PCIs) are considered determinant of poor outcome in patients undergoing coronary artery bypass grafting (CABG), but scarce data exist to substantiate this. Methods and Results Patients who underwent CABG without history of prior PCI or with PCI performed >30 days before surgery were selected for the present analysis from the prospective, multicenter E‐CABG (European Multicenter Study on Coronary Artery Bypass Grafting) registry. Out of 6563 patients with data on preoperative SYNTAX (Synergy between PCI With Taxus and Cardiac Surgery) score, 1181 patients (18.0%) had undergone PCI >30 days before CABG. Of these, 11.6% underwent a single PCI, 4.4% 2 PCIs, and 2.1% ≥3 PCIs. PCI of a single main coronary vessel was performed in 11.3%, of 2 main vessels in 4.9%, and of 3 main vessels in 1.6% of patients. Multivariable analysis showed that differences in early mortality and other outcomes were not significantly different in the study cohorts. The adjusted hospital/30‐day mortality rate was 1.8% in patients without history of prior PCI, 1.9% in those with a history of 1 PCI, 1.4% after 2 PCIs, and 2.5% after ≥3 PCIs (adjusted P=0.8). The adjusted hospital/30‐day mortality rate was 2.0% in those who had undergone PCI of 1 main coronary vessel, 1.3% after PCI of 2 main vessels, and 3.1% after PCI of 3 main coronary vessels (adjusted P=0.6). Conclusions Multiple prior PCIs are not associated with increased risk of early adverse events in patients undergoing isolated CABG. The present results are conditional to survival after PCI and should not be viewed as a support for a policy of multiple PCI as opposed to earlier CABG. Clinical Trial Registration URL: http://www.Clinicaltrials.gov. Unique identifier: NCT02319083.

Published
2018
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2. A single dose of erythropoietin reduces perioperative transfusions in cardiac surgery: results of a prospective single-blind randomized controlled trial

Author

Ricardo Bello, M Falco, Daniele Maselli, Alessandro Bellisario, Luca Weltert, Beatrice Rondinelli, Luca Pierelli, Franco Turani, and Ruggero De Paulis

Subjects
medicine.medical_specialty, business.industry, Incidence (epidemiology), Immunology, Hematology, Perioperative, law.invention, Cardiac surgery, Randomized controlled trial, law, Erythropoietin, Relative risk, Anesthesia, medicine, Clinical endpoint, Immunology and Allergy, business, Adverse effect, medicine.drug
Abstract

BACKGROUND We conducted a prospective single-blind randomized study to assess whether a single 80,000 IU dose of human recombinant erythropoietin (HRE), given just 2 days before cardiac surgery, could be effective in reducing perioperative allogeneic red blood cell transfusion (aRBCt). STUDY DESIGN AND METHODS Six-hundred patients presenting with preoperative hemoglobin (Hb) level of not more than 14.5 g/dL were randomly assigned to either HRE or control. The primary endpoint was the incidence of perioperative aRBCt. The secondary endpoints were mortality and the incidence of adverse events in the first 45 days after surgery, Hb level on Postoperative Day 4, and number of units of RBC transfusions in the first 4 days after surgery. RESULTS A total of 17% (HRE) versus 39% (control) required transfusion (relative risk, 0.436; p

Published
2015
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3. Incidence and prognostic impact of bleeding and transfusion after coronary surgery in low-risk patients

Author

Giuseppe Santarpino, Marco Zanobini, Tuomas Tauriainen, Filiberto Serraino, Carmelo Dominici, Riccardo Gherli, Marisa De Feo, Fausto Biancari, Francesco Musumeci, Francesca Fiorentino, Francesco Santini, Daniel Reichart, Sidney Chocron, Giuseppe Gatti, Antonio Salsano, Ciro Bancone, Francesco Nicolini, Antonino S. Rubino, Karl Bounader, Theodor Fischlein, Giuseppe Faggian, Giovanni Mariscalco, Matteo Saccocci, Jean Philippe Verhoye, Peter Svenarud, Luca Maschietto, Saverio Nardella, Vito G. Ruggieri, Francesco Onorati, Andrea Perrotti, Eeva-Maija Kinnunen, Magnus Dalén, Tiziano Gherli, Ilaria Franzese, Carmelo Mignosa, Daniele Maselli, Kinnunen, Em, De Feo, M, Reichart, D, Tauriainen, T, Gatti, G, Onorati, F, Maschietto, L, Bancone, C, Fiorentino, F, Chocron, S, Bounader, K, Dalén, M, Svenarud, P, Faggian, G, Franzese, I, Santarpino, G, Fischlein, T, Maselli, D, Dominici, C, Nardella, S, Gherli, R, Musumeci, F, Rubino, A, Mignosa, C, Mariscalco, G, Serraino, Fg, Santini, F, Salsano, A, Nicolini, F, Gherli, T, Zanobini, M, Saccocci, M, Ruggieri, Vg, Philippe Verhoye, J, Perrotti, A, and Biancari, F.

Subjects
Excessive Bleeding, Male, Registrie, medicine.medical_specialty, Blood transfusion, Blood management, Prognosi, medicine.medical_treatment, Tertiary Care Center, Immunology, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Aged, Coronary Artery Bypass, Europe, Female, Humans, Incidence, Male, Middle Aged, Postoperative Hemorrhage, Prognosis, Prospective Studies, Risk Factors, Tertiary Care Centers, Blood Transfusion, Registries, Medicine, Humans, Immunology and Allergy, Blood Transfusion, Prospective Studies, Registries, Coronary Artery Bypass, Adverse effect, Prospective cohort study, Stroke, Aged, business.industry, Coronary Artery Bypa, Incidence, Risk Factor, Perioperative, Hematology, Middle Aged, medicine.disease, Prognosis, Surgery, Cardiac surgery, Europe, Prospective Studie, Female, 030228 respiratory system, business, Human
Abstract

BACKGROUND Excessive bleeding and blood transfusion are associated with adverse outcome after cardiac surgery, but their mechanistic effects are difficult to disentangle in patients with increased operative risk. This study aimed to evaluate the incidence and prognostic impact of bleeding and transfusion of blood products in low-risk patients undergoing coronary artery bypass grafting (CABG). STUDY DESIGN AND METHODS Sixteen tertiary European centers of cardiac surgery contributed to the prospective European registry of CABG (E-CABG). The severity of bleeding was defined by the E-CABG bleeding severity classification and universal definition of perioperative bleeding (UDPB) classification. RESULTS Of 1213 patients with EuroSCORE II of less than 2% (mean, 1.1 ± 0.4%), 18.5% suffered from mild bleeding (E-CABG bleeding Grade 1) and 3.4% experienced severe bleeding (E-CABG bleeding Grade 2-3). Similarly, 19.7% had UDPB Class 2 and 5.9% had UDPB Classes 3 and 4. Mild and severe bleeding defined by the E-CABG and UDPB classifications were associated with an increased risk of several adverse events as adjusted by multiple covariates. The risk of death, stroke, and acute kidney injury was particularly increased in patients with severe bleeding. CONCLUSION Severe bleeding is rather uncommon in low-risk patients undergoing CABG, but it is associated with an increased risk of major adverse events. Prevention of excessive perioperative bleeding and patient blood management may improve the outcome of cardiac surgery also in low-risk patients.

Published
2017

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