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3. Atrial fibrillation accelerates functional decline in older adults: a 15-year follow-up population-based study.

Author

Okoye, Chukwuma, Qiu, Chengxuan, Xia, Xin, Lip, Gregory Yoke Hong, Bellelli, Giuseppe, Welmer, Anna-Karin, Calderón-Larrañaga, Amaia, and Vetrano, Davide Liborio

Abstract

Aims Atrial fibrillation (AF) has been associated with functional impairment. However, the role exerted by AF on the long-term trajectories of functional mobility remains to be elucidated. This study aimed to evaluate the impact of AF on functional mobility by tracing walking speed (WS) trajectories over 15 years of follow-up in a population-based cohort of individuals aged 60+ years. Methods and results This population-based cohort study included 3141 community-dwelling participants (mean age 73.7 years; 63.6% women) from the Swedish National Study on Aging and Care in Kungsholmen, who were regularly examined from 2001–2004 to 2016–2019. Functional mobility was assessed by measuring WS in a standardized way. The association between AF and WS trajectories was assessed by multivariable joint models accounting for the longitudinal dropouts due to death. Stratified analyses by demographic and clinical factors were performed. The effect-modifying role of oral anticoagulant therapy (OAC), incident heart failure (HF), and incident stroke was finally investigated. At baseline, 285 (9.1%) participants were ascertained to have AF. A faster annual WS decline was observed in persons with AF than in non-AF peers (adjusted β coefficient per year = −0.011, 95% confidence interval: −0.016 to −0.005). Incident HF and stroke were associated with greater WS decline in participants with AF. OAC use was not associated with a slower functional decline. Conclusion Atrial fibrillation is associated with a faster physical function decline in older individuals. Incident HF and stroke possibly accelerate WS decline over time in AF participants. [ABSTRACT FROM AUTHOR]

Published
2024
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4. The Combination of Hyperuricemia and Elevated High-Sensitivity C-Reactive Protein Increased the Risk of Cardiac Conduction Block.

Author

Li, Na, Cui, Liufu, Tse, Gary, Korantzopoulos, Panagiotis, Letsas, Konstantinos P, Bazoukis, George, Chen, Shuohua, Zhang, Nan, Yang, Xuemei, Liu, Peipei, Wu, Lili, Yan, Gan-Xin, Lip, Gregory Yoke Hong, Wu, Shouling, and Liu, Tong

Subjects
BUNDLE-branch block, C-reactive protein, URIC acid, REGRESSION analysis, CONFIDENCE intervals
Abstract

This study aimed to explore the impact of a combination of hyperuricemia (HUA) and excessive high-sensitivity C-reactive protein (hs-CRP) levels on the likelihood of developing cardiac conduction block (CCB). Additionally, it sought to assess whether the influence of uric acid (UA) on CCB is mediated by hs-CRP. Methods: A prospective study was executed utilizing data from the Kailuan cohort, including 81,896 individuals initially free from CCB. The participants were categorized into four groups depending on the existence of HUA and low-grade inflammation (hs-CRP> 3 mg/L). Cox regression analysis was employed to ascertain hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of incident CCB. A mediation analysis was performed to determine if hs-CRP functioned as a mediator in the connection between UA levels and the incidence of CCB. Results: During a median observation period of 11.8 years, we identified 3160 cases of newly occurring CCB. Compared with the low UA/low CRP group, the combination of HUA and low-grade inflammation elevated the CCB risks (HR:1.56, 95% CI:1.22– 1.99), atrioventricular block (AVB) (HR:1.88, 95% CI:1.27– 2.77), and right bundle branch block (HR:1.47, 95% CI:1.02– 2.12), respectively. Mediation analysis revealed that in the HUA group, compared with the non-HUA group, the risk of CCB elevated by 14.0%, with 10.3% of the increase mediated through hs-CRP. Conclusion: HUA combined with elevated hs-CRP increased the risk of CCB, especially AVB. The connection between UA and the CCB risk was partly mediated by hs-CRP. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Perioperative Management in Patients with Atrial Fibrillation Treated with Non-Vitamin K Antagonist Oral Anticoagulants Undergoing Minor Bleeding Risk Procedure: Rationale and Protocol for the PERIXa Study.

Author

Kwon, Soonil, Lee, So-Ryoung, Choi, Eue-Keun, Lee, Kyung-Yeon, Choi, JungMin, Ahn, Hyo-Jeong, Oh, Seil, and Lip, Gregory Yoke Hong

Subjects
ORAL medication, ATRIAL fibrillation, HEMORRHAGE, CATARACT surgery, MORTALITY, GASTROINTESTINAL surgery, FILTERING surgery
Abstract

This study aims to evaluate the safety and effectiveness of a simplified, standardized protocol for perioperative management of direct factor Xa inhibitors in patients, with AF undergoing procedures associated with minor bleeding risk. Methods: This multicenter, prospective single-arm registry study plans to enroll patients undergoing procedures with minor bleeding risk who were prescribed direct factor Xa inhibitors for AF. The procedures with minor bleeding risk will include gastrointestinal endoscopy for diagnostic purposes, selected dental procedures, and ocular surgery for cataracts or glaucoma. For apixaban, patients will withhold the last evening dose and resume either from the evening dose of the procedure day or the following morning, depending on the bleeding risk of the patient. For edoxaban or rivaroxaban, patients will withhold only a single dose on the procedure day. The primary outcome is the occurrence of major bleeding events within 30 days. Secondary outcomes include systemic thromboembolism, all-cause mortality, and a composite of major and clinically relevant non-major bleeding events. Conclusion: This study has the potential to generate evidence regarding the safety of perioperative management for patients, with AF undergoing procedures associated with minor bleeding risk. Trial Registration: Clinicaltrials.gov: NCT05801068. [ABSTRACT FROM AUTHOR]

Published
2024
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6. A study of thrombogenesis in atrial fibrillation and left ventricular dysfunction

Author

Lip, Gregory Yoke Hong

Subjects
616.1
Abstract

Identification of patients at risk of thromboembolism poses a daunting problem. Nevertheless the availability of measurable plasma or serum factors may help to identify those patients at particular risk of thrombogenesis and whom may benefit from prophylactic anticoagulant therapy. My thesis investigates the roles of fibrinogen, fibrin turnover, endothelial dysfunction and lipoprotein(a) in thrombogenesis associated with two cardiovascular conditions at high thromboembolic risk, that is, atrial fibrillation and left ventricular dysfunction. Atrial fibrillation was found to be a common cardiac arrhythmia in a survey of emergency admissions over a six month period to my hospital. Heart failure and cerebrovascular events were the commonest presenting features, accounting for about half of all emergency admissions who were found to be in atrial fibrillation. This survey gave a comprehensive profile of how patients with atrial fibrillation were investigated and managed in a district general hospital. For example, a suboptimal application of standard investigations In patients with atrial fibrillation was identified together with a reluctance to perform cardioversion or to commence anticoagulant therapy. This being despite the increasingly important roles for these two therapeutic manoeuvres in the current management of atrial fibrillation. One possible reason for the low rate of introducing anticoagulation may be the uncertainty of many physicians in identifying patients at high thromboembolic risk. The availability of a suitable plasma marker of thrombogenesis may assist decision-making in these patients. Factors such as fibrinogen, von Willebrand factor and lipoprotein (a) have been associated with thrombosis, embolism and stroke. In addition, the fibrin D-dimer fragment is a marker of fibrin turnover and is indirectly a measure of intravascular thrombus fonnation. In my study, I have identified abnormalities of these plasma markers suggesting a prothrombotic state in patients with atrial fibrillation and left ventricular aneurysms. Patients with chronic atrial fibrillation, for example, have significant elevations of plasma fibrinogen and von Willebrand factor when compared to normal population values; and this is irrespective of aspirin or warfarin therapy. Those who are on no antithrombotic therapy have the highest levels of plasma fibrin D-dimer, suggesting the highest levels of intravascular fibrin turnover in these patients. In contrast, patients whom are established on warfarin have the lowest fibrin D-dimer levels, consistent with the beneficial effect of warfarin in reducing thrombogenesis. No significant effect on these factors with respect to atrial size, ventricular function (as measured by echocardiography), or underlying valve or ischaemic heart disease was noted. Cardioversion of atrial fibrillation to sinus rhythm replaces the irregular atrial activity of atrial fibrillation with the regular atrial systole of sinus rhythm. If thrombogenesis has a simple mechanical basis, cardioversion of atrial fibrillation should be expected to immediately normalise plasma fibrinogen and fibrin D-dimer levels. This does not appear to be the case, as in patients without warfarin therapy, plasma fibrin D-dimer falls sequentially over two weeks following cardioversion. This is partly due to the clearance of D-dimer from the circulation and that atrial systole may not resume immediately. In addition, there is little change in plasma fibrinogen levels, which may inpart be due to the individual variation in the return of atrial systole. Although clinical studies suggest a 'high risk' period for thromboembolism following cardioversion, no significant peak in plasma fibrinogen or fibrin D-dimer has been noted. This is In keeping with the hypothesis that any emboli are due to pre-formed thrombus rather than formation of new thrombus following cardioversion. Patients who are anticoagulated pre- and post-cardioversion have low plasma D-dimer levels, which do not alter over the two weeks' follow-up, consistent with the prophylactic effects of warfarin in reducing thromboembolic risks during cardioversion. If fibrin D-dimer is a suitable indicator of intravascular thrombogenesis, further evidence may be obtained by a study of patients with paroxysmal atrial fibrillation. These patients are regarded as at intermediate thromboembolic risk when compared to chronic atrial fibrillation and those in sinus rhythm. Patients with paroxysmal atrial fibrillation (on no warfarin therapy) indeed do have intermediate levels of plasma fibrinogen and fibrin D-dimer, in keeping with clinical observations. This suggests that flow abnormalities may be important in thrombogenesis, as sustained irregular atrial activity (in chronic atrial fibrillation) causes greater abnormalities in markers of thrombogenesis when compared to patients with intermittent irregular atrial contractions (for example, paroxysmal atrial fibrillation) and those with normal, regular atrial systolic function (in sinus rhythm).

Published
1994

9. Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study

Author

Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania, Alessandri, C., Serviddio, G., Palange, P., Greco, E., Bruno, G., Averna, M., Giammanco, A., Sposito, P., de Cristofaro, R., Carulli, L., de Gennaro, L., Pellegrini, E., Cominacini, L., Mozzini, C., Pasini, A. F., Sprovieri, M., Spagnuolo, V., Cerqua, G., Cerasola, G., Mulé, G., Barbagallo, M., Lo Sciuto, S., Monteverde, A., Saitta, A., Lo Gullo, A., Malatino, L., Cilia, C., Terranova, V., Pisano, M., Pinto, A., Di Raimondo, D., Tuttolomondo, A., Conigliaro, R., Signorelli, S., de Palma, D., Galderisi, M., Cudemo, G., Galletti, F., Fazio, V., de Luca, N., Meccariello, A., Caputo, D., de Donato, M. T., Iannuzi, A., Bresciani, A., Giunta, R., Utili, R., Iorio, V., Adinolfi, L. E., Sellitto, C., Iuliano, N., Bellis, P., Tirelli, P., Sacerdoti, D., Vanni, D., Iuliano, L., Ciacciarelli, M., Pacelli, A., Palazzuoli, A., Cacciafesta, M., Gueli, N., Lo Iacono, C., Brusco, S., Verrusio, W., Nobili, L., Tarquinio, N., Pellegrini, F., Vincentelli, G. M., Ravallese, F., Santini, C., Letizia, C., Petramala, L., Zinnamosca, L., Minisola, S., Cilli, M., Colangelo, L., Falaschi, P., Martocchia, A., Pastore, F., Bertazzoni, G., Attalla El Halabieh, E., Paradiso, M., Lizzi, E. M., Timmi, S., Battisti, P., Cerci, S., Ciavolella, M., Di Veroli, C., Malci, F., de Ciocchis, A., Abate, D., Castellino, P., Zanoli, L., Fidone, F., Mannarino, E., Pasqualini, L., Oliverio, G., Pende, A., Artom, N., Ricchio, R., Fimognari, F. L., Alletto, M., Messina, S., Sesti, G., Arturi, F., Succurro, E., Fiorentino, T. V., Pedace, E., Scarpino, P. E., Carullo, G., Maio, R., Sciacqua, A., Frugiuele, P., Battaglia, G., Atzori, S., Delitala, G., Angelucci, E., Sestili, S., Traisci, G., de Feudis, L., Di Michele, D., Fava, A., Balsano, C., de Ciantis, P., Desideri, G., Camerota, A., Mezzetti, M., Gresele, P., Vedovati, C., Fierro, T., Puccetti, L., Bertolotti, M., Mussi, C., Boddi, M., Savino, A., Contri, S., Degl’Innocenti, G., Saller, A., Fabris, F., Pesavento, R., Filippi, L., Vedovetto, V., Puato, M., Treleani, M., de Luca, E., de Zaiacomo, F., Giantin, V., Semplicini, A., Minuz, P., Romano, S., Fantin, F., Manica, A., Stockner, I., Pattis, P., Gutmann, B., Catena, C., Colussi, G., Sechi, L. A., Annoni, G., Bruni, A. A., Castagna, A., Spinelli, D., Miceli, E., Padula, D., Schinco, G., Spreafico, S., Secchi, B., Vanoli, M., Casella, G., Pulixi, E. A., Sansone, L., Serra, M. G., Longo, S., Antonaci, S., Belfiore, A., Frualdo, M., Palasciano, G., Ricci, L., Ventrella, F., Bianco, C., Santovito, D., Cipollone, F., Nicolai, S., Salvati, F., Rini, G. B., Scozzari, F., Muiesan, M. L., Salvetti, M., Bazza, A., Picardi, A., Vespasiani-Gentilucci, U., de Vincentis, A., Cosio, P., Terzolo, M., Madaffari, B., Parasporo, B., Fenoglio, L., Bracco, C., Melchio, R., Gentili, T., Salvi, A., Nitti, C., Gabrielli, A., Martino, G. P., Capucci, A., Brambatti, M., Sparagna, A., Tirotta, D., Andreozzi, P., Ettorre, E., Viscogliosi, G., Servello, A., Musumeci, M., Delfino, M., Giorgi, A., Glorioso, N., Melis, G., Marras, G., Matta, M., Sacco, A., Stellitano, E., Scordo, A., Russo, F., Caruso, A. A., Porreca, E., Tana, M., Ferri, C., Cheli, P., Portincasa, P., Muscianisi, G., Giordani, S., Stanghellini, V., Sabbà, C., Mancuso, G., Bartone, M., Calipari, D., Arcidiacono, G., Bellanuova, I., Ferraro, M., Marigliano, G., Cozzolino, D., Lampitella, A., Acri, V., Galasso, D., Mazzei, F., Buratti, A., Galasso, S., Porta, M., Brizzi, M. F., Fattorini, A., Sampietro, F., D’Angelo, A., Manfredini, R., Pala, M., Fabbian, F., Moroni, C., Valente, L., Lopreiato, F., Parente, F., Granata, M., Moia, M., Braham, S., Rossi, M., Pesce, M., Gentile, A., Catozzo, V., Baciarello, G., Cosimati, A., Ageno, W., Rancan, E., Guasti, L., Ciccaglioni, A., Negri, S., Polselli, M., Prisco, D., Marcucci, R., Ferro, D., Perri, L., Cangemi, R., Saliola, M., Del Ben, M., Angelico, F., Baratta, F., Migliacci, R., Porciello, G., Corrao, S., Proietti, M., Raparelli, V., Napoleone, L., Talerico, G., Amoroso, D., Romiti, G. F., Ruscio, E., Toriello, F., Sperduti, N., Todisco, T., Di Tanna, G., Sacchetti, M. L., Puddu, P. E., Farcomeni, A., Anzaldi, M., Bazzini, C., Bianchi, P. I., Boari, B., Buonauro, A., Buttà, C., Buzzetti, E., Calabria, S., Capeci, W., Caradio, F., Carleo, P., Carrabba, M. D., Castorani, L., Cecchetto, L., Cicco, S., Cimini, C., Colombo, B. M., de Giorgi, A., de Vuono, S., Del Corso, L., Denegri, A., Di Giosia, P., Durante Mangoni, E., Falsetti, L., Forgione, A., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Masala, M., Miceli, G., Montebianco Abenavoli, L., Murgia, G., Naccarato, P., Pattoneri, P., Perego, F., Pesce, P., Piano, S., Pinna, M., Pinto, D., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santilli, F., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Tassone, E. J., Torres, D., Vazzana, N., Vecchio, C. R., Vidili, G., Vitale, F., Zaccone, V., ARAPACIS Study Collaborators, Raparelli, V, Pastori, D, Pignataro, S, Vestri, A, Pignatelli, P, Cangemi, R, Proietti, M, Davi, G, Hiatt, W, Lip, G, Corazza, G, Perticone, F, Violi, F, Basili, S, Alessandri, C, Serviddio, G, Palange, P, Greco, E, Bruno, G, Averna, M, Giammanco, A, Sposito, P, Decristofaro, R, Carulli, L, Degennaro, L, Pellegrini, E, Cominacini, L, Mozzini, C, Pasini, A, Sprovieri, M, Spagnuolo, V, Cerqua, G, Cerasola, G, Mule, G, Barbagallo, M, Lo Sciuto, S, Monteverde, A, Saitta, A, Lo Gullo, A, Malatino, L, Cilia, C, Terranova, V, Pisano, M, Pinto, A, Diraimondo, D, Tuttolomondo, A, Conigliaro, R, Signorelli, S, Depalma, D, Galderisi, M, Cudemo, G, Galletti, F, Fazio, V, Deluca, N, Meccariello, A, Caputo, D, Dedonato, M, Iannuzi, A, Bresciani, A, Giunta, R, Utili, R, Iorio, V, Adinolfi, L, Sellitto, C, Iuliano, N, Bellis, P, Tirelli, P, Sacerdoti, D, Vanni, D, Iuliano, L, Ciacciarelli, M, Pacelli, A, Palazzuoli, A, Cacciafesta, M, Gueli, N, Lo Iacono, C, Brusco, S, Verrusio, W, Nobili, L, Tarquinio, N, Pellegrini, F, Vincentelli, G, Ravallese, F, Santini, C, Letizia, C, Petramala, L, Zinnamosca, L, Minisola, S, Cilli, M, Colangelo, L, Falaschi, P, Martocchia, A, Pastore, F, Bertazzoni, G, Attalla El Halabieh, E, Paradiso, M, Lizzi, E, Timmi, S, Battisti, P, Cerci, S, Ciavolella, M, Diveroli, C, Malci, F, Deciocchis, A, Abate, D, Castellino, P, Zanoli, L, Fidone, F, Mannarino, E, Pasqualini, L, Oliverio, G, Pende, A, Artom, N, Ricchio, R, Fimognari, F, Alletto, M, Messina, S, Sesti, G, Arturi, F, Succurro, E, Fiorentino, T, Pedace, E, Scarpino, P, Carullo, G, Maio, R, Sciacqua, A, Frugiuele, P, Battaglia, G, Atzori, S, Delitala, G, Angelucci, E, Sestili, S, Traisci, G, Defeudis, L, Dimichele, D, Fava, A, Balsano, C, Deciantis, P, Desideri, G, Camerota, A, Mezzetti, M, Gresele, P, Vedovati, C, Fierro, T, Puccetti, L, Bertolotti, M, Mussi, C, Boddi, M, Savino, A, Contri, S, Degl'Innocenti, G, Saller, A, Fabris, F, Pesavento, R, Filippi, L, Vedovetto, V, Puato, M, Treleani, M, Deluca, E, Dezaiacomo, F, Giantin, V, Semplicini, A, Minuz, P, Romano, S, Fantin, F, Manica, A, Stockner, I, Pattis, P, Gutmann, B, Catena, C, Colussi, G, Sechi, L, Annoni, G, Bruni, A, Castagna, A, Spinelli, D, Miceli, E, Padula, D, Schinco, G, Spreafico, S, Secchi, B, Vanoli, M, Casella, G, Pulixi, E, Sansone, L, Serra, M, Longo, S, Antonaci, S, Belfiore, A, Frualdo, M, Palasciano, G, Ricci, L, Ventrella, F, Bianco, C, Santovito, D, Cipollone, F, Nicolai, S, Salvati, F, Rini, G, Scozzari, F, Muiesan, M, Salvetti, M, Bazza, A, Picardi, A, Vespasiani-Gentilucci, U, Devincentis, A, Cosio, P, Terzolo, M, Madaffari, B, Parasporo, B, Fenoglio, L, Bracco, C, Melchio, R, Gentili, T, Salvi, A, Nitti, C, Gabrielli, A, Martino, G, Capucci, A, Brambatti, M, Sparagna, A, Tirotta, D, Andreozzi, P, Ettorre, E, Viscogliosi, G, Servello, A, Musumeci, M, Delfino, M, Giorgi, A, Glorioso, N, Melis, G, Marras, G, Matta, M, Sacco, A, Stellitano, E, Scordo, A, Russo, F, Caruso, A, Porreca, E, Tana, M, Ferri, C, Cheli, P, Portincasa, P, Muscianisi, G, Giordani, S, Stanghellini, V, Sabba, C, Mancuso, G, Bartone, M, Calipari, D, Arcidiacono, G, Bellanuova, I, Ferraro, M, Marigliano, G, Cozzolino, D, Lampitella, A, Acri, V, Galasso, D, Mazzei, F, Buratti, A, Galasso, S, Porta, M, Brizzi, M, Fattorini, A, Sampietro, F, D'Angelo, A, Manfredini, R, Pala, M, Fabbian, F, Moroni, C, Valente, L, Lopreiato, F, Parente, F, Granata, M, Moia, M, Braham, S, Rossi, M, Pesce, M, Gentile, A, Catozzo, V, Baciarello, G, Cosimati, A, Ageno, W, Rancan, E, Guasti, L, Ciccaglioni, A, Negri, S, Polselli, M, Prisco, D, Marcucci, R, Ferro, D, Perri, L, Saliola, M, Delben, M, Angelico, F, Baratta, F, Migliacci, R, Porciello, G, Corrao, S, Napoleone, L, Talerico, G, Amoroso, D, Romiti, G, Ruscio, E, Toriello, F, Sperduti, N, Todisco, T, Ditanna, G, Sacchetti, M, Puddu, P, Farcomeni, A, Anzaldi, M, Bazzini, C, Bianchi, P, Boari, B, Buonauro, A, Butta, C, Buzzetti, E, Calabria, S, Capeci, W, Caradio, F, Carleo, P, Carrabba, M, Castorani, L, Cecchetto, L, Cicco, S, Cimini, C, Colombo, B, De Giorgi, A, Devuono, S, Delcorso, L, Denegri, A, Digiosia, P, Durante Mangoni, E, Falsetti, L, Forgione, A, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Masala, M, Miceli, G, Montebianco Abenavoli, L, Murgia, G, Naccarato, P, Pattoneri, P, Perego, F, Pesce, P, Piano, S, Pinna, M, Pinto, D, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santilli, F, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Tassone, E, Torres, D, Vazzana, N, Vecchio, C, Vidili, G, Vitale, F, Zaccone, V, Raparelli, V1, Pastori, D1, Pignataro, Sf1, Vestri, Ar2, Pignatelli, P1, Cangemi, R1, Proietti, M3, Davì, G4, Hiatt, Wr5, Lip, Gyh3, Corazza, Gr6, Perticone, F7, Violi, F8, Basili, S1, De Cristofaro, R, De Gennaro, L, Pasini, Af, Mulé, G, Di Raimondo, D, De Palma, D, De Luca, N, De Donato, Mt, Adinolfi, Le, Vincentelli, Gm, Lizzi, Em, Di Veroli, C, De Ciocchis, A, Fimognari, Fl, Fiorentino, Tv, Scarpino, Pe, De Feudis, L, Di Michele, D, De Ciantis, P, De Luca, E, De Zaiacomo, F, Sechi, La, Bruni, Aa, Pulixi, Ea, Serra, Mg, Rini, Gb, Muiesan, Ml, De Vincentis, A, Martino, Gp, Caruso, Aa, Sabbà, C, Brizzi, Mf, Del Ben, M, Romiti, Gf, Di Tanna, G, Sacchetti, Ml, Puddu, Pe, Bianchi, Pi, Buttà, C, Carrabba, Md, Colombo, Bm, De Vuono, S, Del Corso, L, Di Giosia, P, Marra, Am, Tassone, Ej, Vecchio, Cr, Zaccone, V., Pignataro, Sf, Vestri, Ar, Davì, G, Hiatt, Wr, Lip, Gyh, Corazza, Gr, Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania, Alessandri C., Serviddio G., Palange P., Greco E., Bruno G., Averna M., Giammanco A., Sposito P., De Cristofaro R., Carulli L., De Gennaro L., Pellegrini E. Cominacini L., Mozzini C., Pasini A.F., Sprovieri M., Spagnuolo V., Cerqua G., Cerasola G., Mulé G., Barbagallo M., Lo Sciuto S., Monteverde A., Saitta A., Lo Gullo A., Malatino L., Cilia C., Terranova V., Pisano M., Pinto A., Di Raimondo D., Tuttolomondo A., Conigliaro R., Signorelli S., De Palma D., Galderisi M., Cudemo G., Galletti F., Fazio V., De Luca N., Meccariello A., Caputo D., De Donato M. 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B., Scozzari F., Muiesan M.L., Salvetti M., Bazza A., Picardi A., Vespasiani-Gentilucci U., De Vincentis A., Cosio P., Terzolo M., Madaffari B., Parasporo B., Fenoglio L., Bracco C., Melchio R., Gentili T., Salvi A., Nitti C., Gabrielli A., Martino G.P., Capucci A., Brambatti M., Sparagna A., Tirotta D., Andreozzi P., Ettorre E., Viscogliosi G., Servello A., Musumeci M., Delfino M., Giorgi A., Glorioso N., Melis G., Marras G., Matta M., Sacco A., Stellitano E., Scordo A., Russo F., Caruso A.A., Porreca E., Tana M., Ferri C., Cheli P., Portincasa P., Muscianisi G., Giordani S., Stanghellini V., Sabbà C., Mancuso G., Bartone M., Calipari D., Arcidiacono G., Bellanuova I., Ferraro M., Marigliano G., Cozzolino D., Lampitella A., Acri V., Galasso D., Mazzei F., Buratti A., Galasso S., Porta M., Brizzi M.F., Fattorini A., Sampietro F., D’Angelo A., Manfredini R., Pala M., Fabbian F., Moroni C., Valente L., Lopreiato F., Parente F., Granata M., Moia M., Braham S., Rossi M., Pesce M., Gentile A., Catozzo V., Baciarello G., Cosimati A., Ageno W., Rancan E., Guasti L., Ciccaglioni A., Negri S., Polselli M., Prisco D., Marcucci R., Ferro D., Perri L., Cangemi R., Saliola M., Del Ben M., Angelico F., Baratta F., Migliacci R., Porciello G., Corrao S. Data entry and Safety Monitoring Board: Proietti M., Raparelli V., Napoleone L., Talerico G., Amoroso D., Romiti G.F., Ruscio E., Toriello F., Sperduti N., Todisco T., Di Tanna G., Sacchetti M.L., Puddu P.E., Farcomeni A. Simi Young Internists Group: Anzaldi M., Bazzini C., Bianchi P.I., Boari B., Bracco C., Buonauro A., Buttà C., Buzzetti E., Calabria S., Capeci W., Caradio F., Carleo P., Carrabba M.D., Castorani L., Cecchetto L., Cicco S., Cimini C., Colombo B.M., De Giorgi A., De Vuono S., Del Corso L., Denegri A., Di Giosia P., Durante Mangoni E., Falsetti L., Forgione A., Giorgini P., Grassi D., Grembiale A., Hijazi D., Iamele L., Lorusso G., Marchese A., Marra A.M., Masala M., Miceli G., Montebianco Abenavoli L., Murgia G., Naccarato P., Padula D., Pattoneri P., Perego F., Pesce P., Piano S., Pinna M., Pinto D., Pretti V., Pucci G., Salinaro F., Salzano A., Santilli F., Scarpini F., Scicali R., Sirico D., Suppressa P., Talia M., Tassone E.J., Torres D., Vazzana N., Vecchio C.R., Vidili G., Vitale F., Zaccone V., Raparelli Valeria, Pastori Daniele, Pignataro Serena Francesca, Vestri Anna Rita, Pignatelli Pasquale, Cangemi Roberto, Proietti Marco, Davì Giovanni, Hiatt William Robert, Lip Gregory Yoke Hong, Corazza Gino Roberto, Perticone Francesco, Violi Francesco, Basili Stefania, Alessandri C, Serviddio G, Palange P, Greco E, Bruno G, Averna M, Giammanco A, Sposito P, De Cristofaro R, Carulli L, De Gennaro L, Pellegrini E, Cominacini L, Mozzini C, Pasini AF, Sprovieri M, Spagnuolo V, Cerqua G, Cerasola G, Mulé G, Barbagallo M, Lo Sciuto S, Monteverde A, Saitta A, Lo Gullo A, Malatino L, Cilia C, Terranova V, Pisano M, Pinto A, Di Raimondo D, Tuttolomondo A, Conigliaro R, Signorelli S, De Palma D, Galderisi M, Cudemo G, Galletti F, Fazio V, De Luca N, Meccariello A, Caputo D, De Donato MT, Iannuzi A, Bresciani A, Giunta R, Utili R, Iorio V, Adinolfi LE, Sellitto C, Iuliano N, Bellis P, Tirelli P, Sacerdoti D, Vanni D, Iuliano L, Ciacciarelli M, Pacelli A, Palazzuoli A, Cacciafesta M, Gueli N, Lo Iacono C, Brusco S, Verrusio W, Nobili L, Tarquinio N, Pellegrini F, Vincentelli GM, Ravallese F, Santini C, Letizia C, Petramala L, Zinnamosca L, Minisola S, Cilli M, Colangelo L, Falaschi P, Martocchia A, Pastore F, Bertazzoni G, Attalla El Halabieh E, Paradiso M, Lizzi EM, Timmi S, Battisti P, Cerci S, Ciavolella M, Di Veroli C, Malci F, De Ciocchis A, Abate D, Castellino P, Zanoli L, Fidone F, Mannarino E, Pasqualini L, Oliverio G, Pende A, Artom N, Ricchio R, Fimognari FL, Alletto M, Messina S, Sesti G, Arturi F, Succurro E, Fiorentino TV, Pedace E, Scarpino PE, Carullo G, Maio R, Sciacqua A, Frugiuele P, Battaglia G, Atzori S, Delitala G, Angelucci E, Sestili S, Traisci G, De Feudis L, Di Michele D, Fava A, Balsano C, De Ciantis P, Desideri G, Camerota A, Mezzetti M, Gresele P, Vedovati C, Fierro T, Puccetti L, Bertolotti M, Mussi C, Boddi M, Savino A, Contri S, Degl’Innocenti G, Saller A, Fabris F, Pesavento R, Filippi L, Vedovetto V, Puato M, Treleani M, De Luca E, De Zaiacomo F, Giantin V, Semplicini A, Minuz P, Romano S, Fantin F, Manica A, Stockner I, Pattis P, Gutmann B, Catena C, Colussi G, Sechi LA, Annoni G, Bruni AA, Castagna A, Spinelli D, Miceli E, Padula D, Schinco G, Spreafico S, Secchi B, Vanoli M, Casella G, Pulixi EA, Sansone L, Serra MG, Longo S, Antonaci S, Belfiore A, Frualdo M, Palasciano G, Ricci L, Ventrella F, Bianco C, Santovito D, Cipollone F, Nicolai S, Salvati F, Rini GB, Scozzari F, Muiesan ML, Salvetti M, Bazza A, Picardi A, Vespasiani-Gentilucci U, De Vincentis A, Cosio P, Terzolo M, Madaffari B, Parasporo B, Fenoglio L, Bracco C, Melchio R, Gentili T, Salvi A, Nitti C, Gabrielli A, Martino GP, Capucci A, Brambatti M, Sparagna A, Tirotta D, Andreozzi P, Ettorre E, Viscogliosi G, Servello A, Musumeci M, Delfino M, Giorgi A, Glorioso N, Melis G, Marras G, Matta M, Sacco A, Stellitano E, Scordo A, Russo F, Caruso AA, Porreca E, Tana M, Ferri C, Cheli P, Portincasa P, Muscianisi G, Giordani S, Stanghellini V, Sabbà C, Mancuso G, Bartone M, Calipari D, Arcidiacono G, Bellanuova I, Ferraro M, Marigliano G, Cozzolino D, Lampitella A, Acri V, Galasso D, Mazzei F, Buratti A, Galasso S, Porta M, Brizzi MF, Fattorini A, Sampietro F, D’Angelo A, Manfredini R, Pala M, Fabbian F, Moroni C, Valente L, Lopreiato F, Parente F, Granata M, Moia M, Braham S, Rossi M, Pesce M, Gentile A, Catozzo V, Baciarello G, Cosimati A, Ageno W, Rancan E, Guasti L, Ciccaglioni A, Negri S, Polselli M, Prisco D, Marcucci R, Ferro D, Perri L, Cangemi R, Saliola M, Del Ben M, Angelico F, Baratta F, Migliacci R, Porciello G, Corrao S, Proietti M, Raparelli V, Napoleone L, Talerico G, Amoroso D, Romiti GF, Ruscio E, Toriello F, Sperduti N, Todisco T, Di Tanna G, Sacchetti ML, Puddu PE, Farcomeni A, Anzaldi M, Bazzini C, Bianchi PI, Boari B, Buonauro A, Buttà C, Buzzetti E, Calabria S, Capeci W, Caradio F, Carleo P, Carrabba MD, Castorani L, Cecchetto L, Cicco S, Cimini C, Colombo BM, De Giorgi A, De Vuono S, Del Corso L, Denegri A, Di Giosia P, Durante Mangoni E, Falsetti L, Forgione A, Giorgini P, Grassi D, Grembiale A, Hijazi D, Iamele L, Lorusso G, Marchese A, Marra AM, Masala M, Miceli G, Montebianco Abenavoli L, Murgia G, Naccarato P, Pattoneri P, Perego F, Pesce P, Piano S, Pinna M, Pinto D, Pretti V, Pucci G, Salinaro F, Salzano A, Santilli F, Scarpini F, Scicali R, Sirico D, Suppressa P, Talia M, Tassone EJ, Torres D, Vazzana N, Vecchio CR, Vidili G, Vitale F, and Zaccone V

Subjects
Male, Settore MED/09 - Medicina Interna, 030204 cardiovascular system & hematology, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, Risk Factors, Major cardiovascular event, Cause of Death, Risk of mortality, Prevalence, Medicine, 030212 general & internal medicine, Prospective Studies, Registries, Prospective cohort study, Stroke, Cause of death, COPD, Chronic obstructive pulmonary disease, Incidence, Hazard ratio, Atrial fibrillation, Cardiovascular mortality, Major cardiovascular events, Aged, Atrial Fibrillation, Cardiovascular Diseases, Endpoint Determination, Female, Follow-Up Studies, Humans, Italy, Predictive Value of Tests, Internal Medicine, Emergency Medicine, Atrial fibrillation, Cardiovascular mortality, Chronic obstructive pulmonary disease, Major cardiovascular events, Cardiology, Settore SECS-S/01 - Statistica, medicine.medical_specialty, Chronic Obstructive, Socio-culturale, Pulmonary Disease, 03 medical and health sciences, Internal medicine, cardiovascular diseases, business.industry, medicine.disease, business, Mace
Abstract

Chronic obstructive pulmonary disease (COPD) increases the risk of mortality in non-valvular atrial fibrillation (NVAF) patients. Data on the relationship of COPD to major cardiovascular events (MACE) in AF have not been defined. The aim of the study is to assess the predictive value of COPD on incident MACE in NVAF patients over a 3-year follow-up. In the Atrial Fibrillation Registry for Ankle-Brachial Index Prevalence Assessment-Collaborative Italian Study (ARAPACIS) cohort, we evaluate the impact of COPD on the following clinical endpoints: MACE (including vascular death, fatal/non-fatal MI and stroke/TIA), cardiovascular (CV) death and all-cause mortality. Among 2027 NVAF patients, patients with COPD (9%) are more commonly male, elderly and at higher thromboembolic risk. During a median 36.0months follow-up, 186 patients experienced MACE: vascular death (n = 72), MI (n = 57), stroke/TIA (n = 57). All major outcomes (including stroke/TIA, MI, vascular death, and all-cause death) are centrally adjudicated. Kaplan–Meier curves show that NVAF patients with COPD are at higher risk for MACE (p < 0.001), CV death (p < 0.001) and all-cause death (p < 0.001). On Cox proportional hazard analysis, COPD is an independent predictor of MACE (Hazard ratio [HR] 1.77, 95% Confidence Intervals [CI] 1.20–2.61; p = 0.004), CV death (HR 2.73, 95% CI 1.76–4.23; p < 0.0001) and all-cause death (HR 2.16, 95% CI 1.48–3.16; p < 0.0001). COPD is an independent predictor of MACE, CV death and all-cause death during a long-term follow-up of NVAF patients.

Published
2018

10. Correction to: Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study (Internal and Emergency Medicine, (2018), 13, 5, (651-660), 10.1007/s11739-018-1835-9)

Author

Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania, Alessandri, C., Serviddio, G., Palange, P., Greco, E., Bruno, G., Averna, M., Giammanco, A., Sposito, P., De Cristofaro, R., Carulli, L., Di Gennaro, L., Pellegrini, E., Cominacini, L., Mozzini, C., Pasini, A. F., Sprovieri, M., Spagnuolo, V., Cerqua, G., Cerasola, G., Mulé, G., Barbagallo, M., Lo Sciuto, S., Monteverde, A., Saitta, A., Lo Gullo, A., Malatino, L., Cilia, C., Terranova, V., Pisano, M., Pinto, A., Di Raimondo, D., Tuttolomondo, A., Conigliaro, R., Signorelli, S., De Palma, D., Galderisi, M., Cudemo, G., Galletti, F., Fazio, V., De Luca, N., Meccariello, A., Caputo, D., De Donato, M. T., Iannuzi, A., Bresciani, A., Giunta, R., Utili, R., Iorio, V., Adinolfi, L. E., Sellitto, C., Iuliano, N., Bellis, P., Tirelli, P., Sacerdoti, D., Vanni, D., Iuliano, L., Ciacciarelli, M., Pacelli, A., Palazzuoli, A., Cacciafesta, M., Gueli, N., Lo Iacono, C., Brusco, S., Verrusio, W., Nobili, L., Tarquinio, N., Pellegrini, F., Vincentelli, G. M., Ravallese, F., Santini, C., Letizia, C., Petramala, L., Zinnamosca, L., Minisola, S., Cilli, M., Colangelo, L., Falaschi, P., Martocchia, A., Pastore, F., Bertazzoni, G., Attalla El Halabieh, E., Paradiso, M., Lizzi, E. M., Timmi, S., Battisti, P., Cerci, S., Ciavolella, M., Di Veroli, C., Malci, F., De Ciocchis, A., Abate, D., Castellino, P., Zanoli, L., Fidone, F., Mannarino, E., Pasqualini, L., Oliverio, G., Pende, A., Artom, N., Ricchio, R., Fimognari, F. L., Alletto, M., Messina, S., Sesti, G., Arturi, F., Succurro, E., Fiorentino, T. V., Pedace, E., Scarpino, P. E., Carullo, G., Maio, R., Sciacqua, A., Frugiuele, P., Battaglia, G., Atzori, S., Delitala, G., Angelucci, E., Sestili, S., Traisci, G., De Feudis, L., Di Michele, D., Fava, A., Balsano, C., De Ciantis, P., Desideri, G., Camerota, A., Mezzetti, M., Gresele, P., Vedovati, C., Fierro, T., Puccetti, L., Bertolotti, M., Mussi, C., Boddi, M., Savino, A., Contri, S., Degl’Innocenti, G., Saller, A., Fabris, F., Pesavento, R., Filippi, L., Vedovetto, V., Puato, M., Treleani, M., De Luca, E., De Zaiacomo, F., Giantin, V., Semplicini, A., Minuz, P., Romano, S., Fantin, F., Manica, A., Stockner, I., Pattis, P., Gutmann, B., Catena, C., Colussi, G., Sechi, L. A., Annoni, G., Bruni, A. A., Castagna, A., Spinelli, D., Miceli, E., Padula, D., Schinco, G., Spreafico, S., Secchi, B., Vanoli, M., Casella, G., Pulixi, E. A., Sansone, L., Serra, M. G., Longo, S., Antonaci, S., Belfiore, A., Frualdo, M., Palasciano, G., Ricci, L., Ventrella, F., Bianco, C., Santovito, D., Cipollone, F., Nicolai, S., Salvati, F., Rini, G. B., Scozzari, F., Muiesan, M. L., Salvetti, M., Bazza, A., Picardi, A., Vespasiani-Gentilucci, U., De Vincentis, A., Cosio, P., Terzolo, M., Madaffari, B., Parasporo, B., Fenoglio, L., Bracco, C., Melchio, R., Gentili, T., Salvi, A., Nitti, C., Gabrielli, A., Martino, G. P., Capucci, A., Brambatti, M., Sparagna, A., Tirotta, D., Andreozzi, P., Ettorre, E., Viscogliosi, G., Servello, A., Musumeci, M., Delfino, M., Giorgi, A., Glorioso, N., Melis, G., Marras, G., Matta, M., Sacco, A., Stellitano, E., Scordo, A., Russo, F., Caruso, A. A., Porreca, E., Tana, M., Ferri, C., Cheli, P., Portincasa, P., Muscianisi, G., Giordani, S., Stanghellini, V., Sabbà, C., Mancuso, G., Bartone, M., Calipari, D., Arcidiacono, G., Bellanuova, I., Ferraro, M., Marigliano, G., Cozzolino, D., Lampitella, A., Acri, V., Galasso, D., Mazzei, F., Buratti, A., Galasso, S., Porta, M., Brizzi, M. F., Fattorini, A., Sampietro, F., D’Angelo, A., Manfredini, R., Pala, M., Fabbian, F., Moroni, C., Valente, L., Lopreiato, F., Parente, F., Granata, M., Moia, M., Braham, S., Rossi, M., Pesce, M., Gentile, A., Catozzo, V., Baciarello, G., Cosimati, A., Ageno, W., Rancan, E., Guasti, L., Ciccaglioni, A., Negri, S., Polselli, M., Prisco, D., Marcucci, R., Ferro, D., Perri, L., Cangemi, R., Saliola, M., Del Ben, M., Angelico, F., Baratta, F., Migliacci, R., Porciello, G., Corrao, S., Proietti, M., Raparelli, V., Napoleone, L., Talerico, G., Amoroso, D., Romiti, G. F., Ruscio, E., Toriello, F., Sperduti, N., Todisco, T., Di Tanna, G., Sacchetti, M. L., Puddu, P. E., Farcomeni, A., Anzaldi, M., Bazzini, C., Bianchi, P. I., Boari, B., Buonauro, A., Buttà, C., Buzzetti, E., Calabria, S., Capeci, W., Caradio, F., Carleo, P., Carrabba, M. D., Castorani, L., Cecchetto, L., Cicco, S., Cimini, C., Colombo, B. M., De Giorgi, A., De Vuono, S., Del Corso, L., Denegri, A., Di Giosia, P., Durante Mangoni, E., Falsetti, L., Forgione, A., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Masala, M., Miceli, G., Montebianco Abenavoli, L., Murgia, G., Naccarato, P., Pattoneri, P., Perego, F., Pesce, P., Piano, S., Pinna, M., Pinto, D., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santilli, F., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Tassone, E. J., Torres, D., Vazzana, N., Vecchio, C. R., Vidili, G., Vitale, F., Zaccone, V., Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania, Alessandri, C., Serviddio, G., Palange, P., Greco, E., Bruno, G., Averna, M., Giammanco, A., Sposito, P., De cristofaro, R., Carulli, L., Di gennaro, L., Pellegrini, E., Cominacini, L., Mozzini, C., Pasini, A. F., Sprovieri, M., Spagnuolo, V., Cerqua, G., Cerasola, G., Mulé, G., Barbagallo, M., Lo Sciuto, S., Monteverde, A., Saitta, A., Lo Gullo, A., Malatino, L., Cilia, C., Terranova, V., Pisano, M., Pinto, A., Di raimondo, D., Tuttolomondo, A., Conigliaro, R., Signorelli, S., De palma, D., Galderisi, M., Cudemo, G., Galletti, F., Fazio, V., De luca, N., Meccariello, A., Caputo, D., De donato, M. T., Iannuzi, A., Bresciani, A., Giunta, R., Utili, R., Iorio, V., Adinolfi, L. E., Sellitto, C., Iuliano, N., Bellis, P., Tirelli, P., Sacerdoti, D., Vanni, D., Iuliano, L., Ciacciarelli, M., Pacelli, A., Palazzuoli, A., Cacciafesta, M., Gueli, N., Lo Iacono, C., Brusco, S., Verrusio, W., Nobili, L., Tarquinio, N., Pellegrini, F., Vincentelli, G. M., Ravallese, F., Santini, C., Letizia, C., Petramala, L., Zinnamosca, L., Minisola, S., Cilli, M., Colangelo, L., Falaschi, P., Martocchia, A., Pastore, F., Bertazzoni, G., Attalla El Halabieh, E., Paradiso, M., Lizzi, E. M., Timmi, S., Battisti, P., Cerci, S., Ciavolella, M., Di veroli, C., Malci, F., De ciocchis, A., Abate, D., Castellino, P., Zanoli, L., Fidone, F., Mannarino, E., Pasqualini, L., Oliverio, G., Pende, A., Artom, N., Ricchio, R., Fimognari, F. L., Alletto, M., Messina, S., Sesti, G., Arturi, F., Succurro, E., Fiorentino, T. V., Pedace, E., Scarpino, P. E., Carullo, G., Maio, R., Sciacqua, A., Frugiuele, P., Battaglia, G., Atzori, S., Delitala, G., Angelucci, E., Sestili, S., Traisci, G., De feudis, L., Di michele, D., Fava, A., Balsano, C., De ciantis, P., Desideri, G., Camerota, A., Mezzetti, M., Gresele, P., Vedovati, C., Fierro, T., Puccetti, L., Bertolotti, M., Mussi, C., Boddi, M., Savino, A., Contri, S., Degl’Innocenti, G., Saller, A., Fabris, F., Pesavento, R., Filippi, L., Vedovetto, V., Puato, M., Treleani, M., De luca, E., De zaiacomo, F., Giantin, V., Semplicini, A., Minuz, P., Romano, S., Fantin, F., Manica, A., Stockner, I., Pattis, P., Gutmann, B., Catena, C., Colussi, G., Sechi, L. A., Annoni, G., Bruni, A. A., Castagna, A., Spinelli, D., Miceli, E., Padula, D., Schinco, G., Spreafico, S., Secchi, B., Vanoli, M., Casella, G., Pulixi, E. A., Sansone, L., Serra, M. G., Longo, S., Antonaci, S., Belfiore, A., Frualdo, M., Palasciano, G., Ricci, L., Ventrella, F., Bianco, C., Santovito, D., Cipollone, F., Nicolai, S., Salvati, F., Rini, G. B., Scozzari, F., Muiesan, M. L., Salvetti, M., Bazza, A., Picardi, A., Vespasiani-Gentilucci, U., De vincentis, A., Cosio, P., Terzolo, M., Madaffari, B., Parasporo, B., Fenoglio, L., Bracco, C., Melchio, R., Gentili, T., Salvi, A., Nitti, C., Gabrielli, A., Martino, G. P., Capucci, A., Brambatti, M., Sparagna, A., Tirotta, D., Andreozzi, P., Ettorre, E., Viscogliosi, G., Servello, A., Musumeci, M., Delfino, M., Giorgi, A., Glorioso, N., Melis, G., Marras, G., Matta, M., Sacco, A., Stellitano, E., Scordo, A., Russo, F., Caruso, A. A., Porreca, E., Tana, M., Ferri, C., Cheli, P., Portincasa, P., Muscianisi, G., Giordani, S., Stanghellini, V., Sabbà, C., Mancuso, G., Bartone, M., Calipari, D., Arcidiacono, G., Bellanuova, I., Ferraro, M., Marigliano, G., Cozzolino, D., Lampitella, A., Acri, V., Galasso, D., Mazzei, F., Buratti, A., Galasso, S., Porta, M., Brizzi, M. F., Fattorini, A., Sampietro, F., D’Angelo, A., Manfredini, R., Pala, M., Fabbian, F., Moroni, C., Valente, L., Lopreiato, F., Parente, F., Granata, M., Moia, M., Braham, S., Rossi, M., Pesce, M., Gentile, A., Catozzo, V., Baciarello, G., Cosimati, A., Ageno, W., Rancan, E., Guasti, L., Ciccaglioni, A., Negri, S., Polselli, M., Prisco, D., Marcucci, R., Ferro, D., Perri, L., Cangemi, R., Saliola, M., Del ben, M., Angelico, F., Baratta, F., Migliacci, R., Porciello, G., Corrao, S., Proietti, M., Raparelli, V., Napoleone, L., Talerico, G., Amoroso, D., Romiti, G. F., Ruscio, E., Toriello, F., Sperduti, N., Todisco, T., Di tanna, G., Sacchetti, M. L., Puddu, P. E., Farcomeni, A., Anzaldi, M., Bazzini, C., Bianchi, P. I., Boari, B., Buonauro, A., Buttà, C., Buzzetti, E., Calabria, S., Capeci, W., Caradio, F., Carleo, P., Carrabba, M. D., Castorani, L., Cecchetto, L., Cicco, S., Cimini, C., Colombo, B. M., De Giorgi, A., De vuono, S., Del corso, L., Denegri, A., Di giosia, P., Durante Mangoni, E., Falsetti, L., Forgione, A., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Masala, M., Miceli, G., Montebianco Abenavoli, L., Murgia, G., Naccarato, P., Pattoneri, P., Perego, F., Pesce, P., Piano, S., Pinna, M., Pinto, D., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santilli, F., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Tassone, E. J., Torres, D., Vazzana, N., Vecchio, C. R., Vidili, G., Vitale, F., and Zaccone, V.

Subjects
Internal Medicine, Emergency Medicine
Published
2018

11. A Study of Thrombogenesis in Atrial Fibrillation and Left Ventricular Dysfunction

Author

Lip, Gregory Yoke Hong and Lip, Gregory Yoke Hong

Abstract

Identification of patients at risk of thromboembolism poses a daunting problem. Nevertheless the availability of measurable plasma or serum factors may help to identify those patients at particular risk of thrombogenesis and whom may benefit from prophylactic anticoagulant therapy. My thesis investigates the roles of fibrinogen, fibrin turnover, endothelial dysfunction and lipoprotein(a) in thrombogenesis associated with two cardiovascular conditions at high thromboembolic risk, that is, atrial fibrillation and left ventricular dysfunction. Atrial fibrillation was found to be a common cardiac arrhythmia in a survey of emergency admissions over a six month period to my hospital. Heart failure and cerebrovascular events were the commonest presenting features, accounting for about half of all emergency admissions who were found to be in atrial fibrillation. This survey gave a comprehensive profile of how patients with atrial fibrillation were investigated and managed in a district general hospital. For example, a suboptimal application of standard investigations In patients with atrial fibrillation was identified together with a reluctance to perform cardioversion or to commence anticoagulant therapy. This being despite the increasingly important roles for these two therapeutic manoeuvres in the current management of atrial fibrillation. One possible reason for the low rate of introducing anticoagulation may be the uncertainty of many physicians in identifying patients at high thromboembolic risk. The availability of a suitable plasma marker of thrombogenesis may assist decision-making in these patients. Factors such as fibrinogen, von Willebrand factor and lipoprotein (a) have been associated with thrombosis, embolism and stroke. In addition, the fibrin D-dimer fragment is a marker of fibrin turnover and is indirectly a measure of intravascular thrombus fonnation. In my study, I have identified abnormalities of these plasma markers suggesting a prothrombotic state in

12. Correction to: Major adverse cardiovascular events in non-valvular atrial fibrillation with chronic obstructive pulmonary disease: the ARAPACIS study

Author

Raparell, V, Pastori, D, Pignataro, S, Vestri, A, Pignatelli, P, Cangemi, R, Proietti, M, Davì, G, Hiatt, W, Lip, G, Corazza, G, Perticone, F, Violi, F, Basili, S, Alessandri, C, Serviddio, G, Palange, P, Greco, E, Bruno, G, Averna, M, Giammanco, A, Sposito, P, De Cristofaro, R, Carulli, L, Di Gennaro, L, Pellegrini, E, Cominacini, L, Mozzini, C, Pasini, A, Sprovieri, M, Spagnuolo, V, Cerqua, G, Cerasola, G, Mulé, G, Barbagallo, M, Lo Sciuto, S, Monteverde, A, Saitta, A, Lo Gullo, A, Malatino, L, Cilia, C, Terranova, V, Pisano, M, Pinto, A, Di Raimondo, D, Tuttolomondo, A, Conigliaro, R, Signorelli, S, De Palma, D, Galderisi, M, Cudemo, G, Galletti, F, Fazio, V, De Luca, N, Meccariello, A, Caputo, D, De Donato, M, Iannuzi, A, Bresciani, A, Giunta, R, Utili, R, Iorio, V, Adinolfi, L, Sellitto, C, Iuliano, N, Bellis, P, Tirelli, P, Sacerdoti, D, Vanni, D, Iuliano, L, Ciacciarelli, M, Pacelli, A, Palazzuoli, A, Cacciafesta, M, Gueli, N, Lo Iacono, C, Brusco, S, Verrusio, W, Nobili, L, Tarquinio, N, Pellegrini, F, Vincentelli, G, Ravallese, F, Santini, C, Letizia, C, Petramala, L, Zinnamosca, L, Minisola, S, Cilli, M, Colangelo, L, Falaschi, P, Martocchia, A, Pastore, F, Bertazzoni, G, E Halabieh E, Attall, Paradiso, M, Lizzi, E, Timmi, S, Battisti, P, Cerci, S, Ciavolella, M, Di Veroli, C, Malci, F, De Ciocchis, A, Abate, D, Castellino, P, Zanoli, L, Fidone, F, Mannarino, E, Pasqualini, L, Oliverio, G, Pende, A, Artom, N, Ricchio, R, Fimognari, F, Alletto, M, Messina, S, Sesti, G, Arturi, F, Succurro, E, Fiorentino, T, Pedace, E, Scarpino, P, Carullo, G, Maio, R, Sciacqua, A, Frugiuele, P, Battaglia, G, Atzori, S, Delitala, G, Angelucci, E, Sestili, S, Traisci, G, De Feudis, L, Di Michele, D, Fava, A, Balsano, C, De Ciantis, P, Desideri, G, Camerota, A, Mezzetti, M, Gresele, P, Vedovati, C, Fierro, T, Puccetti, L, Bertolotti, M, Mussi, C, Boddi, M, Savino, A, Contri, S, Degl'Innocenti, G, Saller, A, Fabris, F, Pesavento, R, Filippi, L, Vedovetto, V, Puato, M, Treleani, M, De Luca, E, De Zaiacomo, F, Giantin, V, Semplicini, A, Minuz, P, Romano, S, Fantin, F, Manica, A, Stockner, I, Pattis, P, Gutmann, B, Catena, C, Colussi, G, Sechi, L, Annoni, G, Bruni, A, Castagna, A, Spinelli, D, Miceli, E, Padula, D, Schinco, G, Spreafico, S, Secchi, B, Vanoli, M, Casella, G, Pulixi, E, Sansone, L, Serra, M, Longo, S, Antonaci, S, Belfiore, A, Frualdo, M, Palasciano, G, Ricci, L, Ventrella, F, Bianco, C, Santovito, D, Cipollone, F, Nicolai, S, Salvati, F, Rini, G, Scozzari, F, Muiesan, M, Salvetti, M, Bazza, A, Picardi, A, Vespasiani-Gentilucci, U, De Vincentis, A, Cosio, P, Terzolo, M, Madaffari, B, Parasporo, B, Fenoglio, L, Bracco, C, Melchio, R, Gentili, T, Salvi, A, Nitti, C, Gabrielli, A, Martino, G, Capucci, A, Brambatti, M, Sparagna, A, Tirotta, D, Andreozzi, P, Ettorre, E, Viscogliosi, G, Servello, A, Musumeci, M, Delfino, M, Giorgi, A, Glorioso, N, Melis, G, Marras, G, Matta, M, Sacco, A, Stellitano, E, Scordo, A, Russo, F, Caruso, A, Porreca, E, Tana, M, Ferri, C, Cheli, P, Portincasa, P, Muscianisi, G, Giordani, S, Stanghellini, V, Sabbà, C, Mancuso, G, Bartone, M, Calipari, D, Arcidiacono, G, Bellanuova, I, Ferraro, M, Marigliano, G, Cozzolino, D, Lampitella, A, Acri, V, Galasso, D, Mazzei, F, Buratti, A, Galasso, S, Porta, M, Brizzi, M, Fattorini, A, Sampietro, F, D'Angelo, A, Manfredini, R, Pala, M, Fabbian, F, Moroni, C, Valente, L, Lopreiato, F, Parente, F, Granata, M, Moia, M, Braham, S, Rossi, M, Pesce, M, Gentile, A, Catozzo, V, Baciarello, G, Cosimati, A, Ageno, W, Rancan, E, Guasti, L, Ciccaglioni, A, Negri, S, Polselli, M, Prisco, D, Marcucci, R, Ferro, D, Perri, L, Saliola, M, Del Ben, M, Angelico, F, Baratta, F, Migliacci, R, Porciello, G, Corrao, S, Raparelli, V, Napoleone, L, Talerico, G, Amoroso, D, Romiti, G, Ruscio, E, Toriello, F, Sperduti, N, Todisco, T, Di Tanna, G, Sacchetti, M, Puddu, P, Farcomeni, A, Anzaldi, M, Bazzini, C, Bianchi, P, Boari, B, Buonauro, A, Buttà, C, Buzzetti, E, Calabria, S, Capeci, W, Caradio, F, Carleo, P, Carrabba, M, Castorani, L, Cecchetto, L, Cicco, S, Cimini, C, Colombo, B, De Giorgi, A, De Vuono, S, De Corso, L, Denegri, A, D Giosia P, Durant Mangoni, E, Falsetti, L, Forgione, A, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Masala, M, Miceli, G, Montebianc Abenavoli, L, Murgia, G, Naccarato, P, Pattoneri, P, Perego, F, Pesce, P, Piano, S, Pinna, M, Pinto, D, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santilli, F, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Tassone, E, Torres, D, Vazzana, N, Vecchio, C, Vidili, G, Vitale, F, Zaccone, V, ARAPACI Stud Collaborators, Raparelli, Valeria, Pastori, Daniele, Pignataro, Serena Francesca, Vestri, Anna Rita, Pignatelli, Pasquale, Cangemi, Roberto, Proietti, Marco, Davì, Giovanni, Hiatt, William Robert, Lip, Gregory Yoke Hong, Corazza, Gino Roberto, Perticone, Francesco, Violi, Francesco, Basili, Stefania, Alessandri, C., Serviddio, G., Palange, P., Greco, E., Bruno, G., Averna, M., Giammanco, A., Sposito, P., De Cristofaro, R., Carulli, L., Di Gennaro, L., Pellegrini, E., Cominacini, L., Mozzini, C., Pasini, A.F., Sprovieri, M., Spagnuolo, V., Cerqua, G., Cerasola, G., Mulé, G., Barbagallo, M., Lo Sciuto, S., Monteverde, A., Saitta, A., Lo Gullo, A., Malatino, L., Cilia, C., Terranova, V., Pisano, M., Pinto, A., Di Raimondo, D., Tuttolomondo, A., Conigliaro, R., Signorelli, S., De Palma, D., Galderisi, M., Cudemo, G., Galletti, F., Fazio, V., De Luca, N., Meccariello, A., Caputo, D., De Donato, M.T., Iannuzi, A., Bresciani, A., Giunta, R., Utili, R., Iorio, V., Adinolfi, L.E., Sellitto, C., Iuliano, N., Bellis, P., Tirelli, P., Sacerdoti, D., Vanni, D., Iuliano, L., Ciacciarelli, M., Pacelli, A., Palazzuoli, A., Cacciafesta, M., Gueli, N., Lo Iacono, C., Brusco, S., Verrusio, W., Nobili, L., Tarquinio, N., Pellegrini, F., Vincentelli, G.M., Ravallese, F., Santini, C., Letizia, C., Petramala, L., Zinnamosca, L., Minisola, S., Cilli, M., Colangelo, L., Falaschi, P., Martocchia, A., Pastore, F., Bertazzoni, G., Attalla El Halabieh, E., Paradiso, M., Lizzi, E.M., Timmi, S., Battisti, P., Cerci, S., Ciavolella, M., Di Veroli, C., Malci, F., De Ciocchis, A., Abate, D., Castellino, P., Zanoli, L., Fidone, F., Mannarino, E., Pasqualini, L., Oliverio, G., Pende, A., Artom, N., Ricchio, R., Fimognari, F.L., Alletto, M., Messina, S., Sesti, G., Arturi, F., Succurro, E., Fiorentino, T.V., Pedace, E., Scarpino, P.E., Carullo, G., Maio, R., Sciacqua, A., Frugiuele, P., Battaglia, G., Atzori, S., Delitala, G., Angelucci, E., Sestili, S., Traisci, G., De Feudis, L., Di Michele, D., Fava, A., Balsano, C., De Ciantis, P., Desideri, G., Camerota, A., Mezzetti, M., Gresele, P., Vedovati, C., Fierro, T., Puccetti, L., Bertolotti, M., Mussi, C., Boddi, M., Savino, A., Contri, S., Degl’Innocenti, G., Saller, A., Fabris, F., Pesavento, R., Filippi, L., Vedovetto, V., Puato, M., Treleani, M., De Luca, E., De Zaiacomo, F., Giantin, V., Semplicini, A., Minuz, P., Romano, S., Fantin, F., Manica, A., Stockner, I., Pattis, P., Gutmann, B., Catena, C., Colussi, G., Sechi, L.A., Annoni, G., Bruni, A.A., Castagna, A., Spinelli, D., Miceli, E., Padula, D., Schinco, G., Spreafico, S., Secchi, B., Vanoli, M., Casella, G., Pulixi, E.A., Sansone, L., Serra, M.G., Longo, S., Antonaci, S., Belfiore, A., Frualdo, M., Palasciano, G., Ricci, L., Ventrella, F., Bianco, C., Santovito, D., Cipollone, F., Nicolai, S., Salvati, F., Rini, G.B., Scozzari, F., Muiesan, M.L., Salvetti, M., Bazza, A., Picardi, A., Vespasiani-Gentilucci, U., De Vincentis, A., Cosio, P., Terzolo, M., Madaffari, B., Parasporo, B., Fenoglio, L., Bracco, C., Melchio, R., Gentili, T., Salvi, A., Nitti, C., Gabrielli, A., Martino, G.P., Capucci, A., Brambatti, M., Sparagna, A., Tirotta, D., Andreozzi, P., Ettorre, E., Viscogliosi, G., Servello, A., Musumeci, M., Delfino, M., Giorgi, A., Glorioso, N., Melis, G., Marras, G., Matta, M., Sacco, A., Stellitano, E., Scordo, A., Russo, F., Caruso, A.A., Porreca, E., Tana, M., Ferri, C., Cheli, P., Portincasa, P., Muscianisi, G., Giordani, S., Stanghellini, V., Sabbà, C., Mancuso, G., Bartone, M., Calipari, D., Arcidiacono, G., Bellanuova, I., Ferraro, M., Marigliano, G., Cozzolino, D., Lampitella, A., Acri, V., Galasso, D., Mazzei, F., Buratti, A., Galasso, S., Porta, M., Brizzi, M.F., Fattorini, A., Sampietro, F., D’Angelo, A., Manfredini, R., Pala, M., Fabbian, F., Moroni, C., Valente, L., Lopreiato, F., Parente, F., Granata, M., Moia, M., Braham, S., Rossi, M., Pesce, M., Gentile, A., Catozzo, V., Baciarello, G., Cosimati, A., Ageno, W., Rancan, E., Guasti, L., Ciccaglioni, A., Negri, S., Polselli, M., Prisco, D., Marcucci, R., Ferro, D., Perri, L., Cangemi, R., Saliola, M., Del Ben, M., Angelico, F., Baratta, F., Migliacci, R., Porciello, G., Corrao, S., Proietti, M., Raparelli, V., Napoleone, L., Talerico, G., Amoroso, D., Romiti, G.F., Ruscio, E., Toriello, F., Sperduti, N., Todisco, T., Di Tanna, G., Sacchetti, M.L., Puddu, P.E., Farcomeni, A., Anzaldi, M., Bazzini, C., Bianchi, P.I., Boari, B., Buonauro, A., Buttà, C., Buzzetti, E., Calabria, S., Capeci, W., Caradio, F., Carleo, P., Carrabba, M.D., Castorani, L., Cecchetto, L., Cicco, S., Cimini, C., Colombo, B.M., De Giorgi, A., De Vuono, S., Del Corso, L., Denegri, A., Di Giosia, P., Durante Mangoni, E., Falsetti, L., Forgione, A., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A.M., Masala, M., Miceli, G., Montebianco Abenavoli, L., Murgia, G., Naccarato, P., Pattoneri, P., Perego, F., Pesce, P., Piano, S., Pinna, M., Pinto, D., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santilli, F., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Tassone, E.J., Torres, D., Vazzana, N., Vecchio, C.R., Vidili, G., Vitale, F., and Zaccone, V.

Subjects
medicine.medical_specialty, Settore MED/09 - Medicina Interna, business.industry, Internal Medicine, Emergency Medicine, Emergency medicine, medicine, Non valvular atrial fibrillation, Pulmonary disease, business
Abstract

Correction to: Internal and Emergency Medicine (2018) 13:651–660 https://doi.org/10.1007/s11739-018-1835-9 In the original publication, one of the ARAPACIS collaborators Dr. “Leonardo Di Gennaro” name has been erroneously mentioned as “Leonardo De Gennaro”.

Published
2018

13. Atrial fibrillation accelerates functional decline in older adults: a 15-year follow-up population-based study.

Author

Okoye C, Qiu C, Xia X, Lip GYH, Bellelli G, Welmer AK, Calderón-Larrañaga A, and Vetrano DL

Subjects
Humans, Female, Male, Aged, Sweden epidemiology, Follow-Up Studies, Middle Aged, Walking Speed, Independent Living, Risk Factors, Aged, 80 and over, Stroke epidemiology, Stroke physiopathology, Heart Failure physiopathology, Heart Failure epidemiology, Incidence, Time Factors, Anticoagulants therapeutic use, Atrial Fibrillation physiopathology, Atrial Fibrillation epidemiology, Atrial Fibrillation diagnosis
Abstract

Aims: Atrial fibrillation (AF) has been associated with functional impairment. However, the role exerted by AF on the long-term trajectories of functional mobility remains to be elucidated. This study aimed to evaluate the impact of AF on functional mobility by tracing walking speed (WS) trajectories over 15 years of follow-up in a population-based cohort of individuals aged 60+ years., Methods and Results: This population-based cohort study included 3141 community-dwelling participants (mean age 73.7 years; 63.6% women) from the Swedish National Study on Aging and Care in Kungsholmen, who were regularly examined from 2001-2004 to 2016-2019. Functional mobility was assessed by measuring WS in a standardized way. The association between AF and WS trajectories was assessed by multivariable joint models accounting for the longitudinal dropouts due to death. Stratified analyses by demographic and clinical factors were performed. The effect-modifying role of oral anticoagulant therapy (OAC), incident heart failure (HF), and incident stroke was finally investigated. At baseline, 285 (9.1%) participants were ascertained to have AF. A faster annual WS decline was observed in persons with AF than in non-AF peers (adjusted β coefficient per year = -0.011, 95% confidence interval: -0.016 to -0.005). Incident HF and stroke were associated with greater WS decline in participants with AF. OAC use was not associated with a slower functional decline., Conclusion: Atrial fibrillation is associated with a faster physical function decline in older individuals. Incident HF and stroke possibly accelerate WS decline over time in AF participants., Competing Interests: Conflict of interest: none declared., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2024
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14. Risk of stroke or systemic embolism in patients with degenerative mitral stenosis with or without atrial fibrillation: A cohort study.

Author

Steiner DK, Søgaard P, Jensen M, Bjerregaard Larsen T, Lip GYH, and Nielsen PB

Abstract

Background: Atrial fibrillation (AF) is associated with an increased risk of stroke and the combination of AF and mitral stenosis (MS) is associated with a higher risk. In developed nations, degenerative mitral stenosis (DMS) constitutes a sizeable proportion of patients with MS. Current international guidelines do not offer recommendations regarding anticoagulation in these patients. The objective of this study was to describe the incidence of stroke or systemic embolism in patients with DMS with or without prevalent AF., Methods: A cohort study of DMS patients from 1997 to 2018, using data from the Danish health registries. The cohort was stratified based on AF prevalence and prior ischemic stroke. The primary outcome was a diagnosis of ischemic stroke or systemic embolism after 1 year of follow-up from time of DMS diagnosis., Results: The study included 1162 patients with DMS, of which 421 had prevalent AF. The incidence rate of stroke or systemic embolism after 1 year of follow-up was highest in the DMS without AF group (7.58 vs. 6.63 per 100 person-years). In both groups, DMS without AF and DMS with AF, the incidence rate was highest in patients with prior thromboembolic events (29.61 vs. 5.15 and 19.53 vs. 5.15, respectively)., Conclusions: The incidence rate of stroke or systemic embolism was highest in DMS patients without AF. Current Danish guidelines recommend DMS patients should be treated with anticoagulation only with concurrent AF, yet our results call for additional research to establish if DMS patients without AF could benefit from stroke prevention therapy., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Authors.)

Published
2022
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