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3. Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Author

Agabiti Rosei, Claudia, primary, Paini, Anna, additional, Buso, Giacomo, additional, Maloberti, Alessandro, additional, Giannattasio, Cristina, additional, Salvetti, Massimo, additional, Casiglia, Edoardo, additional, Tikhonoff, Valerie, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo Francesco Giuseppe, additional, Cirillo, Massimo, additional, Cirillo, Pietro, additional, Dell’Oro, Raffaella, additional, D’Elia, Lanfranco, additional, Desideri, Giovambattista, additional, Ferri, Claudio, additional, Galletti, Ferruccio, additional, Gesualdo, Loreto, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Masi, Stefano, additional, Masulli, Maria, additional, Mazza, Alberto, additional, Mengozzi, Alessandro, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Virdis, Agostino, additional, Muiesan, Maria Lorenza, additional, and Borghi, Claudio, additional

Published
2024
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5. Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project

Author

D’Elia, Lanfranco, primary, Masulli, Maria, additional, Cirillo, Pietro, additional, Virdis, Agostino, additional, Casiglia, Edoardo, additional, Tikhonoff, Valerie, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo F. G., additional, Cirillo, Massimo, additional, Dell’Oro, Raffaella, additional, Desideri, Giovambattista, additional, Ferri, Claudio, additional, Gesualdo, Loreto, additional, Giannattasio, Cristina, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Maloberti, Alessandro, additional, Masi, Stefano, additional, Mazza, Alberto, additional, Mengozzi, Alessandro, additional, Muiesan, Maria Lorenza, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Salvetti, Massimo, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Borghi, Claudio, additional, and Galletti, Ferruccio, additional

Published
2024
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6. Results of a Telehealth Program in Patients with Cardiovascular Risk Factors in low and Middle-Income Countries

Author

Ciuffarella, C, Maloberti, A, Quarti-Trevano, F, Dell'Oro, R, Facchetti, R, Grassi, G, Ciuffarella, Claudia, Maloberti, Alessandro, Quarti-Trevano, Fosca, Dell'Oro, Raffaella, Facchetti, Rita, Grassi, Guido, Ciuffarella, C, Maloberti, A, Quarti-Trevano, F, Dell'Oro, R, Facchetti, R, Grassi, G, Ciuffarella, Claudia, Maloberti, Alessandro, Quarti-Trevano, Fosca, Dell'Oro, Raffaella, Facchetti, Rita, and Grassi, Guido

Published
2024

7. Serum Uric Acid, Hypertriglyceridemia, and Carotid Plaques: A Sub-Analysis of the URic Acid Right for Heart Health (URRAH) Study

Author

Agabiti Rosei, C, Paini, A, Buso, G, Maloberti, A, Giannattasio, C, Salvetti, M, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Mengozzi, A, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Muiesan, M, Borghi, C, Agabiti Rosei, Claudia, Paini, Anna, Buso, Giacomo, Maloberti, Alessandro, Giannattasio, Cristina, Salvetti, Massimo, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo Francesco Giuseppe, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Muiesan, Maria Lorenza, Borghi, Claudio, Agabiti Rosei, C, Paini, A, Buso, G, Maloberti, A, Giannattasio, C, Salvetti, M, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Mengozzi, A, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Muiesan, M, Borghi, C, Agabiti Rosei, Claudia, Paini, Anna, Buso, Giacomo, Maloberti, Alessandro, Giannattasio, Cristina, Salvetti, Massimo, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo Francesco Giuseppe, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Muiesan, Maria Lorenza, and Borghi, Claudio

Abstract

High levels of serum uric acid (SUA) and triglycerides (TG) might promote high-cardiovascular-risk phenotypes, including subclinical atherosclerosis. An interaction between plaques xanthine oxidase (XO) expression, SUA, and HDL-C has been recently postulated. Subjects from the URic acid Right for heArt Health (URRAH) study with carotid ultrasound and without previous cardiovascular diseases (CVD) (n = 6209), followed over 20 years, were included in the analysis. Hypertriglyceridemia (hTG) was defined as TG ≥ 150 mg/dL. Higher levels of SUA (hSUA) were defined as ≥5.6 mg/dL in men and 5.1 mg/dL in women. A carotid plaque was identified in 1742 subjects (28%). SUA and TG predicted carotid plaque (HR 1.09 [1.04-1.27], p < 0.001 and HR 1.25 [1.09-1.45], p < 0.001) in the whole population, independently of age, sex, diabetes, systolic blood pressure, HDL and LDL cholesterol and treatment. Four different groups were identified (normal SUA and TG, hSUA and normal TG, normal SUA and hTG, hSUA and hTG). The prevalence of plaque was progressively greater in subjects with normal SUA and TG (23%), hSUA and normal TG (31%), normal SUA and hTG (34%), and hSUA and hTG (38%) (Chi-square, 0.0001). Logistic regression analysis showed that hSUA and normal TG [HR 1.159 (1.002 to 1.341); p = 0.001], normal SUA and hTG [HR 1.305 (1.057 to 1.611); p = 0.001], and the combination of hUA and hTG [HR 1.539 (1.274 to 1.859); p = 0.001] were associated with a higher risk of plaque. Our findings demonstrate that SUA is independently associated with the presence of carotid plaque and suggest that the combination of hyperuricemia and hypertriglyceridemia is a stronger determinant of carotid plaque than hSUA or hTG taken as single risk factors. The association between SUA and CVD events may be explained in part by a direct association of UA with carotid plaques.

Published
2024

8. Risk of Cardiovascular Events in Metabolically Healthy Overweight or Obese Adults: Role of LDL-Cholesterol in the Stratification of Risk

Author

Palatini, P, Virdis, A, Masi, S, Mengozzi, A, Casiglia, E, Tikhonoff, V, Cicero, A, Ungar, A, Parati, G, Rivasi, G, Salvetti, M, Barbagallo, C, Bombelli, M, Dell'Oro, R, Bruno, B, Lippa, L, D'Elia, L, Masulli, M, Verdecchia, P, Reboldi, G, Angeli, F, Cianci, R, Mallamaci, F, Cirillo, M, Rattazzi, M, Cirillo, P, Gesualdo, L, Russo, E, Mazza, A, Giannattasio, C, Maloberti, A, Volpe, M, Tocci, G, Iaccarino, G, Nazzaro, P, Galletti, F, Ferri, C, Desideri, G, Viazzi, F, Pontremoli, R, Muiesan, M, Grassi, G, Borghi, C, Palatini, Paolo, Virdis, Agostino, Masi, Stefano, Mengozzi, Alessandro, Casiglia, Edoardo, Tikhonoff, Valerie, Cicero, Arrigo F G, Ungar, Andrea, Parati, Gianfranco, Rivasi, Giulia, Salvetti, Massimo, Barbagallo, Carlo Maria, Bombelli, Michele, Dell'Oro, Raffaella, Bruno, Berardino, Lippa, Luciano, D'Elia, Lanfranco, Masulli, Maria, Verdecchia, Paolo, Reboldi, Gianpaolo, Angeli, Fabio, Cianci, Rosario, Mallamaci, Francesca, Cirillo, Massimo, Rattazzi, Marcello, Cirillo, Pietro, Gesualdo, Loreto, Russo, Elisa, Mazza, Alberto, Giannattasio, Cristina, Maloberti, Alessandro, Volpe, Massimo, Tocci, Giuliano, Iaccarino, Guido, Nazzaro, Pietro, Galletti, Ferruccio, Ferri, Claudio, Desideri, Giovambattista, Viazzi, Francesca, Pontremoli, Roberto, Muiesan, Maria Lorenza, Grassi, Guido, Borghi, Claudio, Palatini, P, Virdis, A, Masi, S, Mengozzi, A, Casiglia, E, Tikhonoff, V, Cicero, A, Ungar, A, Parati, G, Rivasi, G, Salvetti, M, Barbagallo, C, Bombelli, M, Dell'Oro, R, Bruno, B, Lippa, L, D'Elia, L, Masulli, M, Verdecchia, P, Reboldi, G, Angeli, F, Cianci, R, Mallamaci, F, Cirillo, M, Rattazzi, M, Cirillo, P, Gesualdo, L, Russo, E, Mazza, A, Giannattasio, C, Maloberti, A, Volpe, M, Tocci, G, Iaccarino, G, Nazzaro, P, Galletti, F, Ferri, C, Desideri, G, Viazzi, F, Pontremoli, R, Muiesan, M, Grassi, G, Borghi, C, Palatini, Paolo, Virdis, Agostino, Masi, Stefano, Mengozzi, Alessandro, Casiglia, Edoardo, Tikhonoff, Valerie, Cicero, Arrigo F G, Ungar, Andrea, Parati, Gianfranco, Rivasi, Giulia, Salvetti, Massimo, Barbagallo, Carlo Maria, Bombelli, Michele, Dell'Oro, Raffaella, Bruno, Berardino, Lippa, Luciano, D'Elia, Lanfranco, Masulli, Maria, Verdecchia, Paolo, Reboldi, Gianpaolo, Angeli, Fabio, Cianci, Rosario, Mallamaci, Francesca, Cirillo, Massimo, Rattazzi, Marcello, Cirillo, Pietro, Gesualdo, Loreto, Russo, Elisa, Mazza, Alberto, Giannattasio, Cristina, Maloberti, Alessandro, Volpe, Massimo, Tocci, Giuliano, Iaccarino, Guido, Nazzaro, Pietro, Galletti, Ferruccio, Ferri, Claudio, Desideri, Giovambattista, Viazzi, Francesca, Pontremoli, Roberto, Muiesan, Maria Lorenza, Grassi, Guido, and Borghi, Claudio

Abstract

The objective of this study was to investigate the longitudinal association of metabolically healthy overweight/obese adults with major adverse cardiovascular events (MACE) and the effect of LDL-cholesterol levels on this association. This study was conducted with 15,904 participants from the URRAH study grouped according to BMI and metabolic status. Healthy metabolic status was identified with and without including LDL-cholesterol. The risk of MACE during 11.8 years of follow-up was evaluated with multivariable Cox regressions. Among the participants aged <70 years, high BMI was associated with an increased risk of MACE, whereas among the older subjects it was associated with lower risk. Compared to the group with normal weight/healthy metabolic status, the metabolically healthy participants aged <70 years who were overweight/obese had an increased risk of MACE with an adjusted hazard ratio of 3.81 (95% CI, 1.34-10.85, p = 0.012). However, when LDL-cholesterol < 130 mg/dL was included in the definition of healthy metabolic status, no increase in risk was found in the overweight/obese adults compared to the normal weight individuals (hazard ratio 0.70 (0.07-6.71, p = 0.75). The present data show that the risk of MACE is increased in metabolically healthy overweight/obese individuals identified according to standard criteria. However, when LDL-cholesterol is included in the definition, metabolically healthy individuals who are overweight/obese have no increase in risk.

Published
2024

9. Triglyceride-glucose Index and Mortality in a Large Regional-based Italian Database (Urrah Project)

Author

D'Elia, L, Masulli, M, Virdis, A, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, Desideri, G, Ferri, C, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masi, S, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Galletti, F, D'Elia, Lanfranco, Masulli, Maria, Virdis, Agostino, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F G, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, Desideri, Giovambattista, Ferri, Claudio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masi, Stefano, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, Galletti, Ferruccio, D'Elia, L, Masulli, M, Virdis, A, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, Desideri, G, Ferri, C, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masi, S, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Galletti, F, D'Elia, Lanfranco, Masulli, Maria, Virdis, Agostino, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F G, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, Desideri, Giovambattista, Ferri, Claudio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masi, Stefano, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, and Galletti, Ferruccio

Abstract

Purpose: Recently, a novel index (triglyceride-glucose index-TyG) was considered a surrogate marker of insulin resistance (IR); in addition, it was estimated to be a better expression of IR than widely used tools. Few and heterogeneous data are available on the relationship between this index and mortality risk in non-Asian populations. Therefore, we estimated the predictive role of baseline TyG on the incidence of all-cause and cardiovascular (CV) mortality in a large sample of the general population. Moreover, in consideration of the well-recognized role of serum uric acid (SUA) on CV risk and the close correlation between SUA and IR, we also evaluated the combined effect of TyG and SUA on mortality risk. Methods: The analysis included 16,649 participants from the URRAH cohort. The risk of all-cause and CV mortality was evaluated by the Kaplan-Meier estimator and Cox multivariate analysis. Results: During a median follow-up of 144 months, 2569 deaths occurred. We stratified the sample by the optimal cut-off point for all-cause (4.62) and CV mortality (4.53). In the multivariate Cox regression analyses, participants with TyG above cut-off had a significantly higher risk of all-cause and CV mortality, than those with TyG below the cut-off. Moreover, the simultaneous presence of high levels of TyG and SUA was associated with a higher mortality risk than none or only one of the two factors. Conclusions: The results of this study indicate that these TyG (a low-cost and simple non-invasive marker) thresholds are predictive of an increased risk of mortality in a large and homogeneous general population. In addition, these results show a synergic effect of TyG and SUA on the risk of mortality.

Published
2024

10. Neurological hypertensive emergencies: Correlation of blood pressure values with in-hospital outcomes in ischemic stroke

Author

Giani, V, Valobra, T, Capsoni, N, Galasso, M, De Censi, L, Ferretti, C, Sultana, A, Giacalone, A, Garofani, I, Bombelli, M, Ceresa, C, Gheda, S, Agostoni, E, Galbiati, F, Giannattasio, C, Maloberti, A, Giani, Valentina, Valobra, Tommaso, Capsoni, Nicolò, Galasso, Michele, De Censi, Lorenzo, Ferretti, Cecilia, Sultana, Andrea, Giacalone, Annalisa, Garofani, Ilaria, Bombelli, Michele, Ceresa, Chiara, Gheda, Silvia, Agostoni, Elio Clemente, Galbiati, Filippo, Giannattasio, Cristina, Maloberti, Alessandro, Giani, V, Valobra, T, Capsoni, N, Galasso, M, De Censi, L, Ferretti, C, Sultana, A, Giacalone, A, Garofani, I, Bombelli, M, Ceresa, C, Gheda, S, Agostoni, E, Galbiati, F, Giannattasio, C, Maloberti, A, Giani, Valentina, Valobra, Tommaso, Capsoni, Nicolò, Galasso, Michele, De Censi, Lorenzo, Ferretti, Cecilia, Sultana, Andrea, Giacalone, Annalisa, Garofani, Ilaria, Bombelli, Michele, Ceresa, Chiara, Gheda, Silvia, Agostoni, Elio Clemente, Galbiati, Filippo, Giannattasio, Cristina, and Maloberti, Alessandro

Abstract

Background: Few certainties exist regarding optimal management of Blood Pressure (BP) in the very first hours after an ischemic stroke and many questions remain still unanswered. Our work aimed to evaluate the role of BP and its trend as possible determinants of in-hospital mortality (primary outcome), discharge disabilities and hospitalization length (secondary outcomes) in ischemic stroke patients presented with Hypertensive Emergencies (HE). Methods: We retrospectively evaluated patients presented to Niguarda Hospital, Emergency Department (ED), from 2015 to 2017 with a neurological ischemic HE. BP at ED presentation (T0), its management in ED (T1) and its values at the stroke unit admission (T2) were evaluated. Results: 267 patients were included (0.13 % of all ED accesses and 17.9 % of all ischemic strokes). In the whole population, BP values were not associated with in-hospital mortality while T0 and T2 SBP result were associated to discharge disability and hospitalization length. In pre-specified subgroup analysis these associations were confirmed only in untreated subjects (not anti-hypertensive nor thrombolysis). In fact, no significant relationship can be found between BP values and any secondary outcome in thrombolysis and anti-hypertensive treated patients. Conclusions: BP values and its management can not be related to in-hospital mortality in stroke patients, presented with HE, while they are associated to discharge disability and hospitalization length. In subgroup analysis, results were confirmed only in untreated (not anti-hypertensive therapies nor thrombolytic).

Published
2024

11. Long-term increase in serum uric acid and its predictors over a 25 year follow-up: Results of the PAMELA study

Author

Maloberti, A, Dell'Oro, R, Bombelli, M, Quarti-Trevano, F, Facchetti, R, Mancia, G, Grassi, G, Maloberti, Alessandro, Dell'Oro, Raffaella, Bombelli, Michele, Quarti-Trevano, Fosca, Facchetti, Rita, Mancia, Giuseppe, Grassi, Guido, Maloberti, A, Dell'Oro, R, Bombelli, M, Quarti-Trevano, F, Facchetti, R, Mancia, G, Grassi, G, Maloberti, Alessandro, Dell'Oro, Raffaella, Bombelli, Michele, Quarti-Trevano, Fosca, Facchetti, Rita, Mancia, Giuseppe, and Grassi, Guido

Abstract

Background and aims: Hyperuricemia (HU) has been shown to be associated with an adverse impact on cardiovascular and metabolic risk. Scanty data are available in the general population on the longitudinal changes in serum uric acid (SUA), the occurrence of HU and their potential predictors. We examined during a 25-year follow-up the SUA changes and the factors associated with HU development in the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study. Methods and results: We analyzed data collected in 561 subjects of the PAMELA study evaluated during an average follow-up time amounting to 25.4 ± 1.0 years (mean ± SD). HU was defined by the Uric Acid Right for Heart Health (URRAh) cutoff (5.1 for females and 5.6 mg/dl for males). Mean SUA values during follow-up increased from 4.7 ± 1.1 to 5.0 ± 1.2 mg/dl (P<0.001), the average SUA elevation amounting to of 0.3 ± 1.1 mg/dl 26.7 % of the subjects displayed HU at the follow-up. This was associated at the multivariable analysis with female gender, office, home and 24-h blood pressure, diuretic treatment, serum triglycerides and baseline SUA, as well as the increase in waist circumference and the reduction in renal function. Conclusion: The present study provides longitudinal evidence that in the general population during a 25 year follow-up there is a progressive increase in SUA and HU development. Baseline SUA represents the most important factor associated with these modifications. Gender, renal dysfunction, triglycerides, obesity, diuretic treatment and blood pressure represent other variables capable to predict future occurrence of HU.

Published
2024

12. Serum Uric Acid/Serum Creatinine Ratio and Cardiovascular Mortality in Diabetic Individuals—The Uric Acid Right for Heart Health (URRAH) Project

Author

D’Elia, L, Masulli, M, Cirillo, P, Virdis, A, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Dell’Oro, R, Desideri, G, Ferri, C, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masi, S, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Galletti, F, D’Elia, Lanfranco, Masulli, Maria, Cirillo, Pietro, Virdis, Agostino, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F. G., Cirillo, Massimo, Dell’Oro, Raffaella, Desideri, Giovambattista, Ferri, Claudio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masi, Stefano, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, Galletti, Ferruccio, D’Elia, L, Masulli, M, Cirillo, P, Virdis, A, Casiglia, E, Tikhonoff, V, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Dell’Oro, R, Desideri, G, Ferri, C, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masi, S, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Galletti, F, D’Elia, Lanfranco, Masulli, Maria, Cirillo, Pietro, Virdis, Agostino, Casiglia, Edoardo, Tikhonoff, Valerie, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F. G., Cirillo, Massimo, Dell’Oro, Raffaella, Desideri, Giovambattista, Ferri, Claudio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masi, Stefano, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, and Galletti, Ferruccio

Abstract

Several studies have detected a direct association between serum uric acid (SUA) and cardiovascular (CV) risk. In consideration that SUA largely depends on kidney function, some studies explored the role of the serum creatinine (sCr)-normalized SUA (SUA/sCr) ratio in different settings. Previously, the URRAH (URic acid Right for heArt Health) Study has identified a cut-off value of this index to predict CV mortality at 5.35 Units. Therefore, given that no SUA/sCr ratio threshold for CV risk has been identified for patients with diabetes, we aimed to assess the relationship between this index and CV mortality and to validate this threshold in the URRAH subpopulation with diabetes; the URRAH participants with diabetes were studied (n = 2230). The risk of CV mortality was evaluated by the Kaplan–Meier estimator and Cox multivariate analysis. During a median follow-up of 9.2 years, 380 CV deaths occurred. A non-linear inverse association between baseline SUA/sCr ratio and risk of CV mortality was detected. In the whole sample, SUA/sCr ratio > 5.35 Units was not a significant predictor of CV mortality in diabetic patients. However, after stratification by kidney function, values > 5.35 Units were associated with a significantly higher mortality rate only in normal kidney function, while, in participants with overt kidney dysfunction, values of SUA/sCr ratio > 7.50 Units were associated with higher CV mortality. The SUA/sCr ratio threshold, previously proposed by the URRAH Study Group, is predictive of an increased risk of CV mortality in people with diabetes and preserved kidney function. While, in consideration of the strong association among kidney function, SUA, and CV mortality, a different cut-point was detected for diabetics with impaired kidney function. These data highlight the different predictive roles of SUA (and its interaction with kidney function) in CV risk, pointing out the difference in metabolic- and kidney-dependent SUA levels also in diabetic

Published
2024

13. Cardiovascular Structural and Functional Parameters in Idiopathic Pulmonary Fibrosis at Disease Diagnosis

Author

Faverio, P, Maloberti, A, Rebora, P, Intravaia, R, Tognola, C, Toscani, G, Amato, A, Leoni, V, Franco, G, Vitarelli, F, Spiti, S, Luppi, F, Valsecchi, M, Pesci, A, Giannattasio, C, Faverio, Paola, Maloberti, Alessandro, Rebora, Paola, Intravaia, Rita Cristina Myriam, Tognola, Chiara, Toscani, Giorgio, Amato, Anna, Leoni, Valerio, Franco, Giovanni, Vitarelli, Federica, Spiti, Simona, Luppi, Fabrizio, Valsecchi, Maria Grazia, Pesci, Alberto, Giannattasio, Cristina, Faverio, P, Maloberti, A, Rebora, P, Intravaia, R, Tognola, C, Toscani, G, Amato, A, Leoni, V, Franco, G, Vitarelli, F, Spiti, S, Luppi, F, Valsecchi, M, Pesci, A, Giannattasio, C, Faverio, Paola, Maloberti, Alessandro, Rebora, Paola, Intravaia, Rita Cristina Myriam, Tognola, Chiara, Toscani, Giorgio, Amato, Anna, Leoni, Valerio, Franco, Giovanni, Vitarelli, Federica, Spiti, Simona, Luppi, Fabrizio, Valsecchi, Maria Grazia, Pesci, Alberto, and Giannattasio, Cristina

Abstract

Introduction: Prevalence of cardiac and vascular fibrosis in patients with Idiopathic Pulmonary Fibrosis (IPF) has not been extensively evaluated. Aim: In this study, we aimed to evaluate the heart and vessels functional and structural properties in patients with IPF compared to healthy controls. An exploratory analysis regarding disease severity in IPF patients has been done. Methods: We enrolled 50 patients with IPF (at disease diagnosis before antifibrotic therapy initiation) and 50 controls matched for age and gender. Heart was evaluated through echocardiography and plasmatic NT-pro-brain natriuretic peptide that, together with patients’ symptoms, allow to define the presence of Heart Failure (HF) and diastolic dysfunction. Vessels were evaluated through Flow Mediated Dilation (FMD – endothelial function) and Pulse Wave Velocity (PWV—arterial stiffness) Results: Patients with IPF had a prevalence of diastolic disfunction of 83.8%, HF of 37.8% and vascular fibrosis of 76.6%. No statistically significant difference was observed in comparison to the control group who showed prevalence of diastolic disfunction, HF and vascular fibrosis of 67.3%, 24.5% and 84.8%, respectively. Disease severity seems not to affect PWV, FMD, diastolic dysfunction and HF. Conclusions: Patients with IPF early in the disease course do not present a significant CV fibrotic involvement when compared with age- and sex-matched controls. Bigger and adequately powered studies are needed to confirm our preliminary data and longitudinal studies are required in order to understand the time of appearance and progression rate of heart and vascular involvement in IPF subjects.

Published
2024

14. CAROTID-FEMORAL PULSE WAVE VELOCITY PROGRESSION IN HYPERTENSIVE PATIENTS IS ASSOCIATED WITH SUBSEQUENT CV OUTCOMES

Author

Maloberti, A, Rebora, P, Occhino, G, Andreano, A, Intravaia, R, Tognola, C, Toscani, G, Morelli, M, Pezzoli, S, D’Oro, L, Russo, A, Giannattasio, C, Maloberti, Alessandro, Rebora, Paola, Occhino, Giuseppe, Andreano, Anita, Intravaia, Rita Cristina My, Tognola, Chiara, Toscani, Giorgio, Morelli, Martina, Pezzoli, Stefano, D’Oro, Luca Cavalieri, Russo, Antonio, Giannattasio, Cristina, Maloberti, A, Rebora, P, Occhino, G, Andreano, A, Intravaia, R, Tognola, C, Toscani, G, Morelli, M, Pezzoli, S, D’Oro, L, Russo, A, Giannattasio, C, Maloberti, Alessandro, Rebora, Paola, Occhino, Giuseppe, Andreano, Anita, Intravaia, Rita Cristina My, Tognola, Chiara, Toscani, Giorgio, Morelli, Martina, Pezzoli, Stefano, D’Oro, Luca Cavalieri, Russo, Antonio, and Giannattasio, Cristina

Published
2024

15. EFFECT OF ANTI-PCSK9 ANTIBODIES ON ARTERY STRUCTURE AND FUNCTION: THE NIGUARDA HOSPITAL COHORT

Author

Maloberti, A, Toscani, G, Busti, A, Tognola, C, Intravaia, R, De Censi, L, Galasso, M, Daus, F, Giani, V, Gualini, E, Garofani, I, Riccio, A, Biolcati, M, Fabbri, S, Algeri, M, Merlini, P, Giannattasio, C, Morelli, M, Maloberti, Alessandro, Toscani, Giorgio, Busti, Andrea, Tognola, Chiara, Intravaia, Rita Cristina Mi, De Censi, Lorenzo, Galasso, Michele, Daus, Franesca, Giani, Valentina, Gualini, Elena, Garofani, Ilaria, Riccio, Alfonso, Biolcati, Marco, Fabbri, Saverio, Algeri, Michela, Merlini, Piera, Giannattasio, Cristina, Morelli, Martina, Maloberti, A, Toscani, G, Busti, A, Tognola, C, Intravaia, R, De Censi, L, Galasso, M, Daus, F, Giani, V, Gualini, E, Garofani, I, Riccio, A, Biolcati, M, Fabbri, S, Algeri, M, Merlini, P, Giannattasio, C, Morelli, M, Maloberti, Alessandro, Toscani, Giorgio, Busti, Andrea, Tognola, Chiara, Intravaia, Rita Cristina Mi, De Censi, Lorenzo, Galasso, Michele, Daus, Franesca, Giani, Valentina, Gualini, Elena, Garofani, Ilaria, Riccio, Alfonso, Biolcati, Marco, Fabbri, Saverio, Algeri, Michela, Merlini, Piera, Giannattasio, Cristina, and Morelli, Martina

Published
2024

16. HYPERTRIGLYCERIDEMIA IN PATIENTS WITH ACUTE AND CHRONIC CORONARY SYNDROME: PREVALENCE AND THEIR ASSOCIATION WITH EXTREME CARDIOVASCULAR RISK AND LEFT VENTRICULAR FUNCTION

Author

Maloberti, A, Rosa, A, Toscani, G, Caccia, A, Gualini, E, Pezzoli, S, Morelli, M, Busti, A, Colombo, V, Tognola, C, Algeri, M, Intravaia, R, Pirola, R, Giannattasio, C, Garofani, I, Maloberti, Alessandro, Rosa, Antonio La, Toscani, Giorgio, Caccia, Andrea, Gualini, Elena, Pezzoli, Stefano, Morelli, Martina, Busti, Andrea, Colombo, Valentina, Tognola, Chiara, Algeri, Michela, Intravaia, Rita Cristina My, Pirola, Roberto, Giannattasio, Cristina, Garofani, Ilaria, Maloberti, A, Rosa, A, Toscani, G, Caccia, A, Gualini, E, Pezzoli, S, Morelli, M, Busti, A, Colombo, V, Tognola, C, Algeri, M, Intravaia, R, Pirola, R, Giannattasio, C, Garofani, I, Maloberti, Alessandro, Rosa, Antonio La, Toscani, Giorgio, Caccia, Andrea, Gualini, Elena, Pezzoli, Stefano, Morelli, Martina, Busti, Andrea, Colombo, Valentina, Tognola, Chiara, Algeri, Michela, Intravaia, Rita Cristina My, Pirola, Roberto, Giannattasio, Cristina, and Garofani, Ilaria

Published
2024

17. HYPERTENSIVE EMERGENCIES AND URGENCIES: ADHERENCE TO GUIDELIENS AND RELATIONSHIP BETWEEN BLOOD PRESSURE MANAGEMENT AND IN-HOSPITAL MORTALITY

Author

Maloberti, A, Valobra, T, Giani, V, Garofani, I, De Censi, L, Galasso, M, Colombo, V, Menna, A, Giacalone, A, Ferretti, C, Sultana, A, Gheda, S, Capsoni, N, Galbiati, F, Bombelli, M, Giannattasio, C, Maloberti, Alessandro, Valobra, Tommaso, Giani, Valentina, Garofani, Ilaria, De Censi, Lorenzo, Galasso, Michele, Colombo, Valentina, Menna, Alessandro, Annalisa, Giacalone, Ferretti, Cecilia, Sultana, Andrea, Gheda, Silvia, Capsoni, Nicolò, Galbiati, Filippo, Bombelli, Michele, Giannattasio, Cristina, Maloberti, A, Valobra, T, Giani, V, Garofani, I, De Censi, L, Galasso, M, Colombo, V, Menna, A, Giacalone, A, Ferretti, C, Sultana, A, Gheda, S, Capsoni, N, Galbiati, F, Bombelli, M, Giannattasio, C, Maloberti, Alessandro, Valobra, Tommaso, Giani, Valentina, Garofani, Ilaria, De Censi, Lorenzo, Galasso, Michele, Colombo, Valentina, Menna, Alessandro, Annalisa, Giacalone, Ferretti, Cecilia, Sultana, Andrea, Gheda, Silvia, Capsoni, Nicolò, Galbiati, Filippo, Bombelli, Michele, and Giannattasio, Cristina

Published
2024

18. DIAGNOSTIC ACCURACY OF ATTENDED AND UNATTENDED BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH ARTERIAL HYPERTENSION

Author

Mancusi, C, Maloberti, A, Fucile, I, Manzi, M, Pengo, M, Bertacchini, F, Monticone, S, Pucci, G, Mancusi, Costantino, Maloberti, Alessandro, Fucile, Ilaria, Manzi, Maria Virigina, Pengo, Martino, Bertacchini, Fabio, Monticone, Silvia, Pucci, Giacomo, Mancusi, C, Maloberti, A, Fucile, I, Manzi, M, Pengo, M, Bertacchini, F, Monticone, S, Pucci, G, Mancusi, Costantino, Maloberti, Alessandro, Fucile, Ilaria, Manzi, Maria Virigina, Pengo, Martino, Bertacchini, Fabio, Monticone, Silvia, and Pucci, Giacomo

Published
2024

20. Heart Failure with Preserved Ejection Fraction: How to Deal with This Chameleon

Author

Lucà, Fabiana, primary, Oliva, Fabrizio, additional, Abrignani, Maurizio Giuseppe, additional, Di Fusco, Stefania Angela, additional, Gori, Mauro, additional, Giubilato, Simona, additional, Ceravolo, Roberto, additional, Temporelli, Pier Luigi, additional, Cornara, Stefano, additional, Rao, Carmelo Massimiliano, additional, Caretta, Giorgio, additional, Pozzi, Andrea, additional, Binaghi, Giulio, additional, Maloberti, Alessandro, additional, Di Nora, Concetta, additional, Di Matteo, Irene, additional, Pilleri, Anna, additional, Gelsomino, Sandro, additional, Riccio, Carmine, additional, Grimaldi, Massimo, additional, Colivicchi, Furio, additional, and Gulizia, Michele Massimo, additional

Published
2024
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21. Prognostic Value and Relative Cutoffs of Triglycerides Predicting Cardiovascular Outcome in a Large Regional‐Based Italian Database

Author

Tikhonoff, Valérie, primary, Casiglia, Edoardo, additional, Virdis, Agostino, additional, Grassi, Guido, additional, Angeli, Fabio, additional, Arca, Marcello, additional, Barbagallo, Carlo M., additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Cianci, Rosario, additional, Cicero, Arrigo F. G., additional, Cirillo, Massimo, additional, Cirillo, Pietro, additional, Dell'oro, Raffaella, additional, D'elia, Lanfranco, additional, Desideri, Giovambattista, additional, Ferri, Claudio, additional, Galletti, Ferruccio, additional, Gesualdo, Loreto, additional, Giannattasio, Cristina, additional, Iaccarino, Guido, additional, Mallamaci, Francesca, additional, Maloberti, Alessandro, additional, Masi, Stefano, additional, Masulli, Maria, additional, Mazza, Alberto, additional, Mengozzi, Alessandro, additional, Muiesan, Maria Lorenza, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti‐Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Salvetti, Massimo, additional, Temporelli, Pier Luigi, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, and Borghi, Claudio, additional

Published
2024
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22. Twenty-Four–Hour Central (Aortic) Systolic Blood Pressure: Reference Values and Dipping Patterns in Untreated Individuals

Author

Weber, Thomas, Protogerou, Athanase D., Agharazii, Mohsen, Argyris, Antonis, Aoun Bahous, Sola, Banegas, Jose R., Binder, Ronald K., Blacher, Jacques, Araujo Brandao, Andréa, Cruz, Juan J., Danninger, Kathrin, Giannatasio, Cristina, Graciani, Auxiliadora, Hametner, Bernhard, Jankowski, Piotr, Li, Yan, Maloberti, Alessandro, Mayer, Christopher C., McDonnell, Barry J., McEniery, Carmel M., Antonio Mota Gomes, Marco, Machado Gomes, Annelise, Lorenza Muiesan, Maria, Nemcsik, Janos, Paini, Anna, Rodilla, Enrique, Schutte, Aletta E., Sfikakis, Petros P., Terentes-Printzios, Dimitrios, Vallée, Alexandre, Vlachopoulos, Charalambos, Ware, Lisa, Wilkinson, Ian, Zweiker, Robert, Sharman, James E., and Wassertheurer, Siegfried

Published
2022
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23. Management of Patients Treated with Direct Oral Anticoagulants in Clinical Practice and Challenging Scenarios

Author

Lucà, Fabiana, primary, Oliva, Fabrizio, additional, Abrignani, Maurizio Giuseppe, additional, Di Fusco, Stefania Angela, additional, Parrini, Iris, additional, Canale, Maria Laura, additional, Giubilato, Simona, additional, Cornara, Stefano, additional, Nesti, Martina, additional, Rao, Carmelo Massimiliano, additional, Pozzi, Andrea, additional, Binaghi, Giulio, additional, Maloberti, Alessandro, additional, Ceravolo, Roberto, additional, Bisceglia, Irma, additional, Rossini, Roberta, additional, Temporelli, Pier Luigi, additional, Amico, Antonio Francesco, additional, Calvanese, Raimondo, additional, Gelsomino, Sandro, additional, Riccio, Carmine, additional, Grimaldi, Massimo, additional, Colivicchi, Furio, additional, and Gulizia, Michele Massimo, additional

Published
2023
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27. Natural history and clinical burden of moderate aortic stenosis: a systematic review and explorative meta-analysis

Author

Morelli, M, Galasso, M, Esposito, G, Soriano, F, Nava, S, Da Pozzo, C, Bossi, I, Piccaluga, E, Bruschi, G, Maloberti, A, Oliva, F, Oreglia, J, Giannattasio, C, Montalto, C, Morelli, Martina, Galasso, Michele, Esposito, Giuseppe, Soriano, Francesco Stefano, Nava, Stefano, Da Pozzo, Caterina, Bossi, Irene, Piccaluga, Emanuela, Bruschi, Giuseppe, Maloberti, Alessandro, Oliva, Fabrizio, Oreglia, Jacopo Andrea, Giannattasio, Cristina, Montalto, Claudio, Morelli, M, Galasso, M, Esposito, G, Soriano, F, Nava, S, Da Pozzo, C, Bossi, I, Piccaluga, E, Bruschi, G, Maloberti, A, Oliva, F, Oreglia, J, Giannattasio, C, Montalto, C, Morelli, Martina, Galasso, Michele, Esposito, Giuseppe, Soriano, Francesco Stefano, Nava, Stefano, Da Pozzo, Caterina, Bossi, Irene, Piccaluga, Emanuela, Bruschi, Giuseppe, Maloberti, Alessandro, Oliva, Fabrizio, Oreglia, Jacopo Andrea, Giannattasio, Cristina, and Montalto, Claudio

Abstract

Aims: The mortality risk of patients with moderate aortic stenosis is not well known, but recent studies suggested that it might negatively affect prognosis. We aimed to assess the natural history and clinical burden of moderate aortic stenosis and to investigate the interaction of patients' baseline characteristics with prognosis. Methods: Systematic research was conducted on PubMed. The inclusion criteria were inclusion of patients with moderate aortic stenosis; and report of the survival at 1-year follow-up (minimum). Incidence ratios related to all-cause mortality in patients and controls of each study were estimated and then pooled using a fixed effects model. All patients with mild aortic stenosis or without aortic stenosis were considered controls. Meta-regression analysis was performed to assess the impact of left ventricular ejection fraction and age on the prognosis of patients with moderate aortic stenosis. Results: Fifteen studies and 11 596 patients with moderate aortic stenosis were included. All-cause mortality was significantly higher among patients with moderate aortic stenosis than in controls in all timeframes analysed (all P < 0.0001). Left ventricular ejection fraction and sex did not significantly impact on the prognosis of patients with moderate aortic stenosis (P = 0.4584 and P = 0.5792), while increasing age showed a significant interaction with mortality (estimate = 0.0067; 95% confidence interval: 0.0007-0.0127; P = 0.0323). Conclusion: Moderate aortic stenosis is associated with reduced survival. Further studies are necessary to confirm the prognostic impact of this valvulopathy and the possible benefit of aortic valve replacement.

Published
2023

28. The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and its Role in Metabolic Dysregulation

Author

Maloberti, A, Mengozzi, A, Russo, E, Cicero, A, Angeli, F, Agabiti Rosei, E, Barbagallo, C, Bernardino, B, Bombelli, M, Cappelli, F, Casiglia, E, Cianci, R, Ciccarelli, M, Cirillo, M, Cirillo, P, Desideri, G, D'Elia, L, Dell'Oro, R, Facchetti, R, Ferri, C, Galletti, F, Giannattasio, C, Gesualdo, L, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Muiesan, M, Nazzaro, P, Parati, G, Palatini, P, Pauletto, P, Pontremoli, R, Pugliese, N, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Salvetti, M, Tikhonoff, V, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Grassi, G, Borghi, C, Maloberti, Alessandro, Mengozzi, Alessandro, Russo, Elisa, Cicero, Arrigo Francesco Giuseppe, Angeli, Fabio, Agabiti Rosei, Enrico, Barbagallo, Carlo Maria, Bernardino, Bruno, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo, Cianci, Rosario, Ciccarelli, Michele, Cirillo, Massimo, Cirillo, Pietro, Desideri, Giovambattista, D'Elia, Lanfranco, Dell'Oro, Raffaella, Facchetti, Rita, Ferri, Claudio, Galletti, Ferruccio, Giannattasio, Cristina, Gesualdo, Loreto, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza, Nazzaro, Pietro, Parati, Gianfranco, Palatini, Paolo, Pauletto, Paolo, Pontremoli, Roberto, Pugliese, Nicola Riccardo, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Grassi, Guido, Borghi, Claudio, Maloberti, A, Mengozzi, A, Russo, E, Cicero, A, Angeli, F, Agabiti Rosei, E, Barbagallo, C, Bernardino, B, Bombelli, M, Cappelli, F, Casiglia, E, Cianci, R, Ciccarelli, M, Cirillo, M, Cirillo, P, Desideri, G, D'Elia, L, Dell'Oro, R, Facchetti, R, Ferri, C, Galletti, F, Giannattasio, C, Gesualdo, L, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Masulli, M, Mazza, A, Muiesan, M, Nazzaro, P, Parati, G, Palatini, P, Pauletto, P, Pontremoli, R, Pugliese, N, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Salvetti, M, Tikhonoff, V, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Virdis, A, Grassi, G, Borghi, C, Maloberti, Alessandro, Mengozzi, Alessandro, Russo, Elisa, Cicero, Arrigo Francesco Giuseppe, Angeli, Fabio, Agabiti Rosei, Enrico, Barbagallo, Carlo Maria, Bernardino, Bruno, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo, Cianci, Rosario, Ciccarelli, Michele, Cirillo, Massimo, Cirillo, Pietro, Desideri, Giovambattista, D'Elia, Lanfranco, Dell'Oro, Raffaella, Facchetti, Rita, Ferri, Claudio, Galletti, Ferruccio, Giannattasio, Cristina, Gesualdo, Loreto, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza, Nazzaro, Pietro, Parati, Gianfranco, Palatini, Paolo, Pauletto, Paolo, Pontremoli, Roberto, Pugliese, Nicola Riccardo, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Virdis, Agostino, Grassi, Guido, and Borghi, Claudio

Abstract

The relationship between Serum Uric Acid (UA) and Cardiovascular (CV) diseases has already been extensively evaluated, and it was found to be an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke and heart failure. Similarly, also many papers have been published on the association between UA and kidney function, while less is known on the role of UA in metabolic derangement and, particularly, in metabolic syndrome. Despite the substantial number of publications on the topic, there are still some elements of doubt: (1) the better cut-off to be used to refine CV risk (also called CV cut-off); (2) the needing for a correction of UA values for kidney function; and (3) the better definition of its role in metabolic syndrome: is UA simply a marker, a bystander or a key pathological element of metabolic dysregulation?. The Uric acid Right for heArt Health (URRAH) project was designed by the Working Group on uric acid and CV risk of the Italian Society of Hypertension to answer the first question. After the first papers that individuates specific cut-off for different CV disease, subsequent articles have been published responding to the other relevant questions. This review will summarise most of the results obtained so far from the URRAH research project.

Published
2023

29. Impact of the Increase in Left Ventricular Mass on the Risk of Long-Term Cardiovascular Mortality: A Prospective Cohort Study

Author

Bombelli, M, Vanoli, J, Facchetti, R, Maloberti, A, Cuspidi, C, Grassi, G, Mancia, G, Bombelli, Michele, Vanoli, Jennifer, Facchetti, Rita, Maloberti, Alessandro, Cuspidi, Cesare, Grassi, Guido, Mancia, Giuseppe, Bombelli, M, Vanoli, J, Facchetti, R, Maloberti, A, Cuspidi, C, Grassi, G, Mancia, G, Bombelli, Michele, Vanoli, Jennifer, Facchetti, Rita, Maloberti, Alessandro, Cuspidi, Cesare, Grassi, Guido, and Mancia, Giuseppe

Abstract

Background: Left ventricular hypertrophy (LVH) is an independent predictor of cardiovascular events, and evidence has been obtained that an increase of a normal left ventricular mass (LVM) or new-onset LVH over time augments cardiovascular outcomes. Methods: We addressed this issue in a sample of a general population at relatively low cardiovascular risk. We analyzed subjects with normal echocardiographic LVM enrolled in the PAMELA (Pressioni Arteriose Monitorate E Loro Associazioni) study to follow the increase of LVM over time and assess the prognostic impact of this change on the incidence of cardiovascular events (mean follow-up 18.5 years). Results: In 990 subjects with no LVH at baseline, there was a significant average increase of LVM (21.2%), LVMIBSA(18.9%), and LVMIHT(22.3%) more than 10 years later. About a quarter developed LVH. The LVMIBSAchange exhibited an association with the cardiovascular risk mortality during the following 18.5 years, and the association remained significant after adjustment for confounders (hazard ratio, 1.2 [1.0-1.5]). Similar findings were obtained for LVM in absolute values or indexed for height. The association was seen in both genders, but the link with the cardiovascular risk was statistically significant in males only. Conclusions: Thus, although over 10 years, the LVM increase does not reach a LVH status, it is associated with an augmented cardiovascular mortality risk. This suggests that it might be important to consider periodical LVM assessment, even when LVM is within the normal range, to timely detect its increase and cope with the need of cardiovascular risk restratification.

Published
2023

30. Elevated Serum Urea-to-Creatinine Ratio and In-Hospital Death in Patients with Hyponatremia Hospitalized for COVID-19

Author

Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, Genovesi, Simonetta, Regolisti, G, Rebora, P, Occhino, G, Lieti, G, Molon, G, Maloberti, A, Algeri, M, Giannattasio, C, Valsecchi, M, Genovesi, S, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Lieti, Giulia, Molon, Giulio, Maloberti, Alessandro, Algeri, Michela, Giannattasio, Cristina, Valsecchi, Maria Grazia, and Genovesi, Simonetta

Abstract

Hyponatremia is associated with adverse outcomes in hospitalized patients. An elevated value of the serum urea-to-creatinine ratio (UCR) has been proposed as a proxy of hypovolemia. The aim of this study was to investigate the relationship between the UCR and in-hospital death in patients hospitalized with COVID-19 and hyponatremia. We studied 258 patients admitted for COVID-19 between January 2020 and May 2021 with serum sodium at < 135 mmol/L. The primary end-point was all-cause mortality. A 5-unit increase in the serum UCR during hospital stays was associated with an 8% increase in the hazard of all-cause death (HR = 1.08, 95% CI: 1.03–1.14, p = 0.001) after adjusting for potential confounders. In patients with a UCR > 40 at baseline, a > 10 mmol/L increase in serum sodium values within the first week of hospitalization was associated with higher odds of in-hospital death (OR = 2.93, 95% CI: 1.03–8.36, p = 0.044) compared to patients who experienced a < 10 mmol/L change. This was not observed in patients with a UCR < 40. Hypovolemia developing during hospital stays in COVID-19 patients with hyponatremia detected at hospital admission bears an adverse prognostic impact. Moreover, in hypovolemic patients, a > 10 mmol/L increase in serum sodium within the first week of hospital stays may further worsen the in-hospital prognosis.

Published
2023

31. Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

Author

Mengozzi, A, Pugliese, N, Desideri, G, Masi, S, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Casiglia, E, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell’Oro, R, D’Elia, L, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masulli, M, Mazza, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tikhonoff, V, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Virdis, A, Mengozzi, Alessandro, Pugliese, Nicola Riccardo, Desideri, Giovambattista, Masi, Stefano, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F. G., Cirillo, Massimo, Cirillo, Pietro, Dell’Oro, Raffaella, D’Elia, Lanfranco, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, Virdis, Agostino, Mengozzi, A, Pugliese, N, Desideri, G, Masi, S, Angeli, F, Barbagallo, C, Bombelli, M, Cappelli, F, Casiglia, E, Cianci, R, Ciccarelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell’Oro, R, D’Elia, L, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Grassi, G, Iaccarino, G, Lippa, L, Mallamaci, F, Maloberti, A, Masulli, M, Mazza, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Russo, E, Salvetti, M, Tikhonoff, V, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Virdis, A, Mengozzi, Alessandro, Pugliese, Nicola Riccardo, Desideri, Giovambattista, Masi, Stefano, Angeli, Fabio, Barbagallo, Carlo Maria, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo, Cianci, Rosario, Ciccarelli, Michele, Cicero, Arrigo F. G., Cirillo, Massimo, Cirillo, Pietro, Dell’Oro, Raffaella, D’Elia, Lanfranco, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Maloberti, Alessandro, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, and Virdis, Agostino

Abstract

High serum uric acid (SUA) and triglyceride (TG) levels might promote high-cardiovascular risk phenotypes across the cardiometabolic spectrum. However, SUA predictive power in the presence of normal and high TG levels has never been investigated. We included 8124 patients from the URic acid Right for heArt Health (URRAH) study cohort who were followed for over 20 years and had no established cardiovascular disease or uncontrolled metabolic disease. All-cause mortality (ACM) and cardiovascular mortality (CVM) were explored by the Kaplan–Meier estimator and Cox multivariable regression, adopting recently defined SUA cut-offs for ACM (≥4.7 mg/dL) and CVM (≥5.6 mg/dL). Exploratory analysis across cardiometabolic subgroups and a sensitivity analysis using SUA/serum creatinine were performed as validation. SUA predicted ACM (HR 1.25 [1.12–1.40], p < 0.001) and CVM (1.31 [1.11–1.74], p < 0.001) in the whole study population, and according to TG strata: ACM in normotriglyceridemia (HR 1.26 [1.12–1.43], p < 0.001) and hypertriglyceridemia (1.31 [1.02–1.68], p = 0.033), and CVM in normotriglyceridemia (HR 1.46 [1.23–1.73], p < 0.001) and hypertriglyceridemia (HR 1.31 [0.99–1.64], p = 0.060). Exploratory and sensitivity analyses confirmed our findings, suggesting a substantial role of SUA in normotriglyceridemia and hypertriglyceridemia. In conclusion, we report that SUA can predict ACM and CVM in cardiometabolic patients without established cardiovascular disease, independent of TG levels.

Published
2023

32. Lipoprotein(a): Cardiovascular Disease, Aortic Stenosis and New Therapeutic Option

Author

Maloberti, A, Fabbri, S, Colombo, V, Gualini, E, Monticelli, M, Daus, F, Busti, A, Galasso, M, De Censi, L, Algeri, M, Merlini, P, Giannattasio, C, Maloberti, Alessandro, Fabbri, Saverio, Colombo, Valentina, Gualini, Elena, Monticelli, Massimiliano, Daus, Francesca, Busti, Andrea, Galasso, Michele, De Censi, Lorenzo, Algeri, Michela, Merlini, Piera Angelica, Giannattasio, Cristina, Maloberti, A, Fabbri, S, Colombo, V, Gualini, E, Monticelli, M, Daus, F, Busti, A, Galasso, M, De Censi, L, Algeri, M, Merlini, P, Giannattasio, C, Maloberti, Alessandro, Fabbri, Saverio, Colombo, Valentina, Gualini, Elena, Monticelli, Massimiliano, Daus, Francesca, Busti, Andrea, Galasso, Michele, De Censi, Lorenzo, Algeri, Michela, Merlini, Piera Angelica, and Giannattasio, Cristina

Abstract

Atherosclerosis is a chronic and progressive inflammatory process beginning early in life with late clinical manifestation. This slow pathological trend underlines the importance to early identify high-risk patients and to treat intensively risk factors to prevent the onset and/or the progression of atherosclerotic lesions. In addition to the common Cardiovascular (CV) risk factors, new markers able to increase the risk of CV disease have been identified. Among them, high levels of Lipoprotein(a)—Lp(a)—lead to very high risk of future CV diseases; this relationship has been well demonstrated in epidemiological, mendelian randomization and genome-wide association studies as well as in meta-analyses. Recently, new aspects have been identified, such as its association with aortic stenosis. Although till recent years it has been considered an unmodifiable risk factor, specific drugs have been developed with a strong efficacy in reducing the circulating levels of Lp(a) and their capacity to reduce subsequent CV events is under testing in ongoing trials. In this paper we will review all these aspects: from the synthesis, clearance and measurement of Lp(a), through the findings that examine its association with CV diseases and aortic stenosis to the new therapeutic options that will be available in the next years.

Published
2023

33. Hyperuricemia increases the risk of cardiovascular mortality associated with very high HdL-cholesterol level

Author

Palatini, P, Virdis, A, Masi, S, Mengozzi, A, Casiglia, E, Tikhonoff, V, Cicero, A, Ungar, A, Parati, G, Rivasi, G, Salvetti, M, Barbagallo, C, Bombelli, M, Dell'Oro, R, Bruno, B, Lippa, L, D'Elia, L, Masulli, M, Verdecchia, P, Reboldi, G, Angeli, F, Mallamaci, F, Cirillo, M, Rattazzi, M, Cirillo, P, Gesualdo, L, Mazza, A, Giannattasio, C, Maloberti, A, Volpe, M, Tocci, G, Iaccarino, G, Nazzaro, P, Galletti, F, Ferri, C, Desideri, G, Viazzi, F, Pontremoli, R, Muiesan, M, Grassi, G, Borghi, C, Palatini, Paolo, Virdis, Agostino, Masi, Stefano, Mengozzi, Alessandro, Casiglia, Edoardo, Tikhonoff, Valerie, Cicero, Arrigo F G, Ungar, Andrea, Parati, Gianfranco, Rivasi, Giulia, Salvetti, Massimo, Barbagallo, Carlo M, Bombelli, Michele, Dell'Oro, Raffaella, Bruno, Berardino, Lippa, Luciano, D'Elia, Lanfranco, Masulli, Maria, Verdecchia, Paolo, Reboldi, Gianpaolo, Angeli, Fabio, Mallamaci, Francesca, Cirillo, Massimo, Rattazzi, Marcello, Cirillo, Pietro, Gesualdo, Loreto, Mazza, Alberto, Giannattasio, Cristina, Maloberti, Alessandro, Volpe, Massimo, Tocci, Giuliano, Iaccarino, Guido, Nazzaro, Pietro, Galletti, Ferruccio, Ferri, Claudio, Desideri, Giovambattista, Viazzi, Francesca, Pontremoli, Roberto, Muiesan, Maria Lorenza, Grassi, Guido, Borghi, Claudio, Palatini, P, Virdis, A, Masi, S, Mengozzi, A, Casiglia, E, Tikhonoff, V, Cicero, A, Ungar, A, Parati, G, Rivasi, G, Salvetti, M, Barbagallo, C, Bombelli, M, Dell'Oro, R, Bruno, B, Lippa, L, D'Elia, L, Masulli, M, Verdecchia, P, Reboldi, G, Angeli, F, Mallamaci, F, Cirillo, M, Rattazzi, M, Cirillo, P, Gesualdo, L, Mazza, A, Giannattasio, C, Maloberti, A, Volpe, M, Tocci, G, Iaccarino, G, Nazzaro, P, Galletti, F, Ferri, C, Desideri, G, Viazzi, F, Pontremoli, R, Muiesan, M, Grassi, G, Borghi, C, Palatini, Paolo, Virdis, Agostino, Masi, Stefano, Mengozzi, Alessandro, Casiglia, Edoardo, Tikhonoff, Valerie, Cicero, Arrigo F G, Ungar, Andrea, Parati, Gianfranco, Rivasi, Giulia, Salvetti, Massimo, Barbagallo, Carlo M, Bombelli, Michele, Dell'Oro, Raffaella, Bruno, Berardino, Lippa, Luciano, D'Elia, Lanfranco, Masulli, Maria, Verdecchia, Paolo, Reboldi, Gianpaolo, Angeli, Fabio, Mallamaci, Francesca, Cirillo, Massimo, Rattazzi, Marcello, Cirillo, Pietro, Gesualdo, Loreto, Mazza, Alberto, Giannattasio, Cristina, Maloberti, Alessandro, Volpe, Massimo, Tocci, Giuliano, Iaccarino, Guido, Nazzaro, Pietro, Galletti, Ferruccio, Ferri, Claudio, Desideri, Giovambattista, Viazzi, Francesca, Pontremoli, Roberto, Muiesan, Maria Lorenza, Grassi, Guido, and Borghi, Claudio

Abstract

Background and aims: Whether the association between very high HDL-cholesterol levels and cardiovascular mortality (CVM) is modulated by some facilitating factors is unclear. Aim of the study was to investigate whether the risk of CVM associated with very high HDL-cholesterol is increased in subjects with hyperuricemia. Methods and results: Multivariable Cox analyses were made in 18,072 participants from the multicentre URRAH study stratified by sex and HDL-cholesterol category. During a median follow-up of 11.4 years there were 1307 cases of CVM. In multivariable Cox models a J-shaped association was found in the whole population, with the highest risk being present in the high HDL-cholesterol group [>80 mg/dL, adjusted hazard ratio (HR), 1.28; 95%CI, 1.02–1.61; p = 0.031)]. However, a sex-specific analysis revealed that this association was present only in women (HR, 1.34; 95%CI, 1.02–1.77; p = 0.034) but not in men. The risk of CVM related to high HDL-cholesterol was much greater in the women with high uric acid (>0.30 mmol/L, HR 1.61; 95%CI, 1.08–2.39) than in those with low uric acid (HR, 1.17; 95%CI, 0.80–1.72, p for interaction = 0.016). In women older than 70 years with hyperuricemia the risk related to high HDL-cholesterol was 1.83 (95%CI, 1.19–2.80, p < 0.005). Inclusion of BMI in the models weakened the strength of the associations. Conclusion: Our data indicate that very high HDL-cholesterol levels in women are associated with CVM in a J-shaped fashion. The risk of CVM is increased by concomitant hyperuricemia suggesting that a proinflammatory/oxidative state can enhance the detrimental cardiovascular effects associated with high HDL-cholesterol.

Published
2023

34. Negative prognostic impact of electrolyte disorders in patients hospitalized for Covid-19 in a large multicenter study

Author

Genovesi, S, Regolisti, G, Rebora, P, Occhino, G, Belli, M, Molon, G, Citerio, G, Beltrame, A, Maloberti, A, Generali, E, Giannattasio, C, Epis, O, Rossetti, C, Bellelli, G, De Nalda, A, Capua, I, Valsecchi, M, Genovesi, Simonetta, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Belli, Michele, Molon, Giulio, Citerio, Giuseppe, Beltrame, Anna, Maloberti, Alessandro, Generali, Elena, Giannattasio, Cristina, Epis, Oscar Massimiliano, Rossetti, Claudio, Bellelli, Giuseppe, De Nalda, Ana Lleo, Capua, Ilaria, Valsecchi, Maria Grazia, Genovesi, S, Regolisti, G, Rebora, P, Occhino, G, Belli, M, Molon, G, Citerio, G, Beltrame, A, Maloberti, A, Generali, E, Giannattasio, C, Epis, O, Rossetti, C, Bellelli, G, De Nalda, A, Capua, I, Valsecchi, M, Genovesi, Simonetta, Regolisti, Giuseppe, Rebora, Paola, Occhino, Giuseppe, Belli, Michele, Molon, Giulio, Citerio, Giuseppe, Beltrame, Anna, Maloberti, Alessandro, Generali, Elena, Giannattasio, Cristina, Epis, Oscar Massimiliano, Rossetti, Claudio, Bellelli, Giuseppe, De Nalda, Ana Lleo, Capua, Ilaria, and Valsecchi, Maria Grazia

Abstract

Background: The prognostic impact of electrolyte disorders in hospitalized COVID-19 patients is unclear. Methods: The study included all adult patients hospitalized for COVID-19 in four hospitals in Northern Italy between January 2020 and May 2021 with at least one serum potassium and sodium measurement performed within 3 days since admission. Primary outcome was in-hospital death; secondary outcome was Intensive Care Unit (ICU) admission. A cause-specific Cox proportional-hazards regression model was used for investigating the association between potassium and sodium (as either categorical or continuous variables) and mortality or admission to ICU. Results: Analyses included 3,418 adult hospitalized COVID-19 patients. At multivariable analysis, both hyperkalemia (Hazard Ratio, [HR] 1.833, 95% Confidence Interval [CI] 1.371–2.450) and sK above the median (K 5.1 vs 4.1 mmol/L: HR 1.523, 95% CI 1.295–1.798), and hypernatremia (HR 2.313, 95%CI 1.772–3.018) and sNa above the median (Na 149 vs 139 mmol/L: HR 1.442, 95% CI 1.234–1.686), were associated with in-hospital death, whereas hypokalemia and hyponatremia were not. Hyponatremia was associated with increased hazard of ICU admission (HR 1.884, 95%CI 1.389–2.556). Conclusions: Electrolyte disorders detected at hospital admission may allow early identification of COVID-19 patients at increased risk of adverse outcomes.

Published
2023

35. Serum uric acid / serum creatinine ratio as a predictor of cardiovascular events. Detection of prognostic cardiovascular cut-off values

Author

Casiglia, E, Tikhonoff, V, Virdis, A, Grassi, G, Angeli, F, Barbagallo, C, Bombelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Maloberti, A, Masulli, M, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Casiglia, Edoardo, Tikhonoff, Valérie, Virdis, Agostino, Grassi, Guido, Angeli, Fabio, Barbagallo, Carlo M, Bombelli, Michele, Cicero, Arrigo F G, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Giannattasio, Cristina, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Maloberti, Alessandro, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, Borghi, Claudio, Casiglia, E, Tikhonoff, V, Virdis, A, Grassi, G, Angeli, F, Barbagallo, C, Bombelli, M, Cicero, A, Cirillo, M, Cirillo, P, Dell'Oro, R, D'Elia, L, Desideri, G, Ferri, C, Galletti, F, Gesualdo, L, Giannattasio, C, Iaccarino, G, Lippa, L, Mallamaci, F, Masi, S, Maloberti, A, Masulli, M, Mazza, A, Mengozzi, A, Muiesan, M, Nazzaro, P, Palatini, P, Parati, G, Pontremoli, R, Quarti-Trevano, F, Rattazzi, M, Reboldi, G, Rivasi, G, Salvetti, M, Tocci, G, Ungar, A, Verdecchia, P, Viazzi, F, Volpe, M, Borghi, C, Casiglia, Edoardo, Tikhonoff, Valérie, Virdis, Agostino, Grassi, Guido, Angeli, Fabio, Barbagallo, Carlo M, Bombelli, Michele, Cicero, Arrigo F G, Cirillo, Massimo, Cirillo, Pietro, Dell'Oro, Raffaella, D'elia, Lanfranco, Desideri, Giovambattista, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto, Giannattasio, Cristina, Iaccarino, Guido, Lippa, Luciano, Mallamaci, Francesca, Masi, Stefano, Maloberti, Alessandro, Masulli, Maria, Mazza, Alberto, Mengozzi, Alessandro, Muiesan, Maria Lorenza, Nazzaro, Pietro, Palatini, Paolo, Parati, Gianfranco, Pontremoli, Roberto, Quarti-Trevano, Fosca, Rattazzi, Marcello, Reboldi, Gianpaolo, Rivasi, Giulia, Salvetti, Massimo, Tocci, Giuliano, Ungar, Andrea, Verdecchia, Paolo, Viazzi, Francesca, Volpe, Massimo, and Borghi, Claudio

Abstract

Objective:In the frame of the Uric Acid Right for Heart Health (URRAH) study, a nationwide multicenter study involving adult participants recruited on a regional community basis from all the territory of Italy under the patronage of the Working Group on Uric Acid and Cardiovascular Risk of the Italian Society of Hypertension, we searched for the cut-off values of the ratio between serum uric acid (SUA) and serum creatinine (sCr) able to predict cardiovascular (CV) events.Methods:Among 20 724 participants followed-up for 126 ± 64 months, after detecting cut-off by the receiver operating characteristic curves, we calculated by Cox models adjusted for confounders having CV events as dependent variable the hazard ratio (HR) of SUA/sCr > cut-off. We also verified if the role of cut-off varied with increasing SUA/sCr.Results:A plausible prognostic cut-off of SUA/sCr was found and was the same in the whole database, in men and in women (>5.35). The HR of SUA/sCr > cut-off was 1.159 (95% confidence interval [CI] 1.092-1.131, P < 0.03) in all, 1.161 (95% CI 1.021-1.335, P < 0.02) in men, and 1.444 (95% CI 1.012-1.113, P < 0.03) in women. In increasing quintiles of SUA/sCr the cut-offs were >3.08, >4.87, >5.35, >6.22 and >7.58, respectively. The HRs significantly increased from the 3rd to the 5th quintile (1.21, 95% CI 1.032-1.467, P = 0.018; 1.294, 95% CI 1.101-1.521, P = 0.002; and 1.642, 95% CI 1.405-1.919, P < 0.0001; respectively), that is, over 5.35, whereas the 2nd quintile was not significantly different from the 1st (reference).Conclusion:Having SUA/sCr >5.35 is an independent CV risk indicator both in men and women. The cut-off is dynamic and significantly increases with increasing SUA/sCr.

Published
2023

36. The Results of the URRAH (Uric Acid Right for Heart Health) Project: A Focus on Hyperuricemia in Relation to Cardiovascular and Kidney Disease and its Role in Metabolic Dysregulation

Author

Maloberti, Alessandro; https://orcid.org/0000-0002-2612-6264, Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Russo, Elisa, Cicero, Arrigo Francesco Giuseppe; https://orcid.org/0000-0002-4367-3884, Angeli, Fabio; https://orcid.org/0000-0003-4925-7985, Agabiti Rosei, Enrico, Barbagallo, Carlo Maria; https://orcid.org/0000-0002-4114-038X, Bernardino, Bruno, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo; https://orcid.org/0000-0002-0003-3289, Cianci, Rosario, Ciccarelli, Michele; https://orcid.org/0000-0003-2379-1960, Cirillo, Massimo; https://orcid.org/0000-0002-6409-3504, Cirillo, Pietro, Desideri, Giovambattista; https://orcid.org/0000-0002-0145-1271, D'Elia, Lanfranco; https://orcid.org/0000-0002-1782-0211, Dell'Oro, Raffaella, Facchetti, Rita, Ferri, Claudio, Galletti, Ferruccio, Giannattasio, Cristina, Gesualdo, Loreto; https://orcid.org/0000-0002-4861-0911, Iaccarino, Guido, Lippa, Luciano; https://orcid.org/0000-0003-1249-3861, Mallamaci, Francesca, Masi, Stefano; https://orcid.org/0000-0002-7591-3686, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza; https://orcid.org/0000-0002-4007-9441, et al, Maloberti, Alessandro; https://orcid.org/0000-0002-2612-6264, Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Russo, Elisa, Cicero, Arrigo Francesco Giuseppe; https://orcid.org/0000-0002-4367-3884, Angeli, Fabio; https://orcid.org/0000-0003-4925-7985, Agabiti Rosei, Enrico, Barbagallo, Carlo Maria; https://orcid.org/0000-0002-4114-038X, Bernardino, Bruno, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo; https://orcid.org/0000-0002-0003-3289, Cianci, Rosario, Ciccarelli, Michele; https://orcid.org/0000-0003-2379-1960, Cirillo, Massimo; https://orcid.org/0000-0002-6409-3504, Cirillo, Pietro, Desideri, Giovambattista; https://orcid.org/0000-0002-0145-1271, D'Elia, Lanfranco; https://orcid.org/0000-0002-1782-0211, Dell'Oro, Raffaella, Facchetti, Rita, Ferri, Claudio, Galletti, Ferruccio, Giannattasio, Cristina, Gesualdo, Loreto; https://orcid.org/0000-0002-4861-0911, Iaccarino, Guido, Lippa, Luciano; https://orcid.org/0000-0003-1249-3861, Mallamaci, Francesca, Masi, Stefano; https://orcid.org/0000-0002-7591-3686, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza; https://orcid.org/0000-0002-4007-9441, and et al

Abstract

The relationship between Serum Uric Acid (UA) and Cardiovascular (CV) diseases has already been extensively evaluated, and it was found to be an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke and heart failure. Similarly, also many papers have been published on the association between UA and kidney function, while less is known on the role of UA in metabolic derangement and, particularly, in metabolic syndrome. Despite the substantial number of publications on the topic, there are still some elements of doubt: (1) the better cut-off to be used to refine CV risk (also called CV cut-off); (2) the needing for a correction of UA values for kidney function; and (3) the better definition of its role in metabolic syndrome: is UA simply a marker, a bystander or a key pathological element of metabolic dysregulation?. The Uric acid Right for heArt Health (URRAH) project was designed by the Working Group on uric acid and CV risk of the Italian Society of Hypertension to answer the first question. After the first papers that individuates specific cut-off for different CV disease, subsequent articles have been published responding to the other relevant questions. This review will summarise most of the results obtained so far from the URRAH research project.

Published
2023

37. Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

Author

Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Pugliese, Nicola Riccardo; https://orcid.org/0000-0002-5473-227X, Desideri, Giovambattista; https://orcid.org/0000-0002-0145-1271, Masi, Stefano; https://orcid.org/0000-0002-7591-3686, Angeli, Fabio; https://orcid.org/0000-0003-4925-7985, Barbagallo, Carlo Maria; https://orcid.org/0000-0002-4114-038X, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo; https://orcid.org/0000-0002-0003-3289, Cianci, Rosario, Ciccarelli, Michele; https://orcid.org/0000-0003-2379-1960, Cicero, Arrigo F G; https://orcid.org/0000-0002-4367-3884, Cirillo, Massimo; https://orcid.org/0000-0002-6409-3504, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco; https://orcid.org/0000-0002-1782-0211, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto; https://orcid.org/0000-0002-4861-0911, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano; https://orcid.org/0000-0003-1249-3861, Mallamaci, Francesca, Maloberti, Alessandro; https://orcid.org/0000-0002-2612-6264, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza; https://orcid.org/0000-0002-4007-9441, Nazzaro, Pietro, Palatini, Paolo; https://orcid.org/0000-0001-5402-4946, et al, Mengozzi, Alessandro; https://orcid.org/0000-0003-2834-9725, Pugliese, Nicola Riccardo; https://orcid.org/0000-0002-5473-227X, Desideri, Giovambattista; https://orcid.org/0000-0002-0145-1271, Masi, Stefano; https://orcid.org/0000-0002-7591-3686, Angeli, Fabio; https://orcid.org/0000-0003-4925-7985, Barbagallo, Carlo Maria; https://orcid.org/0000-0002-4114-038X, Bombelli, Michele, Cappelli, Federica, Casiglia, Edoardo; https://orcid.org/0000-0002-0003-3289, Cianci, Rosario, Ciccarelli, Michele; https://orcid.org/0000-0003-2379-1960, Cicero, Arrigo F G; https://orcid.org/0000-0002-4367-3884, Cirillo, Massimo; https://orcid.org/0000-0002-6409-3504, Cirillo, Pietro, Dell'Oro, Raffaella, D'Elia, Lanfranco; https://orcid.org/0000-0002-1782-0211, Ferri, Claudio, Galletti, Ferruccio, Gesualdo, Loreto; https://orcid.org/0000-0002-4861-0911, Giannattasio, Cristina, Grassi, Guido, Iaccarino, Guido, Lippa, Luciano; https://orcid.org/0000-0003-1249-3861, Mallamaci, Francesca, Maloberti, Alessandro; https://orcid.org/0000-0002-2612-6264, Masulli, Maria, Mazza, Alberto, Muiesan, Maria Lorenza; https://orcid.org/0000-0002-4007-9441, Nazzaro, Pietro, Palatini, Paolo; https://orcid.org/0000-0001-5402-4946, and et al

Abstract

High serum uric acid (SUA) and triglyceride (TG) levels might promote high-cardiovascular risk phenotypes across the cardiometabolic spectrum. However, SUA predictive power in the presence of normal and high TG levels has never been investigated. We included 8124 patients from the URic acid Right for heArt Health (URRAH) study cohort who were followed for over 20 years and had no established cardiovascular disease or uncontrolled metabolic disease. All-cause mortality (ACM) and cardiovascular mortality (CVM) were explored by the Kaplan-Meier estimator and Cox multivariable regression, adopting recently defined SUA cut-offs for ACM (≥4.7 mg/dL) and CVM (≥5.6 mg/dL). Exploratory analysis across cardiometabolic subgroups and a sensitivity analysis using SUA/serum creatinine were performed as validation. SUA predicted ACM (HR 1.25 [1.12-1.40], p < 0.001) and CVM (1.31 [1.11-1.74], p < 0.001) in the whole study population, and according to TG strata: ACM in normotriglyceridemia (HR 1.26 [1.12-1.43], p < 0.001) and hypertriglyceridemia (1.31 [1.02-1.68], p = 0.033), and CVM in normotriglyceridemia (HR 1.46 [1.23-1.73], p < 0.001) and hypertriglyceridemia (HR 1.31 [0.99-1.64], p = 0.060). Exploratory and sensitivity analyses confirmed our findings, suggesting a substantial role of SUA in normotriglyceridemia and hypertriglyceridemia. In conclusion, we report that SUA can predict ACM and CVM in cardiometabolic patients without established cardiovascular disease, independent of TG levels.

Published
2023

38. Serum uric acid and left ventricular mass index independently predict cardiovascular mortality: The uric acid right for heart health (URRAH) project

Author

Muiesan, Maria Lorenza, Agabiti Rosei, Claudia, Paini, Anna, Casiglia, Edoardo, Cirillo, Massimo, Grassi, Guido, Iaccarino, Guido, Mallamaci, Francesca, Maloberti, Alessandro, Mazza, Alberto, Mengozzi, Alessandro, Palatini, Paolo, Parati, Gianfranco, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Borghi, Claudio, Working Group on Uric Acid and Cardiovascular Risk of the Italia, Muiesan, Maria Lorenza, Agabiti Rosei, Claudia, Paini, Anna, Casiglia, Edoardo, Cirillo, Massimo, Grassi, Guido, Iaccarino, Guido, Mallamaci, Francesca, Maloberti, Alessandro, Mazza, Alberto, Mengozzi, Alessandro, Palatini, Paolo, Parati, Gianfranco, Reboldi, Gianpaolo, Rivasi, Giulia, Russo, Elisa, Salvetti, Massimo, Tikhonoff, Valerie, Tocci, Giuliano, Borghi, Claudio, and Working Group on Uric Acid and Cardiovascular Risk of the Italia

Abstract

UNLABELLED A relationship between serum uric acid (SUA) and cardiovascular (CV) events has been documented in the Uric Acid Right for Heart Health (URRAH) study. AIM of this study was to investigate the association between SUA and left ventricular mass index (LVMI) and whether SUA and LVMI or their combination may predict the incidence of CV death. METHODS Subjects with echocardiographic measurement of LVMI included in the URRAH study (n=10733) were part of this analysis. LV hypertrophy (LVH) was defined as LVMI > 95 g/m2 in women and 115 g/m2 in men. RESULTS A significant association between SUA and LVMI was observed in multiple regression analysis in men: beta 0,095, F 5.47, P< 0.001 and women: beta 0,069, F 4.36, P<0.001. During follow-up 319 CV deaths occurred. Kaplan-Meier curves showed a significantly poorer survival rate in subjects with higher SUA (> 5.6 mg/dl in men and 5.1 mg/dl in women) and LVH (log-rank chi-square 298.105; P<0.0001). At multivariate Cox regression analysis in women LVH alone and the combination of higher SUA and LVH but not hyperuricemia alone, were associated with a higher risk of CV death, while in men hyperuricemia without LVH, LVH without hyperuricemia and their combination were all associated with a higher incidence of CV death. CONCLUSIONS Our findings demonstrate that SUA is independently associated with LVMI and suggest that the combination of hyperuricemia with LVH is an independent and powerful predictor for CV death both in men and women.

Published
2023

39. Serum Uric Acid Predicts All-Cause and Cardiovascular Mortality Independently of Hypertriglyceridemia in Cardiometabolic Patients without Established CV Disease: A Sub-Analysis of the URic acid Right for heArt Health (URRAH) Study

Author

Mengozzi, Alessandro, primary, Pugliese, Nicola Riccardo, additional, Desideri, Giovambattista, additional, Masi, Stefano, additional, Angeli, Fabio, additional, Barbagallo, Carlo Maria, additional, Bombelli, Michele, additional, Cappelli, Federica, additional, Casiglia, Edoardo, additional, Cianci, Rosario, additional, Ciccarelli, Michele, additional, Cicero, Arrigo F. G., additional, Cirillo, Massimo, additional, Cirillo, Pietro, additional, Dell’Oro, Raffaella, additional, D’Elia, Lanfranco, additional, Ferri, Claudio, additional, Galletti, Ferruccio, additional, Gesualdo, Loreto, additional, Giannattasio, Cristina, additional, Grassi, Guido, additional, Iaccarino, Guido, additional, Lippa, Luciano, additional, Mallamaci, Francesca, additional, Maloberti, Alessandro, additional, Masulli, Maria, additional, Mazza, Alberto, additional, Muiesan, Maria Lorenza, additional, Nazzaro, Pietro, additional, Palatini, Paolo, additional, Parati, Gianfranco, additional, Pontremoli, Roberto, additional, Quarti-Trevano, Fosca, additional, Rattazzi, Marcello, additional, Reboldi, Gianpaolo, additional, Rivasi, Giulia, additional, Russo, Elisa, additional, Salvetti, Massimo, additional, Tikhonoff, Valerie, additional, Tocci, Giuliano, additional, Ungar, Andrea, additional, Verdecchia, Paolo, additional, Viazzi, Francesca, additional, Volpe, Massimo, additional, Borghi, Claudio, additional, and Virdis, Agostino, additional

Published
2023
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40. Trends in all-cause mortality of hospitalized patients due to SARS-CoV-2 infection from a monocentric cohort in Milan (Lombardy, Italy)

Author

Ughi, Nicola, Bernasconi, Davide Paolo, Del Gaudio, Francesca, Dicuonzo, Armanda, Maloberti, Alessandro, Giannattasio, Cristina, Tarsia, Paolo, Puoti, Massimo, Scaglione, Francesco, Beltrami, Laura, Colombo, Fabrizio, Bertuzzi, Michaela, Bellone, Andrea, Adinolfi, Antonella, Valsecchi, Maria Grazia, Epis, Oscar Massimiliano, Rossetti, Claudio, Ughi, N, Bernasconi, D, Del Gaudio, F, Dicuonzo, A, Maloberti, A, Giannattasio, C, Tarsia, P, Puoti, M, Scaglione, F, Beltrami, L, Colombo, F, Bertuzzi, M, Bellone, A, Adinolfi, A, Valsecchi, M, Epis, O, and Rossetti, C

Subjects
Case fatality rate, SARS-CoV-2 infection, Public Health, Environmental and Occupational Health, COVID-19, Original Article, Inpatients with COVID-19, Trend of case fatality rate
Abstract

Background Robust data on case fatality rate (CFR) among inpatients with COVID-19 are still lacking, and the role of patient characteristics in in-hospital deaths remains under-investigated. This study quantified the overall CFR and described its trend in a cohort of hospitalized patients with SARS-CoV-2 in Italy. Admission to ICU, death, or discharge were the secondary outcomes. Methods This retrospective study is based on administrative health data and electronic case records of inpatients consecutively admitted to Niguarda Hospital between 21 February and 8 November 2020. Results An overall CFR of 18% was observed. CFR was significantly reduced during the second wave of contagion (1 June to 30 September, 16%) compared with the first wave (21 February to 31 May, 21% p = 0.015). Such reduction was mainly observed among male inpatients between 40 and 80 years with limited comorbidities. Admission to ICU was associated with a high risk of mortality in both waves. The incidence of severe disease and the need for ICU admission were lower in the second wave. Conclusion CFR in SARS-CoV-2 inpatients was demonstrated to decrease over time. This reduction may partly reflect the changes in hospital strategy and clinical practice. The reasons for this improvement should be further investigated to plan an exit strategy in case of future outbreaks. Key messages What is already known on this topic Before the advent of anti-COVID-19 vaccines, a multi-wave pattern of contagion was observed, and this trend conditioned the inpatient case fatality rate (CFR), which varied over time accordingly to the waves of contagion. Only preliminary results on the in-hospital mortality trend are available, along with a partial analysis of its determinants. Consequently, robust data on CFR among inpatients with SARS-CoV-2 infection are still lacking, and the role of patient characteristics in in-hospital deaths remains under-investigated. What this study adds This study shows that the in-hospital mortality in patients with SARS-CoV-2 infection decreases over time. Such reduction was mainly observed among male inpatients between 40 and 80 years with limited comorbidities. Admission to ICU was invariably associated with a high risk of mortality during the whole study period (21 February to 8 November 2020), but the incidence of severe disease and the need for ICU admission were lower in the second wave of contagions (1 October to 8 November 2020). This reduction may partly reflect the impact of changes in hospital strategy and clinical practice. The reasons for this improvement should be further investigated to inform the response to future outbreaks and to plan exit strategy by prioritizing high-risk populations. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-021-01675-y.

Published
2022

42. Lipoprotein(a): Cardiovascular Disease, Aortic Stenosis and New Therapeutic Option

Author

Maloberti, Alessandro, primary, Fabbri, Saverio, additional, Colombo, Valentina, additional, Gualini, Elena, additional, Monticelli, Massimiliano, additional, Daus, Francesca, additional, Busti, Andrea, additional, Galasso, Michele, additional, De Censi, Lorenzo, additional, Algeri, Michela, additional, Merlini, Piera Angelica, additional, and Giannattasio, Cristina, additional

Published
2022
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43. 555 ADHERENCE AND PERSISTENCE OF PCSK9 INHIBITORS IN CLINICAL PRACTICE: THE REAL-WORLD ITALIAN EXPERIENCE (AT-TARGET-IT STUDY)

Author

Marzano, Federica, primary, Basile, Christian, additional, Paolillo, Stefania, additional, Cesaro, Arturo, additional, Buonocore, Davide, additional, Asile, Gaetano, additional, Abbate, Vincenza, additional, Vicidomini, Francesca, additional, Maria Spaccarotella, Carmen Anna, additional, Spirito, Giulio, additional, Maloberti, Alessandro, additional, Iannuzzo, Gabriella, additional, Ciccone, Marco Matteo, additional, D´alleva, Alberto, additional, Corleto, Antonella, additional, Brunetti, Natale Daniele, additional, Indolfi, Ciro, additional, Gargiulo, Paola, additional, and Perrone-filardi, Pasquale, additional

Published
2022
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44. 85 ATRIAL FIBRILLATION INCIDENCE IN SARS-COV-2 INFECTED PATIENTS: PREDICTORS AND RELATIONSHIP WITH IN-HOSPITAL MORTALITY

Author

Maloberti, Alessandro, primary, Giannattasio, Cristina, additional, Rebora, Paola, additional, Occhino, Giuseppe, additional, Ughi, Nicola, additional, Rizzo, Jacopo, additional, Fabbri, Saverio, additional, Leidi, Filippo, additional, Cartella, Iside, additional, Rossetti, Claudio, additional, Epis, Oscar Massimiliano, additional, Molon, Giulio, additional, Bonfanti, Paolo, additional, Valsecchi, Maria Grazia, additional, and Genovesi, Simonetta, additional

Published
2022
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45. P34 24-Hour Ambulatory Brachial Versus Aortic Systolic Blood Pressure: Relationship with Left Ventricular Mass Significantly Differs. Pooled Results from the International 24 Hour Aortic Blood Pressure Consortium (i24ABC)

Author

Wassertheurer, Siegfried, Protogerou, Athanase, Sharman, James, Sala, Enrique Rodilla, Jankowski, Piotr, Muiesan, Maria Lorenza, Giannattasio, Cristina, Hametner, Bernhard, Pascual, Jose Maria, Zweiker, Robert, Argyris, Antonio, Paini, Anna, Wilkinson, Ian, Czarnecka, Danuta, Salvetti, Massimo, Maloberti, Alessandro, McEniery, Carmel, Li, Yan, Nemcsik, Janos, Pucci, Giacomo, Ablasser, Cornelia, Blacher, Jacques, Valleé, Alexandre, de la Sierra, Alejandro, Zhang, Yi, Ji, Hongwei, McDonnell, Barry, Mota, Marco, Paiva, Annelise, Brandao, Andrea, and Weber, Thomas

Published
2019
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46. Relationship Between 24-Hour Ambulatory Central Systolic Blood Pressure and Left Ventricular Mass: A Prospective Multicenter Study

Author

Weber, Thomas, Wassertheurer, Siegfried, Schmidt-Trucksäss, Arno, Rodilla, Enrique, Ablasser, Cornelia, Jankowski, Piotr, Lorenza Muiesan, Maria, Giannattasio, Cristina, Mang, Claudia, Wilkinson, Ian, Kellermair, Jörg, Hametner, Bernhard, Pascual, Jose Maria, Zweiker, Robert, Czarnecka, Danuta, Paini, Anna, Salvetti, Massimo, Maloberti, Alessandro, and McEniery, Carmel

Published
2017
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47. Endothelial Dysfunction in Patients with Advanced Heart Failure Treated with Levosimendan Periodic Infusion Compared with Optimal Medical Therapy: A Pilot Study

Author

Maloberti, Alessandro, primary, Sun, Jinwei, additional, Zannoni, Jessica, additional, Occhi, Lucia, additional, Bassi, Ilaria, additional, Fabbri, Saverio, additional, Colombo, Valentina, additional, Gualini, Elena, additional, Algeri, Michela, additional, Varrenti, Marisa, additional, Masciocco, Gabriella, additional, Perna, Enrico, additional, Oliva, Fabrizio, additional, Cipriani, Manlio, additional, Frigerio, Maria, additional, and Giannattasio, Cristina, additional

Published
2022
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48. Incident Atrial Fibrillation and In-Hospital Mortality in SARS-CoV-2 Patients

Author

Maloberti, Alessandro, primary, Giannattasio, Cristina, additional, Rebora, Paola, additional, Occhino, Giuseppe, additional, Ughi, Nicola, additional, Biolcati, Marco, additional, Gualini, Elena, additional, Rizzi, Jacopo Giulio, additional, Algeri, Michela, additional, Giani, Valentina, additional, Rossetti, Claudio, additional, Epis, Oscar Massimiliano, additional, Molon, Giulio, additional, Beltrame, Anna, additional, Bonfanti, Paolo, additional, Valsecchi, Maria Grazia, additional, and Genovesi, Simonetta, additional

Published
2022
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49. Incident Atrial Fibrillation and In-Hospital Mortality in SARS-CoV-2 Patients

Author

Maloberti, A, Giannattasio, C, Rebora, P, Occhino, G, Ughi, N, Biolcati, M, Gualini, E, Rizzi, J, Algeri, M, Giani, V, Rossetti, C, Epis, O, Molon, G, Beltrame, A, Bonfanti, P, Valsecchi, M, Genovesi, S, Maloberti, Alessandro, Giannattasio, Cristina, Rebora, Paola, Occhino, Giuseppe, Ughi, Nicola, Biolcati, Marco, Gualini, Elena, Rizzi, Jacopo Giulio, Algeri, Michela, Giani, Valentina, Rossetti, Claudio, Epis, Oscar Massimiliano, Molon, Giulio, Beltrame, Anna, Bonfanti, Paolo, Valsecchi, Maria Grazia, Genovesi, Simonetta, Maloberti, A, Giannattasio, C, Rebora, P, Occhino, G, Ughi, N, Biolcati, M, Gualini, E, Rizzi, J, Algeri, M, Giani, V, Rossetti, C, Epis, O, Molon, G, Beltrame, A, Bonfanti, P, Valsecchi, M, Genovesi, S, Maloberti, Alessandro, Giannattasio, Cristina, Rebora, Paola, Occhino, Giuseppe, Ughi, Nicola, Biolcati, Marco, Gualini, Elena, Rizzi, Jacopo Giulio, Algeri, Michela, Giani, Valentina, Rossetti, Claudio, Epis, Oscar Massimiliano, Molon, Giulio, Beltrame, Anna, Bonfanti, Paolo, Valsecchi, Maria Grazia, and Genovesi, Simonetta

Abstract

Background: Among the different cardiovascular (CV) manifestations of the coronavirus disease 2019 (COVID-19), arrhythmia and atrial fibrillation (AF) in particular have recently received special attention. The aims of our study were to estimate the incidence of AF in patients hospitalized for COVID-19, and to evaluate its role as a possible predictor of in-hospital all-cause mortality. (2) Methods: We enrolled 3435 people with SARS-CoV2 infection admitted to three hospitals in Northern Italy from February 2020 to May 2021. We collected data on their clinical history, laboratory tests, pharmacological treatment and intensive care unit (ICU) admission. Incident AF and all-cause in-hospital mortality were considered as outcomes. (3) Results: 145 (4.2%) patients developed AF during hospitalization, with a median time since admission of 3 days (I-III quartile: 0, 12). Patients with incident AF were admitted more frequently to the ICU (39.3 vs. 12.4%, p < 0.001), and more frequently died (37.2 vs. 16.9%, p < 0.001). In the Cox regression model, the significant determinants of incident AF were age (HR: 1.041; 95% CI: 1.022, 1.060 per year), a history of AF (HR: 2.720; 95% CI: 1.508, 4.907), lymphocyte count (HR: 0.584; 95% CI: 0.384, 0.888 per 103/µL), estimated glomerular filtration rate (eGFR, HR: 0.988; 95% CI: 0.980, 0.996 per mL/min) and ICU admission (HR: 5.311; 95% CI: 3.397, 8.302). Incident AF was a predictor of all-cause mortality (HR: 1.405; 95% CI: 1.027, 1.992) along with age (HR: 1.057; 95% CI: 1.047, 1.067), male gender (HR: 1.315; 95% CI: 1.064; 1.626), dementia (HR: 1.373; 95% CI: 1.045, 1.803), lower platelet (HR: 0.997; 95% CI: 0.996, 0.998 per 103/µL) and lymphocyte counts (HR: 0.843; 95% CI: 0.725, 0.982 per 103/µL), C-Reactive protein values (HR: 1.004; 95% CI: 1.003, 1.005 per mg/L), eGFR (HR: 0.990; 95% CI: 0.986, 0.994 per mL/min), and ICU admission (HR: 1.759; 95% CI: 1.292, 2.395). (4) Conclusions: Incident AF is a common complication in C

Published
2022

50. Prescriptive Appropriateness in Primary Cardiovascular Prevention: Data from Niguarda Hospital

Author

Maloberti, A, Ceruti, D, Gualini, E, Colombo, V, Giani, V, Milani, M, Sun, J, Alloni, M, Giannattasio, C, Maloberti, Alessandro, Ceruti, Davide, Gualini, Elena, Colombo, Valentina, Giani, Valentina, Milani, Martina, Sun, Jinwei, Alloni, Marta, Giannattasio, Cristina, Maloberti, A, Ceruti, D, Gualini, E, Colombo, V, Giani, V, Milani, M, Sun, J, Alloni, M, Giannattasio, C, Maloberti, Alessandro, Ceruti, Davide, Gualini, Elena, Colombo, Valentina, Giani, Valentina, Milani, Martina, Sun, Jinwei, Alloni, Marta, and Giannattasio, Cristina

Published
2022

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