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1. Roadmap Consensus on Carotid Artery Plaque Imaging and Impact on Therapy Strategies and Guidelines: An International, Multispecialty, Expert Review and Position Statement

Author

Saba, L, Brinjikji, W, Spence, JD, Wintermark, M, Castillo, M, Borst, GJD, Yang, Q, Yuan, C, Buckler, A, Edjlali, M, Saam, T, Saloner, D, Lal, BK, Capodanno, D, Sun, J, Balu, N, Naylor, R, Lugt, AVD, Wasserman, BA, Kooi, ME, Wardlaw, J, Gillard, J, Lanzino, G, Hedin, U, Mikulis, D, Gupta, A, DeMarco, JK, Hess, C, Goethem, JV, Hatsukami, T, Rothwell, P, Brown, MM, and Moody, AR

Subjects
Biomedical and Clinical Sciences, Neurosciences, Clinical Sciences, Atherosclerosis, Aging, Clinical Research, Cardiovascular, Patient Safety, Stroke, Health Services, Carotid Arteries, Carotid Artery Diseases, Carotid Stenosis, Consensus, Humans, Plaque, Atherosclerotic, Nuclear Medicine & Medical Imaging, Clinical sciences, Physical chemistry
Abstract

Current guidelines for primary and secondary prevention of stroke in patients with carotid atherosclerosis are based on the quantification of the degree of stenosis and symptom status. Recent publications have demonstrated that plaque morphology and composition, independent of the degree of stenosis, are important in the risk stratification of carotid atherosclerotic disease. This finding raises the question as to whether current guidelines are adequate or if they should be updated with new evidence, including imaging for plaque phenotyping, risk stratification, and clinical decision-making in addition to the degree of stenosis. To further this discussion, this roadmap consensus article defines the limits of luminal imaging and highlights the current evidence supporting the role of plaque imaging. Furthermore, we identify gaps in current knowledge and suggest steps to generate high-quality evidence, to add relevant information to guidelines currently based on the quantification of stenosis.

Published
2021

3. Role of continuous glucose monitoring in diabetic patients at high cardiovascular risk: an expert-based multidisciplinary Delphi consensus

Author

Di Mario, C, Genovese, S, Lanza, G, Mannucci, E, Marenzi, G, Sciatti, E, Pitocco, D, Avogaro, A, Bertuzzi, F, Bonora, E, Borghi, C, Buzzetti, R, Carugo, S, Capodanno, D, Consoli, A, Conti, A, Danesi, R, Bartolo, P, Ferrari, G, Favale, S, Giorda, C, Giorgino, F, Girelli, A, Golino, P, Grigioni, F, Indolfi, C, Irace, C, Lovati, E, Maffettone, A, Masulli, M, Oliva, F, Oltrona Visconti, L, Orsi, E, Pagotto, U, Paloscia, L, Parati, G, Perrone, P, Piccirillo, G, Pozzilli, P, Pugliese, G, Purrello, F, Ribichini, F, Rubboli, A, Senni, M, Trevisan, R, Tubili, C, Uguccioni, M, Di Mario C., Genovese S., Lanza G. A., Mannucci E., Marenzi G., Sciatti E., Pitocco D., Avogaro A., Bertuzzi F., Bonora E., Borghi C., Buzzetti R., Carugo S., Capodanno D., Consoli A., Conti A., Danesi R., Bartolo P., Ferrari G. M. D., Favale S., Giorda C., Giorgino F., Girelli A., Golino P., Grigioni F., Indolfi C., Irace C., Lovati E., Maffettone A., Masulli M., Oliva F. G., Oltrona Visconti L., Orsi E., Pagotto U., Paloscia L., Parati G., Perrone P., Piccirillo G., Pozzilli P., Pugliese G., Purrello F., Ribichini F., Rubboli A., Senni M., Trevisan R., Tubili C., Uguccioni M., Di Mario, C, Genovese, S, Lanza, G, Mannucci, E, Marenzi, G, Sciatti, E, Pitocco, D, Avogaro, A, Bertuzzi, F, Bonora, E, Borghi, C, Buzzetti, R, Carugo, S, Capodanno, D, Consoli, A, Conti, A, Danesi, R, Bartolo, P, Ferrari, G, Favale, S, Giorda, C, Giorgino, F, Girelli, A, Golino, P, Grigioni, F, Indolfi, C, Irace, C, Lovati, E, Maffettone, A, Masulli, M, Oliva, F, Oltrona Visconti, L, Orsi, E, Pagotto, U, Paloscia, L, Parati, G, Perrone, P, Piccirillo, G, Pozzilli, P, Pugliese, G, Purrello, F, Ribichini, F, Rubboli, A, Senni, M, Trevisan, R, Tubili, C, Uguccioni, M, Di Mario C., Genovese S., Lanza G. A., Mannucci E., Marenzi G., Sciatti E., Pitocco D., Avogaro A., Bertuzzi F., Bonora E., Borghi C., Buzzetti R., Carugo S., Capodanno D., Consoli A., Conti A., Danesi R., Bartolo P., Ferrari G. M. D., Favale S., Giorda C., Giorgino F., Girelli A., Golino P., Grigioni F., Indolfi C., Irace C., Lovati E., Maffettone A., Masulli M., Oliva F. G., Oltrona Visconti L., Orsi E., Pagotto U., Paloscia L., Parati G., Perrone P., Piccirillo G., Pozzilli P., Pugliese G., Purrello F., Ribichini F., Rubboli A., Senni M., Trevisan R., Tubili C., and Uguccioni M.

Abstract

Background: Continuous glucose monitoring (CGM) shows in more detail the glycaemic pattern of diabetic subjects and provides several new parameters (“glucometrics”) to assess patients’ glycaemia and consensually guide treatment. A better control of glucose levels might result in improvement of clinical outcome and reduce disease complications. This study aimed to gather an expert consensus on the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk or with heart disease. Methods: A list of 22 statements concerning type of patients who can benefit from CGM, prognostic impact of CGM in diabetic patients with heart disease, CGM use during acute cardiovascular events and educational issues of CGM were developed. Using a two-round Delphi methodology, the survey was distributed online to 42 Italian experts (21 diabetologists and 21 cardiologists) who rated their level of agreement with each statement on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results: Forty experts (95%) answered the survey. Every statement achieved a positive consensus. In particular, the panel expressed the feeling that CGM can be prognostically relevant for every diabetic patient (70%) and that is clinically useful also in the management of those with type 2 diabetes not treated with insulin (87.5%). The assessment of time in range (TIR), glycaemic variability (GV) and hypoglycaemic/hyperglycaemic episodes were considered relevant in the management of diabetic patients with heart disease (92.5% for TIR, 95% for GV, 97.5% for time spent in hypoglycaemia) and can improve the prognosis of those with ischaemic heart disease (100% for hypoglycaemia, 90% for hyperglycaemia) or with heart failure (87.5% for hypoglycaemia, 85% for TIR, 87.5% for GV). The experts retained that CGM can be used and can impact the short- and long-term prognosis during an acute cardiovascular event. Lastly, CGM has a

Published
2022

4. Role of continuous glucose monitoring in diabetic patients at high cardiovascular risk: an expert-based multidisciplinary Delphi consensus

Author

Di Mario, Clara, Genovese, S., Lanza, Gaetano Antonio, Mannucci, E., Marenzi, Giancarlo, Sciatti, E., Pitocco, Dario, Avogaro, A., Bertuzzi, Paolo Francesco, Bonora, E., Borghi, Claudio, Buzzetti, R., Carugo, S., Capodanno, D., Consoli, A., Conti, A., Danesi, R., Bartolo, P., Ferrari, G. M. D., Favale, S., Giorda, C., Giorgino, F., Girelli, Alberto, Golino, P., Grigioni, F., Indolfi, C., Irace, C., Lovati, E., Maffettone, A., Masulli, M., Oliva, F. G., Oltrona Visconti, L., Orsi, Cosma Emilio, Pagotto, U., Paloscia, L., Parati, G., Perrone, Pia Alba Gloria, Piccirillo, G., Pozzilli, P., Pugliese, Giuseppe, Purrello, F., Ribichini, F., Rubboli, A., Senni, M., Trevisan, R., Tubili, C., Uguccioni, M., Di Mario, C, Genovese, S, Lanza, G, Mannucci, E, Marenzi, G, Sciatti, E, Pitocco, D, Avogaro, A, Bertuzzi, F, Bonora, E, Borghi, C, Buzzetti, R, Carugo, S, Capodanno, D, Consoli, A, Conti, A, Danesi, R, Bartolo, P, Ferrari, G, Favale, S, Giorda, C, Giorgino, F, Girelli, A, Golino, P, Grigioni, F, Indolfi, C, Irace, C, Lovati, E, Maffettone, A, Masulli, M, Oliva, F, Oltrona Visconti, L, Orsi, E, Pagotto, U, Paloscia, L, Parati, G, Perrone, P, Piccirillo, G, Pozzilli, P, Pugliese, G, Purrello, F, Ribichini, F, Rubboli, A, Senni, M, Trevisan, R, Tubili, C, and Uguccioni, M

Subjects
Blood Glucose, Consensus, Delphi Technique, Heart Diseases, cardiovascular outcome, continuous glucose monitoring, delphi method, glucometrics, glycaemic variability, time in range, Endocrinology, Diabetes and Metabolism, Blood Glucose Self-Monitoring, Delphi method, Settore MED/13 - ENDOCRINOLOGIA, Cardiovascular outcome, Glycaemic variability, Hypoglycemia, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Heart Disease Risk Factors, Risk Factors, Time in range, Glucometric, Humans, Cardiology and Cardiovascular Medicine, Continuous glucose monitoring
Abstract

Background Continuous glucose monitoring (CGM) shows in more detail the glycaemic pattern of diabetic subjects and provides several new parameters (“glucometrics”) to assess patients’ glycaemia and consensually guide treatment. A better control of glucose levels might result in improvement of clinical outcome and reduce disease complications. This study aimed to gather an expert consensus on the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk or with heart disease. Methods A list of 22 statements concerning type of patients who can benefit from CGM, prognostic impact of CGM in diabetic patients with heart disease, CGM use during acute cardiovascular events and educational issues of CGM were developed. Using a two-round Delphi methodology, the survey was distributed online to 42 Italian experts (21 diabetologists and 21 cardiologists) who rated their level of agreement with each statement on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results Forty experts (95%) answered the survey. Every statement achieved a positive consensus. In particular, the panel expressed the feeling that CGM can be prognostically relevant for every diabetic patient (70%) and that is clinically useful also in the management of those with type 2 diabetes not treated with insulin (87.5%). The assessment of time in range (TIR), glycaemic variability (GV) and hypoglycaemic/hyperglycaemic episodes were considered relevant in the management of diabetic patients with heart disease (92.5% for TIR, 95% for GV, 97.5% for time spent in hypoglycaemia) and can improve the prognosis of those with ischaemic heart disease (100% for hypoglycaemia, 90% for hyperglycaemia) or with heart failure (87.5% for hypoglycaemia, 85% for TIR, 87.5% for GV). The experts retained that CGM can be used and can impact the short- and long-term prognosis during an acute cardiovascular event. Lastly, CGM has a recognized educational role for diabetic subjects. Conclusions According to this Delphi consensus, the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk is promising and deserves dedicated studies to confirm the experts’ feelings.

Published
2022

6. Revascularization strategies versus optimal medical therapy in chronic coronary syndrome: a systematic review and network meta-analysis

Author

Galli, M, primary, Benenati, S, additional, Zito, A, additional, Capodanno, D, additional, Biondi-Zoccai, G, additional, Ortega-Paz, L, additional, D'Amario, D, additional, Porto, I, additional, Burzotta, F, additional, Trani, C, additional, De Caterina, R, additional, Escaned, J, additional, Gaudino, M, additional, Angiolillo, D J, additional, and Crea, F, additional

Published
2022
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7. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Back, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Duran, O, Halvorsen, S, Richard Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrieres, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Ryden, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Monique Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren F., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Back M., Benetos A., Biffi A., Boavida J. -M., Capodanno D., Cosyns B., Crawford C. A., Davos C. H., Desormais I., Di Angelantonio E., Duran O. H. F., Halvorsen S., Richard Hobbs F. D., Hollander M., Jankowska E. A., Michal M., Sacco S., Sattar N., Tokgozoglu L., Tonstad S., Tsioufis K. P., van Dis I., van Gelder I. C., Wanner C., Williams B., De Backer G., Regitz-Zagrosek V., Aamodt A. H., Abdelhamid M., Aboyans V., Albus C., Asteggiano R., Borger M. A., Brotons C., Celutkiene J., Cifkova R., Cikes M., Cosentino F., Dagres N., De Backer T., De Bacquer D., Delgado V., Ruijter H. D., Dendale P., Drexel H., Falk V., Fauchier L., Ference B. A., Ferrieres J., Ferrini M., Fisher M., Fliser D., Fras Z., Gaita D., Giampaoli S., Gielen S., Graham I., Jennings C., Jorgensen T., Kautzky-Willer A., Kavousi M., Koenig W., Konradi A., Kotecha D., Landmesser U., Lettino M., Lewis B. S., Linhart A., Lochen M. -L., Makrilakis K., Mancia G., Marques-Vidal P., McEvoy J. W., McGreavy P., Merkely B., Neubeck L., Nielsen J. C., Perk J., Petersen S. E., Petronio A. S., Piepoli M., Pogosova N. G., Prescott E. I. B., Ray K. K., Reiner Z., Richter D. J., Ryden L., Shlyakhto E., Sitges M., Sousa-Uva M., Sudano I., Tiberi M., Touyz R. M., Ungar A., Monique Verschuren W. M., Wiklund O., Wood D., Zamorano J. L., Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Back, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Duran, O, Halvorsen, S, Richard Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrieres, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Ryden, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Monique Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren F., Mach F., Smulders Y. M., Carballo D., Koskinas K. C., Back M., Benetos A., Biffi A., Boavida J. -M., Capodanno D., Cosyns B., Crawford C. A., Davos C. H., Desormais I., Di Angelantonio E., Duran O. H. F., Halvorsen S., Richard Hobbs F. D., Hollander M., Jankowska E. A., Michal M., Sacco S., Sattar N., Tokgozoglu L., Tonstad S., Tsioufis K. P., van Dis I., van Gelder I. C., Wanner C., Williams B., De Backer G., Regitz-Zagrosek V., Aamodt A. H., Abdelhamid M., Aboyans V., Albus C., Asteggiano R., Borger M. A., Brotons C., Celutkiene J., Cifkova R., Cikes M., Cosentino F., Dagres N., De Backer T., De Bacquer D., Delgado V., Ruijter H. D., Dendale P., Drexel H., Falk V., Fauchier L., Ference B. A., Ferrieres J., Ferrini M., Fisher M., Fliser D., Fras Z., Gaita D., Giampaoli S., Gielen S., Graham I., Jennings C., Jorgensen T., Kautzky-Willer A., Kavousi M., Koenig W., Konradi A., Kotecha D., Landmesser U., Lettino M., Lewis B. S., Linhart A., Lochen M. -L., Makrilakis K., Mancia G., Marques-Vidal P., McEvoy J. W., McGreavy P., Merkely B., Neubeck L., Nielsen J. C., Perk J., Petersen S. E., Petronio A. S., Piepoli M., Pogosova N. G., Prescott E. I. B., Ray K. K., Reiner Z., Richter D. J., Ryden L., Shlyakhto E., Sitges M., Sousa-Uva M., Sudano I., Tiberi M., Touyz R. M., Ungar A., Monique Verschuren W. M., Wiklund O., Wood D., and Zamorano J. L.

Published
2021

9. European Society of Cardiology guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1—epidemiology, pathophysiology, and diagnosis

Author

Baigent, C., Windecker, S., Andreini, D., Arbelo, E., Barbato, E., Bartorelli, A.L., Baumbach, A., Behr, E.R., Berti, S., Bueno, H., Capodanno, D., Cappato, R., Chieffo, A., Collet, J.P., Cuisset, T., Simone, G. de, Delgado, V., Dendale, P., Dudek, D., Edvardsen, T., Elvan, A., Gonzalez-Juanatey, J.R., Gori, M., Grobbee, D., Guzik, T.J., Halvorsen, S., Haude, M., Heidbuchel, H., Hindricks, G., Ibanez, B., Karam, N., Katus, H., Klok, F.A., Konstantinides, S.V., Landmesser, U., Leclercq, C., Leonardi, S., Lettino, M., Marenzi, G., Mauri, J., Metra, M., Morici, N., Mueller, C., Petronio, A.S., Polovina, M.M., Potpara, T., Praz, F., Prendergast, B., Prescott, E., Price, S., Pruszczyk, P., Rodriguez-Leor, O., Roffi, M., Romaguera, R., Rosenkranz, S., Sarkozy, A., Scherrenberg, M., Seferovic, P., Senni, M., Spera, F.R., Stefanini, G., Thiele, H., Tomasoni, D., Torracca, L., Touyz, R.M., Wilde, A.A., Williams, B., Task Force Management Covid-19 Eur, Nuffield Department of Population Health [Oxford], University of Oxford, Bern University Hospital [Berne] (Inselspital), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Nutrition, obésité et risque thrombotique (NORT), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Glasgow, Amsterdam UMC - Amsterdam University Medical Center, University College of London [London] (UCL), Baigent, C, Cardiology, Task Force for the management of COVID-19 of the European Society of, Cardiology, ACS - Heart failure & arrhythmias, Task Force Management Covid-19 Eur, University of Oxford [Oxford], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), delgado, victoria/0000-0002-9841-2737, BUENO, HECTOR/0000-0003-0277-7596, Karam, Nicole/0000-0002-3861-6914, Baigent, Colin/0000-0003-4856-7420, Behr, Elijah/0000-0002-8731-2853, Williams, Bryan/0000-0002-8094-1841, Rodriguez-Leor, Oriol/0000-0003-2657-5657, BUENO, HECTOR/0000-0003-0277-7596, Rodriguez-Leor, Oriol/0000-0003-2657-5657, Williams, Bryan/0000-0002-8094-1841, Karam, and Nicole/0000-0002-3861-6914

Subjects
ACE2, Arrhythmias, Biomarkers, Cardiogenic shock, COVID-19, Myocardial, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Physiology, Myocardial injury, Myocarditis, Non-invasive imaging, Humans, Pandemics, Prospective Studies, Cardiology, Cardiovascular Diseases, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Disease, Special Article, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Physiology (medical), injury, Pandemic, Epidemiology, Medicine, AcademicSubjects/MED00200, Intensive care medicine, business.industry, Pathophysiology, Human medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Aims Since its emergence in early 2020, the novel severe acute respiratory syndrome coronavirus 2 causing coronavirus disease 2019 (COVID-19) has reached pandemic levels, and there have been repeated outbreaks across the globe. The aim of this two-part series is to provide practical knowledge and guidance to aid clinicians in the diagnosis and management of cardiovascular disease (CVD) in association with COVID-19. Methods and results A narrative literature review of the available evidence has been performed, and the resulting information has been organized into two parts. The first, reported here, focuses on the epidemiology, pathophysiology, and diagnosis of cardiovascular (CV) conditions that may be manifest in patients with COVID-19. The second part, which will follow in a later edition of the journal, addresses the topics of care pathways, treatment, and follow-up of CV conditions in patients with COVID-19. Conclusion This comprehensive review is not a formal guideline but rather a document that provides a summary of current knowledge and guidance to practicing clinicians managing patients with CVD and COVID-19. The recommendations are mainly the result of observations and personal experience from healthcare providers. Therefore, the information provided here may be subject to change with increasing knowledge, evidence from prospective studies, and changes in the pandemic. Likewise, the guidance provided in the document should not interfere with recommendations provided by local and national healthcare authorities., Graphical Abstract Graphical Abstract

Published
2022

10. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Bäck, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Franco, O, Halvorsen, S, Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Den Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrières, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Rydén, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren, FLJ, Smulders, YM, Koskinas, KC, Boavida, JM, Davos, CH, Franco, OH, Hobbs, FDR, Jankowska, EA, Tsioufis, KP, van Gelder, IC, Aamodt, AH, Borger, MA, Ference, BA, Lewis, BS, Lochen, ML, McEvoy, JW, McGreavy, P, Nielsen, JC, Petersen, SE, Petronio, AS, Pogosova, NG, Prescott, EIB, Ray, KK, Richter, DJ, Touyz, RM, Verschuren, WMM, Zamorano, JL, Visseren, F, Mach, F, Smulders, Y, Carballo, D, Koskinas, K, Bäck, M, Benetos, A, Biffi, A, Boavida, J, Capodanno, D, Cosyns, B, Crawford, C, Davos, C, Desormais, I, Di Angelantonio, E, Franco, O, Halvorsen, S, Hobbs, F, Hollander, M, Jankowska, E, Michal, M, Sacco, S, Sattar, N, Tokgozoglu, L, Tonstad, S, Tsioufis, K, van Dis, I, van Gelder, I, Wanner, C, Williams, B, De Backer, G, Regitz-Zagrosek, V, Aamodt, A, Abdelhamid, M, Aboyans, V, Albus, C, Asteggiano, R, Borger, M, Brotons, C, Celutkiene, J, Cifkova, R, Cikes, M, Cosentino, F, Dagres, N, De Backer, T, De Bacquer, D, Delgado, V, Den Ruijter, H, Dendale, P, Drexel, H, Falk, V, Fauchier, L, Ference, B, Ferrières, J, Ferrini, M, Fisher, M, Fliser, D, Fras, Z, Gaita, D, Giampaoli, S, Gielen, S, Graham, I, Jennings, C, Jorgensen, T, Kautzky-Willer, A, Kavousi, M, Koenig, W, Konradi, A, Kotecha, D, Landmesser, U, Lettino, M, Lewis, B, Linhart, A, Lochen, M, Makrilakis, K, Mancia, G, Marques-Vidal, P, Mcevoy, J, Mcgreavy, P, Merkely, B, Neubeck, L, Nielsen, J, Perk, J, Petersen, S, Petronio, A, Piepoli, M, Pogosova, N, Prescott, E, Ray, K, Reiner, Z, Richter, D, Rydén, L, Shlyakhto, E, Sitges, M, Sousa-Uva, M, Sudano, I, Tiberi, M, Touyz, R, Ungar, A, Verschuren, W, Wiklund, O, Wood, D, Zamorano, J, Visseren, FLJ, Smulders, YM, Koskinas, KC, Boavida, JM, Davos, CH, Franco, OH, Hobbs, FDR, Jankowska, EA, Tsioufis, KP, van Gelder, IC, Aamodt, AH, Borger, MA, Ference, BA, Lewis, BS, Lochen, ML, McEvoy, JW, McGreavy, P, Nielsen, JC, Petersen, SE, Petronio, AS, Pogosova, NG, Prescott, EIB, Ray, KK, Richter, DJ, Touyz, RM, Verschuren, WMM, and Zamorano, JL

Published
2022

11. Comparative effects of guided vs. potent P2Y12 inhibitor therapy in acute coronary syndrome: a network meta-analysis of 61 898 patients from 15 randomized trials

Author

Galli, Mattia, Benenati, S., Franchi, F., Rollini, F., Capodanno, D., Biondi-Zoccai, G., Vescovo, G. M., Cavallari, L. H., Bikdeli, B., Ten Berg, J., Mehran, R., Gibson, C. M., Crea, Filippo, Pereira, N. L., Sibbing, D., Angiolillo, D. J., Galli M., Crea F. (ORCID:0000-0001-9404-8846), Galli, Mattia, Benenati, S., Franchi, F., Rollini, F., Capodanno, D., Biondi-Zoccai, G., Vescovo, G. M., Cavallari, L. H., Bikdeli, B., Ten Berg, J., Mehran, R., Gibson, C. M., Crea, Filippo, Pereira, N. L., Sibbing, D., Angiolillo, D. J., Galli M., and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

AIMS: Guidelines recommend the use of potent P2Y12 inhibitors over clopidogrel for the reduction of ischaemic events in patients with acute coronary syndrome (ACS). However, this comes at the expense of increased bleeding. A guided selection of P2Y12 inhibiting therapy has the potential to overcome this limitation. We aimed at evaluating the comparative safety and efficacy of guided vs. routine selection of potent P2Y12 inhibiting therapy in patients with ACS. METHODS AND RESULTS: We performed a network meta-analysis of randomized controlled trials (RCTs) comparing different oral P2Y12 inhibitors currently recommended for the treatment of patients with ACS (clopidogrel, prasugrel, and ticagrelor). RCTs including a guided approach (i.e. platelet function or genetic testing) vs. standard selection of P2Y12 inhibitors among patients with ACS were also included. Incidence rate ratios (IRR) and associated 95% confidence intervals (CIs) were estimated. P-scores were used to estimate hierarchies of efficacy and safety. The primary efficacy endpoint was major adverse cardiovascular events (MACE) and the primary safety endpoint was all bleeding. A total of 61 898 patients from 15 RCTs were included. Clopidogrel was used as reference treatment. A guided approach was the only strategy associated with reduced MACE (IRR: 0.80, 95% CI: 0.65-0.98) without any significant trade-off in all bleeding (IRR: 1.22, 95% CI: 0.96-1.55). A guided approach and prasugrel were associated with reduced myocardial infarction. A guided approach, prasugrel, and ticagrelor were associated with reduced stent thrombosis. Ticagrelor was also associated with reduced total and cardiovascular mortality. Prasugrel was associated with increased major bleeding. Prasugrel and ticagrelor were associated with increased minor bleeding. The incidence of stroke did not differ between treatments. CONCLUSION: In patients with an ACS, compared with routine selection of potent P2Y12 inhibiting therapy (prasugrel or ti

Published
2022

13. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F.L.J. Mach, F. Smulders, Y.M. Carballo, D. Koskinas, K.C. Back, M. Benetos, A. Biffi, A. Boavida, J.-M. Capodanno, D. Cosyns, B. Crawford, C. Davos, C.H. Desormais, I. Di Angelantonio, E. Franco, O.H. Halvorsen, S. Richard Hobbs, F.D. Hollander, M. Jankowska, E.A. Michal, M. Sacco, S. Sattar, N. Tokgozoglu, L. Tonstad, S. Tsioufis, K.P. Van Dis, I. Van Gelder, I.C. Wanner, C. Williams, B.

Published
2022

14. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

Author

Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Back, M., Benetos, A., Biffi, A., Boavida, J. -M., Capodanno, D., Cosyns, B., Crawford, C., Davos, C. H., Desormais, I., DI Angelantonio, E., Franco, O. H., Halvorsen, S., Hobbs, F. D. R., Hollander, M., Jankowska, E. A., Michal, M., Sacco, S., Sattar, N., Tokgozoglu, L., Tonstad, S., Tsioufis, K. P., Van DIs, I., Van Gelder, I. C., Wanner, C., Williams, B., De Backer, G., Regitz-Zagrosek, V., Aamodt, A. H., Abdelhamid, M., Aboyans, V., Albus, C., Asteggiano, R., Borger, M. A., Brotons, C., Ielutkiene, J., Cifkova, R., Cikes, M., Cosentino, F., Dagres, N., De Backer, T., De Bacquer, D., Delgado, V., Den Ruijter, H., Dendale, P., Drexel, H., Falk, V., Fauchier, L., Ference, B. A., Ferrieres, J., Ferrini, M., Fisher, M., Fliser, D., Fras, Z., Gaita, D., Giampaoli, S., Gielen, S., Graham, I., Jennings, C., Jorgensen, T., Kautzky-Willer, A., Kavousi, M., Koenig, W., Konradi, A., Kotecha, D., Landmesser, U., Lettino, M., Lewis, B. S., Linhart, A., Lochen, M. -L., Makrilakis, K., Mancia, G., Marques-Vidal, P., Mcevoy, J. W., Mcgreavy, P., Merkely, B., Neubeck, L., Nielsen, J. C., Perk, J., Petersen, S. E., Petronio, A. S., Piepoli, M., Pogosova, N. G., Prescott, E. I. B., Ray, K. K., Reiner, Z., Richter, D. J., Ryden, L., Shlyakhto, E., Sitges, M., Sousa-Uva, M., Sudano, I., Tiberi, M., Touyz, R. M., Ungar, A., Verschuren, W. M. M., Wiklund, O., Wood, D., Zamorano, J. L., Crawford, C. A., Franco Duran, O. H., Richard Hobbs, F. D., Dis, I. V., Group, ESC Scientific Document, Clinical sciences, Cardio-vascular diseases, and Cardiology

Subjects
medicine.medical_specialty, Epidemiology, Population, air pollution, population, Guidelines, blood pressure, climate change, diabetes, healthy lifestyle, lifetime benefit, lifetime risk, lipids, nutrition, personalized, prevention, psychosocial factors, risk estimation, risk management, shared decision-making, smoking, stepwise approach, Risk Assessment, Humans, Primary Prevention, Risk Factors, Cardiovascular Diseases, Diabetes mellitus, medicine, Intensive care medicine, education, 610 Medicine & health, Risk management, education.field_of_study, business.industry, medicine.disease, Clinical Practice, Blood pressure, guidelines, Heart failure, Lifetime risk, Disease prevention, Cardiology and Cardiovascular Medicine, business, Stepwise approach, 360 Social problems & social services
Abstract

These are the clinical practice guidelines from the European Society of Cardiology on cardiovascular disease prevention in clinical practice, from 2021.

Published
2022

15. Novel drug-eluting stents in the treatment of de novo coronary lesions

Author

Tamburino C, Capodanno D, and Dipasqua F

Subjects
coronary stents, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Davide Capodanno1,2, Fabio Dipasqua1, Corrado Tamburino1,21Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; 2ETNA Foundation, Catania, ItalyAbstract: Due to safety concerns in recent years, much effort has been devoted to improving the outcomes associated with drug-eluting stents (DESs). This review summarizes the current status of methodological and technical achievements reported in second-generation DES. Novel stents are described based on the component (the platform, the polymer, and the drug) that has undergone the most significant changes compared to earlier generation DES. An overview of the currently available evidence on the use of novel coronary devices in patients undergoing coronary revascularization is also reviewed.Keywords: coronary artery disease, stent, platform, polymer, drug, percutaneous coronary intervention, late lumen loss, follow-up, outcomes

Published
2011

16. Performance of Thin-Strut Stents in Non-Left Main Bifurcation Coronary Lesions: A RAIN Subanalysis

Author

Filippo, O., D Ascenzo, F., Angelini, F., Franchin, L., Cerrato, E., Pennacchi, M., Nuñez-Gil, I., Wojakowski, W., Imori, Y., Trabattoni, D., Huczek, Z., Venuti, G., Muscoli, S., Iannaccone, M., Montabone, A., Marengo, G., Rognoni, A., Parma, R., Figini, F., Mitomo, S., Boccuzzi, G., Mattesini, A., Quadri, G., Wańha, W., Grzegorz Smolka, Rolfo, C., Cortese, B., Ryan, N., Capodanno, D., Chieffo, A., Di Mario, C., Varbella, F., Romeo, F., Sheiban, I., Escaned, J., Helft, G., and Ferrari, G. M.

Subjects
Percutaneous Coronary Intervention, Treatment Outcome, Risk Factors, Humans, Drug-Eluting Stents, Stents, Coronary Artery Disease, Coronary Angiography, Retrospective Studies
Abstract

This study assesses the safety and efficacy of thin-strut stents in non-left main (non-LM) bifurcation coronary lesions.Thinner struts of recent drug-eluting stent (DES) devices are associated with improved outcomes, but data about their performance in challenging scenarios are scant.RAIN was a retrospective multicenter registry enrolling patients with coronary bifurcation lesions or left main (LM) disease treated with thin-strut DESs. Target-lesion revascularization (TLR) was the primary endpoint, while major adverse clinical event (MACE) rate, a composite of all-cause death, myocardial infarction (MI), target-vessel revascularization (TVR), TLR, and stent thrombosis (ST), and its single components were the secondary endpoints. Multivariable analysis was performed to identify predictors of TLR. Outcome incidences according to stenting strategy (provisional vs 2-stent technique), use of final kissing balloon (FKB), and intravascular ultrasound/optical coherence tomography optimization were further investigated in prespecified subanalyses.A total of 1803 patients (59% acute coronary syndrome, 41% stable coronary artery disease) with non-LM bifurcations were enrolled. After a median follow-up of 12 months, TLR incidence was 2.5% (2.2% for provisional stenting and 3.5% for 2-stent technique). MACE rate was 9.4% (all-cause death, 4.1%; MI, 3.2%; TVR, 3.7%; definite ST, 1.1%). After multivariable adjustment, postdilation (hazard ratio [HR], 0.32; 95% confidence interval [CI], 0.15-0.71; P.01) and provisional stenting (HR, 0.62; 95% CI, 0.55-0.89; P=.03) were associated with lower TLR rates. FKB was associated with a lower incidence of TLR in the 2-stent subgroup (P=.03). Intracoronary imaging had no significant impact on the primary endpoint.Thin-strut DES options represent an effective choice in bifurcation lesions. Postdilation and provisional stenting are associated with a reduced risk of TLR. FKB should be recommended in 2-stent techniques.

Published
2021

17. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes

Author

Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thomas, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Leclercq C, Lewis BS, Merkely B, Mueller C, Petersen S, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Knuuti, Juhani, Wijns, William, Saraste, Antti, Capodanno, Davide, Barbato, Emanuele, Funck-Brentano, Christian, Prescott, Eva, Storey, Robert F, Deaton, Christi, Cuisset, Thoma, Agewall, Stefan, Dickstein, Kenneth, Edvardsen, Thor, Escaned, Javier, Gersh, Bernard J, Svitil, Pavel, Gilard, Martine, Hasdai, David, Hatala, Robert, Mahfoud, Felix, Masip, Josep, Muneretto, Claudio, Valgimigli, Marco, Achenbach, Stephan, Bax, Jeroen J, Neumann FJ, Sechtem U, Banning AP, Bonaros N, Bueno H, Bugiardini R, Chieffo A, Crea F, Czerny M, Delgado V, Dendale P, Flachskampf FA, Gohlke H, Grove EL, James S, Katritsis D, Landmesser U, Lettino M, Matter CM, Nathoe H, Niessner A, Patrono C, Petronio AS, Pettersen SE, Piccolo R, Piepoli MF, Popescu BA, Räber L, Richter DJ, Roffi M, Roithinger FX, Shlyakhto E, Sibbing D, Silber S, Simpson IA, Sousa-Uva M, Vardas P, Witkowski A, Zamorano JL, Achenbach S, Agewall S, Barbato E, Bax JJ, Capodanno D, Cuisset T, Deaton C, Dickstein K, Edvardsen T, Escaned J, Funck-Brentano C, Gersh BJ, Gilard M, Hasdai D, Hatala R, Mahfoud F, Masip J, Muneretto C, Prescott E, Saraste A, Storey RF, Svitil P, Valgimigli M, Windecker S, Aboyans V, Baigent C, Collet JP, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee D, Halvorsen S, Hindricks G, Iung B, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen S, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RM, Benkhedda S, Metzler B, Sujayeva V, Cosyns B, Kusljugic Z, Velchev V, Panayi G, Kala P, Haahr-Pedersen SA, Kabil H, Ainla T, Kaukonen T, Cayla G, Pagava Z, Woehrle J, Kanakakis J, Tóth K, Gudnason T, Peace A, Aronson D, Riccio C, Elezi S, Mirrakhimov E, Hansone S, Sarkis A, Babarskiene R, Beissel J, Maempel AJC, Revenco V, de Grooth GJ, Pejkov H, Juliebø V, Lipiec P, Santos J, Chioncel O, Duplyakov D, Bertelli L, Dikic AD, Studenčan M, Bunc M, Alfonso F, Bäck M, Zellweger M, Addad F, Yildirir A, Sirenko Y, Clapp B, Clinical sciences, Cardio-vascular diseases, Cardiology, Knuuti, Juhani [0000-0003-3156-9593], Apollo - University of Cambridge Repository, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), University of Zurich, Knuuti, J., Wijns, W., Achenbach, S., Agewall, S., Barbato, E., Bax, J. J., Capodanno, D., Cuisset, T., Deaton, C., Dickstein, K., Edvardsen, T., Escaned, J., Funck-Brentano, C., Gersh, B. J., Gilard, M., Hasdai, D., Hatala, R., Mahfoud, F., Masip, J., Muneretto, C., Prescott, E., Saraste, A., Storey, R. F., Svitil, P., Valgimigli, M., Windecker, S., Aboyans, V., Baigent, C., Collet, J. -P., Dean, V., Delgado, V., Fitzsimons, D., Gale, C. P., Grobbee, D. E., Halvorsen, S., Hindricks, G., Iung, B., Juni, P., Katus, H. A., Landmesser, U., Leclercq, C., Lettino, M., Lewis, B. S., Merkely, B., Mueller, C., Petersen, S., Petronio, A. S., Richter, D. J., Roffi, M., Shlyakhto, E., Simpson, I. A., Sousa-Uva, M., Touyz, R. M., Benkhedda, S., Metzler, B., Sujayeva, V., Cosyns, B., Kusljugic, Z., Velchev, V., Panayi, G., Kala, P., Haahr-Pedersen, S. A., Kabil, H., Ainla, T., Kaukonen, T., Cayla, G., Pagava, Z., Woehrle, J., Kanakakis, J., Toth, K., Gudnason, T., Peace, A., Aronson, D., Riccio, C., Elezi, S., Mirrakhimov, E., Hansone, S., Sarkis, A., Babarskiene, R., Beissel, J., Cassar Maempel, A. J., Revenco, V., de Grooth, G. J., Pejkov, H., Juliebo, V., Lipiec, P., Santos, J., Chioncel, O., Duplyakov, D., Bertelli, L., Dikic, A. D., Studencan, M., Bunc, M., Alfonso, F., Back, M., Zellweger, M., Addad, F., Yildirir, A., Sirenko, Y., and Clapp, B.

Subjects
anti-ischaemic drug, chronic coronary syndromes, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lipid-lowering drugs, Diagnostic Techniques, Cardiovascular, antithrombotic therapy, Disease, 030204 cardiovascular system & hematology, Guideline, Coronary artery disease, 0302 clinical medicine, Disease management (health), Societies, Medical, ComputingMilieux_MISCELLANEOUS, chronic coronary syndrome, angina pectori, Disease Management, food and beverages, imaging, risk assessment, Syndrome, 3. Good health, Natural history, Europe, Cardiology, Cardiology and Cardiovascular Medicine, coronary artery disease, medicine.medical_specialty, lifestyle modifications, anti-ischaemic drugs, Ischemia, 610 Medicine & health, vasospastic angina, Guidelines, Revascularization, diagnostic testing, 11171 Cardiocentro Ticino, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, angina pectoris, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, medicine, Journal Article, Humans, business.industry, screening, fungi, 030229 sport sciences, medicine.disease, lipid-lowering drug, Angina pectoris, Anti-ischaemic drugs, Antithrombotic therapy, Chronic coronary syndromes, Diagnostic testing, Imaging, Lifestyle modifications, Lipid-lowering drugs, Microvascular angina, Myocardial ischaemia, Myocardial revascularization, Risk assessment, Screening, Vasospastic angina, myocardial ischaemia, myocardial revascularization, Heart failure, microvascular angina, Chronic Disease, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, lifestyle modification, Coronary Artery Disease/diagnosis, business, Fibrinolytic agent
Abstract

Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

Published
2019

18. Management of myocardial revascularisation failure: an expert consensus document of the EAPCI

Author

Stefanini G. G., Alfonso F., Barbato E., Byrne R. A., Capodanno D., Colleran R., Escaned J., Giacoppo D., Kunadian V., Lansky A., Mehilli J., Neumann F. -J., Regazzoli D., Sanz-Sanchez J., Wijns W., Baumbach A., Vahanian A., Stefanini, G. G., Alfonso, F., Barbato, E., Byrne, R. A., Capodanno, D., Colleran, R., Escaned, J., Giacoppo, D., Kunadian, V., Lansky, A., Mehilli, J., Neumann, F. -J., Regazzoli, D., Sanz-Sanchez, J., Wijns, W., Baumbach, A., and Vahanian, A.

Subjects
medicine.medical_specialty, Percutaneous, Consensus, Bypass grafting, Stent thrombosi, Psychological intervention, MEDLINE, Multidisciplinary Heart Team, Consensu, Coronary Artery Disease, Coronary artery disease, Quality of life, medicine, Myocardial Revascularization, Humans, Intensive care medicine, Prior PCI, business.industry, Myocardial revascularisation, Expert consensus, Drug-Eluting Stents, medicine.disease, Treatment Outcome, Quality of Life, Saphenous vein graft, Cardiology and Cardiovascular Medicine, business, In-stent restenosi, Prior cardiovascular surgery, Human
Abstract

Myocardial revascularisation represents the most frequently performed therapeutic intervention worldwide. Current percutaneous and surgical revascularisation techniques provide excellent short- and long-term clinical outcomes. However, despite the technological and procedural advances with the widespread use of drug-eluting stents and arterial bypass grafts in contemporary practice, a considerable proportion of patients require repeat revascularisation procedures during long-term follow-up. The need for repeat revascularisation has a major impact on patients' quality of life and is associated with a significant economic burden. This consensus document summarises the views on the management of myocardial revascularisation failure of an expert panel of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). The present document provides a broad and pragmatic overview of the clinical management of myocardial revascularisation failure with a focus on the three key underlying mechanisms leading to repeat revascularisation: 1) failure of percutaneous coronary interventions, 2) failure of coronary artery bypass grafting, and 3) progression of coronary artery disease in native coronary segments previously untreated. The aim of the present position document is to provide a patient-oriented approach for the management of myocardial revascularisation failure.

Published
2020

22. Effect of post-procedural evidence-based therapy on 2-year prognosis after transcatheter mitral valve repair

Author

Hagnäs, M. J. (Magnus J.), Grasso, C. (Carmelo), Di Salvo, M. E. (Maria Elena), Sardone, A. (Andrea), Rapisarda, P. (Paola), Pelliccia, M. (Matteo), Dipasquale, F. (Francesco), Castania, G. (Giuseppe), Mangiafico, S. (Sarah), Capranzano, P. (Piera), Barbanti, M. (Marco), Denaro, A. (Alessandro), Scandura, S. (Salvatore), Mäkikallio, T. (Timo), Capodanno, D. (Davide), Tamburino, C. (Corrado), Hagnäs, M. J. (Magnus J.), Grasso, C. (Carmelo), Di Salvo, M. E. (Maria Elena), Sardone, A. (Andrea), Rapisarda, P. (Paola), Pelliccia, M. (Matteo), Dipasquale, F. (Francesco), Castania, G. (Giuseppe), Mangiafico, S. (Sarah), Capranzano, P. (Piera), Barbanti, M. (Marco), Denaro, A. (Alessandro), Scandura, S. (Salvatore), Mäkikallio, T. (Timo), Capodanno, D. (Davide), and Tamburino, C. (Corrado)

Published
2021

23. Genetic testing in patients undergoing percutaneous coronary intervention: rationale, evidence and practical recommendations

Author

Galli, Mattia, Franchi, Francesca, Rollini, F., Cavallari, L. H., Capodanno, D., Crea, Filippo, Angiolillo, D. J., Galli M., Franchi F., Crea F. (ORCID:0000-0001-9404-8846), Galli, Mattia, Franchi, Francesca, Rollini, F., Cavallari, L. H., Capodanno, D., Crea, Filippo, Angiolillo, D. J., Galli M., Franchi F., and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Introduction: Clopidogrel is the most frequently utilized P2Y12 inhibitor and is characterized by broad interindividual response variability resulting in impaired platelet inhibition and increased risk of thrombotic complications in a considerable number of patients. The potent P2Y12 inhibitors, prasugrel and ticagrelor, can overcome this limitation but at the expense of an increased risk of bleeding. Genetic variations of the cytochrome P450 (CYP) 2 C19 enzyme, a key determinant in clopidogrel metabolism, have been strongly associated with clopidogrel response profiles prompting investigations of genetic-guided selection of antiplatelet therapy. Areas covered: The present manuscript focuses on the rationale for the use of genetic testing to guide the selection of platelet P2Y12 inhibitors among patients undergoing percutaneous coronary intervention (PCI). Moreover, a comprehensive appraisal of the available evidence and practical recommendations is provided. Expert Commentary: Implementation of genetic testing as a strategy to guide the selection of therapy can result in escalation (i.e. switching to prasugrel or ticagrelor) or de-escalation (i.e. switching to clopidogrel) of P2Y12 inhibiting therapy. Most recent investigations support the clinical benefit of a genetic guided selection of antiplatelet therapy in patients undergo PCI. Integrating the results of genetic testing with clinical and procedural variables represents a promising strategy for a precision medicine approach for the selection of antiplatelet therapy among patients undergoing PCI.

Published
2021

24. Roadmap consensus on carotid artery plaque imaging and impact on therapy strategies and guidelines:An international, multispecialty, expert review and position statement

Author

Saba, L., Brinjikji, W., Spence, J. D., Wintermark, M., Castillo, M., Borst, G. J.D., Yang, Q., Yuan, C., Buckler, A., Edjlali, M., Saam, T., Saloner, D., Lal, B. K., Capodanno, D., Sun, J., Balu, N., Naylor, R., Lugt, A. V.D., Wasserman, B. A., Kooi, M. E., Wardlaw, J., Gillard, J., Lanzino, G., Hedin, U., Mikulis, D., Gupta, A., DeMarco, J. K., Hess, C., Goethem, J. V., Hatsukami, T., Rothwell, P., Brown, M. M., Moody, A. R., Saba, L., Brinjikji, W., Spence, J. D., Wintermark, M., Castillo, M., Borst, G. J.D., Yang, Q., Yuan, C., Buckler, A., Edjlali, M., Saam, T., Saloner, D., Lal, B. K., Capodanno, D., Sun, J., Balu, N., Naylor, R., Lugt, A. V.D., Wasserman, B. A., Kooi, M. E., Wardlaw, J., Gillard, J., Lanzino, G., Hedin, U., Mikulis, D., Gupta, A., DeMarco, J. K., Hess, C., Goethem, J. V., Hatsukami, T., Rothwell, P., Brown, M. M., and Moody, A. R.

Abstract

Current guidelines for primary and secondary prevention of stroke in patients with carotid atherosclerosis are based on the quantification of the degree of stenosis and symptom status. Recent publications have demonstrated that plaque morphology and composition, independent of the degree of stenosis, are important in the risk stratification of carotid atherosclerotic disease. This finding raises the question as to whether current guidelines are adequate or if they should be updated with new evidence, including imaging for plaque phenotyping, risk stratification, and clinical decision-making in addition to the degree of stenosis. To further this discussion, this roadmap consensus article defines the limits of luminal imaging and highlights the current evidence supporting the role of plaque imaging. Furthermore, we identify gaps in current knowledge and suggest steps to generate high-quality evidence, to add relevant information to guidelines currently based on the quantification of stenosis.

Published
2021

25. Safety and efficacy of P2Y12 inhibitor monotherapy in patients undergoing percutaneous coronary interventions

Author

Galli, M., Capodanno, D., Andreotti, Felicita, Crea, Filippo, Angiolillo, D. J., Andreotti F. (ORCID:0000-0002-1456-6430), Crea F. (ORCID:0000-0001-9404-8846), Galli, M., Capodanno, D., Andreotti, Felicita, Crea, Filippo, Angiolillo, D. J., Andreotti F. (ORCID:0000-0002-1456-6430), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Introduction: Antiplatelet therapy represents a key strategy for the prevention of thrombotic complications in patients with both acute and chronic coronary syndromes, particularly those undergoing percutaneous coronary intervention (PCI). Nevertheless, dual antiplatelet therapy (DAPT) is associated with a bleeding risk proportionate to its duration. Ever growing appreciation of the prognostic implications associated with bleeding and the development of safer stent platforms over the past years have led to a number of novel antiplatelet treatment strategies being tested among patients undergoing PCI. Areas covered: P2Y12 inhibitor monotherapy after ashort course DAPT has emerged as ableeding reduction strategy to mitigate such risk while still preventing thrombotic complications. In this review we describe the latest evidence regarding the safety and efficacy of P2Y12 inhibitor monotherapy in patients undergoing PCI in different clinical settings. Expert opinion: P2Y12 inhibitor monotherapy after a brief period of DAPT has emerged as an effective approach to reduce the risk of bleeding without any tradeoff in efficacy (i.e., thrombotic complications). This strategy has shown consistent findings in a number of different clinical settings of patients undergoing PCI. Nevertheless, unanswered questions on the ideal patient and the precise P2Y12 monotherapy regimen warrant further investigation.

Published
2021

26. Roadmap Consensus on Carotid Artery Plaque Imaging and Impact on Therapy Strategies and Guidelines: An International, Multispecialty, Expert Review and Position Statement

Author

Regenerative Medicine and Stem Cells, Brain, Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, CDL Nanomedicine, Saba, L., Brinjikji, W., Spence, J. D., Wintermark, M., Castillo, M., de Borst, G. J. D., Yang, Q., Yuan, C., Buckler, A., Edjlali, M., Saam, T., Saloner, D., Lal, B. K., Capodanno, D., Sun, J., Balu, N., Naylor, R., Lugt, A. V. D., Wasserman, B. A., Kooi, M. E., Wardlaw, J., Gillard, J., Lanzino, G., Hedin, U., Mikulis, D., Gupta, A., DeMarco, J. K., Hess, C., Goethem, J., V, Hatsukami, T., Rothwell, P., Brown, M. M., Moody, A. R., Regenerative Medicine and Stem Cells, Brain, Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, CDL Nanomedicine, Saba, L., Brinjikji, W., Spence, J. D., Wintermark, M., Castillo, M., de Borst, G. J. D., Yang, Q., Yuan, C., Buckler, A., Edjlali, M., Saam, T., Saloner, D., Lal, B. K., Capodanno, D., Sun, J., Balu, N., Naylor, R., Lugt, A. V. D., Wasserman, B. A., Kooi, M. E., Wardlaw, J., Gillard, J., Lanzino, G., Hedin, U., Mikulis, D., Gupta, A., DeMarco, J. K., Hess, C., Goethem, J., V, Hatsukami, T., Rothwell, P., Brown, M. M., and Moody, A. R.

Published
2021

28. A Multidisciplinary Approach on the Perioperative Antithrombotic Management of Patients With Coronary Stents Undergoing Surgery: Surgery After Stenting 2

Author

Rossini, R, Tarantini, G, Musumeci, G, Masiero, G, Barbato, E, Calabrò, P, Capodanno, D, Leonardi, S, Lettino, M, Limbruno, U, Menozzi, A, Marchese, U, Saia, F, Valgimigli, M, Ageno, W, Falanga, A, Corcione, A, Locatelli, A, Montorsi, M, Piazza, D, Stella, A, Bozzani, A, Parolari, A, Carone, R, Angiolillo, D, Rossini R, Tarantini G, Musumeci G, Masiero G, Barbato E, Calabrò P, Capodanno D, Leonardi S, Lettino M, Limbruno U, Menozzi A, Marchese UOA, Saia F, Valgimigli M, Ageno W, Falanga A, Corcione A, Locatelli A, Montorsi M, Piazza D, Stella A, Bozzani A, Parolari A, Carone R, Angiolillo DJ, Rossini, R, Tarantini, G, Musumeci, G, Masiero, G, Barbato, E, Calabrò, P, Capodanno, D, Leonardi, S, Lettino, M, Limbruno, U, Menozzi, A, Marchese, U, Saia, F, Valgimigli, M, Ageno, W, Falanga, A, Corcione, A, Locatelli, A, Montorsi, M, Piazza, D, Stella, A, Bozzani, A, Parolari, A, Carone, R, Angiolillo, D, Rossini R, Tarantini G, Musumeci G, Masiero G, Barbato E, Calabrò P, Capodanno D, Leonardi S, Lettino M, Limbruno U, Menozzi A, Marchese UOA, Saia F, Valgimigli M, Ageno W, Falanga A, Corcione A, Locatelli A, Montorsi M, Piazza D, Stella A, Bozzani A, Parolari A, Carone R, and Angiolillo DJ

Abstract

Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided. These observations underscore the need for a multidisciplinary collaboration among cardiologists, anesthesiologists, hematologists and surgeons to reach this goal. The present document is an update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents (Surgery After Stenting 2) in various types of surgery according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications. Cardiologists defined the thrombotic risk using a “combined ischemic risk” approach, while surgeons classified surgeries according to their inherent hemorrhagic risk. Finally, a multidisciplinary agreement on the most appropriate antithrombotic treatment regimen in the perioperative phase was reached for each surgical procedure.

Published
2018

29. Trial Design Principles for Patients at High Bleeding Risk Undergoing PCI: JACC Scientific Expert Panel

Author

Capodanno, D, Morice, MC, Angiolillo, DJ, Bhatt, DL, Byrne, RA, Colleran, R, Cuisset, T, Cutlip, D, Eerdmans, P, Eikelboom, J, Farb, A, Gibson, C M, Gregson, J, Haude, M, James, SK, Kim, HS, Kimura, T, Konishi, A, Leon, MB, Magee, PFA, Mitsutake, Y, Mylotte, Darren, Pocock, SJ, Rao, SV, Spitzer, Ernest, Stockbridge, N, Valgimigli, M, Varenne, O, Windhovel, U, Krucoff, MW, Urban, P, Mehran, R, and Cardiology

Subjects
Clinical Trials as Topic, Percutaneous Coronary Intervention, Outcome Assessment, Health Care, high bleeding risk, trial design, Humans, Hemorrhage
Abstract

Investigating the balance of risk for thrombotic and bleeding events after percutaneous coronary intervention (PCI) is especially relevant for patients at high bleeding risk (HBR). The Academic Research Consortium for HBR recently proposed a consensus definition in an effort to standardize the patient population included in HBR trials. The aim of this consensus-based document, the second initiative from the Academic Research Consortium for HBR, is to propose recommendations to guide the design of clinical trials of devices and drugs in HBR patients undergoing PCI. The authors discuss the designs of trials in HBR patients undergoing PCI and various aspects of trial design specific to HBR patients, including target populations, intervention and control groups, primary and secondary outcomes, and timing of endpoint reporting.

Published
2020

30. Derivation, Validation, and Prognostic Utility of a Prediction Rule for Nonresponse to Clopidogrel: The ABCD-GENE Score

Author

Angiolillo, D. J., Capodanno, D., Danchin, N., Simon, T., Bergmeijer, T. O., ten Berg, J. M., Sibbing, D., and Price, M. J.

Subjects
Male, Time Factors, Databases, Factual, Pharmacogenomic Variants, Myocardial Infarction, Drug Resistance, outcomes, Risk Assessment, genetic testing, Body Mass Index, Databases, Percutaneous Coronary Intervention, Predictive Value of Tests, Risk Factors, Clinical Decision Rules, Diabetes Mellitus, Humans, Obesity, Renal Insufficiency, Renal Insufficiency, Chronic, Chronic, Factual, Aged, Randomized Controlled Trials as Topic, clopidogrel, Coronary Thrombosis, Age Factors, Reproducibility of Results, Middle Aged, Cytochrome P-450 CYP2C19, Treatment Outcome, Purinergic P2Y Receptor Antagonists, Female, Platelet Aggregation Inhibitors
Published
2020

31. Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease: A comparative analysis from the Italian OBSERVANT study

Author

Barbanti, M, Buccheri, S, Capodanno, D, D'Errigo, P, Ranucci, M, Rosato, S, Santoro, G, Fusco, D, Tamburino, C, Biancari, F, Seccareccia, F, Appendix, I, Pisano, C, Ruvolo, G, and Nardi, P

Subjects
Male, Cardiac Catheterization, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Revascularization, Severity of Illness Index, TAVI, Transcatheter Aortic Valve Replacement, Coronary artery disease, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Aortic valve replacement, Internal medicine, 80 and over, medicine, Humans, Prospective Studies, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Coronary Artery Bypass, CABG, Aged, Aortic stenosis, PCI, SAVR, Aged, 80 and over, Aortic Valve Stenosis, Female, Heart Valve Prosthesis Implantation, Italy, Survival Rate, Treatment Outcome, business.industry, Percutaneous coronary intervention, medicine.disease, Settore MED/23, Stenosis, Concomitant, Conventional PCI, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Background To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

Published
2018

32. Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial

Author

Tomaniak, M. (Mariusz), Chichareon, P. (Ply), Klimczak-Tomaniak, D. (Dominika), Takahashi, K. (Kuniaki), Kogame, N. (Norihiro), Modolo, R. (Rodrigo), Wang, R. (Rutao), Ono, M. (Masafumi), Hara, H. (Hironori), Gao, C. (Chao), Kawashima, H. (Hideyuki), Rademaker-Havinga, T.A.M. (Tessa), Garg, S. (Scot), Curzen, N. (Nick), Haude, M. (Michael), Kochman, W. (Waclav), Gori, T. (Tommaso), Montalescot, G. (Gilles), Angiolillo, D.J. (Dominick J.), Capodanno, D. (Davide), Storey, D. (David), Hamm, C. (Christian), Vranckx, P. (Pascal), Valgimigli, M. (Marco), Windecker, S.W. (Stephan), Onuma, Y. (Yoshinobu), Serruys, P.W.J.C. (Patrick), Anderson, R. (Richard), Tomaniak, M. (Mariusz), Chichareon, P. (Ply), Klimczak-Tomaniak, D. (Dominika), Takahashi, K. (Kuniaki), Kogame, N. (Norihiro), Modolo, R. (Rodrigo), Wang, R. (Rutao), Ono, M. (Masafumi), Hara, H. (Hironori), Gao, C. (Chao), Kawashima, H. (Hideyuki), Rademaker-Havinga, T.A.M. (Tessa), Garg, S. (Scot), Curzen, N. (Nick), Haude, M. (Michael), Kochman, W. (Waclav), Gori, T. (Tommaso), Montalescot, G. (Gilles), Angiolillo, D.J. (Dominick J.), Capodanno, D. (Davide), Storey, D. (David), Hamm, C. (Christian), Vranckx, P. (Pascal), Valgimigli, M. (Marco), Windecker, S.W. (Stephan), Onuma, Y. (Yoshinobu), Serruys, P.W.J.C. (Patrick), and Anderson, R. (Richard)

Abstract

Background: Impaired renal function (IRF) is associated with increased risks of both ischemic and bleeding events. Ticagrelor has been shown to provide greater absolute reduction in ischemic risk following acute coronary syndrome (ACS) in those with versus without IRF. Methods: A pre-specified sub-analysis of the randomized GLOBAL LEADERS trial (n = 15,991) comparing the experimental strategy of 23-month ticagrelor monotherapy (after 1-month ticagrelor and aspirin dual anti-platelet therapy [DAPT]) with 12-month DAPT followed by 12-month aspirin after percutaneous coronary intervention (PCI) in ACS and stable coronary artery disease (CAD) patients stratified according to IRF (glomerular filtration rate < 60 ml/min/1.73 m2). Results: At 2 years, patients with IRF (n = 2171) had a higher rate of the primary endpoint (all-cause mortality or centrally adjudicated, new Q-wave myocardial infarction [MI](hazard ratio [HR] 1.64, 95% confidence interval [CI] 1.35–1.98, padj = 0.001), all-cause death, site-reported MI, all revascularization and BARC 3 or 5 type bleeding, compared with patients without IRF. Among patients with IRF, there were similar rates of the primary endpoint (HR 0.82, 95% CI 0.61–1.11, p = 0.192, pint = 0.680) and BARC 3 or 5 type bleeding (HR 1.10, 95% CI 0.71–1.71, p = 0.656, pint = 0.506) in the experimental versus the reference group. No significant interactions were seen between IRF and treatment effect for any of the secondary outcome variables. Among ACS patients with IRF, there were no between-group differences in the rates of the primary endpoint or BARC 3 or 5 type bleeding; however, the rates of the patient-oriented composite endpoint (POCE) of all-cause death, any stroke, MI, or revascularization (pint = 0.028) and net adverse clinical events (POCE and BARC 3 or 5 type bleeding) (pint = 0.045), were lower in the experimental versus the reference group. No treatment effects were found in stable CAD patients categorized according to presence of

Published
2020
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33. Defining device success for percutaneous coronary intervention trials

Author

Chang, C.C. (Chun Chin), Kogame, N. (Norihiro), Onuma, Y. (Yoshinobu), Byrne, R.A. (Robert), Capodanno, D. (Davide), Windecker, S.W. (Stephan), Morel, M.-A. (Marie-Angèle), Cutlip, D.E. (Donald), Krucoff, M. (Mitchell), Stone, G.W. (Gregg), Lansky, A.J. (Alexandra), Mehran, R. (Roxana), Spitzer, E. (Ernest), Fraser, A.G. (Andrew), Baumbach, A. (Andreas), Serruys, P.W.J.C. (Patrick), Chang, C.C. (Chun Chin), Kogame, N. (Norihiro), Onuma, Y. (Yoshinobu), Byrne, R.A. (Robert), Capodanno, D. (Davide), Windecker, S.W. (Stephan), Morel, M.-A. (Marie-Angèle), Cutlip, D.E. (Donald), Krucoff, M. (Mitchell), Stone, G.W. (Gregg), Lansky, A.J. (Alexandra), Mehran, R. (Roxana), Spitzer, E. (Ernest), Fraser, A.G. (Andrew), Baumbach, A. (Andreas), and Serruys, P.W.J.C. (Patrick)

Abstract

Percutaneous coronary intervention with implantation of drug-eluting stents has become the most commonly performed revascularisation procedure in patients with symptomatic coronary artery disease. Continuous iterations of coronary devices incorporating changes in platform materials, geometry, strut thickness, drug release mechanisms and antiproliferative drugs have progressively reduced the rate of device-related adverse clinical events. Objective performance criteria have been proposed for clinical and angiographic outcomes of drug-eluting stents. The rate of device success has been recognised as an intraprocedural endpoint to evaluate the mechanical ability to complete a procedure with the specific device assigned by protocol in randomised comparative trials. The European Commission and the U.S. Food and Drug Administration both provide guidance documents, including the mechanistic evaluation of coronary stents, which recommend operational definitions of device success. While the majority of clinical trials investigating drugeluting stents have adopted this endpoint definition, inconsistencies in application limit the reliability of comparisons across different trials reporting device success rates. In addition, it is not uncommon that device success rates are not reported by investigators. A consistent definition of device success is essential to allow scientific comparisons of this technical performance endpoint between devices across different trials. Therefore, we performed a systematic evaluation of definitions and reporting of device success in clinical trials. We propose an extended definition as well as considerations for approaching the determination of the device success rates in future percutaneous coronary intervention trials.

Published
2020
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34. Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial

Author

Tomaniak, Mariusz, Chichareon, P, Klimczak-Tomaniak, D, Takahashi, K, Kogame, N, Modolo, R, Wang, RT, Ono, M, Hara, H, Gao, C, Kawashima, H, Rademaker-Havinga, T, Garg, S, Curzen, N, Haude, M, Kochman, J, Gori, T, Montalescot, G, Angiolillo, DJ, Capodanno, D, Storey, RF, Hamm, C, Vranckx, P, Valgimigli, M, Windecker, S, Onuma, Y, Serruys, PWJC, Anderson, R, Tomaniak, Mariusz, Chichareon, P, Klimczak-Tomaniak, D, Takahashi, K, Kogame, N, Modolo, R, Wang, RT, Ono, M, Hara, H, Gao, C, Kawashima, H, Rademaker-Havinga, T, Garg, S, Curzen, N, Haude, M, Kochman, J, Gori, T, Montalescot, G, Angiolillo, DJ, Capodanno, D, Storey, RF, Hamm, C, Vranckx, P, Valgimigli, M, Windecker, S, Onuma, Y, Serruys, PWJC, and Anderson, R

Published
2020

35. Accuracy of the PARIS score and PCI complexity to predict ischemic events in patients treated with very thin stents in unprotected left main or coronary bifurcations

Author

Gallone, G., D'Ascenzo, F., Conrotto, F., Costa, F., Capodanno, D., Muscoli, S., Chieffo, A., Yoichi, I., Pennacchi, M., Quadri, G., Nunez-Gil, I., Bocchino, P. P., Piroli, F., De Filippo, O., Rolfo, C., Wojakowski, W., Trabattoni, D., Huczek, Z., Venuti, G., Montabone, A., Rognoni, A., Parma, R., Figini, F., Mitomo, S., Boccuzzi, G., Mattesini, A., Cerrato, E., Wanha, W., Smolka, G., Cortese, B., Ryan, N., Bo, M., di Mario, C., Varbella, F., Burzotta, F., Sheiban, I., Escaned, J., Helft, G., De Ferrari, G. M., D'Ascenzo F., di Mario C., Burzotta F. (ORCID:0000-0002-6569-9401), Gallone, G., D'Ascenzo, F., Conrotto, F., Costa, F., Capodanno, D., Muscoli, S., Chieffo, A., Yoichi, I., Pennacchi, M., Quadri, G., Nunez-Gil, I., Bocchino, P. P., Piroli, F., De Filippo, O., Rolfo, C., Wojakowski, W., Trabattoni, D., Huczek, Z., Venuti, G., Montabone, A., Rognoni, A., Parma, R., Figini, F., Mitomo, S., Boccuzzi, G., Mattesini, A., Cerrato, E., Wanha, W., Smolka, G., Cortese, B., Ryan, N., Bo, M., di Mario, C., Varbella, F., Burzotta, F., Sheiban, I., Escaned, J., Helft, G., De Ferrari, G. M., D'Ascenzo F., di Mario C., and Burzotta F. (ORCID:0000-0002-6569-9401)

Abstract

Background: The PARIS risk score (PARIS-rs) and percutaneous coronary intervention complexity (PCI-c) predict clinical and procedural residual ischemic risk following PCI. Their accuracy in patients undergoing unprotected left main (ULM) or bifurcation PCI has not been assessed. Methods: The predictive performances of the PARIS-rs (categorized as low, intermediate, and high) and PCI-c (according to guideline-endorsed criteria) were evaluated in 3,002 patients undergoing ULM/bifurcation PCI with very thin strut stents. Results: After 16 (12–22) months, increasing PARIS-rs (8.8% vs. 14.1% vs. 27.4%, p <.001) and PCI-c (15.2% vs. 11%, p =.025) were associated with higher rates of major adverse cardiac events ([MACE], a composite of death, myocardial infarction [MI], and target vessel revascularization), driven by MI/death for PARIS-rs and target lesion revascularization/stent thrombosis for PCI-c (area under the curves for MACE: PARIS-rs 0.60 vs. PCI-c 0.52, p-for-difference <.001). PCI-c accuracy for MACE was higher in low-clinical-risk patients; while PARIS-rs was more accurate in low-procedural-risk patients. ≥12-month dual antiplatelet therapy (DAPT) was associated with a lower MACE rate in high PARIS-rs patients, (adjusted-hazard ratio 0.42 [95% CI: 0.22–0.83], p =.012), with no benefit in low to intermediate PARIS-rs patients. No incremental benefit with longer DAPT was observed in complex PCI. Conclusions: In the setting of ULM/bifurcation PCI, the residual ischemic risk is better predicted by a clinical risk estimator than by PCI complexity, which rather appears to reflect stent/procedure-related events. Careful procedural risk estimation is warranted in patients at low clinical risk, where PCI complexity may substantially contribute to the overall residual ischemic risk.

Published
2020

36. Impact of Kissing Balloon in Patients Treated with Ultrathin Stents for Left Main Lesions and Bifurcations: An Analysis from the RAIN-CARDIOGROUP VII Study

Author

Gaido, L., D'Ascenzo, Francesca, Imori, Y., Wojakowski, W., Saglietto, A., Figini, F., Mattesini, A., Trabattoni, D., Rognoni, A., Tomassini, F., Bernardi, A., Ryan, N., Muscoli, S., Helft, G., De Filippo, O., Parma, R., De Luca, L., Ugo, F., Cerrato, E., Montefusco, A., Pennacchi, M., Wanha, W., Smolka, G., De Lio, G., Bruno, F., Huczek, Z., Boccuzzi, G., Cortese, B., Capodanno, D., Omede, P., Mancone, M., Nunez-Gil, I., Romeo, Fabio, Varbella, F., Rinaldi, M., Escaned, J., Conrotto, F., Burzotta, Francesco, Chieffo, A., Perl, L., D'Amico, M., Di Mario, Clara, Sheiban, I., Gagnor, A., Giammaria, M., De Ferrari, G. M., D'ascenzo F., Romeo F., Burzotta F. (ORCID:0000-0002-6569-9401), Di Mario C., Gaido, L., D'Ascenzo, Francesca, Imori, Y., Wojakowski, W., Saglietto, A., Figini, F., Mattesini, A., Trabattoni, D., Rognoni, A., Tomassini, F., Bernardi, A., Ryan, N., Muscoli, S., Helft, G., De Filippo, O., Parma, R., De Luca, L., Ugo, F., Cerrato, E., Montefusco, A., Pennacchi, M., Wanha, W., Smolka, G., De Lio, G., Bruno, F., Huczek, Z., Boccuzzi, G., Cortese, B., Capodanno, D., Omede, P., Mancone, M., Nunez-Gil, I., Romeo, Fabio, Varbella, F., Rinaldi, M., Escaned, J., Conrotto, F., Burzotta, Francesco, Chieffo, A., Perl, L., D'Amico, M., Di Mario, Clara, Sheiban, I., Gagnor, A., Giammaria, M., De Ferrari, G. M., D'ascenzo F., Romeo F., Burzotta F. (ORCID:0000-0002-6569-9401), and Di Mario C.

Abstract

Background: There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. Methods: All patients undergoing left main or bifurcations percutaneous coronary intervention enrolled in the RAIN registry (Very Thin Stents for Patients With MAIN or BiF in Real Life: The RAIN, a Multicenter Study) evaluating ultrathin stents were included. Major adverse cardiac event (a composite of all-cause death, myocardial infarction, target lesion revascularization, and stent thrombosis) was the primary end point, while its components, along with target vessel revascularization, were the secondary end points. The main analysis was performed comparing patients with and without FKI after adjustment with inverse probability of treatment weighting. Subgroup analyses were performed according to FKI (short [<3 mm] versus long overlap), strategy (provisional versus 2-stent), routine versus bail-out FKI, and the use of imaging and proximal optimization technique. Results: Two thousand seven hundred forty-two patients were included. At 16 months (8-20) follow-up, inverse probability of treatment weighting adjusted rates of major adverse cardiac event were similar between FKI and no-FKI group (15.1% versus 15.5%; P=0.967), this result did not change with use of imaging, proximal optimization technique, or routine versus bail-out FKI. In the 2-stent subgroup, FKI was associated with lower rates of target vessel revascularization (7.8% versus 15.9%; P=0.030) and target lesion revascularization (7.3% versus 15.2%; P=0.032). Short overlap FKI was associated with a lower rate of target lesion revascularization compared with no FKI (2.6% versus 5.4%; P=0.034), while long overlap was not (6.8% versus 5.4%; P=0.567). Conclusions: In patients with bifurcations or unprotected left main treated with ultrathin stents, short overlap FKI is associated with less restenosis. In a 2-st

Published
2020

37. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

Author

Raber, L., Mintz, G. S., Koskinas, K. C., Johnson, T. W., Holm, N. R., Onuma, Y., Radu, M. D., Joner, M., Yu, B., Jia, H., Meneveau, N., De La Torre Hernandez, J. M., Escaned, J., Hill, J., Prati, F., Colombo, A., Di Mario, C., Regar, E., Capodanno, D., Wijns, W., Byrne, R. A., Guagliumi, G., Alfonso, F., Bhindi, R., Ali, Z., Carter, R., University of Zurich, Guagliumi, Giulio, and Cardiology

Subjects
Percutaneous, medicine.medical_treatment, Psychological intervention, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary Angiography, Graft Occlusion, Coronary artery disease, Postoperative Complications, 0302 clinical medicine, Restenosis, Intravascular ultrasound, Percutaneous coronary intervention (PCI), 030212 general & internal medicine, Tomography, Ultrasonography, Interventional, medicine.diagnostic_test, Graft Occlusion, Vascular, Prosthesis Failure, Treatment Outcome, surgical procedures, operative, Stents, Cardiology and Cardiovascular Medicine, Tomography, Optical Coherence, medicine.medical_specialty, Consensus, 610 Medicine & health, 2705 Cardiology and Cardiovascular Medicine, 03 medical and health sciences, Percutaneous Coronary Intervention, Vascular, Medical imaging, medicine, Humans, Medical physics, cardiovascular diseases, Ultrasonography, Interventional, Optical coherence tomography, business.industry, Percutaneous coronary intervention, Stent, Intracoronary imaging, equipment and supplies, medicine.disease, 10020 Clinic for Cardiac Surgery, Optical Coherence, Conventional PCI, business
Abstract

This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

Published
2018

38. Residual mitral regurgitation impact on outcomes after mitraclip therapy: five-year follow-up from the GRASP registry

Author

Caggegi, AM, primary, Capranzano, P, additional, Scandura, S, additional, Mangiafico, S, additional, Castania, G, additional, Salerno, T, additional, Milici, A, additional, De Sanctis, J, additional, Bentivegna, A, additional, Frazzetto, M, additional, Sardone, A, additional, Di Salvo, ME, additional, Grasso, C, additional, Capodanno, D, additional, and Tamburino, C, additional

Published
2021
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40. Incidence, mechanisms and clinical impact of largely uncovered struts in current generation drug-eluting-stents: insight from the TRANSFORM-OCT Study

Author

Bernelli, C, primary, Pellegrini, D, additional, Pescetelli, I, additional, Garbo, R, additional, Sirbu, V, additional, Fiocca, L, additional, Canova, P, additional, Colombo, F, additional, Cereda, A, additional, Boccuzzi, G, additional, Rodriguez Pereira, G.T, additional, Bezerra, H, additional, Saia, F, additional, Capodanno, D, additional, and Guagliumi, G, additional

Published
2020
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41. Aspirin Desensitization in Patients with Coronary Artery Disease

Author

Rossini, R, Iorio, A, Pozzi, R, Bianco, M, Musumeci, G, Leonardi, S, Lettieri, C, Bossi, I, Colombo, P, Rigattieri, S, Dossena, C, Anzuini, A, Capodanno, D, Senni, M, Angiolillo, D, Rossini R, Iorio A, Pozzi R, Bianco M, Musumeci G, Leonardi S, Lettieri C, Bossi I, Colombo P, Rigattieri S, Dossena C, Anzuini A, Capodanno D, Senni M, Angiolillo DJ, Rossini, R, Iorio, A, Pozzi, R, Bianco, M, Musumeci, G, Leonardi, S, Lettieri, C, Bossi, I, Colombo, P, Rigattieri, S, Dossena, C, Anzuini, A, Capodanno, D, Senni, M, Angiolillo, D, Rossini R, Iorio A, Pozzi R, Bianco M, Musumeci G, Leonardi S, Lettieri C, Bossi I, Colombo P, Rigattieri S, Dossena C, Anzuini A, Capodanno D, Senni M, and Angiolillo DJ

Abstract

Background - There are limited data on aspirin (ASA) desensitization for patients with coronary artery disease. The aim of the present study was to assess the safety and efficacy of a standard rapid desensitization protocol in patients with ASA sensitivity undergoing coronary angiography. Methods and Results - This is a prospective, multicenter, observational study including 7 Italian centers including patients with a history of ASA sensitivity undergoing coronary angiography with intent to undergo percutaneous coronary intervention. A total of 330 patients with history of ASA sensitivity with known/suspected stable coronary artery disease or presenting with an acute coronary syndrome, including ST-segment-elevation myocardial infarction were enrolled. Adverse effects to aspirin included urticaria (n=177, 53.6%), angioedema (n=69, 20.9%), asthma (n=65, 19.7%), and anaphylactic reaction (n=19, 5.8%). Among patients with urticaria/angioedema, 13 patients (3.9%) had a history of idiopathic chronic urticaria. All patients underwent a rapid ASA (5.5 hours) desensitization procedure. The desensitization procedure was performed before cardiac catheterization in all patients, except for those (n=78, 23.6%) presenting with ST-segment-elevation myocardial infarction who underwent the desensitization after primary percutaneous coronary intervention. Percutaneous coronary intervention was performed in 235 patients (71%) of the overall study population. The desensitization procedure was successful in 315 patients (95.4%) and in all patients with a history of anaphylactic reaction. Among the 15 patients (4.6%) who did not successfully respond to the desensitization protocol, adverse reactions were minor and responded to treatment with corticosteroids and antihistamines. Among patients with successful in-hospital ASA desensitization, 253 patients (80.3%) continued ASA for at least 12 months. Discontinuation of ASA in the 62 patients (19.7%) who had responded to the desensitization

Published
2017

42. Stroke After Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention: Incidence, Pathogenesis, and Outcomes

Author

Gaudino, M., Angiolillo, D.J. (Dominick), Di Franco, A., Capodanno, D. (Davide), Bakaeen, F., Farkouh, M.E., Fremes, S.E., Holmes, D., Girardi, L.N., Nakamura, S, Head, S.J. (Stuart), Park, S.-J. (Seung-Jung), Mack, M, Serruys, P.W.J.C. (Patrick), Ruel, M. (Marc), Stone, G.W. (Gregg), Tam, D.Y., Vallely, M., Taggart, D.P. (David), Gaudino, M., Angiolillo, D.J. (Dominick), Di Franco, A., Capodanno, D. (Davide), Bakaeen, F., Farkouh, M.E., Fremes, S.E., Holmes, D., Girardi, L.N., Nakamura, S, Head, S.J. (Stuart), Park, S.-J. (Seung-Jung), Mack, M, Serruys, P.W.J.C. (Patrick), Ruel, M. (Marc), Stone, G.W. (Gregg), Tam, D.Y., Vallely, M., and Taggart, D.P. (David)

Published
2019
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43. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk

Author

Urban, P. (Philip), Mehran, R. (Roxana), Colleran, R., Angiolillo, D.J. (Dominick), Byrne, R.A. (Robert), Capodanno, D. (Davide), Cuisset, T, Cutlip, D., Eerdmans, P. (Pedro), Eikelboom, J., Farb, A. (Andrew), Gibson, C. M., Gregson, J, Haude, M. (Michael), James, S.K. (Stefan), Kim, H-S. (Hyo-Soo), Kimura, T. (Takeshi), Konishi, A., Laschinger, J., Leon, M.B. (Martin), Magee, P.A., Mitsutake, Y., Mylotte, D.M. (Darren), Ls, S.P., Price, MJ, Rao, SV, Spitzer, E, Stockbridge, N., Valgimigli, M. (Marco), Varenne, O. (Olivier), Windhoevel, U., Yeh, R.W., Krucoff, M. (Mitchell), Morice, M-C. (Marie-Claude), Urban, P. (Philip), Mehran, R. (Roxana), Colleran, R., Angiolillo, D.J. (Dominick), Byrne, R.A. (Robert), Capodanno, D. (Davide), Cuisset, T, Cutlip, D., Eerdmans, P. (Pedro), Eikelboom, J., Farb, A. (Andrew), Gibson, C. M., Gregson, J, Haude, M. (Michael), James, S.K. (Stefan), Kim, H-S. (Hyo-Soo), Kimura, T. (Takeshi), Konishi, A., Laschinger, J., Leon, M.B. (Martin), Magee, P.A., Mitsutake, Y., Mylotte, D.M. (Darren), Ls, S.P., Price, MJ, Rao, SV, Spitzer, E, Stockbridge, N., Valgimigli, M. (Marco), Varenne, O. (Olivier), Windhoevel, U., Yeh, R.W., Krucoff, M. (Mitchell), and Morice, M-C. (Marie-Claude)

Abstract

Identification and management of patients at high bleeding risk undergoing percutaneous coronary intervention are of major importance, but a lack of standardization in defining this population limits trial design, data interpretation, and clinical decision-making. The Academic Research Consortium for High Bleeding Risk (ARC-HBR) is a collaboration among leading research organizations, regulatory authorities, and physician-scientists from the United States, Asia, and Europe focusing on percutaneous coronary intervention–related bleeding. Two meetings of the 31-member consortium were held in Washington, DC, in April 2018 and in Paris, France, in October 2018. These meetings were organized by the Cardiovascular European Research Center on behalf of the ARC-HBR group and included representatives of the US Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, as well as observers from the pharmaceutical and medical device industries. A consensus definition of patients at high bleeding risk was developed that was based on review of the available evidence. The definition is intended to provide consistency in defining this population for clinical trials and to complement clinical decision-making and regulatory review. The proposed ARC-HBR consensus document represents the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients undergoing percutaneous coronary intervention.

Published
2019
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44. Stroke After Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention: Incidence, Pathogenesis, and Outcomes

Author

Gaudino, M, Angiolillo, DJ, Di Franco, A, Capodanno, D, Bakaeen, F, Farkouh, ME, Fremes, SE, Holmes, D, Girardi, LN, Nakamura, S, Head, Stuart, Park, SJ, Mack, M, Serruys, PWJC, Ruel, M, Stone, GW, Tam, DY, Vallely, M, Taggart, DP, Gaudino, M, Angiolillo, DJ, Di Franco, A, Capodanno, D, Bakaeen, F, Farkouh, ME, Fremes, SE, Holmes, D, Girardi, LN, Nakamura, S, Head, Stuart, Park, SJ, Mack, M, Serruys, PWJC, Ruel, M, Stone, GW, Tam, DY, Vallely, M, and Taggart, DP

Published
2019

45. Defining high bleeding risk in patients undergoing percutaneous coronary intervention: a consensus document from the Academic Research Consortium for High Bleeding Risk

Author

Urban, P, Mehran, R, Colleran, R, Angiolillo, DJ, Byrne, RA, Capodanno, D, Cuisset, T, Cutlip, D, Eerdmans, P, Eikelboom, J, Farb, A, Gibson, C M, Gregson, J, Haude, M, James, SK, Kim, HS, Kimura, T, Konishi, A, Laschinger, J, Leon, MB, Magee, PA, Mitsutake, Y, Mylotte, Darren, Ls, SP, Price, MJ, Rao, SV, Spitzer, Ernest, Stockbridge, N, Valgimigli, M (Marco), Varenne, O, Windhoevel, U, Yeh, RW, Krucoff, MW, Morice, MC, Urban, P, Mehran, R, Colleran, R, Angiolillo, DJ, Byrne, RA, Capodanno, D, Cuisset, T, Cutlip, D, Eerdmans, P, Eikelboom, J, Farb, A, Gibson, C M, Gregson, J, Haude, M, James, SK, Kim, HS, Kimura, T, Konishi, A, Laschinger, J, Leon, MB, Magee, PA, Mitsutake, Y, Mylotte, Darren, Ls, SP, Price, MJ, Rao, SV, Spitzer, Ernest, Stockbridge, N, Valgimigli, M (Marco), Varenne, O, Windhoevel, U, Yeh, RW, Krucoff, MW, and Morice, MC

Published
2019

46. A Multidisciplinary Approach on the Perioperative Antithrombotic Management of Patients With Coronary Stents Undergoing Surgery: Surgery After Stenting 2

Author

Rossini, R., Tarantini, G., Musumeci, G., Masiero, G., Barbato, E., Calabro, P., Capodanno, D., Leonardi, S., Lettino, M., Limbruno, U., Menozzi, A., Marchese, U. O. A., Saia, F., Valgimigli, M., Ageno, W., Falanga, A., Corcione, A., Locatelli, A., Montorsi, M., Piazza, D., Stella, A., Bozzani, A., Parolari, A., Carone, R., Angiolillo, D. J., Rossini, Roberta, Tarantini, Giuseppe, Musumeci, Giuseppe, Masiero, Giulia, Barbato, Emanuele, Calabrò, Paolo, Capodanno, Davide, Leonardi, Sergio, Lettino, Maddalena, Limbruno, Ugo, Menozzi, Alberto, Marchese, U. O. Alfredo, Saia, Francesco, Valgimigli, Marco, Ageno, Walter, Falanga, Anna, Corcione, Antonio, Locatelli, Alessandro, Montorsi, Marco, Piazza, Diego, Stella, Andrea, Bozzani, Antonio, Parolari, Alessandro, Carone, Roberto, Angiolillo, Dominick J., Rossini, R, Tarantini, G, Musumeci, G, Masiero, G, Barbato, E, Calabrò, P, Capodanno, D, Leonardi, S, Lettino, M, Limbruno, U, Menozzi, A, Marchese, U, Saia, F, Valgimigli, M, Ageno, W, Falanga, A, Corcione, A, Locatelli, A, Montorsi, M, Piazza, D, Stella, A, Bozzani, A, Parolari, A, Carone, R, and Angiolillo, D

Subjects
Time Factors, Clinical Decision-Making, Blood Loss, Surgical, Coronary Artery Disease, Postoperative Hemorrhage, Coronary Angiography, anticoagulant therapy, antiplatelet therapy, atrial fibrillation, bleeding, stent, surgery, thrombosis, Cardiology and Cardiovascular Medicine, Risk Assessment, Drug Administration Schedule, Perioperative Care, Percutaneous Coronary Intervention, Fibrinolytic Agents, Risk Factors, thrombosi, Humans, Patient Care Team, Coronary Thrombosis, Anticoagulants, Treatment Outcome, Surgical Procedures, Operative, Stents, Platelet Aggregation Inhibitors
Abstract

Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided. These observations underscore the need for a multidisciplinary collaboration among cardiologists, anesthesiologists, hematologists and surgeons to reach this goal. The present document is an update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents (Surgery After Stenting 2) in various types of surgery according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications. Cardiologists defined the thrombotic risk using a "combined ischemic risk" approach, while surgeons classified surgeries according to their inherent hemorrhagic risk. Finally, a multidisciplinary agreement on the most appropriate antithrombotic treatment regimen in the perioperative phase was reached for each surgical procedure. (C) 2018 by the American College of Cardiology Foundation.

Published
2017

47. Early P2Y12 Inhibitors Escalation in Primary PCI Patients: Insights from the RENOVAMI Registry

Author

Lupi, A. Bona, R.D. Meliga, E. Capodanno, D. Schaffer, A. Bongo, A.S. Gaudio, G. Guasti, L. Alexopoulos, D. Valgimigli, M. Porto, I.

Subjects
cardiovascular diseases
Abstract

Background Early escalation from clopidogrel to new generation P2Y12 inhibitors is common practice in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Real-world data about this strategy, however, are limited. Methods From 2012 to 2015, 1,057 consecutive STEMI patients treated with pPCI in an Italian hub-and-spoke network were prospectively included in an observational registry (RENOVAMI, ClinicalTrials.gov Identifier: NCT01760382). We compared the prevalence, predictive factors and in-hospital outcomes of patients escalated to a new generation P2Y12 inhibitor within the first 24 hours from pPCI with those continuing on admission antiplatelet therapy. Results In the first 24 hours after pPCI, 165 patients (15.6%) were escalated from clopidogrel to a new generation P2Y12 inhibitor, while de-escalation to clopidogrel was occasional (19 patients, 1.8%) and switch between new generation P2Y12 inhibitors was rare (8 patients, 0.8%, all from ticagrelor to prasugrel). Drug eluting stent use (adjusted odds ratio [OR], 2.19, 95% confidence interval [CI], 1.55-3.08, p = 0.0002) and impaired renal function (adjusted OR, 0.19, 95% CI, 0.05-0.77, p = 0.02) were the only independent predictive factors for the decision to escalate. After adjustment for potential confounders, escalation did not predict in-hospital outcomes, whereas the overall use of new generation P2Y12 inhibitors was correlated with a better in-hospital survival (adjusted hazard ratio, 0.47, 95% CI, 0.25-0.91, p = 0.03). Moreover, escalation did not influence bleeding rates. Conclusions In this prospective registry of STEMI patients treated with pPCI and contemporary antiplatelet therapy, early escalation to a new generation P2Y12 inhibitor appeared safe and did not significantly affect in-hospital bleeding rates. © 2018 Schattauer.

Published
2018

48. Transcatheter or surgical treatment of severe aortic stenosis and coronary artery disease:a comparative analysis from the Italian OBSERVANT study

Author

Barbanti, M. (Marco), Buccheri, S. (Sergio), Capodanno, D. (Davide), D'Errigo, P. (Paola), Ranucci, M. (Marco), Rosato, S. (Stefano), Santoro, G. (Gennaro), Fusco, D. (Danilo), Tamburino, C. (Corrado), Biancari, F. (Fausto), Seccareccia, F. (Fulvia), and O. R. (OBSERVANT Research Group)

Subjects
TAVI, aortic stenosis, PCI, cardiovascular diseases, SAVR, CABG, coronary artery disease
Abstract

Background: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). Methods: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session. Results: After propensity-score matching, a total of 472 patients (236 per group) were identified. Among TAVI patients, PCI was performed prior to the procedure in 217 patients (92.0%), whereas concomitant TAVI and PCI were performed in 19 patients (8.0%). At 3-year, there was no difference in survival between the two groups (KM estimate of freedom from death for SAVR and TAVI patients of 0.742 and 0.650, respectively; log-rank p-value of 0.105). The rate of MACCE was comparable between the two groups (KM estimate of freedom from MACCE for SAVR and TAVI patients of 0.683 and 0.582, respectively; log-rank p-value of 0.115). Conclusions: In patients with associated severe AS and CAD, percutaneous treatment (TAVR and staged or concomitant PCI) was comparable to surgical treatment (SAVR and concomitant CABG) with respect to the early and mid-term risk of death from any cause, myocardial infarction, stroke and unplanned revascularization.

Published
2018

49. P972A subgroup analysis from the RAIN-CARDIOGROUP VII study: incidence of adverse events after DAPT cessation in patients treated with ultrathin stents in ULM or coronary bifurcations

Author

Abdirashid, M, primary, D'Ascenzo, F, additional, Helft, G, additional, Boccuzzi, G, additional, Capodanno, D, additional, Giustetto, C, additional, Muscoli, S, additional, Wojakowski, W, additional, Wanha, W, additional, Protasiewicz, M, additional, Smolka, G, additional, Huczek, Z, additional, Kuliczowki, W, additional, Chieffo, A, additional, and Rinaldi, M, additional

Published
2019
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