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Start Over Author "Romanello, Mattia" Topic percutaneous coronary intervention
3 results on '"Romanello, Mattia"'

1. Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease: A meta-analysis of 6 randomized trials and 4,686 patients.

Author

Palmerini T, Serruys P, Kappetein AP, Genereux P, Riva DD, Reggiani LB, Christiansen EH, Holm NR, Thuesen L, Makikallio T, Morice MC, Ahn JM, Park SJ, Thiele H, Boudriot E, Sabatino M, Romanello M, Biondi-Zoccai G, Cavalcante R, Sabik JF, and Stone GW

Subjects
Cause of Death trends, Coronary Artery Disease mortality, Global Health, Humans, Incidence, Survival Rate trends, Coronary Artery Bypass methods, Coronary Artery Disease surgery, Drug-Eluting Stents, Percutaneous Coronary Intervention methods, Postoperative Complications epidemiology, Randomized Controlled Trials as Topic
Abstract

Some but not all randomized controlled trials (RCT) have suggested that percutaneous coronary intervention (PCI) with drug-eluting stents may be an acceptable alternative to coronary artery bypass grafting (CABG) surgery for the treatment of unprotected left main coronary artery disease (ULMCAD). We therefore aimed to compare the risk of all-cause mortality between PCI and CABG in patients with ULMCAD in a pairwise meta-analysis of RCT., Methods: Randomized controlled trials comparing PCI vs CABG for the treatment of ULMCAD were searched through MEDLINE, EMBASE, Cochrane databases, and proceedings of international meetings., Results: Six trials including 4,686 randomized patients were identified. After a median follow-up of 39 months, there were no significant differences between PCI vs CABG in the risk of all-cause mortality (hazard ratio [HR] 0.99, 95% CI 0.76-1.30) or cardiac mortality. However, a significant interaction for cardiac mortality (P interaction = .03) was apparent between randomization arm and SYNTAX score, such that the relative risk for mortality tended to be lower with PCI compared with CABG among patients in the lower SYNTAX score tertile, similar in the intermediate tertile, and higher in the upper SYNTAX score tertile. Percutaneous coronary intervention compared with CABG was associated with a similar long-term composite risk of death, myocardial infarction, or stroke (HR 1.06, 95% CI 0.82-1.37), with fewer events within 30 days after PCI offset by fewer events after 30 days with CABG (P interaction < .0001). Percutaneous coronary intervention was associated with greater rates of unplanned revascularization compared with CABG (HR 1.74, 95% CI 1.47-2.07)., Conclusions: In patients undergoing revascularization for ULMCAD, PCI was associated with similar rates of mortality compared with CABG at a median follow-up of 39 months, but with an interaction effect suggesting relatively lower mortality with PCI in patients with low SYNTAX score and relatively lower mortality with CABG in patients with high SYNTAX score. Both procedures resulted in similar long-term composite rates of death, myocardial infarction, or stroke, with PCI offering an early safety advantage and CABG demonstrating greater durability., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Published
2017
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2. [Contrast-induced acute kidney injury in cardiology].

Author

Genovesi E, Romanello M, and De Caterina R

Subjects
Acute Kidney Injury physiopathology, Acute Kidney Injury prevention & control, Contrast Media administration & dosage, Hospitalization statistics & numerical data, Humans, Incidence, Oxidative Stress, Percutaneous Coronary Intervention methods, Risk Factors, Acute Kidney Injury chemically induced, Contrast Media adverse effects, Percutaneous Coronary Intervention adverse effects
Abstract

The intravascular administration of contrast media is an important tool in cardiovascular imaging, especially in percutaneous coronary interventions (PCI). Owing to the widespread use of these procedures, contrast-induced acute kidney injury (CI-AKI) has become one of the most common types of acute renal failures. CI-AKI is mainly mediated by mechanisms of oxidative damage, and its onset is associated with prolonged hospitalization and significant morbidity and mortality. Preexisting chronic kidney disease, diabetes, age, heart failure, and characteristics related to the procedure (primary or elective PCI, type and amount of contrast medium) are the most important risk factors for the development of post-PCI CI-AKI.For this serious complication, prevention is more important than treatment, and various preventive measures have been widely tested in recent years. However, none of the strategies so far evaluated, with the exception of pre-procedural hydration with isotonic saline, has been shown to effectively prevent CI-AKI in randomized trials in large populations. In this review, we discuss the incidence, risk factors, main pathogenetic mechanisms and current strategies for the prevention of CI-AKI.

Published
2016
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3. Bleeding-Related Deaths in Relation to the Duration of Dual-Antiplatelet Therapy After Coronary Stenting

Author

Abdourahmane Diallo, Bo Xu, Giuseppe Biondi-Zoccai, Seung-Jung Park, Jung-Min Ahn, Philippe Généreux, Gregg W. Stone, Yaling Han, Gilles Montalescot, Hyo-Soo Kim, Stefanie Schüpke, Diego Della Riva, Alexandre Abizaid, Deepak L. Bhatt, Adnan Kastrati, Philippe Gabriel Steg, Martine Gilard, Letizia Bacchi Reggiani, Marco Valgimigli, Yangsoo Jang, Marie Claude Morice, Tullio Palmerini, Myeong Ki Hong, Mattia Romanello, Eric Vicaut, Alaide Chieffo, Gérard Helft, Antonio Colombo, Byeong Keuk Kim, Kyung Woo Park, Fausto Feres, Palmerini, Tullio, Bacchi Reggiani, Letizia, Della Riva, Diego, Romanello, Mattia, Feres, Fausto, Abizaid, Alexandre, Gilard, Martine, Morice, Marie-Claude, Valgimigli, Marco, Hong, Myeong-Ki, Kim, Byeong-Keuk, Jang, Yangsoo, Kim, Hyo-Soo, Park, Kyung Woo, Colombo, Antonio, Chieffo, Alaide, Ahn, Jung-Min, Park, Seung-Jung, Schüpke, Stefanie, Kastrati, Adnan, Montalescot, Gille, Steg, Philippe Gabriel, Diallo, Abdourahmane, Vicaut, Eric, Helft, Gerard, Biondi-Zoccai, Giuseppe, Xu, Bo, Han, Yaling, Genereux, Philippe, Bhatt, Deepak L., Stone, Gregg W, Morice, Marie claude, Hong, Myeong ki, Kim, Byeong keuk, Kim, Hyo soo, Ahn, Jung min, Park, Seung jung, Schã¼pke, Stefanie, Biondi zoccai, Giuseppe, Stone, Gregg W., University of Bologna/Università di Bologna, Instituto de Cardiologia Dante Pazzanese (IDPC), Université de Brest (UBO), Institut Cardiovasculaire Paris Sud [Massy] (ICPS), Inselspital Bern, Yonsei University, Seoul National University [Seoul] (SNU), IRCCS San Raffaele Scientific Institute [Milan, Italie], University of Ulsan, Deutsches Zentrum für Herz-Kreislauf-Forschung partner site, Munich Heart Alliance, German Heart Center = Deutsches Herzzentrum München [Munich, Germany] (GHC), Institut de cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Service de cardiologie [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot, Sorbonne Paris Cité, Unité de Recherche Clinique (Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [APHP]), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Fuwai Hospital of Chinese Academy of Medical Sciences [Beijing, China] (FH-CAMS), General Hospital of Shenyang Military Region [Shenyang, China] (GH-SMR), New York Presbyterian Hospital, Columbia University Medical Center (CUMC), Columbia University [New York], Brigham and Women’s Hospital [Boston, MA], Harvard Medical School [Boston] (HMS), and Lesnik, Philippe

Subjects
medicine.medical_specialty, Multivariate analysis, animal structures, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, MEDLINE, Hemorrhage, 030204 cardiovascular system & hematology, Lower risk, law.invention, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Drug-Eluting Stent, drug-eluting stent, dual antiplatelet therapy, 030212 general & internal medicine, dual antiplatelet therapy, mortality, drug-eluting stents, hemorrhage, humans, percutaneous coronary intervention, platelet aggregation inhibitors, postoperative complications, randomized controlled trials as topic, cardiology and cardiovascular medicine, education, Randomized Controlled Trials as Topic, education.field_of_study, business.industry, Platelet Aggregation Inhibitor, Hazard ratio, Confidence interval, Surgery, [SDV] Life Sciences [q-bio], Drug-eluting stent, Postoperative Complication, business, Cardiology and Cardiovascular Medicine, Human
Abstract

Background Although some randomized controlled trials (RCTs) and meta-analyses have suggested that prolonged dual-antiplatelet therapy (DAPT) may be associated with increased mortality, the mechanistic underpinnings of this association remain unclear. Objectives The aim of this study was to analyze the associations among bleeding, mortality, and DAPT duration after drug-eluting stent implantation in a meta-analysis of RCTs. Methods RCTs comparing different DAPT durations after drug-eluting stent placement were sought through the MEDLINE, Embase, and Cochrane databases and the proceedings of international meetings. Deaths were considered possibly bleeding related if occurring within 1 year of the episodes of bleeding. Primary analysis was by intention-to-treat. Secondary analysis was performed in a modified intention-to-treat population in which events occurring when all patients were on DAPT were excluded. Results Individual patient data were obtained for 6 RCTs, and aggregate data were available for 12 RCTs. Patients with bleeding had significantly higher rates of mortality compared with those without, and in a time-adjusted multivariate analysis, bleeding was an independent predictor of mortality occurring within 1 year of the bleeding episode (hazard ratio: 6.93; 95% confidence interval: 4.53 to 10.60; p< 0.0001). Shorter DAPT was associated with lower rates of all-cause death compared with longer DAPT (hazard ratio: 0.85; 95% confidence interval: 0.73 to 1.00; p= 0.05), which was driven by lower rates of bleeding-related deaths with shorter DAPT compared with prolonged DAPT (hazard ratio: 0.65; 95% confidence interval: 0.43 to 0.99; p= 0.04). Mortality unrelated to bleeding was comparable between the 2groups. Similar results were apparent in the modified intention-to-treat population. Conclusions Bleeding was strongly associated with the occurrence of mortality within 1 year after the bleeding event. Shorter compared with longer DAPT was associated with lower risk for bleeding-related death, a finding that mayunderlie the lower all-cause mortality with shorter DAPT in the RCTs of different DAPT durations after DES.

Published
2017

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