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53. Impact of baseline kidney function on the effects of sodium‐glucose co‐transporter‐2 inhibitors on kidney and heart failure outcomes: A systematic review and meta‐analysis of randomized controlled trials.

Author

Maddaloni, Ernesto, Cavallari, Ilaria, La Porta, Ylenia, Appetecchia, Alessandro, D'Onofrio, Luca, Grigioni, Francesco, Buzzetti, Raffaella, and Holman, Rury R.

Subjects
*KIDNEY failure, *RANDOMIZED controlled trials, *KIDNEY physiology, *HEART failure, *NEPRILYSIN, *GLOMERULAR filtration rate, *SODIUM channels
Abstract

Aim: To determine whether the magnitude of the cardiorenal benefits of sodium‐glucose co‐transporter‐2 inhibitors (SGLT2is) varies with baseline kidney function. Methods: We searched randomized, placebo‐controlled trials testing the effects of SGLT2is on renal and cardiovascular outcomes. Efficacy outcomes, stratified by baseline estimated glomerular filtration rate (eGFR) categories, included renal disease progression, a composite heart failure (HF) outcome and mortality. Results: Thirteen trials testing SGLT2is in 90 402 participants with available eGFR data were included. The risk of bias was judged as low for all trials. SGLT2is reduced the relative risks of renal disease progression by 27% to 57% and of HF outcomes by 13% to 32% across different eGFR categories, with an overall low heterogeneity. Meta‐regression analyses showed a significant direct relationship between baseline eGFR and the magnitude of SGLT2is' renal protection (P =.003). The greatest risk reduction was in participants with an eGFR of 90 ml/min/1.73m2 or higher (HR 0.43, 95% CI: 0.32‐0.58) and the smallest was in those with an eGFR of less than 30 ml/min/1.73m2 (HR 0.73, 95% CI: 0.62‐0.86, P <.001). Conversely, for HF, the greatest risk reduction was in those with an eGFR of less than 30 ml/min/1.73m2 (HR 0.68, 95% CI: 0.48‐0.96) and the smallest was in those with an eGFR of 90 ml/min/1.73m2 or higher (HR 0.87, 95% CI: 0.56‐1.34). Conclusions: SGLT2is reduce the risk of renal and HF outcomes for all eGFR categories. The greatest benefits in terms of kidney protection may be achieved by early initiation of SGLT2is in people with preserved eGFR. The greatest risk reduction for HF outcomes is observed in people with lower eGFR values. [ABSTRACT FROM AUTHOR]

Published
2023
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54. Endothelial Cells Induced Progenitors Into Brown Fat to Reduce Atherosclerosis

Author

Park, Kyoungmin, primary, Li, Qian, additional, Lynes, Matthew D., additional, Yokomizo, Hisashi, additional, Maddaloni, Ernesto, additional, Shinjo, Takanori, additional, St-Louis, Ronald, additional, Li, Qin, additional, Katagiri, Sayaka, additional, Fu, Jialin, additional, Clermont, Allen, additional, Park, Hyunseok, additional, Wu, I-Hsien, additional, Yu, Marc Gregory, additional, Shah, Hetal, additional, Tseng, Yu-Hua, additional, and King, George L., additional

Published
2022
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57. Diastolic Pressure and ACR Are Modifiable Risk Factors of Arterial Stiffness in T2DM Without Cardiovascular Disease

Author

Leto, Gateano, primary, Tartaglione, Lida, additional, Rotondi, Silverio, additional, Pasquali, Marzia, additional, Maddaloni, Ernesto, additional, Mignogna, Carmen, additional, D’Onofrio, Luca, additional, Zampetti, Simona, additional, Carlone, Angela, additional, Muci, Maria Luisa, additional, Mastroluca, Daniela, additional, Fassino, Valeria, additional, Buzzetti, Raffaella, additional, and Mazzaferro, Sandro, additional

Published
2022
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59. Development of a clinical risk score to predict death in patients with COVID‐19

Author

Alhamar, Ghadeer, primary, Maddaloni, Ernesto, additional, Al Shukry, Abdullah, additional, Al‐Sabah, Salman, additional, Al‐Haddad, Mohannad, additional, Al‐Youha, Sarah, additional, Jamal, Mohammed, additional, Almazeedi, Sulaiman, additional, Al‐Shammari, Abdullah A., additional, Abu‐Farha, Mohamed, additional, Abubaker, Jehad, additional, Alattar, Abdulnabi T., additional, AlOzairi, Ebaa, additional, Alessandri, Francesco, additional, D’Onofrio, Luca, additional, Leto, Gaetano, additional, Mastroianni, Carlo Maria, additional, Mignogna, Carmen, additional, Pascarella, Giuseppe, additional, Pugliese, Francesco, additional, Ali, Hamad, additional, Al Mulla, Fahd, additional, Buzzetti, Raffaella, additional, and Pozzilli, Paolo, additional

Published
2022
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63. Reduced early response to SARS‐CoV2 vaccination in people with type 1 and type 2 diabetes, a 6 months follow‐up study: The CoVaDiab study I.

Author

D'Onofrio, Luca, Fogolari, Marta, Amendolara, Rocco, Siena, Antonio, De Fata, Riccardo, Davini, Flavio, Coraggio, Lucia, Mignogna, Carmen, Moretti, Chiara, Maddaloni, Ernesto, Angeletti, Silvia, and Buzzetti, Raffaella

Subjects
TYPE 1 diabetes, TYPE 2 diabetes, SARS-CoV-2, PEOPLE with diabetes, BOOSTER vaccines
Abstract

Introduction: Diabetes mellitus worsens the prognosis of SARS‐CoV‐2 infection, and vaccination has been the major tool for reducing the risk of hospitalisation, and mortality. The primary aim of this study was to evaluate the response to the SARS‐CoV‐2 vaccine in subjects with diabetes and controls. Differences between type 1 (T1D) and type 2 (T2D) diabetes and clinical determinants of vaccination response were also evaluated. Methods: 128 subjects with diabetes (60 with T1D and 62 with T2D) and 202 subjects acting as controls who completed a full vaccination cycle with two doses of mRNA vaccine were enroled. People with previous SARS‐CoV‐2 infection were excluded. Antibodies (Ab) directed against the spike protein of the SARS‐CoV‐2 were evaluated at one and 6 months after vaccination. Results: In the whole cohort, the Ab level was higher among women than in men (p = 0.011) and negatively correlated with age (rho = −0.155, p = 0.005). Subjects with diabetes showed decreased levels of Ab after one month compared to controls (1217[747–1887]BAU/mL vs. 1477[942–2556]BAU/mL, p = 0.002), even after correction for age and gender (p = 0.002). No difference was found between subjects with T1D and T2D. After 6 months, antibody levels significantly decreased in people with and without diabetes, with no differences between groups, although some subjects were lost at follow‐up. In subjects with diabetes, only a significant correlation was found between Ab level and renal function (rho 0.190, p = 0.042). Conclusions: Both T1D and T2D are associated with a reduced early response to vaccination. The serum concentration of Ab significantly reduced over time in both groups, highlighting the relevance of vaccination boosters independently of the presence of diabetes. [ABSTRACT FROM AUTHOR]

Published
2023
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66. Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study

Author

Nusca, Annunziata, primary, Bernardini, Federico, additional, Mangiacapra, Fabio, additional, Maddaloni, Ernesto, additional, Melfi, Rosetta, additional, Ricottini, Elisabetta, additional, Piccirillo, Francesco, additional, Manfrini, Silvia, additional, Ussia, Gian Paolo, additional, and Grigioni, Francesco, additional

Published
2021
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75. Platelet Effects of Anti-diabetic Therapies: New Perspectives in the Management of Patients with Diabetes and Cardiovascular Disease

Author

Nusca, Annunziata, primary, Tuccinardi, Dario, additional, Pieralice, Silvia, additional, Giannone, Sara, additional, Carpenito, Myriam, additional, Monte, Lavinia, additional, Watanabe, Mikiko, additional, Cavallari, Ilaria, additional, Maddaloni, Ernesto, additional, Ussia, Gian Paolo, additional, Manfrini, Silvia, additional, and Grigioni, Francesco, additional

Published
2021
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76. 'H' for Heterogeneity in the Algorithm for Type 2 Diabetes Management

Author

Pieralice Silvia, Maddaloni Ernesto, Zampetti Simona, and Buzzetti Raffaella

Subjects
0301 basic medicine, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Disease, Type 2 diabetes, Disease cluster, Affect (psychology), Risk Assessment, Diabetes Complications, 03 medical and health sciences, Therapeutic approach, 0302 clinical medicine, Diabetes mellitus, Patient-Centered Care, Internal Medicine, Medicine, Humans, Precision Medicine, Intensive care medicine, Socioeconomic status, business.industry, medicine.disease, Response to treatment, 030104 developmental biology, Diabetes Mellitus, Type 2, business, Algorithms, Biomarkers
Abstract

Genetic, socioeconomic and clinical features vary considerably among individuals with type 2 diabetes (T2D) influencing disease development, progression and response to therapy. Although a patient-centred approach to pharmacologic therapy of T2D is widely recommended, patients are often treated similarly, irrespective of the differences that may affect therapeutic response. Addressing the heterogeneity of T2D is a major task of diabetes research to lower the high rate of treatment failure as well as to reduce the risk of long-term complications. A pathophysiology-based clustering system seems the most promising to help in the stratification of diabetes in terms of complication risk and response to treatment. This urges for clinical studies looking at novel biomarkers related to the different metabolic pathways of T2D and able to inform about the therapeutic cluster of each patient. Here, we review the main settings of diabetes heterogeneity, to what extent it has been already addressed and the current gaps in knowledge towards a personalized therapeutic approach that considers the distinctive features of each patient.

Published
2020

77. Effects of the COVID ‐19 lockdown on glycaemic control in subjects with type 2 diabetes: the glycalock study

Author

D'Onofrio, Luca, primary, Pieralice, Silvia, additional, Maddaloni, Ernesto, additional, Mignogna, Carmen, additional, Sterpetti, Sara, additional, Coraggio, Lucia, additional, Luordi, Cecilia, additional, Guarisco, Gloria, additional, Leto, Gaetano, additional, Leonetti, Frida, additional, Manfrini, Silvia, additional, and Buzzetti, Raffaella, additional

Published
2021
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81. Risk of cardiac autonomic neuropathy in latent autoimmune diabetes in adults is similar to type 1 diabetes and lower compared to type 2 diabetes: A cross‐sectional study

Author

Maddaloni, Ernesto, primary, Moretti, Chiara, additional, Del Toro, Rossella, additional, Sterpetti, Sara, additional, Ievolella, Maria Vittoria, additional, Arnesano, Gabriele, additional, Strollo, Rocky, additional, Briganti, Silvia Irina, additional, D'Onofrio, Luca, additional, Pozzilli, Paolo, additional, and Buzzetti, Raffaella, additional

Published
2020
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91. Additional file 1 of Cardiometabolic multimorbidity is associated with a worse Covid-19 prognosis than individual cardiometabolic risk factors: a multicentre retrospective study (CoViDiab II)

Author

Maddaloni, Ernesto, D’Onofrio, Luca, Alessandri, Francesco, Mignogna, Carmen, Leto, Gaetano, Pascarella, Giuseppe, Mezzaroma, Ivano, Lichtner, Miriam, Pozzilli, Paolo, Agrò, Felice Eugenio, Rocco, Monica, Pugliese, Francesco, Lenzi, Andrea, Rury R. Holman, Mastroianni, Claudio Maria, and Buzzetti, Raffaella

Abstract

Additional file 1:Table S1. SARS-CoV-2 infection symptoms at hospitalization in patients with, compared with those without, diabetes and in patients experiencing the primary composite compared with those without. Table S2. Odds ratio (OR) with [95% confidence intervals, CI] for secondary outcomes, unadjusted and adjusted for age and sex. Abbreviations: CV, cardiovascular; COPD, chronic obstructive pulmonary disease.

Published
2020
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92. Ischemic and bleeding risk by type 2 diabetes clusters in patients with acute coronary syndrome.

Author

Cavallari, Ilaria, Maddaloni, Ernesto, Gragnano, Felice, Patti, Giuseppe, Antonucci, Emilia, Calabrò, Paolo, Cirillo, Plinio, Gresele, Paolo, Palareti, Gualtiero, Pengo, Vittorio, Pignatelli, Pasquale, Marcucci, Rossella, the START-ANTIPLATELET collaborators, Moscarella, Elisabetta, Cesaro, Arturo, Grossi, Guido, Berteotti, Martina, De Rosa, Gennaro, Taglialatela, Vittorio, and Digitale, Lucia

Abstract

The risk of ischemic events carried by different clusters of type 2 diabetes mellitus (DM) in the setting of secondary prevention is not definite and the association between DM and bleeding complications is controversial. We explored these issues in the START-ANTIPLATELET, a multicenter Italian registry including acute coronary syndrome (ACS) patients. Study outcome was 1-year incidence of the net composite endpoint including major adverse cardiovascular events (MACE) or any bleeding and its individual components across different DM strata (no DM, DM with or without insulin). Out of 951 patients, 20.0% had diabetes not on insulin and 2.5% had diabetes on insulin. The rate of the net composite endpoint was highest in patients receiving insulin (39.4 per 100 person-years vs 11.7 in diabetic patients not on insulin vs 14.0 in those without DM; p = 0.007). In DM, the higher risk of MACE was regardless of insulin use (p = 0.36). Conversely, the increase in bleeding complications was limited to patients on insulin (Hazard Ratio 2.31, 95% CI 0.93-5.71 vs no DM; p = 0.0105 across DM strata). On top of aspirin, the rates of the net composite endpoint were similar with ticagrelor/prasugrel or clopidogrel irrespective of DM status (p for interaction 0.63). In conclusion, in ACS patients, type 2 DM enhances the risk of MACE regardless of the DM cluster, whereas the propensity to bleeding related to DM seems confined to insulin-treated patients. [ABSTRACT FROM AUTHOR]

Published
2021
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98. 441-P: Chitotriosidase Activity Is Inversely Associated with Diastolic Blood Pressure and HbA1c but Not with Arterial Stiffness in Patients with Type 2 Diabetes without Complications

Author

D'ONOFRIO, LUCA, primary, LUORDI, CECILIA, additional, MIGNOGNA, CARMEN, additional, CARLONE, ANGELA, additional, MORETTI, CHIARA, additional, TARTAGLIONE, LIDA, additional, MADDALONI, ERNESTO, additional, LETO, GAETANO, additional, MAZZAFERRO, SANDRO, additional, and BUZZETTI, RAFFAELLA, additional

Published
2019
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