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1. Book Review

Author

Bianchini E. and Sicurella S.

Subjects
criminological's research, Social pathology. Social and public welfare. Criminology, HV1-9960
Published
2009

5. Heart failure management guided by remote multiparameter monitoring: A meta-analysis

Author

Zito, A, Restivo, A, Ciliberti, G, Laborante, R, Princi, G, Romiti, G, Galli, M, Rodolico, D, Bianchini, E, Cappannoli, L, D'Oria, M, Trani, C, Burzotta, F, Cesario, A, Savarese, G, Crea, F, D'Amario, D, Zito A., Restivo A., Ciliberti G., Laborante R., Princi G., Romiti G. F., Galli M., Rodolico D., Bianchini E., Cappannoli L., D'Oria M., Trani C., Burzotta F., Cesario A., Savarese G., Crea F., D'Amario D., Zito, A, Restivo, A, Ciliberti, G, Laborante, R, Princi, G, Romiti, G, Galli, M, Rodolico, D, Bianchini, E, Cappannoli, L, D'Oria, M, Trani, C, Burzotta, F, Cesario, A, Savarese, G, Crea, F, D'Amario, D, Zito A., Restivo A., Ciliberti G., Laborante R., Princi G., Romiti G. F., Galli M., Rodolico D., Bianchini E., Cappannoli L., D'Oria M., Trani C., Burzotta F., Cesario A., Savarese G., Crea F., and D'Amario D.

Abstract

Background: Several implant-based remote monitoring strategies are currently tested to optimize heart failure (HF) management by anticipating clinical decompensation and preventing hospitalization. Among these solutions, the modern implantable cardioverter-defibrillator and cardiac resynchronization therapy devices have been equipped with sensors allowing continuous monitoring of multiple preclinical markers of worsening HF, including factors of autonomic adaptation, patient activity, and intrathoracic impedance. Objectives: We aimed to assess whether implant-based multiparameter remote monitoring strategy for guided HF management improves clinical outcomes when compared to standard clinical care. Methods: A systematic literature research for randomized controlled trials (RCTs) comparing multiparameter-guided HF management versus standard of care was performed on PubMed, Embase, and CENTRAL databases. Incidence rate ratios (IRRs) and associated 95% confidence intervals (CIs) were calculated using the Poisson regression model with random study effects. The primary outcome was a composite of all-cause death and HF hospitalization events, whereas secondary endpoints included the individual components of the primary outcome. Results: Our meta-analysis included 6 RCTs, amounting to a total of 4869 patients with an average follow-up time of 18 months. Compared with standard clinical management, the multiparameter-guided strategy reduced the risk of the primary composite outcome (IRR 0.83, 95%CI 0.71–0.99), driven by statistically significant effect on both HF hospitalization events (IRR 0.75, 95%CI 0.61–0.93) and all-cause death (IRR 0.80, 95%CI 0.66–0.96). Conclusion: Implant-based multiparameter remote monitoring strategy for guided HF management is associated with significant benefit on clinical outcomes compared to standard clinical care, providing a benefit on both hospitalization events and all-cause death.

Published
2023

7. Predictors of periprocedural myocardial infarction after left main bifurcation percutaneous coronary intervention guided by optical coherence tomography imaging: the PREVENT study

Author

Ricchiuto, A, primary, Lombardi, M, additional, Bianchini, E, additional, Buonpane, A, additional, Maino, A, additional, Busco, M, additional, Leone, A M, additional, Aurigemma, C, additional, Romagnoli, E, additional, Burzotta, F, additional, Trani, C, additional, and Vergallo, R, additional

Published
2023
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11. The Ultrasound Window Into Vascular Ageing: A Technology Review by the VascAgeNet COST Action.

Author

Bianchini, E., Guala, A., Golemati, S., Alastruey, J., Climie, R.E., Dalakleidi, K., Francesconi, M., Fuchs, D., Hartman, Y.A.W., Malik, A.E.F., Makūnaitė, M., Nikita, K.S., Park, C., Pugh, C.J.A., Šatrauskienė, A., Terentes-Printizios, D., Teynor, A., Thijssen, D.H.J., Schmidt-Trucksäss, A., Zupkauskienė, J., Boutouyrie, P., Bruno, R.M., Reesink, K.D., Bianchini, E., Guala, A., Golemati, S., Alastruey, J., Climie, R.E., Dalakleidi, K., Francesconi, M., Fuchs, D., Hartman, Y.A.W., Malik, A.E.F., Makūnaitė, M., Nikita, K.S., Park, C., Pugh, C.J.A., Šatrauskienė, A., Terentes-Printizios, D., Teynor, A., Thijssen, D.H.J., Schmidt-Trucksäss, A., Zupkauskienė, J., Boutouyrie, P., Bruno, R.M., and Reesink, K.D.

Abstract

Contains fulltext : 296790.pdf (Publisher’s version ) (Open Access), Non-invasive ultrasound (US) imaging enables the assessment of the properties of superficial blood vessels. Various modes can be used for vascular characteristics analysis, ranging from radiofrequency (RF) data, Doppler- and standard B/M-mode imaging, to more recent ultra-high frequency and ultrafast techniques. The aim of the present work was to provide an overview of the current state-of-the-art non-invasive US technologies and corresponding vascular ageing characteristics from a technological perspective. Following an introduction about the basic concepts of the US technique, the characteristics considered in this review are clustered into: 1) vessel wall structure; 2) dynamic elastic properties, and 3) reactive vessel properties. The overview shows that ultrasound is a versatile, non-invasive, and safe imaging technique that can be adopted for obtaining information about function, structure, and reactivity in superficial arteries. The most suitable setting for a specific application must be selected according to spatial and temporal resolution requirements. The usefulness of standardization in the validation process and performance metric adoption emerges. Computer-based techniques should always be preferred to manual measures, as long as the algorithms and learning procedures are transparent and well described, and the performance leads to better results. Identification of a minimal clinically important difference is a crucial point for drawing conclusions regarding robustness of the techniques and for the translation into practice of any biomarker.

Published
2023

12. The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: case-control analysis of a retrospective multicentre database

Author

Tebala G. D., Milani M. S., Cirocchi R., Bignell M., Bond-Smith G., Lewis C., Agnoletti V., Catarci M., Di Saverio S., Luridiana G., Catena F., Scatizzi M., Marini P., Lo Dico R., Stracqualursi A., Russo G., D'Errico S., Cianci P., Restini E., Scialandrone G., Guercioni G., Martinez G., Pezzolla A., Altomare D. F., Picciariello A., Trigiante G., Dibra R., Papagni V., Righetti C., Polastri R., Andreuccetti J., Pignata G., D'Alessio R., Arici E., Canfora I., Cillara N., Deserra A., Sechi R., Bianco F., Gili S., Cappiello A., Incollingo P., Biloslavo A., Bellio G., Germani P., De Manzini N., Buiatti M., Paladino F. P., Sasia D., Borghi F., Testa V., Giraudo G., Allisiardi F., Giuffrida M. C., Gerosa M., Fogliati A., Maggioni D., Fabbri N., Feo C. V., Bianchini E., Panzini I., Lizzi V., Tricarico F. G., Di Gioia G., Melino R., Tartaglia N., Ambrosi A., Pavone G., Pacilli M., Vovola F., Belli F., Barberis A., Azzinnaro A., Coratti A., Benigni R., Berti S., Saracco M., Gennai A., Dova L., Farfaglia R., Pata G., Arizzi V., Pandolfo G., Frontali A., Danelli P., Ferrario L., Guerci C., Mariani N. M., Pisani Ceretti A., Nicastro V., Opocher E., Gozzo D., Casoni Pattacini G., Castriconi M., Amendola A., Gaudiello M., Palomba G., Petracca G. L., Perrone G., Giuffrida M., Moretto G., Impellizzeri H., Casaril A., Filosa M., Caizzone A., Agrusti S., Cattaneo G. M., Capelli P., Muratore A., Calabro M., Pipitore Federico N., Cuzzola B., Danna R., Murgese A., Coccolini F., Pieroni E., Chiarugi M., Tartaglia D., Giannessi S., Somigli R., Trafeli M., Fedi M., De Vincenti R., Guariniello A., Grande M., Bagaglini G., Pirozzi B., Guida A. M., Ingallinella S., Don C. P., Siragusa L., Capone O., Cerbo D., Santoro E., Pende V., Fassari A., Mingoli A., Brachini G., Cirillo B., Zambon M., Cicerchia P., Meneghini S., Sapienza P., Puzzovio A., La Torre F., Fransvea P., Di Grezia M., Sganga G., Armellino M. F., Ioia G., Rampone B., Della Corte M., Fleres F., Clarizia G., Bordoni P., Spolini A., Franzini M., Grechi A., Suppo M., Bono D., Scaglione D., Cotsoglou C., Paleini S., Chierici A. P., Uccelli M., Olmi S., Cesana G., Tenreiro N., Marcal A., Martins D., Leal C., Vieira B., Ugarte-Sierra B., Vincene-Rodriguez I., Duran-Ballesteros M., Sanz-Larrainzar A., Ibanez-Aguirre F. J., Yanez-Benites C., Talal I., Blas J. L., Garau R., Clark-Stuart S., Wallace A., Di Carlo A., Wisnia E., Ehsan K., Beck-Sanders K., Godson E., Campbell P., Ahmad R., Ali R., Aswani S. S., Barza A., Carrillo C., Dawani A., Dey A., Elserafy A., Gaspar D., Lazzareschi L., Patel M., Shabana A., Shams M., Shams O., Slack Z., Tebala, Giovanni D, Milani, Marika S, Cirocchi, Roberto, Bignell, Mark, Bond-Smith, Gile, Lewis, Christopher, Agnoletti, Vanni, Catarci, Marco, Di Saverio, Salomone, Luridiana, Gianluigi, Catena, Fausto, Scatizzi, Marco, Marini, Pierluigi, de Manzini, Nicolo', Tebala G.D., Milani M.S., Cirocchi R., Bignell M., Bond-Smith G., Lewis C., Agnoletti V., Catarci M., Di Saverio S., Luridiana G., Catena F., Scatizzi M., Marini P., Lo Dico R., Stracqualursi A., Russo G., D'Errico S., Cianci P., Restini E., Scialandrone G., Guercioni G., Martinez G., Pezzolla A., Altomare D.F., Picciariello A., Trigiante G., Dibra R., Papagni V., Righetti C., Polastri R., Andreuccetti J., Pignata G., D'Alessio R., Arici E., Canfora I., Cillara N., Deserra A., Sechi R., Bianco F., Gili S., Cappiello A., Incollingo P., Biloslavo A., Bellio G., Germani P., De Manzini N., Buiatti M., Paladino F.P., Sasia D., Borghi F., Testa V., Giraudo G., Allisiardi F., Giuffrida M.C., Gerosa M., Fogliati A., Maggioni D., Fabbri N., Feo C.V., Bianchini E., Panzini I., Lizzi V., Tricarico F.G., Di Gioia G., Melino R., Tartaglia N., Ambrosi A., Pavone G., Pacilli M., Vovola F., Belli F., Barberis A., Azzinnaro A., Coratti A., Benigni R., Berti S., Saracco M., Gennai A., Dova L., Farfaglia R., Pata G., Arizzi V., Pandolfo G., Frontali A., Danelli P., Ferrario L., Guerci C., Mariani N.M., Pisani Ceretti A., Nicastro V., Opocher E., Gozzo D., Casoni Pattacini G., Castriconi M., Amendola A., Gaudiello M., Palomba G., Petracca G.L., Perrone G., Giuffrida M., Moretto G., Impellizzeri H., Casaril A., Filosa M., Caizzone A., Agrusti S., Cattaneo G.M., Capelli P., Muratore A., Calabro M., Pipitore Federico N., Cuzzola B., Danna R., Murgese A., Coccolini F., Pieroni E., Chiarugi M., Tartaglia D., Giannessi S., Somigli R., Trafeli M., Fedi M., De Vincenti R., Guariniello A., Grande M., Bagaglini G., Pirozzi B., Guida A.M., Ingallinella S., Don C.P., Siragusa L., Capone O., Cerbo D., Santoro E., Pende V., Fassari A., Mingoli A., Brachini G., Cirillo B., Zambon M., Cicerchia P., Meneghini S., Sapienza P., Puzzovio A., La Torre F., Fransvea P., Di Grezia M., Sganga G., Armellino M.F., Ioia G., Rampone B., Della Corte M., Fleres F., Clarizia G., Bordoni P., Spolini A., Franzini M., Grechi A., Suppo M., Bono D., Scaglione D., Cotsoglou C., Paleini S., Chierici A.P., Uccelli M., Olmi S., Cesana G., Tenreiro N., Marcal A., Martins D., Leal C., Vieira B., Ugarte-Sierra B., Vincene-Rodriguez I., Duran-Ballesteros M., Sanz-Larrainzar A., Ibanez-Aguirre F.J., Yanez-Benites C., Talal I., Blas J.L., Garau R., Clark-Stuart S., Wallace A., Di Carlo A., Wisnia E., Ehsan K., Beck-Sanders K., Godson E., Campbell P., Ahmad R., Ali R., Aswani S.S., Barza A., Carrillo C., Dawani A., Dey A., Elserafy A., Gaspar D., Lazzareschi L., Patel M., Shabana A., Shams M., Shams O., and Slack Z.

Subjects
Hot gallbladder, education, Weekend effect, COVID-19, Settore MED/18 - Chirurgia Generale, Retrospective Studie, Case-Control Studies, Emergency surgery, Hospital Mortality, Humans, Retrospective Studies, Pandemics, Emergency Medicine, Surgery, Case-Control Studie, Human
Abstract

Introduction The concept of “weekend effect”, that is, substandard healthcare during weekends, has never been fully demonstrated, and the different outcomes of emergency surgical patients admitted during weekends may be due to different conditions at admission and/or different therapeutic approaches. Aim of this international audit was to identify any change of pattern of emergency surgical admissions and treatments during weekends. Furthermore, we aimed at investigating the impact of the COVID-19 pandemic on the alleged “weekend effect”. Methods The database of the CovidICE-International Study was interrogated, and 6263 patients were selected for analysis. Non-trauma, 18+ yo patients admitted to 45 emergency surgery units in Europe in the months of March–April 2019 and March–April 2020 were included. Demographic and clinical data were anonymised by the referring centre and centrally collected and analysed with a statistical package. This study was endorsed by the Association of Italian Hospital Surgeons (ACOI) and the World Society of Emergency Surgery (WSES). Results Three-quarters of patients have been admitted during workdays and only 25.7% during weekends. There was no difference in the distribution of gender, age, ASA class and diagnosis during weekends with respect to workdays. The first wave of the COVID pandemic caused a one-third reduction of emergency surgical admission both during workdays and weekends but did not change the relation between workdays and weekends. The treatment was more often surgical for patients admitted during weekends, with no difference between 2019 and 2020, and procedures were more often performed by open surgery. However, patients admitted during weekends had a threefold increased risk of laparoscopy-to-laparotomy conversion (1% vs. 3.4%). Hospital stay was longer in patients admitted during weekends, but those patients had a lower risk of readmission. There was no difference of the rate of rescue surgery between weekends and workdays. Subgroup analysis revealed that interventional procedures for hot gallbladder were less frequently performed on patients admitted during weekends. Conclusions Our analysis revealed that demographic and clinical profiles of patients admitted during weekends do not differ significantly from workdays, but the therapeutic strategy may be different probably due to lack of availability of services and skillsets during weekends. The first wave of the COVID-19 pandemic did not impact on this difference.

Published
2022

16. Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

Author

Charlton, P.H. Paliakaitė, B. Pilt, K. Bachler, M. Zanelli, S. Kulin, D. Allen, J. Hallab, M. Bianchini, E. Mayer, C.C. Terentes-Printzios, D. Dittrich, V. Hametner, B. Veerasingam, D. Žikić, D. Marozas, V.

Subjects
sense organs
Abstract

The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular aging, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarizes research into assessing vascular age from the PPG. Three categories of approaches are described: 1) those which use a single PPG signal (based on pulse wave analysis), 2) those which use multiple PPG signals (such as pulse transit time measurement), and 3) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realize the full potential of photoplethysmography for assessing vascular age.

Published
2022

17. 456P Gait analysis by IMU sensor in myotonic dystrophy type 1.

Author

Tufano, L., Bianchini, E., Bucci, E., Antonini, G., and Garibaldi, M.

Subjects
*WALKING speed, *MYOTONIA atrophica, *GAIT in humans, *DISEASE duration, *PELVIS
Abstract

Gait impairment is a common feature of myotonic dystrophy type 1 (DM1) leading to a 10x higher risk of falls than in healthy subjects (HS). Gait analysis of DM1 patients shows alterations of different spatial-temporal gait parameters. IMU-based gait analysis can be a cost-effective and easy-to-use alternative method. The aim of this study was to compare gait parameters registered through an IMU sensor in DM1 patients versus HS and to investigate the association between gait parameters and clinical, genetic and instrumental features in patients with DM1. 19 DM1 patients and 19 age-, sex- and height-matched HS were enrolled. All subjects performed a 6MWT wearing a lower back-mounted IMU sensor (BTS G-Walk). For DM1 patients, MIRS score, average number of CTG expansion, disease duration, hand grip test, 9-hole peg test and 6MWT were collected. We found a significant reduction in step length and gait symmetry in DM1 patients, associated with reduction in gait speed and 6MWT distance. MIRS 4 patients showed a marked reduction in all the spatial-temporal parameters and a significant difference in pelvis tilt compared with HS. The only difference between MIRS 3 patients and HS was a significant increase of cadence. MIRS score showed a moderate-to-strong negative correlation with all gait parameters while hand grip test showed a strong positive correlation with gait symmetry. Single-IMU gait analysis helps to elucidate gait features in DM1 and could be useful to identify patients with more severe walking impairment and guide treatment and rehabilitation strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Abstracts from the 45th ESAO Congress, 12–15 September 2018, Madrid, Spain

Author

Ligabue G, Simonis F, Fontana F, Giovanella S, Bianchini E, Hazenbrink DHM, Gerritsen KGF, Bajo Rubio MA, Selgas R, and Cappelli G.

Subjects
Biomaterials, 0303 health sciences, 03 medical and health sciences, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, 02 engineering and technology, General Medicine, 021001 nanoscience & nanotechnology, 0210 nano-technology, 030304 developmental biology
Published
2018
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34. Assessing Risk of Osteoporotic Fractures in Primary Care: Development and Validation of the FRA-HS Algorithm

Author

Lapi, F, Bianchini, E, Michieli, R, Pasqua, A, Cricelli, I, Mazzaglia, G, Frediani, B, Prieto-Alhambra, D, Brandi, M, Cricelli, C, Lapi F, Bianchini E, Michieli R, Pasqua A, Cricelli I, Mazzaglia G, Frediani B, Prieto-Alhambra D, Brandi ML, Cricelli C, Lapi, F, Bianchini, E, Michieli, R, Pasqua, A, Cricelli, I, Mazzaglia, G, Frediani, B, Prieto-Alhambra, D, Brandi, M, Cricelli, C, Lapi F, Bianchini E, Michieli R, Pasqua A, Cricelli I, Mazzaglia G, Frediani B, Prieto-Alhambra D, Brandi ML, and Cricelli C

Abstract

We aimed to develop and validate the FRActure Health Search (FRA-HS) score for prediction of risk of osteoporotic fractures in primary care in Italy. We selected a cohort of patients aged 40 years between 1999 and 2002. They were followed until the occurrence of osteoporotic fracture, death, end of data registration, or end of data availability (December 31, 2012). Age, sex, history of osteoporotic fractures, secondary osteoporosis, long-term use of corticosteroids, rheumatoid arthritis, body mass index, smoking, and alcohol abuse/alcohol-related diseases, and the interaction terms sex*use of corticosteroids and age*secondary osteoporosis were entered in a competing-risk regression (Fine and Gray method) to predict the risk of hip/femur or overall major osteoporotic fractures. The coefficients were combined to obtain the FRA-HS for individual patients. Explained variance, discrimination, and calibration measures were computed to evaluate the models accuracy. The final model was tested using an independent data source. The FRA-HS explained 47.36 and 20.6% of the variation for occurrence of hip/femur and overall major osteoporotic fractures, respectively. Area Under Curve was 0.77 and 0.73, respectively. Predicted/observed ratios revealed a margin of error lower than 30% in the 80% of the population. After stratifying by sex, prediction models for hip/femur fractures confirmed acceptable accuracy in both sexes, while poor explained variance (<20%) was observed for overall major fractures. These findings indicate that FRA-HS might be implemented in primary care for risk prediction of hip/femur fractures. General practitioners could be therefore supported by this tool in clinical decision making.

Published
2017

35. Erratum to: Assessing risk of osteoporotic fractures in primary care: development and validation of the FRA-HS algorithm (Calcif Tissue Int, 10.1007/s00223-016-0230-7)

Author

Lapi F., Lapi, F, Bianchini, E, Michieli, R, Pasqua, A, Cricelli, I, Mazzaglia, G, Frediani, B, Prieto-Alhambra, D, Brandi, M, Cricelli, C, Lapi F., Bianchini E., Michieli R., Pasqua A., Cricelli I., Mazzaglia G., Frediani B., Prieto-Alhambra D., Brandi M. L., Cricelli C., Lapi F., Lapi, F, Bianchini, E, Michieli, R, Pasqua, A, Cricelli, I, Mazzaglia, G, Frediani, B, Prieto-Alhambra, D, Brandi, M, Cricelli, C, Lapi F., Bianchini E., Michieli R., Pasqua A., Cricelli I., Mazzaglia G., Frediani B., Prieto-Alhambra D., Brandi M. L., and Cricelli C.

Abstract

The original version of this article contained a mistake whereby the authors’ surnames preceded their first names.The correct order of the authors names is given in this erratum.

Published
2017

36. Elevated thrombin generation in patients with congenital disorder of glycosylation and combined coagulation factor deficiencies

Author

Pascreau T, de la Morena-Barrio ME, Lasne D, Serrano M, Bianchini E, Kossorotoff M, Boddaert N, Bruneel A, Seta N, Vicente V, de Lonlay P, Corral J, and Borgel D

Subjects
congenital disorder of glycosylation, thrombin generation assay, coagulation disorder
Abstract

BACKGROUND: Congenital disorders of glycosylation are rare inherited diseases affecting many different proteins. The lack of glycosylation notably affects the hemostatic system and leads to deficiencies of both procoagulant and anticoagulant factors. OBJECTIVE: To assess the hemostatic balance in patients with multiple coagulation disorders by using a thrombin generation assay. METHOD: We performed conventional coagulation assays and a thrombin generation assay on samples from patients with congenital disorder of glycosylation. The thrombin generation assay was performed before and after activation of the protein C system by the addition of soluble thrombomodulin. RESULTS: A total of 35 patients were included: 71% and 57% had low antithrombin and factor XI levels, respectively. Protein C and protein S levels were abnormally low in 29% and 26% of the patients, respectively, whereas only 11% displayed low factor IX levels. Under baseline conditions, the thrombin generation assay revealed a significantly higher endogenous thrombin potential and thrombin peak in patients, relative to controls. After spiking with thrombomodulin, we observed impaired involvement of the protein C system. Hence, 54% of patients displayed a hypercoagulant phenotype in vitro. All the patients with a history of stroke-like episodes or thrombosis displayed this hypercoagulant phenotype. CONCLUSION: A thrombin generation assay revealed a hypercoagulant in vitro phenotype under baseline condition; this was accentuated by impaired involvement of the protein C system. This procoagulant phenotype may thus reflect the risk of severe vascular complications. Further research will have to determine whether the thrombin generation assay is predictive of vascular events.

Published
2019

38. Time domain modeling of linear viscoelasticity using anelastic displacement fields

Author

Lesieutre, G.A. and Bianchini, E.

Subjects
Time-domain analysis -- Usage, Viscoelasticity -- Research, Displacement transducers -- Research, Science and technology
Abstract

A time domain model of linear viscoelasticity is developed based on a decomposition of the total displacement field into two parts: one elastic, the other anelastic. The anelastic displacement field is used to describe that part of the strain that is not instantaneously proportional to stress. General coupled constitutive equations for (1) the total and (2) the anelastic stresses are developed in terms of the total and anelastic strains, and specialized to the case of isotropic materials. A key feature of the model is the absence of explicit time dependence in the constitutive equations. Apparent time-dependent behavior is described instead by differential equations that govern (1) the motion of mass particles and (2) the relaxation of the anelastic displacement field. These coupled governing equations are developed in a parallel fashion, involving the divergence of appropriate stress tensors. Boundary conditions are also treated: the anelastic displacement field is effectively an internal field, as it is driven exclusively through coupling to the total displacement, and cannot be directly affected by applied loads. In order to illustrate the use of the method, model parameters for a commonly-used high damping polymer are developed from available complex modulus data.

Published
1995

39. Automatic identification of type 2 diabetes, hypertension, ischaemic heart disease, heart failure and their levels of severity from Italian General Practitioners' electronic medical records: A validation study

Author

Gini, R, Schuemie, M, Mazzaglia, G, Lapi, F, Francesconi, P, Pasqua, A, Bianchini, E, Montalbano, C, Roberto, G, Barletta, V, Cricelli, I, Cricelli, C, Dal Co, G, Bellentani, M, Sturkenboom, M, Klazinga, N, Gini R, Schuemie MJ, Mazzaglia G, Lapi F, Francesconi P, Pasqua A, Bianchini E, Montalbano C, Roberto G, Barletta V, Cricelli I, Cricelli C, Dal Co G, Bellentani M, Sturkenboom M, Klazinga N., Gini, R, Schuemie, M, Mazzaglia, G, Lapi, F, Francesconi, P, Pasqua, A, Bianchini, E, Montalbano, C, Roberto, G, Barletta, V, Cricelli, I, Cricelli, C, Dal Co, G, Bellentani, M, Sturkenboom, M, Klazinga, N, Gini R, Schuemie MJ, Mazzaglia G, Lapi F, Francesconi P, Pasqua A, Bianchini E, Montalbano C, Roberto G, Barletta V, Cricelli I, Cricelli C, Dal Co G, Bellentani M, Sturkenboom M, and Klazinga N.

Abstract

Objectives: The Italian project MATRICE aimed to assess how well cases of type 2 diabetes (T2DM), hypertension, ischaemic heart disease (IHD) and heart failure (HF) and their levels of severity can be automatically extracted from the Health Search/CSD Longitudinal Patient Database (HSD). From the medical records of the general practitioners (GP) who volunteered to participate, cases were extracted by algorithms based on diagnosis codes, keywords, drug prescriptions and results of diagnostic tests. A random sample of identified cases was validated by interviewing their GPs. Setting: HSD is a database of primary care medical records. A panel of 12 GPs participated in this validation study. Participants: 300 patients were sampled for each disease, except for HF, where 243 patients were assessed. Outcome measures: The positive predictive value (PPV) was assessed for the presence/absence of each condition against the GP's response to the questionnaire, and Cohen's ? was calculated for agreement on the severity level. Results: The PPV was 100% (99% to 100%) for T2DM and hypertension, 98% (96% to 100%) for IHD and 55% (49% to 61%) for HF. Cohen's kappa for agreement on the severity level was 0.70 for T2DM and 0.69 for hypertension and IHD. Conclusions: This study shows that individuals with T2DM, hypertension or IHD can be validly identified in HSD by automated identification algorithms. Automatic queries for levels of severity of the same diseases compare well with the corresponding clinical definitions, but some misclassification occurs. For HF, further research is needed to refine the current algorithm.

Published
2016

40. Immune-phenotypic characteristics associated with an effective acute-phase response predict a reduced amount of integrated HIV DNA in naïve CD4+ T-cells in patients treated during acute HIV infection

Author

Camiro-Zuñiga, A., primary, Najera-Avila, M.A., additional, Jaramillo-Jante, M.D.R., additional, Gibellini, L., additional, De Biasi, S., additional, Pinti, M., additional, Bianchini, E., additional, Lo Tartaro, D., additional, Neroni, A., additional, Nasi, M., additional, Mussini, C., additional, Soto-Ramírez, L.E., additional, Calva, J.J., additional, Belaunzarán-Zamudio, P.F., additional, Crabtree-Ramirez, B., additional, Sierra-Madero, J.G., additional, Hernández-Leon, C., additional, Mosqueda-Gómez, J.L., additional, Navarro-Álvarez, S., additional, Scott-Algara, D., additional, Cossarizza, A., additional, and Perez-Patrigeon, S., additional

Published
2019
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44. Contemporary antithrombotic strategies in patients with acute coronary syndromes managed without revascularization: insights from the EYESHOT study

Author

De Luca, Leonardo, Leonardi, Sergio, Smecca, Ignazio Maria, Formigli, Dario, Lucci, Donata, Gonzini, Lucio, Tuccillo, Bernardino, Olivari, Zoran, Gulizia, Michele Massimo, Bovenzi, Francesco Maria, De Servi, Stefano, Caporale, R., Cavallini, C., Ceravolo, R., Lupi, A., Musumeci, G., Rakar, S., Maggioni, A. P., Lorimer, A., Orsini, G., Fabbri, Giorgio, Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, Giorgia, Misuraca, G., Manes, M. T., Irace, Lorenzo, Totis, O., Ledda, A., Mauro, C., Boccalatte, M., Iliceto, S., Cacciavillani, L., Savonitto, S., Tortorella, G., Esposito, L., DE ROSA, Paolo, Calabrò, P., Bianchi, R., Napoletano, C., Lalla Piccioni, L., Pavesi, P. C., Boni, Allegra, Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, Paolo, Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Grazioli Gauthier, L., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., Di Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, LAURA CATERINA, Pani, Luisa Anna, Serra, Eleonora, Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, Gabriele, Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Sleiman Helou, J., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, MICHELA MARIA, Caputo, M., Di Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., Di Clemente, D., Felis, S., Castini, D., Rota, C., Casu, Gabriella, Bonano, S., Margheri, M., Ricci Lucchi, G., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Marrara, F., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., Di Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Della Mattia, A., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., Di Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cotti Cometti, V., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., Di Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., Di Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., Di Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Della Casa, S., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., Di Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., and Levantesi, G.

Subjects
Male, Ticagrelor, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Conservative strategy, Population, Acute coronary syndromes, Revascularization, acute coronary syndromes, anticoagulant, antithrombotic therapy, conservative strategy, prasugrel, ticagrelor, aged, coronary care units, female, fibrinolytic agents, follow-up studies, hospital mortality, humans, iItaly, length of stay, male, myocardial revascularization, retrospective studies, survival rate, thrombolytic therapy, practice guidelines as topic, Fibrinolytic Agents, Anticoagulant, Antithrombotic therapy, Prasugrel, Acute Coronary Syndrome, Aged, Coronary Care Units, Female, Follow-Up Studies, Hospital Mortality, Humans, Italy, Length of Stay, Myocardial Revascularization, Retrospective Studies, Survival Rate, Thrombolytic Therapy, Practice Guidelines as Topic, Cardiology and Cardiovascular Medicine, Pharmacology (medical), Internal medicine, Antithrombotic, medicine, education, Survival rate, education.field_of_study, business.industry, Clopidogrel, medicine.disease, Cardiology, business, Fibrinolytic agent, medicine.drug
Abstract

Aims Patients with acute coronary syndromes (ACSs) who are managed without coronary revascularization represent a mixed and understudied population that seems to receive suboptimal pharmacological treatment. Methods and results We assessed patterns of antithrombotic therapies employed during the hospitalization and in-hospital clinical events of medically managed patients with ACS enrolled in the prospective, multicentre, nationwide EYESHOT (EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units) registry. Among the 2585 consecutive ACS patients enrolled in EYESHOT, 783 (30.3%) did not receive any revascularization during hospital admission. Of these, 478 (61.0%) underwent coronary angiography (CA), whereas 305 (39.0%) did not. The median GRACE and CRUSADE risk scores were significantly higher among patients who did not undergo CA compared with those who did (180 vs. 145, P < 0.0001 and 50 vs. 33, P < 0.0001, respectively). Antithrombotic therapies employed during hospitalization significantly differ between patients who received CA and those who did not with unfractioned heparin and novel P2Y12 inhibitors more frequently used in the first group, and low-molecular-weight heparins and clopidogrel in the latter group. During the index hospitalization, patients who did not receive CA presented a higher incidence of ischaemic cerebrovascular events and of mortality compared with those who underwent CA (1.6 vs. 0.2%, P = 0.04 and 7.9 vs. 2.7%, P = 0.0009, respectively). Conclusion Almost one-third of ACS patients are managed without revascularization during the index hospitalization. In this population, a lower use of recommended antiplatelet therapy and worse clinical outcome were observed in those who did not undergo CA when compared with those who did. Clinical Trial Registration Unique identifier: [NCT02015624][1], . [10.1093/ehjcvp/pvv017][2] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02015624&atom=%2Fehjcardpharm%2F1%2F3%2F168.atom [2]: /lookup/doi/10.1093/ehjcvp/pvv017

Published
2015
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47. Quantification of mitochondrial reactive oxygen species in living cells by using multi-laser polychromatic flow cytometry

Author

De Biasi, S, Gibellini, L, Bianchini, E, Nasi, M, Pinti, M, Cossarizza, A., SALVIOLI, STEFANO, De Biasi, S, Gibellini, L, Bianchini, E, Nasi, M, Pinti, M, Salvioli, Stefano, and Cossarizza, A.

Subjects
mitochondria, Multi-laser flow cytometry, Histology, mitoPY1, Apoptosis, ROS, Cell Biology, apoptosi, MitoPY1, multi-laser flow cytometry, Mitochondria, 2734
Abstract

Reactive oxygen species (ROS) are constantly produced in cells, mainly by mitochondria, as a consequence of aerobic respiration. Most ROS derive from superoxide, which is rapidly converted to hydrogen peroxide. ROS are involved in the regulation of several physiological and pathological processes, and the possibility to measure them simultaneously is needed, when the redox status of the cells is modified by experimental/biological conditions. Flow cytometry is the main technology that generates multiple information at the single cell level in a high-throughput manner, and gives rapid and quantitative measurements of different ROS with high sensitivity and reproducibility. Here, we describe a novel approach to detect simultaneously mitochondrial hydrogen peroxide and mitochondrial superoxide in living cells. The staining has been performed by using the fluorescent dyes MitoSOX Red Mitochondrial Superoxide Indicator, Mitochondria Peroxy Yellow 1, Annexin-V Pacific Blue conjugate, TO-PRO-3 iodide, anti-CD4-APC-Cy7 and -CD8-Pacific Orange mAbs. We used this approach to quantify mitochondrial ROS in CD4+ and CD8+ T cells form patients affected by Down syndrome and age- and sex-matched healthy donors. © 2016 International Society for Advancement of Cytometry.

Published
2016

49. Antithrombotic strategies in the catheterization laboratory for patients with acute coronary syndromes undergoing percutaneous coronary interventions: insights from the EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units Registry

Author

De Luca, L., Musumeci, G., Leonardi, S., Gonzini, L., Cavallini, C., Calabro, P., Mauro, C., Cacciavillani, L., Savonitto, S., De Servi, S., Caporale, R., Ceravolo, R., Formigli, D., Lupi, A., Rakar, S., Smecca, I. M., Maggioni, A. P., Lucci, D., Lorimer, A., Orsini, G., Fabbri, G., Bianchini, E., Abrignani, M. G., Bonura, F., Trimarco, B., Galasso, G., Misuraca, G., Manes, M. T., Tuccillo, B., Irace, L., Olivari, Z., Totis, O., Ledda, A., Boccalatte, M., Iliceto, S., Tortorella, G., Esposito, L., De Rosa, P., Bianchi, R., Napoletano, C., Piccioni, L. L., Pavesi, P. C., Bovenzi, F. M., Boni, A., Merenda, R., Wolff, S., De Ferrari, G. M., Camporotondo, R., Gambino, P., Cutaia, A., Picariello, C., Cemin, R., Chiarella, F., Gauthier, L. G., Mircoli, L., Del Pinto, M., Finocchiaro, M. L., Scioli, R., Farina, R., Naddeo, C., Scherillo, M., Santopietro, S., Metra, M., Costa, F., Calculli, G., Troito, G., Pennisi, V., Adornato, E. M. F., Pirelli, S., Fadin, B. M., DI Biase, M., Ieva, R., Zuin, G., Sanfilippo, N., Mancuso, L., Pani, A., Serra, E., Marenzi, G., Assanelli, E. M., Ansalone, G., Cacciotti, L., Morocutti, G., Fresco, C., Berti, S., Paradossi, U., Bozzano, A., Mauro, A., Noussan, P., Zanini, P., Bolognese, L., Falsini, G., Costa, P., Manca, G., Caldarola, P., Locuratolo, N., Cipolla, T., Becchina, M., Cocco, G., Scalera, G., Stefanelli, S., Giunta, N., Sinagra, G., Meloni, L., Lai, O., Chiaranda, G., Luca, G., Helou, J. S., Biscottini, E., Magliari, F., Callerame, M., Uguccioni, M., Pugliese, M., Sanchez, F., Tartaglione, S., Ignone, G., Mavilio, G., Mantovan, R., Bini, R., Caico, S. I., Demolli, V., Proietti, F., Michisanti, M., Musmeci, G., Cantamessa, P., Sicuso, G., Micalef, S. S., Accogli, M., Zaccaria, M., Caputo, M., DI Paolo, G., Piatti, L., Farina, A., Vicinelli, P., Paloscia, L., DI Clemente, D., Felis, S., Castini, D., Rota, C., Casu, G., Bonano, S., Margheri, M., Lucchi, G. R., Serdoz, R., Proietti, P., Autore, C., Conti, E., Russo, V., Orlando, P., Ramondo, A. B., Bontorin, M., Marcolongo, M., Santagostino, M., Maestroni, A., Vitti, P., Rodella, P., Bonetti, P., Elia, M., Lumare, R., Politi, A., Gritti, S., Poletti, F., Mafrici, A., Fusco, R., Bongo, A. S., Bacchini, S., Gasparetto, V., Ferraiuolo, G., De Luca, M., Campana, C., Bonatti, R., Gaita, F., Bergerone, S., Bonmassari, R., Zeni, P., Langialonga, T., Scarcia, A., Caravita, L., Musacchio, E., Augello, G., Usmiani, T., Stomaci, B., Cirino, D., Pierini, S., Bottiglieri, G., Liso, A., Mussardo, M., Tosi, P., Sala, R., Belloni, A., Blengino, S., Lisi, E., Delfino, P., Auguadro, C., Brunazzi, M. C., Pacchioni, E., Fattore, L., Bosco, B., Blandizzi, S., Pajes, G., Patruno, N., Perna, G. P., Francioni, M., Favale, S., Vestito, D., Lombardi, A., Capecchi, A., Ferrero, P., De Vincenzo, C., Magri, G., Indolfi, C., De Rosa, S., Rossi, M., Collarini, L., Agnelli, D., Conti, G., Tonelli, C., Spadaro, C., Negroni, S., DI Noto, G., Lanari, A., Casolo, G., Del Meglio, J., Negrini, M., Celentano, A., Sifola, C., Rellini, G., Mattia, A. D., Molero, U., Piovaccari, G., Grosseto, D., Callegarin, L., Fiasconaro, G., Crivello, R., Thiebat, B., Leone, G., Tamburino, C., Caruso, G., Cassadonte, F., Sassone, B., Fuca, G., Sormani, L., Percoco, G. F., Mazzucco, R., Cazzani, E., Gianni, M., Limido, A., Luvini, M., Guglielmi, R., Mannarini, A., Moruzzi, P., Pastori, P., Golia, B., Marzano, A., Orazi, S., Marchese, I., Anselmi, M., Girardi, P., Nassiacos, D., Meloni, S., Busacca, P., Generali, C. A., Corda, S., Costanza, G., Montalto, S., Argenziano, L., Tommasini, P., Emdin, M., Pasanisi, E. M., Colivicchi, F., Tubaro, M., Azzolini, P., Luciani, C., Doronzo, B., Coppolino, A., Dellavesa, P., Zenone, F., DI Marco, A., De Conti, F., Piccinni, G. C., Gualtieri, M. R., Bisignani, G., Leone, A., Arcuri, G. M., Marinacci, L., Rossi, P., Perotti, S., Cometti, V. C., Arcidiacono, S., Tramontana, M., Bazzucchi, M., Mezzetti, P., Romano, M., Villani, R., DI Giovambattista, R., Volpe, B., Tedesco, L., Carini, M., Vinci, S., Paolini, E. A., Busoni, F., Piergentili, C., Navazio, A., Manca, F., Cocco, F., Pennetta, C. A., Maggiolini, S., Galbiati, R., Bruna, C., Ferrero, L., Brigido, S., Barducci, E., Musacchio, D., Manduca, B., Marchese, D., Patrassi, L. A., Pattarino, F. A., Rocchi, M., Briglia, S., Fanelli, R., Villella, M., Gronda, E., Massa, D., Lenti, V., DI Gregorio, L., Bottero, M., Bazzanini, F., Braggion, G., Antoniceli, R., Caraceni, D., Guzzo, V., DI Giovanni, P., Scarpini, S., Severgnini, B., Musolino, M. F., Casa, S. D., Gobbi, M., Arena, G., Bonizzato, S., Agnoletto, V., Sansoni, S., Pes, R. A. M., Denti, S., Polizzi, G. M., Pino, R., Commisso, B., Merlino, A., DI Lorenzo, L., Porchetta, I., Del Furia, F., Colombi, E., Covini, D., Cavalieri, F., Antonaci, S., Rubino, G., Ciulla, A., Bui, F., Casorelli, E., Caliendo, L., Laezza, A., Americo, L., Schillaci, A. M., Cordoni, M., Barsotti, L., Gaudio, C., Barilla, F., Cannone, M., Memeo, R., Truncellito, L., Andriani, A., Salituri, S., Verrina, F., Pafi, M., Sebastiani, M. L., Amico, A. F., Scolozzi, D., Lupi, G., D'Alea, A., Catanzariti, D., Angheben, C., Ottaviano, A., Levantesi, G., de Luca, Leonardo, Musumeci, Giuseppe, Leonardi, Sergio, Gonzini, Lucio, Cavallini, Claudio, Calabrò, Paolo, Mauro, Ciro, Cacciavillani, Luisa, Savonitto, Stefano, de Servi, Stefano, Caporale, Roberto, Ceravolo, Roberto, Formigli, Dario, Lupi, Alessandro, Rakar, Sadir, Smecca, Ivan, Maggioni, Aldo Pietro, Lucci, Donata, Lorimer, Andrea, Orsini, Giampietro, Fabbri, Gianna, Bianchini, Elisa, Abrignani, Maurizio Giuseppe, Bonura, Francesc, Trimarco, Bruno, Galasso, Gennaro, Misuraca, Gianfranco, Manes, Maria Teresa, Tuccillo, Bernardino, and Irace, Luigi.

Subjects
Male, Prasugrel, medicine.medical_treatment, Myocardial Infarction, antithrombotic therapy, 030204 cardiovascular system & hematology, acute coronary syndromes, bivalirudin, heparins, percutaneous coronary intervention, prasugrel, ticagrelor, 0302 clinical medicine, Antithrombotic, 80 and over, Bivalirudin, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Registries, Aged, 80 and over, General Medicine, Hirudins, Middle Aged, Recombinant Proteins, Italy, Female, Cardiology and Cardiovascular Medicine, Ticagrelor, medicine.drug, medicine.medical_specialty, Platelet Glycoprotein GPIIb-IIIa Complex, NO, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, Acute Coronary Syndrome, Aged, Aspirin, business.industry, Heparin, Percutaneous coronary intervention, Anticoagulants, medicine.disease, Peptide Fragments, Clinical trial, Cross-Sectional Studies, Logistic Models, Conventional PCI, Multivariate Analysis, business
Abstract

Aims In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). Methods EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy. Results Over a 3-week period, a total of 2585 consecutive ACS patients have been enrolled in 203 cardiac care units across Italy. Among these patients, 1755 underwent PCI (923 with ST-elevation myocardial infarction and 832 with non-ST-elevation ACS). In the catheterization laboratory, unfractioned heparin was the most used antithrombotic drug in both ST-elevation myocardial infarction (64.7%) and non-ST-elevation ACS (77.5%) undergoing PCI and, as aspirin, bivalirudin and glycoprotein IIb/IIIa inhibitors (GPIs) more frequently employed before or during PCI compared with the postprocedural period. Any crossover of heparin therapy occurred in 36.0% of cases, whereas switching from one P2Y12 inhibitor to another occurred in 3.7% of patients. Multivariable analysis yielded several independent predictors of GPIs and of bivalirudin use in the catheterization laboratory, mainly related to clinical presentation, PCI complexity and presence of complications during the procedure. Conclusion In our contemporary, nationwide, all-comers cohort of ACS patients undergoing PCI, antithrombotic therapies were commonly initiated before the catheterization laboratory. In the periprocedural period, the most frequently employed drugs were unfractioned heparin, leading to a high rate of crossover, followed by GPIs and bivalirudin, mainly used during complex PCI. Clinical trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02015624.

Published
2017

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