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6. Platelet Inhibition with Ticagrelor 60 mg Versus 90 mg Twice Daily in Elderly Patients with Acute Coronary Syndrome: Rationale and Design of the PLINY THE ELDER Trial

Author

Piccolo, Raffaele, Avvedimento, Marisa, Canonico, Mario Enrico, Gargiulo, Paola, Paolillo, Roberta, Conti, Valeria, Dal Piaz, Fabrizio, Filippelli, Amelia, Morisco, Carmine, Simonetti, Fiorenzo, Leone, Attilio, Marenna, Alessandra, Bruzzese, Dario, Gargiulo, Giuseppe, Stabile, Eugenio, Di Serafino, Luigi, Franzone, Anna, Cirillo, Plinio, and Esposito, Giovanni

Published
2023
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9. Low-Dose Rivaroxaban Plus Aspirin in Patients With Peripheral Artery Disease Undergoing Lower Extremity Revascularization With and Without Concomitant Coronary Artery Disease: Insights From VOYAGER PAD

Author

Morrison, Justin T., Canonico, Mario Enrico, Anand, Sonia S., Patel, Manesh R., Debus, Eike Sebastian, Nehler, Mark R., Hess, Connie N., Hsia, Judith, Capell, Warren H., Muehlhofer, Eva, Haskell, Lloyd P., Berkowitz, Scott D., Bauersachs, Rupert M., and Bonaca, Marc P.

Published
2024
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10. Abstract 16428: Impact of Low-Dose Rivaroxaban Plus Aspirin on Myocardial Infarction in Patients With Peripheral Artery Disease With and Without Concomitant Coronary Artery Disease: Insights From VOYAGER PAD

Author

Canonico, Mario Enrico, Morrison, Justin, Anand, Sonia S, Patel, Manesh R, Debus, Sebastian, Nehler, Mark, Hess, Connie N, Hsia, Judith A, Capell, Warren, Muehlhofer, Eva, Haskell, Lloyd P, Berkowitz, Scott D, Bauersachs, Rupert, and Bonaca, Marc P

Published
2023
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16. Ticagrelor 60 vs. 90 mg in elderly ACS patients undergoing PCI: a randomized, crossover trial

Author

Piccolo, Raffaele, Simonetti, Fiorenzo, Avvedimento, Marisa, Cutillo, Maria, Canonico, Mario Enrico, Conti, Valeria, Gargiulo, Giuseppe, Paolillo, Roberta, Dal Piaz, Fabrizio, Filippelli, Amelia, Charlier, Bruno, Spinelli, Alessandra, Cristiano, Stefano, Cirillo, Plinio, Di Serafino, Luigi, Franzone, Anna, and Esposito, Giovanni

Abstract

Graphical AbstractInhibition of platelet reactivity following ticagrelor 60 mg vs. 90 mg in elderly patients (≥75 years) undergoing PCI for ACS.A total of 50 older patients with ACS undergoing PCI were randomized to ticagrelor 60 mg vs. 90 mg twice daily. Platelet reactivity was similar and non-inferior between the two ticagrelor maintenance doses, although plasma drug concentrations were significantly lower during treatment with ticagrelor 60 mg. ACS, acute coronary syndrome; LTA, light transmittance aggregometry; MEA, multiple electrode aggregometry; PCI, percutaneous coronary intervention; PRU, P2Y12reaction units.

Published
2024
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20. Abstract 9928: Risk Stratification for Amputation in Patients With Symptomatic Peripheral Artery Disease After Lower Extremity Revascularization: Insights From VOYAGER PAD

Author

King, R. Wilson, Nehler, Mark R, Patel, Manesh R, Debus, Sebastian, Anand, Sonia S, Canonico, Mario Enrico, Buchanan, Cullen, Capell, Warren, Hess, Connie N, Ycas, Joseph, Hsia, Judith A, Muehlhofer, Eva, Haskell, Lloyd P, Berkowitz, Scott D, Bauersachs, Rupert, and Bonaca, Marc P

Published
2022
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21. Low-Dose Rivaroxaban Plus Aspirin in Fragile Patients After Lower Extremity Revascularization.

Author

Canonico, Mario Enrico, Low Wang, Cecilia C., Hsia, Judith, Debus, E. Sebastian, Nehler, Mark R., Patel, Manesh R., Anand, Sonia S., Ycas, Joseph, Capell, Warren H., Muehlhofer, Eva, Haskell, Lloyd P., Berkowitz, Scott D., Bauersachs, Rupert, and Bonaca, Marc P.

Subjects
*PERIPHERAL vascular diseases, *FIBRINOLYTIC agents, *GLOMERULAR filtration rate, *MYOCARDIAL infarction, *ISCHEMIC stroke, *LEG amputation, *ANKLE brachial index
Abstract

Rivaroxaban 2.5 mg plus aspirin reduced limb and cardiovascular events and increased bleeding in patients with symptomatic peripheral artery disease (PAD) after lower extremity revascularization in the VOYAGER PAD (Efficacy and Safety of Rivaroxaban in Reducing the Risk of Major Thrombotic Vascular Events in Subjects With Symptomatic Peripheral Artery Disease Undergoing Peripheral Revascularization Procedures of the Lower Extremities) study. Fragile patients are at heightened risk for ischemic and bleeding events. The purpose of this study was to investigate the safety and efficacy of rivaroxaban 2.5 mg in fragile patients from VOYAGER PAD. Patients were categorized as fragile based on prespecified criteria (age >75 years, weight ≤50 kg, or baseline estimated glomerular filtration rate <50 mL/min/1.73 m2). The primary efficacy outcome was the composite of acute limb ischemia, major amputation of a vascular etiology, myocardial infarction, ischemic stroke, or cardiovascular death. The principal safety outcome was TIMI major bleeding. Of 6,564 randomized patients, a total of 1,674 subjects were categorized as fragile at baseline. In the placebo arm, fragile patients were at higher risk of the primary outcome (HR: 1.34; 95% CI: 1.12-1.61) and TIMI major bleeding (HR: 1.57; 95% CI: 0.83-2.96), compared with nonfragile patients. The effect of rivaroxaban on the primary endpoint was not modified by frailty status (fragile HR: 0.93; 95% CI: 0.75-1.15; nonfragile HR: 0.83; 95% CI: 0.72-0.97; P interaction = 0.37). Rivaroxaban increased TIMI major bleeding in fragile (HR: 1.54; 95% CI: 0.82-2.91) and nonfragile patients (HR: 1.37; 95% CI: 0.84-2.23; P interaction = 0.65). Patients with PAD after lower extremity revascularization meeting fragile criteria are at higher risk of ischemic complications and bleeding. Rivaroxaban reduces ischemic risk and increases bleeding regardless of frailty status. These data may assist in personalization of antithrombotic therapy in fragile population. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Safety and Efficacy of Combined Coronary and Peripheral Percutaneous Revascularization: A Proof-of-Concept Study.

Author

Canonico, Mario Enrico, Verde, Nicola, Avvedimento, Marisa, Leone, Attilio, Cutillo, Maria, Simonetti, Fiorenzo, Esposito, Salvatore, Bardi, Luca, Giugliano, Giuseppe, Stabile, Eugenio, Piccolo, Raffaele, and Esposito, Giovanni

Subjects
*MAJOR adverse cardiovascular events, *PERIPHERAL vascular diseases, *PERCUTANEOUS coronary intervention, *CORONARY artery disease, *TREATMENT effectiveness
Abstract

Background. Lower extremity peripheral artery disease (LEPAD) frequently coexists with coronary artery disease (CAD) in patients with multisite vascular disease (MVD). While percutaneous revascularization is well-established for both LEPAD and CAD, limited evidence exists for patients eligible for both procedures. Specifically, the feasibility of concomitant LEPAD and CAD percutaneous revascularization remains unknown. Objectives. To compare the efficacy and safety of concomitant coronary and lower extremity elective percutaneous revascularization. Methods. Between 2012 and 2021, we included 135 patients in an observational, retrospective single-center registry. The population was stratified into two groups: 45 patients (concomitant group) underwent simultaneous coronary and peripheral percutaneous interventions, and 90 patients (deferred group) underwent two separate procedures within one year. The primary efficacy endpoint was major adverse cardiovascular events (MACE) at one year, while the primary safety endpoint was in-hospital contrast-induced nephropathy (CIN). Results. Study groups were well-balanced in baseline characteristics. In terms of coronary features, the concomitant revascularization group more often underwent single-vessel percutaneous coronary intervention (PCI), while the deferred group had multivessel PCI with diffuse coronary disease. No differences were detected in the number of LEPAD lesions between groups. For the primary efficacy endpoint, the incidence of MACE at one year was 37.8% in the concomitant group vs. 34.4% in the deferred group (HR 1.20, 95% CI 0.64–2.10; p = 0.61). No significant differences were found in CIN occurrence between the concomitant and deferred groups (11.1% vs. 8.9%; OR 1.30; 95% CI 0.36–4.21; p = 0.68). Conclusions. Multisite vascular disease patients eligible for CAD and LEPAD percutaneous revascularization exhibited a high cardiovascular risk profile with diffuse multivessel coronary and lower extremity disease. Our study suggests the efficacy and safety of concomitant coronary and lower extremity percutaneous revascularization based on one-year MACE incidence and in-hospital CIN. However, dedicated studies are warranted to confirm the short- and long-term outcomes of the concomitant revascularization strategy. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Temporal Shifts In Guideline-directed Medical Therapy Prescribed At Discharge To Heart Failure Patients In A Large US Integrated Health System

Author

Gluckman, Ty, primary, Chiu, Shih Ting, additional, Rider, Deanna, additional, Tseng, Phil, additional, Mudd, James, additional, Remick, Joshua, additional, Sikirica, Slaven, additional, Carroll, Amy, additional, Granowitz, Craig, additional, Canonico, Mario Enrico, additional, Hsia, Judith, additional, and Bonaca, Marc, additional

Published
2024
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25. Echocardiographic Evaluation of Aortic Stenosis: A Comprehensive Review

Author

Manzo, Rachele, primary, Ilardi, Federica, additional, Nappa, Dalila, additional, Mariani, Andrea, additional, Angellotti, Domenico, additional, Immobile Molaro, Maddalena, additional, Sgherzi, Giulia, additional, Castiello, Domenico Simone, additional, Simonetti, Fiorenzo, additional, Santoro, Ciro, additional, Canonico, Mario Enrico, additional, Avvedimento, Marisa, additional, Piccolo, Raffaele, additional, Franzone, Anna, additional, and Esposito, Giovanni, additional

Published
2023
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26. Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review

Author

Angellotti, Domenico, primary, Manzo, Rachele, additional, Castiello, Domenico Simone, additional, Immobile Molaro, Maddalena, additional, Mariani, Andrea, additional, Iapicca, Cristina, additional, Nappa, Dalila, additional, Simonetti, Fiorenzo, additional, Avvedimento, Marisa, additional, Leone, Attilio, additional, Canonico, Mario Enrico, additional, Spaccarotella, Carmen Anna Maria, additional, Franzone, Anna, additional, Ilardi, Federica, additional, Esposito, Giovanni, additional, and Piccolo, Raffaele, additional

Published
2023
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28. Antithrombotic Therapy in Peripheral Artery Disease: Current Evidence and Future Directions

Author

Canonico, Mario Enrico, primary, Piccolo, Raffaele, additional, Avvedimento, Marisa, additional, Leone, Attilio, additional, Esposito, Salvatore, additional, Franzone, Anna, additional, Giugliano, Giuseppe, additional, Gargiulo, Giuseppe, additional, Hess, Connie N., additional, Berkowitz, Scott D., additional, Hsia, Judith, additional, Cirillo, Plinio, additional, Esposito, Giovanni, additional, and Bonaca, Marc P., additional

Published
2023
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30. sj-pdf-1-vmj-10.1177_1358863X231155308 – Supplemental material for Sex differences in guideline-directed medical therapy in 2021–22 among patients with peripheral artery disease

Author

Canonico, Mario Enrico, Hsia, Judith, Hess, Connie N, and Bonaca, Marc P

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental material, sj-pdf-1-vmj-10.1177_1358863X231155308 for Sex differences in guideline-directed medical therapy in 2021–22 among patients with peripheral artery disease by Mario Enrico Canonico, Judith Hsia, Connie N Hess and Marc P Bonaca in Vascular Medicine

Published
2023
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31. 351 MULTIPLE PHARMACODYNAMIC ASSESSMENTS OF CANGRELOR EFFECTS IN ELECTIVE COMPLEX PCI: DATA FROM PHARMACODYNAMIC EFFECTS OF CANGRELOR IN PATIENTS WITH ACUTE OR CHRONIC CORONARY SYNDROME UNDERGOING PERCUTANEOUS CORONARY INTERVENTION REGISTRY

Author

Sperandeo, Luca, primary, Marenna, Alessandra, additional, Manzi, Lina, additional, Avvedimento, Marisa, additional, Simonetti, Fiorenzo, additional, Canonico, Mario Enrico, additional, Paolillo, Roberta, additional, Spinelli, Alessandra, additional, Borgia, Francesco, additional, Di Serafino, Luigi, additional, Franzone, Anna, additional, Stabile, Eugenio, additional, Piccolo, Raffaele, additional, Cirillo, Plinio, additional, Valgimigli, Marco, additional, Esposito, Giovanni, additional, and Gargiulo, Giuseppe, additional

Published
2022
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36. Cognitive behavioral therapy delivered via digital mobile application for the treatment of type 2 diabetes: Rationale, design, and baseline characteristics of a randomized, controlled trial

Author

Canonico, Mario Enrico, primary, Hsia, Judith, additional, Guthrie, Nicole L., additional, Simmons, Martha, additional, Mehta, Prapti, additional, Lupinacci, Paul, additional, Edwards, Kate, additional, Mosesso, Kara, additional, Gearhart, Michelle, additional, Skuban, Aleksandar, additional, Bonaca, Marc P., additional, and Berman, Mark A., additional

Published
2022
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37. Echocardiographic Evaluation after Transcatheter Aortic Valve Implantation: A Comprehensive Review.

Author

Angellotti, Domenico, Manzo, Rachele, Castiello, Domenico Simone, Immobile Molaro, Maddalena, Mariani, Andrea, Iapicca, Cristina, Nappa, Dalila, Simonetti, Fiorenzo, Avvedimento, Marisa, Leone, Attilio, Canonico, Mario Enrico, Spaccarotella, Carmen Anna Maria, Franzone, Anna, Ilardi, Federica, Esposito, Giovanni, and Piccolo, Raffaele

Subjects
HEART valve prosthesis implantation, ECHOCARDIOGRAPHY, AORTIC stenosis
Abstract

Transcatheter aortic valve implantation (TAVI) is an increasingly popular treatment option for patients with severe aortic stenosis. Recent advancements in technology and imaging tools have significantly contributed to the success of TAVI procedures. Echocardiography plays a pivotal role in the evaluation of TAVI patients, both before and after the procedure. This review aims to provide an overview of the most recent technical advancements in echocardiography and their use in the follow-up of TAVI patients. In particular, the focus will be on the examination of the influence of TAVI on left and right ventricular function, which is frequently accompanied by other structural and functional alterations. Echocardiography has proven to be key also in detecting valve deterioration during extended follow-up. This review will provide valuable insights into the technical advancements in echocardiography and their role in the follow-up of TAVI patients. [ABSTRACT FROM AUTHOR]

Published
2023
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44. Platelet Inhibition with Ticagrelor 60 mg Versus 90 mg Twice Daily in Elderly Patients with Acute Coronary Syndrome: Rationale and Design of the PLINY THE ELDER Trial

Author

Piccolo, Raffaele, primary, Avvedimento, Marisa, additional, Canonico, Mario Enrico, additional, Gargiulo, Paola, additional, Paolillo, Roberta, additional, Conti, Valeria, additional, Dal Piaz, Fabrizio, additional, Filippelli, Amelia, additional, Morisco, Carmine, additional, Simonetti, Fiorenzo, additional, Leone, Attilio, additional, Marenna, Alessandra, additional, Bruzzese, Dario, additional, Gargiulo, Giuseppe, additional, Stabile, Eugenio, additional, Di Serafino, Luigi, additional, Franzone, Anna, additional, Cirillo, Plinio, additional, and Esposito, Giovanni, additional

Published
2022
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45. 777 Prehospital ECG in patients with acute myocardial infarction during the COVID-19 pandemic

Author

Leone, Attilio, Avvedimento, Marisa, Angellotti, Domenico, Simonetti, Fiorenzo, Iapicca, Cristina, Verde, Nicola, Manzi, Lina, Canonico, Mario Enrico, Spinelli, Alessandra, Franzone, Anna, Piccolo, Raffaele, and Esposito, Giovanni

Subjects
AcademicSubjects/MED00200, cardiovascular diseases, Covid-19, Cardiology and Cardiovascular Medicine
Abstract

Aims Primary percutaneous coronary intervention (PCI) represents the preferred revascularization strategy among patients with acute ST-segment elevation myocardial infarction (STEMI). A decline in the rates of primary PCI has been observed globally during the outbreak of coronavirus disease-19 (COVID-19). Fear of exposure to in-hospital infection has been hypothesized as the main mechanism of this phenomenon, also contributing to a delayed presentation of patients with STEMI. However, a formal assessment of initial electrocardiograms (ECGs) among STEMI patients during the COVID-19 pandemic is still lacking. We therefore compared pre-hospital ECGs of STEMI patients hospitalized in Italy after the first reported case of COVID-19 on 21 February 2020 with data from the same period in 2019 to identifying potential changes between the two periods. Methods and results Prehospital ECGs were obtained from the STEMI care network in the Campania region. Deidentified ECGs were analysed by two expert reviewers who were blinded to date of recording. Pathological Q-waves were defined as a Q-wave with a duration ≥40 ms and/or depth ≥25% of the R-wave in the same lead or the presence of a Q-wave equivalent. These criteria have been shown to be associated with final infarct size at cardiac magnetic resonance. For all conventional STEMI, the timing of STEMI onset was estimated with the Anderson-Wilkins (AW) acuteness score, ranging from 1 (least acute) to 4 (most acute). From 21 February 2020 to 16 April 2020, a total of 3239 pre-hospital ECGs were recorded by the emergency medical system and 167 (5.15%) were classified as STEMI. During the same period in 2019, 3505 pre-hospital ECGs were recorded, and 196 (5.59%) were classified as STEMI. There was no difference between the two study periods in terms of age, gender, type, and location of STEMI (Table 1). Pathological Q-waves were present in 54.5% of ECGs recorded during the COVID-19 period compared with 22.1% of ECGs recorded in the same period in 2019 (risk difference 32.3, 95% confidence intervals [CI]: 21.2–43.5 percentage points). There was also an increase in the mean number of Q-waves during the COVID-19 compared with the control period (1.4 vs. 0.9; P Conclusions Prehospital ECGs of STEMI patients during the COVID-19 pandemic presented more frequently with signs of late ischemia compared with the equivalent period in 2019. Approximately, one out of two patients had already pathological Q-waves in the initial ECG. The AW acuteness score is superior to patient history (historical timing) in predicting myocardial salvage and mortality after reperfusion in STEMI patients, thus explaining the higher mortality rate and the increased risk of infarct-related complications observed during the COVID-19 pandemic.

Published
2021
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47. 205 Dual antiplatelet therapy with third generation P2Y12 inhibitors in STEMI patients: impact of body mass index on high on-treatment platelet reactivity

Author

Scudiero, Fernando, primary, Canonico, Mario Enrico, additional, Sanna, Giuseppe Damiano, additional, Avvedimento, Marisa, additional, Leone, Attilio, additional, Saba, Pier Sergio, additional, Silverio, Angelo, additional, Galasso, Gennaro, additional, Porto, Italo, additional, Esposito, Giovanni, additional, and Parodi, Guido, additional

Published
2021
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48. Non-Invasive Assessment of Right Ventricle to Arterial Coupling for Prognosis Stratification of Fibrotic Interstitial Lung Diseases.

Author

Santoro, Ciro, Buonauro, Agostino, Canora, Angelo, Rea, Gaetano, Canonico, Mario Enrico, Esposito, Roberta, Sanduzzi, Alessandro, Esposito, Giovanni, and Bocchino, Marialuisa

Subjects
INTERSTITIAL lung diseases, SPECKLE tracking echocardiography, IDIOPATHIC pulmonary fibrosis, MEDIAN (Mathematics), FIBROSIS, PULMONARY artery
Abstract

Background: The coupling of the right ventricle (RV) to the pulmonary circulation is an indicator of RV performance that can be non-invasively estimated by echocardiography. There are no data about its use in patients affected by fibrotic interstitial lung diseases (f-ILD). Methods: Fifty f-ILD patients, including 27 cases with idiopathic pulmonary fibrosis (IPF) (M = 37; mean age 67 ± 7 years), were studied with standard and speckle-tracking echocardiography and compared with 30 age-matched healthy volunteers. The mean patient follow-up was 70 ± 4 months. Results: Fibrotic ILD patients had a larger right ventricle (RV) and worse diastolic function because the RV global longitudinal strain (GLS) was significantly lower and the systolic pulmonary artery pressure (sPAP) estimates were higher in comparison with those of controls. Conversely, tricuspid annular systolic excursion (TAPSE) did not differ between controls and patients. Median values of TAPSE/sPAP and RV GLS/sPAP were significantly reduced in f-ILD patients (p < 0.0001). Patients with an RV GLS/sPAP below the median value had a shorter survival time (61 vs. 74 months, p = 0.01); this parameter was an independent predictor of a worse outcome. Conclusion: Low estimates of RV GLS/sPAP are predictive of worse outcomes in f-ILD patients. RV coupling seems to be a promising surrogate biomarker of RV performance to discriminate the patient phenotype with significant management and prognosis implications. [ABSTRACT FROM AUTHOR]

Published
2022
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