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2. Pulmonary embolism in patients with COVID-19: characteristics and outcomes in the Cardio-COVID Italy multicenter study

Author

Ameri, Pietro, Inciardi, Riccardo M., Di Pasquale, Mattia, Agostoni, Piergiuseppe, Bellasi, Antonio, Camporotondo, Rita, Canale, Claudia, Carubelli, Valentina, Carugo, Stefano, Catagnano, Francesco, Danzi, Giambattista, Dalla Vecchia, Laura, Giovinazzo, Stefano, Gnecchi, Massimiliano, Guazzi, Marco, Iorio, Anita, La Rovere, Maria Teresa, Leonardi, Sergio, Maccagni, Gloria, Mapelli, Massimo, Margonato, Davide, Merlo, Marco, Monzo, Luca, Mortara, Andrea, Nuzzi, Vincenzo, Piepoli, Massimo, Porto, Italo, Pozzi, Andrea, Provenzale, Giovanni, Sarullo, Filippo, Sinagra, Gianfranco, Tedino, Chiara, Tomasoni, Daniela, Volterrani, Maurizio, Zaccone, Gregorio, Lombardi, Carlo Mario, Senni, Michele, and Metra, Marco

Published
2021
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3. Machine learning for prediction of in-hospital mortality in coronavirus disease 2019 patients: results from an Italian multicenter study

Author

Vezzoli, Marika, Inciardi, Riccardo Maria, Oriecuia, Chiara, Paris, Sara, Murillo, Natalia Herrera, Agostoni, Piergiuseppe, Ameri, Pietro, Bellasi, Antonio, Camporotondo, Rita, Canale, Claudia, Carubelli, Valentina, Carugo, Stefano, Catagnano, Francesco, Danzi, Giambattista, Dalla Vecchia, Laura, Giovinazzo, Stefano, Gnecchi, Massimiliano, Guazzi, Marco, Iorio, Anita, La Rovere, Maria Teresa, Leonardi, Sergio, Maccagni, Gloria, Mapelli, Massimo, Margonato, Davide, Merlo, Marco, Monzo, Luca, Mortara, Andrea, Nuzzi, Vincenzo, Pagnesi, Matteo, Piepoli, Massimo, Porto, Italo, Pozzi, Andrea, Provenzale, Giovanni, Sarullo, Filippo, Senni, Michele, Sinagra, Gianfranco, Tomasoni, Daniela, Adamo, Marianna, Volterrani, Maurizio, Maroldi, Roberto, Metra, Marco, Lombardi, Carlo Mario, and Specchia, Claudia

Published
2022
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4. Procedural and one-year outcomes following drug-eluting stent and drug-coated balloon combination for the treatment of de novo diffuse coronary artery disease: the HYPER Study

Author

BUONO, Andrea, primary, PELLICANO, Mariano, additional, REGAZZOLI, Damiano, additional, DONAHUE, Michael, additional, TEDESCHI, Delio, additional, LOFFI, Marco, additional, ZIMBARDO, Giuseppe, additional, REIMERS, Bernhard, additional, DANZI, Giambattista, additional, DE BLASIO, Giuseppe, additional, TESPILI, Maurizio, additional, and IELASI, Alfonso, additional

Published
2023
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6. 554 Machine learning for prediction of in-hospital mortality in COVID-19 patients: results from an Italian multicentre study

Author

Paris, Sara, primary, Inciardi, Riccardo Maria, additional, Specchia, Claudia, additional, Vezzoli, Marika, additional, Oriecuia, Chiara, additional, Lombardi, Carlo Mario, additional, Murillo, Natalia Herrera, additional, Pagnesi, Matteo, additional, Tomasoni, Daniela, additional, Ameri, Pietro, additional, Carubelli, Valentina, additional, Agostoni, Piergiuseppe, additional, Canale, Claudia, additional, Carugo, Stefano, additional, Danzi, Giambattista, additional, Pasquale, Mattia Di, additional, Sarullo, Filippo, additional, Rovere, Maria Teresa La, additional, Mortara, Andrea, additional, Piepoli, Massimo, additional, Porto, Italo, additional, Sinagra, Gianfranco, additional, Volterrani, Maurizio, additional, Gnecchi, Massimiliano, additional, Leonardi, Sergio, additional, Merlo, Marco, additional, Iorio, Annamaria, additional, Giovinazzo, Stefano, additional, Bellasi, Antonio, additional, Zaccone, Gregorio, additional, Camporotondo, Rita, additional, Catagnano, Francesco, additional, Vecchia, Laura Dalla, additional, Maccagni, Gloria, additional, Mapelli, Massimo, additional, Margonato, Davide, additional, Monzo, Luca, additional, Nuzzi, Vincenzo, additional, Pozzi, Andrea, additional, Provenzale, Giovanni, additional, Tedino, Chiara, additional, Guazzi, Marco, additional, Senni, Michele, additional, and Metra, Marco, additional

Published
2021
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7. Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study

Author

Paris, Sara, primary, Inciardi, Riccardo M, additional, Lombardi, Carlo Mario, additional, Tomasoni, Daniela, additional, Ameri, Pietro, additional, Carubelli, Valentina, additional, Agostoni, Piergiuseppe, additional, Canale, Claudia, additional, Carugo, Stefano, additional, Danzi, Giambattista, additional, Di Pasquale, Mattia, additional, Sarullo, Filippo, additional, La Rovere, Maria Teresa, additional, Mortara, Andrea, additional, Piepoli, Massimo, additional, Porto, Italo, additional, Sinagra, Gianfranco, additional, Volterrani, Maurizio, additional, Gnecchi, Massimiliano, additional, Leonardi, Sergio, additional, Merlo, Marco, additional, Iorio, Annamaria, additional, Giovinazzo, Stefano, additional, Bellasi, Antonio, additional, Zaccone, Gregorio, additional, Camporotondo, Rita, additional, Catagnano, Francesco, additional, Dalla Vecchia, Laura, additional, Maccagni, Gloria, additional, Mapelli, Massimo, additional, Margonato, Davide, additional, Monzo, Luca, additional, Nuzzi, Vincenzo, additional, Pozzi, Andrea, additional, Provenzale, Giovanni, additional, Specchia, Claudia, additional, Tedino, Chiara, additional, Guazzi, Marco, additional, Senni, Michele, additional, and Metra, Marco, additional

Published
2021
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8. Pulmonary embolism in patients with COVID-19: characteristics and outcomes in the Cardio-COVID Italy multicenter study

Author

Ameri, Pietro, primary, Inciardi, Riccardo M., additional, Di Pasquale, Mattia, additional, Agostoni, Piergiuseppe, additional, Bellasi, Antonio, additional, Camporotondo, Rita, additional, Canale, Claudia, additional, Carubelli, Valentina, additional, Carugo, Stefano, additional, Catagnano, Francesco, additional, Danzi, Giambattista, additional, Dalla Vecchia, Laura, additional, Giovinazzo, Stefano, additional, Gnecchi, Massimiliano, additional, Guazzi, Marco, additional, Iorio, Anita, additional, La Rovere, Maria Teresa, additional, Leonardi, Sergio, additional, Maccagni, Gloria, additional, Mapelli, Massimo, additional, Margonato, Davide, additional, Merlo, Marco, additional, Monzo, Luca, additional, Mortara, Andrea, additional, Nuzzi, Vincenzo, additional, Piepoli, Massimo, additional, Porto, Italo, additional, Pozzi, Andrea, additional, Provenzale, Giovanni, additional, Sarullo, Filippo, additional, Sinagra, Gianfranco, additional, Tedino, Chiara, additional, Tomasoni, Daniela, additional, Volterrani, Maurizio, additional, Zaccone, Gregorio, additional, Lombardi, Carlo Mario, additional, Senni, Michele, additional, and Metra, Marco, additional

Published
2020
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9. Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short- and long-term outcomes of coronary balloon angioplasty: the DEBATE study

Author

Serruys, Patrick W., di Mario, Carlo, Piek, Jan, Schroeder, Erwin, Vrints, Christiaan, Probst, Peter, de Bruyne, Bernard, Hanet, Claude, Fleck, Eckart, Verna, Edoardo, Voudris, Vasilis, Geschwind, Herbert, Emanuelsson, Hakan, Mülberger, V., Danzi, Giambattista, Peels, Hans O., Ford, Andrew J., and Boersma, Enc

Published
1997

10. Prognostic value of intracoronary flow velocity and diameter stenosis in assessing the short- and long-term outcomes of coronary balloon angioplasty : The DEBATE study (Doppler Endpoints Balloon Angioplasty Trial Europe)

Author

UCL - MD/MINT - Département de médecine interne, UCL - (MGD) Service de cardiologie, Serruys, Patrick W., di Mario, Carlo, Piek, Jan, Schroeder, Erwin, Vrints, Christian, Probst, Peter, De Bruyne, Bernard, Hanet, Claude, Fleck, Eckart, Haude, Michael, Verna, Edoardo, Voudris, Vasilis, Geschwind, Herbert, Emanuelsson, Hakan, Muhlberger, V., Danzi, Giambattista, Peels, Hans O., Ford, Andrew J., Boersma, Eric, UCL - MD/MINT - Département de médecine interne, UCL - (MGD) Service de cardiologie, Serruys, Patrick W., di Mario, Carlo, Piek, Jan, Schroeder, Erwin, Vrints, Christian, Probst, Peter, De Bruyne, Bernard, Hanet, Claude, Fleck, Eckart, Haude, Michael, Verna, Edoardo, Voudris, Vasilis, Geschwind, Herbert, Emanuelsson, Hakan, Muhlberger, V., Danzi, Giambattista, Peels, Hans O., Ford, Andrew J., and Boersma, Eric

Abstract

Background The aim of this prospective, multicenter study was the identification of Doppler flow velocity measurements predictive of clinical outcome of patients undergoing single-vessel balloon angioplasty with no previous Q-wave myocardial infarction. Methods and Results In 297 patients, a Doppler guidewire was used to measure basal and maximal hyperemic flow velocities proximal and distal to the stenosis before and after angioplasty. In 225 patients with an angiographically successful percutaneous transluminal coronary angioplasty (PTCA), post-procedural distal coronary flow reserve (CFR) and percent diameter stenosis (DS%) were correlated with symptoms and/or ischemia at 1 and 6 months, with the need for target lesion revascularization, and with angiographic restenosis (defined as DS greater than or equal to 50% at follow-up). Logistic regression and receiver operator characteristic curve analyses were applied to determine the prognostic cutoff value of CFR and DS separately and in combination. Optimal cutoff criteria for predictors of these clinical events were DS, 35%; CFR, 2.5. A distal CFR after angioplasty >2.5 with a residual DS less than or equal to 35% identified lesions with a low incidence of recurrence of symptoms at 1 month (10% versus 19%, P=.149) and at 6 months (23% versus 47%, P=.005), a low need for reintervention (16% versus 34%, P=.024), and a low restenosis rate (16% versus 41%, P=.002) compared with patients who did nor meet these criteria. Conclusions Measurements of distal CFR after PTCA, in combination with DS%, have a predictive value, albeit modest for the short-and long-term outcomes after PTCA, and thus may be used to identify patients who will or will not benefit from additional therapy such as stent implantation.

Published
1997

11. Machine learning for prediction of in-hospital mortality in coronavirus disease 2019 patients: results from an Italian multicenter study

Author

Marika Vezzoli, Riccardo Maria Inciardi, Chiara Oriecuia, Sara Paris, Natalia Herrera Murillo, Piergiuseppe Agostoni, Pietro Ameri, Antonio Bellasi, Rita Camporotondo, Claudia Canale, Valentina Carubelli, Stefano Carugo, Francesco Catagnano, Giambattista Danzi, Laura Dalla Vecchia, Stefano Giovinazzo, Massimiliano Gnecchi, Marco Guazzi, Anita Iorio, Maria Teresa La Rovere, Sergio Leonardi, Gloria Maccagni, Massimo Mapelli, Davide Margonato, Marco Merlo, Luca Monzo, Andrea Mortara, Vincenzo Nuzzi, Matteo Pagnesi, Massimo Piepoli, Italo Porto, Andrea Pozzi, Giovanni Provenzale, Filippo Sarullo, Michele Senni, Gianfranco Sinagra, Daniela Tomasoni, Marianna Adamo, Maurizio Volterrani, Roberto Maroldi, Marco Metra, Carlo Mario Lombardi, Claudia Specchia, Vezzoli, Marika, Inciardi, Riccardo Maria, Oriecuia, Chiara, Paris, Sara, Murillo, Natalia Herrera, Agostoni, Piergiuseppe, Ameri, Pietro, Bellasi, Antonio, Camporotondo, Rita, Canale, Claudia, Carubelli, Valentina, Carugo, Stefano, Catagnano, Francesco, Danzi, Giambattista, Dalla Vecchia, Laura, Giovinazzo, Stefano, Gnecchi, Massimiliano, Guazzi, Marco, Iorio, Anita, La Rovere, Maria Teresa, Leonardi, Sergio, Maccagni, Gloria, Mapelli, Massimo, Margonato, Davide, Merlo, Marco, Monzo, Luca, Mortara, Andrea, Nuzzi, Vincenzo, Pagnesi, Matteo, Piepoli, Massimo, Porto, Italo, Pozzi, Andrea, Provenzale, Giovanni, Sarullo, Filippo, Senni, Michele, Sinagra, Gianfranco, Tomasoni, Daniela, Adamo, Marianna, Volterrani, Maurizio, Maroldi, Roberto, Metra, Marco, Lombardi, Carlo Mario, and Specchia, Claudia

Subjects
Aged, 80 and over, Male, SARS-CoV-2, adult, COVID-19, General Medicine, aged, aged, 80 and over, creatinine, female, hospital mortality, humans, machine learning, male, middle aged, SARS-Cov-2, troponin, Middle Aged, Troponin, Machine Learning, Creatinine, 80 and over, Humans, Female, Aged, Hospital Mortality, Cardiology and Cardiovascular Medicine, Human
Abstract

Several risk factors have been identified to predict worse outcomes in patients affected by SARS-CoV-2 infection. Machine learning algorithms represent a novel approach to identifying a prediction model with a good discriminatory capacity to be easily used in clinical practice. The aim of this study was to obtain a risk score for in-hospital mortality in patients with coronavirus disease infection (COVID-19) based on a limited number of features collected at hospital admission.We studied an Italian cohort of consecutive adult Caucasian patients with laboratory-confirmed COVID-19 who were hospitalized in 13 cardiology units during Spring 2020. The Lasso procedure was used to select the most relevant covariates. The dataset was randomly divided into a training set containing 80% of the data, used for estimating the model, and a test set with the remaining 20%. A Random Forest modeled in-hospital mortality with the selected set of covariates: its accuracy was measured by means of the ROC curve, obtaining AUC, sensitivity, specificity and related 95% confidence interval (CI). This model was then compared with the one obtained by the Gradient Boosting Machine (GBM) and with logistic regression. Finally, to understand if each model has the same performance in the training and test set, the two AUCs were compared using the DeLong's test. Among 701 patients enrolled (mean age 67.2 ± 13.2 years, 69.5% male individuals), 165 (23.5%) died during a median hospitalization of 15 (IQR, 9-24) days. Variables selected by the Lasso procedure were: age, oxygen saturation, PaO2/FiO2, creatinine clearance and elevated troponin. Compared with those who survived, deceased patients were older, had a lower blood oxygenation, lower creatinine clearance levels and higher prevalence of elevated troponin (all P 0.001). The best performance out of the samples was provided by Random Forest with an AUC of 0.78 (95% CI: 0.68-0.88) and a sensitivity of 0.88 (95% CI: 0.58-1.00). Moreover, Random Forest was the unique model that provided similar performance in sample and out of sample (DeLong test P = 0.78).In a large COVID-19 population, we showed that a customizable machine learning-based score derived from clinical variables is feasible and effective for the prediction of in-hospital mortality.

Published
2022

12. Pulmonary embolism in patients with COVID-19: characteristics and outcomes in the Cardio-COVID Italy multicenter study

Author

Valentina Carubelli, Carlo Lombardi, Marco Metra, Davide Margonato, Massimiliano Gnecchi, Antonio Bellasi, Maurizio Volterrani, Marco Guazzi, Gregorio Zaccone, Riccardo M. Inciardi, Massimo F Piepoli, Mattia Di Pasquale, Laura Adelaide Dalla Vecchia, Francesco Catagnano, Stefano Carugo, Michele Senni, Sergio Leonardi, Vincenzo Nuzzi, Pietro Ameri, Filippo M. Sarullo, Stefano Giovinazzo, Luca Monzo, Rita Camporotondo, Gianfranco Sinagra, Andrea Mortara, Giovanni Provenzale, Daniela Tomasoni, Marco Merlo, Anita Iorio, Maria Teresa La Rovere, Chiara Tedino, Andrea Pozzi, Claudia Canale, Giambattista Danzi, Piergiuseppe Agostoni, Italo Porto, Gloria Maccagni, Massimo Mapelli, Ameri, Pietro, Inciardi, Riccardo M, Di Pasquale, Mattia, Agostoni, Piergiuseppe, Bellasi, Antonio, Camporotondo, Rita, Canale, Claudia, Carubelli, Valentina, Carugo, Stefano, Catagnano, Francesco, Danzi, Giambattista, Vecchia, Laura Dalla, Giovinazzo, Stefano, Gnecchi, Massimiliano, Guazzi, Marco, Iorio, Anita, La Rovere, Maria Teresa, Leonardi, Sergio, Maccagni, Gloria, Mapelli, Massimo, Margonato, Davide, Merlo, Marco, Monzo, Luca, Mortara, Andrea, Nuzzi, Vincenzo, Piepoli, Massimo, Porto, Italo, Pozzi, Andrea, Provenzale, Giovanni, Sarullo, Filippo, Sinagra, Gianfranco, Tedino, Chiara, Tomasoni, Daniela, Volterrani, Maurizio, Zaccone, Gregorio, Lombardi, Carlo Mario, Senni, Michele, Metra, Marco, Ameri, P, Inciardi, R, Di Pasquale, M, Agostoni, P, Bellasi, A, Camporotondo, R, Canale, C, Carubelli, V, Carugo, S, Catagnano, F, Danzi, G, Dalla Vecchia, L, Giovinazzo, S, Gnecchi, M, Guazzi, M, Iorio, A, La Rovere, M, Leonardi, S, Maccagni, G, Mapelli, M, Margonato, D, Merlo, M, Monzo, L, Mortara, A, Nuzzi, V, Piepoli, M, Porto, I, Pozzi, A, Provenzale, G, Sarullo, F, Sinagra, G, Tedino, C, Tomasoni, D, Volterrani, M, Zaccone, G, Lombardi, C, Senni, M, and Metra, M

Subjects
Male, 030204 cardiovascular system & hematology, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Coagulopathy, 80 and over, Medicine, 030212 general & internal medicine, Hospital Mortality, Anticoagulant, COVID-19, d-dimer, Death, Thromboembolism, Tomography, Aged, 80 and over, education.field_of_study, Incidence (epidemiology), Incidence, Respiration, General Medicine, Middle Aged, Pulmonary embolism, X-Ray Computed, Hospitalization, Italy, Artificial, Breathing, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.drug, medicine.medical_specialty, Population, Hemorrhage, Fibrin Fibrinogen Degradation Products, 03 medical and health sciences, Tocilizumab, Internal medicine, Humans, D-dimer, Aged, Follow-Up Studies, Pulmonary Embolism, Respiration, Artificial, Retrospective Studies, Tomography, X-Ray Computed, education, Original Paper, business.industry, medicine.disease, chemistry, Heart failure, Ritonavir, business, Kidney disease
Abstract

Background Pulmonary embolism (PE) has been described in coronavirus disease 2019 (COVID-19) critically ill patients, but the evidence from more heterogeneous cohorts is limited. Methods Data were retrospectively obtained from consecutive COVID-19 patients admitted to 13 Cardiology Units in Italy, from March 1st to April 9th, 2020, and followed until in-hospital death, discharge, or April 23rd, 2020. The association of baseline variables with computed tomography-confirmed PE was investigated by Cox hazards regression analysis. The relationship between d-dimer levels and PE incidence was evaluated using restricted cubic splines models. Results The study included 689 patients (67.3 ± 13.2 year-old, 69.4% males), of whom 43.6% were non-invasively ventilated and 15.8% invasively. 52 (7.5%) had PE over 15 (9–24) days of follow-up. Compared with those without PE, these subjects had younger age, higher BMI, less often heart failure and chronic kidney disease, more severe cardio-pulmonary involvement, and higher admission d-dimer [4344 (1099–15,118) vs. 818.5 (417–1460) ng/mL, p p p = 0.06). In multivariate regression, only d-dimer was associated with PE (HR 1.72, 95% CI 1.13–2.62; p = 0.01). The relation between d-dimer concentrations and PE incidence was linear, without inflection point. Only two subjects had a baseline d-dimer Conclusions PE occurs in a sizable proportion of hospitalized COVID-19 patients. The implications of bleeding events and the role of d-dimer in this population need to be clarified. Graphic abstract

Published
2021

13. Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients. results of the Cardio-COVID-italy multicentre study

Author

Luca Monzo, Carlo Lombardi, Sara Paris, Chiara Tedino, Maurizio Volterrani, Rita Camporotondo, Marco Metra, Filippo M. Sarullo, Piergiuseppe Agostoni, Antonio Bellasi, Marco Guazzi, Mattia Di Pasquale, Daniela Tomasoni, Sergio Leonardi, Francesco Catagnano, Vincenzo Nuzzi, Riccardo M. Inciardi, Pietro Ameri, Gianfranco Sinagra, Stefano Carugo, Valentina Carubelli, Annamaria Iorio, Claudia Specchia, Italo Porto, Laura Adelaide Dalla Vecchia, Giovanni Provenzale, Michele Senni, Andrea Mortara, Stefano Giovinazzo, Maria Teresa La Rovere, Andrea Pozzi, Massimiliano Gnecchi, Marco Merlo, Gregorio Zaccone, Gloria Maccagni, Davide Margonato, Massimo Mapelli, Claudia Canale, Giambattista Danzi, Massimo F Piepoli, Paris, Sara, Inciardi, Riccardo M, Lombardi, Carlo Mario, Tomasoni, Daniela, Ameri, Pietro, Carubelli, Valentina, Agostoni, Piergiuseppe, Canale, Claudia, Carugo, Stefano, Danzi, Giambattista, Di Pasquale, Mattia, Sarullo, Filippo, La Rovere, Maria Teresa, Mortara, Andrea, Piepoli, Massimo, Porto, Italo, Sinagra, Gianfranco, Volterrani, Maurizio, Gnecchi, Massimiliano, Leonardi, Sergio, Merlo, Marco, Iorio, Annamaria, Giovinazzo, Stefano, Bellasi, Antonio, Zaccone, Gregorio, Camporotondo, Rita, Catagnano, Francesco, Dalla Vecchia, Laura, Maccagni, Gloria, Mapelli, Massimo, Margonato, Davide, Monzo, Luca, Nuzzi, Vincenzo, Pozzi, Andrea, Provenzale, Giovanni, Specchia, Claudia, Tedino, Chiara, Guazzi, Marco, Senni, Michele, Metra, Marco, Paris, S, Inciardi, R, Lombardi, C, Tomasoni, D, Ameri, P, Carubelli, V, Agostoni, P, Canale, C, Carugo, S, Danzi, G, Di Pasquale, M, Sarullo, F, La Rovere, M, Mortara, A, Piepoli, M, Porto, I, Sinagra, G, Volterrani, M, Gnecchi, M, Leonardi, S, Merlo, M, Iorio, A, Giovinazzo, S, Bellasi, A, Zaccone, G, Camporotondo, R, Catagnano, F, Dalla Vecchia, L, Maccagni, G, Mapelli, M, Margonato, D, Monzo, L, Nuzzi, V, Pozzi, A, Provenzale, G, Specchia, C, Tedino, C, Guazzi, M, Senni, M, and Metra, M

Subjects
Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Hospitalized patients, Cardiovascular risk factors, Atrial fibrillation, Coronavirus disease 2019, Outcome, Severe acute respiratory syndrome coronavirus-2 infection, Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Italy, Middle Aged, Risk Factors, SARS-CoV-2, Atrial Fibrillation, COVID-19, Heart Failure, 030204 cardiovascular system & hematology, 03 medical and health sciences, coronavirus disease 2019, 0302 clinical medicine, Interquartile range, Clinical Research, Physiology (medical), Internal medicine, severe acute respiratory syndrome coronavirus-2 infection, 80 and over, Medicine, Clinical significance, AcademicSubjects/MED00200, atrial fibrillation, 030212 general & internal medicine, Stroke, business.industry, outcome, Clinical course, medicine.disease, Cardiology and Cardiovascular Medicine, business
Abstract

Aims To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19). Methods and results We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9–24). Patients with a history of AF were older and with a higher burden of cardiovascular risk factors. Compared to patients without AF, they showed a higher rate of in-hospital death (38.7% vs. 20.8%; P 0.05 for both) and was not related to stroke or bleeding events. Conclusion Among hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities.

Published
2021

14. Implications of atrial fibrillation on the clinical course and outcomes of hospitalized COVID-19 patients: results of the Cardio-COVID-Italy multicentre study.

Author

Paris S, Inciardi RM, Lombardi CM, Tomasoni D, Ameri P, Carubelli V, Agostoni P, Canale C, Carugo S, Danzi G, Di Pasquale M, Sarullo F, La Rovere MT, Mortara A, Piepoli M, Porto I, Sinagra G, Volterrani M, Gnecchi M, Leonardi S, Merlo M, Iorio A, Giovinazzo S, Bellasi A, Zaccone G, Camporotondo R, Catagnano F, Dalla Vecchia L, Maccagni G, Mapelli M, Margonato D, Monzo L, Nuzzi V, Pozzi A, Provenzale G, Specchia C, Tedino C, Guazzi M, Senni M, and Metra M

Subjects
Aged, Aged, 80 and over, Female, Hospital Mortality, Humans, Italy epidemiology, Male, Middle Aged, Risk Factors, SARS-CoV-2, Atrial Fibrillation diagnosis, Atrial Fibrillation epidemiology, COVID-19, Heart Failure diagnosis, Heart Failure epidemiology
Abstract

Aims: To assess the clinical relevance of a history of atrial fibrillation (AF) in hospitalized patients with coronavirus disease 2019 (COVID-19)., Methods and Results: We enrolled 696 consecutive patients (mean age 67.4 ± 13.2 years, 69.7% males) admitted for COVID-19 in 13 Italian cardiology centres between 1 March and 9 April 2020. One hundred and six patients (15%) had a history of AF and the median hospitalization length was 14 days (interquartile range 9-24). Patients with a history of AF were older and with a higher burden of cardiovascular risk factors. Compared to patients without AF, they showed a higher rate of in-hospital death (38.7% vs. 20.8%; P < 0.001). History of AF was associated with an increased risk of death after adjustment for clinical confounders related to COVID-19 severity and cardiovascular comorbidities, including history of heart failure (HF) and increased plasma troponin [adjusted hazard ratio (HR): 1.73; 95% confidence interval (CI) 1.06-2.84; P = 0.029]. Patients with a history of AF also had more in-hospital clinical events including new-onset AF (36.8% vs. 7.9%; P < 0.001), acute HF (25.3% vs. 6.3%; P < 0.001), and multiorgan failure (13.9% vs. 5.8%; P = 0.010). The association between AF and worse outcome was not modified by previous or concomitant use of anticoagulants or steroid therapy (P for interaction >0.05 for both) and was not related to stroke or bleeding events., Conclusion: Among hospitalized patients with COVID-19, a history of AF contributes to worse clinical course with a higher mortality and in-hospital events including new-onset AF, acute HF, and multiorgan failure. The mortality risk remains significant after adjustment for variables associated with COVID-19 severity and comorbidities., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.)

Published
2021
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