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8. Impact of Glomerular Filtration Rate on the Incidence and Prognosis of New-Onset Atrial Fibrillation in Acute Myocardial Infarction

Author

Cosentino, N, Ballarotto, M, Campodonico, J, Milazzo, V, Bonomi, A, Genovesi, S, Moltrasio, M, De Metrio, M, Rubino, M, Veglia, F, Assanelli, E, Marana, I, Grazi, M, Lauri, G, Bartorelli, A, Marenzi, G, Cosentino, Nicola, Ballarotto, Marco, Campodonico, Jeness, Milazzo, Valentina, Bonomi, Alice, Genovesi, Simonetta, Moltrasio, Marco, De Metrio, Monica, Rubino, Mara, Veglia, Fabrizio, Assanelli, Emilio, Marana, Ivana, Grazi, Marco, Lauri, Gianfranco, Bartorelli, Antonio L, Marenzi, Giancarlo, Cosentino, N, Ballarotto, M, Campodonico, J, Milazzo, V, Bonomi, A, Genovesi, S, Moltrasio, M, De Metrio, M, Rubino, M, Veglia, F, Assanelli, E, Marana, I, Grazi, M, Lauri, G, Bartorelli, A, Marenzi, G, Cosentino, Nicola, Ballarotto, Marco, Campodonico, Jeness, Milazzo, Valentina, Bonomi, Alice, Genovesi, Simonetta, Moltrasio, Marco, De Metrio, Monica, Rubino, Mara, Veglia, Fabrizio, Assanelli, Emilio, Marana, Ivana, Grazi, Marco, Lauri, Gianfranco, Bartorelli, Antonio L, and Marenzi, Giancarlo

Abstract

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI) and is associated with a worse prognosis. Patients with chronic kidney disease are more likely to develop AF. Whether the association between AF and glomerular filtration rate (GFR) is also true in AMI has never been investigated. Methods: We prospectively enrolled 2445 AMI patients. New-onset AF was recorded during hospitalization. Estimated GFR was estimated at admission, and patients were grouped according to their GFR (group 1 (n = 1887): GFR >60; group 2 (n = 492): GFR 60–30; group 3 (n = 66): GFR <30 mL/min/1.73 m2). The primary endpoint was AF incidence. In-hospital and long-term (median 5 years) mortality were secondary endpoints. Results: The AF incidence in the population was 10%, and it was 8%, 16%, 24% in groups 1, 2, 3, respectively (p < 0.0001). In the overall population, AF was associated with a higher in-hospital (5% vs. 1%; p < 0.0001) and long-term (34% vs. 13%; p < 0.0001) mortality. In each study group, in-hospital mortality was higher in AF patients (3.5% vs. 0.5%, 6.5% vs. 3.0%, 19% vs. 8%, respectively; p < 0.0001). A similar trend was observed for long-term mortality in three groups (20% vs. 9%, 51% vs. 24%, 81% vs. 50%; p < 0.0001). The higher risk of in-hospital and long-term mortality associated with AF in each group was confirmed after adjustment for major confounders. Conclusions: This study demonstrates that new-onset AF incidence during AMI, as well as the associated in-hospital and long-term mortality, increases in parallel with GFR reduction assessed at admission.

Published
2020

13. Proteome of platelets in patients with coronary artery disease

Author

Banfi, C, Brioschi, M, Marenzi, G, De Metrio, M, Camera, M, Mussoni, L, Tremoli, E, Banfi C., Brioschi M., Marenzi G., De Metrio M., Camera M., Mussoni L., Tremoli E., Banfi, C, Brioschi, M, Marenzi, G, De Metrio, M, Camera, M, Mussoni, L, Tremoli, E, Banfi C., Brioschi M., Marenzi G., De Metrio M., Camera M., Mussoni L., and Tremoli E.

Published
2010

14. High-sensitivity C-reactive protein is within normal levels at the very onset of first ST-segment elevation acute myocardial infarction in 41% of cases: a multiethnic case-control study

Author

Cristell N, Cianflone D, Durante A, Ammirati E, Vanuzzo D, Banfi M, Calori G, Latib A, Crea F, Marenzi G, De Metrio M, Moretti L, Li H, Uren NG, Hu D, Maseri A, Cristell, N, Cianflone, D, Durante, A, Ammirati, E, Vanuzzo, D, Banfi, M, Calori, G, Latib, A, Crea, F, Marenzi, G, De Metrio, M, Moretti, L, Li, H, Uren, Ng, Hu, D, and Maseri, A

Abstract

"OBJECTIVES:. This study sought to assess the prevalence of normal levels of high sensitivity C-reactive protein (hsCRP) at the very onset of ST-segment elevation myocardial infarction (STEMI).. BACKGROUND:. Levels of hsCRP ≥2 mg/l identify individuals who benefit from lipid lowering and possibly anti-inflammatory agents, but how many patients develop infarction in spite of hsCRP levels

Published
2011

15. Effector memory T cells are associated with atherosclerosis in humans and animal models

Author

Ammirati, E., Cianflone, D., Vecchio, V., Banfi, M., Vermi, A., De Metrio, M., Grigore, L., Pellegatta, F., Pirillo, A., Garlaschelli, K., Manfredi, A., Catapano, A., Maseri, A., Palini, A., Norata, Giuseppe, Ammirati, E., Cianflone, D., Vecchio, V., Banfi, M., Vermi, A., De Metrio, M., Grigore, L., Pellegatta, F., Pirillo, A., Garlaschelli, K., Manfredi, A., Catapano, A., Maseri, A., Palini, A., and Norata, Giuseppe

Abstract

Background- Adaptive T-cell response is promoted during atherogenesis and results in the differentiation of näive CD4 + T cells to effector and/or memory cells of specialized T-cell subsets. Aim of this work was to investigate the relationship between circulating CD4 + T-cell subsets and atherosclerosis. Methods and Results- We analyzed 57 subsets of circulating CD4+T cells by 10-parameter/8-color polychromatic flow cytometry (markers: CD3/CD4/CD45RO/CD45RA/CCR7/CCR5/CXCR3/HLA-DR) in peripheral blood from 313 subjects derived from 2 independent cohorts. In the first cohort of subjects from a free-living population (n=183), effector memory T cells (T EM : CD3 + CD4 + CD45RA - CD45RO + CCR7- cells) were strongly related with intima-media thickness of the common carotid artery, even after adjustment for age (r=0.27; P < 0.001). Of note, a significant correlation between T EM and low-density lipoproteins was observed. In the second cohort (n=130), T EM levels were significantly increased in patients with chronic stable angina or acute myocardial infarction compared with controls. HLA-DR+T EM were the T EM subpopulation with the strongest association with the atherosclerotic process (r=0.37; P < 0.01). Finally, in animal models of atherosclerosis, T EM (identified as CD4 + CD44 + CD62L - ) were significantly increased in low-density lipoprotein receptor and apolipoprotein E deficient mice compared with controls and were correlated with the extent of atherosclerotic lesions in the aortic root (r=0.56; P < 0.01). Conclusions- Circulating T EM cells are associated with increased atherosclerosis and coronary artery disease in humans and in animal models and could represent a key CD4 + T-cell subset related to the atherosclerotic process. © 2012. The Authors.

Published
2012

16. Effector Memory T cells Are Associated With Atherosclerosis in Humans and Animal Models

Author

Ammirati, E., primary, Cianflone, D., additional, Vecchio, V., additional, Banfi, M., additional, Vermi, A. C., additional, De Metrio, M., additional, Grigore, L., additional, Pellegatta, F., additional, Pirillo, A., additional, Garlaschelli, K., additional, Manfredi, A. A., additional, Catapano, A. L., additional, Maseri, A., additional, Palini, A. G., additional, and Norata, G. D., additional

Published
2012
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17. Acute kidney injury - Human studies

Author

Locsey, L., primary, Seres, I., additional, Sztanek, F., additional, Harangi, M., additional, Padra, J., additional, Asztalos, L., additional, Paragh, G., additional, Hutchison, C. A., additional, Bevins, A., additional, Langham, R., additional, Mancini, E., additional, Wirta, O., additional, Cockwell, P., additional, Keir, R., additional, Vigano, M., additional, Stella, A., additional, Evans, N., additional, Chappell, M., additional, Fabbrini, P., additional, Onuigbo, M., additional, Onuigbo, N., additional, Kim, S., additional, Chang, J. H., additional, Jung, J. Y., additional, Lee, H. H., additional, Chung, W., additional, Zanoli, L., additional, Rastelli, S., additional, Marcantoni, C., additional, Tamburino, C., additional, Castellino, P., additional, Cho, A., additional, Choi, H., additional, Lee, J. E., additional, Jang, H. R., additional, Huh, W., additional, Kim, Y.-G., additional, Kim, D. J., additional, Oh, H. Y., additional, Garcia-Fernandez, N., additional, Martin-Moreno, P. L., additional, Varo, N., additional, Nunez-Cordoba, J. M., additional, Schlieper, G., additional, Kruger, T., additional, Kelm, M., additional, Floege, J., additional, Westenfeld, R., additional, Cho, A. J., additional, Doganay, S., additional, Oguz, A. K., additional, Ergun, I., additional, Bardachenko, N., additional, Kuryata, O., additional, Bardachenko, L., additional, Ravani, P., additional, Malberti, F., additional, Pirelli, S., additional, Scolari, F., additional, Barrett, B., additional, Presta, P., additional, Lucisano, G., additional, Rubino, A., additional, Serraino, F., additional, Amoruso, T., additional, Renzulli, A., additional, Fuiano, G., additional, Kielstein, J. T., additional, Tolk, S., additional, Heiden, A., additional, Kuhn, C., additional, Hoeper, M. M., additional, Lorenzen, J., additional, Broll, M., additional, Kaever, V., additional, Burhenne, H., additional, Hafer, C., additional, Haller, H., additional, Burkhardt, O., additional, Kielstein, J., additional, Zahalkova, J., additional, Petejova, N., additional, Strojil, J., additional, Urbanek, K., additional, Bertoli, S., additional, Musetti, C., additional, Cabiati, A., additional, Assanelli, E., additional, Lauri, G., additional, Marana, I., additional, De Metrio, M., additional, Rubino, M., additional, Campodonico, J., additional, Grazi, M., additional, Moltrasio, M., additional, Marenzi, G., additional, Unarokov, Z., additional, Mukhoedova, T., additional, Fidalgo, P., additional, Coelho, S., additional, Rodrigues, B., additional, Fernandes, A. P., additional, Papoila, A. L., additional, Liano, F., additional, Soto, K., additional, Vanmassenhove, J., additional, Vanholder, R., additional, Glorieux, G., additional, Van Biesen, W., additional, Challiner, R., additional, Ritchie, J., additional, Hutchison, A., additional, Zaharie, S. I., additional, Maria, D. T., additional, Zaharie, M., additional, Vaduva, C., additional, Grauntanu, C., additional, Cana-Ruiu, D., additional, Mota, E., additional, Hayer, M., additional, Baharani, J., additional, Thomas, M., additional, Eldehni, T., additional, Selby, N., additional, McIntyre, C., additional, Fluck, R., additional, Kolhe, N., additional, Fagugli, R. M., additional, Patera, F., additional, Shah, P. R., additional, Kaswan, K. K., additional, Kute, V. B., additional, Vanikar, A. V., additional, Gumber, M. R., additional, Patel, H. V., additional, Munjappa, B. C., additional, Enginner, D. P., additional, Sainaresh, V. V., additional, Trivedi, H. L., additional, Teixeira, C., additional, Nogueira, E., additional, Lopes, J. A., additional, Almeida, E., additional, Pais de Lacerda, A., additional, Gomes da Costa, A., additional, Franca, C., additional, Mariano, F., additional, Morselli, M., additional, Bergamo, D., additional, Hollo', Z., additional, Scella, S., additional, Maio, M., additional, Tetta, C., additional, Dellavalle, A., additional, Stella, M., additional, Triolo, G., additional, Cantaluppi, V., additional, Quercia, A. D., additional, Bertinetto, P., additional, Giacalone, S., additional, Tamagnone, M., additional, Basso, E., additional, Karvela, E., additional, Gai, M., additional, Leonardi, G., additional, Anania, P., additional, Guarena, C., additional, Fenocchio, C. M., additional, Pacitti, A., additional, Segoloni, G. P., additional, Kim, Y. O., additional, Kim, H. G., additional, Kim, B. S., additional, Song, H. C. S., additional, Min, J.-K., additional, Kim, S. Y., additional, Park, W. D., additional, Dalboni, M., additional, Narciso, R., additional, Quinto, M., additional, Grabulosa, C., additional, Cruz, E., additional, Monte, J., additional, Durao, M., additional, Cendoroglo, M., additional, Santos, O., additional, Batista, M., additional, Bellasi, A., additional, Giannone, S., additional, Mordenti, A., additional, Zanoni, A., additional, Santoro, A., additional, Lee, J. H., additional, Ha, S. H., additional, Kim, J. H., additional, Lee, G. J., additional, Jung, Y. C., additional, Malindretos, P., additional, Koutroumbas, G., additional, Patrinou, A., additional, Zagkotsis, G., additional, Makri, P., additional, Togousidis, I., additional, Syrganis, C., additional, Li Cavoli, G., additional, Tortorici, C., additional, Bono, L., additional, Ferrantelli, A., additional, Giammarresi, C., additional, Zagarrigo, C., additional, Rotolo, U., additional, Kim, H., additional, Jun, K., additional, Choi, W., additional, Krzesinski, J.-M., additional, Parotte, M.-C., additional, Vandevelde, C., additional, Keenan, J., additional, Dieterle, F., additional, Sultana, S., additional, Pinches, M., additional, Ciorciaro, C., additional, Schindler, R., additional, Schmitz, V., additional, Gautier, J.-C., additional, Benain, X., additional, Matchem, J., additional, Murray, P., additional, Adler, S., additional, Haase, M., additional, Haase-Fielitz, A., additional, Devarajan, P., additional, Bellomo, R., additional, Cruz, D. N., additional, Wagener, G., additional, Krawczeski, C. D., additional, Koyner, J. L., additional, Murray, P. T., additional, Zappitelli, M., additional, Goldstein, S., additional, Makris, K., additional, Ronco, C., additional, Martensson, J., additional, Martling, C.-R., additional, Venge, P., additional, Siew, E., additional, Ware, L. B., additional, Ikizler, A., additional, Mertens, P. R., additional, Lacquaniti, A., additional, Buemi, A., additional, Donato, V., additional, Lucisano, S., additional, Buemi, M., additional, Panagoutsos, S., additional, Kriki, P., additional, Mourvati, E., additional, Tziakas, D., additional, Chalikias, G., additional, Stakos, D., additional, Apostolakis, S., additional, Tsigalou, C., additional, Gioka, T., additional, Konstantinides, S., additional, Vargemezis, V., additional, Torregrosa, I., additional, Montoliu, C., additional, Urios, A., additional, Aguado, C., additional, Puchades, M. J., additional, Solis, M. A., additional, Juan, I., additional, Sanjuan, R., additional, Blasco, M., additional, Pineda, J., additional, Carratala, A., additional, Ramos, C., additional, Miguel, A., additional, Niculae, A., additional, Checherita, I. A., additional, Sandulovici, R., additional, David, C., additional, Ciocalteu, A., additional, Espinoza, M., additional, Hidalgo, J., additional, Lorca, E., additional, Santibanez, A., additional, Arancibia, F., additional, Gonzalez, F., additional, Park, M. Y., additional, Kim, E. J., additional, Choi, S. J., additional, Kim, J. K., additional, Hwang, S. D., additional, Lee, K.-h., additional, Seok, S.-J., additional, Yang, J.-O., additional, Lee, E.-Y., additional, Hong, S.-y., additional, Gil, H.-w., additional, Astapenko, E., additional, Shutov, A., additional, Savinova, G., additional, Rechnik, V., additional, Melo, M. J., additional, Raimundo, M., additional, Viegas, A., additional, Camara, I., additional, Antunes, F., additional, Kim, M.-J., additional, Kwon, S. H., additional, Lee, S. W., additional, Song, J. H., additional, and Lee, J. W., additional

Published
2011
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18. Abstracts

Author

Barthelemy, O., primary, Silvain, J., additional, Brieger, D., additional, Bellemain-Appaix, A., additional, Cayla, G., additional, Beygui, F., additional, Lancar, R., additional, Collet, J. P., additional, Mercadier, A., additional, Montalescot, G., additional, Cha, K. S., additional, Nam, Y. H., additional, Kim, J. H., additional, Park, S. Y., additional, Park, T. H., additional, Kim, M. H., additional, Kim, Y. D., additional, Lee, H. C., additional, Ahn, M. S., additional, Hong, T. J., additional, Blanco, R., additional, Blanco, F., additional, Szarfer, J., additional, Garcia Escudero, A., additional, Gigena, G., additional, Gagliardi, J., additional, Rodriguez, A., additional, Sarmiento, R., additional, Affatatto, S., additional, Riccitelli, M., additional, Petris, A., additional, Datcu, M. D., additional, Pop, C., additional, Radoi, M., additional, Arsenescu-Georgescu, C., additional, Petrescu, I., additional, Petrescu, L., additional, Serban, L., additional, Nechita, E., additional, Tatu-Chitoiu, G., additional, Dorobantu, M., additional, Benedek, I., additional, Craiu, E., additional, Sinescu, C., additional, Ionescu, D. D., additional, Ginghina, C., additional, Minescu, B., additional, Izzo, A., additional, Mantovani, P., additional, Tomasi, L., additional, Dall'oglio, L., additional, Bonatti, S., additional, Rosiello, R., additional, Romano, M., additional, Agostini, F., additional, Zanini, R., additional, Zhao, Z. Y., additional, Wu, Y. J., additional, Li, J. J., additional, Yany, Y. J., additional, Qian, H. Y., additional, Tang, Y. D., additional, Timoteo, A. T., additional, Toste, A., additional, Lousinha, A., additional, Ramos, R., additional, Oliveira, J. A., additional, Ferreira, M. L., additional, Ferreira, R. C., additional, Cabades, C., additional, Diez Gil, J. L., additional, Aguar, P., additional, Sanmiguel, D., additional, Lopez-March, A., additional, Marmol, R., additional, Guerra, L., additional, Girbes, V., additional, Ferrando, J., additional, Rincon De Arellano, A., additional, Patricio, L., additional, Blondal, M., additional, Ainla, T., additional, Marandi, T., additional, Eha, J., additional, Oliveira, M. M., additional, Silva, M. N., additional, Cunha, P. S., additional, Feliciano, J., additional, Silva, S., additional, Kanovsky, J., additional, Kala, P., additional, Parenica, J., additional, Poloczek, M., additional, Prymusova, K., additional, Kubkova, L., additional, Spinar, J., additional, Olinic, D., additional, Homorodean, C., additional, Ober, M., additional, Olinic, M., additional, Andrioaia, C., additional, Condac, A., additional, Masmoudi, M., additional, Berdaoui, B., additional, Labidi, S., additional, Tapia Ballesteros, C., additional, Hernandez Luis, C., additional, Sandin, M. G., additional, Vegas, J. M., additional, Andion, R., additional, Martinez, N., additional, Gonzalez, I. A., additional, Alvarado, M., additional, Amat, I. J., additional, San Roman, J. A., additional, Garcia Gonzalez, M. J., additional, Arroyo Ucar, E., additional, Hernandez Garcia, C., additional, Dorta Martin, M., additional, Marrero Rodriguez, F., additional, Dragu, R., additional, Kapeliovich, M., additional, Hammerman, H., additional, Silva, D., additional, Cortez-Dias, N., additional, Jorge, C., additional, Silva Marques, J., additional, Carilho Ferreira, P., additional, Robalo Martins, S., additional, Almeida Ribeiro, M., additional, Calisto, C., additional, Fiuza, M., additional, Lopes, M. G., additional, Milicevic, P., additional, Panic, M., additional, Stankovic, I., additional, Milicevic, D., additional, Kalezic, T., additional, Kafedzic, S., additional, Ilic, I., additional, Cerovic, M., additional, Putnikovic, B., additional, Neskovic, A., additional, Rott, D., additional, Leibowitz, D., additional, Monhart, Z., additional, Reissigova, J., additional, Grunfeldova, H., additional, Jansky, P., additional, Valente, B., additional, Villanueva Benito, I., additional, Solla, I., additional, Paredes, E., additional, Diaz Castro, O., additional, Calvo, F., additional, Baz, J. A., additional, Iniguez, A., additional, Aleksova, A., additional, Gerloni, R., additional, Belfiore, R., additional, Carriere, C., additional, Barbati, G., additional, Fabris, E., additional, Possa, F., additional, Nait, D., additional, Milo, M., additional, Sinagra, G., additional, Marques, N., additional, Mimoso, J., additional, Gomes, V., additional, Agra Bermejo, R. M., additional, Emad Abu Assi, E. A. A., additional, Sergio Raposeiras Roubin, S. R. R., additional, Pilar Cabanas Grandio, P. C. G., additional, Carlos Pena Gil, C. P. G., additional, Jose Maria Garcia Acuna, J. M. G. A., additional, Jose Ramon Gonzalez Juanatey, J. R. G. J., additional, Daly, M. J., additional, Scott, P., additional, Owens, C. G., additional, Tomlin, A., additional, Smith, B., additional, Adgey, A. A. J., additional, Alvarez-Contreras, L. R., additional, Juarez, U., additional, Altamirano, A., additional, Arias, A., additional, Alvarez-San Gabriel, A., additional, Gonzalez-Pacheco, H., additional, Martinez-Sanchez, C., additional, Rahnavardi, M., additional, Keshtkar-Jahromi, M., additional, Vakili, H., additional, Gholamin, S., additional, Razavi, S. M., additional, Gilis-Januszewski, T., additional, Mellwig, K.- P., additional, Wiemer, M., additional, Gilis-Januszewski, J., additional, Peterschroeder, A., additional, Koerfer, J., additional, Horstkotte, D., additional, Vrsalovic, M., additional, Getaldic, B., additional, Vrkic, N., additional, Pintaric, H., additional, Khan, S., additional, Wasan, B., additional, Moretti, L., additional, Grossi, P., additional, Silenzi, S., additional, Testa, M., additional, Candelori, L., additional, Clementi, L. N., additional, Forlini, M., additional, Lando, L., additional, Pezzuoli, M. L., additional, Corradetti, P., additional, Leurent, G., additional, Pennec, P. Y., additional, Filippi, E., additional, Moquet, B., additional, Hacot, J. P., additional, Druelles, P., additional, Rialan, A., additional, Rouault, G., additional, Coudert, I., additional, Le Breton, H., additional, Gevaert, S., additional, Tromp, F., additional, Vandecasteele, E., additional, De Somer, F., additional, Van Belleghem, Y., additional, Bouchez, S., additional, Martens, F., additional, Herck, I., additional, De Pauw, M., additional, Ludka, O., additional, Sepsi, M., additional, Miklik, R., additional, Dusek, L., additional, Tomcikova, D., additional, Garcia-Acuna, J. M., additional, Aguiar-Souto, P., additional, Raposeiras Roubin, S., additional, Agra-Bermejo, R., additional, Jacquet, M., additional, Abu-Assi, E., additional, Gonzalez-Juanatey, J. R., additional, Ibatov, A., additional, Labrova, R., additional, Karlik, R., additional, Lokaj, P., additional, She, Q., additional, Deng, S. B., additional, Huang, S. H., additional, Gu, L. J., additional, Rong, J. I. A. N., additional, Wu, Z. K., additional, Li, Y., additional, Zhang, J., additional, Parascan, L., additional, Campanile, A., additional, Spinelli, L., additional, Santulli, G., additional, Ciccarelli, M., additional, De Gennaro, S., additional, Assante Di Panzillo, E., additional, Trimarco, B., additional, Iaccarino, G., additional, Bobescu, E., additional, Datcu, G., additional, Dobreanu, D., additional, Doka, B., additional, Charniot, J.- C., additional, Cosson, C., additional, Albertini, J. P., additional, Bittar, R., additional, Giral, P., additional, Cherfils, C., additional, Guillerm, E., additional, Bonnefont-Rousselot, D., additional, Rusali, A., additional, Cojocaru, L., additional, Parepa, I., additional, Koizumi, T., additional, Iida, S., additional, Sato, J., additional, Kikutani, T., additional, Muramatsu, T., additional, Nishimura, S., additional, Komiyama, N., additional, Lee, W. P., additional, Ong, B. B., additional, Haralambos, K., additional, Townsend, D., additional, Rees, J. A. E., additional, Williams, E. J., additional, Halcox, J. P., additional, Mcdowell, I., additional, Damjanovic, M., additional, Koracevic, G., additional, Djordjevic-Radojkovic, D., additional, Pavlovic, M., additional, Krstic, N., additional, Ciric-Zdravkovic, S., additional, Stojkovic, A., additional, Perisic, Z., additional, Apostolovic, S., additional, Faustino, A., additional, Seca, L., additional, Barra, S., additional, Caetano, F., additional, Providencia, R., additional, Silva, J., additional, Gomes, P., additional, Costa, G., additional, Costa, M., additional, Leitao-Marques, A., additional, Volkova, A. L., additional, Arutyunov, G. P., additional, Bylova, N. A., additional, Dayter, I. I., additional, Jao, Y. T. F. N., additional, Fang, C. C., additional, Chen, Y., additional, Yu, C. L., additional, Wang, S. P., additional, Valencia, J., additional, Perez-Berbel, P., additional, Ruiz-Nodar, J. M., additional, Pineda, J., additional, Bordes, P., additional, Quintanilla, M., additional, Mainar, V., additional, Sogorb, F., additional, Santos, N., additional, Serrao, M., additional, Cafe, H., additional, Silva, B., additional, Oliveira, R., additional, Caires, G., additional, Drumond, A., additional, Araujo, J., additional, Providencia, R. A., additional, Gomes, P. L., additional, Pais, J. R., additional, Mota, P., additional, Leitao-Marques, A. M., additional, Farhan, S., additional, Jarai, R., additional, Tentzeris, I., additional, Vogel, B., additional, Freynhofer, M. K., additional, Wojta, J., additional, Huber, K., additional, Poli, M., additional, Trambaiolo, P., additional, Corsi, F., additional, De Luca, M., additional, Mustilli, M., additional, Lukic, V., additional, Simonetti, M., additional, Ferraiuolo, G., additional, Lettino, M., additional, Casella, G., additional, Conte, M. R., additional, De Luca, L., additional, Geraci, G., additional, Ceravolo, R., additional, Pani, A., additional, Fradella, G., additional, Schratter, A., additional, Thiele, H., additional, Klemm, T., additional, Demmin, K., additional, Lehmann, D., additional, Mende, M., additional, Schuler, G., additional, Pittl, U., additional, Chernova, A., additional, Nikulina, S. U., additional, Naruke, T., additional, Inomata, T., additional, Yanagisawa, T., additional, Maekawa, E., additional, Mizutani, T., additional, Shinagawa, H., additional, Nishii, M., additional, Takeuchi, I., additional, Takehana, H., additional, Izumi, T., additional, Paulo, C., additional, Mascarenhas, J., additional, Patacho, M., additional, Pimenta, J., additional, Bettencourt, P., additional, Nardai, S., additional, Szabo, G. 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A., additional, Savic, L., additional, Mrdovic, I., additional, Krljanac, G., additional, Perunicic, J., additional, Asanin, M., additional, Lasica, R., additional, Matic, M., additional, Vasiljevic, Z., additional, Ostojic, M., additional, Tichy, M., additional, Andrys, C., additional, Conti, A., additional, Poggioni, C., additional, Viviani, G., additional, Bulletti, F., additional, Boni, V., additional, Luzzi, M., additional, Vicidomini, S., additional, Donati, M., additional, Del Taglia, B., additional, Pini, R., additional, Sousa, O., additional, Fontes-Carvalho, R., additional, Caeiro, D., additional, Dias Ferreira, N., additional, Silva, G., additional, Pereira, E., additional, Ribeiro, J., additional, Albuquerque, A., additional, Gama Ribeiro, V., additional, Murai, M., additional, Takeda, Y., additional, Shinmyo, T., additional, Tanigawa, J., additional, Hazui, H., additional, Nakakohji, T., additional, Ohishi, Y., additional, Hoshiga, M., additional, Ishihara, T., additional, Hanafusa, T., additional, Belohlavek, J., additional, Rohn, V., additional, Kunstyr, J., additional, Lips, M., additional, Semrad, M., additional, Mlejnsky, F., additional, Tosovsky, J., additional, Linhart, A., additional, Lindner, J., additional, Sablik, Z., additional, Samborska-Sablik, A., additional, Drozdz, J., additional, Gaszynski, W., additional, Izquierdo-Gomez, M. M., additional, Juarez-Prera, R., additional, Blanco-Palacios, G., additional, Lakhdar, R., additional, Drissa, M., additional, Jedaida, B., additional, Drissa, H., additional, Sampaio, F., additional, Hsin, H.- T., additional, Huang, J.- H., additional, Chiu, K.- M., additional, Chen, Z.- S., additional, Lin, P.- C., additional, Chen, L.- Y., additional, Chu, S.- H., additional, Efthimiadis, I., additional, Skendros, P., additional, Sarantopoulos, A., additional, Boura, P., additional, Van Der Laan, A. M., additional, Van Der Vleuten, P. A., additional, Klees, M., additional, Tijssen, J. G. P., additional, Backus, B. E., additional, Six, A. J., additional, Kelder, J. H., additional, Mosterd, A., additional, Mast, E. G., additional, Mast, T. P., additional, Braam, R., additional, Tio, R., additional, Veldkamp, R., additional, Doevendans, P. A., additional, Paarup Dridi, N., additional, Holmvang, L., additional, Engstroem, T., additional, Rekik, S., additional, Brunet, J., additional, Hager, F. X., additional, Bayet, G., additional, Meille, L., additional, Quatre, J. M., additional, Sainsous, J., additional, Chu, P.- H., additional, Tang, C.- H., additional, Pogosova, N., additional, Koltunov, I. E., additional, Sapunova, I. D., additional, Vigodin, V. A., additional, Uhliar, R., additional, Schmidt, A., additional, Brockmeyer, B., additional, Suzuki, A., additional, Eki, Y., additional, Higuchi, H., additional, Yukawa, A., additional, Yamauchi, R., additional, Sato, Y., additional, Endo, Y., additional, Salazar Mendigucha Garcia, J., additional, Homs Vila, S., additional, Cequier Fillat, A., additional, Andion Ogando, R., additional, Sandin Fuentes, M., additional, Vegas Valle, J. M., additional, Gonzalez Garcia, I. A., additional, Duro Aguado, I. A., additional, Palomino Doza, A. J., additional, Gomez Salvador, I., additional, San Roman Calvar, J. A., additional, Mamarasulov, T. M., additional, Todorovic, L., additional, Cherneva, Z. C. H., additional, Denchev, S. D., additional, Heltai, K., additional, Boytsov, A., additional, Nikulina, N. N., additional, Zanna, D., additional, Marangelli, V., additional, Caiati, C., additional, Picon Heras, R., additional, Loureiro, M. J., additional, Urazovskaya, I., additional, Vinogradova, D., additional, Vasilieva, E., additional, Shpektor, A., additional, Conti, E., additional, Musumeci, M. B., additional, Lauri, F. M., additional, Dito, E., additional, De Giusti, M., additional, Lallo, A., additional, Fusco, D., additional, Davoli, M., additional, Volpe, M., additional, Autore, C., additional, Gamra, H., additional, Dridi, Z., additional, Hassine, M., additional, Addad, F., additional, Gherissi, I., additional, Reda, A., additional, Mahjoub, M., additional, Bouraoui, S., additional, Abdennadher, M., additional, Betbout, F., additional, Mota, P. M. F. P., additional, Silva, J. D., additional, Jankovic Tomasevic, R., additional, Djordjevic, V., additional, Djordjevic Radojkovic, D., additional, Scafa Udriste, A., additional, Fruntelata, A., additional, Gainoiu, E., additional, Bogdan, S., additional, Zamfir, D., additional, Teodorescu, C., additional, Guran, M., additional, Constantinescu, D., additional, Konopka, A., additional, Banaszewski, M., additional, Wojtkowska, I., additional, Stepinska, J., additional, Vidergold, J. V., additional, Osipova, I. V., additional, Tavrovskaya, T. V., additional, Galkina, J. V., additional, Timofeev, A. V., additional, Vorobyov, R. I., additional, Vorobyova, E. N., additional, Matos, L., additional, Carvalho, A. C. C., additional, Oliveira, W., additional, Cintra, F., additional, Poyares, D., additional, Andersen, M., additional, Martins, R., additional, Tufik, S., additional, Ostadal, P., additional, Brada, J., additional, Horakova, S., additional, Mlcek, M., additional, Hrachovina, V., additional, Kittnar, O., additional, Gorudko, I. V., additional, Buko, I. V., additional, Cherenkevich, S. N., additional, Polonetsky, L. Z., additional, Plotkin, V. Y., additional, Timoshina, M. A., additional, Azanchevskaya, S. V., additional, Chromov-Borisov, N. N., additional, Vorlat, A., additional, Snoep, L., additional, Claeys, M. J., additional, Vrints, C. J., additional, Palazzuoli, A., additional, Caputo, M., additional, Quatrini, I., additional, Calabro, A., additional, Antonelli, G., additional, Campagna, M. S., additional, Franci, B., additional, Nuti, R., additional, Maisel, A., additional, Negrini, M., additional, Minora, T., additional, Marino, P., additional, Seregni, R., additional, Tavlueva, E., additional, Barbarash, O., additional, Barbarash, L., additional, Janota, T., additional, Kudlicka, J., additional, Malik, K., additional, Wichterle, D., additional, Hradec, J., additional, Body, R., additional, Carley, S. D., additional, Mcdowell, G., additional, Nuttall, M., additional, Wibberley, C., additional, France, M., additional, Cruickshank, J. K., additional, Mackway-Jones, K., additional, Leon, M., additional, Cozma, C., additional, Mitu, F., additional, Almeida, D. R., additional, Dias, C. B., additional, Burazor, I., additional, Burazor, M., additional, Krstic, M., additional, Lazovic, M., additional, Vukmanovic, M., additional, Djordjevic, J., additional, Radovanovic, Z., additional, Ilic, D., additional, Bosnjakovic, P., additional, Ferreira, A. C., additional, Mateus, P. S., additional, Fontes, P., additional, Teixeira, T., additional, Conte, G., additional, Menozzi, A., additional, Solinas, E., additional, Bolognesi, M. G., additional, Tadonio, I., additional, Mantovani, F., additional, Cattabiani, A., additional, Vignali, L., additional, Ardissino, D., additional, Tautu, O., additional, Alexandrescu, A., additional, Niculescu, R., additional, Jankovic, R., additional, Bozinovic, N., additional, Santos, C., additional, Costa, F., additional, Cardoso, G., additional, Correia, I., additional, Fountoulaki, K., additional, Kastellanos, S., additional, Voltirakis, E., additional, Kokotos, A., additional, Michalakeas, C., additional, Kontsas, K., additional, Hasioti, K., additional, Iliodromitis, E. T., additional, Sandin Fuentes, M. G., additional, Zatarain Nicolas, E., additional, Martinez Uruena, N., additional, Alvarado Montes De Oca, M., additional, Dytrych, V., additional, Kovarnik, T., additional, Smid, O., additional, Kral, A., additional, Aroutunov, A. G., additional, Intwala, S., additional, Jegere, I., additional, Shaalan, H. S. H., additional, Pagava, Z., additional, Agladze, R., additional, Shakarishvili, R., additional, Sharashidze, N., additional, Gujejiani, L., additional, Saatashvili, G., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Vukotic, S., additional, Rafajlovski, S., additional, Romanovic, R., additional, Antonijevic, N., additional, Gligic, B., additional, Hutyra, M., additional, Skala, T., additional, Horak, D., additional, Vindis, D., additional, Taborsky, M., additional, Contine, A., additional, Del Pinto, M., additional, Angeli, F., additional, Verdecchia, P., additional, Borgognoni, F., additional, Grikstaite, E., additional, Pantano, P., additional, Ambrosio, G., additional, Cavallini, C., additional, Bonanad, C., additional, Sanchis, J., additional, Bodi, V., additional, Nunez, J., additional, Bosch, X., additional, Heras, M., additional, Pellicer, M., additional, Llacer, A., additional, Adao, L., additional, Oliveira, M., additional, Goncalves, H., additional, Primo, J., additional, Gama, V., additional, Lombardi, C., additional, Metra, M., additional, Bugatti, S., additional, Pasotti, E., additional, Quinzani, F., additional, Adamo, M., additional, Villa, C., additional, Rovetta, R., additional, Manerba, A., additional, Mariani, M., additional, Dushpanova, A., additional, Baroni, M., additional, Cerone, E., additional, Nardelli, A., additional, Gianetti, J., additional, Berti, S., additional, Feliciano, F., additional, Soares, R., additional, Santos, S., additional, Kruger, A., additional, Vondrakova, D., additional, Herget, J., additional, Navarro, C., additional, Cromie, N. A., additional, Adgey, J. A. A., additional, Caeiro Pereira, D., additional, Braga, P., additional, Fontes Carvalho, R., additional, Rodrigues, A., additional, Goncalves, M., additional, Simoes, L., additional, and Borisov, K. V., additional

Published
2010
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23. Impact of Glomerular Filtration Rate on the Incidence and Prognosis of New-Onset Atrial Fibrillation in Acute Myocardial Infarction

Author

Gianfranco Lauri, Simonetta Genovesi, Alice Bonomi, Fabrizio Veglia, Marco Ballarotto, Marco Grazi, Valentina Milazzo, Nicola Cosentino, Antonio L. Bartorelli, Marco Moltrasio, Giancarlo Marenzi, Jeness Campodonico, Ivana Marana, Monica De Metrio, Mara Rubino, Emilio Assanelli, Cosentino, N, Ballarotto, M, Campodonico, J, Milazzo, V, Bonomi, A, Genovesi, S, Moltrasio, M, De Metrio, M, Rubino, M, Veglia, F, Assanelli, E, Marana, I, Grazi, M, Lauri, G, Bartorelli, A, and Marenzi, G

Subjects
medicine.medical_specialty, Population, lcsh:Medicine, acute myocardial infarction, Renal function, 030204 cardiovascular system & hematology, urologic and male genital diseases, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Clinical endpoint, atrial fibrillation, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, education, reproductive and urinary physiology, education.field_of_study, urogenital system, business.industry, Incidence (epidemiology), lcsh:R, renal function, Atrial fibrillation, General Medicine, medicine.disease, mortality, female genital diseases and pregnancy complications, Cardiology, Complication, business, Kidney disease
Abstract

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI) and is associated with a worse prognosis. Patients with chronic kidney disease are more likely to develop AF. Whether the association between AF and glomerular filtration rate (GFR) is also true in AMI has never been investigated. Methods: We prospectively enrolled 2445 AMI patients. New-onset AF was recorded during hospitalization. Estimated GFR was estimated at admission, and patients were grouped according to their GFR (group 1 (n = 1887): GFR &gt, 60, group 2 (n = 492): GFR 60&ndash, 30, group 3 (n = 66): GFR &lt, 30 mL/min/1.73 m2). The primary endpoint was AF incidence. In-hospital and long-term (median 5 years) mortality were secondary endpoints. Results: The AF incidence in the population was 10%, and it was 8%, 16%, 24% in groups 1, 2, 3, respectively (p &lt, 0.0001). In the overall population, AF was associated with a higher in-hospital (5% vs. 1%, p &lt, 0.0001) and long-term (34% vs. 13%, 0.0001) mortality. In each study group, in-hospital mortality was higher in AF patients (3.5% vs. 0.5%, 6.5% vs. 3.0%, 19% vs. 8%, respectively, 0.0001). A similar trend was observed for long-term mortality in three groups (20% vs. 9%, 51% vs. 24%, 81% vs. 50%, 0.0001). The higher risk of in-hospital and long-term mortality associated with AF in each group was confirmed after adjustment for major confounders. Conclusions: This study demonstrates that new-onset AF incidence during AMI, as well as the associated in-hospital and long-term mortality, increases in parallel with GFR reduction assessed at admission.

Published
2020
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24. Effector Memory T cells Are Associated With Atherosclerosis in Humans and Animal Models

Author

M. Banfi, Fabio Pellegatta, Alberico L. Catapano, Enrico Ammirati, Angela Pirillo, Domenico Cianflone, Alessio Palini, Viviana Vecchio, Katia Garlaschelli, Angelo A. Manfredi, Attilio Maseri, Giuseppe Danilo Norata, Liliana Grigore, Monica De Metrio, Anna Chiara Vermi, Ammirati, E, Cianflone, Domenico, Vecchio, V, Banfi, M, Vermi, Ac, De Metrio, M, Grigore, L, Pellegatta, F, Pirillo, A, Garlaschelli, K, Manfredi, ANGELO ANDREA M. A., Catapano, Al, Maseri, A, Palini, Ag, and Norata, G. D.

Subjects
Apolipoprotein E, education.field_of_study, C-c chemokine receptor type 7, biology, business.industry, CD3, Population, chemokines, C-C chemokine receptor type 7, CXCR3, medicine.disease, Molecular Cardiology, Coronary artery disease, effector memory T cells, Immunology, biology.protein, Medicine, Myocardial infarction, atherosclerosis, business, education, Cardiology and Cardiovascular Medicine, coronary artery disease, Original Research, Lipoprotein
Abstract

Background Adaptive T‐cell response is promoted during atherogenesis and results in the differentiation of naïve CD4 + T cells to effector and/or memory cells of specialized T‐cell subsets. Aim of this work was to investigate the relationship between circulating CD4 + T‐cell subsets and atherosclerosis. Methods and Results We analyzed 57 subsets of circulating CD4 + T cells by 10‐parameter/8‐color polychromatic flow cytometry (markers: CD3/CD4/CD45RO/CD45RA/CCR7/CCR5/CXCR3/HLA‐DR) in peripheral blood from 313 subjects derived from 2 independent cohorts. In the first cohort of subjects from a free‐living population ( n =183), effector memory T cells (T EM : CD3 + CD4 + CD45RA − CD45RO + CCR7 − cells) were strongly related with intima‐media thickness of the common carotid artery, even after adjustment for age ( r =0.27; P EM and low‐density lipoproteins was observed. In the second cohort ( n =130), T EM levels were significantly increased in patients with chronic stable angina or acute myocardial infarction compared with controls. HLA‐DR + T EM were the T EM subpopulation with the strongest association with the atherosclerotic process ( r =0.37; P EM (identified as CD4 + CD44 + CD62L − ) were significantly increased in low‐density lipoprotein receptor and apolipoprotein E deficient mice compared with controls and were correlated with the extent of atherosclerotic lesions in the aortic root ( r =0.56; P Conclusions Circulating T EM cells are associated with increased atherosclerosis and coronary artery disease in humans and in animal models and could represent a key CD4 + T‐cell subset related to the atherosclerotic process. ( J Am Heart Assoc 2012;1:27‐41.)

Published
2012
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25. Circulating CD4 + CD25 hi CD127 lo Regulatory T-Cell Levels Do Not Reflect the Extent or Severity of Carotid and Coronary Atherosclerosis

Author

Monica De Metrio, Angelo Anzuini, Angelo A. Manfredi, Giancarlo Marenzi, Domenico Cianflone, M. Banfi, Davide Tavano, Altin Palloshi, Katia Garlaschelli, Claudio Panciroli, Gabriele Tumminello, Flavio Airoldi, Alberico L. Catapano, Simona Tramontana, Viviana Vecchio, Enrico Ammirati, Giuseppe Danilo Norata, Liliana Grigore, Alessio Palini, Ammirati, E, Cianflone, Domenico, Banfi, M, Vecchio, V, Palini, A, De Metrio, M, Marenzi, G, Panciroli, C, Tumminello, G, Anzuini, A, Palloshi, A, Grigore, L, Garlaschelli, K, Tramontana, S, Tavano, D, Airoldi, F, Manfredi, ANGELO ANDREA M. A., Catapano, Al, and Norata, Gd

Subjects
education.field_of_study, medicine.medical_specialty, Acute coronary syndrome, business.industry, Population, medicine.disease, Coronary arteries, Coronary artery disease, medicine.anatomical_structure, Internal medicine, medicine.artery, Circulatory system, Cardiology, Medicine, Common carotid artery, Myocardial infarction, Cardiology and Cardiovascular Medicine, business, education, Coronary atherosclerosis
Abstract

Objective— Regulatory T (Treg) cells play a protective role in experimental atherosclerosis. In the present study, we investigated whether the levels of circulating Treg cells relate to the degree of atherosclerosis in carotid and coronary arteries. Methods and Results— We studied 2 distinct populations: (1) 113 subjects, selected from a free-living population (carotid study), in which we measured the intima-media thickness of the common carotid artery, as a surrogate marker of initial atherosclerosis; and (2) 75 controls and 125 patients with coronary artery disease (coronary study): 36 with chronic stable angina, 50 with non-ST-elevation acute coronary syndrome, 39 with ST-elevation acute myocardial infarction. Treg-cell levels were evaluated by flow cytometry (Treg cells identified as CD3 + CD4 + CD25 high CD127 low ) and by mRNA expression of forkhead box P3 or of Treg-associated cytokine interleukin 10. In the carotid study, no correlation was observed between Treg-cell levels and intima-media thickness. No differences in Treg-cell levels were observed comparing rapid versus slow intima-media thickness progressors from a subgroup of patients (n=65), in which prospective data on 6-year intima-media thickness progression were available. In the coronary group, Treg-cell levels were not altered in chronic stable angina patients. In contrast, nonunivocal variations were observed in patients suffering an acute coronary syndrome (with a Treg-cell increase in ST-elevation acute myocardial infarction and a Treg-cell decrease in non-ST-elevation acute coronary syndrome patients). Conclusion— The results suggest that determination of circulating Treg-cell levels based on flow cytometry or mRNA assessment is not a useful indicator of the extent or severity of atherosclerosis.

Published
2010
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26. Proteome of platelets in patients with coronary artery disease

Author

Luciana Mussoni, Giancarlo Marenzi, Maura Brioschi, Elena Tremoli, Marina Camera, Monica De Metrio, Cristina Banfi, Banfi, C, Brioschi, M, Marenzi, G, De Metrio, M, Camera, M, Mussoni, L, and Tremoli, E

Subjects
Blood Platelets, Male, Proteasome Endopeptidase Complex, Cancer Research, medicine.medical_specialty, BIO/12 - BIOCHIMICA CLINICA E BIOLOGIA MOLECOLARE CLINICA, Proteome, platelets, proteomics, coronary artery disease, Molecular Sequence Data, Coronin, Protein degradation, Angina Pectoris, Coronary artery disease, Internal medicine, Genetics, medicine, Humans, Ketoglutarate Dehydrogenase Complex, Platelet, Amino Acid Sequence, Platelet activation, Acute Coronary Syndrome, Molecular Biology, Protein Kinase C, Coronary atherosclerosis, Aged, L-Lactate Dehydrogenase, biology, Microfilament Proteins, Blood Proteins, Cell Biology, Hematology, Middle Aged, Phosphoproteins, medicine.disease, Actins, Pleckstrin homology domain, Endocrinology, Immunology, biology.protein, OGDH, Female
Abstract

Objective This study aimed at investigating the protein patterns of platelets from patients with stable or acute coronary atherosclerosis (CAD), in which platelets play a key role. Materials and Methods A proteomic approach was adopted to investigate specific protein patterns in platelets of patients with non-ST elevation acute coronary syndrome, stable angina, or of subjects with no history of CAD. Results Six differentially expressed proteins were identified: two involved in energy metabolism (2-oxoglutarate dehydrogenase [OGDH], and lactate dehydrogenase [LDH]); three were associated with cytoskeleton-based processes (γ-actin, coronin 1B, and pleckstrin); and one involved in protein degradation (proteasome subunit type 8). Expression levels of OGDH and a cleaved form of γ-actin were significantly higher in the platelets of patients than in controls, whereas that of LDH was higher only in the platelets of patients with acute coronary disease. The increases in protein expression of OGDH and LDH are paralleled by changes in their functional activities. Coronin and proteasome subunit type 8 were less expressed in the platelets of patients, as were the basic isoforms of pleckstrin. Conclusion The platelet proteome is altered in CAD patients with stable or acute coronary syndrome possibly because of the ongoing atherosclerotic process. The identified protein changes not previously connected with CAD were an increase in the energy metabolism enzymes and alterations in the proteins associated with cytoskeleton-based processes, both of which indicate platelet activation.

Published
2010
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27. Questing for circadian dependence in ST-segment-elevation acute myocardial infarction: a multicentric and multiethnic study

Author

Dayi Hu, Domenico Cianflone, Timothy Ravasi, Anna Chiara Vermi, Carlo Vittorio Cannistraci, Giancarlo Marenzi, Monica De Metrio, Neal G. Uren, Enrico Ammirati, Attilio Maseri, Nicole Cristell, Ammirati, E, Cristell, N, Cianflone, Domenico, Vermi, Ac, Marenzi, G, De Metrio, M, Uren, Ng, Hu, D, Ravasi, T, Maseri, A, and Cannistraci, Cv

Subjects
medicine.medical_specialty, biology, Physiology, business.industry, Incidence (epidemiology), medicine.medical_treatment, Ischemia, Percutaneous coronary intervention, medicine.disease, Internal medicine, Physical therapy, biology.protein, Cardiology, Medicine, ST segment, Creatine kinase, cardiovascular diseases, Myocardial infarction, Circadian rhythm, Cardiology and Cardiovascular Medicine, business, Prospective cohort study
Abstract

Rationale: Four monocentric studies reported that circadian rhythms can affect left ventricular infarct size after ST-segment–elevation acute myocardial infarction (STEMI). Objective: To further validate the circadian dependence of infarct size after STEMI in a multicentric and multiethnic population. Methods and Results: We analyzed a prospective cohort of subjects with first STEMI from the First Acute Myocardial Infarction study that enrolled 1099 patients (ischemic time Conclusions: Although the circadian dependence of infarct size supported by previous studies poses an intriguing hypothesis, we were unable to converge toward their conclusions in a multicentric and multiethnic setting. Parameters that vary as a function of latitude could potentially obscure the circadian variations observed in monocentric studies. We believe that, to assess whether circadian rhythms can affect the infarct size, future study design should not only include larger samples but also aim to untangle the molecular time–dynamic mechanisms underlying such a relation.

Published
2013

28. Impact of Prior Statin Therapy on In-Hospital Outcome of STEMI Patients Treated with Primary Percutaneous Coronary Intervention.

Author

Lanza O, Cosentino N, Lucci C, Resta M, Rubino M, Milazzo V, De Metrio M, Trombara F, Campodonico J, Werba JP, Bonomi A, and Marenzi G

Abstract

Background: Prior statin therapy has a cardioprotective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI are still controversial. We retrospectively evaluated the effect of prior statin therapy on in-hospital clinical outcomes in consecutive STEMI patients undergoing primary PCI. Methods: A total of 1790 patients (mean age 67 ± 11 years, 1354 men) were included. At admission, all patients were interrogated about prior (>6 months) statin therapy. The primary endpoint of the study was the composite of in-hospital mortality, acute pulmonary edema, and cardiogenic shock in patients with or without prior statin therapy. Results: A total of 427 patients (24%) were on prior statin therapy. The incidence of the primary endpoint was similar in patients with or without prior statin therapy (15% vs. 16%; p = 0.38). However, at multivariate analysis, prior statin therapy was associated with a lower risk of the primary endpoint, after adjustment for major prognostic predictors (odds ratio 0.61 [95% CI 0.39−0.96]; p = 0.03). Conclusions: This study demonstrated that prior statin therapy is associated with a better in-hospital clinical outcome in patients with STEMI undergoing primary PCI compared to those without prior statin therapy.

Published
2022
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29. Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives.

Author

Cosentino N, Campodonico J, Milazzo V, De Metrio M, Brambilla M, Camera M, and Marenzi G

Subjects
Dietary Supplements, Humans, Platelet Aggregation Inhibitors therapeutic use, Cardiovascular Diseases drug therapy, Vitamin D therapeutic use
Abstract

Vitamin D deficiency is a prevalent condition, occurring in about 30-50% of the population, observed across all ethnicities and among all age groups. Besides the established role of vitamin D in calcium homeostasis, its deficiency is emerging as a new risk factor for cardiovascular disease (CVD). In particular, several epidemiological and clinical studies have reported a close association between low vitamin D levels and major CVDs, such as coronary artery disease, heart failure, and atrial fibrillation. Moreover, in all these clinical settings, vitamin deficiency seems to predispose to increased morbidity, mortality, and recurrent cardiovascular events. Despite this growing evidence, interventional trials with supplementation of vitamin D in patients at risk of or with established CVD are still controversial. In this review, we aimed to summarize the currently available evidence supporting the link between vitamin D deficiency and major CVDs in terms of its prevalence, clinical relevance, prognostic impact, and potential therapeutic implications.

Published
2021
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30. A preprocedural risk score predicts acute kidney injury following primary percutaneous coronary intervention.

Author

Buratti S, Crimi G, Somaschini A, Cornara S, Camporotondo R, Cosentino N, Moltrasio M, Rubino M, De Metrio M, Marana I, De Servi S, Marenzi G, and De Ferrari GM

Subjects
Aged, Contrast Media, Creatinine, Humans, Predictive Value of Tests, Risk Assessment, Risk Factors, Treatment Outcome, Acute Kidney Injury chemically induced, Acute Kidney Injury diagnosis, Acute Kidney Injury epidemiology, Percutaneous Coronary Intervention adverse effects, ST Elevation Myocardial Infarction diagnostic imaging
Abstract

Background: Reliable preprocedural risk scores for the prediction of Contrast-Induced Acute Kidney Injury (CI-AKI) following Percutaneous Coronary Intervention (pPCI) in patients with ST-elevation myocardial infarction (STEMI) are lacking. Aim of this study was to derive and validate a preprocedural Risk Score in this setting., Methods: Two prospectively enrolled patient cohorts were used for derivation and validation (n = 3,736). CI-AKI was defined as creatinine increase ≥0.5 mg/dl <72 h postpPCI. Odds ratios from multivariable logistic regression model were converted to an integer, whose sum represented the Risk Score., Results: Independent CI-AKI predictors were: diabetes, Killip class II-III (2 points each), age > 75 years, anterior MI (3 points), Killip class IV (4 points), estimated GFR < 60 ml/min/1.73m 2 (5 points). The Risk Score c-statistic was 0.84 in both cohorts. Compared with patients with Risk Score ≤ 4, the relative risks of CI-AKI among patients scoring 5-9 were 6.2 (derivation cohort) and 7.1 (validation cohort); among patients scoring ≥10, 19.8, and 21.4, respectively., Conclusions: Among STEMI patients, a simple preprocedural Risk Score accurately and reproducibly predicted the risk of CI-AKI, identifying ¼ of patients with a seven-fold risk and 1/10 of patients with a 20-fold risk. This knowledge may help tailored strategies, including delaying revascularization of nonculprit vessels in patients at high risk of CI-AKI., (© 2020 Wiley Periodicals LLC.)

Published
2021
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31. Mitochondrial Biomarkers in Patients with ST-Elevation Myocardial Infarction and Their Potential Prognostic Implications: A Prospective Observational Study.

Author

Cosentino N, Campodonico J, Moltrasio M, Lucci C, Milazzo V, Rubino M, De Metrio M, Marana I, Grazi M, Bonomi A, Veglia F, Lauri G, Bartorelli AL, and Marenzi G

Abstract

Background: Mitochondrial biomarkers have been investigated in different critical settings, including ST-elevation myocardial infarction (STEMI). Whether they provide prognostic information in STEMI, complementary to troponins, has not been fully elucidated. We prospectively explored the in-hospital and long-term prognostic implications of cytochrome c and cell-free mitochondrial DNA (mtDNA) in STEMI patients undergoing primary percutaneous coronary intervention., Methods: We measured cytochrome c and mtDNA at admission in 466 patients. Patients were grouped according to mitochondrial biomarkers detection: group 1 (-/-; no biomarker detected; n = 28); group 2 (-/+; only one biomarker detected; n = 283); group 3 (+/+; both biomarkers detected; n = 155). A composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema was the primary endpoint. Four-year all-cause mortality was the secondary endpoint., Results: Progressively lower left ventricular ejection fractions (52 ± 8%, 49 ± 8%, 47 ± 9%; p = 0.006) and higher troponin I peaks (54 ± 44, 73 ± 66, 106 ± 81 ng/mL; p = 0.001) were found across the groups. An increase in primary (4%, 14%, 19%; p = 0.03) and secondary (10%, 15%, 23%; p = 0.02) endpoint rate was observed going from group 1 to group 3. The adjusted odds ratio increment of the primary endpoint from one group to the next was 1.65 (95% CI 1.04-2.61; p = 0.03), while the adjusted hazard ratio increment of the secondary endpoint was 1.55 (95% CI 1.12-2.52; p = 0.03). The addition of study group allocation to admission troponin I reclassified 12% and 22% of patients for the primary and secondary endpoint, respectively., Conclusions: Detection of mitochondrial biomarkers is common in STEMI and seems to be associated with in-hospital and long-term outcome independently of troponin., Competing Interests: The authors declare no conflict of interest. The funders had no role in the design of the study, in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results

Published
2021
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32. Diabetes Mellitus and Acute Myocardial Infarction: Impact on Short and Long-Term Mortality.

Author

Milazzo V, Cosentino N, Genovese S, Campodonico J, Mazza M, De Metrio M, and Marenzi G

Subjects
Hospital Mortality, Humans, Risk Factors, Diabetes Mellitus mortality, Myocardial Infarction mortality
Abstract

Diabetes mellitus (DM) is an important risk factor for acute myocardial infarction (AMI) and a frequent co-morbidity in patients hospitalized with AMI, being present in about 30% of cases. Although current treatment of AMI has considerably improved survival in both patients with and without DM, the presence of DM still doubles the case fatality rate during both the acute phase of AMI and at long-term follow-up. This higher mortality risk of DM patients strongly indicates a particular need for better treatment options in these patients and suggests that intensive medical treatment, prolonged surveillance, and stringent control of other risk factors should be carefully pursued and maintained for as long as possible in them.In this review, we will focus on the close association between DM and in-hospital and long-term mortality in AMI patients. We will also aim at providing current evidence on the mechanisms underlying this association and on emerging therapeutic strategies, which may reduce the traditional mortality gap that still differentiates AMI patients with DM from those without.

Published
2021
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33. Prognostic impact of admission high-sensitivity C-reactive protein in acute myocardial infarction patients with and without diabetes mellitus.

Author

Lucci C, Cosentino N, Genovese S, Campodonico J, Milazzo V, De Metrio M, Rondinelli M, Riggio D, Biondi ML, Rubino M, Celentano K, Bonomi A, Capra N, Veglia F, Agostoni P, Bartorelli AL, and Marenzi G

Subjects
Aged, Aged, 80 and over, Biomarkers blood, Diabetes Mellitus diagnosis, Diabetes Mellitus mortality, Female, Hospital Mortality, Humans, Incidence, Male, Middle Aged, Non-ST Elevated Myocardial Infarction diagnosis, Non-ST Elevated Myocardial Infarction mortality, Predictive Value of Tests, Prognosis, Prospective Studies, Pulmonary Edema blood, Pulmonary Edema mortality, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction mortality, Shock, Cardiogenic blood, Shock, Cardiogenic mortality, Up-Regulation, C-Reactive Protein analysis, Diabetes Mellitus blood, Inflammation Mediators blood, Non-ST Elevated Myocardial Infarction blood, Patient Admission, ST Elevation Myocardial Infarction blood
Abstract

Background: High-sensitivity C-reactive protein (hs-CRP) elevation frequently occurs in acute myocardial infarction (AMI) and is associated with adverse outcomes. Since diabetes mellitus (DM) is characterized by an underlying chronic inflammation, hs-CRP may have a different prognostic power in AMI patients with and without DM., Methods: We prospectively included 2064 AMI patients; hs-CRP was measured at hospital admission. Patients were grouped according to hs-CRP quartiles and DM status. The primary endpoint was a composite of in-hospital mortality, cardiogenic shock, and acute pulmonary edema. Two-year all-cause mortality was the secondary endpoint., Results: Twenty-six percent (n = 548) of patients had DM and they had higher hs-CRP levels than non-DM patients (5.32 vs. 3.24 mg/L; P < 0.0001). The primary endpoint incidence in the overall population (7%, 9%, 13%, 22%; P for trend < 0.0001), in DM (14%, 9%, 21%, 27%; P = 0.0001), and non-DM (5%, 8%, 10%, 19%; P < 0.0001) patients increased in parallel with hs-CRP quartiles. The adjusted risk of the primary endpoint increased in parallel with hs-CRP quartiles in DM and non-DM patients but this relationship was less evident in DM patients. In the overall population, the adjusted OR of the primary endpoint associated with an hs-CRP value ≥ 2 mg/L was 2.10 (95% CI 1.46-3.00). For the same risk, hs-CRP was 7 and 2 mg/L in patients with and without DM. A similar behavior was observed for the secondary endpoint when the HR associated with an hs-CRP value ≥ 2 mg/L found in the overall population was 2.25 (95% CI 1.57-3.22). For the same risk, hs-CRP was 8 and 1.5 mg/L in DM and non-DM patients., Conclusions: This study shows that hs-CRP predicts in-hospital outcome and two-year mortality in AMI patients with and without DM. However, in DM patients, the same risk of developing events as in non-DM patients is associated to higher hs-CRP levels.

Published
2020
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34. High-Sensitivity C-Reactive Protein and Acute Kidney Injury in Patients with Acute Myocardial Infarction: A Prospective Observational Study.

Author

Cosentino N, Genovese S, Campodonico J, Bonomi A, Lucci C, Milazzo V, Moltrasio M, Biondi ML, Riggio D, Veglia F, Ceriani R, Celentano K, De Metrio M, Rubino M, Bartorelli AL, and Marenzi G

Abstract

Background. Accumulating evidence suggests that inflammation plays a key role in acute kidney injury (AKI) pathogenesis. We explored the relationship between high-sensitivity C-reactive protein (hs-CRP) and AKI in acute myocardial infarction (AMI). Methods. We prospectively included 2,063 AMI patients in whom hs-CRP was measured at admission. AKI incidence and a clinical composite of in-hospital death, cardiogenic shock, and acute pulmonary edema were the study endpoints. Results . Two-hundred-thirty-four (11%) patients developed AKI. hs-CRP levels were higher in AKI patients (45 ± 87 vs. 16 ± 41 mg/L; p < 0.0001). The incidence and severity of AKI, as well as the rate of the composite endpoint, increased in parallel with hs-CRP quartiles ( p for trend <0.0001 for all comparisons). A significant correlation was found between hs-CRP and the maximal increase of serum creatinine (R = 0.23; p < 0.0001). The AUC of hs-CRP for AKI prediction was 0.69 ( p < 0.001). At reclassification analysis, addition of hs-CRP allowed to properly reclassify 14% of patients when added to creatinine and 8% of patients when added to a clinical model. Conclusions. In AMI, admission hs-CRP is closely associated with AKI development and severity, and with in-hospital outcomes. Future research should focus on whether prophylactic renal strategies in patients with high hs-CRP might prevent AKI and improve outcome.

Published
2019
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35. Reduced Cardio-Renal Function Accounts for Most of the In-Hospital Morbidity and Mortality Risk Among Patients With Type 2 Diabetes Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.

Author

Marenzi G, Cosentino N, Genovese S, Campodonico J, De Metrio M, Rondinelli M, Cornara S, Somaschini A, Camporotondo R, Demarchi A, Milazzo V, Moltrasio M, Rubino M, Marana I, Grazi M, Lauri G, Bonomi A, Veglia F, De Ferrari GM, and Bartorelli AL

Subjects
Acute Kidney Injury complications, Acute Kidney Injury epidemiology, Acute Kidney Injury physiopathology, Acute Kidney Injury surgery, Aged, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 physiopathology, Diabetes Mellitus, Type 2 surgery, Diabetic Angiopathies epidemiology, Diabetic Angiopathies surgery, Diabetic Nephropathies complications, Diabetic Nephropathies epidemiology, Diabetic Nephropathies physiopathology, Diabetic Nephropathies surgery, Female, Heart physiopathology, Humans, Incidence, Kidney physiopathology, Male, Middle Aged, Morbidity, Retrospective Studies, Risk Factors, ST Elevation Myocardial Infarction complications, Treatment Outcome, Diabetes Mellitus, Type 2 epidemiology, Glomerular Filtration Rate physiology, Hospital Mortality, Percutaneous Coronary Intervention adverse effects, Percutaneous Coronary Intervention mortality, Percutaneous Coronary Intervention statistics & numerical data, ST Elevation Myocardial Infarction epidemiology, ST Elevation Myocardial Infarction surgery, Ventricular Function, Left physiology
Abstract

Objective: ST-segment elevation myocardial infarction (STEMI) patients with type 2 diabetes mellitus (DM) have higher in-hospital mortality than those without. Since cardiac and renal functions are the main variables associated with outcome in STEMI, we hypothesized that this prognostic disparity may depend on a higher rate of cardiac and renal dysfunction in DM patients., Research Design and Methods: We retrospectively analyzed 5,152 STEMI patients treated with primary angioplasty. Left ventricular ejection fraction (LVEF) and estimated glomerular filtration rate (eGFR) were evaluated at hospital admission. The primary end point was in-hospital mortality. A composite of in-hospital mortality, cardiogenic shock, and acute kidney injury was the secondary end point., Results: There were 879 patients (17%) with DM. The incidence of LVEF ≤40% (30% vs. 22%), eGFR ≤60 mL/min/1.73 m 2 (27% vs. 18%), or both (12% vs. 6%) was higher ( P < 0.001 for all comparisons) in DM patients. In-hospital mortality was higher in DM patients than in non-DM patients (6.1% vs. 3.5%; P = 0.002), with an unadjusted odds ratio (OR) of 1.81 (95% CI 1.31-2.49; P < 0.001). However, DM was no longer associated with an increased mortality risk after adjustment for cardiac and renal function (OR 1.03, 95% CI 0.68-1.56; P = 0.89). A similar behavior was observed for the secondary end point, with an unadjusted OR for DM of 1.52 (95% CI 1.25-1.85; P < 0.001) and an OR after adjustment for cardiac and renal function of 1.07 (95% CI 0.85-1.36; P = 0.53)., Conclusions: The study indicates that the increased in-hospital mortality and morbidity of DM patients with STEMI is mainly driven by their underlying cardio-renal dysfunction., (© 2019 by the American Diabetes Association.)

Published
2019
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36. A new score based on the PEGASUS-TIMI 54 criteria for risk stratification of patients with acute myocardial infarction.

Author

Cosentino N, Campodonico J, Faggiano P, De Metrio M, Rubino M, Milazzo V, Sbolli M, Perego C, Provini M, Bonomi A, Veglia F, Bartorelli AL, and Marenzi G

Subjects
Aged, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction epidemiology, Prospective Studies, Retrospective Studies, Risk Assessment methods, Risk Assessment trends, Risk Factors, Myocardial Infarction diagnostic imaging, Myocardial Infarction physiopathology, Severity of Illness Index
Abstract

Background: Acute myocardial infarction (AMI) patients are at increased risk of death and recurrent ischemic events. We aimed to elaborate a risk score, based on the PEGASUS-TIMI 54 criteria, to predict mortality and non-fatal AMI in AMI patients., Methods: We retrospectively analyzed two prospectively collected AMI cohorts. We calculated a cut-off for the developed score and investigated its 1-year prognostic power in the derivation cohort (n = 1257). We externally validated our score in 913 AMI patients with a longer follow-up., Results: In the derivation cohort, the area under the curve of the score for the primary endpoint (1-year death and non-fatal AMI) was 0.70 (95% CI 0.65-0.76; P < 0.0001) and a cut-off of 6 was identified. The primary endpoint incidence in patients with a score above and below the cut-off was 12% and 3% (P < 0.001) in the derivation cohort and 16% and 6% in the validation cohort (P < 0.001). At multivariate analysis, the HR for the primary endpoint associated with a score ≥ 6 was 4.45 (P < 0.0001) in the derivation cohort and 2.86 (P < 0.0001) in the validation cohort. One-year major bleeding rate was low (<0.2% overall) and similar between risk groups. The prognostic performance of the score cut-off persisted beyond the first year after AMI in the validation cohort, maintaining a similar risk for death and non-fatal AMI (HR 3) at every following year., Conclusions: Our score, based on the PEGASUS-TIMI 54 criteria, may identify AMI patients at high risk of recurrent ischemic events, who might benefit from thorough preventive strategies., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Published
2019
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37. Impact of Chronic Antiplatelet Therapy on Infarct Size and Bleeding in Patients With Acute Myocardial Infarction.

Author

Campodonico J, Cosentino N, Milazzo V, Rubino M, De Metrio M, Marana I, Moltrasio M, Grazi M, Lauri G, Bonomi A, Veglia F, Chiorino E, Assanelli E, Bartorelli AL, and Marenzi G

Subjects
Aged, Biomarkers blood, Drug Therapy, Combination, Female, Hemorrhage chemically induced, Humans, Male, Middle Aged, Myocardium pathology, Non-ST Elevated Myocardial Infarction blood, Non-ST Elevated Myocardial Infarction diagnosis, Platelet Aggregation Inhibitors adverse effects, Prospective Studies, Risk Assessment, Risk Factors, ST Elevation Myocardial Infarction blood, ST Elevation Myocardial Infarction diagnosis, Time Factors, Treatment Outcome, Troponin I blood, Non-ST Elevated Myocardial Infarction drug therapy, Platelet Aggregation Inhibitors therapeutic use, ST Elevation Myocardial Infarction drug therapy
Abstract

Background: Patients hospitalized with acute myocardial infarction (AMI) are often on prior single antiplatelet therapy (SAPT) or a dual antiplatelet therapy (DAPT). Whether chronic SAPT or DAPT is beneficial or associated with an increased risk in AMI is still controversial., Methods and Results: We prospectively enrolled 1718 consecutive patients with AMI (798 ST-segment elevation myocardial infarction and 920 non-ST-segment elevation myocardial infarction) who were divided according to their chronic APT (no APT, SAPT, or DAPT). The study primary end point was the infarct size, as estimated by troponin I peak. Incidence of major bleeding was also evaluated. Five hundred thirty-six (31%) patients were on chronic SAPT and 215 (13%) on DAPT. A graded increase in Global Registry of Acute Coronary Events (GRACE) and Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) risk scores was found going from patients without APT to those with DAPT, while a progressive smaller troponin I peak was observed with the increasing number of chronic antiplatelet agents (11.2 [interquartile range: 2-45] ng/mL, 6.6 [1-33] ng/mL, and 4.1 [1-24] ng/mL; P < .001 for trend). This result was maintained after adjustment for baseline ischemic risk profile (GRACE score) and other major confounders ( P < .001). The incidence of bleeding was higher in patients on chronic APT than in those without APT (5.2% vs 2.4%; P = .002). However, when the bleeding risk was adjusted for the CRUSADE risk score, chronic SAPT (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 0.77-2.53) and DAPT (OR: 0.70, 95% CI: 0.29-1.70) were not associated with an increased bleeding risk., Conclusion: In patients with AMI, chronic APT is associated with higher baseline ischemic and bleeding risks. Despite this and unexpectedly, they have a smaller infarct size and similar adjusted bleeding risk.

Published
2018
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38. Acute Kidney Injury in Diabetic Patients With Acute Myocardial Infarction: Role of Acute and Chronic Glycemia.

Author

Marenzi G, Cosentino N, Milazzo V, De Metrio M, Rubino M, Campodonico J, Moltrasio M, Marana I, Grazi M, Lauri G, Bonomi A, Barbieri S, Assanelli E, Dalla Cia A, Manfrini R, Ceriani R, and Bartorelli A

Subjects
Acute Kidney Injury blood, Acute Kidney Injury epidemiology, Aged, Chronic Disease, Diabetes Mellitus epidemiology, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Hyperglycemia blood, Hyperglycemia epidemiology, Incidence, Italy epidemiology, Male, Myocardial Infarction blood, Myocardial Infarction epidemiology, Prospective Studies, Risk Factors, Survival Rate trends, Acute Kidney Injury etiology, Blood Glucose metabolism, Diabetes Mellitus blood, Glycated Hemoglobin metabolism, Hyperglycemia complications, Myocardial Infarction complications
Abstract

Background: In acute myocardial infarction, acute hyperglycemia is a predictor of acute kidney injury (AKI), particularly in patients without diabetes mellitus. This emphasizes the importance of an acute glycemic rise rather than glycemia level at admission. We investigated whether, in diabetic patients with acute myocardial infarction, the combined evaluation of acute and chronic glycemic levels may have better prognostic value for AKI than admission glycemia., Methods and Results: At admission, we prospectively measured glycemia and estimated average chronic glucose levels (mg/dL) using glycosylated hemoglobin (HbA 1c ), according to the following formula: 28.7×HbA 1c (%)-46.7. We evaluated the association with AKI of the acute/chronic glycemic ratio and of the difference between acute and chronic glycemia (Δ A-C ). We enrolled 474 diabetic patients with acute myocardial infarction. Of them, 77 (16%) experienced AKI. The incidence of AKI increased in parallel with the acute/chronic glycemic ratio (12%, 14%, 22%; P =0.02 for trend) and Δ A-C (13%, 13%, 23%; P =0.01) but not with admission glycemic tertiles ( P =0.22). At receiver operating characteristic analysis, the acute/chronic glycemic ratio (area under the curve: 0.62 [95% confidence interval, 0.55-0.69]; P =0.001) and Δ A-C (area under the curve: 0.62 [95% confidence interval, 0.54-0.69]; P =0.002) accurately predicted AKI, without difference in the area under the curve between them ( P =0.53). At reclassification analysis, the addition of the acute/chronic glycemic ratio and Δ A-C to acute glycemia allowed proper AKI risk prediction in 16% of patients., Conclusions: In diabetic patients with acute myocardial infarction, AKI is better predicted by the combined evaluation of acute and chronic glycemic values than by assessment of admission glycemia alone., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Published
2018
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39. Prognostic Value of the Acute-to-Chronic Glycemic Ratio at Admission in Acute Myocardial Infarction: A Prospective Study.

Author

Marenzi G, Cosentino N, Milazzo V, De Metrio M, Cecere M, Mosca S, Rubino M, Campodonico J, Moltrasio M, Marana I, Grazi M, Lauri G, Bonomi A, Veglia F, Manfrini R, and Bartorelli AL

Subjects
Acute Disease, Aged, Endpoint Determination, Female, Glycated Hemoglobin analysis, Hospital Mortality, Hospitalization, Humans, Male, Middle Aged, Myocardial Infarction mortality, Prognosis, Prospective Studies, Troponin I blood, Blood Glucose analysis, Hyperglycemia blood, Hyperglycemia mortality, Myocardial Infarction blood, Myocardial Infarction diagnosis
Abstract

Objective: Acute hyperglycemia is a powerful predictor of poor prognosis in acute myocardial infarction (AMI), particularly in patients without diabetes. This emphasizes the importance of an acute glycemic rise rather than glycemia level at admission alone. We investigated in AMI whether the combined evaluation of acute and chronic glycemic levels, as compared with admission glycemia alone, may have a better prognostic value., Research Design and Methods: We prospectively measured admission glycemia and estimated average chronic glucose levels (mg/dL) by the following formula: [(28.7 × glycosylated hemoglobin %) - 46.7], and calculated the acute-to-chronic (A/C) glycemic ratio in 1,553 consecutive AMI patients (mean ± SD age 67 ± 13 years). The primary end point was the combination of in-hospital mortality, acute pulmonary edema, and cardiogenic shock., Results: The primary end point rate increased in parallel with A/C glycemic ratio tertiles (5%, 8%, and 20%, respectively; P for trend <0.0001). A parallel increase was observed in troponin I peak value (15 ± 34 ng/mL, 34 ± 66 ng/mL, and 68 ± 131 ng/mL; P < 0.0001). At multivariable analysis, A/C glycemic ratio remained an independent predictor of the primary end point and of troponin I peak value, even after adjustment for major confounders. At reclassification analyses, A/C glycemic ratio showed the best prognostic power in predicting the primary end point as compared with glycemia at admission in the entire population (net reclassification improvement 12% [95% CI 4-20]; P = 0.003) and, particularly, in patients with diabetes (27% [95% CI 14-40]; P < 0.0001)., Conclusions: In AMI patients with diabetes, A/C glycemic ratio is a better predictor of in-hospital morbidity and mortality than glycemia at admission., (© 2018 by the American Diabetes Association.)

Published
2018
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40. Renal replacement therapy in patients with acute myocardial infarction: Rate of use, clinical predictors and relationship with in-hospital mortality.

Author

Marenzi G, Cosentino N, Marinetti A, Leone AM, Milazzo V, Rubino M, De Metrio M, Cabiati A, Campodonico J, Moltrasio M, Bertoli S, Cecere M, Mosca S, Marana I, Grazi M, Lauri G, Bonomi A, Veglia F, and Bartorelli AL

Subjects
Acute Kidney Injury etiology, Acute Kidney Injury mortality, Aged, Female, Follow-Up Studies, Glomerular Filtration Rate, Hospital Mortality trends, Humans, Italy epidemiology, Male, Non-ST Elevated Myocardial Infarction mortality, Retrospective Studies, ST Elevation Myocardial Infarction mortality, Shock, Cardiogenic mortality, Survival Rate trends, Acute Kidney Injury therapy, Non-ST Elevated Myocardial Infarction complications, Renal Replacement Therapy statistics & numerical data, ST Elevation Myocardial Infarction complications, Shock, Cardiogenic complications
Abstract

Objectives: We evaluated the rate of use, clinical predictors, and in-hospital outcome of renal replacement therapy (RRT) in acute myocardial infarction (AMI) patients., Methods: All consecutive AMI patients admitted to the Coronary Care Unit between January 1st, 2005 and December 31st, 2015 were identified through a search of our prospectively collected clinical database. Patients were grouped according to whether they required RRT or not., Results: Two-thousand-eight-hundred-thirty-nine AMI patients were included. Eighty-three (3%) AMI patients underwent RRT. Variables confirmed at cross validation analysis to be associated with RRT were: admission creatinine >1.5mg/dl (OR 16.9, 95% CI 10.4-27.3), cardiogenic shock (OR 23.0, 95% CI 14.4-36.8), atrial fibrillation (OR 8.6, 95% CI 5.5-13.4), mechanical ventilation (OR 22.6, 95% CI 14.2-36.0), diabetes mellitus (OR 4.8, 95% CI 3.1-7.4), and left ventricular ejection fraction <40% (OR 9.1, 95% CI 5.6-14.7). The AUC for RRT with the combination of these predictors was 0.96 (95% CI 0.94-0.97; P<0.001). In-hospital mortality was significantly higher in RRT patients (41% vs. 2.1%, P<0.001). Oligoanuria as indication for RRT (OR 5.1, 95% CI 1.7-15.4), atrial fibrillation (OR 4.3, 95% CI 1.6-11.5), mechanical ventilation (OR 20.8, 95% CI 6.1-70.4), and cardiogenic shock (OR 12.9, 95% CI 4.4-38.3) independently predicted mortality in RRT-treated patients. The AUC for in-hospital mortality prediction with the combination of these variables was 0.92 (95% CI 0.87-0.98; P<0.001)., Conclusions: Patients with AMI undergoing RRT had strikingly high in-hospital mortality. Use of RRT and its associated mortality were accurately predicted by easily obtainable clinical variables., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2017
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41. Vitamin D and acute myocardial infarction.

Author

Milazzo V, De Metrio M, Cosentino N, Marenzi G, and Tremoli E

Abstract

Vitamin D deficiency is a prevalent condition, cutting across all ethnicities and among all age groups, and occurring in about 30%-50% of the population. Besides vitamin D established role in calcium homeostasis, its deficiency is emerging as a new risk factor for coronary artery disease. Notably, clinical investigations have suggested that there is an association between hypovitaminosis D and acute myocardial infarction (AMI). Not only has it been linked to incident AMI, but also to increased morbidity and mortality in this clinical setting. Moreover, vitamin D deficiency seems to predispose to recurrent adverse cardiovascular events, as it is associated with post-infarction complications and cardiac remodeling in patients with AMI. Several mechanisms underlying the association between vitamin D and AMI risk can be involved. Despite these observational and mechanistic data, interventional trials with supplementation of vitamin D are controversial. In this review, we will discuss the evidence on the association between vitamin D deficiency and AMI, in terms of prevalence and prognostic impact, and the possible mechanisms mediating it. Further research in this direction is warranted and it is likely to open up new avenues for reducing the risk of AMI., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.

Published
2017
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42. Brain natriuretic peptide in acute myocardial infarction: a marker of cardio-renal interaction.

Author

Moltrasio M, Cosentino N, De Metrio M, Rubino M, Cabiati A, Milazzo V, Discacciati A, Marana I, Bonomi A, Veglia F, Lauri G, and Marenzi G

Subjects
Aged, Aged, 80 and over, Biomarkers blood, Female, Hospitalization, Humans, Italy, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Prospective Studies, Stroke Volume, Ventricular Function, Left, Glomerular Filtration Rate, Heart physiopathology, Natriuretic Peptide, Brain blood, Non-ST Elevated Myocardial Infarction blood, ST Elevation Myocardial Infarction blood
Abstract

Aims: Cardiac and renal functions are major independent predictors of outcomes in both ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). As B-type natriuretic peptide (BNP) seems to be a major mediator in the cross-talk between heart and kidneys, we aimed at evaluating its capacity to reflect cardiac and renal function in patients with STEMI and NSTEMI., Methods: We measured BNP plasma levels at hospital admission in 619 patients with STEMI (n = 346) and NSTEMI (n = 273), grouped according to left ventricular ejection fraction (LVEF; > or ≤40%) and estimated glomerular filtration rate (eGFR; > or ≤ 60 ml/min/1.73 m)., Results: Median BNP values were 82 (38-186), 121 (40-342), 219 (80-685), and 474 (124-1263) pg/ml in patients with normal LVEF and eGFR (n = 347), with LVEF 40% or less and eGFR higher than 60 ml/min/1.73 m (n = 120), with LVEF higher than 40% and eGFR 60 ml/min/1.73 m or less (n = 86), and with combined LVEF and eGFR reductions (n = 66), respectively (P < 0.0001). At general linear model, both LVEF higher than 40% (P < 0.0001) and eGFR 60 ml/min/1.73 m or less (P < 0.0001) independently predicted BNP values. At multivariable analysis, BNP, LVEF 40% or less, and eGFR 60 ml/min/1.73 m or less were found to be independent predictors of the combined end point of in-hospital death, cardiogenic shock, need for renal replacement therapy, or mechanical ventilation (P = 0.003; P < 0.0001; P = 0.01, respectively)., Conclusion: BNP plasma levels are closely related to LVEF and eGFR at hospital admission, in both STEMI and NSTEMI patients. Future studies should investigate whether BNP levels can summarize in a single parameter the prognostic information provided separately by cardiac and renal dysfunction.

Published
2016
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43. Acute Kidney Injury Definition and In-Hospital Mortality in Patients Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.

Author

Marenzi G, Cosentino N, Moltrasio M, Rubino M, Crimi G, Buratti S, Grazi M, Milazzo V, Somaschini A, Camporotondo R, Cornara S, De Metrio M, Bonomi A, Veglia F, De Ferrari GM, and Bartorelli AL

Subjects
Acute Kidney Injury diagnosis, Acute Kidney Injury etiology, Aged, Female, Humans, Male, Middle Aged, Percutaneous Coronary Intervention adverse effects, ROC Curve, Risk Factors, ST Elevation Myocardial Infarction mortality, Acute Kidney Injury mortality, Hospital Mortality, Percutaneous Coronary Intervention mortality, ST Elevation Myocardial Infarction surgery
Abstract

Background: Acute kidney injury (AKI) has been associated with increased mortality in ST-segment elevation myocardial infarction. We compared the mortality predictive accuracy of the 3 AKI definitions used most widely for patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention., Methods and Results: We included 3771 patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention at 2 Italian hospitals. AKI incidence was evaluated according to creatinine increases of ≥25% (AKI-25), ≥0.3 mg/dL (AKI-0.3), and ≥0.5 mg/dL (AKI-0.5). The primary end point was in-hospital mortality. Overall, 557 (15%), 522 (14%), and 270 (7%) patients developed AKI-25, AKI-0.3, and AKI-0.5, respectively (P<0.01). All AKI definitions independently predicted in-hospital mortality (adjusted odds ratio 4.9 [95% CI 3.1-7.8], 5.4 [95% CI 3.3-8.6], and 8.3 [95% CI 5.1-13.3], respectively; P<0.01 for all). At receiver operating characteristic analysis, the addition of each AKI definition to combined clinical predictors of mortality (age, sex, left ventricular ejection fraction, admission creatinine, creatine kinase-MB peak) found at stepwise analysis significantly improved mortality prognostication (area under the curve increased from 0.89 for clinical predictor combination alone to 0.92 for AKI-25, 0.92 for AKI-0.3, and 0.93 for AKI-0.5; P<0.01 for all). At reclassification analysis, AKI-0.5 added to clinical predictors, provided the highest score in mortality (net reclassification improvement +10% versus AKI-0.3 [P=0.01] and +8% versus AKI-25 [P=0.05])., Conclusions: Each AKI definition significantly improved the mortality prediction beyond major clinical variables. AKI-0.5 showed a mortality discrimination advantage, suggesting it should be the preferred definition in studies addressing ST-segment elevation myocardial infarction and focusing on short-term mortality., (© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)

Published
2016
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44. B-type natriuretic peptide levels in patients with pericardial effusion undergoing pericardiocentesis.

Author

Lauri G, Rossi C, Rubino M, Cosentino N, Milazzo V, Marana I, Cabiati A, Moltrasio M, De Metrio M, Grazi M, Campodonico J, Assanelli E, Riggio D, Sandri MT, Bonomi A, Veglia F, and Marenzi G

Subjects
Aged, Female, Humans, Male, Middle Aged, Pericardial Effusion metabolism, Prospective Studies, Severity of Illness Index, Natriuretic Peptide, Brain blood, Pericardial Effusion surgery, Pericardiocentesis methods
Abstract

Objectives: Pericardial effusion is characterized by progressive accumulation of fluid within the pericardial space, resulting in increased intra-pericardial pressure and compression of the heart. As B-type natriuretic peptide (BNP) is secreted by the ventricles in response to increased myocardial stretch, we hypothesized that pericardial effusion, as well as its resolution, might influence BNP plasma levels., Methods: We prospectively measured, in 146 consecutive patients with pericardial effusion, BNP plasma levels at baseline, soon after, and 24h after pericardiocentesis. A scoring system based on 7 clinical and echocardiographic parameters was developed, and patients were classified according to the number of variables as having low (0-2), intermediate (3-4), or high (5-7) severity score., Results: Out of the 146 patients, 42 (29%) had normal values (<100pg/ml), whereas 104 (71%) had high BNP values at baseline. In the whole population, baseline BNP levels significantly decreased as the severity score increased (r=-0.21; P=0.01). 24h after pericardiocentesis, a significant increase in BNP was observed in patients with intermediate (P=0.004) score and with high (P<0.001) severity score; no increase occurred in low score patients (P=0.56). The higher was the severity score, the steeper was the increase in BNP through the three time-points considered (P=0.04)., Conclusions: The results of the present study show that BNP plasma levels are suppressed in the presence of severe pericardial effusion, and that they rise after pericardiocentesis. Future studies should investigate the role of BNP in assisting clinicians in the decision-making process of pericardial fluid drainage., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Published
2016
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45. Myocardial Infarct Size in Patients on Long-Term Statin Therapy Undergoing Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction.

Author

Marenzi G, Cosentino N, Cortinovis S, Milazzo V, Rubino M, Cabiati A, De Metrio M, Moltrasio M, Lauri G, Campodonico J, Pontone G, Andreini D, Bonomi A, Veglia F, and Bartorelli A

Subjects
Coronary Angiography, Coronary Circulation drug effects, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Myocardial Infarction diagnosis, Myocardial Infarction surgery, Prospective Studies, Time Factors, Treatment Outcome, Electrocardiography, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Myocardial Infarction drug therapy, Percutaneous Coronary Intervention, Preoperative Care methods
Abstract

Statin pretreatment has been reported to have a cardioprotective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI are still controversial. We prospectively evaluated the effect of long-term statin therapy on infarct size (IS), myocardial salvage index (MSI), and microvascular obstruction (MVO) in consecutive patients with STEMI who underwent primary PCI. Two-hundred thirty patients with STEMI (mean age 61 ± 11 years, 183 men) who underwent primary PCI were evaluated with cardiac magnetic resonance (CMR) imaging during hospitalization (median 4 days after primary PCI). In all patients, we measured peak troponin I level, whereas IS, MSI, and MVO were determined by CMR. Fifty patients (22%) were on long-term statin therapy and showed a significantly lower troponin I peak value compared to patients without previous statins (54 ± 47 vs 88 ± 106 ng/ml; p = 0.02). At CMR evaluation, IS related to the index event was significantly smaller (12.5 ± 11.5 vs 18.5 ± 18.5 g, p = 0.05), and MSI was higher (0.68 ± 0.25 vs 0.52 ± 0.30; p <0.01) in patients with previous statin therapy. MVO was also less frequent (10% vs 20%; p = 0.14) in this group. At multivariate analysis, previous statin therapy remained significantly associated with IS and MSI (p = 0.05 and 0.02, respectively). In conclusion, this study suggests that long-term statin therapy before primary PCI in patients with STEMI is associated with smaller IS and higher MSI. Future studies are warranted to confirm these findings and to investigate potential clinical implications., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Published
2015
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46. Vitamin D plasma levels and in-hospital and 1-year outcomes in acute coronary syndromes: a prospective study.

Author

De Metrio M, Milazzo V, Rubino M, Cabiati A, Moltrasio M, Marana I, Campodonico J, Cosentino N, Veglia F, Bonomi A, Camera M, Tremoli E, and Marenzi G

Subjects
Aged, Aged, 80 and over, Comorbidity, Female, Hospital Mortality, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Vitamin D blood, Acute Coronary Syndrome blood, Acute Coronary Syndrome mortality, Vitamin D analogs & derivatives, Vitamin D Deficiency epidemiology
Abstract

Deficiency in 25-hydroxyvitamin D (25[OH]D), the main circulating form of vitamin D in blood, could be involved in the pathogenesis of acute coronary syndromes (ACS). To date, however, the possible prognostic relevance of 25 (OH)D deficiency in ACS patients remains poorly defined. The purpose of this prospective study was to assess the association between 25 (OH)D levels, at hospital admission, with in-hospital and 1-year morbidity and mortality in an unselected cohort of ACS patients.We measured 25 (OH)D in 814 ACS patients at hospital presentation. Vitamin D serum levels >30 ng/mL were considered as normal; levels between 29 and 21 ng/mL were classified as insufficiency, and levels < 20 ng/mL as deficiency. In-hospital and 1-year outcomes were evaluated according to 25 (OH)D level quartiles, using the lowest quartile as a reference.Ninety-three (11%) patients had normal 25 (OH)D levels, whereas 155 (19%) and 566 (70%) had vitamin D insufficiency and deficiency, respectively. The median 25 (OH)D level was similar in ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) patients (14.1 [IQR 9.0-21.9] ng/mL and 14.05 [IQR 9.1-22.05] ng/mL, respectively; P = .88). The lowest quartile of 25 (OH)D was associated with a higher risk for several in-hospital complications, including mortality. At a median follow-up of 366 (IQR 364-379) days, the lowest quartile of 25 (OH)D, after adjustment for the main confounding factors, remained significantly associated to 1-year mortality (P < .01). Similar results were obtained when STEMI and NSTEMI patients were considered separately.In ACS patients, severe vitamin D deficiency is independently associated with poor in-hospital and 1-year outcomes. Whether low vitamin D levels represent a risk marker or a risk factor in ACS remains to be elucidated.

Published
2015
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47. Prognostic significance of serum creatinine and its change patterns in patients with acute coronary syndromes.

Author

Marenzi G, Cabiati A, Cosentino N, Assanelli E, Milazzo V, Rubino M, Lauri G, Morpurgo M, Moltrasio M, Marana I, De Metrio M, Bonomi A, Veglia F, and Bartorelli A

Subjects
Aged, Female, Humans, Male, Middle Aged, Prognosis, Proportional Hazards Models, ROC Curve, Retrospective Studies, Risk Assessment, Acute Coronary Syndrome blood, Acute Coronary Syndrome mortality, Creatinine blood, Hospital Mortality
Abstract

Background: In acute coronary syndromes (ACS), serum creatinine (sCr) levels have short- and long-term prognostic value. However, it is possible that repeated evaluations of sCr during hospitalization, rather than measuring sCr value at admission only, might improve risk assessment. We investigated the relationship between sCr baseline value, its changes, and in-hospital mortality in patients hospitalized with ACS., Methods: In 2,756 ACS patients, sCr was measured at hospital admission and then daily, until discharge from coronary care unit. Patients were grouped according to the maximum sCr change observed: <0.3 mg/dL change from baseline (stable renal function [SRF] group), ≥0.3 mg/dL decrease (improved renal function [IRF] group), and ≥0.3 mg/dL increase (worsening renal function [WRF] group)., Results: Of the 2,756 patients, 2,163 (78%) had SRF, 292 (11%) had IRF, and 301 (11%) had WRF. In-hospital mortality in the 3 groups was 0.5%, 2%, and 14% (P < .001), respectively. Peak sCr value was a more powerful predictor of mortality (area under the curve 0.86, 95% CI 0.81-0.92) than the initial sCr value (area under the curve 0.69, 95% CI 0.63-0.77; P < .001). When sCr and its change patterns during coronary care unit stay were evaluated together, improved mortality risk stratification was found., Conclusions: In ACS patients, daily sCr value and its change pattern are stronger predictors of in-hospital mortality than the initial sCr value only; thus, their combined evaluation provides a more accurate and dynamic stratification of patients' risk. Finally, the intermediate mortality risk of IRF patients possibly reflects acute kidney injury started before hospitalization., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Published
2015
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48. B-type natriuretic peptide and risk of acute kidney injury in patients hospitalized with acute coronary syndromes*.

Author

Moltrasio M, Cabiati A, Milazzo V, Rubino M, De Metrio M, Discacciati A, Rumi P, Marana I, and Marenzi G

Subjects
Acute Coronary Syndrome therapy, Acute Kidney Injury therapy, Aged, Angioplasty, Balloon, Coronary methods, Biomarkers blood, Cohort Studies, Coronary Care Units, Female, Hospital Mortality, Humans, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, ROC Curve, Renal Dialysis methods, Risk Assessment, Survival Rate, Acute Coronary Syndrome blood, Acute Coronary Syndrome mortality, Acute Kidney Injury blood, Acute Kidney Injury mortality, Cause of Death, Natriuretic Peptide, Brain blood
Abstract

Objectives: To investigate whether admission B-type natriuretic peptide levels predict the development of acute kidney injury in acute coronary syndromes., Design: Prospective study., Setting: Single-center study, 13-bed intensive cardiac care unit at a University Cardiological Center., Patients: Six-hundred thirty-nine acute coronary syndromes patients undergoing emergency and urgent percutaneous coronary intervention., Interventions: None., Measurements and Main Results: We measured B-type natriuretic peptide at hospital admission in acute coronary syndromes patients (55% ST-elevation myocardial infarction and 45% non-ST-elevation myocardial infarction). Acute kidney injury was classified according to the Acute Kidney Injury Network criteria: stage 1 was defined as a serum creatinine increase greater than or equal to 0.3 mg/dL from baseline; stage 2 as a serum creatinine increase greater than two- to three-fold from baseline; stage 3 as a serum creatinine increase greater than three-fold from baseline, or greater than or equal to 4.0 mg/dL with an acute increase greater than 0.5 mg/dL, or need for renal replacement therapy. Acute kidney injury was developed in 85 patients (13%) and had a higher in-hospital mortality than patients without acute kidney injury (14% vs 1%; p < 0.001). B-type natriuretic peptide levels were higher in acute kidney injury patients than in those without acute kidney injury (264 [112-957] vs 98 [44-271] pg/mL; p < 0.001) and showed a significant gradient according to acute kidney injury severity (224 [96-660] pg/mL in stage 1 and 939 [124-1,650] pg/mL in stage 2-3 acute kidney injury; p < 0.001). The risk of developing acute kidney injury increased in parallel with B-type natriuretic peptide quartiles (5%, 9%, 15%, and 24%, respectively; p < 0.001). When B-type natriuretic peptide was evaluated, in terms of capacity to predict acute kidney injury, the area under the curve was 0.702 (95% CI, 0.642-0.762)., Conclusions: In patients hospitalized with acute coronary syndromes, B-type natriuretic peptide levels measured at admission are associated with acute kidney injury as well as its severity.

Published
2014
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49. Questing for circadian dependence in ST-segment-elevation acute myocardial infarction: a multicentric and multiethnic study.

Author

Ammirati E, Cristell N, Cianflone D, Vermi AC, Marenzi G, De Metrio M, Uren NG, Hu D, Ravasi T, Maseri A, and Cannistraci CV

Abstract

Rationale: Four monocentric studies reported that circadian rhythms can affect left ventricular infarct size after ST-segment-elevation acute myocardial infarction (STEMI)., Objective: To further validate the circadian dependence of infarct size after STEMI in a multicentric and multiethnic population., Methods and Results: We analyzed a prospective cohort of subjects with first STEMI from the First Acute Myocardial Infarction study that enrolled 1099 patients (ischemic time <6 hours) in Italy, Scotland, and China. We confirmed a circadian variation of STEMI incidence with an increased morning incidence (from 6:00 am till noon). We investigated the presence of circadian dependence of infarct size plotting the peak creatine kinase against time onset of ischemia. In addition, we studied the patients from the 3 countries separately, including 624 Italians; all patients were treated with percutaneous coronary intervention. We adopted several levels of analysis with different inclusion criteria consistent with previous studies. In all the analyses, we did not find a clear-cut circadian dependence of infarct size after STEMI., Conclusions: Although the circadian dependence of infarct size supported by previous studies poses an intriguing hypothesis, we were unable to converge toward their conclusions in a multicentric and multiethnic setting. Parameters that vary as a function of latitude could potentially obscure the circadian variations observed in monocentric studies. We believe that, to assess whether circadian rhythms can affect the infarct size, future study design should not only include larger samples but also aim to untangle the molecular time-dynamic mechanisms underlying such a relation.

Published
2013
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50. Incidence and relevance of acute kidney injury in patients hospitalized with acute coronary syndromes.

Author

Marenzi G, Cabiati A, Bertoli SV, Assanelli E, Marana I, De Metrio M, Rubino M, Moltrasio M, Grazi M, Campodonico J, Milazzo V, Veglia F, Lauri G, and Bartorelli AL

Subjects
Aged, Female, Hospital Mortality, Hospitalization, Humans, Incidence, Italy epidemiology, Logistic Models, Male, Prognosis, ROC Curve, Retrospective Studies, Risk Factors, Severity of Illness Index, Acute Coronary Syndrome complications, Acute Kidney Injury epidemiology, Acute Kidney Injury etiology
Abstract

Acute kidney injury (AKI) occurs frequently in patients with acute coronary syndromes (ACS) and is associated with adverse short- and long-term outcomes. To date, however, no standardized definition of AKI has been used for patients with ACS. As a result, information on its true incidence and the clinical and prognostic relevance according to the severity of renal function deterioration are still lacking. We retrospectively studied 3,210 patients with ACS. AKI was identified on the basis of the changes in serum creatinine during hospitalization according to the AKI Network criteria. Overall, 409 patients (13%) developed AKI: 262 (64%) had stage 1, 25 (6%) stage 2, and 122 (30%) stage 3 AKI. In-hospital mortality was greater in patients with AKI than in those without AKI (21% vs 1%; p <0.001). The adjusted risk of death increased with increasing AKI severity. Compared to no AKI, the adjusted odds ratio for death was 3.5 (95% confidence interval 1.79 to 6.83) with stage 1 AKI and 31.2 (95% confidence interval 16.96 to 57.45) with stage 2 to 3 AKI. A significant parallel increase in major adverse cardiac events was also observed comparing patients without AKI and those with stage 2 to 3 AKI. In conclusion, in patients with ACS, AKI is a frequent complication, and the graded increase of its severity, as assessed using the AKI Network classification, is associated with a progressive increased risk of in-hospital morbidity and mortality., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Published
2013
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