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4. Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Author

Luca, G. De, Manzo-Silberman, S., Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Okkels, L., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., otto di Uccio, F. Sc, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A.H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martínez-Luengas, I.L., Boccalatte, M., Ojeda, F.B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Forés, J.S., Vignali, L., Pereira, H., Ordoñez, S., Arat Özkan, A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Barrios, A.G., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Bouraghda, M.A., Moura, M., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., Verdoia, M., Luca, G. De, Manzo-Silberman, S., Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Okkels, L., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., otto di Uccio, F. Sc, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A.H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martínez-Luengas, I.L., Boccalatte, M., Ojeda, F.B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Forés, J.S., Vignali, L., Pereira, H., Ordoñez, S., Arat Özkan, A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Barrios, A.G., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Bouraghda, M.A., Moura, M., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Abstract

Item does not contain fulltext, BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Published
2023

5. Age-Related Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry.

Author

Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., Scotto D'Uccio, F., Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra Munoz, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A.H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martínez-Luengas, I.L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Sanchis Forés, J., Vignali, L., Pereira, H., Manzo-Silberman, S., Ordoñez, S., Arat Özkan, A., Scheller, B., Lehitola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J.P., Rocha, Alex, Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Burgadha, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., Verdoia, M., Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Busljetik, O., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Ferrer, G.R.I., Quadros, A., Milewski, M., Scotto D'Uccio, F., Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong Sung Lung, A., Kala, P., Díez Gil, J.L., Carrillo, X., Dirksen, M., Becerra Munoz, V., Lee, M.K., Juzar, D.A., Moura Joaquim, R. de, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A.H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martínez-Luengas, I.L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Sanchis Forés, J., Vignali, L., Pereira, H., Manzo-Silberman, S., Ordoñez, S., Arat Özkan, A., Scheller, B., Lehitola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J.A., Zoni, C.R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C.E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J.P., Rocha, Alex, Tam, F.C., Rodriguez, A., Lukito, A.A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Burgadha, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Abstract

Contains fulltext : 291566.pdf (Publisher’s version ) (Open Access), BACKGROUND: The constraints in the management of patients with ST-segment elevation myocardial infarction (STEMI) during the COVID-19 pandemic have been suggested to have severely impacted mortality levels. The aim of the current analysis is to evaluate the age-related effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI within the registry ISACS-STEMI COVID-19. METHODS: This retrospective multicenter registry was performed in high-volume PPCI centers on four continents and included STEMI patients undergoing PPCI in March-June 2019 and 2020. Patients were divided according to age (< or ≥75 years). The main outcomes were the incidence and timing of PPCI, (ischemia time longer than 12 h and door-to-balloon longer than 30 min), and in-hospital or 30-day mortality. RESULTS: We included 16,683 patients undergoing PPCI in 109 centers. In 2020, during the pandemic, there was a significant reduction in PPCI as compared to 2019 (IRR 0.843 (95%-CI: 0.825-0.861, p < 0.0001). We found a significant age-related reduction (7%, p = 0.015), with a larger effect on elderly than on younger patients. Furthermore, we observed significantly higher 30-day mortality during the pandemic period, especially among the elderly (13.6% vs. 17.9%, adjusted HR (95% CI) = 1.55 [1.24-1.93], p < 0.001) as compared to younger patients (4.8% vs. 5.7%; adjusted HR (95% CI) = 1.25 [1.05-1.49], p = 0.013), as a potential consequence of the significantly longer ischemia time observed during the pandemic. CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures, with a larger reduction and a longer delay to treatment among elderly patients, which may have contributed to increase in-hospital and 30-day mortality during the pandemic.

Published
2023

6. Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction.

Author

Biscaglia, S., Guiducci, V., Escaned, J., Moreno, R., Lanzilotti, V., Santarelli, A., Cerrato, E., Sacchetta, G., Jurado-Roman, A., Menozzi, A., Amat Santos, I., Díez Gil, J. L., Ruozzi, M., Barbierato, M., Fileti, L., Picchi, A., Lodolini, V., Biondi-Zoccai, G., Maietti, E., and Pavasini, R.

Subjects
*MYOCARDIAL infarction, *OLDER patients, *ST elevation myocardial infarction, *PERCUTANEOUS coronary intervention, *ACUTE kidney failure
Abstract

BACKGROUND The benefit of complete revascularization in older patients (≥ 75 years of age) with myocardial infarction and multivessel disease remains unclear. METHODS In this multicenter, randomized trial, we assigned older patients with myocardial infarction and multivessel disease who were undergoing percutaneous coronary intervention (PCI) of the culprit lesion to receive either physiology-guided complete revascularization of nonculprit lesions or to receive no further revascularization. Functionally significant nonculprit lesions were identified either by pressure wire or angiography. The primary outcome was a composite of death, myocardial infarction, stroke, or any revascularization at 1 year. The key secondary outcome was a composite of cardiovascular death or myocardial infarction. Safety was assessed as a composite of contrast-associated acute kidney injury, stroke, or bleeding. RESULTS A total of 1445 patients underwent randomization (720 to receive complete revascularization and 725 to receive culprit-only revascularization). The median age of the patients was 80 years (interquartile range, 77 to 84); 528 patients (36.5%) were women, and 509 (35.2%) were admitted for ST-segment elevation myocardial infarction. A primary-outcome event occurred in 113 patients (15.7%) in the complete-revascularization group and in 152 patients (21.0%) in the culprit-only group (hazard ratio, 0.73; 95% confidence interval [CI], 0.57 to 0.93; P = 0.01). Cardiovascular death or myocardial infarction occurred in 64 patients (8.9%) in the complete-revascularization group and in 98 patients (13.5%) in the culprit-only group (hazard ratio, 0.64; 95% CI, 0.47 to 0.88). The safety outcome did not appear to differ between the groups (22.5% vs. 20.4%; P=0.37). CONCLUSIONS Among patients who were 75 years of age or older with myocardial infarction and multivessel disease, those who underwent physiology-guided complete revascularization had a lower risk of a composite of death, myocardial infarction, stroke, or ischemia-driven revascularization at 1 year than those who received culprit-lesion-only PCI. [ABSTRACT FROM AUTHOR]

Published
2023
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7. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

Author

De Luca G, Algowhary M, Uguz B, Oliveira DC, Ganyukov V, Zimbakov Z, Cercek M, Jensen LO, Loh PH, Calmac L, Roura-Ferrer G, Quadros A, Milewski M, Scotto di Uccio F, von Birgelen C, Versaci F, Ten Berg J, Casella G, Wong ASL, Kala P, Diez Gil JL, Carrillo X, Dirksen MT, Becerra-Muñoz VM, Kang-Yin Lee M, Juzar DA, de Moura Joaquim R, Paladino R, Milicic D, Davlouros P, Bakraceski N, Zilio F, Donazzan L, Kraaijeveld AO, Galasso G, Lux A, Marinucci L, Guiducci V, Menichelli M, Scoccia A, Yamac A, Ugur Mert K, Flores Rios X, Kovarnik T, Kidawa M, Moreu J, Flavien V, Fabris E, Lozano Martìnez-Luengas I, Boccalatte M, Bosa Ojeda F, Arellano-Serrano C, Caiazzo G, Cirrincione G, Kao HL, Sanchis Fores J, Vignali L, Pereira H, Manzo-Silberman S, Ordonez S, Özkan AA, Scheller B, Lehtola H, Teles R, Mantis C, Ylitalo A, Brum Silveira JA, Zoni R, Bessonov I, Savonitto S, Kochiadakis G, Alexopoulos D, Uribe C, Kanakakis J, Faurie B, Gabrielli G, Gutiérrez A, Bachini JP, Rocha A, Tam FC, Rodriguez A, Lukito A, Saint-Joy V, Pessah G, Tuccillo B, Cortese G, Parodi G, Bouraghda MA, Kedhi E, Lamelas P, Suryapranata H, Nardin M, Verdoia M, ISACS-STEMI COVID-19, Collaborators, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L. O., Loh, P. H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong, A. S. L., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M. T., Becerra-Munoz, V. M., Kang-Yin Lee, M., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A. O., Galasso, G., Lux, A., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Lozano Martinez-Luengas, I., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Sanchis Fores, J., Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Ozkan, A. A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Brum Silveira, J. A., Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez, A., Bachini, J. P., Rocha, A., Tam, F. C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M. A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Subjects
Registrie, Male, ST Elevation Myocardial Infarction/diagnosis, Time Factors, Percutaneous, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Coronary Artery Disease, Practice Patterns, 030204 cardiovascular system & hematology, Rate ratio, Time-to-Treatment/trends, Cardiologists, 0302 clinical medicine, Retrospective Studie, Heart Rate, Risk Factors, Pandemic, ST segment, Registries, Hospital Mortality, 030212 general & internal medicine, Myocardial infarction, Practice Patterns, Physicians', 10. No inequality, Percutaneous Coronary Intervention/adverse effects, Hospital Mortality/trends, COVID-19, myocardial infarction, percutaneous coronary intervention, Incidence, Incidence (epidemiology), Middle Aged, 3. Good health, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, Cardiologists/trends, Human, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, Risk Assessment, ST Elevation Myocardial Infarction, Time-to-Treatment, medicine.medical_specialty, Time Factor, Coronavirus disease 2019 (COVID-19), Cardiologist, 03 medical and health sciences, Internal medicine, medicine, Acute Coronary Syndrome, Pandemics, Physicians', SARS-CoV-2, business.industry, Risk Factor, COVID-19, myocardial infarction, percutaneous coronary intervention, Percutaneous coronary intervention, medicine.disease, Practice Patterns, Physicians'/trends, business
Abstract

ObjectiveThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).MethodsThis is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.ResultsIn 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (pConclusionPercutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.Trial registration numberNCT04412655.

Published
2022

11. COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

Author

Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Uccio, F. Scotto di, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong, A.S.Y., Kala, P., Gil, J.L. Diez, Carrillo, X., Dirksen, M.T., Becerra-Muñoz, V.M., Kang-Yin Lee, M., Juzar, D.A., Joaquim, R. de Moura, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A.O., Galasso, G., Lux, A, Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Mert, K. Ugur, Rios, X. Flores, Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martìnez-Luengas, I. Lozano, Boccalatte, M., Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Fores, J. Sanchis, Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Özkan, A.A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Silveira, J.A. Brum, Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutiérrez, A., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., Verdoia, M., Luca, G. De, Algowhary, M., Uguz, B., Oliveira, D.C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L.O., Loh, P.H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., Uccio, F. Scotto di, Birgelen, C. von, Versaci, F., Berg, J ., Casella, G., Wong, A.S.Y., Kala, P., Gil, J.L. Diez, Carrillo, X., Dirksen, M.T., Becerra-Muñoz, V.M., Kang-Yin Lee, M., Juzar, D.A., Joaquim, R. de Moura, Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A.O., Galasso, G., Lux, A, Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A., Mert, K. Ugur, Rios, X. Flores, Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martìnez-Luengas, I. Lozano, Boccalatte, M., Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H.L., Fores, J. Sanchis, Vignali, L., Pereira, H., Manzo-Silberman, S., Ordonez, S., Özkan, A.A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Ylitalo, A., Silveira, J.A. Brum, Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C., Kanakakis, J., Faurie, B., Gabrielli, G., Gutiérrez, A., Bachini, J.P., Rocha, A., Tam, F.C., Rodriguez, A., Lukito, A., Saint-Joy, V., Pessah, G., Tuccillo, B., Cortese, G., Parodi, G., Bouraghda, M.A., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Abstract

Item does not contain fulltext, OBJECTIVE: The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days). METHODS: This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality. RESULTS: In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic. CONCLUSION: Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatmen

Published
2022

13. Complete versus culprit-only strategy in older MI patients with multivessel disease

Author

Biscaglia S, Erriquez A, Serenelli M, D'Ascenzo F, De Ferrari G, Ariza Sole A, Sanchis J, Giannini F, Gallo F, Scala A, Menozzi A, Pighi M, Moreno R, Iannopollo G, Menozzi M, Guiducci V, Tebaldi M, and Campo G

Abstract

AIMS: The revascularization strategy to pursue in older myocardial infarction (MI) patients with multivessel disease (MVD) is currently unknown. For this reason, while waiting for the results of dedicated trials, we sought to compare a complete versus a culprit-only strategy in older MI patients by merging data from four registries.; METHODS AND RESULTS: The inclusion criteria for the target population of the present study were(i) age=75 years; (ii) MI (STE or NSTE); (iii) MVD; (iv) successful treatment of culprit lesion. Propensity scores (PS) were derived using logistic regression (backwardstepwise selection, p

Published
2022

16. Conduction disturbances after TAVR: rates of pacemaker implantation, burden of ventricular pacing and prognostic significance

Author

Bricoli, S, primary, Benatti, G, additional, Vignali, L, additional, Tadonio, I, additional, Notarangelo, MF, additional, Crocamo, A, additional, Gonzi, G, additional, Placci, A, additional, Bottoni, N, additional, Biagi, A, additional, Rossi, L, additional, Guiducci, V, additional, Losi, L, additional, and Zardini, M, additional

Published
2021
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18. PERCUTANEOUS CORONARY INTERVENTIONS IN PATIENTS TREATED WITH ORAL ANTICOAGULANT THERAPY: BASELINE CLINICAL CHARACTERISTICS OF THE PERSEO REGISTRY

Author

Sciahbasi, A, Gargiulo, G, Giacoppo, D, Talarico, G, Calabrò, P, Zilio, F, De Rosa, S, Talanas, G, Tebaldi, M, Andò, G, Rigattieri, S, Misuraca, L, Cortese, B, Musuraca, G, Lucci, V, Guiducci, V, Renda, G, Zezza, L, Versaci, F, Giannico, M, Caruso, M, Fischetti, D, Colletta, M, Santarelli, A, Larosa, C, Iannone, A, Esposito, G, Tarantini, G, Musumeci, G, and Rubboli, A

Published
2024
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21. Design and rationale for the Minimizing Adverse haemorrhagic events by TRansradial access site and systemic Implementation of angioX program

Author

Valgimigli, M, Gagnor, A, Calabrò, P, Rubartelli, P, Garducci, S, Ando', Giuseppe, Santarelli, A, Galli, M, Garbo, R, Bramucci, E, Ierna, S, Briguori, C, Cortese, B, Limbruno, U, Violini, R, Presbitero, P, de Cesare, N, Sganzerla, P, Ausiello, A, Tosi, P, Sardella, G, Sabate, M, Brugaletta, S, Saccone, G, Vandoni, P, Zingarelli, A, Liso, A, Rigattieri, S, Di Lorenzo, E, Vigna, C, Palmieri, C, Falcone, C, De Caterina, R, Caputo, M, Esposito, G, Lupi, A, Mazzarotto, P, Varbella, F, Zaro, T, Nazzaro, M, Rao, Sv, van't Hof, Aw, Omerovic, E, Uguccioni, L, Tamburino, C, Ferrari, F, Ceravolo, R, Tarantino, F, Casu, G, Cremonesi, A, Saia, F, Guiducci, V, Dellavalle, A, Curello, S, Mangiacapra, F, Evola, R, Liistro, F, Creaco, M, Colombo, A, Perkan, A, De Servi, S, Fischetti, D, Pucci, E, Romagnoli, E, Moretti, C, Moretti, L, Turturo, M, Bonmassari, R, Penzo, C, Loi, B, Mauro, C, Gabrielli, G, Micari, A, Petronio, As, Comeglio, M, Fresco, C, Pasquetto, G, Belloni, F, Amico, F., Cardiology, Valgimigli, M, Gagnor, A, Calabrò, P, Rubartelli, P, Garducci, S, Andò, G, Santarelli, A, Galli, M, Garbo, R, Bramucci, E, Ierna, S, Briguori, C, Cortese, B, Limbruno, U, Violini, R, Presbitero, P, de Cesare, N, Sganzerla, P, Ausiello, A, Tosi, P, Sardella, G, Sabate, M, Brugaletta, S, Saccone, G, Vandoni, P, Zingarelli, A, Liso, A, Rigattieri, S, Di Lorenzo, E, Vigna, C, Palmieri, C, Falcone, C, De Caterina, R, Caputo, M, Esposito, G, Lupi, A, Mazzarotto, P, Varbella, F, Zaro, T, Nazzaro, M, Rao, Sv, van't Hof, Aw, Omerovic, E, Uguccioni, L, Tamburino, C, Ferrari, F, Ceravolo, R, Tarantino, F, Casu, G, Cremonesi, A, Saia, F, Guiducci, V, Dellavalle, A, Curello, S, Mangiacapra, F, Evola, R, Liistro, F, Creaco, M, Colombo, A, Perkan, A, De Servi, S, Fischetti, D, Pucci, E, Romagnoli, E, Moretti, C, Moretti, L, Turturo, M, Bonmassari, R, Penzo, C, Loi, B, Mauro, C, Gabrielli, G, Micari, A, Petronio, A, Comeglio, M, Fresco, C, Pasquetto, G, Belloni, F, and Amico, F

Subjects
Male, Hirudin, medicine.medical_treatment, Antithrombin, Myocardial Infarction, Peptide Fragment, Bivalirudin, Myocardial infarction, Stroke, Incidence (epidemiology), Heparin, Hirudins, Middle Aged, Recombinant Protein, Recombinant Proteins, Europe, Femoral Artery, Treatment Outcome, Radial Artery, Cardiology, Female, Survival Analysi, Cardiology and Cardiovascular Medicine, medicine.drug, Human, medicine.medical_specialty, Platelet Glycoprotein GPIIb-IIIa Complex, Postoperative Hemorrhage, Acute Coronary Syndrome, Aged, Antithrombins, Humans, Percutaneous Coronary Intervention, Platelet Aggregation Inhibitors, Survival Analysis, Peptide Fragments, Acute coronary syndromes, Transradial intervention, bivalirudin, Internal medicine, medicine, business.industry, Platelet Aggregation Inhibitor, Percutaneous coronary intervention, medicine.disease, Surgery, Access site, business
Abstract

Background Transradial intervention (TRI) and bivalirudin infusion compared with transfemoral coronary intervention or unfractionated heparin plus glycoprotein IIb/IIIa inhibitors decrease bleeding complications in patients with acute coronary syndromes (ACS). Although bleeding is thought to be associated with worse outcomes, it remains unclear whether TRI and bivalirudin both independently lower ischemic or combined ischemic and bleeding complications in ACS patients undergoing contemporary invasive management. Hypotheses The primary objectives of the MATRIX program are to assess whether TRI or bivalirudin as compared, respectively, with transfemoral coronary intervention (MATRIX access site) or unfractionated heparin plus provisional glycoprotein IIb/IIIa inhibitors, (MATRIX antithrombin) decrease the 30-day incidence of an ischemic (ie, death, myocardial infarction or stroke) or an ischemic and bleeding composite end point across the whole spectrum of ACS patients, including clarifying the optimal duration of bivalirudin infusion after percutaneous coronary intervention (MATRIX treatment duration). Study design The MATRIX (NCT01433627) study, which incorporates 3 randomized comparisons in a nonfactorial manner and primary end points at 30 days and clinical follow-up ≤1 year, is a large-scale, multicenter study with blind event adjudication conducted at approximately 100 European sites. With 8,200 patients in the randomized comparison of access sites and 6,800 individuals participating in the randomized comparison of antithrombin regimens, this study will have ≥85% power for the primary end points. Summary The MATRIX program aims at conclusively ascertaining the role of TRI and bivalirudin infusion in the whole spectrum of ACS patients undergoing contemporary invasive management.

Published
2014

22. Comparing maltreating and foster families in Italian context

Author

Migliorini, Laura, Rania, Nadia, Cardinali, P, Guiducci, V, and Cavanna, Donatella

Subjects
Foster families, Family functioning, Resilience, Maltreating families, Foster families, Resilience, Children’s well-being, Family functioning, Children’s well-being, Maltreating families
Published
2016

25. Comparison of sirolimus-eluting and bare metal stent for treatment of patients with total coronary occlusions: results of the GISSOC II-GISE multicentre randomized trial

Author

Rubartelli, P., Petronio, A. S., Guiducci, V., Sganzerla, P., Bolognese, L., Galli, M., Sheiban, Imad, Chirillo, F., Ramondo, A., Bellotti, S., and di Studio sullo Stent nelle Occlusioni Coronariche II GISE Investigators, G. I.

Subjects
Bare-metal stent, Male, medicine.medical_specialty, medicine.medical_treatment, Revascularization, Coronary Angiography, Coronary artery disease, Restenosis, Angioplasty, Internal medicine, Stent, medicine, Humans, Percutaneous transluminal coronary angioplasty, Sirolimus, business.industry, Percutaneous coronary intervention, Drug-Eluting Stents, Middle Aged, medicine.disease, Treatment Outcome, Coronary Occlusion, Italy, Drug-eluting stent, Coronary artery disease, Percutaneous transluminal coronary angioplasty, Stent, Total coronary occlusion, Total coronary occlusion, Cardiology, Female, Stents, Cardiology and Cardiovascular Medicine, business, Immunosuppressive Agents
Abstract

Aims Percutaneous coronary intervention with bare metal stent (BMS) in chronic total coronary occlusions (CTOs) is associated with a higher rate of angiographic restenosis and reocclusion than that observed in subtotal stenoses. Preliminary reports have suggested a better performance of drug-eluting stents in CTO. In this multicentre, randomized trial, we compared the mid-term angiographic and clinical outcome of sirolimus-eluting stent (SES) or BMS implantation after successful recanalization of CTO. Methods and results Patients with CTO older than 1 month, after successful recanalization, were randomized to implantation of SES (78 patients) or BMS (74 patients) in 13 Italian centres. Clopidogrel therapy was prescribed for 6 months. The primary endpoint was in-segment minimal luminal diameter (MLD) at 8-month follow-up. Secondary clinical endpoints included death, myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR) at 24 months. Patients treated with SES showed, at in-segment analysis, a larger MLD (1.98 ± 0.57 vs. 0.98 ± 0.80 mm, P < 0.001), a lower late luminal loss (−0.06 ± 0.49 vs. 1.11 ± 0.79 mm, P < 0.001), and lower restenosis (9.8 vs. 67.7%, P < 0.001) and reocclusion (0 vs. 17%, P = 0.001) rates. At 24-month follow-up, patients in the SES group experienced fewer major adverse cardiac events (50.0 vs. 17.6%, P < 0.001) mainly due to a lower rate of both TLR (44.9 vs. 8.1%, P < 0.001) and TVR (44.9 vs. 14.9%, P < 0.001). Conclusion In CTO, SES is markedly superior to BMS in terms of restenosis and reocclusion rate, and incidence of repeat revascularization at 24 months. Clinicaltrials.gov identifier: NCT00220558

Published
2010

34. Clinical impact of an inter-hospital transfer strategy in patients with ST-elevation myocardial infarction undergoing primary angioplasty: the Emilia-Romagna ST-segment elevation acute myocardial infarction network

Author

Manari, A., primary, Ortolani, P., additional, Guastaroba, P., additional, Casella, G., additional, Vignali, L., additional, Varani, E., additional, Piovaccari, G., additional, Guiducci, V., additional, Percoco, G., additional, Tondi, S., additional, Passerini, F., additional, Santarelli, A., additional, and Marzocchi, A., additional

Published
2008
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40. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry

Author

Gianluca Caiazzo, Giuseppe De Luca, Sébastien Levesque, Victor Becerra, Filippo Zilio, Gabriele Gabrielli, Xacobe Flores Rios, José Moreu, Tomas Kovarnik, Wojtek Wojakowski, Juan Sanchis Forés, Luca Donazzan, Dimitrios Alexopoulos, Gerard Rourai Ferrer, Luigi Vignali, Alessandra Scoccia, Giuseppe Uccello, Lucia Marinucci, Marco Boccalatte, Lisette Okkels Jensen, Enrico Fabris, Michał Kidawa, Miha Cercek, Ylitalo Antti, Stephane Manzo, Lucian Calmac, Gennaro Galasso, Vincenzo Guiducci, Iñigo Lozano Martínez-Luengas, Petr Kala, Elvin Kedhi, Bruno Scheller, Monica Verdoia, Bor Wilbert, Maurizio Menichelli, Benjamin Faurie, Thomas W Johnson, Alejandro Gutierrez Barrios, José Luis Díez Gil, Giuliana Cortese, Clemens von Birgelen, Guido Parodi, Raul Moreno, Francesco Versaci, Arpad Lux, Santiago Camacho-Freiere, Xavier Carrill, Periklis Davlouros, Mika Laine, Adriaan O. Kraaijeveld, Heidi Lehtola, Jurriën M. ten Berg, Gianni Casella, Vladimir Ganyukov, Ciro De Simone, Nikola Bakraceski, Rui Campante Teles, Maurits T. Dirksen, Francisco Bosa Ojeda, Marija Vavlukis, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, [De Luca,G, Verdoia,M] Division of Cardiology, Azienda Ospedaliero-Universitaria Maggiore della Carità, Università del Piemonte Orientale, Novara, Italy. giuseppe.deluca@med.uniupo.it. [Cercek,M] Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia. [Jensen,LO] Division of Cardiology, Odense Universitets Hospital, Odense, Danemark. [Vavlukis,M] University Clinic for Cardiology, Medical Faculty, Ss' Cyril and Methodius University, Skopje, North Macedonia. [Calmac,L] Clinic Emergency Hospital of Bucharest, Bucharest, Romania. [Johnson,T] Division of Cardiology, Bristol Heart Institute, University Hospitals Bristol, NHSFT & University of Bristol, Bristol, UK. [Roura i Ferrer,G] Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain. [Ganyukov,V] 8Division of Cardiology, State Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia. [Wojakowski,W] Division of Cardiology, Medical University of Silezia, Katowice, Poland. [von Birgelen,C] Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, The Netherlands. [Versaci,F] Division of Cardiology, Ospedale Santa Maria Goretti, Latina, Italy. [Ten Berg,J] Division of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands. [Laine,L] Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. [Dirksen,M] Division of Cardiology, Northwest Clinic, Alkmaar, The Netherlands. [Casella,G] Division of Cardiology, Ospedale Maggiore, Bologna, Italy. [Kala,P] University Hospital Brno, Medical Faculty of Masaryk University Brno, Brno, Czech Republic. [Díez Gil,JL] H. Universitario y Politécnico La Fe, Valencia, Spain. [Becerra,V] Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain. [De Simone,C] Division of Cardiology, Clinica Villa dei Fiori, Acerra, Italy. [Carrill,X] Hospital Germans Triasi Pujol, Badalona, Spain. [Scoccia,A] Division of Cardiology, Ospedale 'Sant'Anna', Ferrara, Italy. [Lux,A] Maastricht University Medical Center, Maastricht, The Netherlands. [Kovarnik,T] University Hospital Prague, Prague, Czech Republic. [Davlouros,P] Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, Patras, Greece. [Gabrielli,G] Interventional Cardiology Unit, Azienda Ospedaliero Universitaria 'Ospedali Riuniti', Ancona, Italy. [Flores Rios,X] Complexo Hospitaliero Universitario La Coruna, La Coruna, Spain. [Bakraceski,N] Center for Cardiovascular Diseases, Ohrid, North Macedonia. [Levesque,S] Center Hospitalier, Universitaire de Poitiers, University Hospital, Poitiers, France. [Guiducci,V] AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy. [Kidawa,M] Central Hospital of Medical University of Lodz, Łódź, Poland. [Marinucci,L] Division of Cardiology, AziendaOspedaliera 'Ospedali Riuniti Marche Nord', Pesaro, Italy. [Zilio,F] Ospedale Santa Chiara di Trento, Trento, Italy. [Galasso,G] Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy. [Fabris,E] Azienda Ospedaliero - Universitaria Ospedali Riuniti Trieste, Trieste, Italy. [Menichelli,M] Division of Cardiology, Ospedale 'F. Spaziani, Frosinone, Italy. [Manzo,S] Division of Cardiology, CHU Lariboisière, AP-HP, Paris VII University, INSERM UMRS 942, Paris, France. [Caiazzo,G] Division of Cardiology, Ospedale 'G Moscati', Aversa, Italy. [Moreu,J] Division of Cardiology, Complejo Hospitalario de Toledo, Toledo, Spain. [Sanchis Forés,J] Division of Cardiology, Hospital Clinico Universitario de Valencia, Valencia, Spain. [Donazzan,L] Division of Cardiology, Ospedale 'S. Maurizio' Bolzano Ospedale 'S. Maurizio', Bolzano, Italy. [Vignali,L] Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, Parma, Italy. [Teles,R] Division of Cardiology, Hospital de Santa Cruz, CHLO - Carnaxide, Carnaxide, Portugal. [Bosa Ojeda,F] Division of Cardiology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain. [Lehtola,H] Division of Cardiology, Oulu University Hospital, Oulu, Finland. [Camacho‑Freiere,S] Division of Cardiology, Juan Ramon Jimenez Hospital, Huelva, Spain. [Kraaijeveld,A] Division of Cardiology, UMC Utrecht, Utrecht, The Netherlands. [Antti,Y] Division of Cardiology, Heart Centre Turku, Turku, Finland. [Boccalatte,M] Division of Cardiology, Ospedale Santa Maria delle Grazie, Pozzuoli, Italy. [Lozano Martínez‑Luengas,I] Division of Cardiology, Hospital Cabueñes, Gijon, Spain. [Scheller,B] Division of Cardiology, Clinical and Experimental Interventional Cardiology, University of Saarland, Saarbrücken, Germany. [Alexopoulos,D] Division of Cardiology, Attikon University Hospital, Athens, Greece. [Faurie,B] Division of Cardiology, Ospedale 'A. Manzoni' Lecco, Lecco, Italy. [Gutierrez Barrios,A] Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, Grenoble, France. [Wilbert,B] Division of Cardiology, Hospital Puerta del Mar, Cadiz, Spain. [Cortese,G] Department of Statistical Sciences, University of Padova, Padova, Italy. [Moreno,R] Division of Cardiology, Hospital la Paz, Madrid, Spain. [Parodi,G] Azienda Ospedaliero-Universitaria Sassari, Sassari, Italy. [Kedhi,E] Division of Cardiology, St-Jan Hospital, Brugge, Belgium. [Verdoia,M] Division of Cardiology, Ospedale degli Infermi, ASL Biella, Ponderano, Italy., HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Roura i Ferrer, G., Ganyukov, V., Wojakowski, W., von Birgelen, C., Versaci, F., Ten Berg, J., Laine, M., Dirksen, M., Casella, G., Kala, P., Diez Gil, J. L., Becerra, V., De Simone, C., Carrill, X., Scoccia, A., Lux, A., Kovarnik, T., Davlouros, P., Gabrielli, G., Flores Rios, X., Bakraceski, N., Levesque, S., Guiducci, V., Kidawa, M., Marinucci, L., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Manzo, S., Caiazzo, G., Moreu, J., Sanchis Fores, J., Donazzan, L., Vignali, L., Teles, R., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Martinez-Luengas, I. L., Scheller, B., Alexopoulos, D., Uccello, G., Faurie, B., Gutierrez Barrios, A., Wilbert, B., Cortese, G., Moreno, R., Parodi, G., Kedhi, E., and Verdoia, M.

Subjects
Registrie, Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Infarto del miocardio con elevación del ST, Time Factors, COVID-19/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings], Phenomena and Processes::Physical Phenomena::Time::Time Factors [Medical Subject Headings], Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, Rate ratio, Geographical Locations::Geographic Locations::Europe::Europe, Eastern [Medical Subject Headings], Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings], Time-to-Treatment/trends, 0302 clinical medicine, Retrospective Studie, Risk Factors, Síndrome coronario agudo, 030212 general & internal medicine, Myocardial infarction, Hospital Mortality, Registries, Diabetes Mellitus/diagnosis, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::Time-to-Treatment [Medical Subject Headings], Persons::Persons::Age Groups::Adult::Aged [Medical Subject Headings], Original Investigation, Percutaneous Coronary Intervention/adverse effects, Aged, COVID-19, Diabetes Mellitus, Europe, Female, Humans, Hypertension, Middle Aged, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Time-to-Treatment, Treatment Outcome, Hospital Mortality/trends, Health Care::Health Services Administration::Organization and Administration::Records as Topic::Registries [Medical Subject Headings], education.field_of_study, Incidence (epidemiology), Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Cardiovascular Surgical Procedures::Vascular Surgical Procedures::Endovascular Procedures::Percutaneous Coronary Intervention [Medical Subject Headings], Diabetes Mellitu, Intervención coronaria percutánea, 3. Good health, surgical procedures, operative, Acute coronary syndrome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, ACUTE MYOCARDIAL-INFARCTION, Time Factor, Population, Health Care::Environment and Public Health::Public Health::Epidemiologic Factors::Causality::Risk Factors [Medical Subject Headings], Europe/epidemiology, Diseases::Cardiovascular Diseases::Vascular Diseases::Hypertension [Medical Subject Headings], 03 medical and health sciences, Hypertension/epidemiology, Internal medicine, Diabetes mellitus, medicine, cardiovascular diseases, education, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Prognosis::Treatment Outcome [Medical Subject Headings], Pandemia, Pandemic, Diseases::Endocrine System Diseases::Diabetes Mellitus [Medical Subject Headings], ST Elevation Myocardial Infarction/mortality, business.industry, Risk Factor, MORTALITY, Percutaneous coronary intervention, Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings], Retrospective cohort study, medicine.disease, Diseases::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [Medical Subject Headings], lcsh:RC666-701, 3121 General medicine, internal medicine and other clinical medicine, Reperfusion, Conventional PCI, Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality [Medical Subject Headings], business
Abstract

Background It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes–ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19. Methods The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April). Main outcomes are the incidences of primary PCI, delayed treatment, and in-hospital mortality. Results A total of 6609 patients underwent primary PCI in 77 centers, located in 18 countries. Diabetes was observed in a total of 1356 patients (20.5%), with similar proportion between 2019 and 2020. During the pandemic, there was a significant reduction in primary PCI as compared to 2019, similar in both patients with (Incidence rate ratio (IRR) 0.79 (95% CI: 0.73–0.85, p p p Furthermore, the pandemic was independently associated with a significant increase in door-to-balloon and total ischemia times only among patients without diabetes, which may have contributed to the higher mortality, during the pandemic, observed in this group of patients. Conclusions The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a similar reduction in primary PCI procedures in both patients with and without diabetes. Hypertension had a significant impact on PCI reduction only among patients without diabetes. We observed a significant increase in ischemia time and door-to-balloon time mainly in absence of diabetes, that contributed to explain the increased mortality observed in this group of patients during the pandemic. Trial registration number: NCT 04412655.

Published
2020

42. Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

Author

Giuseppe De Luca, Stephane Manzo-Silberman, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Cercek, Lisette Okkels, Poay Huan Loh, Lucian Calmac, Gerard Roura i Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Becerra, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Cesar Rodrigo Zoni, Ivan Bessonov, Giuseppe Uccello, George Kochiadakis, Dimitrios Alexopulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie C. C. Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Alfonso Ielasi, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Marcia Moura, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, De Luca, G., Manzo-Silberman, S., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Busljetik, O., Cercek, M., Okkels, L., Loh, P. H., Calmac, L., Ferrer, G. R. I., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M., Becerra, V., Lee, M. K. -Y., Juzar, D. A., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Arpad, L., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A. H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martinez-Luengas, I. L., Boccalatte, M., Ojeda, F. B., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Fores, J. S., Vignali, L., Pereira, H., Ordonez, S., Arat Ozkan, A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J. A., Zoni, C. R., Bessonov, I., Uccello, G., Kochiadakis, G., Alexopulos, D., Uribe, C. E., Kanakakis, J., Faurie, B., Gabrielli, G., Barrios, A. G., Bachini, J. P., Rocha, A., Tam, F. C. C., Rodriguez, A., Lukito, A. A., Saint-Joy, V., Pessah, G., Tuccillo, A., Ielasi, A., Cortese, G., Parodi, G., Bouraghda, M. A., Moura, M., Kedhi, E., Lamelas, P., Suryapranata, H., Nardin, M., and Verdoia, M.

Subjects
IMPACT, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], percutaneous coronary intervention, PRIMARY ANGIOPLASTY, COVID-19, General Medicine, ADMISSION, ST-segment elevation myocardial infarction, INSIGHTS, WUHAN, All institutes and research themes of the Radboud University Medical Center, CLINICAL CHARACTERISTICS, ELEVATION-MYOCARDIAL-INFARCTION, gender, MANAGEMENT, Factors sexuals en les malalties, Sex factors in disease
Abstract

Contains fulltext : 290798.pdf (Publisher’s version ) (Open Access) BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

Published
2023

43. Impact of chronic obstructive pulmonary disease on short-term outcome in patients with ST-elevation myocardial infarction during COVID-19 pandemic

Author

Giuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M. Becerra-Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Arpad Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Vincent Flavien, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João A. Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopoulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Monica Verdoia, De Luca, G., Nardin, M., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Okkels Jensen, L., Loh, P. H., Calmac, L., Roura Ferrer, G., Quadros, A., Milewski, M., Scotto di Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., Kala, P., Diez Gil, J. L., Carrillo, X., Dirksen, M., Becerra-Munoz, V. M., Lee, M. K. -Y., Arifa Juzar, D., de Moura Joaquim, R., Paladino, R., Milicic, D., Davlouros, P., Bakraceski, N., Zilio, F., Donazzan, L., Kraaijeveld, A., Galasso, G., Lux, A., Marinucci, L., Guiducci, V., Menichelli, M., Scoccia, A., Yamac, A. H., Ugur Mert, K., Flores Rios, X., Kovarnik, T., Kidawa, M., Moreu, J., Flavien, V., Fabris, E., Martinez-Luengas, I. L., Boccalatte, M., Bosa Ojeda, F., Arellano-Serrano, C., Caiazzo, G., Cirrincione, G., Kao, H. -L., Sanchis Fores, J., Vignali, L., Pereira, H., Manzo, S., Ordonez, S., Ozkan, A. A., Scheller, B., Lehtola, H., Teles, R., Mantis, C., Antti, Y., Brum Silveira, J. A., Zoni, R., Bessonov, I., Savonitto, S., Kochiadakis, G., Alexopoulos, D., Uribe, C. E., Kanakakis, J., Faurie, B., Gabrielli, G., Gutierrez Barrios, A., Bachini, J. P., Rocha, A., Tam, F. C. -C., Rodriguez, A., Lukito, A. A., Saint-Joy, V., Pessah, G., Tuccillo, A., Cortese, G., Parodi, G., Bouraghda, M. A., Kedhi, E., Lamelas, P., Suryapranata, H., Verdoia, M., MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Chronic Obstructive, ST Elevation Myocardial Infarction/diagnosis, TROPONIN ELEVATION, PRIMARY ANGIOPLASTY, COVID-19 Pandemic, 2020, Pulmonary Disease, STEMI, Pulmonary Disease, Chronic Obstructive, Percutaneous Coronary Intervention, Chronic Obstructive/diagnosis, MANAGEMENT, Pandèmia de COVID-19, 2020, Humans, COPD, Hospital Mortality, Registries, Chronic obstructive pulmonary diseases, Mortality, Pandemics, Malalties pulmonars obstructives cròniques, Aged, COVID-19/epidemiology, Percutaneous Coronary Intervention/adverse effects, Retrospective Studies, SARS-CoV-2, MORTALITY, SEGMENT ELEVATION, Treatment Outcome, COVID-19, ST Elevation Myocardial Infarction, Infart de miocardi, Myocardial infarction, ACUTE EXACERBATION, Pulmonary Disease, Chronic Obstructive/diagnosis
Abstract

Background Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study. Methods In the ISACS-STEMI COVID-19 registry we included retrospectively patients with STEMI treated with primary percutaneous coronary intervention (PCI) between March and June of 2019 and 2020 from 109 high-volume primary PCI centers in 4 continents. Results A total of 15,686 patients were included in this analysis. Of them, 810 (5.2%) subjects had a COPD diagnosis. They were more often elderly and with a more pronounced cardiovascular risk profile. No preminent procedural dissimilarities were noticed except for a lower proportion of dual antiplatelet therapy at discharge among COPD patients (98.9% vs. 98.1%, P = 0.038). With regards to short-term fatal outcomes, both in-hospital and 30-days mortality occurred more frequently among COPD patients, similarly in pre-COVID-19 and COVID-19 era. However, after adjustment for main baseline differences, COPD did not result as independent predictor for in-hospital death (adjusted OR [95% CI] = 0.913[0.658–1.266], P = 0.585) nor for 30-days mortality (adjusted OR [95% CI] = 0.850 [0.620–1.164], P = 0.310). No significant differences were detected in terms of SARS-CoV-2 positivity between the two groups. Conclusion This is one of the largest studies investigating characteristics and outcome of COPD patients with STEMI undergoing primary angioplasty, especially during COVID pandemic. COPD was associated with significantly higher rates of in-hospital and 30-days mortality. However, this association disappeared after adjustment for baseline characteristics. Furthermore, COPD did not significantly affect SARS-CoV-2 positivity. Trial registration number: NCT 04412655 (2nd June 2020).

Published
2022

44. Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI

Author

Giuseppe De Luca, Pierre Deharo, Pierfrancesco Agostoni, Gabriele Gabrielli, Francisco Bosa Ojeda, Ylitalo Antti, Lisette Okkels Jensen, Bor Wilbert, Luigi Vignali, Fortunato Scotto Di Uccio, Dariusz Dudek, Marco Boccalatte, Monica Verdoia, Edouard Benit, Gianni Casella, Heidi Lehtola, Alessandra Scoccia, Tim Kinnaird, Massimo Siviglia, Raul Moreno, Vladimir Ganyukov, Arpad Lux, Mika Laine, Adrian P. Banning, Santiago Camacho-Freiere, Guido Parodi, José Moreu, Michał Kidawa, Miha Cercek, Victor Becerra, Stephane Manzo, Elvin Kedhi, Marija Vavlukis, Filippo Zilio, Ciro De Simone, Nikola Bakraceski, Xavier Carrillo, Giuseppe Uccello, Maurizio Menichelli, Gerard Rourai Ferrer, Dimitrios Alexopoulos, Benjamin Faurie, Jurriën M. ten Berg, Lucia Marinucci, Juan Sanchis Forés, Giovanni Amoroso, Sébastien Levesque, Bernardo Tuccillo, Enrico Fabris, Peter Ludman, Rui Campante Teles, Wojtek Wojakowski, Leonardo Spedicato, Lucian Calmac, Yves Cottin, Maurits T. Dirksen, Petr Kala, Thomas W Johnson, Xacobe Flores Rios, Gianluca Caiazzo, Clemens van Birgelen, Francesco Versaci, Alexander Ijsselmuiden, Luca Donazzan, Kees-Jan Royaards, Adriaan O. Kraaijeveld, Alejandro Gutierrez Barrios, Gennaro Galasso, Vincenzo Guiducci, Julinda Mehilli, Giuseppe Cirrincione, Andrea Santucci, Giuliana Cortese, José Luis Díez Gil, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Periklis Davlouros, Tomas Kovarnik, Arturo García-Touchard, Pieter C. Smits, De Luca, G., Verdoia, M., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., van Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., Lux, A., Kovarnik, T., Davlouros, P., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Bosa Ojeda, F., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Alexopulos, D., Moreno, R., Kedhi, E., Uccello, G., Faurie, B., Gutierrez Barrios, A., Di Uccio, F. S., Wilbert, B., Smits, P., Cortese, G., Parodi, G., Dudek, D., banning, adrian/0000-0002-2842-7861, GUIDUCCI, VINCENZO/0000-0002-0833-2785, vavlukis, marija/0000-0002-4479-6691, Bor, Willem L/0000-0002-3253-5961, DAVLOUROS, PERIKLIS/0000-0002-1439-1992, Uccello, Giuseppe/0000-0002-6163-8468, Kidawa, Michal/0000-0002-5000-6561, [De Luca, Giuseppe] Univ Piemonte Orientale, Div Cardiol, Azienda Osped Univ Maggiore Carita, Novara, Italy, [Verdoia, Monica] Osped Inferm Biella, ASL Biella, Div Cardiol, Biella, Italy, [Cercek, Miha] Univ Med Ctr, Ctr Intens Internal Med, Ljubljana, Slovenia, [Jensen, Lisette Okkels] Odense Univ Hosp, Div Cardiol, Odense, Denmark, [Vavlukis, Marija] Ss Cyril & Methodius Univ, Med Fac, Univ Clin Cardiol, Skopje, North Macedonia, [Calmac, Lucian] Clin Emergency Hosp Bucharest, Bucharest, Romania, [Johnson, Tom] Univ Hosp Bristol NHSFT, Bristol Heart Inst, Div Cardiol, Bristol, Avon, England, [Johnson, Tom] Univ Bristol, Bristol, Avon, England, [Ferrer, Gerard Rourai] Hosp Univ Bellvitge, Heart Dis Inst, Intervent Cardiol Unit, Barcelona, Spain, [Ganyukov, Vladimir] State Res Inst Complex Issues Cardiovasc Dis, Div Cardiol, Kemerovo, Russia, [Wojakowski, Wojtek] Med Univ Silezia, Div Cardiol, Katowice, Poland, [Kinnaird, Tim] Univ Hosp Wales, Div Cardiol, Cardiff, Wales, [van Birgelen, Clemens] Thoraxctr Twente, Dept Cardiol, Med Spectrum Twente, Enschede, Netherlands, [Cottin, Yves] Univ Hosp, Div Cardiol, Dijon, France, [IJsselmuiden, Alexander] Amphia Hosp, Div Cardiol, Breda, Netherlands, [Tuccillo, Bernardo] Osped Mare, Div Cardiol, Naples, Italy, [Di Uccio, Fortunato Scotto] Osped Mare, Div Cardiol, Naples, Italy, [Versaci, Francesco] Osped Santa Maria Goretti, Div Cardiol, Latina, Italy, [Royaards, Kees-Jan] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Smits, Pieter] Maasstad Ziekenhuis, Div Cardiol, Rotterdam, Netherlands, [Ten Berg, Jurrien] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Wilbert, Bor] St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands, [Laine, Mika] Helsinki Univ Cent Hosp, Div Cardiol, Helsinki, Finland, [Dirksen, Maurits] Northwest Clin, Div Cardiol, Alkmaar, Netherlands, [Siviglia, Massimo] Osped Riuniti Reggio Calabria, Div Cardiol, Reggio Di Calabria, Italy, [Casella, Gianni] Osped Maggiore Bologna, Div Cardiol, Bologna, Italy, [Kala, Petr] Masaryk Univ, Univ Hosp Brno, Med Fac, Brno, Czech Republic, [Diez Gil, Jose Luis] H Univ & Politecn La Fe, Valencia, Spain, [Banning, Adrian] John Radcliffe Hosp, Oxford, England, [Becerra, Victor] Hosp Clin Univ Virgen Victoria, Malaga, Spain, [De Simone, Ciro] Clin Villa Fiori, Div Cardiol, Acerra, Italy, [Santucci, Andrea] Osped Santa Maria Misericordia, Perugia, Italy, [Carrillo, Xavier] Hosp Germans Triasi Pujol, Badalona, Spain, [Scoccia, Alessandra] Osped St Anna, Div Cardiol, Ferrara, Italy, [Amoroso, Giovanni] Onze Lieve Vrouwe Gasthuis OLVG, Amsterdam, Netherlands, [Lux, Arpad] Mastricht Univ, Med Ctr, Maastricht, Netherlands, [Kovarnik, Tomas] Charles Univ Hosp, Prague, Czech Republic, [Davlouros, Periklis] Patras Univ Hosp, Invas Cardiol & Congenital Heart Dis, Patras, Greece, [Mehilli, Julinda] Ludwig Maximilians Univ Munchen, Univ Hosp Munich, Munich, Germany, [Gabrielli, Gabriele] Azienda Osped Univ, Intervent Cardiol Unit, Osped Riuniti, Ancona, Italy, [Rios, Xacobe Flores] Complexo Hosp Univ La Coruna, La Coruna, Spain, [Bakraceski, Nikola] Ctr Cardiovasc Dis, Ohrid, North Macedonia, [Levesque, Sebastien] CHU Poitiers, Univ Hosp, Poitiers, France, [Cirrincione, Giuseppe] Osped Civ Arnas, Div Cardiol, Palermo, Italy, [Guiducci, Vincenzo] AUSL IRCCS, Reggio Emilia, Italy, [Kidawa, Michal] Med Univ Lodz, Cent Hosp, Lodz, Poland, [Spedicato, Leonardo] Osped Santa Maria Misericordia, Div Cardiol, Udine, Italy, [Marinucci, Lucia] Osped Riuniti Marche Nord, Div Cardiol, Azienda Osped, Pesaro, Italy, [Ludman, Peter] Univ Hosp Birmingham, Birmingham, W Midlands, England, [Zilio, Filippo] Osped Santa Chiara, Trento, Italy, [Galasso, Gennaro] Osped San Giovanni Dio Ruggi Aragona, Div Cardiol, Salerno, Italy, [Fabris, Enrico] Univ Ospedali Riuniti, Azienda Osped, Trieste, Italy, [Menichelli, Maurizio] Osped F Spaziani, Div Cardiol, Frosinone, Italy, [Garcia-Touchard, Arturo] Hosp Puerta Hierro, Div Cardiol, Majadahonda, Spain, [Manzo, Stephane] Paris 07 Univ, CHU Lariboisiere, AP HP, Div Cardiol,INSERM,UMRS 942, Paris, France, [Caiazzo, Gianluca] Osped G Moscati, Div Cardiol, Aversa, Italy, [Moreu, Jose] Complejo Hosp Toledo, Div Cardiol, Toledo, Spain, [Sanchis Fores, Juan] Hosp Clin Univ Valencia, Div Cardiol, Valencia, Spain, [Donazzan, Luca] Osped S Maurizio Bolzano, Div Cardiol, Bolzano, Italy, [Vignali, Luigi] Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy, [Teles, Rui] Hosp Santa Cruz, Div Cardiol, CHLO Carnaxide, Lisbon, Portugal, [Benit, Edouard] Jessa Ziekenhuis, Div Cardiol, Hasselt, Belgium, [Agostoni, Pierfrancesco] Ziekenhuis Netwerk Antwerpen ZNA Middelheim, Div Cardiol, Antwerp, Belgium, [Bosa Ojeda, Francisco] Hosp Univ Canarias, Div Cardiol, Santa Cruz De Tenerife, Spain, [Lehtola, Heidi] Oulu Univ Hosp, Div Cardiol, Oulu, Finland, [Camacho-Freiere, Santiago] Juan Ramon Jimenez Hosp, Div Cardiol, Huelva, Spain, [Kraaijeveld, Adriaan] UMC Utrecht, Div Cardiol, Utrecht, Netherlands, [Antti, Ylitalo] Univ Hosp, Heart Ctr, Div Cardiol, Turku, Finland, [Boccalatte, Marco] Osped Santa Maria Grazie, Div Cardiol, Pozzuoli, Italy, [Deharo, Pierre] Aix Marseille Univ, CHU Timone, Div Cardiol, Marseille, France, [Lozano Martinez-Luengas, Inigo] Hosp Cabuenes, Div Cardiol, Gijon, Spain, [Scheller, Bruno] Univ Saarland, Div Cardiol Clin & Expt Intervent Cardiol, Homburg, Germany, [Alexopoulos, Dimitrios] Attikon Univ Hosp, Div Cardiol, Athens, Greece, [Moreno, Raul] Hosp Paz, Div Cardiol, Madrid, Spain, [Kedhi, Elvin] St Jan Hosp, Div Cardiol, Brugge, Belgium, [Uccello, Giuseppe] Osped A Manzoni Lecco, Div Cardiol, Lecce, Italy, [Faurie, Benjamin] Grp Hosp Mutualiste Grenoble, Div Cardiol, Grenoble, France, [Gutierrez Barrios, Alejandro] Hosp Puerta Mar, Div Cardiol, Cadiz, Spain, [Cortese, Giuliana] Univ Padua, Dept Stat Sci, Padua, Italy, [Parodi, Guido] Azienda Osped Univ Sassari, Sassari, Italy, [Dudek, Dariusz] Jagiellonian Univ Med Coll, Inst Cardiol, Krakow, Poland, RS: Carim - H01 Clinical atrial fibrillation, and Cardiologie

Subjects
Male, Internationality, medical decision-making, medicine.medical_treatment, 030204 cardiovascular system & hematology, Rate ratio, COVID-19 (coronavirus), Settore MED/06, 0302 clinical medicine, Pandemic, Percutaneous Coronary Intervention/statistics & numerical data, Medicine, Viral, 030212 general & internal medicine, Myocardial infarction, Registries, Acute myocardial-infarction, Original Investigation, STEMI, ST-segment elevation myocardial infarction, Middle Aged, 3. Good health, Europe, fibrinolysis, Female, COVID-19, primary angioplasty, STEMI, Aged, Humans, Percutaneous Coronary Intervention, Retrospective Studies, ST Elevation Myocardial Infarction, Coronavirus Infections, Pandemics, Pneumonia, Viral, Cardiology and Cardiovascular Medicine, Editorial Comment, ACUTE MYOCARDIAL-INFARCTION, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Primary angioplasty, IRR, incidence rate ratio, Europe/epidemiology, 03 medical and health sciences, Betacoronavirus, cardiovascular diseases, Mortality, PCI, percutaneous coronary intervention, DES, drug-eluting stent(s), business.industry, ST Elevation Myocardial Infarction/mortality, PPCI, primary PCI, SARS-CoV-2, MORTALITY, Percutaneous coronary intervention, Retrospective cohort study, Pneumonia, medicine.disease, Confidence interval, ST-segment elevation myocardial infarction, CI, confidence interval, Emergency medicine, COVID-19, STEMI, primary angioplasty, ACS, acute coronary syndrome, business
Abstract

Background The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. Objectives The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of “at-risk” patient cohorts for failure to present or delays to treatment. Methods This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. Results A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p, Central Illustration

Published
2020

45. Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Author

Pierre Deharo, Pieter C. Smits, Giuseppe De Luca, Luigi Vignali, Clemens von Birgelen, Michał Kidawa, Lucia Marinucci, Gabriele Gabrielli, Miha Cercek, Francisco Bosa Ojeda, Bernardo Tuccillo, Lisette Okkels Jensen, Gennaro Galasso, Vincenzo Guiducci, Pierfrancesco Agostoni, Monica Verdoia, Edouard Benit, Ewout Bruwiere, Massimo Siviglia, Maurizio Menichelli, Heidi Lehtola, Stephane Manzo, Benjamin Faurie, Filippo Zilio, Gerard Rourai Ferrer, José Moreu, Guido Parodi, Ylitalo Antti, Rui Campante Teles, Giovanni Amoroso, Jurriën M. ten Berg, Sébastien Levesque, Bor Wilbert, Fortunato Scotto Di Uccio, Maurits T. Dirksen, Raul Moreno, Kees Jan Royaards, Xavier Carrillo, Giuseppe Uccello, Alejandro Gutierrez Barrios, Lucian Calmac, Victor Becerra, Petr Kala, Thomas W Johnson, Wojtek Wojakowski, Marija Vavlukis, Leonardo Spedicato, Adriaan O. Kraaijeveld, Francesco Versaci, Marco Boccalatte, Xacobe Flores Rios, Alessandra Scoccia, Arnoud W J van 't Hof, Efthymia Varytimiadi, Peter Ludman, José Luis Díez Gil, Tomas Kovarnik, Gianni Casella, Tim Kinnaird, Adrian P. Banning, Vladimir Ganyukov, Arturo García-Touchard, Marek Milewski, Ciro De Simone, Nikola Bakraceski, Julinda Mehilli, Giuseppe Cirrincione, Grigorios Tsigkas, Juan Sanchis Forés, Andrea Santucci, Elvin Kedhi, Gianluca Caiazzo, Luca Donazzan, Alexander Ijsselmuiden, Iñigo Lozano Martínez-Luengas, Bruno Scheller, Enrico Fabris, Mika Laine, Yves Cottin, Niels Debel, Santiago Camacho-Freiere, Health Technology & Services Research, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), HUS Heart and Lung Center, Kardiologian yksikkö, De Luca, G., Debel, N., Cercek, M., Jensen, L. O., Vavlukis, M., Calmac, L., Johnson, T., Ferrer, G. R., Ganyukov, V., Wojakowski, W., Kinnaird, T., von Birgelen, C., Cottin, Y., Ijsselmuiden, A., Tuccillo, B., Versaci, F., Royaards, K. -J., Berg, J. T., Laine, M., Dirksen, M., Siviglia, M., Casella, G., Kala, P., Diez Gil, J. L., Banning, A., Becerra, V., De Simone, C., Santucci, A., Carrillo, X., Scoccia, A., Amoroso, G., van't Hof, A. W., Kovarnik, T., Tsigkas, G., Mehilli, J., Gabrielli, G., Rios, X. F., Bakraceski, N., Levesque, S., Cirrincione, G., Guiducci, V., Kidawa, M., Spedicato, L., Marinucci, L., Ludman, P., Zilio, F., Galasso, G., Fabris, E., Menichelli, M., Garcia-Touchard, A., Manzo, S., Caiazzo, G., Moreu, J., Fores, J. S., Donazzan, L., Vignali, L., Teles, R., Benit, E., Agostoni, P., Ojeda, F. B., Lehtola, H., Camacho-Freiere, S., Kraaijeveld, A., Antti, Y., Boccalatte, M., Deharo, P., Martinez-Luengas, I. L., Scheller, B., Varytimiadi, E., Moreno, R., Uccello, G., Faurie, B., Gutierrez Barrios, A., Milewski, M., Bruwiere, E., Smits, P., Wilbert, B., Di Uccio, F. S., Parodi, G., Kedhi, E., Verdoia, M., vavlukis, marija/0000-0002-4479-6691, banning, adrian/0000-0002-2842-7861, Agostoni, Pierfrancesco/0000-0002-1505-9369, Jensen, Lisette Okkels/0000-0002-4838-2429, Cercek, Miha/0000-0001-6193-0349, Milewski, Marek/0000-0001-5459-9125, Johnson, Thomas/0000-0003-4638-601X, and Calmac, Lucian/0000-0002-3031-8023

Subjects
Registrie, ST Elevation Myocardial Infarction/diagnosis, medicine.medical_treatment, PRIMARY ANGIOPLASTY, 030204 cardiovascular system & hematology, SARS-CoV-2, ST segment elevation myocardial infarction, 0302 clinical medicine, Retrospective Studie, Registries, 030212 general & internal medicine, Myocardial infarction, skin and connective tissue diseases, THROMBUS ASPIRATION, Percutaneous Coronary Intervention/adverse effects, Thrombosis(please add them), education.field_of_study, Thrombosis, 3. Good health, Treatment Outcome, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Humans, Reperfusion, Retrospective Studies, COVID-19, Percutaneous Coronary Intervention, ST Elevation Myocardial Infarction, Population, Article, 03 medical and health sciences, Internal medicine, medicine, cardiovascular diseases, Platelet activation, education, METAANALYSIS, business.industry, MORTALITY, ELEVATION MYOCARDIAL-INFARCTION, Percutaneous coronary intervention, Retrospective cohort study, medicine.disease, body regions, 3121 General medicine, internal medicine and other clinical medicine, Heart failure, Conventional PCI, business
Abstract

Background and aims SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p, Graphical abstract Image 1

Published
2021

46. Comparison of long‐term clinical outcomes in multivessel coronary artery disease patients treated either with bioresoarbable polymer sirolimus‐eluting stent or permanent polymer everolimus‐eluting stent: 5‐year results of the CENTURY II randomized clinical trial

Author

Emanuele Barbato, Gert Richardt, Didier Carrié, Bernard Chevalier, William Wijns, Antoinette Neylon, Andrés Iñiguez, Mariano Valdés-Chávarri, Raúl Moreno, Shigeru Saito, Vincenzo Guiducci, Century Ii study investigators, Victor Alfonso Jimenez, Ran Kornowski, Antoni Serra-Peñaranda, Junji Yajima, Iniguez, A., Chevalier, B., Richardt, G., Neylon, A., Jimenez, V. A., Kornowski, R., Carrie, D., Moreno, R., Barbato, E., Serra-Penaranda, A., Guiducci, V., Valdes-Chavarri, M., Yajima, J., Wijns, W., and Saito, S.

Subjects
Target lesion, Male, Time Factors, percutaneous coronary intervention, stent, Polymers, medicine.medical_treatment, Coronary Artery Disease, 030204 cardiovascular system & hematology, Coronary artery disease, Original Studies, law.invention, 0302 clinical medicine, Clinical trials, Randomized controlled trial, Japan, law, Risk Factors, Absorbable Implants, Clinical endpoint, Medicine, Single-Blind Method, 030212 general & internal medicine, Myocardial infarction, Prospective Studies, Drug eluting, coating, clinical trial, Drug-Eluting Stents, General Medicine, Middle Aged, drug eluting, Europe, Treatment Outcome, Cardiology, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Complex PCI, Prosthesis Design, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, Multicenter trial, complex PCI, Republic of Korea, Humans, Radiology, Nuclear Medicine and imaging, structure, Everolimus, Aged, Sirolimus, clinical trials, business.industry, Stent design/structure/coating, percutaneous coronary intervention, stent design, Coronary Stenosis, Stent, Percutaneous coronary intervention, stent, Cardiovascular Agents, medicine.disease, Clinical trial, stent design/structure/coating, stent, business
Abstract

ObjectivesTo assess the long-term safety and efficacy of a sirolimus-eluting stent with bioresorbable polymer (BP-SES; Ultimaster), in comparison to a benchmark everolimus-eluting, permanent polymer stent (PP-EES; Xience), in a prespecified subgroup of patients with multivessel coronary artery disease (MVD) enrolled in the CENTURY II trial. BackgroundThe use of coronary stenting in high-risk subgroups, like MVD patients, is rising. The clinical evidence, including long-term comparative analysis of the efficacy and safety benefits of different new-generation drug eluting stents, however, remains insufficient. MethodsAmong 1,119 patients (intention-to-treat) enrolled in the CENTURY II prospective, randomized, single-blind, multicenter trial, a prespecified subgroup of 456 MVD patients were allocated by stratified randomization to treatment with BP-SES (n =225) or PP-EES (n =231). The previously reported primary endpoint of this study was freedom from target lesion failure (TLF: a composite of cardiac death, target vessel-related myocardial infarction [MI] and clinically-indicated target lesion revascularization) at 9months. ResultsIn this MVD substudy, baseline patient, lesion and procedure characteristics were similar between the treatment arms. At 1 and 5 years, both BP-SES and PP-EES displayed low and comparable rates of TLF (5.3 vs. 7.8%; p =.29 and 10.2 vs. 13.4%; p =.29), and definite or probable stent thrombosis (0.4 vs. 1.3%; p =.33 and 0.9 vs. 1.7%; p =.43), respectively. Composite endpoint of cardiac death and MI, and patient-oriented composite endpoint of any death, MI, and coronary revascularizations were also similar. ConclusionsThese results confirm good long-term safety and efficacy of the studied bioresorbable polymer stent in this high-risk patient population.

Published
2019

47. Physiology-guided revascularization versus optimal medical therapy of nonculprit lesions in elderly patients with myocardial infarction: Rationale and design of the FIRE trial

Author

Francesco Giannini, Andrea Santarelli, Ferdinando Varbella, Iginio Colaiori, Raul Moreno, Enrique Gutiérrez Ibañes, Mila Menozzi, José Luis Díez Gil, Marco Ruozzi, Alfredo Redondo, Javier Escaned, Valerio Lanzilotti, Antonio Colombo, Matteo Tebaldi, Elisa Maietti, Emanuele Barbato, Simone Biscaglia, Francisco Fernández-Avilés, Dariusz Dudek, Ignacio Amat Santos, Gianluca Campo, Giuseppe Biondi Zoccai, Luca Fileti, Vincenzo Guiducci, Biscaglia, S., Guiducci, V., Santarelli, A., Amat Santos, I., Fernandez-Aviles, F., Lanzilotti, V., Varbella, F., Fileti, L., Moreno, R., Giannini, F., Colaiori, I., Menozzi, M., Redondo, A., Ruozzi, M., Gutierrez Ibanes, E., Diez Gil, J. L., Maietti, E., Biondi Zoccai, G., Escaned, J., Tebaldi, M., Barbato, E., Dudek, D., Colombo, A., and Campo, G.

Subjects
Male, medicine.medical_specialty, Prognosi, medicine.medical_treatment, 030204 cardiovascular system & hematology, Revascularization, Coronary Angiography, Conservative Treatment, Severity of Illness Index, Article, NO, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Quality of life, Internal medicine, Functional Statu, Clinical endpoint, medicine, Myocardial Revascularization, Humans, Multicenter Studies as Topic, 030212 general & internal medicine, Myocardial infarction, Mortality, Non-ST Elevated Myocardial Infarction, Stroke, Randomized Controlled Trials as Topic, Aged, business.industry, Cardiovascular Agents, medicine.disease, Prognosis, Aged, Coronary Angiography, Cardiovascular Agents, Conservative Treatment, Functional Status, Mortality, Prognosis, Severity of Illness Index, Myocardial Revascularization, Non-ST Elevated Myocardial Infarction, Postoperative Complications, ST Elevation Myocardial Infarction, Functional Status, Cardiovascular Agent, Sample size determination, cardiovascular system, Cardiology, ST Elevation Myocardial Infarction, Female, Postoperative Complication, Cardiology and Cardiovascular Medicine, business, Medical therapy, All cause mortality, Human
Abstract

Background Myocardial infarction (MI) in elderly patients is associated with unfavorable prognosis, and it is becoming an increasingly prevalent condition. The prognosis of elderly patients is equally impaired in ST-segment elevation (STE) or non-STE (NSTE), and it is markedly worsened by the common presence of multivessel disease (MVD). Given the limited evidence available for elderly patients, it has not yet been established whether, as for younger patients, a complete revascularization strategy in MI patients with MVD should be advocated. We present the design of a dedicated study that will address this research gap. Methods and design The FIRE trial is a prospective, randomized, international, multicenter, open-label study with blinded adjudicated evaluation of outcomes. Patients aged 75years and older, with MI (either STE or NSTE), MVD at coronary artery angiography and a clear culprit lesion will be randomized to culprit-only treatment or to physiology-guided complete revascularization. The primary endpoint will be the patient-oriented composite endpoint (POCE) of all cause death, any MI, any stroke, any revascularization at one year. The key secondary endpoint will be the composite of cardiovascular death and MI. Quality of life and physical performance will be evaluated as well. All components of the primary and key secondary outcome will be tested also at 3 and 5years. The sample size for the study is 1400 patients. Implications The FIRE trial will provide evidence on whether a specific revascularization strategy should be applied to elderly patients presenting MI and MVD in order to improve their clinical outcomes.

Published
2020

48. Impact of sex on comparative outcomes of bivalirudin versus unfractionated heparin in patients with acute coronary syndromes undergoing invasive management: a pre-specified analysis of the MATRIX trial

Author

Arnoud W J van 't Hof, Roberto Diletti, Salvatore Curello, Gabriele Gabrielli, Bruno R. da Costa, Dellavalle A, Ciro Mauro, Antonio Colombo, Pietro Mazzarotto, Camillo Falcone, Elmir Omerovic, Fabio Ferrari, Marco Zimarino, Flavia Belloni, Carlo Penzo, Stefano De Servi, Giampaolo Pasquetto, Salvatore Brugaletta, Emilio Di Lorenzo, Marco Valgimigli, Cataldo Palmieri, Carlo Vigna, Gavino Casu, Giuseppe Gargiulo, Fabio Abate, José M. de la Torre Hernández, Enrico Frigoli, Francesco Liistro, Vincenzo Guiducci, Marco Stefano Nazzaro, Stephan Windecker, Claudio Moretti, Marco Comeglio, Armando Liso, RS: Carim - H01 Clinical atrial fibrillation, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.01 - Clinical atrial fibrillation, Gargiulo, G., da Costa, B. R., Frigoli, E., Palmieri, C., Nazzaro, M. S., Falcone, C., Liso, A., Vigna, C., Abate, F., Comeglio, M., Diletti, R., Gabrielli, G., Di Lorenzo, E., Mazzarotto, P., Zimarino, M., Moretti, C., Colombo, A., Penzo, C., Pasquetto, G., Brugaletta, S., Ferrari, F., Casu, G., Guiducci, V., Dellavalle, A., Liistro, F., Mauro, C., van't Hof, A. W. J., Omerovic, E., Curello, S., de la Torre Hernandez, J. M., de Servi, S., Belloni, F., Windecker, S., Valgimigli, M., and Cardiology

Subjects
Hirudin, Male, adjunctive pharmacotherapy, medicine.medical_treatment, Antithrombin, 030204 cardiovascular system & hematology, Rate ratio, 0302 clinical medicine, access, Peptide Fragment, Bivalirudin, 030212 general & internal medicine, Myocardial infarction, 610 Medicine & health, Stroke, ACS/NSTE-ACS, Hirudins, Recombinant Protein, Recombinant Proteins, stemi, Treatment Outcome, REPLACE-2, Cardiology, Female, Cardiology and Cardiovascular Medicine, INTERVENTION, 360 Social problems & social services, medicine.drug, Human, medicine.medical_specialty, Acute coronary syndrome, ACUTE MYOCARDIAL-INFARCTION, acuity, Revascularization, Antithrombins, EVENTS, 03 medical and health sciences, Percutaneous Coronary Intervention, Internal medicine, medicine, Humans, cardiovascular diseases, Acute Coronary Syndrome, therapy, business.industry, Heparin, MORTALITY, Anticoagulant, association, Percutaneous coronary intervention, Anticoagulants, medicine.disease, Peptide Fragments, business, Mace
Abstract

AIMS To assess whether bivalirudin compared with unfractionated heparin (UFH) is associated with consistent outcomes in male and female patients with acute coronary syndrome (ACS) undergoing invasive management. METHODS AND RESULTS In the MATRIX program,7213 patients were randomized to bivalirudin or UFH.Patients in bivalirudin group were subsequently assigned to receive or not to receive a post-PCI infusion.The 30-day coprimary outcomes were major adverse cardiovascular and cerebrovascular events (MACE),defined as death,myocardial infarction,or stroke,and net adverse clinical events (NACE),defined as MACE or major bleeding.The primary outcome for the comparison of a post-PCI bivalirudin infusion with no post-PCI infusion was a composite of urgent target-vessel revascularization (TVR),definite stent thrombosis (ST),or NACE.The rate of MACE was not significantly lower with bivalirudin than with heparin in male (rate ratio,0.90;95% confidence interval [CI], 0.75-1.07; P=0.22) and female patients (rate ratio, 1.06; 95%CI,0.80-1.40;P=0.67) without significant interaction (Pint=0.31), nor was the rate of NACE (males: rate ratio, 0.85; 95% CI, 0.72-1.01; P=0.07; females: rate ratio, 0.98; 95% CI, 0.76-1.28; P=0.91; Pint=0.38). Post-PCI bivalirudin infusion, as compared with no infusion, did not significantly decrease the rate of urgent TVR, definite ST, or NACE (males: rate ratio, 0.84; 95% CI, 0.66-1.07; P=0.15; females: rate ratio, 1.06; 95% CI, 0.74-1.53; P=0.74;Pint=0.28). CONCLUSIONS In ACS patients, the rates of MACE and NACE were not significantly lower with bivalirudin than with UFH in both sexes.The rate of the composite of urgent TVR,definite ST,or NACE was not significantly lower with a post-PCI bivalirudin infusion than with no post-PCI infusion in both sexes.

Published
2019

49. Attachment mental states and inferred pathways of development in borderline personality disorder: a study using the Adult Attachment Interview

Author

Valentina Guiducci, Lavinia Barone, Andrea Fossati, Barone, L, Fossati, Andrea, and Guiducci, V.

Subjects
Adult, Male, Nosology, medicine.medical_specialty, Adolescent, attachment behavior, developmental pathway, Comorbidity, behavioral disciplines and activities, Young Adult, Borderline Personality Disorder, Interview, Psychological, mental disorders, Developmental and Educational Psychology, medicine, Humans, mental state, risk factors, Psychiatry, Borderline personality disorder, Mental Disorders, Cognition, Middle Aged, medicine.disease, Object Attachment, Psychiatry and Mental health, Eating disorders, Italy, Mood disorders, Mental representation, Anxiety, Female, medicine.symptom, Psychology, Attachment measures, borderline personality disorder, Adult Attachment Interview
Abstract

We report the outcome of an investigation on how specific attachment states of mind and corresponding risk factors related to different DSM Axis I comorbidities in subjects with BPD. Mental representations of attachment in four BPD sub-groups (BPD and Anxiety/Mood Disorders, BPD and Substance Use and Abuse Disorders, BPD and Alcohol Use and Abuse Disorders, and BPD and Eating Disorders) were assessed in 140 BPD subjects using the Adult Attachment Interview (AAI). In addition to the global attachment picture in which Insecure organized (Dismissing 51% and Enmeshed 35%) and Insecure disorganized categories (40%) were overrepresented, significant differences in attachment category were found between the four BPD sub-groups. Axis I comorbidities corresponded with attachment features on the internalizing/externalizing functioning dimension of the disorder. Furthermore, specific constellations of inferred developmental antecedents and attachment states of mind corresponded differentially with the BPD sub-groups. Implications for developmental research and clinical nosology are discussed.

Published
2011

50. Randomized comparison between tirofiban and abciximab to promote complete ST-resolution in primary angioplasty: results of the facilitated angioplasty with tirofiban or abciximab (FATA) in ST-elevation myocardial infarction trial

Author

Antonio, Marzocchi, Antonio, Manari, Giancarlo, Piovaccari, Cinzia, Marrozzini, Sebastiano, Marra, Paolo, Magnavacchi, Pietro, Sangiorgio, Lucia, Marinucci, Nevio, Taglieri, Giovanni, Gordini, Nicola, Binetti, Vincenzo, Guiducci, Nicoletta, Franco, Maria Letizia-Bacchi, Reggiani, Francesco, Saia, Paolo, Guastaroba, Marzocchi A., Manari A., Piovaccari G., Marrozzini C., Marra S., Magnavacchi P., Sangiorgio P., Marinucci L., Taglieri N., Gordini G., Binetti G., Guiducci V., Franco N., Bacchi Reggiani M.L., Saia F., and FATA investigators

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Abciximab, Myocardial Infarction, Myocardial Reperfusion, Coronary Angiography, Electrocardiography, Immunoglobulin Fab Fragments, Internal medicine, Angioplasty, medicine, Humans, Myocardial infarction, Prospective Studies, Angioplasty, Balloon, Coronary, Dose-Response Relationship, Drug, business.industry, ST elevation, Percutaneous coronary intervention, Antibodies, Monoclonal, Drug-Eluting Stents, Tirofiban, Middle Aged, medicine.disease, Treatment Outcome, Glycoprotein IIb/IIIa inhibitors, Anesthesia, Cardiology, Platelet aggregation inhibitor, Tyrosine, Female, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

Aims To test the equivalence of high-dose bolus (HDB) tirofiban vs. abciximab during primary percutaneous coronary intervention (PPCI) in terms of ST-segment resolution (STR). Methods and results The FATA trial (Facilitated Angioplasty with Tirofiban or Abciximab) was a prospective, multicentre, open-label trial that enrolled 692 patients with ST-segment elevation myocardial infarction (STEMI) undergoing PPCI. Patients were randomized 1:1 to receive abciximab ( n = 341) or HDB tirofiban ( n = 351). Primary endpoint was the rate of complete (≥70%) STR 90 min after first balloon inflation. Thirty-day incidence of major bleedings, death, re-infarction and new revascularizations was also evaluated. Baseline characteristics of the two groups were well-balanced, with the exception of previous MI rates (tirofiban 6% vs. abciximab 2.6%, P = 0.03). The procedure was successful in 96.7% of the abciximab and in 96.6% of the tirofiban cohort ( P = 0.94). Complete STR was obtained in 67.05% of the tirofiban and 70.45% of the abciximab group (Δ −3.4%, 95% confidence interval −10.35 to +3.56), which falls beyond the predefined Δ ± 10% equivalence boundaries. Rates of secondary endpoints were similar between the two groups. Conclusion This study failed to show the equivalence of HBD of tirofiban and abciximab as adjunctive therapy to PPCI.

Published
2008

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