Publications by authors named "Alberto Rigatelli"
Unlabelled: . Social-work service in the emergency department to improve care for the vulnerable older patient: a local experience in Italy.
Introduction: The needs of older and frail people are increasing, and specific pathways in healthcare settings are needed.
Aims: The prevalence and prognostic implications of coronary artery disease (CAD) in patients infected by the novel coronavirus 2019 (COVID-19) disease remain unclear.
Methods: We conducted a systematic review and meta-analysis to investigate the prevalence and mortality risk in COVID-19 patients with preexisting CAD. We searched Medline and Scopus to locate all articles published up to December 8, 2021, reporting data of COVID-19 survivors and nonsurvivors with preexisting CAD.
Article Synopsis
- The study aimed to evaluate the risks of recurrent ischemic events and severe bleeding in patients with acute posterior ischemic stroke (PS) and atrial fibrillation (AF) in relation to oral anticoagulant therapy (OAT) and timing of initiation.
- Researchers compared outcomes in 473 patients with PS to 1997 patients with anterior stroke (AS), focusing on events within 90 days of the initial stroke.
- Findings indicated that both PS and AS patients had similar risks of ischemic or hemorrhagic events at 90 days, regardless of when OAT was initiated.
Article Synopsis
- The study investigates when it's best to start oral anticoagulants after an ischemic stroke caused by atrial fibrillation, particularly focusing on patients who received thrombolysis or thrombectomy.
- It combines data from two studies conducted between 2012 and 2016, analyzing patients treated with either Vitamin K antagonists or non-vitamin K oral anticoagulants for secondary stroke prevention.
- Among 2159 patients included, the timing for starting anticoagulants was similar for those treated with reperfusion therapies and those not treated, with low rates of stroke or bleeding complications observed within 90 days.
Article Synopsis
- The study investigates the link between high homocysteine (Hcy) levels and the RoPE score in patients with patent foramen ovale (PFO), revealing that those who underwent closure had significantly higher Hcy levels compared to the control group.
- There was a notable positive correlation between serum Hcy levels and the RoPE score across all patients, and this correlation remained evident in both closure and control groups.
- An Hcy level of 19.5 μg/dL was identified as a significant predictor for a higher RoPE score in the closure group, showing that elevated Hcy levels can indicate risk independently of other conditions like right-to-left shunt or atrial septal aneurysm.
Wall shear stress (WSS) plays a pivotal role on plaque progression in coronary artery disease. We assess the prognostic role of baseline mean WSS in developing a bifurcation-located myocardial infarction (B-MI) over the following 3 years in angiographically non-significant LM bifurcation disease. For this purpose, we retrospectively reviewed the procedural and medical records of consecutive patients evaluated in our center from 1st January 2014 to 1st January 2019 who had a non-significant LM bifurcation disease as evaluated at coronary computed tomography angiography (CCTA) and confirmed by coronary angiography.
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- * Researchers analyzed data from 1,810 patients, discovering that 20% underwent this bridging therapy, and found that bridged patients had worse outcomes, with a higher rate of ischemic events and major bleeding.
- * The results indicate that bridging therapy significantly raises the risk of early complications compared to patients who did not receive it, prompting a reevaluation of its common use in clinical practice.
Article Synopsis
- The study examined the link between types of atrial fibrillation (paroxysmal vs. sustained) and the occurrence of early ischaemic recurrences after an acute stroke in patients.
- Out of 2150 patients, those with sustained atrial fibrillation experienced a higher percentage of early ischaemic recurrences (6.2%) compared to those with paroxysmal atrial fibrillation (3.3%).
- However, after considering other health risks, sustained atrial fibrillation did not show a significantly increased risk for early recurrence, suggesting that other factors may be more influential.
Background In patients with acute ischemic stroke and atrial fibrillation, early anticoagulation prevents ischemic recurrence but with the risk of hemorrhagic transformation ( HT ). The aims of this study were to evaluate in consecutive patients with acute stroke and atrial fibrillation (1) the incidence of early HT, (2) the time to initiation of anticoagulation in patients with HT , (3) the association of HT with ischemic recurrences, and (4) the association of HT with clinical outcome at 90 days. Methods and Results HT was diagnosed by a second brain computed tomographic scan performed 24 to 72 hours after stroke onset.
View Article and Find Full Text PDFSex-related differences in risk factors, type of treatment received and outcomes in patients with atrial fibrillation and acute stroke: Results from the RAF-study (Early Recurrence and Cerebral Bleeding in Patients with Acute Ischemic Stroke and Atrial Fibrillation).
Eur Stroke J
March 2017
Article Synopsis
- Atrial fibrillation increases stroke risk, especially in women, who tend to have worse outcomes than men; this study assesses sex differences in stroke patients with atrial fibrillation regarding risk factors, treatments, and outcomes.
- Data from the RAF-study, involving 1029 patients, revealed women were younger and less likely to receive anticoagulant therapy both before and after stroke compared to men, despite similar timing for starting treatment.
- At 90 days post-stroke, more women were disabled or deceased (57.7%) compared to men (41.1%), highlighting a significant disparity in outcomes related to treatment patterns.
Article Synopsis
- - The study aimed to explore how the prestroke CHADS-VASc score, which assesses stroke risk in patients with atrial fibrillation (AF), relates to the severity of strokes and outcomes like disability and mortality after 90 days.
- - Researchers analyzed data from 1,020 patients with acute ischemic strokes and found that a higher prestroke CHADS-VASc score correlated with more severe strokes at admission and worse functional outcomes 90 days later.
- - The findings suggest that, for patients with AF, a high CHADS-VASc score not only indicates a greater stroke risk but is also linked to increased stroke severity and higher rates of disability and death after three months.
Background And Purposes: This study was designed to derive and validate a score to predict early ischemic events and major bleedings after an acute ischemic stroke in patients with atrial fibrillation.
Methods: The derivation cohort consisted of 854 patients with acute ischemic stroke and atrial fibrillation included in prospective series between January 2012 and March 2014. Older age (hazard ratio 1.
The role of endothelium in the progression of atheromasic disease has already been demonstrated. Endothelin-1 (ET-1) is released from endothelial cells during acute and chronic vascular damage and it appears to be the strongest vasoconstrictor agent known.The aim of this study is to investigate the amount of endothelial damage in patients with unstable angina (UA), as defined by serum levels of ET-1, to verify a possible correlation with increased ischaemic damage by evaluation of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and interleukin 8 (IL-8) levels.
View Article and Find Full Text PDFAnticoagulant therapy is recommended for the secondary prevention of stroke in patients with atrial fibrillation (AF). T he identification of patients at high risk for early recurrence, which are potential candidates to prompt anticoagulation, is crucial to justify the risk of bleeding associated with early anticoagulant treatment. The aim of this study was to evaluate in patients with acute ischemic stroke and AF the association between findings at trans-thoracic echocardiography (TTE) and 90 days recurrence.
View Article and Find Full Text PDFRecent trials and metanalysis even not fully conclusive and still debated, at least suggested that mechanical device-based closure of patent foramen ovale (PFO) is more effective than medical therapy in prevent recurrence of stroke. In a proportion ranging from 20% to nearly 40% of patients in literature, PFO is associated to atrial septal aneurysm (ASA): ASA is a well-known entity often associated with additional fenestration. Additionally small atrial septal defects ("Flat ASD") can present with signs of paradoxical embolism and cannot be easily detected by transthoracic echocardiography or even by transesophageal echocardiography and are usually discovered by intracardiac echocardiography at the moment of transcatheter closure.
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- The study investigates the timing of anticoagulation therapy in patients with acute cardioembolic stroke and atrial fibrillation, focusing on risks for recurrent ischemic events and severe bleeding.
- Out of 1029 patients, 12.6% experienced adverse events within 90 days, with factors like CHA2DS2-VASc score and type of anticoagulant affecting outcomes.
- Starting anticoagulants 4 to 14 days after stroke onset is linked to a significant reduction in complications compared to starting before 4 days or after 14 days.
A clinical-angiographic risk scoring system for coronary artery anomalies.
Asian Cardiovasc Thorac Ann
June 2012
Congenital coronary anomalies remain a debated issue. On the basis of a critical review of the literature and our historical series, we propose a simple clinical profile scoring system for congenital coronary anomalies. A review of literature over the past 30 years was performed, searching for a relationship between the worst coronary anomaly presentation and manifestations and the anatomical and functional features.
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