Publications by authors named "Cappelletti A"

Aims: Accurate selection of patients with severe heart failure (HF) who might benefit from advanced therapies is crucial. The present study investigates the performance of the available risk scores aimed at predicting the risk of mortality in patients with severe HF.

Methods And Results: The risk of 1-year mortality was estimated in patients with severe HF enrolled in the HELP-HF cohort according to the MAGGIC, 3-CHF, ADHF/NT-proBNP, and GWTG-HF risk scores, the number of criteria of the 2018 HFA-ESC definition of advanced HF, I NEED HELP markers, domains fulfilled of the 2019 HFA-ESC definition of frailty, the frailty index, and the INTERMACS profile.

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Utero-vaginal prolapse is a common condition in the female population. In addition to well-known predisposing risk factors malnutrition, autosomal dominant polycystic kidney disease (ADPKD) and dialysis technique may favour its occurrence or aggravation, especially in patients with end-stage kidney disease (ESKD). Depending on severity, a relative contraindication to peritoneal dialysis (PD) could be considered.

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  • A multicenter observational study named CONDIVIDIAMO analyzed the effectiveness of monoclonal antibodies (mAbs) in reducing COVID-19 hospitalizations among outpatients with risk factors for severe disease.
  • The study enrolled 1,534 participants and tracked outcomes over 28 days, recording hospitalizations and deaths, with results showing a 5.6% incidence of hospitalization or death after mAbs treatment.
  • Key risk factors identified for increased hospitalization included older age and immunodeficiency, highlighting the importance of targeting vulnerable populations for mAb treatment.
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  • The study aimed to assess malnutrition's prevalence and impact on patients with severe heart failure (HF), defined by specific clinical markers, using the geriatric nutritional risk index (GNRI).
  • Among 510 patients analyzed, 35.1% were classified as malnourished (GNRI ≤98), with lower body mass index (BMI) and higher natriuretic peptide levels linked to this condition.
  • Results indicated that malnourished patients had significantly higher one-year mortality rates (41.1%) compared to non-malnourished patients (22.4%), highlighting malnutrition as a critical risk factor for mortality in severe HF cases.
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  • A study aimed to validate the multi-domain definition of frailty proposed by the HFA-ESC in patients with heart failure, highlighting its high prevalence.
  • The analysis of 854 patients revealed that the risk of death and hospitalization increased with the number of frailty domains fulfilled, indicating a direct relationship between frailty and adverse health outcomes.
  • The Frailty Index (FI) demonstrated slightly better effectiveness than the domain count in predicting mortality risk, showcasing its potential as a useful tool for assessing frailty in heart failure patients.
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Natural history museums worldwide house billions of apposite specimens, offering the potential for cost-free parasitological datasets. Herein, we provide novel morphological and molecular data (28S and 1) for the polyopisthocotylean from the type-host from Sweden based on newly collected specimens from the Northeast Atlantic, and specimen from T. Odhner's collections at the Swedish Museum of Natural History (Stockholm, Sweden).

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  • A research study aimed to assess the impact of tricuspid regurgitation on outcomes for patients with advanced heart failure, utilizing data from the multicenter HELP-HF registry.
  • The study included 1,085 patients, revealing that those with severe tricuspid regurgitation had significantly higher 1-year all-cause mortality rates compared to those with mild or moderate regurgitation.
  • Key factors linked to severe tricuspid regurgitation included atrial fibrillation and pulmonary hypertension, highlighting the importance of managing this condition for improving patient outcomes.
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  • Hospitalization for heart failure significantly affects outcomes in patients with advanced heart failure, with inpatients showing worse overall health compared to outpatients.
  • In a study of 1149 patients, those hospitalized at enrollment had a higher one-year all-cause mortality or heart failure hospitalization rate (50.9%) than outpatients (36.8%).
  • The findings suggest that hospitalization indicates a poor prognosis, highlighting the need for targeted interventions like mechanical support or heart transplantation for these high-risk patients.
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A panel of 10 experts in obesity from various Latin American countries held a Zoom meeting intending to reach a consensus on the use of anti-obesity medicines and make updated recommendations suitable for the Latin American population based on the available evidence. A questionnaire with 16 questions was developed using the Patient, Intervention, Comparison, Outcome (Result) methodology, which was iterated according to the modified Delphi methodology, and a consensus was reached with 80% or higher agreement. Failure to reach a consensus led to a second round of analysis with a rephrased question and the same rules for agreement.

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Background: The changing demographic of heart failure (HF) increases the exposure to non-cardiovascular (non-CV) events. We investigated the distribution of non-CV mortality/morbidity and the characteristics associated with higher risk of non-CV events in patients with advanced HF.

Methods: Patients from the HELP-HF registry were stratified according to the number of 2018 HFA-ESC criteria for advanced HF.

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Aim: Persistent symptoms despite guideline-directed medical therapy (GDMT) and poor tolerance of GDMT are hallmarks of patients with advanced heart failure (HF) with reduced ejection fraction (HFrEF). However, real-world data on GDMT use, dose, and prognostic implications are lacking.

Methods And Results: We included 699 consecutive patients with HFrEF and at least one 'I NEED HELP' marker for advanced HF enrolled in a multicentre registry.

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Background: The "I Need Help" markers have been proposed to identify patients with advanced heart failure (HF). We evaluated the prognostic impact of these markers on clinical outcomes in a real-world, contemporary, multicenter HF population.

Methods: We included consecutive patients with HF and at least 1 high-risk "I Need Help" marker from 4 centers.

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Aims: Patients with heart failure (HF) with reduced ejection fraction (EF) (HFrEF), mildly reduced EF (HFmrEF), and preserved EF (HFpEF) may all progress to advanced HF, but the impact of EF in the advanced setting is not well established. Our aim was to assess the prognostic impact of EF in patients with at least one 'I NEED HELP' marker for advanced HF.

Methods And Results: Patients with HF and at least one high-risk 'I NEED HELP' criterion from four centres were included in this analysis.

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  • The study focuses on patients with advanced heart failure (HF), specifically analyzing the impact of ischemic etiology on prognosis within this high-risk group, based on the updated 2018 HFA-ESC criteria.
  • Ischemic causes were found to be the most common type of heart failure in patients with both advanced and nonadvanced HF, with statistically significant differences in hospitalization and mortality rates.
  • The research indicates that patients with ischemic heart failure among these groups face a greater risk of death and hospitalization when compared to those with nonischemic causes, emphasizing the need for targeted care strategies.
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The effects of the spatial and temporal variability of environmental factors on viticulture are particularly important in mountainous wine regions due to their complex geomorphology. A typical example is Valtellina, an Italian valley in the middle of the Alpine chain known for its wine production. The aim of this work was to assess the effects of the current climatic conditions on Alpine viticultural production by evaluating the relationship between sugar accumulation, acid degradation, and environmental factors.

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In the last decades, advances in percutaneous coronary intervention (PCI) strategies have significantly reduced the risk of procedural complications and in-hospital mortality of patients with acute coronary syndromes (ACS), thus increasing the population of stable post-ACS patients. This novel epidemiological scenario emphasizes the importance of implementing secondary preventive and follow-up strategies. The follow-up of patients after ACS or elective PCI should be based on common pathways and on the close collaboration between hospital cardiologists and primary care physicians.

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Intra-Aortic Balloon Pump (IABP) efficacy is critically affected by the inflation/deflation timing. Balloon deflation may cause a sucking effect, and a steal phenomenon on carotid flow. Delaying IABP deflation reduces the degree of this flow reversal, but at the same time exposes patients to the risk of increased proto-systolic afterload with detrimental effects on the LV.

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Policies to improve air quality need to be based on effective plans for reducing anthropogenic emissions. In 2020, the outbreak of COVID-19 pandemic resulted in significant reductions of anthropogenic pollutant emissions, offering an unexpected opportunity to observe their consequences on ambient concentrations. Taking the national lockdown occurred in Italy between March and May 2020 as a case study, this work tries to infer if and what lessons may be learnt concerning the impact of emission reduction policies on air quality.

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Background: Left ventricular (LV) remodelling (REM) ensuing after ST-elevation myocardial infarction (STEMI), has typically been studied by echocardiography, which has limitations, or cardiac magnetic resonance (CMR) in early phase that may overestimate infarct size (IS) due to tissue edema and stunning. This prospective, multicenter study investigated LV-REM performing CMR in the subacute phase, and 6 months after STEMI.

Methods And Results: patients with first STEMI undergoing successful primary angioplasty were consecutively enrolled.

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  • The study evaluates the performance of a fourth-generation antigen test for SARS-CoV-2 detection using chemiluminescence immunoassay, comparing it to the more established rt-PCR method, which is known for higher sensitivity and specificity.
  • In a sample of 134 positive and 241 negative rt-PCR test swabs, the immunoassay showed a specificity of 96.7% but a lower sensitivity of only 68.0%, particularly influenced by the viral load present in the samples.
  • The findings suggest that while the antigen test is reliable for identifying negative cases, its sensitivity is less robust than previously thought, with implications for identifying infectious individuals based on viral load.
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Background: Atrial fibrillation (AF) is the most common heart arrhythmia, and its prevalence increases with age. Oral Anticoagulant Therapy (OAT) with non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonists (VKAs) is essential to avoid thromboembolic events in AF. However, this treatment is associated with a high risk of bleeding and low adherence in elderly patients.

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Aim: The pulmonary artery catheter (PAC)-derived cardiac power index (CPI) has been found of prognostic value in cardiogenic shock (CS) patients. The original CPI equation included the right atrial pressure (RAP), accounting for heart filling pressure as a determinant of systolic myocardial work, but this term was subsequently omitted. We hypothesized that the original CPI formula (CPI ) is superior to current CPI for risk stratification in CS.

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