Publications by authors named "Chirillo F"
Outcome data on using cangrelor in older patients are limited. This post hoc analysis of the itAlian pRospective Study on CANGrELOr (ARCANGELO) study aims to assess bleeding and ischemic outcomes with the transition from cangrelor to any oral P2Y inhibitors in age-stratified subgroups (≥75 years-older, <75 years-younger) of patients with acute coronary syndrome who underwent percutaneous coronary intervention (PCI). Of 995 patients, 215 (21.
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- - The study aimed to assess how the presence of raphe (a type of anatomical feature) in patients with bicuspid aortic valve (BAV) correlates with valve dysfunction, aortopathy, and the likelihood of needing aortic valve surgery.
- - Researchers analyzed 695 BAV patients, finding that those with raphe experienced more moderate to severe aortic stenosis and a higher prevalence of aortopathy, particularly Type B, compared to those without raphe.
- - The results indicated that having raphe significantly raises the odds of requiring aortic valve surgery within three years, highlighting the importance of monitoring patients with this anatomical feature.
Article Synopsis
- The ARCANGELO study evaluates the safety and effectiveness of cangrelor, an intravenous P2Y inhibitor, in patients with acute coronary syndrome (ACS) during and after percutaneous coronary intervention (PCI) while transitioning to oral P2Y inhibitors.
- In the study, 995 out of 1004 analyzed patients had a high percentage of ST-segment elevation myocardial infarction, with most undergoing PCI via radial access and receiving drug-eluting stents; bleeding events were low at 5.2% within 30 days post-procedure.
- The findings confirm that cangrelor is a safe and effective option for ACS patients undergoing PCI, with successful transition to oral P2
Background: During the COVID-19 pandemic, the risk of SARS-CoV-2 infection, the public health measures of social distancing, the freedom limitations, quarantine, and the enforced homeworking under the lockdown period, as well as medical causes including COVID-19 infection per se, may have caused major emotional distress, especially in the most vulnerable patients. We aimed to evaluate the variations in the number of admissions due to Takotsubo syndrome (TTS) during the COVID-19 pandemic in the Veneto region. Methods: We retrospectively reviewed and analyzed the number of admissions because of TTS in 13 Divisions of Cardiology located in the Veneto region, the northeastern area of Italy, covering a population of more than 2.
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- The study analyzed hospitalization trends for acute coronary syndrome (ACS) and other acute cardiovascular conditions in the Veneto Region of Italy during the COVID-19 pandemic, comparing data from 2020 to data from 2018 and 2019.
- Researchers found a significant reduction in ACS cases by 27.3% to 32% during the pandemic compared to the historical data, and a similar decrease of 36.5% to 40.6% in acute cardiovascular hospitalizations.
- The study concluded that this decline in hospitalizations could lead to undiagnosed cardiovascular issues, which may increase future morbidity and mortality rates for these conditions.
Article Synopsis
- Intravenous drug users (PWIDs) accounted for 9% of the 677 patients with infective endocarditis (IE) studied in an Italian registry, with most being middle-aged males and having significant comorbidities like HIV and chronic liver disease.* -
- The majority of IE cases in PWIDs affected native heart valves, with echocardiographic diagnoses supported by the presence of vegetation in almost 92% of cases, while Staphylococcus aureus was the predominant microorganism isolated.* -
- Surgery was performed on about half of the PWID patients, primarily involving aortic and mitral valves, and those with right-sided IE generally showed a better prognosis and lower need for surgical interventions.*
Background: The itAlian pRospective Study on CANGrELOr (ARCANGELO) was aimed to assess the safety of using cangrelor during percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) in the daily practice.
Hypothesis: The safety of cangrelor after the transition to oral P2Y12 inhibitors was evaluated as the incidence of bleeding outcomes in the 30 days following PCI according to postauthorization safety study guidelines.
Methods: Adults with ACS who were treated with cangrelor in one of the 28 centers involved in the study.
Article Synopsis
- * In a study of 718 BAV patients followed for over 7 years, the average growth rates were found to be 0.23 mm/year for the aortic root and 0.43 mm/year for the ascending aorta.
- * Key factors influencing the progression of aorta dilation and valve dysfunction included male sex, hypertension, the presence of raphe, and pre-existing valvular issues, highlighting the need for proactive management of cardiovascular health in these patients.
Article Synopsis
- - The condition described is a
- rare heart defect known as Secundum ASD, which involves a large, multi-hole atrial septal aneurysm (ASA) and a double atrial septum.
- - Effective treatment for this type of defect relies heavily on advanced and innovative device technologies.
- - Such technology plays a crucial role in successfully closing these complex septal defect variations.
Challenges in the diagnosis of peripartum cardiomyopathy: a case series.
Eur Heart J Case Rep
February 2021
Article Synopsis
- Peripartum cardiomyopathy (PPCM) is a form of heart failure that can present in various ways, making diagnosis difficult.
- A case series of four patients with PPCM illustrated distinct presentations, including left ventricular dysfunction, thromboembolism, myocardial infarction with no coronary blockages, and sustained ventricular tachycardia.
- Timely clinical assessments and advanced imaging techniques are crucial for accurate diagnosis and treatment of PPCM.
Despite significant diagnostic and therapeutic improvements, infective endocarditis (IE) still carries high morbidity and mortality. In the last three decades, significant variations in epidemiological and clinical profile of IE have been observed. The diagnosis of IE requires an adequate clinical suspicion, given its pleomorphic presentation.
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- The 2015 ESC guidelines emphasize the importance of a multidisciplinary team approach for managing infective endocarditis, involving various health professionals and imaging techniques.
- The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) created a position paper to promote the establishment of Endocarditis Teams within Italy's hospital network, highlighting their role in patient care.
- The proposal suggests a network of 'functional' reference centers linking to 'structural' centers, along with criteria for these centers, while ongoing studies aim to analyze the outcomes and costs of this collaborative model.
Background: Bicuspid aortic valve (BAV) is the most common congenital heart disease, affecting 0.5%-2% of the general population. It is associated not only with notable valvular risk (aortic stenosis and/or regurgitation, endocarditis) but also with aortopathy with a wide spectrum of unpredictable clinical presentations, including aneurysmal dilation of the aortic root and/or ascending thoracic aorta, isthmic coarctation, aortic dissection, or wall rupture.
View Article and Find Full Text PDF[Appropriateness in Cardiology: a statement of the ANMCO Veneto Region].
G Ital Cardiol (Rome)
January 2018
Article Synopsis
- * This problem often stems from a lack of knowledge about guidelines, a defensive medicine mindset, or repeated requests from patients and families.
- * A collaborative effort among cardiologists in the Veneto Region of Italy has produced guidelines for follow-up on common cardiovascular diseases, focusing on appropriate strategies and scientific evidence to help address issues of test inappropriateness and economic viability.
Mortality and timing of surgery in the left-sided infective endocarditis: an Italian multicentre study.
Interact Cardiovasc Thorac Surg
April 2018
Article Synopsis
- This study compares early surgery (within 2 weeks of diagnosis) to late surgery/medical therapy for patients with left-sided infective endocarditis, aiming to assess survival outcomes.
- An analysis of 502 patients revealed that early surgery did not significantly reduce mortality risk compared to late surgery, despite some differences in patient characteristics and conditions.
- The study concludes that while early surgery may not show a clear survival benefit, further randomized trials are necessary before making changes to current treatment practices.
Article Synopsis
- The study investigates the prevalence of predisposing cardiac conditions (PCC) in patients with infective endocarditis (IE) and the effectiveness of antibiotic prophylaxis (AP) during invasive procedures.* -
- Out of 677 patients examined, 341 had PCC, with only a small number undergoing dental procedures, and most had worse outcomes related to nondental procedures.* -
- The findings suggest that the role of AP in preventing IE is limited, as the majority of cases did not stem from dental work, and patients with nondental procedures faced higher surgical and hospital mortality rates.*
Article Synopsis
- A 74-year-old woman with a history of hypertension presented with shortness of breath but no cough or fever.
- An ECG revealed she had atrial fibrillation with a rapid response, prompting a transoesophageal echocardiogram to check for blood clots before cardioversion.
- The echocardiogram showed an unusual echogenic structure near the left atrium, raising a question about the potential diagnosis, with options including endocarditis, thrombus, myxoma, or pulmonary embolism.
Article Synopsis
- The study investigates changing trends in infective endocarditis (IE) in Italy, highlighting an increase in cases among older patients with health issues and medical devices.
- Data was collected from 17 centers, enrolling 677 patients, primarily male with a median age of 62; common causes included Staphylococcus aureus and enterococci.
- The research indicates a shift towards atypical symptom presentation and a notable 14% in-hospital mortality rate, emphasizing the need for updated clinical approaches to manage IE.
Article Synopsis
- Postpericardiotomy syndrome, postoperative atrial fibrillation (AF), and effusions can lead to higher health care costs after cardiac surgery, but colchicine may help reduce these issues.
- This study was a double-blind, placebo-controlled trial involving 360 cardiac surgery patients across 11 Italian centers, assessing the effectiveness of colchicine taken before and after surgery.
- Results showed that there was a significant reduction in postpericardiotomy syndrome for those taking colchicine (19.4% vs. 29.4% for placebo), but no major difference in rates of postoperative AF or effusions between the two groups.
Management of patients with infective endocarditis by a multidisciplinary team approach: an operative protocol.
J Cardiovasc Med (Hagerstown)
September 2013
Article Synopsis
- Infective endocarditis continues to be a severe condition with high rates of illness and death, despite advancements in medical diagnostics and treatments.
- The disease's poor outcomes may be linked to evolving patient demographics, new aggressive pathogens, and inadequate use of diagnostic tools and therapies.
- A proposed solution is a formal multidisciplinary approach involving specialists from various fields to enhance the management and adherence to guidelines, potentially improving patient outcomes.
Article Synopsis
- * The introduction of a formal policy in 2003 allowed for quicker evaluations and timely surgeries within 48 hours for high-risk patients, leading to better outcomes compared to the period when no such policy was in place (1996-2002).
- * The study indicated that even with older patients and those with more co-morbidities in the later period, the health care team's coordinated efforts decreased hospital mortality from 28% to 13% and improved survival rates over three years from 34% to 16%.
Article Synopsis
- - The study evaluated the effectiveness of a multidisciplinary approach introduced in 2003 for treating prosthetic valve endocarditis (PVE), involving a team of specialists who rapidly assessed and treated patients.
- - Comparison between two time periods showed that post-2003, patients were diagnosed earlier, had fewer severe complications, and experienced a significant decrease in both in-hospital and 3-year mortality rates.
- - The collaborative treatment model resulted in more patients being successfully treated with medication alone, highlighting the benefit of structured care for those with PVE.