Publications by authors named "De Felice Francesco"

Background: Prompt reperfusion is critical for patients with ST-segment elevation myocardial infarction (STEMI) to improve outcomes. Yet, variability in regional healthcare delivery may influence treatment times and patient outcomes. We thus aimed at evaluating differences in management and outcomes of STEMI patients across Northern, Central, and Southern Italy, focusing on time-dependent reperfusion and in-hospital logistics.

View Article and Find Full Text PDF
Article Synopsis
  • Plasma metabolomics analysis was conducted on 44 patients with relapsed/refractory B-cell non-Hodgkin lymphoma who were treated with CD19.CAR-T cell therapy, examining various time points before and after treatment.
  • At pre-lymphodepletion, a specific metabolic profile indicated poor outcomes, with high levels of lipoproteins and lactate linked to elevated lactate dehydrogenase.
  • By day 30, two patient clusters were identified: one group experienced long-term remission, while the other, with higher N-GlycA levels, was prone to relapse within a year, suggesting that pro-inflammatory shifts may be associated with relapse risk.
View Article and Find Full Text PDF
Article Synopsis
  • Tethering is a common issue in mitral valve problems, often seen in patients with serious regurgitation, but its true effects on treatment outcomes are not well understood.
  • A study involving over 2,200 patients found that while those with tethering had higher initial rates of cardiac death and rehospitalization, after adjusting for other factors, tethering did not significantly impact long-term outcomes.
  • Consequently, the study suggests that having tethering should not prevent suitable patients from undergoing transcatheter edge-to-edge repair (TEER) for mitral valve issues.
View Article and Find Full Text PDF
Article Synopsis
  • A study collected data from 2,626 patients who underwent Transcatheter Aortic Valve Replacement (TAVR) in Italy from 2007 to 2017, focusing on those with normal or reduced Left Ventricular Ejection Fraction (LVEF).
  • Reduced LVEF patients were further divided into ischemic and nonischemic groups, with the main goal being to track all-cause death and rehospitalizations over 8 years.
  • Results showed that patients with reduced LVEF faced a higher risk of death and rehospitalizations, particularly those with an ischemic cause, highlighting the long-term challenges for these patients post-TAVR.
View Article and Find Full Text PDF
Article Synopsis
  • Transcatheter mitral edge-to-edge repair (TEER) is a minimally invasive option for treating severe mitral regurgitation in patients with high surgical risk, but there are concerns regarding the risk of cerebrovascular accidents (CVAs) after the procedure.
  • In a study of 2,238 patients, the incidence of CVAs was found to be low at 1.47%, with the majority occurring after hospital discharge and linked to preexisting conditions like atrial fibrillation and renal dysfunction.
  • While CVAs did not significantly increase the risk of long-term or cardiac death, the study suggests the need for proactive antithrombotic therapy for patients at higher risk before and after TEER.
View Article and Find Full Text PDF

Background And Aims: Transcatheter aortic valve replacement (TAVR) determined a paradigm shift in the treatment of patients with severe symptomatic aortic stenosis but data on very long-term durability are lacking. We sought to evaluate the clinical and hemodynamic outcomes of the CoreValve porcine pericardial self-expanding bioprosthesis at 12-year follow-up.

Methods: 882 inoperable or high-risk patients were treated with the CoreValve bioprosthesis in 8 Italian high-volume centers between 2007 and 2011.

View Article and Find Full Text PDF
Article Synopsis
  • Researchers studied how heart failure (HF) affects death rates in patients getting a special heart valve repair called M-TEER, focusing on a condition called secondary mitral regurgitation (SMR).
  • They found that patients with advanced HF (serious heart problems) had a higher chance of dying in the next two years, but those who got much better SMR results had lower death risks.
  • The results showed that improving SMR is important for all patients, whether their heart failure is advanced or not, as it can help them live longer.
View Article and Find Full Text PDF
Article Synopsis
  • * Data from the GIOTTO registry was analyzed, focusing on 657 DMR patients divided based on their EuroSCORE risk level; results indicated higher all-cause mortality associated with a EuroSCORE of 4% or more, as well as specific health factors like low left ventricular ejection fraction.
  • * The findings revealed that over half of the patients with DMR had a low EuroSCORE, and successful M
View Article and Find Full Text PDF

BACKGROUNDPredicting immune effector cell-associated neurotoxicity syndrome (ICANS) in patients infused with CAR T cells is still a conundrum. This complication, thought to be consequent to CAR T cell activation, arises a few days after infusion, when circulating CAR T cells are scarce and specific CAR T cell-derived biomarkers are lacking.METHODSCAR+ extracellular vesicle (CAR+EV) release was assessed in human CD19.

View Article and Find Full Text PDF
Article Synopsis
  • Minimally invasive mitral valve repair using the MitraClip device shows beneficial outcomes in patients with significant mitral regurgitation, including those who have had prior valve repairs.
  • A study involving 2,238 patients highlighted that while device and procedural success rates are slightly lower for those with previous valve procedures, overall outcomes such as death and rehospitalization rates remain similar across groups.
  • The findings suggest that transcatheter edge-to-edge repair is a viable option for carefully selected patients even after previous mitral valve interventions.
View Article and Find Full Text PDF
Article Synopsis
  • Transcatheter edge-to-edge repair (TEER) is an effective, minimally invasive method for treating significant mitral regurgitation and has seen advancements in device technology, specifically the NT, NTr, and XTr MitraClip devices.
  • A study analyzed data from a large patient registry to compare these devices, focusing on patient outcomes after the procedure, specifically looking at complications and hospital discharge.
  • Results showed that while the NT group faced worse outcomes initially, adjusted analyses indicated no significant differences in long-term results among the devices, suggesting that newer MitraClip devices provide better outcomes even when used on patients with more complex cases.
View Article and Find Full Text PDF
Article Synopsis
  • The study focused on primary mitral regurgitation (PMR) and how cardiac remodeling affects patient selection for transcatheter edge-to-edge repair (TEER).
  • Researchers analyzed data from 654 patients with PMR, looking at extra-mitral valve (MV) cardiac involvement and tracking outcomes over two years.
  • Results showed that patients with left or right heart involvement had significantly worse survival rates compared to those with no cardiac involvement, highlighting the importance of assessing cardiac involvement for better risk stratification.
View Article and Find Full Text PDF

Atrial functional mitral regurgitation (aFMR) has a peculiar pathophysiology that may have distinctive outcomes. We investigated the impact of transcatheter edge-to-edge repair in aFMR compared with other FMR etiologies. The GIOTTO (GIse registry Of Transcatheter treatment of MR) is a multicenter, prospective study enrolling patients with symptomatic MR treated with MitraClip up to 2020.

View Article and Find Full Text PDF

Limited data are available about the impact of permanent pacemaker (PPM) implantation on long-term survival in patients with a bicuspid aortic valve (BAV) and severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR). We aimed to evaluate the long-term clinical outcomes of patients with BAV with AS who underwent periprocedural PPM implantation after TAVR with a self-expandable prosthesis. Data from patients with BAV and severe AS who underwent TAVR between April 2009 and January 2022 and followed in the framework of the One Hospital ClinicalService-CoreValve Project were collected.

View Article and Find Full Text PDF
Article Synopsis
  • * 443 patients were enrolled, with no significant differences in the rates of serious heart issues like cardiac death and heart attacks between the ACS and CCS groups after 12 months.
  • * Both groups showed similar rates of bleeding complications, indicating that a 1-month DAPT approach is safe for HBR patients undergoing PCI with a specific type of stent (BP-EES).
View Article and Find Full Text PDF

Symptoms of aortic stenosis (AS) are not proportional to its severity and patients with very severe AS (VSAS) remain asymptomatic for a long time. The appropriate time for intervention in patients with VSAS and the effects of transcatheter aortic valve implantation (TAVI) on left ventricular hypertrophy (LVH) remain debated. Our aim was to compare the procedural and 30-day outcomes of TAVI between patients with VSAS and patients with severe AS (SAS) and the changes in LVH.

View Article and Find Full Text PDF

Despite the growing experience with MitraClip in the broad spectrum of mitral regurgitation (MR), limited data are available regarding the independent prognostic role on survival of different mitral regurgitation etiology subtypes. We sought to evaluate the impact of flail leaflet etiology in a large series of patients with primary MR (PMR) who underwent MitraClip treatment. The study included 588 patients with significant PMR from the multicenter GIOTTO (Italian Society of Interventional Cardiology [GIse] registry Of Transcatheter treatment of mitral valve regurgitaTiOn), stratified into 2 groups according to MR etiology: flail (n = 300) and flail (n = 288).

View Article and Find Full Text PDF

Background: The clinical impact of coronary artery disease (CAD) on the prognosis of patients undergoing MitraClip implantation is still unclear.

Methods: One thousand nine hundred fifty-three patients undergoing MitraClip implantation included in the multicenter GIOTTO Registry were stratified according to CAD. Endpoints were all-cause death, cardiac death, and re-hospitalization for heart failure at follow-up (median 15.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigated the link between high postprocedural mean gradient (ppMG) and clinical events in patients with degenerative mitral regurgitation (DMR) after undergoing mitral valve transcatheter edge-to-edge repair (MV-TEER).
  • It included 371 patients and analyzed their outcomes based on different levels of ppMG, finding that while high ppMG alone wasn’t a strong predictor of adverse events, it was linked to increased residual mitral regurgitation (rMR).
  • The combination of elevated ppMG and significant rMR was associated with a higher risk of negative clinical outcomes, highlighting the importance of examining both factors together for patient prognosis.
View Article and Find Full Text PDF

Background: A risk score was recently derived from the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial. However, external validation of this score is still lacking.

Aims: We aimed to validate the COAPT risk score in a large multicentre population undergoing mitral transcatheter edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR).

View Article and Find Full Text PDF

Purpose Of Review: Several studies showed that age alone should not be used as an arbitrary parameter to exclude patients from allogeneic hematopoietic cell transplantation (HCT). The accessibility to allogeneic HCT programs for older patients with hematological diseases is growing up constantly. The Center for International Blood and Marrow Transplant Research has recently shown that over 30% of allogeneic HCT recipients are at least 60 years old and that nearly 4% are aged 70 or more.

View Article and Find Full Text PDF

Disease relapse represents by far the most frequent cause of hematopoietic cell transplantation (HCT) failure. Patients with acute leukemia suffering relapse after HCT have limited conventional treatment options with little possibility of cure and represent, de facto, suitable candidates for the evaluation of novel cellular and biological-based therapies. Donor lymphocyte infusions (DLI) has been one of the first cellular therapies adopted to treat post HCT relapse of acute leukemia patients and still now, it is widely adopted in preemptive and prophylactic settings, with renewed interest for manipulated cellular products such as NK-DLI.

View Article and Find Full Text PDF

Up to half of real-world patients with secondary mitral regurgitation who underwent transcatheter edge-to-edge repair (TEER) do not meet the highly selective COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) criteria. No randomized trials or standardized and validated tools exist to evaluate the risk: benefit ratio of TEER in this specific population. We sought to derive and externally validate a clinical risk score to predict the risk of death or heart failure (HF) hospitalization for COAPT-ineligible patients who underwent TEER (CITE score).

View Article and Find Full Text PDF