Publications by authors named "Federico Piscione"
Article Synopsis
- The study aimed to explore how sex-related factors affect the management and outcomes of chronic coronary syndromes (CCS).
- It analyzed data from a cohort of 5,070 patients, highlighting differences in diagnostic methods, treatment strategies, and cardiovascular history based on sex.
- Although clinical outcomes after one year were similar for both genders, women reported a significantly worse quality of life compared to men.
Background: Worse outcomes have been reported for women, compared with men, after an acute coronary syndrome (ACS). Whether this difference persists in elderly patients undergoing similar invasive treatment has not been studied. We investigated sex-related differences in 1-year outcome of elderly acute coronary syndrome patients treated by percutaneous coronary intervention (PCI).
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- Type A aortic dissection is a serious surgical emergency with high risks, including a 56% chance of in-hospital mortality without surgery and a 10-20% surgical mortality rate within 30 days.
- The primary treatment goals involve replacing the damaged ascending aorta and monitoring the distal aortic false lumen, with various surgical techniques depending on the condition of the aortic valve.
- A case study showcases the successful use of both the Florida sleeve technique and the Vascutek "Thoraflex" hybrid prosthesis to repair the ascending aorta while preserving the native aortic valve and preparing for future interventions.
Article Synopsis
- Heart Failure (HF) is categorized into three types based on ejection fraction: preserved (HFpEF), mid-range (HFmrEF), and reduced (HFrEF), but the underlying molecular mechanisms remain under-explored.
- This study investigated Sirt1 activity in relation to ejection fraction and other parameters in 70 patients across these HF categories, measuring Sirt1 in blood cells and various biomarkers in plasma.
- Results showed that HFpEF had lower Sirt1 and ACE2 activities compared to HFmrEF and HFrEF, with strong positive correlations between Sirt1 activity and ejection fraction in the latter two groups, suggesting that Sirt1 activity can help differentiate HF phenotypes effectively.
Loeffler's Endocarditis: An Integrated Multimodality Approach.
Maria Vincenza Polito Andreas Hagendorff Rodolfo Citro Costantina Prota Angelo Silverio Federico Piscione
J Am Soc Echocardiogr
December 2020
Loeffler's endocarditis (LE) is the cardiac manifestation of hypereosinophilic syndrome, a rare systemic disease characterized by the sustained production of eosinophils leading to organ damage. Few data, principally by case reports, are available regarding the diagnostic workup in patients with suspected LE. Thus, we have performed a systematic search of the literature dealing with imaging in LE and propose an integrated multimodality imaging approach in the cardiac diagnostics of LE patients.
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- - The study aimed to assess how many heart attack survivors achieve their LDL cholesterol goal of 70 mg/dL, identify factors leading to poor lipid control, and evaluate the use of cholesterol-lowering medications beyond the first year after a heart attack.
- - Out of 903 patients analyzed, only 52.5% reached the LDL-C target, with factors like male sex, hypertension, previous heart intervention, and education level influencing LDL-C levels.
- - The findings show a significant portion of patients still struggle with high LDL-C after a heart attack, especially those with lower education; cholesterol-lowering treatments are not adequately utilized in this high-risk group.
Impact of renal dysfunction and acute kidney injury on outcome in elderly patients with acute coronary syndrome undergoing percutaneous coronary intervention.
Eur Heart J Acute Cardiovasc Care
December 2021
Article Synopsis
- * Out of 1,904 patients studied, a significant portion (57% moderate, 11% severe renal dysfunction) showed higher rates of overall and cardiovascular mortality at the 12-month mark compared to those with no or mild dysfunction.
- * The findings suggest that severe renal dysfunction significantly increases the risk of adverse outcomes, highlighting the need for targeted treatment strategies in this high-risk population.
Article Synopsis
- This study examined how diabetes mellitus (DM) affects prognosis in patients with Infective Endocarditis (IE), analyzing 375 cases from 1994 to 2017.
- It found that diabetic patients were older and had more comorbidities like hypertension and heart failure, showing worse heart function and higher in-hospital mortality compared to non-diabetic patients.
- Long-term results indicated that diabetic patients experienced lower survival rates, with DM being linked to increased risk of death and more complications related to the heart.
Article Synopsis
- The study investigates the effects of moderate and severe aortic stenosis (AS) on the function of the right ventricle (RV) using a detailed tissue Doppler imaging approach to assess RV deformation.
- It compares 50 patients with AS to 25 normal control subjects, measuring several parameters including systolic pulmonary artery pressure and myocardial performance index.
- Findings indicate that patients with AS exhibit significantly altered RV function metrics, highlighting the need for focused RV analysis in echocardiographic assessments of AS severity.
Article Synopsis
- Current guidelines recommend considering dual antiplatelet therapy (DAPT) for more than 12 months in selected myocardial infarction (MI) patients.
- A study analyzed data from the EYESHOT Post-MI trial, looking at how cardiologists choose which MI patients should continue DAPT beyond 1 year.
- Findings showed that factors like multiple stents from percutaneous coronary intervention (PCI) and peripheral artery disease (PAD) often lead to DAPT continuation, while atrial fibrillation is linked to its interruption.
Article Synopsis
- The aging population is leading to more older adults experiencing acute coronary syndrome (ACS), with research showing that early revascularization can still benefit these patients significantly.
- *Despite the benefits, the best antiplatelet therapy (APT) for elderly patients is uncertain due to concerns about safety and effectiveness, largely because of age-related health issues.
- *This paper aims to evaluate current knowledge, identify gaps, and discuss ongoing research about APT for elderly patients with ACS, especially those with additional health conditions like chronic kidney disease and diabetes.
Article Synopsis
- The study investigates the relationship between adipokines, insulin resistance (IR), and ischemic heart disease (IHD) in patients with Normal Glucose Tolerance (NGT) undergoing Percutaneous Coronary Intervention (PCI).
- A total of 54 NGT patients were enrolled after screening 679, with results showing a low rate of restenosis (7.4%) and an average follow-up of 29.5 months.
- Adiponectin levels were linked to lower restenosis risk, while higher IR and adiponectin levels were associated with new IHD and the need for further PCI.
Predictors of outcome in patients with de novo diagnosis of heart failure with reduced ejection fraction: Role of combined myocardial and lung Iodine-123 Meta-Iodobenzylguanidine imaging.
Angelo Silverio Maria Vincenza Polito Leonardo Pace Federica D'Auria Gennaro Vitulano Federico Piscione
J Nucl Cardiol
February 2021
Article Synopsis
- The study investigates predictors for outcomes in patients newly diagnosed with heart failure with reduced ejection fraction (HFrEF), focusing on rehospitalizations and mortality rates over follow-up.
- A total of 84 patients were monitored, with notable incidences of rehospitalization (33 cases), cardiac death (18 cases), and all-cause death (24 cases) during an average of 39.9 months.
- Key findings reveal that factors like Late lung to heart ratio and left ventricular end-systolic volume significantly forecast rehospitalization and mortality, enhancing the ability to predict patient outcomes beyond standard echocardiographic measures.
Aim: To evaluate the long-term outcome of patients with Takotsubo syndrome (TTS) and severely reduced left ventricular ejection fraction (LVEF ≤ 35%) at presentation.
Methods And Results: The study population included 326 patients (mean age 69.5 ± 10.
Article Synopsis
- Elderly patients (aged >74) with acute coronary syndrome experience high rates of ischemic and bleeding complications over time, prompting a study to evaluate these rates with different medications.
- The study analyzed average daily ischemic rates (ADIRs) and average daily bleeding rates (ADBRs) over one year for patients undergoing percutaneous coronary intervention, comparing the effects of low-dose prasugrel and clopidogrel.
- Results indicated that ischemic events were consistently higher than bleeding events, with low-dose prasugrel showing better outcomes by reducing ischemic incidents in the subacute and late phases compared to clopidogrel, while bleeding was less with clopidogrel in the late phase.
Article Synopsis
- Elderly patients with acute coronary syndromes were analyzed based on whether they had ST-elevation myocardial infarction (STEMI) or non-ST-elevation acute coronary syndrome (NSTEACS) during a study of those undergoing percutaneous coronary intervention.
- Out of the 1,443 patients over 75 years old, STEMI patients had better baseline health but a lower heart function compared to NSTEACS patients.
- After a year of follow-up, STEMI patients showed a significantly higher risk of cardiovascular deaths and strokes despite having generally more favorable initial health factors.
Background: The prognostic predictors of outcome in patients with functional mitral regurgitation (FMR) undergoing MitraClip implantation (MCi) are still poorly known. The aim of our study is to identify the baseline predictors of outcome in FMR patients candidate to MCi.
Methods: All patients with symptomatic moderate-to-severe or severe FMR undergoing MCi at our institution were consecutively and prospectively enrolled.
Article Synopsis
- This study examined the long-term survival, clinical status, and heart function changes in patients with severe functional mitral regurgitation who underwent MitraClip treatment, analyzing data from 23 studies involving over 3,200 patients.
- The results showed that in-hospital death rates were low, but mortality increased significantly at 1 month, 6 months, 1 year, and 2 years post-treatment, while most patients had improved mitral regurgitation levels and clinical class upon follow-up.
- Atrial fibrillation was found to negatively impact 1-year survival and heart function recovery after the treatment, highlighting the importance of baseline features on patient outcomes.
Aims: To describe the contemporary management by cardiologists of patients after an episode of myocardial infarction (MI).
Methods: The EYESHOT Post-MI was a prospective, observational, nationwide study aimed to evaluate the management of patients referring to cardiologists 1 to 3 years from the last MI event.
Results: Over a 3-month period, 1633 consecutive patients [median 22 (IQR 15-28) months from MI] were enrolled: 1028 (63.
Article Synopsis
- Dual antiplatelet therapy (DAPT) is essential for treating acute coronary syndromes (ACS), and recent guidelines suggest it should last at least 12 months unless there’s a high risk of bleeding.
- The ongoing debate about DAPT duration arises from studies showing a risk of serious events like strokes after 12 months, indicating that extending DAPT could be beneficial (Long DAPT).
- This position paper aims to address real-life clinical situations that may not be covered by current guidelines, offering recommendations to help clinicians decide on the appropriateness of Long DAPT for their patients.
Article Synopsis
- A meta-analysis of six studies with 2,318 patients evaluated the safety and efficacy of bioresorbable vascular scaffolds (BRS) versus everolimus-eluting metallic stents (EES) in patients with acute coronary syndromes (ACS) undergoing treatment.
- Results showed that patients using BRS had a significantly higher rate of stent or scaffold thrombosis (2.3% vs 1.08%) and target lesion revascularization (3.5% vs 2.5%) compared to those with EES.
- Despite these findings, the overall risk for secondary outcomes like myocardial infarction and cardiac death did not differ significantly between the two groups, suggesting BRS might not be the most effective