Design of the PERSEO Registry on the management of patients treated with oral anticoagulants and coronary stent.

Aim: Percutaneous coronary intervention with stent implantation (PCI-S) in patients requiring chronic oral anticoagulant therapy (OAC) is associated with an increased risk of bleeding and ischemic complications. Different randomized studies showed a significant advantage of a double antithrombotic therapy and superiority of direct oral anticoagulant (DOAC) compared with warfarin, but real-world data are limited. Aim is to evaluate the antithrombotic management and clinical outcome of patients with an indication for OAC who undergo PCI-S in a 'real-world' setting.

Anomalous right coronary artery origin from pulmonary artery associated with aortic stenosis, mitral regurgitation, and Vieussens' arterial ring: a very rare association and case.

We report a very rare case of anomalous origin of the right coronary artery from the pulmonary artery associated with severe aortic stenosis, severe mitral regurgitation, and Vieussens' arterial ring (VAR). Diagnosis was made accidentally during preoperative coronary angiography and confirmed by multidetector computed tomography. Surgery was performed with aortic valve replacement, mitral valve annuloplasty, right coronary artery reimplantation into the ascending aorta, and VAR resection.

[Periprocedural management of anticoagulation therapy and in-hospital outcomes in patients with warfarin indication undergoing percutaneous coronary intervention. Data from the WAR-STENT registry].

Background: In patients with an indication for oral anticoagulation (OAC) with warfarin, the management of OAC peri-procedure of percutaneous coronary intervention (PCI) is still not fully defined. To investigate clinical practice and outcomes associated with continuation vs interruption of OAC, with or without bridging with low-molecular-weight heparin (LMWH), we examined the database of the observational, prospective, multicenter Italian WAR-STENT registry.

Methods: The WAR-STENT registry was conducted in 2008-2010 in 37 Italian centers and included 411 consecutive patients in 157 of whom the peri-procedural international normalized ratio (INR) value was available.

Outcome of patients on oral anticoagulation undergoing coronary artery stenting: data from discharge to 12 months in the Warfarin and Coronary Stenting (WAR-STENT) Registry.

Objectives: To obtain further, and more focused, information on the efficacy and safety of the antithrombotic regimens, including triple therapy (TT) of warfarin, aspirin, and clopidogrel; dual therapy (DT) of warfarin and single antiplatelet agent (aspirin or clopidogrel); and dual-antiplatelet therapy (DAPT) of aspirin and clopidogrel, prescribed to patients on oral anticoagulation (OAC) undergoing percutaneous coronary intervention with stent (PCI-S).

Background: The true efficacy and safety of TT, DT, and DAPT in OAC patients undergoing PCI-S is largely undefined.

Methods: We analyzed the database of the prospective, multicenter WARfarin and coronary STENTing (WAR-STENT) registry (ClinicalTrials.

Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry.

Aims: The aim of the study is to describe the course of the echocardiographically measured pulmonary artery systolic pressure (PAsP) in a series of patients included in the Italian Pulmonary Embolism Registry (IPER).

Methods: Patients with confirmed PE received an echo-Doppler evaluation within 24 hours from hospital admission and after one year. Pulmonary hypertension (PH) was considered "likely" , "possible" or "unlikely" with a right ventricular-right atrial (RV-RA) pressure gradient>45 mm Hg, between 32 and 45 mm Hg and ≤31 mm Hg and no additional echocardiographic variables suggestive of PH, respectively.

Acute pulmonary embolism: external validation of an integrated risk stratification model.

Background: In hemodynamically stable patients with acute pulmonary embolism, risk stratification is essential to drive clinical management. In these patients, risk stratification for in-hospital adverse outcomes based on markers of right ventricular dysfunction and injury has been proposed.

Methods: The aim of this study was to validate a model based on the incremental prognostic value of right ventricular dysfunction and injury in hemodynamically stable patients with acute pulmonary embolism.

Pheochromocytoma mimicking a non-ST elevation acute myocardial infarction.

We report a 57 year-old male patient admitted with a diagnosis of non-ST elevation acute myocardial infarction. He had suffered from chest pain, diaphoresis and intense asthenia for three days. The electrocardiogram on admission showed a high frequency sinus tachycardia.

Electrocardiographic abnormalities mimicking myocardial infarction in a patient with intracranial haemorrhage: a possible pitfall for prehospital thrombolysis.

The electrocardiogram, when applied in the prehospital setting, has a significant effect on a patient with chest pain. The potential effect includes both diagnostic and therapeutic issues, including the diagnosis of acute myocardial infarction and the indication for thrombolysis or invasive procedures. We report the case of a man who suffered from a syncope, with a prehospital electrocardiogram showing prominent ST-segment elevation.

Successful treatment of post-exertion acute myocardial infarction by primary angioplasty and stenting in a patient with antiphospholipid antibody syndrome.

Antiphospholipid syndrome is a disorder characterized by arterial and venous thromboses, thrombocytopaenia and stroke. Acute myocardial infarction is rarely associated with this syndrome. The treatment of these patients is a clinical challenge.

[Type A acute aortic dissection presenting as mental status confusion: is it an atypically really uncommon presentation?].

The most common initial symptom of acute aortic dissection is chest or abdominal pain. Nevertheless, in a minority of cases, it may have an atypical presentation, making the diagnosis clinically challenging. This article reports on a case of acute type A aortic dissection presenting as mental status confusion.

A rare cause of cardiogenic shock: catecholamine cardiomyopathy of pheochromocytoma.

Pheochromocytoma is a rare catecholamine secreting tumor that accounts for about 0.04% of cases of hypertension. Other less common cardiovascular manifestations such as arrhythmias, angina pectoris, acute myocardial infarction, dilated cardiomyopathy, acute heart failure, and cardiogenic shock have occasionally been reported.

[Transesophageal echocardiography diagnosis of ruptured aneurysm of the Valsalva sinus associated with aneurysm of the interatrial septum].

Aneurysms of the sinus of Valsalva are uncommon heart defects that often remain undetected unless rupture occurs. They have been reported in association with other cardiac anomalies. The present case report deals with a 51-year-old man who was referred to our division with a diagnosis of recent-onset progressive heart failure.