Publications by authors named "Giuseppe Ando"
Background: The prospective, single-arm, observational, phase 4 ETNA-AF Europe study collected real-world data about safety, effectiveness and therapeutic adherence in European patients with non-valvular atrial fibrillation newly prescribed with edoxaban and followed up for 4 years.
Methods: Overall, 13 164 patients were included in the full-analysis set, which means that they had at least one documentation after baseline at 4 years. The current paper reports about the 3329 Italian patients out of the whole European population.
Article Synopsis
- Acute coronary syndromes (ACS) represent a major challenge in cardiovascular healthcare, even with improvements in treatment and understanding in recent years.
- ACS includes a range of conditions related to sudden, reduced blood flow to the heart, leading to serious health complications.
- Ongoing research and development are crucial for further advancements in diagnosing and managing these conditions effectively.
In acute myocardial infarction (AMI), the urgency of coronary revascularization through percutaneous coronary intervention (PCI) is paramount, offering notable advantages over pharmacologic treatment. However, the persistent risk of adverse events, including recurrent AMI and heart failure post-revascularization, underscores the necessity for enhanced strategies in managing coronary artery disease. Traditional angiography, while widely employed, presents significant limitations by providing only two-dimensional representations of complex three-dimensional vascular structures, hampering the accurate assessment of plaque characteristics and stenosis severity.
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- * Treatment for obstructive CAD focuses on reducing heart events and symptoms, while INOCA requires addressing functional changes in coronary circulation.
- * A precise diagnosis in patients with INOCA is vital for personalized treatment, and the paper emphasizes combining coronary revascularization, medication, and lifestyle changes for effective angina management.
Article Synopsis
- Primary percutaneous coronary intervention (PCI) is the preferred method for treating acute ST-elevation myocardial infarction (STEMI), helping to restore blood flow in blocked arteries.
- Some patients, however, suffer from a 'no-reflow' phenomenon, where blood flow remains compromised despite the artery being opened, usually due to microvascular obstruction from thrombus or plaque.
- There is no clear consensus on preventing or treating no-reflow, and while various medications are used, they only improve blood flow for certain patients; a new idea involving low-dose fibrinolysis during PCI shows promise for enhancing recovery.
Article Synopsis
- International guidelines recommend using direct oral anticoagulants (DOAC) over vitamin K antagonists (VKA) and dual antithrombotic therapy (DAT) over triple antithrombotic therapy (TAT) for patients on oral anticoagulant therapy undergoing percutaneous coronary intervention (PCI) with stents.
- A study involving 1234 patients on oral anticoagulants assessed the outcomes of DOAC versus VKA and DAT versus TAT, focusing on net adverse clinical events (NACE) at a one-year follow-up.
- Results showed DOAC resulted in a lower NACE rate compared to VKA (16% vs 23%), and while DAT and TAT had similar NACE rates, DAT led to
Article Synopsis
- * It can be linked to conditions like subvalvar aortic stenosis, bicuspid aortic valve, or aortic coarctation.
- * Using various imaging techniques is crucial for evaluating the mitral apparatus properly.
Background: The FIRE trial (Functional Assessment in Elderly Myocardial Infarction Patients With Multivessel Disease) enrolled 1445 older (aged ≥75 years) patients with myocardial infarction and multivessel disease in Italy, Spain, and Poland. Patients were randomized to physiology-guided complete revascularization or treatment of the only culprit lesion. Physiology-guided complete revascularization significantly reduced ischemic adverse events at 1 year.
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- The study investigates the "smoker's paradox," where smoking patients with ST segment elevation myocardial infarction (STEMI) appear to have better outcomes compared to non-smokers after treatment.
- Out of 2,546 STEMI patients, 1,007 (41%) were current smokers, who were generally younger and experienced significantly lower in-hospital and 1-year mortality rates.
- The findings suggest that while younger age may partly explain the better outcomes for smokers, smoking habits still independently contribute to reduced mortality after percutaneous coronary intervention (PCI).
Article Synopsis
- This study examines the impact of starting PCSK9 inhibitors (PCSK9i) at the time of hospitalization for acute coronary syndrome (ACS) on lipid levels and cardiovascular (CV) events in a real-world setting.
- It analyzed data from 771 ACS patients, revealing that a significant 68.3% achieved the target LDL-C of < 55 mg/dL within a median of 37 days after hospitalization.
- Results showed that lower LDL-C levels were associated with reduced risks of major cardiovascular events, suggesting that early and aggressive lipid management with PCSK9i is both safe and beneficial for ACS patients.
Article Synopsis
- Patients with high bleeding risk (HBR) following a myocardial infarction (MI) face poor outcomes, and it's uncertain if they benefit from complete revascularization.
- The study aimed to compare the outcomes of physiology-guided complete revascularization versus a culprit-only strategy for HBR patients with MI and multivessel disease.
- Results showed that HBR patients had a higher risk of complications, but those who underwent complete revascularization experienced significantly better outcomes, reducing primary endpoint events.
Article Synopsis
- Acute coronary syndromes (ACS) include serious heart conditions like STEMI and NSTE-ACS, posing significant challenges in treatment due to their complex nature and impacts on health.
- The 2023 European Society of Cardiology (ESC) guidelines for managing ACS highlight updates in treatment timing, patient assessment strategies, and various advanced imaging techniques to improve diagnostic accuracy.
- These guidelines also suggest personalized approaches in antiplatelet therapy and introduce low-dose colchicine, while noting that there are still areas for improvement in adopting personalized care and technology in ACS management.
Social media: Are Twitter/X influencers in cardiology really influencing?
Int J Cardiol Heart Vasc
February 2024
Article Synopsis
- This study looked at how well different online tools (called interaction checkers) agree on drug interactions with certain medications known as DOACs.
- The researchers checked how well these tools identified potential problems when these drugs are taken with others and how they ranked the seriousness of these problems.
- They found that the tools didn’t agree very much, which means we need to find better ways to track and study these interactions in real life.
Article Synopsis
- A study investigates whether P2Y inhibitor monotherapy (P2Y-I) is more effective than aspirin after stopping dual antiplatelet therapy (DAPT) in patients who underwent percutaneous coronary intervention (PCI).
- The updated meta-analysis includes three direct comparisons between P2Y-I and aspirin, revealing that P2Y-I leads to a 39% lower risk of myocardial infarction without an increase in bleeding risk.
- Results suggest that P2Y-I provides a safer option for preventing heart attacks compared to aspirin, though clinicians should carefully choose which patients might benefit the most from this treatment.
Article Synopsis
- * A case is presented involving a 47-year-old man who, six years after BVS implantation for a heart attack, showed restenosis and two coronary aneurysms detected through CT angiography; he was successfully treated with a metallic drug-eluting stent.
- * The discussion emphasizes that coronary aneurysms can often be asymptomatic and highlights the uncertainty around their occurrence after BVS, stressing the need for individualized treatment strategies based on each patient's specific conditions.
Article Synopsis
- * Triple antithrombotic therapy (TAT), consisting of dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC), is used for a short period post-PCI but is followed by a transition to dual antithrombotic therapy (DAT) to reduce bleeding risks.
- * The review examines evidence from clinical trials regarding the best post-procedural antithrombotic strategies for AF patients undergoing PCI, particularly considering factors like age and existing health conditions that affect treatment
Article Synopsis
- Pulmonary embolism (PE) is a serious health issue that can be life-threatening, especially in patients at high risk, who need immediate treatment to avoid worsening conditions or death.
- Recovery from PE can lead to long-term complications, including recurrent cases, bleeding, and psychological issues, which necessitates better management strategies.
- The paper emphasizes the importance of catheter-directed therapies for unstable PE patients, as these offer quicker and safer recovery options compared to traditional treatments, highlighting the need for a patient-centered approach in managing risk and treatment.