Publications by authors named "Leonardo Grisafi"
Background: The PRAISE (PRedicting with Artificial Intelligence riSk aftEr acute coronary syndrome) score is a machine learning-based model for predicting 1-year adverse cardiovascular or bleeding events in patients with acute coronary syndrome (ACS). Its role in predicting arrhythmic complications in ACS remains unknown.
Methods: Atrial fibrillation (AF) and ventricular arrhythmias (VA) were recorded by continuous electrocardiographic monitoring until discharge in a cohort of 365 participants with ACS prospectively enrolled.
Pulmonary embolism in the post-partum period is a critical condition with significant implications for maternal and infant health. We present a case report illustrating the challenges in the clinical management of a patient with intermediate-high risk pulmonary embolism who developed signs of hemodynamic instability in light of current clinical practice.
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- Postoperative atrial fibrillation (POAF) is a frequent complication after heart surgery and is linked to worse health outcomes, highlighting the need for early identification of at-risk patients.* -
- The study examined left atrial strain parameters through preoperative echocardiography in patients undergoing coronary artery bypass graft surgery, finding that a global peak atrial longitudinal strain (PALS) value below 28% significantly indicates a higher risk of developing POAF.* -
- Among 310 patients, those with PALS <28% had a 51% incidence of POAF, compared to 14% for those with PALS ≥28%, suggesting that assessing PALS can help target patients for preventive measures and closer monitoring.*
Article Synopsis
- Echocardiographic Pulmonary to Left Atrial Ratio (ePLAR) is a non-invasive method to evaluate pulmonary function and assess the risk of mortality in COVID-19 patients.
- A study of 100 COVID-19 patients in Italy found that those with ePLAR values over 0.28 m/s had a higher, though not statistically significant, rate of in-hospital death compared to those with lower values (27% vs. 10.8%).
- The research indicates that elevated ePLAR, particularly when combined with high pulmonary arterial pressure, can help identify patients at greater risk of death, suggesting the importance of early ePLAR assessment in hospital settings.
Safety and efficacy of very low LDL-cholesterol intensive lowering: a meta-analysis and meta-regression of randomized trials.
Eur Heart J Cardiovasc Pharmacother
February 2023
Article Synopsis
- A study-level meta-analysis was conducted to evaluate the safety of very low LDL-cholesterol (LDL-C) levels achieved through intense lipid-lowering therapies compared to higher LDL-C levels.
- The analysis included 10 randomized trials with over 38,000 patients in the low LDL-C group, showing no significant differences in major safety outcomes between groups, including adverse events and non-cardiovascular deaths.
- The findings suggest that very low LDL-C levels are safe and associated with a lower occurrence of major adverse cardiovascular events.
Objectives: To investigate outcomes with selective, clopidogrel-based therapies versus conventional treatment in patients undergoing percutaneous coronary intervention (PCI), especially for acute coronary syndrome.
Background: Safety and efficacy of alternative, selective, clopidogrel-based therapies after PCI are not robustly established.
Methods: We performed a study-level meta-analysis on six randomized trials investigating selective clopidogrel-based therapies (three on unguided de-escalation, = 3,473; three on guided clopidogrel therapy, = 7,533).
Clinical outcome data of patients discharged after Coronavirus disease 2019 (COVID-19) are limited and no study has evaluated predictors of cardiovascular prognosis in this setting. Our aim was to assess short-term mortality and cardiovascular outcome after hospitalization for COVID-19. A prospective cohort of 296 consecutive patients discharged after COVID-19 from two Italian institutions during the first wave of the pandemic and followed up to 6 months was included.
View Article and Find Full Text PDFPatients with Coronavirus Disease-2019 (COVID-19) have haemostatic dysfunction and are at higher risk of thrombotic complications. Although age is a major risk factor for outcome impairment in COVID-19, its impact on coagulative patterns here is still unclear. We investigated the association of Endogenous Thrombin Potential (ETP) with thrombotic and haemorrhagic events according to different ages in patients admitted for COVID-19.
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- The study focuses on understanding the varied prognosis of COVID-19 by identifying clinical and laboratory indicators that can predict poor outcomes in hospitalized patients.
- Researchers analyzed data from 664 COVID-19 patients in Northern Italy, discovering that factors like red cell distribution width (RDW), neutrophil-to-lymphocyte (NL) ratio, and platelet count are significant predictors of in-hospital mortality.
- The results suggest that using simple blood tests could help in classifying the severity of COVID-19, ultimately guiding treatment and monitoring strategies for better patient management.
Background: The optimal pharmacological therapy after transcatheter aortic valve implantation (TAVI) remains uncertain. We compared efficacy and safety of various antiplatelet and anticoagulant approaches after TAVI by a network meta-analysis.
Methods: A total of 14 studies (both observational and randomized) were considered, with 24,119 patients included.
A pro-thrombotic milieu and a higher risk of thrombotic events were observed in patients with CoronaVirus disease-19 (COVID-19). Accordingly, recent data suggested a beneficial role of low molecular weight heparin (LMWH), but the optimal dosage of this treatment is unknown. We evaluated the association between prophylactic vs.
View Article and Find Full Text PDFImportance: Although plenty of data exist regarding clinical manifestations, course, case fatality rate, and risk factors associated with mortality in severe coronavirus disease 2019 (COVID-19), long-term respiratory and functional sequelae in survivors of COVID-19 are unknown.
Objective: To evaluate the prevalence of lung function anomalies, exercise function impairment, and psychological sequelae among patients hospitalized for COVID-19, 4 months after discharge.
Design, Setting, And Participants: This prospective cohort study at an academic hospital in Northern Italy was conducted among a consecutive series of patients aged 18 years and older (or their caregivers) who had received a confirmed diagnosis of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection severe enough to require hospital admission from March 1 to June 29, 2020.
Introduction: A hypercoagulable condition was described in patients with coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic mechanism contributing to disease progression and lethality.
Aim: We evaluated if in-hospital administration of heparin improved survival in a large cohort of Italian COVID-19 patients.
Methods: In a retrospective observational study, 2,574 unselected patients hospitalized in 30 clinical centers in Italy from February 19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection were analyzed.
Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods.
View Article and Find Full Text PDFCommon cardiovascular risk factors and in-hospital mortality in 3,894 patients with COVID-19: survival analysis and machine learning-based findings from the multicentre Italian CORIST Study.
Nutr Metab Cardiovasc Dis
October 2020
Article Synopsis
- A study investigated factors contributing to in-hospital death among COVID-19 patients in Italy, analyzing data from 3,894 hospitalized individuals from February to May 2020.
- Key findings showed that impaired renal function, high levels of C-reactive protein, and older age were significant predictors of mortality, with the highest death rates found in Northern Italy (15.6%) compared to Central/Southern regions (6.4%).
- The results indicated that factors like obesity, tobacco use, and cardiovascular conditions did not correlate with mortality risk, emphasizing the importance of renal health and inflammation in COVID-19 outcomes.