Publications by authors named "Luca Donazzan"
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 PDFBackground: Cardiac resynchronization therapy (CRT) is a cornerstone treatment for heart failure, yet the optimal pacing mode remains uncertain. This study investigates the impact of DDDR (rate-adaptive atrial support) versus VDD pacing modes on functional capacity and echocardiographic outcomes in patients with CRT-defibrillators.
Methods: In a multicenter, double-blind, crossover trial, 26 sinus rhythm patients undergoing CRT-defibrillator implantation were randomized to DDDR at 60 beats-per-minute or VDD at 30 beats-per-minute.
Background And Aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic.
Methods And Results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020.
Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic.
View Article and Find Full Text PDFIntroduction: Infection is a significant complication of cardiac implantable electronic device (CIED) therapy. The European TauroPace™ Registry investigates the safety and efficacy of TauroPace™ (TP), an antimicrobial solution containing taurolidine, designed to prevent CIED infections.
Methods: This multicenter study included patients undergoing CIED procedures at participating centers where TP was used as a disinfectant for external hardware surfaces and an antiseptic for irrigating surgical sites.
STENT PANORAMA is a project carried out by the Young Interventional Cardiologists of Triveneto coordinated by the Italian Society of Interventional Cardiology (GISE) Veneto delegation. The project includes two parts: the first, here reported, is aimed at describing in a standardized and easily usable way the main technological characteristics of the latest generation of the drug eluting stents (DES) that are most widely used in the Italian cath-labs. The second, to follow, will aim to summarize the main scientific evidence regarding the performance of individual devices with particular reference to subgroups of clinical interest.
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- Research on contrast-associated acute kidney injury (CA-AKI) in elderly STEMI patients (aged 85+) is limited, but this study highlights its prevalence and impacts.
- In a study with 461 patients (average age 88.6 years), 22.1% developed CA-AKI, with chronic kidney disease as a major predictor.
- Patients with CA-AKI experienced a significantly higher risk of major adverse cardiac and cerebrovascular events (MACCEs) within a year, particularly increased rates of all-cause death and heart failure hospitalization.
Aims: Infections resulting from cardiac implantable electronic device (CIED) implantation are severely impacting on patients' and on health care systems. The use of TYRXTM absorbable antibiotic-eluting envelope has proven to decrease major CIED infections within 12 months of CIED surgery. The aim is to evaluate the impact of the envelope use on infection-related clinical events in a real-world contemporary patient population.
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- * A study involving over 16,600 STEMI patients found a 16% reduction in PPCI procedures in 2020 compared to 2019, with the elderly experiencing the most significant delays.
- * Consequently, there was a notable increase in 30-day mortality rates during the pandemic, particularly among older patients, attributed to longer ischemia times and treatment delays.
Background: The association between QRS narrowing and response to cardiac resynchronization therapy (CRT) has been investigated by several studies, but their findings remain inconclusive. Aim of our study was to explore the relationship between QRS Index and echocardiographic response to CRT.
Methods: This multicenter, retrospective analysis included 326 consecutive patients (mean age was 70.
Background: Sarcopenia is the core component of frailty; however, its role in patients undergoing transcatheter aortic valve replacement (TAVR) is a matter of debate. The Toronto Aortic Stenosis Quality of Life Questionnaire (TASQ) is a validated instrument for assessing quality of life (QoL) in patients with severe aortic stenosis (AS).
Aims: We aim to evaluate the QoL of sarcopenic and non-sarcopenic patients with severe AS undergoing TAVR.
Article Synopsis
- The COVID-19 pandemic significantly reduced the number of primary percutaneous coronary interventions (PPCIs) for ST-segment elevation myocardial infarction (STEMI) patients by 16% in 2020 compared to 2019.
- Despite this reduction affecting both genders equally, 30-day mortality rates increased notably for female patients during the pandemic, while male patients did not show a significant change.
- The analysis highlights the importance of addressing gender-specific outcomes in cardiac care during public health crises.
Article Synopsis
- The "smoking paradox" refers to lower mortality rates in smokers among STEMI patients, particularly in the context of modern primary PCI protocols during the COVID-19 pandemic.
- A large retrospective study revealed that among 16,083 STEMI patients, active smokers had better postprocedural blood flow and lower mortality rates compared to both non-smokers and previous smokers.
- The findings suggest that despite initial challenges in treatment, active smoking was linked to improved heart health outcomes in this patient population, indicating the need for further investigation into this unexpected relationship.
Infections are important complications of cardiac implantable electronic devices (CIED), with a high prognostic impact. Several risk factors for CIED infections are known. Different studies have been published proposing different risk scores, in order to preoperatively assess the individual likelihood of developing a CIED infection.
View Article and Find Full Text PDFBackground: A better selection of patients with left bundle branch block (LBBB) might increase the response to cardiac resynchronization therapy (CRT). The aim of the study was to investigate the association between the Strauss criteria, absence of S wave in V-V the Selvester score and response to CRT.
Methods And Results: The retrospective analysis included all consecutive patients having undergone implantation of biventricular defibrillators in primary prevention between 2018 and 2020.
Article Synopsis
- - The study examined how SARS-CoV-2 positivity affects outcomes for patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI), using data from the ISACS-STEMI COVID-19 registry.
- - Results showed that SARS-CoV-2 positive patients were older, more likely to experience cardiogenic shock, and had worse post-procedural outcomes, including lower blood flow and increased need for thrombectomy.
- - Importantly, SARS-CoV-2 positivity was linked to higher in-hospital mortality (25.7% vs 7%) and significantly increased 30-day mortality rates (34.4% vs 8.5%), indicating that the virus
Background: Chronic obstructive pulmonary disease (COPD) is projected to become the third cause of mortality worldwide. COPD shares several pathophysiological mechanisms with cardiovascular disease, especially atherosclerosis. However, no definite answers are available on the prognostic role of COPD in the setting of ST elevation myocardial infarction (STEMI), especially during COVID-19 pandemic, among patients undergoing primary angioplasty, that is therefore the aim of the current study.
View Article and Find Full Text PDFBackground: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensin-converting-enzyme (ACE)2 and patient's susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment.
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- The study aimed to analyze how the COVID-19 pandemic impacted primary percutaneous coronary intervention (PPCI) procedures and patient outcomes for those with ST elevation myocardial infarction (STEMI) compared to the period before the pandemic.
- It involved a retrospective analysis of data from 16,674 patients across various regions, showing a significant decrease in PPCI procedures during the pandemic (16% reduction) along with increases in treatment delays and mortality rates.
- Findings highlight that older adults were particularly affected, and the increased time to treatment likely contributed to both in-hospital and 30-day mortality rates rising during the pandemic.
Article Synopsis
- SARS-CoV-2 infection in patients undergoing primary percutaneous coronary intervention (PPCI) for STEMI is linked to increased thrombotic complications due to inflammation and endothelial dysfunction.
- In a study of 62 SARS-CoV-2 positive STEMI patients compared to 310 matched negative controls, the positive group showed significantly higher in-hospital mortality (29% vs 5.5%) and complications like stent thrombosis and heart failure.
- The findings highlight the need for careful management of STEMI patients infected with SARS-CoV-2, as they may experience worse outcomes compared to non-infected patients.
Background: Concerns have been raised on a potential interaction between renin-angiotensin system inhibitors (RASI) and the susceptibility to coronavirus disease 2019 (COVID-19). No data have been so far reported on the prognostic impact of RASI in patients suffering from ST-elevation myocardial infarction (STEMI) during COVID-19 pandemic, which was the aim of the present study.
Methods: STEMI patients treated with primary percutaneous coronary intervention (PPCI) and enrolled in the ISACS-STEMI COVID-19 registry were included in the present sub-analysis and divided according to RASI therapy at admission.
Background: It has been suggested the COVID pandemic may have indirectly affected the treatment and outcome of STEMI patients, by avoidance or significant delays in contacting the emergency system. No data have been reported on the impact of diabetes on treatment and outcome of STEMI patients, that was therefore the aim of the current subanalysis conducted in patients included in the International Study on Acute Coronary Syndromes-ST Elevation Myocardial Infarction (ISACS-STEMI) COVID-19.
Methods: The ISACS-STEMI COVID-19 is a retrospective registry performed in European centers with an annual volume of > 120 primary percutaneous coronary intervention (PCI) and assessed STEMI patients, treated with primary PCI during the same periods of the years 2019 versus 2020 (March and April).
Background: The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality.
Objectives: The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of "at-risk" patient cohorts for failure to present or delays to treatment.
Methods: This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020.
Objectives: To investigate, whether renal denervation (RDN) has a direct effect on cardiac sympathetic activity and innervation density.
Background: RDN demonstrated its efficacy not only in reducing blood pressure (BP) in certain patients, but also in decreasing cardiac hypertrophy and arrhythmias. These pleiotropic effects occur partly independent from the observed BP reduction.