Publications by authors named "Luca Parrini"
Article Synopsis
- * They are less likely to receive crucial procedures and effective medications, so assessing factors like frailty and other health conditions is vital for tailoring their care.
- * There is a lack of research on elderly individuals with ACS, making it critical for clinicians to develop targeted strategies to improve these patients' treatment and quality of life as the population ages.
Article Synopsis
- * Managing AF effectively involves a multidisciplinary team (MDT), working closely with cardiologists and other healthcare providers to create a tailored care plan that addresses the complex nature of the disorder.
- * Ongoing evaluation and adjustment of treatment are essential, as new risk factors, symptoms, and advancements in therapies can change the approach to AF management over time.
Article Synopsis
- Atrial fibrillation (AF) is a common issue in cancer patients, and this study aims to evaluate their clinical characteristics and management, particularly focusing on antithrombotic medications.
- The study involved 1,514 patients with recent cancer diagnoses and confirmed AF, finding high rates of cardiovascular diseases and a significant number of patients not receiving optimal anticoagulation treatment upon admission.
- Results indicate a significant underuse of appropriate antithrombotic therapy, suggesting the necessity for improved cardiovascular assessments in the care of cancer patients with AF.
The global population is experiencing an aging trend; however, this increased longevity is not necessarily accompanied by improved health in older age. A significant consequence of this demographic shift is the rising prevalence of multiple chronic illnesses, posing challenges to healthcare systems worldwide. Aging is a major risk factor for multimorbidity, which marks a progressive decline in resilience and a dysregulation of multisystem homeostasis.
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- * Treating AF in pregnant women is tricky since medications can pose risks to both mother and baby; thus, strategies like electrical cardioversion and beta-blockers are preferred for safety and effectiveness.
- * Collaboration among healthcare professionals in a "Pregnancy-Heart Team" enhances patient care, but more research is necessary to establish the best treatment approaches for managing AF in pregnancy.
Aortic stenosis (AS) represents a notable paradigm for cardiovascular (CV) and geriatric disorders owing to comorbidity. Transcatheter aortic valve replacement (TAVR) was initially considered a therapeutic strategy in elderly individuals deemed unsuitable for or at high risk of surgical valve replacement. The progressive improvement in TAVR technology has led to the need to refine older patients' stratification, progressively incorporating the concept of frailty and other geriatric vulnerabilities.
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- There has been a significant rise in the use of direct oral anticoagulants (DOACs) over the past ten years, surpassing vitamin K antagonists (VKAs) due to easier management and better safety profiles.
- Managing anticoagulation for patients on DOACs during surgical or interventional procedures is complex, as some surgeries require stopping DOACs while others can proceed uninterrupted.
- A thorough assessment of patient factors (like age, bleeding history, and organ function) and surgical details is crucial for determining the best timing for stopping and resuming DOACs, necessitating a collaborative approach among healthcare providers.
Article Synopsis
- * Differences in how drugs are metabolized by sex highlight the need for sex-specific medical approaches, yet awareness of this issue is still limited.
- * The paper focuses on evaluating therapeutic strategies for managing common diseases affecting women, emphasizing the importance of individualized treatment guidelines based on gender.
In clinical practice, the number of patients treated with direct oral anticoagulants (DOACs) has consistently increased over the years. Since anticoagulant therapy has been associated with an annual incidence of major bleeding (MB) events of approximately 2% to 3.5%, it is of paramount importance to understand how to manage anticoagulated patients with major or life-threatening bleeding.
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- Cancer significantly increases the risk of developing atrial fibrillation (AF), prompting a study (BLITZ-AF Cancer) to gather data on antithrombotic drug usage in affected patients for better care management.
- Conducted across six European countries, the study enrolled 1,514 patients, revealing a diverse range of underlying health conditions and cancer types; 41.5% had high CHA2DS2-VASc scores indicating a higher stroke risk.
- Findings showed a notable increase in the use of direct oral anticoagulants (DOACs) among patients, suggesting a shift in treatment approach by cardiologists from traditional therapies like vitamin K antagonists to newer alternatives.
Article Synopsis
- * Older patients with heart failure are often underrepresented in clinical trials, creating gaps in treatment strategies that cater to their specific health conditions and vulnerabilities.
- * A review of recent literature showed that BBs can be beneficial for older HFrEF patients, enhancing symptom relief and cardiac function, but more research is needed to better understand their effects in this age group and to optimize treatment approaches.
Article Synopsis
- - Gender significantly influences cardiovascular risk factors and affects prevention, clinical pathways, diagnosis, and treatment, highlighting the need for a more inclusive approach in healthcare.
- - Despite its importance, sex and gender differences in cardiovascular care are often overlooked, leading to disparities in patient outcomes and access to quality care.
- - The paper emphasizes the necessity of increasing female representation in clinical trials and leadership roles, advocating for tailored treatment strategies that consider gender influences on cardiovascular diseases.
Article Synopsis
- Recent advancements in percutaneous treatments for heart conditions have led to increased radiation exposure for interventional cardiologists, raising concerns about associated health risks like cancer and neurodegenerative disorders.
- *The general lack of awareness among operators about their radiation exposure risk, coupled with ineffective preventive measures, highlights a significant safety issue.
- *The ANMCO position paper aims to raise awareness among operators and propose strategies to reduce radiation doses and the associated health risks.*
In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy.
View Article and Find Full Text PDFIt is well established that direct oral anticoagulants (DOACs) are the cornerstone of anticoagulant strategy in atrial fibrillation (AF) and venous thromboembolism (VTE) and should be preferred over vitamin K antagonists (VKAs) since they are superior or non-inferior to VKAs in reducing thromboembolic risk and are associated with a lower risk of intracranial hemorrhage (IH). In addition, many factors, such as fewer pharmacokinetic interactions and less need for monitoring, contribute to the favor of this therapeutic strategy. Although DOACs represent a more suitable option, several issues should be considered in clinical practice, including drug-drug interactions (DDIs), switching to other antithrombotic therapies, preprocedural and postprocedural periods, and the use in patients with chronic renal and liver failure and in those with cancer.
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- More and more doctors are using tests and treatments that might not always be needed, which can replace important check-ups by a doctor.
- It's important to figure out if a test is really necessary to make sure patients get the right care.
- The Choosing Wisely campaign helps doctors know which tests might not be needed, and in Italy, a group of heart doctors has made a list of five treatments that could be too much or even harmful.
Article Synopsis
- Women with heart problems during pregnancy face serious health risks for themselves and their babies.
- More women with past heart issues are having babies now, and older moms and those with other health problems like cancer or COVID-19 add to the risks.
- A team of specialists working together can help make pregnancy and childbirth safer for these women and their babies by providing good advice and monitoring during and after pregnancy.
Patent foramen ovale (PFO) is a common cardiac abnormality with a prevalence of 25% in the general population. PFO has been associated with the paradoxical embolism causing cryptogenic stroke and systemic embolization. Results from clinical trials, meta-analyses, and position papers support percutaneous PFO device closure (PPFOC), especially if interatrial septal aneurysms coexist and in the presence of large shunts in young patients.
View Article and Find Full Text PDFGeriatric patients are an increasing population and cancer treatment in this population is a challenging and unsolved issue. Ageing is characterized by low-grade inflammation (inflamm-ageing), an important driver for age-related diseases such as cardiovascular diseases and cancer. These chronic conditions share pathophysiological bases, risk factors and may coexist.
View Article and Find Full Text PDFBackground and aim. Cancer and atrial fibrillation (AF) may be associated, and anticoagulation, either with vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs), is necessary to prevent thromboembolic events by reducing the risk of bleeding. The log incidence rate ratio (IRR) and 95% confidence interval were used as index statistics.
View Article and Find Full Text PDFPurpose Of Review: Cardio-oncology is an increasingly important field of cardiology that focuses on the detection, monitoring, and treatment of cardiovascular disease (CVD) occurring during and after oncological treatments. The survival rate for childhood cancer patients has dramatically increased thanks to new treatment protocols and cardiovascular (CV) sequelae represent the third most frequent cause of mortality in surviving patients. This study aims to provide a complete and updated review of all the main aspects of cardio-oncology in childhood and to highlight the critical issues.
View Article and Find Full Text PDF[Pregnancy and heart disease: the role of the Pregnancy Heart Team].
G Ital Cardiol (Rome)
August 2022
A significant risk of maternal and fetal morbidity and mortality has been shown to be associated with congenital heart disease or heart disease occurring during pregnancy. Given the increasing number of patients with corrected congenital heart disease who reach fertile age and the more and more common advanced maternal age associated with preexisting or intercurrent comorbidities, a higher incidence of cardiac complications in pregnancy has been reported in the last decades. Improvement in maternal and neonatal outcomes is influenced by a multidisciplinary strategy.
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- Cardiovascular diseases are the leading cause of death for women, even with 30 years of medical advances.
- Women often get heart diseases later in life than men and show unusual symptoms that are hard to recognize.
- The paper discusses how gender affects heart health and looks into the research on diagnosis and treatment for women.