Implementation of a Night Service of Helicopter Transportation to Reduce the Time to Revascularization in STEMI Patients in a Mountainous Region: Impact on Outcomes.

Background: Treatment delays are the most easily audited index of quality of care in the setting of ST-segment elevation myocardial infarction; among the components of ischemia time, system delay has been demonstrated to be a predictor of outcomes, and in a mountainous region it relies mostly upon helicopter rescue service. Aim: The aim of the study is to analyze the impact of the activation of helicopter rescue service for the nighttime for urgent transportation of patients on the time to revascularization and on the outcomes of STEMI patients. Methods: Data were prospectively collected in a database and retrospectively split into two different cohorts, based on the presentation date in the 18 months before, or after, the first day of implementation of the new organizational model.

How to keep the cath-lab of a COVID-free hub center during the pandemic in a hub and spoke cardiology network: a single center's experience.

Background: Northern Italy has been one of the most affected area in the world by the novel severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The healthcare system has been overwhelmed by the huge number of patients in need of mechanical ventilation or intensive care, resulting in a delay of treatment of patients with acute coronary syndrome (ACS), due to a crash in STEMI networks and closure of a certain number of hub centers, and to a delay in patients' seeking for medical evaluation for chest pain or angina-equivalent symptoms.

Methods: In the Trentino region, a mountainous area with about 500,000 inhabitants, very close to Lombardy that was the epicenter of the pandemic in Italy, to avoid these dramatic consequences, we developed a new protocol tailored to our specificity to keep our institution, and above all the cath-lab, clean from the SARS-CoV-2 infection, to ensure full operativity for cardiologic emergencies.

[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.

Sex differences in clinical and angiographic characteristics in spontaneous coronary artery dissection.

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome, mostly in women; however, differences between the sexes should be investigated. Hundred consecutive patients affected by SCAD were identified; coronary lesions were classified according to the most recent classification and clinical and angiographic data of men and women were compared. Men were significantly younger than women, with more cardiovascular risk factors.

[Risk assessment and early predictors of survival after out-of-hospital cardiac arrest in the province of Trento, Italy].

Background: Early prognostication of patients experiencing out-of-hospital cardiac arrest (OHCA) remains difficult, with no recommended risk assessment tool. The aim of this study was to determine and assess the association between available variables with survival at discharge of patients with OHCA in our regional reality.

Methods: We conducted a retrospective observational study in a single-center cohort of 236 consecutive patients with OHCA and return of spontaneous circulation admitted to the S.

A patient-specific mass-spring model for biomechanical simulation of aortic root tissue during transcatheter aortic valve implantation.

The success of transcatheter aortic valve implantation (TAVI) is highly dependent on the prediction of the interaction between the prosthesis and the aortic root anatomy. The simulation of the surgical procedure may be useful to guide artificial valve selection and delivery, nevertheless the introduction of simulation models into the clinical workflow is often hindered by model complexity and computational burden. To address this point, we introduced a patient-specific mass-spring model (MSM) with viscous damping, as a good trade-off between simulation accuracy and time-efficiency.

Twelve-month outcome of patients with an established indication for oral anticoagulation undergoing coronary artery stenting and stratified by the baseline risk of bleeding: Insights from the Warfarin and Coronary Stenting (War-Stent) Registry.

Purpose: To evaluate the outcome of patients with an established indication for oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S) and stratified by the baseline risk of bleeding.

Material And Methods: The database of the prospective, multicentre, observational WAR-STENT registry (ClinicalTrials.gov identifier NCT00722319) was analyzed and patients with atrial fibrillation and CHADS-VASc score ≥2, mechanical heart valve, prior cardiac embolism, intra-cardiac thrombus and recent venous thromboembolism who were treated with either triple (warfarin, aspirin and clopidogrel) or dual (warfarin and clopidogrel) or dual antiplatelet (aspirin and clopidogrel) therapy, identified.

Does pre-existing aortic regurgitation protect from death in patients who develop paravalvular leak after TAVI?

Objective: The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes.

Methods And Results: We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe.