Publications by authors named "Montalto C"
Article Synopsis
- The study evaluates various techniques for guiding percutaneous coronary intervention (PCI) to determine which yields the best patient outcomes.
- It analyzes data from 39 randomized trials involving over 29,000 patients, highlighting that intravascular imaging (like OCT and IVUS) and physiology-guided strategies (like FFR) significantly reduce cardiac death compared to traditional coronary angiography (CA).
- Overall, the results suggest that OCT is the most effective guidance method, leading to lower rates of myocardial infarction, stent thrombosis, and all-cause mortality compared to CA.
Background: A substantial number of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) experience adverse events after TAVI, with health care expenditure. We aimed to investigate cardiac remodeling and long-term outcomes in diabetic patients with severe AS, left ventricular ejection fraction (LVEF) < 50%, and extra-valvular cardiac damage (EVCD) undergoing TAVI treated with sodium-glucose cotransporter-2 inhibitors (SGLT2i) versus other glucose-lowering strategies (no-SGLT2i users).
Methods: Multicenter international registry of consecutive diabetic patients with severe AS, LVEF < 50%, and EVCD undergoing TAVI.
Background: Accurate bleeding risk stratification after percutaneous coronary intervention (PCI) is important for treatment individualization. However, there is still an unmet need for a more precise and standardized identification of high bleeding risk patients. We derived and validated a novel bleeding risk score by augmenting the PRECISE-DAPT score with the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria.
View Article and Find Full Text PDFPurpose: The novel coronavirus disease (COVID-19) has revived the debate on the optimal tidal volume during acute respiratory distress syndrome (ARDS). Some experts recommend 6 mL/kg of predicted body weight (PBW) for all patients, while others suggest 7-9 mL/kg PBW for those with compliance >50 mL/cmHO. We investigated whether a tidal volume ≥ 7 ml/kg PBW may be safe in COVID-19 patients, particularly those with compliance >50 mL/cmHO.
View Article and Find Full Text PDFArticle Synopsis
- Tricuspid insufficiency used to be thought of as not very important, but new research shows it actually plays a big role in causing problems with the right side of the heart.
- New technology is making it possible to treat patients who were too risky for regular surgery, helping them feel better and live better lives.
- The focus now is on getting patients the right care by sending them to specialized centers that know how to diagnose and treat this condition effectively.
Article Synopsis
- * This study assesses the effectiveness, safety, and adherence to NW in obese and overweight diabetic patients compared to standard rehabilitation and counseling over 6 and 12 months after a 3-month intervention.
- * Results will indicate how NW stacks up against other methods in improving cardiovascular performance and will provide insights for developing personalized exercise programs for better health outcomes in this patient group.
Background: There is a growing need for percutaneous coronary intervention (PCI) to be performed within the same transcatheter aortic valve implantation (TAVI) procedure. In such cases, cangrelor, a fast-acting intravenous P2Y12-inhibitor with a short offset, is potential clinical utility to minimize bleeding and vascular complications during large-bore arterial access (LBAA) as well as the thrombotic risk associated with concomitant PCI.
Case Summary: We report two cases of TAVI with an indication to concomitant, high-risk PCI.
Intraprocedural stroke is a well-documented and feared potential risk of cardiovascular transcatheter procedures (TPs). Moreover, subclinical neurological events or covert central nervous system infarctions are concerns related to the development of dementia, future stroke, cognitive decline, and increased risk of mortality. Cerebral protection devices (CPDs) were developed to mitigate the risk of cardioembolic embolism during TPs.
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- The study investigates the risk factors for hospitalization due to heart failure (HF) in patients with acute coronary syndrome (ACS) who have not previously experienced HF or left ventricular dysfunction.
- It analyzed data from 14,699 patients across 16 European centers using both Cox regression and machine learning models, identifying key risk factors such as reduced renal function and left ventricular ejection fraction.
- The CORALYS HF score successfully pinpointed high-risk patients using commonly available information at discharge, indicating a need for further strategies to prevent HF in this specific group.
Article Synopsis
- Anemia, whether existing before hospitalization or developed during the hospital stay, impacts mortality rates in patients with acute coronary syndromes, but its role remains ambiguous.
- A study conducted at Niguarda Hospital analyzed 1294 patients, categorizing them into three groups: those with pre-existing anemia, those who developed anemia during their stay, and those who maintained normal hemoglobin levels.
- Findings indicated that while pre-existing anemia was linked to a higher risk of death, hospital-acquired anemia did not significantly increase long-term mortality risk, suggesting different implications for patient health management.
External validity of the PRECISE-DAPT score in patients undergoing PCI: a systematic review and meta-analysis.
Eur Heart J Cardiovasc Pharmacother
December 2023
Aims: To summarize the totality of evidence validating the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score, ascertaining its aggregate discrimination and validation power in multiple population subsets.
Methods And Results: We searched electronic databases from 2017 (PRECISE-DAPT proposal) up to March 2023 for studies that reported the occurrence of out-of-hospital bleedings according to the PRECISE-DAPT score in patients receiving DAPT following percutaneous coronary intervention (PCI). Pooled odds ratios (OR) with 95% confidence interval (CI) were used as summary statistics and were calculated using a random-effects model.
Background The impact of complete revascularization (CR) on the development of heart failure (HF) in patients with acute coronary syndrome and multivessel coronary artery disease undergoing percutaneous coronary intervention remains to be elucidated. Methods and Results Consecutive patients with acute coronary syndrome with multivessel coronary artery disease from the CORALYS (Incidence and Predictors of Heart Failure After Acute Coronary Syndrome) registry were included. Incidence of first hospitalization for HF or cardiovascular death was the primary end point.
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- The study aimed to evaluate the prognosis and clinical impact of moderate aortic stenosis, as its mortality risk was previously unclear, with a focus on how patient characteristics affect survival.* -
- Researchers analyzed 15 studies involving over 11,500 patients and found significantly higher all-cause mortality rates in those with moderate aortic stenosis compared to controls, regardless of other factors like left ventricular ejection fraction and sex.* -
- The results indicated that age significantly influenced mortality risk, suggesting that older patients with moderate aortic stenosis face a greater risk, and called for further research on the potential benefits of aortic valve replacement.*
Background: To evaluate the long-term clinical outcome of a cohort of patients suffering from moderate tricuspid regurgitation (TR), regardless of its etiology.
Methods: Clinical and echocardiographic follow-up were assessed in 250 patients diagnosed with moderate TR between January 2016 and July 2020. TR progression at follow-up was defined as TR grade increase to at least severe.
Background: In the first report from the MitraBridge registry, MitraClip as a bridge to heart transplantation (HTx) proved to be at 1-year an effective treatment strategy for 119 patients with advanced heart failure (HF) who were potential candidates for HTx. We aimed to determine if benefits of MitraClip procedure as a bridge-to-transplant persist up to 2-years.
Methods: By the end of the enrollment period, a total of 153 advanced HF patients (median age 59 years, left ventricular ejection fraction 26.
Patients ≥ 75 years of age account for about one third of hospitalizations for acute coronary syndromes (ACS). Since the latest European Society of Cardiology guidelines recommend that older ACS patients use the same diagnostic and interventional strategies used by the younger ones, most elderly patients are currently treated invasively. Therefore, an appropriate dual antiplatelet therapy (DAPT) is indicated as part of the secondary prevention strategy to be implemented in such patients.
View Article and Find Full Text PDFBackground And Aims: Ischemic or bleeding events might occur after transcatheter aortic valve replacement (TAVR), with the potential to hamper clinical outcomes. This study aimed to characterize the average daily ischemic risks (ADIRs) and the average daily bleeding risks (ADBRs) over 1-year in all consecutive patients undergoing TAVR.
Methods: ADBR included all bleeding events according to VARC-2 definition, and ADIR included cardiovascular deaths, myocardial infarction and ischemic stroke.
Severe tricuspid regurgitation is associated with the occurrence of right failure and increased morbidity and mortality. Transcatheter heterotopic bi-caval valve implantation might offer symptom relief in these patients that are often at prohibitive surgical risk.
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