Publications by authors named "Parodi Guido"
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.
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- A multicenter study analyzed the effectiveness and safety of intravenous antiplatelet therapies, cangrelor and tirofiban, in STEMI patients undergoing PPCI at seven Italian centers.
- The primary outcome measured was the incidence of TIMI flow < 3 after the procedure and the risk of bleeding (BARC 2-5) in patients receiving either treatment.
- Results showed that cangrelor led to better myocardial blood flow post-PPCI compared to tirofiban, without a higher risk of significant bleeding complications.
Platelet inhibition with orodispersible ticagrelor in acute coronary syndromes according to morphine use: the TASTER study final results.
Eur Heart J Cardiovasc Pharmacother
December 2023
Article Synopsis
- The study aims to investigate whether orodispersible tablet (ODT) ticagrelor can effectively inhibit platelet aggregation in acute coronary syndrome (ACS) patients who are also receiving morphine, comparing it to the standard coated tablet form.
- A total of 130 ACS patients were randomly assigned to receive either ODT or standard ticagrelor loading doses, with assessments made regarding platelet reactivity after treatment, particularly looking for any interaction effects with morphine.
- The results showed that while morphine-treated patients had higher platelet reactivity one hour after the loading dose, there were no significant differences in platelet reactivity between the ODT and standard ticagrelor groups, nor were there significant differences in adverse events related to
Article Synopsis
- The study explores how biological age, rather than just chronological age, affects heart health, focusing on different aging rates and their relation to cardiovascular risks.
- In a sample of 2,614 healthy individuals, researchers identified three heart aging patterns—slow, normal, and accelerated—each associated with varying rates of cardiovascular events.
- Standard echocardiography techniques can effectively measure these aging patterns, helping to predict health outcomes and potentially improve preventive strategies for heart disease.
Article Synopsis
- Researchers developed a machine learning model to predict in-hospital death risk in Takotsubo syndrome (TTS) patients using data from over 3,400 individuals.
- The model included 31 clinical variables and achieved strong performance results, with AUC values indicating high accuracy in identifying patients at risk of death.
- Clustering analysis revealed six distinct patient groups with varying in-hospital death rates, demonstrating the model's ability to stratify risk profiles effectively.
Aims: The aim of this study was to investigate the long-term outcome of takotsubo syndrome (TTS) patients with and without hypertension (HT) and to evaluate the effectiveness of treatment with beta-blockers (BBs) and/or renin-angiotensin-aldosterone system inhibitors (RAASi).
Methods And Results: The study population includes a register-based, multicentre cohort of consecutive patients with TTS, divided into two groups according to the history of HT. Further stratification was performed for BB/RAASi prescription at discharge.
A 44-year-old woman with obstetric antiphospholipid syndrome (APS) presented to our institution with suspected non ST-elevation myocardial infarction (NSTEMI). Shortly after coronary angiography, she developed diplopia, hypotension and chest pain with inferior ST elevation in 12-lead ECG. According to multidisciplinary evaluation, she promptly underwent systemic thrombolysis, with clinical and haemodynamic improvement.
View Article and Find Full Text PDFBackground: Despite the key pathophysiological role of inflammation in the development of coronary artery disease (CAD), the evaluation of inflammatory status has not been clearly established in patients presenting with acute coronary syndrome (ACS). The aim of this study is to evaluate the prevalence of CRP-independent inflammatory patterns in patients referred for primary percutaneous coronary intervention (pPCI) and to determine their one-year relationship with adverse clinical outcomes.
Methods: We carried out a single-centre, observational study consecutively enrolling all patients presenting at a large-volume PCI hub with a diagnosis of ST-segment elevation myocardial infarction (STEMI) and treated with pPCI.
Article Synopsis
- * 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.
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
- A 56-year-old man with no symptoms had an Implantable Cardioverter-Defibrillator (ICD) put in due to a Brugada pattern on his ECG and a family history of sudden cardiac death.
- Seventeen years later, he was hospitalized for heart palpitations, which were found to be caused by atrial flutter.
- During the hospitalization, an echocardiogram unexpectedly showed that he had developed hypertrophic cardiomyopathy.
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.
Article Synopsis
- Left ventricular non-compaction (LVNC) is a specific type of cardiomyopathy marked by unusual heart structure, leading to symptoms like heart failure and risks such as arrhythmias and sudden cardiac death.
- Diagnosing LVNC primarily relies on imaging, and while ECG abnormalities are common in patients, these findings are not specific enough on their own for diagnosis.
- However, when combined with other clinical factors, ECG can help differentiate between normal and pathological heart conditions, aiding in patient management and highlighting signs that need closer monitoring.
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
Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease affecting over 71 million people worldwide. An increased incidence of atherothrombotic events [e.g.
View Article and Find Full Text PDFBackground: 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.
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- The study aimed to assess the long-term benefits of beta-blocker treatment in patients recovering from Takotsubo syndrome (TTS) after discharge, considering the impact of catecholamines on the condition.
- Conducted across multiple centers, the research involved 825 patients diagnosed with TTS, comparing outcomes between those who were prescribed beta-blockers and those who weren't over a median follow-up period of 24 months.
- Results indicated that patients on beta-blockers had significantly lower risks of all-cause and non-cardiac death, particularly benefiting those with hypertension or cardiogenic shock during the acute phase of TTS.
Atrial fibrillation (AF) is the most common arrhythmia worldwide. Thromboembolism from the left atrial appendage (LAA) is the most feared complication in patients with AF. The cornerstone for the management of AF is oral anticoagulation to reduce the incidence of cardioembolic stroke.
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- Pre-existing atrial fibrillation (AF) is common in COVID-19 patients and the study aimed to determine its impact on disease severity and mortality.
- Out of 467 hospitalized COVID-19 patients, 26.1% had a history of AF, with most cases being persistent or permanent in nature.
- The study found that while pre-existing AF increased the risk of developing severe acute respiratory distress syndrome (ARDS), it did not significantly affect the risk of in-hospital mortality.
Left atrial sphericity index (LASI) is an echocardiographic index easily obtained; its use in patients with heart failure (HF) has never been investigated so far. This single-centre study aimed to investigate the usefulness of LASI in an unselected cohort of patients hospitalized for acute HF, and its potential correlation with the amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) levels and with New York Heart Association (NYHA) functional class. Ninety-four consecutive HF patients underwent a transthoracic echocardiogram with a detailed study of the left atrium (LA) including LASI (calculated from the apical four-chamber view as the ratio between the transverse and longitudinal diameters), and blood tests (including NT-proBNP) on the same day.
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- - The study focused on assessing the long-term clinical outcomes of hospitalized COVID-19 patients, specifically examining the relationship between right ventricular (RV) dysfunction and 1-year mortality rates in a cohort of 224 patients from seven hospitals in Italy.
- - RV dysfunction was found in 28% of patients; those affected were older, had a higher prevalence of coronary artery disease, and lower heart function compared to those without RV dysfunction.
- - The research concluded that patients with RV dysfunction had significantly higher 1-year mortality rates (67% vs. 28%) and indicated that RV dysfunction is a common issue in COVID-19 patients, correlating with increased long-term mortality risk.