Publications by authors named "Pier Paolo Bocchino"
External Validation of COAPT Risk Score in Patients Who Underwent Transcatheter Edge-To-Edge Repair of Severe, Functional Mitral Regurgitation: A Multicenter, Observational Italian-Polish Study.
Am J Cardiol
November 2024
Article Synopsis
- The COAPT Risk Score predicts the likelihood of death or hospitalization for heart failure within two years after undergoing transcatheter edge-to-edge repair for mitral regurgitation using the MitraClip device.
- An international study analyzed 344 patients categorized as COAPT eligible or non-eligible based on COAPT trial criteria, finding higher risk scores associated with increased mortality and hospitalization.
- Overall, the COAPT Score had poor predictive accuracy for both groups, showing better performance in lower-risk patients compared to higher-risk patients, suggesting the Score's effectiveness varies according to patient baseline risk.
Background: Heart transplantation and left ventricular assist device (LVAD) implementation are effective treatments for advanced heart failure (HF), although their use is limited by organ availability and the high incidence of adverse events. The efficacy of mitral transcatheter edge-to-edge repair (TEER) as a bridge to transplantation or as a destination therapy in advanced HF is still debated.
Methods: A total of 63 patients with INTERMACS class 3 or 4 with contraindications for LVAD and severe functional mitral regurgitation (FMR) were evaluated for TEER implantation eligibility.
Aims: To describe the use and the relation to outcome of different ventilation strategies in a contemporary, large, prospective registry of cardiogenic shock patients.
Methods And Results: Among 657 patients enrolled from March 2020 to November 2023, 198 (30.1%) received oxygen therapy (OT), 96 (14.
Aims: Haemodynamic assessment can be determinant in phenotyping cardiogenic shock (CS) and guiding patient management. Aim of this study was to evaluate the correlation between echocardiographic and invasive assessment of haemodynamics in acute decompensated heart failure-related CS (ADHF-CS).
Methods And Results: All consecutive ADHF-CS patients (SCAI shock stage ≥B) undergoing right heart catheterization (RHC) between 2020 and 2022 were prospectively enrolled.
Background: In the last few years, percutaneous LAA occlusion (LAAO) has become a plausible alternative in atrial fibrillation (AF) patients with contraindications to anticoagulation therapy. Nevertheless, the optimal antiplatelet strategy following percutaneous LAAO remains to be defined.
Methods: Studies comparing single antiplatelet therapy (SAPT) versus dual antiplatelet therapy (DAPT) following LAAO were systematically searched and screened.
Article Synopsis
- This study aimed to compare different dual antiplatelet therapy (DAPT) strategies for patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), focusing on the effectiveness and safety of de-escalation therapy.
- A systematic review and network meta-analysis were conducted, analyzing data from 23 randomized controlled trials that included a total of 75,064 patients, examining various DAPT strategies.
- Key outcomes measured included cardiovascular mortality, bleeding events, stent thrombosis, and other major cardiovascular events, revealing no significant differences among the six DAPT strategies studied.
Takayasu arteritis (TA) is a chronic granulomatous large vessel arteritis. The renal arteries are affected in up to 60% of patients with TA, with renal artery stenosis (RAS) potentially leading to ischemic nephropathy, severe arterial hypertension, and heart failure. Bilateral RAS may rarely present with recurrent flash pulmonary edema, a life-threatening association which has been termed Pickering syndrome.
View Article and Find Full Text PDFOrgan perfusion pressure at admission and clinical outcomes in patients hospitalized for acute heart failure.
Eur Heart J Acute Cardiovasc Care
February 2024
Article Synopsis
- This study investigates the role of organ perfusion pressure (OPP) as a prognostic marker in acute heart failure (AHF), comparing it to mean arterial pressure (MAP) alone.
- It utilizes data from 200 patients in the SNIP-AHF study, focusing on those with both MAP and central venous pressure (CVP) measurements, to analyze OPP's effectiveness in predicting worsening heart failure within 48 hours.
- Results indicate that OPP is a strong predictor for worsening heart failure, with an optimal cut-off value identified, suggesting that monitoring OPP could improve patient outcomes in AHF management.
Article Synopsis
- Arrhythmogenic cardiomyopathy (ACM) is a hereditary heart condition leading to the abnormal replacement of heart muscle, with this study focusing on the risk of strokes linked to cardiovascular events in ACM patients.
- Among 111 ACM patients monitored over nearly 13 years, 10% experienced cardioembolic ischemic events (CIEs), which occur more frequently in this group compared to the general population.
- Factors such as female sex, specific heart ECG changes, and reduced heart function were related to a higher risk of CIEs, but standard stroke risk assessments like the CHADS-VASc score were not effective in identifying high-risk patients needing anticoagulants.
Background: Older patients who treated by percutaneous coronary intervention (PCI) are at a higher risk of adverse cardiac outcomes. We sought to investigate the clinical impact of bifurcation PCI in older patients from Korea and Italy.
Methods: We selected 5,537 patients who underwent bifurcation PCI from the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) database.
Article Synopsis
- * In a study of 208 patients, those with FMR were younger, had higher rates of coronary artery disease, and experienced more atrial fibrillation compared to DMR patients.
- * FMR patients had significantly higher rates of one-year death (21.6% vs. 10.0%) and major adverse cardiac events (41.2% vs. 21.7%) after TEER, indicating worse outcomes for FMR compared to DMR.
Article Synopsis
- Malnutrition is prevalent in patients undergoing transcatheter edge-to-edge mitral valve repair (TEER), with 74.4% showing some level of malnutrition, but only 20% classified as moderate-severe.
- In a study of 892 patients from the MIVNUT registry, moderate-severe malnutrition was found to significantly increase the risk of mortality (hazard ratio of 2.1) and heart failure admissions (subdistribution hazard ratio of 1.6) during a follow-up period averaging 1.6 years.
- The findings suggest that evaluating nutritional status in patients undergoing TEER could enhance risk assessment and potentially improve patient outcomes.
Aims: Despite evidence of hemodynamic benefit of sodium nitroprusside (SNP) treatment for acute heart failure (AHF), there are limited data about its efficacy and safety. This study aimed to assess the effectiveness and safety of SNP treatment, to explore the impact of N-terminal pro-B natriuretic peptide (NT-proBNP) reduction on clinical endpoints and to identify possible predictors of clinical response.
Methods And Results: Multicenter retrospective cohort study of 200 patients consecutively admitted for AHF in 2 Italian Centers.
Introduction: Long-term follow-up after an acute coronary syndrome (ACS) presents a crucial challenge due to the high residual cardiovascular risk and the potential for major bleeding events. Although several treatment strategies are available, this article focuses on patients who have undergone percutaneous coronary intervention (PCI) for ACS, which is a frequent clinical situation. This position paper aims to support physicians in daily practice to improve the management of ACS patients.
View Article and Find Full Text PDFBackground: Risk stratification for transcatheter edge-to-edge mitral valve repair (TEER) is paramount in the decision-making process for treating severe mitral regurgitation (MR).
Objectives: This study sought to create and validate a user-friendly score (MitraScore) to predict the risk of mortality in patients undergoing TEER.
Methods: The derivation cohort was based on a multicentric international registry that included 1,119 patients referred for TEER between 2012 and 2020.
Article Synopsis
- The study investigates how computed tomography (CT)-defined sarcopenia can assess risks in patients undergoing transcatheter aortic valve implantation (TAVI), highlighting a lack of standardization in definitions and evidence supporting its independent predictive value compared to existing mortality risk tools.
- In a cohort of 391 TAVI patients, the researchers analyzed two types of sarcopenia based on CT scans: psoas muscle area (PMA) and indexed skeletal muscle area (SMI), finding that PMA-sarcopenia was associated with higher all-cause mortality rates after a median follow-up of 24 months.
- The results indicate that while PMA-sarcopenia provides valuable progn
Background: Few data are available regarding the prevalence of left atrium (LA) thrombi in atrial fibrillation (AF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). Methods: We evaluated the prevalence and predictors of LA/LA appendage (LAA) thrombi in non-valvular AF patients treated with NOACs referring to a single centre for a scheduled electrical cardioversion (ECV) or catheter ablation (CA). Transesophageal echocardiography (TEE) was performed within 12 h prior to the index procedure.
View Article and Find Full Text PDFObjectives: We aimed to compare the incidence and timing of major adverse cardiovascular events (MACE) within the first year after spontaneous coronary artery dissection (SCAD) according to the management strategy: conservative versus invasive.
Background: Treatment of SCAD remains controversial.
Methods: A pooled analysis of studies providing separate individual clinical outcomes for conservative and invasive treatment strategies within 1 year after SCAD was performed.
Objectives: The aim of this study was to assess the pooled clinical and echocardiographic outcomes of different isolated transcatheter tricuspid valve repair (ITTVR) strategies for significant (moderate or greater) tricuspid regurgitation (TR).
Background: Significant TR is a common valvular heart disease worldwide.
Methods: Published research was systematically searched for studies evaluating the efficacy and safety of ITTVR for significant TR in adults.
Article Synopsis
- * Patients in this situation typically require dual antiplatelet therapy (DAPT) to prevent severe cardiovascular issues, while also needing oral anticoagulants (OACs) for stroke prevention, leading to a careful balance between reducing heart risks and managing bleeding risks.
- * Recent studies have compared new non-vitamin K oral anticoagulants (NOACs) to traditional vitamin K antagonists in AF patients undergoing PCI, helping to shape current guidelines for these patients by evaluating the benefits and risks of different treatment options. *