Publications by authors named "Tullio Usmiani"

Background: To date delirium prevalence in the adult acute Italian hospital cardiac population is unknown. In a multicenter study, we assessed the prevalence of delirium over a single day among a population of patients admitted to acute cardiac hospital wards in Italy.

Methods: This is a point prevalence study (called "Cardio Delirium Day") which involved 55 Italian cardiologic centers (23 North, 18 Central, 12 South, 2 Sardinia) that collected data on 152 patients older than 65 years hospitalized on March 15, 2023.

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Patient safety is the moral and ethical responsibility of healthcare professionals, representing a constantly evolving field in industrialized countries whose key factors are sustainability, training and prevention. Clinical risk management is primarily concerned with systems issues, but people are of paramount importance to effective teamwork and leadership. Hospitals have recently been urged to adopt the methods of high-fidelity organizations to identify and change ineffective practice patterns: recognizing that little things that go wrong are early warning signs of trouble, near miss and errors become information about the health of systems and learn from them.

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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.

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Article Synopsis
  • Advanced acute heart failure treatment remains complex, particularly with the use of intra-aortic balloon pump (IABP) for patients in cardiogenic shock.
  • International guidelines advise against routine IABP use, following the IABP-SHOCK II trial, which found no reduction in overall mortality for affected patients.
  • The Italian Association of Hospital Cardiologists has released a position paper that reviews clinical data and offers practical recommendations for the effective use of IABP in these medical situations.
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Article Synopsis
  • Treatment of advanced acute heart failure remains complex, and the intra-aortic balloon pump (IABP) is commonly used for managing cardiogenic shock, though its routine use is not recommended according to international guidelines.
  • The IABP-SHOCK II trial found that IABP does not significantly lower all-cause mortality for patients with acute myocardial infarction and cardiogenic shock.
  • The Italian Association of Hospital Cardiologists (ANMCO) has released a position paper reviewing clinical data and offering practical recommendations on IABP use, along with findings from a national survey on its application in Italian hospitals.
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Background: Few studies prospectively assessed risk factors for ventricular fibrillation (VF) during a first myocardial infarction (MI). We designed a nation-wide study aiming to identify clinical and genetic characteristics associated with primary VF; and report here about clinical features.

Methods: PREDESTINATION (PRimary vEntricular fibrillation and suDden dEath during a firST myocardIal iNfArcTION) is an Italian case-control, prospective multicentre study.

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Background: Cystatin C (CyC) role in the detection of contrast induced acute kidney injury (CIAKI) is controversial. This study assessed whether a single CyC determination before coronary angiography (CA)could predict CIAKI and long-term adverse events.

Methods: CyC was assessed before CA in 713 consecutive patients.

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Article Synopsis
  • This study compares the effectiveness and safety of clopidogrel, prasugrel, and ticagrelor in over 19,000 patients with acute coronary syndrome undergoing PCI and looks at the risks of ischemic events and bleeding over time.
  • Results show prasugrel leads to significantly lower rates of net adverse clinical events and major adverse cardiovascular events compared to clopidogrel, while ticagrelor also reduces major adverse cardiovascular events but has a higher bleeding risk.
  • The analysis indicates that clopidogrel’s risk profile peaks at 3 months for ischemic events while prasugrel maintains a balance between ischemia and bleeding, and ticagrelor consistently reduces heart attacks over
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Article Synopsis
  • - The study evaluates the safety and effectiveness of prasugrel and ticagrelor in real-life patients with acute coronary syndrome (ACS) who also have chronic kidney disease (CKD).
  • - Out of 19,255 patients, those with CKD showed higher mortality and reinfarction rates, but the use of potent P2Y12 inhibitors like prasugrel and ticagrelor significantly reduced these risks without increasing major bleeding complications.
  • - The findings suggest that for ACS patients with CKD, using prasugrel and ticagrelor can improve outcomes compared to clopidogrel, making them a safer option for this high-risk group.
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The optimal strategy for patients with an acute myocardial infarction (MI) and multivessel (MV) coronary artery disease complicated by cardiogenic shock (CS) remains unknown. We conducted a meta-analysis of all randomized controlled trials and observational studies that reported adjusted effect measures to evaluate the association of MV-PCI (percutaneous coronary intervention), compared with culprit only (C)-PCI, with cardiovascular events in patients admitted for CS and MV disease. We identified 12 studies (n = 1 randomized controlled trials, n = 11 observational) that included 7,417 patients (n = 1,809 treated with MV-PCI and n = 5,608 with C-PCI).

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Aims: Contrast-induced acute kidney injury (CIAKI) is a common complication after coronary angiography or percutaneous revascularization (PCI). This study aimed to investigate the association of CIAKI with long-term cardiovascular adverse events.

Methods: In total, 980 patients undergoing coronary angiography/PCI were assessed in this prospective cohort study.

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Aims: Contrast-induced acute kidney injury (CIAKI) in patients with chronic kidney disease undergoing coronary angiography or percutaneous coronary intervention is a common iatrogenic complication associated with increased morbidity and mortality. This study compares sodium bicarbonate/isotonic saline/N-acetylcysteine/vitamin C prophylaxis (BS-NAC) against high-volume forced diuresis with matched hydration in CIAKI prevention.

Methods: One-hundred and thirty-three consecutive patients undergoing coronary angiography or percutaneous coronary intervention with estimated glomerular filtration rate less than 60 mL/min/1.

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Background: Contrast-induced acute kidney injury (CIAKI) is a frequent complication after infusion of contrast media in patients undergoing percutaneous coronary intervention. A wide range of CIAKI rates occurs after intervention between 3% and 30%, depending on the definition. The aim of this study was to identify which methodology was more effective at recognizing patients at high risk for in-hospital and out-of-hospital adverse events.

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Aims: To verify feasibility and safety of bone marrow stem cells (BMC) mobilization in patients (pts) with acute myocardial infarction (AMI) and to monitor the clinical effects of BMC mobilization in terms of myocardial perfusion and function.

Methods And Results: Eight male pts (median age: 50.5 years) treated with a primary PTCA were enrolled.

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