Publications by authors named "Vincenzo De Marzo"

Article Synopsis
  • The study investigates the effects of red blood cell (RBC) transfusion on short-term mortality in patients undergoing transapical transcatheter aortic valve implantation (TA-TAVI), where bleeding is common.
  • Out of 11,265 TAVI participants, 548 had TA-TAVI, with 209 receiving RBC transfusions, and the study found a significant association between transfusion and increased 30-day mortality.
  • The research concluded that RBC transfusion independently predicts higher short-term mortality in TA-TAVI patients, regardless of other factors like major bleeding and kidney injury.
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Article Synopsis
  • Dialysis is a serious but rare complication following transcatheter aortic valve replacement, and researchers analyzed the TRITAVI registry to develop a clinical score for assessing this risk.
  • They identified various preprocedural factors (like male sex, diabetes, and anemia) and procedural features (like contrast volume and need for transfusion) that contribute to the risk, resulting in two scoring systems (TRITAVIpre and TRITAVIpost) which demonstrated strong predictive power.
  • The study confirmed that the need for dialysis significantly increases mortality rates, emphasizing the importance of the developed scores in predicting dialysis risk before the procedure.
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Aims: This study aimed to determine whether any change occurred over time in level of evidence (LoE) of therapeutic interventions supporting heart failure (HF) and other European Society of Cardiology guideline recommendations.

Methods And Results: We selected topics with at least three documents released between 2008 and April 2022. Classes of recommendations (CoR) and supporting LoE related to therapeutic interventions within each document were collected and compared over time.

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Article Synopsis
  • The study investigates the best timing for performing percutaneous coronary interventions (PCI) in patients undergoing transcatheter aortic valve implantation (TAVI), a procedure for severe aortic stenosis with existing coronary artery disease (CAD).
  • An analysis of 1,603 patients from the REVASC-TAVI registry shows that performing PCI after TAVI leads to better 2-year clinical outcomes, with significantly lower rates of all-cause death and major complications compared to PCI before or concurrently with TAVI.
  • The findings suggest that scheduling PCI after TAVI may be more beneficial, but further confirmation through randomized clinical trials is needed.
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Aims: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been evaluated in phase 3 randomized-controlled trials (RCTs) that enrolled individuals with heart failure and preserved ejection fraction (HFpEF) based on detailed clinical, biochemical, and echocardiographic criteria (hereafter HF-RCTs), and in cardiovascular outcomes trials (CVOTs) in diabetic patients, in which the diagnosis of HFpEF relied on medical history.

Methods And Results: We performed a study-level meta-analysis of the efficacy of SGLT2i across different definitions of HFpEF. Three HF-RCTs (EMPEROR-Preserved, DELIVER, and SOLOIST-WHF) and four CVOTs (EMPA-REG OUTCOME, DECLARE-TIMI 58, VERTIS-CV, and SCORED) were included, for a total of 14 034 patients.

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Objective: Acute kidney injury (AKI) may complicate transcatheter aortic valve replacement (TAVR) and could be linked to atheroembolization associated with catheter manipulation in the supra-renal (SR) aorta. We sought to determine the impact of SR aortic atheroma burden (SR-AAB) and composition, as well as of the aortic valve calcium score (AV-CS), measured at pre-operative multislice computed tomography (PO-MSCT), on AKI-TAVR.

Methods: All TAVR-patients 3 January-2018 to December-2020 were included.

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Article Synopsis
  • The study assesses the management of stable coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI), highlighting inconsistencies in existing evidence.
  • Using data from the REVASC-TAVI registry with 2407 patients, researchers compared outcomes between those who underwent complete versus incomplete myocardial revascularization.
  • Findings indicate no significant differences in all-cause death or composite outcomes (like stroke and rehospitalization for heart failure) between the two groups after 2 years, suggesting that the completeness of revascularization may not impact outcomes for TAVI patients with stable CAD.
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Therapeutic approaches based on gene silencing technologies represent a new opportunity to manage hypercholesterolemia. Inclisiran is a small interfering RNA that targets proprotein convertase subtilisin/kexin type 9 (PCSK9) mRNA. Clinical studies have demonstrated that inclisiran is effective, safe, and well-tolerated in reducing low-density lipoprotein cholesterol (LDL-C) in patients with familial hypercholesterolemia, atherosclerotic cardiovascular disease, and atherosclerotic cardiovascular disease risk equivalents.

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Background: The COVID-19 pandemic severely impacted global health. The aim of this study was to compare predictors of symptoms-to-emergency-call timing delay in acute coronary syndrome (ACS) and their impact on mortality before and during the COVID-19 outbreak.

Methods: We collected sociodemographic, clinical data, procedural features, preadmission and intra-hospital outcomes of consecutive patients admitted for ACS in seventeen Italian centers from March to April 2018, 2019, and 2020.

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Background Acute kidney injury (AKI) after transcatheter aortic valve replacement (TAVR) is associated with increased mortality. However, it is controversial whether AKI affects prognosis per se, being linked to baseline chronic kidney disease (CKD) and bleeding complications. The aim of this study was to disentangle, applying mediation analysis, the association between AKI and clinical outcome, considering CKD and bleedings.

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Background: The COVID-19 pandemic increased the complexity of the clinical management and pharmacological treatment of patients presenting with an Acute Coronary Syndrome (ACS).

Aim: to explore the incidence and prognostic impact of in-hospital bleeding in patients presenting with ACS before and during the COVID-19 pandemic.

Methods: We evaluated in-hospital Thrombolysis In Myocardial Infarction (TIMI) major and minor bleeding among 2851 patients with ACS from 17 Italian centers during the first wave of the COVID-19 pandemic (i.

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Background: Following the availability of new drugs for chronic heart failure (HF) with reduced ejection fraction (HFrEF), we sought to provide an updated and comparative synthesis of the evidence on HFrEF pharmacotherapy efficacy.

Methods: We performed a Bayesian network meta-analysis of phase 2 and 3 randomized controlled trials (RCTs) of medical therapy in HFrEF patient cohorts with more than 90% of the participants with left ventricular ejection fraction less than 45% and all-cause mortality reported.

Results: Sixty-nine RCTs, accounting for 91,741 subjects, were evaluated.

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Background: The well-known COVID-19 pandemic totally transformed people's lives, paving the way to various psychopathological symptoms. In particular, patients may experience a short- and long-term decreasing in their wellbeing. In this vein, the aim of this paper was to assess the COVID-19 patients' psychopathological profile (post-traumatic stress disorder, distress, anxiety and depression symptoms), detecting possible differences linked to the ventilatory treatments.

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Aims: We assessed the efficacy of the drugs developed after neurohormonal inhibition (NEUi) in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and concomitant chronic kidney disease (CKD).

Methods And Results: The literature was systematically searched for phase 3 randomized controlled trials (RCTs) involving ≥90% patients with left ventricular ejection fraction <45%, of whom <30% were acutely decompensated, and with published information about the subgroup of estimated glomerular filtration rate <60 mL/min/1.73 m2.

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Background: Long-term effects of Coronavirus Disease of 2019 (COVID-19) are of utmost relevance. We aimed to determine: 1) the functional capacity of COVID-19 survivors by cardiopulmonary exercise testing (CPET); 2) the characteristics associated with cardiopulmonary exercise testing (CPET) performance; 3) the safety and tolerability of CPET.

Methods: We prospectively enrolled consecutive patients with laboratory-confirmed COVID-19 from Azienda Sanitaria Locale 3, Genoa.

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Background: Increases in cardiac troponin (cTn) in coronavirus disease 2019 (COVID-19) have been associated with worse prognosis. Nonetheless, data about the significance of cTn in elderly subjects with COVID-19 are lacking.

Methods: From a registry of consecutive patients with COVID-19 admitted to a hub hospital in Italy from 25/02/2020 to 03/07/2020, we selected those ≥ 60 year-old and with cTnI measured within three days from the molecular diagnosis of SARS-CoV-2 infection.

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Aims: Acute kidney injury (AKI) may complicate transcatheter aortic valve replacement (TAVR) leading to higher mortality. The relationship between AKI, obesity, and mortality, however, is controversial. We sought to investigate the impact of body habitus on the prognostic value of AKI in TAVR.

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We report the case of a 72-year-old female patient admitted for worsening heart failure. The patient had undergone aortic valve replacement with a mechanical prosthesis 28 years before and since then she had several acute heart failure episodes, with a progressive increase in transprosthetic gradients, without identifying a specific cause.We describe the diagnostic tools used to reach a diagnosis, with particular emphasis on the use of cine-fluoroscopy that allowed to make the decisively diagnosis of prosthetic valve dysfunction, subsequently confirmed by cardiac computed tomography (CT).

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Peri-procedural myocardial injury (PPMI) is a common complication after transcatheter valve replacement (TAVR), often remaining clinically silent. The role of valve type on PPMI and the association between PPMI and mortality are still unclear. We sought to evaluate predictors and outcome of PPMI after TAVR, and the impact of self-expandable valve (SEV) vs.

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Echocardiographic evaluation of left ventricular ejection fraction (LVEF) provides important information regarding both myocardial function and prognosis. This parameter presents various limitations and does not allow early detection of myocardial dysfunction. LVEF may be related to hemodynamic load, geometric assumptions, to image quality, and it does not reflect myocardial contractility.

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Background: We reviewed frequency, microbiological pattern, predictors, and outcomes of early infections following transcatheter aortic valve replacement (TAVR).

Methods: Five hundred thirty-nine patients who underwent successful TAVR at a single, high-volume center between January 2014 and December 2019 were enrolled. We defined early infections as occurring within 30-day from TAVR.

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