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Coronary Artery Disease: HELP
Articles by Giuseppe Tarantini
Based on 47 articles published since 2009
(Why 47 articles?)
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Between 2009 and 2019, G. Tarantini wrote the following 47 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline A Multidisciplinary Approach on the Perioperative Antithrombotic Management of Patients With Coronary Stents Undergoing Surgery: Surgery After Stenting 2. 2018

Rossini, Roberta / Tarantini, Giuseppe / Musumeci, Giuseppe / Masiero, Giulia / Barbato, Emanuele / Calabrò, Paolo / Capodanno, Davide / Leonardi, Sergio / Lettino, Maddalena / Limbruno, Ugo / Menozzi, Alberto / Marchese, U O Alfredo / Saia, Francesco / Valgimigli, Marco / Ageno, Walter / Falanga, Anna / Corcione, Antonio / Locatelli, Alessandro / Montorsi, Marco / Piazza, Diego / Stella, Andrea / Bozzani, Antonio / Parolari, Alessandro / Carone, Roberto / Angiolillo, Dominick J / Anonymous911159 / Anonymous921159 / Anonymous931159 / Anonymous941159 / Anonymous951159 / Anonymous961159 / Anonymous971159 / Anonymous981159 / Anonymous991159 / Anonymous1001159 / Anonymous1011159 / Anonymous1021159 / Anonymous1031159 / Anonymous1041159 / Anonymous1051159 / Anonymous1061159 / Anonymous1071159 / Anonymous1081159 / Anonymous1091159 / Anonymous1101159 / Anonymous1111159 / Anonymous1121159 / Anonymous1131159. ·Dipartimento Emergenze e Aree Critiche, Ospedale Santa Croce e Carle, Cuneo, Italy. Electronic address: roberta.rossini2@gmail.com. · Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Dipartimento Emergenze e Aree Critiche, Ospedale Santa Croce e Carle, Cuneo, Italy. · Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. · Division of Cardiology, Department of Cardio-Thoracic Sciences, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy. · Division of Cardiology, Cardio-Thoracic-Vascular Department, Azienda Ospedaliero Universitaria "Policlinico-Vittorio Emanuele, Catania, Italy; Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy. · Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. · Cardiovascular Department, Humanitas Research Hospital, Rozzano, Italy. · U.O.C. Cardiologia, Azienda USL Toscana Sudest, Grosseto, Italy. · Unità Operativa di Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Italy. · U.O.C. Cardiologia Interventistica, Anthea Hospital, GVM Care & Research, Bari, Italy. · Cardiology Unit, Cardio-Thoraco-Vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. · Swiss Cardiovascular Centre Bern, Bern University Hospital, Bern, Switzerland. · Degenza Breve Internistica e Centro Trombosi ed Emostasi, Dipartimento di Medicina e Chirurgia, Università dell'Insubria, Varese, Italy. · Department of Immunohematology and Transfusion Medicine, Thrombosis and Hemostasis Center, ASST Papa Giovanni XXIII, Bergamo, Italy. · Department of Anaesthesia and Critical Care, AORN Dei Colli, Naples, Italy. · Dipartimento di Chirurgia Generale, Humanitas Research Hospital and University, Milano, Italy. · Policlinico Vittorio Emanuele di Catania, Catania, Italy. · Chirurgia Vascolare, Università di Bologna, Ospedale Sant'Orsola-Malpighi, Bologna, Italy. · UOC Chirurgia Vascolare, Dipartimento di Scienze Chirurgiche, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy. · Dipartimento di Scienze Biomediche per la Salute, Policlinico San Donato IRCCS, University of Milano, Milan, Italy. · Azienda Ospedaliera Universitaria Città della salute e della scienza, Torino, Italy. · Division of Cardiology, University of Florida, College of Medicine-Jacksonville, Jacksonville, Florida. ·JACC Cardiovasc Interv · Pubmed #29519377.

ABSTRACT: Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided. These observations underscore the need for a multidisciplinary collaboration among cardiologists, anesthesiologists, hematologists and surgeons to reach this goal. The present document is an update on practical recommendations for standardizing management of antithrombotic therapy management in patients treated with coronary stents (Surgery After Stenting 2) in various types of surgery according to the predicted individual risk of thrombotic complications against the anticipated risk of surgical bleeding complications. Cardiologists defined the thrombotic risk using a "combined ischemic risk" approach, while surgeons classified surgeries according to their inherent hemorrhagic risk. Finally, a multidisciplinary agreement on the most appropriate antithrombotic treatment regimen in the perioperative phase was reached for each surgical procedure.

2 Guideline [SICI-GISE Position paper: Use of Absorb BVS in clinical practice]. 2016

Tarantini, Giuseppe / Saia, Francesco / Capranzano, Piera / Cortese, Bernardo / Mojoli, Marco / Boccuzzi, Giacomo / Cuculo, Andrea / Geraci, Salvatore / Mattesini, Alessio / Oreglia, Jacopo / Summaria, Francesco / Testa, Luca / Berti, Sergio / Esposito, Giovanni / La Manna, Alessio / Limbruno, Ugo / Marchese, Alfredo / Mauro, Ciro / Tarantino, Fabio / Salvi, Alessandro / Santoro, Gennaro / Varbella, Ferdinando / Violini, Roberto / Musumeci, Giuseppe. ·Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Policlinico Universitario, Padova. · Dipartimento Cardio-Toraco-Vascolare, Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna. · Dipartimento Cardiovascolare, Ospedale Ferrarotto, Università degli Studi, Catania. · Cardiologia Interventistica, A.O. Fatebenefratelli, Milano. · Cardiologia Interventistica, Azienda Sanitaria Locale Torino 2, Torino. · Dipartimento di Cardiologia, A.O. Ospedali Riuniti, Foggia. · Cardiologia Interventistica, Ospedale S. Giovanni di Dio, Agrigento. · Cardiologia Interventistica, Ospedale Moriggia Pelascini, Gravedona (CO). · Emodinamica, ASST Grande Ospedale Metropolitano Niguarda, Milano. · Dipartimento di Cardiologia, Policlinico Casilino, Roma. · Dipartimento di Cardiologia, IRCCS Policlinico S. Donato, S. Donato Milanese (MI). · U.O. Cardiologia Diagnostica ed Interventistica, Fondazione Toscana "Gabriele Monasterio", Ospedale del Cuore, Massa. · Dipartimento di Scienze Biomediche Avanzate, Università degli Studi "Federico II", Napoli. · U.O.C. Cardiologia, Azienda USL Toscana Sudest, Grosseto. · U.O.C. Cardiologia Interventistica, Anthea Hospital, GVM Care & Research, Bari. · Dipartimento Cardiovascolare, Ospedale Cardarelli, Napoli. · Laboratorio di Emodinamica, U.O. Cardiologia, Ospedale G.B. Morgagni-L. Pierantoni, Forlì. · Dipartimento Cardiovascolare, Ospedali Riuniti, Università degli Studi, Trieste. · Cardiologia Interventistica, AOU Careggi, Firenze. · Dipartimento di Cardiologia, Ospedale degli Infermi, Rivoli (TO). · Cardiologia Interventistica, Ospedale S. Camillo-Forlanini, Roma. · Dipartimento Cardiovascolare, ASST Papa Giovanni XXIII, Bergamo. ·G Ital Cardiol (Rome) · Pubmed #27729667.

ABSTRACT: Drug-eluting stents (DES) are the current gold standard for percutaneous treatment of coronary artery disease. However, DES are associated with a non-negligible risk of long-term adverse events related to persistence of foreign material in the coronary artery wall. In addition, DES implantation causes permanent caging of the native vessel, thus impairing normal vasomotricity and the possibility of using non-invasive coronary imaging or preforming subsequent bypass surgery. On the contrary, coronary bioresorbable stents (BRS) may provide temporary mechanical support to coronary wall without compromising the subsequent recovery of normal vascular physiology, and have the potential to prevent late adverse events related to permanent elements. Several types of BRS have been introduced into clinical practice in Europe or are being tested. However, most of available clinical data relate to a single BRS, the Absorb bioresorbable Vascular Scaffold (Absorb BVS) (Abbott Vascular, Santa Clara, CA). Despite encouraging clinical results, no societal guidelines are available on the use of BRS in clinical practice.A panel of Italian expert cardiologists assembled under the auspices of the Italian Society of Interventional Cardiology (SICI-GISE) for comprehensive discussion and consensus development, with the aim to provide recommendations on the use of bioresorbable stents in terms of clinical indications, procedural aspects, post-percutaneous coronary angioplasty pharmacologic treatment and follow-up. Based on current evidence and BRS availability in Italian cath-labs, the panel decided unanimously to provide specific recommendations for the Absorb BVS device. These recommendations do not necessarily extend to other BRS, unless specified, although significant overlap may exist with Absorb BVS, particularly in terms of clinical rationale.

3 Editorial Management of coronary artery disease with cardiac CT beyond gatekeeping. 2017

Cademartiri, Filippo / Nistri, Stefano / Tarantini, Giuseppe / Maffei, Erica. ·Department of Radiology & Research Center, Montreal Heart Institute/Universitè de Montreal, Montreal, Quebec, Canada. · Department of Radiology, Erasmus Medical Center University, Rotterdam, The Netherlands. · Cardiology Service, CMSR- Veneto Medica, Altavilla Vicentina, Italy. · Department of Cardiology, University of Padua, Padua, Italy. ·Heart · Pubmed #28446549.

ABSTRACT: -- No abstract --

4 Editorial Renal insufficiency and left main coronary artery disease: reconsidering coronary intervention and bypass surgery. 2016

Tarantini, Giuseppe / Barioli, Alberto / Tellaroli, Paola / Fraccaro, Chiara. ·Department of Cardiac, Thoracic and Vascular Sciences, University Hospital of Padua, Padua, Italy. ·Coron Artery Dis · Pubmed #27681273.

ABSTRACT: -- No abstract --

5 Editorial Coronary atherosclerosis: the predictor of cardiovascular events. 2014

Cademartiri, Filippo / Arcadi, Teresa / Tarantini, Giuseppe / Maffei, Erica. ·Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands. ·Cardiology · Pubmed #24903701.

ABSTRACT: -- No abstract --

6 Review Revascularization strategies in STEMI with multivessel disease: when and how. 2018

D'amico, Gianpiero / Basile, Marco / Tarantini, Giuseppe / Marchese, Alfredo. ·Unit of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Padua, Italy - gianpiero.damico@hotmail.it. · Unit of Cardiology, GVM Care and Research, Anthea Hospital, Bari, Italy. · Unit of Cardiology, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Padua, Italy. ·Minerva Cardioangiol · Pubmed #29458248.

ABSTRACT: Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel coronary artery disease is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI). Primary PCI is now considered the gold standard in the treatment for patients with STEMI; however, the optimal reperfusion strategy in patients with STEMI and multivessel disease (MVD) remains uncertain. In this review, we summarize the available evidence on treatment options for patients with STEMI and MVD and highlight current guideline recommendations on this topic.

7 Review Meta-Analysis of the Optimal Percutaneous Revascularization Strategy in Patients With Acute Myocardial Infarction, Cardiogenic Shock, and Multivessel Coronary Artery Disease. 2017

Tarantini, Giuseppe / D'Amico, Gianpiero / Tellaroli, Paola / Colombo, Claudia / Brener, Sorin J. ·Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. Electronic address: giuseppe.tarantini.1@gmail.com. · Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Department of Medicine, Cardiac Catheterization Laboratory, New York Methodist Hospital, Brooklyn, New York. ·Am J Cardiol · Pubmed #28341358.

ABSTRACT: The optimal percutaneous coronary intervention (PCI) revascularization strategy in patients with multivessel (MV) coronary artery disease (CAD) who present with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) has not been systematically addressed. Accordingly, we performed a study-level meta-analysis comparing 2 PCI strategies in these patients-infarct-related artery (IRA) only versus MV revascularization. Studies including patients with AMI and MV CAD complicated with CS who received primary PCI were searched from 2000 to 2016. The primary end points were in-hospital/30-day and mid- to long-term (≥6 month) mortality. Fixed and random effects models were used for analysis. Ten studies (9 prospective and 1 retrospective) involving 6,068 patients met our inclusion criteria. IRA-only PCI was the most frequently used revascularization strategy (4,872 patients, 80%), while MV PCI was performed in 1,196 patients (20%). The MV PCI strategy was associated with higher short-term mortality compared with the IRA-only PCI strategy (odds ratio 1.41, 95% confidence interval 1.15 to 1.71, p = 0.008). There was no difference in mid- to long-term mortality between MV PCI and IRA-only strategies (odds ratio 1.02, 95% confidence interval 0.65 to 1.58, p = 0.94). In conclusion, in patients with AMI and MV CAD complicated by CS, the IRA-only PCI strategy seems to be associated with lower short-term, but not mid- to long-term mortality compared with MV PCI. This finding is different from the revascularization strategy recommended by current professional guidelines and suggests the need for dedicated randomized clinical trials.

8 Review Survival After Varying Revascularization Strategies in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Coronary Artery Disease: A Pairwise and Network Meta-Analysis. 2016

Tarantini, Giuseppe / D'Amico, Gianpiero / Brener, Sorin J / Tellaroli, Paola / Basile, Marco / Schiavo, Alessandro / Mojoli, Marco / Fraccaro, Chiara / Marchese, Alfredo / Musumeci, Giuseppe / Stone, Gregg W. ·Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. Electronic address: giuseppe.tarantini.1@gmail.com. · Cardiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Department of Medicine, Cardiac Catheterization Laboratory, New York Methodist Hospital, New York, New York. · Epidemiology and Public Health Unit, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Anthea Hospital, GVM Care & Research, Cardiology Unit, Bari, Italy. · Papa Giovanni XXIII Hospital, Bergamo, Italy. · Columbia University Medical Center, New York Presbyterian Hospital, and the Cardiovascular Research Foundation, New York, New York. ·JACC Cardiovasc Interv · Pubmed #27609250.

ABSTRACT: OBJECTIVES: The authors conducted a systematic pairwise and network meta-analysis to assess optimal treatment strategies in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV-CAD) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Patients with STEMI and MV-CAD have a worse prognosis than those with single-vessel CAD. The optimal revascularization strategy for these patients is uncertain. METHODS: Studies of revascularization strategies for MV-CAD in STEMI patients undergoing primary PCI published between 2001 and 2015 were identified using an electronic search. Pairwise and network meta-analyses were performed for 3 PCI strategies in prospective and retrospective studies: 1) infarct-related artery (IRA)-only PCI; 2) single procedure MV-PCI; and 3) staged MV-PCI. Information on study design, inclusion and exclusion criteria, and clinical outcomes was extracted. The outcomes of interest were short-term and long-term mortality. RESULTS: Thirty-two studies (13 prospective and 19 retrospective) with 54,148 patients (IRA-only PCI [n = 42,112], single procedure MV-PCI [n = 8,138], and staged MV-PCI [n = 3,898]) were included in the analysis. Pairwise meta-analyses showed that staged MV-PCI was associated with lower short-term and long-term mortality compared with both IRA-only PCI and single stage MV-PCI, whereas IRA-only PCI was associated with lower mortality compared with single stage MV-PCI. Staged MV-PCI was also associated consistently with improved survival in network analyses. CONCLUSIONS: The present systematic review and meta-analysis supports the hypothesis that in patients with MV-CAD presenting with STEMI undergoing primary PCI, a staged multivessel revascularization strategy may improve early and late survival.

9 Review [The worst complication during percutaneous coronary intervention: left main coronary artery dissection]. 2015

Zilio, Filippo / Napodano, Massimo / Fedrigo, Marny / Angelini, Annalisa / Tarantini, Giuseppe. ·Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova. ·G Ital Cardiol (Rome) · Pubmed #26156700.

ABSTRACT: Although rare, left main coronary artery dissection is a cause of periprocedural mortality during percutaneous coronary interventions. We report a case of iatrogenic dissection of the left main coronary artery causing cardiogenic shock, treated by extracorporeal membrane oxygenation (ECMO) support and later on by multiple balloon angioplasty and drug-eluting stent deployment, due to clinical worsening despite patent left coronary arteries with preserved good TIMI flow grade. We also reviewed the management strategies of this complication reported in the literature.

10 Review A multidisciplinary consensus document on follow-up strategies for patients treated with percutaneous coronary intervention. 2015

Rossini, Roberta / Oltrona Visconti, Luigi / Musumeci, Giuseppe / Filippi, Alessandro / Pedretti, Roberto / Lettieri, Corrado / Buffoli, Francesca / Campana, Marco / Capodanno, Davide / Castiglioni, Battistina / Cattaneo, Maria Grazia / Colombo, Paola / De Luca, Leonardo / De Servi, Stefano / Ferlini, Marco / Limbruno, Ugo / Nassiacos, Daniele / Piccaluga, Emanuela / Raisaro, Arturo / Ravizza, PierFranco / Senni, Michele / Tabaglio, Erminio / Tarantini, Giuseppe / Trabattoni, Daniela / Zadra, Alessandro / Riccio, Carmine / Bedogni, Francesco / Febo, Oreste / Brignoli, Ovidio / Ceravolo, Roberto / Sardella, Gennaro / Bongo, Sante / Faggiano, Pompilio / Cricelli, Claudio / Greco, Cesare / Gulizia, Michele Massimo / Berti, Sergio / Bovenzi, Francesco / Anonymous3470811 / Anonymous3480811 / Anonymous3490811 / Anonymous3500811. ·Dipartimento Cardiovascolare, AO Papa Giovanni XXIII, Bergamo, Italia. ·Catheter Cardiovasc Interv · Pubmed #25380511.

ABSTRACT: The number of percutaneous coronary interventions (PCI) is increasing worldwide. Follow-up strategies after PCI are extremely heterogeneous and can greatly affect the cost of medical care. Of note, clinical evaluations and non-invasive exams are often performed to low risk patients. In the present consensus document, practical advises are provided with respect to a tailored follow-up strategy on the basis of patients' risk profile. Three strategies follow-up have been defined and types and timing of clinical and instrumental evaluations are reported. Clinical and interventional cardiologists, cardiac rehabilitators, and general practitioners, who are in charge to manage post-PCI patients, equally contributed to the creation of the present document.

11 Review Comparison of impact of mortality risk on the survival benefit of primary percutaneous coronary intervention versus facilitated percutaneous coronary intervention. 2011

Tarantini, Giuseppe / Facchin, Michela / Frigo, Anna Chiara / Welsh, Robert. ·Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Italy. giuseppe.tarantini.1@unipd.it ·Am J Cardiol · Pubmed #21211598.

ABSTRACT: Available data suggest that thrombolytic therapy facilitated percutaneous coronary intervention (FPCI) is not beneficial, and recent analyses have shown a correlation between mortality risk and outcomes of patients with ST elevation myocardial infarctions treated with FPCI. The aim of this study was to analyze the impact of the mortality risk on the survival benefit of primary percutaneous coronary intervention (PPCI) compared to FPCI. A total of 13 trials enrolling 5,789 patients were pooled for analyses. PPCI survival benefit was calculated as the 30-day mortality after FPCI minus the 30-day mortality after PPCI, and the mortality rate of FPCI was interpreted as a proxy for mortality risk. A weighted metaregression was used to test the relation between mortality risk and explanatory variables. A fixed-effect linear regression analysis modeling the log odds ratio (PPCI/FPCI) as a linear function of the log odds of FPCI mortality was used to estimate the mortality risk that nullified the 30-day survival benefit of PPCI over FPCI. Across all studies, the absolute survival benefit ranged from -5.6 (favoring FPCI) to +7.2 (favoring PPCI). According to the slope of the regression line (-0.7, x-axis intercept -2.1) for the patients with baseline mortality risk > 4.2%, it is unlikely to obtain a survival benefit by FPCI compared to PPCI. In conclusion, the higher the mortality risk of patients with ST elevation myocardial infarctions, the higher the likelihood of a survival advantage of PPCI over FPCI.

12 Clinical Trial "Full-plastic jacket" with everolimus-eluting Absorb bioresorbable vascular scaffolds: Clinical outcomes in the multicenter prospective RAI registry (ClinicalTrials.gov Identifier: NCT02298413). 2018

Tarantini, Giuseppe / Masiero, Giulia / Fovino, Luca Nai / Mojoli, Marco / Varricchio, Attilio / Loi, Bruno / Gistri, Roberto / Misuraca, Leonardo / Gabrielli, Gabriele / Cortese, Bernardo / Pisano, Francesco / Moretti, Luciano / Tumminello, Gabriele / Olivari, Zoran / Mazzarotto, Pietro / Colombo, Alessandro / Calabrò, Paolo / Nicolino, Annamaria / Tellaroli, Paola / Corrado, Donatella / Durante, Alessandro / Steffenino, Giuseppe / Anonymous2021030. ·Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. Electronic address: giuseppe.tarantini.1@unipd.it. · Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Interventional Cardiology, A.O. Monaldi, Naples, Italy. · Cardiology Division, A.O. Brotzu, Cagliari, Italy. · Interventional Cardiology, S. Andrea Hospital, La Spezia, Italy. · U.O. Cardiologia-Emodinamica, Ospedale della Misericordia, Grosseto, Italy. · Interventional Cardiology Unit, Azienda Ospedali Riuniti, Ancona, Italy. · Interventional Cardiology, A.O. Fatebenefratelli, Milan, Italy. · Interventional Cardiology, Parini Regional Hospital, Aosta, Italy. · Cardiology Division, Mazzoni Hospital, Ascoli Piceno, Italy. · Cardinal Massaia Hospital, Asti, Italy. · Cardiology Division, Ca' Foncello Hospital, Treviso, Italy. · Interventional Cardiology, Ospedale Maggiore, Lodi, Italy. · Interventional Cardiology Unit, Luigi Sacco Hospital, Milano, Italy. · Division of Cardiology, Department of Cardio-Thoracic Sciences, Second University of Naples, Naples, Italy. · Interventional Cardiology Unit, Santa Corona General Ospital, Pietra Ligure, Italy. · Biostatistics, Epidemiology and Public Health Unit of Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · "Mario Negri" Research Institute, Milano, Italy. · Cardiology Division, Valduce Hospital, Como, Italy. · USD Emodinamica, A.S.O. S.Croce e Carle, Cuneo, Italy. ·Int J Cardiol · Pubmed #29887475.

ABSTRACT: OBJECTIVES: The objective of this study was to investigate mid-term clinical outcomes of patients treated with 'full-plastic jacket' (FPJ) everolimus-eluting Absorb bioresorbable vascular scaffold (BRS) implantation. BACKGROUND: FPJ with BRS may represent an interesting option for patient with diffuse coronary artery disease (CAD), but data on the clinical impact of FPJ using the Absorb BRS are scant. METHODS: FPJ was defined as the implantation of >56 mm of overlapping BRS in at least one vessel. We compared outcomes of patients receiving Absorb FPJ vs. non-FPJ within the multicenter prospective RAI Registry. RESULTS: Out of 1505 consecutive patients enrolled in the RAI registry, 1384 were eligible for this analysis. Of these, 143 (10.3%) were treated with BRS FPJ. At a median follow-up of 649 days, no differences were observed between FPJ and non-FPJ groups in terms of the device-oriented composite endpoint (DoCE) (5.6% vs. 4.4%, p = 0.675) or the patient-related composite endpoint (PoCE) (20.9% vs. 15.9%, p = 0.149). Patients receiving FPJ had higher rates of target vessel repeat revascularization (TVR) (11.2% vs. 6.3%, p = 0.042). In the FPJ group, there was no cardiac death and only one (very late) stent thrombosis (ST) (0.7%). CONCLUSIONS: Mid-term outcomes of a FPJ PCI strategy in the setting of diffuse CAD did not show a significant increase in composite device- and patient-related events, with rates of cardiac death and ST comparable to non-FPJ Absorb BRS implantation. However, these findings are hypothesis generating and requiring further validation.

13 Clinical Trial Everolimus-Eluting Bioresorbable Vascular Scaffold System in the Treatment of Cardiac Allograft Vasculopathy: the CART (Cardiac Allograft Reparative Therapy) Prospective Multicenter Pilot Study. 2016

Pighi, Michele / Tomai, Fabrizio / Petrolini, Alessandro / de Luca, Leonardo / Tarantini, Giuseppe / Barioli, Alberto / Colombo, Paola / Klugmann, Silvio / Ferlini, Marco / Ormezzano, Maurizio Ferrario / Loi, Bruno / Calabrò, Paolo / Bianchi, Renato Maria / Faggian, Giuseppe / Forni, Alberto / Vassanelli, Corrado / Valgimigli, Marco / Ribichini, Flavio. ·Department of Medicine, University of Verona, Piazzale Aristide Stefani n 1, 37126, Verona, Italy. michele.pighi@hotmail.it. · Department of Cardiovascular Sciences, European Hospital, Via Portuense, 700, 00149, Rome, Italy. · Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Department of Cardiology and Cardiac Surgery, A. De Gasperis Niguarda Ca' Granda Hospital, Milan, Italy. · Department of Cardiovascular Sciences, IRCCS Foundation, Policlinico San Matteo, Pavia, Italy. · Department of Cardiovascular Sciences, Brotzu Hospital, Cagliari, Italy. · Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, Monaldi Hospital, A.O.R.N. dei Colli, Naples, Italy. · Department of Cardiac Surgery, University of Verona, Piazzale Aristide Stefani n 1, 37126, Verona, Italy. · Department of Medicine, University of Verona, Piazzale Aristide Stefani n 1, 37126, Verona, Italy. · Cardialysis, Rotterdam, The Netherlands. ·J Cardiovasc Transl Res · Pubmed #26684009.

ABSTRACT: Cardiac allograft vasculopathy (CAV) is a form of accelerated atherosclerosis, which represents the leading cause of late morbidity and mortality after heart transplantation. The recent bioresorbable vascular scaffold (BVS) technology represents a potential novel therapeutic tool, in the context of CAV, by allowing transient scaffolding and concomitant vessel healing. Eligible subjects will be treated by using the Absorb Everolimus-Eluting BVS (Abbott Vascular, Santa Clara, CA, USA), and evaluated at pre-determined time points, up to 3 years since the index procedure. Both clinical and imaging data will be collected in dedicated case report forms (CRF). All imaging data will be analyzed in an independent core laboratory. The primary aim of the study is to evaluate the angiographic performance at 1 year of second-generation Absorb BVS, in heart transplant recipients affected by CAV.

14 Clinical Trial Eroded Versus Ruptured Plaques at the Culprit Site of STEMI: In Vivo Pathophysiological Features and Response to Primary PCI. 2015

Saia, Francesco / Komukai, Kenichi / Capodanno, Davide / Sirbu, Vasile / Musumeci, Giuseppe / Boccuzzi, Giacomo / Tarantini, Giuseppe / Fineschi, Massimo / Tumminello, Gabriele / Bernelli, Chiara / Niccoli, Giampaolo / Coccato, Micol / Bordoni, Barbara / Bezerra, Hiram / Biondi-Zoccai, Giuseppe / Virmani, Renu / Guagliumi, Giulio / Anonymous4080827. ·Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. Electronic address: francescosaia@hotmail.com. · Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy. · Ferrarotto Hospital, University of Catania, Catania, Italy. · Cardiology Department, Ospedale San Giovanni Bosco, Torino, Italy. · Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Padua, Italy. · Department of Cardiology, Policlinico Le Scotte, Siena, Italy. · Cardiology Department, Ospedale Civile, Asti, Italy. · Institute of Cardiology, Catholic University of the Sacred Heart, Roma, Italy. · Institute of Cardiology, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. · Case Western Reserve University, Cleveland, Ohio. · Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. · CV Path Institute, Gaithersburg, Maryland. ·JACC Cardiovasc Imaging · Pubmed #25890582.

ABSTRACT: OBJECTIVES: The aim of this study was to evaluate the pathophysiological features and response to primary percutaneous coronary intervention (PCI) of nonruptured/eroded plaque versus ruptured plaque as a cause of ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Autopsy series identified nonruptured/eroded plaque and ruptured plaque as the principal pathological substrates underlying coronary thrombosis in STEMI. The real incidence of different plaque morphologies, associated biological factors, superimposed thrombus, and their interaction with primary PCI remain largely unknown. METHODS: In a prospective study, 140 patients with STEMI underwent optical coherence tomography of the infarct-related artery (IRA) before PCI, after everolimus-eluting stent implantation and at 9-month follow-up. Histopathology and immunohistochemistry of thrombus aspirates and serum biomarkers were assessed at baseline. RESULTS: Culprit plaque morphology was adjudicated in 97 patients: 32 plaques (33.0%) with an intact fibrous cap (IFC), 63 (64.9%) plaques with a ruptured fibrous cap (RFC), and 2 (2.1%) spontaneous dissections. Patients with an IFC and RFC had similar clinical characteristics, and serum inflammatory and platelets biomarkers. An IFC presented more frequently with a patent IRA (56.2% vs. 34.9%; p = 0.047), and had fewer lipid areas (lipid-rich areas: 75.0% vs. 100.0%; p < 0.001) and less residual thrombus before stenting (white thrombus: 0.41 mm(3) vs. 1.52 mm(3); p = 0.001; red thrombus: 0 mm(3) vs. 0.29 mm(3); p = 0.001) with a lower peak of creatine kinase-myocardial band (66.6 IU/l vs. 149.8 IU/l; p = 0.025). At the 9-month optical coherence tomography, IFC and RFC had similar high rates of stent strut coverage (92.5% vs. 91.2%; p = 0.15) and similar percentage of volume obstruction (12.6% vs. 10.2%; p = 0.27). No significant differences in clinical outcomes were observed up to 2 years. CONCLUSIONS: In the present study, an IFC was observed at the culprit lesion site of one-third of STEMIs. IFC, compared with RFC, was associated with higher rates of patent IRA at first angiography, fewer lipid areas, and residual endoluminal thrombus. However, no difference in vascular response to everolimus-eluting stent was observed. (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angioplasty [OCTAVIA]; NCT01377207).

15 Clinical Trial Clinical outcome of patients with de novo coronary bifurcation lesions treated with the Tryton Side Branch Stent. The SAFE-TRY prospective multicenter single arm study. 2013

Tarantini, Giuseppe / La Vecchia, Luigi / Galli, Mario / Favero, Luca / D'Amico, Gianpiero / Buja, Paolo / Russo, Filippo / Cabianca, Ester / Napodano, Massimo / Musumeci, Giuseppe / Franceschini, Enrico / Grassi, Giuseppe / Pavei, Andrea / Bonmassari, Roberto / Cernetti, Carlo / Spedicato, Leonardo / Caprioglio, Francesco / Reimers, Bernhard / Isabella, Giambattista. ·Cardiology Clinic, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. Electronic address: giuseppe.tarantini.1@gmail.com. ·Int J Cardiol · Pubmed #24007969.

ABSTRACT: BACKGROUND: Coronary bifurcation lesions represent a difficult problem regularly confronting interventional cardiologist, in part due to the lack of dedicated device. OBJECTIVE: To investigate the feasibility, safety and effectiveness of the Tryton Side Branch Stent (Tryton Medical, Durham, NC, USA), a dedicated bare metal stent deployed in conjunction with a standard drug-eluting stent to treat bifurcation lesions. METHODS: The SAFE-TRY is a prospective single arm multicenter registry including patients with de novo bifurcation lesions in native coronary arteries and syntax score <32. The primary endpoint was target vessel failure (TVF) at 30 days that comprised cardiac death, target vessel myocardial infarction and clinically driven target vessel revascularization. Secondary endpoints included device, angiographic and procedural success, 9-month major adverse cardiac and cerebrovascular event (MACCE), and stent thrombosis (ST) rates (ClinicalTrials.gov identifier: NCT01174433). RESULTS: Among 252 enrolled patients, 24% had diabetes and 35.3% unstable angina. True bifurcation lesions involving both branches occurred in 96.8% of cases with Medina classification 1.1.1 in 62%. The left anterior descending artery and the left main were treated in 70% and 8.3% of the patients, respectively. A 6 Fr guide catheter was used in 61% of the cases. Device, angiographic and procedural success rates were 99.6%, 99.6% and 97.2% respectively. The 30-day TVF was 2.8%; the 9-month MACCE rate was 13.7%, with target lesion revascularization being 4.4%. No definite ST occurred. CONCLUSIONS: This prospective, multicenter study confirmed the feasibility, safety and effectiveness of the Tryton Side Branch Stent to treat patients with de novo complex bifurcation lesions.

16 Article Diagnostic value and prognostic implications of early cardiac magnetic resonance in survivors of out-of-hospital cardiac arrest. 2018

Zorzi, Alessandro / Susana, Angela / De Lazzari, Manuel / Migliore, Federico / Vescovo, Giovanni / Scarpa, Daniele / Baritussio, Anna / Tarantini, Giuseppe / Cacciavillani, Luisa / Giorgi, Benedetta / Basso, Cristina / Iliceto, Sabino / Bucciarelli Ducci, Chiara / Corrado, Domenico / Perazzolo Marra, Martina. ·Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. · Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy; Bristol NIHR Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom. · Division of Radiology, Department of Medicine, Az. Ospedaliera di Padova, Padova, Italy. · Bristol NIHR Cardiovascular Biomedical Research Unit, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom. · Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. Electronic address: domenico.corrado@unipd.it. ·Heart Rhythm · Pubmed #29550522.

ABSTRACT: BACKGROUND: In patients who survived out-of-hospital cardiac arrest (OHCA), it is crucial to establish the underlying cause and its potential reversibility. OBJECTIVE: The purpose of this study was to assess the incremental diagnostic and prognostic role of early cardiac magnetic resonance (CMR) in survivors of OHCA. METHODS: Among 139 consecutive OHCA patients, the study enrolled 44 patients (median age 43 years; 84% male) who underwent coronary angiography and CMR ≤7 days after admission. The CMR protocol included T2-weighted sequences for myocardial edema and late gadolinium enhancement (LGE) sequences for myocardial fibrosis. RESULTS: Coronary angiography identified obstructive coronary artery disease in 18 of 44 patients in whom CMR confirmed the diagnosis of ischemic heart disease by demonstrating subendocardial or transmural LGE. The presence of myocardial edema allowed differentiation between acute myocardial ischemia (n = 12) and postinfarction myocardial scar (n = 6). Among the remaining 26 patients without obstructive coronary artery disease, CMR in 19 (73%) showed dilated cardiomyopathy in 5, myocarditis in 4, mitral valve prolapse associated with LGE in 3, ischemic scar in 2, idiopathic nonischemic scar in 2, arrhythmogenic cardiomyopathy in 1, hypertrophic cardiomyopathy in 1, and takotsubo cardiomyopathy in 1. In this subgroup of 26 patients, 6 (23%) had myocardial edema. During mean follow-up of 36 ± 17 months, all 18 patients with myocardial edema had an uneventful outcome, whereas 9 of 26 (35%) without myocardial edema experienced sudden arrhythmic death (n = 1), appropriate defibrillator interventions (n = 5), and nonarrhythmic death (n = 3; P = .006). CONCLUSION: In survivors of OHCA, early CMR with a comprehensive tissue characterization protocol provided additional diagnostic and prognostic value. The identification of myocardial edema was associated with a favorable long-term outcome.

17 Article Absorb bioresorbable vascular scaffold vs. everolimus-eluting metallic stent in small vessel disease: A propensity matched analysis of COMPARE II, RAI, and MAASSTAD-ABSORB studies. 2018

Tarantini, Giuseppe / Masiero, Giulia / Barioli, Alberto / Paradies, Valeria / Vlachojannis, Georgios / Tellaroli, Paola / Cortese, Bernardo / di Palma, Gaetano / Varricchio, Attilio / Ielasi, Alfonso / Loi, Bruno / Steffenino, Giuseppe / Ueshima, Daisuke / Mojoli, Marco / Smits, Pieter. ·Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Maastad Ziekenhuis, Rotterdam, Netherlands. · Biostatistics, Epidemiology and Public Health Unit of Department of Cardiac, Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy. · Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, P.O. Fatebenefratelli, Italy. · Cardiology Division, Santa Maria della Pietà Hospital, Nola, Naples, Italy. · Cardiology Division, A.O. Bolognini, Seriate, Bergamo, Italy. · Cardiology Division, A.O. Brotzu, Cagliari, Italy. · USD Emodinamica, A.S.O. S.Croce e Carle, Cuneo, Italy. ·Catheter Cardiovasc Interv · Pubmed #29513403.

ABSTRACT: BACKGROUND: Patients with small vessel disease (SVD) are at higher risk of adverse events after PCI compared to non-SVD patients. In this subset, the use of bioresorbable vascular scaffolds (BVS) has raised particular concern. OBJECTIVE: We aimed to compare outcomes of Absorb BVS versus a 2nd-generation metallic everolimus-eluting stents (EES) in the SVD setting, by pooling patients from three large, prospective studies. METHODS: Patients with SVD (reference vessel diameter ≤2.75 mm by QCA) and treated with Absorb BVS were identified in the Italian RAI and the MAASSTAD-Absorb registries. EES controls were identified in the COMPARE II Trial. We performed a propensity-score matching using several clinical and angiographic variables. Implantation technique was not object of matching, being device-specific. RESULTS: Out of 4635 enrolled subjects, 1147 belonged to the SVD population. After matching, we obtained 337 pairs of patients. High clinical and angiographic complexity was found in both groups. Predilation and postdilation rates were significantly higher in BVS patients. No differences were found in terms of the device-oriented composite end-point at 1-year (HR = 1.08, 95%CI 0.5-2.3, P = .8) and 2-years (HR = 1.28, 95% CI: 0.68-2.43, P = .5). Notwithstanding, higher incidence of definite/probable stent thrombosis was observed in the BVS group at 1 year (HR 4.7, 95%CI 0.8-31.4, P = .08) and 2-years (HR = 8.34 95%CI 1.1-60.2, P = .04). CONCLUSION: In this propensity-matched analysis pooling SVD patients of three large prospective studies, incidence of composite device-related events was comparable between BVS and EES up to 2 years follow-up. However, higher rates of stent thrombosis were found in the BVS group.

18 Article [Newer generation self-expandable coronary stent bail-out re-sheathing]. 2017

Barioli, Alberto / Napodano, Massimo / Tarantini, Giuseppe. ·Dipartimento di Scienze Cardiache, Toraciche e Vascolari, Università degli Studi, Padova. ·G Ital Cardiol (Rome) · Pubmed #29189831.

ABSTRACT: Newer generation of self-expandable nitinol coronary stents has proven to be useful in the treatment of bifurcations, tapered vessels, thrombotic lesions, venous grafts and ectatic segments. However, optimal device positioning can be cumbersome, due to the peculiar delivery mechanism which consists of retracting an outer sheath in order to release the stent from the distal edge. We report the case of a 53-year-old man, admitted for unstable angina. Coronary angiography showed a tight stenosis of the proximal left anterior descending coronary artery. As the lesion was located in an ectatic segment of the vessel, we chose to implant a StentysTM (Stentys S.A., Paris, France) device. During the release, the stent jumped forward, resulting in geographic miss. We describe the technique used to retrieve the stent and how we re-deployed it in the proper position; moreover, we examine the lesion characteristics which fostered the migration of the self-apposing stent along the vessel.

19 Article APpropriAteness of percutaneous Coronary interventions in patients with ischaemic HEart disease in Italy: the APACHE pilot study. 2017

Leonardi, Sergio / Marino, Marcello / Crimi, Gabriele / Maiorana, Florinda / Rizzotti, Diego / Lettieri, Corrado / Bettari, Luca / Zuccari, Marco / Sganzerla, Paolo / Tresoldi, Simone / Adamo, Marianna / Ghiringhelli, Sergio / Sponzilli, Carlo / Pasquetto, Giampaolo / Pavei, Andrea / Pedon, Luigi / Bassan, Luciano / Bollati, Mario / Camisasca, Paola / Trabattoni, Daniela / Brancati, Marta / Poli, Arnaldo / Panciroli, Claudio / Lettino, Maddalena / Tarelli, Giuseppe / Tarantini, Giuseppe / De Luca, Leonardo / Varbella, Ferdinando / Musumeci, Giuseppe / De Servi, Stefano. ·Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. · Cardiology, Ospedale Maggiore di Crema, Crema, Italy. · Cardiology, ASST Mantova-Ospedale Carlo Poma, Mantova, Italy. · Cardiology, ASST Cremona-Ospedale di Cremona, Cremona, Italy. · Cardiology, Ospedale Fornaroli di Magenta, Magenta, Italy. · Cardiology, ASST Bergamo Ovest-Ospedale di Treviglio, Treviglio, Italy. · Cardiology, Azienda Ospedaliera di Desio e Vimercate, Vimercate, Italy. · Cardiology, Spedali Civili di Brescia, Brescia, Italy. · Cardiology, Ospedale di Circolo Fondazione Macchi, Varese, Italy. · Cardiology, Ospedale San Paolo, Milano, Italy. · Cardiology, Ospedali Riuniti Padova Sud Madre Teresa di Calcutta, Monselice, Italy. · Cardiology, Presidio Ospedaliero di Conegliano, Conegliano, Italy. · Cardiology, Presidio Ospedaliero di Cittadella, Cittadella, Italy. · Cardiology, ULSS 4 Alto Vicentino, Thiene, Italy. · Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy. · Cardiology, Ospedale San Gerardo, Monza, Italy. · Cardiology, Centro Cardiologico Monzino, Milano, Italy. · Cardiology, Fondazione Poliambulanza, Milano, Italy. · Cardiology, ASST Ovest Milanese, Legnano, Italy. · Cardiology, ASST di Lodi, Lodi, Italy. · Cardiology, Humanitas Research Hospital, Rozzano, Italy. · Cardiology, Ospedale di Padova, Padova, Italy. · Cardiology, Ospedale San Giovanni Evangelista, Tivoli, Italy. · Cardiology, Ospedale degli Infermi, Rivoli, Italy. · Cardiology, ASST-Papa Giovanni XXIII-Bergamo, Bergamo, Italy. · Cardiology, IRCCS MultiMedica, Milano, Italy. ·BMJ Open · Pubmed #28877948.

ABSTRACT: OBJECTIVES: To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. DESIGN: Retrospective, pilot study. SETTING: 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. PARTICIPANTS: 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics. PRIMARY AND SECONDARY OUTCOME MEASURES: Proportion of patients who received appropriate PCI using validated appropriate use scores (ie, AUS≥7). Also, in patients with stable CAD, we examined adherence to the following European Society of Cardiology recommendations: (A) per cent of patients with complex coronary anatomy treated after heart team discussion; (B) per cent of fractional flow reserve-guided PCI for borderline stenoses in patients without documented ischaemia; (C) per cent of patients receiving guideline-directed medical therapy at the time of PCI as well as use of provocative test of ischaemia according to pretest probability (PTP) of CAD. RESULTS: Of the 401 mappable PCIs (91%), 38.7% (95% CI 33.9 to 43.6) were classified as appropriate, 47.6% (95% CI 42.7 to 52.6) as uncertain and 13.7% (95% CI 10.5% to 17.5%) as inappropriate. Median PTP in patients with stable CAD without known coronary anatomy was 69% (78% intermediate PTP, 22% high PTP). Ischaemia testing use was similar (p=0.71) in patients with intermediate (n=140, 63%) and with high PTP (n=40, 66%). In patients with stable CAD (n=352) guideline adherence to the three recommendations explored was: (A) 11%; (B) 25%; (C) 23%. AUS was higher in patients evaluated by the heart team as compared with patients who were not (7 (6.8) vs 5 (4.7); p=0.001). CONCLUSIONS: Use of heart team approaches and adherence to guideline recommendations on coronary revascularisation in a real-world setting is limited. This pilot study documents the feasibility of measuring appropriateness and guideline adherence in clinical practice and identifies substantial opportunities for quality improvement. TRIAL REGISTRATION NUMBER: NCT02748603.

20 Article One-year clinical results of the Italian diffuse/multivessel disease ABSORB prospective registry (IT-DISAPPEARS). 2017

Testa, Luca / De Carlo, Marco / Petrolini, Alessandro / Rapetto, Claudio / Varbella, Ferdinando / Cortese, Bernardo / Gabrielli, Gabriele / Geraci, Salvatore / Loi, Bruno / Boccuzzi, Giacomo / Tarantini, Giuseppe / Fischetti, Dionigi / Calabria, Paolo / Tomai, Fabrizio / Ribichini, Flavio / Tamburino, Corrado / Indolfi, Ciro / Bartorelli, Antonio L / Petronio, Anna Sonia / Bedogni, Francesco. ·Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy. ·EuroIntervention · Pubmed #28504219.

ABSTRACT: AIMS: The present multicentre prospective study, IT-DISAPPEARS, was designed with the aim of evaluating early and long-term clinical outcomes of the Absorb BVS in patients with long coronary lesions and/or multivessel coronary artery disease. The aim of this article is to present the one-year clinical results of this study. METHODS AND RESULTS: Between November 2014 and January 2016, we enrolled 1,002 patients undergoing BVS implantation (long lesion [≥ 24 mm] of a single vessel in 80.4%, at least two BVS in two or three coronary vessels in 8.6% and both criteria in 11%). Clinical presentation was an acute coronary syndrome in 59.8% of patients, including ST-elevation myocardial infarction in 21.8%. The primary endpoint was the device-oriented composite endpoint (DOCE) of cardiac death, target vessel MI, and ischaemia-driven TLR at one year. We implanted 2,040 BVS according to a pre-specified technique. One-year follow-up was available in 956 patients (95.4%). The rate of DOCE was 9.9% (95 patients). Cardiac death occurred in five patients (0.5%), while target vessel MI and TLR each occurred in 45 (4.7%) patients. The one-year rates of all-cause death, non-fatal MI, and any revascularisation were 1.2%, 5.4%, and 10.9%, respectively. The rate of definite/probable scaffold thrombosis was 0.9%. CONCLUSIONS: This is the first study specifically investigating the Absorb technology in patients with a high atherosclerotic burden and multivessel disease. The mandatory adherence to a pre-specified implantation technique led to minimising the risk of device failure reported by other studies, in particular with respect to the rate of DOCE and scaffold thrombosis.

21 Article Thirty-Day Outcomes After Unrestricted Implantation of Bioresorbable Vascular Scaffold (from the Prospective RAI Registry). 2017

Cortese, Bernardo / Ielasi, Alfonso / Moscarella, Elisabetta / Loi, Bruno / Tarantini, Giuseppe / Pisano, Francesco / Durante, Alessandro / Pasquetto, Giampaolo / Colombo, Alessandro / Tumminello, Gabriele / Moretti, Luciano / Calabrò, Paolo / Mazzarotto, Pietro / Varricchio, Attilio / Tespili, Maurizio / Latini, Roberto A / Defilippi, Gianfranco / Corrado, Donatella / Steffenino, Giuseppe / Anonymous3030904. ·Division of Cardiology, ASST Fatebenefratelli-Sacco, "Fatebenefratelli" Hospital, Milan, Italy; Fondazione Monasterio-Centro Nazionale delle Ricerche-Regione Toscana, Massa, Italy. Electronic address: bcortese@gmail.com. · Division of Cardiology, ASST Bergamo Est, "Bolognini" Hospital, Seriate (BG), Italy. · Department of Cardio-Thoracic Science, Presidio Ospedaliero "Monaldi", Azienda Ospedaliera Dei Colli, Napoli, Italy. · Department of Cardiovascular Sciences, "Brotzu" Hospital, Cagliari, Italy. · Department of Cardiac, Thoracic, and Vascular Sciences, University Hospital of Padua, Padua, Italy. · Division of Cardiology, "Parini" Regional Hospital, Aosta, Italy. · Division of Cardiology, "Valduce" Hospital, Como, Italy. · Division of Cardiology, "Riuniti Hospital Padova Sud", Monselice (PD), Italy. · Division of Cardiology, ASST Fatebenefratelli-Sacco, "Sacco" Hospital, Milan, Italy. · Division of Cardiology, "Cardinal Massaia" Hospital, Asti, Italy. · Division of Cardiology, "Mazzoni" Hospital, Ascoli Piceno, Italy. · Division of Cardiology, Second University of Naples, "Monaldi" Hospital, Naples, Italy. · Division of Cardiology, Azienda Socio-Sanitaria Territoriale di Lodi, Lodi, Italy. · Division of Cardiology, ASST Fatebenefratelli-Sacco, "Fatebenefratelli" Hospital, Milan, Italy. · "Istituto di Ricerche Farmacologiche Mario Negri", Milan, Italy. · Interventional Cardiology Unit, "Santa Croce e Carle" Hospital, Cuneo, Italy. ·Am J Cardiol · Pubmed #28438304.

ABSTRACT: The Absorb biovascular scaffold (BVS) is a bioresorbable, everolimus-eluting scaffold whose data on real-world patients with complex lesions are limited. Short-term follow-up from recent studies point to a higher rate of 30-day thrombosis than observed with drug-eluting stents. We aimed to understand the short-term safety and efficacy of BVS. Registro Absorb Italiano (RAI, ClinicalTrials.gov:NCT02298413) is an Italian, prospective, multicenter registry not funded, whose aim is to investigate BVS performance through a 5-year follow-up of all consecutive patients who have undergone successful implantation of ≥1 BVS in different clinical/lesion subsets. Co-primary end points were target lesion revascularization and definite/probable thrombosis. Secondary end point was the occurrence of device-oriented cardiac events. The registry involved 23 centers, with patient enrollment from October 2012 to December 2015. We here report the 30-day outcomes of the whole population of the registry. We enrolled 1,505 consecutive patients, of which 82% were men and 22.4% diabetic. At presentation, 59.6% of the patients had an acute coronary syndrome, including 21% ST-elevation myocardial infarction. All lesions were pre-dilated and in 96.8% of the cases BVS was post-dilated. At 30 days, the co-primary study end point target lesion revascularization occurred in 0.6% of patients and definite/probable BVS thrombosis in 0.8%. There were 2 cases of cardiac and overall death (0.13%). Device-oriented cardiac events occurred in 1% of the patients. In conclusion, our data of consecutive patients suggest that current use of BVS in a wide spectrum of coronary narrowings and clinical settings is associated with good outcome at 30 days.

22 Article [Bioresorbable vascular scaffolds: from science to clinical parctice]. 2017

Masiero, Giulia / Tarantini, Giuseppe. ·Dipartimento di Scienze Cardiologiche, Toraciche e Vascolari, Università degli Studi, Padova. ·G Ital Cardiol (Rome) · Pubmed #28398397.

ABSTRACT: -- No abstract --

23 Article SOURCE 3 Registry: Design and 30-Day Results of the European Postapproval Registry of the Latest Generation of the SAPIEN 3 Transcatheter Heart Valve. 2017

Wendler, Olaf / Schymik, Gerhard / Treede, Hendrik / Baumgartner, Helmut / Dumonteil, Nicolas / Ihlberg, Leo / Neumann, Franz-Josef / Tarantini, Giuseppe / Zamarano, José Luis / Vahanian, Alec. ·From King's Health Partners, London, UK (O.W.) · Municipal Hospital, Karlsruhe, Germany (G.S.) · University Heart Centre, Hamburg, Germany (H.T.) · Department of Cardiovascular Medicine, University Hospital Muenster, Germany (H.B.) · Clinique Pasteur, Toulouse, France (N.D.) · University Central Hospital, Helsinki, Finland (L.I.) · University Heart Centre, Bad Krozingen, Germany (F.-J.N.) · University Padua, Department of Cardiac, Thoracic and Vascular Sciences, Italy (G.T.) · University Hospital Ramon y Cajal, Madrid, Spain (J.L.Z.) · and Hopital Bichat, Paris, France (A.V.). ·Circulation · Pubmed #28104716.

ABSTRACT: BACKGROUND: The SOURCE 3 Registry (SAPIEN Aortic Bioprosthesis European Outcome) is a European multicenter, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3 (Edwards Lifesciences, Irvine, CA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: Here, we present the 30-day outcome of the SOURCE 3 Registry. All data are self-reported, and all participating centers have committed to support their consecutive experience with the SAPIEN 3 transcatheter heart valve, dependent on patient consent, before the start of the study. Adverse events are defined with Valve Academic Research Consortium 2 criteria and adjudicated by an independent clinical events committee. RESULTS: A total of 1950 patients from 80 centers in 10 countries were enrolled between July 2014 and October 2015. Of those, 1947 patients underwent transcatheter aortic valve implantation (TAVI) with the SAPIEN 3 (mean age, 81.6±6.6 years; 48.1% female). Main comorbidities included coronary artery disease (51.5%), renal insufficiency (27.4%), diabetes mellitus (29.5%), chronic obstructive pulmonary disease (16.0%), and a mean logistic EuroSCORE of 18.3±13.2. Transfemoral access was used in 87.1% (n=1695); nontransfemoral, in 252 patients. Conscious sedation was used in 59.9% of transfemoral procedures, and in 50% of patients, TAVI was performed without aortic balloon valvuloplasty. Implantation success (1 valve in the intended location) was 98.3%. Conversion to conventional surgery (0.6%) and use of cardiopulmonary bypass (0.7%) were rare. Adverse events were low, with site-reported 30-day all-cause mortality of 2.2%, cardiovascular mortality of 1.1%, stroke of 1.4%, major vascular complications of 4.1%, life-threatening bleeding of 5%, and post-TAVI pacemaker implantation of 12%. Moderate or greater paravalvular regurgitation was observed in 3.1% of reporting patients. CONCLUSIONS: Results from the SOURCE 3 Registry demonstrate contemporary European trends and good outcomes of TAVI in daily practice when this third-generation TAVI device is used.

24 Article Outcomes in Patients With Transcatheter Aortic Valve Replacement and Left Main Stenting: The TAVR-LM Registry. 2016

Chakravarty, Tarun / Sharma, Rahul / Abramowitz, Yigal / Kapadia, Samir / Latib, Azeem / Jilaihawi, Hasan / Poddar, Kanhaiya Lal / Giustino, Gennaro / Ribeiro, Henrique B / Tchetche, Didier / Monteil, Benoit / Testa, Luca / Tarantini, Giuseppe / Facchin, Michela / Lefèvre, Thierry / Lindman, Brian R / Hariri, Babak / Patel, Jigar / Takahashi, Nobuyuki / Matar, George / Mirocha, James / Cheng, Wen / Tuzcu, Murat E / Sievert, Horst / Rodés-Cabau, Josep / Colombo, Antonio / Finkelstein, Ariel / Fajadet, Jean / Makkar, Raj R. ·Cedars-Sinai Heart Institute, Los Angeles, California. · Cedars-Sinai Heart Institute, Los Angeles, California; Tel Aviv Medical Center, Tel Aviv, Israel. · Cleveland Clinic, Cleveland, Ohio. · San Raffaele Scientific Institute and EMO-GVM Centro Cuore Columbus, Milan, Italy. · Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada. · Clinique Pasteur, Toulouse, France. · IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy. · Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy. · Hopital Privé Jacques Cartier, Massy, France. · Washington University School of Medicine, St. Louis, Missouri. · CardioVascular Center Frankfurt CVC, Frankfurt, Germany. · Tel Aviv Medical Center, Tel Aviv, Israel. · Cedars-Sinai Heart Institute, Los Angeles, California. Electronic address: makkarr@cshs.org. ·J Am Coll Cardiol · Pubmed #26916485.

ABSTRACT: BACKGROUND: A percutaneous approach with transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI) of the left main coronary artery (LM) is frequently used in high-risk patients with coexisting aortic stenosis and LM disease. Outcomes of TAVR plus LM PCI have not been previously reported. OBJECTIVES: The primary objective of the TAVR-LM registry is to evaluate clinical outcomes in patients undergoing TAVR plus LM PCI. METHODS: Clinical, echocardiographic, computed tomographic, and angiographic characteristics were retrospectively collected in 204 patients undergoing TAVR plus LM PCI. In total, 128 matched patient pairs were generated by performing 1:1 case-control matching between 167 patients with pre-existing LM stents undergoing TAVR and 1,188 control patients undergoing TAVR without LM revascularization. RESULTS: One-year mortality (9.4% vs. 10.2%, p = 0.83) was similar between the TAVR plus LM PCI cohort and matched controls. One-year mortality after TAVR plus LM PCI was not different in patients with unprotected compared with protected LMs (7.8% vs. 8.1%, p = 0.88), those undergoing LM PCI within 3 months compared with those with LM PCI greater than 3 months before TAVR (7.4% vs. 8.6%, p = 0.61), and those with ostial versus nonostial LM stents (10.3% vs. 15.6%, p = 0.20). Unplanned LM PCI performed because of TAVR-related coronary complication, compared with planned LM PCI performed for pre-existing LM disease, resulted in increased 30-day (15.8% vs. 3.4%, p = 0.013) and 1-year (21.1% vs. 8.0%, p = 0.071) mortality. CONCLUSIONS: Despite the anatomic proximity of the aortic annulus to the LM, TAVR plus LM PCI is safe and technically feasible, with short- and intermediate-term clinical outcomes comparable with those in patients undergoing TAVR alone. These results suggest that TAVR plus LM PCI is a reasonable option for patients who are at high risk for surgery.

25 Article Risk of Adverse Cardiac and Bleeding Events Following Cardiac and Noncardiac Surgery in Patients With Coronary Stent: How Important Is the Interplay Between Stent Type and Time From Stenting to Surgery? 2016

Saia, Francesco / Belotti, Laura Maria Beatrice / Guastaroba, Paolo / Berardini, Alessandra / Rossini, Roberta / Musumeci, Giuseppe / Tarantini, Giuseppe / Campo, Gianluca / Guiducci, Vincenzo / Tarantino, Fabio / Menozzi, Alberto / Varani, Elisabetta / Santarelli, Andrea / Tondi, Stefano / De Palma, Rossana / Rapezzi, Claudio / Marzocchi, Antonio. ·From the Institute of Cardiology, Cardio-thoraco-vascular Department, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy (F.S., A.B., C.R., A. Marzocchi) · Regional Health Care and Social Agency, Bologna, Italy (L.M.B.B., P.G., R.D.P.) · Cardiovascular Department, Papa Giovanni XXIII Hospital, Bergamo, Italy (R.R., G.M.) · Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy (G.T.) · Cardiology Unit, Department of Medical Sciences, Azienda Ospedaliero-Universitaria S.Anna, Cona (Ferrara), Italy (G.C.) · Interventional Cardiology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy (V.G.) · Interventional Cardiology Unit, Morgagni Hospital, Forlì, Italy (F.T.) · Cardiovascular Department, Maggiore Hospital, Parma, Italy (A. Menozzi) · Cardiovascular Department, S. Maria delle Croci Hospital, Ravenna, Italy (E.V.) · Cardiology department, Ospedale degli Infermi, Rimini, Italy (A.S.) · and Department of Cardiology, Baggiovara Hospital, Modena, Italy (S.T.). ·Circ Cardiovasc Qual Outcomes · Pubmed #26646819.

ABSTRACT: BACKGROUND: Epidemiology and consequences of surgery in patients with coronary stents are not clearly defined, as well as the impact of different stent types in relationship with timing of surgery. METHODS AND RESULTS: Among 39 362 patients with previous coronary stenting enrolled in a multicenter prospective registry and followed for 5 years, 13 128 patients underwent 17 226 surgical procedures. The cumulative incidence of surgery at 30 days, 6 months, 1 year, and 5 years was 3.6%, 9.4%, 14.3%, and 40.0%, respectively, and of cardiac and noncardiac surgery was 0.8%, 2.1%, 2.6%, and 4.0% and 1.3%, 5.1%, 9.1%, and 31.7%, respectively. We assessed the incidence and the predictors of cardiac death, myocardial infarction, and serious bleeding event within 30 days from surgery. Cardiac death occurred in 438 patients (2.5%), myocardial infarction in 256 (1.5%), and serious bleeding event in 1099 (6.4%). Surgery increased 1.58× the risk of cardiac death during follow-up. Along with other risk factors, the interplay between stent type and time from percutaneous coronary intervention to surgery was independently associated with cardiac death/myocardial infarction. In comparison with bare-metal stent implanted >12 months before surgery, old-generation drug-eluting stent was associated with higher risk of events at any time point. Conversely, new-generation drug-eluting stent showed similar safety as bare-metal stent >12 months and between 6 and 12 months and appeared trendly safer between 0 and 6 months. CONCLUSIONS: Surgery is frequent in patients with coronary stents and carries a considerable risk of ischemic and bleeding events. Ischemic risk is inversely related with time from percutaneous coronary intervention to surgery and is influenced by stent type.

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