Giornale italiano di cardiologia最新文献

{"title":"[Clinical pharmacology of combination therapies for the prevention and treatment of cardiovascular diseases].","authors":"Nicola Ferri, Alberto Corsini","doi":"10.1714/4425.44225","DOIUrl":"10.1714/4425.44225","url":null,"abstract":"<p><p>Hypertension and hypercholesterolemia represent two causal factors of atherosclerotic cardiovascular disease and are modulated by different molecular mediators. These mediators represent the pharmacological targets on which oral therapies have been developed for the control of hypertension and hypercholesterolemia. Pharmacological therapy aimed at modulating cardiovascular risk factors has demonstrated clinical efficacy with the results of several phase 3 clinical trials. In particular, the HMG-CoA reductase inhibitors, including rosuvastatin, and the inhibitor of the cholesterol transporter NPC1L1 ezetimibe are effective drugs in reducing levels of low-density lipoprotein cholesterol. On the other side, antihypertensive drugs include renin-angiotensin-aldosterone system inhibitors, such as angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers, calcium channel blockers, beta-blockers and thiazide diuretics. Combination therapy, therefore, represents the most effective and tolerated approach for controlling both risk factors. Based on this evidence, fixed combination therapies have been developed which are useful in simplifying the treatment of patients at high cardiovascular risk. An essential condition for the development of fixed formulations is represented by the complementarity of the pharmacological action of the two or three associated drugs, and similar pharmacokinetic profile allowing the same frequency of administration. Furthermore, the pharmacokinetic profile of the two drugs given in fixed combination must not differ significantly from that observed with the two drugs administered individually. In this review the following fixed combination therapies are examined: rosuvastatin/ezetimibe, ramipril/amlodipine, candesartan/amlodipine, ramipril/amlodipine/hydrochlorothiazide and amlodipine/rosuvastatin, describing their pharmacodynamic and pharmacokinetic characteristics and their bioequivalence with respect to single therapies. This analysis provides essential information for the evaluation of their clinical effectiveness in the control of hypertension and hypercholesterolemia in patients at high cardiovascular risk.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 1","pages":"e6-e16"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Cardiovascular risk stratification: from algorithms to clinical phenotype].","authors":"Furio Colivicchi, Stefania Angela Di Fusco","doi":"10.1714/4425.44224","DOIUrl":"10.1714/4425.44224","url":null,"abstract":"<p><p>For an appropriate implementation of both primary and secondary cardiovascular prevention strategies, stratification of the individual cardiovascular risk is recommended. Given that atherosclerotic cardiovascular diseases have a multifactorial origin, risk stratification should take into consideration several risk factors, both non-modifiable ones such as age, and modifiable ones, such as cholesterol levels, diabetes, blood pressure levels, cigarette smoking, and body weight. For apparently healthy individuals, to define the risk of each subject of having a cardiovascular event within 10 years, the European Society of Cardiology (ESC) guidelines recommend the use of specific risk scores depending on patient's age (SCORE2 between 40 and 69 years, SCORE2-OP ≥70 years). For diabetic patients without evidence of cardiovascular disease, the use of the SCORE2-Diabetes is recommended. In clinical practice, the use of the ESC CVD Risk Calculation application, by entering all the parameters required by the different scores, allows a rapid estimate of individual risk. Patients with known atherosclerotic cardiovascular disease have a very high cardiovascular risk.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 1","pages":"e1-e5"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The contrast that clarifies everything].","authors":"Beatrice Dal Passo, Giulia Passarini","doi":"10.1714/4394.43964","DOIUrl":"10.1714/4394.43964","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"26 1","pages":"e1"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic-therapeutic care pathways for patients with cardiac amyloidosis - SIC/ANMCO Consensus document. Edited by the Italian Cardiac Amyloidosis Network (RIAC)].","authors":"Aldostefano Porcari, Cristina Chimenti, Marco Merlo, Francesco Musca, Giuseppe Vergaro, Massimo Iacoviello, Alberto Aimo, Andrea Di Lenarda, Marco Canepa, Francesco Cappelli, Alberto Cipriani, Gianluca Di Bella, Cinzia Forleo, Massimo Imazio, Giuseppe Limongelli, Simone Longhi, Beatrice Musumeci, Laura Obici, Federico Perfetto, Stefano Perlini, Matteo Serenelli, Daniela Tomasoni, Fabio Vagnarelli, Giampaolo Merlini, Giovanni Palladini, Marco Metra, Furio Colivicchi, Ciro Indolfi, Massimo Grimaldi, Pasquale Perrone Filardi, Michele Emdin, Gianfranco Sinagra, Fabrizio Oliva","doi":"10.1714/4372.43703","DOIUrl":"10.1714/4372.43703","url":null,"abstract":"<p><p>The perspective on cardiac amyloidosis has deeply changed over the last 10 years following major advances in diagnosis and treatment options. This heterogeneous disease requires the interaction among experts of different specialties and subspecialties. Suspicion of disease, timely recognition and confirmation of final diagnosis, prognostic stratification, overall management and therapeutic strategies represent ongoing challenges in the clinical setting. Missing or delayed diagnosis may have significant impact on patient outcome, especially in light-chain amyloidosis. The present inter-society consensus document aims to provide a standardized approach to the diagnosis of cardiac amyloidosis in Italy, and to discuss the challenging clinical scenarios encountered in routine activity for cardiologists and physicians of different specialties dealing with patients with suspected or established cardiac amyloidosis. This document may be adapted to the setting of each specific region.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 12","pages":"900-920"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[2024 ESC Guidelines for the management of chronic coronary syndromes].","authors":"Christiaan Vrints, Felicita Andreotti, Konstantinos C Koskinas, Xavier Rossello, Marianna Adamo, James Ainslie, Adrian Paul Banning, Andrzej Budaj, Ronny R Buechel, Giovanni Alfonso Chiariello, Alaide Chieffo, Ruxandra Maria Christodorescu, Christi Deaton, Torsten Doenst, Hywel W Jones, Vijay Kunadian, Julinda Mehilli, Milan Milojevic, Jan J Piek, Francesca Pugliese, Andrea Rubboli, Anne Grete Semb, Roxy Senior, Jurrien M Ten Berg, Eric Van Belle, Emeline M Van Craenenbroeck, Rafael Vidal-Perez, Simon Winther","doi":"10.1714/4375.43725","DOIUrl":"10.1714/4375.43725","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 12","pages":"e1-e132"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intermediate-high risk pulmonary embolism: time matters. The case of a young breastfeeding woman].","authors":"Marco Giovanni Mennuni, Leonardo Grisafi, Martina Solli, Domenico D'Amario, Francesco De Crescenzo, Vincenzo Galiffa, Roberta Rosso, Giuseppe Patti","doi":"10.1714/4372.43701","DOIUrl":"10.1714/4372.43701","url":null,"abstract":"<p><p>Pulmonary embolism in the post-partum period is a critical condition with significant implications for maternal and infant health. We present a case report illustrating the challenges in the clinical management of a patient with intermediate-high risk pulmonary embolism who developed signs of hemodynamic instability in light of current clinical practice.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 12","pages":"888-890"},"PeriodicalIF":0.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Left atrial appendage closure guided with intracardiac echocardiographic probe via transesophageal route].","authors":"Giorgio Sacchetta, Giulia Laterra, Giombattista Barrano, Claudia Artale, Marco Contarini","doi":"10.1714/4371.43685","DOIUrl":"10.1714/4371.43685","url":null,"abstract":"<p><p>Atrial fibrillation is the most common cardiac arrhythmia in adults and increases the risk of stroke 5-fold. In patients with non-valvular atrial fibrillation, left atrial appendage is the most common site for cardiac thrombus. For this reason, left atrial appendage closure (LAAC) represents an effective alternative to oral anticoagulants in patients who have relative or absolute contraindications to oral anticoagulation. Transesophageal echocardiography (TEE) is considered the gold standard imaging modality to guide LAAC. However, general anesthesia and tracheal intubation are often required with the TEE approach, increasing risks in elderly patients. There is an unmet need to overcome these limitations identifying an ideal \"minimalist approach\" to guide LAAC. Intracardiac echocardiography (ICE) represents a minimalist approach but it suffers from the lack of standardization and it may result in an suboptimal image quality compared with TEE. Another innovative approach is represented by the use of ICE via the transesophageal route (ICE-TEE), which has been already validated to identify the presence of left atrial appendage thrombi and to perform other procedures. In this paper, we suggest that ICE-TEE could be a good alternative imaging technique to guide the LAAC procedure without general anesthesia. A trial is ongoing to demonstrate its safety and effectiveness as ultrasound modality to guide LAAC.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 11","pages":"29S-33S"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[ST-elevation myocardial infarction caused by stent fracture: a case report].","authors":"Marta Mazzotta, Roberta Rosati, Ferdinando Cosentini, Valentina Regazzoni, Paolo Pedroni, Alfredo Spotti, Marco Loffi, Gian Battista Danzi","doi":"10.1714/4371.43687","DOIUrl":"10.1714/4371.43687","url":null,"abstract":"<p><p>Coronary stent fracture is an infrequent event, with an incidence ranging from 1% to 8%. In rare cases, this complication may result in acute occlusion of the affected coronary artery. We report the case of a patient who experienced acute coronary syndrome following a stent fracture implanted 3 years previously. Myocardial infarction was caused by thrombosis occluding the vessel and probably triggered by endothelial injury caused by the protruding metal strut of the fractured stent. Vessel tortuosity, hinge motion, overlapping stents, increased stent length, smaller stent diameter and high post-dilation pressure are risk factors for stent fracture. In conclusion, to ensure proper recognition of this often-misunderstood clinical entity, it is necessary to be aware of its occurrence.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 11","pages":"37S-38S"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The ETNA-AF Europe registry: 4-year data of edoxaban use in atrial fibrillation in the Italian real world compared to the European cohort].","authors":"Letizia Riva, Giuseppe Andò, Maurizio Anselmi, Roberto Cemin, Daniele Nassiacos, Giovanni Fionda, Raffaele De Caterina","doi":"10.1714/0000.43289","DOIUrl":"10.1714/0000.43289","url":null,"abstract":"<p><strong>Background: </strong>The prospective, single-arm, observational, phase 4 ETNA-AF Europe study collected real-world data about safety, effectiveness and therapeutic adherence in European patients with non-valvular atrial fibrillation newly prescribed with edoxaban and followed up for 4 years.</p><p><strong>Methods: </strong>Overall, 13 164 patients were included in the full-analysis set, which means that they had at least one documentation after baseline at 4 years. The current paper reports about the 3329 Italian patients out of the whole European population.</p><p><strong>Results: </strong>In the Italian cohort, median age was 76.0 (69.0-82.0) years, with 57.4% of the patients being ≥75 years old. The CHA2DS2-VASc score was >4 in 586 (18.1%) patients. At baseline, 670 (20.8%) patients were classified as frail by the investigators. Edoxaban 30 mg/day was prescribed to 1013 (31.8%) patients: these were older, with more comorbidities and a lower estimated creatinine clearance compared with those receiving 60 mg/day. All-cause mortality was 4.1%/year and there were very low yearly rates of bleeding and thromboembolic events: major bleeding, 0.9%; intracranial hemorrhage, 0.2%; ischemic stroke, 0.3%; systemic embolism, <0.1%. These events were more frequent in patients ≥75 years or in patients with renal impairment or treated with edoxaban 30 mg/day. Advancing age was not associated with an increased incidence of intracranial bleeding.</p><p><strong>Conclusions: </strong>These findings confirm the favorable long-term safety and effectiveness profile of edoxaban in non-valvular atrial fibrillation patients treated in routine clinical care in Italy.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 11","pages":"819-832"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[2024 ESC Guidelines for the management of elevated blood pressure and hypertension].","authors":"John William McEvoy, Cian P McCarthy, Rosa Maria Bruno, Sofie Brouwers, Michelle D Canavan, Claudio Ceconi, Ruxandra Maria Christodorescu, Stella S Daskalopoulou, Charles J Ferro, Eva Gerdts, Henner Hanssen, Julie Harris, Lucas Lauder, Richard J McManus, Gerard J Molloy, Kazem Rahimi, Vera Regitz-Zagrosek, Gian Paolo Rossi, Else Charlotte Sandset, Bart Scheenaerts, Jan A Staessen, Izabella Uchmanowicz, Maurizio Volterrani, Rhian M Touyz","doi":"10.1714/4361.43518","DOIUrl":"10.1714/4361.43518","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":"25 11","pages":"e1-e107"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}