Minerva cardiology and angiology最新文献

{"title":"Hypercholesterolemia and cardiovascular disease: the dilemma of effective treatment for target achievement according to guidelines and national healthcare policies and a call to action.","authors":"Laura A Dalla Vecchia, Francesco DE Stefano, Maurizio Bussotti, Cosmo Godino, Marco Bernardi, Luigi Spadafora, Edvige Palazzo Adriano, Pasquale Guarini, Roberto F Pedretti","doi":"10.23736/S2724-5683.25.06704-3","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06704-3","url":null,"abstract":"<p><p>The burden of cardiovascular disease (CVD) remains a worldwide challenge. CVDs, in particular atherosclerotic CVD, are still an important cause of mortality and morbidity. The increase in life expectancy is a further determining factor in the epidemiology of CVDs in some countries, such as Italy, which increases the urgency of intervening on modifiable risk factors. Among these, hypercholesterolemia is present in a significant percentage of CVD patients. A linear relationship between the risk of acute events and the plasma level of low-density lipoproteins cholesterol (LDL-C) is well known. The reduction of LDL-C levels leads to a decrease in mortality and morbidity. The overall recommendation is to treat hypercholesterolemia intensively and as early as possible. Statins, ezetimibe, bempedoic acid, pro-protein convertase subtilisin/kexin 9 inhibitors (i.e., the monoclonal antibodies alirocumab and evolocumab, or the small interfering RNA inclisiran) are all available for reaching LDL-C targets according to risk profile. While the real-world data confirm the safety of currently recommended LDL-C targets, data on their actual achievement are discouraging, less than half of patients on therapy reach the LDL-C targets recommended by the most recent ESC/EAS Guidelines. The causes of this critical discrepancy are multiple, arising from the various components that characterize the complex relationship between patient and physician within the healthcare system. A call to action is needed. Doctors should be continuously updated on the latest evidence, follow recommendations and engage the patient in the therapeutic process. Regular monitoring of the effects of the prescribed therapy, also through e-health and telemedicine tools, is essential, as well as changing therapy when LDL-C is not adequately controlled. Finally, health systems should align with guidelines and promote good clinical practices, overcoming a silo system, to impact outcomes in terms of overall sustainability.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding immune involvement in acute coronary syndromes: insights from novel biomarker discovery.","authors":"Marco Borgi, Francesco Mannaioli, Francesco Versaci","doi":"10.23736/S2724-5683.25.06726-2","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06726-2","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of percutaneous coronary intervention in spontaneous coronary artery dissection: between Scylla and Charybdis.","authors":"Marco Lombardi, Jorge Chavez-Solsol, Pablo Salinas, Enrico Cerrato, Rocco Vergallo, Italo Porto, Ferdinando Varbella, Nieves Gonzalo, Javier Escaned, Fernando Macaya-Ten","doi":"10.23736/S2724-5683.24.06680-8","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06680-8","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a distinct and increasingly recognized cause of acute coronary syndromes, primarily affecting young and middle-aged women with few cardiovascular risk factors. While SCAD often resolves spontaneously with conservative management, percutaneous coronary intervention (PCI) is sometimes necessary, especially in patients with ongoing ischemia or high-risk anatomical features. This review summarizes the current state of knowledge regarding the interventional approach in SCAD, emphasizing the rationale for conservative treatment, and the indications for and challenges associated with PCI. It also provides practical recommendations, particularly highlighting technical aspects of PCI in SCAD, the critical role of intracoronary imaging, and the modality and timing of post-PCI surveillance.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of biochemical and economic outcomes in patients treated with PCSK9 inhibitors in a real clinical practice setting.","authors":"Melania Dovizio, Marta Nugnes, Biagio Iacolare, Carmela Nappi, Stefania Saragoni, Margherita Andretta, Antonietta Barbieri, Fausto Bartolini, Gianmarco Chinellato, Mariarosaria Cillo, Stefania Dell'orco, Stefano Grego, Antonella Lavalle, Cataldo Procacci, Davide Re, Luca Degli Esposti","doi":"10.23736/S2724-5683.24.06626-2","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06626-2","url":null,"abstract":"<p><strong>Background: </strong>PCSK9 inhibitors (PCSK9i) in combination with high-dose statins can reduce LDL-cholesterol (LDL-C) levels by 50-60% over statin monotherapy. This analysis investigated biochemical (LDL-C reduction) and economic outcomes in Italian patients treated with PCSK9i or potentially eligible but untreated.</p><p><strong>Methods: </strong>Administrative databases of healthcare institutions covering around 5 million residents were used to identify patients with PCSK9i prescriptions or potentially eligible-untreated patients between 2017 and Oct-2022. Outcomes were assessed during follow-up in cohorts balanced for baseline covariates by propensity score matching (PSM).</p><p><strong>Results: </strong>After PSM-balancing, 2649 treated and 2649 potentially eligible-untreated patients were included: mean age 64.4-64.7 years, 70-68% males, 92-93% with hypertension, 24-25% with diabetes, and 87% with previous atherosclerotic/cardiovascular events. During follow-up, PCSK9i-treated patients versus untreated/eligible showed a reduction of LDL-C levels (68.9±43.9 vs. 100.4±34.6 mg/dL, P<0.0001), hospitalization rates for heart attack (4.5% vs. 6.8%, P=0.0069), heart failure (4.5% vs. 6.6%, P=0.010), and lower all-cause mortality (3.2% vs. 9.5%, P<0.0001). The multivariate Cox model confirmed that eligible-untreated patients had a more than doubled mortality risk compared to the PCSK9i-treated ones (HR: 2.291, 95%CI: 1.651-3.178, P<0.0001). Although mean annualized total healthcare costs were higher in PCSK9i-treated versus untreated/eligible patients (€6745 vs. €4343, P<0.0001), because of the higher drug costs, PCSK9i therapy was associated with reduced expenses for hospitalizations (€1113 vs. €1687, P<0.0001) and specialist outpatient services (€386 vs. €787, P<0.0001).</p><p><strong>Conclusions: </strong>The real-world analysis suggests that therapy with PCSK9i resulted in reduced LDL-C levels, lower mortality rates and cost savings for hospitalizations and specialist services.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tribute to the 60 years of angioplasty celebrating January 16th, 1964's first angioplasty by Charles Dotter: voices from the past, messages to build the future.","authors":"Jean Marco, Chiara DE Biase, Luigi Spadafora, Emanuele Barbato, Davide Capodanno, Francesco Saia, Salvatore DE Rosa, Elad Asher, Mattia Galli, Marco Bernardi, Pierre Sabouret","doi":"10.23736/S2724-5683.25.06571-8","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06571-8","url":null,"abstract":"<p><p>Charles T. Dotter is a recognized pioneer of interventional cardiology as much as the inventor of the angioplasty balloon himself, Andreas R. Grüntzig. Yet, despite Dotter's pioneering role in developing transluminal angioplasty, a recent survey revealed a significant lack of awareness among younger interventional cardiologists and fellows about his contributions, contrasting sharply with their familiarity with Grüntzig. We thereby shed light on Dotter's innovations and the reasons behind his relative obscurity in contemporary discourse, urging the medical community to embrace the lessons from his journey for future success. We explicitly focus on Dotter's early achievements, including his groundbreaking work in 1964, where he performed the first transluminal angioplasty, laying the groundwork for what would become a cornerstone in vascular intervention and creating the eponymous Dotter effect. Despite the initial resistance and skepticism, Dotter's methods eventually found their way to Europe, influencing Grüntzig and leading to the development of the balloon catheter. We also meticulously trace the evolution of angioplasty from Dotter's early experiments to Grüntzig's refinement of the technique and its application in coronary arteries, underscoring the pivotal moments and challenges encountered along the way. Dotter's obscurity stems from a combination of factors, including his confrontational approach and the reluctance of the medical establishment to embrace his radical ideas. Indeed, Dotter's story offers invaluable lessons on the importance of teamwork, perseverance, and the need for a supportive community to foster innovation in medicine.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for recurrence of persistent atrial fibrillation after radiofrequency ablation and correlation with plasma miRNA expression.","authors":"Beibei Ren, Shanglang Cai, Maojing Wang","doi":"10.23736/S2724-5683.24.06402-0","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06402-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study was to investigate the risk factors for recurrence after radiofrequency ablation (RFCA) in patients with persistent atrial fibrillation (PeAF) and analyse its correlation with plasma microribonucleic acid (miRNA) expression based on ultrasound cardiograms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 126 PeAF patients who underwent RFCA were selected as the research subjects (AF group), and 126 healthy subjects matched by gender and age were included as the control (control group). The basic data and biochemical indexes of the included research subjects were collected, and the subjects were followed up for one year after surgery. According to AF recurrence, all research subjects were divided into the recurrence group (45 cases) and the unpredictable group (81 cases). The t-test or Mann-Whitney U Test was adopted to compare B-type natriuretic peptide (BNP), uric acid (UA), glycosylated hemoglobin (HbA&lt;inf&gt;1c&lt;/inf&gt;), and other biochemical indicators among patients in recurrence group and unpredictable group. In addition, left atrial diameter (LAD), left atrial volume (LAV), and left atrial ejection fraction (LAEF) were measured in both groups of patients. Logistic regression analysis was performed to identify the primary risk factors for recurrence among patients with PeAF after RFCA. Furthermore, the receiver operating characteristic (ROC) curve was used to compare the area under the curve (AUC) of the identified risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AF duration in the recurrence group was shorter than that in the unpredictable group (P&lt;0.01). The proportion of patients with a CHADS2 score of two or above in the recurrence group was significantly higher than that in the unpredictable group (P&lt;0.05) in addition to UA (P&lt;0.05) and BNP (P&lt;0.001). Similarly, the LAD and LAV in the recurrence group were significantly higher (P&lt;0.01), and LAEF was also found to be superior (P&lt;0.05) in comparison to the unpredictable group. The relative expressions of plasma miRNA-150 and miRNA-133 of the patients in the AF group were remarkably reduced compared with those in the control group (P&lt;0.05), while the relative expressions of miRNA-206, miRNA-21, miRNA-31, miRNA-27b, and miRNA-328 were all significantly increased (P&lt;0.05) in contrast to those in the control group, and the plasma miRNA-21 (P&lt;0.001) and miRNA-27b (P&lt;0.05) expression of the patients in the recurrence group were significantly higher than that in the unpredictable group. AF duration (odds ratio (OR) = 1.182, 95% confidence interval (CI): 1.021~1.357), LAD (OR=2.066, 95% CI: 1.203~4.491), miRNA-21 (OR=1.253, 95% CI: 1.012-1.647), and miRNA-27b (OR=1.186, 95% CI: 1.006-1.391) were all correlated with recurrence among patients with PeAF after RFCA (P&lt;0.05). The AUCs of AF duration, LAD, miRNA-21, and miRNA-27b LAD were found to be 0.654, 0.703, 0.795, and 0.815, respectively. The sensitivity values were 0.687, 0.701, 0.734, and 0.789, while the correspo","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in coronary artery disease and dyslipidemia-related mortality in the USA from 1999-2020.","authors":"Muhammad R Cheema, Faizan Ahmed, Farman Ali, Zulfiqar Q Baloch, Abdul M Minhas, Faisal Khosa, Nishant Shah","doi":"10.23736/S2724-5683.24.06664-X","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06664-X","url":null,"abstract":"<p><strong>Background: </strong>This study examined trends and disparities in USA mortality rates associated with the co-occurrence of coronary artery disease (CAD) and dyslipidemia from 1999-2020.</p><p><strong>Methods: </strong>Data were obtained from the multiple cause of death files using CDC WONDER, spanning 1999-2020. ICD-10 codes (I20-I25 for CAD and E78 for dyslipidemia) identified CAD and dyslipidemia-related deaths in adults aged 25 and older. Statistical analyses examined demographic and regional mortality distributions. Joinpoint regression analysis determined trends in age-adjusted mortality rates (AAMR), estimating annual percentage changes (APC).</p><p><strong>Results: </strong>Between 1999 and 2020, 613,969 CAD and dyslipidemia-related deaths occurred in the USA. The AAMR per 100,000 increased from 6.2 in 1999 to 19.0 in 2020. The AAMR rose sharply from 1999-2005 (APC: 10.2; 95% CI: 9.1, 11.3), increased from 2005-2010 (APC: 3.3; 95% CI: 2.6, 5.0), stabilized through 2010-2016 (APC: 0.8; 95% CI: -0.5, 1.4), and increased again from 2016-2019 (APC: 3.0; 95% CI: 1.7, 4.7). Men accounted for 59.8% of deaths, with an AAMR of 18.2, compared to 8.7 for women. Non-Hispanic (NH) American Indian (13.4) and NH white populations (13.3) had the highest AAMRs, followed by NH black or African American (12), Hispanic or Latino (9.8), and NH Asian or Pacific Islanders (9.1). The Midwest had the highest AAMR (14.1), followed by the West (13.8), South (12.2), and Northeast (11.3). Nonmetropolitan areas had higher AAMRs (14.7) compared to metropolitan areas (12.4).</p><p><strong>Conclusions: </strong>Mortality due to concurrent CAD and dyslipidemia is increasing. Targeted interventions are needed to reduce mortality among vulnerable groups.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myocardial deformation analysis in cardiac amyloidosis: a feasible and clinical-oriented evaluation?","authors":"Annagrazia Cecere, Martina Perazzolo Marra","doi":"10.23736/S2724-5683.25.06821-8","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06821-8","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum uric acid and drug-eluting stent implantation for coronary bifurcated lesions.","authors":"Hongjie Gao, Dongchao Liu, Zheng Xue, Jingxian Qi, Liang Yin, Bing Duan, Lin Wu, Kun Yang, Bulang Gao, Qinying Cao, Jie Mi","doi":"10.23736/S2724-5683.24.06658-4","DOIUrl":"https://doi.org/10.23736/S2724-5683.24.06658-4","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to investigate the effect of hyperuricemia on prognosis of drug-eluting stent implantation for coronary bifurcated lesions and the value of uric acid levels in predicting the prognosis.</p><p><strong>Methods: </strong>Patients with coronary bifurcation lesions treated with drug-eluting stent implantation were retrospectively enrolled. The clinical, interventional and follow-up data were analyzed.</p><p><strong>Results: </strong>Totally, 308 patients were enrolled and were divided into three groups according to the uric acid levels: group Q1 (N.=105), Q2 (N.=101), and Q3 (N.=102). Before PCI, the stenosis rate was 0.85 (0.80, 0.90) for the main coronary artery and 0.50 (0.50, 0.50) for the branch artery. After PCI and stent deployment, the arterial stenosis rate was 0.20 (0.20, 0.20) for the main coronary artery and 0.50 (0.50, 0.50) for the branch artery. At 36-month follow-up, seven patients died of different reasons, with five patients in group Q1, one in group Q2, and one in group Q3, 96 patients were readmitted for treatment of angina pectoris, with 18 in Q1 group, 29 in Q2 group, and 49 in Q3 group. Twenty-seven patients experienced revascularization because of deterioration of the condition, including six patients in group Q1, seven in group Q2, and 14 in group Q3. After correction of the confounding factors, the readmission rate of angina pectoris was significantly (P<0.001) increased with the increase of the uric acid level: Q3 vs. Q1 (220.47/1000 vs. 66.69/1000 person years, HR 3.65, 95% CI 1.92-6.96) and Q2 vs. Q1 (113.76/1000 vs. 66.69/1000 person years, HR 2.20,95% CI 1.16-4.18).</p><p><strong>Conclusions: </strong>Increased uric acid level is an independent risk factor for cardiogenic readmission rather than for all-cause mortality and revascularization after drug-eluting stent implantation for patients with coronary bifurcation lesions.</p>","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular dementia: at the crossroads of brain and heart health.","authors":"Ahmed Sayed, Gerardo Lo Russo","doi":"10.23736/S2724-5683.25.06894-2","DOIUrl":"https://doi.org/10.23736/S2724-5683.25.06894-2","url":null,"abstract":"","PeriodicalId":18668,"journal":{"name":"Minerva cardiology and angiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}