The benefit of physical exercise is well established, but, at the same time, it is now well known that an intense sports activity can trigger adverse cardiac events and increase sport-related death. Since 1982, Italy has a State law which obliges athletes to undergo a pre-participation evaluation, based on history, physical examination, ECG and stress test. From its introduction, a significant reduction in cardiac sport-related adverse events has been shown. During the pre-participation screening, some cardiological issues or suspects can arise and the sports medicine doctor should deal with them before releasing the certification for participation in competitive sport. In order to give precious advices to these colleagues and help athletes to securely practice sport, the Italian Society of Sports Cardiology, the Italian Federation of Sports Medicine and the other cardiological scientific societies gathered in the COCIS Committee, periodically produce and publish a booklet named "Cardiological Protocols for Competitive Sports Eligibility". The object of this review is to underline the recent 2023 version innovations when compared to previous editions.
{"title":"[Recommendations for competitive sports eligibility: what's new in the 2023 COCIS protocols].","authors":"Giampiero Patrizi, Lucia Tardini","doi":"10.1714/4269.42467","DOIUrl":"10.1714/4269.42467","url":null,"abstract":"<p><p>The benefit of physical exercise is well established, but, at the same time, it is now well known that an intense sports activity can trigger adverse cardiac events and increase sport-related death. Since 1982, Italy has a State law which obliges athletes to undergo a pre-participation evaluation, based on history, physical examination, ECG and stress test. From its introduction, a significant reduction in cardiac sport-related adverse events has been shown. During the pre-participation screening, some cardiological issues or suspects can arise and the sports medicine doctor should deal with them before releasing the certification for participation in competitive sport. In order to give precious advices to these colleagues and help athletes to securely practice sport, the Italian Society of Sports Cardiology, the Italian Federation of Sports Medicine and the other cardiological scientific societies gathered in the COCIS Committee, periodically produce and publish a booklet named \"Cardiological Protocols for Competitive Sports Eligibility\". The object of this review is to underline the recent 2023 version innovations when compared to previous editions.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161124","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}
A 60-year-old man with hypercholesterolemia and hypertension presented with acute coronary syndrome (SCA). The ECG showed lateral ischemia (T-wave inversion in V4-V6, D1 and aVL) and echocardiography showed normal left ventricular wall motion. Coronary angiography showed critical atherosclerotic lesions in the distal part of the left circumflex artery (LCx, culprit lesion), chronic total occlusion of the right coronary artery (RCA), significant but not critical stenosis in the middle part of left anterior descending artery (LAD), and a coronary artery to pulmonary artery (PA) fistula originating from the proximal part of the LAD and emptying into the PA via a coronary saccular aneurysm (12 x 12 x 10 mm). A multidetector row computed tomography angiography (CTA) confirmed the coronary artery fistula, which was treated with surgical approach. The patient underwent aneurysmorrhaphy with CAF closure and coronary artery bypass grafting on the RCA and LCx. The postoperative course was uneventful and the patient was discharged on postoperative day 14. CTA was useful for understanding the spatial relation of the CAF and the connection with the PA.
一名患有高胆固醇血症和高血压的 60 岁男子出现急性冠状动脉综合征(SCA)。心电图显示侧壁缺血(V4-V6、D1和aVL出现T波倒置),超声心动图显示左心室壁运动正常。冠状动脉造影显示左侧环状动脉(LCx,罪魁祸首)远端存在严重的动脉粥样硬化病变,右侧冠状动脉(RCA)慢性全闭塞、左前降支动脉(LAD)中段有明显但非严重狭窄,冠状动脉至肺动脉(PA)瘘源于左前降支动脉近端,通过冠状动脉囊状动脉瘤(12 x 12 x 10 毫米)流入肺动脉。多切面行计算机断层扫描血管造影术(CTA)证实了冠状动脉瘘,并采用手术方法进行了治疗。患者接受了动脉瘤夹闭术,并在 RCA 和 LCx 上进行了冠状动脉搭桥术。术后过程顺利,患者于术后第14天出院。CTA 有助于了解 CAF 的空间关系以及与 PA 的连接。
{"title":"[Surgical treatment of coronary artery to pulmonary artery fistula with a saccular aneurysm].","authors":"Gerardo Musuraca, Cristiana Giovanelli, Clotilde Terraneo, Nicola Osti, Alessandro Motta, Carlo Angheben, Remo Albiero","doi":"10.1714/4287.42691","DOIUrl":"10.1714/4287.42691","url":null,"abstract":"<p><p>A 60-year-old man with hypercholesterolemia and hypertension presented with acute coronary syndrome (SCA). The ECG showed lateral ischemia (T-wave inversion in V4-V6, D1 and aVL) and echocardiography showed normal left ventricular wall motion. Coronary angiography showed critical atherosclerotic lesions in the distal part of the left circumflex artery (LCx, culprit lesion), chronic total occlusion of the right coronary artery (RCA), significant but not critical stenosis in the middle part of left anterior descending artery (LAD), and a coronary artery to pulmonary artery (PA) fistula originating from the proximal part of the LAD and emptying into the PA via a coronary saccular aneurysm (12 x 12 x 10 mm). A multidetector row computed tomography angiography (CTA) confirmed the coronary artery fistula, which was treated with surgical approach. The patient underwent aneurysmorrhaphy with CAF closure and coronary artery bypass grafting on the RCA and LCx. The postoperative course was uneventful and the patient was discharged on postoperative day 14. CTA was useful for understanding the spatial relation of the CAF and the connection with the PA.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442423","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}
Giulia Masiero, Alberto Barioli, Marco Borghesi, Luca Donazzan, Enrico Fabris, Tommaso Fabris, Chiara Fraccaro, Andrea Gratta, Daniele Giacoppo, Davide Lanzellotti, Mattia Lunardi, Concetta Mammone, Giuseppe Marchese, Marco Mojoli, Luca Nai Fovino, Andrea Pascotto, Filippo Zilio, Gabriele Pesarini
STENT PANORAMA is a project carried out by the Young Interventional Cardiologists of Triveneto coordinated by the Italian Society of Interventional Cardiology (GISE) Veneto delegation. The project includes two parts: the first, here reported, is aimed at describing in a standardized and easily usable way the main technological characteristics of the latest generation of the drug eluting stents (DES) that are most widely used in the Italian cath-labs. The second, to follow, will aim to summarize the main scientific evidence regarding the performance of individual devices with particular reference to subgroups of clinical interest. The ambitious goal of the STENT PANORAMA working group is to provide the interventional cardiologist with a thorough, practical, and functional knowledge of the DES currently available in the modern therapeutic armamentarium to promote a therapeutic strategy tailored to the patient.
STENT PANORAMA 是由意大利介入心脏病学会威尼托代表处协调的 Triveneto 青年介入心脏病专家开展的一个项目。该项目包括两个部分:第一部分在此报道,旨在以标准化和易于使用的方式描述意大利阴式实验室最广泛使用的最新一代药物洗脱支架(DES)的主要技术特点。接下来的第二部分将总结有关单个设备性能的主要科学证据,特别是与临床相关的亚组。STENT PANORAMA 工作组的宏伟目标是为介入心脏病专家提供有关现代治疗设备中现有 DES 的全面、实用和功能性知识,以促进为患者量身定制治疗策略。
{"title":"[Drug-eluting stents in contemporary interventional practice: the STENT PANORAMA project (Part I)].","authors":"Giulia Masiero, Alberto Barioli, Marco Borghesi, Luca Donazzan, Enrico Fabris, Tommaso Fabris, Chiara Fraccaro, Andrea Gratta, Daniele Giacoppo, Davide Lanzellotti, Mattia Lunardi, Concetta Mammone, Giuseppe Marchese, Marco Mojoli, Luca Nai Fovino, Andrea Pascotto, Filippo Zilio, Gabriele Pesarini","doi":"10.1714/4287.42690","DOIUrl":"https://doi.org/10.1714/4287.42690","url":null,"abstract":"<p><p>STENT PANORAMA is a project carried out by the Young Interventional Cardiologists of Triveneto coordinated by the Italian Society of Interventional Cardiology (GISE) Veneto delegation. The project includes two parts: the first, here reported, is aimed at describing in a standardized and easily usable way the main technological characteristics of the latest generation of the drug eluting stents (DES) that are most widely used in the Italian cath-labs. The second, to follow, will aim to summarize the main scientific evidence regarding the performance of individual devices with particular reference to subgroups of clinical interest. The ambitious goal of the STENT PANORAMA working group is to provide the interventional cardiologist with a thorough, practical, and functional knowledge of the DES currently available in the modern therapeutic armamentarium to promote a therapeutic strategy tailored to the patient.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442448","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}
The term "extreme sports" includes a range of sporting activities, predominantly individual, practised outdoors in a wild and non-competitive environment, which have in common the critical role of environmental variables, the importance of qualitative parameters in evaluating performance, the centrality of technological elements and the high perceived risk which, together with the spectacularity, attracts the attention of the media, favoring its popularity. Despite their diversity, these disciplines share specific risks and physiological and pathophysiological aspects. The average age of participants is generally higher than that of traditional and competitive sports, and the prevalence of male subjects implies a higher likelihood of cardiological evaluation whose path has yet to be codified like that of traditional sports. The risk of severe injuries in these sports is not higher than that of traditional sports and non-sporting activities. In contrast, the risk of cardiovascular events is documented only for some sports practised in the mountains, such as mountaineering, skiing and mountain biking, and it does not appear to be higher than that of equivalent physical activities performed at low altitudes. The diagnostic and prognostic criteria for cardiological counseling of enthusiasts are not defined. Environmental exposure to extremes of temperature, altitude, wind and humidity, and dehydration are typical characteristics of these activities, which should be addressed with adequate experience, preparation and equipment to minimize the potential impact on health. Finally, many of these activities are often conducted in "remote areas" compared to the possibility of emergency response, which should be considered in the risk assessment of an acute cardiovascular event. The definition of cardiovascular risk constitutes an open area of research to allow the practice of these sports to an increasing number of participants.
{"title":"[\"Extreme sports\" in patients with heart disease: an informative approach to patient counseling].","authors":"Francesco Feletti, Stefano Savonitto","doi":"10.1714/4269.42468","DOIUrl":"10.1714/4269.42468","url":null,"abstract":"<p><p>The term \"extreme sports\" includes a range of sporting activities, predominantly individual, practised outdoors in a wild and non-competitive environment, which have in common the critical role of environmental variables, the importance of qualitative parameters in evaluating performance, the centrality of technological elements and the high perceived risk which, together with the spectacularity, attracts the attention of the media, favoring its popularity. Despite their diversity, these disciplines share specific risks and physiological and pathophysiological aspects. The average age of participants is generally higher than that of traditional and competitive sports, and the prevalence of male subjects implies a higher likelihood of cardiological evaluation whose path has yet to be codified like that of traditional sports. The risk of severe injuries in these sports is not higher than that of traditional sports and non-sporting activities. In contrast, the risk of cardiovascular events is documented only for some sports practised in the mountains, such as mountaineering, skiing and mountain biking, and it does not appear to be higher than that of equivalent physical activities performed at low altitudes. The diagnostic and prognostic criteria for cardiological counseling of enthusiasts are not defined. Environmental exposure to extremes of temperature, altitude, wind and humidity, and dehydration are typical characteristics of these activities, which should be addressed with adequate experience, preparation and equipment to minimize the potential impact on health. Finally, many of these activities are often conducted in \"remote areas\" compared to the possibility of emergency response, which should be considered in the risk assessment of an acute cardiovascular event. The definition of cardiovascular risk constitutes an open area of research to allow the practice of these sports to an increasing number of participants.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161146","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}
Marco Busco, Alfredo Ricchiuto, Francesco Bianchini, Gianluca Anastasia, Fabio Pescetelli, Matteo Vercellino, Enrico Romagnoli, Francesco Burzotta, Carlo Trani, Italo Porto, Cristina Aurigemma, Rocco Vergallo
Coronary calcific disease represents one of the main challenges for the interventional cardiologist, for whom optimal lesion preparation and percutaneous coronary intervention optimization are paramount for correct management. In this perspective, intravascular imaging using optical coherence tomography (OCT) is becoming an increasingly indispensable tool. This work aims to provide a detailed overview of the complexity of calcified lesions, first analyzing their various morphologies and their clinical impact: spotty calcium seems to be more present in plaques at higher risk of destabilization, while diffuse calcification is typical of stable coronary stenosis; the eruptive calcific nodule is one of the three culprit lesion phenotypes responsible for acute coronary syndromes.In the second part of this review, the available technologies for the treatment of calcified lesions are described, with the aid of illustrative OCT images. Intravascular lithotripsy causes fractures at various levels of the calcified plaque, both circumferentially and longitudinally, with an improvement in vessel compliance; atherectomy acts by modifying the composition of the plaque with selective action on the hard calcific component. OCT, providing a comprehensive overview of lesion characteristics, can guide in the selection of the most appropriate therapeutic strategy, while also offering important information on the effectiveness of the chosen treatment.
{"title":"[Optical coherence tomography imaging for the evaluation and treatment of calcified coronary artery disease].","authors":"Marco Busco, Alfredo Ricchiuto, Francesco Bianchini, Gianluca Anastasia, Fabio Pescetelli, Matteo Vercellino, Enrico Romagnoli, Francesco Burzotta, Carlo Trani, Italo Porto, Cristina Aurigemma, Rocco Vergallo","doi":"10.1714/4287.42688","DOIUrl":"10.1714/4287.42688","url":null,"abstract":"<p><p>Coronary calcific disease represents one of the main challenges for the interventional cardiologist, for whom optimal lesion preparation and percutaneous coronary intervention optimization are paramount for correct management. In this perspective, intravascular imaging using optical coherence tomography (OCT) is becoming an increasingly indispensable tool. This work aims to provide a detailed overview of the complexity of calcified lesions, first analyzing their various morphologies and their clinical impact: spotty calcium seems to be more present in plaques at higher risk of destabilization, while diffuse calcification is typical of stable coronary stenosis; the eruptive calcific nodule is one of the three culprit lesion phenotypes responsible for acute coronary syndromes.In the second part of this review, the available technologies for the treatment of calcified lesions are described, with the aid of illustrative OCT images. Intravascular lithotripsy causes fractures at various levels of the calcified plaque, both circumferentially and longitudinally, with an improvement in vessel compliance; atherectomy acts by modifying the composition of the plaque with selective action on the hard calcific component. OCT, providing a comprehensive overview of lesion characteristics, can guide in the selection of the most appropriate therapeutic strategy, while also offering important information on the effectiveness of the chosen treatment.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442450","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":"In questo numero.","authors":"","doi":"10.1714/4252.42290","DOIUrl":"https://doi.org/10.1714/4252.42290","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863439","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}
Marco B Ancona, Domitilla Gentile, Luca A Ferri, Fabrizio Monaco, Filippo Russo, Barbara Bellini, Ciro Vella, Giulia Ghizzoni, Greca Zanda, Eustachio Agricola, Giulio Truci, Luigi Beretta, Stefano Turi, Giovanni Landoni, Matteo Montorfano
Patent foramen ovale (PFO) is a remnant of normal fetal anatomy which may persist into adulthood, mostly asymptomatic. In some adults, PFO may result in a potential for shunting venous thromboembolism to the arterial circulation; less frequently it can cause interatrial, right-to-left shunting of deoxygenated blood. The pathogenesis of several medical conditions is related to the presence of PFO. Some randomized clinical trials have shown evidence of benefit for device closure as compared with medical therapy in patients with cryptogenic stroke. The literature reported several cases of carbon dioxide embolism during general laparoscopic surgery and sometimes stroke after laparoscopic or neurosurgery but there are neither prospective studies addressing these issues, nor randomized clinical trials assessing the effectiveness of pharmacotherapy or interventional procedures at decreasing risk. The European position paper suggests routine monitoring in non-cardiac surgery of patients with a PFO and no actual indications for closure. This article aims to further stratify the risk of periprocedural stroke and paradoxical embolism in this category of patients.
{"title":"[Management of patent foramen ovale in non-cardiac surgery].","authors":"Marco B Ancona, Domitilla Gentile, Luca A Ferri, Fabrizio Monaco, Filippo Russo, Barbara Bellini, Ciro Vella, Giulia Ghizzoni, Greca Zanda, Eustachio Agricola, Giulio Truci, Luigi Beretta, Stefano Turi, Giovanni Landoni, Matteo Montorfano","doi":"10.1714/4252.42291","DOIUrl":"10.1714/4252.42291","url":null,"abstract":"<p><p>Patent foramen ovale (PFO) is a remnant of normal fetal anatomy which may persist into adulthood, mostly asymptomatic. In some adults, PFO may result in a potential for shunting venous thromboembolism to the arterial circulation; less frequently it can cause interatrial, right-to-left shunting of deoxygenated blood. The pathogenesis of several medical conditions is related to the presence of PFO. Some randomized clinical trials have shown evidence of benefit for device closure as compared with medical therapy in patients with cryptogenic stroke. The literature reported several cases of carbon dioxide embolism during general laparoscopic surgery and sometimes stroke after laparoscopic or neurosurgery but there are neither prospective studies addressing these issues, nor randomized clinical trials assessing the effectiveness of pharmacotherapy or interventional procedures at decreasing risk. The European position paper suggests routine monitoring in non-cardiac surgery of patients with a PFO and no actual indications for closure. This article aims to further stratify the risk of periprocedural stroke and paradoxical embolism in this category of patients.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848584","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}
Vittoria Rizzello, Maria Denitza Tinti, Mauro Gori, Marco Marini, Vittorio Palmieri, Luisa De Gennaro, Paolo Manca, Maria Vittoria Matassini, Concetta Di Nora, Matteo Bianco, Samuela Carigi, Piero Gentile, Giuseppe Leonardi, Francesco Orso, Marco Gorini, Lucio Gonzini, Donata Lucci, Aldo Pietro Maggioni, Renata De Maria, Luigi Tavazzi
The Italian Network on Congestive Heart Failure (IN-CHF) project, later known as IN-HF Online, was launched in 1995 to provide the Italian cardiology community with a digital tool, standardized across the country, for managing outpatients with heart failure (HF), that enabled the creation of a database for clinical, educational and scientific purposes. During its almost three decades of activity, this observational research program has achieved highly positive scientific results. Indeed, IN-HF fostered professional relationships among individuals working in different centers, established a cultural network for the care of HF patients, periodically updated on the scientific advances, and allowed the assessment of several clinical, epidemiological, and prognostic features. These findings have been published in numerous national and international journals, as summarized in the present overview.
{"title":"[The IN-HF Registry: the history and the scientific production for the Italian cardiology community].","authors":"Vittoria Rizzello, Maria Denitza Tinti, Mauro Gori, Marco Marini, Vittorio Palmieri, Luisa De Gennaro, Paolo Manca, Maria Vittoria Matassini, Concetta Di Nora, Matteo Bianco, Samuela Carigi, Piero Gentile, Giuseppe Leonardi, Francesco Orso, Marco Gorini, Lucio Gonzini, Donata Lucci, Aldo Pietro Maggioni, Renata De Maria, Luigi Tavazzi","doi":"10.1714/4252.42293","DOIUrl":"https://doi.org/10.1714/4252.42293","url":null,"abstract":"<p><p>The Italian Network on Congestive Heart Failure (IN-CHF) project, later known as IN-HF Online, was launched in 1995 to provide the Italian cardiology community with a digital tool, standardized across the country, for managing outpatients with heart failure (HF), that enabled the creation of a database for clinical, educational and scientific purposes. During its almost three decades of activity, this observational research program has achieved highly positive scientific results. Indeed, IN-HF fostered professional relationships among individuals working in different centers, established a cultural network for the care of HF patients, periodically updated on the scientific advances, and allowed the assessment of several clinical, epidemiological, and prognostic features. These findings have been published in numerous national and international journals, as summarized in the present overview.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851021","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}
Furio Colivicchi, Marcello Arca, Stefania Angela Di Fusco, Angela Pirillo, Alberico L Catapano
Over the last decade, several innovative therapeutic options have been developed and marketed for the management of hypercholesterolemia. However, the impossibility of a contextual update of international guidelines and the limits imposed by national regulatory authorities do not allow the use of these treatments in many patients, in particular in those at higher cardiovascular risk. Real-world studies show that the use of lipid-lowering therapies is inadequate even among patients at higher cardiovascular risk, with only 20% achieving recommended low-density lipoprotein cholesterol (LDL-C) levels and the use of combination therapies implemented in only 24% of patients. This review aims to highlight the benefits of an approach based on combination therapy and to propose a therapeutic algorithm that includes oral combination therapy, where necessary also in triple association (statin, ezetimibe and bempedoic acid), as an initial approach based on the most favorable cost-effectiveness ratio for patients at higher cardiovascular risk and the use of injectable anti-proprotein convertase subtilisin/kexin 9 therapies if the recommended LDL-C goal is not achieved.
{"title":"[STEP-RCV Project - A scientific expert panel for patients at high and very high cardiovascular risk: how to streamline lipid-lowering therapy].","authors":"Furio Colivicchi, Marcello Arca, Stefania Angela Di Fusco, Angela Pirillo, Alberico L Catapano","doi":"10.1714/4252.42295","DOIUrl":"https://doi.org/10.1714/4252.42295","url":null,"abstract":"<p><p>Over the last decade, several innovative therapeutic options have been developed and marketed for the management of hypercholesterolemia. However, the impossibility of a contextual update of international guidelines and the limits imposed by national regulatory authorities do not allow the use of these treatments in many patients, in particular in those at higher cardiovascular risk. Real-world studies show that the use of lipid-lowering therapies is inadequate even among patients at higher cardiovascular risk, with only 20% achieving recommended low-density lipoprotein cholesterol (LDL-C) levels and the use of combination therapies implemented in only 24% of patients. This review aims to highlight the benefits of an approach based on combination therapy and to propose a therapeutic algorithm that includes oral combination therapy, where necessary also in triple association (statin, ezetimibe and bempedoic acid), as an initial approach based on the most favorable cost-effectiveness ratio for patients at higher cardiovascular risk and the use of injectable anti-proprotein convertase subtilisin/kexin 9 therapies if the recommended LDL-C goal is not achieved.</p>","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853361","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}
Giuseppe Boriani, Marta Mantovani, Benedetta Cherubini, Enrico Tartaglia, Niccolò Bonini
{"title":"[Management and treatment of atrial fibrillation in cancer patients: an important decision-making hub in cardio-oncology].","authors":"Giuseppe Boriani, Marta Mantovani, Benedetta Cherubini, Enrico Tartaglia, Niccolò Bonini","doi":"10.1714/4252.42298","DOIUrl":"https://doi.org/10.1714/4252.42298","url":null,"abstract":"","PeriodicalId":12510,"journal":{"name":"Giornale italiano di cardiologia","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855824","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}