Valeria Ferrero - Academia.edu (original) (raw)
Papers by Valeria Ferrero
J Pharmacol Exp Ther, 2009
Peroxisome proliferator-activated receptor (PPAR) activation reduces inflammation and atheroscler... more Peroxisome proliferator-activated receptor (PPAR) activation reduces inflammation and atherosclerosis, but recent evidence raised concerns about its beneficial clinical effects. However, the effects of gender on PPAR expression and basal cytokine release have not been investigated. In the present study, we evaluated PPAR-gamma and -alpha expression, as well as cytokine release, in monocyte/macrophages from 15 male and 15 female patients with coronary artery disease (CAD) in comparison with healthy controls. Both expression and activation of PPAR-alpha and PPAR-gamma proteins were evaluated by Western blot and electrophoretic mobility shift assay. Gene expression was evaluated by real-time polymerase chain reaction; cytokine release was measured by enzyme-linked immunosorbent assay. Monocyte/macrophages of CAD patients yielded a constitutively enhanced (approximately 10-fold; p < 0.001) protein expression of PPAR-gamma, but not PPAR-alpha, compared with healthy controls. Evaluation of PPAR-gamma gene expression showed a 60-fold increase in monocytes from CAD patients, compared with healthy donors. Moreover, monocytes spontaneously released higher amounts of proinflammatory cytokines than macrophages. It is interesting that monocytes from CAD females expressed significantly higher levels of PPAR-gamma protein compared with male patients (p < 0.05) and showed the lowest basal release of tumor necrosis factor-alpha. These results indicate that the expression of PPAR-gamma is significantly higher in CAD patients than in healthy donors and that, together with cytokine release, it seems to be gender-related. In fact, CAD women demonstrated the highest PPAR-gamma expression and the lowest cytokine release. Such differences may, in part, modulate the response to PPAR-gamma activators.
The American Journal of Cardiology, 2003
The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial... more The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial compliance and biochemical variables in healthy postmenopausal women. The secondary objective was the evaluation of a possible role of genetic polymorphisms in modulating these effects.
American Journal of Hypertension, 2001
Journal of Medical Case Reports, 2007
Introduction: Delayed-enhancement magnetic resonance imaging (DE-MRI) has been recently proposed ... more Introduction: Delayed-enhancement magnetic resonance imaging (DE-MRI) has been recently proposed as an alternative tool in identifying myocardial viability and transmural distribution of necrosis in the myocardium.
The American Journal of Cardiology, 2000
American Journal of Hypertension, 2001
We assessed the I/D polymorphism of the ACE gene using conventional PCR in 422 symptomatic ischem... more We assessed the I/D polymorphism of the ACE gene using conventional PCR in 422 symptomatic ischemic patients referred to our catheterization unit; a second independent PCR was performed in D/D patients using specific primers to avoid D allele underestimation. Patients were classified as having stable (nϭ176) or unstable angina (nϭ246). Both groups were in Hardy-Weinberg equilibrium. The genotype distribution and the D allele frequency (p) in the two groups are shown in the table.
Italian heart journal : official journal of the Italian Federation of Cardiology, 2000
A growing variety of coronary stents is becoming available on the market. Results of randomized t... more A growing variety of coronary stents is becoming available on the market. Results of randomized trials may be difficult to apply to less selected patients, and experience with every device cannot be obtained in every center. Detailed information about the immediate and long-term results achieved with one device can be a helpful reference for interventional cardiologists. The aim of this study was to test the applicability and the clinical and angiographic results, both immediate and at 6 months, of the Multilink coronary stent in a cohort of unselected patients undergoing coronary angioplasty. From March 1997 to June 1998 coronary angioplasty was performed in 391 patients in our center, with the use of stents in 339 patients. Three hundred and seventeen Multilink stents were successfully implanted in 295 lesions in 277 patients; an acute coronary syndrome was present in 209 cases (75%), and lesion types B2 and C accounted for 30% of lesions. In 7 cases (2.4%) the Multilink stent did...
The aim of this study was to determine the cellular localization of angiotensin I-converting enzy... more The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque.
The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial... more The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial compliance and biochemical variables in healthy postmenopausal women. The secondary objective was the evaluation of a possible role of genetic polymorphisms in modulating these effects.
diuretics and ACE inhibitor, digitalis if required). 17 patients were randomly assigned Bs in add... more diuretics and ACE inhibitor, digitalis if required). 17 patients were randomly assigned Bs in addition to standard therapy. We started Bs at 1,25 mg daily, increasing to 1,25 mg every 2 weeks (if tolerated) and to 5 mg. 18 patients were assigned standard therapy. The following tests were performed before randomization and after 3 months of treatment: 6-minute walk test, Minnesota QL questionnaire, echocardiographic measurements, 24-hour Holter recordings with time (SDNN) and frequency (LF, HF) domain measures of heart rate variability, NYHA functional classification.
Atrial enlargement and supraventricular arhythmias are commonly observed in hypertrophic-hyperten... more Atrial enlargement and supraventricular arhythmias are commonly observed in hypertrophic-hypertensive hearts, and ventricular arrhythmias are frequently developed by patients with left ventricular hypertrophy (LVH). Our previous observations pointed out that the contemporary presence of atrial volume enlargement (AVE) and LVH can increase the risk of pre-arrhythmogenic patterns evaluated by signal averaged electrocardiography. Left atrial diameter is considered a routine measure of atrial enlargement but it shows only partial information about a tridimensional structure. 44 hypertensive (H) subjects (W.H.O. guidelines) with LVH were submitted to an echocardiographic evaluation of atrial dimensions (Simpson's volumes) and to a 24-hour Holter ECG monitoring in order to verify if AVE and supraventricular activity can exhibit a parallel development in the hypertensive heart. Exclusion criteria were ischemic heart disease, secondary hypertension, renal diseases, valvular diseases. A linear correlation, reaching statistical evidence, was found between AVE and supraventricular activity evaluated by Lown classification. So LVH, as a factor of ventricular stiffness, is only a possible predictor of arrhythmic consequences in the hypertensive heart, because the interplay between AVE and LVH can surely produce an higher risk of cardiac arrhythmias.
The I/D polymorphism of the ACE gene exerts a codominat effect on the plasma ACE level. Diseases ... more The I/D polymorphism of the ACE gene exerts a codominat effect on the plasma ACE level. Diseases known or suspected to be affected by elevated ACE activity would be more likely in patients (pts) with the D allele of the ACE gene. However, the increased ACE activity has never been demonstrated to be a cardiovascular risk factor despite the multiple interactions of ACE with hypertension and atherosclerosis.
The International Journal of Cardiovascular Imaging formerly The International Journal of Cardiac Imaging, 2004
Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamib... more Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamibi uptake in myocardial single photon emission tomography (SPECT). The aim of this study was to evaluate whether the acute administration of TMZ improved myocardial perfusion and modified left ventricular ejection fraction (LVEF) in ischaemic left ventricular impairment. Methods: Thirty-one patients (23 males, age 66 years) with prior myocardial infarction (>6 months) and echocardiographic LVEF £ 45% underwent coronary angiography, rest basal myocardial SPECT (after 3-day placebo administration) and rest TMZ myocardial SPECT [after 3-day TMZ administration (60 mg/die)]. The left ventricle was analysed in 16 segments. The summed placebo score (SPS) and the summed TMZ score (STS) were calculated with a 5-point scale (from 0 ¼ normal uptake to 4 ¼ absent uptake) by two blinded operators. The GATED Tc-99m SPECT was always provided. Results: After TMZ administration GATED LVEF improved from 26.5 ± 9.7% to 29.1 ± 11.3% (p ¼ 0.04) and left ventricular end-systolic volume (LVESV) was reduced from 90.2 ± 40.7 to 85.6 ± 39.2 ml/mq (p ¼ 0.006). Similarly the addition of TMZ to myocardial SPECT significantly reduced the STS compared to SPS (21.5 ± 11 vs. 26.6 ± 10.5 p ¼ 0.0001). Eleven patients (35.5%) had an echocardiographic LVEF £ 30%; in these patients who had severe ventricular dysfunction, GATED LVEF and LVESV did not change after TMZ (20.2 ± 5.7% vs. 21 ± 6.9% p ¼ 0.6; 116.7 ± 35.3 ml vs. 112.6 ± 32.3 ml p ¼ 0.08, respectively). Conclusion: In comparison with placebo, the addition of TMZ to myocardial Tc-99m tetrofosmin SPECT improved myocardial perfusion and LVEF, reducing LVESV. These effects were lost in patients with more severe ventricular dysfunction.
Journal of cardiovascular translational research, 2014
First-generation drug-eluting stents (DES) have been associated with impaired localized coronary ... more First-generation drug-eluting stents (DES) have been associated with impaired localized coronary vasomotion and delayed endothelialization. We aimed to compare coronary vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative coronary angiography was performed offline. Endothelium independent vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs -4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs -4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent vasom...
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2005
To assess efficacy and safety of oral treatment with prednisone at immunosuppressive dose after p... more To assess efficacy and safety of oral treatment with prednisone at immunosuppressive dose after percutaneous coronary interventions (PCI) in patients with multi-vessel coronary artery disease (CAD). Eighty-six consecutive patients with multi-vessel CAD were successfully treated with multiple PCI. Forty-three patients (115 coronary stenoses), with C-reactive protein >3mg/L 48 hours after PCI and in absence of contra-indications received 45-day high-dose oral prednisone treatment (study-group). Forty-three patients (106 coronary stenoses), did not receive prednisone (control-group). The primary clinical endpoint was 12-month event-free survival rate (defined as freedom from death, myocardial infarction, and the need for target vessel revascularisation). Angiographic restenosis at 8 months was assessed in the study group only. Event-free survival rates were 93 and 69.8% in the study and the control group, respectively (relative risk 0.34, 95%CI: 0.12 to 0.96, p=0.006). Target vessel...
EuroIntervention, 2009
To present the long-term results of prednisone-treated patients enrolled in the IMPRESS studies. ... more To present the long-term results of prednisone-treated patients enrolled in the IMPRESS studies. Such studies demonstrated the efficacy of a short course of immunosuppression with oral prednisone after percutaneous coronary intervention (PCI) with bare metal stent (BMS) implantation compared to BMS alone at one year. Eighty-four non-diabetic patients with elevated C-reactive protein after PCI treated with BMS and prednisone, were followed clinically for a minimum of five years. Event-free survival was defined as freedom from death, myocardial infarction, and need for target vessel revascularisation. Event-free survival rate at a mean of 6.5 +/- 1.4 years was significantly better in prednisone-treated patients of the IMPRESS and IMPRESS-2/MVD respectively compared to their original control arms: 87.8 versus 47.6%, relative risk: 7.9; 95%CI: 2.6-24.1, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001, log-rank=13.06, p=0.0003; and 93 versus 60.5%, relative risk: 8.7; 95%CI: 2.3-32.7, p=0.0004, log-rank=13,18, p=0.0003, respectively. The event-free survival was 54.1% in controls and 90.5% in the prednisone group; relative risk: 8.1; 95%CI: 3.5-18.7, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001, log-rank= 26.33, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001. The clinical benefits of oral treatment with prednisone after conventional PCI in non-diabetic patients with evidence of systemic inflammation after stenting are maintained at long-term follow-up, either in patients with single or multivessel coronary artery disease.
J Pharmacol Exp Ther, 2009
Peroxisome proliferator-activated receptor (PPAR) activation reduces inflammation and atheroscler... more Peroxisome proliferator-activated receptor (PPAR) activation reduces inflammation and atherosclerosis, but recent evidence raised concerns about its beneficial clinical effects. However, the effects of gender on PPAR expression and basal cytokine release have not been investigated. In the present study, we evaluated PPAR-gamma and -alpha expression, as well as cytokine release, in monocyte/macrophages from 15 male and 15 female patients with coronary artery disease (CAD) in comparison with healthy controls. Both expression and activation of PPAR-alpha and PPAR-gamma proteins were evaluated by Western blot and electrophoretic mobility shift assay. Gene expression was evaluated by real-time polymerase chain reaction; cytokine release was measured by enzyme-linked immunosorbent assay. Monocyte/macrophages of CAD patients yielded a constitutively enhanced (approximately 10-fold; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) protein expression of PPAR-gamma, but not PPAR-alpha, compared with healthy controls. Evaluation of PPAR-gamma gene expression showed a 60-fold increase in monocytes from CAD patients, compared with healthy donors. Moreover, monocytes spontaneously released higher amounts of proinflammatory cytokines than macrophages. It is interesting that monocytes from CAD females expressed significantly higher levels of PPAR-gamma protein compared with male patients (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05) and showed the lowest basal release of tumor necrosis factor-alpha. These results indicate that the expression of PPAR-gamma is significantly higher in CAD patients than in healthy donors and that, together with cytokine release, it seems to be gender-related. In fact, CAD women demonstrated the highest PPAR-gamma expression and the lowest cytokine release. Such differences may, in part, modulate the response to PPAR-gamma activators.
The American Journal of Cardiology, 2003
The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial... more The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial compliance and biochemical variables in healthy postmenopausal women. The secondary objective was the evaluation of a possible role of genetic polymorphisms in modulating these effects.
American Journal of Hypertension, 2001
Journal of Medical Case Reports, 2007
Introduction: Delayed-enhancement magnetic resonance imaging (DE-MRI) has been recently proposed ... more Introduction: Delayed-enhancement magnetic resonance imaging (DE-MRI) has been recently proposed as an alternative tool in identifying myocardial viability and transmural distribution of necrosis in the myocardium.
The American Journal of Cardiology, 2000
American Journal of Hypertension, 2001
We assessed the I/D polymorphism of the ACE gene using conventional PCR in 422 symptomatic ischem... more We assessed the I/D polymorphism of the ACE gene using conventional PCR in 422 symptomatic ischemic patients referred to our catheterization unit; a second independent PCR was performed in D/D patients using specific primers to avoid D allele underestimation. Patients were classified as having stable (nϭ176) or unstable angina (nϭ246). Both groups were in Hardy-Weinberg equilibrium. The genotype distribution and the D allele frequency (p) in the two groups are shown in the table.
Italian heart journal : official journal of the Italian Federation of Cardiology, 2000
A growing variety of coronary stents is becoming available on the market. Results of randomized t... more A growing variety of coronary stents is becoming available on the market. Results of randomized trials may be difficult to apply to less selected patients, and experience with every device cannot be obtained in every center. Detailed information about the immediate and long-term results achieved with one device can be a helpful reference for interventional cardiologists. The aim of this study was to test the applicability and the clinical and angiographic results, both immediate and at 6 months, of the Multilink coronary stent in a cohort of unselected patients undergoing coronary angioplasty. From March 1997 to June 1998 coronary angioplasty was performed in 391 patients in our center, with the use of stents in 339 patients. Three hundred and seventeen Multilink stents were successfully implanted in 295 lesions in 277 patients; an acute coronary syndrome was present in 209 cases (75%), and lesion types B2 and C accounted for 30% of lesions. In 7 cases (2.4%) the Multilink stent did...
The aim of this study was to determine the cellular localization of angiotensin I-converting enzy... more The aim of this study was to determine the cellular localization of angiotensin I-converting enzyme (ACE) in the atherosclerotic plaque and its correlation with inflammation and cellular proliferation. BACKGROUND Angiotensin I-converting enzyme inhibitors reduce the incidence of vascular events; therefore, tissue ACE may play a determinant role in the pathophysiology of the atherosclerotic plaque.
The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial... more The study aimed at analysing the 6-month effects of hormone replacement therapy (HRT) on arterial compliance and biochemical variables in healthy postmenopausal women. The secondary objective was the evaluation of a possible role of genetic polymorphisms in modulating these effects.
diuretics and ACE inhibitor, digitalis if required). 17 patients were randomly assigned Bs in add... more diuretics and ACE inhibitor, digitalis if required). 17 patients were randomly assigned Bs in addition to standard therapy. We started Bs at 1,25 mg daily, increasing to 1,25 mg every 2 weeks (if tolerated) and to 5 mg. 18 patients were assigned standard therapy. The following tests were performed before randomization and after 3 months of treatment: 6-minute walk test, Minnesota QL questionnaire, echocardiographic measurements, 24-hour Holter recordings with time (SDNN) and frequency (LF, HF) domain measures of heart rate variability, NYHA functional classification.
Atrial enlargement and supraventricular arhythmias are commonly observed in hypertrophic-hyperten... more Atrial enlargement and supraventricular arhythmias are commonly observed in hypertrophic-hypertensive hearts, and ventricular arrhythmias are frequently developed by patients with left ventricular hypertrophy (LVH). Our previous observations pointed out that the contemporary presence of atrial volume enlargement (AVE) and LVH can increase the risk of pre-arrhythmogenic patterns evaluated by signal averaged electrocardiography. Left atrial diameter is considered a routine measure of atrial enlargement but it shows only partial information about a tridimensional structure. 44 hypertensive (H) subjects (W.H.O. guidelines) with LVH were submitted to an echocardiographic evaluation of atrial dimensions (Simpson's volumes) and to a 24-hour Holter ECG monitoring in order to verify if AVE and supraventricular activity can exhibit a parallel development in the hypertensive heart. Exclusion criteria were ischemic heart disease, secondary hypertension, renal diseases, valvular diseases. A linear correlation, reaching statistical evidence, was found between AVE and supraventricular activity evaluated by Lown classification. So LVH, as a factor of ventricular stiffness, is only a possible predictor of arrhythmic consequences in the hypertensive heart, because the interplay between AVE and LVH can surely produce an higher risk of cardiac arrhythmias.
The I/D polymorphism of the ACE gene exerts a codominat effect on the plasma ACE level. Diseases ... more The I/D polymorphism of the ACE gene exerts a codominat effect on the plasma ACE level. Diseases known or suspected to be affected by elevated ACE activity would be more likely in patients (pts) with the D allele of the ACE gene. However, the increased ACE activity has never been demonstrated to be a cardiovascular risk factor despite the multiple interactions of ACE with hypertension and atherosclerosis.
The International Journal of Cardiovascular Imaging formerly The International Journal of Cardiac Imaging, 2004
Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamib... more Trimetazidine (TMZ) increases the mithocondrial oxidative metabolism and improves Tc-99m sestamibi uptake in myocardial single photon emission tomography (SPECT). The aim of this study was to evaluate whether the acute administration of TMZ improved myocardial perfusion and modified left ventricular ejection fraction (LVEF) in ischaemic left ventricular impairment. Methods: Thirty-one patients (23 males, age 66 years) with prior myocardial infarction (>6 months) and echocardiographic LVEF £ 45% underwent coronary angiography, rest basal myocardial SPECT (after 3-day placebo administration) and rest TMZ myocardial SPECT [after 3-day TMZ administration (60 mg/die)]. The left ventricle was analysed in 16 segments. The summed placebo score (SPS) and the summed TMZ score (STS) were calculated with a 5-point scale (from 0 ¼ normal uptake to 4 ¼ absent uptake) by two blinded operators. The GATED Tc-99m SPECT was always provided. Results: After TMZ administration GATED LVEF improved from 26.5 ± 9.7% to 29.1 ± 11.3% (p ¼ 0.04) and left ventricular end-systolic volume (LVESV) was reduced from 90.2 ± 40.7 to 85.6 ± 39.2 ml/mq (p ¼ 0.006). Similarly the addition of TMZ to myocardial SPECT significantly reduced the STS compared to SPS (21.5 ± 11 vs. 26.6 ± 10.5 p ¼ 0.0001). Eleven patients (35.5%) had an echocardiographic LVEF £ 30%; in these patients who had severe ventricular dysfunction, GATED LVEF and LVESV did not change after TMZ (20.2 ± 5.7% vs. 21 ± 6.9% p ¼ 0.6; 116.7 ± 35.3 ml vs. 112.6 ± 32.3 ml p ¼ 0.08, respectively). Conclusion: In comparison with placebo, the addition of TMZ to myocardial Tc-99m tetrofosmin SPECT improved myocardial perfusion and LVEF, reducing LVESV. These effects were lost in patients with more severe ventricular dysfunction.
Journal of cardiovascular translational research, 2014
First-generation drug-eluting stents (DES) have been associated with impaired localized coronary ... more First-generation drug-eluting stents (DES) have been associated with impaired localized coronary vasomotion and delayed endothelialization. We aimed to compare coronary vasomotion after implantation of a newer-generation everolimus-eluting stent (EES), with a first-generation paclitaxel-eluting stent (PES). Coronary vasomotion was studied in 19 patients with EES and 13 with PES. Vasomotor response was measured proximally and distally to the stent and in a remote vessel (reference segment). Quantitative coronary angiography was performed offline. Endothelium independent vasomotion did not differ significantly between the two groups. EES showed significant vasodilatation while PES showed vasoconstriction at both proximal (+4.5 ± 3.6 vs -4.2 ± 6.9, p < 0.001) and distal (+4.6 ± 7.9 vs -4.8 ± 9.3, p = 0.003) segments. The reference segment did not show any significant difference in vasodilatation between the two groups (+9.8 ± 6.4 vs +7.2 ± 5.2, p = 0.17). Endothelium-dependent vasom...
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2005
To assess efficacy and safety of oral treatment with prednisone at immunosuppressive dose after p... more To assess efficacy and safety of oral treatment with prednisone at immunosuppressive dose after percutaneous coronary interventions (PCI) in patients with multi-vessel coronary artery disease (CAD). Eighty-six consecutive patients with multi-vessel CAD were successfully treated with multiple PCI. Forty-three patients (115 coronary stenoses), with C-reactive protein >3mg/L 48 hours after PCI and in absence of contra-indications received 45-day high-dose oral prednisone treatment (study-group). Forty-three patients (106 coronary stenoses), did not receive prednisone (control-group). The primary clinical endpoint was 12-month event-free survival rate (defined as freedom from death, myocardial infarction, and the need for target vessel revascularisation). Angiographic restenosis at 8 months was assessed in the study group only. Event-free survival rates were 93 and 69.8% in the study and the control group, respectively (relative risk 0.34, 95%CI: 0.12 to 0.96, p=0.006). Target vessel...
EuroIntervention, 2009
To present the long-term results of prednisone-treated patients enrolled in the IMPRESS studies. ... more To present the long-term results of prednisone-treated patients enrolled in the IMPRESS studies. Such studies demonstrated the efficacy of a short course of immunosuppression with oral prednisone after percutaneous coronary intervention (PCI) with bare metal stent (BMS) implantation compared to BMS alone at one year. Eighty-four non-diabetic patients with elevated C-reactive protein after PCI treated with BMS and prednisone, were followed clinically for a minimum of five years. Event-free survival was defined as freedom from death, myocardial infarction, and need for target vessel revascularisation. Event-free survival rate at a mean of 6.5 +/- 1.4 years was significantly better in prednisone-treated patients of the IMPRESS and IMPRESS-2/MVD respectively compared to their original control arms: 87.8 versus 47.6%, relative risk: 7.9; 95%CI: 2.6-24.1, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001, log-rank=13.06, p=0.0003; and 93 versus 60.5%, relative risk: 8.7; 95%CI: 2.3-32.7, p=0.0004, log-rank=13,18, p=0.0003, respectively. The event-free survival was 54.1% in controls and 90.5% in the prednisone group; relative risk: 8.1; 95%CI: 3.5-18.7, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001, log-rank= 26.33, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.0001. The clinical benefits of oral treatment with prednisone after conventional PCI in non-diabetic patients with evidence of systemic inflammation after stenting are maintained at long-term follow-up, either in patients with single or multivessel coronary artery disease.