Publications by authors named "Davide Di Vece"

Background: Cocaine is a global health burden and the cause of a significant number of emergency department consultations. Its association with acute myocardial infarction (AMI) is known, however, data are still rare. The aim of this study was to define causative pathologies behind cocaine-induced AMI (CI-AMI) and to analyze their clinical features.

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Background: Inflammatory bowel diseases (IBD) have been associated with an increased long-term risk of coronary artery disease due to chronic systemic inflammation.

Aim: To evaluate the risk of major adverse cardiovascular events (MACE) after coronary interventions.

Methods: In this nationwide cohort study of adults undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) (2012-2022), patients with IBD were propensity score-matched 1:10 to comparators without IBD.

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Objectives: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and myocardial infarction. Accurate diagnosis is crucial for appropriate management. This study aimed to compare late enhancement (LE) imaging using photon-counting detector (PCD)-CT with cardiac MRI in patients with SCAD in the acute phase and during follow-up and to introduce a novel approach for visualizing myocardial extracellular volume (ECV) distribution in the myocardium.

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Cardiovascular diseases remain the leading cause of global morbidity and mortality. Validated risk scores are the basis of guideline-recommended care, but most scores lack the capacity to integrate complex and multidimensional data. Limitations inherent to traditional risk prediction models and the growing burden of residual cardiovascular risk highlight the need for refined strategies that go beyond conventional paradigms.

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Purpose Of Review: Complement system activation is implicated in various stages of atherogenesis, from fatty streak formation to plaque destabilization and thrombus formation, with its dreadful clinical sequelae such as myocardial infarction, stroke and premature death. In this review, we consider these issues and explore recent studies on complement activation in atherosclerotic plaque initiation and progression.

Recent Findings: Complement pathways impact plaque stability and healing through the modulation of inflammatory processes.

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Takotsubo syndrome (TTS) is a complex cardiovascular condition characterized by transient left and/or right ventricular dysfunction in the absence of a coronary artery culprit lesion. The InterTAK registry, a large international collaborative registry, has significantly advanced our understanding of TTS. This review summarizes key findings from the InterTAK registry, including epidemiology, clinical presentation, comorbidities, outcomes, and treatment.

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Emerging evidence suggests the role of mechanical circulatory support (MCS) devices in the therapy of refractory cardiogenic shock (CS). However, largerandomized trials addressing the role of Impella in the therapy of infarct-associated CS are sparse. As such, evidence coming from comprehensive retrospective studies or meta-analyses is of major importance in order to clarify the role of the Impella device in this setting.

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Background: The impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on mortality following myocardial infarction (MI) remains uncertain. Additionally, the role of type 2 diabetes mellitus (T2DM) and heart failure (HF) in modulating the effectiveness of these drugs post-MI are not fully understood. This meta-analysis aimed to assess the association of SGLT2 inhibitors with all-cause mortality in post-MI patients and to explore key moderators influencing this benefit.

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Background: The global impact of the COVID-19 pandemic has prompted the search for strategies to improve outcomes in affected individuals, including those initially managed in outpatient settings. Thromboembolic events have been reported as a concerning complication.

Objectives: The aim of this study was to evaluate efficacy and safety of primary thromboprophylaxis in outpatients with COVID-19.

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Aims: Sodium-glucose co-transporter inhibitors (SGLTis) have cardiovascular protective effects. We aimed to assess the effects of SGLTis on individual hard clinical endpoints and quality of life (QoL) in patients with cardiovascular risk factors.

Methods And Results: Data was searched in PubMed, Embase, Cochrane Library and clinicaltrials.

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Cardiovascular alterations are common in patients who had ischaemic stroke, haemorrhagic stroke and other acute brain disorders such as seizures. These cardiac complications are important drivers of morbidity and mortality and comprise blood-based detection of cardiomyocyte damage, ECG changes, heart failure and arrhythmia. Recently, the concept of a distinct 'stroke-heart syndrome' has been formulated as a pathophysiological framework for poststroke cardiac complications.

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Article Synopsis
  • The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
  • It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
  • The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
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  • Spontaneous coronary artery dissection (SCAD) is a significant cause of heart issues during and after pregnancy, marked by spontaneous tears in artery walls.
  • Three cases of pregnancy-related SCAD were examined, all occurring post-partum, highlighting varying degrees of severity and complications among the patients.
  • The study emphasizes the unpredictable nature of SCAD during pregnancy, with some patients experiencing life-threatening events while others had uncomplicated outcomes, showcasing the need for awareness and careful management.
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  • The study investigated changes in demographics, risk factors, clinical presentations, and outcomes of takotsubo syndrome (TTS) patients from 2004 to 2021, using data from the InterTAK registry.
  • Over the years, the proportion of male patients increased, and there was a rise in cases of midventricular TTS as well as significant growth in the incidence of physical triggers.
  • There was also a notable increase in 60-day mortality rates, although no significant change in 1-year mortality when excluding early deaths was observed, indicating a complex evolution of TTS and its management in recent years.
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Article Synopsis
  • - Takotsubo syndrome (TTS) resembles acute coronary syndrome but is a separate condition that can sometimes lead to serious issues like cardiogenic shock.
  • - Cardiogenic shock occurs in 1-20% of TTS cases and can be caused by multiple factors, such as pump failure and complications in heart function.
  • - Accurate and early identification of the mechanism behind cardiogenic shock is crucial for providing the right treatment and improving patient outcomes in TTS cases.
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Background: Left atrial appendage closure (LAAC) represents an alternative to oral anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation (AF). While transoesophageal echocardiography is the current standard for guiding LAAC procedures, several centers have employed fluoroscopic guidance alone. However, data on long-term outcomes are lacking.

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Objective: We aimed to assess the effect of SGLT2i on arrhythmias by conducting a meta-analysis using data from randomized controlled trials(RCTs).

Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have shown cardioprotective effects via multiple mechanisms that may also contribute to decrease arrhythmias risk.

Methods: We searched in databases (PubMed, Embase, Cochrane Library, and clinicaltrials.

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Article Synopsis
  • Acute coronary syndromes (ACS) pose significant challenges globally, and they can lead to out-of-hospital cardiac arrest (OHCA), which has low survival rates despite medical advancements.
  • This study developed the FACTOR score—a tool to predict in-hospital mortality for OHCA patients undergoing coronary angiography, based on admission variables like age, downtime, first detected rhythm, and epinephrine administration.
  • The FACTOR score showed strong predictive accuracy, with an area under the curve of 0.823 in the derivation cohort and 0.828 in the validation cohort, potentially aiding healthcare providers in better managing resources and patient care.
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  • Coronary microvascular dysfunction (CMD) is linked to Takotsubo syndrome (TTS), and the study compares a new measurement method (caIMR) to traditional techniques for assessing CMD in TTS patients and controls.
  • Results showed that all TTS patients had elevated caIMR values across all coronary arteries, which normalized after about 28 months post-event.
  • Higher caIMR levels were associated with a greater risk of serious in-hospital outcomes, including death and cardiac complications in TTS patients.
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