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| 1 | Antiplatelet therapy in very elderly and comorbid patients with acute coronary syndromes显示文摘With population ageing and rise of life expectancy,a progressively increasing proportion of patients presenting with an acute coronary syndrome(ACS)are older adults,including those at extreme chronological age.Increasing amounts of data,including randomized clinical trials,have shown that the benefits of an early revascularization are maintained also at very old age,resulting in improved outcome after an acute coronary event.On the contrary,the optimal antiplatelet therapy(APT)remains unclear in these patients,because of both safety and efficacy concerns.Indeed,age-related multiple organ dysfunction and high prevalence of comorbidities may on the one hand reduce the therapeutic effects of administered drugs;on the other hand,it leads to increased vulnerability to drug toxicity and side effects.Therefore,management of APT is particularly challenging in elderly patients because of higher risk of both ischemic and bleeding events.The aim of the present paper is to review the current evidence,gaps in knowledge and ongoing research regarding APT in the setting of an ACS in elderly and very elderly patients,and in those with significant comorbidities including chronic kidney disease,diabetes mellitus and frailty. | Roberta De Rosa Federico Piscione Gennaro Galasso Stefano De Servi Stefano Savonitto | 2019 | Journal of Geriatric Cardiology2019，16，2： | 4 |
| 2 | 急性心肌梗死阿昔单抗、瑞替普酶、支架联合研究(CARESS-in-AMI)中的即刻恤管成形术与常规治疗联合挽救性血管成形术的比较:一项前瞻性、开放、多中心随机试验显示文摘背景当90min内不能进行直接经皮冠状动脉介入术(PCI)时,溶栓就仍是ST段抬高型心肌梗死(STEMI)的治疗选择。然而,溶栓治疗之后患者的最佳后续处理仍不确定。为了评估最佳处理方案,作者把在非介入医院用溶栓和阿昔单抗治疗的STEMI患者随机分为即刻进行PCI与常规药物治疗联合挽救性血管成形术两组。
方法给予法国、意大利和波兰等国家的600例年龄≤75岁、有≥1项高危特征(广泛性ST段抬高、新发左柬支传导阻滞、既往有心肌梗死、Killip分级≥2级或左室射血分数≤35%)的住院患者半量瑞替普酶、阿昔单抗、肝素和阿司匹林治疗,并随机分配为转诊至最近的介入中心进行即刻PCI或仅在持续ST段抬高、临床征象加重时转诊。主要结局为30d时死亡、再梗死或顽固性心肌缺血的复合指标,采用意向治疗分析。研究在Clinical Trials.gov的注册编号为00220571。
结果分配至即刻PCI组的299例患者中,289例(97.0%)进行了血管造影,255例(85.6%)进行了PCI。在常规治疗/挽救性PCI组中有91例(30.3%)患者进行了挽救性PCI。即刻PCI组出现主要结局指标的患者为13例(4.4%),而常规治疗辟乞救性PCI组为32例(10.7%)(HR0-40,95%C10.21~0.76;对数秩检验P=0.004)。即刻PCI组严重出血患者为10例,而常规治疗/挽救性PCI组为7例(3.4%vs2.3%,P=0.47)。即刻PCI组卒中患者为2例.而常规治疗/挽救性PCI组为4例(0.7%vs 1.3%.P=0.50)。
结论 在非介入中心,采用半量瑞替普酶和阿昔单抗治疗的高危STEMI患者即刻转诊进行PCI可改善结局。 | Carlo Di Maria Dariusz Duded Federico Piscione Waldemar Mielecki Stefano Savonitto Ernesto Murena Konstantinos Dimopoulos 郭占宏(译) | 2008 | 世界临床医学2008，2，5： | 3 |
| 3 | Late reopening of an occluded infarct related artery improves left ventricular function and long term clinical outcome显示文摘 | Piscione F Galasso G De Luca G | 2005 | Heart2005，91，5： | 1 |
| 4 | Divergent effects of serotonin on coronary artery dimensions and blood flow in patients with coronary atherosclerosis and control patients显示文摘 | Golino P Piscione F Willerson JT | 1994 | N Engl J Med1994，324，： | 1 |
| 5 | Impact of gene polymorphisms, platelet reactivity and the SYN- TAX score on 1-year elinical outcomes in patients with non-ST-segment elevation acute coronary syndrome un- dergoing pereutaneous coronary intervention: the GE- PRESS study 显示文摘 | Palmerini T Calabrb P Piscione F | 2014 | JACC Cardiovasc Interv2014，7，10： | 1 |
| 6 | Influence of Reverisible Segemental Left Ventricular Disfunction of Heart Rate Variability in Patients with One-vessel Coronary Heart Disease显示文摘 | Petretta M Piscione F | 1994 | J Am Coll Cardiol1994，24，2： | 1 |
| 7 | Myocardial expression of FOXO3a-Atrogin-1 pathway in human heart failure显示文摘 | Galasso G De Rosa R Piscione F | 2010 | Eur J Heart Fail2010，12，12： | 1 |
| 8 | Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions:data from a multicenter,prospective,observational study(TOAST-GISE)显示文摘 | OLIVARI Z RUBARTELLI P PISCIONE F | 2003 | J Am Coll Cardiol2003，41，： | 1 |
| 9 | Increased inflammatory artery disease in patiences , with concomitant coronary and peripheral atherosclerrosis显示文摘 | Brevetti G Piscione F Silvestro A | 2003 | Thromb Haemost2003，89，6： | 1 |
| 10 | A new approach to percutaneous coronary revascularization in patients requiring underferrable non-cardiac surgery显示文摘 | Piscione F Cassese S Galasso G | | American Journal of Cardiology0，，： | 1 |
| 11 | Role of β2 adrenergic receptots in human atherosclerotic coronary arteries显示文摘 | Barbato E Piscione F Bartunek J | | 0，，03： | 1 |
| 12 | Paired changes in electromechanical delay and musculo-tendinous stiffness after endurance or plyometric training显示文摘 | GROSSET J F PISCIONE J LAMBERTZ D | 2009 | Eur J Appl Physiol2009，105，1： | 1 |
| 13 | Immediate results and one-year clinical outcome after the percutaneous coronary intervenetions in chronic total occlusions:data from a multicenter,prospective observational study (TOAST-GISE)显示文摘 | OLIVARI Z RUBARTELLI P PISCIONE F | 2003 | J Am Coll Cardiol2003，41，10： | 1 |
| 14 | Divergent effects of serotonin on coronary artery dimensions and blood flow in patients with coronary atherosclerosis and control patients显示文摘 | Golino P Piscione F Willerson JT | 1994 | N Engl J Med1994，324，： | 1 |
| 15 | Immediate results and one year clinical outcome after percutaneous coronary in- terventions in chronic total occlusions data from a multi- center, prospective, observational study (TOAST-GISE) 显示文摘 | Olivari Z Rubartelli P Piscione F | 2003 | Journal of the American College of Cardiology2003，41，10： | 1 |
| 16 | Im-mediate angioplasty versus standard therapy with res-cue angioplasty after thrombolysis in the CombinedAbciximab Reteplase Stent Study in Acute MyocardialInfarction (CARESS-in-AMI): an open,prospective?randomised, multicentre trial显示文摘 | DI MARIO C DUDEK D PISCIONE F | 2008 | Lancet2008，371，： | 1 |
| 17 | Increased inflammatory status and higher prevalence of three-vessel coronary artery disease in patients with concomitant coronary and peripheral atherosclerosis显示文摘 | Brevetti G Piscione F Silvestro A | 2003 | Thromb Haemost2003，89，6： | 1 |
| 18 | Local effect of serotonin released during coronary angioplasty显示文摘 | Piscione F Benedict CR | 1994 | New Engl J Med1994，330，2： | 1 |
| 19 | Increased inflammatory status and higher prevalence of three-vessel coronary artery disease in patients with concomitant coronary and peripheral atherosclerosis显示文摘 | Brevetti G Piscione F Silvestro A | 2003 | Thromb Haemost2003，89，： | 1 |
| 20 | Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE) 显示文摘 | Olivari Z Rubartelli P Piscione F | 2003 | J Am CoU Cardiol2003，41，10： | 1 |
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