Demographic and training variations across cardiology subspecialties in Italy: a national survey Federico Fortuni, Giuseppe Ciliberti, Pietro Scicchitano, Luca Franchin, Stefano Cangemi, Stefano Cornara, Antonella Spinelli, Enrica Vitale, Michele Magnesa, Filippo Zilio, Federico Nardi, Domenico Gabrielli, Furio Colivicchi, Fabrizio Oliva, Massimo Grimaldi Journal of Cardiovascular Medicine, 2026 Background Advances in cardiovascular medicine and subspecialization have improved patient care but exposed persistent workforce disparities. Evidence on sex, age, and training mobility within cardiology is fragmented, and comprehensive analyses across subspecialties are lacking. Methods A nationwide survey was conducted by the Italian Association of Hospital Cardiologists (ANMCO) during its 2025 National Congress. The questionnaire included 17 multiple-choice items covering demographics, sex distribution, age, and training patterns across five subspecialties: interventional cardiology, clinical cardiology/acute care, cardiovascular imaging, heart failure, and electrophysiology. Responses were analyzed using descriptive statistics. Results A total of 355 cardiologists responded, 51% of whom were women, with 53% aged >45 years. Significant sex-based differences were observed across subspecialties ( P 50% in 51% of responses). Age distributions also differed significantly ( P < 0.001), with interventional cardiology, clinical cardiology, and electrophysiology dominated by the 40–50-years age range, whereas imaging showed a higher proportion of younger cardiologists. Training mobility varied but did not reach statistical significance ( P = 0.054), with greater local stability in electrophysiology and higher external training reported in imaging and clinical cardiology. Stratification by respondent sex confirmed similar perceptions of female underrepresentation. Conclusions This survey highlights persistent gender imbalances, mid-career clustering, and heterogeneous training mobility across Italian cardiology subspecialties. Targeted national and international strategies are needed to promote equity, strengthen training pathways, and support sustainable workforce development.
Long-term outcomes and predictors of mortality in patients with chronic ischemic left ventricular dysfunction undergoing PCI: A multicenter study Andrea Pezzato, Enrico Fabris, Gloria Lorenzon, Caterina Gregorio, Stefano Poli, Luca Franchin, Marco Mojoli, Andrea Pascotto, Marco Merlo, Matteo Dal Ferro, Giancarlo Vitrella, Serena Rakar, Leonardo Spedicato, Andrea Perkan, Daniela Pavan, Massimo Imazio, Gianfranco Sinagra International Journal of Cardiology, 2026 BACKGROUND: Patients with chronic ischemic left ventricular (LV) dysfunction represent a high-risk population. While percutaneous coronary intervention (PCI) is commonly performed in this setting, long-term outcome data and predictors of adverse events are limited. OBJECTIVE: To analyse patients with chronic ischemic LV dysfunction who underwent PCI and evaluate predictors of all-cause mortality and myocardial infarction (MI). METHODS: We performed a retrospective, multicenter, observational study including consecutive patients (2016-2022) from three Italian hub hospitals who underwent PCI with LV ejection fraction (LVEF) < 50 % due to chronic ischemic disease. RESULTS: 279 patients were included; median age 71 (IQR 64-78) years, 76.7 % male, 46.2 % diabetic, 26.2 % with chronic kidney disease (CKD) and 33.0 % with prior MI. Median LVEF was 35 % (28-40). Over a median follow-up of 53 (36-73) months, death and MI occurred in 33.7 % of the patients. Multiple Cox regression identified baseline NYHA class (HR 1.54, 95 % CI 1.15-2.06, p = 0.004) and CKD (HR 1.91, 95 % CI 1.24-2.95, p = 0.003) as independent predictors of death or MI. IPTW Adjusted Cox proportional hazard models showed that complete revascularization (HR 0.57, 95 %CI 0.32-0.99, p = 0.047), and PCI of LAD (HR 0.52, 95 %CI 0.33-0.81, p = 0.004), were independent predictors of death and MI. CONCLUSIONS: In this multicenter real-world cohort, heart failure severity and comorbidities adversely affected prognosis, while complete revascularization and PCI of the LAD were associated with reduced risk of death and MI. These findings underscore the importance of careful patient profiling as well as the importance of the revascularization to optimize prognosis in this high-risk population.
Percutaneous Mechanical Circulatory Support Devices in Cardiogenic Shock: A Narrative Review in Light of Recent Evidence Vincenzo Paragliola, Marco Gamardella, Luca Franchin, Maurizio Bertaina, Francesco Colombo, Paola Zanini, Salvatore Colangelo, Pierluigi Sbarra, Giacomo Boccuzzi, Mario Iannaccone Journal of Clinical Medicine, 2025 Cardiogenic shock (CS) is a complex, life-threatening syndrome characterized by inadequate tissue perfusion due to impaired cardiac function. Acute myocardial infarction (AMI) and acute decompensated heart failure are the leading causes, with mortality remaining high despite advances in revascularization and supportive care. The Society for Cardiovascular Angiography and Interventions (SCAI) classification allows risk stratification and guides clinical decision making by capturing the spectrum of shock severity. Percutaneous mechanical circulatory support (pMCS) devices, such as the intra-aortic balloon pump (IABP) and Impella, aim to stabilize hemodynamics by augmenting cardiac output and unloading the left ventricle. However, randomized trials and meta-analyses have not demonstrated a consistent survival advantage of Impella over IABP, while reporting higher rates of bleeding and vascular complications. Landmark trials, including ECLS-SHOCK and DanGer, have provided conflicting results, likely reflecting differences in baseline severity and timing of device implantation. Veno-arterial extracorporeal membrane oxygenator (VA-ECMO) offers full cardiopulmonary support but increases left ventricular afterload, potentially worsening myocardial injury. Combined strategies such as ECPELLA (Impella + VA-ECMO) or ECMO + IABP may mitigate left ventricle (LV) overload and improve bridging to recovery or advanced therapies, although evidence remains largely observational and complication rates are considerable. In right-sided or biventricular failure, tailored options (e.g., Impella RP, Bi-Pella) guided by invasive hemodynamics may be required. Current evidence suggests that pMCS benefits are limited to carefully selected subgroups, underscoring the importance of early diagnosis, prompt referral, and individualized intervention. Robust randomized data are still needed to define the optimal role of pMCS in AMI-related CS.
Colchicine and Atherosclerotic Coronary Artery Disease: An Updated Review Simona Giubilato, Giuseppe Ciliberti, Pietro Scicchitano, Antonio Di Monaco, Federico Fortuni, Filippo Zilio, Claudio Mario Ciampi, Stefano Cangemi, Antonella Spinelli, Laura Gatto, Luca Franchin, Stefano Cornara, Michele Magnesa, Carlotta Sorini Dini, Enrica Vitale, Nicola Gasparetto, Giovanna Geraci, Roberta Rossini, Roberta Della Bona, Federico Nardi, Domenico Gabrielli, Michele Massimo Gulizia, Massimo Grimaldi, Fabrizio Oliva, Massimo Imazio Journal of Clinical Medicine, 2025 Atherosclerotic coronary artery disease remains a leading cause of morbidity and mortality worldwide, despite advances in lipid-lowering and antithrombotic therapies. Increasing evidence highlights the pivotal role of inflammation in all stages of atherosclerosis, from plaque formation to rupture. Colchicine, a well-known anti-inflammatory drug traditionally used in gout and pericarditis, has emerged as a promising agent in the secondary prevention of cardiovascular events. Recent clinical trials have demonstrated significant reductions in cardiovascular outcomes with low-dose colchicine, especially in patients with stable CAD and following myocardial infarction. This review provides an updated overview of the pathophysiological rationale for colchicine use in atherosclerosis, summarizes key clinical trial data, and discusses potential mechanisms, safety considerations, and future directions.
The role of simulation in medical education, clinical risk management, and enhancing patient care in cardiology F. Zilio, Simona Giubilato, P. Caldarola, Giuseppe Ciliberti, A. Di Monaco, Carlotta Sorini Dini, G. Iannopollo, Stefano Cornara, Luca Franchin, Enrica Vitale, Giovanni Falsini, Michele Magnesa, Federico Fortuni, Roberta Della Bona, Laura Gatto, Nicola Gasparetto, Antonella Spinelli, L. Roncon, Stefano Cangemi, Francesco Borrello, G. Geraci, C. Riccio, Claudio Bilato, Federico Nardi, Serafina Valente, Roberta Rossini, M. Gulizia, D. Gabrielli, F. Colivicchi, Massimo Grimaldi, Fabrizio Oliva Giornale Italiano Di Cardiologia, 2025 In applied sciences, including medicine, simulation refers to a model of reality that employs a variety of techniques and technologies, along with diverse professional expertise, to facilitate the dynamic analysis and prediction of events or processes based on specific predefined conditions. Simulation is of paramount importance to improve the skills of medical staff, to speed up learning and to optimize clinical practice in different settings, including cardiology. Literature shows that simulation is more effective than other learning strategies, supporting both upgrading of staff's clinical skills and patients' safety, reducing the risk of medical error. Moreover, andragogical principles highlight the need for personalized training programs, in order to meet healthcare professionals' needs, while practicing in a safe environment, improving technical skills, clinical decision making, stress management, cooperation, and teamwork. This review written by the Management and Quality Working Group, by the Young Cardiologists Working Group, and by the Professional Responsibility and Safety of Care Study Group of the the Italian Association of Hospital Cardiologists (ANMCO) highlights the crucial role of simulation in managing high-risk situations commonly encountered in cardiology, emphasizing the importance of continuous high-quality training. It also describes how ANMCO is promoting simulation as a strategy for implementing quality in the field of cardiology.
Diagnosis and treatment of iron deficiency in heart failure Federico Fortuni, Giuseppe Ciliberti, Mauro Gori, Pietro Scicchitano, Michele Magnesa, Antonella Spinelli, Enrica Vitale, Concetta Di Nora, Luca Franchin, Stefano Cornara, Paolo Manca, Stefano Cangemi, Samuela Carigi, Furio Colivicchi, Massimo Grimaldi, Fabrizio Oliva Giornale Italiano Di Cardiologia, 2025 I pazienti con scompenso cardiaco (SC) presentano frequentemente una carenza marziale, con una prevalenza di sideropenia stimata intorno al 50%. Nei pazienti affetti da SC, la carenza marziale è associata ad una riduzione della capacità funzionale, della qualità di vita e ad un aumento del rischio di ospedalizzazioni e mortalità. Pertanto, la diagnosi tempestiva e il trattamento della sideropenia sono essenziali per migliorare gli esiti clinici nei pazienti con SC a frazione di eiezione ridotta o lievemente ridotta, mentre i dati sui benefici della supplementazione di ferro nei pazienti con SC a frazione di eiezione preservata restano ancora limitati. Questa revisione della letteratura ha l’obiettivo di fornire una panoramica sulla prevalenza, i criteri diagnostici, le evidenze disponibili, le indicazioni, le formulazioni di ferro e i protocolli raccomandati per l’identificazione e il trattamento della carenza marziale nei pazienti con SC.
Non-invasive physiological assessment of intermediate coronary stenoses from plain angiography through artificial intelligence: the STARFLOW system Ovidio De Filippo, Raffaele Mineo, Michele Millesimo, Wojciech Wańha, Federica Proietto Salanitri, Antonio Greco, Antonio Maria Leone, Luca Franchin, Simone Palazzo, Giorgio Quadri, Domenico Tuttolomondo, Enrico Fabris, Gianluca Campo, Alessandra Truffa Giachet, Francesco Bruno, Mario Iannaccone, Giacomo Boccuzzi, Nicola Gaibazzi, Ferdinando Varbella, Wojciech Wojakowski, Michele Maremmani, Guglielmo Gallone, Gianfranco Sinagra, Davide Capodanno, Giuseppe Musumeci, Paolo Boretto, Pawel Pawlus, Andrea Saglietto, Francesco Burzotta, Marco Aldinucci, Daniela Giordano, Gaetano Maria De Ferrari, Concetto Spampinato, Fabrizio D'Ascenzo European Heart Journal Quality of Care and Clinical Outcomes, 2025
Ten questions about the athlete's heart: A guide for the clinical cardiologist Giornale Italiano Di Cardiologia, 2025
Ten questions about infective endocarditis Federico Fortuni, Giuseppe Ciliberti, N. Marsan, Victoria Delgado, Luca Franchin, Michele Magnesa, Antonella Spinelli, Enrica Vitale, Stefano Cangemi, Stefano Cornara, D. Gabrielli, F. Colivicchi, Massimo Grimaldi, Fabrizio Oliva Giornale Italiano Di Cardiologia, 2024
In-hospital outcomes in nonagenarian patients undergoing primary percutaneous coronary intervention Filippo ANGELINI, Luca FRANCHIN, Pier P. BOCCHINO, Nuccia MORICI, Wojciech WAŃHA, Stefano SAVONITTO, Daniela TRABATTONI, Enrico CERRATO, Lucia BARBIERI, Federico FORTUNI, Leonardo DE LUCA, Antonio GRECO, Ovidio DE FILIPPO, Antonio MONTEFUSCO, Andrea MONTABONE, Anna E. RUBINO, Sebastiano GILI, Giorgio QUADRI, Alberto SOMASCHINI, Stefano CORNARA, Stefano CARUGO, Davide CAPODANNO, Wojciech WOJAKOWSKI, Veronica DUSI, Fabrizio D’ASCENZO, Gaetano M. DE FERRARI Minerva Cardiology and Angiology, 2023
Three-Dimensional Finger Test: A New Echocardiographic Method to Locate the Best Access Site During NeoChord Procedure Alessandro Vairo, Rossella Manai, Lorenzo Gaiero, Paolo Desalvo, Matteo Bellettini, Lorenzo Zaccaro, Andrea Rinaudo, Luca Franchin, Francesco Piroli, Francesco Bruno, Viviana Sebastiano, Erik Cura Stura, Cristina Barbero, Matteo Marro, Riccardo Faletti, Gianluca Alunni, Gaetano Maria De Ferrari, Mauro Rinaldi, Stefano Salizzoni Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery, 2023
Two-Year clinical outcomes after coronary bifurcation stenting in older patients from Korea and Italy Ju Hyeon Kim, Luca Franchin, Soon Jun Hong, Jung-Joon Cha, Subin Lim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim, Ovidio De Filippo, Hyeon-Cheol Gwon, Francesco Piroli, Hyo-Soo Kim, Wojciech Wanha, Ki Hong Choi, Young Bin Song, Giuseppe Patti, Chang-Wook Nam, Francesco Bruno, Jeehoon Kang, Pier Paolo Bocchino, Gaetano Maria De Ferrari, Bon-Kwon Koo, Fabrizio D’Ascenzo Frontiers in Cardiovascular Medicine, 2023
Transcatheter Aortic Valve Implantation With or Without Predilation: A Meta-Analysis Federico Conrotto, Fabrizio D’Ascenzo, Luca Franchin, Francesco Bruno, Mamas Mamas, Konstantinos Toutouzas, Thomas Cuisset, Florence Leclercq, Nicolas Dumonteil, Azeem Latib, Luis Nombela-Franco, Andreas Schaefer, R. David Anderson, Laura Marruncheddu, Guglielmo Gallone, Ovidio De Filippo, Michele La Torre, Mauro Rinaldi, Pierluigi Omedè, Stefano Salizzoni, Gaetano Ferrari Journal of Invasive Cardiology, 2022
Aortic valve replacement vs. balloon-expandable and self-expandable transcatheter implantation: A network meta-analysis Fabrizio D'Ascenzo, Francesco Bruno, Luca Baldetti, Ovidio De Filippo, Giorgio Marengo, Susanna Breviario, Francesco Melillo, Hans Gustav Hørsted Thyregod, Holger Thiele, Lars Sondergaard, Jeffrey J. Popma, Susheel Kodali, Luca Franchin, Margherita Annaratone, Laura Marruncheddu, Guglielmo Gallone, Gabriele Crimi, Michele La Torre, Mauro Rinaldi, Pierluigi Omedè, Federico Conrotto, Stefano Salizzoni, Gaetano Maria De Ferrari International Journal of Cardiology, 2021
Fractional flow reserve guided versus angiographic guided surgical revascularization: A meta-analysis Francesco Bruno, Fabrizio D'Ascenzo, Giorgio Marengo, Roberto Manfredi, Andrea Saglietto, Guglielmo Gallone, Luca Franchin, Francesco Piroli, Filippo Angelini, Ovidio De Filippo, Federico Conrotto, Pierluigi Omedè, Antonio Montefusco, Mauro Pennone, Massimo Boffini, Marco Pocar, Mauro Rinaldi, Gaetano Maria De Ferrari Catheterization and Cardiovascular Interventions, 2021
Non-invasive ventilation for SARS-CoV-2 acute respiratory failure: A subanalysis from the HOPE COVID-19 registry Maurizio Bertaina, Ivan J Nuñez-Gil, Luca Franchin, Inmaculada Fernández Rozas, Ramón Arroyo-Espliguero, María C Viana-Llamas, Rodolfo Romero, Charbel Maroun Eid, Aitor Uribarri, Víctor Manuel Becerra-Muñoz, Jia Huang, Emilio Alfonso, Fernando Marmol-Mosquera, Fabrizio Ugo, Enrico Cerrato, Lucia Fernandez-Presa, Sergio Raposeiras Roubin, Gisela Feltes Guzman, Adelina Gonzalez, Mohammad Abumayyaleh, Antonio Fernandez-Ortiz, Carlos Macaya, Vicente Estrada Emergency Medicine Journal, 2021
Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: A RAIN-CARDIOGROUP VII sub-study Luca Franchin, Francesco Piroli, Fabrizio D’Ascenzo, Ivan Nuñez-Gil, Wojciech Wojakowski, Yoichi Imori, Daniela Trabattoni, Zenon Huczek, Giuseppe Venuti, Saverio Muscoli, Andrea Montabone, Andrea Rognoni, Radoslaw Parma, Filippo Figini, Satoru Mitomo, Giorgio Quadri, Wojciech Wańha, Bernardo Cortese, Ovidio De Filippo, Nicola Ryan, Ferdinando Varbella, Imad Sheiban, Gerard Helft, Gaetano M. De Ferrari Journal of Cardiovascular Medicine, 2021
Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy Ovidio De Filippo, Fabrizio D’Ascenzo, Filippo Angelini, Pier Paolo Bocchino, Federico Conrotto, Andrea Saglietto, Gioel Gabrio Secco, Gianluca Campo, Guglielmo Gallone, Roberto Verardi, Luca Gaido, Mario Iannaccone, Marcello Galvani, Fabrizio Ugo, Umberto Barbero, Vincenzo Infantino, Luca Olivotti, Marco Mennuni, Sebastiano Gili, Fabio Infusino, Matteo Vercellino, Ottavio Zucchetti, Gianni Casella, Massimo Giammaria, Giacomo Boccuzzi, Paolo Tolomeo, Baldassarre Doronzo, Gaetano Senatore, Walter Grosso Marra, Andrea Rognoni, Daniela Trabattoni, Luca Franchin, Andrea Borin, Francesco Bruno, Alessandro Galluzzo, Alfonso Gambino, Annamaria Nicolino, Alessandra Truffa Giachet, Gennaro Sardella, Francesco Fedele, Silvia Monticone, Antonio Montefusco, Pierluigi Omedè, Mauro Pennone, Giuseppe Patti, Massimo Mancone, Gaetano M. De Ferrari New England Journal of Medicine, 2020
