Department of Cardio-Thoracic-Vascular Diseases, Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Coronary arterial age for mortality prediction and risk reclassification in SCORE COVID-19 registry: When vascular age runs faster or slower than chronological age Alberto Cereda, Marco Toselli, Anna Palmisano, Marco Stracqualursi, Gabriele Tumminello, Francesco Giannini, Stefano Lucreziotti, Antonio Esposito Age and Ageing, 2026 Background Coronary arterial age (CAA), derived from coronary artery calcium (CAC) percentiles from the Multi-Ethnic Study of Atherosclerosis (MESA), reflects vascular biological ageing. Its prognostic role in acute settings such as COVID-19 remains unclear. Methods We analysed 1482 hospitalized patients from the multicentre SCORE-COVID registry undergoing chest CT. CAA was estimated from CAC percentiles; ΔAge was defined as CAA minus chronological age. A calcium-adjusted biological age (BioAge) was also assessed. The primary endpoint was 30-day all-cause mortality. Results Chronological age and CAA showed similar discrimination (AUC 0.76 vs 0.74; P = .466) and were independently associated with mortality and increased stepwise across ΔAge strata. CAA mainly improved specificity by down-classifying survivors. While no significant interaction was observed between CAA and the 4C score, ΔAge significantly re-stratified mortality risk among patients at high 4C risk. Conclusions CAA demonstrated prognostic performance comparable to chronological age for short-term mortality in COVID-19 and added clinically relevant information on vascular ageing. BioAge meaningfully refined risk stratification among patients at high clinical risk, supporting its use as an adjunctive biomarker whenever chest CT imaging is available.
Drug coated balloon angioplasty for de novo coronary lesions in large vessels: a systematic review and meta-analysis Cecilia Gobbi, Francesco Giangiacomi, Ioannis Merinopoulos, Elisa Gherbesi, Andrea Faggiano, Guido Pasero, Lucia Barbieri, Gabriele Tumminello, Federico Colombo, Luca Mircoli, Massimiliano Ruscica, Vassilios S. Vassiliou, Simon C. Eccleshall, Stefano Carugo Scientific Reports, 2025 We aimed to investigate the safety of drug-coated balloon (DCB)-only percutaneous coronary intervention compared to drug-eluting stent (DES) for de novo lesions in large vessels. To pursue this goal, we conducted a systematic review and meta-analysis following the PRISMA guidelines. The analysis included studies that utilized DCB-only or hybrid angioplasty for de novo lesions in large coronary vessel (> 2.75 mm). The primary outcome was to assess the target lesion revascularization (TLR) rate, while secondary outcomes included cardiac death, myocardial infarction (MI), and the composite of these. A total of 15 studies, comprising 3975 patients (of whom 2114 treated with DCB) were included. Median age was 62 ± 1.5 years, with 77.4% being male. Overall, 26.9% had diabetes, and 67.6% were diagnosed with acute coronary syndrome. Over a pooled follow-up of 20.6 ± 1.9 months, the incidence of TLR was 4% in the pooled DBC group. Additionally, over a pooled follow-up of 25.8 ± 2.7 months, no significant differences were observed in incidence of TLR between the DCB group and the DES group (4.3% vs. 6.9%, odds ratio 0.71, 95% confidence interval 0.50-1.01, p = 0.059). Furthermore, there were no differences in incidence of cardiac death and MI. DCB angioplasty treatment of de novo lesions in large coronary vessels could be a safe and effective strategy in both acute and chronic coronary settings. The incidence of target lesion revascularization appears to be similar to that of contemporary DES.
One-Year Results of the Magmaris BRS in Coronary Artery Disease Patients: The IT-MASTERS Registry Stefano Galli, Domenico Tavella, Marco Sesana, Ferdinando Varbella, Dario Buccheri, Chiara Bernelli, Massimo Leoncini, Salvatore Saccà, Chiara Fraccaro, Francesco Pisano, Gabriele Tumminello, Angelo Leone, Agostino Lopizzo, Vittorio Pascale, Altin Palloshi, Paolo Buja, Gioel Gabrio Secco, Claudio Larosa, Alfredo Marchese, Flavio Ribichini, Giulia Lorenzoni, Dario Gregori, Giuseppe Tarantini American Journal of Cardiology, 2025
Short-Term Outcomes of Two Self-Expanding Transcatheter Valves in Sievers Type 1 Bicuspid Aortic Valve Stenosis: The “Proof-of-Concept” CLASS Effect Study Andrea Buono, Paolo Alberto Del Sole, Andrea Zito, Barbara Bellini, Nicholas Montarello, Abdul Amir, Samuel Sossalla, Chiara De Biase, Giuliano Costa, Tommaso Fabris, Mauro Massussi, Giulia Costa, Riccardo Gorla, Michele Bellamoli, Angela McInerney, Victoria Vilalta, Mario Garcia Gomez, Marco Gennari, Enrico Giacomin, Gabriele Tumminello, Claudio Montalto, Andrea Scotti, Greta Cattaneo, Antonio Giovanni Cammardella, Mariano Pellicano, Michele Galasso, Mauro Gitto, Nawzad Saleh, Matthias Renker, Claudio Sanfilippo, Antonio Messina, Pier Pasquale Leone, Emiliano Bianchini, Giovanni Esposito, Carlo Trani, Francesco Saia, Alfonso Ielasi, Ady Orbach, Mao Chen, Stefano Carugo, Raj R. Makkar, Azeem Latib, Helge Möllmann, Francesco Soriano, Luca Favero, Antonio Mangieri, Federico De Marco, Marianna Adamo, Xavier Carrillo Suarez, Marco De Carlo, Ignacio Amat-Santos, Diego Maffeo, Francesco Bedogni, Marco Barbanti, Francesco Burzotta, Daniel J. Blackman, Didier Tchètchè, Ole De Backer, Giuseppe Tarantini, Matteo Montorfano, Andreas Rück, Won-Keun Kim, Darren Mylotte Journal of Vascular Diseases, 2025 Background: Self-expanding transcatheter heart valves (SEVs) are often used to treat Sievers type 1 bicuspid aortic valve (BAV) stenosis. It remains unclear, however, if different SEVs yield similar outcomes in BAV stenosis, a class effect, or if the unique design features of different SEVs produce disparate clinical results. Objectives: This is a “proof-of-concept” study that compares procedural and clinical outcomes of Acurate neo2 and Evolut Pro/Pro+/Fx platforms in Sievers type 1 BAV stenosis. Methods: The CLASS effect is a retrospective, multicenter registry that enrolls patients with raphe-type 1 BAV stenosis undergoing TAVI at 29 international centers, who received Acurate neo2 and Evolut Pro/Pro+/Fx devices. An inverse probability of treatment weighting (IPTW) analysis was performed to adjust for baseline imbalances. Primary endpoints included VARC-3 technical success, 30-day device success, and early safety according to VARC-3. Results: Among 389 eligible patients, 155 and 234 patients were treated with Acurate neo2 and Evolut platforms, respectively. A higher rate of technical success was observed in the Evolut group (Acurate neo2 vs. Evolut: 93.4% vs. 97.1%, OR 0.41, 95% CI 0.19–0.83, and p = 0.017). At 30 days, device success was comparable (90.1% vs. 89.4%, OR 1.09, 95% CI 0.68–1.75, and p = 0.733), whereas Acurate neo2 was associated with a higher rate of early safety (84.1% vs. 70.4%, OR 2.22, 95% CI 1.56–3.17, and p < 0.001), which was mainly driven by a lower risk of new permanent pacemaker implantation (PPI) (6.3% vs. 19.5%, OR 0.28, 95% CI 0.16–0.46, and p < 0.001). Conclusions: Acurate neo2 and Evolut Pro/Pro+/Fx platforms provide similarly effective procedural and short-term outcomes in Sievers type 1 BAV stenosis. However, Evolut was associated with a higher technical success, while Acurate neo2 demonstrated a lower incidence of new PPI.
Meta-Analytic Review of Coronary Angiography in Peri-Procedural Myocardial Injury and Infarction After Cardiac Surgery Alberto Francesco Cereda, Marco Toselli, Paolo Cimaglia, Antonio Gabriele Franchina, Lorenzo Tua, Matteo Carlà, Gabriele Tumminello, Paolo Aseni, Giuseppe Massimo Sangiorgi, Marco Biolcati, Andrea Spangaro, Matteo Rocchetti, Eleonora Pezzoli, Paolo Vanelli, Stefano Lucreziotti Journal of Clinical Medicine, 2025 Introduction: Peri-procedural myocardial infarction (PMI) after cardiac surgery is a significant yet often under-recognised complication, sometimes necessitating urgent coronary angiography (PMI-rCA). This meta-analysis evaluates its prevalence, angiographic findings, management strategies, and associated mortality. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Data from nine studies comprising 104,445 post-cardiac surgery patients were analysed. Among them, those undergoing PMI-rCA were categorised by treatment strategy: conservative management, percutaneous coronary intervention (PCI), or reperform surgery. A network meta-analysis compared mortality risks across these groups, with findings visualised using forest plots, network diagrams, and SUCRA rankings. Results: PMI-rCA was performed in 1205 patients (2%). Of these, 34.3% had no significant angiographic abnormalities, 53.7% exhibited graft failure, and 10.4% had native vessel ischemia. Management strategies included conservative treatment (55.5%), PCI (23.5%), and reperforming surgery (21%). Network meta-analysis indicated that conservative management was associated with the lowest mortality risk, followed by PCI, while reperforming surgery had the highest risk. Discussion: These findings highlight the complexity of PMI diagnosis and treatment. The high proportion of patients without significant angiographic abnormalities raises concerns about potential overuse of invasive procedures. Meanwhile, PCI appears to be a more favourable interventional strategy than reperforming surgery in terms of mortality outcomes. Conclusions: PMI requiring coronary angiography is uncommon but clinically significant, with a 16% mortality rate. A tailored, risk-based approach is essential to optimise management, balancing conservative therapy, PCI, and reperforming surgery based on individual patient profiles.
Efficacy and Safety of Sirolimus-Coated Balloon Angioplasty in De Novo Lesions in Large Coronary Vessels: A Propensity Score-Matched Study Cecilia Gobbi, Francesco Giangiacomi, Guido Pasero, Andrea Faggiano, Lucia Barbieri, Gabriele Tumminello, Federico Colombo, Massimiliano Ruscica, Valentina Ardizzone, Edoardo Genta, Luca Mircoli, Stefano Galli, Stefano Carugo Catheterization and Cardiovascular Interventions, 2025 BackgroundEvidence regarding drug‐coated balloon (DCB)‐only angioplasty in de novo lesions of large vessels is still limited and mainly focused on paclitaxel‐coated balloon. We aimed to analyze the safety and efficacy of sirolimus‐coated balloon (SCB)‐only angioplasty in de novo lesions in large vessels compared to drug‐eluting stent (DES).MethodsIn this retrospective, dual‐center, case‐control study, we enrolled all consecutive patients treated between January 2022 and January 2024 with SCB‐only angioplasty in de novo lesion in large vessel (> 2.75 mm) compared to a propensity‐score matched contemporary population treated with DES. The primary endpoint was the rate of target lesion revascularization (TLR), while secondary endpoints were cardiac death (CD), target vessel revascularization (TVR), myocardial infarction (MI), and target lesion failure (TLF), defined as a composite of them.ResultsThe mean age was 70.1 ± 9.8 years in the SCB group (n = 92) and 67.9 ± 9.6 years in the DES group (n = 92) (p = 0.76). The median follow‐up was 19.5 ± 12 months in the SCB group and 20.1 ± 13.1 months in the DES group (p = 0.47). TLR occurred in 6.7% of patients in the SCB group and 5.6% in the DES group (p = 0.75). The incidence of MI, TVR, and TLF were similar between the two groups (4.3% vs 3.3%, p = 0.7, 2.2% vs 3.4%, p = 0.65% and 9.8% vs 8.7%, p = 0.79). CD occurred in 4.3% in the SCB group, compared to 3.3% in the DES group (p = 0.70).ConclusionOur study suggests that SCB angioplasty is both safe and effective in the treatment of de novo lesions of large vessels compared with DES.
Indications, Management, and Short- and Medium-Term Outcomes of Patients with Chronic Coronary Occlusion Treated with Percutaneous Revascularization—A Single-Center Study Lucia Barbieri, Gabriele Tumminello, Lorenzo Mafrici, Guido Pasero, Luca Mircoli, Federico Colombo, Cecilia Gobbi, Alessandra S. Rizzuto, Stefano Carugo Journal of Cardiovascular Development and Disease, 2025 The diagnosis of chronic total occlusion (CTO), characterized by the complete obstruction of a coronary artery for at least three months, remains challenging and can be entirely asymptomatic. Since the indications for performing a recanalization procedure for CTO do not originate from randomized controlled trials, this study aimed to assess the indications, management, and procedural outcomes of patients undergoing percutaneous revascularization (PCI) for a CTO, ensuring that the population was as uniform as possible regarding technologies and methodological approaches. Forty-one consecutive patients who underwent PCI for CTO recanalization were enrolled from January 2021 to 2024. Additional outcomes included mortality, major adverse cardiovascular events, and the presence of residual cardiac symptoms, with a median follow-up of 449 days and an interquartile range of 230–643 days. Our real-life study confirmed that PCI for CTO has a high success rate and a low incidence of major complications.
A Case of Infarct Myocardial Fissure Alberto Cereda Anatolian Journal of Cardiology, 2025 A Case of Infarct Myocardial FissureA 63-year-old man was admitted to an emergency department for chest pain and recurrence of hypotensive syncope.The patient stated that he had experienced thoracic pain lasting 30 minutes followed by syncope 5 days before.Afterwards, he felt well and did not seek any medical consultation.Upon initial medical examination, he was awake, sweaty, hypotensive, with diffuse mottling, and complained of persistent thoracic pain.His initial blood pressure was 80/40 mm Hg with signs of peripheral hypoperfusion in the setting of cardiogenic shock.The electrocardiogram revealed profound Q waves and negative T waves in inferior leads (Figure 1A) Bedside cardiac ultrasound showed hyperechoic pericardium with cardiac tamponade (Figure 1B).Chest CT showed the absence of aortic pathology and confirmed the presence of a pericardial blood effusion with transmural perfusion defects of the posterolateral myocardial segments (Figure 1C,D,E,F,G, Video 1).The patient was transferred in an emergency to cardiac surgery to
Secondary access and routine protection wire for transfemoral transcatheter aortic valve replacement: the SURF-TAVR registry Ottavia Cozzi, Prem Ratan, Giulia Costa, Luca Branca, Mauro Boiago, Simone Fezzi, Matteo Biroli, Andrea Munafò, Claudio Montalto, Francesco Colombo, Francesco Gallo, Dario Pellegrini, Matteo Casenghi, Enrico Giacomin, Damiano Regazzoli, Alessandro Sticchi, Chiara De Biase, Mauro Chiarito, Marco De Carlo, Marianna Adamo, Didier Tchètchè, Carlo Cernetti, Emanuele Barbato, Alfonso Ielasi, Gabriele Tumminello, Alessia Azzano, Elvis Brscic, Matteo Vercellino, Marco Busco, Diego Maffeo, Marco Barbierato, Giacomo G. Boccuzzi, Flavio Ribichini, Federico De Marco, Jacopo Oreglia, Giulio Stefanini, Bernhard Reimers, Antonio Mangieri Clinical Research in Cardiology, 2025
Outcome and Morphofunctional Changes on Cardiac Magnetic Resonance in Patients with Acute Myocarditis Following mRNA COVID-19 Vaccination Enrico Ammirati, Laura Lupi, Matteo Palazzini, Michele Ciabatti, Valentina A. Rossi, Piero Gentile, Aitor Uribarri, Chiara R. Vecchio, Daniele Nassiacos, Alberto Cereda, Cristina Conca, Gabriele Tumminello, Nicolas Piriou, Coline Lelarge, Patrizia Pedrotti, Miriam Stucchi, Giovanni Peretto, Michele Galasso, Florent Huang, Umberto Ianni, Antonio Procopio, Gianluigi Saponara, Paolo Cimaglia, Daniela Tomasoni, Francesco Moroni, Annalisa Turco, Simone Sala, Giuseppe Di Tano, Entela Bollano, Claudio Moro, Antonio Abbate, Roberta Della Bona, Italo Porto, Stefano Carugo, Jeness Campodonico, Gianluca Pontone, Aurelia Grosu, Leonardo Bolognese, Jorge Salamanca, Pablo Diez-Villanueva, Krzysztof Ozieranski, Agata Tyminska, Loren Sardo Infirri, Daniel Bromage, Antonio Cannatà, Kimberly N. Hong, Marianna Adamo, Giuseppina Quattrocchi, Alberto Foà, Luciano Potena, Andrea Garascia, Cristina Giannattasio, Eric D. Adler, Gianfranco Sinagra, Frank Ruschitzka, Paolo G. Camici, Marco Metra, Maurizio Pieroni Circulation Heart Failure, 2023
Systematic Review and Meta-Analysis of Oral Anticoagulant Therapy in Atrial Fibrillation Cancer Patients Alberto Cereda, Stefano Lucreziotti, Antonio Gabriele Franchina, Alessandra Laricchia, Valentina De Regibus, Barbara Conconi, Matteo Carlà, Andrea Spangaro, Matteo Rocchetti, Luca Ponti, Alessandro Minardi, Elena Sala, Giuseppe Massimo Sangiorgi, Gabriele Tumminello, Lucia Barbieri, Stefano Carugo, Paolo Aseni Cancers, 2023
Systematic review and meta-analysis on coronary calcifications in COVID-19 A. Cereda, L. Allievi, A. Palmisano, G. Tumminello, L. Barbieri, A. Mangieri, A. Laricchia, A. Khokhar, F. Giannini, M. Toselli, G. M. Sangiorgi, A. Esposito, P. Aseni, S. Lucreziotti, A. Mafrici, S. Carugo Emergency Radiology, 2022
The hidden interplay between sex and COVID-19 mortality: the role of cardiovascular calcification Alberto Cereda, Marco Toselli, Anna Palmisano, Davide Vignale, Riccardo Leone, Valeria Nicoletti, Chiara Gnasso, Antonio Mangieri, Arif Khokhar, Gianluca Campo, Alessandra Scoccia, Matteo Bertini, Marco Loffi, Pietro Sergio, Daniele Andreini, Gianluca Pontone, Gianmarco Iannopollo, Tommaso Nannini, Davide Ippolito, Giacomo Bellani, Gianluigi Patelli, Francesca Besana, Luigi Vignali, Nicola Sverzellati, Mario Iannaccone, Paolo Giacomo Vaudano, Giuseppe Massimo Sangiorgi, Piergiorgio Turchio, Alberto Monello, Gabriele Tumminello, Aldo Pietro Maggioni, Claudio Rapezzi, Antonio Colombo, Francesco Giannini, Antonio Esposito Geroscience, 2021
One-year clinical outcomes after unrestricted implantation of the Absorb bioresorbable scaffold (RAI registry) Alfonso Ielasi, Bernardo Cortese, Elisabetta Moscarella, Bruno Loi, Giuseppe Tarantini, Attilio Varricchio, Francesco Pisano, Alessandro Durante, Giampaolo Pasquetto, Alessandro Colombo, Gabriele Tumminello, Luciano Moretti, Paolo Calabrò, Pietro Mazzarotto, Maurizio Tespili, Pedro Silva Orrego, Donatella Corrado, Giuseppe Steffenino Eurointervention, 2018
Clinical findings after bioresorbable vascular scaffold implantation in an unrestricted cohort of patients with ST-segment elevation myocardial infarction (from the RAI registry) Elisabetta Moscarella, Alfonso Ielasi, Attilio Varricchio, Maria Carmen De Angelis, Bruno Loi, Giuseppe Tarantini, Paolo Calabrò, Bernardo Cortese, Pietro Mazzarotto, Gabriele Gabrielli, Francesco Pisano, Michela Facchin, Leonardo Misuraca, Valerio Lucci, Roberto Gistri, Gabriele Tumminello, Luciano Moretti, Alessandro Colombo, Alessandro Durante, Massimo Fineschi, Davide Piraino, Maurizio Ferrario, Sebastian Coscarelli, Annamaria Nicolino, Maurizio Tespili, Donatella Corrado, Giuseppe Steffenino International Journal of Cardiology, 2018
Thirty-Day Outcomes After Unrestricted Implantation of Bioresorbable Vascular Scaffold (from the Prospective RAI Registry) Bernardo Cortese, Alfonso Ielasi, Elisabetta Moscarella, Bruno Loi, Giuseppe Tarantini, Francesco Pisano, Alessandro Durante, Giampaolo Pasquetto, Alessandro Colombo, Gabriele Tumminello, Luciano Moretti, Paolo Calabrò, Pietro Mazzarotto, Attilio Varricchio, Maurizio Tespili, Roberto A. Latini, Gianfranco Defilippi, Donatella Corrado, Giuseppe Steffenino American Journal of Cardiology, 2017