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Nov 11, 2019 · Among patients with atrial fibrillation and recent PCI, stent thrombosis is rare, with the majority of events occurring early after PCI. Rates of stent thrombosis were lower with aspirin compared with placebo and with apixaban compared with VKA.
- Renato D. Lopes, Sergio Leonardi, Daniel M. Wojdyla, Amit N. Vora, Laine Thomas, Robert F. Storey, D...
- 2020
- Introduction
- Methods
- Results
- Discussion
- Limitations
- Conclusions
- Author Contributions
- Acknowledgements
- Funding
- Data Availability
To achieve the highest attainable standard of health,1we must translate the best scientific evidence into clinical practice, hospital policies, and eventually patient care. An ideal model of care should provide equitable access to every eligible patient, govern the utilization of the limited existing resources, prioritize diagnostic and therapeutic...
Study design, patients, and programme features
The study was designed to promote—and measure—the inclusion of the entire population of patients admitted with ACS in the participating hospitals.3 Eligibility was therefore set broad with minimal restrictions (protocol, see Supplementary material online). Briefly, all screened patients with evidence of suspected ACS in the clinical chart, as documented by symptoms of myocardial ischaemia, raised troponin values, or new electrocardiogram (ECG) changes (with or without ST elevation), were elig...
Measures of quality process and follow up
The two co-primary quality indicators variables were (i) timely reperfusion in patients admitted with STEACS intended for urgent reperfusion (S1) and (ii) optimal medical therapy in patients discharged alive with a final diagnosis of AMI or UA, which were selected for their presumed relevance and complementarity. Timely reperfusion was defined as the proportion of S1 patients with acceptable time delay, i.e. less than 60 min of door-to-arterial access for reperfusion for non-transfer patients...
Data collection, quality control, strategies for patients inclusion, and data sharing
Data collection was performed by dedicated staff at each site that was trained on the protocol, operations, and conventions for patients’ inclusion. To maximize consistency, we used guidelines for most common scenarios (see Supplementary material online). We used REDCap for data collection, a secure online web application with a central monitor providing guidance and technical advice for staff entering the data via a dedicated helpdesk. To minimize common errors, we designed consistency check...
From September 2015 to January 2021, 5107 patients were enrolled from six Italian hospitals. Of these, 1524 were enrolled during the single-centre phase (September 2015 to December 2017) and 3583 during the multicentre phase (January 2018–2021).3 Patients’ characteristics by qualifying ACS stratum, and timing of principal diagnostic tests during ho...
The concept of clinical governance is a vision of the ideal system of care rather than a single testable hypothesis. In the present study we intended to structure this concept by proposing an integrated approach for health care delivery in patients with ACS that aim to universal patients’ inclusion and to identify priorities in the diagnosis and th...
A study limitation may be related to the use of the ICD-9CM coding system for ACS screening and identification. This is the standard administrative coding system in Italy but it is obsolete in several other countries and is not currently recommended by the World Health Organization. While the assumptions for the codes we used are presumably valid w...
We describe an integrated approach to quality improvement in patients with ACS that verify and quantifies consecutive inclusion and could identify and mitigate across-hospitals variations in access to care, that measure and suggest an approach by priority of multiple indicators of quality for diagnosis and therapy, and that share transparently this...
S.L. wrote the first draft of the manuscript, which was critically revised and checked for consistency by the steering committee members. All remaining authors critically revised the manuscript. S.L. submitted the manuscript for publication on behalf of the authors.
Editorial support was provided by Ms. Daniela Civardi, Cardiovascular Clinical Research Center, Fondazione IRCCS Policlinico S.Matteo, Pavia. Rasheed Gazmawi, Filippo Andrea Valenza, Francesco Alfio Russo, Sebastiano Carli, Francesco Matteo Dioniso, Alberto Barengo, Chiara Castelli, Federico Fortuni, Anna Peschiera, Pamela Candito, Marco Scorza, Ma...
The study was sponsored by Fondazione IRCCS Policlinico San Matteo in Pavia, was approved by the institutional review board of each participating hospital and was supported in part by a competitive grant: externally sponsored research of AstraZeneca (ESR-16–12480).
The complete set of de-identified participant data collected along with explicative documents, including annotated case report form and study protocol will be shared. Data will be available upon request.
- Leonardi, Sergio
Jan 3, 2024 · Antithrombotic therapy represents the cornerstone of the pharmacological treatment in patients with acute coronary syndrome (ACS). The optimal combination and duration of antithrombotic therapy is still matter of debate requiring a critical assessment of patient comorbidities, clinical presentation, revascularization modality and/or ...
Mar 3, 2022 · Prof Sergio Leonardi reported grants and personal fees from AstraZeneca and personal fees from BMS/Pfizer, Novo Nordisk, and Chiesi outside the submitted work. Prof Carlo Mario Lombardi received speaker and advisor honoraria from Novartis and Astra Zeneca.
- 10.1016/j.amjcard.2021.11.054
- 2022/03/03
- Am J Cardiol. 2022 Mar 15; 167: 125-132.
RESUME. Contexte: On ignore quelle est la strategie optimale et le moment le plus approprie pour la revascularisation chez les patients stables sur le plan hemodynamique qui ont subi un infarctus du myocarde avec elevation du segment ST et presentent une atteinte polyvasculaire.
RESUM E. Contexte : L’efficacite comparative de l’accès transradial (ATR) par rapport à l’accès transfemoral (ATF) chez les patients souffrant d’un syndrome coronarien aigu (SCA) et subissant une intervention coro- narienne percutanee (ICP) complexe reste incertaine.
Aug 8, 2023 · The impact of complete revascularization (CR) on the development of heart failure (HF) in patients with acute coronary syndrome and multivessel coronary artery disease undergoing percutaneous coronary intervention remains to be elucidated. Methods and Results.
