bluuebunny/crossref_metadata_2025_split huggingface dataset:
P350 CARDIOLOGY SPECIALISTS OPERATING IN THE VENETO REGION: AN ANALYSIS COVERING THE PERIOD BETWEEN 2013 AND 2019
Authors: Zuin M , Picariello C , Rigatelli G , Roncon L , Bilato C 
Published: May 2022

Abstract

Background
The continuous aging of the population and the impact of cardiovascular diseases in terms of morbidity and mortality require a continuous and constant increase in health personnel throughout the country. The aim of the study is to evaluate the trend of cardiologist specialists available for the population living in the Veneto Region between 2013 and 2019.

Materials and Methods
Data regarding the population living in Veneto region during the study period as well as the absolute number of cardiologists referred to 1000 inhabitants and the regional old–age index were extracted from the ISTAT portal (dati.istat.it) and then processed. The temporal variation in the number of cardiologist specialists operating in the Veneto region was evaluated with the Jonckheere–Terpstra test.

Results
Between 2013 and 2019, the resident population in Veneto varied from 4,926,818 to 4,879,133 inhabitants. Cardiology specialists increased from 759 in 2013 to 869 in 2019; in particular, their availability, for every 1000 inhabitants, change from 0.15 to 0.18 with a total increase in the period considered of 0.4% (p for trend = 0.68), despite a continuous aging of the resident population, as evidenced by the old–age index (from 146.8 in 2013 to 173.1 in 2019, p = 0.01). The maximum increase in the number of specialists registered was 0.01 per 1000 inhabitants. (Figure 1).

Conclusions
The availability of cardiology specialists in the Veneto Region, despite showing a slight positive althoug non significaqnt trend in recent years, continues to be lower than the care burden and the type of resident population, often elderly and with multiple comorbidities.
P352 HEALTH SURVEILLANCE FOR ENTRY INTO THE CARDIOLOGY DEPARTMENT IN TIMES OF SARS–COV2 PANDEMIC
Authors: Cappannelli S , Tedesco T , Fischer B , Capponi E , Buccolieri M , Cardile M , Cosmi D , Di Pasquale T , Martinelli S , Pagnotta F , Piccioni N , Rey L , Murrone A 
Published: May 2022

Abstract

Introduction
The SARS–Cov2 pandemic has made it necessary to implement drastic measures to contain the infection and at the same time start a regulated process of protection of health workers (OS) and hospitalized patients (PR).

Objective
To verify the effectiveness of the health surveillance measures for SARS–COoV2 infection put in place to protect the OS and PR in the Cardiology of the Gubbio–Gualdo Tadino Hospital (AUSL Umbria 1).

Material and methods
we conducted a retrospective analysis, in the period 1 April 2020– 30 November 2021, on OS and PR in our Cardiology–UTIC OU. The protocols used for health surveillance provided, in all phases of the pandemic, the well–known general prevention measures (PPE, hand hygiene, distancing, per–triage). In phase 1 of the pandemic, molecular swabs were also carried out every 14 days at the OS and only at the entrance to the PR, in phase 2 antigenic tests every 5 days at the OS and molecular swabs at the entrance and after 48 hours at the PR while in the current phase 3 an antigenic test every 10 days at the OS and PR a molecular swab at T0 and T2 and an antigenic test at the 5th day and subsequently every 5 days.

Results
A total of 320 subjects, a sample of PR (300, 15 patients month) and all OS (20) were analyzed. A total of 2658 swabs were carried out (1088 molecular and 1570 antigenic) and only two positive OS were found in phase 1 of the pandemic alone, while in phase 2 and 3 no OS or PR was positive.

Conclusions
The application of the general rules for the prevention of SARS–Cov2 infection and the definition of precise intra–hospital pathways, together with the application of a hospital health surveillance protocol, has made it possible to significantly limit infections within the OU. In addition, the rapid identification of positive OS allowed for rapid isolation avoiding the spread of infection to PR and other OS. Bibliography: COVID and gender resources. Johns Hopkins Bloomberg School of Public Health. https://coronavirus.jhu.edu/map.html ISS, National Survey on COVID–19 contagion in residential and social health structures, 30 March 2020; Guidelines for health activities in phase 1, phase 2 and phase 3 of the pandemic. Umbria Region.
P358 THE ROLE OF ADHERENCE TO LIPID–LOWERING THERAPIES IN ACHIEVING LIPID TARGET: FINDINGS FROM REAL–WORLD ANALYSIS IN ITALY
Authors: Degli Esposti L , Borghi C , Galvani M , Giacomini E , Manotti P , Marra A , Passaro A , Perrone V , Pieraccini F , Sangiorgi D , Navazio A 
Published: May 2022

Abstract
The objective of the present real–world analysis was to evaluate the impact of adherence to lipid–lowering drugs in reaching the lipid target in settings of clinical practice in Italy.
The analysis was based on administrative and laboratory database of selected Healthcare Units in Italy covering approximately 10% of Italian population. Adult patients prescribed with statin and with at least a low–density lipoprotein (LDL) determination were included between 2012 and 2019. The index date was defined as the first prescription for statin within the inclusion period. Patients fell into 4 clusters collectively exhaustive and mutually exclusive based on their characteristics assessed during the year prior index date. Patients were considered as adherent if they had a proportion of days covered (PDC)≥80%. Among overall patients prescribed statin and with a LDL determination, 1% was with familial hypercholesterolemia, 28% with previous cardiovascular events, 21% with diabetes and 50% in primary prevention. Regardless their risk profile, the increasing of adherence was related to a higher achievement of LDL–target, with an increment of + 53.2% among familial hypercholesterolemia, +43.1% in diabetes and +30% in previous cardiovascular events and primary prevention clusters while progressing from low (PDC&lt;40%) to high (PDC≥80%) levels of adherence. However, while in diabetes and primary prevention clusters 80% and 86% of adherent patients, respectively, had their cholesterol level under control, in the familial hypercholesterolemia and previous cardiovascular events clusters only 46% of adherent patients achieve the lipid target.
The analysis showed adherence to be a key factor for cholesterol control. However, our findings underline a therapeutic need for patients that, although adherent, fail to achieve the lipid target, especially among patients with previous cardiovascular events (that have low level of LDL to achieve) and with familial hypercholesterolemia (that have high LDL basal level), suggesting therapeutic intensification should be applied.
P359 ACHIEVING THERAPEUTIC GOAL ON LDL IN HIGH AND VERY HIGH RISK PATIENTS IN A DEDICATED OUTPATIENT CLINIC
Authors: Napolitano B , Maretta A , Spagnuolo V , Balsano M 
Published: May 2022

Abstract

Background
High LDL cholesterol levels represent an important risk factor for development of cardiovascular disease. Reduction of LDL reduces cardiovascular risk. Current guidelines (ESC 2019) recommend ambitious LDL levels for high and very high risk patients. But, in clinical practice, just a part of these patients achieve the ESC 2019 goals (DA VINCI Study).

Patients and Methods
We evaluated, in the first 152 patients, at high and very high cardiovascular risk, consecutively afferent to our dedicated clinic for hyperlipidaemia (Lipid Center CS), the achievement of the therapeutic goal of LDL according to ESC 2019 guidelines. All patients were on lipid–lowering drug treatment from at least twelve months and the last blood tests were no less recent than three months.

Results
Of all patients, 82 were female. The mean age was 65.24±10.33 years. Thirty patients were in secondary prevention. Of all patients, 70% reached the therapeutic goal (77% with very high risk and 68% with high risk). Fifty nine% were taking high–intensity lipid–lowering therapy. Seventy one% were taking combination therapy. Thirty four% were treated with PCSK9 inhibitors.

Discussion
Taking note of the limited number of the sample, our therapeutic results achieved are higher than that achieved in the DA VINCI study in which only 60% of patients from west Europe reached the therapeutic goal. A dedicated clinic for hyerlipidaemia and the high use of combination therapy with intensive drugs and extensive use of PCSK9 inhibitors may justify the results of our study. Our center did not participated in the DA VINCI study.
P362 GENDER DIFFERENCE IN PSYCHOLOGICAL STRESS SYMPTOMS IN CARDIAC OUTPATIENTS AT THE TIME OF COVID–19 PANDEMIC. THE ABC STUDY ON HEART DISEASE
Authors: Berton G , Mahmoud H , Cavuto F , Bagato F , Palmieri R , Stocchero L , Selvestrel E , Allocca G , Lorenzon E , Merotto D 
Published: May 2022

Abstract

Introduction
COronaVIrus Disease 2019 (COVID–19) exerts a significant impact on public health since it has reached a pandemic level in March 2020 and a high rate of negative mental health outcomes has been reported in the Italian general population.

Purpose
We aimed to investigate the pandemic impact on the psychological status of, COVID–19 negative, cardiac patients and if there are any gender differences.

Methods
Consecutive COVID–19 free patients who were presented to the cardiac outpatient clinic of Conegliano general hospital were divided into 2 groups according to their presentation, either before or during the COVID–19 Pandemic. The presence or absence of stress symptoms was established based on the patient’s self–assessment psycho–emotion questionnaire based on a reproduced form of Cohen’s perceived stress scale.

Results
A total of 310 patients were included in this analysis. Patients’ mean age was 65±18.5 years, males were 57% with 128 (41%) and 132 (59%) patients presented before and during the pandemic respectively. Both patients’ groups shared most of the demographic and clinical characteristics. In all patients, stress symptoms were reported in (52% VS 60%; p = 0.15) for patients who were presented before and during the pandemic, respectively. In male patients, stress symptoms were more frequent in patients who were presented during the pandemic (59%) compared to the pre–pandemic presented male patients (43%); (p = 0.03). Yet, no difference in the frequency of stress symptoms was observed in female patients. In an age–adjusted logistic regression analysis, psychological stress was significantly higher in male patients who were presented during the pandemic (Odds Ratio [OR]=2.0; 95% confidence interval [CI]=1.1–3.6; p = 0.03). Although, no significant difference was observed in female patients (OR = 0.8; 95% CI = 0.4–1.7; p = 0.63). Same results were obtained using the fully adjusted model, (OR = 1.9; 95% CI = 1.0–3.5; p = 0.04) and (OR = 0.8; 95% CI = 0.4–1.7; p = 0.64), for male and female patients, respectively.

Conclusion
Psychological stress symptoms has been observed more frequently in male patients seen during the COVID–19 pandemic, with almost double risk compared to the pre–pandemic, independently from baseline clinical characteristics. No difference in the frequency of stress symptoms was observed in female patients.
P363 HIGH–SENSITIVITY TROPONINS FOR OUTCOME PREDICTION IN THE GENERAL POPULATION: A SYSTEMATIC REVIEW AND META–ANALYSIS
Authors: Aimo A , Georgiopoulos G , Panichella G , Vergaro G , Passino C , Emdin M , Clerico A 
Published: May 2022

Abstract

Background
High–sensitivity (hs) assays allow to measure cardiac troponin T and I (cTnT/I) even in healthy individuals. The higher hs–cTn values, the higher the ongoing cardiomyocyte damage, and then reasonably the risk of developing symptomatic cardiac disease.

Methods
We retrieved all studies evaluating the prognostic value of hs–cTnT or I in the general population. We calculated pooled hazard ratio (HR) values for all–cause and cardiovascular death, cardiovascular events and heart failure (HF) hospitalization.

Results
We included 24 studies for a total of 203,202 subjects; 11 studies assessed hs–cTnT and 14 hs–cTnI. One standard deviation (SD) increase in baseline hs–cTn was associated with a 23% higher risk of all–cause death (HR 1.226, 95% CI 1.083–1.388, p &lt; 0.001, I2=88.5%); all these studies measured hs–cTnI. In an exploratory analysis on 3 studies with 25,760 subjects, hs–cTn predicted cardiovascular death (HR 1.822, 95% CI 1.241–2.674, p = 0.002, I2=87.2%). After synthesizing 9 studies with 58,565 subjects, hs–cTn predicted cardiovascular events (HR 1.328, 95% CI 1.167–1.513, p &lt; 0.001, I2=93.8%). Both hs–cTnT (HR 1.627, 95% CI 1.145–2.311, p &lt; 0.001) and hs–cTnI (HR 1.260, 95% CI 1.115–1.423, p &lt; 0.001; p for interaction &lt;0.001). Furthermore, in 10 studies with 61,467 subjects, hs–cTn predicted HF hospitalization (HR 1.493, 95% CI 1.368–1.630, p &lt; 0.001, I2=76.6%). Both hs–cTnT (HR 1.566, 95% CI 1.303–1.883, p &lt; 0.001) and hs–cTnI (HR 1.467, 95% CI 1.321–1.628, p &lt; 0.001) were associated with HF hospitalization (p for interaction &lt;0.001).

Conclusions
Hs–cTn values hold strong prognostic value in subjects from the general population, predicting the risk of all–cause and cardiovascular mortality, cardiovascular events, and HF hospitalization.
P365 CARDIOVASCULAR RISK SCORE MAY BE USEFUL IN STRATIFY DEATH RISK IN HOSPITALIZED COVID19 PATIENTS
Authors: Cicco S , Mozzini C , Marozzi M , Carella R , De Fazio G , Vacca A , Cariddi C , Setti A , Pappagallo F , Solimando A , Ria R 
Published: May 2022

Abstract

Background
COVID–19 induce a robust systemic inflammation. Patients with cardiovascular disease (CVD) present an increased death risk. However, many efforts are spent to identify possible predictors of negative outcomes in order to have a more specific clinical setting. CVD score are useful tools in evaluation of risk of cardiovascular events Aim: We evaluated oxygenation and characteristics in COVID–19 according to cardiovascular risk stratification performed using Framingham (FRS) and Atherosclerotic cardiovascular disease (ASCVD) risk scores.

Material and Methods
We evaluated 155 COVID–19 patients (110 males and 45 females, aged 67.43±14.72 yrs). All patients underwent to a complete physical examination, chest imaging, laboratory tests, and blood gas analysis at the time of diagnosis. Seventeen patients died (10 males and 7 females, aged 74.71±7.23 yrs) while the remaining 138 patients (100 males and 38 females, aged 66.07±15.16 yrs) were alive at discharge.

Results
No differences there were in Hb, C–reactive protein nor in d–dimers between the two groups. Compared to alive, died group presents a significant increase in white blood cells (p &lt; 0.05) and d–dimers (p &lt; 0.05). No difference there were in pCO2, SO2, and in alveolar arteriolar oxygen difference (A–aDO2). On the contrary, in died patients there is an increased pO2 (p &lt; 0.05) and a decreased ratio between oxygen inspired and pO2 (P/F; p &lt; 0.05). Died patients have increased both in FRS (27.37±5.03 vs 21.33±9.49, p &lt; 0.05) and ASCVD (40.18±20.36 vs 21.47±17.23, p &lt; 0.05). FRS, but not ASCVD, presents a negative correlation to P/F (r–0.42, p &lt; 0.05) in died while no correlation was found in alive. No other correlation has been found with blood gas parameters or in the phlogosis parameters evaluated in the two groups. ROC curve analysis showed a good performance in prediction of death for both scores (AUC FRS 0.71, ASCVD 0.77) with a good sensitivity (FRS 76.92%, ASVCD 75.00%) and specificity (FRS 65.00%, ASCVD 81.13%).

Discussion
CVD may be considered as a major risk factor for death in COVID–19 patients. The increase risk relates to a reduced lung capacity but it is not related to alteration in gas exchange. Similarly, CV risk results independent from inflammatory state we found. CVD risk score may be useful to stratify patients at admittance for a better treatment
P366 EFFECTS OF EXERCISE REHABILITATION IN PATIENTS WITH LONG COVID–19
Authors: De Marzo V , Barbara C , Maragliano P , Lotti R , Guglielmi G , Porcile A , Russo C , Griffo R , Makikallio T , Hautala A , Porto I , Clavario P 
Published: May 2022

Abstract
Moving from the first COVID–19 pandemic to the chronic phase of COVID–19, more than 50 long–term detrimental effects have been recognized in the so–called long COVID–19 syndrome. The exact mechanisms underlying the exercise capacity reduction and functional limitations are unknown, however, rehabilitation could play a pivotal role. The aim of this study was to evaluate whether a combination of aerobic and resistance training performed in the same session for 8 weeks could be well–tolerated and effective in long COVID–19 patients with reduced exercise capacity [(&lt;85% of predicted peak aerobic capacity (VO2peak)] at 3–month from hospital discharge after COVID–19. The exercise training program included 3 exercise sessions per week. Each session included: a) aerobic exercise (starting at 30 min and increasing to 60 min) with 5 min warm–up and 5–min cool down; b) nine major muscle group resistance exercises (for the lower extremity: leg extension/flexion, abduction/adduction, and leg press; for the upper extremity: push–up/pull–down; for the core muscles: abdomen, back). The intensity of aerobic exercise was defined according to VO2peaktest results targeting the 80% level of lactate threshold in Watts. Resistance training load was determined for each muscle groups according to the results of the maximal dynamic strength testing (1RM; one repetition maximum) and was confirmed and updated after 4 weeks by defining new 1RM values. Resistance training prescription loading was defined as 40% of 1RM, 2 sets (3 sets for last two weeks) and 12 repetitions for each muscle group. The duration of a single training session was approximately 90 min. Out of 220 patients screened, 50 patients (aged 55.8±9.7 years, 15 women, body mass index 26.6±5.2 kg/m2) were enrolled. Mean exercise training sessions was 66.1±34.0; none of the patients dropped out from the study. VO2peak increased 15% and peak ventilation 9% (p &lt; 0.001 for both). After the training program, mean percentage of VO2peak significantly increased (+14.2%, p &lt; 0.001). Muscle strength increased markedly for all major muscle groups ranging from 16% to 33% increase (p &lt; 0.010). An exercise rehabilitation with combined aerobic and resistance exercises for 8 weeks increases markedly both cardiorespiratory and musculoskeletal fitness in long COVID–19 patients. These results may highlight the importance of regular exercise rehabilitation aiming to promote daily activities, independent living, and better quality of life.
P368 PHYSICAL AND PSYCHOLOGICAL RECONDITIONING IN LONG COVID SYNDROME: RESULTS OF AN OUT–OF–HOSPITAL EXERCISED–BASED CARDIOVASCULAR REHABILITATION PROGRAM
Authors: Compagno S , Palermi S , Pescatore V , Brugin E , Tegon G , Sarto M , Marin R , Calzavara V , Nizzetto M , Scevola M , Albertin C , Biffi A , Giada F 
Published: May 2022

Abstract

Background
Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID–19 infection. Natural history and treatments of this syndrome are still poorly understood, even if evidence suggests the potential role of physical rehabilitation in improving symptoms in these subjects.

Aim
The aim of the present study was to evaluate safety, effectiveness and feasibility of a multidisciplinary, out–of–hospital, exercise–based cardiac rehabilitation (EBCR) program, of two months duration, in improving symptoms and physical and psychological parameters in patients with LCS Methods Thirty consecutive patients with LCS (18 males, mean age 58 years) underwent an accurate medical screening process including anthropometric and muscular strength evaluation, cardiopulmonary exercise test (CPET), quality of life (QoL) and psychological appraisal before and after an EBCR program.

Results
At baseline, all LCS patients were strongly symptomatic and showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during the exercise training sessions. After the EBCR program, COVID–19 residual symptoms significantly decreased and significant improvements in upper and lower limb muscular strength, CPET parameters, perceived physical and mental health, depression and anxiety were observed.

Conclusions
The present study confirms the severe physical and psychological impairment of patients with LCS and suggests that a multidisciplinary EBCR program could promote their physical and psychological recovery
P370 INNOVATIVE TELEMONITORED MODEL OF PHYSICAL EXERCISE PRESCRIPTION IN SECONDARY PREVENTION DURING THE QUARANTINE
Authors: Lordi R , Veronese S , Piccinini A , Ferro A , Zerbini V , Piva T , Raisi A , Mandini S , Grazzi G , Sassone B , Pasanisi G 
Published: May 2022

Abstract

Introduction
COVID–19 pandemic induced the emanation of extraordinary measures like quarantine, that can be considered a risk factor for both physical and mental health in the population. In particular, gym’s closure and the need to stay home didn’t allow people to perform physical activity easily, with a consequent worsening of cardiovascular risk factors. During quarantine some general recommendations have been disseminated, but little is known about specific guidelines for home–based exercise prescription in patients with cardiovascular disease. Therefore, the purpose of this study is to develop home–based physical exercise programs for cardiac patients referred to the Center for Exercise Science and Sports of University of Ferrara.

Methods
On the basis of exercise capacity obtained from the last functional evaluation, performed in presence before the closure, three structured workouts were realized following the guidelines. They are composed as follows: warm–up, strenght and balance exercises alternate to indoor walking, cool–down. Patients received an explicative iconographic via e–mail or smartphone. Some domiciliary sessions were supervised by an operator through video connection.

Results
All patients showed excellent compliance with the proposed program. Adherence has been verified through biweekly recalls. No adverse events occurred.

Conclusions
Telemonitored exercise prescription in cardiac outpatients was effective and safe, helping to prevent negative consequences of the abrupt cessation of physical activity due to COVID–19 pandemic. These evidence could be useful even after the end of pandemic, for all those patients that are less likely to participate in traditional cardiovascular rehabilitation programs because of difficulties in reaching facilities or leaving home.