bluuebunny/crossref_metadata_2025_split huggingface dataset:
ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN YOUNG PATIENTS: RISK FACTORS AND PROGNOSIS
Authors: Chamtouri Ikram , Souissi Rania , Amdouni Nesrine , Kaddoussi Rania , Abdallah Wajih , Jomaa Walid , Ben Hamda Khaldoun , Maatouk Faouzi 
Published: June 2022

Objective:
ST elevation myocardial infarction (STEMI) is a common event in old adult. However, STEMI remains poorly described in young. We aimed to assess risk factors, angiographic results and in-hospital prognosis in young < 45 years presented with STEMI.

Design and method:
All patients hospitalized for STEMI and aged between 18 and 65 years were retrospectively enrolled in this study. Young patients < 45 years were compared to those (less young) aged more than 45 and less than 65 years. Demographic informations, risk factors, angiographic profile and prognosis were collected.

Results:
Among 1210 STEMI patients, 251 (20.7%) patients were young. Two young patients and four less young did not have coronary angiography because of premature death.
No significant difference was demonstrated in term of in-hospital complications such as acute heart failure, cardiogenic shock, ventricular arrhythmia, atrio-ventricular block between the two groups. Compared to less young patients, in-hospital mortality accounted for 3.40% in young versus 4.6% (p = 0.3). Smoking was identified as a significant predictors factors of mortality (p = 0.015) in young patients.

Conclusions:
In contrast to “less young” patients, STEMI in young is characterized by predominance of smoking, cannabis consumption and family history of CAD as risk factors, more MINOCA and diffuse coronary lesions with no difference in term of in-hospital mortality.
THE EFFECT OF COVID-19 VACCINE ON ARTERIAL FUNCTION
Authors: Terentes-Printzios Dimitrios , Gardikioti Vasiliki , Solomou Eirini , Emmanouil Eleni , Gourgouli Ioanna , Xydis Panagiotis , Christopoulou Georgia , Georgakopoulos Christos , Dima Ioanna , Miliou Antigoni , Lazaros George , Pirounaki Maria , Tsioufis Konstantinos , Vlachopoulos Charalambos 
Published: June 2022

Objective:
To fight the COVID-19 pandemic, messenger RNA (mRNA) vaccines were the first to be adopted by vaccination programs worldwide. We sought to investigate the short-term effect of mRNA vaccine administration on endothelial function and arterial stiffness.

Design and method:
Thirty-two participants (mean age 37 ± 8 years, 20 men) that received the BNT162b2 mRNA COVID-19 vaccine were studied in 3 sessions in a sequence-randomized, sham-controlled, assessor-blinded, cross-over design. The primary outcome was endothelial function assessed by brachial artery flow-mediated dilatation (FMD), and secondary outcomes were aortic stiffness, evaluated with carotid-femoral pulse wave velocity (PWV) and augmentation index (AIx@75), and inflammation measured by high-sensitivity C-reactive protein (hsCRP) in blood samples. The outcomes were assessed prior to, and at 8 h, 24 h post the 1st dose of vaccination, and 8 h, 24 h, and 48 h post the 2nd.

Results:
There was an increase in hsCRP that was apparent at 24 h after both the 1st dose (-0.60 [95% Confidence intervals [CI]: -1.60 to -0.20], p = 0.013) and the 2nd dose (max median difference at 48 h -6.60 [95% CI: -9.80 to -3.40], p < 0.001) compared to sham. The vaccine did not change PWV or AIx@75. FMD remained unchanged during the 1st dose but decreased significantly by 1.5% (95% CI: 0.1% to 2.9%, p = 0.037) at 24 h post the 2nd dose. FMD values returned towards baseline at 48 h.

Conclusions:
Our study shows that the mRNA vaccine causes a prominent increase in inflammatory markers, especially after the 2nd dose, and a transient deterioration of endothelial function at 24 h that returns towards baseline at 48 h. These results confirm the short-term cardiovascular safety of the vaccine.
CORONAVIRUS DISEASE-2019 IS ASSOCIATED WITH ARTERIAL STIFFNESS IMPAIRMENT: A META-ANALYSIS OF OBSERVATIONAL STUDIES
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Sviggou Asimina , Aidinis Asterios , Kordalis Vasilios , Pyrpasopoulou Athina , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Coronavirus disease-2019 (COVID-19) still represents a global nightmare, associated with significant morbidity and mortality, despite the development of effective vaccines. Cardiovascular complications are frequent among infected subjects. Arterial stiffness is an accurate prognostic marker of cardiovascular disease, with pulse wave velocity (PWV) being the gold-standard for arterial stiffness quantification. Herein we sought to determine whether there is a significant difference in PWV between COVID-19 positive subjects and healthy controls.

Design and method:
We searched two major databases (PubMed and Cochrane Library) from inception to 10th December 2021 for observational studies assessing the effect of SARS-CoV-2 on arterial stiffness. We set as primary efficacy outcome the mean difference in PWV between infected patients and healthy controls.

Results:
We finally pooled data from 4 observational studies in a total of 327 subjects. SARS-CoV-2 positive patients exhibited significantly greater PWV compared to healthy controls (mean difference = 1.32 m/s, 95 CI; 0.46 – 2.18, I2 = 62%, p = 0.0003).

Conclusions:
COVID-19 is associated with significantly increased PWV. However, it remains unclear whether PWV could be a significant prognostic marker of cardiovascular complications among infected subjects.
COLCHICINE FOR THE PREVENTION OF COVID-19 “HARD” OUTCOMES: ALL THAT GLITTERS IS NOT GOLD. AN UPDATED ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Previous meta-analyses of observational studies and randomized controlled trials demonstrated a mortality benefit with colchicine in patients with COVID-19, leading to the amendment of treatment protocols against the disease worldwide. COVID-19 pandemic still remains a global nightmare, requiring a decisive treatment strategy.

Design and method:
We sought to determine whether colchicine compared to standard of care offers a true benefit, both in the in-hospital and out of hospital setting, for the prevention of surrogate COVID-19 outcomes. We searched PubMed and Cochrane Library databases for relevant published randomized controlled trials up to 12th November 2021. We set as primary efficacy outcome the surrogate endpoint of COVID-19 death and as secondary efficacy outcome that of mechanical ventilation.

Results:
We finally included 6 randomized controlled trials in at total of 15,624 subjects with documented COVID-19 infection. All trials except for one enrolled hospitalized patients. Colchicine was not superior to standard of care in terms of prevention of COVID-19 death (RR = 0.63, 95% CI; 0.33 – 1.20, I2 = 28%). In addition, colchicine did not result in a significant decrease in the risk for mechanical ventilation during disease course (RR = 0.66, 95% CI; 0.36 – 1.20, I2 = 48%).

Conclusions:
The present pooled analysis of relevant, published randomized controlled trials so far does not support the routine use of colchicine for the prevention of surrogate COVID-19 outcomes in daily clinical practice, either in the in-hospital or in the community therapeutic management of patients with COVID-19.
DYNAMICS OF ECHOCARDIOGRAPHY CHARACTERISTICS OF THE MYOCARDIUM IN PATIENTS WITH CONFIRMED DIAGNOSIS OF COVID-19
Authors: Minushkina Larisa , Davydova Tatyana , Chuprik Natalya , Snigirova Anna 
Published: June 2022

Objective:
It has now been shown that the SARS-Cov2 virus can be found in myocardial tissue. It is still unknown whether persistence of the virus in cardiomyocytes always leads to clinically significant heart damage. The aim of the study is to assess the dynamics of echocardiography characteristics in patients with COVID-19 in primary care clinic.

Design and method:
Material and methods 210 patients were enrolled into the study between Oct and Dec 2020. The mean age was 51.6 ± 14.61 years, 100 (47, 6%) men. All patients had no cardiovascular disease prior to enrollment. 57 patients (26.1%) underwent COVID-19 without significant lung damage on CT, 114 patients (54.1%) had CT1 lung damage, - 31 patients (14.2%) - CT2, 7 patients (3, 2%) - CT 3, 1 patient (0.5%) - CT-4. All patients were examined by Echo before COVID-19 disease and after the discharge from the hospital using Vivid 9 GE with assessment of standard parameters and global longitudinal strain (GLS).

Results:
In the examined group of patients, 1 case of mild myocarditis and 1 case of pericarditis were recorded. No significant dynamics of the parameters of the LV was revealed by standart Echo. There was a significant increase in the size of the RV from 2.38 ± 0.233 cm to 2.57 ± 0.327 cm (p < 0.001) after the disease. Patients with lung lesions CT2 and higher had lower GLS (17.7 ± 1.06 and 18.7 ± 0.72%, p = 0.032), higher LA size (4.29 ± 0.39 and 3.59 ± 0.49 cm, p = 0,036) and RV size (2.54 ± 0.32 and 2.39 ± 0.23 cm, p = 0.013) compared with patients without lung involvement or with CT1. There was a weak significant correlation between the GLS and the dynamics of the RV diameter (r = 0.288, p < 0.001).

Conclusions:
After the transferred coronavirus infection, changes are detected mainly in the right ventricle, the severity of which correlates with the severity of lung damage
Left ventricular changes can be detected mainly in severe infection and mainly by assessing the global longitudinal deformity of the left ventricle.
IMPAIRED BETA-2ADRENERGIC ENDOTHELIUM-DEPENDENT VASODILATION IS REVERSED BY PHOSPHODIESTERASE INHIBITION IN PATIENTS PREVIOUSLY HOSPITALIZED WITH COVID-19
Authors: Faconti Luca , Farukh Bushra , McNally Ryan , Brett Sally , Chowienczyk Philip 
Published: June 2022

Objective:
Endothelial dysfunction is thought to underlie many of the complications of COVID-19 but to what degree this persists after recovery is unknown. Here we examine endothelial function in subjects previously hospitalized with COVID-19, those with mild symptoms who were not hospitalized and negative controls (absence of SARS-CoV-2-antibodies). Endothelial function was measured as pulse wave response to the 2 adrenergic agonist salbutamol (PWRS) which is mediated through the nitric oxide - cyclic guanosine monophosphate pathway (NO-cGMP).

Design and method:
Echocardiography was used to exclude subjects with cardiac abnormalities. Tonometry of the radial artery (SphygmoCor, AtCor Medical, Sydney, Australia) was performed in duplicate by a single operator before and after inhalation of 200 mcg of salbutamol using a spacer device. The PWRS was taken as the change from baseline in augmentation index (Aix) as calculated by the SphygmoCor system. In a sub-sample, PWRS was assessed in the presence and absence of the phosphodiesterase type 5 inhibitor sildenafil which inhibits the breakdown of cGMP.

Results:
We recruited 88 subjects (49 men) aged 47.9 ± 14.3 (mean ± SD) years of whom 32 were previously hospitalized with COVID-19 (~6 months). Subjects previously hospitalized with COVID-19 were all previously assessed in a dedicated pulmonary clinic. Age, gender, BMI, smoking status, diabetes and estimated 10-year cardiovascular risk (Q-RISKâ3) were similar between the groups. Administration of salbutamol reduced AIx in controls and those with mild COVID-19 but produced an increase in AIx in previously hospitalized COVID-19 cases (mean [95% CI]): -2.85 [-5.52, -0.188] %, -2.32 [-5.17,0.54] %, and 3.03 [0.06, 6.00] % respectively, P = 0.017 between the groups. In a sub-sample (11 hospitalized and 11 non-hospitalized) the PWRS was measured again 30 minutes after oral administration of sildenafil 25 mg. This produced a greater reduction in AIx: -5.28 [-9.00, -1.54] % in non-hospitalized and a reduction: -3.90 [-7.60, -0.21] % in hospitalized patients, and an overall improvement in the PWRS (P = 0.006).

Conclusions:
In subjects previously hospitalized with severe COVID-19, endothelial function is impaired for many months after hospital discharge and the impaired NO-cGMP mediated vasodilation may be reversed by sildenafil.
COMPARISON BETWEEN FIRST AND SECOND/THIRD WAVE OF SARS-COV-2 MODERATE TO SEVERE INFECTION IN ELDERLY PATIENTS IN AN NORTH ITALIAN HOSPITAL SETTING
Authors: Boari Gianluca , Leidi Francesca , Accordini Beatrice , Mangili Benedetta , Ghidelli Chiara , Archenti Giulia , Chiarini Giulia , Malerba Paolo , Gorla Giulia , Corbani Andrea , Scarano Ottavio , Napoli Federico , Bonetti Silvia , Braglia-Orlandini Federico , Faustini Cristina , Bianco Gianluca , Ferrari-Toninelli Giulia , Turini Daniele , Guarinoni Vittoria , Saottini Michele , Manzoni Francesca , Marengoni Alessandra , Rosei Claudia Agabiti , De Ciuceis Carolina , Rizzoni Damiano 
Published: June 2022

Objective:
Worldwide spread of SARS-CoV-2 caused a pandemic as never were seen in the last fifty years and represented a major clinical problem in Lombardy, one of the most affected Italian Regions, in terms of death toll and long-term sequelae. This is particularly true when elder people are considered; therefore, we conducted a retrospective cohort study in the General Medicine of our Hospital.

Design and method:
In the present study we recorded data of patients older than 65 years, admitted to a COVID-19 unit during 2020 and 2021; we compared the characteristics of in-patients admitted in the first (March-May 2020) and the second/third pandemic waves (October 2020-May 2021)

Results:
A total of 407 patients 65 year-old and older were included, 185 during the first wave and 222 during second/third waves; 63 (34%) of them died during the first and 36 (16%) during the second/third wave. No significant differences were found according to main comorbidities and chronic prescriptions between the two groups of patients, whereas those admitted during the second/third wave were slightly older.
Number of in-hospital adverse events were similar in the two samples. Main differences between the two groups were: a lower mean number of days with symptoms before hospitalization, and a less severe laboratory, respiratory ed radiologic profile.
Further, steroid treatment was highly implemented during the second/third wave.

Conclusions:
Older patients admitted to hospital since the beginning of the pandemic showed diverse clinical severity profile according to different waves; patient admitted during the first wave had worse respiratory, radiological and laboratory parameters than those admitted in the second/third wave; further difference was found in COVID-19 treatment during hospital stay as steroids were largely administered during the latter waves
ACUTE MYOCARDITIS FOLLOWING COVID-19 VACCINATION: A PECULIAR CASE SERIES
Authors: Corradetti Sara , Sclafani Matteo , Mistrulli Raffaella , Gallo Giovanna , Pagannone Erika , Di Girolamo Marco , Autore Camillo , Volpe Massimo , Battistoni Allegra 
Published: June 2022

Objective:
Although acute myocarditis has not been observed as an adverse event in landmark trials of COVID-19 vaccines, it has been reported as a rare complication in real-world. The study aims to report a single-center experience on this issue.

Design and method:
We identified five cases of acute myocarditis with consistent temporal association to administration of COVID-19 vaccine and described clinical, serological, echocardiographic and cardiac magnetic resonance findings both in the acute phase and after a median follow up of 6 months.

Results:
All five patients received a COVID-19 vaccination dose within 24 to 96 hours before the onset of symptoms. Four patients received an mRNA vaccine (Comirnaty or Spikevax) and one received the adenovirus vaccine (Janssen). Only one patient had a known prior COVID-19 infection. All patients presented with chest pain and troponin I elevation occurring after the first vaccine dose in four cases. All patients tested negative for acute COVID-19 infection by polymerase chain reaction at admission. Blood tests revealed no or only mild inflammatory serological changes. Only one patient developed an increase in white blood cell count. None had specific changes on electrocardiography and echocardiography demonstrated preserved left ventricular systolic function and no regional wall motion abnormalities in all patients. Three patients underwent coronary angiography since risk factors and troponin trends raised clinical suspicion of acute coronary syndrome, none showed evidence of obstructive coronary artery disease. All patients had a mild to moderate disease not complicated by acute heart failure or arrhythmias. Cardiac Magnetic Resonance was performed in four cases and showed myocardial oedema and late gadolinium enhancement during the acute phase with persistence of areas of late gadolinium enhancement after a median follow-up of 6 months. None had further symptoms or hospitalizations since discharge.

Conclusions:
Acute myocarditis following COVID-19 vaccination is a well-defined clinical entity.
Our findings suggest an immune rather than inflammatory pathogenesis and a benign course without clinical complication after a median follow-up of 6 months, but further studies are needed to define the prognostic significance of persistent findings on cardiac magnetic resonance.
ARTERIAL HYPERTENSION SEVERITY INFLUENCE ON COVID19 SEVERITY AND ICU ADMISSION
Authors: Vintila Ana Maria , Horumba Mihaela , Miron Paul , Balan Razvan , Catrangiu Maria Beatrice , Negoescu Iris Andreea , Trifan Iuliana , Homentcovschi Corina , Siliste Roxana , Savulescu-Fiedler Ilinca 
Published: June 2022

Objective:
Our aim was to assess whether COVID19 positive hypertensive patients were more likely to develop severe symptoms resulting in ICU management and mechanical ventilation.

Design and method:
We performed a retrospective study on consecutive patients hospitalised for COVID19 admitted to our department between 1st of September and 1st of December 2021. Collected data included medical history, treatment, echocardiographic data and lab test results. SPSS version 23 was used for descriptive and inferential statistics.

Results:
A total of 139 COVID19 patients were included in the study with a median age of 68 years (range: 18–91), 51.1% males. Up to 85.2% of patients were either unvaccinated or had incomplete vaccination courses.
Of the lot, 64.7% of patients had known arterial hypertension (HTN) - up to 25.9% of patients had grade 3 HTN. Hypertensive patients were generally older (68 vs 62 y, p < 0.001) and with a female predominance (77.9% of women vs. 52.1% of men, p = 0.001). About a third of patients (32.4%) required ICU management. The number of patients requiring ICU treatment (32.2% vs. 32.7%, p = 0.552) or mechanical ventilation (33.3% vs. 28.6%, p = 0.352) were similar irrespective of HTN diagnosis. However, grade 3 HTN patients had a higher relative risk of developing severe COVID19 (RR: 2.021 | 1.49 - 2.71).

Conclusions:
Many of the patients hospitalised for COVID19 in our department were either unvaccinated or had incomplete vaccination courses. Arterial hypertension is the most common finding among patients hospitalised for COVID19 and up to a third of patients had severe hypertension. A third of all patients required ICU management and grade 3 HTN was more likely to be associated with severe COVID19 and respiratory failure.
SHORT-TERM BLOOD PRESSURE ALTERATIONS AFTER COVID-19 VACCINATION
Authors: Sanidas Elias , Papadopoulos Dimitrios , Anastasiou Theoharis , Velliou Maria , Michalaki Eftixia , Fotsali Anastasia , Golemati Spyretta , Mantzourani Marina , Barbetseas John 
Published: June 2022

Objective:
A non-immediate hypertensive response short after COVID-19 vaccination has been reported. Mild to moderate elevated arterial blood pressure (BP) levels have been documented few days after a single or two-doses vaccine. This study sought to investigate this observation as a potential side effect in patients with known hypertension and healthy controls.

Design and method:
A total of 100 vaccinated patients between the age of 50 to 70 years old were studied. They were randomly assigned to one of the approved and available vaccines (Pfizer, Astra Zeneca, Moderna, Johnson & Johnson). Half of them were hypertensives under medical treatment and half of them were not. All participants had systolic BP < 140mmHg and diastolic BP < 90mmHg before vaccination and volunteered for standard daily home BP measurements (HBPM) and ambulatory BP measurements (ABPM) between the 1st and the 21st day after considered fully COVID-19 vaccinated.

Results:
All patients, hypertensives or not, had at some point a recorded hypertensive response for both systolic (SBP) and diastolic (DBP) BP after considered fully vaccinated. Hypertensives were older and with higher body mass index (BMI). Some of the hypertensive patients received additional medication whereas some of the non-hypertensive patients started life modification changes and systematic BP measurements for a possible diagnosis of hypertension.

Conclusions:
Vaccination for COVID-19 seems to be related with a short period of hypertensive response. This phenomenon was partial and mostly observed in older overweight hypertensives.
OPTIMIZATION OF BLOOD PRESSURE CONTROL AND ANGIOPROTECTION WITH FIXED COMBINATION OF LISINOPRIL + AMLODIPINE + ROSUVASTATIN IN PATIENTS AFTER A COVID-19
Authors: Nedogoda Sergey , Ledyaeva Alla , Chumachek Elena , Tsoma Vera , Salasyuk Alla , Lutova Viktoriya , Popova Ekaterina , Vlasov Daniil , Bychkova Olga , Labaznikova Viktoriya , Evdokimov Konstantin 
Published: June 2022

Objective:
Evaluation of the capability of a fixed combination of lisinopril + amlodipine + rosuvastatin (ECWAMER) in achieving additional angioprotection in patients with arterial hypertension (AH) and high pulse wave velocity (PWV) in patients after confirmed COVID-19 had 75 – 95% lung involvement, complicated by bilateral polysegmental viral pneumonia, with genetically engineered biological drugs (GIBD) therapy, who had not previously received combined antihypertensive therapy (AHT).

Design and method:
An open-label observational study with a duration of 12 weeks has been carried out. 30 patients who not previously received combined AHT was included. Patients underwent daily monitoring of blood pressure (ABPM), applanation tonometry (determination of the augmentation index (IA) and central blood pressure (CSAD)), measurement of PWV, laboratory tests (lipid composition of blood, fasting glucose, C-reactive protein - CRP, OAC, ferritin, fibrinogen, D-dimer, ALT, AST, creatinine, uric acid) before and after prescribing a fixed combination of lisinopril + amlodipine + rosuvastatin (ECVAMER).

Results:
At baseline, the patients had an increase in office blood pressure to 152.6 / 89.1 mm Hg. After prescribing a fixed combination of lisinopril + amlodipine + rosuvastatin, there was a decrease in systolic blood pressure (SBP) by 15.8% and diastolic blood pressure (DBP) by 12.2%. According to ABPM data, the decrease in SBP was 15% and DBP - 9%, decreased PWV by 23.8%, IA by 9%, CSAP by 12.4% (p < 0.05 for all comparisons with the baseline value). Vascular age (SV) was initially increased to 41.9 years with a passport age of 35.03 years. After the end of therapy, there was a significant decrease in CO up to 36.5 years, LDL by 46.8%, triglycerides by 16.8% and an increase in HDL by 10.7% (p < 0.05 for all comparisons with the baseline value). In addition, the levels of CRP, fibrinogen, D-dimer, glucose, and uric acid significantly decreased.

Conclusions:
The fixed combination of lisinopril + amlodipine + rosuvastatin provides better blood pressure control, improved vascular elasticity, and also improves lipid and carbohydrate metabolism in patients, reduces inflammation in patients with hypertension and hyperlipidemia after suffering from severe and extremely severe COVID-19.