Marco Magnoni

• MD
• Medical Doctor at San Raffaele Scientific Institute

Background: Despite the association between uric acid and cardiovascular disease has been known for decades, the prognostic value of serum uric acid (UA) in all clinical manifestations of acute coronary syndrome (ACS), namely ST-elevation myocardial infarction (STEMI), NSTEMI and unstable angina, has not been definitively assessed. Methods: This...

Background: High-sensitivity cardiac troponin T (hsTnT) was recently approved for clinical use by the Food and Drug Administration. The transition from contemporary to hsTnT assays requires a thorough understanding of the clinical differences between these assays. Hypothesis: HsTnT may provide a more accurate prognostic stratification than conte...

The growing discoveries coming from clinical and basic research during the past decades have revolutionized our knowledge regarding pathophysiologic mechanisms underlying the atherosclerotic process and its thrombotic complications. The traditional view focusing on the severity of stenosis of atherosclerotic plaque has given way to the evidence tha...

Background: Neovascularization is a marker of plaque vulnerability that can be assessed noninvasively using contrast-enhanced ultrasound (CEUS). The presence and extent of plaque neovascularization and their relation to cardiovascular risk factors and treatments were assessed in asymptomatic patients with carotid stenosis of intermediate severity...

BACKGROUND The relationship between the extent and severity of stress-induced ischemia and the extent and severity of anatomic coronary artery disease (CAD) in patients with obstructive CAD is multifactorial and includes the intensity of stress achieved, type of testing used, presence and extent of prior infarction, collateral blood flow, plaque ch...

Background: Anatomic complete revascularization (ACR) and functional complete revascularization (FCR) have been associated with reduced death and myocardial infarction (MI) in some prior studies. The impact of complete revascularization (CR) in patients undergoing an invasive (INV) compared with a conservative (CON) management strategy has not bee...

Background HDL is endowed with several metabolic, vascular, and immunoinflammatory protective functions. Among them, a key property is to promote reverse cholesterol transport from cells back to the liver. The aim of this study was to estimate the association of scavenger receptor class B type I (SR-BI)- and ATP binding cassette transporter A1 (ABC...

Stratification according high cardiovascular (CV) risk categories, still represents a clinical challenge. In this analysis of the CAPIRE study (NCT02157662), we investigate whether inflammation could fit between CV risk factors (RFs) and the presence of coronary artery disease (CAD). In total, 544 patients were included and categorized according wi...

Background Proteomics of atypical phenotypes may help unravel cardiovascular disease mechanisms.AimWe aimed to prospectively screen the proteome of four types of individuals: with or without coronary artery disease (CAD), each with or without multiple risk factors. Associations with individual risk factors and circulating biomarkers were also teste...

Traditional cardiovascular (CV) risk factors (RFs) and coronary artery disease (CAD) do not always show a direct correlation. We investigated the metabolic differences in a cohort of patients with a high CV risk profile who developed, or did not develop, among those enrolled in the Coronary Atherosclerosis in Outlier Subjects: Protective and Novel...

Background High mannose has previously associated with insulin resistance and cardiovascular disease (CVD). Our objective is to establish whether mannose is associated with anatomical evidence of coronary artery disease (CAD). Methods Plasma mannose concentrations were measured by liquid chromatography/tandem mass spectrometry in a discovery cohor...

Background and Aims CD31 is cleaved at the surface of activated leukocytes, yielding a short soluble (s)CD31 form that circulates together with the long one, physiologically produced by endothelial cells. In pathologic vascular conditions, the decreased production of the long form may be in balance with the release of the leukocyte-shed short form,...

Background Traditional cardiovascular risk factors (RFs) and coronary artery disease (CAD) do not always run parallel. We investigated functional-metabolic correlations of CAD, RFs, or neither in the CAPIRE (Coronary Atherosclerosis in Outlier Subjects: Protective and Novel Individual Risk Factors Evaluation) 2 × 2 phenotypic observational study....

Background and aims Extent of subclinical atherosclerosis has been associated with brain parenchymal loss in community-dwelling aged subjects. Identification of patient-related and plaque-related markers could identify subjects at higher risk of brain atrophy, independent of cerebrovascular accidents. Aim of the study was to investigate the relatio...

Background High-risk coronary atherosclerosis features evaluated coronary CT angiography (CCTA) were suggested to have a prognostic role. The present study aimed to evaluate the association of circulating biomarkers with high-risk plaque features assessed by CCTA. Methods A consecutive cohort of subjects who underwent CCTA because of suspected CAD...

Background: It is unclear if strategies to rule-out myocardial infarction (MI) based on a single high-sensitivity troponin T (hsTnT) measurement at the emergency department (ED) presentation may also exclude unstable angina. Methods: We measured hsTnT ex-post on the admission frozen blood sample of 644 subjects with Braunwald IIIB CK-MB-negative...

Coronary microcirculation plays a central role in the regulation of myocardial perfusion. Functional and structural abnormalities of coronary microvasculature may result in myocardial perfusion impairment and ischemia. The term coronary microvascular dysfunction (CMD) is common to different clinical conditions in which the reduction of coronary flo...

Objective: Coronary artery disease (CAD) is a major challenge in patients with type 2 diabetes (T2D). Coronary computed tomography angiography (CCTA) provides a detailed anatomic map of the coronary circulation. Proteomics are increasingly used to improve diagnostic and therapeutic algorithms. We hypothesized that the protein panel is differential...

Background and aims: The Mediterranean diet (MD) affects the risk of myocardial infarction and long-term prognosis after a coronary event. Limited data are available regarding the influence of MD on short-term prognosis. We assessed the impact of the MD adherence on in-hospital and short-term outcome in patients with first ST-elevation Myocardial...

Background: Systemic lupus erythematosus (SLE) is associated with a constellation of complications affecting multiple organs, including neuropsychiatric manifestations (NPSLE) and ischaemic events, leading to increased long-term morbidity. Antiphospholipid antibodies (aPL) are a major determinant of vascular inflammation and thromboembolic risk. Th...

Objective: To prospectively assess the performance of the systemic lupus erythematosus (SLE) responder index (SRI) and the lupus low disease activity state (LLDAS) in a cohort-based, "real-life" clinical setting. Methods: One hundred and thirty-one consecutive patients with SLE were subdivided into two groups based on the need or not to escalate...

Objectives: This study sought to assess whether coronary atherosclerosis analysis by coronary computed tomography angiography (CTA) may improve prognostic stratification among patients with diffuse coronary artery disease (CAD) BACKGROUND: Coronary CTA has recently emerged as a promising noninvasive tool for advanced analysis of coronary atheroscl...

Background Systemic lupus erythematosus (SLE) is a chronic multi-organ autoimmune disease characterised by a heterogeneous pathogenic background and by protean clinical manifestations. Recent efforts in identifying novel agents for therapeutic interventions have led to disappointing results and designing a reliable way to assess drug efficacy and v...

Background and aims: Brain white matter hyperintensities (WMHs) have been associated with an increased risk of ischemic stroke and considered as markers of brain ischemia. Progression of WMHs in asymptomatic patients with non-hemodynamically significant carotid plaque could represent a putative marker of plaque vulnerability. We prospectively eval...

Atherosclerosis is one of the leading causes of death and disability worldwide. It is a complex disease characterized by lipid accumulation within the arterial wall, inflammation, local neoangiogenesis, and apoptosis. Innate immune effectors, in particular monocytes and macrophages, play a pivotal role in atherosclerosis initiation and progression....

Objective: This study aimed to assess the protective role of dietary habits and Mediterranean diet adherence in first acute myocardial infarction in patients enrolled in the multicenter and multiethnic FAMI (First Acute Myocardial Infarction) study. Methods: In this study we analyzed a multiethnic case-control population of 1478 individuals (858...

Background We explored the relation between blood concentrations of monocyte/lymphocyte subsets and carotid artery plaque macrophage content, measured by positron emission tomography (PET) with ¹¹C-PK11195. Methods and results In 9 patients with carotid plaques we performed ¹¹C-PK11195-PET/computed tomography angiography imaging and measurement of...

Diseases affecting the brain contribute to a substantial proportion of morbidity and mortality in the general population. Conditions such as stroke, dementia and cognitive impairment have a prominent impact on global public health. Despite the heterogeneous clinical manifestations of these conditions and their diverse prognostic implications, curre...

Background and aims Plaque border irregularity is a known imaging characteristic of vulnerable plaques, but its evaluation heavily relies on subjective evaluation and operator expertise. Aim of the present work is to propose a novel fractal-analysis based method for the quantification of atherosclerotic plaque border irregularity and assess its rel...

Patients database. Study database, employed for the presented analysis. (PDF)

Reproducibility database. Results of the blinded analyses for reproducibility assessment. (PDF)

White matter hyperintensities (WMH) can be incidentally found in patients with carotid atherosclerosis on brain magnetic resonance imaging (MRI). We investigated the relationship between WMH and characteristics of carotid plaques in asymptomatic patients without indication for carotid revascularization. We prospectively screened 235 consecutive pat...

Background and aim: Patients with Systemic Lupus Erythematosus (SLE) present increased cardiovascular mortality compared to the general population. Few studies have assessed the long-term development and progression of carotid atherosclerotic plaque in SLE patients. Our aim was to investigate the association of clinical and laboratory markers of d...

Background and aims: Monocytes are known to play a key role in the initiation and progression of atherosclerosis and contribute to plaque destabilization through the generation of signals that promote inflammation and neoangiogenesis. In humans, studies investigating the features of circulating monocytes in advanced atherosclerotic lesions are lac...

Background: The widespread use of brain imaging has led to increased recognition of subclinical brain abnormalities, including white matter hyperintensities (WMH) and silent brain infarctions (SBI), which have a vascular origin, and have been associated to a high risk of stroke, disability and dementia. Carotid atherosclerosis (CA) may be causativ...

Background A relationship between systemic inflammation and increased cardiovascular risk is often postulated. Simple and affordable clinical predictors of increased cardiovascular risk in patients with autoimmune disease, however, are not yet available in the clinical practice. Objectives To address the role of clinical, serological markers of di...

Background: The 2013 ACC/AHA cholesterol treatment guidelines have introduced a new cardiovascular risk assessment approach (PCE) and have revisited the threshold for prescribing statins. This study aims to compare the ex ante application of the ACC/AHA and the ATP-III guideline models by using a multiethnic case-control study. Methods: ATP-III-...

We demonstrate that in patients with stress cardiomyopathy the type of triggering event is associated with different clinical, instrumental, and laboratory features that characterize the phenotype at presentation.

Alteration of circulating T-cell subpopulations may reflect the local immune process in plaques [(1)][1], providing insights on atherosclerosis pathogenesis. Only limited knowledge concerning the relationship between circulating lymphocytes and features of atherosclerotic lesions is available [(2

Background. I benefici dell'uso dell'angio-tomografia coronarica (CTCA) in pazienti con angina stabile non sono stati sistematicamente studiati. Scopo dello studio è stato quello di valutare gli effetti dell'impiego del-la CTCA sulla diagnosi, la gestione clinica e la prognosi di pazienti riferiti a valutazione cardiologica ambula-toriale per sospe...

We worked out a position paper on cardiac-computed tomography (CCT) endorsed by the Working Group on CCT and Nuclear Cardiology of the Italian Society of Cardiology. The CCT clinical indications were discussed and formulated according to the following two modalities: a brief paragraph dedicated to each indication, with the description of clinical u...

Atherosclerosis is the focal expression of a systemic disease affecting medium- and large-sized arteries, in which traditional cardiovascular risk factor and immune factors play a key role. It is well accepted that circulating biomarkers, including C-reactive protein and interleukin-6, reliably predict major cardiovascular events, including myocard...

The association between postoperative atrial fibrillation (POAF) and renal function was previously grounded in patients undergoing coronary artery bypass grafting through unknown mechanisms. We aim to investigate the association between renal function and POAF in a cohort composed mostly of patients undergoing valve surgery and to explore the role...

Far from being merely a passive cholesterol accumulation within the arterial wall, the development of atherosclerosis is currently known to imply both inflammation and immune effector mechanisms. Adaptive immunity has been implicated in the process of disease initiation and progression interwined with traditional cardiovascular risk factors. Althou...

In large-vessel vasculitides, inflammatory infiltrates may cause thickening of the involved arterial vessel wall leading to progressive stenosis and occlusion. Dilatation, aneurysm formation, and thrombosis may also ensue. Activated macrophages and T lymphocytes are fundamental elements in vascular inflammation. The amount and density of the inflam...

Rationale: To date, the decision to perform carotid endarterectomy (CEA) in asymptomatic patients has been solely based on the severity of the stenosis on ultrasound. Targeted new non-invasive imaging strategies that allow characterization of plaque composition, in term of inflammation and neovascularization and biological activity might help to id...

Plasma lipid levels are recognized as determinants of cardiovascular disease. Dietary interventions should be considered as first line intervention. NCORP study aims at exploring the effect of meal pattern on lipid profile. Four groups were selected: patients with atherosclerotic plaque (AP) and risk factors (RF) represented by Framingham risk dete...

Inherited connective tissue diseases such as Marfan syndrome are frequently associated with cardiovascular manifestations. Aortic involvement with dilation and dissection is the most common finding and the major cause of death in Marfan syndrome patients. We report the echocardiographic study of a 53-year-old male patient with uncommon coexistence...

Several lines of evidence suggest the involvement of infectious agents in the pathogenesis of atherosclerosis. Furthermore, a correlation between infection-driven inflammatory burden and acute manifestation of coronary artery disease has been hypothesized. The aim of this work was to assess whether human herpesvirus (HHV)-6 and HHV-8, two DNA virus...

Serum bilirubin has demonstrated potent antioxidant properties in vitro and in vivo, appears to be particularly effective at suppressing oxidation of lipids, and may improve endothelial function. Various studies have shown that people with low bilirubin levels have higher rates of cardiovascular disease. In support of a causal relationship, prospec...

A 70-year-old woman was referred to cardiac evaluation because of the detection of dilation of the main pulmonary artery by chest computed tomography performed before the removal of a thoracic lipoma. The computed tomography scan with contrast also excluded arterial thromboembolism of the main and distal pulmonary branches. The patient had a previ...

A 35-year-old woman was admitted to our institute with a 5-year history of fatigue and low-grade fever. Six months before admission, she had pain in the neck and in the infrascapular region. On admission, the patient's heart rate was 80 bpm, her temperature was 37.3°C, and her blood pressure was 130/70 mm Hg in the right arm and 110/70 mm Hg in the...

A 53-year-old woman with no risk factors was admitted to our hospital in December 2006 because of worsening angina and positive exercise stress test. Two months earlier, she had been admitted to another hospital because of prolonged epigastrial pain without radiation, which had subsided just before she reached the hospital, that was associated with...

Standard ultrasound has a poor accuracy in the detection of carotid plaque surface irregularities and ulcers, which are features of vulnerable lesions. Sonographic contrast agents can improve vessel wall lumen definition, thus potentially overcoming this limitation. Recent studies also suggest that contrast ultrasound can be used to study intraplaq...

Arterial vasa vasorum (VV) are known to be involved in the atherosclerotic process. The aim of the present study was to explore whether ultrasound imaging with contrast agent is able to visualize adventitial VV in human carotid atherosclerosis. We studied with standard ultrasound 25 patients with carotid stenosis >50% (ATS group) and 15 patients wi...

This study was designed to evaluate contrast-enhanced ultrasound imaging of carotid atherosclerosis as a clinical tool to study intraplaque neovascularization. Plaque neovascularization is associated with plaque vulnerability and symptomatic disease; therefore, imaging of neovascularization in carotid atherosclerosis may represent a useful tool for...

A 67-year-old man was admitted to a coronary care unit for non-ST-segment elevation myocardial infarction with complicating acute heart failure. Severe mitral regurgitation was detected by echocardiography at presentation. Repeat echocardiography carried out during another ischemic episode revealed a marked reduction in the patient's mitral regurgi...

Two previous reports have reported myocardial infarction during ovarian hyperstimulation syndrome, a complication of controlled ovarian stimulation characterized by ascites, pleural effusion, hemoconcentration and an increased thromboembolic risk, but no association with the initial phase (before treatment with human chorionic gonadotropin) of a no...

Objective: It has been previously shown that spontaneous premature ventricular contractions (PVCs) evoke, in concomitance with an early and late blood pressure (BP) fall and overshoot, an early sympathoexcitation and a later period of sympathoinhibition respectively. The present study was designed to examine whether the sympathetic adjustments to P...

The present study was aimed at determining whether the concomitant presence of hypertension (HT) and heart failure (HF) exerts additive effects on the neuroadrenergic abnormalities characterizing the above mentioned cardiovascular diseases. In 8 normotensive control subjects (C, age: 54.9 ± 4.8 yrs, mean ± SEM), 7 untreated HT, 10 normotensive untr...

Studies performed in animal models of hypertension have shown that an elevated pulse pressure (PP) adversely affects the mechanical properties of the arterial vessels. Whether this is also the case in essential hypertension is unknown, however. In 11 untreated essential hypertensives (HHT, age 46.8±1.7, mean±SEM) with PP values amounting to 60.4±1....