Rita Trinchero's research while affiliated with Ospedale Maria Vittoria and other places

Publications (112)

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Background Infective endocarditis (IE) is a common and serious complication in patients receiving chronic hemodialysis (HD). Objectives This study sought to investigate whether there are significant differences in complications, cardiac surgery, relapses, and mortality between IE cases in HD and non-HD patients. Methods Prospective cohort study (...
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Background. The impact of early valve surgery (EVS) on the outcome of Staphylococcus aureus (SA) prosthetic valve infective endocarditis (PVIE) is unresolved. The objective of this study was to evaluate the association between EVS, performed within the first 60 days of hospitalization, and outcome of SA PVIE within the International Collaboration o...
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AimsThe purpose of this study was to investigate and summarize available evidence on the efficacy and safety of colchicine for pericarditis prevention. Disease recurrence is the major and most common complication of pericarditis and its prevention may reduce morbidity and management costs. Colchicine has been intensively studied in the last decade...
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Colchicine is effective for the treatment of acute pericarditis and first recurrences. However, conclusive data are lacking for the efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis. We did this multicentre, double-blind trial at four general hospitals in northern Italy. Adult patients with multiple recurrences...
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Purpose: Despite a large amount of data on recurrent pericarditis, conclusive data are lacking to demonstrate the efficacy and safety of colchicine for the treatment of the first attack of acute pericarditis. The Investigation on Colchicine in Acute Pericarditis (ICAP) trial is a prospective, randomized, double-blind, placebo-controlled, multicente...
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Purpose: Systemic inflammatory diseases (SIDs) are inflammatory syndromes with involvement of at least two organ systems. Classical SIDs include vasculitis, connective tissue diseases, and granulomatous diseases. Cardiac involvement may affect especially the pericardium, but also the myocardium, coronary arteries, the endocardium, and major vessels...
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Background Colchicine is effective for the treatment of recurrent pericarditis. However, conclusive data are lacking regarding the use of colchicine during a first attack of acute pericarditis and in the prevention of recurrent symptoms. Methods In a multicenter, double-blind trial, eligible adults with acute pericarditis were randomly assigned to...
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We appreciate your interest in the COPPS postoperative atrial fibrillation (POAF) substudy.1 Your letter has 2 main queries: The time of colchicine administration, and the possible beneficial effects of concomitant use of �-blockers as a potential confounding factor in the trial results.
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The purpose of this study was to investigate the efficacy and safety of colchicine for pericarditis prevention. Recurrent pericarditis prevention is a major management goal that may reduce morbidity and management costs. Although empiric anti-inflammatory therapy is considered the mainstay of treatment, no specific drug has been proven to be effica...
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Inflammation and pericarditis may be contributing factors for postoperative atrial fibrillation (POAF), and both are potentially affected by antiinflammatory drugs and colchicine, which has been shown to be safe and efficacious for the prevention of pericarditis and the postpericardiotomy syndrome (PPS). The aim of the Colchicine for the Prevention...
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No preventive pharmacologic strategies have been proven efficacious for the prevention of postoperative effusions after cardiac surgery. Colchicine is safe and efficacious for the prevention of pericarditis. On this basis, we realized a substudy of the COPPS trial to assess the efficacy and safety of colchicine for the prevention of postoperative p...
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Recurrence is the most common complication of pericarditis, affecting 10% to 50% of patients. Objective: To evaluate the efficacy and safety of colchicine for the secondary prevention of recurrent pericarditis. Prospective, randomized, double-blind, placebo-controlled multicenter trial. (ClinicalTrials.gov registration number: NCT00128414) Setting:...
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Constrictive pericarditis (CP) is considered a rare, dreaded possible complication of acute pericarditis. Nevertheless, there is a lack of prospective studies that have evaluated the specific risk according to different etiologies. The aim of this study is to evaluate the risk of CP after acute pericarditis in a prospective cohort study with long-t...
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Contemporary series of postpericardiotomy syndrome (PPS) are lacking. The aim of this study was to evaluate the incidence, time course, features at presentation, risk factors, and prognosis of PPS. The study population consisted of 360 consecutive candidates to cardiac surgery enrolled in a prospective cohort study. PPS was diagnosed in 54 patients...
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The natural history of postpericardiotomy syndrome (PPS), a relatively common complication of cardiac surgery, varies from mild self-limited episodes to cases with protracted courses, recurrences, and readmissions. Preventive strategies may be valuable to decrease morbidity and management costs. We thus aimed to conduct a comprehensive systematic r...
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The role of inflammatory markers is not well defined for either diagnosis or treatment of pericarditis. The aim of this study is to prospectively evaluate the frequency of high-sensitivity C-reactive protein (hs-CRP) elevation in patients with acute pericarditis, its time course of normalization, and the possible importance for diagnosis, therapy,...
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Illicit drugs such as cocaine, and methadone can induce acquired long QT syndrome. The aim of this study was to evaluate the prevalence of cardiovascular disease and to assess the risk of torsades de pointes in substance abuse patients either with methadone or buprenorphine maintenance therapy, or without any specific therapy for opiate addiction....
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Pericardial effusion may be detected as an incidental finding during echocardiography or following a diagnostic imaging study for a symptomatic patient. When a pericardial effusion is detected the first step is to assess its size, hemodynamic importance, and possible associated diseases. The more common causes of pericardial effusions include infec...
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No drug has been proven efficacious to prevent the post-pericardiotomy syndrome (PPS), but colchicine seems safe and effective for the treatment and prevention of pericarditis. The aim of the COlchicine for the Prevention of the Post-pericardiotomy Syndrome (COPPS) trial is to test the efficacy and safety of colchicine for the primary prevention of...
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The treatment of pericardial diseases is largely empirical because of the relative lack of randomized trials compared with other cardiovascular diseases. The main forms of pericardial diseases that can be encountered in the clinical setting include acute and recurrent pericarditis, pericardial effusion with or without cardiac tamponade, and constri...
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The treatment of pericardial diseases is largely empirical because of the relative lack of randomized trials compared with other cardiovascular diseases. The main forms of pericardial diseases that can be encountered in the clinical setting include acute and recurrent pericarditis, pericardial effusion with or without cardiac tamponade, and constri...
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To review the current major diagnostic issues on the diagnosis of acute and recurrent pericarditis. To review the current available evidence, we performed a through search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines from National Guidelines Clearin...
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Prosthetic valve endocarditis (PVE) is associated with significant mortality and morbidity.1 Despite medical advances in surgical techniques, PVE continues to complicate cardiac valve surgery. The incidence is highest within the first 12 months following surgery and affecting 1–3% of patients.2 PVE can arise early or late after surgery. According t...
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Relatively few data have been published on the management of pericardial diseases during pregnancy. Pericardial involvement is sporadic during pregnancy, and pregnant women do not show any specific predisposition to pericardial diseases. The more common form of pericardial involvement is hydropericardium, usually as a benign mild effusion recorded...
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The management of pericardial diseases is largely empirical because of the relative lack of randomized trials. The first published guidelines1,2 are a first attempt to organize current knowledge. At present, no specific guidelines have been issued by the American Heart Association and American College of Cardiology. After a literature review includ...
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Antibiotic prophylaxis of patients believed to be at a risk of developing infective endocarditis has been recently revisited with limited indications compared with the previous body of knowledge in use by the medical community. As a consequence, most of the healthcare specialists in cardiology and infectious diseases have doubts related to the enor...
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The management of pericardial diseases is largely empirical because of the relative lack of randomized trials that involve patients with these conditions. A first attempt to bring together and organize current knowledge resulted in the publication of the first guidelines on the management of pericardial diseases. Nevertheless, a number of observati...
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The treatment of pericarditis remains largely empirical owing to a relative lack of randomized, controlled trials; nevertheless, a number of observational studies and the first randomized trials are moving the management of pericardial diseases on the road to evidence-based medicine. Moreover, emerging data suggest that treatment can be tailored to...
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Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular...
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Prospective data were collected from 743 consecutive patients with ST-segment elevation acute myocardial infarctions (AMIs) treated with primary percutaneous coronary intervention (mean age 65.3 +/- 11.6 years, 36.7% women). Early post-AMI pericarditis was diagnosed in 31 patients (4.2%; mean age 62.1 +/- 13.4 years, 41.9% women), with an increasin...
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We have followed 6 pregnancies in women affected by idiopathic pericarditis from 2002 to 2008, the largest reported clinical series. Four women were treated with aspirin 800 mg three times daily; in 3 women aspirin was gradually stopped at 20 weeks gestation, while in one case aspirin was continued till delivery. All the women were treated with pre...
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The cause of acute and recurrent pericarditis is often a major concern for the clinicians in clinical practice. Several possible causes of pericarditis can be listed, as the pericardium may be involved in a large number of systemic disorders or may be diseased, as an isolated process. The reported diagnostic yield of extensive laboratory evaluation...
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Colchicine has been effectively used in the treatment of several inflammatory conditions, such as gouty attacks, serositis related to familial Mediterranean fever, Behçet syndrome, and more recently also in acute and recurrent pericarditis. Growing evidence has shown that the drug may be useful to treat an acute attack and may be a way to cope with...
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Pericarditis is a common clinical problem, above all in its incessant and recurrent forms. Treatment should be targeted according to etiology, but this is often unfeasible with a conventional approach, because most cases are labeled as "idiopathic" in the majority of immunocompetent patients from developed countries. Clinical risk stratification of...
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Colchicine has been effectively used in the treatment of several inflammatory conditions, such as gouty attacks, serositis related to familial Mediterranean fever, Behçet syndrome and more recently, in acute and recurrent pericarditis. Colchicine concentrates in white blood cells, particularly polymorphonuclear cells, inhibiting tubulin polymerizat...
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Corticosteroid use is widespread in recurrent pericarditis, even if rarely indicated, and high doses (eg, prednisone 1.0 to 1.5 mg . kg(-1) . d(-1)) are generally recommended, although only weak evidence supports their use with possible severe side effects. The aim of this work was to compare side effects, recurrences and other complications, and h...
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A positive result for antinuclear antibodies (ANA), often as a fortuitous observation, may be cause for concern in idiopathic recurrent pericarditis (IRP), nevertheless data are lacking on their prevalence and clinical significance. This study is sought to investigate the prevalence and clinical significance of ANA in IRP. ANA titres were assessed...
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Acute pericarditis is often accompanied by some degree of myocarditis. In clinical practice both pericarditis and myocarditis coexist because they share common etiologic agents, mainly cardiotropic viruses. The term "myopericarditis" indicates a primarily "pericarditic syndrome" and it is responsible for the majority of cases. The clinical presenta...
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In the last 30 years, major improvements have been made in understanding the pathogenesis, diagnosis and treatment of infective endocarditis. Nevertheless, mortality still remains high, close to 30-40% at 1 year, and its reduction remains the main challenge. Moreover, important epidemiological changes have been recorded. Social changes in Western c...
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To investigate the relative incidence, clinical presentation and prognosis of myopericarditis among patients with idiopathic or viral acute pericarditis. Prospective observational clinical cohort study. Two general hospitals from an urban area of 220 000 inhabitants. 274 consecutive cases of idiopathic or viral acute pericarditis between January 20...
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Acute pericarditis is recorded in about 5% of patients admitted to emergency departments in Western Europe and the US for nonischemic chest pain, and recurs in approximately 30% of cases.1, 2, ³ In developed countries, 80–85% of cases reported in major clinical surveys with unselected patients and a traditional diagnostic approach are labeled idiop...
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To review currently available knowledge on presentation, clinical features and management of heart failure (HF) in elderly people. To review currently available evidence, we performed a thorough search of several evidence-based sources of information, including Cochrane Database of Systematic Reviews, Clinical Evidence, Evidence-based guidelines fr...
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Colchicine seems to be well tolerated and effective in the treatment and prevention of pericarditis. A preliminary clinical trial has shown that colchicine may be considered not only for the treatment of postpericardiotomy syndrome (PPS), but also for its primary prevention. The COPPS study is a multicentre, double-blind, randomised trial. On the t...
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Acute pericarditis is a common disorder in several clinical settings, and may be the first manifestation of an underlying systemic disease. Disease management is often troublesome and concerns may arise regarding the fear of missing a specific etiology, the possible complications, particularly the evolution toward constrictive pericarditis, and the...
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Colchicine appears to be safe and effective in the treatment and prevention of recurrent pericarditis after failure of conventional therapies in case reports and non-randomized observational studies without control groups. On this basis, colchicine has been proposed as a therapeutic choice in the 2004 guidelines of the European Society of Cardiolog...
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Preliminary data have shown that colchicine may be considered for the prevention of the postpericardiotomy syndrome (PPS). The COlchicine for the Prevention of Post-pericardiotomy Syndrome (COPPS) study is a multicenter, double blind, placebo-controlled, randomized trial that will enroll 360 patients after cardiac surgery. The primary end point wil...
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After a systematic review of all publications on recurrent pericarditis from 1966 to 2006, we identified 8 major clinical series including a total of 230 patients with idiopathic recurrent pericarditis (mean age 46 years, men/women ratio: 0.9). After a mean follow-up of 61 months, the complication rate was 3.5% cardiac tamponade and 0% constrictive...
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We report a difficult case of a 45-year-old woman with refractory recurrent pericarditis, who was treated with several different medical therapies, pericardial window, and pericardiectomy. This case suggests that more invasive diagnostic and therapeutic choices, such as pericardial window and pericardiectomy, should be carefully considered for poss...
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Colchicine is safe and effective in the treatment and prevention of recurrent pericarditis after failure of conventional treatment. The recent guidelines of the European Society of Cardiology suggest that colchicine might be useful even in the treatment of the first episode. However, the use of the drug is not based on any strong evidence obtained...
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We describe a case of successful percutaneous transluminal coronary angioplasty and stenting from the left radial approach in a patient with effort angina due to two tight stenoses at the distal anastomosis site of the internal mammary artery grafts. The left radial approach has several advantages compared with the conventional femoral approach: a...
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The pericardium is involved in a large number of systemic disorders, and acute pericarditis may be due to several causes. The diagnosis is based on clinical criteria, and laboratory testing is not routinely recommended. Deciding on the extent of the diagnostic evaluation requires good clinical judgement based on a careful evaluation of the risk-ben...
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Recurrent pericarditis is one of the most troublesome complications of acute pericarditis and, despite recent advances, remains one of the most challenging problems in pericardial diseases. The exact recurrence rate is unknown, but a reasonable estimate is 30%. The diagnosis is based on clinical criteria, and only routine laboratory testing is requ...
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Recurrent pericarditis is the most troublesome problem to tackle in the management of pericardial diseases. Therapeutic modalities usually assume the etiology is autoimmunity, but several cases may be related to infectious etiology or previous inadequate treatments. Therapeutic choices are non-specific and varied. Several small prospective studies...
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The clinical search for indicators of poor prognosis of acute pericarditis may be useful for clinical triage of patients at high risk of specific causal conditions or complications. The aim of the present article is to assess the relationship between clinical features at presentation and specific causes or complications. A total of 453 patients age...
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Intravenous drug users (IVDUs) are at increased risk of infective endocarditis. Moreover, HIV infection is common in IVDUs, with a reported prevalence of 40-90%. The clinical features of IVDUs with infective endocarditis and HIV infection may be peculiar. Few data have been reported on the diagnostic accuracy of Duke criteria in IVDUs with or witho...
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The most frequent pericardial emergency is cardiac tamponade, but complications of an acute coronary syndrome and aortic dissection may also involve the pericardium. Acute pericarditis can also represent a medical emergency due to chest pain of upsetting intensity. Decompensations in chronic advanced constriction and in the clinical course of purul...
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Infective endocarditis is a disease that continues to evolve in response to changing host conditions and other factors.
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HIV infection is one of the leading causes of acquired heart disease. Because of its high diffusion, systematic echocardiographic monitoring has been proposed to exclude cardiovascular involvement in these patients. The aim of this study was to evaluate an alternative clinical approach by which echocardiographic screening is limited to patients wit...
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Colchicine seems to be a good drug for treating recurrences of pericarditis after conventional treatment failure, but no clinical trial has tested the effects of colchicine as first-line drug for the treatment of the first recurrence of pericarditis. A prospective, randomized, open-label design was used to investigate the safety and efficacy of col...
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The incidence of sudden cardiac death ranges from 0.4 to 1.28 every 1000 inhabitants per year. Sudden cardiac death is responsible for about 10% of all deaths in Italy in 2000. It is unpredictable and is related to malignant ventricular arrhythmias that may be interrupted in more than 70% of cases. Survival rates generally do not exceed 5% in out-o...
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Colchicine is effective and safe for the treatment and prevention of recurrent pericarditis and might ultimately serve as the initial mode of treatment, especially in idiopathic cases. The aim of this work was to verify the safety and efficacy of colchicine as an adjunct to conventional therapy for the treatment of the first episode of acute perica...
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Fifty-five of 294 consecutive patients with acute pericarditis had first attacks of recurrent pericarditis and were evaluated and treated according to a management protocol. Corticosteroids were restricted to aspirin contraindication or failure. Colchicine was added in cases of aspirin and prednisone failure and was the treatment of choice for the...
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Neoplastic etiology was found in 33 of 450 patients with acute pericardial disease (7.3%). Acute pericardial disease was the first manifestation of previously unknown malignancies in 18 of 450 patients (4.0%), and lung cancer was the most common malignancy (72.2%, p = 0.02). The following clinical characteristics were associated with a greater prob...
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To date, no studies have evaluated the usefulness of the Duke vs the modified Duke criteria for the early diagnosis of infective endocarditis (IE), nor is it known whether a probabilistic approach may be useful in establishing an early clinical diagnosis of IE. The aim of this study was (1) to assess and compare the clinical usefulness of the Duke...
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Only 30% of survivors from out-of-hospital cardiac arrest receive basic life support (BLS) before the arrival of emergency personnel. This is also due to reluctance to perform BLS, especially mouth-to-mouth ventilation without barrier devices in victims who are unknown to the rescuer (either layperson or healthcare provider). To evaluate the incide...
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Acute pericardial diseases are common disorders in several clinical settings. The presentation may include acute pericarditis and its recurrences, incidental pericardial effusion, cardiac tamponade, and occasionally constrictive pericarditis. New diagnostic techniques have improved the sampling and analysis of pericardial fluid and allow a comprehe...
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Reperfusion therapy of ST-elevation myocardial infarction (STEMI) with primary coronary angioplasty (PTCA) is becoming an accepted therapeutical strategy because of a lower incidence of reinfarction, of hemorrhagic stroke and for a greater reduction of the infarct size in comparison to thrombolytic therapy. In this study we evaluated the feasibilit...
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Recurrent pain without clinical evidence of acute pericarditis was recorded in 27 of 275 patients (9.8%; mean age 55.6 +/- 16.0 years, female/male ratio 20/7) with previous viral or idiopathic acute pericarditis. Female gender (odds ratio [OR] 4.3, 95% confidence interval [CI] 1.8 to 10.6), previous use of corticosteroids (OR 5.2, 95% CI 2.2 to 12....
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Main pulmonary artery aneurysms are a rare entity with few available published data. As reported in the literature, operative treatment is commonly recommended but the relation between the size of the aneurysm, its localization, and the risk of rupture is not as well defined as for aortic aneurysms. Proximal lesions that involve the main branches o...