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Gender Difference in the Effects of COVID-19 Pandemic on Mechanical Reperfusion and 30-Day Mortality for STEMI: Results of the ISACS-STEMI COVID-19 Registry

G. De Luca, S. Manzo-Silberman, M. Algowhary, B. Uguz, DC. Oliveira, V. Ganyukov, O. Busljetik, M. Cercek, L. Okkels, PH. Loh, L. Calmac, GRI. Ferrer, A. Quadros, M. Milewski, F. Scotto di Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G....

. 2023 ; 12 (3) : . [pub] 20230123

Status neindexováno Jazyk angličtina Země Švýcarsko

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc23003107

BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.

ACTION Study Group Institute of Cardiology Hôpital Pitié Salpêtrière Sorbonne University 75651 Paris France

Azienda Ospedaliera Lavagna 16033 Lavagna Italy

Azienda Ospedaliero Universitaria Ospedali Riuniti 34142 Trieste Italy

Cardiology Department Hospital Garcia de Orta Pragal 2805 267 Almada Portugal

Cardiology Division Department of Internal Medicine National Taiwan University Hospital Tapei 8865600 Taiwan

Cardiology Institute Istanbul University 34000 Instanbul Turkey

Cardiovascular Department Pelita Harapan University Heart Center Siloam Lippo Village Hospital Tangerang Banten 15810 Indonesia

Center for Cardiovascular Diseases 6000 Ohrid North Macedonia

Center Hospitalier d'Antibes Juan Les Pins 06600 Antibes France

Central Hospital of Medical University of Lodz 90 008 Lodz Poland

Clinic Emergency Hospital of Bucharest 014461 Bucharest Romania

Complexo Hospetaliero Universitario La Coruna 15001 La Coruna Spain

Department of Cardiology and Cardiovascular Interventions Instituto Nacional de Cirugía Cardíaca Montevideo 11700 Uruguay

Department of Cardiology and Vascular Medicine University of Indonesia National Cardiovascular Center Harapan Kita Jakarta 11420 Indonesia

Department of Cardiology Bezmialem Vakif University Hospital 34093 Istanbul Turkey

Department of Cardiology Medical Center Ljubljana 1000 Ljubljana Slovenia

Department of Cardiology Medisch Spectrum Twente Thoraxcentrum Twente 7541 Enschede The Netherlands

Department of Cardiology National Heart Center Singapore 169609 Singapore

Department of Cardiology National University Hospital Singapore 117597 Singapore

Department of Cardiology Queen Elizabeth Hospital University of Hong Kong Hong Kong

Department of Cardiology Queen Mary Hospital University of Hong Kong Hong Kong

Department of Cardiology University Hospital Centre University of Zagreb 10000 Zagreb Croatia

Department of Heart and Vascular Surgery State Research Institute for Complex Issues of Cardiovascular Diseases 650000 Kemerovo Russia

Department of Internal Medicine Ospedale Riuniti 25121 Brescia Italy

Department of Statistical Sciences University of Padova 35121 Padova Italy

Department of Teaching and Research Instituto de Cardiología de Corrientes Juana F Cabral Corrientes W3400CDS Argentina

Division of Cardiology 3584 Utrecht The Netherlands

Division of Cardiology Alexandra Hospital 10431 Athens Greece

Division of Cardiology AOU Policlinico G Martino Department of Clinical and Experimental Medicine University of Messina 98124 Messina Italy

Division of Cardiology Assiut University Heart Hospital Assiut University Asyut 71515 Egypt

Division of Cardiology Attikon University Hospital 10431 Athens Greece

Division of Cardiology AUSL IRCCS Reggio Emilia 42121 Reggio Emilia Italy

Division of Cardiology Azienda Ospedaliera Ospedali Riuniti Marche Nord 61121 Pesaro Italy

Division of Cardiology Blida University Hospital Blida 09000 Algeria

Division of Cardiology Bursa City Hospital 16000 Bursa Turkey

Division of Cardiology Center Hospitalier Universitaire de Lille 59000 Lille France

Division of Cardiology Clinica Villa dei Fiori 80011 Acerra Italy

Division of Cardiology Clinical and Experimental Interventional Cardiology University of Saarland 66123 Saarbrücken Germany

Division of Cardiology Complejo Hospitalario de Toledo 45001 Toledo Spain

Division of Cardiology Faculty of Medicine Eskisehir Osmangazi University 02640 Eskisehir Turkey

Division of Cardiology Groupe Hospitalier Mutualiste de Grenoble 38000 Grenoble France

Division of Cardiology Heart Centre Turku 20521 Turku Finland

Division of Cardiology Hopital Erasmus Universitè Libre de Bruxelles 1070 Brussels Belgium

Division of Cardiology Hospiatl Cordoba Cordoba 5000 Argentina

Division of Cardiology Hospital Cabueñes 33201 Gijon Spain

Division of Cardiology Hospital Clinico Universitario de Valencia 46010 Valencia Spain

Division of Cardiology Hospital de Santa Cruz CHLO Nova Medical School CEDOC 1000 Lisbon Portugal

Division of Cardiology Hospital de Santo António 4099 001 Porto Portugal

Division of Cardiology Hospital Puerta de Hierro Majadahonda 28222 Majadahonda Spain

Division of Cardiology Hospital Puerta del Mar 11001 Cadiz Spain

Division of Cardiology Hospital Universitario de Canarias 38001 Santa Cruz de Tenerife Spain

Division of Cardiology Kontantopoulion Hospital 10431 Athens Greece

Division of Cardiology Medical University of Silezia 40 002 Katowice Poland

Division of Cardiology Northwest Clinics 1811 Alkmaar The Netherlands

Division of Cardiology Nuovo Galeazzi Sant'Ambrogio Hospital 20161 Milan Italy

Division of Cardiology Odense Universitets Hospital 5000 Odense Denmark

Division of Cardiology Ospedale A Manzoni 23900 Lecco Italy

Division of Cardiology Ospedale Civico Arnas 90100 Palermo Italy

Division of Cardiology Ospedale degli Infermi ASL 13900 Biella Italy

Division of Cardiology Ospedale del Mare 00156 Napoli Italy

Division of Cardiology Ospedale F Spaziani 03100 Frosinone Italy

Division of Cardiology Ospedale G Moscati 81031 Aversa Italy

Division of Cardiology Ospedale Maggiore Bologna 40100 Bologna Italy

Division of Cardiology Ospedale S Maurizio Bolzano 39100 Bolzano Italy

Division of Cardiology Ospedale San Giovanni di Dio e Ruggi d'Aragona 84070 Salerno Italy

Division of Cardiology Ospedale Sant'Anna 44121 Ferrara Italy

Division of Cardiology Ospedale Santa Chiara di Trento 38014 Trento Italy

Division of Cardiology Ospedale Santa Maria delle Grazie 80078 Pozzuoli Italy

Division of Cardiology Ospedale Santa Maria Goretti Latina 04100 Latina Italy

Division of Cardiology Otamendi Hospital Buenos Aires 1001 Argentina

Division of Cardiology Oulu University Hospital 90220 Oulu Finland

Division of Cardiology Radboud University Medical Center 6525 Nijmegen The Netherlands

Division of Cardiology St Antonius Hospital 3434 Nieuwegein The Netherlands

Division of Cardiology Universidad UPB Universidad CES Medellín 050001 Colombia

Hospital Clínico Universitario Virgen de la Victoria 29000 Malaga Spain

Hospital Germans Triasi Pujol 8918 Badalona Spain

Instituto Cardiovascular de Buenos Aires Buenos Aires 1428 Argentina

Instituto de Cardiologia de Santa Catarina Praia Comprida São José 88103 901 Brazil

Instituto de Cardiologia do Rio Grande do Sul Porto Alegre 90040 371 Brazil

Instituto de Cardiologia Integral Montevideo 11700 Uruguay

Interventional Cardiology Unit Azienda Ospedaliera Sanitaria 43121 Parma Italy

Interventional Cardiology Unit Azienda Ospedaliero Universitaria Ospedali Riuniti 60100 Ancona Italy

Interventional Cardiology Unit Heart Disease Institute Hospital Universitari de Bellvitge 08016 Barcelona Spain

Invasive Cardiology and Congenital Heart Disease Patras University Hospital 26221 Patras Greece

Iraklion University Hospital 70001 Crete Greece

Maastricht University Medical Center 6229 Maastricht The Netherlands

Pronto de Socorro Cardiologico Prof Luis Tavares Centro PROCAPE Federal University of Pernambuco Recife 50670 901 Brazil

Sección de la Unidad de Hemodinámica H Universitario y Politécnico La Fe 46001 Valencia Spain

Tyumen Cardiology Research Center Tomsk National Research Medical Center Russian Academy of Science 634000 634538 Tomsk Russia

University Clinic for Cardiology Medical Faculty Ss' Cyril and Methodius University 1000 Skopje North Macedonia

University Hospital Brno Medical Faculty of Masaryk University 60200 Brno Czech Republic

University Hospital Prague 12808 Prague Czech Republic

Citace poskytuje Crossref.org

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$a BACKGROUND: Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. METHODS: This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March-June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. RESULTS: We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825-0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31-2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96-1.34], p = 0.12). CONCLUSIONS: The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females. Trial registration number: NCT 04412655.
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$a Cercek, Miha $u Department of Cardiology, Medical Center Ljubljana, 1000 Ljubljana, Slovenia
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$a Okkels, Lisette $u Division of Cardiology, Odense Universitets Hospital, 5000 Odense, Denmark
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$a Loh, Poay Huan $u Department of Cardiology, National University Hospital, Singapore 117597, Singapore
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$a Calmac, Lucian $u Clinic Emergency Hospital of Bucharest, 014461 Bucharest, Romania $1 https://orcid.org/0000000230318023
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$a Ferrer, Gerard Roura I $u Interventional Cardiology Unit, Heart Disease Institute, Hospital Universitari de Bellvitge, 08016 Barcelona, Spain
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$a Quadros, Alexandre $u Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre 90040-371, Brazil
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$a Milewski, Marek $u Division of Cardiology, Medical University of Silezia, 40-002 Katowice, Poland $1 https://orcid.org/0000000154599125
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$a Scotto di Uccio, Fortunato $u Division of Cardiology, Ospedale del Mare, 00156 Napoli, Italy
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$a von Birgelen, Clemens $u Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, 7541 Enschede, The Netherlands
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$a Versaci, Francesco $u Division of Cardiology, Ospedale Santa Maria Goretti Latina, 04100 Latina, Italy
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$a Ten Berg, Jurrien $u Division of Cardiology, St. Antonius Hospital, 3434 Nieuwegein, The Netherlands
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$a Casella, Gianni $u Division of Cardiology, Ospedale Maggiore Bologna, 40100 Bologna, Italy
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$a Wong Sung Lung, Aaron $u Department of Cardiology, National Heart Center, Singapore 169609, Singapore
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$a Kala, Petr $u University Hospital Brno, Medical Faculty of Masaryk University, 60200 Brno, Czech Republic
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$a Díez Gil, José Luis $u Sección de la Unidad de Hemodinámica H. Universitario y Politécnico La Fe, 46001 Valencia, Spain
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$a Carrillo, Xavier $u Hospital Germans Triasi Pujol, 8918 Badalona, Spain
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$a Dirksen, Maurits $u Division of Cardiology, Northwest Clinics, 1811 Alkmaar, The Netherlands $1 https://orcid.org/0000000232634054
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$a Becerra, Victor $u Hospital Clínico Universitario Virgen de la Victoria, 29000 Malaga, Spain
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$a Lee, Michael Kang-Yin $u Department of Cardiology, Queen Elizabeth Hospital, University of Hong Kong, Hong Kong
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$a Juzar, Dafsah Arifa $u Department of Cardiology and Vascular Medicine, University of Indonesia National Cardiovascular Center "Harapan Kita", Jakarta 11420, Indonesia
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$a de Moura Joaquim, Rodrigo $u Instituto de Cardiologia de Santa Catarina Praia Comprida, São José 88103-901, Brazil
700    1_
$a Paladino, Roberto $u Division of Cardiology, Clinica Villa dei Fiori, 80011 Acerra, Italy
700    1_
$a Milicic, Davor $u Department of Cardiology, University Hospital Centre, University of Zagreb, 10000 Zagreb, Croatia
700    1_
$a Davlouros, Periklis $u Invasive Cardiology and Congenital Heart Disease, Patras University Hospital, 26221 Patras, Greece
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$a Bakraceski, Nikola $u Center for Cardiovascular Diseases, 6000 Ohrid, North Macedonia $1 https://orcid.org/0000000293950093
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$a Zilio, Filippo $u Division of Cardiology, Ospedale Santa Chiara di Trento, 38014 Trento, Italy $1 https://orcid.org/0000000272174961
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$a Donazzan, Luca $u Division of Cardiology, Ospedale "S. Maurizio" Bolzano, 39100 Bolzano, Italy $1 https://orcid.org/0000000269392159
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$a Kraaijeveld, Adriaan $u Division of Cardiology, 3584 Utrecht, The Netherlands
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$a Galasso, Gennaro $u Division of Cardiology, Ospedale San Giovanni di Dio e Ruggi d'Aragona, 84070 Salerno, Italy $1 https://orcid.org/0000000272657613
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$a Arpad, Lux $u Maastricht University Medical Center, 6229 Maastricht, The Netherlands
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$a Marinucci, Lucia $u Division of Cardiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", 61121 Pesaro, Italy $1 https://orcid.org/0000000315434453
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$a Guiducci, Vincenzo $u Division of Cardiology, AUSL-IRCCS Reggio Emilia, 42121 Reggio Emilia, Italy
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$a Menichelli, Maurizio $u Division of Cardiology, Ospedale "F. Spaziani", 03100 Frosinone, Italy
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$a Scoccia, Alessandra $u Division of Cardiology, Ospedale "Sant'Anna", 44121 Ferrara, Italy $1 https://orcid.org/0000000316988845
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$a Yamac, Aylin Hatice $u Department of Cardiology, Bezmialem Vakif University Hospital, 34093 Istanbul, Turkey
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$a Ugur Mert, Kadir $u Division of Cardiology, Faculty of Medicine, Eskisehir Osmangazi University, 02640 Eskisehir, Turkey $1 https://orcid.org/0000000213315365
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$a Flores Rios, Xacobe $u Complexo Hospetaliero Universitario La Coruna, 15001 La Coruna, Spain
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$a Kovarnik, Tomas $u University Hospital Prague, 12808 Prague, Czech Republic
700    1_
$a Kidawa, Michal $u Central Hospital of Medical University of Lodz, 90-008 Lodz, Poland
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$a Moreu, Josè $u Division of Cardiology, Complejo Hospitalario de Toledo, 45001 Toledo, Spain $1 https://orcid.org/0000000340200325
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$a Flavien, Vincent $u Division of Cardiology, Center Hospitalier Universitaire de Lille, 59000 Lille, France
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$a Fabris, Enrico $u Azienda Ospedaliero-Universitaria Ospedali Riuniti, 34142 Trieste, Italy $1 https://orcid.org/0000000194580736
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$a Martínez-Luengas, Iñigo Lozano $u Division of Cardiology, Hospital Cabueñes, 33201 Gijon, Spain
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$a Boccalatte, Marco $u Division of Cardiology, Ospedale Santa Maria delle Grazie, 80078 Pozzuoli, Italy
700    1_
$a Ojeda, Francisco Bosa $u Division of Cardiology, Hospital Universitario de Canarias, 38001 Santa Cruz de Tenerife, Spain
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$a Arellano-Serrano, Carlos $u Division of Cardiology, Hospital Puerta de Hierro Majadahonda, 28222 Majadahonda, Spain
700    1_
$a Caiazzo, Gianluca $u Division of Cardiology, Ospedale "G Moscati", 81031 Aversa, Italy
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$a Cirrincione, Giuseppe $u Division of Cardiology, Ospedale Civico Arnas, 90100 Palermo, Italy
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$a Kao, Hsien-Li $u Cardiology Division, Department of Internal Medicine, National Taiwan University Hospital, Tapei 8865600, Taiwan
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$a Forés, Juan Sanchis $u Division of Cardiology, Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain $1 https://orcid.org/0000000307978709
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$a Vignali, Luigi $u Interventional Cardiology Unit, Azienda Ospedaliera Sanitaria, 43121 Parma, Italy
700    1_
$a Pereira, Helder $u Cardiology Department, Hospital Garcia de Orta, Pragal, 2805-267 Almada, Portugal
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$a Ordoñez, Santiago $u Instituto Cardiovascular de Buenos Aires, Buenos Aires 1428, Argentina $1 https://orcid.org/0000000172389703
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$a Arat Özkan, Alev $u Cardiology Institute, Istanbul University, 34000 Instanbul, Turkey $1 https://orcid.org/0000000180647231
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$a Scheller, Bruno $u Division of Cardiology, Clinical and Experimental Interventional Cardiology, University of Saarland, 66123 Saarbrücken, Germany
700    1_
$a Lehtola, Heidi $u Division of Cardiology, Oulu University Hospital, 90220 Oulu, Finland
700    1_
$a Teles, Rui $u Division of Cardiology, Hospital de Santa Cruz, CHLO-Nova Medical School, CEDOC, 1000 Lisbon, Portugal $1 https://orcid.org/0000000279526878
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$a Mantis, Christos $u Division of Cardiology, Kontantopoulion Hospital, 10431 Athens, Greece $1 https://orcid.org/0000000204243638
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$a Antti, Ylitalo $u Division of Cardiology, Heart Centre Turku, 20521 Turku, Finland
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$a Brum Silveira, João António $u Division of Cardiology, Hospital de Santo António, 4099-001 Porto, Portugal
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$a Zoni, Cesar Rodrigo $u Department of Teaching and Research, Instituto de Cardiología de Corrientes "Juana F. Cabral", Corrientes W3400CDS, Argentina $1 https://orcid.org/000000029467334X
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$a Bessonov, Ivan $u Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, 634000-634538 Tomsk, Russia $1 https://orcid.org/0000000305785962
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$a Uccello, Giuseppe $u Division of Cardiology, Ospedale "A. Manzoni", 23900 Lecco, Italy
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$a Kochiadakis, George $u Iraklion University Hospital, 70001 Crete, Greece
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$a Alexopulos, Dimitrios $u Division of Cardiology, Attikon University Hospital, 10431 Athens, Greece
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$a Uribe, Carlos E $u Division of Cardiology, Universidad UPB, Universidad CES, Medellín 050001, Colombia
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$a Kanakakis, John $u Division of Cardiology, Alexandra Hospital, 10431 Athens, Greece
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$a Faurie, Benjamin $u Division of Cardiology, Groupe Hospitalier Mutualiste de Grenoble, 38000 Grenoble, France
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$a Gabrielli, Gabriele $u Interventional Cardiology Unit, Azienda Ospedaliero Universitaria"Ospedali Riuniti", 60100 Ancona, Italy
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$a Barrios, Alejandro Gutierrez $u Division of Cardiology, Hospital Puerta del Mar, 11001 Cadiz, Spain
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$a Bachini, Juan Pablo $u Instituto de Cardiologia Integral, Montevideo 11700, Uruguay
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$a Rocha, Alex $u Department of Cardiology and Cardiovascular Interventions, Instituto Nacional de Cirugía Cardíaca, Montevideo 11700, Uruguay
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$a Tam, Frankie C C $u Department of Cardiology, Queen Mary Hospital, University of Hong Kong, Hong Kong
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$a Rodriguez, Alfredo $u Division of Cardiology, Otamendi Hospital, Buenos Aires 1001, Argentina
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$a Lukito, Antonia Anna $u Cardiovascular Department Pelita Harapan University, Heart Center Siloam Lippo Village Hospital, Tangerang, Banten 15810, Indonesia $1 https://orcid.org/0000000185198949
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$a Saint-Joy, Veauthyelau $u Center Hospitalier d'Antibes Juan Les Pins, 06600 Antibes, France
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$a Pessah, Gustavo $u Division of Cardiology, Hospiatl Cordoba, Cordoba 5000, Argentina
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$a Tuccillo, Andrea $u Division of Cardiology, Ospedale del Mare, 00156 Napoli, Italy
700    1_
$a Ielasi, Alfonso $u Division of Cardiology, Nuovo Galeazzi-Sant'Ambrogio Hospital, 20161 Milan, Italy
700    1_
$a Cortese, Giuliana $u Department of Statistical Sciences, University of Padova, 35121 Padova, Italy
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$a Parodi, Guido $u Azienda Ospedaliera Lavagna, 16033 Lavagna, Italy $1 https://orcid.org/0000000297189107
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$a Bouraghda, Mohamed Abed $u Division of Cardiology, Blida University Hospital, Blida 09000, Algeria $1 https://orcid.org/0000000277201850
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$a Moura, Marcia $u Instituto de Cardiologia do Rio Grande do Sul, Porto Alegre 90040-371, Brazil
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$a Kedhi, Elvin $u Division of Cardiology, Hopital Erasmus, Universitè Libre de Bruxelles, 1070 Brussels, Belgium
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$a Lamelas, Pablo $u Instituto Cardiovascular de Buenos Aires, Buenos Aires 1428, Argentina
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$a Suryapranata, Harry $u Division of Cardiology, Radboud University Medical Center, 6525 Nijmegen, The Netherlands
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$a Nardin, Matteo $u Department of Internal Medicine, Ospedale Riuniti, 25121 Brescia, Italy $1 https://orcid.org/0000000346686661
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$a Verdoia, Monica $u Division of Cardiology, Ospedale degli Infermi, ASL, 13900 Biella, Italy $1 https://orcid.org/0000000165068397
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