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Article ; Online: Guidance for the antithrombotic management of persons with haemophilia and cardiovascular disease.

Mannucci, Pier Mannuccio / Agosti, Pasquale / Lettino, Maddalena

Haemophilia : the official journal of the World Federation of Hemophilia

2023 Volume 29, Issue 6, Page(s) 1390–1393

MeSH term(s)	Humans ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/prevention & control ; Hemophilia A/complications ; Hemophilia A/drug therapy ; Fibrinolytic Agents/therapeutic use
Chemical Substances	Fibrinolytic Agents
Language	English
Publishing date	2023-09-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1229713-6
ISSN	1365-2516 ; 1351-8216 ; 1355-0691
ISSN (online)	1365-2516
ISSN	1351-8216 ; 1355-0691
DOI	10.1111/hae.14874
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Zs.A 4249: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: How the Hemostasis Laboratory Can Help Clinicians to Manage Patients on Oral Anticoagulants.

Tripodi, Armando / Clerici, Marigrazia / Scalambrino, Erica / Agosti, Pasquale / Bucciarelli, Paolo / Peyvandi, Flora

Mediterranean journal of hematology and infectious diseases

2024 Volume 16, Issue 1, Page(s) e2024027

Abstract: Oral anticoagulants are widely used to treat or prevent cardiovascular diseases in millions of patients worldwide. They are the drugs of choice for stroke prevention and systemic embolism in patients with non-valvular atrial fibrillation and prosthetic ... ...

Abstract	Oral anticoagulants are widely used to treat or prevent cardiovascular diseases in millions of patients worldwide. They are the drugs of choice for stroke prevention and systemic embolism in patients with non-valvular atrial fibrillation and prosthetic heart valves, as well as for treatment/prevention of venous thromboembolism. Oral anticoagulants include vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs). The hemostasis laboratory plays a crucial role in the management of treated patients, spanning from dose adjustment based on laboratory testing that applies to VKAs to the measurement of drug concentrations in special situations that apply to DOACs. This article aims to overview how the hemostasis laboratory can help clinicians manage patients on oral anticoagulants. Special interest is devoted to the international normalized ratio, used to manage patients on VKAs and to the measurement of DOAC concentrations, for which the role of the laboratory is still not very well defined, and most interferences of DOACs with some of the most common hemostatic parameters are not widely appreciated.
Language	English
Publishing date	2024-03-01
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	2674750-9
ISSN	2035-3006
ISSN	2035-3006
DOI	10.4084/MJHID.2024.027
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Article ; Online: Undiagnosed cognitive impairment in older adults hospitalized in internal medicine wards: Data from the REPOSI registry.

Agosti, Pasquale / Novella, Alessio / Custodero, Carlo / Elli, Chiara / Pasina, Luca

European journal of internal medicine

2023 Volume 117, Page(s) 129–133

MeSH term(s)	Humans ; Aged ; Internal Medicine ; Hospitalization ; Hospitals ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/epidemiology ; Registries
Language	English
Publishing date	2023-08-04
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2023.07.030
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Zs.A 2608: Show issues

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Article ; Online: Treatment of immune-mediated thrombotic thrombocytopenic purpura without plasma exchange.

Capecchi, Marco / Gazzola, Giada / Agosti, Pasquale / De Leo, Pasqualina / Mancini, Ilaria / Ferrari, Barbara / Giannotta, Juri Alessandro / Artoni, Andrea / Peyvandi, Flora

Haematologica

2024

Abstract: Not available. ...

Abstract	Not available.
Language	English
Publishing date	2024-02-22
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2333-4
ISSN	1592-8721 ; 0017-6567 ; 0390-6078
ISSN (online)	1592-8721
ISSN	0017-6567 ; 0390-6078
DOI	10.3324/haematol.2023.284438
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Uh III Zs.76: Show issues

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Article ; Online: Minimum factor VIII levels to prevent joint bleeding in mild hemophilia A.

Agosti, Pasquale / Siboni, Simona Maria / Scardo, Sara / Torri, Adriana / Gualtierotti, Roberta / Peyvandi, Flora

Blood advances

2023 Volume 7, Issue 23, Page(s) 7209–7215

Abstract: The severity of the bleeding phenotype in patients with hemophilia A (HA) broadly correlates with the degree of coagulation factor VIII (FVIII) deficiency in plasma. However, the FVIII level necessary to achieve the goal of zero joint bleeds remains ... ...

Abstract	The severity of the bleeding phenotype in patients with hemophilia A (HA) broadly correlates with the degree of coagulation factor VIII (FVIII) deficiency in plasma. However, the FVIII level necessary to achieve the goal of zero joint bleeds remains unclear. This study aimed to identify the minimum FVIII level necessary to prevent joint bleeds in patients with HA. In this retrospective study, patients with congenital mild HA treated on demand, aged ≥16 years, with no history of FVIII inhibitors, followed at the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center in Milan, were enrolled. We investigated 270 male patients with a median age of 45 years (16-88) and median lifelong FVIII of 21 IU/dL. One hundred patients (37%) had a lifelong history of at least 1 joint bleed. The mean annualized joint bleeding rate (AJBR) and spontaneous AJBR were 0.016 (standard deviation [SD], 0.032) and 0.001 (SD, 0.010), respectively. After adjusting for age, for each IU/dL increase in FVIII, there was a 6% reduction in AJBR and an 11% reduction in spontaneous AJBR. The minimum FVIII levels needed to prevent lifelong any joint bleeds and spontaneous joint bleeds resulted to be 19.2 IU/dL and 17.7 IU/dL, respectively. In this large cohort of persons with mild HA, we identified the minimum FVIII levels needed to prevent total and spontaneous joint bleeds (19.2 IU/dL and 17.7 IU/dL, respectively). These findings could suggest important implications for the accurate design of prophylactic therapies for persons with moderate and severe HA, including gene therapy.
MeSH term(s)	Humans ; Male ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Hemophilia A/complications ; Factor VIII/therapeutic use ; Retrospective Studies ; Hemarthrosis/prevention & control ; Hemorrhage/prevention & control ; Hemorrhage/chemically induced ; Hemostatics
Chemical Substances	Factor VIII (9001-27-8) ; Hemostatics
Language	English
Publishing date	2023-09-27
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2915908-8
ISSN	2473-9537 ; 2473-9529
ISSN (online)	2473-9537
ISSN	2473-9529
DOI	10.1182/bloodadvances.2023011366
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Zs.A 7153: Show issues

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Article ; Online: Development and validation of the Medical Attitudes Towards Deprescribing Questionnaire.

Agosti, Pasquale / D'Avanzo, Barbara / Monti, Igor / Cortesi, Laura / Nobili, Alessandro / Tettamanti, Mauro

Internal and emergency medicine

2023 Volume 19, Issue 2, Page(s) 413–422

Abstract: Polypharmacy and inappropriate prescriptions in the elderly are widely discussed themes in scientific literature. Although more and more studies showed the safety and feasibility of deprescribing strategies, these are not implemented in clinical practice. ...

Abstract	Polypharmacy and inappropriate prescriptions in the elderly are widely discussed themes in scientific literature. Although more and more studies showed the safety and feasibility of deprescribing strategies, these are not implemented in clinical practice. In order to measure the attitudes of Italian doctors towards deprescribing and address their awareness, experiences, difficulties in applying these strategies and potential suggestions, we aimed to develop and validate a questionnaire, the Medical Attitudes Towards Deprescribing Questionnaire (MATD-Q). Between November 2017 and October 2018 an e-mail was sent to internists, geriatricians and general practitioners, to invite them to connect to a platform and answer to the questionnaire, consisting in 38 items (with a five level score) and five questions. After 2-3 weeks, a second e-mail was sent for a second completion of the questionnaire. Test-retest reliability was assessed by means of the intraclass correlation coefficient (ICC). The correlations between items were assessed by means of Pearson linear correlation coefficients and Cronbach Alpha was used to assess internal consistency. A total of 77 questionnaires completed twice were collected. By a principal component analysis we defined a smaller set of variables (n = 12), which resulted to be representative of the 38-item questionnaire.The final version of the questionnaire we developed (MATDQ-12), after validation in other cohorts, could be a useful tool to measure the efficacy of educational interventions aimed at improving the attitude of physicians towards deprescribing strategies with the final goal to allow their implementation in clinical practice.
MeSH term(s)	Humans ; Aged ; Deprescriptions ; Reproducibility of Results ; Physicians ; Surveys and Questionnaires ; Polypharmacy
Language	English
Publishing date	2023-12-20
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-023-03489-0
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Zs.A 6673: Show issues

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Article ; Online: Safety and efficacy of combined dual antiplatelet therapy and factor VIII prophylaxis in patients with haemophilia A after acute coronary syndrome.

Agosti, Pasquale / Siboni, Simona Maria / Ciavarella, Alessandro / Arcudi, Sara / Boggio, Federico / Gualtierotti, Roberta / Peyvandi, Flora

Haemophilia : the official journal of the World Federation of Hemophilia

2024 Volume 30, Issue 2, Page(s) 336–344

Abstract: Introduction: The increased life expectancy of patients with haemophilia A (HA) has led to a growing prevalence of cardiovascular risk factors and events. There is still scarce evidence on the safety and appropriate duration of dual antiplatelet therapy ...

Abstract	Introduction: The increased life expectancy of patients with haemophilia A (HA) has led to a growing prevalence of cardiovascular risk factors and events. There is still scarce evidence on the safety and appropriate duration of dual antiplatelet therapy (DAPT) after acute coronary syndrome (ACS) in HA patients. Aim: We describe our experience on the clinical management of Italian HA patients after ACS. Methods: Nine patients with congenital HA treated with DAPT after a revascularization procedure performed for ACS have been enrolled and followed at the Angelo Bianchi Bonomi Haemophilia and Thrombosis Center in Milan between 2005 and September 2022. The safety and efficacy of DAPT with or without FVIII prophylaxis were assessed. Results: Ten ACS events occurred in the nine HA patients (four mild and five severe). All events were treated with percutaneous transluminal coronary angioplasty with deployment of 1 to 3 drug-eluting stents followed by DAPT for 1-12 months. All patients except one were treated with FVIII prophylaxis during DAPT aimed at achieving FVIII trough levels ≥20-30 IU/dL. DAPT was effective in all cases in preventing early ACS recurrence, with only a late recurrence. We observed two clinically relevant non-major bleeds (one in a patient without FVIII prophylaxis) and three minor bleeds. No venous thrombosis occurred. Conclusion: The long-term secondary antithrombotic prevention consisting of DAPT and FVIII prophylaxis achieving a trough level of 20-30 IU/dL can be effective and safe in HA patients.
MeSH term(s)	Humans ; Platelet Aggregation Inhibitors/adverse effects ; Acute Coronary Syndrome/complications ; Acute Coronary Syndrome/drug therapy ; Hemophilia A/drug therapy ; Factor VIII ; Thrombosis/etiology ; Hemostatics/therapeutic use ; Drug Therapy, Combination ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/methods ; Treatment Outcome
Chemical Substances	Platelet Aggregation Inhibitors ; Factor VIII (9001-27-8) ; Hemostatics
Language	English
Publishing date	2024-02-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1229713-6
ISSN	1365-2516 ; 1351-8216 ; 1355-0691
ISSN (online)	1365-2516
ISSN	1351-8216 ; 1355-0691
DOI	10.1111/hae.14963
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Zs.A 4249: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Effect of Physical Activity Intervention on Gait Speed by Frailty Condition: A Randomized Clinical Trial.

Custodero, Carlo / Agosti, Pasquale / Anton, Stephen D / Manini, Todd M / Lozupone, Madia / Panza, Francesco / Pahor, Marco / Sabbà, Carlo / Solfrizzi, Vincenzo

Journal of the American Medical Directors Association

2023 Volume 24, Issue 4, Page(s) 489–496

Abstract: Objectives: There is uncertainty about effects of physical activity on physical performance, such as gait speed, among community-dwelling older adults according to their physical frailty status. We determined whether a long-term, moderate-intensity ... ...

Abstract	Objectives: There is uncertainty about effects of physical activity on physical performance, such as gait speed, among community-dwelling older adults according to their physical frailty status. We determined whether a long-term, moderate-intensity physical activity program was associated with different responses on gait speed over 4 m and 400 m based on physical frailty status. Design: Post hoc analysis from the Lifestyle Interventions and Independence for Elders (LIFE) (NCT01072500), a single-blind randomized clinical trial testing the effect of physical activity intervention compared with health education program. Setting and participants: We analyzed data on 1623 community-dwelling older adults (78.9 ± 5.2 years) at risk for mobility disability. Methods: Physical frailty was assessed at baseline using the Study of Osteoporotic Fractures frailty index. Gait speed over 4 m and 400 m was measured at baseline, and 6, 12, and 24 months. Results: We estimated significantly better 400-m gait speed at 6, 12, and 24 months for nonfrail older adults in the physical activity group, but not for frail participants. Among frail participants, physical activity showed a potentially clinically meaningful benefit on 400-m gait speed at 6 months (0.055; 95% CI 0.016-0.094; P = .005), compared with the healthy educational intervention, only in those who, at baseline, were able to rise from a chair 5 times without using their arms. Conclusions and implications: A well-structured physical activity program produced a faster 400-m gait speed potentially able to prevent mobility disability among physically frail individuals with preserved muscle strength in lower limbs.
MeSH term(s)	Humans ; Aged ; Frailty ; Walking Speed ; Single-Blind Method ; Exercise ; Life Style ; Frail Elderly
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Intramural ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2023.01.023
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Zs.A 5971: Show issues

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Article: Emerging metabolic risk factors in hepatocellular carcinoma and their influence on the liver microenvironment.

Agosti, Pasquale / Sabbà, Carlo / Mazzocca, Antonio

Biochimica et biophysica acta. Molecular basis of disease

2017 Volume 1864, Issue 2, Page(s) 607–617

Abstract: Despite the reducing incidence of chronic hepatitis infections, an unexpected increasing incidence of hepatocellular carcinoma (HCC) has being occurred. This may be explained by the increasing number of HCCs developing on steatosis (NAFLD) and ... ...

Abstract	Despite the reducing incidence of chronic hepatitis infections, an unexpected increasing incidence of hepatocellular carcinoma (HCC) has being occurred. This may be explained by the increasing number of HCCs developing on steatosis (NAFLD) and steatohepatitis (NASH), related to metabolic risk factors (i.e. diabetes mellitus type II, obesity, metabolic syndrome), which are becoming emerging risk factors for HCC. This led to a growing scientific interest on the oncogenic mechanisms underlying the transition from NAFLD to HCC. However, patients with NASH receive significantly less HCC surveillance than patients with chronic hepatitis, and no specific preventive pharmacological treatments have recommended for NASH-related HCC. This review focuses on the pathogenic role of the emerging factors involved in the transition from NAFLD/NASH to HCC, including microbiota, insulin resistance, inflammation, lipid and bile acids metabolism. It will be emphasize their impact on the liver microenvironment, the implications in clinical practice and the future directions of research.
MeSH term(s)	Adipokines/metabolism ; Animals ; Bile Acids and Salts/analysis ; Carcinoma, Hepatocellular/metabolism ; Cellular Senescence ; Fatty Liver/pathology ; Humans ; Inflammation ; Insulin Resistance ; Lipid Metabolism ; Lipids/blood ; Liver/pathology ; Liver Neoplasms/metabolism ; Liver Neoplasms/pathology ; Non-alcoholic Fatty Liver Disease/pathology ; Obesity/physiopathology ; Phenotype ; Precancerous Conditions ; Prognosis ; Risk Factors ; Tumor Microenvironment
Chemical Substances	Adipokines ; Bile Acids and Salts ; Lipids
Language	English
Publishing date	2017-11-29
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	60-7
ISSN	1879-2596 ; 1879-260X ; 1872-8006 ; 1879-2642 ; 1879-2618 ; 1879-2650 ; 0925-4439 ; 0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 1570-9639 ; 1874-9399
ISSN (online)	1879-2596 ; 1879-260X ; 1872-8006 ; 1879-2642 ; 1879-2618 ; 1879-2650
ISSN	0925-4439 ; 0006-3002 ; 0005-2728 ; 0005-2736 ; 0304-4165 ; 0167-4838 ; 1388-1981 ; 0167-4889 ; 0167-4781 ; 0304-419X ; 1570-9639 ; 1874-9399
DOI	10.1016/j.bbadis.2017.11.026
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Article ; Online: Factor V Leiden but not the factor II 20210G>A mutation is a risk factor for premature coronary artery disease: a case-control study in Iran.

Agosti, Pasquale / Mancini, Ilaria / Sadeghian, Saeed / Pagliari, Maria Teresa / Abbasi, Seyed Hesameddin / Pourhosseini, Hamidreza / Boroumand, Mohammadali / Lotfi-Tokaldany, Masoumeh / Pappalardo, Emanuela / Maino, Alberto / Rosendaal, Frits R / Peyvandi, Flora

Research and practice in thrombosis and haemostasis

2023 Volume 7, Issue 1, Page(s) 100048

Abstract: Background: Factor V Leiden (FVL) and factor II c.∗97G>A (rs1799963) are genetic risk factors for venous thromboembolism. Their contribution to coronary artery disease (CAD) is less clear.: Objectives: This study aimed to investigate the association ... ...

Abstract	Background: Factor V Leiden (FVL) and factor II c.∗97G>A (rs1799963) are genetic risk factors for venous thromboembolism. Their contribution to coronary artery disease (CAD) is less clear. Objectives: This study aimed to investigate the association between FVL, rs1799963, and premature CAD in Iranians. Methods: We performed a genetic case-control study of 944 cases and 1081 controls from the premature CAD Milano-Iran study, including patients aged 18-55 (female) and 18-45 years (male) who underwent coronary angiography at the Tehran Heart Centre (Iran) in 2004-2011. Cases had luminal stenosis ≥50% in at least 1 main coronary artery or branch. Controls were age- and sex-matched with no CAD history. FVL and rs1799963 were genotyped using TaqMan SNP genotyping assays. Association was tested by logistic regression adjusted for matching factors and ethnicity. Effect modification by sex and cardiovascular risk factors (metabolic [obesity, hypertension, hyperlipidemia, and diabetes], and smoking) was assessed. Results: The risk of premature CAD was increased by 50% in FVL carriers (adjusted odds ratio [adjOR] 1.54 [95% CI, 0.95-2.48]) and slightly reduced in rs1799963 carriers (adjOR 0.71 [95% CI, 0.40-1.27]). These effects were more pronounced in women than men (FVL, adjOR 1.66 vs 1.25; rs1799963, adjOR 0.60 vs 1.07). The risk of premature CAD was substantially increased in carriers of FVL with at least 1 metabolic risk factor compared with noncarriers without metabolic risk factors (adjOR 25.14 [95% CI, 12.51-50.52]). Conclusion: FVL but not FII rs1799963 was associated with an increased risk of CAD in young Iranians. This risk increased considerably when combined with metabolic cardiovascular risk factors.
Language	English
Publishing date	2023-01-11
Publishing country	United States
Document type	Journal Article
ISSN	2475-0379
ISSN (online)	2475-0379
DOI	10.1016/j.rpth.2023.100048
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