Giulia Angeloni

Outcomes of the tacrolimus drug-eluting Janus stent: a prospective two-centre registry in high-risk patients.

Background To date, only two drug-eluting stents (DES) have been extensively tested in both randomized controlled clinical trials and large ‘real world’ registries: sirolimus-DES (Cypher stent, Cordis, Miami Lakes, Florida, USA) and paclitaxel-DES (Taxus stent, Boston Scientific, Natick, Massachusetts, USA). Recently, a new polymer-free tacrolimus-eluting Carbofilm-coated stent, the Janus stent (Sorin Biomedica, Saluggia, Italy), has entered the market but only few clinical data testing its safety and efficacy in selected patients are available. Thus, we performed a prospective registry of consecutive, unselected patients receiving this new DES. Methods A total of 118 patients scheduled for percutaneous coronary intervention (PCI) with DES were enrolled in two separate centers. End-points were: (i) immediate angiographic failure; (ii) major adverse coronary events (MACE) defined as the composite of cardiovascular death, nonfatal myocardial infarction (MI) and target lesion revascularization (TLR); (iii) clinically driven TLR; (iv) and stent thrombosis at 6-month follow-up. Results A total of 192 Janus stents were successfully implanted during elective (36%) or urgent PCIs (64%), including patients with ST elevation MI (16%). Twenty-four percent of patients were diabetics and 27% underwent multivessel PCI. Target lesions were B2-C type in 54%, in-stent restenosis in 8%, and located in degenerated venous grafts in 9%. Angiographic failure was observed in five of the 147 (3.4%) lesions treated. Total MACE rate at 6-month follow-up was 22% and clinically-driven TLR was carried out in 14% of patients. Stent thrombosis occurred in 4% of cases. Conclusion This registry of the new tacrolimus-eluting Carbofilm-coated Janus stent showed an incidence of MACE, TLR and stent thrombosis higher than that reported in previous similar studies on DES. Whether this risk is due to this specific device or to the unselected (i.e. high-risk) population warrants further research.

Serum uric acid on admission predicts in-hospital mortality in patients with acute coronary syndrome

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 retrospective analysis included patients from previous SPAI and FAMI studies with the aim to investigate the association between serum uric acid and major adverse cardiovascular events at 180days from hospital admission. RESULTS 1548 patients were considered and divided in four groups, according UA concentration. Uricemia was significantly associated with gender, BMI, arterial hypertension, HDL-cholesterol, triglycerides, metabolic syndrome and glomerular filtration rate in univariate analysis. Multivariate logistic regression indicated that UA >6.0mg/dL on admission increased the risk of in-hospital mortality in overall population (OR 2.9, 95%CI 1.4-6.1; p=0.0057) and in patients with de novo ACS (OR 3.2, 95%CI 1.5-6.8; p=0.0033). Comparable results were also obtained after adjusting the model for age, gender, body mass index, glomerular filtration rate, metabolic syndrome, acute revascularization and ethnicity. A positive correlation was observed between UA and C reactive protein concentrations in in-hospital deaths only (rho 0.41, p=0.027). CONCLUSION In patients with acute coronary syndrome, uricemia levels above the current international reference limit (6.0mg/dl) were associated with in-hospital mortality, independently from ethnicity and renal function.

Characterization and comparison of cold brew and cold drip coffee extraction methods: Cold brew and cold drip coffee extraction methods

BACKGROUND Each region of the world has its own methods, protocols, instruments and procedures regarding how to brew coffee. The final result in the cup is strongly affected by the extraction method, and many studies have focused on this subject. However, few studies have investigated slow, cold extraction methods, despite their popularity among baristas. Therefore, the present study aimed to characterize and compare two cold extraction methods: cold brew and cold drip. RESULTS Physical and chemical analyses were used to describe coffee beverages in terms of pH, total solids, refractive index, density and viscosity. Caffeine and cinnamic acids were quantified using high-performance liquid chromatography (HPLC)/diode array detector and HPLC/mass spectrometry. A sensory evaluation included aroma, flavor and textural attributes. CONCLUSIONS Significant differences were found in the chemical and physical parameters, both between and within the two methods, as a function of the extraction temperature and contact time. Similarly, the sensory evaluation found differences in flavor profiles, as measured in terms of bitterness, sweetness, sourness and global intensity.

A Technological Solution to Modulate the Aroma Profile during Beer Fermentation

During the production of fermented alcoholic beverages, such as wine or beer, the loss of aroma active compounds (AACs) has a significant impact on the overall product aroma. This paper presents the results of an experimental technique in which a condenser was placed on the top of the fermenter in order to reduce such losses. AAC concentrations in beers produced in this way were compared with a control produced without a condenser. There were two main findings: (i) some AACs could be recovered during fermentation and (ii) the technique stimulated the de novo synthesis of esters from carboxylic acids and alcohols. In particular, the production of ethyl esters from the reaction between ethanol and organic acids and the production of acetates from the reaction between acetic acid and alcohols were demonstrated. Consequently, the addition of the condenser changed the final aroma of the beverage. The effect was confirmed by a panel test and AAC quantitation using HS-SPME-GC-MS. The technique could be used by brewers as a tool to modulate the flavor and aroma of beer.

What kind of coffee do you drink? An investigation on effects of eight different extraction methods

The chemical composition of brewed coffee depends on numerous factors: the beans, post-harvest processing and, finally, the extraction method. In recent decades, numerous coffee-based beverages, obtained using different extraction techniques have entered the market. This study characterizes and compares eight extraction coffee methods from a chemical-physical point of view, starting from the same raw material. Specifically, three types of Espresso, Moka, French Press, and 3 filter coffee that for the first time are reported in the scientific literature Cold Brew, V60, and Aeropress are compared. Physical measurements included the quantification of total dissolved solids, density, pH, conductivity, and viscosity. Chemical analyses identified 15 chlorogenic acids (CGAs): six caffeoylquinic acids, one p-Coumaroylquinic acid, one Feruloylquinic Acid, four Caffeoylquinic lactones, and three Dicaffeoylquinic acids. Maximum caffeine and CGA concentrations were found in Espresso coffees, while Moka and filtered coffees were three to six times less concentrated. The classic Espresso method was most efficient for caffeine and CGA recovery, with a yield almost double that of other methods. Per-cup caffeine and CGAs were higher in Cold Brew than Espresso coffees, as a function of the volume of beverage, which ranged from 30 mL (for espresso) to 120 mL (for filtered coffees). In light of these results, it is not possible to establish how many cups of coffee can be consumed per day without exceeding the recommended doses, since according to the applied brewing method, the content of the bioactive substances varies considerably.