Luigi Santoro
ARCO
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Luigi Santoro.
Journal of the American College of Cardiology | 1993
Giulio Zuanetti; Roberto Latini; Aldo P. Maggioni; Luigi Santoro; Maria Grazia Franzosi
OBJECTIVES This study was conducted to determine the role of insulin-dependent and noninsulin-dependent diabetes in the prognosis of patients after myocardial infarction and treatment with fibrinolytic agents. BACKGROUND Several studies have shown that diabetic patients have a high mortality rate after acute myocardial infarction. However, the impact of diabetes on survival in patients treated with fibrinolytic agents is still undefined. It is also not known whether the type of diabetes or gender affects prognosis. METHODS We analyzed prevalence and prognostic significance of a history of diabetes in patients enrolled in the GISSI-2 study, all of whom received fibrinolytic agents. The incidence of deaths in the hospital and at 6 months after study entry was computed for patients without diabetes and for insulin-dependent and noninsulin-dependent diabetic patients; relative risks were evaluated by univariate and multivariate analysis. RESULTS Information on diabetic status was available for 11,667 patients, 94.2% of those randomized in the GISSI-2 study. The prevalence of diabetes was higher in women than in men (8.75% vs. 1.85%, p < 0.01 for insulin-dependent and 23.7% vs. 13.8%, p < 0.01 for noninsulin-dependent diabetic patients). The type of fibrinolytic agent did not affect mortality rates; the increase in in-hospital mortality of diabetic patients was moderate and similar for men with insulin- and noninsulin-dependent diabetes (8.7% and 10.1%, respectively, vs. 5.8% in nondiabetic patients); in women, mortality was markedly higher for insulin-dependent and only slightly higher for noninsulin-dependent diabetic patients (24.0% and 15.8%, respectively, vs. 13.9% for nondiabetic patients). The adjusted relative risks were 1.9 (95% confidence interval 1.2 to 2.9) for insulin-dependent diabetic women and 1.4 (95% confidence interval 1.1 to 1.8) for noninsulin-dependent diabetic men. The mortality rate after discharge showed a similar gender difference, and in insulin-dependent diabetic women, prognosis was ominous even in the absence of left ventricular damage before discharge. CONCLUSIONS A history of diabetes is associated with a worse prognosis after myocardial infarction, even in patients treated with fibrinolytic agents. Gender and type of diabetes appear to be critical in affecting survival. In men, both insulin-dependent and noninsulin-dependent diabetes are associated with a moderately higher mortality rate; in women, insulin-dependent diabetes is, in itself, a strong risk factor for death after myocardial infarction.
Circulation | 1997
Giulio Zuanetti; Roberto Latini; Aldo P. Maggioni; MariaGrazia Franzosi; Luigi Santoro; Gianni Tognoni
BACKGROUND Mortality of diabetic patients with acute myocardial infarction (MI) remains high despite recent improvement in their management. There is a need to evaluate efficacy and safety of novel treatments of MI in this high-risk population. We evaluated whether treatment with an ACE inhibitor begun within 24 hours from the onset of symptoms is able to decrease mortality and morbidity of diabetic patients with acute MI. METHODS AND RESULTS A retrospective analysis of the data of the GISSI-3 study in patients with and without a history of diabetes was performed. Patients with suspected acute MI were randomized to treatment with lisinopril (2.5 to 5 up to 10 mg/d) with or without nitroglycerin (5 to 20 microg I.V. then 10 mg/d) begun within 24 hours and continued for 6 weeks. The main end point was mortality at 6 weeks, and the secondary end point was a combined evaluation of mortality and severe left ventricular dysfunction. Information on diabetic status was available for 18,131 patients (approximately 94% of the total population enrolled), of whom 2790 patients had a history of diabetes. Treatment with lisinopril was associated with a decreased 6-week mortality in diabetic patients (8.7% versus 12.4%; OR, 0.68; 95% CI, 0.53 to 0.86; 37+/-12 lives saved per 1000 treated patients), an effect that was significantly (P<.025) higher than that observed in nondiabetic patients. The survival benefit in diabetics was mostly maintained at 6 months despite withdrawal from treatment at 6 weeks (12.9% versus 16.1%; OR, 0.77; 95% CI, 0.62 to 0.95). CONCLUSIONS Early treatment with the ACE inhibitor lisinopril in diabetic patients with acute MI is associated with a decreased 6-week mortality. This beneficial effect supports a widespread and early use of ACE inhibitors in diabetic patients with acute MI. The burden of mortality plus morbidity for ventricular dysfunction in diabetics remains clinically important and warrants further testing of novel therapeutic approaches.
Journal of Hypertension | 1996
Claudio Fresco; Fausto Avanzini; Stefano Bosi; Maria Grazia Franzosi; Aldo P. Maggioni; Luigi Santoro; Giancarlo Bellanti
Objective To assess the prognostic value of a history of hypertension in patients with acute myocardial infarction (AMI) treated with thrombolysis. Design Retrospective adjusted analysis of outcome data of patients with AMI randomly allocated to treatment in a controlled study of alteplase versus streptokinase and heparin versus no heparin. Setting A highly representative sample (about 90%) of Italian Coronary Care Units. Patients Patients with (n=3306) and without (n=7406) a history of treated hypertension. Main outcome measures Morbidity and mortality during hospital stay and the next 6 months. Results Patients with a history of hypertension had a significantly higher mortality, both in hospital and during the next 6 months. The difference persisted also after a multivariate analysis including all major prognostic factors for in-hospital and 6-month mortality, respectively. Left ventricular failure and recurrent ischaemic events (angina and re-infarction) were also significantly more frequent in hypertensives both during their hospital stay and during follow-up study. Conclusions A history of hypertension is a negative independent prognostic factor after acute myocardial infarction treated with thrombolysis.
Annals of Epidemiology | 1993
Barbara D'Avanzo; Carlo La Vecchia; Gianni Tognoni; Silvia Franceschi; Maria Grazia Franzosi; Alessandro Nobili; Luigi Santoro; Giovanni Scarsi
Abstract The relationship between coffee consumption and acute myocardial infarction (AMI) was analyzed using data from a case-control study conducted in 1988 to 1989 within the framework of the GISSI-2 trial on streptokinase versus alteplase and heparin versus no heparin in the treatment of AMI. A total of 801 male patients with AMI and 792 control subjects who were hospitalized in several Italian regions for diseases unrelated to known or potential risk factors for cardiovascular diseases were included. Compared with coffee nondrinkers, the multivariate relative risks (RRs), after allowance for age, education, body mass index, smoking habits, alcohol consumption, family history of AMI, cholesterol level, history of diabetes, and hypertension, were 0.8 (95% confidence interval (CI), 0.5 to 1.2) for consumption of one cup/d, 1.3 (95% CI, 0.9 to 2.0) for two cups/d, 1.8 (95% CI, 1.1 to 2.7) for three cups, 2.5 (95% CI, 1.5 to 4.1) for four cups, and 2.6 (95% CI, 1.6 to 4.2) for five cups or more. The trend in risk with dose was statistically significant ( P
Journal of the American College of Cardiology | 1994
Paolo Marino; Giorgio Paolo Nidasio; Giorgio Golia; Maria Grazia Franzosi; Aldo P. Maggioni; Eugenio Santoro; Luigi Santoro; Piero Zardini
OBJECTIVES To test whether acute reperfusion of the infarct-related vessel after an acute myocardial infarction is associated with a subsequent reduction in spontaneous ventricular arrhythmias that is independent of ventricular ejection fraction, 1,944 patients from the GISSI-2 study population were studied. The patients were selected on the basis of a first myocardial infarction and the availability of two-dimensional echocardiographic ejection fraction and data on the number of premature ventricular contractions per hour on Holter monitoring. BACKGROUND It has been suggested that postthrombolytic reperfusion of the culprit vessel may be associated with an increased electrical stability of the infarcted heart, irrespective of its residual pump performance. METHODS The predischarge relation between ejection fraction and number of premature ventricular contractions per hour was plotted according to the occurrence (1,309 patients) or not (635 patients) of acute reperfusion, identified noninvasively according to the modifications of the ST segment in serial electrocardiograms obtained in the first 24 h after infarction. RESULTS The frequency of premature ventricular contractions increased in a linear fashion with decreasing ejection fraction in both cohorts (p < 0.005 and p < 0.0001); however, there was no significant difference between the slopes and the intercepts of the two regression lines, so that the relation between ejection fraction and number of premature ventricular contractions per hour could be adequately described by a single equation: y (number of premature ventricular contractions) = 33.0-0.42x (ejection fraction) (r = -0.107, p < 0.0001). The results were the same even when differences between group characteristics were accounted for in a multiple regression model. CONCLUSIONS It is concluded that 1) the number of premature ventricular contractions per hour after an acute myocardial infarction is dependent in a linear, inverse fashion on the residual ventricular ejection fraction, and 2) this relation is independent of the occurrence of reperfusion in the acute phase of infarction.
Circulation | 1998
Maria Grazia Franzosi; Eugenio Santoro; Claudio De Vita; Enrico Geraci; Antonio Lotto; Aldo P. Maggioni; Francesco Mauri; Fausto Rovelli; Luigi Santoro; Luigi Tavazzi; Gianni Tognoni
Journal of the American College of Cardiology | 1994
Francesco Mauri; Aldo P. Maggioni; Maria Grazia Franzosi; Claudio De Vita; Eugenio Santqro; Luigi Santoro; Pantaleo Giannuzzi; Gianni Tognoni
Pharmacological Research | 1998
Serge Masson; Roberto Latini; Maurizio Bevilacqua; Tarcisio Vago; Fabrizio Sessa; Mauro Torri; Adriana Anesini; Monica Salio; Elena Pasotti; Davide Agnello; Luigi Santoro; Anna Catania; Pietro Ghezzi; Tiziano Moccetti; Aldo P. Maggioni
American Heart Journal | 2002
Fausto Avanzini; Gabriele Ferrario; Luigi Santoro; Paolo Peci; Paolo Giani; Eugenio Santoro; Maria Grazia Franzosi; Gianni Tognoni
Journal of the American College of Cardiology | 2002
Francesco Mauri; Maria Grazia Franzosi; Aldo P. Maggioni; Eugenio Santoro; Luigi Santoro