Manes MT, Ciliberti G, Mannarini A
… +12 more, Pavan D, Di Fusco SA, Khoury G, Aschieri D, Scardovi B, Bruno N, Cocozza S, Geraci G, Gulizia MM, Gabrielli D, Colivicchi F, Grimaldi M
G Ital Cardiol (Rome)
· 2026 Jun · PMID 42200232
·
Publisher ↗
Artificial intelligence is increasingly used in cardiovascular medicine, with applications in diagnosis, risk prediction, and clinical decision-making. However, emerging evidence suggests that these tools may exhibit dif...Artificial intelligence is increasingly used in cardiovascular medicine, with applications in diagnosis, risk prediction, and clinical decision-making. However, emerging evidence suggests that these tools may exhibit differences in performance between men and women, with the potential to amplify existing disparities in cardiovascular care. This narrative review examines the role of sex and gender in artificial intelligence models applied to cardiology, focusing on the main areas of application, including electrocardiography, cardiovascular imaging, risk prediction, and clinical decision support systems. In many settings, models demonstrate good overall performance; however, stratified analyses reveal reduced sensitivity and higher rates of false-negative results in women. These differences may lead to underdiagnosis, delayed treatment, and inadequate risk stratification. Major contributing factors include the underrepresentation of women in training datasets, the lack of sex-specific variables, and the use of non-sex-specific diagnostic criteria. A systematic evaluation of model performance across subgroups, together with the integration of sex- and gender-specific variables, is essential to ensure a more equitable and clinically appropriate use of artificial intelligence in cardiovascular practice.
Ciccirillo F, Abrignani MG, Alfarano M
… +37 more, Amico AF, Aquaro GD, Bilato C, Binaghi G, Caldarola P, Chimenti C, Corda M, De Chiara BC, De Fazio S, De Luca L, Di Fusco SA, Di Ienno L, Di Marco M, Di Tano G, Egidy Assenza G, Fasoli M, Garascia A, Geraci G, Gori M, Iacoviello M, Lucà F, Mannarini A, Milli M, Montalto A, Navazio A, Parrini I, Pascale V, Pisanò ECL, Roncon L, Scelsi L, Scicchitano P, Scotto di Uccio F, Tizzani E, Gabrielli D, Oliva F, Nardi F, Grimaldi M
G Ital Cardiol (Rome)
· 2026 May · PMID 42084299
·
Publisher ↗
Substance use represents a relevant yet underrecognized determinant of cardiovascular diseases, acting through substance-specific and often multifactorial mechanisms. This document proposes the concept of substance-relat...Substance use represents a relevant yet underrecognized determinant of cardiovascular diseases, acting through substance-specific and often multifactorial mechanisms. This document proposes the concept of substance-related cardiovascular diseases (Sr-CVD) as a possible novel nosological entity, outlining its main clinical implications. Available epidemiological and pathophysiological evidence is reviewed, and the clinical, instrumental, and therapeutic-management features of the main cardiovascular conditions associated with substance use are described. These elements support clinical suspicion, differential diagnosis, and a precision medicine approach. In cases where a definite causal relationship cannot be established, the term "cardiovascular diseases in individuals with substance use" is proposed to identify a population at increased cardiovascular risk with specific clinical needs. Sr-CVD represent a heterogeneous group of conditions requiring a structured and multidisciplinary clinical approach. The introduction of this conceptual framework may improve the recognition, management, and prevention of substance-related cardiovascular damage.
Lucà F, Aschieri D, Battistoni I
… +15 more, Bilato C, Di Fusco SA, Geraci G, Gil Ad V, Iacovoni A, Mabritto B, Milli M, Scicchitano P, Vigorito F, Gulizia MM, Colivicchi F, Gabrielli D, Oliva F, Nardi F, Grimaldi M
G Ital Cardiol (Rome)
· 2026 May · PMID 42084298
·
Publisher ↗
Sudden cardiac death remains a major clinical and social challenge. The number of cases still remains higher in Italy, both involving patients suffering from overt heart disease and those otherwise healthy. The heterogen...Sudden cardiac death remains a major clinical and social challenge. The number of cases still remains higher in Italy, both involving patients suffering from overt heart disease and those otherwise healthy. The heterogeneous mechanisms leading to cardiac arrest call for a comprehensive preventive strategy plan that combines clinical assessment, advanced diagnostic tools, and public health initiatives. The need for counteracting a transient period of elevated risk - as in post-infarction - forces to the use of a wearable cardioverter-defibrillator as it provides temporary protection while awaiting definitive reassessment. On the contrary, when cardiac arrest affects young and apparently healthy individuals, preventive efforts necessarily extend to their families to identify inherited conditions that would otherwise remain unrecognized. In the out-of-hospital setting, survival largely depends on the actions taken within the first few minutes. Therefore accessible defibrillators, widespread community training, and the active involvement of law enforcement agencies and schools can significantly enhance the response to out-of-hospital cardiac arrest. This paper ultimately outlines a roadmap that integrates clinical risk stratification, the expansion of territorial networks, broad training initiatives, and consistent institutional coordination. The goal is to establish a coherent national framework that can reduce regional disparities, enhance the early identification of at-risk individuals, and improve survival rates after cardiac arrest.
Di Fusco SA, Aschieri D, Battistoni I
… +16 more, Bilato C, Geraci G, Gil Ad V, Iacovoni A, Lucà F, Mabritto B, Milli M, Scicchitano P, Vigorito F, Ceravolo R, Gulizia MM, Colivicchi F, Gabrielli D, Oliva F, Nardi F, Grimaldi M
G Ital Cardiol (Rome)
· 2026 May · PMID 42084297
·
Publisher ↗
Primary cardiovascular prevention was one of the main topics discussed during the 2025 ANMCO General States. The focus on this theme is due to the evidence that, although in high-income countries cardiovascular mortality...Primary cardiovascular prevention was one of the main topics discussed during the 2025 ANMCO General States. The focus on this theme is due to the evidence that, although in high-income countries cardiovascular mortality has declined over the decades, the downward trend has slowed in the last years. Cardiovascular disease remains a leading cause of death worldwide, and a substantial proportion of cardiovascular events, including deaths, occurs in individuals with no previous history of disease. In this paper, the initiatives that ANMCO implements with the Heart Care Foundation to spread the culture of primary prevention are presented: from days dedicated to cardiovascular disease screening to training campaigns in schools and information and awareness campaigns through various digital tools (web pages, social media). Another aspect that ANMCO focuses on to foster cardiovascular prevention is the implementation of the One Health approach promoted by the World Health Organization. A healthy diet like the Mediterranean diet represents not only a lifestyle that promotes cardiovascular prevention but also an approach to health that respects and protects the environment. In addition, there are the "silent killers", environmental factors such as air pollution, noise and light pollution, and chemical pollution of land and water, all emerging risk factors that should be considered as targets of a One Health approach.
Di Fusco SA, Scicchitano P, Bilato C
… +20 more, Aschieri D, Battistoni I, Dalla Valle C, Geraci G, Gil Ad V, Giubilato S, Iacovoni A, Lucà F, Mabritto BMT, Milli M, Pollarolo L, Parente A, Temporelli PL, Vigorito F, Zuin M, Gabrielli D, Colivicchi F, Oliva F, Nardi F, Grimaldi M
G Ital Cardiol (Rome)
· 2026 May · PMID 42084295
·
Publisher ↗
Preventing the development and progression of atherosclerotic cardiovascular disease is a challenge that is part of the mission of many clinicians, particularly those working in cardiology. Given the demonstrated cumulat...Preventing the development and progression of atherosclerotic cardiovascular disease is a challenge that is part of the mission of many clinicians, particularly those working in cardiology. Given the demonstrated cumulative effect of risk factors, early recognition of these factors and the implementation of both pharmacological and non-pharmacological interventions allows for more effective prevention of cardiovascular events. The purpose of this ANMCO position paper is to guide clinicians in the early identification of conditions that increase the risk of developing cardiovascular events and to provide guidance on the most appropriate interventions. The paper briefly reviews the evidence supporting the cumulative impact of traditional risk factors over time. The role of risk stratification tools such as SCORE2, SCORE2-OP, and SCORE2-Diabetes, as well as emerging biomarkers, is discussed. For risk factors such as hypertension, dyslipidemia, and diabetes, the recommended targets and current therapeutic options are illustrated. The pharmacological interventions currently available for managing obesity-associated cardiovascular risk and the indications for antiplatelet treatment in the context of primary prevention are also discussed. Overall, early diagnosis and primary prevention are the foundation of an efficient and economically sustainable healthcare system.
Bennati E, Canale ML, Pozza A
… +16 more, Oliva S, Tedeschi A, Greco A, Egidy Assenza G, Balducci A, Derchi ME, Adorisio R, Chinali M, Chessa M, Gabrielli D, Favilli S, Colivicchi F, Nardi F, Grimaldi M, Oliva F, Rinelli G
G Ital Cardiol (Rome)
· 2026 May · PMID 42051189
·
Publisher ↗
New cancer treatments led to a clear survival gain in childhood cancer patients in recent decades, but cardiovascular disease among long-term survivors represents the leading non-cancer cause of morbidity and mortality....New cancer treatments led to a clear survival gain in childhood cancer patients in recent decades, but cardiovascular disease among long-term survivors represents the leading non-cancer cause of morbidity and mortality. The population of childhood, adolescent, and young adult (CAYA) cancer survivors is growing fast and is characterized by an increased cardiovascular risk, therefore requiring long-term cardiovascular surveillance for early diagnosis and timely treatment of cardiotoxicity. To increase follow-up adherence and implement preventive strategies, it is essential to ensure the transition process from pediatric to adult care. This document is the result of the collaboration between ANMCO and SICPED to ensure long-term care for CAYA cancer survivors and to guide clinicians in the transition phase.
Santucci A, Sclafani R, Notaristefano S
… +10 more, Aimi A, Bordoni E, Del Pinto M, Broccatelli A, Castellani C, Severini D, Murrone A, Capponi E, Verdecchia P, Cavallini C
G Ital Cardiol (Rome)
· 2026 May · PMID 42051187
·
Publisher ↗
BACKGROUND: Optimization of the management of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) in terms of relationships between centers with and without cardiac catheterization facilities is still open...BACKGROUND: Optimization of the management of patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) in terms of relationships between centers with and without cardiac catheterization facilities is still open to debate. We investigated the practical application of a fast-track model for the management of patients with NSTE-ACS in the Perugia Hub Hospital Area (Italy). METHODS: The protocol involved invasive coronary angiography (ICA) at the Hub center after the patient had been transported safely by ambulance with a doctor and nurses from the Spoke center to the Hub center's catheterization laboratory, and then transferred back to the original facility at the end of the procedure in a similar manner. We defined an efficacy outcome (percentage of patients admitted to Spoke centers who, as described above, underwent ICA within 72 h after admission) and a safety outcome (major adverse events during the procedure, transport, and in the first 24 h after return to the Spoke center). RESULTS: Overall, 1048 patients with NSTE-ACS between January 2020 and June 2025 were included in the study. Of these, 91% underwent ICA within the 72 h timeframe. A total of 644 patients (61.5%) underwent immediate percutaneous coronary intervention (PCI) at the Hub center, and 91 of these were retained at the Hub center due to the complexity of their clinical condition. Four serious adverse events occurred: one cardiovascular death due to cardiogenic shock, one severe femoral hematoma, and two acute stent thromboses occurring 5 and 6 h after the procedure, respectively, which required emergency referral for primary PCI. CONCLUSIONS: The above fast-track protocol proved feasible and associated with both logistical benefits and high patient safety. Rapid access to coronary revascularization and immediate return transport to the center of origin were guaranteed in this patient population.
Bianco M, Di Nora C, Battistoni I
… +24 more, Tagliamonte G, Madrid A, Rizzo M, Scudeler L, Carigi S, De Gennaro L, Manca P, Matassini MV, Rizzello V, Tinti MD, Palmieri V, De Maria R, Corda M, Navazio A, Della Valle C, Halasz G, Temporelli PL, Iacoviello M, Colivicchi F, Grimaldi M, Oliva F, Gori M, a nome dell’Area Scompenso Cardiaco ANMCO, dell’Area Cronicità Cardiologica ANMCO e dell’Area Cardiorenale e Metabolica ANMCO
G Ital Cardiol (Rome)
· 2026 May · PMID 42051186
·
Publisher ↗
Congestion management is a key therapeutic target in heart failure, closely linked to both prognosis and quality of life. Loop diuretics play an important role in the management of decongestive therapy, but their efficac...Congestion management is a key therapeutic target in heart failure, closely linked to both prognosis and quality of life. Loop diuretics play an important role in the management of decongestive therapy, but their efficacy is often limited by diuretic resistance and empiric dosing strategies. In this context, the concept of sequential nephron blockade - combining agents acting on different tubular segments, such as thiazide diuretics - has gained relevance. More recently, sodium-glucose co-transporter 2 inhibitors have emerged as effective decongestive agents, offering modest but sustained osmotic-diuretic effects, synergistic with loop diuretics, and a favorable safety profile with low impact on electrolytes, blood pressure, or renal function. Optimal decongestion, however, requires a tailored and dynamic approach, guided by clinical and laboratory markers (e.g. early spot urinary sodium), aimed at enhancing diuretic response while minimizing risks such as worsening renal function, electrolyte disturbances, or metabolic alkalosis. Patient education and home-based monitoring - potentially supported by point-of-care technologies - are critical to improve adherence and reduce inappropriate diuretic use in the chronic management of heart failure.
Doimo S, Casula M, D'Alleva A
… +20 more, Cappannelli S, Angelini F, Dusi V, Lumera S, Pizzetti FL, Gori M, Marini M, Limonta R, Tinti D, Carigi S, Bilato C, Pignalberi C, Colivicchi F, Nardi F, Grimaldi M, Oliva F, Calvanese R, a nome dell’Area Aritmie, Area Nursing e delle Professioni Sanitarie, Area Scompenso Cardiaco dell’Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO)
G Ital Cardiol (Rome)
· 2026 May · PMID 42051185
·
Publisher ↗
The growing number of heart failure patients with cardiac implantable electronic devices (CIEDs) requires a systematic integration of telemonitoring data into a multidisciplinary care pathway. This review critically appr...The growing number of heart failure patients with cardiac implantable electronic devices (CIEDs) requires a systematic integration of telemonitoring data into a multidisciplinary care pathway. This review critically appraises the emerging evidence on the latest predictive algorithms embedded in CIEDs and delineates the pivotal roles of nurses/technicians remote-monitoring specialists and case managers as the operational interface between the patient and the clinical team. This review also proposes an organizational model that integrates the pacemaker/device clinic with the heart failure clinic, aiming to detect the subclinical phase of the disease, improve quality of life, reduce hospitalizations, and optimize healthcare system costs.
Bisceglia I, Tinti L, Pastori D
… +7 more, Canale ML, Quagliariello V, Maurea N, Oliva S, Gabrielli D, Colivicchi F, Camilli M
G Ital Cardiol (Rome)
· 2026 May · PMID 42051184
·
Publisher ↗
Cholesterol is an essential component of cellular membranes and a precursor of biologically active molecules that are fundamental in maintaining organism homeostasis. Interest on the role of cholesterol and lipid-lowerin...Cholesterol is an essential component of cellular membranes and a precursor of biologically active molecules that are fundamental in maintaining organism homeostasis. Interest on the role of cholesterol and lipid-lowering agents in cancer patients has progressively grown, following the evidence that cholesterol metabolism is altered in tumor cells. Intracellular cholesterol levels clearly influence oncogenic signaling pathways, while lipid-lowering drugs offer cardioprotective effects for individuals undergoing potentially cardiotoxic therapies. In this review, we aimed at summarizing the evidences on lipid metabolism alterations in cancer cells, the effects of various antineoplastic drugs on lipid metabolism, and the potential role of lipid-lowering therapies in patients with cancer, with a particular focus on more recently introduced agents such as PCSK9 inhibitors and bempedoic acid.