Padua at the forefront of interventional cardiology

The group led by Giuseppe Tarantini, professor of Diseases of the Cardiovascular System at the University of Padua and director of the UOSD of Interventional Cardiology at the Azienda Ospedale Università di Padova, is once again, for the second consecutive year, among the leading figures at the congress of the European Society of Cardiology, the world’s largest cardiology event. 

The new study was presented as a Late-Breaking Clinical Trial before thousands of specialists and was published in the prestigious "European Heart Journal", which confirms its position as the leading international scientific journal in the field of cardiology by impact factor. The work strengthens and broadens the results of the previous research published by the same Padua-based group in the "New England Journal of Medicine", now extending the analysis to around 4,000 patients and including, alongside Western countries, populations from East Asia. 

At the heart of the clinical investigation is an increasingly personalised approach to the treatment of heart attack. The principle is not to limit treatment to reopening the artery responsible for the acute event, but to assess the entire coronary tree and also treat the other stenoses that have real haemodynamic significance, namely those actually capable of causing ischaemia. The aim is to achieve complete yet selective revascularisation, reducing as far as possible the risk of new cardiovascular events. Once optimal ischaemic protection has been achieved, it then becomes possible to address the other major front in post-heart attack therapy: the risk of bleeding. 

Traditionally, after angioplasty and stenting, patients were treated for months with dual antiplatelet therapy. The new data indicate, however, that in appropriately selected patients and after optimal revascularisation it is possible to reduce dual antiplatelet therapy to just one month, subsequently continuing with a less intensive strategy without losing protection against ischaemic events. 

The benefit is significant: a reduction in major bleeding of around 50%. The clinical message is therefore very clear: treat all genuinely dangerous coronary lesions, reduce the risk of further ischaemia, and subsequently avoid antiplatelet therapy that is more intensive and prolonged than necessary. 

Confirmation of the results in Western and East Asian populations strengthens the scientific robustness of the study and the possibility of applying this strategy on an international scale. This further consolidates a scientific pathway that may have a direct impact on clinical practice and on future international guidelines for the treatment of heart attack. 

Giuseppe Tarantini: "The Cardiology department of the Azienda Ospedale Università di Padova once again consolidates its role of excellence in the landscape of cardiovascular research and innovation. This result testifies to the quality and robustness of the work carried out every day by the professionals of Interventional Cardiology and Haemodynamics in Padova and, above all, confirms the value of a model based on the integration of clinical activity, scientific research, education and therapeutic innovation. The ability to develop and apply ever more advanced diagnostic and therapeutic approaches, together with participation in research projects of high scientific profile, helps to strengthen the position of the Azienda Ospedale Università Padova and the University of Padua as a point of reference in the field of cardiovascular medicine at national, European and international level. A result that therefore rewards not only the excellence of the skills and specialist expertise involved, but also the ability to create synergy between care, research and innovation with the aim of translating the progress of scientific research into new treatment opportunities and a concrete benefit for patients".