Gargiulo, Giuseppe (2018) Personalized medicine in interventional cardiology: pharmacologic and mechanical strategies to balance ischemic and bleeding complications during and after percutaneous cardiovascular interventions -- Searching for and fighting with a Chimera --. [Tesi di dottorato]

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Item Type: Tesi di dottorato
Resource language: English
Title: Personalized medicine in interventional cardiology: pharmacologic and mechanical strategies to balance ischemic and bleeding complications during and after percutaneous cardiovascular interventions -- Searching for and fighting with a Chimera --
Creators:
CreatorsEmail
Gargiulo, Giuseppepeppegar83@libero.it
Date: 5 December 2018
Number of Pages: 419
Institution: Università degli Studi di Napoli Federico II
Department: Scienze Biomediche Avanzate
Dottorato: Cardiovascular Pathophysiology and Therapeutics
Ciclo di dottorato: 31
Coordinatore del Corso di dottorato:
nomeemail
Trimarco, Brunotrimarco@unina.it
Tutor:
nomeemail
Esposito, GiovanniUNSPECIFIED
Valgimigli, MarcoUNSPECIFIED
Date: 5 December 2018
Number of Pages: 419
Keywords: Percutaneous cradiovascular interventions; clinical outcomes; ischemia; bleeding; personalized medicine; risk balance;
Settori scientifico-disciplinari del MIUR: Area 06 - Scienze mediche > MED/11 - Malattie dell'apparato cardiovascolare
Date Deposited: 26 Dec 2018 17:40
Last Modified: 30 Jun 2020 08:43
URI: http://www.fedoa.unina.it/id/eprint/12474

Collection description

In the Greek mythology, the Chimera was a monstrous firebreathing hybrid creature of Lycia in Asia Minor, composed of the parts of more than one animal (usually depicted as a lion, with the head of a goat arising from its back, and a tail of snake). Homer's brief description in the Iliad is the earliest surviving literary reference. The term Chimera has come to describe any mythical or fictional animal with parts taken from various animals, or to describe anything composed of very disparate parts, or perceived as wildly imaginative, implausible, difficult to realize or utopian. Bellerophon was the hero who fought and killed the Chimera. When he arrived in Lycia, the Chimera was truly ferocious, and he could not harm the monster even while riding on Pegasus. He felt the heat of the breath the Chimera expelled, and was struck with an idea. He got a large block of lead and mounted it on his spear. Then he flew head-on towards the Chimera, holding out the spear as far as he could. Before he broke off his attack, he managed to lodge the block of lead inside the Chimera's throat. The beast's firebreath melted the lead, and blocked its air passage. The Chimera suffocated, and Bellerophon returned victorious to King Iobates. Percutaneous cardiovascular interventions are the cornerstone treatment of cardiovascular diseases. Antithrombotic therapy during and after these interventions is fundamental to prevent ischemic recurrences, but has the risk to increase bleeding complications. To find the optimal strategy to prevent ischemia without affecting bleeding in all patients is matter of ongoing discussion and research, and probably remains a chimera. Like Bellerophon searching for and fighting with the Chimera, clinicians should be aware of the trade-off of both bleeding and ischemia and their impact on patients’ health, thus searching for the optimal therapy which has not to face with a single animal (ischemia or bleeding), rather must account and balance for the effects on both these entities. In such a context, personalized medicine characterized by individualization of therapies patient-by-patient based on the individual risk/benefit profile appears to be a promising approach that clinicians might adopt to kill this nightmare.

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