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33) Lippi, G; Cervellin, G (2012) Degradation of Troponin I in Serum or Plasma: Mechanisms, and Analytical and Clinical Implications SEMINARS IN THROMBOSIS AND HEMOSTASIS 38(2):222-229 IF=4.169 [Article] A prolongedmyocardial ischemia, which results from a total deprivation of blood supply to an area of cardiacmuscle for an appreciable period of time, is the leading mechanism responsible for acute myocardial infarction (AMI). The irreversible injury of myocardiocytes and the subsequent release of a variety of intracellular components into blood is the cornerstone of the diagnosis of AMI. Cardiac troponins are advocated as the biochemical gold standards among the various biomarkers of plaque instability, plaque rupture, ischemia, reversible cellular injury, and early and late necrosis (i.e., irreversible injury). The assessment of cardiac troponins in the diagnostic approach of patients with chest pain presents, however, some specific challenges due to the complex mechanisms of release from the injured myocardium, as well as to the enzymatic degradation by cardiac and extracardiac proteases (i.e., calpains, caspases, cathepsin L, and gelatinase A) that might alter the immunoreactivity (and thus laboratory detection) of the molecules. These two aspects will be discussed in this article, with specific focus on cardiac troponin I, as a variety of immunoassays based on antibodies which recognize different epitopes on the molecule is available for the measurement of this important cardiac biomarker. 34) Lippi, G; Cervellin, G; Aloe, R; Montagnana, M; Salvagno, GL; Guidi, GC (2012) Non-commutability of results of highly sensitive troponin I and T immunoassays BIOCHEMIA MEDICA 22(1):127-129 IF=1.085 [Article] Introduction: The measurement of cardiospecific troponins is pivotal in the diagnostic and prognostic approach of patients with suspected acute myocardial infarction (AMI). However, no information is available on the commutability of results between the novel highly-sensitive (HS) troponin T (TnT) and I (TnI) immunoassays. Materials and methods: The study population consisted in 47 consecutive patients presenting at the emergency department (ED) of the Academic Hospital of Parma with suspected AMI. TnI was measured with the novel prototype Beckman Coulter HS- AccuTnI immunoassay on Access 2, whereas TnT was measured with the Roche HS-TnT immunoassay on Cobas. Results: Eight out of the 47 patients (17%) were finally diagnosed as having an AMI. The overall correlation between TnT and TnI for total patient group was acceptable (r = 0.944; P < 0.01). Nevertheless, when the analysis of data was carried out in separate groups according to the final diagnosis of AMI, two different equation results were obtained, i.e., HS-TnT = HS-AccuTnI x 0.349 + 20 (r = 0.823; P
myocardial infarction in the emergency department ANNALS OF CLINICAL BIOCHEMISTRY 49():205- 206 IF=2.209 [Letter] 36) Lippi, G; Cervellin, G; Targher, G (2012) Random plasma glucose measurement may improve the diagnostic specificity of highly sensitive troponin in the emergency department INTERNATIONAL JOURNAL OF CARDIOLOGY 155(1):172-173 IF=6.802 [Letter] 37) Lippi, G; Favaloro, EJ (2012) Coagulopathies and Thrombosis: Usual and Unusual Causes and Associations, Part VI Preface SEMINARS IN THROMBOSIS AND HEMOSTASIS 38(2):125-128 IF=4.169 [Editorial Material] 38) Lippi, G; Favaloro, EJ; Cervellin, G (2012) Hemostatic Properties of the Lymph: Relationships with Occlusion and Thrombosis SEMINARS IN THROMBOSIS AND HEMOSTASIS 38(2):213-221 IF=4.169 [Article] Lymphatic thrombosis is a rare occurrence, and although its frequency is likely underestimated, its burden remains substantially lower than that of venous or arterial thrombosis. Current evidence suggests that despite measurable levels of fibrinogen, von Willebrand factor and other coagulation factors in the lymph, fibrin generation is substantially inhibited under physiological conditions, essentially making the lymph a hypocoagulable biological fluid. Although factor VIIa-tissue factor-catalyzed activation of factor X is possible in the lymph, fibrin generation is largely counteracted by the unavailability of cell surface anionic phospholipids such as those physiologically present on blood platelets, combined with only low levels of coagulation factors, and the strong inhibitory activity of heparin, antithrombin, and tissue factor pathway inhibitor. Enhanced fibrinolytic activity further contributes to reduce the development and growth of lymph clots. Nevertheless, lymphatic thrombosis is occasionally detected, especially in the thoracic duct, axillary, or inguinal lymphatics. Pathogenetic mechanisms are supported by the release of thromboplastin substances from the injured lymphatic endothelium accompanied by chronic obstruction of lymph flow in the presence of a hypercoagulable milieu, thereby mirroring the Virchow triad that otherwise characterizes venous thrombosis. In theory, any source of lymphatic vessel occlusion, such as internal obliteration, external compression, or increased lymphatic pressure, might predispose to localized lymphatic thrombosis. The leading pathologies that can trigger thrombosis in the lymphatic vessels include cancer (due to external compression, neoplastic obliteration of the lymphatic lumen by metastatic cells, or lymphatic dysfunction after lymph node dissection), infections (especially lymphatic filariasis or sustained by Chlamydia trachomatis, Mycobacterium tuberculosis, Treponema pallidum, or Streptococcus pyogenes), congestive heart failure, chronic edema and inflammation of the distal lower limb, complications of central venous catheterization, coronary artery bypass grafting, thoracic outlet syndrome, and amyloidosis. 39) Lippi, G; Favaloro, EJ; Simundic, AM (2012) Biomedical research platforms and their influence on article submissions and journal rankings: An update. BIOCHEMIA MEDICA 22(1):7-14 IF=1.085 [Editorial Material]
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COLLEGIO DI DIREZIONE - Azienda Ospedaliera di Parma

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