Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
07 Mar 2024
Historique:
medline: 6 3 2024
pubmed: 6 3 2024
entrez: 6 3 2024
Statut: ppublish

Résumé

Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking. We conducted a prospective, multicenter, observational study involving patients who were undergoing carotid endarterectomy for asymptomatic carotid artery disease. The excised carotid plaque specimens were analyzed for the presence of MNPs with the use of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Inflammatory biomarkers were assessed with enzyme-linked immunosorbent assay and immunohistochemical assay. The primary end point was a composite of myocardial infarction, stroke, or death from any cause among patients who had evidence of MNPs in plaque as compared with patients with plaque that showed no evidence of MNPs. A total of 304 patients were enrolled in the study, and 257 completed a mean (±SD) follow-up of 33.7±6.9 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4%), with a mean level of 21.7±24.5 μg per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2±2.4 μg per milligram of plaque. Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine. Patients in whom MNPs were detected within the atheroma were at higher risk for a primary end-point event than those in whom these substances were not detected (hazard ratio, 4.53; 95% confidence interval, 2.00 to 10.27; P<0.001). In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected. (Funded by Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale and others; ClinicalTrials.gov number, NCT05900947.).

Sections du résumé

BACKGROUND BACKGROUND
Microplastics and nanoplastics (MNPs) are emerging as a potential risk factor for cardiovascular disease in preclinical studies. Direct evidence that this risk extends to humans is lacking.
METHODS METHODS
We conducted a prospective, multicenter, observational study involving patients who were undergoing carotid endarterectomy for asymptomatic carotid artery disease. The excised carotid plaque specimens were analyzed for the presence of MNPs with the use of pyrolysis-gas chromatography-mass spectrometry, stable isotope analysis, and electron microscopy. Inflammatory biomarkers were assessed with enzyme-linked immunosorbent assay and immunohistochemical assay. The primary end point was a composite of myocardial infarction, stroke, or death from any cause among patients who had evidence of MNPs in plaque as compared with patients with plaque that showed no evidence of MNPs.
RESULTS RESULTS
A total of 304 patients were enrolled in the study, and 257 completed a mean (±SD) follow-up of 33.7±6.9 months. Polyethylene was detected in carotid artery plaque of 150 patients (58.4%), with a mean level of 21.7±24.5 μg per milligram of plaque; 31 patients (12.1%) also had measurable amounts of polyvinyl chloride, with a mean level of 5.2±2.4 μg per milligram of plaque. Electron microscopy revealed visible, jagged-edged foreign particles among plaque macrophages and scattered in the external debris. Radiographic examination showed that some of these particles included chlorine. Patients in whom MNPs were detected within the atheroma were at higher risk for a primary end-point event than those in whom these substances were not detected (hazard ratio, 4.53; 95% confidence interval, 2.00 to 10.27; P<0.001).
CONCLUSIONS CONCLUSIONS
In this study, patients with carotid artery plaque in which MNPs were detected had a higher risk of a composite of myocardial infarction, stroke, or death from any cause at 34 months of follow-up than those in whom MNPs were not detected. (Funded by Programmi di Ricerca Scientifica di Rilevante Interesse Nazionale and others; ClinicalTrials.gov number, NCT05900947.).

Identifiants

DOI: 10.1056/NEJMoa2309822 PMID: 38446676
pubmed: 38446676
doi: 10.1056/NEJMoa2309822
doi:

Banques de données

ClinicalTrials.gov
['NCT05900947']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

900-910

Subventions

Organisme : CLC NIH HHS
ID : 1R35ES031702 and R01ES017290 to SR
Pays : United States

Informations de copyright

Copyright © 2024 Massachusetts Medical Society.

Auteurs

Raffaele Marfella (R)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).
ORCID: 0000-0003-3960-9270

Francesco Prattichizzo (F)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Celestino Sardu (C)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Gianluca Fulgenzi (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Laura Graciotti (L)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Tatiana Spadoni (T)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Nunzia D'Onofrio (N)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Lucia Scisciola (L)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Rosalba La Grotta (R)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Chiara Frigé (C)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Valeria Pellegrini (V)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Maurizio Municinò (M)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Mario Siniscalchi (M)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Fabio Spinetti (F)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Gennaro Vigliotti (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Carmine Vecchione (C)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Albino Carrizzo (A)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Giulio Accarino (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Antonio Squillante (A)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Giuseppe Spaziano (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Davida Mirra (D)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Renata Esposito (R)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Simona Altieri (S)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Giovanni Falco (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).
ORCID: 0009-0006-6683-881X

Angelo Fenti (A)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Simona Galoppo (S)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Silvana Canzano (S)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Ferdinando C Sasso (FC)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Giulia Matacchione (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Fabiola Olivieri (F)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Franca Ferraraccio (F)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Iacopo Panarese (I)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Pasquale Paolisso (P)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Emanuele Barbato (E)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Carmine Lubritto (C)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Maria L Balestrieri (ML)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Ciro Mauro (C)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Augusto E Caballero (AE)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Sanjay Rajagopalan (S)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Antonio Ceriello (A)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Bruno D'Agostino (B)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Pasquale Iovino (P)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

Giuseppe Paolisso (G)

From the Departments of Advanced Medical and Surgical Sciences (R.M., C.S., L.S., F.C.S., G.P.), Precision Medicine (N.D., M.L.B.), Engineering (A.F., S.G.), and Mental Health and Public Medicine, Section of Statistics (F.F., I.P.), University of Campania Luigi Vanvitelli, the Department of Forensic, Evaluative, and Necroscopic Medicine, Azienda Sanitaria Locale Napoli 2 Nord (M.M.), the Department of Cardiology, Hospital Cardarelli (M.S., C.M.), the Department of Vascular Surgery, Ospedale del Mare Azienda Sanitaria Locale Napoli 1 (F.S., G.V.), Environmental Technologies, spinoff of University of Campania Luigi Vanvitelli (S.C.), and the Department of Advanced Biomedical Sciences, University Federico II (P.P.), Naples, IRCCS MultiMedica, Milan (F.P., R.L.G., C.F., V.P., A. Ceriello), the Departments of Clinical and Molecular Sciences (G. Fulgenzi, F.O.) and Excellence SBSP-Biomedical Sciences and Public Health (L.G., T.S.), Polytechnic University of Marche, and IRCCS Istituto Nazionale Ricovero e Cura per Anziani (G.M., F.O.), Ancona, the Vascular Physiopathology Unit, IRCCS Neuromed, Pozzilli (C.V.), the Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno (C.V., A. Carrizzo, G.A., A.S.), the Department of Environmental, Biologic, and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta (G.S., D.M., R.E., S.A., G. Falco, C.L., B.D., P.I.), and the Department of Clinical and Molecular Medicine, Sapienza University of Rome (E.B.), and UniCAMILLUS, International Medical University (G.P.), Rome - all in Italy; Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (P.P.); Harvard Medical School and the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston (A.E.C.); and University Hospitals, Case Western Reserve School of Medicine, Cleveland (S.R.).

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