Stefano Migliaro

Dr. Stefano Migliaro


Research Focus & Metrics

Academic Career Length

7Years (2020-Present)

(Calculated once Scilit publication data is synced: current year − year of first publication + 1)

Representative Publications

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8 August 2020 in Current Cardiology Reports
Verified
Journal Article
Open access
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Domenico D'AmarioDomenico D'Amario
Domenico D'Amario
Massimiliano CamilliMassimiliano Camilli
Massimiliano Camilli
SMStefano Migliaro
Stefano Migliaro
Francesco CanonicoFrancesco Canonico
Francesco Canonico
MGMattia Galli
Mattia Galli
GSGianluigi Savarese
Gianluigi Savarese
Purpose of Review: The aim of this report is to describe the main aspects of sex-related differences in non-ischemic dilated cardiomyopathies (DCM), focusing on chemotherapy-induced heart failure (HF) and investigating the possible therapeutic implications and clinical management applications in the era of personalized medicine. Recent Findings: In cardio-oncology, molecular and multimodality imaging studies confirm that sex differences do exist, affecting the therapeutic cardioprotective strategies and, therefore, the long-term outcomes. Interestingly, compelling evidences suggest that sex-specific characteristics in drug toxicity might predict differences in the therapeutic response, most likely due to the tangled interplay between cancer and HF, which probably share common underlying mechanisms. Summary: Cardiovascular diseases show many sex-related differences in prevalence, etiology, phenotype expression, and outcomes. Complex molecular mechanisms underlie this diverse pathological manifestations, from sex-determined differential gene expression to sex hormone interaction with their receptors in the heart. Non-ischemic DCM is an umbrella definition that incorporates several etiologies, including chemotherapy-induced cardiomyopathies. The role of sex as a risk factor for cardiotoxicity is poorly explored. However, understanding the various features of disease manifestation and outcomes is of paramount importance for a prompt and tailored evaluation.

Verified
Journal Article
Open access
PDF file
SMStefano Migliaro
Stefano Migliaro
RCRoberto Celotto
Roberto Celotto
RTRomina Teliti
Romina Teliti
SMSimona Mariani
Simona Mariani
LALuca Altamura
Luca Altamura
FTFabrizio Tomai
Fabrizio Tomai
Background/Objectives: Multivessel coronary artery disease (CAD) remains a challenging condition requiring multidisciplinary decision-making, particularly when determining between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Recent advancements in artificial intelligence (AI), particularly generative language models like ChatGPT, present an opportunity to assist in the decision-making process. However, their ability to replicate human clinical judgment in complex scenarios, such as multivessel CAD, remains untested. Methods: The aim of this study was to evaluate the concordance between recommendations from AI (ChatGPT) and those from heart team (HT) in the management of multivessel CAD, with a focus on comparing treatment strategies such as PCI and CABG. A retrospective observational study was conducted on 137 patients with multivessel CAD, discussed at multidisciplinary HT meetings in 2024. Standardized clinical vignettes, including clinical and anatomical data, were presented to ChatGPT for treatment recommendations. The AI’s responses were compared with the HT’s decisions regarding PCI or CABG. Statistical analysis was performed to assess the level of agreement and predictive value of ChatGPT’s recommendations. Results: ChatGPT achieved an overall accuracy of 65% in its recommendations. The agreement rate was higher for CABG (82.4%) than for PCI (44.4%). Discordance was identified in 48 patients, with a notable bias towards recommending CABG. Factors such as age, diabetes, and chronic kidney disease were predictors of discordance, although no significant factors emerged for the PCI or CABG subgroups. Conclusions: AI, particularly ChatGPT, demonstrated modest concordance with HT decisions in the management of multivessel CAD, especially favoring CABG. While AI offers potential as a decision-support tool, its current limitations highlight the continued need for human clinical judgment in complex cases. Further research is required to optimize AI integration into clinical decision-making frameworks.