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Bujak K, Brugaletta S. Reply: Cardiovascular outcomes after 2-stent or stepwise provisional techniques for coronary bifurcation lesions. EUROINTERVENTION 2024; 20:e458-e459. [PMID: 38562072 PMCID: PMC10979380 DOI: 10.4244/eij-d-24-00025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 04/04/2024]
Affiliation(s)
- Kamil Bujak
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Verardi FM, Bujak K, Tolomeo P, Gómez-Lara J, Jiménez-Díaz V, Jiménez M, Jiménez-Quevedo P, Diletti R, Bordes P, Campo G, Silvestro A, Maristany J, Flores X, de Miguel-Castro A, Íñiguez A, Ielasi A, Tespili M, Lenzen M, Gonzalo N, Tebaldi M, Biscaglia S, Vidal-Cales P, Ortega-Paz L, Romaguera R, Gómez-Hospital JA, Serruys PW, Sabaté M, Brugaletta S. Ten-year prognostic impact of target versus non-target vessel failure after STEMI. Insight from the EXAMINATION-EXTEND trial. Rev Esp Cardiol (Engl Ed) 2024; 77:215-225. [PMID: 37506972 DOI: 10.1016/j.rec.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION AND OBJECTIVES After ST-segment myocardial infarction (STEMI), the impact of different adverse events on prognosis remains unknown. We aimed to assess very long-term predictors of patient-oriented composite endpoints (POCE) and investigate whether the occurrence of target vessel failure (TVF) vs a non-TVF event as the first event could potentially influence subsequent outcomes. METHODS The EXAMINATION-EXTEND trial randomized STEMI patients to receive either an everolimus-eluting stent or a bare-metal stent. The follow-up period was 10 years. Predictors of POCE (a composite of all-cause death, any myocardial infarction, or any revascularization) were evaluated in the overall study population. The patients were stratified based on the type of first event (TVF-first vs non-TVF-first) and were compared in terms of subsequent POCE. TVF was defined as a composite of cardiac death, TV myocardial infarction, or TV revascularization. RESULTS Out of the 1498 enrolled patients, 529 (35.3%) experienced a POCE during the 10-year follow-up. Independent predictors of POCE were age, diabetes mellitus, previous myocardial infarction, peripheral arterial disease, and multivessel coronary disease. The first event was a TVF in 296 patients and was a non-TVF in 233 patients. No significant differences were observed between TVF-first and non-TVF-first patients in terms of subsequent POCE (21.7% vs 39.3%, time ratio 1.79; 95%CI, 0.87-3.67;P=.12) or its individual components. CONCLUSIONS At the 10-year follow-up, approximately one-third of STEMI patients had experienced at least 1 POCE. Independent predictors of these events were age, diabetes, and more extensive atherosclerotic disease. The occurrence of a TVF or a non-TVF as the first event did not seem to influence subsequent outcomes. TRIAL REGISTRATION NUMBER NCT04462315.
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Affiliation(s)
- Filippo Maria Verardi
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain; Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Kamil Bujak
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain; 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Paolo Tolomeo
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Josep Gómez-Lara
- Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Jiménez-Díaz
- Departamento de Cardiología, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain; Investigación Cardiovascular, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), Servizo Galego de Saúde-Universidade de Vigo (SERGAS-UVIGO), Vigo, Pontevedra, Spain
| | - Marcelo Jiménez
- Departamento de Cardiología, Hospital Universitari Sant Pau, Barcelona, Spain
| | - Pilar Jiménez-Quevedo
- Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, Spain
| | | | - Pascual Bordes
- Departamento de Cardiología, Hospital General de Alicante, Alicante, Spain
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Antonio Silvestro
- Cardiology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Jaume Maristany
- Departamento de Cardiología, Hospital Son Dureta, Palma de Mallorca, Spain
| | - Xacobe Flores
- Departamento de Cardiología, Hospital Universitario de A Coruña, A Coruña, Spain
| | | | - Andrés Íñiguez
- Departamento de Cardiología, Hospital Alvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Alfonso Ielasi
- Cardiology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | - Maurizio Tespili
- Cardiology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Galeazzi Sant'Ambrogio, Milan, Italy
| | | | - Nieves Gonzalo
- Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense, Madrid, Spain
| | - Matteo Tebaldi
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Simone Biscaglia
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Pablo Vidal-Cales
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain
| | - Luis Ortega-Paz
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain; Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, United States
| | - Rafael Romaguera
- Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Antoni Gómez-Hospital
- Institut d'Investigació Biomèdica de Bellvitge, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway, Ireland
| | - Manel Sabaté
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain
| | - Salvatore Brugaletta
- Institut Clínic Cardiovascular, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Hospital Clínic, Barcelona, Spain.
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Januszek R, Bujak K, Kasprzycki K, Gąsior M, Bartuś S. Prognosis of patients with renal failure one year following non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. Hellenic J Cardiol 2024; 76:48-57. [PMID: 37499942 DOI: 10.1016/j.hjc.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/17/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE Kidney failure is highly prevalent in patients with non-ST-elevation myocardial infarction (NSTEMI). The aim of the study was to evaluate the prognostic significance of baseline renal function regarding in-hospital and 1-year mortality among patients with NSTEMI and treated with percutaneous coronary intervention (PCI). METHODS Data were obtained from the Polish Registry of Acute Coronary Syndromes (PL-ACS) and included 47,052 NSTEMI patients treated with PCI between 2017 and 2021. The cumulative incidence of all-cause mortality during the 1-year follow-up was presented using the Kaplan-Meier curves. The multivariable Cox regression model was created to adjust the relationship between eGFR (as a spline term) and all-cause mortality for potential confounders. RESULTS After considering the exclusion criteria, 20,834 cases were evaluated, with a median eGFR of 72.7 (IQR 56.6-87.5) mL/min/1.73 m2. The median age was 69 (62-76) years. The study comprised 4,505 patients with normal (90-120), 10,189 with mild (60-89), 5,539 with moderate (30-59), and 601 with severe eGFR impairment (15-29). Lower eGFR was associated with worse baseline clinical profile and longer in-hospital delay to coronary angiography. There was a stepwise increase in the crude all-cause death rates across the groups at 1 year. The Cox regression model with a spline term revealed that the relationship between eGFR and the risk of death at 1 year was non-linear (reverse J-shaped), and the risk was the lowest in patients with eGFR∼90 mL/min/1.73 m2. CONCLUSIONS There is a J-curve relationship between the eGFR value and 1-year all-cause mortality in patients with NSTEMI and treated with PCI.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Jakubowskiego 2, 30-688 Kraków, Poland.
| | - Kamil Bujak
- Silesian Centre for Heart Diseases in Zabrze, ul. Marii Curie Skłodowskiej 9, 41-800 Zabrze, Poland; 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. Marii Curie Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Karol Kasprzycki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Mariusz Gąsior
- Silesian Centre for Heart Diseases in Zabrze, ul. Marii Curie Skłodowskiej 9, 41-800 Zabrze, Poland; 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. Marii Curie Skłodowskiej 9, 41-800 Zabrze, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, ul. Jakubowskiego 2, 30-688 Kraków, Poland; Jagiellonian University Medical College, ul. św. Anny 12, 31-008 Kraków, Poland
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Brust K, Śmiech K, Bujak K, Roleder T, Gąsior M. The characteristic of acute coronary syndromes of patients with multivessel coronary artery disease in centers with and without cardiac surgery on-site. Cardiol J 2024:VM/OJS/J/95152. [PMID: 38247436 DOI: 10.5603/cj.95152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/19/2023] [Accepted: 12/23/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Multivessel disease (MVD) is diagnosed in a fair number of patients with acute coronary syndrome (ACS). There are 36 cardiac-surgery (CS) centres and 157 catheterization laboratories dedicated to treat ACS in Poland. The aim of the study was to analyze MVD patient outcomes presented with ACS in centers with or without CS on-site. METHODS The present study is a retrospective analysis (2017-2020) of MVD ACS patients (n = 4618) outcomes between those treated in centers with CS on site (n = 595) and those without CS (n = 4023). RESULTS Patients in CS centers had a higher prevalence of renal failure (13.3% vs. 8.8%, p ≤ 0.001) and a more frequent history of coronary angioplasty - percutaneous coronary intervention (18.9% vs. 14.4%, p = 0.005). During the coronary angiography a femoral artery access was more often used in CS center patients (47.1% vs. 15.2%, p < 0.001). Percutaneous coronary intervention of MVD was more often performed in CS centers (74.6% vs. 71.0%, p = 0.054). In-hospital death (7.6% vs. 4.6%, p = 0.002), reinfarction (1.1% vs. 0.1%, p < 0.001), hemorrhagic complications (6.4% vs. 1.6%, p < 0.001), recurrent target vessel revascularization (1.8% vs. 0.4%, p ≤ 0.001) and pulmonary edema (3.7% vs. 1.5%, p < 0.001) occurred more often in CS centers. CONCLUSIONS The safety of ACS treatment in MVD patients in centers without CS on site is non-inferior to their treatment in centers with CS on site. Interestingly, there were more in-hospital adverse events observed in ACS MVD patients treated in centers with CS.
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Affiliation(s)
| | | | - Kamil Bujak
- Silesian Center for Heart Diseases, Zabrze, Poland
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Tajstra M, Bryniarski L, Bujak K, Wilczek K, Gil R, Dobrzycki S, Wojakowski W, Legutko J, Gierlotka M, Gąsior M. Impact of chronic total occlusion on prognosis in cardiogenic shock due to unprotected left main coronary artery culprit lesion. Insights from the Polish Registry of Acute Coronary Syndromes. Kardiol Pol 2024; 82:166-174. [PMID: 38493472 DOI: 10.33963/v.phj.98889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Notwithstanding readily available revascularization, significant advancements in mechanical circulatory support, and pharmacological progress, cardiogenic shock (CS) secondary to unprotected left main culprit lesion-related acute myocardial infarction (ULMCL-related AMI) is associated with very high mortality. In this population, chronic total occlusion (CTO) is relatively frequent. AIMS This study sought to assess the association between the presence of CTO and 12-month mortality in patients with CS due to ULMCL-related AMI. RESULTS The study included consecutive patients admitted for AMI-related CS with ULMCL who underwent percutaneous coronary intervention (PCI) and were enrolled in the prospective Polish Registry of Acute Coronary Syndromes (PL-ACS) between January 2017 and December 2021. The patients were stratified into two groups based on the presence of at least one CTO. The primary endpoint was all-cause death at 12 months. Of the 250 included patients, 60 (24%) patients had one or more CTOs of a major coronary artery (+CTO), and in 190 (76%) patients, the presence of CTO was not observed (-CTO). The 12-month mortality rates for the +CTO and -CTO patients were 85% and 69.8%, respectively (P log-rank = 0.03). After multivariable adjustment for differences in the baseline characteristics, the presence of CTO remained significantly associated with higher 12-month mortality (hazard ratio, 1.423; 95% CI, 1.027-1.973; P = 0.034). CONCLUSIONS Our analysis showed that in patients with CS due to ULMCL-related AMI treated with PCI, the presence of CTO is associated with worse 12-month prognosis.
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Affiliation(s)
- Mateusz Tajstra
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland.
| | - Leszek Bryniarski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Krzysztof Wilczek
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Robert Gil
- State Medical Institute of the Ministry of Interior and Administration, Warszawa, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Zabrze, Poland
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Bujak K, Rinaldi R, Vidal-Cales P, Montone RA, Diletti R, Gąsior M, Crea F, Sabaté M, Brugaletta S. Immediate versus staged complete revascularization in acute coronary syndrome: A meta-analysis of randomized controlled trials. Int J Cardiol 2023; 393:131397. [PMID: 37769973 DOI: 10.1016/j.ijcard.2023.131397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/11/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Clinical guidelines recommend a complete revascularization (CR) in patients with acute coronary syndromes (ACS) and multivessel disease (MVD). However, its optimal timing is unclear. The aim of this meta-analysis was to compare the clinical outcomes following immediate versus staged CR in ACS. METHODS PubMed and Scopus were searched until March 2023 for randomized controlled trials (RCTs) comparing immediate versus staged CR. The primary endpoint was major adverse cardiovascular event (MACE) at the longest follow-up. Secondary outcomes were all-cause death, cardiovascular death, myocardial infarction (MI), any unplanned revascularization, target-vessel revascularization (TVR), and stent thrombosis. Safety outcomes were major bleeding, contrast volume, procedure duration, and length of hospitalization. RESULTS Eight RCTs were included (3559 patients, weighted mean follow-up 12.5 months). There were no differences in the primary endpoint (OR 0.74, 95%CI: 0.54-1.01) and in the secondary endpoints of death, and stent thrombosis between the two CR strategies. Immediate CR was associated with a lower risk of recurrent MI (OR 0.51, 95% CI 0.34-0.76), any unplanned revascularization (OR 0.59, 95%CI: 0.43-0.80), and TVR (OR 0.61, 95% CI 0.45-0.84) compared to staged CR. Immediate CR was also associated with lower total contrast volume and shorter total procedure duration and hospitalization length compared to staged CR without differences in major bleedings. CONCLUSION No difference was found between immediate and staged CR regarding MACE, or deaths rates at one year. Immediate CR may be associated with a lower risk of recurrent MI and unplanned coronary revascularization than staged CR.
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Affiliation(s)
- Kamil Bujak
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Riccardo Rinaldi
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Pablo Vidal-Cales
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Rocco Antonio Montone
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Roberto Diletti
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Filippo Crea
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Manel Sabaté
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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Bujak K, Verardi FM, Arevalos V, Gabani R, Spione F, Rajwa P, Milasinovic D, Stankovic G, Gasior M, Sabaté M, Brugaletta S. Clinical outcomes following different stenting techniques for coronary bifurcation lesions: a systematic review and network meta-analysis of randomised controlled trials. EUROINTERVENTION 2023; 19:664-675. [PMID: 37533321 PMCID: PMC10587845 DOI: 10.4244/eij-d-23-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/30/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Controversy still exists regarding the optimal treatment of coronary bifurcation lesions. AIMS We aimed to analyse the evidence from randomised controlled trials (RCTs) to compare outcomes following different bifurcation stenting techniques. METHODS We systematically searched for RCTs comparing different techniques published up to July 2022. We then conducted a pairwise meta-analysis to compare outcomes between provisional stenting (PS) versus upfront 2-stent techniques. Moreover, we performed a network meta-analysis (NMA) to compare all strategies with each other. The primary endpoint was major adverse cardiac events (MACE). RESULTS Twenty-four RCTs (6,890 patients) analysed PS, T-stenting, double-kissing (DK)-crush, crush, or culotte stenting. The pairwise meta-analysis did not reveal a significant difference between the PS and 2-stent techniques. However, the prespecified sensitivity analysis, which included RCTs exclusively enrolling patients with true bifurcation lesions, showed a lower rate of MACE following 2-stent techniques, and meta-regression indicated that a longer side branch lesion was associated with a greater benefit from the 2-stent strategy, which was the most apparent in RCTs with a mean lesion length >11 mm. NMA revealed that DK-crush was associated with the lowest MACE rate (odds ratio 0.47, 95% confidence interval: 0.36-0.62; p<0.01; PS as a reference). CONCLUSIONS Overall, 2-stent techniques were not significantly better than PS in terms of clinical outcomes. However, the results of the sensitivity analysis suggested that there might be a benefit of a 2-stent approach in selected patients with true bifurcation lesions, especially in the case of long side branch lesions. An NMA revealed that DK-crush was associated with the lowest event rates when compared with other techniques.
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Affiliation(s)
- Kamil Bujak
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Filippo Maria Verardi
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | - Victor Arevalos
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rami Gabani
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Francesco Spione
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Stankovic
- Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mariusz Gasior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Manel Sabaté
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
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Bujak K, Vidal-Cales P, Gabani R, Rinaldi R, Gomez-Lara J, Ortega-Paz L, Jimenez-Diaz V, Jimenez-Kockar M, Jimenez-Quevedo P, Diletti R, Campo G, Silvestro A, Maristany J, Flores X, Oyarzabal L, De Miguel-Castro A, Iñiguez A, Nombela-Franco L, Ielasi A, Tespili M, Lenzen M, Biscaglia S, Al-Shaibani S, Romaguera R, Gomez-Hospital JA, Gasior M, Serruys PW, Sabate M, Brugaletta S. Relationship between stent length and very long-term target lesion failure following percutaneous coronary intervention for ST-elevation myocardial infarction in the drug-eluting stents era: insights from the EXAMINATION-EXTEND study. Am Heart J 2023; 264:72-82. [PMID: 37279839 DOI: 10.1016/j.ahj.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/07/2023] [Accepted: 05/28/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little data exist on the relationship between total stent length (TSL) and cardiovascular outcomes at very-long follow-up in patients with ST-elevation myocardial infarction (STEMI) in the 2nd generation drug-eluting stents (DES) era. AIM To analyze the relationship between TSL and 10-year target-lesion failure (TLF) in STEMI patients treated with percutaneous coronary intervention enrolled in the EXAMINATION-EXTEND. METHODS The EXAMINATION-EXTEND was an extended-follow-up study of the EXAMINATION trial, which randomized 1:1 STEMI patients to receive DES or bare metal stent (BMS). The primary endpoint was TLF, defined as a composite of target lesion revascularization (TLR), target vessel myocardial infarction (TVMI), or definite/probable stent thrombosis (ST). Relationship between stent length and TLF was evaluated in the whole study group in a multiple-adjusted Cox regression model with TSL as a quantitative variable. Subgroup analysis was also performed according to stent type, diameter, and overlap. RESULTS A total of 1,489 patients with a median TSL of 23 mm (Q1-Q318-35 mm) were included. TSL was associated with TLF at 10 years (adjusted HR per 5 mm increase of 1.07; 95% CI, 1.01-1.14; P = .02). This effect was mainly driven by TLR and was consistent regardless of stent type, diameter, or overlap. There was no significant relationship between TSL and TV-MI or ST. CONCLUSIONS In STEMI patients, there is a direct relationship between TSL implanted in the culprit vessel and the risk of TLF at 10 years, mainly driven by TLR. The use of DES did not modify this association.
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Affiliation(s)
- Kamil Bujak
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Pablo Vidal-Cales
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rami Gabani
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Riccardo Rinaldi
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| | - Josep Gomez-Lara
- Hospital Universitari de Bellvitge, Institut d´Investigació Biomedica de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Luis Ortega-Paz
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL
| | | | | | | | - Roberto Diletti
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Gianluca Campo
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | | | | | | | - Loreto Oyarzabal
- Hospital Universitari de Bellvitge, Institut d´Investigació Biomedica de Bellvitge, L'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | - Mattie Lenzen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Simone Biscaglia
- Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona, Italy
| | | | - Rafael Romaguera
- Hospital Universitari de Bellvitge, Institut d´Investigació Biomedica de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Joan Antoni Gomez-Hospital
- Hospital Universitari de Bellvitge, Institut d´Investigació Biomedica de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Mariusz Gasior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Patrick W Serruys
- International Center of Circulatory Health, Imperial College London, London, United Kingdom; Department of Cardiology, National University of Ireland, Galway, Galway, Ireland
| | - Manel Sabate
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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Piegza M, Dębski P, Bujak K, Jaworska I, Gorczyca P, Pudlo R, Żerdziński M, Piegza J. Cognitive functions and sense of coherence in patients with carotid artery stenosis-Preliminary report. Front Psychiatry 2023; 14:1237130. [PMID: 37817831 PMCID: PMC10560880 DOI: 10.3389/fpsyt.2023.1237130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/11/2023] [Indexed: 10/12/2023] Open
Abstract
Background There is scarcely any data in the available literature on the relationship between sense of coherence (SOC) and cognitive functioning, and no information on the relationship between SOC and cognitive parameters in patients with carotid atherosclerosis. Aim The aim of this paper was to determine the relationship of SOC measured prior to carotid artery stenting (CAS) with neurocognitive functioning in patients with carotid atherosclerosis 12 months after CAS. Methods A total of 35 patients with carotid atherosclerosis completed the SOC-29 Orientation to Life Questionnaire (SOC-29) and completed a cognitive test battery twice, i.e., before (baseline-T1) and 12 months after stent implantation (follow-up-T2). Selected cognitive functions such as memory, attention, perception, visuospatial and executive functions and non-verbal fluency were assessed. Results One year after the procedure, patients with a higher SOC and sense of manageability present better performance in visual memory. Higher SOC and sense of meaningfulness are positively related to the speed of understanding the changing rules of card sorting (WCST). Conclusion Higher overall SOC and a component of sense of meaningfulness and manageability may be related to better cognitive functioning 1 year after the procedure.
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Affiliation(s)
- Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Paweł Dębski
- Institute of Psychology, Faculty of Social Sciences and Humanities, Humanitas University in Sosnowiec, Sosnowiec, Poland
| | - Kamil Bujak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Robert Pudlo
- Department of Psychoprophylaxis, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Gory, Poland
| | - Maciej Żerdziński
- Faculty of Medicine, Academy of Silesia, Katowice, Poland
- Department of Psychiatry, Dr. Krzysztof Czuma’s Psychiatric Center, Katowice, Poland
| | - Jacek Piegza
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, Zabrze, Poland
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Pyka Ł, Hudzik B, Bujak K, Gąsior M. Reviving a failing heart in real life: Are the results of the REVIVED trial applicable to an all-comer population? Kardiol Pol 2023; 81:1006-1008. [PMID: 37401579 DOI: 10.33963/kp.a2023.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Łukasz Pyka
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Bartosz Hudzik
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Bujak K, Gąsior M, Tajstra M, Pres D, Gierlotka M, Wilczek K, Feusette P, Liszka R, Cieśla D, Trzeciak P, Lesiak M, Witkowski A, Legutko J, Wojakowski W, Dudek D, Budaj A. Stepwise relationship between delay in percutaneous coronary intervention and long-term mortality in patients with non-ST-segment elevation myocardial infarction. Kardiol Pol 2023; 81:746-753. [PMID: 37270830 DOI: 10.33963/kp.a2023.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Current guidelines recommend coronary catheterization in patients with non-ST- -segment elevation myocardial infarction (NSTEMI) within 24 hours of hospital admission. However, whether there is a stepwise relationship between the time to percutaneous coronary intervention (PCI) and long-term mortality in patients with NSTEMI treated invasively within 24 hours of admission has not been established yet. AIMS The study aimed to evaluate the association between door-to-PCI time and all-cause mortality at 12 and 36 months in NSTEMI patients presenting directly to a PCI-capable center who underwent PCI within the first 24 hours of hospitalization. METHODS We analyzed data of patients hospitalized for NSTEMI between 2007-2019, included in the nationwide registry of acute coronary syndromes. Patients were stratified into twelve groups based on 2-hour intervals of door-to-PCI time. The mortality rates of patients within those groups were adjusted for 33 confounding variables by the propensity score weighting method using overlap weights. RESULTS A total of 37 589 patients were included in the study. The median age of included patients was 66.7 (interquartile range [IQR], 59.0-75.8) years; 66.7% were male, and the median GRACE (Global Registry of Acute Coronary Events) score was 115 (98-133). There were increased 12-month and 36-month mortality rates in consecutive groups of patients stratified by 2-hour door-to-PCI time intervals. After adjustment for patient characteristics, there was a significant positive correlation between the time to PCI and the mortality rates (rs = 0.61; P = 0.04 and rs = 0.65; P = 0.02 for 12-month and 36-month mortality, respectively). CONCLUSIONS The longer the door-to-PCI time, the higher were 12-month and 36-month all-cause mortality rates in NSTEMI patients.
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Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Damian Pres
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Krzysztof Wilczek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Feusette
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Radosław Liszka
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Daniel Cieśla
- Department of Science and New Technologies, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Budaj
- Department of Cardiology, Centre of Postgraduate Medical Education, Grochowski Hospital, Warszawa, Poland
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12
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Bujak K, Hudzik B, Pyka Ł, Skrzypek M, Brugaletta S, Sabaté M, Tajstra M, Legutko J, Wojakowski W, Gąsior M. Outcomes of coronary revascularization vs. optimal medical therapy alone for ischemic left ventricular dysfunction: A meta-analysis of randomized controlled trials. Kardiol Pol 2023; 81:909-912. [PMID: 37270833 DOI: 10.33963/kp.a2023.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 06/06/2023]
Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
| | - Bartosz Hudzik
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Łukasz Pyka
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Michał Skrzypek
- Department of Biostatistics, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Salvatore Brugaletta
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Manel Sabaté
- Hospital Clínic, Cardiovascular Clinic Institute, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jacek Legutko
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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13
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Bil J, Kern A, Bujak K, Gierlotka M, Legutko J, Gąsior M, Wańha W, Gromadziński L, Gil RJ. Clinical characteristics and 12-month outcomes of patients with myocardial infarction with nonobstructive coronary arteries before and during the COVID-19 pandemic. Pol Arch Intern Med 2023; 133:16405. [PMID: 36602860 DOI: 10.20452/pamw.16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION SARS‑CoV‑2 infection is associated with an increased risk of thromboembolic complications. Thromboembolism is one of the possible causes of myocardial infarction with nonobstructive coronary arteries (MINOCA). OBJECTIVES We aimed to compare the characteristics and 12‑month clinical outcomes of patients with MINOCA treated before and during the COVID‑19 pandemic. PATIENTS AND METHODS We retrospectively analyzed data of 51 734 patients with acute myocardial infarction registered in the nationwide Polish Registry of Acute Coronary Syndromes database in 2019 and 2020. The final study group included 3178 patients with MINOCA. We compared the baseline characteristics, management strategies, and 12‑month clinical outcomes of the MINOCA patients treated before (2019) and during the COVID‑19 pandemic (2020). RESULTS The rate of MINOCA was higher in 2019 than in 2020 (6.3% vs 5.9%; P = 0.03). The only difference between the groups was a higher hypercholesterolemia rate before the pandemic (33.9% vs 28.2%; P <0.001). In‑hospital stroke was observed more frequently during the pandemic (0% vs 0.3%; P = 0.01), whereas other in‑hospital complications were similar between the groups. Most patients were discharged on aspirin (85.6%), a β‑blocker (73.1%), an angiotensin‑converting enzyme inhibitor / angiotensin receptor blocker (70.2%), and a statin (62.7%), but only 50.6% of the participants received a P2Y12 inhibitor. There was no difference in 12‑month all‑cause mortality between the patients with MINOCA treated before and during the pandemic (9.2% vs 11%; P = 0.09). CONCLUSIONS We observed a lower percentage of MINOCA cases and higher in‑hospital stroke rates in the MINOCA patients treated during the COVID‑19 pandemic (2020). The possible association between worse clinical outcomes of the MINOCA patients treated during the pandemic and the increased risk for thromboembolic complications of SARS‑CoV‑2 infection needs further evaluation.
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Affiliation(s)
- Jacek Bil
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, Warsaw, Poland.
| | - Adam Kern
- Department of Cardiology and Internal Medicine, University of Warmia and Mazury, Olsztyn, Poland
- Department of Cardiology, Regional Specialist Hospital, Olsztyn, Poland
| | - Kamil Bujak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Robert J Gil
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, Warsaw, Poland
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14
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Nowowiejska-Wiewióra A, Wita K, Mędrala Z, Tomkiewicz-Pająk L, Bujak K, Mizia-Stec K, Brzychczy P, Gąsior M, Gąsior Z, Kulbat A, Kalarus Z, Wojakowski W, Trzeciak P, Witkowski A, Banach M, Legutko J. Dyslipidemia treatment and attainment of LDL-cholesterol treatment goals in patients participating in the Managed Care for Acute Myocardial Infarction Survivors program. Kardiol Pol 2023; 81:359-365. [PMID: 36871294 DOI: 10.33963/kp.a2023.0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 03/07/2023]
Abstract
BACKGROUND Patients after acute myocardial infarction (AMI) are at very high cardiovascular (CV) risk. Therefore, appropriate management of dyslipidemia with adequate lipid-lowering therapy is crucial for preventing subsequent CV events in these patients. AIMS Our analysis aimed to assess the treatment of dyslipidemia and the attainment of low-density lipoprotein (LDL) -cholesterol treatment goals in patients after AMI who participated in the Managed Care for Acute Myocardial Infarction Survivors (MACAMIS) program. METHODS This study is a retrospective analysis of consecutive patients with AMI who agreed to participate and completed the 12-month MACAMIS program at one of three tertiary referral cardiovascular centers in Poland between October 2017 and January 2021. RESULTS 1499 patients after AMI were enrolled in the study. High-intensity statin therapy was prescribed to 85.5% of analyzed patients at hospital discharge. Combined therapy with high-intensity statin and ezetimibe increased from 2.1% at hospital discharge to 18.2% after 12 months. In the whole study cohort, 20.4% of patients achieved the LDL-C target of CONCLUSIONS: Our analysis suggests that participation in the managed care program might be associated with improved quality of dyslipidemia management in AMI patients. Nonetheless, only one-fifth of patients who completed the program achieved the treatment goal for LDL-C. This highlights the constant need for optimizing lipid-lowering therapy to meet treatment targets and to reduce CV risk in patients after AMI.
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Affiliation(s)
- Alicja Nowowiejska-Wiewióra
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Krystian Wita
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia Katowice, Poland
| | - Zofia Mędrala
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Lidia Tomkiewicz-Pająk
- Jagiellonian University Medical College, Institute of Cardiology, Department of Interventional Cardiology, Kraków, Poland.,Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Mizia-Stec
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia Katowice, Poland
| | - Piotr Brzychczy
- Studenet Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Gąsior
- 2nd Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia Katowice, Poland
| | - Aleksandra Kulbat
- Studenet Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College
| | - Zbigniew Kalarus
- Division of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland, Department of Cardiology Silesian Center for Heart Diseases
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, Łódź, Poland
| | - Jacek Legutko
- Jagiellonian University Medical College, Institute of Cardiology, Department of Interventional Cardiology, Kraków, Poland.,Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
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15
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Kaziród-Wolski K, Sielski J, Gąsior M, Bujak K, Hawranek M, Pyka Ł, Gierlotka M, Pawłowski T, Siudak Z. Factors affecting short- and long-term survival of patients with acute coronary syndrome treated invasively using intravascular ultrasound and fractional flow reserve: Analysis of data from the Polish Registry of Acute Coronary Syndromes 2017-2020. Kardiol Pol 2023; 81:265-272. [PMID: 36404732 DOI: 10.33963/kp.a2022.0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 03/30/2023]
Abstract
BACKGROUND Intravascular ultrasound (IVUS) and fractional flow reserve (FFR) are invasive procedures increasingly used in treating acute coronary syndrome (ACS). AIMS This study aimed to evaluate the frequency of IVUS and FFR use in patients with ACS in Poland and to assess the safety of these procedures as well as their impact on short- and long-term survival. METHODS AND RESULTS This retrospective study included 103849 patients enrolled in the Polish Registry of Acute Coronary Syndromes in 2017-2020. IVUS was performed in 1727 patients, FFR in 1537 patients, and both procedures in 37 patients. The frequency of performing FFR in ACS patients increased over the years from 1.3% to 1.8% (P <0.0001) and IVUS from 1.7% to 2.3% (P <0.0001). In the FFR and/or IVUS group, a similar incidence of stroke, reinfarction, target vessel revascularization, and major bleeding was observed while in-hospital mortality was lower (0% for IVUS + FFR vs. 0.9% for FFR vs. 2.3% for IVUS vs. 3.7 for no procedure; P <0.0001). FFR and IVUS did not affect the 30-day and one-year prognosis. CONCLUSION In recent years, the number of FFR and IVUS procedures performed in patients with ACS in Poland has increased. There was lower in-hospital mortality in the FFR and/or IVUS group in ACS patients, and no differences in the incidence of stroke, reinfarction, target vessel revascularization, and major bleeding were observed. Performing FFR and IVUS in ACS patients does not significantly affect 30-day or one-year mortality.
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Affiliation(s)
| | - Janusz Sielski
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Łukasz Pyka
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | | | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
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Verardi FM, Bujak K, Sabaté M, Brugaletta S. 29 PROGNOSTIC IMPACT OF TARGET VESSEL FAILURE AS FIRST EVENT AFTER ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: INSIGHT FORM 10-YEAR FOLLOW-UP OF THE EXAMINATION EXTEND TRIAL. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartjsupp/suac121.557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Outcome after primary PCI for ST-segment elevation myocardial infarction may be very different. Either it may be free of events during years or it may be characterized by many recurrent events. It is unknown whether to have a target vessel failure (TVF) as first event may impact subsequent outcomes during follow-up. We aim to evaluate very long-term outcomes of STEMI patients according to the occurrence of TVF as the first event during follow-up.
Methods
EXAMINATION-EXTEND trial randomized STEMI patients to everolimus-eluting stent or bare-metal stent with 10-year follow-up. All the patients were stratified according to their first event (TVF-First vs. NonTVF-First). TVF was defined as the composite of TV cardiac death, TV myocardial infarction, or TV revascularization. The primary endpoint of this study was 10-year POCE, defined as the composite of all-cause death, any myocardial infarction, or any revascularization.
Results
Out of the 1498 enrolled patients, 161 (10.7%) had a TVF as first clinical event during follow-up. TVF-First patients had higher rates of previous MI or PCI, with less use of manual thrombectomy, and received more BMS with a longer total stent length. On multivariate analysis, manual thrombectomy and bare-metal stent implantation were independent predictors of TVF as first event. Ten-year adjusted POCE was statistically higher in TVF-First patients compared to the NonTVF-First group (31.1% vs 27.5%, adjHR: 1.82; 95%CI: 1.34 - 2.48; p < 0.001).
Conclusions
In our STEMI population TVF occurred in 10.7% as the first event during follow-up. At 10-year follow-up, patients who experienced a TVF as first event exhibited a high risk for subsequent POCE events as compared to patients who did not.
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Affiliation(s)
- Filippo Maria Verardi
- Hospital Clinic, Cardiovascular Clinic Institute , Barcelona , Spain
- Cardiology Unit, Azienda Ospedaliera Universitaria Di Ferrara , Cona , Italy
| | - Kamil Bujak
- Hospital Clinic, Cardiovascular Clinic Institute , Barcelona , Spain
- 3rd Department Of Cardiology, Faculty Of Medical Sciences In Zabrze, Medical University Of Silesia , Katowice , Poland
| | - Manel Sabaté
- Hospital Clinic, Cardiovascular Clinic Institute , Barcelona , Spain
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Brust K, Smiech K, Bujak K, Roleder T, Gasior M. The characteristic of acute coronary syndromes of patients with multivessel coronary artery disease in centers with and without cardiac surgery on-site – data from PL-ACS registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Every year more than 100,000 acute coronary syndromes are diagnosed in Poland. There are 36 cardio-surgical centers and more than 157 catheterization laboratories available in Poland dedicated to treat acute coronary syndromes. MVD patients have a considerable clinically relevant burden of adverse cardiovascular events following ACS.
Purpose
The aim of the study was to analyze the outcomes of acute coronary syndrome (ACS) treatment in Polish patients with the multivessel coronary disease (MVD) in the centers with and without cardiac surgery (CS) on site.
Methods
This was a retrospective analysis (1st January, 2017 to 31st December, 2020) of ACS patients outcomes using data from PL-ACS registry. PL-ACS registry is a polish archive of the ACS patients, which data are obtained from all cardiology and cardiac surgery departments in Poland. The registry is supervised by the Polish Ministry of Health. The following analysis considered only patients with MVD. MVD was defined as the presence of ≥70% diameter stenosis of three or more epicardial coronary arteries. For the purpose of this analysis the MVD patients (n=4618) were divided to two groups: those treated in the centers with the cardiac surgery department on site (CS group, n=595) and those without (non-CS group, n=4023).
Results
Patients in the CS group were elder (70.8 vs. 69.0, p=0.008) as compared to the non-CS group. There were no differences in sex (male 68.6% vs. 67.2%, p=0.49) and BMI (27.5% vs. 27.7%, p=0.12) were between both groups. There was no statistically significant difference between the types of acute coronary syndrome, between CS and non-CS group – [STEMI (34.6% vs 31.1%), NSTEMI (53.6% vs 55.3%), UA (11.8% vs 13.6%), p=0.16]. Patients in the CS group had higher prevalence of renal failure (13.3% vs. 8.8%, p≤0.001) and a more frequent had a history of a past coronary angioplasty (18.9% vs. 14.4%, p=0.005). During the coronary angiography a femoral artery access was more often used in CS group patients (47.1% vs. 15.2%, p<0.001). Percutaneous coronary intervention of MVD was more often performed in the CS group (74.6% vs. 71.0%, p=0.054). In-hospital death (7.6% vs. 4.6%, p=0.002), reinfarction (1.1% vs. 0.1%, p<0.001), hemorrhagic complications (6.4% vs. 1.6%, p<0.001), recurrent target vessel revascularization (1.8% vs. 0.4%, p≤0.001) and pulmonary oedema (3.7% vs. 1.5%, p<0.001) occurred more often in the CS group.
Conclusions
The safety of ACS treatment in MVD patients in centers without CS on site is non-inferior to treatment of such patients in center with CS on site. Interestingly, there were more in-hospital adverse cardiac events observed in ACS MVD patients treated in center with CS on-site. However, in centers with CS on site ACS MVD patients had a higher co-morbidity and were subjected to a higher number of PCIs. It suggests that in general, centers with CS-onsite treat more severe patients as compared to those without CS on-site.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Brust
- Regional Specialist Hospital, Research and Development Center , Wroclaw , Poland
| | - K Smiech
- Regional Specialist Hospital, Research and Development Center , Wroclaw , Poland
| | - K Bujak
- Silesian Center for Heart Diseases (SCHD) , Zabrze , Poland
| | - T Roleder
- Regional Specialist Hospital, Research and Development Center , Wroclaw , Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD) , Zabrze , Poland
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Piegza M, Jaworska I, Bujak K, Dębski P, Kunert Ł, Badura-Brzoza K, Żerdziński M, Błachut M, Piegza J. Symptoms of Anxiety and Depression and Sense of Coherence in Patients Undergoing Carotid Artery Stenting. Int J Environ Res Public Health 2022; 19:12222. [PMID: 36231523 PMCID: PMC9565029 DOI: 10.3390/ijerph191912222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The sense of coherence is lower in patients with somatic diseases and psychiatric disorders. PURPOSE The purpose of this study was to evaluate the intensity of depression and anxiety symptoms and their relationship with the sense of coherence and to try to determine the relationship between the strength of sense of coherence and symptoms of depression and anxiety with the presence of symptoms of carotid atherosclerosis in a group of patients undergoing carotid artery stenting. METHODS 35 patients, including 13 with symptomatic atherosclerosis in the carotid arteries, completed self-report tests: Hospital Scale of Depression and Anxiety (HADS) and the SOC-29 Life Orientation Questionnaire (SOC-29), 22 of whom also rated their subjective feelings of anxiety and depression on a scale included in the author's questionnaire. RESULTS Both symptomatic and asymptomatic patients did not differ significantly in the severity of depression, but they differed in anxiety levels as assessed by the HADS scale. There were no differences in the overall strength of sense of coherence and its individual components. Nearly 12% of those undergoing carotid artery stenting have pronounced anxiety symptoms, and just over 14% have pronounced depression symptoms. A higher overall sense of coherence and its components are associated with lower severity of depression symptoms. Lower severity of anxiety correlates negatively with a higher sense of understanding, meaningfulness, and holistic Sense of Coherence (SOC). Manageability appeared higher in men. CONCLUSIONS SOC is an important health-promoting factor that is preferably related to mental health parameters of patients with carotid atherosclerosis.
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Affiliation(s)
- Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie Gory, Poland
| | - Izabela Jaworska
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Kamil Bujak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
| | - Paweł Dębski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie Gory, Poland
| | - Łukasz Kunert
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie Gory, Poland
| | - Karina Badura-Brzoza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie Gory, Poland
| | - Maciej Żerdziński
- Dr. Krzysztof Czuma’s Psychiatric Center, Psychiatric Department No 2, 40-340 Katowice, Poland
| | - Michał Błachut
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 42-612 Tarnowskie Gory, Poland
| | - Jacek Piegza
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Silesian Center for Heart Diseases, Medical University of Silesia in Katowice, 41-800 Zabrze, Poland
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Brust K, Śmiech K, Bujak K, Roleder T, Gąsior M. TCT-106 The Treatment of Acute Coronary Syndromes Related to Multivessel Coronary Artery Disease: Data From the PL-ACS Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Tyczyński P, Gąsior M, Bujak K, Witkowski A, Pyka Ł, Gierlotka M, Milewski K, Hiczkiewicz J, Sobieszek G, Styczkiewicz M, Chmielak Z. Aspiration thrombectomy for patients with acute coronary syndromes and culprit lesions located in coronary bypass grafts. Data from the PL-ACS registry. Kardiol Pol 2022; 80:846-848. [PMID: 35851464 DOI: 10.33963/kp.a2022.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Paweł Tyczyński
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland.
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Łukasz Pyka
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Krzysztof Milewski
- 2nd Department of Cardiology, American Heart of Poland, Bielsko-Biała, Poland
| | - Jarosław Hiczkiewicz
- Clinical Department of Cardiology, Nowa Sol Multidisciplinary Hospital, Nowa Sol, Poland
| | - Grzegorz Sobieszek
- Department of Cardiology, 1st Military Clinical Hospital with the Outpatient Clinic, Lublin, Poland
| | - Marek Styczkiewicz
- Department of Cardiology, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | - Zbigniew Chmielak
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
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21
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Bujak K, Nadolny K, Trzeciak P, Gałązkowski R, Ładny JR, Gąsior M. Does the presence of physician-staffed emergency medical services improve the prognosis in out-of-hospital cardiac arrest? A propensity score matching analysis. Kardiol Pol 2022; 80:685-692. [PMID: 35445741 DOI: 10.33963/kp.a2022.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Substantial differences in survival after out-of-hospital cardiac arrest (OHCA) have been observed between countries. These might be attributed to the organization of emergency medical service (EMS) systems, including prehospital physician involvement. However, limited data exist on the physician's role in improving survival after OHCA. AIMS To compare prehospital and in-hospital outcomes of OHCA patients attended by physician-staffed EMS vs. paramedic-staffed EMS units. METHODS Among all patients enrolled in the regional, prospective registry of OHCA in southern Poland, we excluded those aged <18 years, with unwitnessed or EMS-witnessed cardiac arrest, without attempted cardiopulmonary resuscitation (CPR), attended by more than one EMS, or with traumatic cardiac arrest. The groups were matched 1:1 using propensity scores for baseline characteristic variables that might influence physician-staffed EMS dispatch. RESULTS A total of 812 OHCA cases were included in the current analysis. Among them, 351 patients were attended by physician-staffed EMS. There were no differences in baseline characteristics in the propensity-score matched cohort consisting of 351 pairs. The return of spontaneous circulation (ROSC) was more often achieved in the physician-staffed EMS group (42.7% vs. 33.3%; P = 0.01). The prehospital survival rate was also higher in this group (34.1% vs. 19.2%; P <0.01). However, there were no significant differences in survival rate to discharge between cases treated by physician-staffed and paramedic-staffed EMS (9.7% vs. 7.0%; P = 0.22). CONCLUSIONS OHCA patients attended by physician-staffed EMS were more likely to have ROSC and survive till hospital admission. However, better prehospital outcomes might not translate into improved in-hospital prognosis in these patients.
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Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland.,Departament of Health Sciences, WSB University, Dąbrowa Górnicza, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Robert Gałązkowski
- Department of Emergency Medical Service, Medical University of Warsaw, Warszawa, Poland
| | - Jerzy Robert Ładny
- Department of Emergency Medicine, Medical University of Bialystok, Białystok, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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22
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Pres D, Tajstra M, Mitkowski P, Ciślak A, Bujak K, Kaźmierczak J, Sterliński M, Mizia-Stec K, Sierpiński R, Gąsior M, Szumowski Ł, Kalarus Z. Prediction of early death after myocardial infarction in patients with reduced left ventricular ejection fraction. The search for new indications for cardioverter-defibrillator implantation (ICD). Kardiol Pol 2021; 79:1343-1352. [PMID: 34897630 DOI: 10.33963/kp.a2021.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 12/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The highest rate of death is in the first few weeks after myocardial infarction (MI). However, the assessment of indications for primary prevention implantable cardioverter-defibrillator (ICD) implantation should be postponed until at least 40 days after MI. AIMS Our aim was to identify the subgroup of high-risk patients with reduced left ventricular ejection fraction (LVEF) who would benefit from primary prevention ICD implantation within 40 days of MI. METHODS Out of 205 606 patients with MI, in this study, we included 18 736 patients treated invasively, with LVEF <40%, who survived until hospital discharge. Patients were divided into two groups according to the survival status at 40 days - patients who died within this period (n = 1331) and patients who survived (n = 17405). RESULTS Among all patients who died within 12-months after MI, 37.7% did die during the first 40 days. Patients with cardiac arrest before hospital admission or within the first 48 hours of hospitalization (hazard ratio [HR], 3.35; 95% confidence interval [CI], 2.82-3.98; P <0.0001], cardiogenic shock before admission or during hospitalization (HR, 3.06; 95% CI, 2.62-3.59; P <0.0001), unsuccessful percutaneous coronary interventions (PCI; HR, 2.42; 95% CI, 2.11-2.84; P <0.0001), LVEF <20% (ref. LVEF ≥30%; HR, 2.75; 95% CI, 2.25-3.36; P <0.0001) had approximately threefold and patients with chronic kidney disease almost 1.5-times (HR, 1.25; 95% CI, 1.47-3.59; P = 0.0053) higher 40-day mortality compared to patients without these risk factors. The most striking differences in mortality between these subgroups were observed shortly after discharge. CONCLUSIONS The highest risk of death in patients with reduced LVEF who survived until hospital discharge occurred within the first 40 days after MI. There is a possibility to select patients with the worst prognosis and treat them more aggressively.
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Affiliation(s)
- Damian Pres
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Przemysław Mitkowski
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aneta Ciślak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Maciej Sterliński
- Department of Arrhythmia, National Institute of Cardiology, Warszawa, Poland
| | | | | | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Łukasz Szumowski
- Department od Arrhythmia, Institute of Cardiology, Warszawa, Poland
| | - Zbigniew Kalarus
- 1st Department of Cardiology, Congenital Heart Diseases, and Electrotherapy, Silesian Center for Heart Diseases, Zabrze, Poland
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Bujak K, Lejawa M, Fronczek M, Lekston A, Gąsior M, Osadnik T. Polymorphisms of genes coding for telomerase reverse transcriptase and telomerase RNA component and the need for target lesion revascularization after percutaneous coronary intervention. Pol Arch Intern Med 2021; 131:299-301. [PMID: 33570898 DOI: 10.20452/pamw.15810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Mateusz Lejawa
- Kardio-Med Silesia, Zabrze, Poland,Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Martyna Fronczek
- Kardio-Med Silesia, Zabrze, Poland,Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland,2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland
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Januszek R, Bujak K, Gąsior M, Legutko J, Bartuś S. Survival rate after acute myocardial infarction in patients treated with percutaneous coronary intervention within the left main coronary artery according to time of admission. Medicine (Baltimore) 2021; 100:e24360. [PMID: 33530230 PMCID: PMC7850639 DOI: 10.1097/md.0000000000024360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/21/2020] [Indexed: 01/05/2023] Open
Abstract
The relationship regarding time of percutaneous coronary intervention (PCI) and clinical outcomes in patients with acute myocardial infarction (AMI) treated within the left main coronary artery (LMCA) is less investigated compared to the overall group of patients with AMI.Therefore, we aimed to assess the relationship between time of PCI (day- vs night-time) and overall mortality rate in patients treated due to AMI within the LMCA.This cross-sectional study included 443,805 AMI patients hospitalized between 2006 and 2018 enrolled in the Polish Registry of Acute Coronary Syndromes. We extracted 5,404 patients treated within the LMCA. The number of patients were treated during daytime hours (7:00 am-10:59 pm) was 2809 while 473 patients underwent treatment during night-time hours (11:00 pm-6:59 am). Differences in cardiac mortality rates between night- and day-hours among patients treated with PCI during the follow-up period were assessed via the Kaplan-Meier method.The 30-day (20.3% vs 14.9%, P = .003) and 12-month (31.7% vs 26.2%, P = .001) overall mortality rates were significantly greater among patients treated during night-time, which was confirmed by comparison using Kaplan-Maier survival curves (P = .001). The time of PCI was not found among predictors of survival in multiple regression analysis (hazard ratio: 1.22; 95% confidence interval: 0.96-1.55, P = .099).Patients treated during night-time in comparison to the day-time are related to higher in-hospital, 30-day and 12-month mortality. This is probably largely a consequence that the night-time, in comparison to the day-time, of treatment of patients with AMI with PCI within the LMCA is and indicator of higher comorbidity and clinical acuity of patients undergoing therapy. Therefore, the night-time was not found to be an independent predictor of greater mortality rate during the 12-months follow-up period.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital
- Institute of Cardiology, Jagiellonian University Medical College
- Department of Clinical Rehabilitation, University school of Physical Education, Kraków
| | - Kamil Bujak
- Third Department of Cardiology, Silesian Centre for Heart Diseases, Zabrze
- School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice
| | - Mariusz Gąsior
- Third Department of Cardiology, Silesian Centre for Heart Diseases, Zabrze
- School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital
- Institute of Cardiology, Jagiellonian University Medical College
- Jagiellonian University Medical College, Kraków, Poland
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Nadolny K, Bujak K, Obremska M, Zysko D, Sterlinski M, Szarpak L, Kubica J, Ladny JR, Gasior M. Glasgow Coma Scale score of more than four on admission predicts in-hospital survival in patients after out-of-hospital cardiac arrest. Am J Emerg Med 2021; 42:90-94. [PMID: 33497899 DOI: 10.1016/j.ajem.2021.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 10/22/2022] Open
Abstract
AIM The aim of the study was to assess the usefulness of the Glasgow Coma Scale (GCS) score assessed by EMS team in predicting survival to hospital discharge in patients after out-of-hospital cardiac arrest (OHCA). METHODS Silesian Registry of OHCA (SIL-OHCA) is a prospective, population-based regional registry of OHCAs. All cases of OHCAs between the 1st of January 2018 and the 31st of December 2018 were included. Data were collected by EMS using a paper-based, Utstein-style form. OHCA patients aged ≥18 years, with CPR attempted or continued by EMS, who survived to hospital admission, were included in the current analysis. Patients who did not achieve return of spontaneous circulation (ROSC) in the field, with missing data on GCS after ROSC or survival status at discharge were excluded from the study. RESULTS Two hundred eighteen patients with OHCA, who achieved ROSC, were included in the present analysis. ROC analysis revealed GCS = 4 as a cut-off value in predicting survival to discharge (AUC 0.735; 95%CI 0.655-0.816; p < 0.001). Variables significantly associated with in-hospital survival were young age, short response time, witnessed event, previous myocardial infarction, chest pain before OHCA, initial shockable rhythm, coronary angiography, and GCS > 4. On the other hand, epinephrine administration, intubation, the need for dispatching two ambulances, and/or a physician-staffed ambulance were associated with a worse prognosis. Multivariable logistic regression analysis revealed GCS > 4 as an independent predictor of in-hospital survival after OHCA (OR of 6.4; 95% CI 2.0-20.3; p < 0.0001). Other independent predictors of survival were the lack of epinephrine administration, previous myocardial infarction, coronary angiography, and the patient's age. CONCLUSION The survival to hospital discharge after OHCA could be predicted by the GCS score on hospital admission.
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Affiliation(s)
- Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland; Faculty of Medicine, Katowice School of Technology, Katowice, Poland.
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marta Obremska
- Department of Preclinical Research, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Zysko
- Department of Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Maciej Sterlinski
- 1st Department of Heart Arrhythmia National Institute of Cardiology, Warsaw, Poland
| | | | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Jerzy Robert Ladny
- Department Emergency Medicine, University Medicine of Białystok, Bialystok, Poland
| | - Mariusz Gasior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Hawranek M, Grygier M, Bujak K, Bartuś S, Gierlotka M, Wojakowski W, Legutko J, Lesiak M, Pączek P, Kleinrok A, Milewski K, Kubica J, Tajstra M, Dudek D, Witkowski A, Gąsior M. Characteristics of patients from the Polish Registry of Acute Coronary Syndromes during the COVID-19 pandemic: the first report. Kardiol Pol 2021; 79:192-195. [PMID: 33463992 DOI: 10.33963/kp.15756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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27
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Konieczkowska J, Bujak K, Schab-Balcerzak E. A short review of the photomechanical effect in azo-containing amorphous (glassy) polymers. EXPRESS POLYM LETT 2021. [DOI: 10.3144/expresspolymlett.2021.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bujak K, Lejawa M, Gąsior M, Osadnik T. The CTGF gene -945 G/C polymorphism is associated with target lesion revascularization for in-stent restenosis. Exp Mol Pathol 2020; 118:104598. [PMID: 33358742 DOI: 10.1016/j.yexmp.2020.104598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND AIMS Previous studies have shown that transforming growth factor β (TGF-β) and vascular endothelial growth factor A (VEGF-A) pathways are involved in the in-stent restenosis (ISR) process. The present study aimed to assess the relationship between single-nucleotide polymorphisms (SNPs) in genes encoding downstream proteins of TGF-β and VEGF-A pathways and the risk of target lesion revascularization (TLR) for in-stent restenosis. METHODS A total of 657 patients (with 781 treated lesions) who underwent percutaneous coronary intervention (PCI) with stent implantation at our center between 2007 and 2012 and completed a 4-year follow-up for clinically-driven TLR, were included. SNPs in CTGF (rs6918698), TGFBR2 (rs2228048), SMAD3 (rs17293632), KDR (rs2071559), CCL2 (rs1024610) were genotyped using TaqMan assay. RESULTS Major allele carriers of CTGF gene -945 G/C polymorphism (rs6918698) were significantly less likely to underwent clinically-driven TLR during follow-up than minor allele carriers. After adjustment for clinical, angiographic, and procedural covariates, CTGF polymorphism was significantly associated with TLR, and minor allele (C) carriers had nearly two times higher risk of developing ISR requiring TLR (HR of 1.93, 95%CI 1.15-3.24) compared to patients with major (GG) genotype. No significant relationship was found between other analyzed polymorphisms and cumulative incidence of TLR at 4-years. CONCLUSIONS Our results suggest that functional -945 G/C polymorphism in the gene encoding connective tissue growth factor is associated with the need for TLR in patients who underwent PCI for stable coronary artery disease.
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Affiliation(s)
- Kamil Bujak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Mateusz Lejawa
- Kardio-Med Silesia, Zabrze, Poland; Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland
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Januszek R, Bujak K, Gasior M, Dudek D, Bartus S. Patient survival after acute myocardial infarction treated with primary percutaneous coronary intervention within the left main coronary artery according to time of admission. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Previously published studies assessing the time effect of primary percutaneous intervention (PCI) on long-term clinical outcomes in an overall group of patients with acute coronary syndromes has been widely investigated. It has been suggested that night-time admission may negatively influence long-term overall mortality. Patients treated within the left main coronary artery (LMCA) belong a narrow group of high-risk procedures that require an operator and a team with high skills.
Purpose
The aim of the presented study was to assess the relationship between the time of pPCI (day- vs. night-time) and overall mortality among patients treated due to AMI within the LMCA.
Methods
This observational study was performed on 443,805 patients hospitalised due to non-ST segment elevation myocardial infarction (NSTEMI) or ST-segment elevation myocardial infarction (STEMI). Patients were prospectively enrolled between January 2006 and December 2018 in the ongoing Polish Registry of Acute Coronary Syndromes (PL-ACS). From the overall group of patients, the authors selected 5,404 patients treated within the LMCA. After taking exclusion criteria into consideration, the patients were divided according to time of PCI treatment: daytime hours (7:00 a.m.-10:59 p.m.) – 2,809 patients and night-time hours (11:00 p.m. - 6.59 a.m.) – 473 patients.
Results
Patients treated during night-time and daytime did not differ significantly in age (70.79 [61.52–79.73] vs. 69.73 [60.8–78.82] years, p=0.13) or gender – males (67.6% vs. 67.0%, p=0.79). Patients treated during daytime presented with significantly higher rate of STEMIs (67.2% vs. 49.9%) and lower rate of NSTEMIs (32.8% vs. 50.1%) in comparison to those treated during night-time (p<0.001). The 30-day and 12-month overall mortality rates were significantly greater among patients treated during night-time hours (20.3% vs. 14.9%, p=0.003) and (31.7% vs. 26.2%, p=0.001). Kaplan-Maier survival curves confirmed this relationship (p=0.001). Multiple regression analysis did not confirm that the time of pPCI (day- vs. night-time) is significantly related to survival (hazard ratio [HR]: 1.22; 95% confidence interval [CI]: 0.96–1.55, p=0.099). However, significance was achieved for the left ventricle ejection fraction (HR: 0.95; 95% CI: 0.94–0.95, p<0.001), systolic blood pressure on admission (HR: 0.995; 95% CI: 0.991–0.998, p=0.005), age (HR: 1.04; 95% CI: 1.03–1.05, p<0.001), the use of intra-aortic balloon counterpulsation (HR: 1.04; 95% CI: 1.03–1.05, p<0.001) and diagnosed peripheral artery disease (HR: 1.55; 95% CI: 1.2–2.01, p<0.001).
Conclusions
The time of pPCI (day- vs. night-time) in patients with AMI and treated within the LMCA is related to the overall 30-day and 12-month survival which is poorer in those treated during the night-time. However, this relationship was not confirmed by multiple regression analysis and was not found to be significant among other stronger predictors.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- R Januszek
- University Hospital of Krakow, Krakow, Poland
| | - K Bujak
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - D Dudek
- Jagiellonian University, Krakow, Poland
| | - S Bartus
- Jagiellonian University, Krakow, Poland
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Osadnik T, Pawlas N, Lejawa M, Lisik M, Osadnik K, Fronczek M, Bujak K, Gąsior M. Genetic and environmental factors associated with homocysteine concentrations in a population of healthy young adults. Analysis of the MAGNETIC study. Nutr Metab Cardiovasc Dis 2020; 30:939-947. [PMID: 32404292 DOI: 10.1016/j.numecd.2020.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 01/25/2020] [Accepted: 01/27/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Elevated homocysteine concentration is associated with a higher risk of cardiovascular disease. The aim of our study was to determine the environmental and genetic factors associated with serum homocysteine concentration in healthy young adults. Moreover, we aimed to determine the cutoff value of homocysteine concentration for predicting unfavorable MTHFR genotype and to investigate whether this association is modified by dietary patterns and serum folate status. METHODS AND RESULTS A total of 744 healthy individuals, aged 18-35 years, were included in the study. Diet quality was assessed by establishing diet quality scores and adherence to the pro-Healthy Diet Index (pHDI) and non-Healthy Diet Index (nHDI). Genotyping was performed using the TaqMan method. Multivariate analysis showed that pHDI, creatinine, folate concentrations, and the T/T genotype of the C677T polymorphism in MTHFR, as well as the interaction between the T/T genotype of MTHFR (C677T polymorphism) and folate level, were most strongly related to homocysteine concentrations. The specificity of a homocysteine >13.1 μmol/l in predicting T/T homozygous status was 76% (area under the curve 0.68). CONCLUSION Healthy dietary patterns, folate, and creatinine levels, as well as the C677T polymorphism, proved to be the strongest predictors of homocysteine concentrations. T/T genotype of MTHFR modifies the relationship between folate and homocysteine.
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Affiliation(s)
- Tadeusz Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; 2nd Department of Cardiology and Angiology, Silesian Centre for Heart Diseases, Zabrze, Poland.
| | - Natalia Pawlas
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | - Mateusz Lejawa
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; Kardio-Med Silesia, Zabrze, Poland
| | - Małgorzata Lisik
- Genetic Outpatient Maria Skłodowska-Curie Memorial Cancer Center, Institute of Oncology Gliwice Branch, Poland
| | - Kamila Osadnik
- Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Martyna Fronczek
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland; Kardio-Med Silesia, Zabrze, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Rajwa P, Życzkowski M, Paradysz A, Bujak K, Bryniarski P. Evaluation of the prognostic value of LMR, PLR, NLR, and dNLR in urothelial bladder cancer patients treated with radical cystectomy. Eur Rev Med Pharmacol Sci 2019; 22:3027-3037. [PMID: 29863247 DOI: 10.26355/eurrev_201805_15060] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Our aim was to evaluate the association between preoperative LMR, PLR, NLR, dNLR, and survival of urothelial bladder cancer (UBC) patients treated with radical cystectomy (RC). We also analyzed the relationship between preoperative blood-based inflammatory biomarkers' levels and postoperative in-hospital complications. PATIENTS AND METHODS This retrospective study included 144 UBC patients, who underwent RC between 2003 and 2015. The study endpoints were cancer-specific survival (CSS) and overall survival (OS). RESULTS Univariable analysis revealed that continuous LMR, PLR, NLR and dNLR were significantly associated with CSS and OS. On multivariable regression model analysis, continuous LMR, NLR, and dNLR independently predicted both endpoints. Furthermore, the group of patients with lower LMR values had a greater chance of developing postoperative in-hospital complications. CONCLUSIONS Our findings indicate that the cheap and simple blood-based biomarkers may be valuable in identifying UBC patients treated with RC, who are at higher risk of all-cause and cancer-related mortality.
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Affiliation(s)
- P Rajwa
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
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Borowicz A, Nadolny K, Bujak K, Cieśla D, Gąsior M, Hudzik B. Paramedic versus physician-staffed ambulances and prehospital delays in the management of patients with ST-segment elevation myocardial infarction. Cardiol J 2019; 28:110-117. [PMID: 31313273 DOI: 10.5603/cj.a2019.0072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/03/2019] [Accepted: 06/23/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Time delays to reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) still remain a considerable drawback in many healthcare systems. Emergency medical service (EMS) has a critical role in the early management of STEMI. Under investigation herein, was whether the use of physician-staffed ambulances leads to shorter pre-hospital delays in STEMI patients. METHODS This was an observational and retrospective study, using data from the registry of the Silesian regional EMS system in Katowice, Poland and the Polish Registry on Acute Coronary Syndromes (PL-ACS) for a study period of January 1, 2013 to December 31, 2016. The study population (n = 717) was divided into two groups: group 1 (n = 546 patients) - physician-staffed ambulances and group 2 (n = 171 patients) - paramedic-staffed ambulances. RESULTS Responses during the day and night shifts were similar. Paramedic-led ambulances more often transmitted 12-lead electrocardiogram (ECG) to the percutaneous coronary intervention centers. All EMS time intervals were similar in both groups. The type of EMS dispatched to patients (physicianstaffed vs. paramedic/nurse-only staffed ambulance) was adjusted for ECG transmission, sex had no impact on in-hospital mortality (odds ratio [OR] 1.41; 95% confidence interval [CI] 0.79-1.95; p = 0.4). However, service time exceeding 42 min was an independent predictor of in-hospital mortality (OR 4.19; 95% CI 1.27-13.89; p = 0.019). In-hospital mortality rate was higher in the two upper quartiles of service time in the entire study population. CONCLUSIONS These findings suggest that both physician-led and paramedic-led ambulances meet the criteria set out by the Polish and European authorities. All EMS time intervals are similar regardless of the type of EMS unit dispatched. A physician being present on board did not have a prognostic impact on outcomes.
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Affiliation(s)
- Artur Borowicz
- Voivodeship Rescue Service in Katowice, Katowice, Poland
| | - Klaudiusz Nadolny
- Voivodeship Rescue Service in Katowice, Katowice, Poland.,Department of Emergency Medicine, Medical University of Bialystok, Bialystok.,University of Strategic Planning in Dabrowa Gornicza, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil
| | - Daniel Cieśla
- Department of Science, Biostatistics and New Technologies, Silesian Center for Heart Disease, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil
| | - Bartosz Hudzik
- 3rd Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Sil. .,Department of Cardiovascular Disease Prevention, School of Public Health in Bytom, Medical University of Silesia.
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Osadnik T, Pawlas N, Osadnik K, Bujak K, Góral M, Lejawa M, Fronczek M, Reguła R, Czarnecka H, Gawlita M, Strzelczyk JK, Gonera M, Gierlotka M, Poloński L, Gąsior M. High progesterone levels are associated with family history of premature coronary artery disease in young healthy adult men. PLoS One 2019; 14:e0215302. [PMID: 30986240 PMCID: PMC6464341 DOI: 10.1371/journal.pone.0215302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/29/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND & AIMS The offspring of patients with premature coronary artery disease (P-CAD) are at higher risk for cardiovascular disease, compared with subjects without a family history (FH) of P-CAD. The increased risk for cardiovascular disease in subjects with FH of early-onset CAD results from unfavorable genetic variants as well as social, behavioral and environmental factors, which are more prevalent in this group. Previous studies have shown that specific sex hormone levels may be associated with the risk of cardiovascular disease. The aim of this study was to compare wide range of biochemical marker levels including i.e. the levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone, estradiol, testosterone and sex-hormone binding globulin (SHBG) between young healthy male adults with and without FH of P-CAD. METHODS The study group consisted of young healthy Polish male adults enrolled in a MAGNETIC case-control study, who were recruited between July 2015 and October 2017. The inclusion criteria were as follows: male sex, age ≥18 and ≤35 years old, FH of P-CAD (cases) or no P-CAD in first-degree relatives (controls). The comparison of continuous and categorical variables was performed using the Student's t-test or the U-Mann-Whitney test, and Fisher's exact test, respectively. The correlations between FSH, LH, testosterone, progesterone, SHBG and other laboratory parameters were assessed using the Spearman rank correlation test. Both univariable and multivariable logistic regression analyses were performed to assess the association between analyzed variables and FH of P-CAD. RESULTS A total of 411 subjects (223 cases and 188 controls) were included in the study. There was a higher prevalence of major cardiovascular risk factors in subjects with FH of P-CAD (smoking, higher total and LDL cholesterol levels, higher body mass index and lower HDL cholesterol level). Moreover, the offspring of patients with P-CAD had lower SHBG level, and higher LH and progesterone levels in the crude comparison, compared with individuals without FH of P-CAD. After adjustment for confounding variables, progesterone and LH were determined to be independently associated with FH of P-CAD. CONCLUSION Progesterone and LH levels are significantly associated with FH of P-CAD, independent of traditional risk factors for CAD.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Natalia Pawlas
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
- Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | - Kamila Osadnik
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marta Góral
- Students’ Scientific Society, 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mateusz Lejawa
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Martyna Fronczek
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Hanna Czarnecka
- Clinical Laboratory, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marcin Gawlita
- Department of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Gonera
- Regional Specialized Hospital No. 4, Anesthesiology and Intensive Care Unit, Bytom, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
- Department of Cardiology, University Hospital in Opole, Faculty of Natural Sciences and Technology, Institute of Medicine, University of Opole, Opole, Poland
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Osadnik T, Bujak K, Osadnik K, Czarnecka H, Pawlas N, Reguła R, Fronczek M, Lejawa M, Gawlita M, Gonera M, Góral M, Strzelczyk JK, Gierlotka M, Lekston A, Kasperczyk J, Poloński L, Gąsior M. Novel inflammatory biomarkers may reflect subclinical inflammation in young healthy adults with obesity. Endokrynol Pol 2019; 70:135-142. [PMID: 30633318 DOI: 10.5603/ep.a2019.0002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Obesity is often accompanied by low-grade inflammation. In recent years a few blood-based inflammatory markers - neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein ratio (MHR) - have been identified. They have been proven to correlate well with established inflammatory markers such as hsCRP and have a prognostic value among others in patients with coronary artery disease, heart failure, and malignancies. The aim of the study was to find markers associated with obesity in young heathy adults. MATERIAL AND METHODS The study group included 321 young healthy adults aged 18-35 years (210 males and 111 females). Partial least squares regression analysis was used to find variables associated with body mass index (BMI), except MHR. Analysed variables included complete blood count, lipid profile, sex hormone levels, acute-phase protein levels, and blood-based inflammatory markers. RESULTS Variables with the strongest association with BMI in the group of men were HDL% and apolipoprotein B, and in the group of women, HDL, HDL%, triglycerides, and MHR. Novel inflammatory markers were not associated with BMI. We found significant (p < 0.001) correlations between novel biomarkers (NLR, dNLR) and hsCRP and fibrinogen levels in the group of subjects with obesity. CONCLUSIONS Blood-based inflammatory markers significantly correlate with hsCRP and fibrinogen in young healthy adults with obesity, which may reflect the subclinical inflammation in this group of individuals.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland. .,Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Kamila Osadnik
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Hanna Czarnecka
- Clinical Laboratory, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Natalia Pawlas
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.,Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Martyna Fronczek
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.,Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Mateusz Lejawa
- Chair and Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.,Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Marcin Gawlita
- Department of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Gonera
- Regional Specialised Hospital No. 4, Anaesthesiology and Intensive Care Unit, Bytom, Poland
| | - Marta Góral
- Students' Scientific Society, 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.,Department of Cardiology, University Hospital in Opole, Faculty of Natural Sciences and Technology, Institute of Medicine, University of Opole, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Janusz Kasperczyk
- Centre of Polymer and Carbon Materials of the Polish Academy of Sciences Zabrze, Poland
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Nadolny K, Bujak K, Kucap M, Trzeciak P, Hudzik B, Borowicz A, Gąsior M. The Silesian Registry of Out-of-Hospital Cardiac Arrest: Study design and results of a three-month pilot study. Cardiol J 2018; 27:566-574. [PMID: 30444257 DOI: 10.5603/cj.a2018.0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/08/2018] [Accepted: 10/11/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Despite the introduction of the concept known as "Chain of Survival" has significantly increased survival rates in patients with out-of-hospital cardiac arrest (OHCA), short-term mortality in this group of patients is still very high. Epidemiological data on OHCA in Poland are limited. The aim of this study was to create a prospective registry on OHCA covering a population of 2.7 million inhabitants of Upper Silesia in Poland. Presented herein is the study design and results of a 3-month pilot study. METHODS The Silesian Registry of Out-of-Hospital Cardiac Arrest (SIL-OHCA) is a prospective, population-based registry of OHCA, of minimum duration which was planned for 12 months; from January 1st, 2018 to December 31st, 2018. The first 3 months of the study constituted the pilot phase. The inclusion criterion is the occurrence of OHCA in the course of activity of the Voivodeship Rescue Service in Katowice, Poland. RESULTS During the 3-month pilot phase of the study there were 390 cases of OHCA in which cardiopulmonary resuscitation was undertaken. Estimated frequency of OHCA in the population analyzed was 57 per 100,000 population per year. Shockable rhythm was present in 25.8% of cases. Return of spontaneous circulation was achieved in 35.1% of the whole cohort. 28.7% of patients were admitted to the hospital, including 2.8% of patients, who were admitted during an ongoing cardiopulmonary resuscitation. CONCLUSIONS Prehospital survival of patients with OHCA in Poland is still unsatisfactory. It is believed that data collected in SIL-OHCA registry will allow identification factors, which require improvement in order to reduce short- and long-term mortality of patients with OHCA.
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Affiliation(s)
- Klaudiusz Nadolny
- Voivodeship Rescue Service, Katowice, Poland.,Department of Emergency Medicine, Medical University of Białystok, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Michał Kucap
- Voivodeship Rescue Service, Katowice, Poland.,Department of Anaesthesiology Nursing & Intensive Care, Faculty of Health, Medical University of Gdańsk, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Bartosz Hudzik
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.,Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia in Katowice, Poland
| | | | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Osadnik T, Pawlas N, Lonnie M, Osadnik K, Lejawa M, Wądołowska L, Bujak K, Fronczek M, Reguła R, Gawlita M, Strzelczyk JK, Góral M, Gierlotka M, Poloński L, Gąsior M. Family History of Premature Coronary Artery Disease (P-CAD)-A Non-Modifiable Risk Factor? Dietary Patterns of Young Healthy Offspring of P-CAD Patients: A Case-Control Study (MAGNETIC Project). Nutrients 2018; 10:E1488. [PMID: 30322041 PMCID: PMC6213507 DOI: 10.3390/nu10101488] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/20/2018] [Accepted: 09/30/2018] [Indexed: 01/08/2023] Open
Abstract
Dietary habits of healthy offspring with a positive family history of premature coronary artery disease (P-CAD) have not been studied so far. The aim of this study was twofold: (1) to identify dietary patterns in a sample of young healthy adults with (cases) and without (controls) family history of P-CAD, and (2) to study the association between dietary patterns and family history of P-CAD. The data came from the MAGNETIC case-control study. The participants were healthy adults aged 18⁻35 years old, with (n = 351) and without a family history of P-CAD (n = 338). Dietary data were collected with food frequency questionnaire FFQ-6. Dietary patterns (DP) were derived using principal component analysis (PCA). The associations between the adherence to DPs and family history of P-CAD were investigated using logistic regression. Two models were created: crude and adjusted for age, sex, smoking status, place of residence, financial situation, education, and physical activity at leisure time. Three DPs were identified: 'prudent', 'westernized traditional' and 'dairy, breakfast cereals, and treats'. In both crude and adjusted models, subjects with family history of P-CAD showed higher adherence by 31% and 25% to 'westernized traditional' DP (odds ratio (OR) 1.31, 95% confidence interval (95% CI): 1.12⁻1.53; p < 0.005; per 1 unit of standard deviation (SD) of DP score and adjOR 1.25, 95% CI: 1.06⁻1.48; p = 0.007; per 1 unit of SD of DP score, respectively). Young healthy adults with family history of P-CAD present unfavorable dietary patterns and are potentially a target group for CAD primary prevention programs.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
| | - Natalia Pawlas
- Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 38, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
- Institute of Occupational Medicine and Environmental Health, Kościelna 13, 40-001 Sosnowiec, Poland.
| | - Marta Lonnie
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland.
| | - Kamila Osadnik
- Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 38, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
| | - Mateusz Lejawa
- Department of Pharmacology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 38, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Skłodowskiej-Curie 10C, 41-800 Zabrze, Poland.
| | - Lidia Wądołowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45f, 10-718 Olsztyn, Poland.
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
| | - Martyna Fronczek
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 19, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
| | - Marcin Gawlita
- Department of Environmental Medicine and Epidemiology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 19, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry in Zabrze, Jordana 19, 41-808 Zabrze, Medical University of Silesia, 40-055 Katowice, Poland.
| | - Marta Góral
- Students' Scientific Society, 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
- Department of Cardiology, University Hospital in Opole, Faculty of Natural Sciences and Technology, Institute of Medicine, University of Opole, W. Witosa 26, 45-401 Opole, Poland.
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie 9, 41-800 Zabrze, Poland.
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Kamińska J, Leszczyńska A, Bujak K, Szyguła-Jurkiewicz B. The role of the I/D polymorphism in the angiotensin-converting enzyme gene in selected cardiovascular diseases. POSTEP HIG MED DOSW 2018. [DOI: 10.5604/01.3001.0012.2427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Angiotensin converting enzyme (ACE) plays an essential role in the functioning of two important systems in the human body by catalysing the synthesis of angiotensin II in the renin-angiotensin-aldosterone system and by degrading bradykinin in the kinin-kallikrein involved in the development of many cardiovascular conditions. It has been shown that ACE
activity is largely genetically determined. More than nine hundred various polymorphisms,
mostly single nucleotide polymorphisms, have been detected in the ACE gene; however, the
most researched one is still the insertion/deletion polymorphism located in intron 16, which
determines fifty per cent of variability of ACE activity. It is stated that DD homozygotes have
the highest ACE serum activity, which can indicate a higher risk of developing certain cardiovascular
diseases in patients with this genotype. Therefore, the I/D polymorphism has been
analysed in thousands of studies, mainly in the context of cardiovascular conditions risk. The
correlation between ACE I/D polymorphism and the risk of particular diseases, its cooperation
with other risk factors or its influence on therapy among patients with conditions such as
coronary artery disease, hypertension, atrial fibrillation and heart failure have been searched.
Unfortunately, the results of those studies have often turned out ambiguous or even contrary.
We herein present a summary of the most essential analyses and current knowledge about
the role of the I/D polymorphism in the evaluation of risk and treatment efficacy of most
common cardiovascular conditions.
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Affiliation(s)
- Justyna Kamińska
- Studenckie Koło Naukowe, III Katedra i Oddział Kliniczny Kardiologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
| | - Aneta Leszczyńska
- Studenckie Koło Naukowe, III Katedra i Oddział Kliniczny Kardiologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
| | - Kamil Bujak
- III Katedra i Oddział Kliniczny Kardiologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
| | - Bożena Szyguła-Jurkiewicz
- III Katedra i Oddział Kliniczny Kardiologii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
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Rajwa P, Życzkowski M, Paradysz A, Slabon-Turska M, Suliga K, Bujak K, Bryniarski P. Novel hematological biomarkers predict survival in renal cell carcinoma patients treated with nephrectomy. Arch Med Sci 2017; 16:1062-1071. [PMID: 32863995 PMCID: PMC7444725 DOI: 10.5114/aoms.2017.70250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 08/16/2017] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The association between novel blood-based inflammatory indices and patient survival has been reported with reference to various cancers. The aim of this study was to investigate the prognostic value of preoperative platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), derived neutrophil-lymphocyte ratio (dNLR) and lymphocyte-monocyte ratio (LMR) in patients with renal cell carcinoma (RCC) treated with nephrectomy. MATERIAL AND METHODS From 2003 to 2012, 455 patients who underwent partial or radical nephrectomy for RCC were enrolled in the study. The study endpoints were overall survival (OS) and cancer-specific survival (CSS). RESULTS The median follow-up was 70 months. Groups of patients with high levels of PLR, NLR and dNLR and a low level of LMR more often underwent radical nephrectomy, had a higher cancer stage in the TNM classification, and were more frequently diagnosed with tumor necrosis in histopathological examination. Both cancer-specific mortality and overall mortality were significantly higher in patients with high PLR, NLR and dNLR and low LMR. Multivariate analysis of CSS, adjusted for standard clinicopathological factors, identified only dNLR (p = 0.006) as an independent prognostic factor. PLR (p = 0.0002), dNLR (p = 0.0003) and NLR (p = 0.002), but not LMR (p = 0.1), achieved prognostic significance in multivariable analysis regarding OS. CONCLUSIONS Only dNLR was an independent prognostic factor for CSS and OS. Nevertheless, our study indicates that all examined complete blood count-based biomarkers may be useful tools in managing RCC patients treated with a surgical approach.
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Affiliation(s)
- Paweł Rajwa
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marcin Życzkowski
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Andrzej Paradysz
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Monika Slabon-Turska
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Kamil Suliga
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Kamil Bujak
- 3 Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Piotr Bryniarski
- Department of Urology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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Wasilewski J, Pyka Ł, Hawranek M, Tajstra M, Skrzypek M, Wasiak M, Suliga K, Bujak K, Gąsior M. Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry. Cardiol J 2017; 25:377-385. [PMID: 28353308 DOI: 10.5603/cj.a2017.0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 03/27/2017] [Accepted: 02/03/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Previous studies have reported that in patients with heart failure, an increased value of red cell distribution width (RDW) is associated with adverse outcomes. Nonetheless, data regarding the association between RDW values and long-term mortality in patients with left ventricular systolic dysfunction (LVSD) are lacking. The aim of this investigation was to examine the relationship between mortality and RDW in patients with ischemic and non-ischemic LVSD. METHODS Under analysis was 1734 patients with a left ventricular ejection fraction (LVEF) ≤ 35% of whom were hospitalized between 2009 and 2013. Patients were divided into three groups based on RDW tertiles. Low, medium and high tertiles were defined as RDW ≤ 13.4%, 13.4% < RDW ≤ 14.6% and RDW > 14.6%, respectively. RESULTS There was a stepwise relationship between RDW intervals and comorbidities. Patients with the highest RDW values were older and more often diagnosed with anemia, diabetes, atrial fibrillation and chronic kidney disease. The main finding of our analysis was the presence of an 8-fold increase in all-cause mortality in the entire cohort between high and low RDW tertile. Cox hazard analysis identi-fied RDW as an independent predictive factor of mortality in all patients (HR 2.8; 95% CI 2.1-3.8; p < 0.0001) and in subgroups of patients with ischemic (HR 2.8; 95% CI 2.0-3.9; p < 0.0001) and non-ischemic (HR 3.3; 95% CI 2.01-5.5; p < 0.0001) LVSD. CONCLUSIONS The highest RDW tertile was independently associated with higher long-term mortality compared with low and medium tertiles, both in all patients with a LVEF ≤ 35% and in subgroups of patients with ischemic and non-ischemic LVSD.
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Affiliation(s)
| | - Łukasz Pyka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
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Osadnik T, Strzelczyk JK, Lekston A, Reguła R, Bujak K, Fronczek M, Gawlita M, Gonera M, Wasilewski J, Szyguła-Jurkiewicz B, Gierlotka M, Gąsior M. The association of functional polymorphisms in genes encoding growth factors for endothelial cells and smooth muscle cells with the severity of coronary artery disease. BMC Cardiovasc Disord 2016; 16:218. [PMID: 27835972 PMCID: PMC5106826 DOI: 10.1186/s12872-016-0402-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 11/08/2016] [Indexed: 12/18/2022] Open
Abstract
Background Despite the important roles of vascular smooth muscle cells and endothelial cells in atherosclerotic lesion formation, data regarding the associations of functional polymorphisms in the genes encoding growth factors with the severity of coronary artery disease (CAD) are lacking. The aim of the present study is to analyze the relationships between functional polymorphisms in genes encoding basic fibroblast growth factor (bFGF, FGF2), epidermal growth factor (EGF), insulin-like growth factor-1 (IGF-1), platelet derived growth factor-B (PDGFB), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor A (VEGF-A) and the severity of coronary atherosclerosis in patients with stable CAD undergoing their first coronary angiography. Methods In total, 319 patients with stable CAD who underwent their first coronary angiography at the Silesian Centre for Heart Diseases in Zabrze, Poland were included in the analysis. CAD burden was assessed using the Gensini score. The TaqMan method was used for genotyping of selected functional polymorphisms in the FGF2, PDGFB, TGFB1, IGF1 and VEGFA genes, while rs4444903 in the EGF gene was genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The associations between the selected polymorphisms and the Gensini were calculated both for the whole cohort and for a subgroup of patients without previous myocardial infarction (MI). Results There were no differences in the distribution of the Gensini score between the genotypes of the analyzed polymorphisms in FGF2, EGF, IGF1, PDFGB, and TGFB1 in the whole cohort and in the subgroup of patients without previous MI. The Gensini score for VEGFA rs699947 single-nucleotide polymorphism (SNP) in patients without previous myocardial infarction, after correction for multiple testing, was highest in patients with the A/A genotype, lower in heterozygotes and lowest in patients with the C/C genotype, (p value for trend = 0.013, false discovery rate (FDR) = 0.02). After adjustment for clinical variables, and correction for multiple comparisons the association between the VEGFA genotype and Gensini score remained only nominally significant (p = 0.04, FDR = 0.19) under the dominant genetic model in patients without previous MI. Conclusions We were unable to find strong association between analyzed polymorphisms in growth factors and the severity of coronary artery disease, although there was a trend toward association between rs699947 and the severity of CAD in patients without previous MI. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0402-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland. .,Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Curie-Skłodowskiej Street 10C, 41-800, Zabrze, Poland.
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Jordana Street 19, 41-808, Zabrze, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Martyna Fronczek
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Curie-Skłodowskiej Street 10C, 41-800, Zabrze, Poland.,Silesian Center for Heart Diseases, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Marcin Gawlita
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Małgorzata Gonera
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Jarosław Wasilewski
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Bożena Szyguła-Jurkiewicz
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
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Osadnik T, Bujak K, Lekston A. Is GLUT1 a potential target for in-stent restenosis treatment? Int J Cardiol 2016; 223:199-200. [DOI: 10.1016/j.ijcard.2016.08.071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/04/2016] [Indexed: 10/21/2022]
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Osadnik T, Strzelczyk JK, Fronczek M, Bujak K, Reguła R, Gonera M, Gawlita M, Kurek A, Wasilewski J, Lekston A, Gierlotka M, Hawranek M, Ostrowska Z, Wiczkowski A, Poloński L, Gąsior M. Relationship of the rs1799752 polymorphism of the angiotensin-converting enzyme gene and the rs699 polymorphism of the angiotensinogen gene to the process of in-stent restenosis in a population of Polish patients with stable coronary artery disease. Adv Med Sci 2016; 61:276-281. [PMID: 27162064 DOI: 10.1016/j.advms.2016.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 02/24/2016] [Accepted: 03/18/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The renin-angiotensin-aldosterone system may influence in-stent restenosis (ISR) via angiotensin II, which stimulates the production of growth factors for smooth muscle cells. The aim of this work is to assess the influence of the rs1799752 polymorphism of the angiotensin-converting enzyme (ACE) gene and the rs699 polymorphism of the angiotensinogen (AGT) gene on the ISR in Polish patients with stable coronary artery disease (SCAD) who underwent stent implantation. MATERIAL/METHODS Two hundred and sixty-five patients with SCAD were included in the study. All patients underwent stent implantation upon admission to the hospital and had subsequent coronary angiography performed. The patients were divided into two groups - those with significant ISR (n=53) and those without ISR (n=212). The ACE polymorphism was assessed using the classical PCR method and the AGT polymorphism was determined using the TaqMan method for SNP genotyping. RESULTS No difference in the frequency of angiographically significant ISR occurrence associated with the different ACE and AGT gene polymorphisms was observed. In a multivariable analysis, after correction for clinical variables, the relationship between the ACE and AGT genotypes within the scope of the analyzed polymorphisms and the process of restenosis was not found using a dominant, recessive and log-additive model. Late lumen loss was also independent of the genotypes of the polymorphisms before and after correction with angiographic variables. CONCLUSIONS The rs1799752 polymorphism and the rs699 polymorphism had no relationship with the occurrence of angiographically significant ISR and late lumen loss in a group of Polish patients who underwent metal stent implantation.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland; Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland.
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Martyna Fronczek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland; Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Małgorzata Gonera
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gawlita
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Anna Kurek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Jarosław Wasilewski
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Zofia Ostrowska
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Wiczkowski
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
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Wasilewski J, Desperak P, Hawranek M, Ciślak A, Osadnik T, Pyka Ł, Gawlita M, Bujak K, Niedziela J, Krawczyk M, Gąsior M. Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study. Platelets 2016; 27:452-8. [PMID: 26939525 DOI: 10.3109/09537104.2016.1143919] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) is a simple and reliable indicator of platelet size that correlates with platelet activation and their ability to aggregate. We studied the predictive value of MPV in patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI). METHODS We analyzed the consecutive records of 1001 patients who were hospitalized due to NSTEMI at our center. The primary end point was a composite end point that included the rates of all-cause death, non-fatal myocardial infarction, and acute coronary syndrome (ACS) driven revascularization at 12 months. The enrolled patients were stratified according to the quartile of the MPV level at admission. RESULTS Along with the increasing quartile of MPV, the 12-month composite end point increased significantly (p = 0.010), and this association remained significant after the risk-adjusted analyses (per 1 fL higher MPV; adjusted hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.02-1.27; p = 0.026). In the multivariate analysis, the MPV was also an independent factor of all-cause mortality (per 1 fL increase; adjusted HR 1.34; 95% CI 1.12-1.61; p = 0.0014) and death or non-fatal myocardial infarction (per 1 fL increase; adjusted HR 1.16; 95% CI 1.03-1.31; p = 0.017). CONCLUSION In patients with NSTEMI treated with PCI, a high MPV value was associated with a significantly increased incidence of long-term adverse events, particularly for all-cause mortality.
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Affiliation(s)
- Jarosław Wasilewski
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Piotr Desperak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Hawranek
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Aneta Ciślak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Tadeusz Osadnik
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.,c Genomics Laboratory, Kardio-Med Silesia Science and Technology Park , Zabrze , Poland
| | - Łukasz Pyka
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Marcin Gawlita
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Kamil Bujak
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Jacek Niedziela
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Krawczyk
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Mariusz Gąsior
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
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Osadnik T, Strzelczyk JK, Reguła R, Bujak K, Fronczek M, Gonera M, Gawlita M, Wasilewski J, Lekston A, Kurek A, Gierlotka M, Trzeciak P, Hawranek M, Ostrowska Z, Wiczkowski A, Poloński L, Gąsior M. The Relationships between Polymorphisms in Genes Encoding the Growth Factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A and the Restenosis Process in Patients with Stable Coronary Artery Disease Treated with Bare Metal Stent. PLoS One 2016; 11:e0150500. [PMID: 26930482 PMCID: PMC4773170 DOI: 10.1371/journal.pone.0150500] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/15/2016] [Indexed: 12/22/2022] Open
Abstract
Background Neointima forming after stent implantation consists of vascular smooth muscle cells (VSMCs) in 90%. Growth factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A play an important role in VSMC proliferation and migration to the tunica intima after arterial wall injury. The aim of this paper was an analysis of functional polymorphisms in genes encoding TGF-β1, PDGFB, EGF, bFGF and VEGF-A in relation to in-stent restenosis (ISR). Materials and Methods 265 patients with a stable coronary artery disease (SCAD) hospitalized in our center in the years 2007–2011 were included in the study. All patients underwent stent implantation at admission to the hospital and had another coronary angiography performed due to recurrence of the ailments or a positive result of the test assessing the coronary flow reserve. Angiographically significant ISR was defined as stenosis >50% in the stented coronary artery segment. The patients were divided into two groups–with angiographically significant ISR (n = 53) and without significant ISR (n = 212). Additionally, the assessment of late lumen loss (LLL) in vessel was performed. EGF rs4444903 polymorphism was genotyped using the PCR-RFLP method whilst rs1800470 (TGFB1), rs2285094 (PDGFB) rs308395 (bFGF) and rs699947 (VEGF-A) were determined using the TaqMan method. Results Angiographically significant ISR was significantly less frequently observed in the group of patients with the A/A genotype of rs1800470 polymorphism (TGFB1) versus patients with A/G and G/G genotypes. In the multivariable analysis, LLL was significantly lower in patients with the A/A genotype of rs1800470 (TGFB1) versus those with the A/G and G/G genotypes and higher in patients with the A/A genotype of the VEGF-A polymorphism versus the A/C and C/C genotypes. The C/C genotype of rs2285094 (PDGFB) was associated with greater LLL compared to C/T heterozygotes and T/T homozygotes. Conclusions The polymorphisms rs1800470, rs2285094 and rs6999447 of the TGFB1, PDGFB and VEGF-A genes, respectively, are associated with LLL in patients with SCAD treated by PCI with a metal stent implantation.
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Affiliation(s)
- Tadeusz Osadnik
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
- * E-mail:
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Rafał Reguła
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Kamil Bujak
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Martyna Fronczek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Małgorzata Gonera
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gawlita
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Jarosław Wasilewski
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Anna Kurek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marek Gierlotka
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Przemysław Trzeciak
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Michał Hawranek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Zofia Ostrowska
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Wiczkowski
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Lech Poloński
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
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Wasilewski J, Poloński L, Lekston A, Osadnik T, Reguła R, Bujak K, Kurek A. Who is eligible for randomized trials? A comparison between the exclusion criteria defined by the ISCHEMIA trial and 3102 real-world patients with stable coronary artery disease undergoing stent implantation in a single cardiology center. Trials 2015; 16:411. [PMID: 26373291 PMCID: PMC4570660 DOI: 10.1186/s13063-015-0934-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 08/28/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Randomized controlled trials are the gold standard for evaluating therapy; however, controversy exists regarding the applicability of such results to daily practice, as patients are often pre-selected and may not reflect real-world clinical settings. We studied the eligibility criteria for 3102 "real-life" patients with stable coronary artery disease (SCAD) according to the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial exclusion criteria. The aim of our analysis was to estimate the percentage of real-life patients who would have met the exclusion criteria for the ISCHEMIA trial. METHODS We analyzed 3102 patients with SCAD referred to the Silesian Center for Heart Disease who underwent both coronary angiography and stent implantation between January 2006 and December 2011. The patients were divided into two groups. Group A was composed of patients with SCAD who would have been excluded from the ongoing ISCHEMIA trial, whereas group B represented the remaining patients. RESULTS A total of 1900 (61.3%) patients met at least one of the exclusion criteria. The most frequent exclusion criterion noted was revascularization within the previous 12 months (938 patients; 49.4%), followed by unacceptable level of angina symptoms (532 patients; 28 %), low ejection fraction (467 patients; 24.6%), and acute coronary syndrome within the previous 2 months (456 patients; 24%). Patients from our cohort who would have been excluded from the ISCHEMIA trial were older, had more comorbidities, and experienced worse long-term outcomes. CONCLUSIONS The ISCHEMIA trial exclusion criteria ruled out the majority of the patients with SCAD undergoing percutaneous coronary intervention in "real life". Our cohort of patients who would have been excluded from the ISCHEMIA trial had more comorbidities and experienced significantly worse long-term outcomes than patients who did not meet the ISCHEMIA trial exclusion criteria. TRIAL REGISTRATION ClinicalTrials.gov NCT01471522.
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Affiliation(s)
- Jarosław Wasilewski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Lech Poloński
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Andrzej Lekston
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Tadeusz Osadnik
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Rafał Reguła
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Kamil Bujak
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Anna Kurek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
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Osadnik T, Strzelczyk J, Bujak K, Reguła R, Wasilewski J, Fronczek M, Kurek A, Gawlita M, Gonera M, Gierlotka M, Lekston A, Hawranek M, Myrda K, Wiczkowski A, Ostrowska Z, Gąsior M, Poloński L. Functional polymorphism rs710218 in the gene coding GLUT1 protein is associated with in-stent restenosis. Biomark Med 2015; 9:743-50. [DOI: 10.2217/bmm.15.36] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: To analyze the association between in-stent restenosis (ISR) and polymorphisms in genes coding IGF-1, IGFBP3, ITGB3 and GLUT1, which play an important role in the smooth muscle cell proliferation and extracellular matrix synthesis – the main components of neointima. Materials & methods: We analyzed 265 patients who underwent bare metal stent implantation. Results: The differences in the occurrence of ISR between genotypes of the analyzed polymorphisms in the IGF-1, IGFBP3 and ITGB3 were not statistically significant. The T/T genotype of the rs710218 polymorphism in the GLUT1 (SLC2A1) gene was more common in the ISR group compared with non-ISR patients (81.1 vs 64.8%; p = 0.02). In a multivariable model the A/A and A/T genotype remained correlated with lower occurrence of ISR (odds ratio: 0.45; 95% CI: 0.21–0.97; p = 0.03). Conclusion: The rs710218 polymorphism in the gene coding GLUT1 protein is a novel risk factor for ISR.
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Affiliation(s)
- Tadeusz Osadnik
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Joanna Strzelczyk
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Kamil Bujak
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Rafał Reguła
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Jarosław Wasilewski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Martyna Fronczek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Anna Kurek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Marcin Gawlita
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Małgorzata Gonera
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Marek Gierlotka
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Andrzej Lekston
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Michał Hawranek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Krzysztof Myrda
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Andrzej Wiczkowski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Zofia Ostrowska
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Mariusz Gąsior
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Lech Poloński
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
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