1
|
Maciorowska M, Uziębło-Życzkowska B, Gorczyca-Głowacka I, Wożakowska-Kapłon B, Jelonek O, Wójcik M, Błaszczyk R, Kapłon-Cieślicka A, Gawałko M, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Krzciuk M, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Krzesiński P. Oral anticoagulation therapy in atrial fibrillation patients at high risk of bleeding: Clinical characteristics and treatment strategies based on data from the Polish multicenter register of atrial fibrillation (POL-AF). Kardiol Pol 2024; 82:37-45. [PMID: 38230462 DOI: 10.33963/v.kp.98356] [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: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Despite its benefits, oral anticoagulant (OAC) therapy in patients with atrial fibrillation (AF) is associated with hemorrhagic complications. AIMS We aimed to evaluate clinical characteristics of AF patients at high risk of bleeding and the frequency of OAC use as well as identify factors that predict nonuse of OACs in these patients. METHODS Consecutive AF patients hospitalized for urgent or planned reasons in cardiac centers were prospectively included in the registry in 2019. Patients with HAS-BLED ≥3 (high HAS-BLED group) were assumed to have a high risk of bleeding. RESULTS Among 3598 patients enrolled in the study, 29.2% were at high risk of bleeding (44.7% female; median [Q1-Q3] age 72 [65-81], CHA2DS2-VASc score 5 [4-6], HAS-BLED 3 [3-4]). In this group, 14.5% of patients did not receive OACs, 68% received NOACs, and 17.5% VKAs. In multivariable analysis, the independent predictors of nonuse of oral OACs were as follows: creatinine level (odds ratio [OR], 1.441; 95% confidence interval [CI], 1.174-1.768; P <0.001), a history of gastrointestinal bleeding (OR, 2.918; 95% CI, 1.395-6.103; P = 0.004), malignant neoplasm (OR, 3.127; 95% CI, 1.332-7.343; P = 0.009), and a history of strokes or transient ischemic attacks (OR, 0.327; 95% CI, 0.166-0.642; P = 0.001). CONCLUSIONS OACs were used much less frequently in the group with a high HAS-BLED score than in the group with a low score. Independent predictors of nonuse of OACs were creatinine levels, a history of gastrointestinal bleeding, and malignant neoplasms. A history of stroke or transient ischemic attack increased the chances of receiving therapy.
Collapse
Affiliation(s)
- Małgorzata Maciorowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warszawa, Poland.
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warszawa, Poland
| | | | - Beata Wożakowska-Kapłon
- Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland
| | - Olga Jelonek
- Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, Lublin, Poland
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, Lublin, Poland
| | | | - Monika Gawałko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
- Department of Cardiology, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, Essen, Germany
| | - Tomasz Tokarek
- Center for Invasive Cardiology, Electrotherapy and Angiology, Nowy Sącz, Poland
- Center for Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Jacek Bil
- Centre of Postgraduate Medical Education, Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Michał Wojewódzki
- Centre of Postgraduate Medical Education, Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, Ostrowiec Świętokrzyski, Poland
| | - Małgorzata Krzciuk
- Department of Cardiology, Regional Hospital, Ostrowiec Świętokrzyski, Poland
| | - Janusz Bednarski
- Department of Cardiology, St John Paul II Western Hospital, Clinic of Cardiology, Grodzisk Mazowiecki, Poland
- Lazarski University, Warszawa, Poland
| | - Elwira Bakuła-Ostalska
- Department of Cardiology, St John Paul II Western Hospital, Clinic of Cardiology, Grodzisk Mazowiecki, Poland
| | | | - Anna Szyszkowska
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warszawa, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warszawa, Poland
| | - Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Warszawa, Poland
| |
Collapse
|
2
|
Mamcarz A, Wełnicki M, Drożdż J, Grabowski M, Jankowski P, Kuchar E, Leszek P, Mitkowski P, Wysocki J. The role of pneumococcal vaccination in reducing cardiovascular risk in cardiac patients: Expert opinion of the Prevention Committee of the Polish Cardiac Society supported by the Polish Vaccinology Society. Kardiol Pol 2023; 81:1038-1046. [PMID: 37660388 DOI: 10.33963/v.kp.96718] [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: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 09/05/2023]
Abstract
Respiratory diseases have been the fourth most common cause of death in Poland in recent years. Respiratory infection, especially pneumonia, can lead to exacerbation of chronic cardiovascular disease.Streptococcus pneumoniae is the most common bacterial pathogen causing community-acquired pneumonia. Pneumococci are also the most common pathogen complicating the course of infection with the influenza virus. Pneumonia, especially invasive pneumococcal disease, is associated with risk of death in the course of respiratory failure or sepsis and also with worsening of the prognosis for existing cardiovascular disease. Despite those facts, recommendations for pneumococcal vaccination are still not well established in cardiovascular guidelines. This expert opinion aims to summarize current knowledge on the importance of preventing invasive pneumococcal disease in cardiac patients.
Collapse
Affiliation(s)
- Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland.
| | - Marcin Wełnicki
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Jarosław Drożdż
- 2nd Department of Cardiology, Medical University of Lodz, Łódź, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Piotr Jankowski
- Department of Internal Diseases and Gerontocardiology, Center of Postgraduate Medical Education in Warsaw, Warszawa, Poland
| | - Ernest Kuchar
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warszawa, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantation Medicine, Cardinal Stefan Wyszynski Institute of Cardiology in Warsaw, Warszawa, Poland
| | - Przemysław Mitkowski
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Jacek Wysocki
- Chair and Department of Health Prophylaxis, Medical University of Poznan, Poznań, Poland
| |
Collapse
|
3
|
Kasprzak JD, Gorczyca-Głowacka I, Sobczak-Kaleta M, Barylski M, Drożdż J, Filipiak KJ, Kapłon-Cieślicka A, Lelonek M, Mamcarz A, Ochijewicz D, Ryś-Czaporowska A, Starzyk K, Szymański FM, Wełnicki M, Wożakowska-Kapłon B. Pharmacotherapy of heart failure A.D. 2023. Expert opinion of Working Group on Cardiovascular Pharmacotherapy, Polish Cardiac Society. Kardiol Pol 2023:VM/OJS/J/95406. [PMID: 37179465 DOI: 10.33963/kp.a2023.0110] [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: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
Heart failure (HF) remains one of the most common causes of hospitalization and mortality among Polish patients. The position of the Section of Cardiovascular Pharmacotherapy presents the currently applicable options for pharmacological treatment of HF based on the latest European and American guidelines from 2021-2022 in relation to Polish health care conditions. Treatment of HF varies depending on its clinical presentation (acute/chronic) or left ventricular ejection fraction. Initial treatment of symptomatic patients with features of volume overload is based on diuretics, especially loop drugs. Treatment aimed at reducing mortality and hospitalization should include: drugs blocking the renin-angiotensin-aldosterone system (preferably angiotensin receptor antagonist/neprilisin inhibitor, i.e. sacubitril/valsartan, selected beta-blockers (no class effect - options include bisoprolol, metoprolol succinate, or vasodilatory beta-blockers - carvedilol and nebivolol), mineralocorticoid receptor antagonist and sodium-glucose cotransporter type 2 inhibitor (flozin), constituting the 4 pillars of pharmacotherapy. Their effectiveness of the above-mentioned has been confirmed in numerous prospective, randomized trials. The current HF treatment strategy is based on the fastest possible implementation of all four mentioned classes of drugs due to their independent, additive action. It is also important to individualize therapy according to comorbidities, blood pressure, resting heart rate, or presence of arrhythmia. The manuscript emphasizes cardio- and nephroprotective role of flozins in HF therapy, regardless of ejection fraction. We propose practical guidelines for the use of medicines, the profile of adverse reactions, drug interactions, as well as pharmacoeconomic aspects. The principles of treatment with ivabradine, digoxin, vericiguat, iron supplementation or antiplatelet and anticoagulant therapy were also discussed, along with recent novel drugs including omecamtiv mecarbil, tolvaptan or coenzyme Q10 as well as progress in the prevention and treatment of hyperkalemia. Based on the latest recommendations, treatment regimens for different types of HF were discussed.
Collapse
Affiliation(s)
| | | | | | - Marcin Barylski
- Department of Internal Diseases and Cardiac Rehabilitation, Medical University of Lodz, Łódź, Poland
| | - Jarosław Drożdż
- 2nd Department of Cardiology, Medical University Lodz, Łódź, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Sciences, Maria Sklodowska-Curie Medical Academy, Warszawa, Poland
| | | | - Małgorzata Lelonek
- Nonivasive Cardiology Unit, Chair of Internal Medicine and Cardiology, Medical University of Lodz, Łódź, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Dorota Ochijewicz
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Polska
| | - Anna Ryś-Czaporowska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Polska
| | - Katarzyna Starzyk
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- 1st Department of Cardiology and Electrotherapy, Świętokrzyskie Cardiology Center, Kielce, Poland
| | - Filip M Szymański
- Department of Civilization Diseases, Faculty of Medicine, Collegium Medicum, Stefan Cardinal Wyszynski University in Warsaw, Warszawa, Polan
| | - Marcin Wełnicki
- 1st Department of Cardiology and Electrotherapy, Świętokrzyskie Cardiology Center, Kielce, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland
- 1st Department of Cardiology and Electrotherapy, Świętokrzyskie Cardiology Center, Kielce, Poland
| |
Collapse
|
4
|
Demi L, Wolfram F, Klersy C, De Silvestri A, Ferretti VV, Muller M, Miller D, Feletti F, Wełnicki M, Buda N, Skoczylas A, Pomiecko A, Damjanovic D, Olszewski R, Kirkpatrick AW, Breitkreutz R, Mathis G, Soldati G, Smargiassi A, Inchingolo R, Perrone T. New International Guidelines and Consensus on the Use of Lung Ultrasound. J Ultrasound Med 2023; 42:309-344. [PMID: 35993596 PMCID: PMC10086956 DOI: 10.1002/jum.16088] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [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: 03/07/2022] [Revised: 06/28/2022] [Accepted: 07/31/2022] [Indexed: 05/02/2023]
Abstract
Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements.
Collapse
Affiliation(s)
- Libertario Demi
- Department of Information Engineering and Computer ScienceUniversity of TrentoTrentoItaly
| | - Frank Wolfram
- Department of Thoracic and Vascular SurgerySRH Wald‐Klinikum GeraGeraGermany
| | - Catherine Klersy
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | - Annalisa De Silvestri
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | | | - Marie Muller
- Department of Mechanical and Aerospace EngineeringNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Douglas Miller
- Department of RadiologyMichigan MedicineAnn ArborMichiganUSA
| | - Francesco Feletti
- Department of Diagnostic ImagingUnit of Radiology of the Hospital of Ravenna, Ausl RomagnaRavennaItaly
- Department of Translational Medicine and for RomagnaUniversità Degli Studi di FerraraFerraraItaly
| | - Marcin Wełnicki
- 3rd Department of Internal Medicine and CardiologyMedical University of WarsawWarsawPoland
| | - Natalia Buda
- Department of Internal Medicine, Connective Tissue Disease and GeriatricsMedical University of GdanskGdanskPoland
| | - Agnieszka Skoczylas
- Geriatrics DepartmentNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrzej Pomiecko
- Clinic of Pediatrics, Hematology and OncologyUniversity Clinical CenterGdańskPoland
| | - Domagoj Damjanovic
- Heart Center Freiburg University, Department of Cardiovascular Surgery, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Robert Olszewski
- Department of Gerontology, Public Health and DidacticsNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrew W. Kirkpatrick
- Departments of Critical Care Medicine and SurgeryUniversity of Calgary and the TeleMentored Ultrasound Supported Medical Interventions Research GroupCalgaryCanada
| | - Raoul Breitkreutz
- FOM Hochschule für Oekonomie & Management gGmbHDepartment of Health and SocialEssenGermany
| | - Gebhart Mathis
- Emergency UltrasoundAustrian Society for Ultrasound in Medicine and BiologyViennaAustria
| | - Gino Soldati
- Diagnostic and Interventional Ultrasound UnitValledel Serchio General HospitalLuccaItaly
| | - Andrea Smargiassi
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
| | - Riccardo Inchingolo
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
| | | |
Collapse
|
5
|
Gorczyca-Głowacka I, Wełnicki M, Mamcarz A, Filipiak KJ, Wożakowska-Kapłon B, Barylski M, Szymański FM, Kasprzak JD, Tomasiewcz K. Metabolic associated fatty liver disease and cardiovascular risk: The expert opinion of the Working Group on Cardiovascular Pharmacotherapy of the Polish Cardiac Society. Kardiol Pol 2023; 81:207-214. [PMID: 36866400 DOI: 10.33963/kp.a2023.0022] [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: 01/22/2023] [Accepted: 01/22/2023] [Indexed: 03/04/2023]
Abstract
The diagnosis of metabolic associated fatty liver disease (MAFLD) is significant for patients' prognosis, as the disease accelerates the development of cardiovascular complications and, on the other hand, cardiometabolic conditions are risk factors for the development of fatty liver diseases. This expert opinion presents principles of MAFLD diagnosis and standards of management to reduce cardiovascular risks in patients with MAFLD.
Collapse
Affiliation(s)
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warszawa, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warszawa, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Sciences, Maria Sklodowska-Curie Medical Academy in Warsaw, Warszawa, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland.,1st Department of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Center in Kielce, Kielce, Poland
| | - Marcin Barylski
- Department of Internal Diseases and Cardiological Physiotherapy, Medical University in Lodz, Łódź, Poland
| | - Filip M Szymański
- Department of Civilization Diseases, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Warszawa, Poland
| | | | - Krzysztof Tomasiewcz
- Chair and Department of Infectious Diseases, the Medical University in Lublin, Lublin, Poland
| |
Collapse
|
6
|
Szyszkowska A, Kuźma Ł, Wożakowska-Kapłon B, Gorczyca-Głowacka I, Jelonek O, Uziębło-Życzkowska B, Krzesiński P, Wójcik M, Błaszczyk R, Gawałko M, Kapłon-Cieślicka A, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Krzciuk M, Bednarski J, Bakuła E, Wełnicki M, Mamcarz A, Tomaszuk-Kazberuk A. Do Patients with Atrial Fibrillation and a History of Ischemic Stroke Overuse Reduced Doses of NOACs?-Results of the Polish Atrial Fibrillation (POL-AF) Registry. Int J Environ Res Public Health 2022; 19:11939. [PMID: 36231257 PMCID: PMC9564626 DOI: 10.3390/ijerph191911939] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of our study was to assess if patients with AF (atrial fibrillation) and a history of ischemic stroke (IS) excessively receive reduced doses of NOACs (non-vitamin K antagonist oral anticoagulants). METHODS The Polish AF (POL-AF) registry is a prospective, observational, multicenter study, including patients with AF from 10 cardiology hospital centers. In this study we focused on patients with IS in their past. RESULTS Among 3999 patients enrolled in the POL-AF registry, 479 (12%) had a previous history of IS. Compared to patients without IS history, post-stroke subjects had a higher CHA2DS2-VASc score (median score 7 vs. 4, p < 0.05). Of these subjects, 439 (92%) had anticoagulation therapy, 83 (18.9%) were treated with a vitamin K antagonist (VKA), 135 (30.8%) with rivaroxaban, 112 (25.5%) with dabigatran, and 109 (24.8%) with apixaban. There were a significant number of patients after IS with reduced doses of NOACs (48.9% for rivaroxaban, 45.5% for dabigatran, and 36.7% for apixaban). In many cases, patients were prescribed reduced doses of NOACs without any indication for reduction (28.8% of rivaroxaban use, 56.9% of dabigatran use, and 60.0% of apixaban use-out of reduced dosage groups, p = 0.06). CONCLUSIONS A significant proportion of AF patients received reduced doses of NOAC after ischemic stroke in a sizeable number of cases, without indication for dose reduction.
Collapse
Affiliation(s)
- Anna Szyszkowska
- Department of Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Beata Wożakowska-Kapłon
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Iwona Gorczyca-Głowacka
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Olga Jelonek
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Monika Gawałko
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
- Department of Cardiology, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht, 6229 ER Maastricht, The Netherlands
- Institute of Pharmacology, West German Heart and Vascular Centre, University Duisburg-Essen, 45147 Essen, Germany
| | | | - Tomasz Tokarek
- Center for Invasive Cardiology, Electrotherapy and Angiology, 38-400 Nowy Sacz, Poland
| | - Renata Rajtar-Salwa
- Cardiology and Cardiovascular Interventions Clinical Department, The University Hospital, 30-688 Krakow, Poland
| | - Jacek Bil
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland
| | - Michał Wojewódzki
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, 02-776 Warsaw, Poland
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland
| | - Małgorzata Krzciuk
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swietokrzyski, Poland
| | - Janusz Bednarski
- Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland
| | - Elwira Bakuła
- Department of Cardiology, St. John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | |
Collapse
|
7
|
Gorczyca-Głowacka I, Kapłon-Cieślicka A, Wełnicki M, Szymański F, Barylski M, Mamcarz A, Filipiak KJ, Wożakowska-Kapłon B. Rules for the use of reduced doses of non-vitamin K antagonist oral anticoagulants in the prevention of thromboembolic complications in patients with atrial fibrillation. The opinion of the Working Group on Cardiovascular Pharmacotherapy of the Polish Cardiac Society. Kardiol Pol 2022; 80:1299-1306. [PMID: 36601886 DOI: 10.33963/kp.a2022.0286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/04/2022] [Indexed: 01/06/2023]
Affiliation(s)
| | | | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Filip Szymański
- Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Warszawa, Poland
| | - Marcin Barylski
- Department of Internal Diseases and Cardiac Rehabilitation, Medical University of Lodz, Łódź, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Sciences, Maria Skłodowska-Curie Medical Academy in Warsaw, Warszawa, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland.,1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Center in Kielce, Kielce, Poland
| |
Collapse
|
8
|
Wełnicki M, Gorczyca-Głowacka I, Mamcarz A, Filipiak KJ, Wożakowska-Kapłon B, Barylski M, Szymański FM, Kasprzak JD, Grabowski M, Dzida G. The use of GLP-1 analogues in the treatment of diabetes in patients with cardiovascular diseases. The expert opinion of the Working Group of Cardiovascular Pharmacotherapy of the Polish Cardiac Society. Kardiol Pol 2022; 80:1286-1289. [PMID: 36601885 DOI: 10.33963/kp.a2022.0282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/04/2022] [Indexed: 01/06/2023]
Affiliation(s)
- Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warszawa, Poland.
| | | | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Sciences, Maria Sklodowska-Curie Medical Academy, Warszawa, Poland
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, Jan Kochanowski University in Kielce, Kielce, Poland.,1st Department of Cardiology and Electrotherapy, Świętokrzyskie Cardiology Center, Kielce, Poland
| | - Marcin Barylski
- Department of Internal Diseases and Cardiac Rehabilitation, Medical University of Lodz, Łódź, Poland
| | - Filip M Szymański
- Departament of Civilization Diseases, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Warszawa, Poland
| | - Jarosław D Kasprzak
- 1st Chair and Department of Cardiology, Medical University of Lodz, Łódź, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Grzegorz Dzida
- Department of Internal Diseases, Medical University of Lublin, Lublin, Poland
| |
Collapse
|
9
|
Szpotowicz A, Gorczyca-Głowacka I, Uziębło-Życzkowska B, Maciorowska M, Wójcik M, Błaszczyk R, Kapłon-Cieślicka A, Gawałko M, Budnik M, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Krzciuk M, Wożakowska-Kapłon B. Czy wynik CHA2DS2-VASc determinuje leczenie przeciwzakrzepowe u pacjentów z migotaniem przedsionków? Dane z POLish Atrial Fibrillation (POL-AF) Registry? Folia Cardiologica 2021. [DOI: 10.5603/fc.a2021.0053] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
10
|
Wełnicki M. The heart in the tentacles of an octopus. Commentary on the case report “Late-onset takotsubo cardiomyopathy after acute pulmonary embolism” by Aleksandra Wilk et al. Folia Cardiologica 2021. [DOI: 10.5603/fc.2021.0041] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
11
|
Gawałko M, Budnik M, Gorczyca I, Jelonek O, Uziębło-Życzkowska B, Maciorowska M, Wójcik M, Błaszczyk R, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Krzciuk M, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Kapłon-Cieślicka A. Characteristics and Treatment of Atrial Fibrillation with Respect to the Presence or Absence of Heart Failure. Insights from the Multicenter Polish Atrial Fibrillation (POL-AF) Registry. J Clin Med 2021; 10:jcm10071341. [PMID: 33804992 PMCID: PMC8036873 DOI: 10.3390/jcm10071341] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background: We aimed to assess characteristics and treatment of AF patients with and without heart failure (HF). Methods: The prospective, observational Polish Atrial Fibrillation (POL-AF) Registry included consecutive patients with AF hospitalized in 10 Polish cardiology centers in 2019–2020. Results: Among 3999 AF patients, 2822 (71%) had HF (AF/HF group). Half of AF/HF patients had preserved ejection fraction (HFpEF). Compared to patients without HF (AF/non–HF), AF/HF patients were older, more often male, more often had permanent AF, and had more comorbidities. Of AF/HF patients, 98% had class I indications to oral anticoagulation (OAC). Still, 16% of patients were not treated with OAC at hospital admission, and 9%—at discharge (regardless of the presence of HF and its subtypes). Of patients not receiving OAC upon admission, 61% were prescribed OAC (most often apixaban) at discharge. AF/non–HF patients more often converted from AF at admission to sinus rhythm at discharge compared to AF/HF patients (55% vs. 30%), despite cardioversion performed as often in both groups. Class I antiarrhythmics were more often prescribed in AF/non–HF than in AF/HF group (13% vs. 8%), but still as many as 15% of HFpEF patients received them. Conclusions: Over 70% of hospitalized AF patients have coexisting HF. A significant number of AF patients does not receive the recommended OAC.
Collapse
Affiliation(s)
- Monika Gawałko
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (M.B.)
| | - Monika Budnik
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (M.B.)
| | - Iwona Gorczyca
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland; (I.G.); (O.J.)
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Olga Jelonek
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland; (I.G.); (O.J.)
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.)
| | - Małgorzata Maciorowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.)
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (T.T.); (R.R.-S.)
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (T.T.); (R.R.-S.)
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Michał Wojewódzki
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Świętokrzyski, Poland; (A.S.); (M.K.)
| | - Małgorzata Krzciuk
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Świętokrzyski, Poland; (A.S.); (M.K.)
| | - Janusz Bednarski
- Department of Cardiology, St John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | - Elwira Bakuła-Ostalska
- Department of Cardiology, St John Paul’s II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | - Anna Tomaszuk-Kazberuk
- Department of Cardiology, University Hospital of Białystok, 15-276 Białystok, Poland; (A.T.-K.); (A.S.)
| | - Anna Szyszkowska
- Department of Cardiology, University Hospital of Białystok, 15-276 Białystok, Poland; (A.T.-K.); (A.S.)
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Agnieszka Kapłon-Cieślicka
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (M.B.)
- Correspondence: ; Tel.: +48-22-599-29-58
| |
Collapse
|
12
|
Śliż D, Parol D, Wełnicki M, Chomiuk T, Grabowska I, Dąbrowska D, Król W, Price S, Braksator W, Mamcarz A. Macronutrient intake, carbohydrate metabolism and cholesterol in Polish male amateur athletes on a vegan diet. NUTR BULL 2021. [DOI: 10.1111/nbu.12491] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Daniel Śliż
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
- Public Health School Centre of Postgraduate Medical Education Warsaw Poland
| | - D. Parol
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
| | - M. Wełnicki
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
| | - T. Chomiuk
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
| | - I. Grabowska
- Faculty of Physical Education and Sport in Biała Podlaska Józef Piłsudski University of Physical Education in Warsaw Warsaw Poland
| | - D. Dąbrowska
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
| | - W. Król
- Department of Sports Cardiology and Noninvasive Cardiovascular Imaging Medical University of Warsaw Warsaw Poland
| | - S. Price
- Department of Sports Cardiology and Noninvasive Cardiovascular Imaging Medical University of Warsaw Warsaw Poland
| | - W. Braksator
- Department of Sports Cardiology and Noninvasive Cardiovascular Imaging Medical University of Warsaw Warsaw Poland
| | - A. Mamcarz
- 3rd Department of Internal Medicine and Cardiology Medical University of Warsaw Warsaw Poland
| |
Collapse
|
13
|
Kiliszek M, Uziębło-Życzkowska B, Gorczyca I, Maciorowska M, Jelonek O, Wożakowska-Kapłon B, Wójcik M, Błaszczyk R, Gawałko M, Kapłon-Cieślicka A, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Krzciuk M, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Krzesiński P. Symptomatic and Asymptomatic Patients in the Polish Atrial Fibrillation (POL-AF) Registry. J Clin Med 2021; 10:jcm10051091. [PMID: 33807883 PMCID: PMC7961425 DOI: 10.3390/jcm10051091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) can cause severe symptoms, but it is frequently asymptomatic. We aimed to compare the clinical features of patients with asymptomatic and symptomatic AF. METHODS A prospective, observational, multicenter study was performed (the Polish Atrial Fibrillation (POL-AF) registry). Consecutive hospitalized AF patients over 18 years of age were enrolled at ten centers. The data were collected for two weeks during each month of 2019. RESULTS A total of 2785 patients were analyzed, of whom 1360 were asymptomatic (48.8%). Asymptomatic patients were more frequently observed to have coronary artery disease (57.5% vs. 49.1%, p < 0.0001), heart failure with preserved ejection fraction (39.8% vs. 26.5%, p < 0.0001), a previous thromboembolic event (18.2% vs. 13.1%, p = 0.0002), and paroxysmal AF (52.3% vs. 45.2%, p = 0.0002). In multivariate analysis, history of electrical cardioversion, paroxysmal AF, heart failure, coronary artery disease, previous thromboembolic event, and higher left ventricular ejection fraction were predictors of a lack of AF symptoms. First-diagnosed AF was a predictor of AF symptoms. CONCLUSIONS In comparison to symptomatic patients, more of those hospitalized with asymptomatic AF had been previously diagnosed with this arrhythmia and other cardiovascular diseases. However, they presented with better left ventricular function and were more frequently treated with cardiovascular medicines.
Collapse
Affiliation(s)
- Marek Kiliszek
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.); (P.K.)
- Correspondence: ; Tel.: +48-261-817-909
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.); (P.K.)
| | - Iwona Gorczyca
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
| | - Małgorzata Maciorowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.); (P.K.)
| | - Olga Jelonek
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
| | - Beata Wożakowska-Kapłon
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Monika Gawałko
- 1st Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (A.K.-C.)
| | | | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (T.T.); (R.R.-S.)
- Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, 30-688 Kraków, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (T.T.); (R.R.-S.)
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Michał Wojewódzki
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Świętokrzyski, Poland; (A.S.); (M.K.)
| | - Małgorzata Krzciuk
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Świętokrzyski, Poland; (A.S.); (M.K.)
| | - Janusz Bednarski
- Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | - Elwira Bakuła-Ostalska
- Department of Cardiology, St. John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | | | - Anna Szyszkowska
- Department of Cardiology, University Hospital of Bialystok, 15-276 Białystok, Poland;
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (B.U.-Ż.); (M.M.); (P.K.)
| |
Collapse
|
14
|
Uziębło-Życzkowska B, Krzesiński P, Maciorowska M, Gorczyca I, Jelonek O, Wójcik M, Błaszczyk R, Kapłon-Cieślicka A, Gawałko M, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Krzciuk M, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Wożakowska-Kapłon B. Antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, including compliance with current guidelines-data from the POLish Atrial Fibrillation (POL-AF) Registry. Cardiovasc Diagn Ther 2021; 11:14-27. [PMID: 33708474 DOI: 10.21037/cdt-20-839] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Although triple antithrombotic therapy (TAT) is recommended in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), guidelines allow an option of dual antithrombotic therapy (DAT). This study assesses the everyday practice of 10 cardiology departments in antithrombotic therapy in AF patients undergoing PCI and its agreement with current guidelines. Methods This analysis included medical data of AF patients enrolled in the prospective, observational registry (The POLish Atrial Fibrillation-POL-AF) that underwent PCI [elective or due to acute coronary syndrome (ACS)]. Results Of the 3,999 consecutive subjects included, a final analysis was performed on 359 patients that underwent PCI: 148 with urgent PCI due to ACSand 211 patients with elective PCI. Eighty patients in the ACS-group and 120 patients in the elective-PCI group were treated with TAT, although guidelines also allowed DAT. Of 316 patients treated with oral anticoagulants as a part of combination therapy, 275 were on non-vitamin K antagonist oral anticoagulant (NOAC). Reduced doses of NOAC were used in 74 patients treated with rivaroxaban, 60 patients with dabigatran, and 54 patients with apixaban. The proportion of patients treated with reduced NOAC doses adequately to the guidelines was 29%, 100%, and 33% for rivaroxaban, dabigatran, and apixaban, respectively. Inappropriate low doses of NOACs were used in 71% of subjects on rivaroxaban and 67% on apixaban. Conclusions In patients with AF undergoing PCI, NOACs are definitely preferred over vitamin-K antagonists (VKAs) in TAT/DAT, and an aggressive antithrombotic strategy with TAT is frequently chosen even if DAT is permissible by the guidelines. Label adherence of using reduced NOAC dose during combination therapy is not satisfactory for apixaban and rivaroxaban and probably results from too cautious an approach to the known indications for reduced therapy. The study is registered in the database Clinical Trials-NCT04419012.
Collapse
Affiliation(s)
| | - Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland
| | - Małgorzata Maciorowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Warsaw, Poland
| | - Iwona Gorczyca
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland.,Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
| | - Olga Jelonek
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland.,Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, Lublin, Poland
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, Lublin, Poland
| | | | - Monika Gawałko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - Michał Wojewódzki
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, Ostrowiec Świętokrzyski, Poland
| | - Małgorzata Krzciuk
- Department of Cardiology, Regional Hospital, Ostrowiec Świętokrzyski, Poland
| | - Janusz Bednarski
- Department of Cardiology, St John Paul II Western Hospital, Grodzisk Mazowiecki, Poland
| | | | | | - Anna Szyszkowska
- Department of Cardiology, University Hospital of Bialystok, Białystok, Poland
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warsaw, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, Warsaw, Poland
| | - Beata Wożakowska-Kapłon
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, Kielce, Poland.,Collegium Medicum, The Jan Kochanowski University, Kielce, Poland
| |
Collapse
|
15
|
Wełnicki M, Buksińska-Lisik M, Mamcarz A. Two Strategies for the Dosage of Acenocoumarol Co-Administered with Rifampicin in Staphylococcal Prosthetic Valve Endocarditis. Antibiotics (Basel) 2021; 10:antibiotics10010038. [PMID: 33401531 PMCID: PMC7824006 DOI: 10.3390/antibiotics10010038] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/23/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
According to current European Society of Cardiology guidelines, for staphylococcal prosthetic valve endocarditis, rifampicin should be one of the drugs used. However, there is a concomitant need for vitamin K antagonists in patients with mechanical prostheses. It is widely known that rifampicin interacts with vitamin K antagonists (VKA), and this interaction makes it difficult to maintain the INR (international normalized ratio) value in the therapeutic range. We present two clinical cases of staphylococcal prosthetic valve endocarditis patients. Two different strategies for dealing with adverse drug interactions have been applied. In the first case, the dose of warfarin was up-titrated until the optimal INR value was obtained. In the second case, due to the history of labile INR values, a decision was made to modify the dosage of warfarin, taking into account pharmacological aspects of drug interactions.
Collapse
|
16
|
Gorczyca I, Jelonek O, Uziębło-Życzkowska B, Chrapek M, Maciorowska M, Wójcik M, Błaszczyk R, Kapłon-Cieślicka A, Gawałko M, Budnik M, Tokarek T, Rajtar-Salwa R, Bil J, Wojewódzki M, Szpotowicz A, Bednarski J, Bakuła-Ostalska E, Tomaszuk-Kazberuk A, Szyszkowska A, Wełnicki M, Mamcarz A, Wożakowska-Kapłon B. Trends in the Prescription of Non-Vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation: Results of the Polish Atrial Fibrillation (POL-AF) Registry. J Clin Med 2020; 9:jcm9113565. [PMID: 33167503 PMCID: PMC7694480 DOI: 10.3390/jcm9113565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/30/2020] [Accepted: 11/03/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Current guidelines do not suggest in which groups of patients with atrial fibrillation (AF) individual non-vitamin K antagonist oral anticoagulants (NOACs) should be used for the prevention of thromboembolic complications. The aim of this study was to evaluate the frequency of use of apixaban, dabigatran, and rivaroxaban, and attempt to identify factors predisposing their administration. Methods: The Polish Atrial Fibrillation (POL-AF) registry is a prospective, non-interventional study, including consecutive patients with AF hospitalized in ten Polish cardiology centers during the period ranging from January to December 2019. In this study, all patients were treated with NOACs. Results: Among the 2971 patients included in the analysis, 40.4% were treated with rivaroxaban, 32% with apixaban, and 27.6% with dabigatran. The mean age of the total population was 72 ± 11.5 years and 43% were female. A reduced dose of NOAC was used in 35% of patients treated with apixaban, 39.7% of patients treated with dabigatran, and 34.4% of patients treated with rivaroxaban. Independent predictors of the use of apixaban were previous bleeding (OR 2.37, CI 1.67–3.38), GFR < 60 mL/min (OR 1.38, CI 1.25–1.64), heart failure (OR 1.38, CI 1.14–1.67) and age (per 5 years) (OR 1.14, CI 1.09–1.19). GFR < 60 mL/min (OR 0.79, CI 0.66–0.95), female (OR 0.8, CI 0.67–0.96) and age (per 5 years) (OR 0.95, CI 0.91–0.99) diminished the chance of using dabigatran. Previous bleeding (OR 0.43, CI 0.28–0.64), vascular disease (OR 0.84, CI 0.70–0.99), and age (per 5 years) (OR 0.94, CI 0.90–0.97) diminished the chance of choosing rivaroxaban. Conclusions: In hospitalized patients with AF, the most frequently chosen NOAC was rivaroxaban. Apixaban was chosen more often in patients after bleeding, and in those who were advanced in years, with heart failure and impaired renal function. Impaired renal function and female gender were factors that diminished the chance of using dabigatran. Previous bleeding and vascular disease was the factor that diminished the chance of using rivaroxaban. Dabigatran and rivaroxaban have been used less frequently in elderly patients.
Collapse
Affiliation(s)
- Iwona Gorczyca
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Olga Jelonek
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| | - Beata Uziębło-Życzkowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
- Correspondence: ; Tel.: +48-261-816-376
| | - Magdalena Chrapek
- Faculty of Natural Sciences, The Jan Kochanowski University, 25-369 Kielce, Poland;
| | - Małgorzata Maciorowska
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | - Maciej Wójcik
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Robert Błaszczyk
- Department of Cardiology, Medical University of Lublin, 20-059 Lublin, Poland; (M.W.); (R.B.)
| | - Agnieszka Kapłon-Cieślicka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.K.-C.); (M.G.); (M.B.)
| | - Monika Gawałko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.K.-C.); (M.G.); (M.B.)
| | - Monika Budnik
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland; (A.K.-C.); (M.G.); (M.B.)
| | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (T.T.); (R.R.-S.)
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (T.T.); (R.R.-S.)
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Michał Wojewódzki
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, 02-507 Warsaw, Poland; (J.B.); (M.W.)
| | - Anna Szpotowicz
- Department of Cardiology, Regional Hospital, 27-400 Ostrowiec Swiętokrzyski, Poland;
| | - Janusz Bednarski
- Department of Cardiology, St John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | - Elwira Bakuła-Ostalska
- Department of Cardiology, St John Paul II Western Hospital, 05-825 Grodzisk Mazowiecki, Poland; (J.B.); (E.B.-O.)
| | - Anna Tomaszuk-Kazberuk
- Department of Cardiology, Medical University, 15-276 Bialystok, Poland; (A.T.-K.); (A.S.)
| | - Anna Szyszkowska
- Department of Cardiology, Medical University, 15-276 Bialystok, Poland; (A.T.-K.); (A.S.)
| | - Marcin Wełnicki
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Artur Mamcarz
- 3rd Department of Internal Diseases and Cardiology, Warsaw Medical University, 02-091 Warsaw, Poland; (M.W.); (A.M.)
| | - Beata Wożakowska-Kapłon
- Collegium Medicum, The Jan Kochanowski University, 25-369 Kielce, Poland; (I.G.); (O.J.); (B.W.-K.)
- 1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland
| |
Collapse
|
17
|
Adamska-Wełnicka A, Wełnicki M, Krzesiński P, Niemczyk S, Lubas A. Multi-Method Complex Approach for Hydration Assessment Does Not Detect a Hydration Difference in Hemodialysis versus Peritoneal Dialysis Patient. Diagnostics (Basel) 2020; 10:diagnostics10100767. [PMID: 33003347 PMCID: PMC7599655 DOI: 10.3390/diagnostics10100767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/30/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 12/19/2022] Open
Abstract
Assessment of hydration status is essential in monitoring the effectiveness of renal replacement therapy and is usually based on physical examination. However, comparisons of hydration status achieved with different dialysis methods are not conclusive. We compared the hydration status of patients on chronic hemodialysis (HD, n = 60) and peritoneal dialysis (PD, n = 20) in a comprehensive assessment including physical examination and additional methods. The mean age of the 80 chronically dialyzed patients (53 males, 27 females) was 58.1 ± 13.9 years. The clinical evaluation took into account the presence of peripheral edema, dyspnea, and crackling over the lung fields. Additional tests included lung ultrasound, electrical bioimpedance (performed in 79 patients), impedance cardiography, ultrasound assessment of large abdominal vessels (performed in 79 patients), select echocardiographic parameters (obtained in 78 patients), and serum NT-proBNP concentration. Residual diuresis volume was significantly higher in the PD group. We found no significant differences between the two groups in any other baseline characteristics or in the results of the clinical examination or additional tests. The use of different methods for assessing hydration does not allow differentiation of patients treated with dialysis in terms of the dialysis technique used. Therefore, it seems reasonable to use common algorithms to objectify the hydration status of these patients.
Collapse
Affiliation(s)
- Anna Adamska-Wełnicka
- Clinic of Nephrology and Internal Medicine, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
- Correspondence:
| | - Marcin Wełnicki
- 3rd Clinic of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Paweł Krzesiński
- Clinic of Cardiology and Internal Medicine, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | - Stanisław Niemczyk
- Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, 04-141 Warsaw, Poland; (S.N.); (A.L.)
| | - Arkadiusz Lubas
- Department of Internal Medicine, Nephrology and Dialysotherapy, Military Institute of Medicine, 04-141 Warsaw, Poland; (S.N.); (A.L.)
| |
Collapse
|
18
|
Buda N, Segura-Grau E, Cylwik J, Wełnicki M. Lung ultrasound in the diagnosis of COVID-19 infection - A case series and review of the literature. Adv Med Sci 2020; 65:378-385. [PMID: 32659729 PMCID: PMC7315981 DOI: 10.1016/j.advms.2020.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/29/2020] [Accepted: 06/20/2020] [Indexed: 01/08/2023]
Abstract
COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and spreading worldwide has become a serious challenge for the entire health care system as regards infection prevention, rapid diagnosis, and treatment. Lung ultrasound (LUS) is a dynamically developing diagnostic method used in intensive care, cardiology and nephrology, it can also be helpful in diagnosing and monitoring pneumonia. Interstitial pneumonia appears to be the most common clinical manifestation of coronavirus infection. We present 4 case reports of COVID-19 involving the lungs, in which transthoracic lung ultrasound was successfully utilized as a constituent of bedside diagnostics and a review of the literature concerning potential use of LUS in COVID-19 diagnostics. The possibility to perform this examination repeatedly, its non-invasiveness and high sensitivity make it an important element of care provided for patients with viral pneumonia.
Collapse
|
19
|
Adamska-Wełnicka A, Lubas A, Wełnicki M, Niemczyk S. FP166Overhydration recognized in bioelectrical impedance is independently affected only by the magnitude of peripheral oedemas in dialyzed patients. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp166] [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: 11/13/2022] Open
|
20
|
Szymański FM, Barylski M, Cybulska B, Wożakowska-Kapłon B, Krasiński Z, Mamcarz A, Widecka K, Płatek AE, Dudek D, Mickiewicz A, Kobayashi A, Dzida G, Grajek S, Wełnicki M, Zubilewicz T, Ufnal M, Hering D, Mizia-Stec K, Kasprzak J, Koziński M, Imiela J, Narkiewicz K, Gorczyca I, Postuła M, Jaguszewski MJ, Filipiak KJ. Recommendation for the management of dyslipidemia in Poland — Third Declaration of Sopot. Interdisciplinary Expert Position Statement endorsed by the Polish Cardiac Society Working Group on Cardiovascular Pharmacotherapy. Cardiol J 2018; 25:655-665. [DOI: 10.5603/cj.2018.0141] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/14/2018] [Indexed: 11/25/2022] Open
|
21
|
Buda N, Kosiak W, Radzikowska E, Olszewski R, Jassem E, Grabczak EM, Pomiecko A, Piotrkowski J, Piskunowicz M, Sołtysiak M, Skoczyński S, Jaczewski G, Odrowska J, Skoczylas A, Wełnicki M, Wiśniewski J, Zamojska A. Polish recommendations for lung ultrasound in internal medicine (POLLUS-IM). J Ultrason 2018; 18:198-206. [PMID: 30451402 PMCID: PMC6442220 DOI: 10.15557/jou.2018.0030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study was to establish recommendations for the use of lung ultrasound in internal medicine, based on reliable data and expert opinions. Methods The bibliography from the databases (Pubmed, Medline, OVID, Embase) has been fully reviewed up to August 2017. Members of the expert group assessed the credibility of the literature data. Then, in three rounds, a discussion was held on individual recommendations (in accordance with the Delphi procedure) followed by secret voting. Results Thirty-eight recommendations for the use of lung ultrasound in internal medicine were established as well as discussed and subjected to secret voting in three rounds. The first 31 recommendations concerned the use of ultrasound in the diagnosis of the following conditions: pneumothorax, pulmonary consolidation, pneumonia, atelectasis, pulmonary embolism, malignant neoplastic lesions, interstitial lung lesions, cardiogenic pulmonary edema, interstitial lung diseases with fibrosis, dyspnea, pleural pain and acute cough. Furthermore, seven additional statements were made regarding the technical conditions of lung ultrasound examination and the need for training in the basics of lung ultrasound in a group of doctors during their specialization programs and medical students. The panel of experts established a consensus on all 38 recommendations.
Collapse
Affiliation(s)
- Natalia Buda
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Kosiak
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Elżbieta Radzikowska
- III Department of Lung Disease, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Robert Olszewski
- Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation ; Department of Ultrasound, Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Ewa Jassem
- Department of Pneumonology and Allergology, Medial University of Gdansk, Gdansk, Poland
| | - Elżbieta Magdalena Grabczak
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Pomiecko
- Department of Pediatrics, Hematology and Oncology, University Clinical Centre in Gdansk, Gdansk, Poland
| | - Jakub Piotrkowski
- Independent Public Health Care Facility of the Ministry of the Internal Affairs with the Oncology Centre in Olsztyn, Olsztyn, Poland
| | | | - Malwina Sołtysiak
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | - Szymon Skoczyński
- Department of Pneumology, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Jaczewski
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, Warsaw, Poland
| | | | - Agnieszka Skoczylas
- Department of Geriatrics, National Institute of Geriatrics Rheumatology and Rehabilitation
| | - Marcin Wełnicki
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Wiśniewski
- Department of Pediatrics, Hematology and Oncology, University Clinical Centre in Gdansk, Gdansk, Poland
| | - Anna Zamojska
- Department of Econometrics at the Faculty of Management, University of Gdansk, Gdansk, Poland
| | | |
Collapse
|
22
|
Kasprzak JD, Dąbrowski R, Barylski M, Mamcarz A, Wełnicki M, Filipiak KJ, Lodziński P, Kozłowski D, Wożakowska-Kapłon B. Doustne antykoagulanty nowej generacji — aspekty praktyczne. Stanowisko Sekcji Farmakoterapii Sercowo-Naczyniowej Polskiego Towarzystwa Kardiologicznego. Folia Cardiologica 2016. [DOI: 10.5603/fc.2016.0064] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
23
|
Wełnicki M, Śliż D, Filipiak KJ, Szeligowska J, Naurszewicz M, Siebert J, Mamcarz A. [Difference in efficacy of dyslipidaemia treatment in obese and not obese women. Analysis of date from 3ST-POL study]. Przegl Lek 2016; 73:353-358. [PMID: 29668197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Cardiovascular diseases remain the first cause of premature death in polish society. In Poland mortality concerned with cardiovascular diseases is higher in women than in men. Dyslipidemia is one of the most important and one of the most common risk factor of cardiovascular diseases. The efficacy of treatment of dyslipidaemia in Poland remains poor however there is lack of date as far as influence of sex and coexistence obesity on efficacy of treatment of dyslipidaemia is concerned. AIM Evaluation of difference in efficacy of treatment of dyslipidaemia in obese women and women with body mass index less than 30 kg/m2. Date from 3ST-POL Study. METHODS Post hoc analysis of date of 3ST-POL Study, conducted in 2007- 2008. The Study refers to efficacy of treatment of dyslipidaemia in ambulatory polish patients which remain under supervision of general practitioners, cardiologist or dialectologist. RESULTS Women comprise 53% (n=26099) of population of 3ST-POL Study. In 21769 of those it was possible to calculate body mass index (BMI). 16% of women ware obese. 70% of those in comparison of with 67.6% of women with BMI<30 kg/m2 were at high cardiovascular risk. (p<0.01). There was no difference in mean doses of statins between all groups (mean daily dose was 20 mg and 24 mg for atorvastatin and simvastatin respectively). LDL goal was reached in 9.67% vs, 15.8% of obese high risk and not at high risk women respectively (p<0.01). Total cholesterol goal was reached in 9.01% vs. 12.39% obese high risk and not at high risk women respectively (p<0.01). In group with BMI<30 kg/m2 LDL and total cholesterol goals in high risk and not at high risk women were reached in 10.02% vs. 14.46% and in 8.86% vs. 13.05% respectively (p<0.01 for both). Mean concentration of all lipids, except for triglycerides, was higher in non-obese women. CONCLUSIONS The efficacy of treatment of dyslipidaemia in women from 3ST-POL study was higher in patients with lower global cardiovascular risk. Obesity or lack of it has no influence of that difference. Nevertheless global efficacy was very poor as far as both – LDL and total cholesterol goals were concerned. Moreover there were now difference in mean statins doses between groups. This may be due to therapeutic inertia of physicians.
Collapse
|
24
|
Wełnicki M, Mamcarz A. [Is erectile dysfunction an independent risk factor of coronary heart disease or another clinical manifestation of progressive atherosclerosis?]. Kardiol Pol 2012; 70:953-957. [PMID: 22993009] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Marcin Wełnicki
- III Klinika Chorób Wewnętrznych i Kardiologii, Warszawski Uniwersytet Medyczny, ul. Solec 93, 00–382 Warszawa.
| | | |
Collapse
|
25
|
Wełnicki M, Mamcarz A. [Does cardiovascular comorbidities are important as far as ophthalmology treatment is concerned?]. Klin Oczna 2012; 114:156-160. [PMID: 23346808] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Majority of patients with glaucoma, age-related maculopathy or diabetic macular edema is old. Therefore arterial hypertension, coronary arterial disease, diabetes and dyslipidemia are common finding in patients with sick eye. In this article some situations needing cooperation of cardiologist and ophthalmologist have been pointed. The influence of treatment of hypertension on glaucoma outcomes and the influence of intraocular injections of biological drugs on cardiovascular risk seems to be the most important issues.
Collapse
Affiliation(s)
- Marcin Wełnicki
- III Klinika Chorób Wewnetrznych i Kardiologii, Warszawskiego Uniwersytetu Medycznego.
| | | |
Collapse
|
26
|
Wełnicki M, Mamcarz A. [New versus classic risk factors]. Kardiol Pol 2010; 68:1225. [PMID: 21108197] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Marcin Wełnicki
- III Klinika Chorób Wewnętrznych i Kardiologii, II Wydział Lekarski, Warszawski Uniwersytet Medyczny, Warszawa
| | | |
Collapse
|
27
|
Górecki AI, Stec S, Kucharska I, Wełnicki M, Zaborska B, Kryński T, Kułakowski P. [Predictors of efficacy initial low energy of external rectilinear biphasic cardioversion in persistent atrial fibrillation]. Pol Merkur Lekarski 2007; 23:408-412. [PMID: 18432122] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
UNLABELLED Rectilinear biphasic cardioversion (Bi-DC) has been shown to be very effective for restoration of sinus rhythm in patients with persistent atrial fibrillation (AF). There is, however, limited information on factors influencing effectiveness of the initial energy of 50 J for Bi-DC of atrial fibrillation. AIM OF THE STUDY Evaluation of efficacy of 50 J shock of Bi-DC for restoration sinus rhythm and development of point score system to predict high conversion rate of 50 J shock in persistent atrial fibrillation. MATERIAL AND METHODS The study group was composed of 502 consecutive Bi-DC in-patients with persistent atrial fibrillation who underwent cardioversion according to the standard protocol (50 J --> 1 J/kg m.c. --> 2 J/kg m.c. --> 200 J). Factors influencing effectiveness of 50 J shock were defined. RESULTS Rectilinear biphasic cardioversion of shock of 50 J was successful in 157 (31%) patients. In multivariate analysis independent factors associated with efficacy of 50 J shock were: atrial fibrillation duration < 7 months (OR: 14.3, CI: 5.83 - 35.2, p < 0.001), left ventricular ejection fraction--LVEF > 40% (OR: 5.67, CI: 1.22 - 26.3, p = 0.027), body weight < 78 kg (OR: 3.17, CI: 1.52 - 6.59, p = 0.002), permanent pacemaker (OR: 2.98, CI: 1.20 - 7.40, p = 0.018), LA diameter < 4.5 cm (OR: 2.80, CI: 1.19 - 6.58, p = 0.02). A simplified point score system was developed to predict the chance for termination of atrial fibrillation (the score gives 5 points for atrial fibrillation duration < 7 months; 2 points for EF > 40%; 1 point for pacemaker, body weight < 78 kg and LA < 4.5 cm, each). High effectiveness (65%) of 50 J shock was achieved in patients with > 9 points of scoring system and 80% in this group when atrial fibrillation duration is shorter than 3 months. Effectiveness of 50 J shock was very low in the remaining group (0 points--0%; 1-3 points--5%; 4-6 points--21%; 7-8 points--34%, respectively). CONCLUSION The efficacy of initial shock of 50 J for termination of atrial fibrillation is limited and is not recommended for general population of patients with atrial fibrillation referred for Bi-DC. 50 J might be considered in patients with pacemakers without factors associated with failure of 50 J to terminate atrial fibrillation: atrial fibrillation duration > 7 months, lower LVEF increased LA diameter, body weight > 78 kg. The shock of 50 J is effective in more than 60% of patients, if they achieved 9 or 10 points in proposed score. The highest efficacy of 50 J shock (80%) is possible to reach in this group if atrial fibrillation duration is shorter than 3 months.
Collapse
|
28
|
Abstract
The full sequence of the genome-linked viral protein (VPg) cistron located in the central part of potato virus Y (common strain) genome has been identified. The VPg gene codes for a protein of 188 amino acids, with significant homology to other known potyviral VPg polypeptides. A three-dimensional model structure of VPg is proposed on the basis of similarity of hydrophobic-hydrophilic residue distribution to the sequence of malate dehydrogenase of known crystal structure. The 5' end of the viral RNA can be fitted to interact with the protein through the exposed hydroxyl group of Tyr-64, in agreement with experimental data. The complex favors stereochemically the formation of a phosphodiester bond [5'-(O4-tyrosylphospho)adenylate] typical for representatives of picornavirus-like viruses. The chemical mechanisms of viral RNA binding to VPg are discussed on the basis of the model structure of protein-RNA complex.
Collapse
Affiliation(s)
- D Płochocka
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland
| | | | | | | |
Collapse
|
29
|
Wełnicki M, Zekanowski C, Zagórski W. Digoxigenin-labelled molecular probe for the simultaneous detection of three potato pathogens: potato spindle tuber viroid (PSTVd), potato virus Y (PVY), and potato leafroll virus (PLRV). Acta Biochim Pol 1994. [DOI: 10.18388/abp.1994_4702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A molecular probe, p3POT, was constructed of PSTVd, PVY, PLRV cDNA fragments introduced into pUC18 vector. Sequencing of the inserts revealed that cloned fragments covered conservative parts of pathogenic genomes. Dot-blot hybridization of digoxigenin-labelled construct to crude extracts from plants infected with different potato viruses proved high sensitivity and specificity of the p3POT probe. This makes p3POT probe an useful tool for the routine testing, and selection of virus-free potatoes.
Collapse
|
30
|
Zekanowski C, Wełnicki M, Skrzeczkowski J, Zagórski W. Detection of potato spindle tuber viroid (PSTV) in dormant potato tubers by concatameric cDNA probe. J Virol Methods 1990; 30:127-30. [PMID: 2086594 DOI: 10.1016/0166-0934(90)90050-p] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 12/30/2022]
Abstract
The 32P-labelled concatameric insert cut out from a plasmid pSPAv6.2(+), containing 6.2 copies of a full-length PSTV, was used to detect PSTV in dormant potato tubers by dot-blot hybridisation assay. The concatameric insert probe was 4 times more sensitive than the monomeric one. This allowed the detection of 0.5 pg of viroid RNA. The sensitivity makes th eoligomeric cDNA probe a useful alternative to cDNA probes.
Collapse
Affiliation(s)
- C Zekanowski
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw
| | | | | | | |
Collapse
|
31
|
Wełnicki M, Skrzeczkowski J, Sołtyńska A, Jończyk P, Markiewicz W, Kierzek R, Imiołczyk B, Zagórski W. Characterisation of synthetic DNA probe detecting potato spindle tuber viroid. J Virol Methods 1989; 24:141-52. [PMID: 2668314 DOI: 10.1016/0166-0934(89)90016-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 01/02/2023]
Abstract
Chemically synthesized DNA fragments complementary to selected regions of the potato spindle tuber viroid (PSTV) genome were cloned into Escherichia coli plasmid pUC9. One of the recombinant plasmids (pIBB4) with a 87 bp insert representing the central region of the PSTV genome (nucleotides 88 to 174) was used after labelling by nick translation for detecting PSTV by dot-blot hybridization. The molecular probe was almost as sensitive as the one carrying the full genomic PSTV copy (pAV401), detecting down to 20 pg of PSTV RNA in 8-15 micrograms of infected tissue. The specificity of the test was high; no signals were created by extracts from healthy plants or plants infected with a variety of common potato viruses. The probe is potentially useful in studies on mixed infections of potatoes with different viruses, and in selection of certified seed material.
Collapse
Affiliation(s)
- M Wełnicki
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw
| | | | | | | | | | | | | | | |
Collapse
|