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Glądys K, Siudak Z, Trzeciak P, Siłka W, Skrzypek M, Chyrchel M, Gąsior M, Januszek R. Mortality of patients presented with acute ST-segment elevation myocardial infarction according to the status of standard modifiable cardiovascular risk factors. Am J Med Sci 2024; 367:328-336. [PMID: 38320673 DOI: 10.1016/j.amjms.2024.01.025] [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: 08/18/2023] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Standard modifiable cardiovascular risk factors (SMuRFs) remain well-established elements of assessing cardiovascular risk scores. However, there is growing evidence that patients presented without known SMuRFs at admission demonstrate worse post-myocardial outcomes. The aim of the study was to assess the influence of the SMuRF status on short- and long-term mortality rates in patients with first-time ST-segment elevation myocardial infarction (STEMI). METHODS This observational, cross-sectional study covered 182,726 patients admitted between 2003-2020 to the CathLabs, according to data from the Polish Registry of Acute Coronary Syndrome. Both baseline characteristics and mortality (in-hospital, 30-day, and 12-month) were examined and stratified by SMuRF status. The predictors of mortality were assessed at selected time points by multivariable analysis. RESULTS The majority of STEMI patients had at least one SMuRF (88.7%), however, mortality rates of SMuRF-less individuals were greater at selected time points of the follow-up (p < 0.001), and persisted at a higher level during each year of the follow-up period compared to the SMuRF group and general population. Furthermore, the SMuRFs status constituted an independent predictor of mortality at the 30-day (OR: 1.345; 95% CI: 1.142-1.585, p < 0.001) and 12-month (OR: 1.174; 95% CI: 1.054-1.308, p < 0.001) follow-ups. CONCLUSIONS SMuRF-less individuals presented with STEMI are at an increased risk of all-cause mortality compared to those with at least one SMuRF. Consequently, further investigations regarding the recognition and treatment of risk factors, irrespective of SMuRF status, are indicated.
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Affiliation(s)
- Kinga Glądys
- Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Michał Skrzypek
- Department of Biostatistics, School of Public Health in Bytom, Medical University of Silesia in Katowice, Poland
| | - Michał Chyrchel
- 2nd Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Rafał Januszek
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland.
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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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Roczniak J, Tarnawski A, Dziewierz A, Glanowski S, Pawlik A, Sabatowski K, Januszek R, Rzeszutko Ł, Surdacki A, Bartuś S, Chyrchel M. Radial artery spasms - angiographic morphology, risk factors and management. Postepy Kardiol Interwencyjnej 2024; 20:53-61. [PMID: 38616935 PMCID: PMC11008508 DOI: 10.5114/aic.2024.136936] [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: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction Radial artery is the preferred access for coronary interventions. However, the procedure is sometimes interrupted by a spasm which causes pain, prolongs the procedure, and can force the access crossover. Aim To observe factors contributing to a symptomatic radial artery spasm. Material and methods In this prospective study, we present results of 103 consecutive patients regarding radial artery spasm and angiographic image of the punctured artery. Angiography of the radial artery was performed in 70 (68.0%) patients. Potential risk factors for radial artery spasm were evaluated. Results The overall incidence of the radial artery spasm was high - 25 (24.3%). Signs of spasm were present in 37.1% of radial artery angiographies before the procedure and 60.1% after, however, it did not always indicate a symptomatic spasm. Risk factors related to radial artery spasm included female sex (OR = 2.94, p = 0.02), failure of the first puncture attempt (OR = 3.12, p = 0.014) and use of non-hydrophilic sheath (OR = 9.56, p = 0.036). Radial artery narrowing at the tip of the sheath was also a risk factor for spasm (p = 0.022). No spasms were observed after hydrophilic sheath application (n = 13). The administration of a radial cocktail was not observed to significantly decrease the spasm odds. Conclusions Risk factors for radial artery spasm include female sex and multiple puncture attempts. Hydrophilic sheath coating protects against radial artery spasm. Overall signs of a spasm in the angiography are common and do not imply a symptomatic spasm, which can be predicted by a tight narrowing at the tip of the sheath.
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Affiliation(s)
- Jan Roczniak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | | | - Artur Dziewierz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Szymon Glanowski
- Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Karol Sabatowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Rafał Januszek
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Krakow, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
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Januszek R, Kołtowski Ł, Tomaniak M, Wańha W, Wojakowski W, Grygier M, Siłka W, Jan Horszczaruk G, Czarniak B, Kręcki R, Guzik B, Legutko J, Pawłowski T, Wnęk P, Roik M, Sławek-Szmyt S, Jaguszewski M, Roleder T, Dziarmaga M, Bartuś S. Implementation of Microcirculation Examination in Clinical Practice-Insights from the Nationwide POL-MKW Registry. Medicina (Kaunas) 2024; 60:277. [PMID: 38399564 PMCID: PMC10890290 DOI: 10.3390/medicina60020277] [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: 11/20/2023] [Revised: 12/10/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The assessment of coronary microcirculation may facilitate risk stratification and treatment adjustment. The aim of this study was to evaluate patients' clinical presentation and treatment following coronary microcirculation assessment, as well as factors associated with an abnormal coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) values. Materials and Results: This retrospective analysis included 223 patients gathered from the national registry of invasive coronary microvascular testing collected between 2018 and 2023. Results: The frequency of coronary microcirculatory assessments in Poland has steadily increased since 2018. Patients with impaired IMR (≥25) were less burdened with comorbidities. Patients with normal IMR underwent revascularisation attempts more frequently (11.9% vs. 29.8%, p = 0.003). After microcirculation testing, calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitors were added more often for patients with IMR and CFR abnormalities, respectively, as compared to control groups. Moreover, patients with coronary microvascular dysfunction (CMD, defined as CFR and/or IMR abnormality), regardless of treatment choice following microcirculation assessment, were provided with trimetazidine (23.2%) and dihydropyridine CCBs (26.4%) more frequently than those without CMD who were treated conservatively (6.8%) and by revascularisation (4.2% with p = 0.002 and 0% with p < 0.001, respectively). Multivariable analysis revealed no association between angina symptoms and IMR or CFR impairment. Conclusions: The frequency of coronary microcirculatory assessments in Poland has steadily increased. Angina symptoms were not associated with either IMR or CFR impairment. After microcirculation assessment, patients with impaired microcirculation, expressed as either low CFR, high IMR or both, received additional pharmacotherapy treatment more often.
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Affiliation(s)
- Rafał Januszek
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, 30-705 Kraków, Poland
| | - Łukasz Kołtowski
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (Ł.K.); (M.T.)
| | - Mariusz Tomaniak
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland; (Ł.K.); (M.T.)
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (W.W.); (W.W.)
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (W.W.); (W.W.)
| | - Marek Grygier
- 1st Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (M.G.); (S.S.-S.)
| | - Wojciech Siłka
- Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland; (W.S.); (S.B.)
| | - Grzegorz Jan Horszczaruk
- Faculty of Medical Science, Collegium Medicum. Cardinal Stefan Wyszyński University in Warsaw, 01-938 Warsaw, Poland;
- Department of Cardiology, Voivodeship Hospital in Łomża, 18-404 Łomża, Poland
| | - Bartosz Czarniak
- Provincial Specialist Hospital in Wloclawek, 87-800 Włocławek, Poland;
| | | | - Bartłomiej Guzik
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland; (B.G.); (J.L.)
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, św. Anny 12, 31-007 Kraków, Poland; (B.G.); (J.L.)
- Department of Interventional Cardiology, The John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Tomasz Pawłowski
- Department of Cardiology, National Institute of Medicine of the Ministry of Internal Affairs and Administration, 02-507 Warsaw, Poland;
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Paweł Wnęk
- Provincial Specialist Hospital in Wroclaw, 51-124 Wrocław, Poland;
| | - Marek Roik
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Sylwia Sławek-Szmyt
- 1st Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland; (M.G.); (S.S.-S.)
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland;
| | - Tomasz Roleder
- Department of Cardiology, Wroclaw Medical University, 50-556 Wrocław, Poland;
| | - Miłosz Dziarmaga
- Department of Cardiology-Intensive Therapy and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznań, Poland;
| | - Stanisław Bartuś
- Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland; (W.S.); (S.B.)
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Chyrchel M, Bartuś S, Piechocki M, Glądys K, Januszek R, Surdacki A, Rzeszutko Ł. Is single-catheter technique for coronary angiography an optimal tool for beginners in interventional cardiology?-randomized controlled study TRACT 2: Transradial Coronary Angiography Trial 2. Cardiovasc Diagn Ther 2023; 13:1019-1029. [PMID: 38162109 PMCID: PMC10753231 DOI: 10.21037/cdt-23-212] [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: 05/14/2023] [Accepted: 09/22/2023] [Indexed: 01/03/2024]
Abstract
Background Transradial coronary angiography can be performed using a dual-catheter technique (DCT) or single-catheter technique (SCT). The current study aimed to compare DxTerity SCT Ultra and the Trapease curve SCT catheters with DCT catheters in procedures performed by young, less experienced, interventional cardiologists. Methods For this prospective, single-blinded, randomized study 107 were enrolled and assigned to 1 of 3 groups. They underwent planned coronary angiography at the Second Department of Cardiology Jagiellonian University in Kraków. In groups 1 (n=37) and 2 (n=35), DxTerity SCT Ultra catheters and the Trapease curve were used, respectively. In control group 3 (n=35), standard DCT Judkins catheters were applied. One patient was excluded from group 2, bringing the total number of cases analysed to 106. The study endpoints comprised the percentage of optimal stability, proper ostial artery engagement, a good quality angiogram, the duration of each procedure stage, the amount of contrast and the radiation dose. Results The highest percentage of optimal stability was observed in group 1 for the right coronary artery (RCA): 94%, and in group 3, for the left coronary artery (LCA): 85%. The necessity to change the catheter was most common in group 2. Group 1 was characterised by a shorter total procedural time. The contrast volume was higher in group 2, while there were no differences in radiation dose. Conclusions SCT is at least as adequate as DCT for young cardiologists. SCT was associated with lower necessity of catheter exchange during RCA visualization. The DxTerity Ultra curve catheter allows shortening the total procedure time.
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Affiliation(s)
- Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Piechocki
- Students’ Scientific Group, Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Kinga Glądys
- Students’ Scientific Group, Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Roczniak J, Chyrchel M, Pawlik A, Januszek R, Wizimirski M, Bartuś S. Multi-device complete revascularization of severely calcified multi-vessel coronary artery disease with left ventricular support of Impella CP under Swan-Ganz catheter monitoring. Kardiol Pol 2023; 81:1153-1154. [PMID: 37660379 DOI: 10.33963/v.kp.96978] [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: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Jan Roczniak
- Jagiellonian University Medical College, Kraków, Poland.
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Wizimirski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Januszek R, Balan R. Predictors of New and Persistent New Left Bundle Branch Block One Year after the Implantation of a Sutureless and Rapid-Deployment Aortic Valve Prosthesis. Diseases 2023; 11:100. [PMID: 37606471 PMCID: PMC10443328 DOI: 10.3390/diseases11030100] [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: 05/27/2023] [Revised: 07/20/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Conduction disorders following aortic valve replacement therapy (AVR), either surgical or percutaneous, are related to a higher risk of complete atrioventricular block and permanent pacemaker implantation (PPI). AIM The objective of this study was to assess risk factors regarding the incidence of new postoperative and persistent new left bundle branch block (LBBB) 1 year after the implantation of a sutureless/rapid-deployment (SURD) aortic valve prosthesis. MATERIAL AND METHODS The current study included 200 consecutive patients treated with isolated or concomitant AVR between May 2014 and May 2017 at the Department of Cardiac Surgery in Pasawa with SURD aortic valve EDWARDS INTUITY EliteTM implantation. The patients were divided according to the presence of new postoperative LBBB (67 patients, 33.5%) and persistent new LBBB 1 year after AVR (35 patients, 17.5%). A comparative analysis was performed between patients with and without new LBBB after AVR and those with and without persistent LBBB 1 year after AVR. Univariate and multivariate regression analyses were conducted to extract the risk factors of LBBB occurrence. RESULTS Among the risk factors for the lack of new LBBB development after AVR, Euroscore II (p < 0.001) was found, while for the occurrence of persistent new LBBB 1 year after AVR, atrial fibrillation (p = 0.001), length of hospital stay (p = 0.001) and body mass index (p = 0.004) were noted. CONCLUSIONS Patients with new or persistent new LBBB 1 year after AVR had lower mean Euroscore II and BMI values. Their stay at the hospital was also shorter.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Robert Balan
- Department of Cardiac Surgery, Klinikum Passau, 94-032 Passau, Germany;
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Maruszak N, Pilch W, Januszek R, Malinowski KP, Surdacki A, Chyrchel M. Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction. J Pers Med 2023; 13:1217. [PMID: 37623467 PMCID: PMC10455189 DOI: 10.3390/jpm13081217] [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: 06/04/2023] [Revised: 06/29/2023] [Accepted: 07/29/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND AND AIMS Primary percutaneous coronary intervention (PCI) is regarded as the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). Thrombolysis in Myocardial Infarction (TIMI) flow grade has been an important and cohesive predictor of outcomes in STEMI patients. We sought to evaluate potential variables associated with the risk of suboptimal TIMI flow after PCI in patients with anterior wall STEMI. METHODS We evaluated 107 patients admitted to our hospital between 1 January 2019 and 31 December 2021 with a diagnosis of anterior wall STEMI treated with primary PCI. RESULTS Suboptimal TIMI flow grade (≤2) after PCI occurred in 14 (13%) patients while grade 3 was found in 93 (87%) of them presenting with anterior wall STEMI. Failure to achieve optimal TIMI 3 flow grade after PCI was associated with lower TIMI grade prior to PCI (OR 0.5477, 95% CI 0.2589-0.9324, p = 0.02), greater troponin concentration before (OR 1.0001, 95% CI 1-1.0001, p = 0.0028) and after PCI (OR 1.0001, 95% CI 1-1.0001, p = 0.0452) as well as lower mean minimal systolic blood pressure (OR 0.9653, 95% CI 0.9271-0.9985, p = 0.04). CONCLUSIONS Among predictors of suboptimal TIMI flow grade after PCI, we noted lower TIMI grade flow pre-PCI, greater serum troponin concentrations in the periprocedural period and lower mean minimal systolic blood pressure.
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Affiliation(s)
- Natalia Maruszak
- Faculty of Medicine, Student Scientific Group at Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland; (N.M.); (W.P.)
| | - Weronika Pilch
- Faculty of Medicine, Student Scientific Group at Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland; (N.M.); (W.P.)
| | - Rafał Januszek
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland (M.C.)
| | - Krzysztof Piotr Malinowski
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Kopernika 7E Str., 31-034 Kraków, Poland
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Medyczna 7 Str., 30-688 Kraków, Poland
| | - Andrzej Surdacki
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland (M.C.)
| | - Michał Chyrchel
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland (M.C.)
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Januszek R, Kocik B, Siłka W, Gregorczyk-Maga I, Mika P. The Effects of Cardiac Rehabilitation including Nordic Walking in Patients with Chronic Coronary Syndromes after Percutaneous Coronary Interventions in Elective Mode. Medicina (Kaunas) 2023; 59:1355. [PMID: 37512165 PMCID: PMC10384741 DOI: 10.3390/medicina59071355] [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] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/28/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
Background: Percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS) is a worldwide method of coronary revascularisation. The aim of this study was to assess the immediate and long-term effects of Nordic Walking (NW) training added to a standard cardiac rehabilitation programme on physical activity (PA) and capacity and life quality, as well as selected proatherogenic risk factors. Methods: The studied group comprised 50 patients (considering exclusion criteria, 40 patients), aged 56-70, with CCS after elective PCI qualified them for a 6-weeks-long cardiac rehabilitation. The follow-up period lasted 4 months, and control visits occurred at 2 and 4 months. The studied patients were randomly divided into two groups: control group-standard cardiac rehabilitation programme and experimental group-standard cardiac rehabilitation programme additionally combined with NW training. Results: The cardiac rehabilitation programme in the experimental, compared to the control group, increased intense PA (from 731.43 ± 909.9 to 2740 ± 2875.96 vs. from 211.43 ± 259.43 to 582.86 ± 1289.74 MET min/week) and aerobic efficiency-VO2peak (from 8.67 ± 0.88 to 9.96 ± 1.35 vs. from 7.39 ± 2 to 7.41 ± 2.46 METs), as well as quality of life according to the WHOQOL-BREF questionnaire (from 3.57 ± 0.51 to 4.14 ± 0.36 vs. from 3.29 ± 0.47 to 3.57 ± 0.51 points). The walking distance assessed with the 6-min walk test did not differ between the groups before the beginning of the rehabilitation programme. Both at the I follow-up and II follow-up time points, a significant increase in the walking distance was noted in the control and experimental groups compared to baseline, and the difference between both groups was significant at the end of follow-up (378.57 ± 71.35 vs. 469.29 ± 58.07, p = 0.003). Moreover, NW had a positive effect on the modulation within selected biochemical risk factors of atherosclerosis, as well as subjective quality of life and well-being. Conclusions: Introducing NW training into the cardiac rehabilitation process proved to be a more effective form of therapy in patients with CCS treated via PCI, as compared to the standard cardiac rehabilitation programme alone.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
| | - Bożena Kocik
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
| | - Wojciech Siłka
- Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Piotr Mika
- Institute of Clinical Rehabilitation, University of Physical Education in Krakow, 31-571 Krakow, Poland
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Januszek R, De Luca G, Siłka W, Bryniarski L, Malinowski KP, Surdacki A, Wańha W, Bartuś S, Piotrowska A, Bartuś K, Pytlak K, Siudak Z. Single versus Dual-Operator Approaches for Percutaneous Coronary Interventions within Chronic Total Occlusion-An Analysis of 27,788 Patients. J Clin Med 2023; 12:4684. [PMID: 37510798 PMCID: PMC10380720 DOI: 10.3390/jcm12144684] [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: 05/28/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Since the treatment of chronic total occlusion (CTO) with percutaneous coronary intervention (PCI) is associated with high procedural complexity, it has been suggested to use a multi-operator approach. This study was aimed at evaluating the procedural outcomes of single (SO) versus dual-operator (DO) CTO-PCI approaches. (2) Methods: This retrospective analysis included data from the Polish Registry of Invasive Cardiology Procedures (ORPKI), collected between January 2014 and December 2020. To compare the DO and SO approaches, propensity score matching was introduced with equalized baseline features. (3) Results: The DO approach was applied in 3604 (13%) out of 27,788 CTO-PCI cases. Patients undergoing DO CTO-PCI experienced puncture-site bleeding less often than the SO group (0.1% vs. 0.3%, p = 0.03). No differences were found in the technical success rate (successful revascularization with thrombolysis in myocardial infarction flow grade 2/3) of the SO (72.4%) versus the DO approach (71.2%). Moreover, the presence of either multi-vessel (MVD) or left main coronary artery disease (LMCA) (odds ratio (OR), 1.67 (95% confidence interval (CI), 1.20-2.32); p = 0.002), as well as lower annual and total operator volumes of PCI and CTO-PCI, could be noted as factors linked with the DO approach. (4) Conclusions: Due to the retrospective character, the findings of this study have to be considered only as hypothesis-generating. DO CTO-PCI was infrequent and was performed on patients who were more likely to have LMCA lesions or MVD. Operators collaboratively performing CTO-PCIs were more likely to have less experience. Puncture-site bleeding occurred less often in the dual-operator group; however, second-operator involvement had no impact on the technical success of the intervention.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Giuseppe De Luca
- Division of Cardiology, AOU Policlinico G. Martino, University of Messina, 98166 Messina, Italy
- Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, 20161 Milan, Italy
| | - Wojciech Siłka
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Leszek Bryniarski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Krzysztof Piotr Malinowski
- Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-635 Katowice, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-008 Kraków, Poland
| | - Aleksandra Piotrowska
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Kraków, Poland
| | - Kamil Pytlak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, 25-369 Kielce, Poland
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11
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Januszek R, Siudak Z, Malinowski KP, Wańha W, Surowiec S, Heba G, Pawlik A, Kameczura T, Wojakowski W, Jaguszewski M, Kołodziej A, Bryniarski L, Bartuś K, Surdacki A, Dobrzycki S, Legutko J, Bartuś S. Factors determining the frequency of optical coherence tomography and intravascular ultrasound use in patients treated with percutaneous coronary interventions in recent years: Analysis based on a large national registry. Kardiol Pol 2023; 81:969-977. [PMID: 37401576 DOI: 10.33963/kp.a2023.0151] [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: 06/11/2023] [Accepted: 06/11/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have demonstrated improvement in the clinical outcome of patients undergoing percutaneous coronary intervention (PCI). AIMS We aimed to examine the frequency of implementing OCT and IVUS during coronary angiography (CA) and PCI in everyday practice in Poland. Factors related to the more common choice of these imaging techniques were determined. METHODS Data from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) were procured for analysis. Between January 2014 and December 2021, we extracted data on 1 452 135 CAs, 11 710 using IVUS (0.8%) and 1471 with OCT (0.1%) and 838 297 PCIs, 15 436 with IVUS (1.8%) and 1680 with OCT (0.2%). We assessed the determining factors for applying IVUS and OCT via multiple regression logistics models. RESULTS The frequency of applying IVUS during CAs and PCIs increased significantly between the years 2014 and 2021. In 2021, it reached 1.54% for CAs and 4.42% for PCIs, while for OCT, there was a rise regarding the CA group, namely 0.13% in 2021, and, in the PCI group, 0.43%. Age was one of the factors significantly associated with the frequency of using IVUS/OCT during CA/PCI, which was confirmed by multivariate analysis (Odds ratio: 0.981 for IVUS and 0.973 for OCT use with PCI). CONCLUSION The frequency at which IVUS and OCT were used has undergone a significant increase in previous years. This increase can be largely attributed to the current reimbursement policies. Further improvement is required for this frequency to be at a satisfactory level.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Krzysztof Piotr Malinowski
- Jagiellonian University Medical College, Faculty of Medicine, Department of Bioinformatics and Telemedicine, Kraków, Poland
- Jagiellonian University Medical College, Centre for Digital Medicine and Robotics, Kraków, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Sławomir Surowiec
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Grzegorz Heba
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Tomasz Kameczura
- Chair of Electroradiology, Faculty of Medicine, University of Rzeszow, Rzeszów, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Agnieszka Kołodziej
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Leszek Bryniarski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Polan
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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12
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Pawlik A, Litwinowicz R, Kowalewski M, Suwalski P, Deja M, Widenka K, Tobota Z, Maruszewski B, Rzeszutko Ł, Januszek R, Plens K, Legutko J, Bartuś S, Kapelak B, Bartuś K. The impact of sex on in-hospital and long-term mortality rates in patients undergoing surgical aortic valve replacement: The SAVR and SEX study. Kardiol Pol 2023; 81:754-762. [PMID: 37366256 DOI: 10.33963/kp.a2023.0138] [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: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Surgical aortic valve replacement (SAVR) is among the most commonly performed valvular surgeries. Despite many previous studies conducted in this setting, the impact of sex on outcomes in patients undergoing SAVR is still unclear. AIMS This study aimed to define sex differences in short- and long-term mortality in patients undergoing SAVR. METHODS We analyzed retrospectively all the patients undergoing isolated SAVR from January 2006 to March 2020 in the Department of Cardiovascular Surgery and Transplantology in John Paul II Hospital in Kraków. The primary endpoint was in-hospital and long-term mortality. Secondary endpoints included the duration of hospital stay and perioperative complications. Groups of men and women were compared with regard to the prosthesis type. Propensity score matching was performed to adjust for differences in baseline characteristics. RESULTS A total number of 4 510 patients undergoing isolated surgical SAVR were analyzed. A follow- up median (interquartile range [IQR]) was 2120 (1000-3452) days. Females made up 41.55% of the cohort and were older, displayed more non-cardiac comorbidities, and faced a higher operative risk. In both sexes, bioprostheses were more often applied (55.5% vs. 44.5%; P <0.0001). In univariable analysis, sex was not linked to in-hospital mortality (3.7% vs. 3%; P = 0.15) and late mortality rates (23.37% vs. 23.52 %; P = 0.9). Upon adjustment for baseline characteristics (propensity score matching analysis) and considering 5-year survival, a long-term prognosis turned out to be better in women (86.8%) compared to men (82.7%, P = 0.03). CONCLUSIONS A key finding from this study suggests that female sex was not associated with higher in-hospital and late mortality rates compared to men. Further studies are needed to confirm longterm benefits in women undergoing SAVR.
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Affiliation(s)
- Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Radosław Litwinowicz
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Center of Postgraduate Medical Education, Warszawa, Poland
- Department of Cardio-Thoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Piotr Suwalski
- Department of Cardiac Surgery, Medical University of Silesia, School of Medicine in Katowice, Katowice, Poland
| | - Marek Deja
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Center of Postgraduate Medical Education, Warszawa, Poland
| | - Kazimierz Widenka
- Clinical Department of Cardiac Surgery, District Hospital no. 2, University of Rzeszow, Rzeszów, Poland
| | | | | | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Jacek Legutko
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Bogusław Kapelak
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
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13
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Zdzierak B, Pawlik A, Bartuś S, Januszek R. Successful percutaneous retrieval of a guidewire remnant entrapped under a coronary stent. Pol Arch Intern Med 2023; 133:16447. [PMID: 36861416 DOI: 10.20452/pamw.16447] [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] [Indexed: 03/03/2023]
Affiliation(s)
- Barbara Zdzierak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Rafał Januszek
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Wańha W, Kołodziejczak M, Kowalewski M, Januszek R, Kuźma Ł, Jaguszewski M, Tomaniak M, Darocha S, Kupczyńska K, Dobrowolski P, Tymińska A, Ciepłucha A, Sokolska J, Kapłon-Cieślicka A, Kułach A, Wybraniec M, Roleder T, Tajstra M, Nadolny K, Darocha T, Sierakowska K, Pawłowski T, Gierlotka M, Leskiak M, Wita K, Gil R, Trzeciak P. Out-of-hospital cardiac arrest: Do we have to perform coronary angiography? Cardiol J 2023:VM/OJS/J/92653. [PMID: 37183538 DOI: 10.5603/cj.a2023.0032] [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: 11/09/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 05/16/2023] Open
Abstract
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of global mortality, while survivors are burdened with long-term neurological and cardiovascular complications. OHCA management at the hospital level remains challenging, due to heterogeneity of OHCA presentation, the critical status of OHCA patients reaching the return of spontaneous circulation (ROSC), and the demands of post ROSC treatment. The validity and optimal timing for coronary angiography is one important, yet not fully defined, component of OHCA management. Guidelines state clear recommendations for coronary angiography in OHCA patients with shockable rhythms, cardiogenic shock, or in patients with ST-segment elevation observed in electrocardiography after ROSC. However, there is no established consensus on the angiographic management in other clinical settings. While coronary angiography may accelerate the diagnostic and therapeutic process (provided OHCA was a consequence of coronary artery disease), it might come at the cost of impaired post-resuscitation care quality due to postponing of intensive care management. The aim of the current statement paper is to discuss clinical strategies for the management of OHCA including the stratification to invasive procedures and the rationale behind the risk-benefit ratio of coronary angiography, especially with patients in critical condition.
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
- "Club 30", Polish Cardiac Society, Poland.
| | - Michalina Kołodziejczak
- Department of Anesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Center of Postgraduate Medical Education, Warsaw, Poland
- Thoracic Research Center, Innovative Medical Forum, Collegium Medicum Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Rafał Januszek
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Poland
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Mariusz Tomaniak
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Szymon Darocha
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Center of Postgraduate Medical Education Fryderyk Chopin Hospital in European Health Center Otwock, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Karolina Kupczyńska
- Chair and Department of Cardiology, Medical University of Lodz, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Piotr Dobrowolski
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Agata Tymińska
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Aleksandra Ciepłucha
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Justyna Sokolska
- Department of Cardiovascular Imaging, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Agnieszka Kapłon-Cieślicka
- First Department of Cardiology, Medical University of Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Andrzej Kułach
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Maciej Wybraniec
- Department of Cardiology, Medical University of Silesia, Katowice, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Tomasz Roleder
- Department of Cardiology, Regional Specialist Hospital in Wroclaw, Poland
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mateusz Tajstra
- Third 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
- Department of Health Sciences, WSB University, Dabrowa Gornicza, Poland
| | - Tomasz Darocha
- Department of Anesthesiology and Intensive Therapy, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Sierakowska
- Department of Anesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Tomasz Pawłowski
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland
| | - Maciej Leskiak
- First Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Krystian Wita
- First Department of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Robert Gil
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Centre of Postgraduate Medical Education, Warsaw, Poland
- "Club 30", Polish Cardiac Society, Poland
| | - Przemysław Trzeciak
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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15
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Januszek R, Cugowska M, Rzeszutko Ł, Bartuś S, Pawlik A. Ecmella application in a critically ill patient with cardiogenic shock. Kardiol Pol 2023:VM/OJS/J/94494. [PMID: 37096952] [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: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 04/26/2023]
Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Monika Cugowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
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16
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Kasprzycki K, Bartuś S, Januszek R. Effective use of the cutting balloon technique for treatment of intramural hematoma complicating a complex percutaneous intervention in a patient with multivessel disease and severely decreased left ventricular ejection fraction. Kardiol Pol 2023; 81:188-189. [PMID: 36446074 DOI: 10.33963/kp.a2022.0271] [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: 11/11/2022] [Accepted: 11/11/2022] [Indexed: 03/04/2023]
Affiliation(s)
- Karol Kasprzycki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
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17
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Chyrchel M, Gallina T, Januszek R, Szafrański O, Gębska M, Surdacki A. The Reduction of Left Ventricle Ejection Fraction after Multi-Vessel PCI during Acute Myocardial Infarction as a Predictor of Major Adverse Cardiac Events in Long-Term Follow-Up. Int J Environ Res Public Health 2022; 19:ijerph192013160. [PMID: 36293739 PMCID: PMC9603361 DOI: 10.3390/ijerph192013160] [Citation(s) in RCA: 2] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 06/08/2023]
Abstract
BACKGROUND Revascularisation strategy in patients with multi-vessel coronary disease and acute myocardial infarction (AMI) remains challenging. One of the potential treatment options is complete percutaneous revascularisation during index hospitalisation. This strategy could positively influence left ventricle ejection fraction (LVEF). AIM To investigate the long-term changes in LVEF and clinical outcome among patients with AMI after complete coronary revascularisation (CCR). METHODS Records of 171 patients with a diagnosis of AMI and multi-vessel coronary artery disease (CAD) on index angiography, in whom CCR was performed as a staged procedure during initial hospitalisation, were analysed. Clinical data were collected from in-hospital medical records and discharge letters. Cardiac ultrasound (CU), with particular assessment of LVEF, was performed one day before discharge. Follow-up (FU) CU was collected from the out-patient department at least six months ± one week after discharge. Follow-up data, including major adverse cardiac events (MACE), were collected during follow-up visits by telephone. Depending on the LVEF change during the follow-up period, patients were divided into two groups. Patients with a decrease in the LVEF (D-LVEF group) were compared with patients with no changes (preserved) or improvement regarding LVEF (P/I-LVEF). RESULTS The median duration of the follow-up was 19 months (14-24 months). The median change in LVEF during observation was -5.0p% (IQR (-7.0)-(-2.75p.%)) in the D-LVEF group and +4.0% (IQR 1.0-5.0p%) in the P/I-LVEF group. Among patients in the P/I-LVEF group, there was a sub-group of patients with no change in LVEF (28 patients), and one demonstrating improvement in LVEF (104 patients). In the subgroup of patients with improved LVEF, the median change in LVEF was 4.5p% (IQR 2-6.25p%). Among patients with decreasing LVEF, there was a significantly higher risk of MACE (15 vs. 2.3%, p = 0.031), especially non-fatal AMI (10 vs. 0%, p = 0.017). We found the following among predictors concerning increased risk of MACE occurrence: urgent PCI (p = 0.004), hospitalisations regardless of cause (p = 0.028), EF worsening (p = 0.025), fasting glucose serum concentration (p = 0.024) and fasting triglyceride serum concentration (p = 0.027). CONCLUSIONS Complete revascularisation (CR) at baseline (one stage) in patients with AMI and multi-vessel disease is associated with LVEF improvement and MACE rate reduction. Patients with worse LVEF have poor clinical outcome and a higher rate of MACE.
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Affiliation(s)
- Michał Chyrchel
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Tomasz Gallina
- Student Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Rafał Januszek
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Oskar Szafrański
- Student Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
| | - Monika Gębska
- Department of Cardiology, District Hospital, ul. Jagiellońska 36, 97-500 Radomsko, Poland
| | - Andrzej Surdacki
- Second Department of Cardiology, Jagiellonian University Medical College, ul. Jakubowskiego 2, 30-688 Kraków, Poland
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18
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Januszek R, Bryniarski L, Siudak Z, Malinowski KP, Surowiec S, Wanha W, Wojakowski W, Bryniarski K, Legutko J, Kambis M, Di Mario C, Bartus K, Bartus S. Procedural outcomes and annual operator volume among patients treated with percutaneous coronary intervention of chronic total occlusions – analysis based on a large national registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2070] [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
It has been demonstrated that low operator and institutional volume is associated with poorer procedural and long-term clinical outcomes in general population of patients treated with percutaneous coronary interventions (PCI).
Purpose
The aim of the current study was to assess the relationship between operator volume and procedural outcomes of patients treated with PCI within chronic total occlusion (CTO).
Methods
Data for conducting the current analysis were obtained from the national registry of percutaneous coronary interventions (ORPKI) maintained in cooperation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study covered data obtained from the registry from January 2014 to December 2020. To investigate the association between operator and all periprocedural complications, coronary artery perforation (CAP) and TIMI flow grade 2/3 after PCI in the presence of confounding and clustering effects, we used multivariable, mixed effects logistic regression modelling.
Results
During the investigated period, there were 162 active CathLabs, at which 747,033 PCI procedures were performed during the time of observation. Of those 14,924 were CTO-PCI procedures. Considering the number of CTO-PCIs performed annually by individual operators during the analyzed 7 years we assessed differences between four groups (≤10; >10≤20; >20≤30 and >30 procedures). We demonstrated by nonlinear relationship with annualised CTO-PCI operator volume that operators performing more than 40 PCI with CTO per year have lower number of the overall periprocedural complications (Fig. 1) including CAP, as well greater procedural success rates (Fig. 2) compared to operators performing less procedures (p<0.0001).
Conclusions
High-volume CTO operators achieve a greater procedural success with a lower frequency of periprocedural complications. This study suggests that the cut-off of 50 CTO-PCIs per year recommended in the EuroCTO Consensus remains a reasonable compromise to optimize outcome and maintain local availability. Special CTO training programs and a higher annual case load might increase the overall quality of CTO PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Januszek
- University Hospital of Krakow , Krakow , Poland
| | | | - Z Siudak
- The Jan Kochanowski University in Kielce , Kielce , Poland
| | | | - S Surowiec
- University Hospital of Krakow , Krakow , Poland
| | - W Wanha
- School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - W Wojakowski
- School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | | | - J Legutko
- Jagiellonian University , Krakow , Poland
| | - M Kambis
- University Heart Center Freiburg-Bad Krozingen , Bad Krozingen , Germany
| | - C Di Mario
- Careggi University Hospital , Florence , Italy
| | - K Bartus
- Jagiellonian University , Krakow , Poland
| | - S Bartus
- Jagiellonian University , Krakow , Poland
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19
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Chyrchel M, Siudak Z, Rzeszutko Ł, Roczniak J, Piechocki M, Koziołek W, Malinowski KP, Januszek R, Bartuś S, Surdacki A. Culprit plaque location within the left circumflex coronary artery predicts clinical outcomes in patients experiencing acute coronary syndromes with percutaneous coronary intervention: Data from the ORPKI registry. Kardiol Pol 2022; 80:926-936. [DOI: 10.33963/kp.a2022.0150] [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] [Received: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 11/07/2022]
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20
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Bartuś S, Siłka W, Kasprzycki K, Sabatowski K, Malinowski KP, Rzeszutko Ł, Chyrchel M, Bryniarski L, Surdacki A, Bartuś K, Januszek R. Experience with Optical Coherence Tomography Enhanced by a Novel Software (Ultreon™ 1.0 Software)-The First One Hundred Cases. Medicina (Kaunas) 2022; 58:medicina58091227. [PMID: 36143904 PMCID: PMC9505439 DOI: 10.3390/medicina58091227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/18/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022]
Abstract
Introduction: Optical coherence tomography (OCT) intravascular imaging including the latest version Ultreon™ 1.0 Software (Abbott Vascular, Santa Clara, CA, USA), not only improve patients prognosis, but also facilitates improved percutaneous coronary intervention (PCI). Objectives: The aim of the study was to compare procedure related decision making, procedural indices, clinical outcomes according to the extent of stent expansion and assess risk factors of underexpansion in patients treated with PCI using OCT. Methods: The study comprised 100 patients, which were divided in groups according to the extent of stent expansion: <90 (29 patients) and ≥90% (71 patients). Comparison of OCT parameters, selected clinical and procedural characteristics was performed between groups. We assessed clinical outcomes during the follow-up: major adverse cardiovascular events and risk factors of stent underexpansion. Results: Patients from the stent underexpansion group were treated more often in the past with percutaneous peripheral interventions (p=0.02), no other significant differences being noted in general characteristics, procedural characteristics or clinical outcomes comparing both groups. Significant predictors of stent underexpansion assessed by simple linear univariable analysis included: hypercholesterolemia, obstructive bronchial diseases and treatment with inhalators, family history of cardiovascular disease, PCI of other than the left main coronary artery, stent and drug-eluting stent implantation, PCI without drug-eluting balloon, paclitaxel antimitotic agent, greater maximal stent diameter and lower mean Euroscore II value. Univariable logistic regression analysis revealed a correlation between stent underexpansion and greater creatinine serum concentration before [OR: 0.97, 95%CI: 0.95-0.99, p=0.01] and after PCI [OR: 0.98, 95%CI: 0.96-0.99, p=0.02]. Conclusions: Based on the presented analysis, the degree of stent expansion is not related to the selected procedural, OCT imaging indices and clinical outcomes. Logistic regression analysis confirmed such a relationship for creatinine level.
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Affiliation(s)
- Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-202 Kraków, Poland
| | - Wojciech Siłka
- Students’ Scientific Group, the Second Department of Cardiology, Jagiellonian University Medical College, 31-034 Kraków, Poland
| | - Karol Kasprzycki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Karol Sabatowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
| | - Krzysztof Piotr Malinowski
- Faculty of Medicine, Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, 31-530 Kraków, Poland
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, 31-530 Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-202 Kraków, Poland
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-202 Kraków, Poland
| | - Leszek Bryniarski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-202 Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Institute of Cardiology, Jagiellonian University Medical College, 31-202 Kraków, Poland
| | - Krzysztof Bartuś
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, 31-530 Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland
- Correspondence:
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21
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Januszek R, Malinowski K, Surowiec S, Wańha W, Wojakowski W, Bryniarski K, Legutko J, di Mario C, Bartus K, Bartus S. TCT-111 Annual Operator Volume and Procedural Outcomes Among Patients Treated With Percutaneous Coronary Intervention of Chronic Total Occlusions—Analysis Based on a Large National Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.134] [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: 10/14/2022]
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22
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Bartuś S, Rzeszutko Ł, Januszek R. Simultaneous angiographic and instantaneous wave-free ratio co-registration assisted with intravascular ultrasound for optimal assessment of left main coronary artery ostial stenosis and optimization of the angioplasty effect. Cardiol J 2022; 29:720-721. [PMID: 35794835 PMCID: PMC9273243 DOI: 10.5603/cj.2022.0064] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/15/2022] [Accepted: 05/18/2022] [Indexed: 12/01/2022] Open
Affiliation(s)
- Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,Jagiellonian University Medical College, Krakow, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
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23
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Wańha W, Bil J, Kołodziejczak M, Kowalówka A, Kowalewski M, Hudziak D, Gocoł R, Januszek R, Figatowski T, Milewski M, Tomasiewicz B, Kübler P, Hrymniak B, Desperak P, Kuźma Ł, Milewski K, Góra B, Łoś A, Kulczycki J, Włodarczak A, Skorupski W, Grygier M, Lesiak M, D'Ascenzo F, Andres M, Kleczynski P, Litwinowicz R, Borin A, Smolka G, Reczuch K, Gruchała M, Gil RJ, Jaguszewski M, Bartuś K, Suwalski P, Dobrzycki S, Dudek D, Bartuś S, Ga̧sior M, Ochała A, Lansky AJ, Deja M, Legutko J, Kedhi E, Wojakowski W. Percutaneous Coronary Intervention vs. Coronary Artery Bypass Grafting for Treating In-Stent Restenosis in Unprotected-Left Main: LM-DRAGON-Registry. Front Cardiovasc Med 2022; 9:849971. [PMID: 35615559 PMCID: PMC9125786 DOI: 10.3389/fcvm.2022.849971] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/04/2022] [Indexed: 12/29/2022] Open
Abstract
Background Data regarding management of patients with unprotected left main coronary artery in-stent restenosis (LM-ISR) are scarce. Objectives This study investigated the safety and effectiveness of percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) for the treatment of unprotected LM-ISR. Methods Consecutive patients who underwent PCI or CABG for unprotected LM-ISR were enrolled. The primary endpoint was a composite of major adverse cardiac and cerebrovascular events (MACCE), defined as cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), and stroke. Results A total of 305 patients were enrolled, of which 203(66.6%) underwent PCI and 102(33.4%) underwent CABG. At 30-day follow-up, a lower risk of cardiac death was observed in the PCI group, compared with the CABG-treated group (2.1% vs. 7.1%, HR 3.48, 95%CI 1.01–11.8, p = 0.04). At a median of 3.5 years [interquartile range (IQR) 1.3–5.5] follow-up, MACCE occurred in 27.7% vs. 29.6% (HR 0.82, 95%CI 0.52–1.32, p = 0.43) in PCI- and CABG-treated patients, respectively. There were no significant differences between PCI and CABG in cardiac death (9.9% vs. 18.4%; HR 1.56, 95%CI 0.81–3.00, p = 0.18), MI (7.9% vs. 5.1%, HR 0.44, 95%CI 0.15–1.27, p = 0.13), or stroke (2.1% vs. 4.1%, HR 1.79, 95%CI 0.45–7.16, p = 0.41). TVR was more frequently needed in the PCI group (15.2% vs. 6.1%, HR 0.35, 95%CI 0.15–0.85, p = 0.02). Conclusions This analysis of patients with LM-ISR revealed a lower incidence of cardiac death in PCI compared with CABG in short-term follow-up. During the long-term follow-up, no differences in MACCE were observed, but patients treated with CABG less often required TVR. Visual overview A visual overview is available for this article. Registration https://www.clinicaltrials.gov; Unique identifier: NCT04968977.
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- *Correspondence: Wojciech Wańha
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Michalina Kołodziejczak
- Department of Anaesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
- Yale University School of Medicine, New Haven, CT, United States
| | - Adam Kowalówka
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland
- Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Damian Hudziak
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Radosław Gocoł
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Rafał Januszek
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Figatowski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Marek Milewski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Brunon Tomasiewicz
- Department of Heart Disease, Centre for Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, Wrocław, Poland
| | - Piotr Kübler
- Department of Heart Disease, Centre for Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, Wrocław, Poland
| | - Bruno Hrymniak
- Department of Heart Disease, Centre for Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, Wrocław, Poland
| | - Piotr Desperak
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Krzysztof Milewski
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland
| | - Bartłomiej Góra
- Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland
| | - Andrzej Łoś
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jan Kulczycki
- Department of Cardiology, Miedziowe Centrum Zdrowia, Lubin, Poland
| | | | - Wojciech Skorupski
- Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Marek Grygier
- Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Marek Andres
- Department of Interventional Cardiology, Jagiellonian University Medical College Institute of Cardiology, John Paul II Hospital, Krakow, Poland
| | - Paweł Kleczynski
- Department of Interventional Cardiology, Jagiellonian University Medical College Institute of Cardiology, John Paul II Hospital, Krakow, Poland
| | - Radosław Litwinowicz
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Krakow, Poland
| | - Andrea Borin
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Reczuch
- Department of Heart Disease, Centre for Heart Disease, University Hospital Wroclaw, Wroclaw Medical University, Wrocław, Poland
| | - Marcin Gruchała
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Robert J. Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Krakow, Poland
| | - Piotr Suwalski
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Dariusz Dudek
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Mariusz Ga̧sior
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Ochała
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Marek Deja
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Jagiellonian University Medical College Institute of Cardiology, John Paul II Hospital, Krakow, Poland
| | - Elvin Kedhi
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- Division of Cardiology, St-Jan Hospital, Brugge, Belgium
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
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24
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Wolny R, Kowalik I, Januszek R, Bil J, Figatowski T, Milewski M, Tomasiewicz B, Walczak T, Hrymniak B, Desperak P, Niezgoda P, Chudzik M, Kuźma Ł, Kralisz P, D'Ascenzo F, Hudziak D, Jaguszewski M, Reczuch K, Kubica J, Gil RJ, Dobrzycki S, Bartuś S, Gąsior M, Ochała A, Witkowski A, Wojakowski W, Wańha W. Long-term outcomes following drug-eluting balloons vs. thin-strut drug-eluting stents for treatment of recurrent restenosis in drug-eluting stents. Kardiol Pol 2022; 80:765-773. [PMID: 35445739 DOI: 10.33963/kp.a2022.0106] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is limited data on the optimal revascularization strategy in patients with recurrent in-stent restenosis (R-ISR). AIMS To compare the long-term outcomes of patients treated with either a thin-strut drug-eluting stent (thin-DES) or a drug-eluting balloon (DEB) for R-ISR in a drug-eluting stent (DES). METHODS A multicenter DEB-DRAGON registry was used to retrospectively identify patients with R-ISR who received either a thin-DES or a DEB. Propensity score matching was applied to adjust for baseline differences. The primary outcome was target lesion revascularization (TLR). RESULTS Out of 311 patients (mean age, 67 years; 63% male) with R-ISR, 86 (27.7%) were treated with a thin-DES and 225 (72.3%) with a DEB. Median follow-up was 2.6 years. TLR occurred in 18 (20.9%) patients who received thin-DES and 61 (27.1%) patients treated with DEB (hazard ratio [HR], 0.57; 95% confidence interval [CI], 0.33-0.98; log-rank P = 0.04). The difference remained significant in a propensity score-matched cohort of 57 patients treated with thin-DES and 57 patients treated with a DEB (17.5 vs. 33.3%, respectively; HR, 0.38; 95% CI, 0.17-0.86; P = 0.01). The risks of device-oriented adverse cardiac events and all-cause mortality were similar after thin-DES or DEB in both unadjusted and propensity score-matched cohorts. In a multivariable Cox proportional hazard model, the treatment with a thin-DES was an independent predictor of a TLR-free survival (HR, 0.33; 95% CI 0.13-0.84; P = 0.02). CONCLUSIONS In patients with R-ISR implantation of a thin-DES is associated with a lower risk of repeated revascularization compared with angioplasty with a DEB.
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Affiliation(s)
- Rafał Wolny
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland.
| | - Ilona Kowalik
- Department of Biostatistics, National Institute of Cardiology, Warszawa, Poland
| | - Rafał Januszek
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek Bil
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Tomasz Figatowski
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Marek Milewski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Brunon Tomasiewicz
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Tomasz Walczak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland.,Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Bruno Hrymniak
- Department of Cardiology, Center for Heart Diseases, 4th Military Hospital, Wrocław, Poland
| | - Piotr Desperak
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Niezgoda
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Damian Hudziak
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Miłosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Krzysztof Reczuch
- Institute of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Robert J Gil
- Department of Invasive Cardiology, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Andrzej Ochała
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
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Januszek R, Wańha W, Siudak Z, Malinowski K, Wojakowski W, Reczuch K, Dobrzycki S, Lesiak M, Gil R, Witkowski A, Bartuś S. TCTAP A-036 Annual Operator Volume Among Patients Treated Using Percutaneous Coronary Interventions With Rotational Atherectomy and Procedural Outcomes - Analysis Based on a Large National Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.03.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wańha W, Tomaniak M, Bil J, Januszek R, Wolny R, Opolski M, Kuźma Ł, Janas A, Figatowski T, Lewicki Ł, Kulczycki J, Wlodarczak A, Tomasiewicz B, Iwańczyk S, Sacha J, Koltowski Ł, Dziarmaga M, Jaguszewski M, Olajossy B, Dyrbuś K, Reczuch K, Gil R, Dobrzycki S, Kochman J, Ochala A, Witkowski A, Lesiak M, D'Ascenzo F, Bartuś S, Wojakowski W. TCTAP A-054 Shockwave Intravascular Lithotripsy as a Novel Strategy for the Treatment of Stent Underexpansion Caused by Calcified Plaques. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.03.077] [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: 11/26/2022]
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27
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Wańha W, Tomaniak M, Wańczura P, Bil J, Januszek R, Wolny R, Opolski MP, Kuźma Ł, Janas A, Figatowski T, Gąsior P, Milewski M, Roleder-Dylewska M, Lewicki Ł, Kulczycki J, Włodarczak A, Tomasiewicz B, Iwańczyk S, Sacha J, Koltowski Ł, Dziarmaga M, Jaguszewski M, Kralisz P, Olajossy B, Sobieszek G, Dyrbuś K, Łebek M, Smolka G, Reczuch K, Gil RJ, Dobrzycki S, Kwiatkowski P, Rogala M, Gąsior M, Ochała A, Kochman J, Witkowski A, Lesiak M, D’Ascenzo F, Bartuś S, Wojakowski W. Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry. J Clin Med 2022; 11:jcm11071779. [PMID: 35407387 PMCID: PMC9000023 DOI: 10.3390/jcm11071779] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [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: 03/06/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/09/2023] Open
Abstract
Background: Whereas the efficacy and safety of intravascular lithotripsy (IVL) have been confirmed in de novo calcified coronary lesions, little is known about its utility in treating stent underexpansion. This study aimed to investigate the impact of IVL in treating stent underexpansion. Methods and Results: Consecutive patients with stent underexpansion treated with IVL entered the multicenter IVL-Dragon Registry. The procedural success (primary efficacy endpoint) was defined as a relative stent expansion >80%. Thirty days device-oriented composite endpoint (DOCE) (defined as a composite of cardiac death, target lesion revascularization, or target vessel myocardial infarction) was the secondary endpoint. A total of 62 patients were enrolled. The primary efficacy endpoint was achieved in 72.6% of patients. Both stent underexpansion 58.5% (47.5−69.7) vs. 11.4% (5.8−20.7), p < 0.001, and the stenotic area 82.6% (72.4−90.8) vs. 21.5% (11.1−37.2), p < 0.001, measured by quantitative coronary angiography improved significantly after IVL. Intravascular imaging confirmed increased stent expansion following IVL from 37.5% (16.0−66.0) to 86.0% (69.2−90.7), p < 0.001, by optical coherence tomography and from 57.0% (31.5−77.2) to 89.0% (85.0−92.0), p = 0.002, by intravascular ultrasound. Secondary endpoint occurred in one (1.6%) patient caused by cardiac death. There was no target lesion revascularization or target vessel myocardial infarction during the 30-day follow-up. Conclusions: In this real-life, largest-to-date analysis of IVL use to manage underexpanded stent, IVL proved to be an effective and safe method for facilitating stent expansion and increasing luminal gain.
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
- Correspondence: ; Tel.: +48-32-359-80-00; Fax: +48-32-202-87-54
| | - Mariusz Tomaniak
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland; (M.T.); (Ł.K.); (J.K.)
| | - Piotr Wańczura
- Department of Cardiology, The Ministry of Internal Affairs and Administration Hospital, 35-111 Rzeszów, Poland;
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (R.J.G.)
| | - Rafał Januszek
- Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (R.J.); (S.B.)
| | - Rafał Wolny
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland; (R.W.); (M.P.O.); (A.W.)
| | - Maksymilian P. Opolski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland; (R.W.); (M.P.O.); (A.W.)
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland; (Ł.K.); (P.K.); (S.D.)
| | - Adam Janas
- Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Kraków University, 30-705 Krakow, Poland;
| | - Tomasz Figatowski
- First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (T.F.); (M.J.)
| | - Paweł Gąsior
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
| | - Marek Milewski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
| | - Magda Roleder-Dylewska
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
| | - Łukasz Lewicki
- Department of Invasive Cardiology, University Center for Cardiology, 80-211 Gdansk, Poland;
| | - Jan Kulczycki
- Department of Cardiology, Miedziowe Centrum Zdrowia, 59-300 Lubin, Poland; (J.K.); (A.W.)
| | - Adrian Włodarczak
- Department of Cardiology, Miedziowe Centrum Zdrowia, 59-300 Lubin, Poland; (J.K.); (A.W.)
| | - Brunon Tomasiewicz
- Centre for Heart Disease, University Hospital, 50-558 Wroclaw, Poland; (B.T.); (K.R.)
- Department of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Sylwia Iwańczyk
- Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (S.I.); (M.L.)
| | - Jerzy Sacha
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, 45-040 Opole, Poland;
| | - Łukasz Koltowski
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland; (M.T.); (Ł.K.); (J.K.)
| | - Miłosz Dziarmaga
- Department of Cardiology—Intensive Therapy and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland;
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland; (T.F.); (M.J.)
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland; (Ł.K.); (P.K.); (S.D.)
| | - Bartosz Olajossy
- 1st Military Hospital in Lublin, 20-049 Lublin, Poland; (B.O.); (G.S.)
| | | | - Krzysztof Dyrbuś
- Third Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (K.D.); (M.G.)
| | - Mariusz Łebek
- Upper Silesia Medical Centre, 40-635 Katowice, Poland;
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
| | - Krzysztof Reczuch
- Centre for Heart Disease, University Hospital, 50-558 Wroclaw, Poland; (B.T.); (K.R.)
- Department of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Robert J. Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland; (J.B.); (R.J.G.)
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland; (Ł.K.); (P.K.); (S.D.)
| | - Piotr Kwiatkowski
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland;
| | | | - Mariusz Gąsior
- Third Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland; (K.D.); (M.G.)
| | - Andrzej Ochała
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
| | - Janusz Kochman
- 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland; (M.T.); (Ł.K.); (J.K.)
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland; (R.W.); (M.P.O.); (A.W.)
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (S.I.); (M.L.)
| | - Fabrizio D’Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, 10124 Turin, Italy;
| | - Stanisław Bartuś
- Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland; (R.J.); (S.B.)
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland; (P.G.); (M.M.); (M.R.-D.); (G.S.); (A.O.); (W.W.)
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Januszek R, Siudak Z, Malinowski KP, Wańha W, Wojakowski W, Reczuch K, Dobrzycki S, Lesiak M, Hawranek M, Gil RJ, Witkowski A, Lekston A, Gąsior M, Chyrchel M, Jędrychowska M, Bartuś K, Zajdel W, Legutko J, Bartuś S. Annual operator volume among patients treated using percutaneous coronary interventions with rotational atherectomy and procedural outcomes: Analysis based on a large national registry. Catheter Cardiovasc Interv 2022; 99:1723-1732. [PMID: 35318789 DOI: 10.1002/ccd.30155] [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: 11/08/2021] [Revised: 01/31/2022] [Accepted: 03/05/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Low operator and institutional volume are associated with poorer procedural and long-term clinical outcomes in the general population of patients treated with percutaneous coronary interventions (PCI). AIM To assess the relationship between operator experience and procedural outcomes of patients treated with PCI and rotational atherectomy (RA). METHODS Data for conducting the current analysis were obtained from the national registry of percutaneous coronary interventions (ORPKI) maintained in cooperation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study covers data from January 2014 to December 2020. RESULTS During the investigated period, there were 162 active CathLabs, at which 747,033 PCI procedures were performed by 851 operators (377 RA operators [44.3%]). Of those, 5188 were PCI with RA procedures; average 30 ± 61 per site/7 years (Me: 3; Q1-Q3: 0-31); 6 ± 18 per operator/7 years (Me: 0; Q1-Q3: 0-3). Considering the number of RA procedures annually performed by individual operators during the analyzed 7 years, the first quartile totaled (Q1: < =2.57), the second (Q2: < =5.57), and the third (Q3: < =11.57), while the fourth quartile was (Q4: > 11.57). The maximum number of procedures was 39.86 annually per operator. We demonstrated, through a nonlinear relationship with annualized operator volume and risk-adjusted, that operators performing more PCI with RA per year (fourth quartile) have a lower number of the overall periprocedural complications (p = 0.019). CONCLUSIONS High-volume RA operators are related to lower overall periprocedural complication occurrence in patients treated with RA in comparison to low-volume operators.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Department of Internal Medicine, Jan Kochanowski University, Kielce, Poland
| | - Krzysztof P Malinowski
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Faculty of Medicine, Kraków, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Sławomir Dobrzycki
- Department of Invasive Cardiology, State Teaching Hospital, Medical University of Białystok, Białystok, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Robert J Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Magdalena Jędrychowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Wojciech Zajdel
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Wanha W, Tomaniak M, Wańczura P, Bil J, Januszek R, Wolny R, Opolski MP, Kuźma Ł, Milewski M, Lewicki L, Kulczycki J, Iwańczyk S, Sacha J, Janas A, Dziarmaga M, Jaguszewski M, Koltowski L, Olajossy B, Dyrbuś K, Gil R, Bartuś S, Reczuch K, Kochman J, Lesiak M, Wojakowski W. INTRAVASCULAR LITHOTRIPSY FOR THE TREATMENT OF STENT UNDEREXPANSION: THE MULTICENTER IVL-DRAGON REGISTRY. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01594-7] [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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30
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Januszek S, Siwiec N, Januszek R, Kluz M, Lebed R, Toś P, Góra T, Plens K, Dąbrowski K, Sidorowicz M, Szcześniewska A, Barnaś E, Kalandyk-Osinko K, Darmochwal-Kolarz D, Kluz T. Approach of Pregnant Women from Poland and the Ukraine to COVID-19 Vaccination—The Role of Medical Consultation. Vaccines (Basel) 2022; 10:vaccines10020255. [PMID: 35214718 PMCID: PMC8880363 DOI: 10.3390/vaccines10020255] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 12/25/2021] [Revised: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 12/14/2022] Open
Abstract
There are many arguments for the safety and efficacy of COVID-19 vaccines in pregnancy. The aim of this study is to describe the level of vaccination acceptance, to find the factors that most influence the decision to vaccinate, and to describe the scale of changes in vaccination acceptance influenced by medical information on the safety, efficacy, and benefits of vaccination among pregnant women. A total of 300 patients completed the questionnaire, including 150 in Poland and 150 in the Ukraine. The level of vaccination acceptance was assessed before and after medical consultation. There were 53 (35.3%) patients with the intention to get vaccinated in Poland and 25 (16.7%) in the Ukraine. After consultation with a physician, this increased to 109 (72.6%) in Poland and 69 (46%) in the Ukraine. The main factors influencing the acceptance of vaccinations were the fear of harming the foetus (OR-0.119, CI-0.039–0.324 p < 0.001), complications in pregnancy (OR-0.073 CI-0.023–0.197 p < 0.001), and limitations in the vaccination programme (OR-0.026 CI-0.001–0.207 p < 0.001). Medical information about the safety, effectiveness and benefits of vaccinations among pregnant women, provided during a medical visit, may increase the acceptance of vaccinations by 105.6%, as among Polish patients, and by 176%, as among pregnant women from the Ukraine.
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Affiliation(s)
- Sławomir Januszek
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Correspondence: ; Tel.: +48-535860429
| | - Natalia Siwiec
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland;
| | - Marta Kluz
- Department of Pathology, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland;
| | - Roman Lebed
- Khmelnytsky Regional Perinatal Centre, 29-016 Khmelnytskyi, Ukraine;
| | - Paweł Toś
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Góra
- Department of Gynecology and Obstetrics, Jan Paweł II Hospital, 35-241 Rzeszów, Poland;
- Department of Obstetrics and Perinatology, Medical College, Jagiellonian University, 31-501 Kraków, Poland
| | | | - Krzysztof Dąbrowski
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Marcin Sidorowicz
- Department of Perinatology, City Hospital in Ruda Śląska, Gynecology and Obstetrics, 41-717 Ruda Śląska, Poland; (K.D.); (M.S.)
| | - Aleksandra Szcześniewska
- Departament of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, 93-338 Łodź, Poland;
| | - Edyta Barnaś
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Katarzyna Kalandyk-Osinko
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
| | - Dorota Darmochwal-Kolarz
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
- Department of Gynecology and Obstetrics, University Hospital No. 2, 35-301 Rzeszów, Poland;
| | - Tomasz Kluz
- Department of Gynecology, Oncology and Obstetrics, Fryderyk Chopin University Hospital No. 1, 35-055 Rzeszów, Poland; (N.S.); (K.K.-O.); (T.K.)
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszów University, 35-316 Rzeszów, Poland; (E.B.); (D.D.-K.)
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31
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Pawlik A, Januszek R, Rzeszutko Ł, Bartuś S, Bryniarski L. High-risk percutaneous coronary angioplasty with rotational atherectomy and left ventricular assist device of chronically occluded left ascending artery in an obese patient with very low ejection fraction. Kardiol Pol 2022; 80:491-492. [PMID: 35113999 DOI: 10.33963/kp.a2022.0034] [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: 02/03/2022] [Accepted: 02/03/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | | | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Leszek Bryniarski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland. .,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
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32
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Pawlik A, Januszek R, Rzeszutko Ł, Bartuś S. Percutaneous coronary intervention combining rotational atherectomy and intravascular lithotripsy in two vessels with edge restenosis assisted by percutaneous left ventricular pump support. Kardiol Pol 2022; 80:370-371. [PMID: 35113994 DOI: 10.33963/kp.a2022.0027] [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: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Januszek R, Pawlik A, Rzeszutko Ł, Bartuś K, Bartuś S. Clinical outcomes in patients undergoing complex, high-risk percutaneous coronary intervention and haemodynamic support with intra-aortic balloon versus Impella pump: Real-life single-centre preliminary results. Kardiol Pol 2022; 80:1224-1231. [PMID: 36047958 DOI: 10.33963/kp.a2022.0203] [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: 08/10/2022] [Accepted: 08/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Patients and mechanical circulatory support assortment, as well as periprocedural and post-procedural clinical outcomes in complex high-risk percutaneous coronary interventions (PCIs) underpinned by percutaneous left ventricular assist devices (pLVAD) are the subject of debate. AIMS The study aimed to identify differences between patients qualified for complex high-risk PCIs with an intra-aortic balloon pump (IABP) or Impella pump support and to compare peri- and post-procedural clinical outcomes. METHODS The presented analysis is a single-center study, which comprised consecutive patients undergoing complex high-risk PCIs performed with the pLVAD, either IABP or Impella. Patients included in the current analysis were recruited between January 2018 and December 2021. There were 28 (56%) patients in the Impella group and 22 (44%) in the IABP group. The primary endpoints included overall mortality and major adverse cardiovascular events (MACE) such as all-cause mortality, myocardial infarction, revascularization, and cerebrovascular events. RESULTS Patients from the IABP group were significantly older, had higher left ventricular ejection fraction (LVEF), and less frequent history of PCI, while the in-hospital risk of death assessed by EuroSCORE II remained similar in the Impella and IABP groups (median interquartile range [IQR] 2.8 [2-3.8] vs. 2.5 [1.8-5.2]; P = 0.73). Patients undergoing complex high-risk PCIs with pLVAD support presented similar results during the follow-up, assessed by log-rank estimates in terms of MACE (P = 0.41) and mortality rate (P = 0.65). CONCLUSIONS The use of pLVAD devices in patients undergoing complex high-risk PCIs, with reduced left ventricular ejection fraction, is a promising treatment option for patients disqualified from surgery by cardiac surgeons.
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Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Łukasz Rzeszutko
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Januszek R, Pawlik A, Sabatowski K, Rzeszutko Ł, Bartuś S. Myocardial infarction with nonobstructive coronary arteries in a woman: Takotsubo cardiomyopathy or true myocardial infarction? Kardiol Pol 2022; 80:1154-1155. [PMID: 36165003 DOI: 10.33963/kp.a2022.0225] [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: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 12/07/2022]
Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Karol Sabatowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Bartuś S, Rzeszutko Ł, Januszek R. Optical coherence tomography enhanced by novel software to better visualize the mechanism of atherosclerosis and improve the effects of percutaneous coronary intervention. Kardiol Pol 2021; 80:99-100. [PMID: 34870318 DOI: 10.33963/kp.a2021.0171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 12/05/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
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Kaziród-Wolski K, Sielski J, Sidło J, Januszek R, Siudak Z. The Most Relevant Factors Affecting the Perioperative Death Rate in Patients with Acute Coronary Syndrome and COVID-19, Based on Annual Follow-Up in the ORPKI Registry. Biomedicines 2021; 9:biomedicines9121813. [PMID: 34944629 PMCID: PMC8698975 DOI: 10.3390/biomedicines9121813] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 01/14/2023] Open
Abstract
Background: The COVID-19 pandemic is significantly affecting the functioning of the entire healthcare system. The disease itself may be associated with thromboembolic complications. The purpose of this study is to compare patients with acute coronary syndrome (ACS) and patients with ACS who were diagnosed with COVID-19 in terms of their clinical profile, management, treatment complications, and prognosis. Methods: We analyzed 47,940 cases of patients treated for ACS in 2020, including 44,952 patients (93.8%) who were not diagnosed with COVID-19 and 2988 patients (6.2%) who tested positive for COVID-19. Results: Patients with COVID-19 were significantly more likely to experience out-of-hospital sudden cardiac arrest (7.9 vs. 1.1%; p < 0.0001) and be transported directly to a catheterization laboratory (21.3% vs. 8.1%; p < 0.0001). Mortality was significantly higher in this group (0.9% vs. 0.4%; p < 0.0001). The risk of perioperative death was increased by age over 65 years, use of glycoprotein IIb/IIIa inhibitors (GPI IIb/IIIa), femoral access, critical left main stem coronary artery (LMCA) vascular lesions, ST elevation myocardial infarction (STEMI), and no-reflow phenomenon. Conclusions: Despite the pandemic, patients with COVID-19 were treated equally to healthy patients. Efficient organization of the healthcare system allowed the prompt transportation of patients to catheterization laboratories. The study group was characterized by a worse prognosis that was affected by multiple factors.
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Affiliation(s)
- Karol Kaziród-Wolski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (K.K.-W.); (J.S.); (Z.S.)
| | - Janusz Sielski
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (K.K.-W.); (J.S.); (Z.S.)
- Correspondence:
| | - Jacek Sidło
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (K.K.-W.); (J.S.); (Z.S.)
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Krakow, Poland;
- Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Medical College, Jagiellonian University, 30-688 Krakow, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland; (K.K.-W.); (J.S.); (Z.S.)
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Januszek R, Zabojszcz M, Cyran-Stemplewska S, Kręcisz B, Bartuś S, Siudak Z. Impact of psoriasis on ticagrelor platelet activity versus clopidogrel in patients with chronic coronary syndromes treated via percutaneous coronary intervention. Pol Arch Intern Med 2021; 131. [PMID: 34612030 DOI: 10.20452/pamw.16105] [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] [Indexed: 11/23/2022]
Affiliation(s)
- Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland.
| | | | | | - Beata Kręcisz
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Department of Cardiology and Cardiovascular Interventions, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
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Sabatowski K, Malinowski KP, Siudak Z, Reczuch K, Dobrzycki S, Lesiak M, Hawranek M, Gil RJ, Witkowski A, Wojakowski W, Lekston A, Gąsior M, Wańha W, Legutko J, Ekkert M, Jędrychowska M, Chyrchel M, Surdacki A, Bartuś S, Januszek R. Sex-related differences and rotational atherectomy - analysis of 5 177 percutaneous coronary interventions based on a large national registry from between 2014 and 2020. Kardiol Pol 2021; 79:1320-1327. [PMID: 34643261 DOI: 10.33963/kp.a2021.0131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and differ according to sex. AIMS To assess trends in sex-related percentage shares in following years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death. METHODS Based on the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), we analyzed 751 113 patients treated with PCI between 2014 and 2020. We extracted 5 177 (0.7%) patients treated with RA, 3 552 of them (68.6%) being men. To determine risk factors of periprocedural complications and death, multivariable analysis was performed. RESULTS The proportion of PCIs involving RA increase between 2014 and 2020 (P < 0.001). Almost twice as many RA procedures pertain to men (68.55%), while the percentage share did not change in following years. Data are reported as mean (standard deviation). The female patients were older (75.2 [8.3] vs 70.5 [9.2] years; P < 0.001). When considering periprocedural complications, their overall rate (3.45% vs 2.31%; P = 0.01) and death rate (0.68% vs 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor of greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007). CONCLUSIONS The majority of patients treated with RA are men and sex-related distribution was stable during the analyzed period of time. Female sex is a risk factor of greater periprocedural complications and mortality in patients treated with RA.
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Affiliation(s)
- Karol Sabatowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Krzysztof Piotr Malinowski
- Jagiellonian University Medical College, Faculty of Medicine, Department of Bioinformatics and Telemedicine, Kraków, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | | | - Sławomir Dobrzycki
- Department of Invasive Cardiology, State Teaching Hospital, Medical University of Bialystok, Białystok, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Robert Julian Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warszawa, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warszawa, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Centre for Heart Diseases in Zabrze, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Wojciech Wańha
- Department 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, John Paul II Hospital, Kraków, Poland
| | - Michał Ekkert
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Magdalena Jędrychowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland
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Januszek R, Bil J, Figatowski T, Tomasiewicz B, Desperak P, Niezgoda P, Reczuch K, Kubica J, Gil RJ, Bartus S, Gasior M, Witkowski A, Jaguszewski M, Wojakowski W, Wanha W. Duration of dual antiplatelet therapy and long-term outcomes following drug-eluting balloon or drug-eluting stents for treatment of in-stent restenosis (DAPT-Dragon Registry). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2141] [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: 11/12/2022] Open
Abstract
Abstract
Objectives
The aim of the DAPT-DRAGON registry was to asses long-term outcomes and the length of dual antiplatelet therapy (DAPT) in patients treated with percutaneous coronary intervention (PCI) due to drug-eluting stent in stent restenosis (DES-ISR) with drug-eluting balloons (DEB) or thin-DES.
Background
Data regarding the duration of DAPT in patients with DES-ISR treated with PCI is still undergoing research and observation, and the adequate duration of DAPT in this group of patients is not unambiguously sanctioned.
Methods
Overall, 1,367 consecutive patients with DES-ISR who underwent PCI with DEB or DES, were entered into the multi-center DAPT-DRAGON Registry (Fig. 1). The mean age was 66.7±9 years (70.5% males). The median follow-up was 3.3 years. There were 34.1% patients with chronic coronary syndrome, 35.2% with unstable angina, 2.9% with ST segment elevation myocardial infarction and 27.7% with non-ST segment elevation myocardial infarction (MI). We assessed selected study endpoints according to the duration of DAPT (≤3 vs. >3 months and ≤6 vs. >6 months), before and after propensity score matching (PSM): stroke, target lesion revascularization (TLR), target vessel revascularization (TVR), MI, death and device-oriented composite endpoints (DOCE).
Results
Among predictors of increased DOCE rate before PSM, we demonstrated: PCI with DEB vs. DES (p<0.001), recurrent ISR (p=0.002), treatment with glycoprotein IIb/IIIa inhibitor during PCI (p<0.001), lower left ventricle ejection fraction (p=0.004) and extent of stenosis (p<0.001). Pairwise contrast analysis considering type of PCI (thin-DES vs. DEB) and duration of DAPT (≤6 vs. >6 months) before PSM revealed superiority of thin-DES+DAPT >6 months vs. DEB+DAPT >6 months for DOCE (p<0.001), TVR (p=0.02) and TLR (p=0.01). After PSM analysis, the length of DAPT (≤3 vs. >3 months) had no significant influence on assessed long-term outcomes, while the percentage of stroke free survival was significantly lower in the group of patients with DAPT ≤6 months vs. >6 months (p=0.01; Fig. 2).
Conclusions
Long-term treatment with DAPT (>6 months) in patients with DES-ISR with DES implantation is related to better long-term outcomes in terms of lower rate of DOCE, TVR and TLR compared to PCI with DEB. DAPT >6 months is related to a greater rate of strokes, independently of the type of treatment (thin-DES and DEB) compared to DAPT ≤6 months.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- R Januszek
- University Hospital of Krakow, Krakow, Poland
| | - J Bil
- Grochowski Hospital, Medical Centre for Postgraduate Education, Warsaw, Poland
| | | | | | - P Desperak
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - P Niezgoda
- Nicolaus Copernicus University, Bydgoszcz, Poland
| | - K Reczuch
- Wroclaw Medical University, Wroclaw, Poland
| | - J Kubica
- Nicolaus Copernicus University, Bydgoszcz, Poland
| | - R J Gil
- Grochowski Hospital, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - S Bartus
- Jagiellonian University, Krakow, Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - A Witkowski
- Institute of Cardiology in Warsaw, Warsaw, Poland
| | | | - W Wojakowski
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - W Wanha
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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Sabatowski K, Malinowski KP, Reczuch K, Dobrzycki S, Lesiak M, Hawranek M, Gil RJ, Witkowski A, Wojakowski W, Lekston A, Gasior M, Wanha W, Legutko J, Bartus S, Januszek R. Gender distribution in patients treated with rotablation – analysis of 5,177 percutaneous coronary interventions based on a large national registry from between 2014 and 2020. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2140] [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: 11/15/2022] Open
Abstract
Abstract
Background
Patients undergoing percutaneous coronary intervention (PCI) procedures using rotational atherectomy (RA) are a special group of patients characterised by the presence of massive calcifications in the coronary arteries. Due to a significant increase regarding the frequency of these procedures in recent years and the distinctiveness of this narrow group of patients among all patients undergoing PCIs, we have characterised the group according to gender.
Aims
The aim of analysis was to assess the gender percentage share in following years and differences between both groups of Polish patients undergoing PCI with rotational RA between 2014 and 2020.
Methods
Based on the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), we analysed 751,113 patients treated with PCI between 2014 and 2020. Then, we extracted 5,177 (0.7%) treated with PCI and RA, 3,552 of them (68.6%) were males. Selected indices among the two groups were compared using the t-test for continuous variables, the χ2 test or the likelihood-ratio test for nominal variables where appropriate. To compare means of samples in the following years, one-way ANOVA test was used.
Results
The results of the study indicate an upward RA tendency in successive years (p<0.001). Moreover, this tendency and its increase was greater between the years 2016–2019 (Fig. 1). Almost twice as many RA procedures pertain to men, while the percentage share did not undergo a significant change in following years (Fig. 2). The mean age was 72±9 years in the overall group. In the total group, there were 2,873 patients (55.49%) with chronic coronary syndrome, 1,033 (19.95%) with unstable angina, 654 (12.63%) with non-ST segment elevation myocardial infarction (NSTEMI) and 494 (9.54%) with ST segment elevation myocardial infarction (STEMI).
Females were significantly older in comparison to males [75.2±8.3 vs. 70.5±9.2, p<0.001], more often diabetics [613 (37.72%) vs. 1,068 (30.07%), p<0.001], less often smokers [173 (10.6%) vs. 635 (17.9%), p<0.001] and were significantly more often treated due to acute coronary syndrome [780 (48.8%) vs. 1,401 (40.5%), p<0.001]. Considering periprocedural complications among females, there were more cardiac arrests [13 (0.8%) vs. 10 (0.28%), p=0.01] and deaths [11 (0.68%) vs. 6 (0.17%), p=0.006] when compared to males.
Conclusion
The percentage of RA among overall PCIs has been still growing in recent years in Poland. The majority of patients treated with RA are men. Gender distribution did not change significantly among patients treated with PCI and RA during the analysed period of time.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | - K Reczuch
- Military Hospital of Wroclaw, Wroclaw, Poland
| | - S Dobrzycki
- Medical University of Bialystok, Bialystok, Poland
| | - M Lesiak
- Poznan University of Medical Sciences, Poznan, Poland
| | - M Hawranek
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - R J Gil
- Grochowski Hospital, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - A Witkowski
- Institute of Cardiology in Warsaw, Warsaw, Poland
| | - W Wojakowski
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - A Lekston
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - M Gasior
- Silesian Center for Heart Diseases (SCHD), Zabrze, Poland
| | - W Wanha
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - J Legutko
- Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - S Bartus
- Jagiellonian University, Krakow, Poland
| | - R Januszek
- University Hospital of Krakow, Krakow, Poland
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Staszczak B, Malinowski KP, Siudak Z, Wanha W, Surdacki A, Wojakowski W, Legutko J, Bartus K, Bartus S, Januszek R. Frequency and predictors of coronary angiography and percutaneous coronary intervention related stroke. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2153] [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: 11/14/2022] Open
Abstract
Abstract
Background
Acute stroke related to percutaneous coronary interventions (PCIs) is an infrequent complication, although potentially life-threatening and often leading to serious disability, characterised by high morbidity and mortality rate. However, particular data on periprocedural complications, predictors, prognosis and the type of coronary intervention has not yet been adequately investigated.
Aim
The aim of the present study was to assess the relationship between the type of coronary procedure [coronary angiography (CA) and PCI] and incidence of stroke as well as predictors of stroke.
Material and methods
This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI), which covered the period between January 2014 and December 2019 and included 1,177,161 coronary procedures. Among them, 650,674 patients underwent isolated CA and 526,487 underwent PCI. Stroke was diagnosed in 157 patients (0.013%), of which 100 (0.015%) refers to patients admitted for CA and 57 (0.011%) in patients qualified for PCI. Subsequently, the mentioned groups were analysed for similarities and compared. Multivariate analysis was performed to separate predictors of stroke in patients undergoing coronary angiography and PCI.
Results
The amount of patients with periprocedural stroke was higher in a group treated with isolated CA during the analysed time. The mean age of the patients, who developed cerebral stroke, was significantly higher in the overall group (71.4±10.6 vs. 66.7±10.8; p<0.001). Patients with stroke, in comparison to non-stroke group, were treated more often from femoral access for CA (p<0.001) and PCI (p=0.04), they had a history of prior stroke for CA (p<0.001) and PCI (p<0.001) more often, and acute myocardial infarction at admission for CA (p<0.001) and PCI (p=0.01). They were also more frequently transported directly to the catheterisation laboratory for CA (p<0.001) and PCI (p=0.002). Predictors of periprocedural stroke, assessed by multivariate analysis for CA, are presented at Fig. 1 and for PCI at Fig. 2.
Conclusions
Based on the large national registry, PCI is associated with fewer risk factors and lower rate of periprocedural strokes than isolated CA.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- B Staszczak
- University Hospital of Krakow, Krakow, Poland
| | | | - Z Siudak
- The Jan Kochanowski University in Kielce, Kielce, Poland
| | - W Wanha
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - A Surdacki
- University Hospital of Krakow, Krakow, Poland
| | - W Wojakowski
- School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - J Legutko
- Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - K Bartus
- Jagiellonian University, Krakow, Poland
| | - S Bartus
- Jagiellonian University, Krakow, Poland
| | - R Januszek
- University Hospital of Krakow, Krakow, Poland
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Wańha W, Bil J, Januszek R, Gilis-Malinowska N, Figatowski T, Milewski M, Pawlik A, Staszczak B, Wybraniec M, Tomasiewicz B, Kübler P, Kuliczkowski W, Walczak T, Hrymniak B, Desperak P, Mielczarek M, Ciecwierz D, Niezgoda P, Wolny R, Chudzik M, Kuźma Ł, Kralisz P, Kedhi E, D'Ascenzo F, Hudziak D, Kowalówka A, Smolka G, Reczuch K, Gruchała M, Kubica J, Gil RJ, Dobrzycki S, Dudek D, Bartuś S, Gąsior M, Ochała A, Witkowski A, Jaguszewski M, Wojakowski W. Long-Term Outcomes Following Drug-Eluting Balloons Versus Thin-Strut Drug-Eluting Stents for Treatment of In-Stent Restenosis (DEB-Dragon-Registry). Circ Cardiovasc Interv 2021; 14:e010868. [PMID: 34474584 DOI: 10.1161/circinterventions.121.010868] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski)
| | - Jacek Bil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland (J.B., R.J.G.)
| | - Rafał Januszek
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland (R.J., A.P., B.S., D.D., S.B.).,Department of Clinical Rehabilitation, University of Physical Education, Krakow, Poland (R.J.)
| | - Natasza Gilis-Malinowska
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Tomasz Figatowski
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Marek Milewski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski)
| | - Artur Pawlik
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland (R.J., A.P., B.S., D.D., S.B.)
| | - Bartłomiej Staszczak
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland (R.J., A.P., B.S., D.D., S.B.)
| | - Maciej Wybraniec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Poland (M.W.)
| | - Brunon Tomasiewicz
- Centre for Heart Disease, University Hospital Wroclaw Department of Heart Disease, Wroclaw Medical University, Poland (B.T., P.K., W.K., K.R.)
| | - Piotr Kübler
- Centre for Heart Disease, University Hospital Wroclaw Department of Heart Disease, Wroclaw Medical University, Poland (B.T., P.K., W.K., K.R.)
| | - Wiktor Kuliczkowski
- Centre for Heart Disease, University Hospital Wroclaw Department of Heart Disease, Wroclaw Medical University, Poland (B.T., P.K., W.K., K.R.)
| | - Tomasz Walczak
- Department of Cardiology, 4th Military Hospital, Wroclaw, Poland (T.W., B.H.)
| | - Bruno Hrymniak
- Department of Cardiology, 4th Military Hospital, Wroclaw, Poland (T.W., B.H.)
| | - Piotr Desperak
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland (P.D., M. Gąsior)
| | - Maksymilian Mielczarek
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Dariusz Ciecwierz
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Piotr Niezgoda
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland (P.N., J.K.)
| | - Rafał Wolny
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland (R.W., A.W.)
| | | | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Poland (L.K., P.K., S.D.)
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Bialystok, Poland (L.K., P.K., S.D.)
| | - Elvin Kedhi
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski).,AZ Sint Jan Brugge, Belgium (E.K.)
| | - Fabrizio D'Ascenzo
- Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Italy (F.D.)
| | - Damian Hudziak
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland (D.H., A.K.)
| | - Adam Kowalówka
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland (D.H., A.K.)
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski)
| | - Krzysztof Reczuch
- Centre for Heart Disease, University Hospital Wroclaw Department of Heart Disease, Wroclaw Medical University, Poland (B.T., P.K., W.K., K.R.)
| | - Marcin Gruchała
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Jacek Kubica
- Department of Cardiology and Internal Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland (P.N., J.K.)
| | - Robert J Gil
- Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Warsaw, Poland (J.B., R.J.G.)
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Poland (L.K., P.K., S.D.)
| | - Dariusz Dudek
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland (R.J., A.P., B.S., D.D., S.B.)
| | - Stanisław Bartuś
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland (R.J., A.P., B.S., D.D., S.B.)
| | - Mariusz Gąsior
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland (P.D., M. Gąsior)
| | - Andrzej Ochała
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski)
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland (R.W., A.W.)
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Poland (N.G.-M., T.F., M. Mielczarek, D.C., M. Gruchała, M.J.)
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (W. Wańha, M. Milewski, E.K., G.S., A.O., W. Wojakowski)
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Staszczak B, Malinowski KP, Wańha W, Siudak Z, Jędrychowska M, Susuł M, Surowiec S, Darocha S, Surdacki A, Kurzyna M, Wojakowski W, Legutko J, Bartuś K, Bartuś S, Januszek R. Frequency and predictors of diagnostic coronary angiography and percutaneous coronary intervention related to stroke. Kardiol Pol 2021; 79:1099-1106. [PMID: 34472076 DOI: 10.33963/kp.a2021.0100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/31/2021] [Accepted: 08/31/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Stroke related to percutaneous coronary interventions (PCIs) is an infrequent complication, which can be potentially life-threatening and can lead to serious disability. AIMS This study aimed to assess the relationship between the type of coronary procedure and incidence of stroke, as well as its predictors. METHODS This retrospective analysis was performed on prospectively collected data gathered in the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) between January 2014 and December 2019 and included 1177 161 coronary procedures. Among them, 650 674 patients underwent isolated diagnostic coronary angiography (DCA), and 526 487 PCI. Stroke was diagnosed in 157 patients (0.013%), of which 100 (0.015%) happened during DCA and 57 (0.011%) during PCI. Multivariable logistic regression analysis was performed to separate predictors of stroke in patients undergoing coronary angiography and PCI. RESULTS The percentage of patients with periprocedural stroke was higher in the group treated with isolated DCA during the analyzed time. Among predictors of stroke in patients undergoing DCA, we confirmed prior stroke (P <0.001), contrast amount (P = 0.007), femoral access (P = 0.002), unfractionated heparin use (P = 0.01), direct transport to the catheterization laboratory (P = 0.04), older age (P <0.001) and multi-vessel disease (P <0.001). While for PCI ± DCA, these were prior stroke (P <0.001), thrombolysis (P = 0.003), treatment with bivalirudin (P <0.001), and acetylsalicylic acid loading during PCI (P = 0.003). CONCLUSIONS Based on the large national registry, PCI ± DCA is associated with fewer risk factors and a lower rate of periprocedural strokes than isolated DCA.
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Affiliation(s)
- Bartłomiej Staszczak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | | | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Magdalena Jędrychowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Michał Susuł
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Sławomir Surowiec
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Szymon Darocha
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Center of Postgraduate Medical Education, European Health Center, Otwock, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Center of Postgraduate Medical Education, European Health Center, Otwock, Poland
| | - Wojciech Wojakowski
- Department 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, John Paul II Hospital, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.,Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland. .,Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland.
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44
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Jędrychowska M, Siudak Z, Malinowski KP, Zandecki Ł, Zabojszcz M, Kameczura T, Mika P, Bartuś K, Wańha W, Wojakowski W, Legutko J, Bartuś S, Januszek R. ST-segment elevation myocardial infarction with non-obstructive coronary arteries: Score derivation for prediction based on a large national registry. PLoS One 2021; 16:e0254427. [PMID: 34351919 PMCID: PMC8341573 DOI: 10.1371/journal.pone.0254427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/18/2020] [Accepted: 06/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acute myocardial infarction with ST-segment elevation (STEMI) and obstructive coronary arteries (MI-CAD) are treated with primary percutaneous coronary interventions (pPCI), while patients with STEMI and non-obstructive coronary arteries (MINOCA), usually require non-invasive therapy. The aim of the study is to design a score for predicting suspected MINOCA among an overall group of STEMI patients. MATERIALS AND METHODS Based on the Polish national registry of PCIs, we evaluated patients between 2014 and 2019, and selected 526,490 subjects treated with PCI and 650,728 treated using only coronary angiography. These subjects were chosen out of 1,177,218 patients who underwent coronary angiography. Then, we selected 124,663 individuals treated with pPCI due to STEMI and 5,695 patients with STEMI and MINOCA. The score for suspected MINOCA was created using the regression model, while the coefficients calculated for the final model were used to construct a predictive model in the form of a nomogram. RESULTS Patients with MINOCA differ significantly from those in the MI-CAD group; they were significantly younger, less often males and demonstrated smaller burden of concomitant diseases. The model allowed to show that patients who scored more than 600 points had a 19% probability of MINOCA, while for those scoring more than 650 points, the likelihood was 71%. The other end of the MINOCA probability scale was marginal for patients who scored less than 500 points (< .2%). CONCLUSIONS Based on the created MINOCA score presented in the current publication, we are able to distinguish MINOCA from MI-CAD patients in the STEMI group.
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Affiliation(s)
- Magdalena Jędrychowska
- 2 Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | - Łukasz Zandecki
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | - Tomasz Kameczura
- Chair of Electroradiology, Faculty of Medicine, University of Rzeszów, Rzeszów, Poland
| | - Piotr Mika
- Department of Clinical Rehabilitation, University School of Physical Education, Kraków, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Department 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, John Paul II Hospital, Kraków, Poland
| | - Stanisław Bartuś
- 2 Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2 Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- 2 Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Department of Clinical Rehabilitation, University School of Physical Education, Kraków, Poland
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Staszczak B, Siudak Z, Malinowski KP, Jędrychowska M, Zabojszcz M, Dolecka-Ślusarczyk M, Janion-Sadowska A, Susuł M, Tokarek T, Bartuś J, Pawlik A, Socha S, Surdacki A, Bartuś S, Januszek R. Clinical outcomes in patients with acute myocardial infarction treated with primary percutaneous coronary intervention stratified according to duration of pain-to-balloon time and type of myocardial infarction. Cardiol J 2021; 30:734-746. [PMID: 34240403 PMCID: PMC10635712 DOI: 10.5603/cj.a2021.0074] [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: 07/03/2020] [Revised: 11/30/2020] [Accepted: 02/28/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Based on the clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI), treated with primary percutaneous coronary intervention (pPCI), this study intended to assess mortality and major adverse cardiac and cerebrovascular event (MACCE) rates according to duration of pain-to-balloon (PTB) time and type of MI. METHODS This is a retrospective cohort study based on the prospectively collected ORPKI registry which covers PCIs performed in Poland chosen between January 2014 and December 2017. Under assessment were 1,994 STEMI and 923 NSTEMI patients. Study endpoints included mortality and MACCE rates (in-hospital, 30-day, 12- and 36-month). Predictors of all-cause mortality in the overall group, STEMI and NSTEMI were assessed by multivariable analysis. RESULTS Kaplan-Meier survival curve analysis did not reveal significant differences between the STEMI and NSTEMI group for all-cause mortality or MACCE at the 36-month follow-up. While in the long PTB time group, MACCE rate was significantly greater in STEMI patients when compared to NSTEMI (p = 0.004). Among STEMI patients, the short, medium and long PTB time groups differed significantly in the rate of all-cause mortality (p = 0.006) and MACCE (p = 0.04) at 1,095 days of follow-up, which were the greatest in the long PTB time group. CONCLUSIONS Before considering the length of PTB time, there were no statistically significant differences in mortality or MACCE frequency between the STEMI and NSTEMI group at 36-month follow-up. Longer PTB times are related to significantly greater mortality at the 36-month follow-up in the STEMI, but not in the NSTEMI group.
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Affiliation(s)
- Bartłomiej Staszczak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | | | - Magdalena Jędrychowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | | | | | | | - Michał Susuł
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Tomasz Tokarek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Joanna Bartuś
- Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Sylwia Socha
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Andrzej Surdacki
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Rafał Januszek
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
- University of Physical Education, Department of Clinical Rehabilitation, Krakow, Poland.
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Kaczmarczyk P, Frołow M, Januszek R, Belowski A, Gregorczyk-Maga I, Chlopicki S, Maga P. Endothelial function in patients with critical and non-critical limb ischemia undergoing endovascular treatment. Kardiol Pol 2021; 79:804-812. [PMID: 34002844 DOI: 10.33963/kp.a2021.0010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease. CLI patients, compared to non-CLI, achieve worse treatment outcomes and generate higher costs. AIMS The aim of the study was to compare endothelial function and clinical outcomes in CLI and non-CLI patients after percutaneous transluminal angioplasty (PTA). METHODS In this prospective, follow-up study, 30 CLI patients and 40 non-CLI patients underwent PTA. Endothelial function was assessed based on flow-mediated dilatation (FMD), reactive-hyperaemia index (RHI), while the ankle-brachial index, toe-brachial index and the Rutherford scale were used for PAD progression evaluation. The results were assessed before as well as 1, 3, 6 and 12 months after PTA. RESULTS There were no differences at the baseline regarding to endothelial function between both groups. Neither FMD nor RHI changed after PTA in any of the groups, although there was a difference in median RHI value between CLI and non-CLI patients regarding the 1st and 6th month of the follow-up (RHI6-RHI1 = 0.08 in CLI and -0.15 in non-CLI; P = 0.01). The larger baseline intima-media (IMT) in the CLI group allowed to predict a greater number of reintervention (P = 0.01) and major adverse event rates (P = 0.03). CLI patients presented larger decrease in the Rutherford scale compared to non-CLI (P < 0.001). CONCLUSIONS Baseline IMT was predictive for re-interventions and major adverse event rates. Although neither of groups exhibited significant changes in endothelial function, we proved differences between them regarding to changes in RHI.
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Affiliation(s)
- Paweł Kaczmarczyk
- Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marzena Frołow
- Department of Angiology, Jagiellonian University Medical College, Kraków, Poland.,Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Kraków, Poland
| | - Rafał Januszek
- 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland
| | - Andrzej Belowski
- Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Stefan Chlopicki
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University, Kraków, Poland.,Chair of Pharmacology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Maga
- Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
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47
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Wańha W, Januszek R, Kołodziejczak M, Kuźma Ł, Tajstra M, Figatowski T, Smolarek-Nicpoń M, Gruz-Kwapisz M, Tomasiewicz B, Bartuś J, Łoś A, Jagielak D, Roleder T, Włodarczak A, Kulczycki J, Kowalewski M, Hudziak D, Stachowiak P, Gorący J, Sierakowska K, Reczuch K, Jaguszewski M, Dobrzycki S, Smolka G, Bartuś S, Ochała A, Gąsior M, Wojakowski W. Procedural and 1-year outcomes following large vessel coronary artery perforation treated by covered stents implantation: Multicentre CRACK registry. PLoS One 2021; 16:e0249698. [PMID: 33979357 PMCID: PMC8115813 DOI: 10.1371/journal.pone.0249698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 12/22/2020] [Accepted: 03/24/2021] [Indexed: 11/25/2022] Open
Abstract
Background Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation. Methods This multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. The primary endpoint was the composite of major adverse cardiac events (MACEs), defined as cardiac death, target lesion revascularization (TLR), and myocardial infarction (MI). Results The registry included 119 patients (mean age: 68.9 ± 9.7 years, 55.5% men). Acute coronary syndrome, including: unstable angina 21 (17.6%), NSTEMI 26 (21.8%), and STEMI 26 (21.8%), was the presenting diagnosis in 61.3%, and chronic coronary syndromes in 38.7% of patients. The most common lesion type, according to ACC/AHA classification, was type C lesion in 47 (39.5%) of cases. A total of 52 patients (43.7%) had type 3 Ellis classification, 28 patients (23.5%) had type 2 followed by 39 patients (32.8%) with type 1 perforation. Complex PCI was performed in 73 (61.3%) of patients. Periprocedural death occurred in eight patients (6.7%), of which two patients had emergency cardiac surgery. Those patients were excluded from the one-year analysis. Successful sealing of the perforation was achieved in 99 (83.2%) patients. During the follow-up, 26 (26.2%) patients experienced MACE [7 (7.1%) cardiac deaths, 13 (13.1%) TLR, 11 (11.0%) MIs]. Stent thrombosis (ST) occurred in 6 (6.1%) patients [4(4.0%) acute ST, 1(1.0%) subacute ST and 1(1.0%) late ST]. Conclusions The use of covered stents is an effective treatment of CAP. The procedural and 1-year outcomes of CAP treated by CS implantation showed that such patients should remain under follow-up due to relatively high risk of MACE.
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Affiliation(s)
- Wojciech Wańha
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
- * E-mail:
| | - Rafał Januszek
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Michalina Kołodziejczak
- Department of Anaesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland
| | - Mateusz Tajstra
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Tomasz Figatowski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Malwina Smolarek-Nicpoń
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Monika Gruz-Kwapisz
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Jerzy Bartuś
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Łoś
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Dariusz Jagielak
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Tomasz Roleder
- Regional Specialist Hospital, Research and Development Center, Wroclaw, Poland
| | | | - Jan Kulczycki
- Department of Cardiology, Miedziowe Centrum Zdrowia, Lubin, Poland
| | - Mariusz Kowalewski
- Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland
- Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
| | - Damian Hudziak
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Paweł Stachowiak
- Regional Specialist Hospital, Research and Development Center, Wroclaw, Poland
- Department of Cardiology, Pomeranian Medical University, Szczecin, Poland
| | - Jarosław Gorący
- Department of Cardiology, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna Sierakowska
- Department of Anaesthesiology and Intensive Care, Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Antoni Jurasz University Hospital No. 1, Bydgoszcz, Poland
| | | | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Stanisław Bartuś
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Andrzej Ochała
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
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Gregorczyk-Maga I, Szustkiewicz-Karoń A, Kaszuba M, Januszek R, Rahnama M, Jurczak A, Maga P. Prognostic markers of post-traumatic dental external root resorption in children-a pilot study. Dent Traumatol 2021; 37:699-705. [PMID: 33970554 DOI: 10.1111/edt.12682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/13/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND External inflammatory root resorption (EIRR) is a frequent complication of traumatic dental injuries (TDI). The aim of this cohort study was to identify novel non-invasive markers of post-traumatic EIRR by assessing the changes in the pulp's blood flow and the composition of gingival sulcus fluid (GCF) in children after dental trauma. MATERIAL AND METHODS Thirty-two children were enrolled and assessed within 48 h of a TDI to their permanent incisors and during an additional three visits over a 6-months follow up period. During each visit, a radiograph and laser Doppler flow (LDF) measurements of the pulp blood flow were performed on the injured tooth, and the GCF was sampled. The permanent first molar tooth of the same subject served as a control for the LDF measurements and the GCF sampling. Concentrations of IL-1α in the GCF were measured using enzyme-linked immunosorbent assays. Radiographs were used to confirm EIRR. RESULTS EIRR occurred in fourteen (43.8%) teeth in 32 patients. The teeth with EIRR showed diminished LDF readings when compared with controls at all visits. The LDF readings of the injured teeth continued to decrease at follow up visits. In the EIRR group, levels of IL-1α in the GCF of teeth with EIRR were increased and significantly higher than those of the control teeth at the visit when EIRR was diagnosed. The IL-1α levels were significantly higher in the EIRR group when compared to the injured teeth of patients without EIRR at the last follow-up visit. CONCLUSIONS The occurrence of EIRR after mechanical trauma of permanent teeth with complete root development is accompanied by a significant reduction in the blood flow of the tooth's pulp. It is accompanied by an increase in concentrations of IL-1α in the GCF of EIRR affected teeth. The results of this pilot study identified the use of IL-1α in GCF and LDF as non-invasive markers of EIRR.
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Affiliation(s)
- Iwona Gregorczyk-Maga
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
| | | | - Marek Kaszuba
- Faculty of Health Sciences, Institute of Physiotherapy, Jagiellonian University Medical College, Kraków, Poland
| | - Rafał Januszek
- Department of Clinical Rehabilitation, University of Physical Education, Kraków, Poland
| | - Mansur Rahnama
- Faculty of Dentistry, Chair and Department of Dental Surgery, Medical University of Lublin, Lublin, Poland
| | - Anna Jurczak
- Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Maga
- Faculty of Medicine, Department of Angiology, Jagiellonian University Medical College, Kraków, Poland
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49
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Januszek R, Bartuś S. Stent underexpansion due to heavy calcification in a patient with recent acute coronary syndrome successfully treated with lithotripsy. Kardiol Pol 2021; 79:875-876. [PMID: 33909386 DOI: 10.33963/kp.15970] [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] [Received: 05/06/2021] [Indexed: 11/23/2022]
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50
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Wańha W, Januszek R, Kuźma Ł, Figatowski T, Kołodziejczak M, Żak M, Smolarek M, Gruz-Kwapisz MM, Wybraniec M, Tajstra M, Tomasiewicz B, Łoś A, Jagielak D, Roleder T, Wlodarczak A, Kulczycki J, Hudziak D, Stachowiak P, Reczuch K, Jaguszewski M, Dobrzycki S, Smolka G, Bartuś S, Ochala A, Gąsior M, Wojakowski W. TCTAP A-028 Procedural and 1-year Outcomes Following Large Vessel Coronary Artery Perforation Treated by Covered Stents Implantation: Multicenter CRACK Registry. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.03.052] [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: 12/01/2022]
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