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Roczniak J, Bober M, Chyrchel M, Bartuś S, Rzeszutko Ł. Minimum contrast PCI using a guide extension catheter and IVUS with Philips SyncVision co-registration. Kardiol Pol 2024:VM/OJS/J/100183. [PMID: 38712777 DOI: 10.33963/v.phj.100183] [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: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024]
Affiliation(s)
- Jan Roczniak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Marcin Bober
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Michał Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Departament of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Departament of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Departament of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Zdzierak B, Krawczyk-Ożóg A, Zasada W, Bartuś S, Dziewierz A. Successful treatment of extensive coronary artery dissection with cutting balloon. Kardiol Pol 2024:VM/OJS/J/100135. [PMID: 38638094 DOI: 10.33963/v.phj.100135] [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: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Affiliation(s)
- Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Department of Anatomy, HEART - Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Kraków, Poland
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- KCRI, Kraków, Poland
| | - Stanisław Bartuś
- Clinical 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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Pawlik A, Roczniak J, Sabatowski K, Chyrchel M, Rzeszutko Ł, Bartuś S. Axillary access for a left ventricular assist device during percutaneous angioplasty. Kardiol Pol 2024; 82:458-459. [PMID: 38493467 DOI: 10.33963/v.phj.99550] [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: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Jan Roczniak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Karol Sabatowski
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 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
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 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, 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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Batko J, Jakiel R, Krawczyk-Ożóg A, Litwinowicz R, Hołda J, Bartuś S, Bartuś K, Hołda MK, Konieczyńska M. Definition and anatomical description of the left atrial appendage neck. Clin Anat 2024; 37:201-209. [PMID: 38031393 DOI: 10.1002/ca.24125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 12/01/2023]
Abstract
The left atrial appendage (LAA) is well known as a source of cardiac thrombus formation. Despite its clinical importance, the LAA neck is still anatomically poorly defined. Therefore, this study aimed to define the LAA neck and determine its morphometric characteristics. We performed three-dimensional reconstructions of the heart chambers based on contrast-enhanced electrocardiography-gated computed tomography scans of 200 patients (47% females, 66.5 ± 13.6 years old). The LAA neck was defined as a truncated cone-shaped canal bounded proximally by the LAA orifice and distally by the lobe origin and was present in 98.0% of cases. The central axis of the LAA neck was 14.7 ± 2.3 mm. The mean area of the LAA neck walls was 856.6 ± 316.7 mm2 . The LAA neck can be divided into aortic, arterial (the smallest), venous (the largest), and free surfaces. All areas have a trapezoidal shape with a broader proximal base. There were no statistically significant differences in the morphometric characteristics of the LAA neck between LAA types. Statistically significant differences between the sexes in the main morphometric parameters of the LAA neck were found in the central axis length and the LAA neck wall area. The LAA neck can be evaluated from computed tomography scans and their three-dimensional reconstructions. The current study provides a complex morphometric analysis of the LAA neck. The precise definition and morphometric details of the LAA neck presented in this study may influence the effectiveness and safety of LAA exclusion procedures.
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Affiliation(s)
- Jakub Batko
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
- CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
- Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Rafał Jakiel
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Agata Krawczyk-Ożóg
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital in Cracow, Krakow, Poland
| | - Radosław Litwinowicz
- CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
- Thoracic Research Centre, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- Department of Cardiac Surgery, Regional Specialist Hospital, Grudziądz, Poland
| | - Jakub Hołda
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital in Cracow, Krakow, Poland
| | - Krzysztof Bartuś
- Department of Cardiovascular Surgery and Transplantology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz K Hołda
- HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
- Department of Diagnostic Medicine, John Paul II Hospital in Kraków, Krakow, Poland
- Division of Cardiovascular Sciences, The University of Manchester, Manchester, UK
| | - Małgorzata Konieczyńska
- Department of Diagnostic Medicine, John Paul II Hospital in Kraków, Krakow, Poland
- Department of Thromboembolic Diseases, Jagiellonian University Medical College, Cracow, 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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Węgiel M, Surmiak M, Malinowski KP, Dziewierz A, Surdacki A, Bartuś S, Rakowski T. In-Hospital Levels of Circulating MicroRNAs as Potential Predictors of Left Ventricular Remodeling Post-Myocardial Infarction. Medicina (Kaunas) 2024; 60:149. [PMID: 38256409 PMCID: PMC10819680 DOI: 10.3390/medicina60010149] [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: 12/06/2023] [Revised: 01/01/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
Background and Objectives: Biochemical and molecular regulation of both adaptive and pathological responses of heart tissue to ischemic injury is widely investigated. However, it is still not fully understood. Several biomarkers are tested as predictors of left ventricle (LV) remodeling after myocardial infarction (MI). The aim of this study was to assess the relationship between selected microRNAs (miRNAs) and LV function and morphology in patients after MI. Materials and Methods: Selected miRNAs related to heart failure were assessed in the acute phase of MI: miR-150-3p, miR-21-5p, miR-19b-3p, miR-155-5p, miR-22-5p. Echocardiography with 3D imaging was performed at baseline and after 6 months. Remodeling was defined as >20% increase in LV end-diastolic volume, whereas reverse remodeling was defined as >10% reduction in LV end-systolic volume. Results: Eighty patients entered the registry. Remodeling occurred in 26% and reverse remodeling was reported in 51% of patients. In the presented study, none of the analyzed miRNAs were found to be a significant LV remodeling predictor. The observed correlations between miRNAs and other circulating biomarkers of myocardial remodeling were relatively weak. Conclusions: Our analysis does not demonstrate an association between the analyzed miRNAs and LV remodeling in patients with MI.
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Affiliation(s)
- Michał Węgiel
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 30-688 Krakow, Poland; (M.W.); (A.D.); (S.B.)
| | - Marcin Surmiak
- Department of Internal Medicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Krzysztof Piotr Malinowski
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 30-688 Krakow, Poland; (M.W.); (A.D.); (S.B.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 30-688 Krakow, Poland; (M.W.); (A.D.); (S.B.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 30-688 Krakow, Poland; (M.W.); (A.D.); (S.B.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Tomasz Rakowski
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital in Krakow, 30-688 Krakow, Poland; (M.W.); (A.D.); (S.B.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
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Sorysz D, Dziewierz A, Opalinska M, Sowa-Staszczak A, Grochowska A, Malinowski KP, Maruszak N, Bartuś S, Dudek D. 18F-fluorodeoxyglucose and 18F-sodium fluoride positron emission tomography imaging in assessing early stages of aortic valve degeneration after transcatheter aortic valve implantation. Pol Arch Intern Med 2023; 133:16607. [PMID: 37966038 DOI: 10.20452/pamw.16607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Transcatheter aortic valve implantation (TAVI) is a standard treatment for severe aortic stenosis, primarily in elderly patients. With an increasing number of procedures and younger patients, understanding the valve degeneration and its risk factors becomes crucial. OBJECTIVES We aimed to utilize 18F‑sodium fluoride (18F‑NaF) and 18F‑fluorodeoxyglucose (18F‑FDG) positron emission tomography/computed tomography (PET/CT) to evaluate early TAVI valve degeneration. PATIENTS AND METHODS In this prospective study with a prespecified follow‑up protocol, 71 TAVI patients underwent baseline transthoracic and transesophageal echocardiography, and PET/CT with 18F‑NaF and 18F‑FDG. Of these, 31 patients completed 24‑month control examinations, while the others were lost to mortality and the COVID‑19 pandemic. We measured PET tracer activity and compared 18F‑NaF and 18F‑FDG PET/CT uptake at baseline and 24‑month follow‑up. RESULTS PET/CT and echocardiography data were analyzed for 31 of the 71 enrolled TAVI patients at a median age of 84 years (interquartile range, 80-86). After TAVI, an improvement in the valve function was observed. During follow‑up, the valve function remained stable. PET/CT demonstrated an increase in 18F‑FDG maximal uptake in the inner (tissue‑to‑background ratio, P = 0.009) and outer (P = 0.01) sides of the TAVI valve stent, but no difference in 18F‑NaF maximal activity (inner, P = 0.17; outer, P = 0.57). CONCLUSIONS Twenty‑four months post‑TAVI, an increase in 18F‑FDG uptake, indicative of inflammation, was observed in the valve, while the uptake of the calcification marker (18F‑NaF) remained stable. Theseobservations might suggest early stages of TAVI valve degeneration, although further investigation is required to confirm this interpretation.
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Affiliation(s)
- Danuta Sorysz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marta Opalinska
- Clinical Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Kraków, Poland
- Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Sowa-Staszczak
- Clinical Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Kraków, Poland
- Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Grochowska
- Department of Radiology, University Hospital, Kraków, Poland
| | - Krzysztof P Malinowski
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Kraków, Poland
| | - Natalia Maruszak
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Dariusz Dudek
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Kraków, Poland
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10
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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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11
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Zdzierak B, Zasada W, Rakowski T, Krawczyk-Ożóg A, Bartuś S, Surdacki A, Dziewierz A. Influence of diabetes mellitus on the invasive assessment of myocardial ischemia in patients with coronary artery disease. Pol Arch Intern Med 2023; 133:16502. [PMID: 37227217 DOI: 10.20452/pamw.16502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Current guidelines recommend physiological evaluation of borderline coronary artery stenoses using hyperemic (fractional flow reserve [FFR]) and nonhyperemic (instantaneous wave‑free ratio [iFR] and resting full‑cycle ratio [RFR]) methods. However, comorbidities, such as diabetes mellitus (DM), may influence the results of the assessment. OBJECTIVES We sought to investigate the impact of DM and insulin treatment on the discordance between FFR and iFR/RFR. PATIENTS AND METHODS A total of 417 intermediate stenoses in 381 patients underwent FFR and iFR/RFR assessment. FFR lower than or equal to 0.8 and iFR/RFR lower than or equal to 0.89 indicated significant ischemia. The patients were categorized based on DM diagnosis and insulin treatment status. RESULTS Of the 381 patients, 154 (40.4%) had DM. Among these, 58 patients (37.7%) received insulin treatment. Diabetic patients had higher body mass index and glycated hemoglobin levels, and lower ejection fraction. FFR and iFR/RFR analyses were conducted in 417 vessels with available measurements for both tests. A good correlation between FFR and iFR/RFR was confirmed in both diabetic (R = 0.77) and nondiabetic (R = 0.74) patients. Discordance between FFR and iFR/RFR occurred in approximately 20% of cases, and the frequency of discordance was not affected by the diabetic status. However, insulin‑treated DM was independently associated with a higher risk of negative FFR and positive iFR/RFR discordance (odds ratio, 4.61; 95% CI, 1.38-15.4; P = 0.01). Also, the optimal cutoff value for FFR identifying significant ischemia in DM patients treated with insulin was higher (0.84) than the generally recommended value. CONCLUSIONS The rate of FFR and iFR/FFR discordance was similar regardless of the diabetes status, and insulin‑treated DM was associated with an increased risk of negative FFR and positive iFR/RFR discordance.
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Affiliation(s)
- Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- KCRI, Kraków, Poland
| | - Tomasz Rakowski
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Department of Anatomy, HEART – Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
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12
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Maruszak N, Sorysz D, Rakowski T, Bartuś S. Complex subvalvular aortic stenosis, a bicuspid aortic valve with ventricular septal defect, patent ductus arteriosus, and aortic coarctation: A challenging combination. Kardiol Pol 2023; 81:1149-1150. [PMID: 37997854 DOI: 10.33963/v.kp.96165] [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: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Natalia Maruszak
- Student Scientific Group at Second Department of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Danuta Sorysz
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Tomasz Rakowski
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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13
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Pietrasik A, Gąsecka A, Pawłowski T, Sacha J, Grygier M, Bielawski G, Balak W, Sukiennik A, Burzyńska P, Witkowski A, Warniełło M, Rzeszutko Ł, Bartuś S, Pawlik A, Kaczyński M, Gil R, Kuliczkowski W, Reczuch K, Protasiewicz M, Kleczyński P, Wańczura P, Gurba S, Kochanowska A, Łomiak M, Cacko A, Skorupski W, Zarębiński M, Pawluczuk P, Włodarczak S, Włodarczak A, Ściborski K, Telichowski A, Pluciński M, Hiczkiewicz J, Konsek K, Hawranek M, Gąsior M, Peruga J, Fiutowski M, Romanek R, Kasprzyk P, Ciećwierz D, Ochała A, Wojakowski W, Legutko J, Kochman J. Multicenter registry of Impella-assisted high-risk percutaneous coronary interventions and cardiogenic shock in Poland (IMPELLA-PL). Kardiol Pol 2023; 81:1103-1112. [PMID: 37937354 DOI: 10.33963/v.kp.97218] [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: 09/01/2023] [Accepted: 09/01/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Impella is a percutaneous mechanical circulatory support device for treatment of cardiogenic shock (CS) and high-risk percutaneous coronary interventions (HR-PCIs). IMPELLA-PL is a national retrospective registry of Impella-treated CS and HR-PCI patients in 20 Polish interventional cardiological centers, conducted from January 2014 until December 2021. AIMS We aimed to determine the efficacy and safety of Impella using real-world data from IMPELLA-PL and compare these with other registries. METHODS IMPELLA-PL data were analyzed to determine primary endpoints: in-hospital mortality and rates of mortality and major adverse cardiovascular and cerebrovascular events (MACCE) at 12 months post-discharge. RESULTS Of 308 patients, 18% had CS and 82% underwent HR-PCI. In-hospital mortality rates were 76.4% and 8.3% in the CS and HR-PCI groups, respectively. The 12-month mortality rates were 80.0% and 18.2%, and post-discharge MACCE rates were 9.1% and 22.5%, respectively. Any access site bleeding occurred in 30.9% of CS patients and 14.6% of HR-PCI patients, limb ischemia in 12.7% and 2.4%, and hemolysis in 10.9% and 1.6%, respectively. CONCLUSIONS Impella is safe and effective during HR-PCIs, in accordance with previous registry analyses. The risk profile and mortality in CS patients were higher than in other registries, and the potential benefits of Impella in CS require investigation.
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Affiliation(s)
| | - Aleksandra Gąsecka
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland.
| | - Tomasz Pawłowski
- National Medical Institute of the Ministry of the Interior and Administration, Warszawa, Poland
| | - Jerzy Sacha
- Department of Cardiology, University Hospital in Opole, Opole, Poland
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Gabriel Bielawski
- 2nd Department of Cardiology, Jan Biziel University Hospital No. 2, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Wojciech Balak
- 2nd Department of Cardiology, Jan Biziel University Hospital No. 2, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Adam Sukiennik
- Department of Cardiology and Internal Diseases, University Hospital No. 1, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Paulina Burzyńska
- Department of Cardiology and Internal Diseases, University Hospital No. 1, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Mateusz Warniełło
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | | | | | - Artur Pawlik
- Department of Cardiology, University Hospital, Kraków, Poland
| | - Mateusz Kaczyński
- National Medical Institute of the Ministry of the Interior and Administration, Warszawa, Poland
| | - Robert Gil
- National Medical Institute of the Ministry of the Interior and Administration, Warszawa, Poland
| | | | - Krzysztof Reczuch
- Department of Heart Diseases, Wroclaw Medical University, Wrocław, Poland
| | | | - Pawel Kleczyński
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland
| | - Piotr Wańczura
- College of Medical Sciences, University of Rzeszow, Rzeszów, Poland
| | - Sebastian Gurba
- College of Medical Sciences, University of Rzeszow, Rzeszów, Poland
| | - Anna Kochanowska
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Michał Łomiak
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Andrzej Cacko
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | | | - Maciej Zarębiński
- Independent Public Specialist Western Hospital John Paul II, Grodzisk Mazowiecki, Poland
| | - Piotr Pawluczuk
- Independent Public Specialist Western Hospital John Paul II, Grodzisk Mazowiecki, Poland
| | | | | | | | - Artur Telichowski
- Center for Heart Diseases, Military Hospital in Wroclaw, Wrocław, Poland
| | - Mieszko Pluciński
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Gora, Zielona Góra, Poland
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, Nowa Sól, Poland
| | - Jarosław Hiczkiewicz
- Department of Interventional Cardiology and Cardiac Surgery, Collegium Medicum, University of Zielona Gora, Zielona Góra, Poland
- Department of Cardiology, Nowa Sól Multidisciplinary Hospital, Nowa Sól, Poland
| | - Karolina Konsek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jan Peruga
- 1st Department of Cardiology, Bieganski Hospital, Medical University, Łódź, Poland
| | - Marcin Fiutowski
- 1st Department of Cardiology, Bieganski Hospital, Medical University, Łódź, Poland
| | - Robert Romanek
- Department of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, Bydgoszcz, Poland
| | - Piotr Kasprzyk
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Dariusz Ciećwierz
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Andrzej Ochała
- 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
| | - Janusz Kochman
- Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
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14
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Zasada W, Zdzierak B, Rakowski T, Bobrowska B, Krawczyk-Ożóg A, Surowiec S, Bartuś S, Surdacki A, Dziewierz A. The Impact of Age on the Physiological Assessment of Borderline Coronary Stenoses. Medicina (Kaunas) 2023; 59:1863. [PMID: 37893581 PMCID: PMC10608417 DOI: 10.3390/medicina59101863] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Coronary angiography is the gold standard for diagnosing coronary artery disease (CAD). In the case of borderline changes, patients require further diagnosis through ischemia assessment via one of the recommended methods of invasive evaluation. This study aimed to assess whether clinical factors influence the risk of a positive result in invasive myocardial ischemia assessment and if these potential factors change with the patient's age and the consistency of ischemia assessment. Materials and Methods: Data were collected retrospectively on all consecutive patients hospitalized in the University Hospital in Krakow between 2020 and 2021, on whom physiological assessments of coronary circulation were performed. Patients were divided into two groups: patients aged 60 or younger and patients older than 60. Results: Despite the older patients having more risk factors for CAD, their physiological assessment results of borderline lesions were similar to those of the younger patients. Positive fractional flow reserve (FFR) assessments were obtained from almost 50% of vessels. In the younger patients, cigarette use and type 2 diabetes mellitus increased the risk of a positive FFR result by 3.5 and 2.5 times, respectively. In the older patients, male gender and peripheral vascular disease significantly increased the risk of a positive FFR by 2.5 and 2 times, respectively. Conclusions: Clinical characteristics of patients undergoing physiological assessment of borderline coronary stenosis varied significantly by age. Refining the definition of borderline lesions to include age, gender, and other factors may improve the identification of patients who would benefit from physiological assessment and coronary revascularization.
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Affiliation(s)
- Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- KCRI, 30-347 Krakow, Poland
| | - Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
| | - Tomasz Rakowski
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Beata Bobrowska
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- Department of Anatomy, HEART-Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, 31-034 Krakow, Poland
| | - Sławomir Surowiec
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland; (W.Z.); (T.R.)
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
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Rajtar-Salwa R, Bobrowska B, Batko J, Bartuś S, Petkow-Dimitrow P, Krawczyk-Ożóg A. Lipid-Lowering Therapy after Acute Coronary Syndrome in Outpatient Practice-How to Achieve Goal. J Clin Med 2023; 12:6579. [PMID: 37892717 PMCID: PMC10607515 DOI: 10.3390/jcm12206579] [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: 09/18/2023] [Revised: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Secondary prevention of cardiovascular disease involves the use of optimal pharmacological treatment and modification of risk factors through lifestyle changes. Recent evidence demonstrates that the major initiating event in atherogenesis is the storage of low-density lipoproteins. OBJECTIVES We aimed to compare the efficacy in achieving the therapeutic lipid target in relation to the frequency of follow-up at selected time points and to determine the safety and tolerability of cholesterol-lowering drugs (statins, ezetimibe). METHODS This was a prospective analysis of 72 consecutive patients hospitalized for acute coronary syndrome: ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Patients were consecutively divided into two groups: first, with follow-up and laboratory tests at 1, 3, 6 and 12 months after hospital discharge, including 32 patients; second, including 40 patients with follow-up and laboratory tests 12 months after hospital discharge. RESULTS A significant reduction in LDL-C level was observed at 12 months in both groups. LDL-C level was significantly lower in group 1 than in group 2 after 12 months (p = 0.02). Total cholesterol level was significantly lower in group 1 than in group 2 after 12 months. After 12 months of therapy, 21 (65.6%) patients in group 1 and 17 (42.5%) in group 2 had LDL-C < 1.4 mmol/L. In group 1, we observed a significant decrease in LDL-C, triglyceride, and total cholesterol levels at 1, 3, 6 and 12 months (p < 0.05). CONCLUSIONS The group of patients with more frequent follow-up visits showed a greater reduction in LDL-C level than the group with only one visit after a 12-month hospital discharge.
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Affiliation(s)
- Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (R.R.-S.); (B.B.); (S.B.); (P.P.-D.)
| | - Beata Bobrowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (R.R.-S.); (B.B.); (S.B.); (P.P.-D.)
| | - Jakub Batko
- Department of Anatomy, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- CAROL—Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (R.R.-S.); (B.B.); (S.B.); (P.P.-D.)
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Kraków, Poland
| | - Paweł Petkow-Dimitrow
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (R.R.-S.); (B.B.); (S.B.); (P.P.-D.)
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Kraków, Poland
| | - Agata Krawczyk-Ożóg
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Kraków, Poland; (R.R.-S.); (B.B.); (S.B.); (P.P.-D.)
- Department of Anatomy, Jagiellonian University Medical College, 31-008 Kraków, Poland;
- CAROL—Cardiothoracic Anatomy Research Operative Lab, Department of Cardiovascular Surgery and Transplantology Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland
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16
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Trzeciak P, Stępińska J, Gil R, Hawranek M, Nadolny K, Tycińska A, Bartuś S, Gierlotka M, Kałużna-Oleksy M, Zymliński R, Grygier M, Wojakowski W, Gąsior M. Management of myocardial infarction complicated by cardiogenic shock: Expert opinion of the Association of Intensive Cardiac Care and Association of Cardiovascular Interventions of the Polish Society of Cardiology. Kardiol Pol 2023; 81:1312-1324. [PMID: 37823758 DOI: 10.33963/v.kp.97817] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 10/13/2023]
Abstract
Despite significant advances in interventional cardiology and mechanical circulatory support (MCS) techniques, outcomes for patients with myocardial infarction (MI) complicated by cardiogenic shock (CS) remain suboptimal. This expert consensus aims to provide information on the current management of patients with MI complicated by CS in Poland and to propose solutions, including systemic ones, for all stages of care. The document uses data from the Polish PL-ACS Registry of Acute Coronary Syndromes, which includes records of more than 820 000 hospital admissions. We describe the role of medical rescue teams, highlighting the necessity to expand their range of competencies at the level of prehospital care. We emphasize the importance of treating the underlying cause of CS and direct patient transfer to centers capable of performing percutaneous coronary interventions. We present current recommendations of scientific societies on MCS use. We underline the role of the Cardiac Shock Team in the management of patients with MI complicated by CS. Such teams should comprise an interventional cardiologist, a cardiothoracic surgeon, and an intensive care physician. Patients should be transferred to highly specialized CS centers, following the example of so-called Cardiac Shock Care Centers described in some other countries. We propose criteria for the operation of such centers Other important aspects discussed in the document include the role of rehabilitation, multidisciplinary care, and long-term follow-up of treatment outcomes. The document was developed in cooperation with experts from different scientific societies in Poland, which illustrates the importance of interdisciplinary care in this patient population.
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Affiliation(s)
- Przemysław Trzeciak
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.
| | - Janina Stępińska
- Department of Medical Communication, School of Public Health, Centre of Postgraduate Medical Education, Warszawa, Poland
| | - Robert Gil
- Department of Cardiology, Ministry of Interior and Administration National Medical Institute, Warszawa, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Faculty of Medicine, Silesian Academy in Katowice, Katowice, Poland
- Regional Ambulance Service in Sosnowiec, Sosnowiec, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Marta Kałużna-Oleksy
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Robert Zymliński
- Institute of Cardiac Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznań University of Medical Sciences, Poznań, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia in Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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17
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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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18
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Leszek P, Klotzka A, Bartuś S, Burchardt P, Czarnecka AM, Długosz-Danecka M, Gierlotka M, Koseła-Paterczyk H, Krawczyk-Ożóg A, Kubiatowski T, Kurzyna M, Maciejczyk A, Mitkowski P, Prejbisz A, Rutkowski P, Sierko E, Sterliński M, Szmit S, Szwiec M, Tajstra M, Tycińska A, Witkowski A, Wojakowski W, Cybulska-Stopa B. A practical approach to the 2022 ESC cardio-oncology guidelines: Comments by a team of experts - cardiologists and oncologists. Kardiol Pol 2023; 81:1047-1063. [PMID: 37660389 DOI: 10.33963/v.kp.96840] [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: 08/04/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Przemysław Leszek
- Department of Heart Failure and Transplantology, Department of Mechanical Circulatory Support and Transplant, National Institute of Cardiology, Warszawa, Poland.
| | - Aneta Klotzka
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Burchardt
- Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiology, J Struś Hospital, Poznań, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
- Department of Experimental Pharmacology, Mossakowski Medical Research Center, Polish Academy of Sciences, Warszawa, Poland
| | - Monika Długosz-Danecka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Kraków, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medial Sciences, University of Opole, Opole, Poland
| | - Hanna Koseła-Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Agata Krawczyk-Ożóg
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Kubiatowski
- University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
- Chemotherapy Department, Grochowski Hospital in Warsaw, Warszawa, Poland
| | - Marcin Kurzyna
- Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology Center of Postgraduate Medical Education in EHC Otwock, ERN-Lung Member, Otwock, Poland
| | - Adam Maciejczyk
- Department of Radiotherapy, Lower Silesian Center of Oncology, Katowice, Poland
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland
| | - Przemysław Mitkowski
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Aleksander Prejbisz
- Department of Epidemiology, Cardiovascular Prevention and Health Promotion, National Institute of Cardiology, Warszawa, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Ewa Sierko
- Department of Radiotherapy I, Maria Sklodowska-Curie Bialystok Oncology Center, Białystok, Poland
- Department of Oncology, Medical University of Bialystok, Białystok, Poland
| | | | - Sebastian Szmit
- Department of Cardio-Oncology, Center of Postgraduate Medical Education, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
- Clinic of Oncological Diagnostics and Cardio-Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warszawa, Poland
| | - Marek Szwiec
- Department of Surgery and Oncology, University of Zielona Gora, Zielona Góra, Poland
- Clinical Department of Oncology, University Hospital of K. Marcinkowski in Zielona Gora, Zielona Góra, Poland
| | - Mateusz Tajstra
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Adam Witkowski
- Departament of Interventional Cardiology & Angiology National Institute of Cardiology, Warszawa, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases Medical University of Silesia, Katowice, Poland
| | - Bożena Cybulska-Stopa
- Department of Oncology, Lower Silesian Center of Oncology, Pulmonology and Hematology, Wrocław, Poland
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19
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Kasprzycki K, Petkow-Dimitrow P, Krawczyk-Ożóg A, Bartuś S, Rajtar-Salwa R. Anatomic Variations of Renal Arteries as an Important Factor in the Effectiveness of Renal Denervation in Resistant Hypertension. J Cardiovasc Dev Dis 2023; 10:371. [PMID: 37754800 PMCID: PMC10531508 DOI: 10.3390/jcdd10090371] [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: 06/29/2023] [Revised: 08/20/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
Hypertension remains the leading cause of death worldwide. Despite advances in drug-based treatment, many patients do not achieve target blood pressure. In recent years, there has been an increased interest in invasive hypertension treatment methods. Long-term effects and factors affecting renal denervation effectiveness are still under investigation. Some investigators found that the renal arteries' morphology is crucial in renal denervation effectiveness. Accessory renal arteries occur in 20-30% of the population and even more frequently in patients with resistant hypertension. Diversity in renal vascularization and innervation may complicate the renal denervation procedure and increase the number of people who will not benefit from treatment. Based on previous studies, it has been shown that the presence of accessory renal arteries, and in particular, the lack of their complete denervation, reduces the procedure's effectiveness. The following review presents the anatomical assessment of the renal arteries, emphasizing the importance of imaging tests. Examples of imaging and denervation methods to optimize the procedure are presented. The development of new-generation catheters and the advancement in knowledge of renal arteries anatomy may improve the effectiveness of treatment and reduce the number of patients who do not respond to treatment.
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Affiliation(s)
- Karol Kasprzycki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
| | - Paweł Petkow-Dimitrow
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Agata Krawczyk-Ożóg
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- Department of Anatomy, Jagiellonian University Medical College, 33-332 Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
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20
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Mitkowski P, Witkowski A, Stępińska J, Banach M, Jankowski P, Gąsior M, Wita K, Bartuś S, Burchardt P, Farkowski MM, Gierlotka M, Gil R, Leszek P, Sterliński M, Szymański P, Tajstra M, Tycińska A, Wojakowski W. Position of the Polish Cardiac Society on therapeutic targets for LDL cholesterol concentrations in secondary prevention of myocardial infarctions. Kardiol Pol 2023; 81:818-823. [PMID: 37489830 DOI: 10.33963/kp.a2023.0162] [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: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 07/26/2023]
Abstract
Cardiovascular diseases account for 43% of deaths in Poland. The COVID-19 pandemic increased the number of cardiovascular deaths by as much as 16.7%. Lipid metabolism disorders are observed in about 20 million Poles. Lipid disorders are usually asymptomatic, they cause a significant increase in the risk of cardiovascular diseases. Up to 20% of patients who experience an acute coronary syndrome (ACS) may experience a recurrence of a cardiovascular event within a year, and up to 40% of these patients may be re-hospitalized. Within 5 years after a myocardial infarction, 18% of patients suffer a second ACS and 13% have got a stroke. Lipid-lowering therapy is an extremely important element of comprehensive management, both in primary and secondary prevention, and its main goal is to prevent or extend the time to the onset of heart or vascular disease and reduce the risk of cardiovascular events. A patient with a history of ACS belongs to the group of a very high risk of a cardiovascular event due to atherosclerosis. In this group of patients, low-density lipoprotein cholesterol levels should be aimed below 55 mg/dl (1.4 mmol/l). Many scientific guidelines define the extreme risk group, which includes not only patients with two cardiovascular events within two years, but also patients with a history of ACS and additional clinical factors: peripheral vascular disease, multivessel disease (multilevel atherosclerosis), or multivessel coronary disease, or familial hypercholesterolemia, or diabetes with at least one additional risk factor: elevated Lp(a) >50 mg/dl or hsCRP >3 mg/l, or chronic kidney disease (eGFR <60 ml/min/1.73 m²). In this group of patients, the LDL-C level should be aimed at below 40 mg/dl (1.0 mmol/l). Achieving therapeutic goals in patients after ACS should occur as soon as possible. For this purpose, a high-dose potent statin should be added to the therapy at the time of diagnosis, and ezetimibe should be added if the goal is not achieved after 4-6 weeks. Combination therapy may be considered in selected patients from the beginning. After 4-6 weeks of combination therapy, if the goal is still not achieved, adding a proprotein convertase subtilisin/kexin type 9 protein inhibitor or inclisiran should be considered. In order to increase compliance with the recommendations, Polish Cardiac Society and Polish Lipid Society propose to attach in the patient's discharge letter a statement clearly specifying what drugs should be used and what LDL-C values should be achieved. It is necessary to cooperate between the patient and the doctor, to follow the recommendations and take medicines regularly, to achieve and maintain therapeutic goals.
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Affiliation(s)
- Przemysław Mitkowski
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Adam Witkowski
- Department of Cardiology and Interventional Angiology, Institute of Cardiology in Warsaw, Warszawa, Poland
| | - Janina Stępińska
- Centre of Postgraduate Medical Education in Warsaw, Warszawa, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University in Lodz, Łódź, Poland
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Piotr Jankowski
- Department of Internal Diseases and Gerontocardiology, Centre of Postgraduate Medical Education in Warsaw, Warszawa, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Krystian Wita
- 1st Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Burchardt
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznań, Poland
- Department of Cardiology, Jozef Strus Hospital, Poznań, Poland
| | - Michał M Farkowski
- Center of Clinical Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Robert Gil
- Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, Institute of Cardiology, Warszawa, Poland
| | - Maciej Sterliński
- 1st Department of Arrhytmia, Institute of Cardiology, Warszawa, Poland
| | - Piotr Szymański
- Center of Clinical Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland
| | - Mateusz Tajstra
- 3rd Department of Cardiology, Medical University of Silesia in Katowice, Silesian Center for Heart Disease, Zabrze, Poland
| | - Agnieszka Tycińska
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia Katowice, Poland
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21
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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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22
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Zdzierak B, Zasada W, Krawczyk-Ożóg A, Rakowski T, Bartuś S, Surdacki A, Dziewierz A. Influence of sex on the functional assessment of myocardial ischemia. Kardiol Pol 2023; 81:895-902. [PMID: 37448217 DOI: 10.33963/kp.a2023.0154] [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: 06/24/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Fractional flow reserve (FFR) and non-hyperemic resting pressure ratios, such as instantaneous wave-free ratio (iFR) and resting full-cycle ratio (RFR), are recommended for evaluating the significance of angiographically intermediate coronary stenoses. Despite their usefulness, approximately 20% of assessed lesions exhibit discordance between FFR and iFR/RFR. AIMS The role of sex in this discrepancy remains uncertain; thus, we aimed to investigate its impact on the discordance between FFR and iFR/RFR. METHODS We reviewed 417 consecutive intermediate stenotic lesions from 381 patients, stratified by sex and assessed with both FFR and iFR/RFR. FFR ≤0.80 and iFR/RFR ≤0.89 were considered positive for ischemia. RESULTS Of the 381 patients, 92 (24.1%) were women. Women were older, had a lower estimated glomerular filtration rate (eGFR), higher ejection fraction, and were more likely to have peripheral artery disease than men. Median FFR and iFR/RFR values were lower in men than in women (FFR 0.86 vs. 0.80; P <0.001; iFR 0.92 vs. 0.90; P = 0.049). However, overall discordance prevalence was similar for both sexes (20.6% vs. 15.1%; P = 0.22). In men, eGFR, insulin-treated diabetes mellitus, and arterial hypertension were predictors of positive FFR | negative iFR/RFR discordance, while eGFR, insulin-treated diabetes mellitus, atrial fibrillation, and chronic obstructive pulmonary disease were predictors of negative FFR | positive iFR/RFR discordance. No factors associated with either discordance were identified in women. CONCLUSIONS FFR and iFR/RFR results indicating significant ischemia were more common in men than women when assessing intermediate coronary stenoses. Nevertheless, sex did not predict discordant results.
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Affiliation(s)
- Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- KCRI, Kraków, Poland
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Department of Anatomy, HEART - Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Rakowski
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Artur Dziewierz
- Clinical 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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23
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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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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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25
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Sorysz D, Węgiel M, Wiktorowicz A, Rajtar-Salwa R, Bobrowska B, Bartuś S. Diffuse large B-cell lymphoma as a rare cause of acute de novo heart failure. Pol Arch Intern Med 2023; 133:16496. [PMID: 37162327 DOI: 10.20452/pamw.16496] [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: 05/11/2023]
Affiliation(s)
- Danuta Sorysz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland; Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Michał Węgiel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Agata Wiktorowicz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Beata Bobrowska
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Bobrowska B, Zasada W, Zawada M, Surdacki A, Bartuś S, Rajtar-Salwa R. Autosomal recessive hypercholesterolemia: the first experience in Poland. Pol Arch Intern Med 2023; 133:16498. [PMID: 37171179 DOI: 10.20452/pamw.16498] [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: 05/13/2023]
Affiliation(s)
- Beata Bobrowska
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- KCRI, Kraków, Poland
| | - Magdalena Zawada
- Department of Hematology Diagnostics and Genetics, University Hospital, Kraków, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Renata Rajtar-Salwa
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
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Huczek Z, Protasiewicz M, Dąbrowski M, Parma R, Hudziak D, Olszówka P, Targoński R, Grodecki K, Frank M, Scisło P, Kralisz P, Trębacz J, Sacha J, Wilczek K, Walczak A, Smolka G, Kleczyński P, Milewski K, Hawranek M, Kochman J, Lesiak M, Dudek D, Witkowski A, Legutko J, Bartuś S, Wilimski R, Wojakowski W, Grygier M. Transcatheter aortic valve implantation for failed surgical and transcatheter prostheses. Expert Opinion of the Association of Percutaneous Cardiovascular Interventions of the Polish Cardiac Society. Kardiol Pol 2023:VM/OJS/J/96066. [PMID: 37319015 DOI: 10.33963/kp.a2023.0131] [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: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/17/2023]
Affiliation(s)
- Zenon Huczek
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland.
| | - Marcin Protasiewicz
- Department and Clinic of Cardiology, Wrocław Medical University, Wrocław, Poland
| | - Maciej Dąbrowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Radosław Parma
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Damian Hudziak
- Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
| | - Piotr Olszówka
- Department of Cardiac Surgery, District Hospital No. 2, Rzeszów, Poland
| | - Radosław Targoński
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Kajetan Grodecki
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Marek Frank
- Department of Cardiac Surgery, Medical University of Bialystok, Białystok, Poland
| | - Piotr Scisło
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Paweł Kralisz
- Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Jarosław Trębacz
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
| | - Jerzy Sacha
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
| | - Krzysztof Wilczek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Zabrze, Poland
- Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Andrzej Walczak
- Department of Cardiac Surgery, Medical University of Łódz, Łódź, Poland
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Paweł Kleczyński
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | | | - Michał Hawranek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Zabrze, Poland
- Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Janusz Kochman
- 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Dariusz Dudek
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Kraków, Poland
- Maria Cecilia Hospital, Cotignola RA, Italy
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Jacek Legutko
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Kraków, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Radosław Wilimski
- Department of Cardiac Surgery, Medical University of Warsaw, Warszawa, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Marek Grygier
- 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
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Kasprzycki K, Krawczyk-Ożóg A, Rzeszutko Ł, Bartuś S, Rajtar-Salwa R. Redo of sympathetic renal denervation in a patient with resistant hypertension and anatomical variation of renal arteries. Postepy Kardiol Interwencyjnej 2023; 19:190-191. [PMID: 37465630 PMCID: PMC10351066 DOI: 10.5114/aic.2023.129220] [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: 04/12/2023] [Accepted: 05/14/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Karol Kasprzycki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Łukasz Rzeszutko
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- 2 Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- 2 Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Rajtar-Salwa
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
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29
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Siudak Z, Hawranek M, Kleczyński P, Bartuś S, Kusa J, Milewski K, Opolski MP, Pawłowski T, Protasiewicz M, Smolka G, Malinowski KP, Dudek D, Grygier M. Interventional cardiology in Poland in 2022. Annual summary report of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) and Jagiellonian University Medical College. Postepy Kardiol Interwencyjnej 2023; 19:82-85. [PMID: 37465633 PMCID: PMC10351074 DOI: 10.5114/aic.2023.129205] [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: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Michał Hawranek
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Paweł Kleczyński
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
| | - Stanisław Bartuś
- 2 Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Jacek Kusa
- Medical University of Silesia, Katowice, Poland
- Regional Specialist Hospital, Wroclaw, Poland
| | - Krzysztof Milewski
- University of Technology, Faculty of Medicine, Katowice, Poland
- American Heart of Poland SA, Katowice, Poland
| | - Maksymilian P. Opolski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland
| | - Tomasz Pawłowski
- Department of Cardiology, Central Clinical Hospital of Internal Affairs, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Marcin Protasiewicz
- Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Grzegorz Smolka
- Department of Cardiology and Structural Heart Diseases, 3 Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Krzysztof P. Malinowski
- 2 Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Dariusz Dudek
- Digital Medicine and Robotics Center, Jagiellonian University Medical College, Krakow, Poland
| | - Marek Grygier
- 1 Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
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30
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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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31
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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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32
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Rakowski T, Węgiel M, Malinowski KP, Siudak Z, Zasada W, Zdzierak B, Tokarek T, Rzeszutko Ł, Dudek D, Bartuś S, Surdacki A, Dziewierz A. Thrombus containing lesions strategies during primary percutaneous coronary interventions in ST-segment elevation myocardial infarction: insights from ORPKI National Registry. J Thromb Thrombolysis 2023:10.1007/s11239-023-02811-z. [PMID: 37093352 DOI: 10.1007/s11239-023-02811-z] [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] [Accepted: 04/09/2023] [Indexed: 04/25/2023]
Abstract
In the era of potent P2Y12 inhibitors, according to current guidelines, treatment with glycoprotein IIb/IIIa inhibitors (GPIs) should be limited to bail-out and/or highly thrombotic situations. Similarly, the recommendation for aspiration thrombectomy (AT) is downgraded to very selective use. We examine the prevalence, and predictors of GPI and AT use in STEMI patients referred to primary percutaneous coronary intervention (PCI). Data on 116,873 consecutive STEMI patients referred to primary PCI in Poland between 2015 and 2020 were analyzed. GPIs were administered in 29.3%, AT was used in 11.6%, and combined treatment with both in 6.1%. There was a mild trend toward a decrease in GPI and AT usage during the analyzed years. On the contrary, there was a rapid growth of the ticagrelor/prasugrel usage rate from 6.5 to 48.1%. Occluded infarct-related artery at baseline and no-reflow during PCI were the strongest predictors of GPI administration (OR 2.3; 95% CI 2.22-2.38 and OR 3.47; 95% CI 3.13-3.84, respectively) and combined usage of GPI and AT (OR 4.4; 95% CI 4.08-4.8 and OR 3.49; 95% CI 3.08-3.95 respectively) in a multivariate logistic regression model. Similarly, the administration of ticagrelor/prasugrel was an independent predictor of both adjunctive treatment strategies. In STEMI patients in Poland, GPIs are selectively used in one in four patients during primary PCI, and the combined usage of GPI and AT is marginal. Despite the rapid growth in potent P2Y12 inhibitors usage in recent years, GPIs are selectively used at a stable rate during PCI in highly thrombotic lesions.
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Affiliation(s)
- Tomasz Rakowski
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Michał Węgiel
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Krzysztof P Malinowski
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Tomasz Tokarek
- Center for Invasive Cardiology, Electrotherapy and Angiology, Nowy Sacz, Poland
- Center for Innovative Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Rzeszutko
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Dariusz Dudek
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Andrzej Surdacki
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Artur Dziewierz
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688, Kraków, Poland.
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
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Kańtoch A, Chyrchel B, Surowiec S, Chyrchel M, Rzeszutko Ł, Surdacki A, Bartuś S, Bryniarski L. How multislice computed tomography (MSCT) of the coronary arteries can change the chronic total occlusion (CTO) recanalization procedure? Kardiol Pol 2023:VM/OJS/J/94734. [PMID: 36999724 DOI: 10.33963/kp.a2023.0078] [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: 03/19/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Anna Kańtoch
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
| | - Bernadeta Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Sławomir Surowiec
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, 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
| | - Łukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 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
| | - Leszek Bryniarski
- 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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Ładziński S, Niedziela J, Witkowski A, Bartuś S, Lesiak M, Milewski K, Gierlotka M, Trzeciak P, Gąsior M, Wojakowski W. The influence of severe mitral regurgitation on major adverse cardiac and cerebrovascular events after myocardial infarction in 1-year follow-up: Data from PL-ACS registry. Kardiol Pol 2023:VM/OJS/J/94495. [PMID: 36929297 DOI: 10.33963/kp.a2023.0064] [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: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Mitral regurgitation (MR) is frequently observed in patients with myocardial infarction (MI). However, the incidence of severe MR in contemporary population is unknown. AIMS The study evaluates the prevalence and prognostic impact of severe MR in contemporary population of patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). METHODS The study group consists of 8062 patients enrolled in the Polish Registry of Acute Coronary Syndromes over the years 2017‒2019. Only the patients with full echocardiography performed during the index hospitalization were eligible. Primary composite outcome was 12-month major adverse cardiac and cerebrovascular events (MACCE) (death, non-fatal MI, stroke and heart failure [HF] hospitalization) compared between patients with and without severe MR. RESULTS 5561 NSTEMI patients and 2501 STEMI patients were enrolled into the study. Severe MR occurred in 66 (1.19%) NSTEMI patients and 30 (1.19%) STEMI patients. Multivariable regression models revealed that severe MR is an independent risk factor of all-cause death in 12-month observation (odds ratio [OR], 1.839; 95% confidence interval [CI], 1.012‒3.343; P = 0.046) in all MI patients. Patients with NSTEMI and severe MR had higher mortality (22.7% vs. 7.1%), HF rehospitalization rate (39.4% vs. 12.9%) and MACCE occurrence (54.5% vs. 29.3%). Severe MR was associated with higher mortality (20% vs. 6%) and higher HF rehospitalization (30% vs. 9.8%), stroke (10% vs. 0.8%) and MACCE rates (50% vs. 23.1%) in STEMI patients. CONCLUSIONS Severe MR is associated with higher mortality and MACCE occurrence in patients with MI in 12-month follow-up. Severe MR is an independent risk factor of all-cause death.
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Affiliation(s)
- Szymon Ładziński
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
| | - Jacek Niedziela
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warszawa, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Medical College, Jagiellonian University, Kraków, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Krzysztof Milewski
- Research and Development Center, American Heart of Poland, Warszawa, Poland
| | - Marek Gierlotka
- Department of Cardiology, Faculty of Medicine, University of Opole, Opole, Poland
| | - Przemysław Trzeciak
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
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Pawlik A, Kołcz J, Szeliga J, Bartuś S, Góreczny S. Stenting of a non-stenosed left main coronary artery in a 16-months old infant resulting in significant hemodynamic improvement. Kardiol Pol 2023; 81:417-418. [PMID: 36871305 DOI: 10.33963/kp.a2023.0053] [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: 02/05/2023] [Accepted: 02/05/2023] [Indexed: 03/07/2023]
Affiliation(s)
- Artur Pawlik
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Jacek Kołcz
- Department of Pediatric Cardiac Surgery, University Children's Hospital, Jagiellonian University Medical College, Kraków, Poland
| | - Judyta Szeliga
- Department of Pediatric Cardiology, University Children's Hospital, 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
| | - Sebastian Góreczny
- Department of Pediatric Cardiology, University Children's Hospital, Jagiellonian University Medical College, Kraków, Poland.
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Krawczyk-Ożóg A, Batko J, Koziej M, Tokarek T, Sorysz D, Siudak Z, Dudek D, Bartuś S, Surdacki A, Hołda MK. Computed tomography and transthoracic echocardiography for assessment of left ventricle geometry in patients with aortic valve stenosis. Postepy Kardiol Interwencyjnej 2023; 19:47-55. [PMID: 37090214 PMCID: PMC10114178 DOI: 10.5114/aic.2023.124406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/27/2022] [Indexed: 04/25/2023] Open
Abstract
Introduction Standard transthoracic echocardiography (TTE) often is not sufficient to properly visualize the geometry of the left ventricle. One of the clinical imaging modalities that can be used for this purpose is contrast-enhanced, electrocardiologically gated cardiac computed tomography (CT). Aim To compare cardiac CT and TTE as tools for assessing geometry and function of the left ventricle in patients with severe aortic stenosis. Material and methods We analyzed 58 consecutive patients (43.1% males, mean age 81.4 ±6.0 years) with severe aortic stenosis, who underwent both cardiac CT and TTE. Results Left ventricle major axis length is significantly longer in CT than in TTE (81.5 ±11.7 mm vs. 74.6 ±13.5 mm, p = 0.004). No difference was found in end-systolic left ventricle volume between the two imaging methods, while end-diastolic volume of the left ventricle was significantly larger when measured in CT than in both 2D biplane and 3D triplane TTE. The stroke volume was not different between the 2D biplane TTE and CT. No significant difference was found between CT and TTE in the calculation of ejection fraction and LV mass/indexed LV mass (p > 0.05). Conclusions The use of three-dimensional postprocessing provides a very accurate image of heart structures in CT, which in some aspects may significantly differ from the values estimated by TTE.
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Affiliation(s)
- Agata Krawczyk-Ożóg
- HEART – Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Jakub Batko
- HEART – Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz Koziej
- HEART – Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Tomasz Tokarek
- Center for Innovative Medical Education, Jagiellonian University Medical College, Krakow, Poland
- Center for Invasive Cardiology, Electrotherapy and Angiology, Nowy Sacz, Poland
| | - Danuta Sorysz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Science, Jan Kochanowski University, Kielce, Poland
| | - Dariusz Dudek
- Digital Medicine and Robotics Center, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- Clinical 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
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Mateusz K. Hołda
- HEART – Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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Krawczyk-Ożóg A, Hołda MK, Batko J, Bartuś S, Rajtar-Salwa R. Three-dimensional cardiac computed tomography compared with autopsied material for the assessment of the mitral valve. Clin Anat 2023; 36:250-255. [PMID: 36271778 DOI: 10.1002/ca.23967] [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: 07/23/2022] [Accepted: 10/17/2022] [Indexed: 11/08/2022]
Abstract
To compare the morphometrical features of non-diseased mitral valves imaged in three-dimensional (3D) cardiac computed tomography with those analyzed macroscopically in autopsied healthy human hearts. A total of 51 cardiac computed tomography scans and 120 adult autopsied human hearts without cardiovascular disease were examined. The 3D reconstruction and visualization software (Mimics Innovation Suite 22, Materialise) was used for heart chambers semi-automatic segmentation and myocardial manual segmentation to visualize a 3D structure of the mitral valve complex and to perform all measurements. Direct comparison of corresponding mitral valve parameters revealed significant differences between obtained results. Significantly larger intercommisural diameter, aorto-mural diameter, and perimeter of the mitral annulus were observed in tomographic scans (all p < 0.0001). However, the intercommissural/aorto-mural diameter ratio showed comparable values for both groups. Nevertheless, the size of anterior mitral leaflet was higher in autopsied material. The height of the P2 scallops was the only parameter that show no significant difference between two groups (p = 0.3). The use of 3D postprocessing algorithms provides a very accurate image of the mitral valve structure, which could be useful for the precise non-invasive assessment of mitral valve size and structure. Three-dimensional contrast enhanced cardiac computed tomography significantly overestimates the measurements of the mitral annulus compared to postmortem analysis.
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Affiliation(s)
- Agata Krawczyk-Ożóg
- Department of Anatomy, HEART - Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Krakow, Poland.,Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
| | - Mateusz K Hołda
- Department of Anatomy, HEART - Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Krakow, Poland.,Division of Cardiovascular Sciences, The University of Manchester, UK
| | - Jakub Batko
- Department of Anatomy, HEART - Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, Krakow, Poland
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.,2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Renata Rajtar-Salwa
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
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Zdzierak B, Zasada W, Krawczyk-Ożóg A, Rakowski T, Bartuś S, Surdacki A, Dziewierz A. Comparison of Fractional Flow Reserve with Resting Non-Hyperemic Indices in Patients with Coronary Artery Disease. J Cardiovasc Dev Dis 2023; 10:jcdd10020034. [PMID: 36826530 PMCID: PMC9959762 DOI: 10.3390/jcdd10020034] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Guidelines recommend using hyperemic (FFR) and non-hyperemic (iFR/RFR) methods of evaluating coronary artery stenoses in patients with coronary artery disease. However, in some cases, achieved results indicating significant ischemia may differ between those methods. Thus, we sought to identify predictors of such a discrepancy. Data were collected on all consecutive patients with chronic coronary syndrome hospitalized between 2020 and 2021. For 279 patients (417 vessels), results for both FFR and iFR/RFR were available. Values of ≤0.80 for FFR and ≤0.89 for iFR/RFR were considered positive for ischemia. Discordant measurements of FFR and iFR/RFR were observed in 80 (19.2%) patients. Atrial fibrillation was the only predictor of the overall FFR and iFR/RFR discordance - OR (95%CI) 1.90 (1.02-3.51); p = 0.040. The chance of positive FFR and negative iFR/RFR decreased independently with age - OR (95%CI) 0.96 (0.93-0.99); p = 0.024. On the contrary, insulin-treated diabetes mellitus was the predictor of negative FFR and positive iFR/RFR discrepancy - OR (95%CI) 4.61 (1.38-15.40); p = 0.013. In everyday clinical practice, iFR/FFR correlates well with FFR. However, discordance between these methods is quite common. Physicians should be aware of the risk of such discordance in patients with atrial fibrillation, advanced age, and insulin-treated diabetes mellitus.
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Affiliation(s)
- Barbara Zdzierak
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
| | - Wojciech Zasada
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- KCRI, 30-347 Krakow, Poland
| | - Agata Krawczyk-Ożóg
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- Department of Anatomy, HEART-Heart Embryology and Anatomy Research Team, Jagiellonian University Medical College, 33-332 Krakow, Poland
| | - Tomasz Rakowski
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Andrzej Surdacki
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, 30-688 Krakow, Poland
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 30-688 Krakow, Poland
- Correspondence: ; Tel.: +48-12-400-2250
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Ostrowska M, Kasprzak M, Stolarek W, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Matuszewska-Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gajda R, Gąsior M, Gruchała M, Drożdż J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J, Kubica J. Comparison of reorganized versus unaltered cardiology departments during the COVID-19 era: a subanalysis of the COV-HF-SIRIO 6 study. Cardiol J 2023:VM/OJS/J/91790. [PMID: 36651570 DOI: 10.5603/cj.a2023.0002] [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: 09/07/2022] [Revised: 10/24/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Since the beginning of the coronavirus disease-2019 (COVID-19) pandemic, numerous cardiology departments were reorganized to provide care for COVID-19 patients. We aimed to compare the impact of the COVID-19 pandemic on hospital admissions and in-hospital mortality in reorganized vs. unaltered cardiology departments. METHODS The present subanalysis is a multicenter retrospective COV-HF-SIRIO 6 study that includes all patients (n = 101,433) hospitalized in 24 cardiology departments in Poland between January 1, 2019 and December 31, 2020, with a focus on patients with acute heart failure (AHF). RESULTS Reduction of all-cause hospitalizations was 50.6% vs. 21.3% for reorganized vs. unaltered cardiology departments in 2020 vs. 2019, respectively (p < 0.0001). Considering AHF alone respective reductions by 46.5% and 15.2% were registered (p < 0.0001). A higher percentage of patients was brought in by ambulance to reorganized vs. unaltered cardiology departments (51.7% vs. 34.6%; p < 0.0001) alongside with a lower rate of self-referrals (45.7% vs. 58.4%; p < 0.0001). The rate of all-cause in-hospital mortality in AHF patients was higher in reorganized than unaltered cardiology departments (10.9% vs. 6.4%; p < 0.0001). After the exclusion of patients with concomitant COVID-19, the mortality rates did not differ significantly (6.9% vs. 6.4%; p = 0.55). CONCLUSIONS In cardiology departments reorganized to provide care for COVID-19 patients vs. unaltered ones, observed: i) a greater reduction in hospital admissions in 2020 vs. 2019; ii) higher rates of patients brought by ambulance and lower rates of self-referrals; and iii) higher all-cause in-hospital mortality for AHF due to COVID-19 related deaths.
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Affiliation(s)
| | - Michał Kasprzak
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Wioleta Stolarek
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Jacek Kryś
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Aldona Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Adamski
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | | | - Edyta Anielska-Michalak
- Department of Cardiology, Marian Zyndram-Kościałkowski Ministry of Interior and Administration Hospital, Białystok, Poland
| | - Oliwia Matuszewska-Brycht
- Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Łódź, Poland
| | - Andrzej Curzytek
- Department of Cardiology, Hospital of the Ministry of Interior and Administration, Rzeszów, Poland
| | - Aneta Dudek
- 1st Department of Cardiology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Paweł Grzelakowski
- Department of Cardiology and Cardiac Surgery, 10th Military Hospital and Polyclinic, Bydgoszcz, Poland
| | - Leszek Kamiński
- Department of Cardiology Independent Public Healthcare in Przeworsk, Przeworsk, Poland
| | - Andrzej Kleinrok
- Institute of Humanities and Medicine, Academy of Zamosc, Zamość, Poland
| | | | - Marek Koziński
- Department of Cardiology and Internal Diseases, Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdynia, Poland
| | - Paweł Król
- Department of Cardiology, Tertiary Care Hospital, Ciechanów, Poland
| | - Tomasz Kulawik
- Department of Cardiology, Masovian Rehabilitation Center, Pruszków, Poland
| | - Gleb Minczew
- Department of Cardiology, District Hospital, Tuchola, Poland
| | - Marcin Mindykowski
- Department of Cardiology, Dr. Emil Warmiński Tertiary Care Municipal Hospital, Bydgoszcz, Poland
| | - Agnieszka Pawlak
- Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration, Warszawa, Poland.,Mossakowski Medical Research Institute, Polish Academy of Sciences,, Warszawa, Poland
| | - Janusz Prokopczuk
- Department of Cardiology, Polish Hospitals,, Kędzierzyn Koźle, Poland
| | - Grzegorz Skonieczny
- Department of Cardiology and Intensive Cardiac Care Unit, District Polyclinic Hospital, Toruń, Poland
| | - Bożena Sobkowicz
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Sergiusz Sowiński
- Department of Cardiology and Cardiac Intensive Care, Tertiary Care Municipal Hospital, Toruń, Poland
| | - Sebastian Stankala
- Cardiology Subdivision of Heart Failure. St. Elizabeth Hospital, Biała, Poland
| | - Paweł Szymański
- Department of Cardiology, Interventional Cardiology and Electrophysiology with Cardiac Intensive Care Unit, Tertiary Care Hospital in Grudziądz, Grudziądz, Poland
| | - Andrzej Wester
- 1st Department of Physiology, Institute of Medical Sciences, University of Opole 2, Cardiology Center of Kluczbork SCANMED SA,, Kluczbork, Poland
| | | | - Stanisław Bartuś
- 2nd Department of Cardiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital,, Warszawa, Poland
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, Częstochowa, Poland.,Gajda-Med District Hospital, Pułtusk, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medicine in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdansk, Poland
| | - Jarosław Drożdż
- Department of Cardiology, Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Łódź, Poland
| | | | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Centre of Postgraduate Medical Education, Warszawa, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital in Krakow, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, National Institute of Cardiology, Warszawa, Poland
| | | | - Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Agnieszka Tycińska
- Department of Cardiology, Medical University in Białystok, Białystok, Poland
| | - Tomasz Zdrojewski
- Department of Arterial Hypertension and Diabetology, Medical University of Gdansk, Poland
| | | | - Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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Sorysz D, Dziewierz A, Rzeszutko Ł, Wiktorowicz A, Wojakowski W, Parma R, Skoczyńska A, Kleczyński P, Stąpór M, Dudek D, Legutko J, Bartuś S. Safety and efficacy of repeated balloon aortic valvuloplasty in patients with symptomatic severe aortic stenosis. Kardiol Pol 2023; 81:366-372. [PMID: 36648223 DOI: 10.33963/kp.a2023.0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Long-term outcomes of balloon aortic valvuloplasty (BAV) in patients with severe symptomatic aortic stenosis (AS) are poor, and this procedure needs to be repeated in selected cases. AIMS We aimed to investigate the safety and efficacy of repeated BAV (reBAV). METHODS We included consecutive patients who underwent reBAV in three Polish centers between 2010 and 2019. Baseline clinical, echocardiographic, procedural, and outcome data were analyzed. RESULTS Thirty-five patients (median age 81.5 years, 57.1% women) who underwent reBAV were enrolled. In 42.9% of the patients, index BAV was considered a palliative treatment, and in 54.3% a bridge to definitive treatment. Index BAV decreased peak aortic valve gradient (pAVG) from a median of 78.0 mm Hg to 46.0 mm Hg (P <0.001). After a mean of 255.8 days, reBAV was performed. In most cases (71.4%), the reason for reBAV was the worsening of heart failure symptoms and in 54.3% of patients, reBAV was still considered a palliative option. A decrease in pAVG max from a median of 73.0 mm Hg to 45.0 mm Hg (P <0.001), comparable to index BAV, was observed. The frequency of complications were numerically higher for repeated procedures. During the median (IQR) follow-up of 403.0 (152.0-787.0) days from the index procedure, 80.0% of the patients died. CONCLUSIONS Acute hemodynamic results of reBAV are comparable to those achieved during index BAV. However, reBAV may carry an increased risk of complications. Moreover, mortality is high due to unfavorable risk profiles or delays in receiving definitive therapy.
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Affiliation(s)
- Danuta Sorysz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
| | - Artur Dziewierz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Łukasz Rzeszutko
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Agata Wiktorowicz
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
| | - Wojciech Wojakowski
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Radosław Parma
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Skoczyńska
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Paweł Kleczyński
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Stąpór
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Dariusz Dudek
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- Digital Medicine & Robotics Center, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek Legutko
- Clinical Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisław Bartuś
- Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
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Pyka Ł, Hudzik B, Bartuś S, Buszman P, Gierlotka M, Wojakowski W, Hiczkiewicz J, Kleinrok A, Skrzypek M, Kuliczkowski W, Gąsior M. Anticoagulation for Atrial Fibrillation in Acute Coronary Syndrome Survivors Reduces Major Cardiovascular Events and Mortality. J Cardiovasc Pharmacol Ther 2023; 28:10742484231212106. [PMID: 38158229 DOI: 10.1177/10742484231212106] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The prevalence of atrial fibrillation (AF) in acute coronary syndrome (ACS) patients is increasing. Data on outcomes of anticoagulation in ACS patients with AF are lacking. The aim of our study was to investigate the prevalence of stroke, myocardial infarction, bleeding complications, and all-cause mortality in this population. PL-ACS and AMI-PL registries gather an all-comer population of ACS patients in Poland, exceeding half a million records. We have selected ACS survivors with concomitant AF on admission, divided them into subgroups with regard to the administered anticoagulation, and followed up with them for a 12-month period (n = 13,973). Subsequently, groups were propensity score matched for age, sex, ejection fraction, diabetes, heart failure, renal impairment, and type of ACS. The study population was divided with regard to the administration of anticoagulation. Anticoagulation was prescribed in 2,466 patients (17.6%). The (D)OAC+ patients were younger; however, comorbidities were more prevalent in this group. The 12-month follow-up showed that the (D)OAC+ patients had significantly lower rates of all-cause mortality, myocardial infarction, and ischemic stroke, with no significant increase in bleeding events. After matching, the study groups consisted of 2,194 patients each and showed no differences in baseline characteristics. The outcomes of the 12-month observation were similar to the findings before matching. This all-comer national registry analysis shows that the use of guideline-recommended therapy and anticoagulation in ACS survivors with AF is associated with a lower rate of all-cause mortality, recurrent myocardial infarction, and ischemic stroke.
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Affiliation(s)
- Łukasz Pyka
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Bartosz Hudzik
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
- Department of Cardiovascular Disease Prevention, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Katowice, Poland
| | - Stanisław Bartuś
- Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Paweł Buszman
- Department of Epidemiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Marek Gierlotka
- Department of Cardiology, University of Opole, Opole, Poland
| | - Wojciech Wojakowski
- Department of Cardiology and Structural Heart Diseases, Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Jarosław Hiczkiewicz
- Clinical Department of Cardiology, Nowa Sól Multidisciplinary Hospital, Nowa Sól, Poland
| | - Andrzej Kleinrok
- Department of Cardiology, The Pope John Paul II Province Hospital of Zamość, Zamość, Poland
| | - Michał Skrzypek
- Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia, Bytom, Poland
| | | | - Mariusz Gąsior
- Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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Kubica J, Kubica A, Grzelakowska K, Stolarek W, Grąbczewska Z, Michalski P, Niezgoda P, Bartuś S, Budaj A, Dąbrowski M, Drożdż J, Gellert R, Jaguszewski MJ, Jankowski P, Legutko J, Lesiak M, Leszek P, Małyszko J, Mitkowski P, Nessler J, Pawlaczyk K, Siller-Matula J, Stompór T, Wolnik B, Navarese EP. Inhibitors of sodium-glucose transport protein 2: A new multidirectional therapeutic option for heart failure patients. Cardiol J 2023; 30:143-149. [PMID: 34708866 PMCID: PMC9987542 DOI: 10.5603/cj.a2021.0133] [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: 07/19/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022] Open
Abstract
Several mechanisms have been suggested to explain positive cardiovascular effects observed in studies with sodium-glucose co-transporter 2 (SGLT2) inhibitors. The reduction in glucose reabsorption in proximal tubuli induced by SGLT2 inhibitors increases urinary glucose and sodium excretion resulting in increased osmotic diuresis and consequently in decreased plasma volume, followed by reduced preload. In addition, the hemodynamic effects of SGLT2 inhibition were observed in both hyper and euglycemic patients. Due to the complex and multidirectional effects induced by SGLT2 inhibitors, this originally antidiabetic group of drugs has been successfully used to treat patients with heart failure as well as for subjects with chronic kidney disease. Moreover, their therapeutic potential seems to be even broader than the indications studied to date.
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Affiliation(s)
- Jacek Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Aldona Kubica
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Wioleta Stolarek
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Zofia Grąbczewska
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Michalski
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Piotr Niezgoda
- Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Andrzej Budaj
- Center of Postgraduate Medical Education, Department of Cardiology, Grochowski Hospital, Warsaw, Poland
| | | | - Jarosław Drożdż
- 2nd Department of Cardiology, Chair of Cardiology, Cardiac Surgery and Vascular Diseases, Medical University of Lodz, Poland
| | - Ryszard Gellert
- Department of Nephrology and Internal Medicine, Center of Postgraduate Medical Education, Warsaw, Poland
| | | | - Piotr Jankowski
- 1st Department of Cardiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital in Krakow, Poland
| | - Maciej Lesiak
- Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Przemysław Leszek
- Department of Heart Failure and Transplantology, National Institute of Cardiology, Warsaw, Poland
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Poland
| | | | - Jadwiga Nessler
- Department of Coronary Artery Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Pawlaczyk
- Department of Nephrology, Transplantology and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Jolanta Siller-Matula
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Poland.,Department of Cardiology, Medical University of Vienna, Austria
| | - Tomasz Stompór
- Chair of Internal Medicine Department of Nephrology, Hypertension and Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Poland
| | - Bogumił Wolnik
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Poland
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43
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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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Dziewierz A, Zdzierak B, Malinowski KP, Siudak Z, Zasada W, Tokarek T, Zabojszcz M, Dolecka-Ślusarczyk M, Dudek D, Bartuś S, Surdacki A, Rakowski T. Diabetes Mellitus Is Still a Strong Predictor of Periprocedural Outcomes of Primary Percutaneous Coronary Interventions in Patients Presenting with ST-Segment Elevation Myocardial Infarction (from the ORPKI Polish National Registry). J Clin Med 2022; 11:jcm11216284. [PMID: 36362512 PMCID: PMC9657628 DOI: 10.3390/jcm11216284] [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: 09/12/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 11/16/2022] Open
Abstract
The impact of diabetes mellitus (DM) on outcomes of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) was confirmed by several studies. However, it is unclear whether this effect is still present in large groups of unselected patients undergoing up-to-date treatment. Thus, we sought to assess the impact of DM on periprocedural outcomes of primary PCI in STEMI using data from the Polish National Registry of PCI. Data on 150,782 STEMI patients undergoing primary PCI were collected. Of them, 26,360 (17.5%) patients had DM. Patients with DM were higher-risk individuals who experienced longer reperfusion delays and were less likely to have closed infarct-related artery at baseline (TIMI 0 + 1 flow: 73.2% vs. 72.0%; p < 0.0001) and achieve optimal reperfusion after PCI (TIMI 3 flow: 91.8% vs. 88.5%; p < 0.0001). The periprocedural mortality (1.1% vs. 1.9%; p < 0.0001) was higher in patients with DM and DM was identified as an independent predictor of periprocedural death. In conclusion, despite continuous progress in STEMI treatment, DM remains a strong predictor of periprocedural mortality. However, this detrimental effect of DM may be partially explained by the overall higher risk profile of diabetic patients.
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Affiliation(s)
- Artur Dziewierz
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Barbara Zdzierak
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Krzysztof P. Malinowski
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Digital Medicine & Robotics Center, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Zbigniew Siudak
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | - Wojciech Zasada
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Tomasz Tokarek
- Center for Invasive Cardiology, Electrotherapy and Angiology, 33-300 Nowy Sacz, Poland
- Center for Innovative Medical Education, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Michał Zabojszcz
- Collegium Medicum, Jan Kochanowski University, 25-369 Kielce, Poland
| | | | - Dariusz Dudek
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Digital Medicine & Robotics Center, Jagiellonian University Medical College, 31-008 Krakow, Poland
- Center for Invasive Cardiology, Electrotherapy and Angiology, 33-300 Nowy Sacz, Poland
| | - Stanisław Bartuś
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Andrzej Surdacki
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
| | - Tomasz Rakowski
- 2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego St., 30-688 Krakow, Poland
- Correspondence: ; Tel.: +48-12-400-22-50
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45
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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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46
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Terlecki M, Wojciechowska W, Klocek M, Olszanecka A, Bednarski A, Drożdż T, Pavlinec C, Lis P, Zając M, Rusinek J, Siudak Z, Bartuś S, Rajzer M. Impact of concomitant COVID-19 on the outcome of patients with acute myocardial infarction undergoing coronary artery angiography. Front Cardiovasc Med 2022; 9:917250. [PMID: 36211554 PMCID: PMC9536466 DOI: 10.3389/fcvm.2022.917250] [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: 04/10/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background The impact of COVID-19 on the outcome of patients with MI has not been studied widely. We aimed to evaluate the relationship between concomitant COVID-19 and the clinical course of patients admitted due to acute myocardial infarction (MI). Methods There was a comparison of retrospective data between patients with MI who were qualified for coronary angiography with concomitant COVID-19 and control group of patients treated for MI in the preceding year before the onset of the pandemic. In-hospital clinical data and the incidence of death from any cause on 30 days were obtained. Results Data of 39 MI patients with concomitant COVID-19 (COVID-19 MI) and 196 MI patients without COVID-19 in pre-pandemic era (non-COVID-19 MI) were assessed. Compared with non-COVID-19 MI, COVID-19 MI was in a more severe clinical state on admission (lower systolic blood pressure: 128.51 ± 19.76 vs. 141.11 ± 32.47 mmHg, p = 0.024), higher: respiratory rate [median (interquartile range), 16 (14–18) vs. 12 (12–14)/min, p < 0.001], GRACE score (178.50 ± 46.46 vs. 161.23 ± 49.74, p = 0.041), percentage of prolonged (>24 h) time since MI symptoms onset to coronary intervention (35.9 vs. 15.3%; p = 0.004), and cardiovascular drugs were prescribed less frequently (beta-blockers: 64.1 vs. 92.8%, p = 0.009), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers: 61.5 vs. 81.1%, p < 0.001, statins: 71.8 vs. 94.4%, p < 0.001). Concomitant COVID-19 was associated with seven-fold increased risk of 30-day mortality (HR 7.117; 95% CI: 2.79–18.14; p < 0.001). Conclusion Patients admitted due to MI with COVID-19 have an increased 30-day mortality. Efforts should be focused on infection prevention and implementation of optimal management to improve the outcomes in those patients.
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Affiliation(s)
- Michał Terlecki
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Wiktoria Wojciechowska
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Klocek
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Olszanecka
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Bednarski
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Drożdż
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Christopher Pavlinec
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Paweł Lis
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej Zając
- Student's Scientific Group in the First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Jakub Rusinek
- Student's Scientific Group in the First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Siudak
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Stanisław Bartuś
- Second Department of Cardiology, Jagiellonian University Medical College, Kraków, Poland
| | - Marek Rajzer
- First Department of Cardiology, Interventional Electrocardiology and Arterial Hypertension, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Marek Rajzer
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47
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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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48
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Ostrowska M, Kasprzak M, Stolarek W, Grzelakowska K, Kryś J, Kubica A, Adamski P, Podhajski P, Navarese EP, Anielska-Michalak E, Matuszewska-Brycht O, Curzytek A, Dudek A, Gromadziński L, Grzelakowski P, Kamiński L, Kleinrok A, Kostkiewicz M, Koziński M, Król P, Kulawik T, Minczew G, Mindykowski M, Pawlak A, Prokopczuk J, Skonieczny G, Sobkowicz B, Sowiński S, Stankala S, Szymański P, Wester A, Wilczewski P, Bartuś S, Budaj A, Gajda R, Gąsior M, Gruchała M, Drożdż J, Jaguszewski M, Jankowski P, Legutko J, Lesiak M, Leszek P, Mitkowski P, Nessler J, Tomaszuk-Kazberuk A, Tycińska A, Zdrojewski T, Kaźmierczak J, Kubica J. Longer Hospitalizations and Higher In-Hospital Mortality for Acute Heart Failure during the COVID-19 Pandemic in Larger vs. Smaller Cardiology Departments: Subanalysis of the COV-HF-SIRIO 6 Multicenter Study. Rev Cardiovasc Med 2022. [DOI: 10.31083/j.rcm2309292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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49
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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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50
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Długosz D, Surdacki A, Zawiślak B, Bartuś S, Chyrchel B. Impaired Left Ventricular Circumferential Midwall Systolic Performance Appears Linked to Depressed Preload, but Not Intrinsic Contractile Dysfunction or Excessive Afterload, in Paradoxical Low-Flow/Low-Gradient Severe Aortic Stenosis. J Clin Med 2022; 11:2873. [PMID: 35628998 PMCID: PMC9144151 DOI: 10.3390/jcm11102873] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/30/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Paradoxical low-flow/low-gradient aortic stenosis (P-LFLG-AS) occurs in about one-third of patients with severe AS and preserved left ventricular (LV) ejection fraction (EF). Our aim was to differentiate between altered LV loading conditions and contractility as determinants of subtle LV systolic dysfunction in P-LFLG-AS. We retrospectively analyzed medical records of patients with isolated severe degenerative AS and preserved EF (30 subjects with P-LFLG-AS and 30 patients with normal-flow/high-gradient severe AS (NFHG-AS)), without relevant coexistent diseases (e.g., diabetes, coronary artery disease and chronic kidney disease) or any abnormalities which could account for a low-flow state. Patients with P-LFLG-AS and NFHG-AS did not differ in aortic valve area index and most clinical characteristics. Compared to NFHG-AS, subjects with P-LFLG-AS exhibited smaller LV end-diastolic diameter (LVd) (44 ± 5 vs. 54 ± 5 mm, p < 0.001) (consistent with lower LV preload) with pronounced concentric remodeling, higher valvulo-arterial impedance (3.8 ± 1.1 vs. 2.2 ± 0.5 mmHg per mL/m2, p < 0.001) and diminished systemic arterial compliance (0.45 ± 0.11 vs. 0.76 ± 0.23 mL/m2 per mmHg, p < 0.001), while circumferential end-systolic LV midwall stress (cESS), an estimate of afterload at the LV level, was similar in P-LFLG-AS and NFHG-AS (175 ± 83 vs. 198 ± 69 hPa, p = 0.3). LV midwall fractional shortening (mwFS) was depressed in P-LFLG-AS vs. NFHG-AS (12.3 ± 3.5 vs. 14.7 ± 2.9%, p = 0.006) despite similar EF (61 ± 6 vs. 59 ± 8%, p = 0.4). By multiple regression, the presence of P-LFLG-AS remained a significant predictor of lower mwFS compared to NFHG-AS upon adjustment for cESS (β ± SEM: −2.35 ± 0.67, p < 0.001); however, the significance was lost after further correction for LVd (β = −1.10 ± 0.85, p = 0.21). In conclusion, the association of P-LFLG-AS with a lower cESS-adjusted mwFS, an index of afterload-corrected LV circumferential systolic function at the midwall level, appears secondary to a smaller LV end-diastolic cavity size according to the Frank−Starling law. Thus, low LV preload, not intrinsic contractile dysfunction or excessive afterload, may account for impaired LV circumferential midwall systolic performance in P-LFLG-AS.
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Affiliation(s)
- Dorota Długosz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland; (D.D.); (A.S.); (S.B.)
| | - Andrzej Surdacki
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland; (D.D.); (A.S.); (S.B.)
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University, 2 Jakubowskiego Street, 30-688 Cracow, Poland
| | - Barbara Zawiślak
- Intensive Care Unit, Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland;
| | - Stanisław Bartuś
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland; (D.D.); (A.S.); (S.B.)
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University, 2 Jakubowskiego Street, 30-688 Cracow, Poland
| | - Bernadeta Chyrchel
- Department of Cardiology and Cardiovascular Interventions, University Hospital, 2 Jakubowskiego Street, 30-688 Cracow, Poland; (D.D.); (A.S.); (S.B.)
- Second Department of Cardiology, Institute of Cardiology, Jagiellonian University, 2 Jakubowskiego Street, 30-688 Cracow, Poland
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