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Suchodolski A, Głowacki J, Wasilewski J, Szulik M. Anomalous left coronary artery from the pulmonary artery (ALCAPA) in adult patients - a multimodality imaging approach. Pol J Radiol 2024; 89:e115-e121. [PMID: 38510551 PMCID: PMC10953507 DOI: 10.5114/pjr.2024.135736] [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: 11/19/2023] [Accepted: 12/27/2023] [Indexed: 03/22/2024] Open
Abstract
Purpose Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital ano-maly of the origin of the coronary arteries. The prevalence of this anomaly in the adult patient population is low, and therefore there is virtually no original research on this topic. Reports are limited to case reports. Material and methods We evaluated 16,264 computed tomography (CT) exams (cardiac and chest) performed in our heart imaging department between 2015 and 2022 on a dual-source 128-slice CT scanner (SOMATOM Definition Flash, Siemens Healthineers, Forchheim, Germany) and established a retrospective registry of adult patients (> 18 years old) with ALCAPA. The study included 7 cases. Next, we collected clinical and echocardiographic data, which could be assessed retrospectively. Results We found 7 cases of ALCAPA in adult patients (0.043%). Three of them were female, and 4 were male. The age varied between 20 and 60 years. Echocardiographic findings, as well as the clinical course, varied widely. Conclusions ALCAPA is an extremely rare anomaly, which nonetheless must be taken into clinical consideration. This lesion may be fatal during infancy. Data regarding adult patients is scarce. Multicentre registries are needed to establish a more detailed clinical profile of adults with this anomaly.
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Affiliation(s)
- Alexander Suchodolski
- Doctoral school, Department of Cardiology and Electrotherapy, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jan Głowacki
- Department of Radiology and Radiodiagnostics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Computed Tomography Laboratory, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Jarosław Wasilewski
- Third Department of Cardiology, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariola Szulik
- Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
- Department of Medical and Health Sciences, WSB University Faculty of Applied Sciences, Dąbrowa Górnicza, Poland
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Wasilewski J, Czaja-Ziółkowska MZ, Gąsior M. The site-specific distribution of atheromatous plaques in the coronary arteries. Postepy Kardiol Interwencyjnej 2023; 19:195-201. [PMID: 37854963 PMCID: PMC10580840 DOI: 10.5114/aic.2023.131471] [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: 05/11/2023] [Accepted: 06/19/2023] [Indexed: 10/20/2023] Open
Abstract
The etiology of atherosclerosis is still unknown, but there are several hypotheses trying to explain this complex disease. Most consider atherosclerosis as a cholesterol storage disease. However, hypercholesterolemia is not a cause but a risk factor. Besides, like other well-known systemic risk factors, it does not explain the uneven distribution of atheromatous plaques in the vasculature. Atherosclerotic lesions develop mainly at vulnerable "risk points" of the arterial wall such as curvatures and near side branches, and predominantly in the left anterior descending (LAD), while the left circumflex (LCx) artery is relatively spared. Furthermore, atheromatous plaques are present mainly in the proximal segments in the LAD and LCx, in contrast to the right coronary artery (RCA), where plaques are more evenly distributed. The hemodynamic theory explains to some extent the distribution of atherosclerotic lesions and considers atherosclerosis as a reactive biological response of endothelial cells to wall shear stress. In this review, we discuss the interplay of concentration of low-density lipoproteins at the luminal surface and local hemodynamic forces (disturbed flow) that reduce wall shear stress in the process of plaque formation. Moreover, we present the distribution of atheromatous plaques in the coronary arteries in autopsy studies and imaging methods such as cardiac computed tomography angiography and invasive coronary angiography.
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Affiliation(s)
- Jarosław Wasilewski
- 3 Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Mariusz Gąsior
- 3 Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
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Czaja-Ziółkowska M, Głowacki J, Krysiński M, Gąsior M, Wasilewski J. Relationship between left main trifurcation angulation, calcium score, and the onset of plaque formation. Kardiol Pol 2023; 81:48-53. [PMID: 35775448 DOI: 10.33963/kp.a2022.0161] [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: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND It has been suggested that a wider left main (LM) bifurcation angle is associated with the development of atherosclerosis. However, the relationship between LM trifurcation angulation and atherosclerosis has not been investigated. AIMS We aimed to investigate the relationship between LM trifurcation angulation and the presence of calcifications in the left coronary artery (LCA) using coronary computed tomography angiography (CCTA). Furthermore, we assessed the relationship between LM trifurcation angulation and the age at which calcification originated. METHODS The LM trifurcation angle and coronary artery calcium (CAC) score in the LCA were measured. Based on observational studies, we assumed that CAC progression is 25% per year on average. Then, we calculated the age at which LCA CAC scores were lower than 0.1 Agatston units. RESULTS Of 266 patients, 52 patients (mean age of [standard deviation, SD] 61 [6] years; 28 men) with LM trifurcation were included in the study. Calcified plaques occurred in the LCA in 36 patients (69.2%). The mean LM trifurcation angle in patients with a diseased LCA was wider than that in patients with a normal LCA (108° [33°] vs. 91° [28°]; P = 0.04). Pearson correlation coefficient showed that the wider the LM trifurcation angle was, the earlier the calcification in the LCA may be expected (r = -0.34; P = 0.04 with outliers; r = -0.43; P = 0.009 without outliers). CONCLUSIONS A wider LM trifurcation angle is associated with a higher LCA CAC score. Moreover, the LM trifurcation angle has a significant impact on the earlier onset of atherosclerosis.
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Affiliation(s)
- Monika Czaja-Ziółkowska
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Jan Głowacki
- Department of Radiology, Silesian Medical University, Poland.,Computed Tomography Laboratory, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Mateusz Krysiński
- Silesian Center for Heart Diseases, Zabrze, Poland.,American Heart of Poland Inc. Center for Cardiovascular Research and Development, Poland
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Adamczyk M, Wasilewski J, Niedziela JT, Zembala MO, Gąsior M. Baseline characteristics, management and long-term outcomes of different etiologies of cardiac tamponade evaluated in a cohort of 340 patients. Kardiochir Torakochirurgia Pol 2021; 18:216-220. [PMID: 35079262 PMCID: PMC8768860 DOI: 10.5114/kitp.2021.112187] [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] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/19/2021] [Indexed: 12/02/2022]
Abstract
INTRODUCTION Studies on the etiology of cardiac tamponade (CT) are scarce or lacking follow-up, and usually include small or highly selected groups of patients. AIM To evaluate the various etiologies and outcomes of CT in a cohort of patients treated in a tertiary care hospital encompassing cardiology, cardiac surgery and intensive care units. MATERIAL AND METHODS We retrospectively analyzed all adult patients hospitalized in the Silesian Centre for Heart Diseases in Zabrze (Poland) between January 2008 and December 2018, who required therapeutic pericardiocentesis or pericardiotomy due to CT. All various etiologies of CT were presented and assigned to the main etiology groups. For each group basic characteristics, in-hospital management, in-hospital and up to 2-year mortality were analyzed. RESULT Among 340 patients with CT, 56% were men. The leading etiology groups included patients after invasive cardiac procedures, patients following postpericardiotomy (PCT) syndrome and the patients with neoplasm. Patients with end stage renal failure, PCT and iatrogenic CTs were the most disease burdened groups. The highest need for advanced therapy and in-hospital mortality were observed for the acute myocardial infarction group, in contrast to PCT. CONCLUSIONS Within our cohort of patients, the invasive cardiac procedures overtake neoplastic causation of cardiac tamponade. The worst in-hospital prognosis was noted for CT following acute myocardial infarction and both iatrogenic invasive cardiac and cardiac surgery procedures. The highest long-term mortality was recorded for patients with end stage renal failure and the neoplastic group.
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Affiliation(s)
- Mária Adamczyk
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Jarosław Wasilewski
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Jacek T. Niedziela
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Michał O. Zembala
- Department of Cardiac, Vascular and Endovascular Surgery and Transplantation, Silesian Center for Heart Diseases, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Poland
| | - Mariusz Gąsior
- 3 Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland
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Głowacki J, Krysiński M, Czaja-Ziółkowska M, Wasilewski J. Machine Learning-based Algorithm Enables the Exclusion of Obstructive Coronary Artery Disease in the Patients Who Underwent Coronary Artery Calcium Scoring. Acad Radiol 2020; 27:1416-1421. [PMID: 31839566 DOI: 10.1016/j.acra.2019.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 10/09/2019] [Accepted: 11/20/2019] [Indexed: 12/11/2022]
Abstract
RATIONALE AND OBJECTIVES An application of artificial intelligence to screen for obstructive coronary artery disease (CAD) after coronary artery calcium scoring (CACS) test. MATERIALS AND METHODS As an initial step we analyzed a group of 435 patients (23% male, mean age 61 ± 10) with low to moderate probability of CAD, who underwent clinically indicated CACS and coronary computed tomography angiography. Based on those data we elaborated a gradient boosting machine (GBM) model for prediction of obstructive CAD. Later the model was evaluated on a control group of 126 consecutive patients (31% male, mean age 59 ± 10). RESULTS Stratified 10-fold cross-validation performed on the group of 435 patients demonstrated the GBM model's sensitivity at 100 ± 0% and specificity at 69.8 ± 3.6%, while the outcomes (confusion matrix) of a clinical application on the group of 126 patients were: 73 true negative, 0 false negative, 20 true positive, and 33 false positive. CONCLUSION The GBM algorithm showcased a considerably high discriminatory power for excluding the presence of obstructive CAD, with negative predictive value and positive predictive value of 100% and 38%, respectively.
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Kurdziel M, Wasilewski J, Gierszewska K, Pytel G, Poloński L, Gąsior M. Effect of extreme altitude mountaineering on iron status. Pol Arch Intern Med 2018; 128:134-137. [PMID: 29511151 DOI: 10.20452/pamw.4216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kurdziel M, Wasilewski J, Gierszewska K, Kazik A, Pytel G, Wacławski J, Krajewski A, Kurek A, Poloński L, Gąsior M. Echocardiographic Assessment of Right Ventricle Dimensions and Function After Exposure to Extreme Altitude: Is an Expedition to 8000 m Hazardous for Right Ventricular Function? High Alt Med Biol 2017; 18:330-337. [PMID: 28816526 DOI: 10.1089/ham.2017.0019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Kurdziel, Marta, Jarosław Wasilewski, Karolina Gierszewska, Anna Kazik, Gracjan Pytel, Jacek Wacławski, Adam Krajewski, Anna Kurek, Lech Poloński, and Mariusz Gąsior. Echocardiographic assessment of right ventricle dimensions and function after exposure to extreme altitude: Is an expedition to 8000 m hazardous for right ventricular function? High Alt Med Biol 18:330-337, 2017.-Although the right ventricle (RV) is under great hypoxic stress at altitude, still little is known what happens to the RV after descent. The aim of this study was to evaluate RV dimensions and function after exposure to extreme altitude. Therefore, echocardiographic examination was performed according to a protocol that focused on the RV in 11 healthy subjects participating in an expedition to K2 (8611 m) or Broad Peak (BP, 8051 m). In comparison to measurements before the expedition, after 7-8 weeks of sojourn above 2300 meters with the aim of climbing K2 and BP, the RV Tei index increased (0.5 ± 0.1 vs. 0.4 ± 0.1; p = 0.028), and RV free wall longitudinal systolic strain (RVFWLSS) decreased (-23.1% ± 2.7% vs. -25.9% ± 2.4%; p = 0.043). Decrease in peak systolic strain and strain rate was observed in the basal and mid segments of the RV free wall (respectively: -24.4% ± 4.4% vs. -30.9% ± 6.5%; -1.4 ± 0.3 s-1 vs. -1.8 ± 0.3 s-1; -28.7% ± 3.9% vs. -34% ± 3.3%; -1.5 ± 0.2 s-1 vs. -1.9 ± 0.3 s-1; p for all <0.05). The linear RV dimensions, the proximal and distal RV outflow tracks, increased (respectively: 31.3 ± 4 mm vs. 29.2 ± 3 mm, p = 0.025; 27 ± 2.7 mm vs. 24.8 ± 3 mm, p = 0.012). We found that exposure to extreme altitude may cause RV dilatation and a decrease in RV performance. The Tei index and RVFWLSS are sensitive performance indices to detect changes in RV function after the exposure to hypoxic stress. The observed alterations seem to be a manifestation of physiological adaptation to high-altitude condition in healthy individuals.
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Affiliation(s)
- Marta Kurdziel
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Jarosław Wasilewski
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Karolina Gierszewska
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Anna Kazik
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Gracjan Pytel
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Jacek Wacławski
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Adam Krajewski
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Anna Kurek
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Lech Poloński
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
| | - Mariusz Gąsior
- 1 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland .,2 Silesian Center for Heart Diseases , Zabrze, Poland
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Wasilewski J, Pyka Ł, Hawranek M, Tajstra M, Skrzypek M, Wasiak M, Suliga K, Bujak K, Gąsior M. Prognostic value of red blood cell distribution width in patients with left ventricular systolic dysfunction: Insights from the COMMIT-HF registry. Cardiol J 2017; 25:377-385. [PMID: 28353308 DOI: 10.5603/cj.a2017.0037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 03/27/2017] [Accepted: 02/03/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Previous studies have reported that in patients with heart failure, an increased value of red cell distribution width (RDW) is associated with adverse outcomes. Nonetheless, data regarding the association between RDW values and long-term mortality in patients with left ventricular systolic dysfunction (LVSD) are lacking. The aim of this investigation was to examine the relationship between mortality and RDW in patients with ischemic and non-ischemic LVSD. METHODS Under analysis was 1734 patients with a left ventricular ejection fraction (LVEF) ≤ 35% of whom were hospitalized between 2009 and 2013. Patients were divided into three groups based on RDW tertiles. Low, medium and high tertiles were defined as RDW ≤ 13.4%, 13.4% < RDW ≤ 14.6% and RDW > 14.6%, respectively. RESULTS There was a stepwise relationship between RDW intervals and comorbidities. Patients with the highest RDW values were older and more often diagnosed with anemia, diabetes, atrial fibrillation and chronic kidney disease. The main finding of our analysis was the presence of an 8-fold increase in all-cause mortality in the entire cohort between high and low RDW tertile. Cox hazard analysis identi-fied RDW as an independent predictive factor of mortality in all patients (HR 2.8; 95% CI 2.1-3.8; p < 0.0001) and in subgroups of patients with ischemic (HR 2.8; 95% CI 2.0-3.9; p < 0.0001) and non-ischemic (HR 3.3; 95% CI 2.01-5.5; p < 0.0001) LVSD. CONCLUSIONS The highest RDW tertile was independently associated with higher long-term mortality compared with low and medium tertiles, both in all patients with a LVEF ≤ 35% and in subgroups of patients with ischemic and non-ischemic LVSD.
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Affiliation(s)
| | - Łukasz Pyka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland.
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Osadnik T, Strzelczyk JK, Lekston A, Reguła R, Bujak K, Fronczek M, Gawlita M, Gonera M, Wasilewski J, Szyguła-Jurkiewicz B, Gierlotka M, Gąsior M. The association of functional polymorphisms in genes encoding growth factors for endothelial cells and smooth muscle cells with the severity of coronary artery disease. BMC Cardiovasc Disord 2016; 16:218. [PMID: 27835972 PMCID: PMC5106826 DOI: 10.1186/s12872-016-0402-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 11/08/2016] [Indexed: 12/18/2022] Open
Abstract
Background Despite the important roles of vascular smooth muscle cells and endothelial cells in atherosclerotic lesion formation, data regarding the associations of functional polymorphisms in the genes encoding growth factors with the severity of coronary artery disease (CAD) are lacking. The aim of the present study is to analyze the relationships between functional polymorphisms in genes encoding basic fibroblast growth factor (bFGF, FGF2), epidermal growth factor (EGF), insulin-like growth factor-1 (IGF-1), platelet derived growth factor-B (PDGFB), transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor A (VEGF-A) and the severity of coronary atherosclerosis in patients with stable CAD undergoing their first coronary angiography. Methods In total, 319 patients with stable CAD who underwent their first coronary angiography at the Silesian Centre for Heart Diseases in Zabrze, Poland were included in the analysis. CAD burden was assessed using the Gensini score. The TaqMan method was used for genotyping of selected functional polymorphisms in the FGF2, PDGFB, TGFB1, IGF1 and VEGFA genes, while rs4444903 in the EGF gene was genotyped using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The associations between the selected polymorphisms and the Gensini were calculated both for the whole cohort and for a subgroup of patients without previous myocardial infarction (MI). Results There were no differences in the distribution of the Gensini score between the genotypes of the analyzed polymorphisms in FGF2, EGF, IGF1, PDFGB, and TGFB1 in the whole cohort and in the subgroup of patients without previous MI. The Gensini score for VEGFA rs699947 single-nucleotide polymorphism (SNP) in patients without previous myocardial infarction, after correction for multiple testing, was highest in patients with the A/A genotype, lower in heterozygotes and lowest in patients with the C/C genotype, (p value for trend = 0.013, false discovery rate (FDR) = 0.02). After adjustment for clinical variables, and correction for multiple comparisons the association between the VEGFA genotype and Gensini score remained only nominally significant (p = 0.04, FDR = 0.19) under the dominant genetic model in patients without previous MI. Conclusions We were unable to find strong association between analyzed polymorphisms in growth factors and the severity of coronary artery disease, although there was a trend toward association between rs699947 and the severity of CAD in patients without previous MI. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0402-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland. .,Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Curie-Skłodowskiej Street 10C, 41-800, Zabrze, Poland.
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Jordana Street 19, 41-808, Zabrze, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Martyna Fronczek
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Marii Curie-Skłodowskiej Street 10C, 41-800, Zabrze, Poland.,Silesian Center for Heart Diseases, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Marcin Gawlita
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Małgorzata Gonera
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Jarosław Wasilewski
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Bożena Szyguła-Jurkiewicz
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Marii Curie-Skłodowskiej Street 9, 41-800, Zabrze, Poland
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Trzeciak P, Wożakowska-Kapłon B, Niedziela J, Gierlotka M, Hawranek M, Lekston A, Wasilewski J, Poloński L, Gąsior M. Comparison of Inhospital and 12- and 36-Month Outcomes After Acute Coronary Syndrome in Men Versus Women <40 Years (from the PL-ACS Registry). Am J Cardiol 2016; 118:1300-1305. [PMID: 27616341 DOI: 10.1016/j.amjcard.2016.07.067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 07/28/2016] [Accepted: 07/28/2016] [Indexed: 11/19/2022]
Abstract
The study was aimed to compare the characteristics and inhospital and 12- and 36-month outcomes of men and women <40 years with acute coronary syndrome (ACS). The analysis involved 932 patients <40 years with ACS in the Silesia region enrolled into the ongoing, prospective Polish Registry of Acute Coronary Syndromes from January 2006 to December 2014. The composite end point involved death, recurrence of ACS, a need for percutaneous coronary intervention, and coronary artery bypass graft surgery within 12 and 36 months after ACS. Compared with men, women <40 years were less frequently smokers (66.1% vs 55.4%, p = 0008), had older average age (35.6 ± 4.2 vs 34.7 ± 4.4, p = 0.002), more often had unstable angina at admission (29.1% vs 19.3%, p <0.001), and less frequently had ST-elevation myocardial infarction: 41.3% versus 51.3%, p = 0.02, at admission. There was no significant difference in the mortality (4.8% vs 3.1%, p = 0.29) and the composite end point (21.6% vs 16.0%, p = 0.14) within 12 months after ACS. Compared with men, women had a higher incidence of the composite end point (28.4% vs 20.1%, p = 0.04) and indicated a tendency of a higher mortality within the 36-month follow-up period (9.2% vs 5.0%, p = 0.055). Female gender turned out to be an independent risk factor of death in the multivariate analysis (hazard ratio 2.76, 95% confidence interval 1.21 to 6.31, p <0.016). In conclusion, women had a higher incidence of the composite end point and showed a tendency toward a higher mortality than the men within the 36-month follow-up period.
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Affiliation(s)
- Przemysław Trzeciak
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Beata Wożakowska-Kapłon
- First Clinical Department of Cardiology, Świętokrzyskie Centre of Cardiology, Kielce, Poland; University of Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Jacek Niedziela
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Marek Gierlotka
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Michał Hawranek
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jarosław Wasilewski
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Lech Poloński
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, SMDZ in Zabrze, Medical University of Silesia, Katowice, Poland
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Hudzik B, Szkodziński J, Wasilewski J, Gierlotka M, Lekston A, Poloński L, Gąsior M. A novel simplified thrombo-inflammatory score portends poor outcome in diabetic patients following myocardial infarction. Biomark Med 2016; 10:1129-1139. [PMID: 27733057 DOI: 10.2217/bmm-2016-0145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
AIM We investigated prognostic value of novel simplified thrombo-inflammatory score (sTIPS) in patients with ST-elevation myocardial infarction (STEMI) and diabetes mellitus. METHODS A total of 465 patients with diabetes mellitus and STEMI were included in the study. Based on admission cut-off values for predicting in-hospital mortality of white blood cell count (>13.4 × 103/mm3) and mean platelet volume-to-platelet count ratio (>0.06), the patients were assigned 0 point for having the lower value of each variable and 1 point for having the upper value of each variable. sTIPS was calculated as the sum of these two variables. RESULTS Kaplan-Meier curves demonstrated that higher sTIPS categories were associated with higher in-hospital and 12-month mortality. One-point increment in the score was associated with 51% increase in the risk of in-hospital death and 89% increase in the risk of long term. CONCLUSION sTIPS is useful in predicting worse immediate and long-term outcomes following STEMI.
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Affiliation(s)
- Bartosz Hudzik
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Janusz Szkodziński
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jarosław Wasilewski
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Marek Gierlotka
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Lech Poloński
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, Silesian Center for Heart Disease, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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Osadnik T, Strzelczyk JK, Fronczek M, Bujak K, Reguła R, Gonera M, Gawlita M, Kurek A, Wasilewski J, Lekston A, Gierlotka M, Hawranek M, Ostrowska Z, Wiczkowski A, Poloński L, Gąsior M. Relationship of the rs1799752 polymorphism of the angiotensin-converting enzyme gene and the rs699 polymorphism of the angiotensinogen gene to the process of in-stent restenosis in a population of Polish patients with stable coronary artery disease. Adv Med Sci 2016; 61:276-281. [PMID: 27162064 DOI: 10.1016/j.advms.2016.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 02/24/2016] [Accepted: 03/18/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The renin-angiotensin-aldosterone system may influence in-stent restenosis (ISR) via angiotensin II, which stimulates the production of growth factors for smooth muscle cells. The aim of this work is to assess the influence of the rs1799752 polymorphism of the angiotensin-converting enzyme (ACE) gene and the rs699 polymorphism of the angiotensinogen (AGT) gene on the ISR in Polish patients with stable coronary artery disease (SCAD) who underwent stent implantation. MATERIAL/METHODS Two hundred and sixty-five patients with SCAD were included in the study. All patients underwent stent implantation upon admission to the hospital and had subsequent coronary angiography performed. The patients were divided into two groups - those with significant ISR (n=53) and those without ISR (n=212). The ACE polymorphism was assessed using the classical PCR method and the AGT polymorphism was determined using the TaqMan method for SNP genotyping. RESULTS No difference in the frequency of angiographically significant ISR occurrence associated with the different ACE and AGT gene polymorphisms was observed. In a multivariable analysis, after correction for clinical variables, the relationship between the ACE and AGT genotypes within the scope of the analyzed polymorphisms and the process of restenosis was not found using a dominant, recessive and log-additive model. Late lumen loss was also independent of the genotypes of the polymorphisms before and after correction with angiographic variables. CONCLUSIONS The rs1799752 polymorphism and the rs699 polymorphism had no relationship with the occurrence of angiographically significant ISR and late lumen loss in a group of Polish patients who underwent metal stent implantation.
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Affiliation(s)
- Tadeusz Osadnik
- 2nd Department of Cardiology and Angiology, Silesian Center for Heart Diseases, Zabrze, Poland; Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland.
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Martyna Fronczek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland; Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Kamil Bujak
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Rafał Reguła
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Małgorzata Gonera
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gawlita
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Anna Kurek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Jarosław Wasilewski
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Lekston
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marek Gierlotka
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Michał Hawranek
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Zofia Ostrowska
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Wiczkowski
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Lech Poloński
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
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Ciślak A, Skrzypek M, Gierlotka M, Cieśla D, Buchta P, Wasilewski J, Zdrojewski T, Pawlas N, Kasperczyk S, Gąsior M. 136-82: Air quality risk factors of hospitalization of patients with atrial fibrillation living in the highly urbanized region of Poland. Europace 2016. [DOI: 10.1093/europace/18.suppl_1.i111] [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: 11/12/2022] Open
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14
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Wasilewski J, Pyka Ł, Hawranek M, Osadnik T, Kurek A, Skrzypek M, Niedziela J, Desperak P, Kułaczkowska Z, Brzezina M, Krawczyk M, Gąsior M. Prognostic value of neutrophil‑to‑lymphocyte ratio in predicting long-term mortality in patients with ischemic and nonischemic heart failure. ACTA ACUST UNITED AC 2016; 126:166-73. [PMID: 26991886 DOI: 10.20452/pamw.3316] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Previous studies have shown that an elevated neutrophil-to-lymphocyte ratio (NLR) was associated with a poorer long-term prognosis in patients with heart failure (HF). OBJECTIVES We aimed to study the predictive value of the NLR in patients with left ventricular ejection fraction of 35% or lower. The second objective was to establish whether the NLR has the same prognostic value in patients with ischemic and nonischemic HF. PATIENTS AND METHODS The study group consisted of a cohort of patients with HF (1387 men, 347 women; median age, 61 years) from the prospective COMMIT-HF registry. The primary endpoint was all-cause mortality. Patients were divided into tertiles based on the NLR values on admission. The first (low), second (medium), and third (high) tertiles were defined as NLR ≤2.04 (n = 578), NLR 2.05-3.1 (n = 578) and NLR >3.1 (n = 578), respectively. RESULTS During long-term follow-up, 443 deaths were reported. The 12-month mortality in patients in the third NLR tertile was almost 3-fold higher compared with those in the first tertile (7.61% vs 20.07%; P <0.001). In a multivariate analysis, the NLR was an independent factor of mortality (hazard ratio [HR], 2.31; 95% confidence interval [CI], 1.82-2.92; P <0.0001). In addition, the multivariate analysis revealed that the third NLR tertile in the ischemic HF group was an independent factor related to longterm mortality (HR, 1.51; 95% CI, 1.11-2.04; P = 0.008). In the nonischemic HF group, the influence of the NLR on long-term survival was not confirmed. CONCLUSIONS The association between the NLR and the risk of death in long-term follow-up was confirmed only in the subgroup of patients with ischemic HF.
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Wasilewski J, Desperak P, Hawranek M, Ciślak A, Osadnik T, Pyka Ł, Gawlita M, Bujak K, Niedziela J, Krawczyk M, Gąsior M. Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study. Platelets 2016; 27:452-8. [PMID: 26939525 DOI: 10.3109/09537104.2016.1143919] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) is a simple and reliable indicator of platelet size that correlates with platelet activation and their ability to aggregate. We studied the predictive value of MPV in patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI). METHODS We analyzed the consecutive records of 1001 patients who were hospitalized due to NSTEMI at our center. The primary end point was a composite end point that included the rates of all-cause death, non-fatal myocardial infarction, and acute coronary syndrome (ACS) driven revascularization at 12 months. The enrolled patients were stratified according to the quartile of the MPV level at admission. RESULTS Along with the increasing quartile of MPV, the 12-month composite end point increased significantly (p = 0.010), and this association remained significant after the risk-adjusted analyses (per 1 fL higher MPV; adjusted hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.02-1.27; p = 0.026). In the multivariate analysis, the MPV was also an independent factor of all-cause mortality (per 1 fL increase; adjusted HR 1.34; 95% CI 1.12-1.61; p = 0.0014) and death or non-fatal myocardial infarction (per 1 fL increase; adjusted HR 1.16; 95% CI 1.03-1.31; p = 0.017). CONCLUSION In patients with NSTEMI treated with PCI, a high MPV value was associated with a significantly increased incidence of long-term adverse events, particularly for all-cause mortality.
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Affiliation(s)
- Jarosław Wasilewski
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Piotr Desperak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Hawranek
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Aneta Ciślak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Tadeusz Osadnik
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.,c Genomics Laboratory, Kardio-Med Silesia Science and Technology Park , Zabrze , Poland
| | - Łukasz Pyka
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Marcin Gawlita
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Kamil Bujak
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Jacek Niedziela
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Krawczyk
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Mariusz Gąsior
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
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16
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Osadnik T, Strzelczyk JK, Reguła R, Bujak K, Fronczek M, Gonera M, Gawlita M, Wasilewski J, Lekston A, Kurek A, Gierlotka M, Trzeciak P, Hawranek M, Ostrowska Z, Wiczkowski A, Poloński L, Gąsior M. The Relationships between Polymorphisms in Genes Encoding the Growth Factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A and the Restenosis Process in Patients with Stable Coronary Artery Disease Treated with Bare Metal Stent. PLoS One 2016; 11:e0150500. [PMID: 26930482 PMCID: PMC4773170 DOI: 10.1371/journal.pone.0150500] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 02/15/2016] [Indexed: 12/22/2022] Open
Abstract
Background Neointima forming after stent implantation consists of vascular smooth muscle cells (VSMCs) in 90%. Growth factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A play an important role in VSMC proliferation and migration to the tunica intima after arterial wall injury. The aim of this paper was an analysis of functional polymorphisms in genes encoding TGF-β1, PDGFB, EGF, bFGF and VEGF-A in relation to in-stent restenosis (ISR). Materials and Methods 265 patients with a stable coronary artery disease (SCAD) hospitalized in our center in the years 2007–2011 were included in the study. All patients underwent stent implantation at admission to the hospital and had another coronary angiography performed due to recurrence of the ailments or a positive result of the test assessing the coronary flow reserve. Angiographically significant ISR was defined as stenosis >50% in the stented coronary artery segment. The patients were divided into two groups–with angiographically significant ISR (n = 53) and without significant ISR (n = 212). Additionally, the assessment of late lumen loss (LLL) in vessel was performed. EGF rs4444903 polymorphism was genotyped using the PCR-RFLP method whilst rs1800470 (TGFB1), rs2285094 (PDGFB) rs308395 (bFGF) and rs699947 (VEGF-A) were determined using the TaqMan method. Results Angiographically significant ISR was significantly less frequently observed in the group of patients with the A/A genotype of rs1800470 polymorphism (TGFB1) versus patients with A/G and G/G genotypes. In the multivariable analysis, LLL was significantly lower in patients with the A/A genotype of rs1800470 (TGFB1) versus those with the A/G and G/G genotypes and higher in patients with the A/A genotype of the VEGF-A polymorphism versus the A/C and C/C genotypes. The C/C genotype of rs2285094 (PDGFB) was associated with greater LLL compared to C/T heterozygotes and T/T homozygotes. Conclusions The polymorphisms rs1800470, rs2285094 and rs6999447 of the TGFB1, PDGFB and VEGF-A genes, respectively, are associated with LLL in patients with SCAD treated by PCI with a metal stent implantation.
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Affiliation(s)
- Tadeusz Osadnik
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
- * E-mail:
| | - Joanna Katarzyna Strzelczyk
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Rafał Reguła
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Kamil Bujak
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Martyna Fronczek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
- Genomics Laboratory, Kardio-Med Silesia Science and Technology Park, Zabrze, Poland
| | - Małgorzata Gonera
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marcin Gawlita
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Jarosław Wasilewski
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Lekston
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Anna Kurek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Marek Gierlotka
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Przemysław Trzeciak
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Michał Hawranek
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Zofia Ostrowska
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Andrzej Wiczkowski
- Department of Medical and Molecular Biology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Lech Poloński
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Mariusz Gąsior
- Third Department of Cardiology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
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Kurdziel M, Gierlaszyńska K, Kazik A, Kurek A, Pytel G, Wacławski J, Wasilewski J, Fiszer R, Gadula-Gacek E, Białkowski J, Gąsior M. Should People with Patent Foramen Ovale Go to High Altitude? A Case Report of an Alpinist with a Patent Foramen Ovale Exposed to Extreme Altitude. High Alt Med Biol 2016; 17:54-5. [PMID: 26901450 DOI: 10.1089/ham.2015.0060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marta Kurdziel
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Karolina Gierlaszyńska
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Anna Kazik
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Anna Kurek
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Gracjan Pytel
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Jacek Wacławski
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Jarosław Wasilewski
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Roland Fiszer
- 2 Department of Congenital Heart Diseases and Pediatric Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Elżbieta Gadula-Gacek
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland
| | - Jacek Białkowski
- 2 Department of Congenital Heart Diseases and Pediatric Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland .,3 School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
| | - Mariusz Gąsior
- 1 3rd Chair and Department of Cardiology, Silesian Center for Heart Diseases , Zabrze, Poland .,3 School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia , Katowice, Poland
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Wasilewski J, Poloński L, Lekston A, Osadnik T, Reguła R, Bujak K, Kurek A. Who is eligible for randomized trials? A comparison between the exclusion criteria defined by the ISCHEMIA trial and 3102 real-world patients with stable coronary artery disease undergoing stent implantation in a single cardiology center. Trials 2015; 16:411. [PMID: 26373291 PMCID: PMC4570660 DOI: 10.1186/s13063-015-0934-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 08/28/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Randomized controlled trials are the gold standard for evaluating therapy; however, controversy exists regarding the applicability of such results to daily practice, as patients are often pre-selected and may not reflect real-world clinical settings. We studied the eligibility criteria for 3102 "real-life" patients with stable coronary artery disease (SCAD) according to the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial exclusion criteria. The aim of our analysis was to estimate the percentage of real-life patients who would have met the exclusion criteria for the ISCHEMIA trial. METHODS We analyzed 3102 patients with SCAD referred to the Silesian Center for Heart Disease who underwent both coronary angiography and stent implantation between January 2006 and December 2011. The patients were divided into two groups. Group A was composed of patients with SCAD who would have been excluded from the ongoing ISCHEMIA trial, whereas group B represented the remaining patients. RESULTS A total of 1900 (61.3%) patients met at least one of the exclusion criteria. The most frequent exclusion criterion noted was revascularization within the previous 12 months (938 patients; 49.4%), followed by unacceptable level of angina symptoms (532 patients; 28 %), low ejection fraction (467 patients; 24.6%), and acute coronary syndrome within the previous 2 months (456 patients; 24%). Patients from our cohort who would have been excluded from the ISCHEMIA trial were older, had more comorbidities, and experienced worse long-term outcomes. CONCLUSIONS The ISCHEMIA trial exclusion criteria ruled out the majority of the patients with SCAD undergoing percutaneous coronary intervention in "real life". Our cohort of patients who would have been excluded from the ISCHEMIA trial had more comorbidities and experienced significantly worse long-term outcomes than patients who did not meet the ISCHEMIA trial exclusion criteria. TRIAL REGISTRATION ClinicalTrials.gov NCT01471522.
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Affiliation(s)
- Jarosław Wasilewski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Lech Poloński
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Andrzej Lekston
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Tadeusz Osadnik
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Rafał Reguła
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Kamil Bujak
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
| | - Anna Kurek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Marii Skłodowskiej-Curie Street 9, 41-800, Zabrze, Poland.
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Osadnik T, Strzelczyk J, Bujak K, Reguła R, Wasilewski J, Fronczek M, Kurek A, Gawlita M, Gonera M, Gierlotka M, Lekston A, Hawranek M, Myrda K, Wiczkowski A, Ostrowska Z, Gąsior M, Poloński L. Functional polymorphism rs710218 in the gene coding GLUT1 protein is associated with in-stent restenosis. Biomark Med 2015; 9:743-50. [DOI: 10.2217/bmm.15.36] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: To analyze the association between in-stent restenosis (ISR) and polymorphisms in genes coding IGF-1, IGFBP3, ITGB3 and GLUT1, which play an important role in the smooth muscle cell proliferation and extracellular matrix synthesis – the main components of neointima. Materials & methods: We analyzed 265 patients who underwent bare metal stent implantation. Results: The differences in the occurrence of ISR between genotypes of the analyzed polymorphisms in the IGF-1, IGFBP3 and ITGB3 were not statistically significant. The T/T genotype of the rs710218 polymorphism in the GLUT1 (SLC2A1) gene was more common in the ISR group compared with non-ISR patients (81.1 vs 64.8%; p = 0.02). In a multivariable model the A/A and A/T genotype remained correlated with lower occurrence of ISR (odds ratio: 0.45; 95% CI: 0.21–0.97; p = 0.03). Conclusion: The rs710218 polymorphism in the gene coding GLUT1 protein is a novel risk factor for ISR.
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Affiliation(s)
- Tadeusz Osadnik
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Joanna Strzelczyk
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Kamil Bujak
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Rafał Reguła
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Jarosław Wasilewski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Martyna Fronczek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Anna Kurek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Marcin Gawlita
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Małgorzata Gonera
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Marek Gierlotka
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Andrzej Lekston
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Michał Hawranek
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Krzysztof Myrda
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Andrzej Wiczkowski
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Zofia Ostrowska
- Medical University of Silesia, School of Medicine with the Division of Dentistry, Department of Medical and Molecular Biology, Jordana Street 19, 41-808 Zabrze, Poland
| | - Mariusz Gąsior
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
| | - Lech Poloński
- Medical University of Silesia, School of Medicine with the Division of Dentistry, 3rd Department of Cardiology, Silesian Centre for Heart Diseases, Marii Skłodowskiej Curie Street 9, 41-800 Zabrze, Poland
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Wasilewski J, Roleder M, Niedziela J, Nowakowski A, Osadnik T, Głowacki J, Mirota K, Poloński L. The role of septal perforators and "myocardial bridging effect" in atherosclerotic plaque distribution in the coronary artery disease. Pol J Radiol 2015; 80:195-201. [PMID: 25922625 PMCID: PMC4404747 DOI: 10.12659/pjr.893227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 12/19/2014] [Indexed: 11/09/2022] Open
Abstract
The distribution of atherosclerotic plaque burden in the human coronary arteries is not uniform. Plaques are located mostly in the left anterior descending artery (LAD), then in the right coronary artery (RCA), circumflex branch (LCx) and the left main coronary artery (LM) in a decreasing order of frequency. In the LAD and LCx, plaques tend to cluster within the proximal segment, while in the RCA their distribution is more uniform. Several factors have been involved in this phenomenon, particularly flow patterns in the left and right coronary artery. Nevertheless, it does not explain the difference in lesion frequency between the LAD and the LCx as these are both parts of the left coronary artery. Branching points are considered to be the risk points of atherosclerosis. In the LCx, the number of side branches is lower than in the LAD or RCA and there are no septal perforators with intramuscular courses like in the proximal third of the LAD and the posterior descending artery (PDA). We hypothesized that septal branches generate disturbed flow in the LAD and PDA in a similar fashion to the myocardial bridge (myocardial bridging effect). This coronary architecture determines the non-uniform plaque distribution in coronary arteries and LAD predisposition to plaque formation.
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Affiliation(s)
- Jarosław Wasilewski
- 3 Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Marcin Roleder
- 3 Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Jacek Niedziela
- 3 Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Andrzej Nowakowski
- Department of Mechanical Engineering, University of Sheffield, Sheffield, U.K
| | - Tadeusz Osadnik
- 3 Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Jan Głowacki
- Department of Diagnostic Imaging, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
| | - Kryspin Mirota
- Department of Mechanical Engineering Fundamentals, Faculty of Mechanical Engineering and Computer Science, University of Bielsko-Biała, Bielsko-Biała, Poland
| | - Lech Poloński
- 3 Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland
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Niedziela J, Hudzik B, Niedziela N, Gąsior M, Gierlotka M, Wasilewski J, Myrda K, Lekston A, Poloński L, Rozentryt P. The obesity paradox in acute coronary syndrome: a meta-analysis. Eur J Epidemiol 2014; 29:801-12. [PMID: 25354991 PMCID: PMC4220102 DOI: 10.1007/s10654-014-9961-9] [Citation(s) in RCA: 161] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/15/2014] [Indexed: 12/17/2022]
Abstract
In the general population, the lowest mortality risk is considered to be for the body mass index (BMI) range of 20-24.9 kg/m(2). In chronic diseases (chronic kidney disease, chronic heart failure or chronic obstructive pulmonary disease) the best survival is observed in overweight or obese patients. Recently above-mentioned phenomenon, called obesity paradox, has been described in patients with coronary artery disease. Our aim was to analyze the relationship between BMI and total mortality in patients after acute coronary syndrome (ACS) in the context of obesity paradox. We searched scientific databases for studies describing relation in body mass index with mortality in patients with ACS. The study selection process was performed according to PRISMA statement. Crude mortality rates, odds ratio or risk ratio for all-cause mortality were extracted from articles and included into meta-analysis. 26 studies and 218,532 patients with ACS were included into meta-analysis. The highest risk of mortality was found in Low BMI patients--RR 1.47 (95 % CI 1.24-1.74). Overweight, obese and severely obese patients had lower mortality compared with those with normal BMI-RR 0.70 (95 % CI 0.64-0.76), RR 0.60, (95 % CI 0.53-0.68) and RR 0.70 (95 % CI 0.58-0.86), respectively. The obesity paradox in patients with ACS has been confirmed. Although it seems to be clear and quite obvious, outcomes should be interpreted with caution. It is remarkable that obese patients had more often diabetes mellitus and/or hypertension, but they were younger and had less bleeding complications, which could have influence on their survival.
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Affiliation(s)
- Jacek Niedziela
- Third Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, M. Curie-Skłodowskiej 9, 41-800, Zabrze, Poland,
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Osadnik T, Strzelczyk J, Hawranek M, Lekston A, Wasilewski J, Kurek A, Gutowski AR, Wilczek K, Dyrbuś K, Gierlotka M, Wiczkowski A, Gąsior M, Szafranek A, Poloński L. Red cell distribution width is associated with long-term prognosis in patients with stable coronary artery disease. BMC Cardiovasc Disord 2013; 13:113. [PMID: 24320974 PMCID: PMC4028953 DOI: 10.1186/1471-2261-13-113] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [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: 10/13/2013] [Accepted: 12/01/2013] [Indexed: 11/21/2022] Open
Abstract
Background Data regarding the association between red cell distribution width (RDW) values and mortality in patients with stable coronary artery disease are scarce. We aimed to investigate the link between mortality and RDW in patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI). Methods We analyzed 2550 consecutive patients with stable coronary artery disease who underwent PCI between 2007 and 2011 at our institution. The patients were divided into four groups according to RDW quartiles. The association between the RDW values and the outcomes was assessed using Cox proportional regression analysis after adjusting for clinical, echocardiographic, hemodynamic and laboratory data in the whole population and in subgroups stratified by gender, presence of diabetes, anemia or heart failure. Results In the entire population, there was a stepwise relationship between RDW intervals and comorbidities. Patients with the highest RDW values were older and more often burdened with diabetes, heart failure and chronic kidney disease. There was an almost 4-fold increase in mortality during an average of 2.5 years of follow-up between the group of patients with RDW values lower than 13.1% (25th percentile) and the group with RDW values higher than 14.1% (75th percentile), (4.3% vs. 17.1%, p < 0.0001). After adjusting for the covariates, RDW remained significantly associated with mortality in the whole cohort (HR-1.23 [95% CI (1.13-1.35), p < 0.0001]) and in the subgroups stratified by gender, age (over and under 75 years), presence of anemia, diabetes, heart failure and chronic kidney disease. Conclusion Higher RDW values correspond to higher comorbidity burdens and higher mortality. RDW is an independent predictor of mortality in patients with stable coronary artery disease.
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Affiliation(s)
- Tadeusz Osadnik
- IIIrd Chair and Department of Cardiology, Silesian Centre for Heart Diseases, Medical University of Silesia in Katowice, Medical Faculty in Zabrze, Ul, Marii Skłodowskiej Curie 9, 41-800, Zabrze, Poland.
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Osadnik T, Rozentryt P, Regula R, Strzelczyk J, Wasilewski J, Tajstra M, Hawranek M, Dyrbus K, Lekston A, Gasior M. Change in creatinine level from any cause is associated with long term prognosis in patients with stable angina pectoris undergoing elective percutaneous coronary intervention. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wasilewski J, Głowacki J, Poloński L. Not at random location of atherosclerotic lesions in thoracic aorta and their prognostic significance in relation to the risk of cardiovascular events. Pol J Radiol 2013; 78:38-42. [PMID: 23807883 PMCID: PMC3693835 DOI: 10.12659/pjr.883944] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 12/03/2012] [Accepted: 02/14/2013] [Indexed: 11/18/2022] Open
Abstract
Thoracic aortic calcium deposits are frequently detected on tomography of the chest, and in other imaging modalities. Numerous studies indicated the correlation of hemodynamic parameters such as wall shear stress in relation to distribution aortic calcifications. This publication discusses similarities and differences of two distinct pathomechanisms of arterial calcifications: intimal associated with atherosclerosis and medial knows as Mönckeberg’s arteriosclerosis. This review also analyzes the frequent coexistence of aortic calcification and coronary artery disease in terms of risk of cardiovascular events.
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Affiliation(s)
- Jarosław Wasilewski
- III Department of Cardiology, Medical University of Silesia, Katowice, Silesian Center for Heart Diseases, Zabrze, Poland
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Nowicki J, Wasilewski J. Synthesis and Surfactant Properties of Triethanolammonium Salts of N-Acylated N-Carboxyethylglycine. TENSIDE SURFACT DET 2013. [DOI: 10.3139/113.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Monotriethanolammonium salts of N-acylated N-carboxyethylglycine were obtained. Acid chlorides were used in the acylation reaction. The products contained about 25% of fatty acid under acylation conditions, which resulted from the adopted synthesis conditions. Triethanolammonium salts of N-acyl-N-carboxyethylglycine offered good surface active properties — these were confirmed in tests of standard detergent formulations, which were compared to those of corresponding commercial products.
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Nowicki J, Wasilewski J, Poskrobko J. Synthesis and Surfactant Properties of New Ester-capped Poly(oxyalkylated) Alcohols. TENSIDE SURFACT DET 2013. [DOI: 10.3139/113.100267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
A new group of nonionic ester surfactants was synthesized. New esters were obtained in high yields from commercially available poly(oxyalkylated) alcohols and fatty acid chlorides under mild reaction conditions. Their structures were confirmed by GPC and HPLC chromatography. The surface properties such as critical micelle concentration (c.m.c.), surface excess concentration, Gc.m.c., and surface area per molecule, Ac.m.c., were determined. The emulsification properties of the new esters were investigated.
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Komasa J, Słupski R, Jankowski K, Wasilewski J, Teale AM. High accuracy ab initio studies of electron-densities for the ground state of Be-like atomic systems. J Chem Phys 2013; 138:164306. [PMID: 23635137 DOI: 10.1063/1.4800766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Benchmark results for electron densities in the ground states of Li(-), Be, C(2+), Ne(6+), and Ar(14+) have been generated from very accurate variational wave functions represented in terms of extensive basis sets of exponentially correlated Gaussian functions. For Ne(6+), and Ar(14+), the upper bounds to the energies improve over previous results known from the literature. For the remaining systems our bounds are from 0.1 to 1.1 μhartree higher than the most accurate ones. We present in graphical and, partially, numerical form results both for the radial electron densities and for the difference radial density distributions (DRD) (defined with respect to the Hartree-Fock radial density) that highlight the impact of correlation effects on electron densities. Next, we have employed these DRD distributions in studies of the performance of several broadly used orbital-based quantum-chemical methods in accounting for correlation effects on the density. Our computed benchmark densities for Be have been also applied for testing the possibility of using the mathematically strict result concerning exact atomic electron densities, obtained by Ahlrichs et al. [Phys. Rev. A 23, 2106 (1981)], for the determination of the reliability range of computed densities in the long-range asymptotic region. The results obtained for Be are encouraging.
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Affiliation(s)
- J Komasa
- Faculty of Chemistry, A. Mickiewicz University, Poznań, Poland
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Wasilewski J, Mirota K, Wilczek K, Głowacki J, Poloński L. Calcific aortic valve damage as a risk factor for cardiovascular events. Pol J Radiol 2012; 77:30-4. [PMID: 23269934 PMCID: PMC3529709 DOI: 10.12659/pjr.883626] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 10/22/2012] [Indexed: 11/25/2022] Open
Abstract
Aortic valve calcification (AVC) is a common disease of the elderly. It is a progressive disease ranging from mild valve thickening to severe calcification with aortic valve stenosis. Risk factors for AVC are similar to those for atherosclerosis: age, gender, hypercholesterolemia, diabetes, hypertension, smoking and renal failure. AVC shares many similarities to atherosclerosis, including inflammatory cells and calcium deposits, and correlates with coronary plaque burden. Presence of AVC is associated with increased risk of adverse cardiovascular events. The objective for this review is to discuss the clinical features, natural history and prognostic significance of aortic valve calcifications, including mechanical and hemodynamic factors of flow distribution.
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Affiliation(s)
- Jarosław Wasilewski
- 3 Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland
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Gierlotka M, Gąsior M, Wilczek K, Wasilewski J, Hawranek M, Tajstra M, Osadnik T, Banasiak W, Poloński L. Temporal trends in the treatment and outcomes of patients With non-ST-segment elevation myocardial infarction in Poland from 2004-2010 (from the Polish Registry of Acute Coronary Syndromes). Am J Cardiol 2012; 109:779-86. [PMID: 22189010 DOI: 10.1016/j.amjcard.2011.10.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 10/28/2011] [Accepted: 10/28/2011] [Indexed: 11/16/2022]
Abstract
The aim of this work was to analyze temporal trends in clinical presentation, treatment methods, and outcomes of patients in Poland with non-ST-segment elevation myocardial infarction (NSTEMI) from 2004 to 2010. A total of 90,153 patients with NSTEMI enrolled in the Polish Registry of Acute Coronary Syndromes (PL-ACS) from 2004 to 2010 were analyzed. The main outcome measure was all-cause mortality after 12 months, identified from official mortality records. The percentage of admissions for NSTEMI among all acute coronary syndromes increased from 24% in 2004 to 38% in 2010 (p < 0.0001). From 2004 to 2010, the percentage of invasive treatment for NSTEMI increased significantly, almost threefold, to 83% (p < 0.0001). The frequency of recurrent myocardial infarction and stroke during hospitalization decreased significantly over the years, while the frequency of major bleeding increased. Twelve-month mortality decreased significantly throughout the time period, from 19.1% to 14.5%, but was stable in patients treated invasively and slightly higher in the last years in patients treated noninvasively. The invasive treatment of NSTEMI (relative risk 0.62, 95% confidence interval 0.57 to 0.67, p < 0.0001), together with the pharmacotherapy recommended by the guidelines, had a significant impact on reducing 12-month mortality in a multifactor analysis. In conclusion, the distinct improvement in the short- and long-term prognoses of patients with NSTEMI may be in part the result of the popularization of invasive treatment and the optimization of pharmacotherapy.
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Affiliation(s)
- Marek Gierlotka
- Silesian Center for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
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Wasilewski J, Poloński L. [Shear-activated nanotherapeutics. Are we witnessing a breakthrough in the treatment of thrombosis and atherosclerosis?]. Kardiol Pol 2012; 70:876. [PMID: 22933231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Wasilewski J, Kiljański T, Miszalski-Jamka K. [Role of shear stress and endothelial mechanotransduction in atherogenesis]. Kardiol Pol 2011; 69:717-720. [PMID: 21769796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Jankowski K, Nowakowski K, Grabowski I, Wasilewski J. Coverage of dynamic correlation effects by density functional theory functionals: Density-based analysis for neon. J Chem Phys 2009; 130:164102. [DOI: 10.1063/1.3116157] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Łojewska J, Wasilewski J, Terelak K, Łojewski T, Kołodziej A. Selective oxidation of methylal as a new catalytic route to concentrated formaldehyde: Reaction kinetic profile in gradientless flow reactor. CATAL COMMUN 2008. [DOI: 10.1016/j.catcom.2008.02.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Kłosiewicz-Wasek B, Ceremuzyński L, Poloński L, Lukaszewicz R, Wasilewski J. Association between carotid artery atherosclerosis and coronary artery disease in young females. Reference to sex hormone profile. Kardiol Pol 2008; 66:127-134. [PMID: 18344150] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Atherosclerosis of coronary and peripheral arteries occurs rarely in premenopausal women. It has been postulated that sex hormones protect the vascular wall. AIM To evaluate whether ultrasound assessment of the changes in the wall of carotid arteries provides any useful information on the severity of atherosclerosis of the coronary vessels as well as whether the atherosclerotic changes in the wall of carotid arteries are accompanied by oestrogen insufficiency in the premenopausal age. METHODS The studied group consisted of 65 regularly menstruating women: 21 with coronary artery disease (CAD) revealed by angiography or after myocardial infarction (mean age 44 years)--the CAD group; and 44 healthy woman (mean age 43 years)--the control group. The severity of atherosclerotic changes was determined based on computer-assisted measurement of the intima-media complex thickness (IMC-T) in the common carotid artery. In all women prospective measurement of sex hormone profile was done with enzymatic immunoassay: oestradiol at day 7-9 and day 19-21 of the menstrual cycle and follicle-stimulating hormone (FSH). RESULTS The IMC-T value was greater in the CAD group than the control group (0.696+/-0.124 mm and 0.518+/-0.064 mm respectively, p=0.001). The IMC-T (>0.6 mm) was a good indicator of the occurrence of CAD (OR 15.6, 95% CI 3.65-71.1, p <0.0001), with a sensitivity of 73.7% and a specificity of 84.8%. There was a negative correlation between oestradiol level at day 19-21 of the menstrual cycle and IMC-T (r=-0.28, p=0.05). CONCLUSIONS The IMC-T value >0.6 mm was found to be a sensitive and specific ultrasound parameter that can be useful in detecting the presence of CAD in premenopausal women. The results of the study also suggest a possible association between hormonal profile and early atherosclerotic changes in carotid arteries in premenopausal women.
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Wasilewski J, Turczyński B, Słowińska L, Kowalik V, Osadnik T, Poloński L. Haemorheological factors and myocardial reperfusion in patients with ST-elevation myocardial infarction undergoing primary coronary intervention. Kardiol Pol 2007; 65:778-85; discussion 786-7. [PMID: 17694459] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
INTRODUCTION The no-reperfusion phenomenon occurs in a considerable number of patients despite restoration of the infarct-related artery (IRA) patency. Factors responsible for this phenomenon include myocardial structural changes, whereas haemorheological parameters that significantly contribute to microvascular resistance, have not been studied so far. AIM To determine the possible relationship between blood and plasma viscosity, red blood cell aggregation and their deformability, and myocardial reperfusion following effective mechanical intervention of IRA. METHODS The analysis included 23 patients with myocardial infarction treated with primary coronary angioplasty with resultant TIMI (Thrombolysis in Myocardial Infarction) grade 3 flow. Myocardial reperfusion was found effective if myocardial perfusion grade (MPG) was 3. Blood and plasma viscosity were assessed using a Brookfield rotation viscometer. Red blood cell aggregation and deformability were measured with a Laser Optical Rotational Cell Analyzer (LORCA). Patients were divided into two groups with respect to obtained MPG: reperfusion group (14 subjects) and no-reperfusion group (9 patients). RESULTS Corrected whole blood viscosity and plasma viscosity were significantly higher in the no-reperfusion group and exceeded the values obtained in the reperfused patients by 14% (p <0.05) and 10.5% (p <0.01), respectively. Red blood cell deformability index at shear stress ranging from 1.75 Pa to 60.03 Pa was significantly lower in the no-reperfusion group. Red blood cell aggregation index was significantly higher (by 14.3%, p <0.05), whereas aggregation halftime was significantly shorter (by 58%, p <0.05) in the no-reperfusion group. CONCLUSIONS Our results indicate that haemorheological disturbances may be an important factor contributing to no-reperfusion after effective mechanical opening of IRA.
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Affiliation(s)
- Jarosław Wasilewski
- III Katedra i Oddział Kliniczny Kardiologii, Slaskie Centrum Chorób Serca, ul Szpitalna 2, 41-800 Zabrze.
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Wasilewski J, Osadnik T, Poloński L. High baseline fibrinogen concentration as a risk factor of no tissue reperfusion in ST-segment elevation acute myocardial infarction treated with successful primary percutaneous coronary intervention. Kardiol Pol 2006; 64:967-72; discussion 973-4. [PMID: 17054028] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND In a large group of patients with myocardial infarction, lack of tissue reperfusion following successful recanalisation of the infarct-related epicardial artery is seen. Blood flow in the microcirculation depends not only on structural changes in the microvasculature but also on rheological features of the blood itself. AIM To investigate the association between baseline fibrinogen concentration and myocardial reperfusion following successful coronary angioplasty. METHODOLOGY In 105 patients with acute ST-segment elevation myocardial infarction, baseline fibrinogen concentration was compared between patients with successful tissue reperfusion (n=79) and with no myocardial reperfusion (n=26) measured as the degree of ST-segment normalisation after successful recanalisation of the infarct-related artery. RESULTS Baseline fibrinogen concentration was significantly higher in the no-reperfusion group than in the reperfusion group (523+/-198.02 mg/dl vs 395.56+/-144.98 mg/dl, p=0.0004). In the overall study population, fibrinogen level correlated positively with maximum creatine kinase MB fraction concentration (r=0.25, p=0.012) and duration of chest pain (r=0.31, p=0.002). Mean fibrinogen concentration was higher in patients with anterior myocardial infarction than in patients with the infarct-related artery other than the left anterior descending artery. The risk of no-reflow phenomenon assessed in multivariate analysis was higher if duration of chest pain was longer (OR=1.46, CI 95% 1.06-2.16, p=0.001) and baseline fibrinogen concentration higher (OR=1.51, CI 95% 1.011-4.58, p=0.021). CONCLUSIONS Baseline fibrinogen concentration following successful mechanical recanalisation of the infarct-related coronary artery is an independent risk factor of a lack of myocardial reperfusion and it positively correlates with maximum creatine kinase MB fraction concentration and duration of chest pain. High fibrinogen concentration may affect rheological parameters of the blood and play an important role in the pathomechanism of myocardial no-reperfusion phenomenon following successful mechanical recanalisation of the infarct-related coronary artery.
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Affiliation(s)
- Jarosław Wasilewski
- III Katedra i Oddział Kliniczny Kardiologii SlAM, ul. Szpitalna 2, 41-800 Zabrze, Poland.
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Grygierczyk G, Wasilewski J, Łomankiewicz D, Klimczok W, Kowalska T. Use of Complexation TLC to Investigate Monosulfides. II. Silica Impregnated with the Cd(II), Sr(II), Eu(III), and V(IV) Cations as Stationary Phase. J LIQ CHROMATOGR R T 2006. [DOI: 10.1081/jlc-120024535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- G. Grygierczyk
- a Institute of Chemistry , Silesian University , 9 Szkolna Str., 40‐006 , Katowice , Poland
| | - J. Wasilewski
- b Department of Biochemistry , University of Warmia and Mazury , Olsztyn , Poland
| | - D. Łomankiewicz
- a Institute of Chemistry , Silesian University , 9 Szkolna Str., 40‐006 , Katowice , Poland
| | - W. Klimczok
- a Institute of Chemistry , Silesian University , 9 Szkolna Str., 40‐006 , Katowice , Poland
| | - T. Kowalska
- a Institute of Chemistry , Silesian University , 9 Szkolna Str., 40‐006 , Katowice , Poland
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Wasilewski J, Osadnik T, Dzióbek B, Ziebik T, Poloński L. [Pulmonary arterial hypertension complicating portal hypertension and liver biliary cirrhosis--a case report]. Kardiol Pol 2006; 64:193-7. [PMID: 16502374] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Pulmonary arterial hypertension is a serious and severe complication of liver cirrhosis and portal hypertension. We present a case of a 47 year old female who developed pulmonary hypertension and right ventricular heart failure symptoms 6 years from the diagnosis of liver biliary cirrhosis and portal hypertension.
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Affiliation(s)
- Jarosław Wasilewski
- Oddział Kliniczny Kardiologii, Slaska Akademia Medyczna, Slaskie Centrum Chorób Serca, ul. Szpitalna 2, 41-800 Zabrze.
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Szyguła-Jurkiewicz B, Wasilewski J, Wilczek K, Osadnik T, Trzeciak P, Lekston A, Wojnicz R, Poloński L. [Twelve-month outcome of 658 patients with acute coronary syndrome without ST-segment elevation assigned to early invasive strategy]. Wiad Lek 2006; 59:497-501. [PMID: 17209347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
UNLABELLED We aimed at assessing the frequency of death, myocardial infarction, unstable angina, repeat revascularization, cardiovascular hospitalisation during 12 months in patients assigned to early invasive strategy. MATERIAL AND METHOD We analysed 658 consecutive patients with acute coronary syndrome (ACS) without ST-segment elevation hospitalized between January 2000 and February 2003. Patients had to fulfill the following criteria: 1) rest angina within 24 hours prior to admission, 2) at least one of the following: ST-segment depression (> or = 0,05 mV), transient (< 20 min) ST-segment elevation (> or = 0,05 mV), T-wave inversion (> or = 1 mV) in at least 2 contiguous leads, positive serum cardiac markers. RESULTS All patients underwent coronary angiography followed by PCI (percutaneous coronary interventions) in 71.8% of patients. 18.2% were assigned to CABG (coronary artery bypass graft) and 8.7% of patients were treated conservatively. 1.3% of patients underwent PCI followed by an elective CABG surgery. In-hospital mortality rate was.,3%. 3.3% patients died after hospital discharge. The frequency of myocardial infarction, unstable angina and repeat PCI at 12 months was 2.1%, 16.8% and 11.5% respectively. The rate of cardiovascular hospitalisation was 15.6%. Multivariate analysis identified two independent predictors ofdeath: diabetes mellitus (OR: 7.02, 95% CI: 1.5-13.8, p = 0.03) and heart failure (OR: 12.6, 95% CI: 2.86-16.6 p = 0.005). CONCLUSIONS Early invasive strategy in analysed group yields good long-term outcomes with low rate of adverse ischemic events. Independent predictors of deaths were diabetes mellitus and heart failure.
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Affiliation(s)
- Bozena Szyguła-Jurkiewicz
- Z III Katedry i Oddzialu Klinicznego Kardiologii Slaskiej Akademii Medycznej, Katowicach Slaskie Centrum Chorób Serca, Zabrzu.
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Wilczek K, Poloński L, Gasior M, Gierlotka M, Adamowicz-Czoch E, Wasilewski J, Kalarus Z, Klosa Z. [Female-male. Can they be treated the the same way? Primary analysis of data from the National Registry of Acute Coronary Syndrome PL-ACS]. Kardiol Pol 2005; 62 Suppl 1:I60-I66. [PMID: 19810344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Krzysztof Wilczek
- III Katedra i Oddział Kliniczny Kardiologii, Slaska Akademia Medyczna, Slaskie Centrum Chorób Serca, Zabrze
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Wasilewski J, Poloński L, Zembala M. [What should we know analyzing outcomes of registry of acute coronary events?]. Kardiol Pol 2005; 62 Suppl 1:I8-I12. [PMID: 19810335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Jarosław Wasilewski
- III Katedra i Oddział Kliniczny Kardiologii, Slaska Akademia Medyczna, Slaskie Centrum Chorób Serca, Zabrze
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Gasior M, Trzeciak P, Wilczek K, Kondys M, Wasilewski J, Lekston A, Szkodziński J, Wojnar R, Gierlotka M, Wnek A, Zebik T, Szyguła-Jurkiewicz B, Poloński L. [Comparison of coronary angioplasty results in two groups of patients with myocardial infarction: aged 40 years or younger, and older than 40 years--an in-hospital observation]. Wiad Lek 2003; 56:103-8. [PMID: 12923953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
The aim of the study was a comparison of coronary angioplasty as the method of myocardial infarction treatment in the two groups of patients: 1st--aged 40 years and younger, and 2nd--older than 40 years of age. The 1st group consisted of 50 patients in the mean age of 36.5 +/- 3.5 years, the 2nd group included 617 patients in the mean age of 58.3 +/- 10.1 years. There was no difference between the two groups in pain duration, infarct localization, thrombolysis, and cardiogenic shock. The younger compared with the older patients were significantly more often of male gender: 45 (90.0%) vs 456 (73.9%), (p = 0.01). The young patients were more often smokers: 41 (82.0%) vs 393 (64.0%), (p = 0.01). There was no significant difference in an incidence of other coronary risk factors. Coronary angiogram showed that there was no significant difference between the both groups in the infarct-related artery localization, TIMI flow before PTCA and number of stenosed arteries. The frequency successful PTCA (TIMI 3 flow, residual stenosis below 30%) was similar in both groups: 45 (90.0%) vs 549 (89.1%), (p = 0.3). There was no significant difference between two groups in the efficacy of treatment, incidence of reocclusion, complications, and mortality during hospitalization.
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Affiliation(s)
- Mariusz Gasior
- III Katedry i Oddziału Klinicznego Kardiologii Slaskiej Akademii Medycznej, Slaskie Centrum Chorób Serca w Zabrzu.
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Gasior M, Wasilewski J, Gierlotka M, Zebik T, Szkodziński J, Kondys M, Lekston A, Wilczek K, Wojnar R, Wnek A, Wojnicz R, Szyguła B, Adamowicz E, Zembala M, Poloński L. [Cardiogenic shock in the course of myocardial infarction--the results of treatment during hospitalization and in long-term follow-up]. Wiad Lek 2003; 56:4-9. [PMID: 12901260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
UNLABELLED Cardiogenic shock develops in 5-15% of patients hospitalised with acute myocardial infarction. It is responsible for more than a half of all hospital deaths with survival rate of about 20%. Conventional medical therapy with use of adrenergic, vasoactive, inotropic and thrombolytic agents has failed to improve survival. Treatment strategy combine hemodynamic stabilisation with restoration of coronary blood flow. The aim of the study was evaluation of mechanical restoration of coronary blood flow in infarction related artery and to assess its influence on mortality in patients with myocardial infarction complicated by cardiogenic shock. We retrospectively analysed 58 subjects: 26 patients treated by primary angioplasty, 25 patients with PTCA angioplasty after streptokinase treatment and 7 ones treated conservatively. TIMI 3 flow in angioplasty treated patients was achieved in 70.6% with in hospital mortality rate 14%, however, when reperfusion was unsuccessful the mortality was high (80%). 12 months follow-up mortality rate was 41.8%. CONCLUSION Successful reperfusion with coronary angioplasty of the infarct-related artery can significantly reduce mortality rate in patients with cardiogenic shock. Patients who survived in-hospital period have favourable one-year prognosis.
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Affiliation(s)
- Mariusz Gasior
- III Katedry i Klinicznego Oddziału Kardiologii, Slaskiego Centrum Chorób Serca, Zabrzu.
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Gasior M, Wasilewski J, Gierlotka M, Zebik T, Lekston A, Wojnar R, Kondys M, Szkodziński J, Wilczek K, Wnek A, Piegza J, Dyrbuś K, Hawranek M, Szyguła-Jurkiewicz B, Honisz G, Kalarus Z, Poloński L. Myocardial infarction in patients with diabetes. Results of primary coronary angioplasty. Kardiol Pol 2003; 58:438-48; discussion 448. [PMID: 14556010] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Although the introduction of primary percutaneous coronary interventions (PCI) improved the outcome of patients with acute myocardial infarction (MI), diabetes remains a significant factor which worsens prognosis. AIM To compare the immediate and in-hospital results of PCI in patients with acute MI with or without diabetes. METHODS The outcome of 139 patients with diabetes and 528 patients without diabetes was compared. Thrombolytic therapy was administered prior to PCI to 43.2% of patients with diabetes and 42.4% of patients without diabetes. RESULTS Patients with diabetes were older, more frequently of female gender and had higher incidence of hypertension as well as multi-vessel coronary artery disease. PCI was effective in 85.6% of diabetics and 90.2% of non-diabetic patients (NS). The reocclusion rate was significantly higher in diabetics than in non-diabetics (11.5% vs 5.5%, p=0.012) whereas the incidence of haemorrhagic complications was similar. Mortality rates were comparable in both groups (7.2% in diabetics vs 5.9% in non-diabetics, NS). CONCLUSIONS 1) Immediate efficacy of primary PCI for acute MI is similar in diabetics and non-diabetics, however, the in-hospital reocclusion rate is higher in the former group of patients. 2) In-hospital mortality is not affected by the presence of diabetes. 3) Thrombolytic and invasive treatment of diabetic patients with acute MI is not associated with an increased risk of bleeding.
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Affiliation(s)
- Mariusz Gasior
- III Chair and Department of Cardiology, Silesian Medical Academy, Silesian Center for Heart Diseases, Zabrze, Poland
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Poloński L, Gasior M, Wasilewski J, Wilczek K, Wnek A, Adamowicz-Czoch E, Sikora J, Lekston A, Zebik T, Gierlotka M, Wojnar R, Szkodziński J, Kondys M, Szyguła-Jurkiewicz B, Wołk R, Zembala M. Outcomes of primary coronary angioplasty and angioplasty after initial thrombolysis in the treatment of 374 consecutive patients with acute myocardial infarction. Am Heart J 2003; 145:855-61. [PMID: 12766744 DOI: 10.1016/s0002-8703(02)94823-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In patients with acute myocardial infarction (MI), the efficacy of thrombolysis is low. Angioplasty after failed thrombolysis (rescue percutaneous coronary angioplasty [PTCA]) has been associated with an increase in the incidence of inhospital complications. It has been proposed that these complications result from the procedure itself. Thus, the aim of this study was to compare the efficacy, inhospital complications, and mortality rate of patients with MI who are treated with primary PTCA and PTCA after initial thrombolysis (rescue or immediate rescue) in an experienced clinical center specializing in percutaneous coronary interventions. METHODS AND RESULTS The study group consisted of consecutive patients with MI treated with primary PTCA (n = 195) or PTCA after initial thrombolysis (n = 179). The study was performed in a referral center with a 24-hour catheter-laboratory service. The success rate of the procedure was 90.5% and 88.2% in the PTCA after initial thrombolysis group and primary PTCA group, respectively. The groups did not differ in the frequency of reocclusion, emergency surgical revascularization (coronary artery bypass grafting), or stroke. In patients without cardiogenic shock, the inhospital mortality rates were 3.2% and 0.6% in the rescue and immediate rescue group and primary PTCA group, respectively (not significant). In a subgroup of patients with cardiogenic shock, the mortality rate was 36.0% in the initial thrombolysis PTCA group and 30.8% in the primary PTCA group. However, after successful PTCA in this subgroup, the mortality rate dropped to 18% and 10%, respectively. CONCLUSIONS After initial thrombolysis, PTCA is safe, effective, and likely to restore grade 3 Thrombolysis In Myocardial Infarction flow in about 90% of patients. When available, immediate rescue PTCA should be performed in all patients, including patients with cardiogenic shock.
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Affiliation(s)
- Lech Poloński
- Third Department of Cardiology of the Silesian School of Medicine, Zabrze, Poland.
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Jankowski K, Rubiniec K, Wasilewski J. Coupled cluster energy dependence on reference-state choice: impact of cluster operator structure. Chem Phys Lett 2001. [DOI: 10.1016/s0009-2614(01)00709-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wasilewski J, Gasior M, Adamowicz E, Szyguła B, Zebik T, Gierlotka M, Poloński L. [ST-segment shift in V1-V3 in patients with inferior wall infarction depend on angiographic localization of right artery occlusion]. Pol Arch Med Wewn 2001; 105:297-302. [PMID: 11761801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Two electrocardiographic types of inferior wall infarct were isolated based on angiographic localization of right coronary artery occlusion. In proximal occlusion of RCA before right ventricular branch there is no depression or more rarely elevation of ST segment in V1-V3 especially in V1 (the first morphological type). ST segment depression in V1-V3 (second morphological type) is characteristic for distal segment of RCA occlusion.
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Affiliation(s)
- J Wasilewski
- III Katedra i Kliniczny Oddział Kardiologii Sl. AM, Slaskie Centrum Chorób Serca w Zabrzu
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