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Oleksiak A, Kępka C, Rucińska K, Marcinkiewicz K, Demkow M, Kruk M. High-density lipoprotein cholesterol, triglycerides, and characteristics of coronary atherosclerosis in patients with significant coronary artery disease newly diagnosed by computed tomography coronary angiography. Kardiol Pol 2023; 81:273-280. [PMID: 36475513 DOI: 10.33963/kp.a2022.0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 12/04/2022] [Indexed: 03/30/2023]
Abstract
BACKGROUND The Current European Society of Cardiology guidelines indicate specific target low-density lipoprotein cholesterol (LDL-C) levels for different cardiovascular risk categories in terms of prevention. However, the target for high-density lipoprotein cholesterol (HDL-C) and triglycerides has not been established. AIM The study aims to investigate the associations betweenHDL-C,triglycerides, andcoronary plaque characteristics. METHODS This was a prospective single-center study with enrolled consecutive patients with newly diagnosed significant (≥1stenosis ≥50%) CAD on computed tomography coronary angiography (CTCA). Patients had lipids andCTCA analysis, including high-risk plaque (HRP) features: low-attenuation plaque (LAP), napkin-ring sign (NRS), positive remodeling (PR), and spotty calcium (SC), type of the plaque (calcified, noncalcified, mixed), and their composition (calcified, fibrous, fibro-fatty, necrotic core). RESULTS The study included 300 patients (191 men, 66 [8] years). Sixty-six percent of them had lipid-lowering therapy. HRPwas found in 208 patients. There was no association between LDL-C, plaque composition, and HRP presence. There was a negative correlation between HDL-C, fibro-fatty and necrotic core plaque components (P = 0.0002, P = 0.0009). There was a positive correlation between triglycerides and necrotic core (P = 0.038). There were differences in HDL-C and triglycerides in patients with and without NRS (47 vs. 53 mg/dl, P = 0.0002 and 128 vs. 109 mg/dl, P = 0.02). In logistic regression, HDL-C (odds ratio [OR], 0.95;95% confidence interval [CI], 0.93-0.98; P <0.001), triglycerides (OR, 1.00; 95% CI, 1.00-1.01; P = 0.02), and male sex (OR, 3.04; 95% CI, 1.41-6.52; P = 0.004) were NRS predictors. In multivariable regression, only HDL-C (OR, 0.96; 95% CI, 0.93-0.99; P = 0.02) was an independent predictor of NRS. CONCLUSION Lower HDL-C and higher triglycerides were associated with NRS presence and more necrotic core plaque components in coronary plaques in patients with newly diagnosed CAD.
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Affiliation(s)
- Anna Oleksiak
- Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warszawa, Poland.
| | - Cezary Kępka
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland
| | - Karolina Rucińska
- Department of Cardiac Surgery and Transplantology, National Institute of Cardiology, Warszawa, Poland
| | - Kamil Marcinkiewicz
- Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warszawa, Poland
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland
| | - Mariusz Kruk
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warszawa, Poland
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Oleksiak A, Kępka C, Rucińska K, Marcinkiewicz K, Demkow M, Kruk M. Hemoglobin level as a predictor of major adverse cardiac events during a long-term follow-up in patients with coronary artery disease. Pol Arch Intern Med 2022; 132. [PMID: 36468226 DOI: 10.20452/pamw.16377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Anna Oleksiak
- Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warsaw, Poland.
| | - Cezary Kępka
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Karolina Rucińska
- Department of Cardiac Surgery and Transplantology, National Institute of Cardiology, Warsaw, Poland
| | - Kamil Marcinkiewicz
- Department of Intensive Cardiac Therapy, National Institute of Cardiology, Warsaw, Poland
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland
| | - Mariusz Kruk
- Department of Coronary and Structural Heart Diseases, National Institute of Cardiology, Warsaw, Poland
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Marcinkiewicz K, Petryka-Mazurkiewicz J, Nowicki MM, Kuriata J, Dzielińska Z, Demkow M, Konopka A. Acute heart failure in the course of fulminant myocarditis requiring mechanical circulatory support in a healthy young patient after coronavirus disease 2019. Kardiol Pol 2021; 79:583-584. [PMID: 34125938 DOI: 10.33963/kp.15888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Kamil Marcinkiewicz
- Department of Intensive Cardiac Therapy, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland.
| | - Joanna Petryka-Mazurkiewicz
- Department of Coronary and Structural Heart Diseases, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland.,Magnetic Resonance Unit, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
| | - Michał M Nowicki
- Department of Intensive Cardiac Therapy, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
| | - Jarosław Kuriata
- Department of Cardiac Surgery and Transplantology, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
| | - Zofia Dzielińska
- Department of Coronary and Structural Heart Diseases, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
| | - Marcin Demkow
- Department of Coronary and Structural Heart Diseases, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
| | - Anna Konopka
- Department of Intensive Cardiac Therapy, The Cardinal Stefan Wyszynski Institute of Cardiology, Warszawa, Poland
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Marcinkiewicz K, Baranowski R. Death recorded by Holter monitoring due to multiple traumatic injuries as a consequence of a car accident. Kardiol Pol 2020; 78:1301-1303. [PMID: 33293498 DOI: 10.33963/kp.15702] [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: 11/23/2022]
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Baranowski R, Kalin K, Marcinkiewicz K, Orczykowski M, Bilińska M, Szumowski Ł. Positional sleep disordered breathing in patients with arrhythmia. Should we advise our patients to avoid supine position during sleep? J Electrocardiol 2019; 57:138-142. [PMID: 31655416 DOI: 10.1016/j.jelectrocard.2019.09.019] [Citation(s) in RCA: 2] [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] [Received: 05/20/2019] [Revised: 08/27/2019] [Accepted: 09/18/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Sleep disordered breathing [SDB] is a well-known problem in patients with cardiovascular diseases. Around 50% of pts. with SDB present positional sleep disordered breathing [PSDB]. AIMS The aim of this study was the investigation of the frequency of PSDB in patients with different forms of arrhythmias. METHODS We analyzed the presence of SDB in 53 pts. with diagnosed atrial fibrillation (paroxysmal or persistent), 88 pts. before ablation of ventricular ectopy and 110 pts. that had Holter monitoring due to the symptoms suggesting arrhythmia. RESULTS Finally, we could collect all the data in 243 pts. - 150 men 93 women. AHI < 15 was recorded in 136 (56%) pts., AHI > 15 in 107 (44%) pts. Moderate sleep disordered breathing was diagnosed in 59 (24%) pts. (AHI 15-30), severe sleep disordered breathing (AHI > 30) was recognized in 48 (20%) pts. In all of the analyzed groups, AHI in supine position was significantly higher than in nonsupine position. PSDB was recorded in 55% of pts. with AHI > 15 and in 29% of pts. (n = 14) with AHI > 30. Percentage of time in supine position was an independent factor related with the presence of at least moderate or severe sleep disordered breathing. CONCLUSION 1. Moderate or severe SDB is recorded in 44% of pts. with arrhythmias, almost 50% of them have positional SDB. 2. Percent of time of sleeping in supine position has an important independent impact on the presence of SDB. 3. Big studies should be conducted to verify if avoidance of sleeping in supine position may improve clinical outcome. CONDENSED ABSTRACT Sleep disordered breathing SDB is a frequent problem of pts. with cardiovascular diseases. It may influence the prognosis. Moderate or severe SDB is recorded in 44% of pts. with arrhythmias, almost 50% of them have positional SDB. Percent of time of sleeping in supine position has an important independent impact on the presence of SDB. 3. Big studies should be conducted to verify if avoidance of sleeping in supine position may improve clinical outcome. What is new?
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Affiliation(s)
- Rafał Baranowski
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland.
| | - Katarzyna Kalin
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Kamil Marcinkiewicz
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Michał Orczykowski
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Maria Bilińska
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
| | - Łukasz Szumowski
- Department of Heart Rhythm Disorders, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland
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Orczykowski M, Borowiec K, Biernacka E, Bodalski R, Urbanek P, Derejko P, Kodziszewska K, Woźniak O, Fronczak A, Marcinkiewicz K, Guzek K, Fil A, Warmiński G, Hoffman P, Bilińska M, Szumowski Ł. Ablation of atrial tachyarrhythmias late after surgical correction of tetralogy of Fallot: long-term follow-up. Kardiol Pol 2018. [PMID: 29537482 DOI: 10.5603/kp.a2018.0070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND After the surgical correction of tetralogy of Fallot, surgical scars and natural obstacles form pathways capable of supporting an atrial tachyarrhythmia (AT). Radiofrequency (RF) ablation is effective, although the few studies published on this topic had relatively short follow-up periods. AIM The aims of the study were to evaluate the acute and long-term effects of RF ablation of AT and examine the charac-teristics of arrhythmia recurrence. METHODS Tetralogy of Fallot patients (n = 16, age 44.7 ± 10.7 years) referred for ablation of ATs, appearing 25.7 ± 9.6 years after repair, were studied. RESULTS Twenty-five ATs were ablated, including 16 cavo-tricuspid isthmus atrial flutters (CTI-AFLs) and nine intraatrial reentrant tachycardia (IART). In one patient with paroxysmal atrial fibrillation (PAF), pulmonary vein isolation was also performed. Ten patients had permanent, and six had paroxysmal arrhythmia prior to the first ablation. Four patients had PAF. Regardless of the type of first ablated arrhythmia, all 16 patients required CTI-AFL ablation. The effectiveness of the first RF ablation reached 88%. The acute efficacy of RF ablation was 100% for CTI-AFL and 78% for IART. Long-term follow-up was possible in 15 out of 16 patients (mean follow-up 68.8 ± 36.6 months). Four patients were free of sustained arrhythmia, nine (60%) had AF. After the last RF ablation, an episode suggestive of CTI-AFL/IART was documented only in one patient. CONCLUSIONS Ablation of CTI-AFL/IART in tetralogy of Fallot patients is safe and effective. AF was observed in most patients during the long-term follow-up. Regardless of the type of the first ablated arrhythmia, all patients required CTI-AFL ablation.
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Affiliation(s)
- Michał Orczykowski
- Klinika Zaburzeń Rytmu Serca, Instytut Kardiologii w Warszawie; National Institute of Cardiology, Arrhythmia Department, Warsaw, Poland.
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Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L, Słomian A. Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients. Postepy Dermatol Alergol 2018; 35:60-66. [PMID: 29599673 PMCID: PMC5872236 DOI: 10.5114/pdia.2016.62287] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 05/31/2016] [Accepted: 07/21/2016] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Research has demonstrated a link between psoriasis and a multitude of psychological impairments; however, relatively few studies have examined the importance of site of skin lesions for negative psychological outcomes in psoriasis patients. AIM To investigate relationships between anatomical location of psoriatic lesions and experiences of stigmatization, negative emotional attitude towards the body, depression and social anxiety. MATERIAL AND METHODS Adult psoriasis patients (N = 193) completed the Stigmatization Scale, the Body Emotions Scale, the Beck Depression Inventory and the Social Anxiety Questionnaire. The body surface area index was used to assess the location and extent of psoriasis. RESULTS Feelings of stigmatization were found to be most closely related to the presence of psoriatic lesions on the chest, and the arms and hands. Higher levels of social anxiety were found to be most closely related to the location of psoriatic lesions on the head and neck. Negative emotional attitude towards the body was found to be most closely related to the location of psoriatic lesions on the arms and hands, and on the head and neck. Higher levels of depressive symptoms were most closely related to the presence of psoriatic lesions on the head and neck, the arms and hands, and the genital area. CONCLUSIONS The presence of psoriatic lesions on the head, neck, and chest, and also on the arms and hands and the genital area, should alert clinicians to a higher risk of psychological impairments. This may help to better recognize and prevent cumulative life course impairment.
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Affiliation(s)
- Patryk Łakuta
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
- Institute of Psychology, University of Silesia, Katowice, Poland
| | | | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
| | | | - Anna Słomian
- Group of Provincial Psychological Outpatients Clinics, Katowice, Poland
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Baranowski R, Marcinkiewicz K, Kalin K, Bilinska M, Szumowski Ł. P5522Supine position during sleep in patients with suspected or diagnosed arrhythmia - an important factor that determines the presence of sleep apnea. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5522] [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: 11/15/2022] Open
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Wańha W, Kawecki D, Roleder T, Pluta A, Marcinkiewicz K, Morawiec B, Dola J, Gładysz S, Pawłowski T, Smolka G, Ochała A, Nowalany-Kozielska E, Wojakowski W. Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents. Cardiorenal Med 2017; 7:85-95. [PMID: 28611782 DOI: 10.1159/000452745] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 10/18/2016] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The following registry (Katowice-Zabrze retrospective registry) aimed to assess the influence of a chronic kidney disease (CKD) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) using either first-generation (DES-I) or second-generation (DES-II) drug-eluting stents. METHODS The study group consisted of 1,908 consecutive patients, of whom 331 (17.3%) had CKD. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/m2. We evaluated the major adverse cardiac and cerebral events (MACCE), i.e., the composite of death, myocardial infarction (MI), stroke, and target vessel revascularization at the 12-month follow-up. RESULTS CKD patients had a lower left ventricular ejection fraction and more often a history of MI and PCI. Coronary angiography revealed that multivessel coronary artery disease, intracoronary thrombus, and extensive calcifications were more frequent in patients with CKD. However, the SYNTAX score did not vary between patients with or without CKD. There was a higher rate of in-hospital bleedings requiring blood transfusion in patients with CKD. At the 1-year follow-up, MACCE (17.8 vs. 12.6%, HR = 1.46 [95% CI 1.05-2.03], p = 0.009) and death (8.4 vs. 2.3%, HR = 3.9 [95% CI 2.0-7.5], p < 0.001) were more often observed in CKD patients. Multivariable Cox analysis revealed that CKD was an independent risk predictor of death after PCI at the 1-year follow-up (HR = 2.1 [95% CI 1.2-3.6], p = 0.004). In comparison to DES-I, the use of DES-II did not decrease the adverse effect of CKD on MACCE. CONCLUSION CKD patients had an increased risk of in-hospital bleeding requiring blood transfusion and a higher risk of MACCE and death at the 12-month follow-up. The use of second-generation DES did not improve clinical outcomes in patients with CKD at the 12-month follow-up.
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Affiliation(s)
- Wojciech Wańha
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Damian Kawecki
- Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Tomasz Roleder
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Pluta
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Kamil Marcinkiewicz
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Beata Morawiec
- Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Janusz Dola
- Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland
| | - Sylwia Gładysz
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Tomasz Pawłowski
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Smolka
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Andrzej Ochała
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | | | - Wojciech Wojakowski
- Third Division of Cardiology, Medical University of Silesia, Katowice, Poland
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Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. How does stigma affect people with psoriasis? Postepy Dermatol Alergol 2017; 34:36-41. [PMID: 28261029 PMCID: PMC5329101 DOI: 10.5114/pdia.2016.62286] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [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: 12/14/2015] [Accepted: 01/14/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Psoriasis is associated with a major additional psychological burden. AIM To investigate whether the extent of skin involvement, stigmatization, and perceived social support are related to depressive symptoms in psoriasis patients. MATERIAL AND METHODS One hundred and forty-eight psoriasis patients completed in the BSA, the Beck Depression Inventory, Stigmatization Scale, and Multidimensional Scale of Perceived Social Support. RESULTS Almost 13% of participants obtained a BDI total score indicating moderate depressive symptoms. The results of regression analysis revealed that greater depression severity in psoriasis patients is associated with higher levels of psoriasis-related stigma, lower perceived social support, female gender and a shorter duration of the disease, explaining 43% of the variance of depression. The stigmatization was the most powerful predictor of depressive symptoms for psoriasis patients and accounted for 33% of the variance. CONCLUSIONS The extent of psoriasis does not directly lead to mood disturbance in these patients. Rather, social stigma accounted for this relationship. Strategies for reducing the stigma attached to patients with psoriasis are required.
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Affiliation(s)
- Patryk Łakuta
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | | | - Beata Bergler-Czop
- Departament of Dermatology, Medical University of Silesia, Katowice, Poland
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Wojtyna E, Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. Gender, Body Image and Social Support: Biopsychosocial Deter-minants of Depression Among Patients with Psoriasis. Acta Derm Venereol 2017; 97:91-97. [PMID: 27304233 DOI: 10.2340/00015555-2483] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to examine the importance of psychosocial factors, such as emotional and instrumental social support, distress, and assumptions about appearance and its salience to one's self-worth, and to relate these factors to depressive symptoms in patients with psoriasis, according to gender. A group of 219 patients with psoriasis, aged 18-70 years completed the Beck Depression Inventory, the Appearance Schemas Inventory-Revised, the Berlin Social Support Scales, and the Distress Thermometer. Body Surface Area index was used to assess the severity of psoriasis. The main contributors to depression were: female gender, beliefs about appearance and its salience to one's self-worth, greater psychological distress, and lower levels of emotional social support. Therefore, improving the body image of patients with psoriasis, by reducing its salience in their personal lives, may play a role in the prevention of depression, especially in women.
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Affiliation(s)
- Ewa Wojtyna
- Institute of Psychology, University of Silesia, 40-126 Katowice, Poland.
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Łakuta P, Marcinkiewicz K, Bergler-Czop B, Brzezińska-Wcisło L. The relationship between psoriasis and depression: A multiple mediation model. Body Image 2016; 19:126-132. [PMID: 27690315 DOI: 10.1016/j.bodyim.2016.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 08/12/2016] [Accepted: 08/13/2016] [Indexed: 12/13/2022]
Abstract
This study examined the relationship between psoriasis and depression, proposing a multiple mediation model to analyse the relationship. A total of 193 patients with psoriasis aged 20-67 years completed the Beck Depression Inventory, the Stigmatization Scale, the Appearance Schemas Inventory-Revised, and the Body Emotions Scale. The Body Surface Area index was used to assess severity of psoriasis. Serial multiple mediation analysis revealed that experiences of stigmatization, maladaptive beliefs about appearance and its salience to one's self-evaluation, and negative emotional attitudes towards the body, jointly, sequentially mediated the relationship between the presence of skin lesions of psoriasis and depressive symptoms. These results highlight the importance of the associations between stigmatization and cognitive and affective aspects of body image in relation to depression in patients with psoriasis. We suggest that prevention and intervention programs for psoriasis patients that target body image enhancement would be worthy of further research.
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Affiliation(s)
- Patryk Łakuta
- SWPS University of Social Sciences and Humanities, 19/31 Chodakowska, 03-815 Warsaw, Poland; Institute of Psychology, University of Silesia, 53 Grażyńskiego, 40-126 Katowice, Poland.
| | | | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia, 20/24 Francuska, 40-027 Katowice, Poland
| | - Ligia Brzezińska-Wcisło
- Department of Dermatology, Medical University of Silesia, 20/24 Francuska, 40-027 Katowice, Poland
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Wanha W, Kawecki D, Roleder T, Pluta A, Marcinkiewicz K, Morawiec B, Kret M, Pawlowski T, Smolka G, Ochala A, Wojakowski W. Gender differences and bleeding complications after PCI on first and second generation DES. SCAND CARDIOVASC J 2016; 51:53-60. [PMID: 27471987 DOI: 10.1080/14017431.2016.1219044] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to evaluate gender differences in the long-term clinical outcomes and safety of patients treated with first- and second generation DES. METHODS The Katowice-Zabrze Registry included 1916 consecutive patients treated with either first or second generation DES. We evaluated major adverse cardiac and cerebrovascular events (MACCE) [composite of death, myocardial infarction (MI), stroke and target vessel revascularization (TVR)] at 12-month follow-up. Safety end point was bleeding complications and stent thrombosis. RESULTS Registry included [unstable angina (UA) 1500(78%), non-ST-segment elevation myocardial infarction (NSTEMI) 285 (15%), ST-segment elevation myocardial infarction/left bundle branch block (STEMI/LBBB) 131 (7%)]. There were 35.5% females and 64.5% males. Women were older and had higher prevalence of comorbidities. Males more often had multivessel disease and higher Syntax score when comparable to females. We did not observed difference in acute and subacute stent thrombosis in our data, however, females had more in-hospital bleeding complications. Univariable Cox regression analysis revealed that women had similar outcomes when compared to men in terms of a risk of death, MI, TVR, stroke and MACCE at 1-year follow-up. There were no differences between males and females in MACCE when first- and second generation DES were analyzed separately. CONCLUSION Despite higher risk profile, women treated with DES have similar outcomes as males in 1-year follow-up. However there is, an increased risk of in-hospital bleedings in women.
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Affiliation(s)
- Wojciech Wanha
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Damian Kawecki
- b Division of Cardiology , Medical University of Silesia , Zabrze , Poland
| | - Tomasz Roleder
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Aleksandra Pluta
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Kamil Marcinkiewicz
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Beata Morawiec
- b Division of Cardiology , Medical University of Silesia , Zabrze , Poland
| | - Mariusz Kret
- c Department of Cardiology , Specialistic Hospital , Tarnow , Poland
| | - Tomasz Pawlowski
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Grzegorz Smolka
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Andrzej Ochala
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
| | - Wojciech Wojakowski
- a Third Division of Cardiology , Medical University of Silesia , Katowice , Poland
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Kawecki D, Morawiec B, Dola J, Wanha W, Smolka G, Pluta A, Marcinkiewicz K, Ochała A, Nowalany-Kozielska E, Wojakowski W. First- Versus Second-Generation Drug-Eluting Stents in Acute Coronary Syndromes (Katowice-Zabrze Registry). Arq Bras Cardiol 2016; 106:373-81. [PMID: 27058257 PMCID: PMC4914001 DOI: 10.5935/abc.20160043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/25/2015] [Accepted: 01/06/2016] [Indexed: 12/03/2022] Open
Abstract
Background There are sparse data on the performance of different types of drug-eluting
stents (DES) in acute and real-life setting. Objective The aim of the study was to compare the safety and efficacy of first- versus
second-generation DES in patients with acute coronary syndromes (ACS). Methods This all-comer registry enrolled consecutive patients diagnosed with ACS and
treated with percutaneous coronary intervention with the implantation of
first- or second-generation DES in one-year follow-up. The primary efficacy
endpoint was defined as major adverse cardiac and cerebrovascular event
(MACCE), a composite of all-cause death, nonfatal myocardial infarction,
target-vessel revascularization and stroke. The primary safety outcome was
definite stent thrombosis (ST) at one year. Results From the total of 1916 patients enrolled into the registry, 1328 patients
were diagnosed with ACS. Of them, 426 were treated with first- and 902 with
second-generation DES. There was no significant difference in the incidence
of MACCE between two types of DES at one year. The rate of acute and
subacute ST was higher in first- vs. second-generation DES (1.6% vs. 0.1%, p
< 0.001, and 1.2% vs. 0.2%, p = 0.025, respectively), but there was no
difference regarding late ST (0.7% vs. 0.2%, respectively, p = 0.18) and
gastrointestinal bleeding (2.1% vs. 1.1%, p = 0.21). In Cox regression,
first-generation DES was an independent predictor for cumulative ST (HR 3.29
[1.30-8.31], p = 0.01). Conclusions In an all-comer registry of ACS, the one-year rate of MACCE was comparable
in groups treated with first- and second-generation DES. The use of
first-generation DES was associated with higher rates of acute and subacute
ST and was an independent predictor of cumulative ST.
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Affiliation(s)
- Damian Kawecki
- 2, Zabrze Medical University of Silesia, Katowice, Poland
| | - Beata Morawiec
- 2, Zabrze Medical University of Silesia, Katowice, Poland
| | - Janusz Dola
- 2, Zabrze Medical University of Silesia, Katowice, Poland
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Wańha W, Kawecki D, Roleder T, Pluta A, Marcinkiewicz K, Dola J, Morawiec B, Krzych Ł, Pawłowski T, Smolka G, Ochała A, Nowalany-Kozielska E, Tendera M, Wojakowski W. Impact of anaemia on long-term outcomes in patients treated with first- and second-generation drug-eluting stents; Katowice-Zabrze Registry. Kardiol Pol 2015; 74:561-9. [PMID: 26575311 DOI: 10.5603/kp.a2015.0217] [Citation(s) in RCA: 5] [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] [Received: 05/18/2015] [Revised: 07/23/2015] [Accepted: 09/24/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Coexisting anaemia is associated with an increased risk of major adverse cardiac and cerebrovascular events (MACCE) and bleeding complications after percutaneous coronary intervention (PCI), especially in patients with acute coronary syndrome. AIM To assess the impact of anaemia in patients with coronary artery disease (CAD) treated with first- and second-generation drug-eluting stents (DES) on one-year MACCE. METHODS AND RESULTS The registry included 1916 consecutive patients (UA: n = 1502, 78.3%; NSTEMI: n = 283, 14.7%; STEMI/LBBB: n = 131, 6.8%) treated either with first- (34%) or second-generation (66%) DES. The study population was divided into two groups: patients presenting with anaemia 217 (11%) and without anaemia 1699 (89%) prior to PCI. Anaemia was defined according to World Heart Organisation (haemoglobin [Hb] level < 13 g/dL for men and < 12 g/dL for women). Patients with anaemia were older (69, IQR: 61-75 vs. 62, IQR: 56-70, p < 0.001), had higher prevalence of co-morbidities: diabetes (44.7% vs. 36.4%, p = 0.020), chronic kidney disease (31.3% vs. 19.4%; p < 0.001), peripheral artery disease (10.1% vs. 5.4%, p = 0.005), and lower left ventricular ejection fraction values (50, IQR: 40-57% vs. 55, IQR: 45-60%; p < 0.001). No difference between gender in frequency of anaemia was found. Patients with anaemia more often had prior myocardial infarction (MI) (57.6% vs. 46.4%; p = 0.002) and coronary artery bypass grafting (31.3% vs. 19.4%; p < 0.001) in comparison to patients without anaemia. They also more often had multivessel disease in angiography (36.4% vs. 26.1%; p = 0.001) and more complexity CAD as measured by SYNTAX score (21, IQR: 12-27 points vs. 14, IQR: 8-22 points; p = 0.001). In-hospital risk of acute heart failure (2.7% vs. 0.7%; p = 0.006) and bleeding requiring transfusion (3.2% vs. 0.5%; p < 0.001) was significantly higher in patients with anaemia. One-year follow-up showed that there was higher rate of death in patients with anaemia. However, there were no differences in MI, stroke, target vessel revascularisation (TVR) and MACCE in comparison to patients with normal Hb. There were no differences according to type of DES (first vs. second generation) in the population of patients with anaemia. CONCLUSIONS In patients with anaemia there is a significantly higher risk of death in 12-month follow-up, but anaemia has no impact on the incidence of MI, repeat revascularisation, stroke and MACCE. There is no advantage of II-DES over I-DES generation in terms of MACCE and TVR in patients with anaemia.
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Affiliation(s)
- Wojciech Wańha
- 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland.
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Kawecki D, Morawiec B, Dola J, Wańha W, Smolka G, Pluta A, Marcinkiewicz K, Ochała A, Nowalany-Kozielska E, Wojakowski W. Comparison of First- and Second-Generation Drug-Eluting Stents in an All-Comer Population of Patients with Diabetes Mellitus (from Katowice-Zabrze Registry). Med Sci Monit 2015; 21:3261-9. [PMID: 26506478 PMCID: PMC4629626 DOI: 10.12659/msm.895095] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background This study compared safety and efficacy of first- and second-generation DES in an unrestricted, real-life population of diabetic patients undergoing PCI. Material/Methods The study was a subanalysis of diabetic patients from the all-comer Katowice-Zabrze Registry of patients undergoing PCI with the implantation of either first- (Paclitaxel-, Sirolimus-eluting stents) or second-generation DES (Zotarolimus-, Everolimus-, Biolimus-eluting stents). Efficacy defined as major adverse cardiac and cerebrovascular events (MACCE: death, myocardial infarction, target vessel revascularization, stroke) and safety defined as stent thrombosis (ST) were evaluated at 1 year. Results From the total of 1916 patients, 717 were diabetics. Among them, 257 (36%) were treated with first-generation DES (230 [89%] Paclitaxel-eluting stents, 27 [11%] Sirolimus-eluting stents), 460 with second-generation DES (171 [37%] Zotarolimus-eluting stents, 243 [53%] Everolimus-eluting stents, 46 [10%] Biolimus-eluting stents). Rate of MACCE was equal in both groups (p=0.54). Second-generation DES had a better safety profile than first-generation DES (log-rank for cumulative ST at 1 year p<0.001). First-generation DES was a risk factor for ST (HR 5.75 [1.16–28.47], p=0.03) but not for MACCE (HR 0.89 [0.6–1.32], p=0.57). Conclusions In a real-life setting of diabetic patients undergoing PCI, second-generation DES had lower risk of ST and similar MACCE rate compared to first-generation DES.
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Affiliation(s)
- Damian Kawecki
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Beata Morawiec
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Janusz Dola
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Wojciech Wańha
- 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Smolka
- 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Pluta
- 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | | | - Andrzej Ochała
- 3rd Division of Cardiology, Medical University of Silesia, Katowice, Poland
| | - Ewa Nowalany-Kozielska
- 2nd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
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Wanha WM, Kawecki D, Ochala B, Roleder T, Morawiec B, Dola J, Pluta A, Marcinkiewicz K, Smolka GA, Ochala AJ, Tendera M, Wojakowski W. TCT-575 Comparison of clinical outcomes and safety of first and second-generation DES in women and men [Katowice-Zabrze Registry on first and second generation DES]. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.638] [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: 11/29/2022]
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Kawecki D, Wanha WM, Morawiec B, Dola J, Pluta A, Marcinkiewicz K, Roleder T, Smolka GA, Ochala AJ, Tendera M, Wojakowski W. TCT-574 Comparison of everolimus-eluting stents with first (paclitaxel, sirolimus) and second-generation (zotarolimus, biolimus) drug-eluting stents in patients with acute coronary syndromes [Katowice-Zabrze Registry on first and second generation DES]. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wojakowski W, Wanha W, Roleder T, Ochala B, Dola J, Morawiec B, Pluta A, Marcinkiewicz K, Ochala A, Kawecki D, Tendera M. USE OF SECOND GENERATION DES DOES NOT IMPROVE THE LONG-TERM OUTCOME IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN COMPARISON TO FIRST GENERATION DES. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61874-x] [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: 11/29/2022]
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Wojakowski W, Wanha W, Pluta A, Marcinkiewicz K, Dola J, Kawecki D, Morawiac B, Krzych L, Ochala A, Tendera M. TCTAP A-075 Prognostic Significance of Anemia in Patients Undergoing PCI with First and Second Generation DES (Katowice Registry). J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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