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Janion-Sadowska A.,Swietokrzyskie Cardiology Center
Przegla̧d lekarski | Year: 2012

Diseases of the circulatory system are the most common cause of death among women. It should be emphasized that this problem is still underestimated in daily practice. As women are less likely to have significant stenosis in coronary angiography than men, they are regarded to be at smaller risk. At the same time, numerous studies prove that the prognosis of women with ischemic heart disease is serious. Therefore, some researchers suggest distinguishing the so-called "female pattern" of ischemic heart disease, characterized by persistent, often atypical chest pain, positive results for noninvasive tests evaluating ischemia and no significant changes in coronary angiography. It is relevant in the diagnosis of women to assess the global risk, taking into consideration such parameters as inflammation indicators, endothelial dysfunction and microvascular reactivity. There is still no data on optimal treatment, but there seems to be a clear benefit from intensive modification and elimination of risk factors, as well as typical pharmacotherapy with angiotensin-converting enzyme inhibitors, beta-blockers and statins. Source


Sadowski M.,Swietokrzyskie Cardiology Center | Zabczyk M.,Jagiellonian University | Undas A.,Jagiellonian University
Atherosclerosis | Year: 2014

Objectives: We investigated whether markers of platelet, neutrophil and endothelial activation, plasma fibrin clot properties and patient clinical profile may characterize coronary thrombus composition in ST-segment elevation myocardial infarction (STEMI) patients. Methods: A total of 40 intracoronary thrombi obtained 4.0-16.5h since chest pain onset by manual aspiration during primary coronary intervention (PCI) were assessed using scanning electron microscopy. Plasma fibrin clot permeation coefficient (Ks) and clot lysis time (CLT), together with platelet and endothelial activation, fibrinolysis, and inflammation markers, were measured exvivo in 16 patients on admission (pre-PCI group) and on the next morning in 24 patients (post-PCI group). Results: Fibrin, erythrocyte, platelet and white blood cell content in the thrombi were estimated at 49.1%, 24.2%, 11.6% and 3.7% respectively. In the pre-PCI group, in addition to fibrinogen, P-selectin and plasminogen activator inhibitor-1 were positively correlated with thrombus fibrin content. In the post-PCI group, in addition to von Willebrand factor antigen (vWF:Ag), soluble CD40 ligand and myeloperoxidase (MPO) were positively correlated with thrombus fibrin content. After adjustment for fibrinogen and onset-to-thrombectomy time circulating vWF:Ag in both groups, and MPO and P-selectin in the pre-PCI group were the independent predictors of fibrin-rich intracoronary thrombus presence. Other predictors were renal impairment, arterial hypertension and time from symptom onset to thrombus aspiration in all patients. Conclusions: In STEMI patients coronary thrombus composition is partly characterized by plasma markers of platelet, neutrophil and endothelial activation, with a varying contribution of these factors over time. © 2014 Elsevier Ireland Ltd. Source


Stpien E.,Jagiellonian University | Fedak D.,Jagiellonian University | Klimeczek P.,Center for Diagnosis Prevention and Telemedicine | Wilkosz T.,Center for Diagnosis Prevention and Telemedicine | And 4 more authors.
Hypertension Research | Year: 2012

We conducted a cross-sectional observation study that included 500 asymptomatic subjects to investigate the relationship between bone metabolism and coronary artery calcification (CAC) in hypertensive conditions. Osteoprotegerin (OPG) and osteopontin (OPN) levels and their associations with hypertension were analyzed to predict CAC in 316 subjects. Multislice computed tomography was used to quantify CAC. Multivariate analysis of variance was used to test the non-interactive effects of hypertension, CAC severity and biomarker levels, and the logistic regression model was applied to predict the risk of CAC. OPG and OPN concentrations were significantly higher in the hypertensive than the normotensive subjects, at 3.0 (2.3-4.0) pmol l -1 and 51 (21-136) ng ml -1 vs. 2.4 (2.0-3.0) pmol l -1 and 41 (13-63) ng ml -1, respectively. The OPG level, but not OPN level, increased with age (r0.29; P=0.0001). Zero or minimal CAC (10 Agatston units (AU)) was observed in 63% of the subjects, mild (11-100 AU) in 17%, moderate (101-400 AU) in 12% and severe (401-1000 AU)-to-extensive (> 1000 AU) in 8%. In hypertensive subjects, only glomerular filtration rate (GFR) (Β=-0.67) and gender (Β=0.52) were significant predictors for CAC (R=0.68). In normotensive patients, GFR (Β=-0.81), gender (Β=0.48) and log-transformed OPG levels (Β=-0.15) were significant predictors for CAC. OPG levels were associated with an increased risk of CAC in normotensive subjects only (odds ratio: 3.37; 95% confidence interval (1.63-6.57); P=0.0002). OPG predicted a premature state of vascular calcification in asymptomatic normotensive individuals, and renal function significantly contributed to this process in both hypertensive and normotensive subjects. © 2012 The Japanese Society of Hypertension All rights reserved. Source


Wozakowska-Kaplon B.,Jan Kochanowski University | Wozakowska-Kaplon B.,Swietokrzyskie Cardiology Center | Wlosowicz M.,Jan Kochanowski University | Gorczyca-Michta I.,Swietokrzyskie Cardiology Center | Gorska R.,Medical University of Warsaw
Cardiology Journal | Year: 2013

Background: Periodontitis may contribute to destabilization of atherosclerotic plaque leading to acute coronary syndrome and myocardial infarction (MI). The aim of the paper was to evaluate the state of the oral cavity and test the association between chosen parameters of acute, hospital phase MI in patients aged 60 and younger. Methods: We examined patients with acute MI, age 60. Control group consisted of matched group of patients with stable angina. Patients enrolled in the study underwent dental, cardiovascular and biochemical examination. Left ventricular ejection fraction (LVEF) was measured during echocardiographic examination, intima-media thickness (IMT) was assessed by ultrasonographic examination at the same time.n Results: The case group included 112 hospital patients with acute MI. Patients with acute MI were characterized by higher level of cardiovascular disease risk factors and poor oral health status in comparison to the control group. There was higher prevalence of edentulousness (p = 0.0039) and advanced periodontal disease (APD) (p < 0.0001) in the case group than in the control group. Patients with edentulousness and APD were characterized by the highest levels of fibrinogen, interleukine-6, tumor necrosis factor-α, increased IMT and numerous atherosclerotic plaques. Logistic regression analysis revealed association between biomarkers of myocardial injury, LVEF and chosen periodontal parameter (API, CAL, PDI, BI) and edentulousness. Conclusions: Poor oral health status, especially periodontal disease may influence on the occurrence and clinical course of MI. © 2013 Via Medica. Source


Undas A.,Jagiellonian University | Zalewski J.,John Paul II Hospital | Krochin M.,John Paul II Hospital | Siudak Z.,Jagiellonian University | And 6 more authors.
Arteriosclerosis, Thrombosis, and Vascular Biology | Year: 2010

OBJECTIVES-: We sought to investigate whether patients with in-stent thrombosis (IST) display altered plasma fibrin clot properties. METHODS AND RESULTS-: We studied 47 definite IST patients, including 15 with acute, 26 subacute and 6 late IST, and 48 controls matched for demographics, cardiovascular risk factors, concomitant treatment and angiographic/stent parameters. Plasma clot permeability (Ks), which indicates a pore size, turbidity (lag phase, indicating the rate of fibrin clot formation, ΔAbsmax, maximum absorbance of a fibrin gel, reflecting the fiber thickness), lysis time (t50%) and maximum rate of d-dimer release from clots (D-Drate) were determined 2 to 73 (median 14.7) months after IST. Patients with IST had 21% lower Ks, 14% higher ΔAbsmax, 11% lower D-Drate, 30% longer t50% (all P<0.0001) and 5% shorter lag phase compared to controls (P=0.042). There were no correlations between clot variables and the time of IST or that from IST to blood sampling. Multiple regression analysis showed that Ks (odds ratio=0.36 per 0.1 μm, P<0.001), D-Drate (odds ratio=0.16 per 0.01 mg/L/min, P<0.001) and stent length (odds ratio=1.1 per 1 mm, P=0.043) were independent predictors of IST (R=0.58, P<0.001). CONCLUSIONS-: IST patients tend to form dense fibrin clots resistant to lysis, and altered plasma fibrin clot features might contribute to the occurrence of IST. © 2010 American Heart Association, Inc. Source

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