Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Feb 2019
Case ReportsRight ventricular thrombi treated with apixaban in a patient with arrhythmogenic right ventricular cardiomyopathy.
Abstract
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Pol. Arch. Med. Wewn. · Feb 2019
Platelet to red cell distribution width ratio for predicting clopidogrel efficacy in patients undergoing percutaneous coronary interventions: insights from the ONSIDE-TEST study.
INTRODUCTION Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel remains a cornerstone of pharmacotherapy after percutaneous coronary intervention (PCI). It has been demonstrated that even up to 30% of patients receiving DAPT have inadequate response to clopidogrel, namely, high on‑treatment platelet reactivity (HPR). The platelet to red cell distribution width (P‑RDW) ratio represents an indicator of cardiovascular risk and may be related to HPR. ⋯ Using a cut‑off level of 15.23, the P‑RDW ratio predicted HPR with a sensitivity of 69% and specificity of 75% (odds ratio, 6.67; 95% CI, 0.561-0.890; P = 0.02; are under the receiver operating characteristic curve, 0.723). CONCLUSIONS The P‑RDW ratio may serve as a supplementary tool for identification of patients at risk of HPR. Further studies are warranted to assess its role in planning DAPT among patients undergoing PCI.
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Pol. Arch. Med. Wewn. · Feb 2019
Comparative StudyDifferences in clinical characteristics and 1-year outcomes of hospitalized patients with heart failure in ESC-HF Pilot and ESC-HF-LT registries.
INTRODUCTION The management of heart failure (HF) has changed significantly in recent decades. OBJECTIVES We analyzed the clinical profile, 1‑year outcomes, predictors of mortality, and hospital readmissions in hospitalized patients enrolled in the European Society of Cardiology Heart Failure Pilot Survey (ESC‑HF Pilot) and Heart Failure Long‑Term Registry (ESC‑HF‑LT). PATIENTS AND METHODS The analysis included hospitalized Polish patients from both registries. ⋯ The percentage of patients receiving drugs for HF (diuretics, angiotensin‑converting enzyme inhibitors, angiotensin receptor blockers, β‑blockers, mineralocorticoid receptor antagonists), anticoagulants, cardiac resynchronization therapy, and implantable cardioverter‑defibrillator were higher in the ESC‑HF‑LT group in comparison with the ESC‑HF Pilot group. CONCLUSIONS Patients from the ESC‑HF‑LT registry had a lower risk of death or hospitalization for worsening HF despite the fact that they were older and had more comorbidities. The results might suggest an improvement in physicians' adherence to the guidelines on the management of HF in the ESC‑HF‑LT registry.
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Pol. Arch. Med. Wewn. · Feb 2019
Obstructive and nonobstructive coronary artery disease in long-lasting type 1 diabetes: a 7-year prospective cohort study.
INTRODUCTION It is widely believed that patients with diabetes are at increased risk of severe and premature coronary artery disease (CAD) when compared with nondiabetic individuals. OBJECTIVES The aim of the study was to evaluate the prevalence, 7‑year incidence, predictors, and outcomes of obstructive and nonobstructive CAD in patients with long‑lasting type 1 diabetes. PATIENTS AND METHODS We enrolled 2330 patients at a median age of 50 years and a median diabetes duration of 32 years. ⋯ CONCLUSIONS Nonobstructive CAD was the most frequent coronary complication in patients with type 1 diabetes. Both obstructive and nonobstructive CAD showed a similar incidence of nonfatal outcomes and selected predictors. Positive ETT/SPECT results were related to glycemic control only in patients with nonobstructive CAD.