Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Sep 2024
Heterogeneous and overlapping mechanisms of ischemia and non-obstructive coronary arteries: in-hospital results of the MOSAIC-COR registry.
Ischemia and nonobstructive coronary arteries (INOCA) remains a significant clinical issue. Recent guidelines underscore the importance of comprehensive coronary physiology assessment to make specific diagnoses and implement tailored treatment strategies. ⋯ The patients diagnosed with INOCA in the MOSAIC‑COR registry exhibit significant symptomatology and a high prevalence of typical cardiovascular risk factors. Myocardial ischemia in this population may be generated by various pathomechanisms that may overlap.
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Pol. Arch. Med. Wewn. · Sep 2024
Kynurenines in heart failure with preserved ejection fraction: an influence of type 2 diabetes.
Given their association with inflammatory processes and oxidative stress, tryptophan metabolites involved in the kynurenine pathway (KP) play a role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes (T2D). ⋯ The study showed altered tryptophan metabolism in patients with HFpEF, highlighting a possible connection. The findings suggest potential implications for targeted therapeutic strategies focusing on tryptophan metabolism and cardiac function in patients with HFpEF and T2D.
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Pol. Arch. Med. Wewn. · Sep 2024
Short- and long-term outcomes of mechanical thrombectomy in acute ischemic stroke patients with chronic kidney disease.
Chronic kidney disease (CKD) is a risk factor of acute ischemic stroke (AIS). Outcomes of treatment with mechanical thrombectomy (MT) in patients with CKD seem to be poorer than in the general population. Long‑term follow‑up studies are lacking. ⋯ MT outcomes in CKD patients are worse, especially in advanced stages of the disease, but CKD is not independently associated with poor prognosis. CKD alone should not be a contraindication for MT in otherwise eligible patients, although patients with impaired kidney function require more careful postprocedural monitoring.
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Pol. Arch. Med. Wewn. · Sep 2024
Cardiovascular risk and preclinical atherosclerosis are associated with white matter hyperintensities in apparently healthy adults: the population-based cross-sectional study BIALYSTOK PLUS.
White matter hyperintensities, present in patients and asymptomatic individuals, have been previously shown to be associated with atherosclerosis risk factors, such as high blood pressure, hypercholesterolemia, smoking, and diabetes. ⋯ The cardiovascular risk class, presence of carotid plaques, increased intima‑media complex thickness, and diabetes are the main risk factors for white matter hyperintensities in apparently healthy adults. People without hypertension or diabetes but with higher CVR are also at a risk for developing white matter hyperintensities, which emphasizes the importance of CVR assessment for prediction of neurodegenerative changes.