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1. Recommendations of the Experts of the Polish Cardiac Society (PCS) and the Polish Lipid Association (PoLA) on the diagnosis and management of elevated lipoprotein(a) levels

Author

Bożena Sosnowska, Janina Stepinska, Przemyslaw Mitkowski, Agata Bielecka-Dabrowa, Beata Bobrowska, Jan Budzianowski, Pawel Burchardt, Krzysztof Chlebus, Piotr Dobrowolski, Mariusz Gasior, Piotr Jankowski, Jacek Kubica, Agnieszka Mickiewicz, Malgorzata Mysliwiec, Tadeusz Osadnik, Aleksander Prejbisz, Renata Rajtar-Salwa, Krystian Wita, Adam Witkowski, Robert Gil, and Maciej Banach

Subjects
cardiovascular disease, lipoprotein(a), management, recommendations, cardiovascular risk, Medicine
Abstract

Lipoprotein(a) [Lp(a)] is made up of a low-density lipoprotein (LDL) particle and a specific apolipoprotein(a). The blood concentration of Lp(a) is approximately 90% genetically determined, and the main genetic factor determining Lp(a) levels is the size of the apo(a) isoform, which is determined by the number of KIV2 domain repeats. The size of the apo(a) isoform is inversely proportional to the blood concentration of Lp(a). Lp(a) is a strong and independent cardiovascular risk factor. Elevated Lp(a) levels ≥ 50 mg/dl (≥ 125 nmol/l) are estimated to occur in more than 1.5 billion people worldwide. However, determination of Lp(a) levels is performed far too rarely, including Poland, where, in fact, it is only since the 2021 guidelines of the Polish Lipid Association (PoLA) and five other scientific societies that Lp(a) measurements have begun to be performed. Determination of Lp(a) concentrations is not easy due to, among other things, the different sizes of the apo(a) isoforms; however, the currently available certified tests make it possible to distinguish between people with low and high cardiovascular risk with a high degree of precision. In 2022, the first guidelines for the management of patients with elevated lipoprotein(a) levels were published by the European Atherosclerosis Society (EAS) and the American Heart Association (AHA). The first Polish guidelines are the result of the work of experts from the two scientific societies and their aim is to provide clear, practical recommendations for the determination and management of elevated Lp(a) levels.

Published
2024
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3. Heart rate variability comparison between young males after 4–6 weeks from the end of SARS-CoV-2 infection and controls

Author

Mateusz Soliński, Agnieszka Pawlak, Monika Petelczyc, Teodor Buchner, Joanna Aftyka, Robert Gil, Zbigniew J. Król, and Jan J. Żebrowski

Subjects
Medicine, Science
Abstract

Abstract Due to the prolonged inflammatory process induced by infection of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), indices of autonomic nervous system dysfunction may persist long after viral shedding. Previous studies showed significant changes in HRV parameters in severe (including fatal) infection of SARS-CoV-2. However, few studies have comprehensively examined HRV in individuals who previously presented as asymptomatic or mildly symptomatic cases of COVID-19. In this study, we examined HRV in asymptomatic or mildly symptomatic individuals 5–7 weeks following positive confirmation of SARS-CoV-2 infection. Sixty-five ECG Holter recordings from young (mean age 22.6 ± 3.4 years), physically fit male subjects 4–6 weeks after the second negative test (considered to be the start of recovery) and twenty-six control male subjects (mean age 23.2 ± 2.9 years) were considered in the study. Night-time RR time series were extracted from ECG signals. Selected linear as well as nonlinear HRV parameters were calculated. We found significant differences in Porta’s symbolic analysis parameters V0 and V2 (p

Published
2022
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4. SARS-CoV-2 infection activating a novel variant of the NOTCH3 gene and subsequently causing development of CADASIL

Author

Zbigniew J. Król, Małgorzata Dorobek, Maciej Dąbrowski, Justyna Zielińska-Turek, Bartosz Mruk, Jerzy Walecki, Katarzyna Sklinda, Robert Gil, Agnieszka Pawlak, Marzena Wojtaszewska, Adrian Lejman, Paula Dobosz, Paweł Zawadzki, Aneta Pawłowska, Michał Szczepaniak, Dorota Król, Artur Zaczyński, and Waldemar Wierzba

Subjects
sars-cov-2, covid-19, encephalitis, cadasil, whole genome sequencing, notch3 gene, Medicine
Abstract

Introduction In the following study we describe the diagnostic process and further case analysis of a 30-year-old woman admitted with typical COVID-19 symptoms, who subsequently developed additional symptoms suggesting cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy (CADASIL). Material and methods Other than the standard diagnostic procedures, whole genome sequencing (WGS) was used, which led to following findings. A new variant of the NOTCH3 gene, which led to CADASIL-like symptoms, was found, and it had been most likely activated by the SARS-CoV-2 infection. This novel variant in NOTCH3 has not been found in existing databases and has never been mentioned in research concerning CADASIL before. Results Furthermore, after subjecting the patient’s close relatives to WGS it was found that no other examined person demonstrated the same genetic mutation. Conclusions It seems therefore that the new variant of NOTCH3 is of de novo origin in the patient’s genome. Additionally, the relatively early onset of CADASIL and the unexpectedly severe COVID-19 infection suggest that the two occurred simultaneously: the infection with SARS-CoV-2 accelerated development of CADASIL symptoms and the unusual variant of the NOTCH3 gene contributed to the more severe course of COVID-19.

Published
2022
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7. Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER): protocol for a prospective observational nationwide study

Author

Agnieszka Kapłon-Cieślicka, Maciej Lesiak, Wojciech Wojakowski, Slawomir Dobrzycki, Mariusz Kowalewski, Krzysztof Reczuch, Roberto Lorusso, Michalina Kołodziejczak, Wojciech Wańha, Radoslaw Litwinowicz, Michal Pasierski, Rafal Januszek, Łukasz Kuźma, Marek Grygier, Robert Gil, Tomasz Pawłowski, Krzysztof Bartuś, Stanislaw Bartuś, Marek Andrzej Deja, Grzegorz Smolka, and Piotr Suwalski

Subjects
Medicine
Abstract

Introduction Atrial fibrillation (AF) is a prevalent disease considerably contributing to the worldwide cardiovascular burden. For patients at high thromboembolic risk (CHA2DS2-VASc ≥3) and not suitable for chronic oral anticoagulation, owing to history of major bleeding or other contraindications, left atrial appendage occlusion (LAAO) is indicated for stroke prevention, as it lowers patient’s ischaemic burden without augmentation in their anticoagulation profile.Methods and analysis Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER) will be conducted in 10 heart surgery and cardiology centres across Poland to assess the outcomes of LAAO performed by fully thoracoscopic-epicardial, percutaneous-endocardial or hybrid endo-epicardial approach. The registry will include patients with nonvalvular AF at a high risk of thromboembolic and bleeding complications (CHA2DS2-VASc Score ≥2 for males, ≥3 for females, HASBLED score ≥2) referred for LAAO. The first primary outcome is composite procedure-related complications, all-cause death or major bleeding at 12 months. The second primary outcome is a composite of ischaemic stroke or systemic embolism at 12 months. The third primary outcome is the device-specific success assessed by an independent core laboratory at 3–6 weeks. The quality of life (QoL) will be assessed as well based on the QoL EQ-5D-5L questionnaire. Medication and drug adherence will be assessed as well.Ethics and dissemination Before enrolment, a detailed explanation is provided by the investigator and patients are given time to make an informed decision. The patient’s data will be protected according to the requirements of Polish law, General Data Protection Regulation (GDPR) and hospital Standard Operating Procedures. The study will be conducted in accordance with the Declaration of Helsinki. Ethical approval was granted by the local Bioethics Committee of the Upper-Silesian Medical Centre of the Silesian Medical University in Katowice (decision number KNW/0022/KB/284/19). The results will be published in peer-reviewed journals and presented during national and international conferences.Trial registration number NCT05144958.

Published
2022
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8. Convalescent plasma treatment is associated with lower mortality and better outcomes in high-risk COVID-19 patients – propensity-score matched case-control study

Author

Adam Tworek, Krzysztof Jaroń, Beata Uszyńska-Kałuża, Andrzej Rydzewski, Robert Gil, Andrzej Deptała, Edward Franek, Rafał Wójtowicz, Katarzyna Życińska, Irena Walecka, Małgorzata Cicha, Waldemar Wierzba, Artur Zaczyński, Zbigniew J. Król, and Grażyna Rydzewska

Subjects
SARS-CoV-2, COVID-19, convalescent plasma, Infectious and parasitic diseases, RC109-216
Abstract

Objective: This study aimed to investigate the efficacy and safety of convalescent plasma (CP) transfusion in a group of high-risk COVID-19 patients. Methods: This prospective study included 204 patients from a single tertiary-care hospital, hospitalized with COVID-19, of whom 102 were treated with CP administration and standard care (PG) and 102 others who received standard care only (CG). The CG was selected from 336 hospitalized patients using the propensity-score matching (PSM) technique using age, MEWS score, and comorbidities. The primary outcome was mortality rate; secondary outcomes were the requirement of a ventilator, length of ventilator need, length of intensive care unit (ICU) stay, and length of overall hospital confinement. Additionally, parameters predicting death in COVID-19 patients were identified. Results: Findings confirmed a significantly lower mortality rate in the PG versus the CG (13.7% vs. 34.3 %, p = 0.001) and a significant difference in the cumulative incidence of death between the two groups (p

Published
2021
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10. Misdiagnosed Aortic Intramural Hematoma and the Role of Intravascular Ultrasound Imaging in Detection of Acute Aortic Syndrome: A Case Report

Author

Niya Mileva, Gianluca Rigatelli, Robert Gil, and Dobrin Vassilev

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Acute aortic syndrome includes classic aortic dissection, aortic intramural hematoma, and penetrating atherosclerotic ulcer – a group of conditions that are defined by their dynamic evolution and similar clinical manifestation. Accurate diagnosis and prompt treatment are essential as all the aforementioned conditions are a significant threat to a patient’s life. However, acute aortic syndrome and especially aortic intramural hematoma may be challenging diagnostic problems. Intravascular ultrasound imaging is a diagnostic method that can be useful for more thorough evaluation of the aortic lesion and can particularly aid in discerning the different forms of acute aortic syndrome. We present a case of a patient with aortic intramural hematoma that was missed by conventional imaging studies but was successfully visualized with intravascular ultrasound imaging.

Published
2018
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11. Boutonniere Versus Pseudoboutonniere Deformities: Pathoanatomy, Diagnosis, and Treatment

Author

Zachary C. Hanson, Robert Gil Thompson, James R. Andrews, and Gary M. Lourie

Subjects
Orthopedics and Sports Medicine, Surgery
Abstract

Finger injuries involving the proximal interphalangeal (PIP) joint are common, particularly among athletes. Injury severity is often underappreciated at initial presentation and may be dismissed broadly as a "jammed finger" injury. Delayed diagnosis and treatment of certain injuries can have an important impact on the patient's chance of regaining full function. Central slip and PIP volar plate injuries are frequently encountered injuries that, if left untreated, can lead to the permanent loss of function of the proximal interphalangeal joint. Despite the differing mechanisms of these 2 pathologies, volar plate hyperextension injuries often present with a PIP joint flexion contracture and mild distal interphalangeal joint hyperextension deformity. This is similar to a boutonniere deformity seen after an injury to the central slip, and thus, has been referred to as a "pseudo-boutonnière" deformity. Distinguishing these 2 diagnoses is important, as treatment differs, and highlights the importance of thoroughly understanding the anatomy and relevant clinical applications when evaluating PIP joint injuries.

Published
2023
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13. Out-of-hospital cardiac arrest: Do we have to perform coronary angiography?

Author

Wojciech Wańha, Michalina Kołodziejczak, Mariusz Kowalewski, Rafał Januszek, Łukasz Kuźma, Miłosz Jaguszewski, Mariusz Tomaniak, Szymon Darocha, Karolina Kupczyńska, Piotr Dobrowolski, Agata Tymińska, Aleksandra Ciepłucha, Justyna Sokolska, Agnieszka Kapłon-Cieślicka, Andrzej Kułach, Maciej Wybraniec, Tomasz Roleder, Mateusz Tajstra, Klaudiusz Nadolny, Tomasz Darocha, Katarzyna Sierakowska, Tomasz Pawłowski, Marek Gierlotka, Maciej Leskiak, Krystian Wita, Robert Gil, and Przemysław Trzeciak

Subjects
General Medicine, Cardiology and Cardiovascular Medicine
Published
2023
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14. Pre-hospital treatment of patients with acute coronary syndrome: Recommendations for medical emergency teams. Expert position update 2022

Author

Jacek Kubica, Piotr Adamski, Jerzy R. Ładny, Jarosław Kaźmierczak, Tomasz Fabiszak, Krzysztof J. Filipiak, Robert Gajda, Mariusz Gąsior, Zbigniew Gąsior, Robert Gil, Jarosław Gorący, Stefan Grajek, Leszek Gromadziński, Marcin Gruchała, Grzegorz Grześk, Piotr Hoffman, Miłosz J. Jaguszewski, Marianna Janion, Piotr Jankowski, Zbigniew Kalarus, Jarosław D. Kasprzak, Andrzej Kleinrok, Wacław Kochman, Aldona Kubica, Wiktor Kuliczkowski, Jacek Legutko, Maciej Lesiak, Klaudiusz Nadolny, Eliano P. Navarese, Piotr Niezgoda, Małgorzata Ostrowska, Przemysław Paciorek, Jolanta Siller-Matula, Łukasz Szarpak, Dariusz Timler, Adam Witkowski, Wojciech Wojakowski, Andrzej Wysokiński, and Marzenna Zielińska

Subjects
Emergency Medical Services, Humans, General Medicine, Acute Coronary Syndrome, Emergency Service, Hospital, Cardiology and Cardiovascular Medicine, Hospitals
Published
2022
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15. Leveraging calcium score CT radiomics for heart failure risk prediction

Author

Prerna Singh, Ammar Hoori, Joshua Freeze, Tao Hu, Nour Tashtish, Robert Gilkeson, Shuo Li, Sanjay Rajagopalan, David L. Wilson, and Sadeer Al-Kindi

Subjects
Medicine, Science
Abstract

Abstract Studies have used extensive clinical information to predict time-to-heart failure (HF) in patients with and without diabetes mellitus (DM). We aimed to determine a screening method using only computed tomography calcium scoring (CTCS) to assess HF risk. We analyzed CTCS scans from 1,998 patients (336 with type 2 diabetes) from a no-charge coronary artery calcium score registry (CLARIFY Study, Clinicaltrials.gov NCT04075162). We used deep learning to segment epicardial adipose tissue (EAT) and engineered radiomic features of calcifications (“calcium-omics”) and EAT (“fat-omics”). We developed models incorporating radiomics to predict risk of incident HF in patients with and without type 2 diabetes. At a median follow-up of 1.7 years, 5% had incident HF. In the overall cohort, fat-omics (C-index: 77.3) outperformed models using clinical factors, EAT volume, Agatston score, calcium-omics, and calcium-and-fat-omics to predict HF. For DM patients, the calcium-omics model (C-index: 81.8) outperformed other models. In conclusion, CTCS-based models combining calcium and fat-omics can predict incident HF, outperforming prediction scores based on clinical factors.Please check article title if captured correctly.YesPlease check and confirm that the authors and their respective affiliations have been correctly identified and amend if necessary.Yes

Published
2024
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16. Ticagrelor Monotherapy After PCI in High-Risk Patients With Prior MI

Author

Mauro Chiarito, Usman Baber, Davide Cao, Samin K. Sharma, George Dangas, Dominick J. Angiolillo, Carlo Briguori, David J. Cohen, Dariusz Dudek, Vladimír Džavík, Javier Escaned, Robert Gil, Christian W. Hamm, Timothy Henry, Kurt Huber, Adnan Kastrati, Upendra Kaul, Ran Kornowski, Mitchell Krucoff, Vijay Kunadian, Shamir R. Mehta, David Moliterno, E. Magnus Ohman, Keith Oldroyd, Gennaro Sardella, Zhang Zhongjie, Samantha Sartori, Giulio Stefanini, Richard Shlofmitz, P. Gabriel Steg, Giora Weisz, Bernhard Witzenbichler, Ya-ling Han, Stuart Pocock, C. Michael Gibson, and Roxana Mehran

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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17. Which patients at risk of cardiovascular disease might benefit the most from inclisiran? – The expert opinion of the Polish experts. The compromise between EBM and possibilities in healthcare

Author

Maciej Banach, Jarosław Kaźmierczak, Przemysław Mitkowski, Krystian Wita, Marlena Broncel, Mariusz Gąsior, Marek Gierlotka, Robert Gil, Piotr Jankowski, Maciej Niewada, and Adam Witkowski

Subjects
drug program, lipid lowering therapy, high risk patients, General Medicine, Poland, inclisiran, reimbursement
Abstract

It is the statement of the Polish Experts on the group of patients that might benefit the most from inclisiran. We indicated the fastest way to have inclisiran available for the polish patients, with the necessary changes of the existing drug program for PCSK9 inhibitors (B-101), explaining why it is the optimal way, and why, taking into account available EBM data (the ORION program), inclisiran should be added to this program. We also present some perspective on the future necessary changes in the availability of the innovative therapies such us PCSK9 targeted therapy, what, taking into account the effectiveness of LDL-C goal achievement in Poland for very high CVD risk patients (only 17%), seems to be critically important. Obviously it needs to be combined with our continuous attempts to improve the effectiveness and therapy adherence to available cheap therapy with statins and ezetimibe.

Published
2022

18. Ticagrelor with and without aspirin in patients with a prior coronary artery bypass graft undergoing percutaneous coronary intervention: the TWILIGHT-CABG study

Author

Gennaro Sardella, Frans J. Beerkens, George Dangas, Davide Cao, Usman Baber, Samantha Sartori, David J. Cohen, Carlo Briguori, Robert Gil, Johny Nicolas, Zhongjie Zhang, Dariusz Dudek, Vijay Kunadian, Ran Kornowski, Giora Weisz, Bimmer Claessen, Steven Marx, Javier Escaned, Kurt Huber, Timothy Collier, David J. Moliterno, E. Magnus Ohman, Mitchell W. Krucoff, Adnan Kastrati, Phillipe Gabriel Steg, Dominick J. Angiolillo, Shamir Mehta, Richard Shlofmitz, Samin Sharma, Stuart Pocock, Charles Michael Gibson, Roxana Mehran, Cardiology, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Stroke, Ticagrelor, Percutaneous Coronary Intervention, Treatment Outcome, Aspirin, Myocardial Infarction, Humans, Drug Therapy, Combination, Hemorrhage, Coronary Artery Bypass, Cardiology and Cardiovascular Medicine, Platelet Aggregation Inhibitors
Abstract

BACKGROUND: Prior coronary artery bypass graft surgery (CABG) patients undergoing percutaneous coronary intervention (PCI) are often older and present with multiple comorbidities. Ticagrelor monotherapy after a short course of dual antiplatelet therapy (DAPT) has emerged as an effective bleeding-avoidance strategy among high-risk patients. AIMS: We aimed to examine the effects of ticagrelor with or without aspirin in prior CABG patients undergoing PCI within the TWILIGHT trial. METHODS: After 3 months of ticagrelor plus aspirin, patients were randomised to either aspirin or placebo, in addition to ticagrelor, for 12 months and compared by prior CABG status. The primary endpoint was Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding. The key secondary endpoint was all-cause death, myocardial infarction (MI), or stroke. RESULTS: Out of 7,119 patients, a total of 703 (10.8%) patients had prior CABG within the randomised cohort. Prior CABG patients had more comorbidities and a higher incidence of BARC type 2, 3, or 5 bleeding and death, MI or stroke at 1 year after randomisation, compared with patients without prior CABG. Ticagrelor monotherapy was associated with significantly less BARC 2, 3, or 5 bleeding among prior CABG patients compared with DAPT (4.9% vs 9.6%, hazard ratio [HR] 0.50, 95% confidence interval [CI]: 0.28 to 0.90; pinteraction=0.676) and similar rates of death, MI or stroke (10.0% vs 8.7%, HR 1.14, 95% CI: 0.70 to 1.87; pinteraction=0.484). When comparing target vessel type, treatment effects were consistent among graft- and native-vessel interventions. CONCLUSIONS: In high-risk patients with prior CABG, ticagrelor monotherapy reduced bleeding without compromising ischaemic outcomes compared with ticagrelor plus aspirin.

Published
2022

20. Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER)

Author

Mariusz Kowalewski, Wojciech Wańha, Radoslaw Litwinowicz, Michalina Kołodziejczak, Michal Pasierski, Rafal Januszek, Łukasz Kuźma, Marek Grygier, Maciej Lesiak, Agnieszka Kapłon-Cieślicka, Krzysztof Reczuch, Robert Gil, Tomasz Pawłowski, Krzysztof Bartuś, Sławomir Dobrzycki, Roberto Lorusso, Stanislaw Bartuś, Marek Andrzej Deja, Grzegorz Smolka, Wojciech Wojakowski, Piotr Suwalski, MUMC+: MA Cardiothoracale Chirurgie (3), CTC, and RS: Carim - V04 Surgical intervention

Subjects
Male, Anticoagulants, Urodela, Hemorrhage, General Medicine, Brain Ischemia, Stroke, Observational Studies as Topic, Brain Ischemia/complications, Treatment Outcome, Anticoagulants/therapeutic use, Thromboembolism, Hemorrhage/chemically induced, Atrial Fibrillation, Quality of Life, Animals, Humans, Atrial Appendage, Female, Registries, Atrial Appendage/surgery, Atrial Fibrillation/complications, Thromboembolism/etiology, Stroke/complications
Abstract

IntroductionAtrial fibrillation (AF) is a prevalent disease considerably contributing to the worldwide cardiovascular burden. For patients at high thromboembolic risk (CHA2DS2-VASc ≥3) and not suitable for chronic oral anticoagulation, owing to history of major bleeding or other contraindications, left atrial appendage occlusion (LAAO) is indicated for stroke prevention, as it lowers patient’s ischaemic burden without augmentation in their anticoagulation profile.Methods and analysisStand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER) will be conducted in 10 heart surgery and cardiology centres across Poland to assess the outcomes of LAAO performed by fully thoracoscopic-epicardial, percutaneous-endocardial or hybrid endo-epicardial approach. The registry will include patients with nonvalvular AF at a high risk of thromboembolic and bleeding complications (CHA2DS2-VASc Score ≥2 for males, ≥3 for females, HASBLED score ≥2) referred for LAAO. The first primary outcome is composite procedure-related complications, all-cause death or major bleeding at 12 months. The second primary outcome is a composite of ischaemic stroke or systemic embolism at 12 months. The third primary outcome is the device-specific success assessed by an independent core laboratory at 3–6 weeks. The quality of life (QoL) will be assessed as well based on the QoL EQ-5D-5L questionnaire. Medication and drug adherence will be assessed as well.Ethics and disseminationBefore enrolment, a detailed explanation is provided by the investigator and patients are given time to make an informed decision. The patient’s data will be protected according to the requirements of Polish law, General Data Protection Regulation (GDPR) and hospital Standard Operating Procedures. The study will be conducted in accordance with the Declaration of Helsinki. Ethical approval was granted by the local Bioethics Committee of the Upper-Silesian Medical Centre of the Silesian Medical University in Katowice (decision number KNW/0022/KB/284/19). The results will be published in peer-reviewed journals and presented during national and international conferences.Trial registration numberNCT05144958.

Published
2022
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22. Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI

Author

Marco Valgimigli, Roxana Mehran, Anna Franzone, Bruno R. da Costa, Usman Baber, Raffaele Piccolo, Eùgene P. McFadden, Pascal Vranckx, Dominick J. Angiolillo, Sergio Leonardi, Davide Cao, George D. Dangas, Shamir R. Mehta, Patrick W. Serruys, C. Michael Gibson, Gabriel P. Steg, Samin K. Sharma, Christian Hamm, Richard Shlofmitz, Christoph Liebetrau, Carlo Briguori, Luc Janssens, Kurt Huber, Maurizio Ferrario, Vijay Kunadian, David J. Cohen, Aleksander Zurakowski, Keith G. Oldroyd, Han Yaling, Dariuz Dudek, Samantha Sartori, Brian Kirkham, Javier Escaned, Dik Heg, Stephan Windecker, Stuart Pocock, Peter Jüni, Patrick Serruys, Shamir Mehta, Michael C. Gibson, Adnan Kastrati, Mitchel Krucoff, Magnus E. Ohman, Paul Gurbel, Timothy D. Henry, David Moliterno, Dierik Heg, Eugene McFadden, Steven O. Marx, Bruce Darrow, Nicola Corvaja, Douglas DeStefano, Newsha Ghodsi, Jose Meller, Theresa Franklin-Bond, Jin Young Cha, Zaha Waseem, Giora Weisz, Ran Kornowski, Keith Oldroyd, Upendra Kaul, Bernhard Witzenbichler, Vladimir Dzavik, Robert Gil, Gennaro Sardella, Edouard Benit, Roberto Diletti, Marcello Dominici, Ton Slagboom, Paweł Buszman, Leonardo Bolognese, Carlo Tumscitz, Krzysztof Bryniarski, Adel Aminian, Mathias Vrolix, Ivo Petrov, Scot Garg, Christoph Naber, Janusz Prokopczuk, and Philippe Gabriel Steg

Subjects
medicine.medical_specialty, Aspirin, animal structures, business.industry, medicine.medical_treatment, Hazard ratio, Percutaneous coronary intervention, 030204 cardiovascular system & hematology, Lower risk, medicine.disease, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Conventional PCI, medicine, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, business, Ticagrelor, Stroke, medicine.drug
Abstract

Objectives The aim of this study was to compare ticagrelor monotherapy with dual-antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with drug-eluting stents. Background The role of abbreviated DAPT followed by an oral P2Y12 inhibitor after PCI remains uncertain. Methods Two randomized trials, including 14,628 patients undergoing PCI, comparing ticagrelor monotherapy with standard DAPT on centrally adjudicated endpoints were identified, and individual patient data were analyzed using 1-step fixed-effect models. The protocol was registered in PROSPERO ( CRD42019143120 ). The primary outcomes were the composite of Bleeding Academic Research Consortium type 3 or 5 bleeding tested for superiority and, if met, the composite of all-cause death, myocardial infarction, or stroke at 1 year, tested for noninferiority against a margin of 1.25 on a hazard ratio (HR) scale. Results Bleeding Academic Research Consortium type 3 or 5 bleeding occurred in fewer patients with ticagrelor than DAPT (0.9% vs. 1.7%, respectively; HR: 0.56; 95% confidence interval [CI]: 0.41 to 0.75; p Conclusions Ticagrelor monotherapy was associated with a lower risk for major bleeding compared with standard DAPT, without a concomitant increase in ischemic events.

Published
2021
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23. Boutonniere Versus Pseudoboutonniere Deformities: Pathoanatomy, Diagnosis, and Treatment.

Author

Hanson, Zachary C., Thompson, Robert Gil, Andrews, James R., and Lourie, Gary M.

Abstract

Finger injuries involving the proximal interphalangeal (PIP) joint are common, particularly among athletes. Injury severity is often underappreciated at initial presentation and may be dismissed broadly as a "jammed finger" injury. Delayed diagnosis and treatment of certain injuries can have an important impact on the patient's chance of regaining full function. Central slip and PIP volar plate injuries are frequently encountered injuries that, if left untreated, can lead to the permanent loss of function of the proximal interphalangeal joint. Despite the differing mechanisms of these 2 pathologies, volar plate hyperextension injuries often present with a PIP joint flexion contracture and mild distal interphalangeal joint hyperextension deformity. This is similar to a boutonniere deformity seen after an injury to the central slip, and thus, has been referred to as a "pseudo-boutonnière" deformity. Distinguishing these 2 diagnoses is important, as treatment differs, and highlights the importance of thoroughly understanding the anatomy and relevant clinical applications when evaluating PIP joint injuries. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Quantitative MODS-Wayne assay for rapid detection of pyrazinamide resistance in Mycobacterium tuberculosis from sputum samples

Author

Emily Toscano-Guerra, Roberto Alcántara, Katherine Lozano Untiveros, Robert Gilman, Louis Grandjean, Mirko Zimic, and Patricia Sheen

Subjects
Tuberculosis, pyrazinamide, pyrazinoic acid, resistance, MODS-Wayne, Microbiology, QR1-502
Abstract

ABSTRACT Tuberculosis (TB) remains a significant global health challenge, exacerbated by the emergence of drug-resistant strains, such as those resistant to pyrazinamide (PZA). The current scarcity of affordable and precise quantitative diagnostic tests for PZA resistance underscores the urgent need for more accessible diagnostic tools. We evaluated PZA susceptibility in 264 TB-positive samples by quantifying pyrazinoic acid (POA) production, using both the MODS-Wayne qualitative assay and our newly developed quantitative approach (MODS-WQ). The MODS-WQ was assessed in 7H9 medium (MODS-WQ7H9) or citrate buffer (MODS-WQCB), with POA levels measured via spectrophotometry against a calibration curve. PZA susceptibility determinations were based on a composite reference standard. Associations between POA levels and pyrazinamidase mutations were explored. The composite standard detected PZA resistance in 23.5% of the samples, which accounts for 62.8% of the multidrug-resistant (MDR) samples. The MODS-WQ established specific POA cutoffs of 123.25 µM for MODS-WQ7H9 and 664.7 µM for MODS-WQCB, with sensitivities of 81.3% and 92.3% and specificities of 77.2% and 95.9%, respectively. Notably, samples with mutations in the pyrazinamidase metal-binding site exhibited significantly lower POA levels compared with mutations in the enzyme periphery. Furthermore, a significant correlation was found between POA production and PZA resistance, Bactec Growth Index, and minimum inhibitory concentration (MIC) values. This study presents a novel, direct, and accessible susceptibility test for PZA resistance that quantifies POA, enhancing the detection capabilities for this condition. The citrate-buffered MODS-WQ assay demonstrated high sensitivity and specificity for quantifying POA, confirming that POA production is a reliable indicator of PZA resistance.IMPORTANCEPZA susceptibility testing continues to be a challenge, particularly in countries with high TB incidence. In response to this pressing need, we have developed a quantitative MODS-Wayne (MODS-WQ) assay. This approach offers a direct and cost-effective solution representing a significant advancement in TB diagnostics, particularly benefiting resource-limited laboratories, primarily in developing regions. The MODS-WQ assay stands out for its ability to quantify pyrazinoic acid (POA) production, as a reliable indicator of PZA resistance. Unlike traditional qualitative assays, MODS-WQ eliminates the inherent subjectivity in interpretation, providing more accurate and actionable results. Moreover, the MODS-WQ approach accounts for critical factors influencing PZA resistance, including enzymatic efficiency and efflux pump activity. By integrating these factors into the detection process, our methodology offers a comprehensive understanding of PZA resistance levels, enabling tailored treatment strategies for patients.

Published
2024
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25. Methods to compare sites concerning a category’s change during various time intervals

Author

Thomas Mumuni Bilintoh, Robert Gilmore Pontius, and Aiyin Zhang

Subjects
Alternation, land change, time series, Marsh, Trajectories, Mathematical geography. Cartography, GA1-1776, Environmental sciences, GE1-350
Abstract

This paper presents new methods to analyze a category’s change through a time series of maps, even when the time intervals have inconsistent durations. The methods include an option to facilitate comparison among sites by expressing results as an annual percentage of each site’s unified size. A site’s unified size is the union of where the category exists at any of the site’s time points. The methods also specify gross losses, gross gains, eight trajectories, and three components: Quantity, Exchange, and Alternation. The illustrative application compares maps of the marsh category for three Long-Term Ecological Research sites: Plum Island Ecosystems (PIE), Georgia Coastal Ecosystems (GCE), and the Virginia Coast Reserve (VCR). The application analyzes marsh’s changes during two time intervals that have unequal durations within each site’s distinct temporal extent. Results show that PIE has the fastest change during each site’s temporal extent. Gross change is more than double the quantity change for all sites. Exchange accounts for most of the change in GCE, while Alternation accounts for most of the change in PIE and VCR. The methods provide more information than popular methods that quantify annual net change. Our timeseriesTrajectories R package performs the analysis and is available for free at https://github.com/bilintoh/timeseriesTrajectories.

Published
2024
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26. The Thousand Polish Genomes—A Database of Polish Variant Allele Frequencies

Author

Elżbieta Kaja, Adrian Lejman, Dawid Sielski, Mateusz Sypniewski, Tomasz Gambin, Mateusz Dawidziuk, Tomasz Suchocki, Paweł Golik, Marzena Wojtaszewska, Magdalena Mroczek, Maria Stępień, Joanna Szyda, Karolina Lisiak-Teodorczyk, Filip Wolbach, Daria Kołodziejska, Katarzyna Ferdyn, Maciej Dąbrowski, Alicja Woźna, Marcin Żytkiewicz, Anna Bodora-Troińska, Waldemar Elikowski, Zbigniew J. Król, Artur Zaczyński, Agnieszka Pawlak, Robert Gil, Waldemar Wierzba, Paula Dobosz, Katarzyna Zawadzka, Paweł Zawadzki, and Paweł Sztromwasser

Subjects
Genome, Human, Organic Chemistry, General Medicine, Catalysis, Computer Science Applications, Mitochondrial Proteins, Inorganic Chemistry, Genetics, Population, Gene Frequency, variant, allele frequency, genome, whole-genome sequencing, population genomics, allelic distribution, Polish genomes, Humans, Poland, Physical and Theoretical Chemistry, Molecular Biology, Alleles, Spectroscopy
Abstract

Although Slavic populations account for over 4.5% of world inhabitants, no centralised, open-source reference database of genetic variation of any Slavic population exists to date. Such data are crucial for clinical genetics, biomedical research, as well as archeological and historical studies. The Polish population, which is homogenous and sedentary in its nature but influenced by many migrations of the past, is unique and could serve as a genetic reference for the Slavic nations. In this study, we analysed whole genomes of 1222 Poles to identify and genotype a wide spectrum of genomic variation, such as small and structural variants, runs of homozygosity, mitochondrial haplogroups, and de novo variants. Common variant analyses showed that the Polish cohort is highly homogenous and shares ancestry with other European populations. In rare variant analyses, we identified 32 autosomal-recessive genes with significantly different frequencies of pathogenic alleles in the Polish population as compared to the non-Finish Europeans, including C2, TGM5, NUP93, C19orf12, and PROP1. The allele frequencies for small and structural variants, calculated for 1076 unrelated individuals, are released publicly as The Thousand Polish Genomes database, and will contribute to the worldwide genomic resources available to researchers and clinicians.

Published
2022
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27. Clinical use of intracoronary imaging modalities in Poland. Expert opinion of the Association of Cardiovascular Interventions of the Polish Cardiac Society

Author

Tomasz Pawłowski, Jacek Legutko, Janusz Kochman, Tomasz Roleder, Jerzy Pręgowski, Zbigniew Chmielak, Jacek Kubica, Andrzej Ochała, Radosław Parma, Marek Grygier, Dariusz Dudek, Wojciech Wojakowski, Stanisław Bartuś, Adam Witkowski, and Robert Gil

Subjects
Humans, Coronary Artery Disease, Poland, Cardiology and Cardiovascular Medicine, Coronary Vessels, Expert Testimony, Tomography, Optical Coherence, Ultrasonography, Interventional
Abstract

The article presents the most common, current indications for the use of intravascular invasive imag-ing diagnostic techniques, i.e. intravascular ultrasound and optical coherence tomography in Polish invasive cardiology centers. The application of the above-mentioned techniques in the diagnosis of stenosis of the left main coronary artery, optimization of stent implantation procedures, treatment of calcified lesions, and other clinically important issues are discussed.

Published
2022

29. SARS-CoV-2 infection activating a novel variant of NOTCH3 Gene and subsequently causing development of Cerebral Autosomal Dominant Arteriopathy with Sub-cortical Infarcts and Leukoencephalopathy (CADASIL)

Author

Król, Zbigniew, primary, Dorobek, Małgorzata, additional, Dąbrowski, Maciej, additional, Zielińska-Turek, Justyna, additional, Mruk, Bartosz, additional, Walecki, Jerzy, additional, Sklinda, Katarzyna, additional, Robert, Gil, additional, Pawlak, Agnieszka, additional, Wojtaszewska, Marzena, additional, Lejman, Adrian, additional, Dobosz, Paula, additional, Zawadzki, Paweł, additional, Pawłowska, Aneta, additional, Szczepaniak, Michał, additional, Król, Dorota, additional, Zaczyński, Artur, additional, and Wierzba, Waldemar, additional

Published
2022
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30. Ticagrelor monotherapy after PCI in patients with concomitant diabetes mellitus and chronic kidney disease : TWILIGHT DM-CKD

Author

Payam Dehghani, Davide Cao, Usman Baber, Johny Nicolas, Samantha Sartori, Carlo A Pivato, Zhongjie Zhang, George Dangas, Dominick J Angiolillo, Carlo Briguori, David J Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W Krucoff, Vijay Kunadian, Shamir Mehta, David J Moliterno, E Magnus Ohman, Javier Escaned, Gennaro Sardella, Samin K Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, Stuart Pocock, and Roxana Mehran

Subjects
Stroke, Ticagrelor, Percutaneous Coronary Intervention, Aspirin, Diabetes Mellitus, Myocardial Infarction, Humans, Drug Therapy, Combination, Hemorrhage, Pharmacology (medical), Renal Insufficiency, Chronic, Cardiology and Cardiovascular Medicine, Platelet Aggregation Inhibitors
Abstract

Aims We aimed to evaluate the treatment effects of ticagrelor monotherapy in the very high risk cohort of patients with concomitant diabetes mellitus (DM) and chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI). Methods and results In the TWILIGHT (Ticagrelor with Aspirin or Alone in High-Risk Patients after Coronary Intervention) trial, after 3-month dual antiplatelet therapy with ticagrelor and aspirin post-PCI, event-free patients were randomized to either aspirin or placebo in addition to ticagrelor for 12 months. Those with available information on DM and CKD status were included in this subanalysis and were stratified by the presence or absence of either condition: 3391 (54.1%) had neither DM nor CKD (DM−/CKD−), 1822 (29.0%) had DM only (DM+/CKD−), 561 (8.9%) had CKD only (DM−/CKD+), and 8.0% had both DM and CKD (DM+/CKD+). The incidence of the primary endpoint of Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding did not differ according to DM/CKD status (P-trend = 0.13), but there was a significant increase in BARC 3 or 5 bleeding (P-trend < 0.001) as well as the key secondary endpoint of death, myocardial infarction, or stroke (P-trend < 0.001). Ticagrelor plus placebo reduced bleeding events compared with ticagrelor plus aspirin across all four groups, including DM+/CKD+ patients with respect to BARC 2–5 [4.5% vs. 8.7%; hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.24–1.01] as well as BARC 3–5 (0.8% vs. 5.3%; HR 0.15, 95% CI 0.03–0.53) bleeding, with no evidence of heterogeneity. The risk of death, myocardial infarction, or stroke was similar between treatment arms across all groups. Conclusion Irrespective of the presence of DM, CKD, and their combination, ticagrelor monotherapy reduced the risk of bleeding without a significant increase in ischaemic events compared with ticagrelor plus aspirin.

Published
2022

31. Bleeding and ischemic outcomes with ticagrelor monotherapy according to Body Mass Index

Author

Vijay Kunadian, Usman Baber, Carlo A. Pivato, Davide Cao, George Dangas, Samantha Sartori, Zhongjie Zhang, Dominick J. Angiolillo, Carlo Briguori, David J. Cohen, Timothy Collier, Dariusz Dudek, Michael Gibson, Robert Gil, Kurt Huber, Upendra Kaul, Ran Kornowski, Mitchell W. Krucoff, Payam Dehghani, Shamir Mehta, David J. Moliterno, E. Magnus Ohman, Javier Escaned, Gennaro Sardella, Samin K. Sharma, Richard Shlofmitz, Giora Weisz, Bernhard Witzenbichler, Vladimír Džavík, Paul Gurbel, Christian W. Hamm, Timothy Henry, Adnan Kastrati, Steven O. Marx, Keith Oldroyd, P. Gabriel Steg, Stuart Pocock, and Roxana Mehran

Subjects
Ticagrelor, Percutaneous Coronary Intervention, Treatment Outcome, Aspirin, Humans, Drug Therapy, Combination, Hemorrhage, Obesity, Overweight, Cardiology and Cardiovascular Medicine, Platelet Aggregation Inhibitors, Body Mass Index
Abstract

There is a paucity of data regarding the safety and efficacy of different antiplatelet regimens according to standardized body mass index (BMI) categories.The aim of this study was to investigate bleeding and ischemic outcomes according to BMI in the TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention) trial.The TWILIGHT trial randomized high-risk patients to ticagrelor plus aspirin or ticagrelor plus placebo at 3 months after percutaneous coronary intervention. In this secondary analysis, patients were stratified by standard BMI categories, as recommended by the European Society of Cardiology Working Group on Thrombosis (normal weight [BMI 18.5-24.99 kg/mAmong 7,038 patients randomized and with available BMI, 1,807 (25.7%) were normal weight, 2,927 (41.6%) were overweight, and 2,304 (32.7%) were obese. In normal-weight, overweight, and obese patients, ticagrelor monotherapy, compared with ticagrelor plus aspirin, reduced the primary endpoint of Bleeding Academic Research Consortium type 2, 3, or 5 bleeding (normal weight: HR: 0.48 [95% CI: 0.32-0.73]; overweight: HR: 0.57 [95% CI: 0.41-0.78]; obese: HR: 0.63 [95% CI: 0.44-0.91]; P for interaction = 0.627), without any increase in the composite ischemic endpoint of all-cause death, myocardial infarction, or stroke (normal weight: HR: 1.36 [95% CI: 0.84-2.19]; overweight: HR: 0.92 [95% CI: 0.63-1.35]; obese: HR: 0.84 [95% CI: 0.56-1.25]; P for interaction = 0.290). These findings were consistent with the prespecified analysis by median BMI.Among high-risk patients undergoing percutaneous coronary intervention, ticagrelor monotherapy, compared with ticagrelor plus aspirin, reduced bleeding events without any increase in ischemic risk across different BMI categories.

Published
2022

33. Ultrastructural Changes in Mitochondria in Patients with Dilated Cardiomyopathy and Parvovirus B19 Detected in Heart Tissue without Myocarditis

Author

Agnieszka Pawlak, Magdalena Gewartowska, Maciej Przybylski, Mateusz Kuffner, Diana Wiligórska, Robert Gil, Zbigniew Król, and Malgorzata Frontczak-Baniewicz

Subjects
viral infection, electron microscopy, dilated cardiomyopathy, parvovirus B19, mitochondria, Medicine (miscellaneous)
Abstract

Understanding the meaning of parvovirus B19 (PB19V) in an etiology of dilated cardiomyopathy (DCM) is difficult. Viruses change the dynamics of the mitochondria by interfering with the mitochondrial process/function, causing the alteration of mitochondrial morphology. In this study, the ultrastructural changes in the mitochondria in endomyocardial biopsy (EMB) samples from patients with DCM and PB19V were determined. Methods: The PB19V evaluation was performed in EMB specimens by real-time PCR in 20 patients (age: 28 ± 6 years). The biopsy specimens were examined by histo- and immunohistochemistry to detect the inflammatory response. The ultrastructural features of the mitochondria were evaluated by electron microscopy. Results: The presence of PB19V in the heart tissue without the presence of inflammatory process, defined according to Dallas and immunohistochemical criteria, was associated with ultrastructural changes in the mitochondria. Distinctive ultrastructural pathologies were indicated, such as the presence of mitochondria in the vicinity of the expanded sarcoplasmic reticulum with amorphous material, blurred structure of mitochondria, interrupted outer mitochondrial membrane and mitophagy. Conclusions: Extending diagnostics with ultrastructural analysis of biopsy samples provides new knowledge of the changes associated with the presence of PB19V in the heart tissue. The observed changes can be a basis for searching for the damage mechanisms, as well as for new therapeutic solutions.

Published
2021

34. Abstract 11354: Registry Based Mid-Term Mortality After Stenting of Distal Left Main Stenosis with Regular, Third Generation Drug Eluting Stent or Dedicated Bifurcation Stent or Surgery

Author

Dobrin Vassilev, Galina Zlatancheva, Monika Shumkova, Pavel Nikolov, Kiril Karamfiloff, and Robert Gil

Subjects
Physiology (medical), Cardiology and Cardiovascular Medicine
Abstract

Background: The aim of the current study was to identify predictors of cardiac mortality at mid-term follow up after PCI (DES vs. dedicated bifurcation stent) or CABG. Methods: All patients with distal LM stenosis≥50% were included in prospective registry starting from 01.2015.The exclusion criteria for registry are cardiogenic shock,a priory life expectancy duration < 1 year,lack of inform consent.All patients were prospectively followed about the alive status through the national security number data base. Results: For three year follow up period (median 35 months, IQR 18-50) 303 patients were included.220 patients were stented with 3 rd generation DES, 43 with dedicated bifurcation stent BiOSS (Balton, Poland),and rest were sent for CABG.The mean age was 67 ± 10 years,72% were males,37% diabetics,all with hypertension, 97% dyslipidemia,15% PAD,9% COPD,16% carotid artery disease,previous MI 28%,previous PCI 50% - without significant difference between three groups.The frequency of acute coronary syndrome during admission was 11%-without difference in frequency between groups.The patient referred to CABG had significantly lower left ventricular EDV and ESV,more severe mitral regurgitation and kinetic disturbances,higher SYNTAX score and longer lesion length.On univariate COX regression analysis, the following factors were associated with mortality:age, NYHA class,GFR,baseline troponin,hemoglobin,LV EF,mitral regurgitation,kinetics disturbances,treatment with beta blockers,ACE inhibitors,statin,atrial fibrillation,SYNTAX score,lesion length.The type of treatment was not associated with differences in mortality.On COX multiple regression survival analysis independent predictors of survival were:age (HR=1.036, CI 1.005-1.068, p= .023);COPD (HR= 2.313, CI 1.170-4.572, p= .016);GFR (HR= .988, CI .978-1.000, p= .048);hemoglobin(HR= .970, CI .955- .986, p= .000);left ventricular EF (HR= .958, CI .832- .985, p= .003). Conclusions: The type of treatment was not associated with mid-term mortality.Our data demonstrate that dedicated bifurcation stent could be used safely for distal LM stenosis treatment with similar safety as 3 rd generation DES.

Published
2021
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36. Enhancing cardiovascular risk prediction through AI-enabled calcium-omics

Author

Ammar Hoori, Sadeer Al-Kindi, Tao Hu, Yingnan Song, Hao Wu, Juhwan Lee, Nour Tashtish, Pingfu Fu, Robert Gilkeson, Sanjay Rajagopalan, and David L. Wilson

Subjects
Medicine, Science
Abstract

Abstract Whole-heart coronary calcium Agatston score is a well-established predictor of major adverse cardiovascular events (MACE), but it does not account for individual calcification features related to the pathophysiology of the disease (e.g., multiple-vessel disease, spread of the disease along the vessel, stable calcifications, numbers of lesions, and density). We used novel, hand-crafted calcification features (calcium-omics); Cox time-to-event modeling; elastic net; and up and down synthetic sampling methods for imbalanced data, to assess MACE risk. We used 2457 CT calcium score (CTCS) images enriched for MACE events from our large no-cost CLARIFY program (ClinicalTrials.gov Identifier: NCT04075162). Among calcium-omics features, numbers of calcifications, LAD mass, and diffusivity (a measure of spatial distribution) were especially important determinants of increased risk, with dense calcification (> 1000HU, stable calcifications) associated with reduced risk Our calcium-omics model with (training/testing, 80/20) gave C-index (80.5%/71.6%) and 2-year AUC (82.4%/74.8%). Although the C-index is notoriously impervious to model improvements, calcium-omics compared favorably to Agatston and gave a significant difference (P

Published
2024
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38. A hydraulic track drive systems resistive force simulation: Considerations for system electrification

Author

Hugh Coyle, Charles Young, Nicola Anderson, Lee Johnston, and Robert Gilmour

Subjects
Tracked vehicle, Hydraulic track drive, Resistive force modelling, Mobile rock crushers, Technology
Abstract

An overview of hydraulic track drive systems employed in mobile rock crushers for the mining industry is provided. A mathematical model was developed to analyse thrust and resistive forces experienced during typical machine operations, including flat-plane tracking, incline climbing, and pivot turning. The model provides a basis for assessing power demands required to transition from hydraulic to electric drive systems by quantifying relevant resistive forces involved. Simulink simulations of the track loading, transverse and longitudinal resistive forces, and frictional forces were performed to evaluate system performance under various operational conditions. Results show that incline tracking climbing a slope generate significantly higher resistive forces than straight tracking or pivot turning tracking. This study addresses the challenges of electrifying large-scale off-road machinery by providing insights into the operational demands of the hydraulic system. The findings offer a foundation for subsequent research into electric alternatives that can deliver comparable power densities, improve energy efficiency, and reduce emissions. Potential areas for further investigation include battery optimisation, advancements in electric motor technology, and hybrid solutions that bridge hydraulic and fully electric systems.

Published
2025
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40. Ticagrelor Monotherapy After PCI in High-Risk Patients With Prior MI: A Prespecified TWILIGHT Substudy

Author

Mauro, Chiarito, Usman, Baber, Davide, Cao, Samin K, Sharma, George, Dangas, Dominick J, Angiolillo, Carlo, Briguori, David J, Cohen, Dariusz, Dudek, Vladimír, Džavík, Javier, Escaned, Robert, Gil, Christian W, Hamm, Timothy, Henry, Kurt, Huber, Adnan, Kastrati, Upendra, Kaul, Ran, Kornowski, Mitchell, Krucoff, Vijay, Kunadian, Shamir R, Mehta, David, Moliterno, E Magnus, Ohman, Keith, Oldroyd, Gennaro, Sardella, Zhang, Zhongjie, Samantha, Sartori, Giulio, Stefanini, Richard, Shlofmitz, P Gabriel, Steg, Giora, Weisz, Bernhard, Witzenbichler, Ya-Ling, Han, Stuart, Pocock, C Michael, Gibson, and Roxana, Mehran

Subjects
Ticagrelor, Percutaneous Coronary Intervention, Treatment Outcome, Myocardial Infarction, Humans, Drug Therapy, Combination, Drug-Eluting Stents, Platelet Aggregation Inhibitors
Abstract

The aim of this study was to evaluate if patients with prior myocardial infarction (MI) could benefit from ticagrelor monotherapy in terms of bleeding reduction without any compromise in ischemic event prevention.Patients with history of MI who undergo percutaneous coronary intervention (PCI) remain at risk for recurrent ischemic events. The optimal antithrombotic strategy for this cohort remains debated.In this prespecified analysis of the randomized TWILIGHT (Ticagrelor With Aspirin or Alone in High-Risk Patients after Coronary Intervention) trial, the authors evaluated the impact of history of MI on treatment effect of ticagrelor monotherapy versus ticagrelor plus aspirin in patients undergoing PCI with drug-eluting stent with at least 1 clinical and 1 angiographic high-risk feature and free from adverse events at 3 months after index PCI. The primary endpoint was Bleeding Academic Research Consortium type 2, 3, or 5 bleeding, and the key secondary endpoint was the composite of all-cause death, MI, or stroke, both at 12 months after randomization.A total of 1,937 patients (29.7%) with and 4,595 patients (70.3%) without prior MI were randomized to ticagrelor and placebo or ticagrelor and aspirin. At 1 year after randomization, patients with prior MI experienced higher rates of death, MI, or stroke (5.7% vs 3.2%; P 0.001) but similar BARC types 2 to 5 bleeding (5.0% vs 5.5%; P = 0.677) compared with patients without prior MI. Ticagrelor monotherapy consistently reduced the risk for the primary bleeding outcome in patients with (3.4% vs 6.7%; HR: 0.50; 95% CI: 0.33-0.76) and without (4.2% vs 7.0%; HR: 0.58; 95% CI: 0.45-0.76; PTicagrelor monotherapy is associated with significantly lower risk for bleeding events compared with ticagrelor plus aspirin, without any compromise in ischemic prevention, among high-risk patients with history of MI undergoing PCI. (Ticagrelor With Aspirin or Alone in High-Risk Patients After Coronary Intervention [TWILIGHT]; NCT02270242).

Published
2021

41. TCTAP A-054 Shockwave Intravascular Lithotripsy as a Novel Strategy for the Treatment of Stent Underexpansion Caused by Calcified Plaques

Author

Wojciech Wańha, Mariusz Tomaniak, Jacek Bil, Rafał Januszek, Rafał Wolny, Maksymilian Opolski, Łukasz Kuźma, Adam Janas, Tomasz Figatowski, Łukasz Lewicki, Jakub Kulczycki, Adrian Wlodarczak, Brunon Tomasiewicz, Sylwia Iwańczyk, Jerzy Sacha, Łukasz Koltowski, Miłosz Dziarmaga, Miłosz Jaguszewski, Bartosz Olajossy, Krzysztof Dyrbuś, Krzysztof Reczuch, Robert Gil, Sławomir Dobrzycki, Janusz Kochman, Andrzej Ochala, Adam Witkowski, Maciej Lesiak, Fabrizio D'Ascenzo, Sławomir Bartuś, and Wojciech Wojakowski

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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42. Athletic Trainers' Effect on Population Health: Improving Access to and Quality of Care

Author

W. Franklin Sease, John Thorpe, Charles Thigpen, Robert Gil Gilliland, Cole G. Chapman, and Ellen Shanley

Subjects
Male, Trainer, South Carolina, Physical Therapy, Sports Therapy and Rehabilitation, Context (language use), Population health, Sports Medicine, Tertiary care, Cohort Studies, 03 medical and health sciences, Athletic training, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Injury prevention, Humans, Orthopedics and Sports Medicine, Quality of care, School Health Services, Original Research, 030222 orthopedics, Medical education, Schools, Population Health, Scope (project management), Health Care Costs, 030229 sport sciences, General Medicine, Quality Improvement, Athletes, Athletic Injuries, Female, Psychology, Sports
Abstract

Context The scope of athletic training practice combined with the magnitude of scholastic athletic injuries means that the scholastic athletic trainer (AT) is uniquely positioned to positively affect the overall health care of this population. The AT is equipped to serve in the prevention and primary management of injuries and return to activity of scholastic athletes. However, to optimize the musculoskeletal health of all athletes within a given setting, the gaps in clinical care must be continuously evaluated. Quality improvement (QI) approaches are often used to establish a framework for delivering care that promotes the best health status of the targeted population. Objective To describe the creation, implementation, and early results of a QI initiative aimed at advancing the health of the scholastic athletes served in the Greenville County, South Carolina, school district. Design Cohort study. Patients or Other Participants A total of 49 793 athletes. Main Outcome Measure(s) The QI framework consisted of a process that documented the magnitude of athletic injuries, established risk factors for injury, defined intervention steps for at-risk athletes, and evaluated the QI process before and after implementation. The results were regularly reported to participating stakeholders, including ATs, athletic directors, coaches, parents, and athletes. Results After the QI process, injury rates decreased (absolute risk difference between the 2011–2012 and 2016–2017 academic years = 22%) and resources were more strategically allocated, which resulted in a decrease in health care costs of more than 50%. Conclusions Collectively, the QI framework as described provides a systematic process for empowering the AT as the foundation of the scholastic sports medicine team.

Published
2019
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43. TCT-188 Safety and Efficacy of Intravascular Lithotripsy in the Management of Stent Underexpansion Among Elderly Patients

Author

Mariusz Tomaniak, Janusz Kochman, Rafał Januszek, Rafał Wolny, Maksymilian Opolski, Łukasz Kuźma, Lukasz Lewicki, Jacek Bil, Jan Kulczycki, Adrian Wlodarczak, Brunon Tomasiewicz, Sylwia Iwanczyk, Jerzy Sacha, Lukasz Koltowski, Milosz Dziarmaga, Milosz Jaguszewski, Pawel Kralisz, Grzegorz Sobieszek, Krzysztof Dyrbus, Piotr Wańczura, Mariusz Łebek, Krzysztof Reczuch, Tomasz Pawlowski, Robert Gil, Slawomir Dobrzycki, Piotr Kwiatkowski, Mariusz Gąsior, Andrzej Ochala, Adam Witkowski, Maciej Lesiak, Fabrizio D’Ascenzo, Stanislaw Bartus, Wojciech Wojakowski, and Wojciech Wańha

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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44. Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Author

Alison Halliday, Richard Bulbulia, Leo H Bonati, Johanna Chester, Andrea Cradduck-Bamford, Richard Peto, Hongchao Pan, John Potter, Hans Henning Eckstein, Barbara Farrell, Marcus Flather, Averil Mansfield, Boby Mihaylova, Kazim Rahimi, David Simpson, Dafydd Thomas, Peter Sandercock, Richard Gray, Andrew Molyneux, Cliff P Shearman, Peter Rothwell, Anna Belli, Will Herrington, Parminder Judge, Peter Leopold, Marion Mafham, Michael Gough, Piergiorgio Cao, Sumaira MacDonald, Vasha Bari, Clive Berry, S Bradshaw, Wojciech Brudlo, Alison Clarke, Robin Cox, Susan Fathers, Kamran Gaba, Mo Gray, Elizabeth Hayter, Constance Holliday, Rijo Kurien, Michael Lay, Steffi le Conte, Jessica McManus, Zahra Madgwick, Dylan Morris, Andrew Munday, Sandra Pickworth, Wiktor Ostasz, Michiel Poorthuis, Sue Richards, Louisa Teixeira, Sergey Tochlin, Lynda Tully, Carol Wallis, Monique Willet, Alan Young, Renato Casana, Chiara Malloggi, Andrea Odero Jr, Vincenzo Silani, Gianfranco Parati, Giuseppe Malchiodi, Giovanni Malferrari, Francesco Strozzi, Nicola Tusini, Enrico Vecchiati, Gioacchino Coppi, Antonio Lauricella, Roberto Moratto, Roberto Silingardi, Jessica Veronesi, Andrea Zini, Emanuele Ferrero, Michelangelo Ferri, Andrea Gaggiano, Carmelo Labate, Franco Nessi, Daniele Psacharopulo, Andrea Viazzo, Giovanni Malacrida, Daniela Mazzaccaro, Giovanni Meola, Alfredo Modafferi, Giovanni Nano, Maria Teresa Occhiuto, Paolo Righini, Silvia Stegher, Stefano Chiarandini, Filippo Griselli, Sandro Lepidi, Fabio Pozzi Mucelli, Marcello Naccarato, Mario D'Oria, Barbara Ziani, Andrea Stella, Mortalla Dieng, Gianluca Faggioli, Mauro Gargiulo, Sergio Palermo, Rodolfo Pini, Giovanni Maria Puddu, Andrea Vacirca, Domenico Angiletta, Claudio Desantis, Davide Marinazzo, Giovanni Mastrangelo, Guido Regina, Raffaele Pulli, Paolo Bianchi, Lea Cireni, Elisabetta Coppi, Rocco Pizzirusso, Filippo Scalise, Giovanni Sorropago, Valerio Tolva, Valeria Caso, Enrico Cieri, Paola DeRango, Luca Farchioni, Giacomo Isernia, Massimo Lenti, Gian Battista Parlani, Guglielmo Pupo, Grazia Pula, Gioele Simonte, Fabio Verzini, Federico Carimati, Maria Luisa Delodovici, Federico Fontana, Gabriele Piffaretti, Matteo Tozzi, Efrem Civilini, Giorgio Poletto, Bernhard Reimers, Barbara Praquin, Sonia Ronchey, Laura Capoccia, Wassim Mansour, Enrico Sbarigia, Francesco Speziale, Pasqualino Sirignano, Danilo Toni, Roberto Galeotti, Vincenzo Gasbarro, Francesco Mascoli, Tiberio Rocca, Elpiniki Tsolaki, Giulia Bernardini, Ester DeMarco, Alessia Giaquinta, Francesco Patti, Massimiliano Veroux, Pierfrancesco Veroux, Carla Virgilio, Nicola Mangialardi, Matteo Orrico, Vincenzo Di Lazzaro, Nunzio Montelione, Francesco Spinelli, Francesco Stilo, Carlo Cernetti, Sandro Irsara, Giuseppe Maccarrone, Diego Tonello, Adriana Visonà, Beniamino Zalunardo, Emiliano Chisci, Stefano Michelagnoli, Nicola Troisi, Maela Masato, Massimo Dei Negri, Andrea Pacchioni, Salvatore Saccà, Giovanni Amatucci, Alfredo Cannizzaro, Federico Accrocca, Cesare Ambrogi, Renzo Barbazza, Giustino Marcucci, Andrea Siani, Guido Bajardi, Giovanni Savettieri, Angelo Argentieri, Riccardo Corbetta, Attilio Odero, Pietro Quaretti, Federico Z Thyrion, Alessandro Cappelli, Domenico Benevento, Gianmarco De Donato, Maria Agnese Mele, Giancarlo Palasciano, Daniela Pieragalli, Alessandro Rossi, Carlo Setacci, Francesco Setacci, Domenico Palombo, Maria Cecilia Perfumo, Edoardo Martelli, Aldo Paolucci, Santi Trimarchi, Viviana Grassi, Luigi Grimaldi, Giuliana La Rosa, Domenico Mirabella, Matteo Scialabba, Leonildo Sichel, Costantino L D'Angelo, Gian Franco Fadda, Holta Kasemi, Mario Marino, Francesco Burzotta, Francesco Alberto Codispoti, Angela Ferrante, Giovanni Tinelli, Yamume Tshomba, Claudio Vincenzoni, Deborah Amis, Dawn Anderson, Martin Catterson, Mike Clarke, Michelle Davis, Anand Dixit, Alexander Dyker, Gary Ford, Ralph Jackson, Sreevalsan Kappadath, David Lambert, Tim Lees, Stephen Louw, James McCaslin, Noala Parr, Rebecca Robson, Gerard Stansby, Lucy Wales, Vera Wealleans, Lesley Wilson, Michael Wyatt, Hardeep Baht, Ibrahim Balogun, Ilse Burger, Tracy Cosier, Linda Cowie, Gunaratnam Gunathilagan, David Hargroves, Robert Insall, Sally Jones, Hannah Rudenko, Natasha Schumacher, Jawaharlal Senaratne, George Thomas, Audrey Thomson, Tom Webb, Ellen Brown, Bernard Esisi, Ali Mehrzad, Shane MacSweeney, Norman McConachie, Alison Southam, Wayne Sunman, Ahmed Abdul-Hamiq, Jenny Bryce, Ian Chetter, Duncan Ettles, Raghuram Lakshminarayan, Kim Mitchelson, Christopher Rhymes, Graham Robinson, Paul Scott, Alison Vickers, Ray Ashleigh, Stephen Butterfield, Ed Gamble, Jonathan Ghosh, Charles N McCollum, Mark Welch, Sarah Welsh, Leszek Wolowczyk, Mary Donnelly, Stephen D'Souza, Anselm A Egun, Bindu Gregary, Thomas Joseph, Christine Kelly, Shuja Punekar, M Asad Rahi, Sonia Raj, Dare Seriki, George Thomson, James Brown, Ragunath Durairajan, Iris Grunwald, Paul Guyler, Paula Harman, Matthew Jakeways, Christopher Khuoge, Ashish Kundu, Thayalini Loganathan, Nisha Menon, Raji O Prabakaran, Devesh Sinha, Vicky Thompson, Sharon Tysoe, Dennis Briley, Chris Darby, Linda Hands, Dominic Howard, Wilhelm Kuker, Ursula Schulz, Rachel Teal, David Barer, Andrew Brown, Susan Crawford, Paul Dunlop, Ramesh Krishnamurthy, Nikhil Majmudar, Duncan Mitchell, Min P Myint, Richard O'Brien, Janice O'Connell, Naweed Sattar, Shanmugam Vetrivel, Jonathan Beard, Trevor Cleveland, Peter Gaines, John Humphreys, Alison Jenkins, Craig King, Daniel Kusuma, Ralph Lindert, Robbie Lonsdale, Raj Nair, Shah Nawaz, Faith Okhuoya, Douglas Turner, Graham Venables, Paul Dorman, Andrea Hughes, Deborah Jones, David Mendelow, Helen Rodgers, Aidas Raudoniitis, Peter Enevoldson, Hans Nahser, Imelda O'Brien, Francesco Torella, Dave Watling, Richard White, Pauline Brown, Dipankar Dutta, Lorraine Emerson, Paula Hilltout, Sachin Kulkarni, Jackie Morrison, Keith Poskitt, Fiona Slim, Sarah Smith, Amanda Tyler, Joanne Waldron, Mark Whyman, Milda Bajoriene, Lucy Baker, Amanda Colston, Bekky Eliot-Jones, Gita Gramizadeh, Catherine Lewis-Clarke, Laura McCafferty, Deborah Oliver, Debbie Palmer, Abhijeet Patil, Suzannah Pegler, Gopi Ramadurai, Aisling Roberts, Tracey Sargent, Shivaprasad Siddegowda, Ravi Singh-Ranger, Akintunde Williams, Lucy Williams, Steve Windebank, Tadas Zuromskis, Lanka Alwis, Jane Angus, Asaipillai Asokanathan, Caroline Fornolles, Diana Hardy, Sophy Hunte, Frances Justin, Duke Phiri, Marie Mitabouana-Kibou, Lakshmanan Sekaran, Sakthivel Sethuraman, Margaret L Tate, Joyce Akyea-Mensah, Stephen Ball, Angela Chrisopoulou, Elizabeth Keene, Alison Phair, Steven Rogers, John V Smyth, Colin Bicknell, Jeremy Chataway, Nicholas Cheshire, Andrew Clifton, Caroline Eley, Richard Gibbs, Mohammad Hamady, Beth Hazel, Alex James, Michael Jenkins, Nyma Khanom, Austin Lacey, Maz Mireskandari, Joanna O'Reilly, Antony Pereira, Tina Sachs, John Wolfe, Philip Davey, Gill Rogers, Gemma Smith, Gareth Tervit, Ian Nichol, Andrew Parry, Gavin Young, Simon Ashley, James Barwell, Francis Dix, Azlisham M Nor, Chris Parry, Angela Birt, Paul Davies, Jim George, Anne Graham, Leon Jonker, Nicci Kelsall, Caroline Potts, Toni Wilson, Jamie Crinnion, Larissa Cuenoud, Nikola Aleksic, Srdan Babic, Nenad Ilijevski, Đorde Radak, Dragan Sagic, Slobodan Tanaskovic, Momcilo Colic, Vladimir Cvetic, Lazar Davidovic, Dejana R Jovanovic, Igor Koncar, Perica Mutavdžic, Miloš Sladojevic, Ivan Tomic, Eike S Debus, Ulrich Grzyska, Dagmar Otto, Götz Thomalla, Jessica Barlinn, Johannes Gerber, Kathrin Haase, Christian Hartmann, Stefan Ludwig, Volker Pütz, Christian Reeps, Christine Schmidt, Norbert Weiss, Sebastian Werth, Simon Winzer, Janine Gemper, Albrecht Günther, Bianka Heiling, Elisabeth Jochmann, Panagiota Karvouniari, Carsten Klingner, Thomas Mayer, Julia Schubert, Friederike Schulze-Hartung, Jürgen Zanow, Yvonne Bausback, Franka Borger, Spiridon Botsios, Daniela Branzan, Sven Bräunlich, Henryk Hölzer, Janin Lenzer, Christopher Piorkowski, Nadine Richter, Johannes Schuster, Dierk Scheinert, Andrej Schmidt, Holger Staab, Matthias Ulrich, Martin Werner, Hermann Berger, Gábor Biró, Hans-Henning Eckstein, Michael Kallmayer, Kornelia Kreiser, Alexander Zimmermann, Bärbel Berekoven, Klaus Frerker, Vera Gordon, Giovanni Torsello, Sebastian Arnold, Cora Dienel, Martin Storck, Bernhard Biermaier, Hans Martin Gissler, Christof Klötzsch, Tomas Pfeiffer, Ralph Schneider, Leander Söhl, Michael Wennrich, Angelika Alonso, Michael Keese, Christoph Groden, Andreas Cöster, Andreas Engelhardt, Christoph-Maria Ratusinski, Bengt Berg, Martin Delle, Johan Formgren, Peter Gillgren, Lotta Jarl, Torbjörn B Kall, Peter Konrad, Niklas Nyman, Claes Skiöldebrand, Johnny Steuer, Rabbe Takolander, Jonas Malmstedt, Stefan Acosta, Katarina Björses, Kerstin Brandt, Nuno Dias, Anders Gottsäter, Jan Holst, Thorarinn Kristmundsson, Tobias Kühme, Tilo Kölbel, Bengt Lindblad, Mats Lindh, Martin Malina, Tomas Ohrlander, Tim Resch, Viola Rönnle, Björn Sonesson, Margareta Warvsten, Zbigniew Zdanowski, Erik Campbell, Per Kjellin, Hans Lindgren, Johan Nyberg, Björn Petersen, Gunnar Plate, Håkan Pärsson, Peter Qvarfordt, Pavel Ignatenko, Andrey Karpenko, Vladimir Starodubtsev, Mikhail A Chernyavsky, Maria S Golovkova, Boris B Komakha, Nikolay N Zherdev, Andrey Belyasnik, Pavel Chechulov, Dmitry Kandyba, Igor Stepanishchev, Csaba Csobay-Novák, Edit Dósa, László Entz, Balázs Nemes, Zoltán Szeberin, Pál Barzó, Mihaly Bodosi, Eniko Fákó, Béla Fülöp, Tamás Németh, Szilárd Pazdernyik, Krisztina Skoba, Erika Vörös, Eleni Chatzinikou, Athanasios Giannoukas, Christos Karathanos, Stylianos Koutsias, Georgios Kouvelos, Miltiadis Matsagkas, Styliani Ralli, Christos Rountas, Nikolaos Rousas, Konstantinos Spanos, Elias Brountzos, John D Kakisis, Andreas Lazaris, Konstantinos G Moulakakis, Leonidas Stefanis, Georgios Tsivgoulis, Spyros Vasdekis, Constantine N Antonopoulos, Ion Bellenis, Dimitrios Maras, Antonios Polydorou, Victoria Polydorou, Antonios Tavernarakis, Nikolaos Ioannou, Maria Terzoudi, Miltos Lazarides, Michalis Mantatzis, Kostas Vadikolias, Lukasz Dzieciuchowicz, Marcin Gabriel, Zbigniew Krasinski, Grzegorz Oszkinis, Fryderyk Pukacki, Maciej Slowinski, Michal-Goran Stanišic, Ryszard Staniszewski, Jolanta Tomczak, Maciej Zielinski, Piotr Myrcha, Dorota Rózanski, Stanislaw Drelichowski, Wojciech Iwanowski, Katarzyna Koncewicz, Pawel Bialek, Zbigniew Biejat, Wojciech Czepel, Anna Czlonkowska, Anatol Dowzenko, Julia Jedrzejewska, Adam Kobayashi, Jerzy Leszczynski, Andrzej Malek, Jerzy Polanski, Robert Proczka, Maciej Skorski, Mieczyslaw Szostek, Piotr Andziak, Maciej Dratwicki, Robert Gil, Miroslaw Nowicki, Jaroslaw Pniewski, Jaroslaw Rzezak, Piotr Seweryniak, Pawel Dabek, Michal Juszynski, Grzegorz Madycki, Bartosz Pacewski, Witold Raciborski, Piotr Slowinski, Walerian Staszkiewicz, Martin Bombic, Vladimír Chlouba, Jirí Fiedler, Karel Hes, Petr Koštál, Jindrich Sova, Zdenek Kríž, Mojmír Prívara, Michal Reif, Robert Staffa, Robert Vlachovský, Bohuslav Vojtíšek, Tomáš Hrbác, Martin Kuliha, Václav Procházka, Martin Roubec, David Školoudík, David Netuka, Anna Šteklácová, Vladimír Beneš III, Pavel Buchvald, Ladislav Endrych, Miroslav Šercl, Walter Campos Jr, Ivan B Casella, Nelson de Luccia, André E V Estenssoro, Calógero Presti, Pedro Puech-Leão, Celso R B Neves, Erasmo S da Silva, Cid J Sitrângulo Jr, José A T Monteiro, Gisela Tinone, Marcelo Bellini Dalio, Edwaldo E Joviliano, Octávio M Pontes Neto, Mauricio Serra Ribeiro, Patrick Cras, Jeroen M H Hendriks, Mieke Hoppenbrouwers, Patrick Lauwers, Caroline Loos, Laetitia Yperzeele, Mia Geenens, Dimitri Hemelsoet, Isabelle van Herzeele, Frank Vermassen, Parla Astarci, Frank Hammer, Valérie Lacroix, André Peeters, Robert Verhelst, Silvana Cirelli, Pol Dormal, Annelies Grimonprez, Bart Lambrecht, Philipe Lerut, Eddy Thues, Guy De Koster, Quentin Desiron, Alain Maertens de Noordhout, Danielle Malmendier, Mireille Massoz, Georges Saad, Marc Bosiers, Joren Callaert, Koen Deloose, Estrella Blanco Cañibano, Beatriz García Fresnillo, Mercedes Guerra Requena, Pilar C Morata Barrado, Miguel Muela Méndez, Antonio Yusta Izquierdo, Fernando Aparici Robles, Paula Blanes Orti, Luis García Dominguez, Rafael Martínez López, Manuel Miralles Hernández, José I Tembl Ferrairo, Ángel Chamorro, Juan Macho, Víctor Obach, Vincent Riambau, Luis San Román, Frank J Ahlhelm, Kristine Blackham, Stefan Engelter, Thomas Eugster, Henrik Gensicke, Lorenz Gürke, Philippe Lyrer, Luigi Mariani, Marina Maurer, Edin Mujagic, Mandy Müller, Marios Psychogios, Peter Stierli, Christoph Stippich, Christopher Traenka, Thomas Wolff, Benjamin Wagner, Martina M Wiegert, Sandra Clarke, Michael Diepers, Ernst Gröchenig, Philipp Gruber, Andrej Isaak, Timo Kahles, Regula Marti, Krassen Nedeltchev, Luca Remonda, Nadir Tissira, Martina Valença Falcão, Gert J de Borst, Rob H Lo, Frans L Moll, Raechel Toorop, Bart H van der Worp, Evert J Vonken, Jaap L Kappelle, Ommid Jahrome, Floris Vos, Wouter Schuiling, Hendrik van Overhagen, Rudolf W M Keunen, Bob Knippenberg, Jan J Wever, Jan W Lardenoije, Michel Reijnen, Luuk Smeets, Steven van Sterkenburg, Gustav Fraedrich, Elke Gizewski, Ingrid Gruber, Michael Knoflach, Stefan Kiechl, Barbara Rantner, Timur Abdulamit, Patrice Bergeron, Raymond Padovani, Jean-Christophe Trastour, Jean-Marie Cardon, Anne Le Gallou-Wittenberg, Eric Allaire, Jean-Pierre Becquemin, Frédéric Cochennec-Paliwoda, Pascal Desgranges, Hassan Hosseini, Hicham Kobeiter, Jean Marzelle, Mohammed A Almekhlafi, Simerpreet Bal, Phillip A Barber, Shelagh B Coutts, Andrew M Demchuk, Muneer Eesa, Michelle Gillies, Mayank Goyal, Michael D Hill, Mark E Hudon, Anitha Jambula, Carol Kenney, Gary Klein, Marie McClelland, Alim Mitha, Bijoy K Menon, William F Morrish, Steven Peters, Karla J Ryckborst, Greg Samis, Supriya Save, Eric E Smith, Peter Stys, Suresh Subramaniam, Garnette R Sutherland, Tim Watson, John H Wong, L Zimmel, Vojko Flis, Jože Matela, Kazimir Miksic, Franko Milotic, Božidar Mrdja, Barbara Stirn, Erih Tetickovic, Mladen Gasparini, Anton Grad, Ingrid Kompara, Zoren Miloševic, Veronika Palmiste, Toomas Toomsoo, Balzhan Aidashova, Nursultan Kospanov, Roman Lyssenko, Daulet Mussagaliev, Rafi Beyar, Aaron Hoffman, Tony Karram, Arthur Kerner, Eugenia Nikolsky, Samy Nitecki, Silva Andonova, Chavdar Bachvarov, Vesko Petrov, Ivan Cvjetko, Vinko Vidjak, Damir Halužan, Mladen Petrunic, Bao Liu, Chang-Wei Liu, Daniel Bartko, Peter Beno, František Rusnák, Kamil Zelenák, Masayuki Ezura, Takashi Inoue, Naoto Kimura, Ryushi Kondo, Yasushi Matsumoto, Hiroaki Shimizu, Hidenori Endo, Eisuke Furui, Søren Bakke, Kristen Krohg-Sørensen, Terje Nome, Mona Skjelland, Bjørn Tennøe, João Albuquerque e Castro, Gonçalo Alves, Frederico Bastos Gonçalves, José de Aragão Morais, Ana C Garcia, Hugo Valentim, Leonor Vasconcelos, Fernando Belcastro, Fernando Cura, Patricio Zaefferer, Foad Abd-Allah, Mohamed H Eldessoki, Hussein Heshmat Kassem, Haytham Soliman Gharieb, Mary P Colgan, Syed N Haider, Joe Harbison, Prakash Madhavan, Dermot Moore, Gregor Shanik, Viviane Kazan, Munier Nazzal, Vicki Ramsey-Williams, ACST-2 Collaborative Group, Group, ACST-2 Collaborative, Halliday A., Bulbulia R., Bonati L.H., Chester J., Cradduck-Bamford A., Peto R., Pan H., Potter J., Henning Eckstein H., Farrell B., Flather M., Mansfield A., Mihaylova B., Rahimi K., Simpson D., Thomas D., Sandercock P., Gray R., Molyneux A., Shearman C.P., Rothwell P., Belli A., Herrington W., Judge P., Leopold P., Mafham M., Gough M., Cao P., MacDonald S., Bari V., Berry C., Bradshaw S., Brudlo W., Clarke A., Cox R., Fathers S., Gaba K., Gray M., Hayter E., Holliday C., Kurien R., Lay M., le Conte S., McManus J., Madgwick Z., Morris D., Munday A., Pickworth S., Ostasz W., Poorthuis M., Richards S., Teixeira L., Tochlin S., Tully L., Wallis C., Willet M., Young A., Casana R., Malloggi C., Odero A., Silani V., Parati G., Malchiodi G., Malferrari G., Strozzi F., Tusini N., Vecchiati E., Coppi G., Lauricella A., Moratto R., Silingardi R., Veronesi J., Zini A., Ferrero E., Ferri M., Gaggiano A., Labate C., Nessi F., Psacharopulo D., Viazzo A., Malacrida G., Mazzaccaro D., Meola G., Modafferi A., Nano G., Occhiuto M.T., Righini P., Stegher S., Chiarandini S., Griselli F., Lepidi S., Pozzi Mucelli F., Naccarato M., D'Oria M., Ziani B., Stella A., Dieng M., Faggioli G., Gargiulo M., Palermo S., Pini R., Puddu G.M., Vacirca A., Angiletta D., Desantis C., Marinazzo D., Mastrangelo G., Regina G., Pulli R., Bianchi P., Cireni L., Coppi E., Pizzirusso R., Scalise F., Sorropago G., Tolva V., Caso V., Cieri E., DeRango P., Farchioni L., Isernia G., Lenti M., Parlani G.B., Pupo G., Pula G., Simonte G., Verzini F., Carimati F., Delodovici M.L., Fontana F., Piffaretti G., Tozzi M., Civilini E., Poletto G., Reimers B., Praquin B., Ronchey S., Capoccia L., Mansour W., Sbarigia E., Speziale F., Sirignano P., Toni D., Galeotti R., Gasbarro V., Mascoli F., Rocca T., Tsolaki E., Bernardini G., DeMarco E., Giaquinta A., Patti F., Veroux M., Veroux P., Virgilio C., Mangialardi N., Orrico M., Di Lazzaro V., Montelione N., Spinelli F., Stilo F., Cernetti C., Irsara S., Maccarrone G., Tonello D., Visona A., Zalunardo B., Chisci E., Michelagnoli S., Troisi N., Masato M., Dei Negri M., Pacchioni A., Sacca S., Amatucci G., Cannizzaro A., Accrocca F., Ambrogi C., Barbazza R., Marcucci G., Siani A., Bajardi G., Savettieri G., Argentieri A., Corbetta R., Quaretti P., Thyrion F.Z., Cappelli A., Benevento D., De Donato G., Mele M.A., Palasciano G., Pieragalli D., Rossi A., Setacci C., Setacci F., Palombo D., Perfumo M.C., Martelli E., Paolucci A., Trimarchi S., Grassi V., Grimaldi L., La Rosa G., Mirabella D., Scialabba M., Sichel L., D'Angelo C.L., Fadda G.F., Kasemi H., Marino M., Burzotta F., Codispoti F.A., Ferrante A., Tinelli G., Tshomba Y., Vincenzoni C., Amis D., Anderson D., Catterson M., Clarke M., Davis M., Dixit A., Dyker A., Ford G., Jackson R., Kappadath S., Lambert D., Lees T., Louw S., McCaslin J., Parr N., Robson R., Stansby G., Wales L., Wealleans V., Wilson L., Wyatt M., Baht H., Balogun I., Burger I., Cosier T., Cowie L., Gunathilagan G., Hargroves D., Insall R., Jones S., Rudenko H., Schumacher N., Senaratne J., Thomas G., Thomson A., Webb T., Brown E., Esisi B., Mehrzad A., MacSweeney S., McConachie N., Southam A., Sunman W., Abdul-Hamiq A., Bryce J., Chetter I., Ettles D., Lakshminarayan R., Mitchelson K., Rhymes C., Robinson G., Scott P., Vickers A., Ashleigh R., Butterfield S., Gamble E., Ghosh J., McCollum C.N., Welch M., Welsh S., Wolowczyk L., Donnelly M., D'Souza S., Egun A.A., Gregary B., Joseph T., Kelly C., Punekar S., Rahi M.A., Raj S., Seriki D., Thomson G., Brown J., Durairajan R., Grunwald I., Guyler P., Harman P., Jakeways M., Khuoge C., Kundu A., Loganathan T., Menon N., Prabakaran R.O., Sinha D., Thompson V., Tysoe S., Briley D., Darby C., Hands L., Howard D., Kuker W., Schulz U., Teal R., Barer D., Brown A., Crawford S., Dunlop P., Krishnamurthy R., Majmudar N., Mitchell D., Myint M.P., O'Brien R., O'Connell J., Sattar N., Vetrivel S., Beard J., Cleveland T., Gaines P., Humphreys J., Jenkins A., King C., Kusuma D., Lindert R., Lonsdale R., Nair R., Nawaz S., Okhuoya F., Turner D., Venables G., Dorman P., Hughes A., Jones D., Mendelow D., Rodgers H., Raudoniitis A., Enevoldson P., Nahser H., O'Brien I., Torella F., Watling D., White R., Brown P., Dutta D., Emerson L., Hilltout P., Kulkarni S., Morrison J., Poskitt K., Slim F., Smith S., Tyler A., Waldron J., Whyman M., Bajoriene M., Baker L., Colston A., Eliot-Jones B., Gramizadeh G., Lewis-Clarke C., McCafferty L., Oliver D., Palmer D., Patil A., Pegler S., Ramadurai G., Roberts A., Sargent T., Siddegowda S., Singh-Ranger R., Williams A., Williams L., Windebank S., Zuromskis T., Alwis L., Angus J., Asokanathan A., Fornolles C., Hardy D., Hunte S., Justin F., Phiri D., Mitabouana-Kibou M., Sekaran L., Sethuraman S., Tate M.L., Akyea-Mensah J., Ball S., Chrisopoulou A., Keene E., Phair A., Rogers S., Smyth J.V., Bicknell C., Chataway J., Cheshire N., Clifton A., Eley C., Gibbs R., Hamady M., Hazel B., James A., Jenkins M., Khanom N., Lacey A., Mireskandari M., O'Reilly J., Pereira A., Sachs T., Wolfe J., Davey P., Rogers G., Smith G., Tervit G., Nichol I., Parry A., Young G., Ashley S., Barwell J., Dix F., Nor A.M., Parry C., Birt A., Davies P., George J., Graham A., Jonker L., Kelsall N., Potts C., Wilson T., Crinnion J., Cuenoud L., Aleksic N., Babic S., Ilijevski N., Radak, Sagic D., Tanaskovic S., Colic M., Cvetic V., Davidovic L., Jovanovic D.R., Koncar I., Mutavdzic P., Sladojevic M., Tomic I., Debus E.S., Grzyska U., Otto D., Thomalla G., Barlinn J., Gerber J., Haase K., Hartmann C., Ludwig S., Putz V., Reeps C., Schmidt C., Weiss N., Werth S., Winzer S., Gemper J., Gunther A., Heiling B., Jochmann E., Karvouniari P., Klingner C., Mayer T., Schubert J., Schulze-Hartung F., Zanow J., Bausback Y., Borger F., Botsios S., Branzan D., Braunlich S., Holzer H., Lenzer J., Piorkowski C., Richter N., Schuster J., Scheinert D., Schmidt A., Staab H., Ulrich M., Werner M., Berger H., Biro G., Eckstein H.-H., Kallmayer M., Kreiser K., Zimmermann A., Berekoven B., Frerker K., Gordon V., Torsello G., Arnold S., Dienel C., Storck M., Biermaier B., Gissler H.M., Klotzsch C., Pfeiffer T., Schneider R., Sohl L., Wennrich M., Alonso A., Keese M., Groden C., Coster A., Engelhardt A., Ratusinski C.-M., Berg B., Delle M., Formgren J., Gillgren P., Jarl L., Kall T.B., Konrad P., Nyman N., Skioldebrand C., Steuer J., Takolander R., Malmstedt J., Acosta S., Bjorses K., Brandt K., Dias N., Gottsater A., Holst J., Kristmundsson T., Kuhme T., Kolbel T., Lindblad B., Lindh M., Malina M., Ohrlander T., Resch T., Ronnle V., Sonesson B., Warvsten M., Zdanowski Z., Campbell E., Kjellin P., Lindgren H., Nyberg J., Petersen B., Plate G., Parsson H., Qvarfordt P., Ignatenko P., Karpenko A., Starodubtsev V., Chernyavsky M.A., Golovkova M.S., Komakha B.B., Zherdev N.N., Belyasnik A., Chechulov P., Kandyba D., Stepanishchev I., Csobay-Novak C., Dosa E., Entz L., Nemes B., Szeberin Z., Barzo P., Bodosi M., Fako E., Fulop B., Nemeth T., Pazdernyik S., Skoba K., Voros E., Chatzinikou E., Giannoukas A., Karathanos C., Koutsias S., Kouvelos G., Matsagkas M., Ralli S., Rountas C., Rousas N., Spanos K., Brountzos E., Kakisis J.D., Lazaris A., Moulakakis K.G., Stefanis L., Tsivgoulis G., Vasdekis S., Antonopoulos C.N., Bellenis I., Maras D., Polydorou A., Polydorou V., Tavernarakis A., Ioannou N., Terzoudi M., Lazarides M., Mantatzis M., Vadikolias K., Dzieciuchowicz L., Gabriel M., Krasinski Z., Oszkinis G., Pukacki F., Slowinski M., Stanisic M.-G., Staniszewski R., Tomczak J., Zielinski M., Myrcha P., Rozanski D., Drelichowski S., Iwanowski W., Koncewicz K., Bialek P., Biejat Z., Czepel W., Czlonkowska A., Dowzenko A., Jedrzejewska J., Kobayashi A., Leszczynski J., Malek A., Polanski J., Proczka R., Skorski M., Szostek M., Andziak P., Dratwicki M., Gil R., Nowicki M., Pniewski J., Rzezak J., Seweryniak P., Dabek P., Juszynski M., Madycki G., Pacewski B., Raciborski W., Slowinski P., Staszkiewicz W., Bombic M., Chlouba V., Fiedler J., Hes K., Kostal P., Sova J., Kriz Z., Privara M., Reif M., Staffa R., Vlachovsky R., Vojtisek B., Hrbac T., Kuliha M., Prochazka V., Roubec M., Skoloudik D., Netuka D., Steklacova A., Benes III V., Buchvald P., Endrych L., Sercl M., Campos W., Casella I.B., de Luccia N., Estenssoro A.E.V., Presti C., Puech-Leao P., Neves C.R.B., da Silva E.S., Sitrangulo C.J., Monteiro J.A.T., Tinone G., Bellini Dalio M., Joviliano E.E., Pontes Neto O.M., Serra Ribeiro M., Cras P., Hendriks J.M.H., Hoppenbrouwers M., Lauwers P., Loos C., Yperzeele L., Geenens M., Hemelsoet D., van Herzeele I., Vermassen F., Astarci P., Hammer F., Lacroix V., Peeters A., Verhelst R., Cirelli S., Dormal P., Grimonprez A., Lambrecht B., Lerut P., Thues E., De Koster G., Desiron Q., Maertens de Noordhout A., Malmendier D., Massoz M., Saad G., Bosiers M., Callaert J., Deloose K., Blanco Canibano E., Garcia Fresnillo B., Guerra Requena M., Morata Barrado P.C., Muela Mendez M., Yusta Izquierdo A., Aparici Robles F., Blanes Orti P., Garcia Dominguez L., Martinez Lopez R., Miralles Hernandez M., Tembl Ferrairo J.I., Chamorro A., Macho J., Obach V., Riambau V., San Roman L., Ahlhelm F.J., Blackham K., Engelter S., Eugster T., Gensicke H., Gurke L., Lyrer P., Mariani L., Maurer M., Mujagic E., Muller M., Psychogios M., Stierli P., Stippich C., Traenka C., Wolff T., Wagner B., Wiegert M.M., Clarke S., Diepers M., Grochenig E., Gruber P., Isaak A., Kahles T., Marti R., Nedeltchev K., Remonda L., Tissira N., Valenca Falcao M., de Borst G.J., Lo R.H., Moll F.L., Toorop R., van der Worp B.H., Vonken E.J., Kappelle J.L., Jahrome O., Vos F., Schuiling W., van Overhagen H., Keunen R.W.M., Knippenberg B., Wever J.J., Lardenoije J.W., Reijnen M., Smeets L., van Sterkenburg S., Fraedrich G., Gizewski E., Gruber I., Knoflach M., Kiechl S., Rantner B., Abdulamit T., Bergeron P., Padovani R., Trastour J.-C., Cardon J.-M., Le Gallou-Wittenberg A., Allaire E., Becquemin J.-P., Cochennec-Paliwoda F., Desgranges P., Hosseini H., Kobeiter H., Marzelle J., Almekhlafi M.A., Bal S., Barber P.A., Coutts S.B., Demchuk A.M., Eesa M., Gillies M., Goyal M., Hill M.D., Hudon M.E., Jambula A., Kenney C., Klein G., McClelland M., Mitha A., Menon B.K., Morrish W.F., Peters S., Ryckborst K.J., Samis G., Save S., Smith E.E., Stys P., Subramaniam S., Sutherland G.R., Watson T., Wong J.H., Zimmel L., Flis V., Matela J., Miksic K., Milotic F., Mrdja B., Stirn B., Tetickovic E., Gasparini M., Grad A., Kompara I., Milosevic Z., Palmiste V., Toomsoo T., Aidashova B., Kospanov N., Lyssenko R., Mussagaliev D., Beyar R., Hoffman A., Karram T., Kerner A., Nikolsky E., Nitecki S., Andonova S., Bachvarov C., Petrov V., Cvjetko I., Vidjak V., Haluzan D., Petrunic M., Liu B., Liu C.-W., Bartko D., Beno P., Rusnak F., Zelenak K., Ezura M., Inoue T., Kimura N., Kondo R., Matsumoto Y., Shimizu H., Endo H., Furui E., Bakke S., Krohg-Sorensen K., Nome T., Skjelland M., Tennoe B., Albuquerque e Castro J., Alves G., Bastos Goncalves F., de Aragao Morais J., Garcia A.C., Valentim H., Vasconcelos L., Belcastro F., Cura F., Zaefferer P., Abd-Allah F., Eldessoki M.H., Heshmat Kassem H., Soliman Gharieb H., Colgan M.P., Haider S.N., Harbison J., Madhavan P., Moore D., Shanik G., Kazan V., Nazzal M., Ramsey-Williams V., and Gargiulo M

Subjects
Male, medicine.medical_specialty, Time Factors, Time Factor, medicine.medical_treatment, Carotid Stenosi, MEDLINE, Carotid endarterectomy, Rate ratio, Risk Assessment, Asymptomatic, law.invention, Randomized controlled trial, law, Risk Factors, carotid artery stenting (CAS), carotid endarterectomy (CEA), Stent, medicine, Humans, Carotid Stenosis, Stroke, Endarterectomy, Aged, Endarterectomy, Carotid, business.industry, carotid artery, Risk Factor, Articles, General Medicine, trial, medicine.disease, Settore MED/22 - CHIRURGIA VASCOLARE, Surgery, Stenosis, Treatment Outcome, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Female, Stents, Human medicine, medicine.symptom, business, Human
Abstract

Summary Background Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding UK Medical Research Council and Health Technology Assessment Programme.

Published
2021

45. Initiation of the COVID-19 vaccination program in Poland: vaccination of the patient 'zero' and first experience from the Central Clinical Hospital of the Ministry of Internal Affairs and Administration

Author

Agnieszka, Szarowska, Artur, Zaczyński, Piotr, Szymański, Beata, Borawska, Iwona, Szarek, Irena, Szoszkiewicz, Sławomir, Butkiewicz, Dorota, Szydlarska, Robert, Gil, Andrzej, Śliwczyński, Alicja, Jakubowska, Zbigniew, Król, Waldemar, Wierzba, and On Behalf Of, The Central Clinical Hospital Of The Ministry Of Internal Affairs And Administration Program Coordination Group

Subjects
Government Programs, Male, COVID-19 Vaccines, Vaccination Coverage, Immunization Programs, Humans, Female, Poland, Public Health, Patient Acceptance of Health Care, Coronavirus Infections
Published
2021

46. Initiation of COVID-19 vaccination program in poland: vaccination of patient 'Zero'. First experience from Central Clinical Hospital of Ministry of Internal Affairs and Administration

Author

Agnieszka Szarowska, Artur Zaczyński, Piotr Szymański, Beata Borawska, Iwona Szarek, Irena Szostkiewicz, Sławomir Butkiewicz, Dorota Szydlarska, Robert Gil, Andrzej Śliwczyński, Alicja Jakubowska, Zbigniew Król, Waldemar Wierzba, and for the CSK MSWiA Program Coordination Group

Subjects
Vaccination, 2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Emergency medicine, Internal Medicine, MEDLINE, medicine, Christian ministry, business, Administration (government)
Published
2020
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47. Clinical characteristics and short-term outcomes of patients with coronavirus disease 2019: a retrospective single-center experience of a designated hospital in Poland

Author

Błażej, Nowak, Piotr, Szymański, Igor, Pańkowski, Agnieszka, Szarowska, Katarzyna, Życińska, Wojciech, Rogowski, Robert, Gil, Mariusz, Furmanek, Jacek, Tatur, Artur, Zaczyński, Zbigniew, Król, and Waldemar, Wierzba

Subjects
Adult, Male, Critical Care, SARS-CoV-2, Pneumonia, Viral, COVID-19, Middle Aged, Hospitalization, Betacoronavirus, Intensive Care Units, Severe acute respiratory syndrome-related coronavirus, Humans, Female, Poland, Coronavirus Infections, Pandemics, Biomarkers, Aged, Retrospective Studies
Abstract

Since the first reported case of coronavirus disease 2019 (COVID‑19) in Poland, the worldwide pandemic has spread throughout the country, leading to many hospital admissions. There has been an urgent need to determine clinical characteristics of Polish patients with laboratory‑confirmed severe acute respiratory syndrome coronavirus 2 (SARS‑CoV 2) infection in the clinical setting.The aim of this retrospective study was to outline characteristics and short‑ term outcomes of SARS‑CoV‑2-positive patients.We retrospectively assessed 169 consecutive patients with laboratory‑ confirmed COVID‑ 19 with regard to their clinical manifestations, radiological findings, treatment, complications, and outcomes.Of the 169 patients, more than half was aged 65 years or older (88; 52.1%), 51.5% were male, and 78.3% had comorbidities. The majority of patients (106; 62.7%) were transferred from outbreak locations in medical facilities. The most common symptoms on admission were fever (42%), shortness of breath (35%), and fatigue (33%). Twenty seven (15.4%) patients required intensive care unit admission. Overall mortality was 26.3% (n = 46) and was significantly higher in patients transferred from other facilities (38 out of 106; 35.8%), than in patients admitted directly to the hospital (8 out of 63; 12.69%; P0.001). Seventeen out of 29 patients admitted to the intensive care unit died (mortality, 58.6%), including 30 out of 41 patients with acute respiratory distress syndrome (73.2% mortality rate).Polish patients with COVID‑19 have similar characteristics and risk factors for adverse outcomes to those observed in countries in which outbreaks occurred earlier. Significantly higher mortality in patients transferred from other centers warrants special attention and transfer policy should be verified.

Published
2020

48. TCTAP A-036 Annual Operator Volume Among Patients Treated Using Percutaneous Coronary Interventions With Rotational Atherectomy and Procedural Outcomes - Analysis Based on a Large National Registry

Author

Rafał Januszek, Wojciech Wańha, Zbigniew Siudak, Krzysztof Malinowski, Wojciech Wojakowski, Krzysztof Reczuch, Sławomir Dobrzycki, Maciej Lesiak, Robert Gil, Adam Witkowski, and Stanisław Bartuś

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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49. TICAGRELOR MONOTHERAPY AFTER PCI ACROSS THE SPECTRUM OF HIGH-RISK PATIENTS: A DEEP DIVE INTO THE TWILIGHT TRIAL

Author

Johny Nicolas, Philippe Gabriel Steg, Davide Cao, Usman Baber, Samantha Sartori, Zhongjie Zhang, Samin K. Sharma, David J. Cohen, Dominick J. Angiolillo, Tim Collier, Javier Escaned, Robert Gil, Frans Beerkens, Vladimír Džavík, Timothy D. Henry, Kurt Huber, Ran Kornowski, E Magnus Ohman, Mitchell W. Krucoff, Vijay Kunadian, Stuart J. Pocock, Charles Michael Gibson, George D. Dangas, and Roxana Mehran

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
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50. INTRAVASCULAR LITHOTRIPSY FOR THE TREATMENT OF STENT UNDEREXPANSION: THE MULTICENTER IVL-DRAGON REGISTRY

Author

Wojciech Wanha, Mariusz Tomaniak, Piotr Wańczura, Jacek Bil, Rafał Januszek, Rafał Wolny, Maksymilian P. Opolski, Łukasz Kuźma, Marek Milewski, Lukasz Lewicki, Jan Kulczycki, Sylwia Iwańczyk, Jerzy Sacha, Adam Janas, Milosz Dziarmaga, Milosz Jaguszewski, Lukasz Koltowski, Bartosz Olajossy, Krzysztof Dyrbuś, Robert Gil, Stanisław Bartuś, Krzysztof Reczuch, Janusz Kochman, Maciej Lesiak, and Wojciech Wojakowski

Subjects
Cardiology and Cardiovascular Medicine
Published
2022
Full Text
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