Evaluation of the bleeding risk for patients who have used Clopidogrel or Ticagrelor: the aggregation of platelets and FERMT3 gene's polymorphism investigations.

Antiaggregants have been imposed for the patients with cardiovascular diseases after stent’s implantation operations. Antiaggregants do not often cause the expected effect of drugs. However, the new generation of antiaggregants can cause a severe bleeding. If we want to impose the proper antiaggregant and its dose, we need identify genes and other factors which determine this effect of drugs

Factors Determining Ticagrelor-Induced Dyspnea in Patients with Acute Coronary Syndrome

(1) Background: The aim of this study was to determine clinical and genetic factors predicting the development of dyspnea in patients receiving ticagrelor. (2) Methods: A total of 277 patients with acute myocardial infarction (with and without ST-segment elevation), who underwent coronary angiography and PTCA with stent implantation and treated with antiplatelet drugs (ticagrelor and aspirin), were enrolled in this study. Platelet aggregation (induction with high-sensitivity ADP, ADP HS) testing was performed using a MULTIPLATE analyzer and reagents for the determination of P2Y12 receptor activity. Venous blood samples were collected for genotyping. (3) Results: Patients experiencing ticagrelor-related dyspnea had lower ADP HS. ROC curve analysis showed that an ADP HS cut-off of ≤19.5 U was associated with the development of dyspnea. The ADP HS value of ≤19.5 U and any dose of atorvastatin lower than 80 mg (or no atorvastatin) increased the risk of dyspnea by more than 4 and 2 times, respectively (OR = 4.07, p ≤ 0.001 and OR = 2.25; p = 0.008). (4) Conclusion: A lower ADP HS value possibly indicates greater ticagrelor activity and a higher plasma concentration of this drug. Atorvastatin might have an impact on the occurrence of ticagrelor-related dyspnea by affecting ticagrelor metabolism. No impact of any genetic variant on the development of dyspnea was determined

Report on adult educators’ competence training for the development of immigrant and asylum seeker digital entrepreneurship (EDUAIM)

Report on Adult Educators’ Competence Training for the Development of Immigrant and Asylum Seeker Digital Entrepreneurship (EDUAIM

The Predictive Value of Tissue Doppler Indices for Early Recurrence of Atrial Fibrillation After Electrical Cardioversion

Purpose: Spectral tissue Doppler-derived E/e' ratio has been proposed as the best parameter for prediction of atrial fibrillation (AF). Relaxation and contraction are equivalent parts of a continuous cardiac cycle, where systolic and diastolic abnormalities have a variable contribution to the left ventricle (LV) failure. The aim of this study was to investigate whether the E/(e'xs') ratio is a better index than E/e' to predict AF recurrence and to determine the changes of spectral tissue Doppler indices 1 month after the electrical cardioversion (ECV). Patients and methods: The study included 77 persistent AF patients with restored sinus rhythm (SR) after ECV. Only patients with normal LV ejection fraction (EF) were included. Echocardiography and NT-proBNP laboratory findings were performed. A primary outcome was the early (within 1 month) recurrence of AF. Results: After a 1 month follow-up period, 39 patients (50.6%) were in SR. E/e' (HR=1.74, P=0.001) and E/(e'×s') ratios (HR=8.17, P=0.01) were significant predictors of AF recurrence. E/(e'×s') in combination with LV end-diastolic diameter >49.3 mm and NT-proBNP >2000 ng/L demonstrated a higher contribution in the model to predict AF recurrence compared to the E/e' ratio (18.94, P=0.005 vs 1.95, P=0.001). On ROC analysis, E/(e'×s') and E/e' showed similar diagnostic accuracy (E/(e'×s'), AUC=0.71, P=0.002 and E/e', AUC=0.75, P<0.0001). Average e' value significantly decreased after 1 month in SR (from 10.76±1.24 to 8.96±1.47 cm/s, P=0.01), E wave did not change significantly and E/e' ratio tended to improve. A decrease of average e' and an increase of average s' values led to significant improvement of E/(e'xs') ratio. Conclusion: E/(e'xs') and E/e' ratios are comparable to predict early AF recurrence after ECV in patients with persistent AF. The e' value decreased significantly after 1 month follow-up period after ECV for persistent AF patients