Mean platelet volume and its prognostic value in acute coronary syndrome complicated by cardiogenic shock

Background: Elevated mean platelet volume (MPV) has been recently discussed as a predictorof death in patients with acute coronary syndrome (ACS), but the cut-off point of MPV inrelation to poor prognosis has not been estimated so far. The aim of this study was to evaluate MPV and its prognostic value in ACS complicated by cardiogenic shock (CS). Such an analysisin patients with the most serious and fatal complication of ACS has not been performed inpreviously published research.Methods: Fifty three patients with ACS complicated by CS (age 68.9 ± 11.4, 49% women, 92% STEMI, 55% fatal CS) and 53 age- and gender-matched patients with uncomplicated ACS as a control group (age 69.1 ± 10.6, 49% women, 92% STEMI, 0% fatal) were includedin our prospective study from 2010 to 2012. All the patients underwent successful primary percutaneous coronary intervention. MPV was determined on admission (MPV1) and in consecutive two days of hospitalization (MPV2, MPV3). The blood sample was analyzed immediately after collection in EDTA tubes using an automatic blood counter.Results: MPV1 was similar in both groups (8.91 ± 1.11 fl vs. 8.57 ± 0.74 fl, NS). Furthermore, there were no statistically significant differences in MPV value in fatal and nonfatal CS(8.90 ± 1.18 fl vs. 8.93 ± 1.05 fl, NS).Conclusions: The above results suggest that MPV cannot be considered a predictor of poorin-hospital outcome in patients with ACS complicated by cardiogenic shock

Occupationally related cardiovascular diseases — significant health problem among employees

Choroby układu krążenia (CVD) są jedną z najważniejszych przyczyn zachorowań i umieralności w populacji polskiej i europejskiej, stanowiąc blisko połowę przyczyn zgonów. Dane epidemiologiczne dotyczące rozpowszechnienia CVD dowodzą ich istotnej roli w kształtowaniu sytuacji zdrowotnej ludności, w tym osób w wieku produkcyjnym, aktywnych zawodowo. W środowisku pracy może wystąpić narażenie na wiele czynników ryzyka CVD, zarówno klasycznych, jak i typowo zawodowych. Dodatkowo choroby te mogą stanowić ograniczenie lub przeciwwskazanie do podjęcia i/lub kontynuowania wykonywania zawodu. Szerokie rozpowszechnienie CVD, także w populacji osób młodych, oraz możliwość modyfikacji znanych czynników ryzyka, w tym również tych występujących na stanowisku pracy nakazuje poszukiwanie sposobów profilaktyki i wczesnego wykrywania CVD, aby zminimalizować ich negatywne skutki medyczne i społeczno-ekonomiczne zarówno w odniesieniu do jednostki, jak i ogółu populacji. Celem pracy była prezentacja związku najistotniejszych z punktu widzenia epidemiologii CVD z pracą zawodową, a także wykazanie istotnej roli poradnictwa zawodowego i opieki profilaktycznej oraz ich wpływu na kształtowanie ryzyka sercowo-naczyniowego wśród osób pracujących.Cardiovascular diseases (CVD) are a major cause of morbidity and mortality in the population of Poland and Europe. They constitute nearly half of the total causes of death. Epidemiological data on the prevalence of cardiovascular diseases have shown their crucial role in modifying the health situation of the population, including people in the working age. Work environment may modify or entail an exposure to a number of classic and professional cardiovascular risk factors. In addition, cardiovascular diseases may be a limitation or contraindication to take and/or to continue the occupation. High prevalence of CVD, including the young population and the ability to modify the known risk factors, including those occurring in the workplace, requires the searchfor the possibilities of prevention and early detection of CVD in order to minimize their negative effects on medical and socio-economical level, both in terms of to the individual patient and the general population. The aim of the study was to present the relationship between the most important cardiovascular diseases and occupation, as well as to demonstrate the important role of the preventive care and its impact on the cardiovascular risk

Patients with the tako-tsubo cardiomyopathy-clinical evaluation and outcome

AbstractObjectiveTako-tsubo cardiomyopathy (TTC) or is a rare, acute, reversible cardiac dysfunction mimicking an acute coronary syndrome (ACS) and usually connected with a preceding intense physical or emotional stress trigger. This case series-observational study is to evaluate the clinical findings (including the depression and anxiety disorders) and outcome in patients with the tako-tsubo cardiomyopathy treated in our Centre, during 18 month period.MethodsFrom the group of 730 patients, who were admitted with the suspected acute myocardial infarct, ten patients, who fulfilled diagnostic criteria for TTC, were evaluated. For each patient we assessed: clinical characteristic, previous medical history including coronary disease risk factors and preceding stress trigger, 12-leads electrocardiography and laboratory tests. All patients underwent coronary-artery angiography, trans-thoracic echocardiography and completed the questionnaire evaluating the depression and anxiety disorders.ResultsThe estimated prevalence and clinical features of patients with the tako-tsubo cardiomyopathy in our Centre were similar to those in the literature, with the wide range of stress triggers. There was a statistically significant improvement in the ejection fraction during the hospitalization. Psychological tests revealed the 0.7 occurrence of depression or anxiety disorders among our patients.ConclusionsThe exact pathogenesis of the tako-tsubo cardiomyopathy remains uncertain, but it is important to take it into account as a differential diagnosis in patients with the clinical features of myocardial infarct in the absence of coronary artery stenosis

Apelin and Atrial Fibrillation: The Role in the Arrhythmia Recurrence Prognosis

Apelin is a novel peptide of wide expression and multiple biological functions including the crucial role in cardiovascular homeostasis. The apelin role in the pathophysiology of heart rhythm disorders is considered, although the reports are scarce so far. The purpose of this study is to investigate the potential utility of apelin as a marker of arrhythmia recurrence after direct-current cardioversion (DC). The prospective, observational study included 60 patients (aged 41–86; 30% female) with nonvalvular, persistent atrial fibrillation from the group of 204 consecutive patients scheduled for DC during the 12-month period (from May 2010 to May 2011) in the Cardiology Clinic Medical University of Lodz, Poland. The study group was divided into SCD (successful DC), 45 (75%) patients, and NDC (nonsuccessful DC), 15 (25%) patients. Within the SCD group, the subgroups were distinguished depending on the time sinus rhythm maintenance after DC: up to 7 days (SDC-7), 11 patients; 7 to 30 days (SDC-30), 12 patients; over 90 days (SDC-90), 22 patients. Patients were evaluated during the hospitalization and within the 3-month follow-up period. The apelin level was determined within the plasma samples collected at the admission, using the commercially available enzyme-linked immunosorbent assay (ELISA) Kit for apelin-36. It was found that the median value of initial apelin in the subset of patients from groups NDC + SDC-7 + SDC-30 is significantly higher than from group SDC-90 (p=0.0463); there was no relationship between NDC and SCD overall. Neither of the compared subgroup pairs revealed statistically significant correlation between the proBNP concentration and the DC effectiveness in our population. In conclusion, in our study, proBNP was not a marker of arrhythmia recurrence whereas higher apelin concentration at the admission indicated patients in whom DC was not effective or they had an arrhythmia recurrence within a month-period observation

Work-related rhinitis – Is it always an occupational disease?

Rhinitis is a chronic inflammatory disease of the upper respiratory tract, characterized by a high prevalence and a complex pathogenesis. Work-related rhinitis (WRR) can be divided into occupational rhinitis (OR) and work-exacerbated rhinitis (WER). It is not only considered as a disease entity but also in the context of medical certification as the allergic disease associated with occupational exposure. Epidemiology of work-related rhinitis has been found to vary depending on the occupation and specific exposure, on the other hand the prevalence data may be underestimated due to the lack of uniform diagnostic criteria. This paper reviews the issues comprising the pathogenesis, epidemiology, diagnosis and treatment of patients with work-related rhinitis. It also discusses the significance of the disease in occupational medicine, particularly in terms of preventive worker care, general principles of good practice in primary and secondary WRR prevention and the necessary directions of changes in medical certification in the cases of occupational rhinitis. Med Pr 2016;67(6):801–81

Rare cardiovascular diseases in the context of occupational health care

In Poland like in other European countries a favorable trend towards reducing morbidity and mortality from cardiovascular disease has been observed. Nevertheless they are still one of the most important health problems in the population, responsible for nearly half of all deaths, including premature deaths. They also affect the quality of life in terms of health and socio-economic development, limiting the possibility of taking and/or continuing employment. Nowadays, cardiovascular diseases have become more common among young, professionally active people. Their professional activity, work organization and exposure to a broad range of occupational factors and environmental conditions may significantly influence the development and course of the cardiovascular disease. The aim of the study was to present the relationship between occupation and some rarer diseases and cardiovascular pathologies, as well as those in which this relationship has not as yet been fully evidenced, however, they may play an important role in workers’ health care. In this paper tako-tsubo cardiomyopathy, aortic aneurysm, aortic dissection, pericardial tamponade, Brugada syndrome and sudden cardiac death are discussed. In addition, the authors indicate new issues emerging along with the development of modern diagnostic and therapeutic techniques in cardiology, such as the care of patients with implanted pace-maker and the use of automated external defibrillators. These issues are presented in the context of their relationship with the occupation, taking into account the activities possibly to be undertaken under preventive care programs. Med Pr 2014;65(6):847–85