Katarzyna Czerwinska-Jelonkiewicz
Center for Cardiovascular Research and Development, American Heart of Poland, Czajek 41 Katowice Marek Cisowski
I Oddział Kardiochirurgiczny, Polsko-Amerykańskie Kliniki Serca, Armii Krajowej 101 Bielsko-Biała Andrzej Bochenek
American Heart of Poland, Czajek 41 Katowice Piotr Buszman
Center for Cardiovascular Research and Development, American Heart of Poland, Czajek 41 Katowice Piotr Kunik
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Magdalena Mularska
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Krzysztof Kocot
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Piotr Politowski
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Jakub Braczkowski
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Agata Trznadel
Katedra Chorób Wewnętrznych, Autoimmunologicznych i Metabolicznych, Śląski Uniwersytet Medyczny, Medyków 14 Katowice Paweł Buszman
Center for Cardiovascular Research and Development, American Heart of Poland, Czajek 41 Katowice
BACKGROUND
Periprocedural antithrombotic prophylaxis in patients subjected to surgical valve replacement (VR) is unin-vestigated. Low molecule weight heparin (LMWH) might be considered as an alternative to unfractionated heparin (UFH). However, the safety and efficacy of this prophylaxis is unknown.
AIM
This study was aimed to investigate the safety and efficacy of periprocedural LMWH prophylaxis and to determine optimal dosage and time of its cessation/initiation.
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METHODS
This was the retrospective, single-center observational analysis of pts who underwent VR between 2015–
2016. In-hospital endpoints were: 1. bleeding, 2. transfusions, 3. reoperation due to bleeding, 4. throm-boembolic events.
RESULTS
On the basis of 388 pts included we proved that the first dosage of LMWH on the day of VR was a risk factor for bleeding OR 1.069 95%CI [1.035–1.103]; p < 0.0001, transfusions OR 1.039 95%CI [1.009–1.070];p
= 0.008 and reoperation due to bleeding OR 1.201 95%CI [1.123–1.282]; p < 0.0001, with > 40 mg/
day as a predictor. Higher dosage of LMWH premedication was an independent risk factor for bleeding OR 1.019 95%CI [1.001–1.037]; p = 0.03 and transfusion OR 1.026 95%CI[1.005–1.048]; p = 0.01, with
> 60 mg/day as a predictor for these events. LMWH used within 24-hours before VR increased the risk of transfusion AUC 0.636 95%CI [0.496–0.762]; p = 0.04.
CONCLUSIONS
Bleedings are the main early events after surgical valve replacement. Safety and efficacy of LMWH peri-pro-cedural prophylaxis depend on dosage and time of its administration. The most optimal for peri-properi-pro-cedural prophylaxis in VR population is LMWH in dosage recommended for deep vein thrombosis prophylaxis, ceased at least one day before VR.
Figure 1.
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Poziom 8-hydroksy-2’-deoksyguanozyny w moczu u pacjentów z sarkoidozą serca
Urinary 8-hydroxy-2’-deoxyguanosine (U-8-OHdG) level in patients with cardiac sarcoidosis
Justyna Błaut-Jurkowska
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
Magdalena Kaznica-Wiatr
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
Lidia Tomkiewicz-Pajak
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
Agnieszka Zygadło
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
Piotr Podolec
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
Maria Olszowska
Klinika Chorób Serca i Naczyń, Instytut Kardiologii, Collegium Medicum, Uniwersytet Jagielloński, Krakowski Szpital Specjalistyczny im. Jana Pawła II, Prądnicka 80, Kraków
BACKGROUND
Sarcoidosis is a multisystem disease of unknown etiology characterized by the presence of noncaseat-ing granulomas. 3.7%–54.9% patients with extra-cardiac sarcoidosis have asymptomatic cardiac involve-ment.U-8-OHdG is a marker of oxidative DNA damage. Data from literature suggest that U-8-OHdG reflects inflammatory activity and prognosis in cardiac sarcoidosis.
AIM
The aim of the study was to assess the differences of U-8-OHdG level between patients with cardiac sar-coidosis and in patients with pulmonary sarsar-coidosis but without diagnosis of CS.
Additionally, age, sex, time passed from diagnosis of sarcoidosis, stage of sarcoidosis, left ventricular ejection fraction evaluate in cardiac magnetic resonance (CMR) and laboratory markers of inflammation such as C Reactive Protein level and white blood cells count were analyzed.
METHODS
40 patients (12 females and 28 males), mean age 45.1 ± 12.5 years were enrolled to our study. Cardiac sarcoidosis was diagnosed in 8 patients; 20% (1females and 7 males), mean age 46.125 ± 16.5 years (Group A). 32 patients — 80% (11 females and 21 males) mean age 44.84 ± 7.5 years, were diagnosed with
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pulmonary sarcoidosis but had excluded cardiac sarcoidosis (Group B). All patients had histologically con-firmed pulmonary sarcoidosis. Cardiac sarcoidosis (CS) was diagnosed according to the recommendations proposed by Heart Rhythm Society Expert Consensus Statement on Arrhythmias Associated with Cardiac Sarcoidosis from 2014. U-8-OHdG level were measured using a commercial ELISA kit.
RESULTS
he mean level of U-8-OHdG in patients with pulmonary sarcoidosis was 81.13 ± 26.91 ng/mL. The mean level of U-8-OHdG in patients with CS was lower than in patients with no diagnosis of CS (63.67 ± 43.86 ng/mL vs 85.49 ± 14.25 ng/mL), but those differences were no statistically significant. The level of white blood cells count in patients with CS were statistically significant higher than in patients without CS (p <
0.01). The level of U-8-OHdG in women was statistically significant lover than in men. No statistically sig-nificant correlation was observed between the level of U-8-OHdG and patients age, duration of the disease, stage of sarcoidosis, left ventricular ejection fraction evaluate in CMR, C Reactive Protein level and white blood cells count.
CONCLUSIONS
We observed a trend towards lower level of U-8-OHdG in a group of patients with CS than in patients without CS. However, these differences were not statistically significant.
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