ANTIPLATELET THERAPY AFTER CORONARY ARTERY BYPASS GRAFT SURGERY - UNEVENNESS OF DAILY CLINICAL PRACTICE.

Antiplatelet therapy is an integral part of optimal medicamentous therapy in patients with coronary artery disease. The strategy of antiplatelet/anticoagulant therapy is adjusted (combination of drugs, dosing and duration of therapy) depending on the stage of the disease (acute coronary syndrome with percutaneous coronary intervention, chronic coronary syndrome, or coronary surgical revascularization) and comorbidity of each patient (e.g.

TORSADES DE POINTES IN ELDERLY PATIENT WITH PAROXYSMAL ATRIAL FIBRILLATION TREATED BY SHORT-TERM PARENTERAL AMIODARONE THERAPY.

One of the drugs that are widely used in the treatment of atrial fibrillation is amiodarone. Despite considerable prolongation of the corrected QT interval and a substantial degree of bradycardia, amiodarone exhibits a remarkably low frequency of pro-arrhythmic events and <1.0% incidence of torsades de pointes, mostly after long-term usage.

Changes in Heart Rate Variability after Coronary Artery Bypass Grafting and Clinical Importance of These Findings.

Heart rate variability is a physiological feature indicating the influence of the autonomic nervous system on the heart rate. Association of the reduced heart rate variability due to myocardial infarction and the increased postinfarction mortality was first described more than thirty years ago. Many studies have unequivocally demonstrated that coronary artery bypass grafting surgery generally leads to significant reduction in heart rate variability, which is even more pronounced than after myocardial infarction.

Influence of in-hospital cardiac rehabilitation on psychological status after myocardial infarction in patients with D-type personality.

The aim of this study was to determine the number of D-type personality patients in the group with a history of myocardial infarction (MI) and the influence of comprehensive in-hospital cardiac rehabilitation (iCR) on their psychological status (PS). The study included 316 consecutive patients aged 18 to 65 with MI in the last six months admitted into the programme of iCR. Surgical revascularized patients, clinically unstable patients and patients with sever chronic diseases and disorders were excluded.

Heart Rate Variability after Off-Pump versus On-Pump Coronary Artery Bypass Graft Surgery.

Background. It is known that after coronary artery bypass graft surgery (CABG) heart rate variability (HRV) becomes significantly decreased with a gradual recovery in a few months after surgery. However, literature data about the impact of the off-pump CABG on postoperative HRV are not complete.

[Incidence of major adverse cardiovascular events after cardiac surgery procedures].

The aim of the study was to analyze the incidence of major adverse cardiovascular events after different cardiac surgery procedures. This study included 307 patients who underwent some of cardiac surgery procedures within a period of 6 months of arriving at stationary cardiac rehabilitation. There were 101 patients (33%) who had valve surgery and 206 patients (67%) who underwent coronary artery bypass grafting (CABG).

[Tako-Tsubo cardiomyopathy; reversible left ventricular dysfunction mimicking acute myocardial infarction with ST-elevation].

Tako-Tsubo cardiomyopathy is still en entity of unknown etiology and pathophysiology which clinically manifests with sudden, severe chest pain and/or dyspnea. It is generally triggered by emotional or physical stress and most cases are reported in postmenopausal women. Electrocardiographic changes are similar to acute myocardial infarction with ST-elevation, laboratory markers of myocardial lesion are usually mild to moderately high, and coronary angiography shows no significant pathomorphological changes of epicardial coronary arteries.

Stress cardiomyopathy with ST-segment elevation of the anterolateral location complicated by a secondary massive intracranial bleeding.

Stress cardiomyopathy or Tako-Tsubo Syndrome (TTS) clinically manifests with sudden chest pain and/or dyspnea, and is generally triggered by emotional or physical stress. Electrocardiographic (ECG) changes are similar to acute myocardial infarction with ST-elevation, but coronarography shows no significant pathomorphological changes of coronary arteries. Ventriculography and echocardiography show reversible akinesis and ballooning of the left ventricle apex with reduced ejection fraction.

Characteristics of heart rate variability in war veterans with post-traumatic stress disorder after myocardial infarction.

Objective: The goal of the study was to evaluate differences in heart rate variability (HRV) among post-myocardial infarction (MI) patients, depending on their participation in the Croatian war and on established diagnoses of post-traumatic stress disorder (PTSD).

Methods: The study included 34 male war veterans with diagnosed PTSD who had suffered a first MI and 34 age-matched post-MI patients without PTSD. Cardiac autonomic balance was evaluated through HRV analysis.

Unremitting embolus from cardiac myxoma at circumflex artery trifurcation.

Embolisation of coronary artery from cardiac myxoma is very rare and it is not clear what happens with embolic material inside coronary artery after myocardial infarction. The natural course of myxomatous embolus is important because it determines the mode of surgical intervention. Different options of the course of embolus have been speculated, from spontaneous resorption to growth at artery wall.

[Functional capacity in patients after myocardial infarction dependent on treatment strategy in acute phase of disease].

Background And Aim: Recently published studies suggest that percutaneous coronary inetrvention (PCI) is superior to fibrinolysis in terms of early and late mortality in patients with acute myocardial infarction (MI) with ST-elevation. The aim of this study was to evaluate the influence of treatment strategy in the acute phase of MI on postinfarction functional capacity.

Patients And Methods: This prospective study included 128 consecutive patients with MI, with ST-elevation over 12 weeks from the disease onset.

[Place and role of cardiac rehabilitation in modern cardiology].

Atherosclerotic cardiovascular disease is the major cause of death in middle-aged and older adults in most developing countries in the world. Numerous strong evidences in professional and scientific literature showed that regular aerobic exercise training and cardiac rehabilitation programmes lead to significant reduction in the risk profile and mortality of cardiac patients. However, less than 1/3 of patients eligible for cardiac rehabilitation currently participate in formal rehabilitation programmes in most European countries.

The effect of 3-weeks stationary cardiac rehabilitation on plasma lipids level in 444 patients with coronary heart disease.

The aim of this study was to investigate the effect of 3-weeks stationary cardiac rehabilitation on plasma lipids level in patients with CHD. The study included 444 consecutive patients (364 male and 80 female, mean age 58 +/- 9 year) with CHD who underwent 3-weeks stationary cardiac rehabilitation. Patients were divided into groups depending on their baseline levels of cholesterol and medication therapy: patients with normal (< 5 mmol/L, group I, 129 patients) and elevate plasma level of Total cholesterol (> 5 mmol/L, group II, 315 patients) and subgroups Ia and IIa (with statin in therapy), Ib and IIb (without statin in therapy).