The high risk of obstructive sleep apnea--an independent risk factor of erectile dysfunction in ST-segment elevation myocardial infarction patients.

Introduction: Sleep-related breathing disorders are highly prevalent in patients with established cardiovascular disease. Obstructive sleep apnea (OSA) is associated with several cardiovascular conditions such as hypertension, ischemic heart disease, arrhythmias, and erectile dysfunction (ED).

Aim: The aim of this prospective study was to investigate the prevalence of ED in ST-segment elevation myocardial infarction (STEMI) patients at high risk of OSA, and to evaluate the leading factors that increase the risk of ED.

3ST-POL trial: standards of statin use in Poland in the context of the European Society of Cardiology guidelines.

Introduction: Statins play a crucial role in modern cardiological pharmacotherapy. For the patient, as the beneficiary of an effective pharmacotherapy, it is of utmost importance that his or her physician can take maximum advantage of the whole potential of the available medications.

Objectives: The aim of the study was to analyse the effectiveness of statin treatment in Polish patients treated in an ambulatory setting, in view of the European Society of Cardiology guidelines.

Gene expression profiling in peripheral blood nuclear cells in patients with refractory ischaemic end-stage heart failure.

Functional analysis of up- and down-regulated genes might reveal whether peripheral blood cells may be considered as a material of diagnostic or prognostic value in patients with end-stage heart failure (HF). The aim of the present study was to compare the transcriptomic profile of peripheral blood nuclear cells from 6 male patients with ischaemic end-stage HF with those of 6 male patients with asymptomatic cardiac dysfunction. The expression of genes in peripheral blood nuclear cells in both groups of patients was measured using whole-genome oligonucleotide microarrays utilizing 35 035 oligonucleotide probes.

Clinical presentation, treatment, and long-term outcomes in patients with takotsubo cardiomyopathy. Experience of a single cardiology center.

Introduction: Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS).

Objectives: The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow-up of patients with TTC.

Patients And Methods: Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC.

Can obstructive sleep apnea be a cause of in-stent thrombosis?

We present the case of a 45-year-old patient readmitted to Central University Hospital at 3 a.m. for acute retrosternal chest pain associated with ST-segment elevation in lead I, aVL, V1-V6 in standard 12-lead ECG performed on admission in emergency department.

Factors responsible for "aspirin resistance" - can we identify them?

Background: Aspirin (ASA) is an effective antiplatelet drug that reduces the risk of myocardial infarction, stroke, or death by approximately 25% in patients who are at increased risk of cardiovascular events. However, many patients with cardiovascular disease do not respond to ASA treatment and are deemed ASA resistant. The term "ASA resistance" has been used to describe not only the lack of expected pharmacologic effects of ASA on platelets but also poor clinical outcomes, such as recurrent vascular events, in patients treated with ASA.

Manageability of acute severe heart failure complicated with left ventricular thrombosis during therapy for breast cancer.

Trastuzumab-related cardiac dysfunction may be manageable and completely reversible with suitable cardiac medication, allowing optimal breast cancer treatment to continue. We present the case of a 42-year-old woman who developed severe systolic left ventricular failure with impaired contractility of the right ventricle, pulmonary hypertension, and clots in the left ventricular cavity during adjuvant treatment for breast cancer. The patient was initially diagnosed with early breast cancer and underwent surgery on her left breast.

Availability of automated external defibrillators in the city of Warsaw - status for May 2009.

Background: The most frequent cause of sudden cardiac arrest (SCA) is ventricular fibrillation and ventricular tachycardia. Despite many efforts the prognosis in this patient group is poor. According to the European Resuscitation Council (ERC) recommendations, early defibrillation, preferably in the first 3-5 min, is a key link in the Chain of Survival after SCA.

Does time delay between the primary cardiac arrest and PCI affect outcome?

Objectives: In patients with acute ST-segment elevation acute myocardial infarction (AMI), no data are available on the prognostic value of cardiac arrest (CA) due to ventricular fibrillation (VF) before, during, and after percutaneous coronary intervention (PCI). The aim of our study was to determine differences in prognosis between patients with CA before, during, and after PCI.

Methods: Among 448 patients with first ST-segment elevation AMI, we selected 34 (7.

Lipomatous hypertrophy of the interatrial septum: a rare cause of right ventricular impairment.

We report a case of a 70-year-old woman admitted with symptoms of decompensated heart failure. Magnetic resonance imaging revealed lipomatous hypertrophy of the interatrial septum with partial upper right atrial inflow obstruction, partial obstruction of the right ventricular outflow tract, and excessive accumulation of adipose tissue in the pericardial space. The patient underwent excision of the septal lipomatous mass, which relieved the right ventricular outflow obstruction.

Baseline platelet size is increased in patients with acute coronary syndromes developing early stent thrombosis and predicts future residual platelet reactivity. A case-control study.

Introduction: Pre-procedural predictors of early stent thrombosis (ST) and future response to platelet inhibitors are in demand. We sought to evaluate the impact of baseline platelet indices on the occurrence of early ST and future residual platelet reactivity.

Materials And Methods: Hundred and eight patients with acute coronary syndromes (ACS) in whom stents were implanted were included: 36 consecutive ST cases and 72 matched controls.

Influence of C3435T multidrug resistance gene-1 (MDR-1) polymorphism on platelet reactivity and prognosis in patients with acute coronary syndromes.

Background: Genetic C3435T polymorphism of the multidrug resistance gene-1 (MDR-1) limits oral bioavailability of clopidogrel and influences prognosis in patients with myocardial infarction.

Aim: To assess the effects of C3435T polymorphism on platelet reactivity and prognosis in patients with acute coronary syndromes treated with percutaneous coronary intervention with stenting.

Methods: Ninety-eight patients were divided into subgroups according to closure time (CT) measured with the Platelet Function Analyzer-100 by means of collagen/adenosine diphosphate (CADP) and collagen/epinephrine (CEPI) cartridges.

Interindividual variability in the response to oral antiplatelet drugs: a position paper of the Working Group on antiplatelet drugs resistance appointed by the Section of Cardiovascular Interventions of the Polish Cardiac Society, endorsed by the Working Group on Thrombosis of the European Society of Cardiology.

Oral antiplatelet drugs are a cornerstone of modern pharmacotherapy in cardiovascular atherothrombotic diseases. The efficacy of acetylsalicylic acid (ASA, aspirin) and clopidogrel in decreasing the risk of adverse events in coronary heart disease patients has been well established in the past 20 years. Despite chronic oral antiplatelet therapy, a number of atherothombotic events continue to occur.

Are normal coronary arteries a typical feature of apical ballooning syndrome?

Apical ballooning syndrome (ABS) is a new and uncommon, yet very interesting, clinical phenomenon regarded as one of the important elements of differential diagnosis in acute myocardial infarction. It was first described in 1990. The absence of obstructive coronary artery disease among others is a typical feature of ABS, required to make a final diagnosis.

Usefulness of myocardial necrosis triad markers for predicting 4-year mortality in patients with suspected acute coronary syndrome.

Objective: Cardiac troponins (cTn), creatine kinase-MB (CK-MB), myoglobin (MYO) are commonly used biochemical markers for risk stratification and diagnosis in patients with suspected acute coronary syndrome (ACS). The aim of the study was to analyse the prognostic implications of 3 myocardial necrosis markers measured at admission in the long-term observation.

Methods: The study group consisted of 336 consecutive patients whose concentration of cTnl, CK-MB and MYO were measured at admission.

Coexisting polymorphisms of P2Y12 and CYP2C19 genes as a risk factor for persistent platelet activation with clopidogrel.

Background: Coexisting polymorphisms of the genes affecting clopiogrel resistance may influence platelet activation.

Methods And Results: In 105 patients with acute coronary syndrome (ACS) treated with percutaneous coronary intervention, platelet function was measured and registered as closure time in the test with collagen and adenosine diphosphate (CADP-CT). Patients were followed for 12 months for death or recurrent myocardial infarction (MI).

The effect of off-pump coronary artery bypass grafting on platelet activation in patients on aspirin therapy until surgery day.

Objective: Antiplatelet therapy is a class I indication in perioperative care after coronary artery bypass grafting to prevent graft occlusion. We sought to determine whether continuation of aspirin until surgery day suppresses platelet activity in the early period after off-pump coronary artery bypass grafting (OPCAB).

Material And Methods: Forty-two patients at mean age of 62.

Current possibilities of ACE inhibitor and ARB combination in arterial hypertension and its complications.

The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure regulation and hypertension-related complications. Angiotensin-converting enzyme inhibitors (ACEIs) were the first to be used to block the RAAS and now have many compelling indications in the treatment of hypertension and its cardiovascular and renal complications. Angiotensin II receptor blockers (ARBs), introduced 20 years later, have been shown to be equally as effective as antihypertensive treatment and are also associated with a lower number of side effects.