Showing papers by "Andrzej Rynkiewicz published in 2017"
TL;DR: Analysis of basic laboratory data and echocardiography collected on admission to the hospital may help to identify patients with acute decompensated HF, who are at high risk of in-hospital death.
Abstract: Background: Heart failure (HF) is a growing cause of hospitalisation worldwide, and despite significant progress in its treatment it is still associated with high mortality. Aim: The aim of this study was to find factors predicting in-hospital death in acute decompensated HF by analysis of basic laboratory data and echocardiography, routinely collected on admission to the hospital. Methods: To this single-centre retrospective study we involved 638 consecutive patients hospitalised in the years 2007–2008 due to acute decompensated HF. To the initial univariate analysis we included the results of echocardiography and 36 basic laboratory tests performed at hospital admission. Parameters significantly associated with in-hospital death in univariate analysis were taken to multivariate regression analysis. Results: In-hospital death occurred in 119 cases (median age 75 years; 40.3% females). The multivariate analysis revealed significant association between in-hospital death and: higher leukocyte count (death [D]: 13.5 vs. survival [S]: 8.8 G/L, p < 0.01), higher neutrophil count (D: 10.5 vs. S: 5.9 G/L, p < 0.01), lower lymphocyte count (D: 1.3 vs. S: 1.7 G/L, p < 0.05), higher C-reactive protein concentration (D: 20.8 vs. S: 6.7 mg/dL, p < 0.01), higher serum glucose concentration (D: 167.0 vs. S: 116.0 mg/dL, p < 0.00001), higher serum creatinine concentration (D: 1.5 vs. S: 1.2 mg/dL, p < 0.0001), higher blood urea nitrogen concentration (D: 29.0 vs. S: 22.0 mg/dL, p < 0.00001), and higher aspartate aminotransferase (D: 72.0 vs. S: 27.0 U/L, p < 0.0001). Surprisingly, there was no significant association with echocardiographic parameters. Conclusions: Analysis of basic laboratory data collected on admission to the hospital may help to identify patients with acute decompensated HF, who are at high risk of in-hospital death.
16 citations
Charles University in Prague1, Masaryk University2, University of Debrecen3, University of Zagreb4, Hacettepe University5, Slovak Medical University6, University of Warmia and Mazury in Olsztyn7, Carol Davila University of Medicine and Pharmacy8, Ege University9, University of Latvia10, Vilnius University11, University of Ljubljana12, Cardiovascular Institute of the South13, Kyrgyz State Medical Academy14, University of Ioannina15
TL;DR: The authors' data point to the large population of heterozygous FH patients in the CESE region but low diagnostic rate, however structures through the ScreenPro FH project are being created and it is hoped that the results will appear soon.
Abstract: Uvod: I přes velký pokrok v nedavne době je familiarni hypercholesterolemie (FH) stale jestě celosvětově podceňovane, nedostatecně diagnostikovane, a tedy i nedostatecně lecene onemocněni. O přesne prevalenci pacientů postižených familiarni hypercholesterolemii v regionu středni, východni a jižni Evropy (CESE) mame jen velmi malo informaci. Cilem studie bylo popsat na zakladě dostupných udajů epidemiologickou situaci v regionu CESE. Metody: Vsichni vedouci představitele projektu ScreenPro FH v jednotlivých oblastech byli požadani o poskytnuti lokalnich udajů, ktere se týkaji (a) expertniho odhadu prevalence FH, (b) již fungujicich zdravotnických zařizeni, (c) použitých diagnostických kriterii, (d) poctu pacientů již zavedených v mistni databazi a konecně (e) dostupnosti možnosti lecby (zejmena plazmaferezy). Výsledky: Vzhledem k odhadovane prevalenci FH přibližně 1 : 500 odhadujeme, že celkova populace FH heterozygotů v regionu CESE zahrnuje 588 363 osob. V mistnich databazich se vsak zobrazilo pouze 14 108 osob (2,4 %), přicemž mira zobrazeni se lisila v rozmezi od 0,1 % až 31,6 %. Pouze 4 země oznamily dostupnost LDL aferezy. Zavěr: Nase udaje svědci o velke populaci pacientů postižených heterozygotni formou FH v regionu CESE a zaroveň o nizkých podilech jejich zobrazeni. V ramci projektu ScreenPro FH jsou vsak nyni vytvařeny potřebne struktury a můžeme tak doufat v dosaženi přiznivějsich výsledků.
12 citations
Charles University in Prague1, University of Debrecen2, University of Zagreb3, Hacettepe University4, Slovak Medical University5, Masaryk University6, University of Warmia and Mazury in Olsztyn7, Carol Davila University of Medicine and Pharmacy8, Ege University9, University of Latvia10, Vilnius University11, University of Ljubljana12, Cardiovascular Institute of the South13, Kyrgyz State Medical Academy14, University of Ioannina15
TL;DR: The ScreenPro FH Project is an international network project aiming at improving complex care - from timely screening, through diagnosis to up-to-date treatment of familial hypercholesterolemia in Central, Eastern and Southern Europe.
Abstract: Familiarni hypercholesterolemie (FH) je geneticky podminěne onemocněni s velmi dobře popsaným genetickým přenosem a klinickým průběhem. I přes významný pokrok v nedavne době je familiarni hypercholesterolemie dosud podceňovana, nedostatecně diagnostikovana a tedy i nedostatecně lecena. Jako spolecný rizikový faktor předcasneho vzniku kardiovaskularniho onemocněni navic představuje důležitou výzvu v oblasti zdravotni pece. Projekt ScreenPro FH je zaměřen na rozvoj mezinarodni sitě, ktera podpoři zkvalitňovani komplexni pece – od vcasneho screeningu přes stanoveni diagnozy až k nejmodernějsi lecbě familiarni hypercholesterolemie ve středni, východni a jižni Evropě. Důležitým ukolem projektu je harmonizovat a sjednotit diagnosticke a terapeuticke přistupy v jednotlivých zucastněných zemich, v nichž je situace v každe z nich odlisna. Země s větsimi zkusenostmi by měly sloužit jako vzor pro ty, ktere svou siť FH nyni buduji.
7 citations
TL;DR: Evaluating the suitability of taking into account the following parameters: ApoB/ApoA index, IMT and e-tracking examination, when initiating statin therapy in FH patients found increased risk of cardiovascular events based on ApoA/A poA index and carotid e- tracking or IMT examination in paediatric patients with FH is an indication for statin Therapy initiation.
Abstract: INTRODUCTION Familial hypercholesterolemia (FH) is one of the most common autosomal dominant disorders. It is characterized by elevated LDL cholesterol levels occurring already by early childhood. Awareness of health risks in FH patients should incite health professionals to actively seek and treat children with lipid disorders to reduce their risk of myocardial infarction and stroke. OBJECTIVE The aim of the study was to evaluate the suitability of taking into account the following parameters: ApoB/ApoA index, IMT and e-tracking examination, when initiating statin therapy in FH patients. Materials and methods The study included 57 male and female patients aged 9.57±3.2 years (ranging from 1 year to 17 years), diagnosed with familial hypercholesterolemia confirmed by molecular testing. All the participants had their lipid profile, ApoA and ApoB levels determined. Carotid intima-media thickness (IMT) was measured by carotid ultrasound and arterial stiffness was assessed by e-tracking. The dietary treatment efficacy was monitored in 40 patients and the 12-month combination treatment efficacy in 27 patients. The study was conducted prospectively and retrospectively. Statistical analysis was performed with the EPIINFO Ver. 7.1.1.14 statistical software package. RESULTS Patients with familial hypercholesterolemia had high mean levels of total cholesterol and LDL cholesterol (287±67 mg/dL and 213±73 mg/dL respectively). 34.37% of the study subjects had a markedly increased ApoB/ApoA index. On IMT or e-tracking examination all the subjects (100%) had vascular abnormalities. After 6 months of a low-cholesterol diet, the mean total and LDL cholesterol levels in the serum had been reduced by 7.2% and 6.2%, respectively. Statins in an average dose of 10.42±2.49 mg daily were prescribed to 36 patients. After one year of the statin therapy, the average serum total and LDL cholesterol levels were 203.5±34.8 mg/dL and 139.1±32.1 mg/dL, respectively, and were still above the target values. Moreover, side effects of the statin therapy were monitored. An increase in AST levels seen in the study group was not statistically significant. The mean creatine kinase level was within the range of normal. Moreover, in our study material we estimated the risk of cardiovascular events in relation to the ApoB/ApoA index. Higher cardiovascular risk was found in 34.37% participants. CONCLUSIONS Increased risk of cardiovascular events based on ApoB/ApoA index and carotid e-tracking or IMT examination in paediatric patients with FH is an indication for statin therapy initiation.
1 citations