Classification and definition of acute coronary syndromes - A time for change?

Petr Widimský

Cor Vasa 2014, 56(4):e279-e284 | DOI: 10.1016/j.crvasa.2014.05.003  

Trends in epidemiology and the treatment of acute coronary syndromes in the Czech Republic: Comparison of the CZECH-1 and CZECH-2 registries

Petr Toušek, David Horák, František Toušek, Richard Rokyta, Pavel Červinka, Michael Želízko, Michael Aschermann, Petr Janský, František Holm, Ladislav Pešl, Jiří Jarkovský, Petr Widimský

Cor Vasa 2014, 56(4):e285-e290 | DOI: 10.1016/j.crvasa.2014.06.006  

Two-year survival of STEMI patients in Slovakia. An analysis of the SLOVak registry of Acute Coronary Syndromes (SLOVAKS)

Martin Studenčan, František Kovář, Vasil Hricák, Peter Kurray, Eva Goncalvesová, Iveta Šimková, Gabriel Kamenský

Cor Vasa 2014, 56(4):e297-e303 | DOI: 10.1016/j.crvasa.2014.06.008  

Four 24/7 P-PCI centres performed emergency program in 2011 in Slovakia. In view of the geographic relations and number of residents per centre (1.37 mil. residents/centre) it was possible to consider access to P-PCI as sub-optimal. The aim of the study is an evaluation of two-year survival of STEMI cohort admitted to hospitals in 2011 and confrontation of survival with used treatment strategy. Clinical outputs were analysed using data acquired from the SLOVak registry of Acute Coronary Syndromes (SLOVAKS). In this analysis we have evaluated 1 580 cases of ACS (STEMI, UAP and NSTEMI).80.6% of STEMI patients have been admitted into P-PCI-centres...

Antiplatelet therapy in patients after an acute coronary syndrome. Comparison of the Czech and Slovak Republics. Results of the ATHRO registry

Petr Widimský, Vasil Hricák, Jiří Jarkovský, Zuzana Zbožínková, Simona Littnerová, Daniel Klimeš, Lenka Hýblová, Bronislava Fraňová

Cor Vasa 2014, 56(4):e320-e324 | DOI: 10.1016/j.crvasa.2014.04.009  

Background: The modern treatment of acute coronary syndromes includes early initiation of dual antiplatelet therapy (DAPT) and coronary angiography (CAG) followed by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Recently two new potent antiplatelet agents (ticagrelor and prasugrel) were introduced in clinical practice. The aim of this registry was to analyze the treatment strategies in two neighbor countries: Czech (CZ) and Slovak (SK) Republics.Patients and methods: A total of 1 541 patients was enrolled during one month period in 18 tertiary cardiac centers in CZ (n = 1 026) and 6 centers in SK (n = 515)....

Decrease in annual incidence of acute coronary syndrome and restructuring of coronary care in Latvia

Andrejs Erglis, Aija Maca, Inga Narbute, Sanda Jegere, Svetlana Ratobilska, Agnese Knipse, Vilnis Dzerve, Iveta Bajare, Ilja Zakke

Cor Vasa 2014, 56(4):e325-e332 | DOI: 10.1016/j.crvasa.2014.04.003  

Introduction: Improvement in coronary heart disease prevention and treatment, as well as availability of coronary care facilities, are important measures for reduction of acute coronary syndrome (ACS) incidence. Centralized acute coronary care system is crucial to provide optimal hospitalization and management algorithm for ACS patients.Aim: The aim of the current report was to assess annual incidence of ACS, and quality of acute coronary care in Latvia.Methods: The data from The Latvian Registry of Acute Coronary Syndromes were analyzed covering the time period from year 2005 to year 2010.Results: Since the year 2005 the annual incidence...

The magnitude of percutaneous coronary intervention treatment in high and medium risk non-ST elevation acute coronary syndrome

David Becker, Anna Móri, Gyorgy Bárczi, Hajnalka Vágó, Orsolya Szenczi, Balazs Berta, Krisztina Heltai, Endre Zima, Pal Maurovich-H., Bela Merkely

Cor Vasa 2014, 56(4):e333-e336 | DOI: 10.1016/j.crvasa.2014.04.002  

Introduction: Current ESC guideline supported invasive treatment of non-ST elevation acute coronary syndrome (NSTE-ACS) is guided by GRACE risk model.Objective: The aim of this study was to determine whether the percutaneous coronary intervention treatment in NSTE-ACS ameliorates the long-term mortality assessed by GRACE risk score.Methods: We conducted a retrospective study of a consecutive sample of 680 patients with NSTE-ACS treated by PCI in Heart Center of Semmelweis University. The GRACE risk score was calculated for each patient at admission. The mean of relative risk in each group was assessed and compared with the long-term clinical...

Patency of the infarct-related artery and time-dependant infarct transmurality on cardiovascular magnetic resonance in patients with ST-segment elevation myocardial infarction treated by primary percutaneous intervention

Łukasz A. Małek, Mariusz Kłopotowski, Mateusz Śpiewak, Jolanta Miśko, Witold Rużyłło, Adam Witkowski

Cor Vasa 2014, 56(4):e337-e341 | DOI: 10.1016/j.crvasa.2014.03.003  

Background: Outcome in ST-segment elevation myocardial infarction (STEMI) is affected by patency of the infarct-related artery (IRA) on the initial angiogram. Therefore we decided to assess the relation between patent IRA and time-dependent infarct transmurality.Materials and methods: The study included 62 patients with first STEMI (age 61 ± 9 years, 76% male) undergoing primary percutaneous coronary intervention (PCI). All patients underwent cardiovascular magnetic resonance (CMR) in the sub-acute phase to assess infarct transmurality. Infarction was considered as transmural if mean infarct transmurality exceeded > 75%. IRA patency was...

Why some patients with acute coronary syndrome hospitalised in a university tertiary centre do not undergo coronary angiography? Results from the AHEAD ACS registry

Marián Felšöci, Mária Holická, Jiří Pařenica, Jiří Jarkovský, Roman Miklík, Kateřina Hořáková, Jindřich Špinar

Cor Vasa 2014, 56(4):e369-e375 | DOI: 10.1016/j.crvasa.2014.05.005  

Aim of study: To evaluate in-hospital and long-term mortality of patients with acute coronary syndromes (ACS) not having in-hospital selective coronary angiography (SCA) and to analyze the reasons for conservative approach.Method and patients: A single-center retrospective study using registry data. Over the period from January 2005 through April 2009, a total of 193 ACS patients did not have in-hospital SCA. Fifty-five (28.5%) patients were considered for SCA as a scheduled procedure and/or a recent angiographic finding was available (Group I), in 138 (71.5%) patients, SCA was not considered at all (Group K). The subgroups were to be compared...

ST elevation myocardial infarction and multi-vessel coronary artery disease: complete or incomplete revascularisation?

Vincenzo Vizzi, Thomas W. Johnson, Julian W. Strange, Andreas Baumbach

Cor Vasa 2014, 56(4):e291-e296 | DOI: 10.1016/j.crvasa.2014.07.002  

The most recent guidelines for the treatment of ST elevation myocardial infarction strongly support a prompt mechanical reopening of the occluded culprit coronary artery. However, there is a great debate regarding how to treat the bystander non-culprit coronary artery disease. While data from retrospective studies and registries suggest that it should be treated in a second staged procedure, a recent randomised study has suggested a better outcome for patients receiving complete revascularisation during the index primary PCI. In this paper we aim to address this controversial point, analysing the most recent and important scientific publications and...

Biochemical markers in the diagnosis of myocardial infarction

Tomáš Janota

Cor Vasa 2014, 56(4):e304-e310 | DOI: 10.1016/j.crvasa.2014.06.007  

The diagnosis of myocardial necrosis due to acute myocardial infarction (AMI) and other causes has long been based on the plasma levels of cardiac troponins. Other markers of myocardial injury such as myoglobin, heart-type fatty acid binding protein, glycogen phosphorylase isoenzyme BB, or the early and sensitive total stress marker copeptin remain to be just attractive options used primarily to early rule out AMI and in risk stratification. Recent years have seen the introduction of a routine practice of the high-sensitivity cardiac troponin assays capable of detecting diagnostic elevations in plasma troponin levels as early as the first hours of...

Particularities in coronary revascularization in elderly patients presenting with ST segment elevation acute myocardial infarction (STEMI)

Maria Dorobanţu, Lucian Câlmâc, Andrada Bogdan, Vlad Bătăilă, Bogdan Drăgoescu, Andrei Radu, Mugur Marinescu, Şerban Arvanitopol, Gabriel Tatu-Chiţoiu, Rodica Niculescu

Cor Vasa 2014, 56(4):e342-e347 | DOI: 10.1016/j.crvasa.2014.06.005  

Nowadays, ST elevation acute myocardial infarction (STEMI) is seen with greater incidence in older patients. Current guidelines recommend an immediate invasive evaluation and eventually primary percutaneous coronary intervention (PCI) in all STEMI patients regardless of age. Nevertheless, data in literature show a significant underuse of interventional treatment in older patients with STEMI.Our objective is to assess the in-hospital outcome of the elderly STEMI patients compared to the younger ones in the setting of systematic interventional management. We also discussed some particular aspects which we considered as significant concerning the...

Radionuclide imaging in acute coronary syndromes

Otto Lang

Cor Vasa 2014, 56(4):e354-e361 | DOI: 10.1016/j.crvasa.2014.04.008  

Introduction: Acute coronary syndrome encompasses acute forms of ischemic heart disease, unstable angina and myocardial infarction with or without ST elevation. Chest pain patients have a wide spectrum of cardiac risk from those with typical symptoms and abnormal electrocardiography who require immediate catheter angiography with a view to intervention; at the other end of the spectrum there are those of low risk with atypical symptoms and a normal ECG who can be discharged without investigation. Between these two groups there is a large number of patients with diagnostic uncertainty.Methods: Radionuclide imaging can be useful in different phases...

Vulnerable plaque imaging and acute coronary syndrome

Martin Horváth, Petr Hájek, Cyril Štěchovský, Josef Veselka

Cor Vasa 2014, 56(4):e362-e368 | DOI: 10.1016/j.crvasa.2014.05.002  

The term vulnerable plaque has been established to describe an atherosclerotic lesion with a high probability of causing a future coronary event [1,2]. The identification and stabilization of the lesion before its rupture may reduce the morbidity and mortality caused by coronary artery disease. Modern imaging modalities such as computer tomography coronary angiography, intravascular ultrasound, optical coherence tomography and near-infrared spectroscopy have a potential in finding these vulnerable plaques. This raises opportunities in primary and secondary prevention of coronary artery disease. This review summarizes the current knowledge with an emphasis...

Acute myocardial infarction, primary percutaneous coronary intervention and stent thrombosis in heart transplanted patient: Potential role of elevated coagulation factor VIII

Omar Gómez-Monterrosas, Diego Fernández, Salvatore Brugaletta, Giancarla Scalone, Ander Regueiro, Shuji Otsuki, Marta Farrero, Manel Sabaté

Cor Vasa 2014, 56(4):e311-e315 | DOI: 10.1016/j.crvasa.2014.06.002  

Elevated factor VIII levels have been established as thrombotic risk factor. In this case report, we describe a 51-year-old patient with a history of heart transplantation and acute myocardial infarction, treated by stent implantation who presented with sub-acute stent thrombosis. Elevated factor VIII levels were detected as most plausible cause of this thrombotic event. A review of the literature is also performed.

Non-ST-segment elevation myocardial infarction without culprit lesion - Role of coronary artery spasm

Melanie Kilzheimer, Udo Sechtem, Peter Ong

Cor Vasa 2014, 56(4):e316-e319 | DOI: 10.1016/j.crvasa.2014.05.001  

Rescue venoarterial ECMO in cardiogenic shock complicated by refractory cardiac arrest during percutaneous coronary intervention

Rihard Knafelj, Primoz Trunk, Simon Terseglav, Maja Sostaric, Marko Noc

Cor Vasa 2014, 56(4):e348-e353 | DOI: 10.1016/j.crvasa.2014.02.001  

Cardiogenic shock represents the leading cause of death in hospitalized patients with acute coronary syndromes. Immediate revascularization, either percutaneous or surgical, currently represents the only intervention of proven benefit. Despite the lack of such proof, intra-aortic balloon pump (IABP) and vasoactive drugs are typically used to improve hemodynamic stability on top of revascularization. Mechanical circulatory support devices beyond IABP such as Impella, TandemHeart and venoarterial extracorporeal membrane oxygenation (VA ECMO) are hemodynamically even more effective. Despite the lack of proven survival benefit, this technology might be...

Je změna dosažená v testu šestiminutovou chůzí prediktorem dlouhodobé prognózy pacientů s plicní arteriální hypertenzí?

Doc. MUDr. Martin Hutyra, Ph.D.

Cor Vasa 2014, 56(4):475-476  

Inhibitory ACE, nebo sartany v léčbě hypertenze: zbytečná diskuse?

Doc. MUDr. Jan Václavík, Ph.D., MUDr. Jiří Slíva, Ph.D.

Cor Vasa 2014, 56(4):477-479  

Doporučené postupy pro sekundární prevenci cévní mozkové příhody American Heart Association (AHA)/American Stroke Association (ASA) 2014 pohledem kardiologa

MUDr. Ivo Varvařovský, Ph.D.

Cor Vasa 2014, 56(4):480-481  

Udělení prestižní ceny Světové zdravotnické organizace České kardiologické společnosti

Prof. MUDr. Jaromír Hradec, CSc., FESC

Cor Vasa 2014, 56(4):486  

Zápis ze schůze výboru ČKS konané 8. dubna 2014 v kanceláři ČKS v Praze

P. Widimský, P. Riebauerová

Cor Vasa 2014, 56(4):483-485  

Zápis ze schůze výboru ČKS konané 4. května 2014 v Salonku I + II, Hotelu Holiday Inn Brno

P. Widimský, P. Riebauerová

Cor Vasa 2014, 56(4):485  

David H. Bennett: Srdeční arytmie, praktické poznámky k interpretaci a léčbě

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2014, 56(4):487  

Vladimír Staněk: Kardiologie v praxi

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2014, 56(4):488  

Zpráva ze IV. konference sester pracujících v kardiologii v Novém Smokovci

Bc. Dagmar Hetclová, Karolína Kubová

Cor Vasa 2014, 56(4):473  

Za profesorem Aloisem Zapletalem

Prim. MUDr. Jan Šulc, CSc., FCCP, Doc. MUDr. Oleg Reich, Ph.D.

Cor Vasa 2014, 56(4):472-473  

Editorial Board

Editorial board

Cor Vasa 2014, 56(4):i | DOI: 10.1016/S0010-8650(14)00072-1