Impact of intra-aortic balloon pump on short-term clinical outcomes in ST-elevation myocardial infarction complicated by cardiogenic shock: A ‘real life’ single center experience / Impacto del balón de contrapulsación intraaórtico en el pronóstico clínico a corto plazo de pacientes con infarto agudo de miocardio con elevación del segmento ST complicado con shock cardiogénico: experiencia de «vida real»

OBJECTIVE: To analyze the use and impact of the intra-aortic balloon pump (IABP) upon the 30-day mortality rate and short-term clinical outcome of non-selected patients with ST-elevation acute myocardial infarction (acute STEMI) complicated by cardiogenic shock (CS). DESIGN: A single-center retrospective case-control study was carried out. SETTING: Coronary Care Unit. PATIENTS: Data were collected from 825 consecutive patients with acute STEMI admitted to a Coronary Care Unit from January 2009 to August 2015. Seventy-three patients with CS upon admission subjected to emergency percutaneous coronary intervention (PCI) were finally included in the analysis and were stratified according to IABP use (44 patients receiving IABP). VARIABLES: Cardiovascular history, hemodynamic situation upon admission, angiographic and procedural characteristics, and variables derived from admission to the Coronary Care Unit. RESULTS: Cumulative 30-day mortality was similar in the patients subjected to IABP and in those who received conventional medical therapy only (29.5% and 27.6%, respectively; HR with IABP 1.10, 95% CI 0.38-3.11; p = 0.85). Similarly, no significant differences were found in terms of the short-term clinical outcome between the groups: time on mechanical ventilation, days to hemodynamic stabilization, vasoactive drug requirements and stay in the Coronary Care Unit. Poorer renal function (HR 3.9, 95% CI 1.4-10.6; p = 0.008), known peripheral artery disease (HR 3.3, 95% CI 1.2-9.1; p = 0.019) and a history of diabetes mellitus (HR 3.2, 95% CI 1.2-8.1; p = 0.018) were the only variables independently associated to increased 30-day mortality. CONCLUSION: In our 'real life' experience, IABP does not modify 30-day mortality or the short-term clinical outcome in patients presenting STEMI complicated with CS and subjected to emergency percutaneous coronary revascularization

OBJETIVO: Analizar el uso e impacto del balón de contrapulsación intraaórtico (BCIA) en la mortalidad a 30 días y en los desenlaces clínicos a corto plazo de pacientes con infarto agudo de miocardio con elevación del segmento ST complicado con shock cardiogénico. DISEÑO: Estudio de casos y controles unicéntrico y retrospectivo. Ámbito: Unidad Coronaria. PACIENTES: Los datos fueron obtenidos de 825 pacientes consecutivos admitidos en una unidad coronaria con diagnóstico de infarto agudo de miocardio con elevación del segmento ST desde enero de 2009 hasta agosto de 2015. Un total de 73 pacientes en situación de shock cardiogénico al ingreso derivados a una revascularización coronaria percutánea urgente fueron incluidos para el análisis y estratificados en función de la utilización del BCIA (44 pacientes recibieron BCIA). VARIABLES: Antecedentes cardiológicos, situación hemodinámica al ingreso, características angiográficas y periprocedimiento, y variables derivadas de la estancia en la Unidad Coronaria. RESULTADOS: La mortalidad a 30 días fue similar entre los tratados con BCIA y aquellos con tratamiento convencional (29,5 y 27,6%, respectivamente; HR con BCIA 1,10, IC 95% 0,38-3,11; p = 0,85). Así mismo, no encontramos diferencias significativas con respecto a los desenlaces clínicos a corto plazo: días en ventilación mecánica, tiempo hasta la estabilidad hemodinámica, requerimiento de fármacos vasoactivos y días de estancia en la Unidad Coronaria. En el análisis multivariante, las únicas variables asociadas de forma independiente con una mayor mortalidad a 30 días fueron peor función renal al ingreso (HR 3,9, IC 95% 1,4-10,6; p = 0,008), antecedentes de enfermedad arterial periférica (HR 3,3, IC 95% 1,2-9,1; p = 0,019) y diabetes mellitus (HR 3,2, IC 95% 1,2-8,1; p = 0,018). CONCLUSIÓN: En nuestra experiencia de la «vida real», la utilización del BCIA no modifica la mortalidad a 30 días ni los desenlaces clínicos a corto plazo en pacientes con infarto agudo de miocardio con elevación del segmento ST complicado con shock cardiogénico que son derivados a una estrategia de revascularización coronaria percutánea urgente

Impact of intra-aortic balloon pump on short-term clinical outcomes in ST-elevation myocardial infarction complicated by cardiogenic shock: A "real life" single center experience.

OBJECTIVE: To analyze the use and impact of the intra-aortic balloon pump (IABP) upon the 30-day mortality rate and short-term clinical outcome of non-selected patients with ST-elevation acute myocardial infarction (acute STEMI) complicated by cardiogenic shock (CS). DESIGN: A single-center retrospective case-control study was carried out. SETTING: Coronary Care Unit. PATIENTS: Data were collected from 825 consecutive patients with acute STEMI admitted to a Coronary Care Unit from January 2009 to August 2015. Seventy-three patients with CS upon admission subjected to emergency percutaneous coronary intervention (PCI) were finally included in the analysis and were stratified according to IABP use (44 patients receiving IABP). VARIABLES: Cardiovascular history, hemodynamic situation upon admission, angiographic and procedural characteristics, and variables derived from admission to the Coronary Care Unit. RESULTS: Cumulative 30-day mortality was similar in the patients subjected to IABP and in those who received conventional medical therapy only (29.5% and 27.6%, respectively; HR with IABP 1.10, 95% CI 0.38-3.11; p=0.85). Similarly, no significant differences were found in terms of the short-term clinical outcome between the groups: time on mechanical ventilation, days to hemodynamic stabilization, vasoactive drug requirements and stay in the Coronary Care Unit. Poorer renal function (HR 3.9, 95% CI 1.4-10.6; p=0.008), known peripheral artery disease (HR 3.3, 95% CI 1.2-9.1; p=0.019) and a history of diabetes mellitus (HR 3.2, 95% CI 1.2-8.1; p=0.018) were the only variables independently associated to increased 30-day mortality. CONCLUSION: In our "real life" experience, IABP does not modify 30-day mortality or the short-term clinical outcome in patients presenting STEMI complicated with CS and subjected to emergency percutaneous coronary revascularization.

Valor pronóstico del análisis del vector de bioimpedancia en pacientes ingresados por descompensación aguda de insuficiencia cardiaca: cohorte de validación / Prognostic value of analysing the bioimpedance vector for patients hospitalised for acute decompensated heart failure: a validation cohort

Objetivos. Evaluar el impacto pronóstico del análisis del vector de bioimpedancia (bioelectrical impedance vector analysis [BIVA]) en pacientes ingresados por insuficiencia cardiaca (IC). Material y métodos. Cohorte prospectiva de 105 pacientes ingresados por IC. El BIVA se realizó previo al alta, y la muestra final se dividió en 3 grupos según el valor obtenido: hiperhidratación [hiperH] (>74,3%), normohidratación [normoH] (72,7-74,3%) y deshidratación [desH] (<72,7%). En el seguimiento, se consideraron eventos adversos la mortalidad total y los reingresos por IC. Resultados. Se observó una mayor incidencia de eventos en los pacientes hiperH y desH respecto a los normoH (Kaplan-Meier: log rank 2,1; p=0,04), con un incremento de riesgo independiente en el análisis multivariado (HR 2,6 [1,05-6,44]; p=0,039). Conclusiones. El análisis BIVA en pacientes ingresados por IC permite estratificar el riesgo de reingreso por IC y mortalidad total en el seguimiento a largo plazo (AU)

Objectives. To assess the prognostic impact of the bioimpedance vector (bioelectrical impedance vector analysis [BIVA]) for patients hospitalized for heart failure (HF). Material and methods. A prospective cohort of 105 patients hospitalized for HF. BIVA was performed prior to discharge, and the final sample was divided into 3 groups according to the value obtained: hyperhydration [hyperH] (>74.3%), normal hydration [normoH] (72.7-74.3%) and dehydration [desH] (<72.7%). In the follow-up, total mortality and readmissions for HF were considered adverse events. Results. A higher incidence of events was observed among the patients with hyperH and desH compared with those with normoH (Kaplan-Meier: log-rank, 2.1; p=.04), with an increase in independent risk in the multivariate analysis (HR, 2.6 [1.05-6.44]; p=.039). Conclusions. BIVA helps stratify the risk of readmission for HF and total mortality in the long-term follow-up of patients hospitalized for HF (AU)

Cardiac sympathetic innervation assessed with 123I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator / La valoración de la inervación simpática cardiaca con 123I-MIBG mantiene su utilidad pronóstica en pacientes diabéticos con disfunción ventricular grave evaluados para implante de desfibrilador automático en prevención primaria

Background. Scintigraphy with iodine-123-metaiodobenzylguanidine (123I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if 123I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with 123I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). Material and methods. Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent 123I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of 123I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. Results. During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p = 0.014). Late HMR ≤ 1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p = 0.012) and non-diabetic patients (hazard ratio 12.31; p = 0.023). Conclusions. Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless 123I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients (AU)

Antecedentes. La gammagrafía con yodo-123-metayodobenzilguanidina (123I-MIBG) es una herramienta de la valoración de la actividad simpática cardiaca (ASC) que ha demostrado ser un predictor independiente de supervivencia. Estudios recientes han demostrado que los pacientes diabéticos con insuficiencia cardiaca (IC) presentan mayor deterioro de la ASC. Si 123I-MIBG tiene el mismo valor predictivo en diabéticos y no diabéticos es desconocido. Analizamos si la evaluación de la ASC con 123I-MIBG mantiene su utilidad pronóstica en pacientes diabéticos con IC evaluados para implante de DAI en prevención primaria. Material y métodos. Se incluyeron prospectivamente 78 pacientes (48 diabéticos) consecutivos evaluados para implante de DAI en prevención primaria a los que se les realizó una gammagrafía con 123I-MIBG para evaluar la ASC (índice corazón mediastino - ICM-). Se usó un modelo multivariado de riesgos proporcionales de Cox para analizar la influencia de 123I-MIBG en la predicción de eventos cardiacos tanto en pacientes diabéticos como no diabéticos. La variable principal de resultado es un compuesto de evento arrítmico, muerte cardiaca y hospitalización por IC. Resultados. Durante una media de seguimiento de 19.5 [9.3-29.3] meses, la variable principal de resultado ocurrío en 24 (31%) de los pacientes. El ICM tardío fue significativamente menor en el grupo de pacientes con diabetes mellitus (1.30 vs 1.41, p = 0.014). Un ICM tardío ≤1,30 fue predictor independiente de eventos cardiacos en pacientes diabéticos (HR 4,53; p = 0,012) y no diabéticos (HR 12,31; p = 0,023). Conclusión. Los pacientes diabéticos con IC grave evaluados para implante de DAI en prevención primaria presentan mayor deterioro de la ASC que los no diabéticos. 123I-MIBG mantiene utilidad pronóstica en pacientes diabéticos y no diabéticos con IC (AU)

La ausencia de necrosis por cardiorresonancia en pacientes con miocardiopatía dilatada no filiada sugiere etiología no isquémica aun en presencia de enfermedad coronaria / The abscense of an ischemic pattern on cardiac magnetic resonance in patients with dilated cardiomyopathy of unknown origin suggests nonischemic etiology even with the presence of significan coronary artery disease

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Prognostic value of analysing the bioimpedance vector for patients hospitalised for acute decompensated heart failure: A validation cohort.

OBJECTIVES: To assess the prognostic impact of the bioimpedance vector (bioelectrical impedance vector analysis [BIVA]) for patients hospitalized for heart failure (HF). MATERIAL AND METHODS: A prospective cohort of 105 patients hospitalized for HF. BIVA was performed prior to discharge, and the final sample was divided into 3 groups according to the value obtained: hyperhydration [hyperH] (>74.3%), normal hydration [normoH] (72.7-74.3%) and dehydration [desH] (<72.7%). In the follow-up, total mortality and readmissions for HF were considered adverse events. RESULTS: A higher incidence of events was observed among the patients with hyperH and desH compared with those with normoH (Kaplan-Meier: log-rank, 2.1; p=.04), with an increase in independent risk in the multivariate analysis (HR, 2.6 [1.05-6.44]; p=.039). CONCLUSIONS: BIVA helps stratify the risk of readmission for HF and total mortality in the long-term follow-up of patients hospitalized for HF.

Cardiac sympathetic innervation assessed with (123)I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator.

BACKGROUND: Scintigraphy with iodine-123-metaiodobenzylguanidine ((123)I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if (123)I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with (123)I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). MATERIAL AND METHODS: Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent (123)I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of (123)I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. RESULTS: During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p=0.014). Late HMR≤1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p=0.012) and non-diabetic patients (hazard ratio 12.31; p=0.023). CONCLUSIONS: Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless (123)I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients.

Prescripción de anticoagulación oral en pacientes con fibrilación auricular e ingreso previo en un servicio de cardiología. Experiencia en un hospital terciario / Prescription of oral anticoagulation for patients with atrial fibrillation and previous hospitalization in a cardiology department. Experience in actual practice in a tertiary hospital

Introducción. La fibrilación auricular es el principal motivo de anticoagulación oral en nuestro medio. Los nuevos anticoagulantes orales (NACO) superan las desventajas de los antagonistas de la vitamina K (AVK), aunque existen pocos datos de uso en nuestro medio. Nos planteamos evaluar el uso de NACO y el control en rango terapéutico (CRT) con AVK en un escenario clínico real. Métodos. Análisis de cohortes retrospectivo de 816 ingresos en cardiología durante 3 años con el diagnóstico de fibrilación auricular y tratamiento anticoagulante al alta, evaluando el porcentaje de prescripción de NACO y el CRT con AVK. Se compararon eventos de seguridad y eficacia durante un seguimiento de 15 meses entre los pacientes con NACO, los pacientes con AVK y buen CRT, y aquellos con mal CRT. Resultados. El porcentaje de prescripción de NACO fue del 7,6%. La determinación seriada de INR encontró un 71,3% de pacientes con mal CRT. Aunque los grupos no fueron comparables, se observó una mayor incidencia del evento combinado (ictus o infarto de miocardio, y mortalidad) en los tratados con AVK y mal CRT que en aquellos con NACO (p=0,01). Conclusiones. En pacientes con ingreso previo en cardiología en un hospital terciario y diagnóstico de fibrilación auricular, el índice de prescripción de NACO es bajo y el CRT con AVK es pobre (AU)

Introduction. Atrial fibrillation is the main reason for oral anticoagulation in our community. New oral anticoagulants (NOACs) overcome the disadvantages of vitamin K antagonists (VKAs), although there are scarce data on its use in our community. The aim of our study was to assess the use of NOACs and anticoagulation control using VKA as measured by the time within the therapeutic range (TTR) in an actual clinical scenario. Methods. A retrospective cohort analysis was conducted of 816 patients admitted to cardiology over a period of 3 years, with a diagnosis of atrial fibrillation and anticoagulant treatment at discharge. We assessed the percentage of patients prescribed NOACs and the TTR with VKA. We compared safety and efficacy events during the 15-month follow-up among the patients prescribed NOAC, those prescribed VKA with a good TTR and those with a poor TTR. Results. The percentage of patients prescribed NOAC was 7.6%. Serial INR measurements found that 71.3% of patients had a poor TTR. Although the groups were not comparable, a higher incidence of the combined event was observed in those treated with VKA and a poor TTR compared with those prescribed NOAC (p=.01). Conclusions. For patients with a previous hospitalization in cardiology in a tertiary hospital and a diagnosis of atrial fibrillation, the rate of NOAC prescription is low, and the TTR with VKA was poor (AU)

Prescription of oral anticoagulation for patients with atrial fibrillation and previous hospitalization in a cardiology department. Experience in actual practice in a tertiary hospital. / Prescripción de anticoagulación oral en pacientes con fibrilación auricular e ingreso previo en un servicio de cardiología. Experiencia en un hospital terciario.

INTRODUCTION: Atrial fibrillation is the main reason for oral anticoagulation in our community. New oral anticoagulants (NOACs) overcome the disadvantages of vitamin K antagonists (VKAs), although there are scarce data on its use in our community. The aim of our study was to assess the use of NOACs and anticoagulation control using VKA as measured by the time within the therapeutic range (TTR) in an actual clinical scenario. METHODS: A retrospective cohort analysis was conducted of 816 patients admitted to cardiology over a period of 3 years, with a diagnosis of atrial fibrillation and anticoagulant treatment at discharge. We assessed the percentage of patients prescribed NOACs and the TTR with VKA. We compared safety and efficacy events during the 15-month follow-up among the patients prescribed NOAC, those prescribed VKA with a good TTR and those with a poor TTR. RESULTS: The percentage of patients prescribed NOAC was 7.6%. Serial INR measurements found that 71.3% of patients had a poor TTR. Although the groups were not comparable, a higher incidence of the combined event was observed in those treated with VKA and a poor TTR compared with those prescribed NOAC (p=.01). CONCLUSIONS: For patients with a previous hospitalization in cardiology in a tertiary hospital and a diagnosis of atrial fibrillation, the rate of NOAC prescription is low, and the TTR with VKA was poor.

Lipoproteínas de alta densidad y necrosis miocárdica en pacientes con infarto agudo de miocardio y elevación del segmento ST / High-density lipoproteins and myocardial necrosis in patients with acute myocardial infarction and ST segment elevation

Introducción y objetivo. Las concentraciones plasmáticas de colesterol unido a lipoproteínas de alta densidad (cHDL) descendidas constituyen un indicador de mal pronóstico en pacientes con síndrome coronario agudo. Hemos evaluado la relación entre las cifras de cHDL y la extensión de la necrosis miocárdica estimada por cardiorresonancia magnética en pacientes con infarto agudo de miocardio y elevación persistente del segmento ST en quienes se indicó reperfusión miocárdica. Pacientes y métodos. Análisis retrospectivo de 139 pacientes (edad media: 59,8 años; hombres: 79%) ingresados por infarto agudo de miocardio con elevación persistente del segmento ST y a quienes se efectuó una cardiorresonancia magnética. Las imágenes indicativas de necrosis miocárdica (realce tardío del gadolinio) se cuantificaron y relacionaron con la concentración de cHDL. Resultados. Los pacientes con cHDL≤40mg/dl (69% del total), en comparación con los que tenían un cHDL >40mg/dl, mostraron un área de necrosis miocárdica más extensa: el número de segmentos miocárdicos con patrón de necrosis transmural fue significativamente mayor (4,7 vs. 2,1; p<0,001), al igual que el porcentaje de necrosis miocárdica de la masa miocárdica total (18,2 vs. 11,3%; p=0,01). Los pacientes con disminución de cHDL tuvieron una menor fracción de eyección del ventrículo izquierdo (49,7 vs. 57,2%; p<0,001). Conclusiones. La concentración de cHDL disminuido es muy frecuente en los pacientes con infarto agudo de miocardio y elevación persistente del segmento ST. Este descenso de cHDL se asoció a una mayor área de necrosis y peor fracción de eyección del ventrículo izquierdo(AU)

Introduction and aim. Low plasma levels of high-density lipoprotein cholesterol (HDLC) is a prognostic factor in patients with acute coronary syndrome. The aim of this study was to evaluate the relationship between HDLC and myocardial necrosis estimated by cardiac magnetic resonance (CMR) in patients with acute ST-segment elevation myocardial infarction (STEMI) and reperfusion strategy. Methods. Retrospective analysis of 139 patients (mean age 59.8 years; 79% men) admitted with STEMI who underwent a CMR in the first week. Results. With a comparable reperfusion strategy used and time of ischemia, patients with HDLC ≤ 40mg/dL (69% of total) had more extensive areas of myocardial necrosis after STEMI, in number of segments with late gadolinium enhancement (RTG) with transmural necrosis pattern (4.7 vs. 2.1, P<.001) and in percentage of RTG with respect total mass myocardial (18.2 vs. 11.3%, P<.01), and worst left ventricular ejection fraction (LVEF) (49.7 vs. 57.2%, P<.001). Conclusions. We conclude that low HDLC are very common in patients with STEMI and associated with increased necrosis and a worse LVEF in the CRM study(AU)

High-density lipoproteins and myocardial necrosis in patients with acute myocardial infarction and ST segment elevation.

INTRODUCTION AND AIM: Low plasma levels of high-density lipoprotein cholesterol (HDLC) is a prognostic factor in patients with acute coronary syndrome. The aim of this study was to evaluate the relationship between HDLC and myocardial necrosis estimated by cardiac magnetic resonance (CMR) in patients with acute ST-segment elevation myocardial infarction (STEMI) and reperfusion strategy. METHODS: Retrospective analysis of 139 patients (mean age 59.8 years; 79% men) admitted with STEMI who underwent a CMR in the first week. RESULTS: With a comparable reperfusion strategy used and time of ischemia, patients with HDLC ≤40 mg/dl (69% of total) had more extensive areas of myocardial necrosis after STEMI, in number of segments with late gadolinium enhancement (RTG) with transmural necrosis pattern (4.7 vs. 2.1%, p < .001) and in percentage of RTG with respect to total mass myocardial (18.2 vs. 11.3%, p < .01), and worst left ventricular ejection fraction (LVEF) (49.7 vs. 57.2%, p < .001). CONCLUSIONS: We conclude that low HDLC are very common in patients with STEMI and associated with increased necrosis and a worse LVEF in the CRM study.

PGC-1α induction in pulmonary arterial hypertension.

Idiopathic Pulmonary arterial hypertension (IPAH) is characterized by the obstructive remodelling of pulmonary arteries, and a progressive elevation in pulmonary arterial pressure (PAP) with subsequent right-sided heart failure and dead. Hypoxia induces the expression of peroxisome proliferator activated receptor γ coactivator-1α (PGC-1α) which regulates oxidative metabolism and mitochondrial biogenesis. We have analysed the expression of PGC-1α, cytochrome C (CYTC), superoxide dismutase (SOD), the total antioxidant status (TAS) and the activity of glutathione peroxidase (GPX) in blood samples of IPAH patients. Expression of PGC-1α was detected in IPAH patients but not in healthy volunteers. The mRNA levels of SOD were lower in IPAH patients compared to controls (3.93 ± 0.89 fold change). TAS and GPX activity were lower too in patients compared to healthy donors, (0.13 ± 0.027 versus 0.484 ± 0.048 mM and 56.034 ± 10.37 versus 165.46 ± 11.38 nmol/min/mL, resp.). We found a negative correlation between expression levels of PGC-1α and age, PAP and PVR, as well as a positive correlation with CI, PaO(2), mRNA levels of CYTC and SOD, TAS and GPX activity. These results taken together are indicative of the possible role of PGC-1α as a potential biomarker of the progression of IPAH.