The effects of types of guidewires and pressure applied during stent implantation in the main vessel on the incidence of damage to coronary guidewires during angioplasty of coronary bifurcation lesions-Wide Beast study.

OBJECTIVES: We evaluated the impact of stent inflation pressure and type of guidewire on "jailed" coronary guidewire damage occurring during bifurcation angioplasty. BACKGROUND: Despite new techniques and treatment options during percutaneous coronary intervention (PCI) we still observe peri- and postoperative complications for to various known and unknown reasons. METHODS: Patients undergoing PCI within the coronary bifurcation were randomly assigned to one of four groups: Pilot 50 or BMW guidewire and pressure ≤12 or >12 atm. After PCI each "jailed" guidewire was evaluated under an optical microscope. The Wide Beast Scale (WBS) was developed for the internal purposes of the study and was used for qualitative assessment. Also, the inflation pressure, the patients' characteristics and the technical parameters of the procedure were recorded. RESULTS: The clinical characteristics were similar in all the groups. There was no statistical significance of the degree of damage, rated on the WBS, for either guidewire group with respect to inflation pressure (P = 0.49). The prevalence of guidewire damage was higher in the BMW versus the Pilot 50 group (98.4% vs 67.4% respectively, P = 0.00001) as was the severity of the damage (grades 3 and 4) in BMW versus Pilot 50 (55.6% vs 13.0% respectively, P = 0.00001). CONCLUSIONS: The inflation pressure during stent implantation had no impact on "jailed" guidewire damage. The difference in the prevalence of serious damage and total damage number was statistically significant for the BMW guidewire compared to the Pilot50. The BMW guidewire was an independent predictor of the degree of damage to the guidewire.

Prevalence of low serum vitamin D concentration in an urban population of elderly women in Poland.

INTRODUCTION: So far only scarce data have been published regarding serum vitamin D concentrations in elderly women in Poland. OBJECTIVES: We aimed to assess prevalence of vitamin D deficiency in a population of women aged 60 to 90 years and living in Warsaw. PATIENTS AND METHODS: The study comprised 274 women from the general population (mean age 69.1 -/+5.7 years, body mass index [BMI] 28.9 -/+4.6 kg/m2, serum creatinine concentration 0.7 -/+0.12 mg/dl). Subjects who had been treated with glucocorticoids or antifracture drugs, or supplemented with vitamin D or calcium, were excluded. The study was conducted in winter. Serum vitamin D, calcium, phosphate, and parathyroid hormone (PTH) concentrations were measured. RESULTS: The mean vitamin D concentration was 13.6 ng/ml in the whole examined population. Vitamin D levels above 30 ng/ml were detected in 4% of subjects. Vitamin D insufficiency (20-30 ng/ml) was found in 12.8% of subjects, and its deficiency (<20 ng/ml) in 83.2% of subjects. Vitamin D concentrations in women under and over 70 years of age did not differ significantly. There were no associations of vitamin D concentrations with age, BMI, renal function, or serum calcium concentrations. However, we observed a significant inverse correlation between vitamin D concentrations and PTH. CONCLUSIONS: The prevalence of low vitamin D concentrations in an urban population of elderly women in Poland is very high. Lower vitamin D levels are associated with a higher PTH concentration.