Soluble urokinase plasminogen activator receptor in one-year prediction of major adverse cardiac events in patients after first myocardial infarction treated with primary percutaneous coronary intervention.

INTRODUCTION: Soluble urokinase plasminogen activator receptor (suPAR) level reflects the general condition of the organism and was proved to give independent information in risk stratification of patients. The aim of this study was to assess the usefulness of suPAR in the prediction of adverse cardiac events in patients with first myocardial infarction (MI) undergoing primary percutaneous coronary intervention. Additionally, the diagnostic power of suPAR was assessed. MATERIAL AND METHODS: One hundred and thirty-nine of 150 consecutive patients were included in the study. Serum suPAR level (ELISA, Virogates) as well as C-reactive protein (on admission and at discharge) and maximum troponin T (assessed from successive 6-hour periods of blood collection) were measured. In the 1-year follow-up study the following major adverse cardiac events were observed: myocardial infarction, revascularization, stroke and death. RESULTS: Multi-variable analysis revealed prognostic usefulness only for suPAR and glomerular filtration rate: p < 0.0001 and p = 0.018; OR = 2.59 and OR = 0.98 respectively, with area under the curve in receiver operating characteristic analysis for both parameters simultaneously 0.89 (p < 0.0001). There was no correlation between suPAR level and the left ventricular dysfunction parameters or the MI type. CONCLUSIONS: Soluble urokinase plasminogen activator receptor level appears to be an independent useful biomarker for the prediction of major adverse cardiac events early after first myocardial infarction. The biomarker's level seems to have more prognostic than diagnostic power.

Self-reported physical activity using International Physical Activity Questionnaire in adolescents and young adults with visual impairment.

BACKGROUND: Young people with visual impairment (VI) face many environmental barriers that influence physical activity. OBJECTIVE: The aims of the study were to assess the level of physical activity (PA) in students with VI, with regard to their age, gender, level of VI, body mass index and abdominal obesity (AO), and to identify the percentage of study participants who did not meet the international recommendations for PA. METHODS: Anthropometric measurements were taken to assess the body mass index and waist-to-height ratio. The PA level was measured by the International Physical Activity Questionnaire- Long Form. A sample of 122 students with VI aged 15.1-22.7 years were included in the study. RESULTS: The mean total PA was 8514.5 ± 7201.0 Metabolic Equivalents min/week. Students with normal weight and excess weight had much greater total PA scores than those who were underweight (p < 0.05). Students with abdominal obesity had slightly lower total PA than those without AO. Blind students were engaged less in PA in most of the domains than partially-sighted students. Overall, 39.3% of participants did not meet the recommendation of 75 min/week of vigorous PA, and 23.8% did not meet the recommendation of almost 150 min/week of moderate PA. In total, 32.8% of participants did not meet the international recommendations of 420 min/week moderate or vigorous PA. CONCLUSION: To improve the PA level of students with VI, health promotion initiatives focused on promoting PA during their school days and free time are required, based on innovative methods adjusted to their needs.

The prevalence of abdominal obesity among pupils with visual impairment in Poland.

BACKGROUND: Obesity particularly affects young people with disabilities, whose ability to participate in health promotion programs is reduced. OBJECTIVE: The aim of the study is to determine the prevalence of abdominal obesity among students with visual impairment in Poland according to waist-to-height ratio, including indicators such as gender, age or certain additional coexisting disabilities or disorders. METHODS: A total of 238 students who were blind or partially-sighted, aged 7.35-23.35 years (mean age 15.5; ±3.9 years), were included in the study. Abdominal obesity was estimated using waist-to-height ratio; a cutoff point of ≥0.50 was determined as central obesity. RESULTS: Abdominal obesity was identified among 26.9% [N = 64] of the participants: 33.1% [N = 41] of male students and 20.2% [N = 23] of female students (ch2 = 5.02; p = 0.025; Phi = 0.145). Of all the students, the multivariate logistic regression showed that abdominal obesity was one and a half times more likely to be detected in the 7-9 year age group (OR = 1.56; 95% CI 0.58-4.18; P = 0.376) than the 19-23 year age group. However, among the female subjects, abdominal obesity was over six times more common in the 7-9 year group (OR = 6.48; 95% CI 1.29-32.5; P = 0.022) than in the group of early adults. Central obesity was detected almost three times more frequently among students with visual impairment and additional intellectual disability (OR = 2.99; 95% CI 0.52-17.1; P = 0.215) than those with only visual impairment. CONCLUSION: Prevention programs aimed at reducing abdominal obesity among pupils with visual impairment from special schools are needed.

Body mass index and waist-to-height ratio among schoolchildren with visual impairment: A cross-sectional study.

Children and adolescents with visual impairments may be predisposed to excessive body mass due to restrictions in everyday functioning and the ability to take part in physical activity. This study aimed to estimate the prevalence of obesity, overweight, and abdominal obesity (AO) among blind and partially sighted schoolchildren and to determine whether sociodemographic factors and participation in physical education classes (PEC) are associated with excessive body weight or AO in this group.A cross-sectional sample of 141 partially sighted or blind schoolchildren aged 7 to 18.9 years were included in this study. Anthropometric measurements were performed, and sociodemographic variables and ability to attend PEC were recorded. Overweight and obesity were noted among 21.3% and 14.9% of students, respectively. Although more males than females had excessive body weight (39.2% vs 32.3%), the difference was not significant (chi square test [ch] = 3.197; probability value [P] = 0.362). There was a significant association between mean body mass index standard deviation score and age (results of ANOVA analysis [F] = 5.620; P = 0.0045). A waist-to-height ratio (WHtR) ≥0.50 was observed among 27.7% of pupils. The prevalence of AO in boys and girls was 32.9% and 21.0%, respectively; this difference was not significant (ch = 2.48; P = 0.12). There was a significant relationship between mean WHtR and age (7-9 years: 0.477 ±â€Š0.050; 10-13 years: 0.484 ±â€Š0.065; ≥14 years: 0.454 ±â€Š0.061; results of Kruskal-Wallis test [H] = 8.729; P = 0.023, respectively).Multivariate logistic regression analysis showed that none of the sociodemographic variables examined (except "having siblings") were significantly associated with the occurrence of overweight, obesity, and AO. Subjects with no siblings were 4 times more likely to have WHtR ≥ 0.5 (odds ratio [OR] = 4.22; 95% confidence interval [CI] = 1.33-17.8; P = 0.01).Overweight and obesity were almost 4 times more frequent (OR = 3.74; 95% CI 0.81-17.4) and AO 3 times more frequent (OR = 3.18, 95% CI 0.71-14.2) among students not participating in PEC. Excessive body mass and AO represent an urgent health problem among schoolchildren with visual impairments. Health education concerning healthy eating habits and physical activity should be provided to this group to reduce potential future health costs.

Cardiac rehabilitation improves the blood plasma properties of cardiac patients.

Cardiac rehabilitation (CR) improves exercise tolerance and general function. However, its effects on blood plasma in cardiac patients remain uncertain. Our aim was to examine the effect of comprehensive CR on the oxidative stress parameters and antioxidant plasma status in patients with coronary artery disease (CAD) after cardiac interventions. Exercise-based rehabilitation was established as ergometer training, adjusted for individual patients' physical efficiency. Training was repeated three times a week for two months. The standard biochemical (total cholesterol, HDL, LDL, triglycerides and erythrocyte sedimentation rate) and metabolic parameters (peak oxygen uptake [VO2] and peak workload) were determined. We assessed plasma viscosity, lipid peroxidation, carbonyl compounds levels, glutathione (GSH) and ascorbate (ASC) levels and the non-enzymatic antioxidant capacity of plasma in 12 patients with CAD before and after CR. Parameters were examined before exercise, immediately after exercise, and 1 h later. We also compared morphological and biochemical parameters of blood, as well as other parameters such as heart rate and blood pressure (resting and exercise), VO2max and peak workload (W) before and after CR. Before CR, a significant decrease in GSH concentration was observed 1 h after exercise. Conversely, after CR, GSH, and ASC levels remained unchanged immediately after exercise. However, ASC increased after CR after exercise and 1 h later in comparison to before CR. There was a significant increase in ferric reduction ability of plasma immediately after exercise after CR, when compared with before CR. CR improved several blood biochemical parameters, peak VO2, induced an increase in systolic blood pressure peak, and patients' peak workload. After CR, improvements were detected in oxidative stress parameters, except in the level of carbonyls. These changes may contribute to the increased functional heart capacity and better tolerance to exercise and functional capacity of the patients. These improvements could indicate better prognosis of future cardiac events and hospitalization and better quality of life.

[The use of controlled physical training in patients with acute coronary syndrome treated with intervention - assessment of effects on biochemical parameters and functional myocardial]. / Zastosowanie kontrolowanego treningu fizycznego u chorych po ostrym zespole wiencowym leczonych interwencyjnie - ocena wplywu na parametry biochemiczne i czynnosciowe miesnia serca.

UNLABELLED: Diseases of the cardiovascular system is one of the most common causes of death among people over 65 years. Due to its course and incidence are a major cause of disability and impaired quality of life for seniors, as well as a serious economic problem in health care. Important role in the prevention of cardiovascular disease plays making systematic physical activity, which is a component of any rehabilitation program. Regular physical training by doing cardio-and vasoprotective has a beneficial effect on cardiovascular status and physical performance in patients with diagnosed coronary heart disease, regardless of age. AIM: The aim of this study was to evaluate the effect of controlled exercise on selected biochemical parameters and functional myocardial infarction. MATERIALS AND METHODS: A group of 89 patients were divided into 3 subgroups. In group I (n = 30) was performed 2 weeks cardiac rehabilitation program, in group II (n = 30) 4 weekly. Streamline the program consisted of a series of interval training performed using a bicycle ergometer and general exercise. The remaining group (gr. III, n = 29) participated in individually selected training program. In all subjects before and after the training cycle underwent thoracic impedance plethysmography, also determined the level of plasma natriuretic peptide NT-proBNP and echocardiography and exercise test. RESULTS: After training, in groups, which carried out a controlled physical training, improvement was observed: exercise capacity of patients respectively in group I (p = 0.0003), group II (p = 0.0001) and group III (p = 0.032), stroke volume SV, cardiac output CO and global myocardial contractility, there was also reduction in the concentration of natriuretic peptide NT-proBNP. Furthermore, the correlation between the results shown pletyzmography parameters and NT-proBNP, SV, CO and EF. CONCLUSIONS: Regular physical training as part of the cardiac rehabilitation has a beneficial effect on biochemical parameters and functional myocardial infarction in patients with ACS. Size of the observed changes conditioned by the nature and duration of the training.

The association between galectin-3 and clinical parameters in patients with first acute myocardial infarction treated with primary percutaneous coronary angioplasty.

BACKGROUND: Galectin-3, a biomarker associated with fibrosis and inflammation, has been implicated in development and progression of heart failure (HF) and predicts increased mortality and morbidity in this condition. HF frequently develops after myocardial infarction (MI), contributing to worse outcome. The aim of this study is to assess the association between galectin-3 levels and various clinical parameters in acute phase of first MI treated with primary percutaneous coronary intervention (pPCI) in patients without prior HF. METHODS: We included 145 consecutive patients with first acute MI treated with pPCI with stent implantation. Exclusion criteria were: prior HF, severe valvular diseases, coexisting cancers, connective tissue diseases and cirrhosis. Serum galectin-3 concentration was measured within 3-5 days after onset of acute MI. RESULTS: Thirty-six patients with the highest galectin-3 levels (4th quartile, > 16 ng/mL) were compared to 109 subjects with a biomarker concentration ≤ 16 ng/mL. Elevated galectin-3 levels were more often observed in females, the elderly, subjects with coexisting diabetes, renaldysfunction and permanent atrial fi brillation (AF). Galectin-3 correlated with N-terminal pro-B-type natriuretic peptide (r = 0.27, p < 0.001) and high-sensitivity C-reactive protein (r = 0.20, p < 0.05). Multivariate analysis revealed that only new-onset AF and diuretics treatment during hospitalization were independently associated with galectin-3 levels > 16 ng/mL. CONCLUSIONS: Elevated galectin-3 levels were associated with a higher rate of new-onset AF and diuretics treatment during hospitalization in patients with first MI treated with pPCI without prior HF.

The association between galectin-3 and occurrence of reinfarction early after first myocardial infarction treated invasively.

CONTEXT: Galectin-3, as a biomarker of inflammation and fibrosis, has been reported to be associated with coronary artery disease. OBJECTIVE: The study aimed to assess the relationship between galectin-3 levels and the occurrence of reinfarction early after myocardial infarction (MI). METHODS: The study included 145 consecutive patients with first MI treated invasively. Serum galectin-3 was measured using VIDAS (bioMérieux, Marcy-l'Etoile, France). RESULTS: The independent predictors of reinfarction in our group were as follows: female gender, elevated hs-C-reactive protein and galectin-3 levels (measured both at discharge). CONCLUSIONS: Galectin-3 might be an additional useful biomarker in prediction for reinfarction early after first MI.

[Assessment the lifestyle in patients after recent acute coronary syndrome qualified for cardiac rehabilitation and in healthy subjects]. / Ocena stylu zycia chorych po swiezo przebytym ostrym zespole wiencowym zakwalifikowanych do rehabilitacji kardiologicznej oraz zdrowych.

UNLABELLED: Results of a lot of research indicate that preventive activities consisting in the fighting of risk factors have the greatest influence on the reduction of the incidence of ischaemic heart disease. THE AIM OF THE STUDY was to assess the lifestyle in patients after recent acute coronary syndrome (ACS) qualified for cardiac rehabilitation and in healthy subjects (with no diagnosis of coronary thrombosis). MATERIAL AND METHODS: The research included 86 patients, 64 men and 22 women aged 42-78 (mean age 61.7 +/- 9.6 years) after recent ACS, treated with PCI (percutaneous coronary interventions), and qualified for cardiac rehabilitation (stage II)--group I. The control group included 88 people, 54 men and 34 women aged 34-75 (mean age 56.2 +/- 9.7 years), who were clinically healthy--group II. The assessment of a lifestyle was performed based on the presence of four positive behaviours, i.e. eating appropriate amount of vegetables and (or) fruit every day, refraining from smoking, satisfactory levels of physical activity, and correct body mass. Based on these factors, a lifestyle index was calculated, from 0 (no positive health behaviours) to 4 (all positive health behaviours present), the so-called healthy lifestyle index. RESULTS: Among the examined elements of lifestyle index in ill and healthy subjects, satisfactory physical activity was the rarest (in 16.67% of men and in 9.09% women after ACS and in 16.22% of healthy men and 11.63% healthy women). Healthy lifestyle index was determined in 4.88% of patients after ACS. It was not found in healthy subjects. CONCLUSION: The analysis of the lifestyle index shows that a change of one's lifestyle is necessary as an initial and secondary prevention.

Concentration of natriuretic peptides in patients suffering from idiopathic arterial hypertension and left ventricular diastolic dysfunction confirmed by echocardiography.

Concentration of natriuretic peptides (NPs) in arterial hypertension (AH) patients is higher than that in healthy people. One of the first symptoms of left ventricular hypertrophy (LVH) is left ventricular diastolic dysfunction (LVDD). The aim of this study was to examine whether determination of NPs in blood can be a useful indicator of LVDD detection in idiopathic AH patients. The study was conducted on three groups of patients: group Ia, 19 patients (average age 57 ± 3) with eccentric hypertrophy; group Ib, 13 patients (59 ± 4) with concentric hypertrophy; group II, 33 patients (58 ± 4) without AH or LVH. In all groups, mitral inflow profile was evaluated with Doppler test to detect LVDD, blood flow in upper right pulmonary vein, and concentration of atrial natriuretic peptide (ANP), N-terminal ANP (N-ANP), brain natriuretic peptide (BNP), and N-terminal BNP (N-BNP). In group Ia, significant correlations were observed between the following pairs: ratio of maximum early to late mitral inflow and ANP; deceleration time of early mitral inflow speed and ANP; atrial contraction (AR) and ANP; atrial contraction (AR) and N-ANP; similarly, in group Ib, significant correlations were observed between the following: relative wall thickness and BNP; isovolumic relaxation time and BNP; AR and BNP; relative wall thickness and N-BNP; isovolumic relaxation time and N-BNP; AR and N-BNP.

[Resting heart rate in subjects with carbohydrate disorders]. / Spoczynkowa czynnosc serca u osób z zaburzeniami gospodarki weglowodanowej.

UNLABELLED: Large epidemiological studies conducted during last 25 years confirmed the importance of resting heart rate as an independent risk factor for total and cardiovascular mortality in females and males, both in overall population and in subjects with cardiovascular diseases such as arterial hypertension, myocardial infarction, coronary heart disease, heart failure or left ventricular dysfunction. The aim of the study was to evaluate the resting heart rate (HR) in subjects with carbohydrate disorders. MATERIAL AND METHODS: The study comprised 112 subjects with carbohydrate disorders (54 females and 58 males), aged 30-78 (57.4 +/- 9.6) years. Carbohydrate disorders were diagnosed according to the Polish Diabetes Association criteria from 2007 (group I). 56 subjects had impaired fasting glucose (IFG), 36 - impaired glucose tolerance (IGT) and 20 - type 2 diabetes. Comparative group comprised 30 subjects without cardiovascular diseases and carbohydrate disorders (15 females and 15 males), aged 29-64 (52.7 +/- 8.8) years (group II). The fasting serum glucose level was evaluated using an enzymatic method, Kone Pro biochemical analyzer and bioMérieux Glucose RTU kit. In subjects with fasting glucose level > or = 100 mg/dl, an oral glucose tolerance test (OGTT) was performed. Additionally, in all subjects resting heart rate (HR) was measured, after 10-minute rest, at a room temperature of about 20 degrees C. The measurements were made threefold, every 5 minutes and mean value was assessed. RESULTS: In subjects with carbohydrate disorders HR was significantly higher than in comparative group (82.79 +/- 12.1 vs 69.9 +/- 9.56/min; p < 0.05). In group of subjects with carbohydrate disorders in comparison to comparative group, resting heart rate < 60/min occurred in 1.79 vs 13.33%, in intervals: 60-70/min in 14.29 vs 50%. 71-80/min in 33.93 vs 23.33%, 81-90/min in 25% vs 13.33%, and above 90/min in 25% of studied group (p < 0.05). On the basis of ROC curve analysis and odds ratio (OR) it was shown that HR > or = 72.5/min is an independent risk factor for carbohydrate disorders. CONCLUSIONS: Resting heart rate > or = 72.5/min is an independent risk factor for carbohydrate disorders and increases its risk more than ninefold.

[Estimation of pulse pressure in subjects with carbohydrate disorders]. / Ocena cisnienia tetna u osób z zaburzeniami gospodarki weglowodanowej.

UNLABELLED: Carbohydrate disorders are important and independent risk factor for cardiovascular system diseases. Increased values of pulse pressure are an independent risk factor for cardiovascular complications and total mortality. The aim of the study was to evaluate the pulse pressure in subjects with carbohydrate disorders. MATERIAL AND METHODS: The study comprised 112 subjects with carbohydrate disorders (54 females and 58 males), aged 30-78 (57.4 +/- 9.6) years. Carbohydrate disorders were diagnosed according to the Polish Diabetes Association criteria from 2007 (group 1). 56 subjects had impaired fasting glucose (IFG), 36--impaired glucose tolerance (IGT) and 20--type 2 diabetes. Comparative group comprised 30 subjects without cardiovascular diseases and carbohydrate disorders (15 females and 15 males), aged 29-64 (52.7,4 +/- 8.8) years (group II). The fasting serum glucose level was evaluated using an enzymatic method, Kone-Pro biochemical analyzer and bioMérieux Glucose RTU kit. In subjects with fasting glucose level > or = 100 mg/dl, an oral glucose tolerance test (OGTT) was performed. In all subjects 24-h ambulatory blood pressure monitoring with oscillometric method, using boso-TM-2430PL system (Bosch+Sohn, Germany). Pulse pressure (pp) was evaluated as a mean difference between the systolic and diastolic pressure. RESULTS: In subjects with carbohydrate disorders the mean value of pp was 56.79 +/- 16.28 mmHg and it was significantly higher (p < 0.05) than in comparative group (49.0 +/- 11.1 mmHg). Increased value of pp (> 63 mmHg) was found significantly more often in group with carbohydrate disorders (46% vs 10%) (p < 0.05). On the basis of ROC curve analysis and OR (odds ratio) it was shown that pp > or = 52.5 mmHg results in a threefold increased risk of carbohydrate disorders. CONCLUSIONS: Increased values of pulse pressure are found significantly more often in subjects with carbohydrate disorders. The risk of carbohydrate disorders increases threefold in subjects with pp > or = 52.5 mmHg.

[Exercise testing to estimate dysfunction of the autonomic nervous system in subjects with carbohydrate disorders]. / Test wysilkowy w ocenie dysfunkcji autonomicznego ukladu nerwowego u osób z zaburzeniami gospodarki weglowodanowej.

UNLABELLED: Slow heart rate recovery (HRR) 2 minutes after exercise testing is a predictor of cardiovascular mortality and index of decreased parasympathetic activity. The aim of the study was to evaluate the heart rate recovery in subjects with carbohydrate disorders. MATERIAL AND METHODS: The study comprised 112 subjects with carbohydrate disorders (54 females and 58 males), aged 30-78 (57.4 +/- 9.6) years. Carbohydrate disorders were diagnosed according to the Polish Diabetes Association criteria from 2007 (group I). 56 subjects had impaired fasting glucose (IFG), 36 - impaired glucose tolerance (IGT) and 20 - type 2 diabetes. Comparative group comprised 30 subjects without cardiovascular diseases and carbohydrate disorders (15 females and 15 males), aged 29-64 (52.70 +/- 8.8) years (group II). The fasting serum glucose level was evaluated using an enzymatic method, Kone-Pro biochemical analyzer and bioMérieux Glucose RTU kit. In subjects with fasting glucose level > or = 100 mg/dl, an oral glucose tolerance test (OGTT) was performed. In all subjects submaximal exercise treadmill testing was performed. Heart rate recovery was defined as a difference between the peak heart rate and that after 2 minutes of recovery in sitting position. RESULTS: In subjects with carbohydrate disorders the mean value of HRR was 38.93 +/- 12.08/min and it was significantly lower (p < 0.05) than in comparative group (57.0 +/- 11.44/min). In subjects with carbohydrate disorders negative correlation between HRR and patients' age as well as between HRR and fasting glucose level in males. On the basis of ROC curve analysis and OR (odds ratio) it was shown that HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders. CONCLUSIONS: In subjects with carbohydrate disorders the value of HRR is lowered, what stands for decreased parasympathetic activity and increased cardiovascular risk. HRR < or = 43.5/min results in almost threefold increased risk of carbohydrate disorders.

The influence of risk factors for metabolic syndrome on vascular complications.

We assessed the influence of metabolic syndrome (MetS) characteristics on vascular complications. The study included 108 patients (72 women and 36 men, age 57.0 ± 8.5 years) with MetS that was diagnosed according to International Diabetes Federation criteria. The prevalence of micro- and macrovascular complications was assessed: vascular changes in the fundus of the eye-72%, ischemic heart disease-54.9%, estimated glomerular filtration rate (eGFR) <90 mL/min-38.9%, diabetic foot-5.55%, and cerebrovascular accident-3.7% of patients. A negative correlation between high-density lipoprotein cholesterol (HDL-C) concentration, creatinine levels, and level of vascular changes in the fundus of the eye was found. Moreover, the level of obesity and fasting glucose level had positive correlation with the intensity of vascular changes in the fundus of the eye. Characteristics of MetS (obesity and fasting glucose level) have high impact on advancing vascular complications in these patients. High level of HDL-C decreases the intensity of vascular changes in patients with MetS.

[Vascular complications in patients with metabolic syndrome]. / Powiklania naczyniowe u chorych na zespól metaboliczny.

UNLABELLED: All risk factors of metabolic syndrome (MS) are responsible for endothelial dysfunction what accelerate the development of atherosclerosis. It causes increased cardiovascular risk and development of cardiovascular complications in these subjects. The aim of the study was to assess the presence of vascular complications in subjects with MS. MATERIAL AND METHODS: The study comprised of 108 patients with metabolic syndrome (36 males and 72 females), aged 46-67 (57+/-8.5) years. MS was diagnosed according to the International Diabetes Federation criteria from 2005. Ischaemic heart disease was diagnosed according to the coronarography or patient care documentation. The assessment of nephrological complications was conducted with use of glomerular filtration rate (eGFR) calculated by using the simplified Modification of Diet in Renal Disease Study (MDRD) equation. The occurrence of brain strokes and diabetic foot was estimated basing on medical history and documentation. Vascular complications in the bottom of the eye were assessed with ophtalmoscopic examination and fluorescein angiography. RESULTS: The frequency of vascular complications in subjects with MS was: vascular complications in the bottom of the eye - 72.7% (symptoms of vascular angiopathy without retinopathy - 41.2%, retinopathy - 31.5%), ischaemic heart disease - 54.9%, eGFR < 90 m/min. - 38.9%, diabetic foot - 5.55%. brain stroke - 3.7%. Ischaemic heart disease was present in all subjects with MS qualified to the second and higher class of retinopathy. CONCLUSIONS: In patients with MS, ischaemic heart disease was the most common macroangiopathic complication, with increasing in the frequency together with retinopathy intensification. Changes in the bottom of the eye were the most common microangiopathic complications. Early identification and treatment of metabolic syndrome may have important value in prophylaxis and delay of vascular complications.

[Tissue inhibitor of metalloproteinases-1 level in patients with metabolic syndrome qualified for cardiac rehabilitation]. / Ocena stezenia tkankowego inhibitora metaloproteinaz u chorych na zespól metaboliczny zakwalifikowanych do rehabilitacji kardiologicznej.

UNLABELLED: Each year in Poland, the number of patients treated by PCI and CABG increases. Many of them have metabolic syndrome. After these procedures patients are qualified for cardiac rehabilitation. It is preceded by risk stratification for cardiac events. Metalloproteinases belong to the enzymes responsible for destabilization of atheroma plaques. The activity of metalloproteinases is tightly regulated by their inhibitors. The aim of the study was to estimate plasma tissue inhibitor of metalloproteinases-1 (TIMP-1) level in patients with metabolic syndrome qualified for cardiac rehabilitation after PCI procedures. MATERIAL AND METHODS: The study comprised of 50 subjects with metabolic syndrome (26 males, 24 females) aged 18-65 (mean 50.9+/-11.8) years, qualified for cardiac rehabilitation after PCI procedures and 25 healthy participants (13 males, 12 females) aged 21-55 (mean 50.2+/-12.8) years. The estimation of plasma TIMP-1 level was determined with use of R&D Systems kit. RESULTS: Plasma level of tissue inhibitor of metalloproteinases-1 in subjects with metabolic syndrome was 119.1+/-15.3 ng/ml and it was significantly lower than in group of healthy participants (188.5+/-14.7 ng/ml (p<0.001). CONCLUSIONS: Decreased plasma level of tissue inhibitor of metalloproteinases-1 in subjects with metabolic syndrome qualified for cardiac rehabilitation indicates disturbances of metalloproteinases activity control which take part in destabilization of atheroma plaque. In cardiac rehabilitation of subjects with metabolic syndrome we should pay attention to the type, time and intensity of exercise, because of increased risk of cardiovascular events.

[Plasma nitric oxide and vascular endothelial growth factor levels in patients with metabolic syndrome and co-existing vascular complications]. / Stezenie tlenku azotu i naczyniowo-sródblonkowego czynnika wzrostu w osoczu chorych na zespól metaboliczny ze wspólistniejacymi powiklaniami naczyniowymi.

UNLABELLED: Subjects with metabolic syndrome (MS) are especially exposed to co-existing several cardiovascular risk factors. It's aggregated action leads to the endothelial damage. Tissue hipoxaemia increases VEGF synthesis. NO may also play the crucial role in VEGF synthesis The balance between factors increasing and decreasing VEGF synthesis has special importance in development of vascular complications. The aim of the study was to estimate plasma nitric oxide (NO) and vascular endothelial growth factor (VEGF) levels in patients with metabolic syndrome and vascular complications. MATERIAL AND METHODS: The study was conducted in two groups of patients. I Group--54 patients with metabolic syndrome (diagnosed according to the IDF criteria from 2005) and macro- and microvascular complications, aged 46-67 (58 +/- 6.7) years. II Group--20 healthy subjects, aged 40-61 (51 +/- 5.1) years. Plasma levels of NO and VEGF were determined in all participants. RESULTS: Plasma level of nitric oxide in subjects with metabolic syndrome and vascular complications was 6.48 +/- 1.5 micromol/l and in healthy participants 10.08 +/- 1.09 micromol/l (p < 0.05). Plasma level of vascular endothelial growth factor in subjects with metabolic syndrome and vascular complications was 193.45 +/- 131.0 pg/ml and in healthy participants 71.09 +/- 14.49 pg/ml (p < 0.05). CONCLUSIONS: Endothelial dysfunction seems to be the substantial factor responsible for the vascular complications in subjects with metabolic syndrome, which manifests in increased plasma level of VEGF and decreased plasma level of NO.

Statin therapy in the elderly: a review.

Cardiovascular morbidity is the leading cause of mortality in the developed nations. Elevated serum cholesterol is a major risk factor for ischemic heart disease, one of the common cardiovascular morbidity in older adults, statins have been shown to be effective in reducing serum cholesterol and improving outcomes. Hypercholesterolemia is common in older adults and is one of the major modifiable risk factors. Yet, these patients have often been excluded from major clinical trials of statins and evidence suggests of their underuse. Data from recent clinical trials of statins indicate that the elderly patients with the highest cardiovascular risk are likely to derive the most benefits from cholesterol lowering. With the aging of the population, the prevalence of hypercholesterolemia and cardiovascular morbidity is likely to increase. In this review we evaluate the evidence for the use of statins in older adults.

Left ventricular dysfunction and NT-proBNP levels in patients with one-vessel disease after first ST-elevation myocardial infarction treated with primary coronary angioplasty.

BACKGROUND: Cardiovascular diseases continue to be the main cause of death in the general population. Despite the fact that primary percutaneous coronary intervention (PCI) improves prognosis in patients with acute myocardial infarction (AMI), heart failure can still develop in some of these subjects. Measurement of natriuretic peptide levels has been shown to be useful in the detection of left ventricular (LV) dysfunction and the risk stratification of patients with AMI. AIM: To evaluate the role of NT-proBNP in the identification of patients with early systolic LV dysfunction after first AMI with one--vessel disease successfully treated with primary PCI. METHODS: 161 consecutive patients with first ST-elevation AMI treated with primary PCI with stent implantation (occlusion in infarct-related artery was the patient's only lesion) were included. Measurement of NT-proBNP level and echocardiography were performed on the 4-5th day of AMI. RESULTS: In 53 (33%) patients LV dysfunction (defined as EF < 55%) was detected. The remaining 108 (67%) patients had normal LV systolic function. Multivariate regression analysis revealed that NT-proBNP level > 463.4 pg/ml (median level) was the strongest predictor of EF < 55%. A strong negative correlation between EF and NT-proBNP concentration measured on the 4-5th day of AMI was observed (r = -0.54), which increased with decreasing EF value. CONCLUSIONS: Elevated levels of NT-proBNP are the strongest predictor of early LV dysfunction in low-risk patients after first AMI with one-vessel disease treated with primary PCI with complete coronary revascularisation.

[Characteristic of metabolic syndrome in subjects with or without cardiovascular diseases]. / Charakterystyka zespolu metabolicznego u osób bez chorób i z chorobami ukladu sercowo-naczynlowego.

UNLABELLED: Identification of risk factors of metabolic syndrome (MS) as a part of primary prophylaxis allows early diagnosis and appropriate treatment. Secondary prophylaxis may lead to decreased number of complications and deaths resulting from cardiovascular diseases in subjects with MS. THE AIM OF THE STUDY: To assess the risk factors of MS and incidence of MS in subjects with or without cardiovascular diseases. MATERIAL AND METHODS: There were two groups of patients. I group--600 patients with primary prophylaxis, without cardiovascular diseases, aged 35-60 (49.57 +/- 8.5) and II group--231 patients with cardiovascular diseases (hypertension, ischaemic heart disease, type 2 diabetes), aged 27-69 (56.5 +/- 11.3). MS was diagnosed according to the IDF criteria from 2005. RESULTS: MS was diagnosed in 141 cases of 600 patients with primary prevention what gives 23.5% out of whole study group. In the I group the most common were: abdominal obesity (100%), hypertriglyceridemia (80.2%), hypertension (64.7%) and fasting hyperglycemia (55.2%). MS was diagnosed in 158 cases of 231 patients with cardiovascular disease what gives 68.4% out of whole study group. MS was the most frequent in patients with type 2 diabetes (90.32%), in patients with hypertension (71.58%) and the least common in patients with cardiovascular disease (59.05%). In the II group the most frequent were: abdominal obesity (100%), hypertension (89.24%), fasting hyperglycemia (75.32%). CONCLUSIONS: MS occurs more often in patients with cardiovascular diseases than in the total population. Cardiovascular diseases are connected with fasting hyperglycemia, systolic hypertension and high WHR.