Background/aim: The purpose of the current study was to evaluate the thickness of the epicardial adipose tissue and its association with the degree of coronary artery disease in a group of autopsied cases. Materials and methods: A number of 79 cases were included in the study. Five preestablished incisions of the epicardial adipose tissue (EAT) were made on each of the hearts. These five points were next to/on the path of the major coronary vessels. The degree of coronary atherosclerosis was evaluated during the autopsy. Results: The results revealed the greatest thickness of the EAT on the incision made on the anterior and posterior wall of the right ventricle. EAT was thicker in cases presenting atherosclerosis degree I or II in two of the coronary arteries, the left circumflex artery and left main artery; on the left anterior descending artery, higher EAT thickness associated with fourth degree atherosclerosis. Conclusion: Epicardial adipose tissue thickness was greater at the incision points situated on the right side of the heart. Greater EAT thickness was associated significantly with early atherosclerosis development in three of the coronary arteries (LCx, LMA, LADA).
The risk of bleeding in atrial fibrillation patients on direct oral anticoagulant treatment increases with age; particularly dabigatran is associated with a higher risk of gastrointestinal bleeding in elderly patients, low body mass ([48 kg) and women due to the induced dyspepsia. We aimed to evaluate the safety of direct oral anticoagulants (DOAC) dabigatran, rivaroxaban and apixaban by comparing each agent with a widely used vitamin K antagonist (VKA)-acenocoumarol in terms of bleeding event rates. A retrospective study regarding bleeding events in atrial fibrillation patients treated with oral anticoagulation (OAC) was performed. Haematuria, epistaxis and haemoptysis were considered minor events and intracranial bleeding, gastrointestinal bleeding (superior or inferior), blood transfusion after haemorrhagic events linked to OAC treatment were considered to be major events. A number of 219 atrial fibrillation patients were included using electronic medical records: 118 patients treated with DOAC s (82 using dabigatran, 28 on rivaroxaban regimen and 8 cases treated with apixaban) and 101 cases had vitamin K antagonists treatment (acenocumarol). A total of 75 bleeding events were encountered (70 minor and 5 major). A higher number of events were encountered in patients treated with DOAC s, but with no statistically significant difference compared to acenocumarol. The associated risk factors did not play a decisive role in bleeding events in the two treatment groups. No statistical significant difference was noted between the occurrence of haemorrhagic events and the class of oral anticoagulant treatment used (DOAC vs. VKA).
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