The QFR value at the pressure transducer position (iQFR) was the best corresponding QFR model. iQFR is characterised by high diagnostic accuracy and used in a hybrid model with FFR which may reduce the number of procedures requiring pressure-wire by two-thirds.

ClinicalTrials.gov, NCT03104231. Registered on 28 March 2017.

Background: Coronary artery disease (CAD) and degenerative aortic stenosis often coexist. How-

A b s t r a c t Background:The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied. Aim:The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.Methods: On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.Results: According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401-6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190-7.0225, p = 0.0457).Conclusions: Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.

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p = 0.59; EuroSCORE II, AUC 0.59; p = 0.23; STS, AUC 0.55; p = 0.52; ACEF, AUC 0.54; p = 0.69; Ambler's, AUC 0.54; p = 0.70; OBSERVANT, AUC 0.597; p = 0.21; SURTAVI, AUC 0.535; p = 0.65. SURTAVI model was calibrated best in high-risk patients showing coherence between expected and observed mortality (10.8% vs. 9.4%, p = 0.982). ACEF demonstrated best classification accuracy (17.5% vs. 6.9%, p = 0.053, respectively). Conclusions: None of the investigated risk scales proved to be optimal in predicting 30-day mortality in unselected, real-life population with aortic stenosis referred to TAVI. This data supports primary role of heart team in decision process of selecting patients for TAVI. (Cardiol J 2016; 23, 2: 169-177)

Introduction. Acetylsalicylic acid (ASA) is the antiplatelet drug most used in the perioperative period in patients undergoing coronary artery bypass grafting (CABG). Off-pump coronary artery bypass grafting (OPCAB) is likely to alter platelet (PLT) function to a lesser extent than CABG with the use of cardiopulmonary bypass and may potentially result in high on-aspirin platelet reactivity (HAPR) in the postoperative period. Materials and methods. The aim of this prospective study was to characterise serum thromboxane B 2 (TXB 2) variability and ASA-dependent platelet reactivity in patients with stable coronary artery disease undergoing OPCAB treated with a single daily dose of 75 mg of ASA. Blood sampling was performed 2 hours and 24 hours after ASA intake on the day before surgery, and on the 2 nd and 7 th days after the operation. Results. A PLT counts reduction and a mean platelet volume increase were observed on the 2 nd day after OPCAB. A PLT counts increase was found on the 7 th postoperative day. A significant increase (p = 0.03) in the percentage of patients with insufficient laboratory ASA efficacy (defined by serum TXB 2 ≥ 7.2 ng/mL) was observed on the 7 th postoperative day compared to preoperative values (52% vs 20% respectively, p = 0.02). A significant increase in median platelet reactivity and in the percentage of patients with HAPR (defined by VerifyNow ® Aspirin test result ≥ 550 ARU) was observed on the 7 th postoperative day in comparison with the values before OPCAB (48% vs 12%, p = 0.007). Conclusions. In the group of patients taking a standard daily dose of 75 mg of ASA, a substantial number of patients failed to attain optimal inhibition of serum TXB 2 or had HAPR before surgery and on the 7 th day after OPCAB. A significant decrease in serum TXB 2 levels on the 2 nd day after OPCAB did not correlate with PLT reactivity. The optimal dose of ASA is of interest for further studies of efficacy and clinical outcomes after OPCAB.

Background. The post-cardiac arrest (CA) period is often associated with secondary damage of the brain that leads to severe neurological deficits. The current practice guidelines recommend the use of therapeutic hypothermia (TH) to prevent neurological deficit and improve survival.