PLR proved to have good prognostic value for in-hospital and late mortality. PLR cut-off value for predicting in-hospital mortality was higher to that predicting late mortality. PLR remained an independent risk factor early and late mortality.

Our analysis showed that in patients with ischemic heart failure the presence of the CTO is related to worse long-term prognosis.

No abstract

A b s t r a c tBackground and aim: Heart failure (HF) has become a global health problem and is a significant burden for health-care systems worldwide. It is reported as the reason for 1-4% of all hospital admissions in developed countries. The prognosis in HF remains unfavourable. Having at our disposal a large group of patients with systolic HF at a high-volume reference cardiovascular centre with the possibility to implement complete diagnostics and therapy we decided to analyse the clinical data, administered therapies, and prognosis in HF patients. Methods:The COMMIT-HF is a single-centre observational study that is underway in the Third Chair and Department of Cardiology of the Silesian Centre for Heart Diseases in Zabrze. The study population is a cohort of adult HF patients with left ventricular ejection fraction (LVEF) ≤ 35%. Patients with acute coronary syndromes are excluded from the analysis. Complete patient demographics: medical history, hospitalisation data (diagnostic and therapeutic), and in-hospital results are collected. Twelve-month follow-up is based on the information acquired from the national health-care provider. Results:As of 31 December 2013 a group of 1798 patients have been enrolled (mean age 60.9 ± 12.8 years, 20.3% of subjects female, mean LVEF 26.06 ± 6.09, ischaemic aetiology 64.5%, atrial fibrillation 33.2%, diabetes mellitus 41.2%, chronic kidney disease stage ≥ III 29%). A significant proportion of patients underwent invasive procedures (ICD/CRT-D implantation 61.1%, coronary angiography 56.2%, PCI 19.6%, CABG 5.1%, heart transplantation qualification 5.5%, IABP 2.5%). All-cause 12-month morality was 12.5%. HF-related rehospitalisation rate was 28.9%. Conclusions:The COMMIT-HF study will provide valuable information on the HF patient population. Initial analyses show that in this difficult patient population satisfactory long-term results can be achieved.

No abstract

IntroductionRevascularization of patients with heavily calcified coronary arteries can be a challenge for interventional cardiologists. The procedural success rate in these patients can be improved by using rotational atherectomy (RA).AimTo compare in-hospital outcomes and those at 12-month follow-up between patients who underwent RA as a bailout procedure secondary to failed conventional angioplasty or as an elective procedure.Material and methodsThis is a retrospective analysis of 156 consecutive patients hospitalized at a high-volume percutaneous coronary intervention (PCI) center who underwent RA. In 43 (27.6%) patients, RA was performed on an elective basis (group 1). In 113 (72.4%) patients RA was carried out after unsuccessful traditional angioplasty (group 2).ResultsPatients in group 1 more often had a history of peripheral vascular disease (32.6% vs. 15.9%; p = 0.03). Group 1 was dominated by patients with multivessel disease (62.8% vs. 33.6%; p < 0.001). The left main coronary artery was more often treated in group 1 (25.6% vs. 2.7%; p < 0.001). Success rates in the two groups were similar: 93.0% for group 1 and 91.2% for group 2 (p = 0.71). The rate of in-hospital complications did not significantly differ between the groups. Twelve-month MI, TLR, and TVR rates were similar in both groups. There was no difference in the 12-month survival rate (86.1% vs. 92.0% in group 2; p = 0.27) or MACE (16.3% vs. 15.0%; p = 0.8).ConclusionsRotational atherectomy is associated with high efficacy and a relatively low risk of complications, with no significant differences in outcomes between patients treated with primary and secondary RA procedures.

A b s t r a c tBackground and aim: Heart failure (HF) is a major cause of death in cardiovascular disease. In a post-STICH landscape, we lack data on the role of percutaneous coronary intervention (PCI) in systolic HF patients. Complete revascularisation remains a key unanswered question in ischaemic HF. Methods:The COMMIT-HF is an ongoing systolic HF registry (inclusion criteria: HF with left ventricular ejection fraction ≤ 35%, exclusion: acute coronary syndrome). A total of 1798 patients were enrolled. A group of patients with multi-vessel coronary artery disease qualified for PCI were selected and divided into complete (n = 188) and incomplete revascularisation (n = 159) groups. Completeness of revascularisation was defined as successful PCI of every angiographically significant lesion in all arteries with a diameter of ≥ 2 mm without a patent surgical graft. Patients were followed up for a period of at least 12 months with all-cause mortality defined as the primary endpoint. Results:The study groups showed no significant differences in clinical status and echocardiographic parameters, with a lower comorbidity rate in the complete revascularisation group. Procedural characteristics were comparable. There were no significant differences in complication rates. All-cause mortality was significantly lower in the complete revascularisation group after 12-months (6.4% vs. 20.1%, p < 0.001). Multivariate analysis confirmed that achievement of complete revascularisation was an independent factor improving survival (HR 0.39; 95% CI 0.18-0.81, p = 0.01). Conclusions:Percutaneous coronary intervention can be a safe and feasible method of revascularisation in ischaemic HF. Achievement of complete revascularisation with PCI was related to improved outcomes in the analysed patient population.

Background There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI) therapy with dedicated DES platforms. The LM‐STENTYS is a multicenter registry aimed at evaluating clinical outcome after PCI of LM performed with a self‐apposing Stentys DES implantation. Methods The registry consists of 175 consecutive patients treated with Stentys DES implanted to LM. The primary endpoint was the composite of major adverse cardiac and cerebral events (MACCE) defined as cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stroke assessed after 1 year. The secondary endpoint was stent thrombosis (ST) at 1 year. Results The median age was 69 years (IQR, 62–78 years). Acute coronary syndrome (ACS) was the presenting diagnosis in 117 (66.9%) patients [74 (63.2%) unstable angina, 31 (26.5%) NSTEMI, 12 (10.3%) STEMI] and stable angina (SA) was present in 58 (33.1%) patients. The median SYNTAX score was 23.0 (IQR, 18.7–32.2) in the SA group and 25.0 (IQR, 20.0–30.7) in the ACS group. During 1‐year follow‐up in the SA group two (3.4%) MACCE occurred, both of them were cardiac deaths. In ACS patients there were 19 (16.2%) MACCE [9 (7.7%) cardiac deaths, 11 (9.4%) MIs, 11(9.4%) TLR, 1(0.9%) stroke]. Altogether, three (1.7%) cases of acute ST were noted, all of them in ACS subset. Conclusion LM PCI using self‐apposing Stentys DES showed favorable clinical outcomes at 1‐year in patients with SA. Events of ST in the ACS group warrant further research.