BackgroundMany patients with coronary artery disease (CAD) have overlapping gastroenterological causes of recurrent chest pain, mainly due to gastroesophageal reflux (GER) and aspirin-induced gastrointestinal tract damage. These symptoms can be alleviated by proton pump inhibitors (PPIs). The study addressed whether omeprazole treatment also affects general health-related quality of life (HRQL) in patients with CAD.Study48 patients with more than 50% narrowing of the coronary arteries on angiography without clinically overt gastrointestinal symptoms were studied. In a double-blind, placebo-controlled, cross-over study design, patients were randomized to take omeprazole 20 mg bid or a placebo for two weeks, and then crossed over to the other study arm. The SF-36 questionnaire was completed before treatment and again after two weeks of therapy.ResultsPatients treated with omeprazole in comparison to the subjects taking the placebo had significantly greater values for the SF-36 survey (which relates to both physical and mental health), as well as for bodily pain, general health perception, and physical health. In comparison to the baseline values, therapy with omeprazole led to a significant increase in the three summarized health components: total SF-36; physical and mental health; and in the following detailed health concept scores: physical functioning, limitations due to physical health problems, bodily pain and emotional well-being.ConclusionsA double dose of omeprazole improved the general HRQL in patients with CAD without severe gastrointestinal symptoms more effectively than the placebo.

Background. The outcome of endovascular therapy can be influenced by a number of factors, either demographic, biochemical, angiographic or procedural. Knowledge about these factors may help in the individualization of therapeutic methods, surveillance intensity, and should, ultimately, improve intervention efficacy.Objectives. The aim of this study was to estimate the effect of clinical and biochemical factors on the late outcome of lower limb artery stenting.Material and methods. The medical documentation of 91 patients with at least a 1 year follow-up after the stenting of a lower limb artery was retrospectively evaluated. Uni-and multivariate analyses were performed.Results. Primary patency within an approximately 1.5-year follow-up amounted to 68.2%. The probability of freedom from target lesion revascularization was significantly greater in patients with dyslipidemia. According to the Cox proportional-hazards analysis, the risk of target extremity revascularization was significantly affected by the following (hazard ratio [HR], 95% confidence interval): Age (0.93, 0.88-0.99); dyslipidemia at inclusion (0.046, 0.01-0.23); LDL blood concentration (1.02; 1.01-1.04); hematocrit (1.2, 1.02-1.42); mean platelet volume (0.66, 0.44-0.99); INR (1.58, 1.13-2.21); and aPTT (1.18, 1.07-1.3).Conclusions. Endovascular treatment with stenting in patients with atherosclerotic peripheral arterial disease is effective, but the risk of primary patency loss was affected by the presence of dyslipidemia, age, and blood coagulation parameters. The effect of dyslipidemia on stent failure occurrence should be evaluated in further studies.

IntroductionAbout 20–30% of the population have peripheral artery disease. Many of them require intervention, with a percutaneous procedure currently being the first choice. However, the outcomes of these interventions need regular evaluation due to continuous progress in endovascular techniques and the devices used.AimThe aim of this study was to analyze procedural factors influencing the outcome of endovascular intervention in patients stented for the first time due to lower extremity atherosclerosis.Material and methodsThe medical documentation of 91 patients with at least 1 year of follow-up after stenting of a lower limb artery was retrospectively evaluated. Uni- and multivariate analyses were performed.ResultsThe mean observation time was 544.4 ±502.9 days. The primary patency of a stent after such a follow-up was 68.1%. Cox proportional hazard analysis revealed that the risk of target lesion revascularization was affected by the following (hazard risk, 95% confidence interval): the number of vascular segments with significant lesions (13.14, 2.28–75.8); critical limb ischemia (5.68, 1.23–26.2); localization of the target lesion in an aorto-iliac in comparison with a femoro-popliteal vascular segment (0.37, 0.14–0.7); aorto-iliac lesion class according to the TASC-II consensus (1.96, 1.1–3.8); and claudication distance (1.02, 1.01–1.03).ConclusionsThe common primary patency of a stent implanted into either an aorto-iliac or a femoro-popliteal vascular segment was similar to that found in other reports. The main factors affecting the outcome of the endovascular procedures performed were mainly related to atherosclerosis severity, not to the type of technique or device used.

A b s t r a c tIntroduction: Endothelial dysfunction is the main pathomechanism of atherosclerotic processes and their complications. Revascularization and control of atherosclerosis risk factors may improve the global endothelial function.Aim: Assessment of the relationships between the level of selected atherosclerosis risk factors and changes in noninvasive endothelial function parameters during one year long follow-up after superficial femoral artery (SFA) stenting.Material and methods: Seventeen male patients after SFA stenting were studied. Before the endovascular procedure, one day after it, and after 1, 3, 6, and 12 months after SFA stenting the values of global endothelial function parameters were evaluated, as follows: ankle-brachial index (ABI), flow-mediated brachial artery dilatation, distensibility coefficient, and Doppler parameters of blood flow in brachial and common carotid arteries in response to brachial ischemia and nitroglycerin sublingual application as well as intima-media complex thickness.Results: Of the studied parameters only ABI improved significantly after SFA stenting. The changes in values of investigated endothelial function parameters were related to presence of atherosclerotic risk factors, such as age above 62 years, hypercholesterolemia, diabetes, and hypertension. Generally, global endothelial function tests were worse in patients with these conditions before the endovascular procedure, then they improved to reach the level observed in individuals without cardiovascular risk factors already after 3 to 6 months after SFA stenting.Conclusions: The SFA stenting together with adequate pharmacotherapy may reduce the negative effect of comorbidities on the global endothelial function and vasodilatation reserve of brachial and carotid arteries.Key words: endothelium, atherosclerosis, superficial femoral artery stenting S t r e s z c z e n i e Wstęp: Zaburzenie funkcji śródbłonka jest podstawowym mechanizmem patogenetycznym rozwoju i powikłań miażdżycy naczyń. Wiadomo, że zabieg rewaskularyzacyjny i kontrola czynników ryzyka rozwoju miażdżycy mogą poprawiać globalną funkcję śródbłonka.Cel: Ocena związku wybranych czynników ryzyka wystąpienia miażdżycy ze zmianami wartości nieinwazyjnych wskaźników funkcji śródbłonka w ciągu rocznej obserwacji pacjentów po stentowaniu tętnicy udowej powierzchownej (TUP).Materiał i metody: Analizie poddano wartości wskaźników zaburzenia funkcji śródbłonka u 17 mężczyzn leczonych metodą stentowania TUP z powodu chromania przestankowego. Przed zabiegiem, w dobę po stentowaniu TUP, oraz po 1, 3, 6 i 12 miesiącach od wykonania procedury wewnątrznaczyniowej zbadano: wskaźnik kostka-ramię (WKR), dylatację tętnicy ramiennej oraz wskaźnik rozszerzalności tętnicy ramiennej i szyjnej w odpowiedzi na niedokrwienie i podanie nitrogliceryny, a także parametry dopplerowskie przepływu w tętnicy ramiennej i grubość kompleksu intima-media tętnicy szyjnej wspólnej.

Background: Disturbances in atrial microcirculation is recognized as a risk factor for atrial fibrillation (AF). AIM: The aim of this study was to determine the associations between circulating soluble vascular cell adhesion molecule-1 (sVCAM-1) and the risk of AF and a one-year prognosis among consecutive inpatients. Methods: Eighty consecutive inpatients hospitalized due to non-valvular AF and 80 consecutive inpatients admitted for exacerbation of chronic coronary syndrome (control group) were enrolled in the study. A cardiologic workup was performed and blood sVCAM-1 concentration was determined using the ELISA method. Results: Patients with AF had similar blood sVCAM-1 concentration compared to the control group. AF patients treated with new oral anticoagulants (NOACs) were significantly less likely to have a sVCAM-1 concentration elevated above the median value than patients treated with warfarin (34.2% vs 65.8%; p = 0.01). Patients with an increased percentage of fat mass (FM) had lower sVCAM-1 concentration. The risk of all-cause mortality and MACE during follow-up rose in individuals with elevated sVCAM-1 (≥ 1242 and