Our results indicate that the clinical benefits of clopidogrel are not associated with a parallel reduction in markers of coagulation activation. Early suppression of coagulation markers most likely reflects the effects of heparin. The persistence of thrombin generation despite long-term clopidogrel and aspirin therapy suggests that even more intensive antithrombotic therapy may be required in these patients.

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Background: There is significant evidence that reactive oxygen species play an important role in endothelial dysfunction, ischemia/reperfusion injury as well as in the pathogenesis of diabetes mellitus (DM). It is also known that vitamins C and E have substantial antioxidant properties. However, clinical evidence concerning this topic is insufficient so far. The aim of the present study was to determine if the administration of vitamins C and E influences the outcome in diabetic patients with acute myocardial infarction (AMI). Methods: Among 800 patients with AMI included in the MIVIT (Myocardial Infarction and Vitamins) study, 122 patients (15%) had confirmed DM. A retrospective analysis of the influence of vitamins C and E on 30-day cardiac mortality in patients with or without DM was performed. Results: There was a significant reduction in 30-day cardiac mortality in diabetic patients treated with antioxidant vitamins C and E [5 (8%) vs. 14 (22%); OR 0.32, 95% CI 0.11–0.93; p = 0.036]. Such an effect has not been observed in patients without DM [19 (6%) vs. 19 (6%); OR 0.97, 95% CI 0.51–1.85; p = 0.94]. Conclusion: The results suggest that early administration of antioxidant vitamins C and E in patients with AMI and concomitant DM reduces cardiac mortality.

, , W Wo oj jc ci ie ec ch h W Wo oj ja ak ko ow ws sk ki i 3 3 , , Z Zb bi ig gn ni ie ew w P Pe er ru ug ga a 5 5 , , A Al le ek ks sa an nd de er r A Ar ra as sz zk ki ie ew wi ic cz z 6 6 , , T To om ma as sz z D De ep pt tu uc ch h 4 4 , , M Ma ał łg go or rz za at ta a S Sz zk ku ut tn ni ik k 7 7 , , M Ma ac ci ie ej j L Le es si ia ak k Association on Cardiovascular Interventions of PCSOnce again in the pages of Progress in Interventional Cardiology we publish a summary of the achievements of Polish interventional cardiology. Data for the year 2011 were collected from the database of the Association of Cardiovascular Interventions of the Polish Cardiac Society (AISN PTK) and annual summary reports from all of the catheterization laboratories in Poland. The dynamic development of percutaneous interventional procedures, but also problems with contracting and the valuation of interventional procedures in the past year, are reflected in the numbers of individual procedures.An upward trend regarding the number of interventional cardiology procedures observed for many years has been sustained in 2011. This applies to both diagnostic procedures (coronary angiography) and therapeutic -percutaneous coronary interventions (PCIs). This was mainly related to the opening of new catheterization laboratories, whose number increased to 137 (an increase of 13 catheterization laboratories during one year).This figure indicates that currently there are 3.6 interventional cardiology centers for one million inhabitants or in other words that there is one center per approximately 280 thousand inhabitants. Importantly, most of them (114, 83%) operate in 24 h hemodynamic shifts admitting patients with acute coronary syndromes (ACS). Most catheterization laboratories regularly sent reports on their activities to the AISN PTK database (96% of the cath labs) and all cath labs provided a summary report for the previous year.A total of 88 laboratories are accredited: 15 laboratories have accreditation class A, 51 class B, and 22 cath labs have the highest class C accreditation. Unfortunately, we must once again state that 36% of laboratories operate without accreditation of the Polish Cardiac Society, which is an important element of quality and safety control for patients treated with percutaneous interventions in Poland. The number of invasive cardiology centers per 1 million inhabitants in different provinces is presented in Figure 1. There is still inhomogeneity regarding the saturation of different provinces with catheterization laboratories: there are a little more than 2 centers per 1 million inhabitants in the Zachodniopomorskie province, while in the Świę-tokrzyskie province there are more than 5 centers per 1 million inhabitants.There are currently 705 physicians performing interventional cardiology procedures registered in the AISN PTK database (increase of 7% in comparison to the year 2010): 142 performing diagnostic procedures (20%), 532 independent operators (75%) and 31 physicians during training. Three hundred and e...

Use of modern attributes of interventional cardiology like DES stents, radial approach, and treatment of higher risk patients has increased in Poland in 2005-2011. The adoption of the "Stent for Life" initiative has resulted in an increasing number of percutaneous coronary procedures over the years.