Aim: The aim of this study was to determine the impact of genetic and nongenetic factors on treatment outcomes in patients receiving dual antiplatelet therapy after percutaneous coronary intervention and stent implantation. Materials & methods: Patients (n = 628) used clopidogrel or ticagrelor for at least 1 week before platelet aggregation test. Results: Multivariate binary regression analysis demonstrated that aspirin use and CYP4F2 T allele significantly increased odds for bleeding in clopidogrel users (OR: 2.488, 95% CI: 1.452–4.265; p = 0.001 and OR: 1.573, 95% CI: 1.066–2.320; respectively; p = 0.022). CYP4F2 T allele significantly increased odds for bleeding in ticagrelor users (OR: 8.270, 95% CI: 3.917–17.462; p < 0.001). Conclusion: Aspirin use and CYP4F2 T allele were significantly associated with bleeding during dual antiplatelet therapy.
Aims: The goals of this study were to develop a new technique that could pave the way for a quicker determination of CYP4F2 rs3093135 and CYP2C19 rs4244285 variants directly from a patient’s blood and to attempt to apply this technique in clinical practice. Patients & methods: The study included 144 consecutive patients admitted with ST elevation myocardial infarction. A blood-direct PCR and real-time PCR were used to detect variants of interest. Results & conclusion: Patients with bleeding events had the CYP2C19 GG (*1*1) variant more frequently than patients without bleeding events. The CYP4F2 TT variant was more frequently detected in patients with bleeding events 3 months after hospitalization.
Funding Acknowledgements Type of funding sources: None. INTRODUCTION The right ventricular global longitudinal strain (RV GLS) increasingly has been used for the prognosis of mortality in the heart failure patients. However, the relationship of RV strains to other RV functional parameters and its dependency of functional tricuspid regurgitation (TR) as a result of left heart valvular disease is not well studied. PURPOSE To investigate the relationship of RV geometry, functional and strain parameters to the predominant left heart aetiology in patients with functional TR as a result of left heart valvular disease. METHODS Prospective observational cohort study enrolled patients with functional TR caused by left heart valvular disease for whom surgical valvular repairment is scheduled. Patients with ischemic heart disease (assessed by coronary angiography) were excluded from the analysis. The current study included 52 patients with full sets of preoperative echocardiographic parameters. Echocardiographic quantification included the following parameters: the RV geometry (RV diameters, RV area), functional (velocity of the tricuspid annular systolic motion (S’) and RV fractional area change (FAC)) and strain parameters (RV GLS, longitudinal RV free wall strain (RVFWS) and longitudinal strains of each segment of RV free wall). The severity of TR was measured quantitively according the recent ESC guidelines. Patients were divided into groups according to the predominant left heart valvular disease causing moderate or severe functional TR: 1. TR caused by primary severe mitral regurgitation (MR) due to mitral valve (MV) prolapse and MV chordae rupture; 2. TR caused by other left heart valvular pathologies (severe aortic stenosis [16 pts.], severe rheumatic aortic and MV disease [11 pts], severe aortic regurgitation [3 pts]). The statistical analyses were performed using SPSS statistical software. RESULTS In 52 patients of current analysis 64% were female, mean age was 67 ± 9. The distribution of echocardiography parameters in study groups are shown in Table 1. The RV geometry parameters and parameter of TR severity (effective regurgitant orifice area (EROA) did not differ significantly between these two groups. The RV longitudinal function (S’) and RV strain parameters (RV GLS and longitudinal RVFWS) were better in severe MR group. CONCLUSIONS Although the right ventricular geometry and severity of functional tricuspid regurgitation does not depend on different predominant left heart valvular disease causing significant functional tricuspid regurgitation, the right ventricular longitudinal function and longitudinal right ventricular free wall strain are less affected and remains unimpaired in patients with functional tricuspid regurgitation caused by severe primary mitral regurgitation. Abstract Figure.
Funding Acknowledgements Type of funding sources: None. INTRODUCTION The prevalence of untreated moderate and severe functional tricuspid regurgitation (TR) eventually leads to heart failure and is associated with poor prognosis. Therefore, tricuspid annuloplasty (TA) is offered as a first-line treatment for significant functional TR. However, studies to investigate factors leading to recurrent TR after TA are still scarce. AIM The aim is to investigate the relationship between right ventricular (RV) geometry and function parameters and recurrent TR after TA. METHODS Prospective observational cohort study enrolled patients with moderate or severe functional TR caused by left heart valvular disease who underwent surgical tricuspid valve (TV) repair. The dominant pathology was severe mitral regurgitation. Patients with ischemic heart disease (assessed by coronary angiography) were excluded from the analysis. The current study included 60 patients with full sets of preoperative 2D and 3D echocardiographic parameters. Echocardiographic quantification included the following parameters: the RV and RA geometry, functional (velocity of the tricuspid annular systolic motion [S’] and RV fractional area change [FAC], tricuspid annular plane systolic excursion [TAPSE] and RV ejection fraction (EF)). The severity of TR was measured quantitatively according to the recent ESC guidelines. Patients were divided into two groups according to the outcomes of TA: effective (38 pts.) and ineffective (22 pts.) TV repair. Effective TA was considered if TR 1 year after surgery was mild, while ineffective – TR was moderate or severe (recurrent TR). The statistical analysis was performed using SPSS statistical software, univariate logistic regression was used. RESULTS In 60 patients of current analysis 67% were female, mean age was 67 ± 9 years. The odds ratio for risk of ineffective TA are shown in Table 1. Age, gender, body mass index, left ventricular (LV) functional, as well as left atrial parameters did not differ between effective and ineffective TA groups. When analysing echocardiographic parameters in univariate logistic regression, RV and RA geometry, TV annulus diameter had predictive value for ineffective TA. Preoperative effective regurgitant orifice area (EROA) did not differ significantly between two groups (ineffective TA vs. effective TA; 31 [60] mm2 vs. 24 [17] mm2, p = 0.308 respectively). Meanwhile, none of the RV functional parameters were significant. CONCLUSION Recurrent moderate or severe functional tricuspid regurgitation after tricuspid annuloplasty is associated with preoperative tricuspid annulus size, RA and RV geometry, but not with changes of RV function. Abstract Figure.
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