Michał Kasprzak - Academia.edu (original) (raw)

Papers by Michał Kasprzak

Cardiology Journal

This article is available in open access under Creative Common Attribution-Non-Commercial-No Deri... more This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

Journal of Clinical Medicine

Concomitant systemic essential hypertension (HTN) in adults with a secundum atrial septal defect ... more Concomitant systemic essential hypertension (HTN) in adults with a secundum atrial septal defect (ASD) can unfavorably affect the hemodynamics and transcatheter ASD closure (ASDC) effects. This study aims to assess the effectiveness and safety of ASDC in adults with HTN in real-world clinical practice. Right ventricular (RV) reverse remodeling (RVR) and the lack of a left-to-right interatrial residual shunt (NoRS) in echocardiography 24 h and 6 months (6 M) post-ASDC, and ASDC-related complications within 6 M were evaluated in 184 adults: 79 with HTN (HTN+) and 105 without HTN (HTN−). Compared to HTN−, HTN+ patients were older and had a greater RV size and the prevalence of atrial arrhythmias, chronic heart failure, nonobstructive coronary artery disease, diabetes, hyperlipidemia, and left ventricular diastolic dysfunction. ASDC was successful and resulted in RVR, NoRS, and a lack of ASDC-related complications in the majority of HTN+ patients both at 24 h and 6 M. HTN+ and HTN− did ...

Journal of Clinical Medicine, 2021

Objective: To evaluate the diagnostic performance of selected baseline electrocardiographic (ECG)... more Objective: To evaluate the diagnostic performance of selected baseline electrocardiographic (ECG) parameters as predictors of left ventricular remodeling (LVR) in patients with a first ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods: The study was performed as a single-center cohort study, with 249 patients (74.7% males) included in the final analysis. Nine baseline ECG parameters were evaluated, with respect to occurrence of LVR 6 months after STEMI (defined as an echocardiography-assessed relative >20% increase in end-diastolic left ventricular volume compared with the value at discharge from hospital). Results: The baseline ECG predictors of LVR, identified in univariate analysis, included the number of leads with ST-segment elevation (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.03–1.38, p = 0.0212), number of leads with Q-waves (OR 1.21, 95% CI 1.07–1.37, p = 0.0033), sum of ST-segment elevatio...

Medical Research Journal, 2021

Introduction: A COVID-19 pandemic has resulted in noticeable changes in the functioning of the De... more Introduction: A COVID-19 pandemic has resulted in noticeable changes in the functioning of the Department of Cardiology, dr A. Jurasz University Hospital no. 1 in Bydgoszcz. This study aims to compare the functioning of the university cardiology department in the pandemic year 2020 to the previous years. Materials and methods: The retrospective analysis of patients hospitalized in the Department of Cardiology, dr A. Jurasz University Hospital no 1 in Bydgoszcz, Poland, has been performed. Collected data included the number of patients admitted to the hospital, medical diagnoses, performed procedures and in-hospital mortality. Results: Throughout 2020 numbers of both new hospitalizations and diagnostic or therapeutic procedures in electrophysiology, echocardiography and invasive cardiology showed a major decrease. The greatest impact was observed in March, April, and the last 3 months of the year. The pandemic also affected in-hospital mortality. Conclusions: The observed decrease in the number of hospital admissions of specialized cardiac procedures performed in 2020 may have a serious impact on future patients' profile.

Medical Research Journal, 2021

Folia Cardiologica, 2017

Wstep . Celem pracy byla ocena adherence z zastosowaniem nowej skali w populacji osob z chorobą w... more Wstep . Celem pracy byla ocena adherence z zastosowaniem nowej skali w populacji osob z chorobą wiencową (CAD) po zawale serca (MI) w odniesieniu do parametrow socjodemograficznych i klinicznych. Material i metody . Badanie przeprowadzono w populacji 100 kolejnych osob (40 kobiet, 60 mezczyzn) w wieku 30–88 lat, średnio 63,4 roku, pol roku po hospitalizacji z powodu MI. Wyniki . Wyniki oceny w Adherence in Chronic Diseases Scale (ACDS) zawieraly sie miedzy 6 a 28 punktow; mediana wynosila 24 punkty (21–28). Wynik wysoki (> 26 pkt.) osiągnely 24 osoby, 53 badanych uzyskalo wynik średni (miedzy 21 a 26 pkt.), a 23 — niski wynik (< 21 pkt.). Dla optymalnego modelu regresji wielorakiej wspolczynnik korelacji R wynosil 0,539, a skorygowany wspolczynnik determinacji R2 — 0,26 (p = 0,000002). Niezaleznymi czynnikami wplywającymi na adherence ocenianymi w ACDS byly: subiektywna ocena stanu zdrowia (b = 0,48 ± 0,23; p = 0,036), wiek badanych (b = –0,11 ± 0,04; p = 0,004), wiecej niz je...

Journal of Clinical Medicine, 2021

Objective: To assess the performance of ten electrocardiographic (ECG) parameters regarding the p... more Objective: To assess the performance of ten electrocardiographic (ECG) parameters regarding the prediction of left ventricular systolic dysfunction (LVSD) after a first ST-segment-elevation myocardial infarction (STEMI). Methods: We analyzed 249 patients (74.7% males) treated with primary percutaneous coronary intervention (PCI) included into a single-center cohort study. We sought associations between baseline and post-PCI ECG parameters and the presence of LVSD (defined as left ventricular ejection fraction [LVEF] ≤ 40% on echocardiography) 6 months after STEMI. Results: Patients presenting with LVSD (n = 52) had significantly higher values of heart rate, number of leads with ST-segment elevation and pathological Q-waves, as well as total and maximal ST-segment elevation at baseline and directly after PCI compared with patients without LVSD. They also showed a significantly higher prevalence of anterior STEMI and considerably wider QRS complex after PCI, while QRS duration measure...

Cardiology Journal, 2021

Medical Research Journal, 2021

Introduction: Post-COVID syndrome is a common finding during the first year after SARS-CoV-2 infe... more Introduction: Post-COVID syndrome is a common finding during the first year after SARS-CoV-2 infection affecting the daily living of many patients. The aim of this study was to assess the functioning of patients with post-COVID syndrome. Material and methods: A self-reported questionnaire-the Functioning in Chronic Illness Scale (FCIS)-was applied in 79 (30 women, 49 men) patients (mean age of 62.7 ± 13.6 years), suffering from post-COVID syndrome 5.8 ± 2.3 months after discharge from hospital. Results: The mean FCIS score was 86.2 ± 12.8 points, corresponding to medium functioning level. The mean score in the first, second and third subscale was 27.0 ± 6.4; 27.5 ± 3.7; and 31.7 ± 4.3 points respectively. Better functioning was observed in men vs women: the FCIS score 88.59 ± 10.95 vs 82.20 ± 14.71; p = 0.02 and in the youngest patients: first (< 59 years) vs second (59-67 years) vs third tercile (> 67 years): FCIS score 92.76 ± 14.84 vs 83.15 ± 11.64 vs 83.07 ± 9.68; p = 0.01). The amount of time from COVID-19-related hospitalisation did not affect the FCIS score. Conclusion: Symptoms of post-COVID syndrome influencing patients' functioning persist within the first year regardless of the time elapsing from the disease. Men and younger patients demonstrate better functioning abilities.

Medical Research Journal, 2018

Introduction. Notwithstanding the development of modern diagnostic-therapeutic techniques, cardio... more Introduction. Notwithstanding the development of modern diagnostic-therapeutic techniques, cardiovascular diseases still pose a grave health, social, and economic issue. Patients hospitalised for acute coronary syndrome should, in addition to establishing an optimal pharmacotherapy, be made aware of how to prevent this disease and recognise it using its typical symptoms and signs. Objective. The objective of the study was to evaluate the effectiveness of educational intervention based on educational brochures in patients with myocardial infarction with regard to socio-demographic factors and baseline patients' knowledge. Material and methods. The single-centre, prospective, observational study was conducted in a cohort of 248 patients with myocardial infarction (women n = 72, men n = 176), hospitalised between May 2015 and July 2016. Consistently with the results of univariate analysis, multivariate analysis identified age (-3.73/10 years; p < 0.0006) and the level of education (10.37; p < 0.0001) as independent factors influencing patients' prehospital knowledge. Results. According to multivariate analysis of the level of knowledge following the educational intervention, the only factors affecting the process of learning were age (-2.04/10 years; p < 0.03) and remaining in a steady relationship (9.7; p = 0.0003). Among factors influencing the increase of knowledge, only the level of education was of statistical significance (-6.09; p < 0.02). Conclusions. The educational brochure proved to be an effective tool for therapeutic education, allowing minimisation of the disparities between the examined groups and improvement of the breadth of patients' knowledge.

Cardiology Journal, 2013

Background: The healthcare professionals involved in in-hospital treatment of myocardial infarcti... more Background: The healthcare professionals involved in in-hospital treatment of myocardial infarction (MI) are also responsible to patients for their education before leaving the hospital. This education aims to modify patient behaviour in order to reduce relevant risk factors and improve self-control and adherence to medications. The aim of the study was to analyse the relationship between readiness for discharge from hospital and adherence to treatment at follow-up in MI patients. Methods: An observational, single-center, MI cohort study with 6-month follow-up was conducted between May 2015 and July 2016. The Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD-MIS) and the Adherence in Chronic Diseases Scale (ACDS) were applied. Results: Two hundred and thirteen patients aged 30-91 years (62.91 ± 11.26) were enrolled in the study. The RHD-MIS general score ranged from 29 to 69 points (51.16 ± 9.87). A high level of readiness was found in 66 patients (31%), intermediate in 92 (43.2%), and low in 55 (25.8%) of patients. Adherence level assessed with the ACDS 6-months after discharge from hospital ranged from 7 to 28 points (23.34 ± 4.06). An increase in objective assessment of patient knowledge according to RHD-MIS subscale resulted in significantly higher level of adherence at the follow-up visit (p = 0.0154); R Spearman = 0.16671, p = 0.015; p for trend = 0.005. During the 6-month follow-up 3 (1.41%) patients died and 17 (7.98%) were hospitalized for a subsequent acute coronary syndrome. Conclusions: This study provided preliminary evidence of a long-term association between the results of assessment of readiness for discharge from hospital and adherence to treatment in patients after MI.

Medical Research Journal, 2018

Introduction. Conscious implementation of a therapeutic plan immediately after discharge from hos... more Introduction. Conscious implementation of a therapeutic plan immediately after discharge from hospital is pivotal in myocardial infarction survivors. Obesity and overweight are known as factors increasing the risk of adverse cardiovascular events and worsening long-term clinical outcome. The aim of the study was to assess the knowledge regarding cardiovascular diseases in patients with myocardial infarction undergoing in-hospital brochure-based education in relation to the prevalence of overweight and obesity. Patients and methods. A prospective, single-centre, cohort, observational study was conducted in 228 patients hospitalised due to myocardial infarction (women n = 52, men n = 176). A dedicated questionnaire containing 20 single-choice questions was applied for the knowledge assessment. Patients were divided into three groups depending on the BMI level (normal, overweight, obesity). Results. Comparison of patients' knowledge at baseline and on the day of discharge revealed a significant increase of overall result (p = 0.0264) and of knowledge about prophylaxis (p = 0.0115). Multivariate analysis showed education level (-5.82 ± 2.576, p = 0.025) and BMI (-4.54 ± 1.771, p = 0.011) as independent factors determining the overall increase in patients' knowledge. Conclusions. Educational interventions in overweight and obese patients should be intensified. The brochure is an effective educational tool.

Platelets, 2019

The aim of the study was to evaluate diurnal changes of tissue factor (TF) and tissue factor path... more The aim of the study was to evaluate diurnal changes of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) concentrations in relation to on-treatment platelet reactivity. The study group included 51 patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention and dual antiplatelet therapy. TF and TFPI concentrations were assessed using enzyme-linked immunosorbent assay kits. We found a significant increase of TF concentration in clopidogrel-resistant, but not clopidogrel-sensitive, patients at 10.00 a.m. (410.66 pg/mL) in comparison with 6.00 a.m. (250.99 pg/mL), 14.00 p.m. (255.12 pg/mL) and 19.00 p.m. (267.58 pg/mL). Moreover, TF concentration at 10.00 a.m. was 30% higher in clopidogrel-resistant than clopidogrel-sensitive patients (p = .043). We failed to demonstrate diurnal variation in TFPI concentration in clopidogrel-resistant patients. However, TFPI concentration in clopidogrel-sensitive patients was significantly higher at 10.00 a.m. as compared with other sampling points (p < .05). We observed a marked elevation in TF concentration at 10.00 a.m. only in aspirin-resistant patients and a significant increase in TFPI concentration at 10 a.m. only in aspirin-sensitive patients. Our findings suggest the presence of diurnal variations in TF and TFPI concentrations in AMI patients, with the highest thrombotic risk in patients with high on-treatment platelet reactivity in the midmorning.

Catheterization and Cardiovascular Interventions, 2018

Background: There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI)... more 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.

Patient preference and adherence, 2018

A substantial subset of patients after myocardial infarction (MI) discontinue pivotal medication ... more A substantial subset of patients after myocardial infarction (MI) discontinue pivotal medication early after discharge. In particular, cessation of antiplatelet treatment may lead to catastrophic ischemic events. Thus, adherence to prescribed medication in patients after MI is an issue of medical and social concern. The aim of the study was to evaluate the level of adherence to treatment using a newly developed scale in patients after MI treated with percutaneous coronary intervention. A single-center, prospective, observational cohort clinical study with a 6-month follow-up was performed. Patients with physical or cognitive impairment, prisoners, soldiers, and family members and coworkers of the researchers were excluded from the study. The impact of selected sociodemographic and clinical factors on adherence was evaluated in 221 patients (63 women and 158 men) aged 30 to 91 years. The results obtained with the Adherence in Chronic Diseases Scale (ACDS) ranged from 7 to 28 points; ...

Medical Research Journal, 2017

Introduction. The objective of the research was to study the knowledge about ischaemic heart dise... more Introduction. The objective of the research was to study the knowledge about ischaemic heart disease and learning preferences of hospitalised patients as a result of myocardial infarction. Methods. The tested group comprised of 248 patients, aged 63 ± 11.25, who were hospitalised as a result of myocardial infarction A questionnaire with 20 single-choice questions was used in the research. The questionnaire tested the knowledge of the patients as far as ischaemic heart disease, myocardial infarction symptoms, and preventive healthcare are concerned. The patients were divided into groups depending on what knowledge sources on ischaemic heart disease they preferred-brochures, magazines, radio and TV, individual talks, group talks, films, the Internet. Results. The proportion of correct answers was 58.49 ± 19.89%; in the area of the disease knowledge 62.74 ± 31.52%; in the area of the preventive healthcare 57.14 ± 23.38%; and in the area of the disease symptoms 56.94 ± 25.84%. The source of health knowledge selected the most was educational brochures (80.2%), while radio and TV was selected the least (17.6%). The knowledge varied depending on patients' preferences: so those who selected films-the knowledge of the disease symptoms was higher compared to the others (64.44 ± 26.93% vs. 55.27 ± 25.35%; p = 0.02; those who selected individual talks-the knowledge of the disease symptoms was lower compared to the others (55.33 ± 24.80 vs. 61.68 ± 26.51; p = 0.007); those who selected group talks-the knowledge of the disease symptoms was higher compared to the others (62.30 ± 28.07 vs. 55.16 ± 24.96; p = 0.02). As far the other two areas of knowledge are concerned, there were no significant differences in any group. Conclusions. Educational brochures are the most preferred source of knowledge about ischaemic heart disease by hospitalised patients as a result of myocardial infarction. The knowledge of ischaemic heart disease in patients with myocardial infarction is inadequate and it is not connected with patients' preferences from the point of view of learning methods.

Pharmacological Reports, 2017

Background: Digoxin is the oldest drug used in the pharmacotherapy of heart failure (HF). However... more Background: Digoxin is the oldest drug used in the pharmacotherapy of heart failure (HF). However, digoxin remains an important therapeutic option for patients with persistent symptoms of HF occurring despite the implementation of standard pharmacotherapy. Digoxin concentration serum (SCD) should equal 1-2 ng/ml. The aim of our study was to measure of SCD among the hospitalized patients as well as to determine the selected factors influencing the concentration of the digoxin in the blood. Methods: The presented research was based on a retrospective analysis including 2149 patients treated with digoxin and hospitalized between 1980 and 2000. Was used for the determination of SCD automatic analyzer TDX ABBOTT GmbH-fluorescence polarization immunoassay (FPIA), with therapeutic range for digoxin of 0.8-2.0 ng/ml. Results: Average SCD result in the study population was located within the therapeutic range and amounted 1.06 ng/ml (55.7 % of patients). Statistically significant differences in digoxin level were observed depending on the way of medicine administration (p=0.000001) and the daily amount (p=0.001). Moreover, statistically significant differences in digoxin level were observed depending on sex (p=0.00002). Conclusions: An elevated level of digoxin was observed in the case of patients who received the medication both orally and intravenously, together with an increase in the daily amount of digoxin doses. It was confirmed that an elevated digoxin level occurs in the course of treatment in the case of women.

Trials, Jan 11, 2017

Hypercholesterolemia is one of the main risk factors for cardiovascular disease. The first line t... more Hypercholesterolemia is one of the main risk factors for cardiovascular disease. The first line treatment for hypercholesterolemia is statin therapy. When the expected low-density lipoprotein cholesterol (LDL-C) concentration is not achieved, the pharmacotherapy may be extended by combining the statin with the cholesterol absorption inhibitor ezetimibe. The study is designed as a randomized, open-label, single-center, crossover study evaluating the effectiveness of combined therapy with rosuvastatin and ezetimibe for hypercholesterolemia. The study is planned to include 200 patients with hypercholesterolemia ineffectively treated with statins for at least 6 weeks. After enrollment participants are randomized into one of two arms receiving rosuvastatin and ezetimibe. In the first arm the study drug is administered in the morning (8:00 am) for 6 weeks and then in the evening for the next 6 weeks; in the second arm the study drug is administered at first in the evening (8:00 pm) for th...

Medical Research Journal, 2016

Non-adherence rates to antiplatelet drugs in patients with acute myocardial infarction (AMI) rang... more Non-adherence rates to antiplatelet drugs in patients with acute myocardial infarction (AMI) range from 13% to 60%. We aimed to evaluate whether individual health education can improve adherence to treatment with clopidogrel in patients after AMI. This was a prospective, single-center, randomized clinical trial with a 12-month follow-up. Patients with AMI treated with percutaneous coronary intervention (PCI) were enrolled. The primary endpoint was defined as non-adherence to clopidogrel during follow-up (drug availability ≤ 80%). Secondary endpoints included platelet function assessment, adverse cardiovascular (CV) events (CV death, PCI for ACS, unscheduled CV hospitalization). There were 191 patients enrolled in the study and divided into two groups: the individual education (IE) group (100 patients) and the standard treatment (ST) group (91 patients). Adherence to the treatment with clopidogrel based on the data from the National Health Fund did not differ significantly between the IE and ST groups [76.7% (30.7-99.7%) v. 84.4% (46.5-99.7%); p = 0.25]. There was a substantial difference in the prevalence of unscheduled CV hospitalizations between both groups, IE and ST respectively [22 (22.0%) v. 10 (11.0%); p = 0.042]. The rate of CV death and ACS treated with PCI during follow-up was low and did not differ between groups. In conclusion, the program of individual health education did not improve adherence to treatment with clopidogrel. The expected benefits of medication are not achievable at current levels of adherence. The self-reported adherence assessment is unreliable and cannot be used for effective treatment guidance.

Medical Research Journal, 2015

Background. Many reports have demonstrated excessive variability in response to clopidogrel, the ... more Background. Many reports have demonstrated excessive variability in response to clopidogrel, the most commonly used P2Y12 receptor antagonist. Clopidogrel resistant patients are at increased risk of cardiovascular (CV) events. Prasugrel is a new P2Y12 inhibitor that provides greater and faster platelet inhibition and reduces CV events more effectively than clopidogrel. The aim of this study was to evaluate the variability and efficacy of prasugrel antiplatelet activity in patients presenting with acute coronary syndrome (ACS). Materials and methods. The study was designed as a prospective, single-center, non-randomized, observational trial. Platelet reactivity (PR) was assessed with the VeryfyNow assay three times during hospitalization in forty-two patients undergoing percutaneous coronary intervention (PCI) for ACS and treated with standard doses of prasugrel. Results. Platelet aggregation with prasugrel displayed relatively high variability. The platelet aggregation was lowest on the 3 rd day of the treatment at 4 p.m. and was significantly different from the measurements obtained on the 3 rd and 4 th day in the morning (6.0 v. 8.5 U; p = 0.0005 and 6.0 v. 36.5 U; p < 0.00001, respectively), with the latter two differing significantly from each other (p = 0.002). All participants were successfully treated with prasugrel achieving PR < 208 PRU in each measurement, whereas 42.9-80.9% (depending on sampling point) of patients presented very low platelet activity. The subgroups of stable and persistent low PR included a higher percentage of active smokers (73.3 v. 40.7%; p = 0.04 and 80.0 v. 43.8%; p = 0.04, respectively). Conclusions. Prasugrel treatment is associated with high variability of PR. Nonetheless, prasugrel is a highly effective antiplatelet drug. Active smoking may predispose to strong and stable on-prasugrel platelet inhibition.

Cardiology Journal

Journal of Clinical Medicine

Journal of Clinical Medicine, 2021

Medical Research Journal, 2021

Folia Cardiologica, 2017

Journal of Clinical Medicine, 2021

Cardiology Journal, 2021

Medical Research Journal, 2021

Medical Research Journal, 2018

Cardiology Journal, 2013

Medical Research Journal, 2018

Platelets, 2019

Catheterization and Cardiovascular Interventions, 2018

Patient preference and adherence, 2018

Medical Research Journal, 2017

Pharmacological Reports, 2017

Trials, Jan 11, 2017

Medical Research Journal, 2016

Medical Research Journal, 2015