Sławomir Dobrzycki - Academia.edu (original) (raw)

Papers by Sławomir Dobrzycki

Wstęp. Obecnie w społeczeństwach zamożnych i upr zemysłowionych, spadek aktywnościfizycznej oraz ... more Wstęp. Obecnie w społeczeństwach zamożnych i upr zemysłowionych, spadek aktywnościfizycznej oraz wzrost spożycia wysoko przetworzonych pokarmów i stosowanie diety bogatejw sól, wiąże się ze wzrostem zapadalności na choroby cywilizacy jne (otyłość, nadciśnienietętnicze, cukrzycę, chorobę wieńcową), co w konsekwencji powoduje wzrost występowaniaprzewlekłej niewydolności serca w tych społeczeństwach.Cel. Celem badania była analiza pacjentów z niewydolnością serca, ze szczególnym uwzględnieniemchorych na cukrzycę typu 2 kierowanych do Kliniki Kardiologii Inwazyjnej w Białymstokuw celu wykonania koronarografii.Materiał i metody. Do badania włączono 94 pacjentów z niewydolnością serca potwierdzonąw badaniu echokardiograficznym, określaną jako obniżenie frakcji wyrzutowej ≤ 40%.Wyniki. W grupie 94 pacjentów o średnim wieku 68,6 ± 9,27 roku, mężczyźni stanowili 78,7%(n = 74). Choroba wieńcowa występowała u 85.1% chorych (n = 80). Cukrzycę stwierdzonou 31,9% badanych. Pacjenci z cukr zycą ch...

Results of acute myocardial infarction treatment in patients transferred from community hospitals... more Results of acute myocardial infarction treatment in patients transferred from community hospitals for primary coronary angioplasty Introduction: Primary percutaneous transluminal coronary angioplasty (PTCA) is one of reperfusion strategies in acute myocardial infarction (AMI). There is not much data about the results of patients from community hospitals, transferred to refferal centre. The aim of the study to compare the results of primary PTCA in patients with AMI transferred from community hospitals, for PTCA and patients refered directly to the cath-lab.

Folia Cardiologica, 2002

Wstep: Pierwotna angioplastyka wiencowa (PTCA) jest jedną z metod leczenia reperfuzyjnego ostrego... more Wstep: Pierwotna angioplastyka wiencowa (PTCA) jest jedną z metod leczenia reperfuzyjnego ostrego zawalu serca (AMI). Zagadnienie potencjalnego wplywu plci na wyniki pierwotnej PTCA nie zostalo dotychczas jednoznacznie wyjaśnione. Celem niniejszego badania jest analiza porownawcza wynikow leczenia kobiet z AMI za pomocą pierwotnej PTCA. Material i metody: Analizą objeto 552 pacjentow (w wieku 26-78 lat) z AMI do 12 h od początku bolu, leczonych za pomocą pierwotnej PTCA. Grupe badaną stanowily 143 kobiety,grupe kontrolną - 409 mezczyzn. W obu grupach oceniano przeplyw w tetnicy dozawalowej przed zabiegiem, skutecznośc zabiegu oraz czestośc epizodow sercowo-naczyniowych w czasie obserwacji szpitalnej. Wyniki: Śmiertelnośc szpitalna nie roznila sie istotnie miedzy grupami. Wyniosla ona 4,9% w grupie badanej i 4,6% w grupie kontrolnej. Po wylączeniu z analizy chorych we wstrząsie kardiogennym śmiertelnośc szpitalna wyniosla 1,5% w grupie badanej i 2,0% w grupie kontrolnej (roznica niei...

Journal of Clinical Medicine, 2021

Over the next decades, the prevalence of atrial fibrillation (AF) is estimated to double. Our aim... more Over the next decades, the prevalence of atrial fibrillation (AF) is estimated to double. Our aim was to investigate the causes of the long-term mortality in relation to the diagnosis of atrial fibrillation (AF) and chronic coronary syndrome (CCS). The analysed population consisted of 7367 consecutive patients referred for elective coronary angiography enrolled in a large single-centre retrospective registry, out of whom 1484 had AF and 2881 were diagnosed with obstructive CCS. During follow-up (median = 2029 days), 1201 patients died. The highest all-cause death was seen in AF(+)/CCS(+) [194/527; 36.8%], followed by AF(+)/CCS(−) [210/957; 21.9%], AF(−)/CCS(+) [(459/2354; 19.5%)] subgroups. AF ([HR]AC = 1.48, 95%CI, 1.09–2.01; HRCV = 1.34, 95%CI, 1.07–1.68) and obstructive CCS (HRAC = 1.90, 95%CI, 1.56–2.31; HRCV = 2.27, 95%CI, 1.94–2.65) together with age, male gender, heart failure, obstructive pulmonary disease, diabetes were predictors of both all-cause and CV mortality. The mai...

PLOS ONE, 2021

Background Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary art... more Background Data regarding the clinical outcomes of covered stents (CSs) used to seal coronary artery perforations (CAPs) in the all-comer population are scarce. The aim of the CRACK Registry was to evaluate the procedural, 30-days and 1-year outcomes after CAP treated by CS implantation. Methods This multicenter all-comer registry included data of consecutive patients with CAP treated by CS implantation. The primary endpoint was the composite of major adverse cardiac events (MACEs), defined as cardiac death, target lesion revascularization (TLR), and myocardial infarction (MI). Results The registry included 119 patients (mean age: 68.9 ± 9.7 years, 55.5% men). Acute coronary syndrome, including: unstable angina 21 (17.6%), NSTEMI 26 (21.8%), and STEMI 26 (21.8%), was the presenting diagnosis in 61.3%, and chronic coronary syndromes in 38.7% of patients. The most common lesion type, according to ACC/AHA classification, was type C lesion in 47 (39.5%) of cases. A total of 52 patients ...

Renal Failure, 2020

Introduction: Coexistence of chronic kidney disease (CKD) in the case of acute coronary syndromes... more Introduction: Coexistence of chronic kidney disease (CKD) in the case of acute coronary syndromes (ACS) significantly worsens the outcomes. Aim: The aim of our study was to assess renal function impact on mortality among patients with ACS. Materials and methods: The study was based on records of 21,985 patients hospitalized in the Medical University of Bialystok in 2009-2015. Inclusion criteria were ACS. Exclusion criteria were: death within 24 h of admission, eGFR <15 ml/min/1.73 m 2 , hemodialysis. Mean observation time was 2296 days. Results: Criteria were met by 2213 patients. CKD occurred in 24.1% (N ¼ 533) and more often affected those with NSTEMI (26.2 (337) vs. 21.2 (196), p ¼ .006). STEMI patients had higher incidence of post-contrast acute kidney injury (PC-AKI) (5 (46) vs. 4.1 (53), p < .001). During the study, 705 people died (31.9%), more often with NSTEMI (33.2% (428) vs. 29.95% (277), p < .001). However, from a group of patients suffering from PC-AKI 57.6% died. The risk of PC-AKI increased with creatinine concentration (RR: 2.990, 95%CI: 1.567-5.721, p < .001), occurrence of diabetes mellitus (RR: 2.143, 95%CI: 1.029-4.463, p ¼ .042), atrial fibrillation (RR: 2.289, 95%CI: 1.056-4.959, p ¼ .036). Risk of death was greater with an increase in postprocedural creatinine concentration (RR: 2.254, 95%CI: 1.481-3.424, p < .001). Conclusion: PC-AKI is a major complication in patients with ACS, occurs more frequently in STEMI and may be a prognostic marker of long-term mortality in patients undergoing percutaneous coronary intervention (PCI). More attention should be given to the prevention and diagnosis of PC-AKI but necessary PCI should not be withheld in fear of PC-AKI.

Journal of Clinical Medicine, 2020

The relationship between periprocedural complications and the type of vascular access in patients... more The relationship between periprocedural complications and the type of vascular access in patients with prior history of coronary artery bypass grafting (CABG) and treated with percutaneous coronary interventions (PCIs) is less investigated than in the overall group of patients treated with PCI. The aim of the current study was to assess the relationship between the type of vascular access and selected periprocedural complications in a group of patients with prior history of CABG and treated with PCIs. Based on a Polish nationwide registry of interventional cardiology procedures called ORPKI, the authors analyzed 536,826 patients treated with PCI between 2014 and 2018. The authors extracted 32,225 cases with prior history of CABG. Then, patients with femoral and radial access as well as right and left radial access were compared. This comparison was proceeded by propensity score matching (PSM). After PSM, a multifactorial analysis revealed that patients treated with PCI from femoral ...

Advances in Interventional Cardiology, 2019

Introduction: The availability of rotational atherectomy (RA) has recently increased in Poland, w... more Introduction: The availability of rotational atherectomy (RA) has recently increased in Poland, which was followed by an increase in the rate of RA procedures and catheterization laboratories performing RA. Aim: To assess current trends regarding the rapid increase in the number of RA procedures and catheterization laboratories performing RA. Material an methods: We analyzed patients treated with percutaneous coronary intervention (PCI) in the years 2014-2017 available in the nationwide ORPKI dataset. From the overall 431,467 patients treated with PCI, we extracted 1,873 treated with RA. We analyzed the relationship between frequency of RA usage, its distribution between low and high volume centers and procedural outcomes, procedural-related complications and the PCI effectiveness expressed as the target vessel patency rate after PCI. Results: The number of RA procedures increased from 181 in 2014 (0.19%) to 698 in 2017 (0.61%), with an over twofold increase in the number of catheterization laboratories performing RA from 25 (15.5%) in 2014 to 55 (34.1%) in 2017. Besides the fact that patient characteristics have changed in the most recent years, the rate of procedural success expressed as procedure-related complications remained stable in the 3 years 2015-2017 and was around 3%, while the procedural effectiveness expressed as patent target coronary artery after PCI was stable and over 98% in all of the analyzed years. Conclusions: Along with the increasing number of RA procedures and catheterization laboratories performing RA in Poland, the procedural effectiveness remained stable during an observational period of 4 years.

Arterial Hypertension, 2006

Background Hypertension is one of the cardiovascular disease (CVD) risk factors and is present in... more Background Hypertension is one of the cardiovascular disease (CVD) risk factors and is present in approximately 70-85% of patients with chronic renal failure. Contrast nephropathy is a potentially serious complication of diagnostic coronarography in patients with chronic kidney disease (CKD). The current K/DOQI guidelines advocate creatinine-based equations for estimating GFR to identify patients with potential CKD and to classify them into different stages on the basis of these values. Material and methods Assessement of prevalence of CKD using estimating GRF according to MDRD, Cockroft-Gault and Jeliffe formulas in 549 normotensive and 588 hypertensive patients with normal serum creatinine undergoing percutaneous coronary interventions due to ischemic heart disease. Results In the group of normotensives with normal serum creatinine according to Cockcroft-Gault stage 2 CKD i.e. GRF 60-89 ml/min was found in 46.60% and stage 3 CKD i.e. GRF 30-59 ml/min was found in 26.53% of patients. According to MDRD stage 2 was found in 48.64% and stage 3 in 6.46% of patients. According to Jeliffe formula stage 2 was found in 55.27%, stage 3 in 21.3% of patients. In the group of hypertensives according to Cockcroft-Gault stage 2 CKD was found in 47.13%, stage 3 in 20.56% of patients. According to MDRD stage 2 was found in 48.46%, stage 3-in 7.47% of patients. According to Jeliffe formula stage 2 was found in 53.67%, stage 3-in 20.56% of patients. Prevalence of CKD was similar between normotensives and hypertensives. Hypertensives were more likely to be dyslipidemic. Conclusions The prevalence of CKD is high (over 50%) in normotensives and hypertensives undergoing coronarography despite normal creatinine. The risk of contrast nephropathy is enhanced in these patients, therefore GRF should be estimated. It is an inexpensive, reliable and widely available method.

Forum Zaburzen Metabolicznych, 2013

Cukrzyca w niewydolności serca Diabetes in heart failure StreSzczenie Wstęp. Obecnie w społeczeńs... more Cukrzyca w niewydolności serca Diabetes in heart failure StreSzczenie Wstęp. Obecnie w społeczeństwach zamożnych i uprzemysłowionych, spadek aktywności fizycznej oraz wzrost spożycia wysoko przetworzonych pokarmów i stosowanie diety bogatej w sól, wiąże się ze wzrostem zapadalności na choroby cywilizacyjne (otyłość, nadciśnienie tętnicze, cukrzycę, chorobę wieńcową), co w konsekwencji powoduje wzrost występowania przewlekłej niewydolności serca w tych społeczeństwach. Cel. Celem badania była analiza pacjentów z niewydolnością serca, ze szczególnym uwzględnieniem chorych na cukrzycę typu 2 kierowanych do Kliniki Kardiologii Inwazyjnej w Białymstoku w celu wykonania koronarografii. Materiał i metody. Do badania włączono 94 pacjentów z niewydolnością serca potwierdzoną w badaniu echokardiograficznym, określaną jako obniżenie frakcji wyrzutowej ≤ 40%. Wyniki. W grupie 94 pacjentów o średnim wieku 68,6 ± 9,27 roku, mężczyźni stanowili 78,7% (n = 74). Choroba wieńcowa występowała u 85.1% chorych (n = 80). Cukrzycę stwierdzono u 31,9% badanych. Pacjenci z cukrzycą charakteryzowali się większym wskaźnikiem masy ciała, dyslipidemią, częstszym występowaniem nadciśnienia tętniczego, wyższym stężeniem glukozy przy przyjęciu w porównaniu z pacjentami bez cukrzycy. Zwracało uwagę, mimo ciężkiej niewydolności serca, dobre wyrównanie cukrzycy (HbA 1C > 6,4%). W badaniu echokardiograficznym różnice dotyczyły grubości tylnej ściany lewej komory. Leczenie było zbliżone w obu grupach poza antagonistami wapnia, które przyjmował większy odsetek pacjentów z cukrzycą. Wnioski. W badanej grupie pacjentów z niewydolnością serca, aż 31,9% chorowało na cukrzycę typu 2. Populacja chorych na cukrzycę typu 2 charakteryzowała się istotnym statystycznie wyższym stężeniem triglicerydów, glikemii oraz większą grubością tylnej ściany lewej komory i wyższym wskaźnikiem masy ciała. Pacjenci z niewydolnością serca chorujący na cukrzycę potrzebują kompleksowego i nowoczesnego leczenia.

Genome Medicine, 2015

Background: Heart failure (HF) is the most common cause of morbidity and mortality in developed c... more Background: Heart failure (HF) is the most common cause of morbidity and mortality in developed countries. Here, we identify biologically relevant transcripts that are significantly altered in the early phase of myocardial infarction and are associated with the development of post-myocardial infarction HF. Methods: We collected peripheral blood samples from patients with ST-segment elevation myocardial infarction (STEMI): n = 111 and n = 41 patients from the study and validation groups, respectively. Control groups comprised patients with a stable coronary artery disease and without a history of myocardial infarction. Based on plasma NT-proBNP level and left ventricular ejection fraction parameters the STEMI patients were divided into HF and non-HF groups. Microarrays were used to analyze mRNA levels in peripheral blood mononuclear cells (PBMCs) isolated from the study group at four time points and control group. Microarray results were validated by RT-qPCR using whole blood RNA from the validation group. Results: Samples from the first three time points (admission, discharge, and 1 month after AMI) were compared with the samples from the same patients collected 6 months after AMI (stable phase) and with the control group. The greatest differences in transcriptional profiles were observed on admission and they gradually stabilized during the follow-up. We have also identified a set of genes the expression of which on the first day of STEMI differed significantly between patients who developed HF after 6 months of observation and those who did not. RNASE1, FMN1, and JDP2 were selected for further analysis and their early up-regulation was confirmed in HF patients from both the study and validation groups. Significant correlations were found between expression levels of these biomarkers and clinical parameters. The receiver operating characteristic (ROC) curves indicated a good prognostic value of the genes chosen. Conclusions: This study demonstrates an altered gene expression profile in PBMCs during acute myocardial infarction and through the follow-up. The identified gene expression changes at the early phase of STEMI that differentiated the patients who developed HF from those who did not could serve as a convenient tool contributing to the prognosis of heart failure.

Journal of the American College of Cardiology, 2014

, respectively. At 4-months rates of TLF (2.1% vs 4.0%; p¼0.44), TVF (2.1% vs 4.0%; p¼0.44) and s... more , respectively. At 4-months rates of TLF (2.1% vs 4.0%; p¼0.44), TVF (2.1% vs 4.0%; p¼0.44) and stent thrombosis (0.0% vs 1.0%; p¼0.33) were low and similar in Ultimaster and Xience arms respectively. The 9-month primary outcome details will be provided at presentation. Conclusions: The short term clinical outcomes in bifurcations with the new Ultimaster DES shows potential. The planned 5-year follow-up of patients will allow more clear assessment.

Kidney and Blood Pressure Research, 2014

Background/Aims: There are no data concerning renal function in population with valvular and non-... more Background/Aims: There are no data concerning renal function in population with valvular and non-valvular atrial fibrillation (AF). To assess renal function in patients with AF, the association between eGFR and AF perpetuation, in-hospital mortality. Methods: We studied 1523 patients with AF. Patients with chronic kidney disease (CKD) were compared to population with preserved renal function. Results: CKD was more frequently observed in patients with valvular AF(p=0.009). In non-valvular AF patients eGFR <60ml/min./1,73m2 had more often permanent AF(p<0.0001). In patients with CKD CHA2DS2VASc score was 4.1±1.5 and HAS-BLED score was 2.1±1.2 and it was higher as compared to population with preserved renal function (p<0.0001 vs p<0.0001). The odds of permanent AF in patients with non-valvular AF and CKD were increased 1.82 times(OR=1.82,p<0.0001,95%CI:1.46-2.27). The odds of permanent AF in patients with valvular AF and CKD were not significantly increased(OR=1.46,p=0.2...

Advances in Interventional Cardiology, 2011

A case of an 85-year-old patient with unstable coronary heart disease treated with complex percut... more A case of an 85-year-old patient with unstable coronary heart disease treated with complex percutaneous coronary intervention of the left main coronary artery, left anterior descending artery and circumflex artery with rotablation and implantation of three drugeluting stents (Rota-DES technique) is presented.

Folia Cardiologica …, 2004

Wstêp: Obecnie uwa¿ a siê pierwotn±angioplastykê wieñcow±(PCI) za metodê lepsz±od fibrynolizy w l... more Wstêp: Obecnie uwa¿ a siê pierwotn±angioplastykê wieñcow±(PCI) za metodê lepsz±od fibrynolizy w leczeniu ostrego zawa³u serca z uniesieniem odcinka ST. Nie ustalono jednoznacznie, czy dla pacjentów przyjêtych do o¶ rodków rejonowych niedysponuj±cych ...

Journal of the American College of Cardiology, 2012

Results: Bifurcation lesion characteristics and DES use were similar in all groups. Patients unde... more Results: Bifurcation lesion characteristics and DES use were similar in all groups. Patients undergoing CU stenting had a higher side branch stent diameter when compared to the TS and CR groups (Table). Over a mean follow up of 63 months, the TLR rate (Figure) was lowest in the CU group (CU-2.1% vs TS-4.3% vs CR-16.2%; log rank p ϭ 0.033). Conclusions: Despite CR being used more commonly than CU and TS techniques, the CU technique is associated with lower long-term TLR rates. Anatomical factors such as SB diameter may play a role in the choice of the technique used.