Kardiol Pol
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To develop a global cardiovascular disease (CVD) mortality risk model for the Polish population and to verify these data in the context of the SCORE risk algorithm. ⋯ 1. Long-term follow-up of WOBASZ and WOBASZ Senior study participants allowed assessment of the inde-pendent association of the evaluated cardiovascular risk factors with CVD mortality in the Polish population. 2. Validation of the SCORE risk algorithm to estimate individual global CVD risk in the Polish population showed a high predictive value of this algorithm.
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The chain of survival is a set of most important factors affecting survival after an out-of-hospital cardiac arrest (OHCA). Recognising the difficulties in applying the chain is the key to improving outcomes. Early return of spontaneous circulation (ROSC) after a cardiac arrest is a fundamental factor for patient survival. ⋯ No significant relation was found between the location of OHCA and ROSC despite the fact that the time to ambulance arrival was significantly shorter in urban areas. In rural areas, resuscitation was more frequently initiated by the event witnesses. Both in urban and rural areas, OHCA was most commonly due to cardiac causes, and the initial recorded cardiac rhythm was a non-shockable one.
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Patients suffering from cardiogenic shock, with no response to conventional therapy, may significantly improve when put on support devices such as extracorporeal membrane oxygenation (ECMO), which maintains systemic and pulmonary circulation, and decongests the heart. This publication presents authors' own experience in qualifying and treating patients with cardiogenic shock, with the use of veno-arterial (VA) ECMO modality. ⋯ VA ECMO is an acceptable therapy for patients in a severe state of cardiogenic shock. In-hospital mortality rate was 59%, and 41% patients (12 subjects) were successfully treated with VA ECMO in course of cardiogenic shock.
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Coronary artery disease (CAD) in young adults under 40 years of age is a growing medical, social, psychological and economical problem, related to the prevalence of civilization-related diseases and unhealthy lifestyle. The problem of CAD in young people has not been characterised as well as in older individuals, as the available data mostly come from case reports and small series, often related to genetic aspects and familial occurrence of the disease. ⋯ The population of young patients with CAD is predominantly male, rural, and characterised by a low socio-economic status. The aetiology of CAD in this patient group differs significantly from that in older patients and it is often associated with an unhealthy lifestyle related to rapid civilization changes. The rates of CAD risk factors in young adults are high and the most important risk factors are dyslipidaemia, smoking, and overweight/obesity. Single vessel disease and STEMI presentation were predominant in young patients. Short-term prognosis in young ACS patients is excellent, but long-term prognosis is significantly worse. Further studies on CAD in young adults are warranted, particularly in larger patient populations.