Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Feb 2022
Multicenter StudyTranscatheter aortic valve-in-valve implantation for failed surgical bioprostheses: results from Polish Transcatheter Aortic Valve-in-Valve Implantation (ViV-TAVI) Registry.
Transcatheter aortic valve‑in ‑valve implantation (ViV‑TAVI) has emerged as an alternative to redo surgery in patients with failed surgical aortic bioprosthesis. ⋯ Transcatheter treatment of failed bioprostheses is increasingly common, with the best hemodynamic effect shown for supra ‑annular valves. The introduction of second‑generation valves has improved procedural and clinical outcomes.
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Pol. Arch. Med. Wewn. · Feb 2022
ReviewAspirin‑induced asthma: a still evolving area of basic and clinical research.
The first modern description of respiratory syndrome of aspirin hypersensitivity was published over half of the century ago, but the pathogenesis of the disease is still elusive. Just a few years after discovery how aspirin works, Andrew Szczeklik and his co‑workers described that asthmatics with aspirin hypersensitivity cross‑react to the whole class of nonsteroidal anti‑inflammatory drugs. It took rest of his life to seek for an answer on how this disease, nowadays referred to as N ‑ERD, develops and how it can be treated. ⋯ Involvement of blood platelets and recently described mucosal basophils are areas of ongoing studies in the disease. Aspirin hypersensitivity is an acquired condition; therefore, the search for genetic predisposition using classic association studies was inconclusive. There is a new hope to explain mechanisms of aspirin hypersensitivity by studies of innate lymphoid cells, which have a central role in the regulation of respiratory mucosa function in asthma.
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Pol. Arch. Med. Wewn. · Feb 2022
Predictors of one-year mortality in ambulatory patients with advanced heart failure awaiting heart transplantation.
Heart failure (HF) is a complex syndrome involving diverse pathways and pathological processes that can manifest themselves in circulation as abnormal levels of various biomarkers. ⋯ Our study showed that higher serum hs ‑CRP, NT‑proBNP, and procalcitonin levels and lower serum sodium levels were independent risk factors for death during a 1‑year follow‑up in patients with advanced HF. Procalcitonin showed the strongest predictive power, sensitivity, and specificity, allowing for an effective identification of 1‑year survivors and nonsurvivors awaiting heart transplant.
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Pol. Arch. Med. Wewn. · Feb 2022
ReviewStatins in prevention of thromboembolic events: from seminal studies to recent advances.
Statins, 3‑hydroxy‑methylglutaryl coenzyme A reductase inhibitors, reduce the rate of cardiovascular events in primary and secondary prevention, and represent a cornerstone in the management of atherosclerotic vascular disease. Statins were also shown to be effective in lowering the risk of venous thromboembolism (VTE) in its primary and secondary prevention, but their use in VTE prophylaxis is still not approved and recommended in current guidelines. Several antithrombotic mechanisms of these cholesterol‑lowering agents, largely independent of the magnitude of low‑ density lipoprotein cholesterol reduction, were demonstrated in a broad spectrum of experimental in vitro and in vivo models. ⋯ Anticoagulant properties of statins, reported for the first time 25 years ago, involve downregulation of tissue factor expression with a subsequent decreased thrombin generation and inhibition of thrombin‑mediated reactions, including factor V and factor XIII activation, and enhanced endothelial thrombomodulin expression resulting in increased protein C activation. Enhanced fibrinolysis was also reported partly as a result of reduced activity of fibrinolysis inhibitors such as plasminogen activator inhibitor‑1 (PAI‑1) and thrombin‑activatable fibrinolysis inhibitor. This review summarizes the findings of the studies from the 1990s until the most recent reports to update our knowledge on the impact of statins on blood coagulation and its potential clinical relevance.