Polskie Archiwum Medycyny Wewnętrznej
-
Pol. Arch. Med. Wewn. · Jun 2024
Endothelial function in patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors is not related to cardiovascular risk assessed by SCORE2 algorithm.
Tyrosine kinase inhibitors (TKIs) revolutionized treatment of chronic myeloid leukemia (CML), but are endowed with negative effects on endothelial function. ⋯ Endothelial function in CML patients treated with TKIs was not related to cardiovascular risk based on SCORE2/SCORE2‑OP algorithms but correlated with CML‑specific factors, including duration of TKI treatment. FMSF‑based assessment of skin microcirculation was a sensitive method for detecting the vascular effects of TKIs.
-
Pol. Arch. Med. Wewn. · Jun 2024
Indirect impact of the war in Ukraine on primary percutaneous coronary interventions for ST-elevation myocardial infarction in Poland.
The Russian invasion of Ukraine in February 2022 resulted in displacement of approximately 12.5 million refugees to adjacent countries, including Poland, which may have strained health care service delivery. ⋯ Following the Russian invasion of Ukraine, there was only a modest and temporary increase in the number of primary PCIs, predominantly in the centers situated within 100 km of the Polish-Ukrainian border, although no significant impact on in‑hospital fatality rate was found.
-
Pol. Arch. Med. Wewn. · Jun 2024
ReviewTherapeutic strategies in preclinical stages of rheumatoid arthritis.
Modern therapies and treatment algorithms, such as the treat‑to‑target strategy, have significantly improved outcomes in patients with rheumatoid arthritis (RA) over the past decades. Moreover, the concept of the "window of opportunity" has led to earlier diagnosis and better treatment outcomes. ⋯ The initiation of treatment in preclinical phases of RA is expected to delay, halt, or even prevent the disease onset or progression in the long term. This review summarizes this new concept, discusses current studies including an overview of therapeutic algorithms and findings, and provides a critical evaluation of pharmacologic approach in the preclinical stages of RA.
-
Pol. Arch. Med. Wewn. · Jun 2024
A systematic screening and heart team approach contributes to unravel novel risk factors in revascularisation candidates of complex coronary artery disease: a machine learning approach.
The baseline characteristics affecting mortality following percutaneous or surgical revascularization in patients with left main and / or 3‑vessel coronary artery disease (CAD) observed in real‑world practice differ from those established in randomized controlled trials (RCTs) due to the constraints of inclusion / exclusion criteria. ⋯ A machine learning approach improved the detection of registry‑specific risk factors in all‑comer patients amenable to surgical or percutaneous revascularization who were evaluated by a heart team. The risk factors identified in RCTs are not necessarily the same as those detected in real clinical practice when systematic screening is applied.