Publications by authors named "Filip M Szymanski"

84 Publications

Prevalence of lower urinary tract symptoms in patients with cardiovascular disease.

Cent European J Urol 2021 10;74(2):190-195. Epub 2021 Apr 10.

Faculty of Medicine, Cardinal Stefan Wyszyński University in Warsaw, Poland.

Introduction: The presence of lower urinary tract symptoms (LUTS) might be linked with elevated cardiovascular risk. There is a lack of data showing the prevalence of LUTS in the population of patients with cardiovascular diseases. The current study aimed to determine the prevalence of LUTS in patients hospitalized due to a cardiovascular disease.

Material And Methods: Patients hospitalized in a tertiary cardiology department due to a primary diagnosis of cardiovascular disease (including coronary artery disease, heart failure and arrhythmia) were included in the study. All patients were screened for LUTS and assessed using the International Prostate Symptoms Score (IPSS).

Results: From 166 patients (age 62.8 ±12.1 years), moderate to severe LUTS was diagnosed in 62 patients (37.3%). Patients with LUTS were significantly older, but there were no other factors associated with LUTS. When we divided patients according to LUTS severity, we saw an increasing prevalence of arterial hypertension (69.5% vs 72.9% vs 100%), diabetes mellitus (29.5% vs 33.3% vs 38.5%), coronary artery disease (68.6% vs 72.9% vs 92.3%), but the observations were not statistically significant. Patients with coronary artery disease had significantly higher severity of LUTS compared to patients with arrhythmia or heart failure (mean IPSS 8.88 vs 5.6 vs 5.5, p = 0.004).

Conclusions: The prevalence of LUTS in patients with cardiovascular diseases is high, affecting 37.3% of the studied population. Patients with coronary artery disease have significantly higher severity of LUTS compared to other cardiovascular diseases.
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http://dx.doi.org/10.5173/ceju.2021.0370.R1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318018PMC
April 2021

"Health outcomes in COPD smokers using heated tobacco products: a 3‑year follow‑up: comment".

Intern Emerg Med 2021 11 13;16(8):2331-2333. Epub 2021 May 13.

Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.

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http://dx.doi.org/10.1007/s11739-021-02753-5DOI Listing
November 2021

Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?

Curr Probl Cardiol 2020 Sep 12;45(9):100645. Epub 2020 Jun 12.

COVID-19 pandemic changed the current state of healthcare, especially in terms of reorganization of resources. Chief complaints of patients admitted to hospitals changed drastically in the proceeding months, which worsened the treatment of many acute and chronic conditions involving cardiovascular system pathologies and resources were moved in order to fight COVID-19. Moreover, the pandemic had long-term effects not only on healthcare but also national security on global scale. The COVID-19 drastically changed perception of global health and safety, trust in healthcare professionals as well as patients' willingness to seek medical help. The long-term effect of the epidemic, in terms of its impact cardiovascular disease progression and prognosis remain to be observed. The current paper discusses the impact of COVID-19 on healthcare and national security based on the currently available data.
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http://dx.doi.org/10.1016/j.cpcardiol.2020.100645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291989PMC
September 2020

Usefulness of the 2MACE score as a predictor of long-term all-cause mortality in patients with atrial fibrillation.

Pol Arch Intern Med 2020 08 15;130(7-8):635-639. Epub 2020 Jun 15.

Department of Heart Diseases, Medical Centre of Postgraduate Education, Warsaw, Poland

Introduction: 2MACE is a risk assessment score designed to stratify cardiovascular risk in patients with atrial fibrillation (AF). Early detection of increased cardiovascular risk is of vital importance in this population, as it helps reduce mortality and morbidity rates.

Objectives: This study aimed to assess the utility of the 2MACE score in predicting long‑term mortality in patients with AF.

Patients And Methods: This was a post hoc analysis of a prospective observational cohort study including consecutive patients with nonvalvular AF, who were followed for a median duration of 81 months.

Results: The final analysis included 1351 patients (men, 53.1%; median [interquartile range] age, 71 [62-80] years). During the follow‑up, 142 patients (10.5%) died. Deceased patients were more often classified as high risk according to the 2MACE score than survivors (80.3% vs 53.2%; P <0.0001). The receiver operator characteristic curve analysis demonstrated that the 2MACE score had a good predictive value for long‑ term all cause mortality (area under the curve, 0.73; 95% CI, 0.69-0.78). The mortality rate was significantly increased in patients with a 2MACE score of 3 or higher (hazard ratio, 3.40; 95% CI, 2.33-5.49).

Conclusions: The 2MACE score is a good predictor of long‑ term all cause mortality in patients with AF. A progressive increase in the mortality rate was observed with an increasing 2MACE score.
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http://dx.doi.org/10.20452/pamw.15431DOI Listing
August 2020

Co-treatment of lower urinary tract symptoms and cardiovascular disease - where do we stand?

Cent European J Urol 2020 23;73(1):42-45. Epub 2020 Mar 23.

1 Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Introduction: The relationship between cardiovascular disease (CVD) and lower urinary tract symptoms (LUTS) is well established. A healthy lifestyle with a good quality diet and regular physical activity is important for reducing the severity of LUTS.

Material And Methods: A literature search was performed on the subject of association between LUTS and cardiovascular risk.

Results: The recent data indicates that therapy for cardiovascular risk reduction might also reduce the severity of LUTS (e.g. statins reduce the risk of benign prostatic hyperplasia [BPH] and slow down the progression of LUTS in patients with hyperlipidaemia). Hypertensive patients treated with angiotensin II receptor blockers have a lower severity of LUTS. This paper shortly discusses the relationship between the occurrence of LUTS and CVD and the potential clinical implications regarding the management of the patients.

Conclusions: Patients with lower urinary tract symptoms require a holistic approach and cooperation of a urologist and cardiologist to diagnose concomitant cardiovascular diseases as early as possible and implement appropriate treatment. Antihypertensive, antithrombotic, hypolipemic therapies and healthy lifestyles reduce not only cardiovascular mortality, but also might reduce the severity of LUTS.
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http://dx.doi.org/10.5173/ceju.2020.0029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203768PMC
March 2020

History of Lyme Disease as a Predictor of Atrial Fibrillation.

Am J Cardiol 2020 06 13;125(11):1651-1654. Epub 2020 Mar 13.

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

In many cases, atrial fibrillation (AF) is associated with a history of cardiac inflammation. One of the potential pathogens responsible for atrial inflammation might be Borrelia burgdorferi - a pathogen involved in Lyme carditis. This study aimed to assess whether the serological history of Borrelia infection was associated with the risk of AF. The study included 113 AF patients and 109 patients in sinus rhythm. All patients underwent a clinical evaluation, echocardiography and had their blood taken for the assessment of anti-Borrelia IgG antibodies. Patients with AF compared with the non-AF group had more often serological signs of Borrelia infection (34.5% vs 6.4%; p <0.0001). The multivariate analysis showed that positive results for anti-Borrelia IgG antibodies were a strong independent predictor of AF (odds ratio 8.21; 95% confidence interval 3.08 to 21.88; p < 0.0001). In conclusion, presented data show that exposure to Borrelia spp. infection is associated with an increased risk of AF. Whether the early treatment of Lyme disease lowers the risk of AF development remains to be explored.
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http://dx.doi.org/10.1016/j.amjcard.2020.03.003DOI Listing
June 2020

Acute Myocardial Infarction Due to Antiphospholipid Syndrome - Case Report and Review of the Literature.

Curr Probl Cardiol 2021 Mar 20;46(3):100552. Epub 2020 Feb 20.

We present a case of acute myocardial infarction secondary to arterial thromboembolism in a 25-year-old man with systemic lupus erythematosus and antiphospholipid syndrome (APS). To our knowledge, based on the literature review, this patient is the youngest one with the acute coronary syndrome as a complication of APS. Acute myocardial infarction secondary to arterial thromboembolism is a rare presentation of APS. There are different recommended anticoagulation strategies in APS patients according to the presence of thrombosis of arterial or venous origin. Potential difficulties in the treatment may occur based on the clinical scenarios. A large number of APS patients require lifelong oral anticoagulation with vitamin K antagonists. Some non-vitamin K oral anticoagulants are being studied as drugs potentially useful in APS treatment. The recent studies suggest the role of aGAPSS score in assessing the risk of a recurrent thrombotic event as well as acute myocardial infarction in APS patients.
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http://dx.doi.org/10.1016/j.cpcardiol.2020.100552DOI Listing
March 2021

Visfatin as a predictor of obstructive sleep apnea in atrial fibrillation patients.

Sleep Breath 2020 Sep 13;24(3):1215-1218. Epub 2020 Mar 13.

Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background: Obstructive sleep apnea (OSA) often coexists with atrial fibrillation (AF) and makes the course of AF worse. The negative impact of OSA on AF may be due to atrial stretch, hypoxia, hypertension, obesity, fibrosis, and inflammation. Several mediators are thought to be responsible for this correlation, among them adipokines such as visfatin. This study aimed to assess the association between visfatin concentrations and OSA in patients with AF.

Aims: This study aimed to assess the association between visfatin concentrations and OSA in AF patients.

Methods: In a tertiary Cardiology Department, hospitalized patients previously diagnosed with AF were enrolled in the study. Diagnosis of OSA was made based on a respiratory polygraphy and patients had blood samples taken for assessment of plasma visfatin concentration.

Results: A total of 266 patients with AF (65% men, age 57.6 ± 10.1) were enrolled, and 121 (45%) were diagnosed with OSA. Patients with OSA had higher visfatin concentrations than those without OSA (2.13 ± 0.17 vs. 1.70 ± 0.21 ng/mL; p = 0.04). Patients with mild OSA had visfatin levels equal to 1.77 ± 0.17 ng/mL, moderate OSA 2.38 ± 0.18 ng/mL, and severe OSA 3.55 ± 0.61 ng/mL (p for trend = 0.017). Multivariate regression analysis showed that increased visfatin concentrations were associated with the risk of OSA (odds ratio 1.92; 95% confidence interval 1.09-3.40).

Conclusions: Patients with AF who were diagnosed with OSA had significantly higher plasma visfatin levels which increased according to the severity of OSA. Furthermore, multivariate regression analysis identified visfatin concentration over 1.25 ng/mL, male sex, age over 59.1 years, and permanent AF as the factors showing independent correlation with OSA.
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http://dx.doi.org/10.1007/s11325-020-02025-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426319PMC
September 2020

Management of bleeding in patients hospitalized in the intensive cardiac care unit: expert opinion of the Association of Intensive Cardiac Care and Section of Cardiovascular Pharmacotherapy of the Polish Cardiac Society in cooperation with specialists in other fields of medicine.

Kardiol Pol 2019 Dec 9;77(12):1206-1229. Epub 2019 Dec 9.

Intensive Cardiac Therapy Clinic, Institute of Cardiology, Warsaw, Poland

Nowadays, the intensive cardiac care unit (ICCU) provides care for patients with acute coronary syndrome, acute and exacerbated chronic heart failure, cardiogenic shock, sudden cardiac arrest, electrical storm, as well as with indications for urgent cardiac surgical treatment. Most of these patients require the use of 1, 2, or frequently even 3 drugs that act on the blood coagulation pathway. While antithrombotic drugs prevent thromboembolic events, they are associated with a higher risk of bleeding. In this population of patients, bleeding may often have a worse impact on prognosis than the primary disease. In this expert opinion of the Association of Intensive Cardiac Care, we presented practical guidelines on the management of bleeding in patients hospitalized at the ICCU, including bleeding risk reduction and treatment recommendations. Because of multiple comorbidities and diverse organs that may be the source of bleeding, we provided also recommendations from specialists in other fields of medicine. We hope that this document will facilitate the management of one of the most challenging populations at the ICCU.
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http://dx.doi.org/10.33963/KP.15097DOI Listing
December 2019

Usefulness of Visfatin as a Predictor of Atrial Fibrillation Recurrence After Ablation Procedure.

Am J Cardiol 2020 02 7;125(3):415-419. Epub 2019 Nov 7.

1(st) Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Visfatin is an adipokine produced by visceral fat tissue and takes part in fibrosis and inflammatory response. In the heart muscle, it is connected with the progression of atherosclerosis. Currently, there is no data on how visfatin affects atrial fibrillation (AF) onset. The study aimed to establish if baseline visfatin levels are connected with the risk of arrhythmia recurrence after AF ablation. In this prospective, long-term, observational study, we enrolled 290 consecutive patients admitted for AF ablation. All patients were screened for cardiovascular risk factors and had blood serum taken to measure visfatin concentrations before the ablation procedure. The end point of the study was a recurrence of the AF, defined as at least one AF episode of at any moment during the follow-up period. The screening included AF of at least 30 second duration assessed with electrocardiogram (ECG) monitoring, including 24-hour ECG Holter monitoring, implantable pacemakers, implantable defibrillators, or subcutaneous ECG monitoring devices. After excluding patients disqualified from the procedure the study population consisted of 236 patients, mean age 57.8 years (64.8% male). Mean body mass index in the population was 29.6  ±  4.8 kg/m and arterial hypertension was highly prevalent (73.3% of patients). In 129 (54.7%) cases we observed recurrence of AF during the follow-up period. Patients with AF recurrence had higher visfatin levels (1.7 ± 2.4 vs 2.1 ± 1.9 ng/ml; p <0.0001) and multivariate logistic regression analysis containing age, sex, and other independent variables showed that patients with elevated visfatin levels were almost 3-time more likely to experience AF recurrence (odds ratio 2.92; 95% confidence interval 1.60 to 5.32). In conclusion, patients with higher visfatin levels are at elevated risk of arrhythmia recurrence after ablation for AF. Visfatin can be a useful marker for risk stratification in this group of patients.
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http://dx.doi.org/10.1016/j.amjcard.2019.10.052DOI Listing
February 2020

Prevalence of obstructive sleep apnea in patients with peripheral arterial diseases.

Sleep Breath 2020 Sep 14;24(3):1035-1041. Epub 2019 Nov 14.

Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background: The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist.

Aims: The aim of the study was to determine the prevalence of OSA in the population of patients with PAD.

Methods: Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea-hypopnea index (AHI) was ≥5 per hour.

Results: From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m, p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease.

Conclusions: The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.
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http://dx.doi.org/10.1007/s11325-019-01950-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426286PMC
September 2020

Correlations between Vancouver type of periprosthetic femur fracture and treatment outcomes.

J Orthop 2019 Nov-Dec;16(6):517-521. Epub 2019 May 27.

Department of Orthopaedics and Traumatology, Medical University of Warsaw, Warsaw, Poland.

Objective: Periprosthetic femur fractures are one of the most severe complications of total hip arthroplasty.

Methods: The aim of this study was to assess outcomes of periprosthetic femur fractures based on the Vancouver classifications of fractures.

Results: Sixty-four patients were enrolled into the study. Type B1 fractures were the most common - 33 cases. In comparison to patients with type B3 fracture, patients with type B1 fracture significantly less often experienced postoperative pain.

Conclusion: Study shown that in the context of both objective outcomes of the operation and patient satisfaction, the most unfavourable prognosis is after type B3.
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http://dx.doi.org/10.1016/j.jor.2019.05.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6818390PMC
May 2019

CHA2DS2-VASc score and fibrinogen concentration in patients with atrial fibrillation.

Adv Clin Exp Med 2019 Nov;28(11):1451-1457

1st Department of Cardiology, Medical University of Warsaw, Poland.

Background: Assessment of thromboembolic risk is crucial in choosing appropriate treatment in atrial fibrillation (AF). Current guidelines recommend basing the decision on the CHA2DS2-VASc score. However, the score is based only on clinical parameters and therefore its relationship with laboratory-assessed coagulation status might not always be objective.

Objectives: The aim of this study was to assess if the CHA2DS2-VASc score is associated with blood parameters in AF patients.

Material And Methods: Patients with continuous AF prequalified for catheter ablation were enrolled into the study and had CHA2DS2-VASc calculated and blood taken for coagulation parameters.

Results: The study population comprised of 266 patients (65.0% males; age 57.6 ±10.1 years). Patients were divided into those with CHA2DS2-VASc score 0, and those with ≥1 points, respectively requiring and not requiring anticoagulation treatment. The group with CHA2DS2-VASc = 0 (12% of patients) compared to those with CHA2DS2-VASc ≥ 1 had a significantly lower fibrinogen concentration (285.6 ±82.0 vs 322.6 ±76.4 mg/dL; p = 0.02). Partial thromboplastin time was not significantly different between groups (p > 0.05). Differences were noticed in parameters concerning red blood cells. Lower risk patients had a lower red blood cell count (4.9 ±0.4 vs 5.1 ±6.0 106/μL); p = 0.03), higher hemoglobin concentration (14.9 ±1.0 vs 14.3 ±1.4 g/dL; p = 0.04), and higher hematocrit (43.5 ±2.6 vs 41.7 ±4.7%; p = 0.001). It was observed that along with the increase in CHA2DS2-VASc score mean fibrinogen concentration increased (p-value for trend = 0.04).

Conclusions: In summary, a higher CHA2DS2-VASc score is independently associated with an increase in fibrinogen concentration. Further research is needed to assess the value of fibrinogen in thromboembolic risk assessment.
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http://dx.doi.org/10.17219/acem/104557DOI Listing
November 2019

Giant small-cell neuroendocrine carcinoma infiltrating the heart.

Kardiol Pol 2018 ;76(6):1023

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Pawińskiego 4, 02-097 Warszawa, Poland.

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http://dx.doi.org/10.5603/KP.2018.0123DOI Listing
November 2018

Comparison of hypertension epidemiology and treatment in Poland and Australia.

Kardiol Pol 2018 9;76(3):520-528. Epub 2018 Jan 9.

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

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http://dx.doi.org/10.5603/KP.a2018.0002DOI Listing
November 2018

Utilisation of lipid-lowering therapies in outpatient settings in Poland: epidemiological survey Economedica Dyslipidaemia 2015.

Kardiol Pol 2018 9;76(3):648-654. Epub 2018 Jan 9.

1st Department of Cardiology, Banacha 1a, 02-097 Warsaw, Poland.

Background: Dyslipidaemia, especially elevated low-density lipoprotein cholesterol (LDL-C), is one of the most important cardiovascular risk factors. Treatment of dyslipidaemia and prevention of cardiovascular disease (CVD) with lipid-lowering drugs is one of the key issues in reducing cardiovascular mortality. Nevertheless, underutilisation of statins and lipid-lowering drugs is still a problem globally.

Aim: The present study aimed to describe the utilisation of lipid-lowering drugs in groups of patients with indications for statin treatment and elevated LDL-C.

Methods: The study included adult patients with an indication for the use of a lipid-lowering therapy, currently using or not using such therapy because of contraindications or statin intolerance, in whom LDL-C concentration was > 70 mg/dL, treated in outpatient settings. All patients were screened for CVD and had blood cholesterol concentration assessed. Patients were also divided into: (1) patients with vascular disease; (2) patients with diabetes mellitus; (3) aged ≥ 65 years; and (4) patients without the three mentioned risk factors.

Results: The study group consisted of 2812 (51.4% male) patients. Major cardiovascular risk factors including arterial hyper-tension, type 2 diabetes mellitus, and smoking were highly prevalent in the study population (86.2%, 44.1%, and 23.3%, respectively). Out of the prespecified risk factors (vascular disease, diabetes mellitus, age ≥ 65 years) the study population was divided into patients without any of the mentioned risk factors (n = 520), those with all the three risk factors (n = 368), two out of three risk factors (n = 934), and one risk factor (n = 990). The study showed that 89.6% of patients were treated with statins (47.8% with atorvastatin, 27.8% with rosuvastatin, and 13.8% with simvastatin). Fenofibrate was used in 5.8% of the population and ezetimibe in 2.7%. In the whole group, 7.1% of patients did not receive any type of lipid-lowering therapy. Atorvastatin was more often used in patients with all the three prespecified risk factors, while rosuvastatin was used in patients without any of the risk factors.

Conclusions: The most often-used lipid-lowering drugs in Poland are statins, with atorvastatin and rosuvastatin being used the most common of these. The present study shows that some patients with LDL-C concentration > 70 mg/dL and indications for lipid-lowering are not treated accordingly.
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http://dx.doi.org/10.5603/KP.2018.0004DOI Listing
November 2018

Evaluation of the prevalence of periodontal disease as a non-classical risk factor in the group of patients undergoing hip and/or knee arthroplasty.

Kardiol Pol 2018 3;76(3):633-636. Epub 2018 Jan 3.

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

Background: Periodontal disease is a chronic disease causing an inflammatory process that affects various organs and is as-sociated with an increased risk of many diseases, including bone and cardiovascular disease.

Aim: The aim of this study was to establish the prevalence of periodontal disease in continuous patients scheduled for hip or knee replacement surgery.

Methods: The study was a prospective, epidemiological analysis performed in consecutive patients scheduled for total joint (hip or knee) replacement surgery. Patients enrolled into the study were screened for classical risk factors and had a dental evaluation performed for the diagnosis of periodontal disease.

Results: The study population consisted of 228 patients. A total of 137 (60.1%) patients were scheduled for a hip replace-ment surgery, while 91 (39.9%) had a knee replacement. The mean age of the study population was 66.8 ± 12.2 years, and 83 (36.4%) patients were male. A clinically significant disease was present in 65 (28.5%) cases, while all (100%) of the patients had at least minimal signs of periodontal disease. In patients with periodontal disease the percentage of tartar involvement of the teeth was 33.1 ± 26.8%, mean dental plaque coverage was 48.1 ± 29.8%, and bleeding occurred at a rate of 35.4 ± 29%. As for the hygiene level, it was generally poor in the majority of patients with periodontal disease. No differences in terms of baseline risk factors were present between patients with and without periodontal disease.

Conclusions: In conclusion, periodontal diseases are highly prevalent in patients undergoing hip and/or knee replacement surgery. The presence of the periodontal disease is possibly associated with a worse prognosis and should be treated.
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http://dx.doi.org/10.5603/KP.a2017.0263DOI Listing
November 2018

Seasonal trends in hypertension in Poland: evidence from Google search engine query data.

Kardiol Pol 2018 3;76(3):637-641. Epub 2018 Jan 3.

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

Background: Various conditions, including arterial hypertension, exhibit seasonal trends in their occurrence and magnitude. Those trends correspond to an interest exhibited in the number of Internet searches for the specific conditions per month.

Aim: The aim of the study was to show seasonal trends in the hypertension prevalence in Poland relate to the data from the Google Trends tool.

Methods: Internet search engine query data were retrieved from Google Trends from January 2008 to November 2017. Data were calculated as a monthly normalised search volume from the nine-year period. Data was presented for specific geographic regions, including Poland, the United States of America, Australia, and worldwide for the following search terms: "arterial hypertension (pol. nadciśnienie tętnicze)", "hypertension (pol. nadciśnienie)" and "hypertension medical condition". Seasonal effects were calculated using regression models and presented graphically.

Results: In Poland the search volume is the highest between November and May, while patients exhibit the least interest in arterial hypertension during summer holidays (p < 0.05). Seasonal variations are comparable in the United States of America representing a Northern hemisphere country, while in Australia (Southern hemisphere) they exhibit a contrary trend.

Conclusions: In conclusion, arterial hypertension is more likely to occur during winter months, which correlates with increased interest in the search phrase "hypertension" in Google.
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http://dx.doi.org/10.5603/KP.a2017.0264DOI Listing
November 2018

Epidemiology of dyslipidaemia in professional drivers: results of RACER-ABPM (Risk of Adverse Cardiovascular Events among professional dRivers in Poland - Ambulatory Blood Pressure Monitoring) study.

Kardiol Pol 2018 1;76(2):396-400. Epub 2017 Dec 1.

1st Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; Department of General & Experimental Pathology with Centre for Preclinical Research and Technology (CEPT), Medical University of Warsaw, Pawinskiego 3a, 02-097 Warsaw, Poland.

Background: Professional drivers are a group exposed to many cardiovascular risk factors. Non-systematic working hours, prolonged stress, low physical activity, along with irregular, and in most cases, unhealthy meals are common aspects of the normal working schedule of most of the professional drivers. These translate into high risk of cardiovascular disease (CVD).

Aim: The aim of the current analysis was to establish the prevalence of dyslipidaemia in a group of continuous professional drivers.

Methods: The RACER (Risk of Adverse Cardiovascular Events among professional dRivers in Poland - Ambulatory Blood Pressure Monitoring) study is a prospective study focused on assessing cardiovascular risk factors in professional drivers. Patients included in the study were screened for classical and non-classical cardiovascular risk factors and had an ambulatory blood pressure monitoring (ABPM) performed. Out of the whole RACER study population, 144 drivers were included into the RACER-ABPM study.

Results: Out of this group 135 (95.7%) were male, and the mean age was 50.2 ± 9.3 years, and mean body mass index was 32.3 ± 3.0 kg/m². A family history of CVD was noted in 21.3% of patients, 28.1% were current smokers, and 2.9% had diabetes mellitus. Out of those patients, 72.2% had low-density lipoprotein cholesterol (LDL-C) level > 115 mg/dL, 85.5% had LDL-C > 100 mg/dL, and 96.7% had LDL-C > 70 mg/dL. High-density lipoprotein cholesterol < 40 mg/dL in men and < 45 mg/dL in women was present in 84.4% of cases. Triglycerides > 150 mg/dL were found in 28.9% of cases.

Conclusions: In conclusion, dyslipidaemia is highly prevalent in professional drivers. Obesity is one of the major contributors to the cardiovascular risk, and dyslipidaemia along with other risk factors highly prevalent in this subgroup accounts for poorer prognosis.
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http://dx.doi.org/10.5603/KP.a2017.0229DOI Listing
December 2018

Risk assessment according to the SCORE risk chart - from history, through present, to the future.

Kardiol Pol 2018 13;76(1):63-68. Epub 2017 Nov 13.

Department of Orthopaedics and Traumatology, Medical University of Warsaw, Warsaw, Poland.

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http://dx.doi.org/10.5603/KP.a2017.0202DOI Listing
November 2018

Negative predictors of treatment success in outpatient therapy of arterial hypertension in Poland. Results of the CONTROL NT observational registry.

Kardiol Pol 2018 13;76(2):353-361. Epub 2017 Nov 13.

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Background: Identification of factors interfering with adequate control of arterial hypertension (HT) in the course of antihypertensive therapy is necessary to reduce the incidence of cardiovascular disorders and optimise clinical practice guidelines.

Aim: The study objective was to conduct a screening assessment of the rate of uncontrolled hypertension among hypertensive patients coming to a routine follow-up visit, and to characterise patients with inadequate control of HT in the aspect of their cardiovascular risk profile and therapeutic strategies used.

Methods: The CONTROL NT registry was a nationwide observational study performed by physicians in the outpatient setting in Poland. Patient data were collected twice: between April and September 2011 and between January and August 2012. Dur-ing screening, the physician completed a questionnaire with patient basic clinical information. The impact of the selected demographic and clinical parameters on treatment success defined as blood pressure (BP) lowering to < 140/90 mmHg when measured in the office at the second visit was investigated with univariate and multivariate logistic regression models.

Results: In total 1288 outpatient physicians participated in the CONTROL NT registry. In the screened group of 34,919 patients with a history of HT, 66.9% had abnormal BP readings in the office. In 15,262 patients with inadequate control of hypertension included in further analysis, the mean age was 59.3 ± 11.9 years, 47.9% were women, the disease duration was 8.2 ± 6.5 years and antihypertensive therapy was used for 7.4 ± 6.0 years. At least three cardiovascular risk factors were found in 46% of patients, with the most common dyslipidaemia (77.4%) and abdominal obesity (74.8%). In 56.6% of patients at least one concomitant disease was diagnosed, the most common being diabetes (29.8%). At the time of enrolment 21.5% of patients received no antihypertensive drugs, one, two, three (or more) drug combinations and fixed-dose combina-tions were received by 16.8%, 28.5%, 31.5% and 4.0% of patients, respectively. The most commonly used drug class was angiotensin-converting enzyme inhibitors (50%), followed by beta-blockers (42%) and diuretics (39%). Significant negative predictors of BP control included: body mass index ≥ 30 kg/m², heart rate ≥ 70 bpm, history of hypertension ≥ 7 years, and kidney disease (the odds ratios adjusted by age and gender - 0.61; 0.76; 0.79; and 0.76, respectively).

Conclusions: The percentage of Polish outpatients with adequate HT control is unsatisfactory. Patients with diabetes, chronic kidney disease, dyslipidaemia, overweight or obesity, longer disease and treatment duration and poor treatment compliance require a particularly careful assessment of risk factors and comorbidities, appropriate therapy intensification, and more frequent use of antihypertensive fixed-dose combinations.
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http://dx.doi.org/10.5603/KP.a2017.0211DOI Listing
December 2018

Prevalence of Hypertension in Professional Drivers (from the RACER-ABPM Study).

Am J Cardiol 2017 Nov 8;120(10):1792-1796. Epub 2017 Aug 8.

1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Professional drivers are a group exposed to many cardiovascular risk factors. Nonsystematic working hours, stress, low physical activity, and unhealthy dietary habits are common among professional drivers. These translate into high risk of cardiovascular disease. The aim of the current analysis was to establish the prevalence of arterial hypertension in a group of continuous professional drivers. The RACER (Risk of Adverse Cardiovascular Events among professional dRivers in Poland) study is a prospective study focused on assessing cardiovascular risk factors in professional drivers. Patients included in the study were screened for the classical and nonclassical cardiovascular risk factors and had an ambulatory blood pressure monitoring (ABPM) performed. Of the RACER study population, 144 drivers were included into the RACER-ABPM study. Of this group 135 (95.7%) were male at mean age of 50.2 ± 9.3 years, with mean body mass index of 32.3 ± 3.0 kg/m. In 21.3% of patients, family history of cardiovascular disease was noted, 28.1% were current smokers, and 2.9% had diabetes mellitus. Arterial hypertension was previously diagnosed in 39 patients (27.9%). In ABPM, the mean 24-hour blood pressure (BP) values were 130.3 ± 14.3 and 80.9 ± 9.9 for systolic and diastolic BP, respectively, and 46.1% of patients could be categorized as dippers. Based on the ABPM results, arterial hypertension was diagnosed in 104 of patients (73.8%). Patients with hypertension tend to be more often male and have a family history of cardiovascular disease. In conclusion, arterial hypertension is highly prevalent in professional drivers. Also abnormal day-to-night BP value patterns are often seen in this group.
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http://dx.doi.org/10.1016/j.amjcard.2017.07.086DOI Listing
November 2017

Cardioorthopedics - is it necessary in clinical practice? A study of patients with hip replacement surgery.

Kardiol Pol 2017 ;75(8):729-735

Department of Orthopaedics and Traumatology, Medical University of Warsaw, Warsaw, Poland, Poland.

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http://dx.doi.org/10.5603/KP.2017.0151DOI Listing
December 2017

Peripheral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial - protocol for an observational cohort study.

Kardiol Pol 2017 17;75(12):1332-1338. Epub 2017 Jul 17.

I Katedra i Klinika Kardiologii, Warszawski Uniwersytet Medyczny..

Background: Peripheral arterial disease (PAD) is in fact a group of disease entities with different symptoms and course but a common underlying cause, i.e. atherosclerosis. Atherosclerosis is known to be aggravated by several cardiovascular risk factors, including obstructive sleep apnoea (OSA).

Aim: Following paper is a protocol for the Peripheral ARtery Atherosclerotic DIsease and SlEep disordered breathing (PARADISE) trial, which aims to describe the prevalence of OSA in PAD patients scheduled for revascularisation, and to determine the effect of OSA on the procedure outcomes.

Methods: The PARADISE study is an observational cohort trial. It plans to include 200 consecutive patients hospitalised for revascularisation due to PAD. In every patient an overnight sleep study will be performed to diagnose sleep disorders. Accord¬ing to the results of the test, patients will be divided into two groups: group A - patients with OSA, and group B - patients without OSA (control group). All patients will also be screened for classical and non-classical cardiovascular risk factors. In some of the patients, during surgery, a fragment of atherosclerotic plaque will be collected for further testing. Patients will be followed for one year for adverse events and end-points. Primary end-point of the study will be the failure of revascularisa¬tion defined as recurrence or new onset of the symptoms of ischaemia from the treated region, a need for re-operation or procedure revision, or recurrence of ischaemia signs on the imaging tests.

Discussion: The data obtained will help determine the incidence of OSA in the population of patients with PAD. The au¬thors expect to show that, as with other cardiovascular diseases associated with atherosclerosis, also in patients with PAD the incidence of undiagnosed OSA is high and its presence is associated with elevated cholesterol, inflammatory markers, and higher prevalence of arterial hypertension and poor control of other cardiovascular risk factors. In addition, due to increased oxidative stress and vascular endothelial injury associated with OSA, patients afflicted with this condition will not only have more advanced atherosclerotic lesions, but also in their histopathological examination their atherosclerotic plaque will exhibit evidence of greater instability and adverse morphology. We also expect to show that in patients with OSA, achieving cor¬rect control of cardiovascular risk factors will be more difficult. The study may improve PAD control through assuring better multispecialty care in PAD patients.
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http://dx.doi.org/10.5603/KP.a2017.0150DOI Listing
January 2018
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