0000000000056231
AUTHOR
Krzysztof Wilczek
Annual Trends in Total Ischemic Time and One-Year Fatalities: The Paradox of STEMI Network Performance Assessment
This study is aimed at assessing trends and relations between total ischemic time, the major quality measure of systemic delay, and case-fatality at the population or patient level in response to growing cardiovascular risk and a constant need to shorten the time to treatment in ST-segment elevation myocardial infarction (STEMI). Data from a prospective nationwide registry of STEMI patients admitted between 2006 and 2013 who were treated with primary percutaneous coronary intervention (PCI) were analyzed. Total ischemic time was calculated as the time from the onset of symptoms to primary PCI and was determined as individual and annual. The primary end-point was one-year, all-cause case-fat…
Impact of routine invasive strategy on outcomes in patients with non-ST-segment elevation myocardial infarction during 2005–2014: A report from the Polish Registry of Acute Coronary Syndromes (PL-ACS)
Background: Non-ST-segment elevation myocardial infarction (NSTEMI) has become the most frequently encountered type of myocardial infarction. The patient clinical profile and management has evolved over the past decade. As there is still a scarcity of data on the latest trends in NSTEMI, changes herein were observed and assessed in the treatment and outcomes in Poland between 2005 and 2014. Methods: A total of 197,192 patients with NSTEMI who enrolled in the Polish Registry of Acute Coronary Syndromes (PL-ACS) between 2005 and 2014 were analyzed. In-hospital and 12-month mortality were assessed. Results: Coronary angiography use increased from 35.8% in 2005–2007 to 90.7% in 2012–2014 (p < 0…
Mortality of patients with ST-segment elevation myocardial infarction and cardiogenic shock treated by PCI is correlated to the infarct-related artery - Results from the PL-ACS Registry
Background: Mortality of patients with ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock (CS) on admission remains high despite invasive treatment. The aim of this analysis was to assess the relationship between the infarct-related artery (IRA) and the early and 12-month outcomes of patients with STEMI and CS treated by percutaneous coronary intervention (PCI). Methods: Two thousand ninety patients with STEMI and CS registered in the prospective Polish Registry of Acute Coronary Syndromes from October 2003 to November 2009 were included. Results: The in-hospital mortality in the left main (LM), left anterior descending artery (LAD), circumflex artery (Cx), and right …
Impact of chronic total occlusion artery on 12-month mortality in patients with non-ST-segment elevation myocardial infarction treated by percutaneous coronary intervention (from the PL-ACS Registry).
Abstract Background Three-vessel coronary artery disease is associated with high mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). The purpose of this study was to assess the impact on 12‐month mortality of chronic total occlusion (CTO) in the non-infarct-related artery (non-IRA), as assessed by coronary angiography during percutaneous coronary intervention (PCI) for NSTEMI, of patients with 3-vessel disease. Methods The study included all of the NSTEMI patients with 3-vessel disease by coronary angiogram who were treated by PCI and who were registered in the prospective Polish Registry of Acute Coronary Syndromes (PL-ACS) from July 2007 to November 2009. T…
Gender-related disparities in the treatment and outcomes in patients with non-ST-segment elevation myocardial infarction: results from the Polish Registry of Acute Coronary Syndromes (PL-ACS) in the years 2012–2014
Introduction: Gender-related differences in the treatment of patients with non-ST elevation myocardial infarction (NSTEMI) have been reported in many previous studies despite the fact that an equal approach is recommended in all current guidelines. The aim of the study was to investigate whether gender-related discrepancies in the management of NSTEMI patients have changed. Material and methods: Between 2012 and 2014 a total of 66,667 patients (38.3% of whom were women) with the final diagnosis of NSTEMI were included into the retrospective analysis of the Polish Registry of Acute Coronary Syndromes (PL-ACS). Differences in clinical profile, treatment, and outcomes were analysed. Results: W…
Gender-related differences in men and women with ST-segment elevation myocardial infarction and incomplete infarct-related artery flow restoration: a multicenter national registry
Introduction: Little is known about gender-related differences in ST-segment elevation myocardial infarction (STEMI) and incomplete infarct-related artery (IRA) reperfusion after primary percutaneous coronary intervention (pPCI). Aim: To evaluate gender-related differences in clinical characteristics and prognosis in patients with STEMI and incomplete IRA reperfusion after pPCI. Material and methods: From 42,752 STEMI patients hospitalized between 2009 and 2011 in Poland we analyzed a group of 984 (36%) females and 1,746 (64%) males with less than Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow following pPCI. Results: Women were older than men (72.0 ±11.3 vs. 64.0 ±11.7 years; p …
Long-term outcomes in men and women with ST-segment elevation myocardial infarction and incomplete reperfusion after a primary percutaneous coronary intervention
Background The failure of reperfusion therapy in patients with ST-segment elevation myocardial infarction (STEMI) is more frequent than considered previously. Aim To evaluate sex-related differences in long-term outcomes in patients with STEMI and incomplete infarct-related artery reperfusion after a primary percutaneous coronary intervention. Patients and methods Of consecutive 42 752 patients with STEMI hospitalized between 2009 and 2011 in Poland, we analyzed a group of 766 (35%) women and 1453 (65%) men with less than thrombolysis in myocardial infarction (TIMI) flow grade 3 following a primary percutaneous coronary intervention. Results In the 2-year follow-up, the mortality rate among…
Outcomes of a routine invasive strategy in elderly patients with non-ST-segment elevation myocardial infarction from 2005 to 2014: results from the PL-ACS registry.
Background Elderly patients (≥75 years old) with non-ST-segment elevation myocardial infarction (NSTEMI) represent a large subgroup of all cases. They are rarely included in randomized trials because of comorbidities and concerns about complications. Furthermore, invasive treatments are used less frequently in this patient group. The aim of this study was to analyze trends in invasive procedures and outcomes in elderly patients with NSTEMI from 2005 to 2014. Patients and methods We analyzed 68 978 elderly patients with NSTEMI enrolled in the prospective, nationwide Polish Registry of Acute Coronary Syndromes from 2005 to 2014. Results Elderly patients accounted for 34.9% of all patients wit…