Kreisās koronārās artērijas kopējā stumbra perkutānās intervences pētniecības aspekti Latvijā

Perkutānas koronāras intervences (PCI) loma kreisās koronārās artērijas stumbra (LM) bojājumu ārstēšanā pasaulē pēdējās 2 dekādēs ir būtiski mainījusies un lielu pienesumu tajā ir devusi arī Latvijas pieredze un pētījumi. Šī darba mērķis ir salīdzināt LM perkutānas koronāras intervences (PCI) ar zālēm pārklāta (DES) un parasta metāla (BMS) stentu drošību un efektivitāti ilgtermiņā, apkopot “reālas dzīves” LM PCI reģistra datus un pētīt jaunas PCI stratēģijas drošību un efektivitāti īstu LM bifurkācijas ārstēšanā, tādējādi demonstrējot LM PCI kā drošu un efektīvu ārstēšanas metodi tūlītēji un ilgtermiņā un vienlaicīgi arī apkopojot Latvijas pieredzi LM PCI veikšanā.

Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia

Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia The aim of the study was to characterise coronary artery disease (CAD) outpatients in Latvia by risk factors (RF) including heart rate (HR), physical examination data, clinical data and treatment. Twelve practitioners had each examined and questioned 6 to 12 patients with established CAD (n = 120). The most frequent cardiovascular (CV) RF and co-morbidity were dyslipidemia (94.2%) and hypertension (78.3%), respectively. Prevalence of increased resting HR (≥70 bpm) was 35.9% and 33.6%, when measured by pulse palpation and electrocardiography, respectively. Regarding other RFs, prevalence of treated…

TCT-361 Heart Team Approach to CAD Management in Patients Undergoing Elective Vascular Surgery Who Have Asymptomatic Ischemia-producing Coronary Stenosis

Patients undergoing peripheral vascular surgery (PVS) are at increased risk of post-op MI/death due to unrecognized CAD. Coronary CTA-derived fractional flow reserve (FFRCT) reliably identifies lesion-specific ischemia (LSI) in stable chest pain patients but has not been used in PVS patients. We

Decrease in annual incidence of acute coronary syndrome and restructuring of coronary care in Latvia

Abstract Introduction Improvement in coronary heart disease prevention and treatment, as well as availability of coronary care facilities, is important for the reduction of acute coronary syndrome (ACS) incidence. Centralized acute coronary care system is crucial to provide optimal hospitalization and management algorithm for ACS patients. Aim The aim of the current report was to assess the annual incidence of ACS and the quality of acute coronary care in Latvia. Methods The Data from The Latvian Registry of Acute Coronary Syndromes were analyzed covering the time period from 2005 to 2010. Results Since the year 2005 the annual incidence of hospitalization due to ACS decreased significantly…

Intravascular Ultrasound-based Imaging Modalities for Tissue Characterisation

Atherosclerosis is the leading cause of cardiovascular mortality and morbidity in the developed world. Intravascular ultrasound (IVUS) is a widely used imaging modality providing complementary diagnostic information to angiography regarding the vessel wall of the coronary arteries. IVUS has been used for assessment of ambiguous angiographic lesions, evaluation of new interventional devices and in atherosclerosis progression-regression trials. However, the standard gray-scale IVUS has limited value for the accurate identification of specific plaque components. This limitation has been partially over- come by introduction of new IVUS-based imaging methods such as: virtual histology IVUS, iMAP…

TCT-43 First-in-human experience of a novel transradial device for embolic deflection during transcatheter aortic valve replacement

The average stroke rate in contemporary transcatheter aortic valve replacement (TAVR) studies is 4.4%. The majority of the TAVR studies are non-randomized registries, hence, neurological outcomes may be underreported. Over 50% of all TAVR related strokes occur during the procedure or on the same day

TCTAP A-059 Intrahospital and Long-term Outcomes After True Bifurcation Stenting

Bifurcation percutaneous coronary intervention (PCI) is challenging and is associated with lower rate of procedural success and higher risk of complications. The aim of this study was to evaluate intrahospital and long-term outcomes of patients who underwent PCI for bifurcation lesions involving

Insufficient control of heart rate in stable coronary artery disease patients in Latvia

Background and objective:\ud Heart rate (HR) ≥70 beats per minute (bpm) increases cardiovascular risk in coronary artery disease (CAD) patients. The objective of the analysis is to characterize HR as well as other clinical parameters in outpatients with stable CAD in Latvia.<p></p>\ud \ud Materials and methods:\ud CLARIFY is an ongoing international registry of outpatients with established CAD. Latvian data regarding 120 patients enrolled in CLARIFY and collected at baseline visit during 2009–2010 were analyzed.<p></p>\ud \ud Results:\ud The mean HR was 67.7 ± 9.5 and 66.9 ± 10.7 bpm when measured by pulse palpation and electrocardiography, respectively. HR &#8…

Original paper: A new type of polyphenols-containing dietary supplement for correction of lipids and inflammatory markers in patients with coronary artery disease

Abstract Objective: To evaluate the impact of two original compositions of polyphenols-containing dietary supplement on lipid profile and level of C-reactive protein (CRP) in patients with angiographycally verified coronary artery disease (CAD). Design and methods: 167 patients were selected during their scheduled post-event elective bicycle stress-test examination. All patients received standard CAD therapy and permanent statin therapy and had elevated total cholesterol (TC > 5.0 mmol/L) and/or CRP (>3.5 mg/L) levels. The study consisted of 2 days of polyphenol depletion followed by a 12-week supplementation period in a randomized, blinded, placebo-uncontrolled parallel design. Two d…

A Population-Based Cross-Sectional Study of Cardiovascular Risk Factor in Latvia

Background and Objective. To date, the epidemiological studies of noncommunicable diseases in Latvia were more episodic and covered only selected areas. The first national crosssectional population-based survey of cardiovascular risk factors after regaining independence was carried out to provide reliable information on the cardiovascular risk factor profile in adults. Material and Methods. Computerized random sampling from the Registry of Latvian population was carried out. A total of 6000 enrolled subjects aged 25–74 years were divided into 10 age subgroups. The data of 3807 respondents (63.5% of all) were included into the final analysis. Results. The mean number of cardiovascular risk f…

Uzņēmējdarbības vides analīze Latvijā

Izvēlēta bakalaura darba tēma ir “Uzņēmējdarbības vides analīze Latvijā”. Izveidot konkurētspējīgu ekonomiku nav iespējams bez uzņēmējdarbībai labvēlīgas vides radīšanas. Latvijā tiek konsekventi uzlabota uzņēmējdarbības vide un ir panākts ievērojams progress un uzlabojumi uzņēmējdarbības reģistrēšanā, nodokļu politikā, muitas likumdošanā, robežšķērsošanas procedūrās, būvniecībā u.c. jomās, tomēr vēl joprojām ir virkne neatrisinātu jautājumu un problēmu, kas ierobežo uzņēmējdarbību. Bakalaura darba mērķis ir izpētīt uzņēmējdarbības makro vidi un uzņēmējdarbības attīstību raksturojošos rādītājus Latvijā, kā arī atklāt labvēlīgas uzņēmējdarbības vides izveidi kavējošos faktorus un izstrādāt p…

Tissue characteristics in non-culprit lesions during the acute coronary event and at ten months follow-up

Introduction: It is not well established how the medication recommended in the guidelines will affect plaque compositional changes in non-culprit segments after STEMI. We hypothesized that the proportion of necrotic tissue in the non-culprit lesion in the culprit artery would decrease ten months after STEMI. Methods: In 63 consecutive STEMI patients the non-culprit segment in the culprit artery was analyzed with iMap intravascular ultrasound (IVUS) at the time of the index procedure and 10 months later. The non-culprit segment was identified as being 20mm proximal to the most stenotic culprit segment. All patients were recommended to receive the drug therapy outlined in the STEMI guidelines…

Comparison of Percutaneous Coronary Intervention (With Drug-Eluting Stents) Versus Coronary Artery Bypass Grafting in Women With Severe Narrowing of the Left Main Coronary Artery (from the Women-Drug-Eluting stent for LefT main coronary Artery disease Registry)

Women typically present with coronary artery disease later than men with more unfavorable clinical and anatomic characteristics. It is unknown whether differences exist in women undergoing treatment for unprotected left main coronary artery (ULMCA) disease. Our aim was to evaluate long-term clinical outcomes in women treated with percutaneous coronary intervention (PCI) with drug-eluting stents versus coronary artery bypass grafting (CABG). All consecutive women from the Drug-Eluting stent for LefT main coronary Artery disease registry with ULMCA disease were analyzed. A propensity matching was performed to adjust for baseline differences. In total, 817 women were included: 489 (59.8%) unde…

Bone marrow mononuclear cell separation yield in myocardium infarction, coronary disease and type 2 diabetes and dilated cardiomyopathy patient groups

Computing Methods for Composite Clinical Endpoints in Unprotected Left Main Coronary Artery Revascularization

Abstract Objectives The study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease. Background TTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance. Methods The TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 interna…

Tissue characterization comparison of culprit lesions between stable coronary disease and ST elevation myocardial infarction patients