1st Internal department

Kardiorenalnim (KR) syndromem v tomto sděleni rozumime hlavně primarni postiženi srdecni funkce s naslednou poruchou renalni hemodynamyky. Srdecni selhani vede k poklesu srdecniho výdeje a aktivaci vazokonstrikcnich působků, tim postupně dochazi ke sniženi prokrveni ledvin, vazokonstrikci renalnich cev, poklesu glomerularni filtrace s postupným rozvojem renalniho selhani. Jsou rozebrany patofyziologicke mechanizmy, charaktenstika nemocných, uloha leků u KR syndromu, vztah proteinurie a anemie u KR syndromu a užiti biomarkerů a plicni hypertenze v prognoze nemocných s KR syndromem.

Murin J. CLARIFY registry-five-years follow-up of patients with chronic coronary syndrome. Cardiology Lett. 2020;29(2):93-96 Abstract. Coronary artery disease (CAD) is one of the most common and serious cardiovascular (CV) diseases in the developed countries. Last year there was a change in the classification of CAD presented at the ESC Congress, 2019. The dynamic nature of the CAD process results in various clinical presentations, which can be categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). Stable CAD has been renamed to Chronic Coronary Syndrome (CCS). CLARIFY registry (32 703 patients with CCS from 45 countries) was a prospective observational registry (starting Nov 2009-Jun 2010 with 5-years follow-up) and its data were analyzed: a) Primary outcome endpoint (CV mortality/nonfatal myocardial infarction, MI) rate was 8.0% (male: 8.1% and female: 7.6%), b) Cox proportional hazards model showed main independent predictors of primary end-point: prior hospitalization for heart failure, current smoking, atrial fibrillation, prior MI and stroke, diabetes, current angina and peripheral artery disease. c) There was an interaction between angina and prior MI. Among patients with prior MI was angina associated with higher primary event rate (11.8%) versus (8.2%) in patients without angina. Among patients without prior MI were event rates similar for patients with (6.3%) or without (6.4%) angina. Prescription rates of evidence based secondary prevention therapies were high. Patients with both angina and MI are in a high-risk subgroup and these patients need intensive treatment. Ref. 14, on-line full text (Free, PDF) www.cardiologyletters.sk Key words: chronic coronary syndrome-myocardial infarction-angina pectoris-cardiovascular mortality Murin J. CLARIFY register-päťročné sledovanie pacientov s chronickým koronárnym syndrómom. Cardiology Lett. 2020;29(2):93-96 Abstrakt. Ischemická choroba srdca (ICHS) je jednou z najčastejších a závažných kardiovaskulárnych (KV) ochorení vo vyspelých krajinách. Minulý rok sa zmenila klasifikácia stabilnej formy ICHS, čo bolo prezentované na ESC kongrese 2019. Dynamická podstata procesov ICHS vyúsťuje do rôznorodých klinických prejavov, ktoré môžu byť kategorizované ako akútne koronárne syndrómy (AKS) alebo chronické koronárne syndrómy (ChKS). Stabilné formy ICHS boli premenované na chronické koronárne syndrómy. CLARIFY register (32 703 pacientov v 45 krajinách s ChKS) bol prospektívnym observačným registrom (november 2009-jún 2010 s päťročným sledovaním) a jeho údaje boli analyzované: a) Primárny end-point (KV mortalita/nefatálny infarkt (IM) sa vyskytol u 8,0 % pacientov (muži 8,1 % a ženy 7,6 %). b) Coxov štatistický model analýzy ukázal tieto nezávislé prediktory výskytu primárneho end-pointu: predchádzajúca hospitalizácia pre srdcové zlyhávanie, aktívne fajčenie, predsieňová fibrilácia, prekonaný IM alebo cievna mozgová príhoda, diabetes, prítomná angína pektoris a periférne arteriálne ochorenie. c) Zistila sa inte

Kardiovaskulárne ochorenia u žien sú často podceňované. Ženy sa významne odlišujú od mužov v epidemiológii, morbidite a mortalite, v diagnostike, etiológii a rizikových faktoroch, komorbiditách, v odpovedi na farmakologickú i nefarmakologickú liečbu chronického srdcového zlyhávania. V našom písomníctve chýba prehľadový článok, ktorý by sa zaoberal touto problematikou, hoci v zahraničí sa venujú tejto téme už niekoľko rokov.

AimsTo assess the proportion of patients with heart failure and reduced ejection fraction (HFrEF) who are eligible for sacubitril/valsartan (LCZ696) based on the European Medicines Agency/Food and Drug Administration (EMA/FDA) label, the PARADIGM‐HF trial and the 2016 ESC guidelines, and the association between eligibility and outcomes.Methods and resultsOutpatients with HFrEF in the ESC‐EORP‐HFA Long‐Term Heart Failure (HF‐LT) Registry between March 2011 and November 2013 were considered. Criteria for LCZ696 based on EMA/FDA label, PARADIGM‐HF and ESC guidelines were applied. Of 5443 patients, 2197 and 2373 had complete information for trial and guideline eligibility assessment, and 84%, 12% and 12% met EMA/FDA label, PARADIGM‐HF and guideline criteria, respectively. Absent PARADIGM‐HF criteria were low natriuretic peptides (21%), hyperkalemia (4%), hypotension (7%) and sub‐optimal pharmacotherapy (74%); absent Guidelines criteria were LVEF>35% (23%), insufficient NP levels (30%...