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Coronary Artery Disease: HELP
Articles by Andrzej Ochala
Based on 16 articles published since 2010
(Why 16 articles?)

Between 2010 and 2020, Andrzej Ochała wrote the following 16 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Guideline [Bioresorbable scaffolds in the treatment of coronary artery disease. Expert consensus statement of the Association of Cardiovascular Interventions of the Polish Cardiac Society (ACVI PCS)]. 2017

Reczuch, Krzysztof / Milewski, Krzysztof / Wąsek, Wojciech / Rzeszutko, Łukasz / Wojakowski, Wojciech / Hawranek, Michał / Włodarczak, Adrian / Pawłowski, Tomasz / Kochman, Janusz / Dobrzycki, Sławomir / Grygier, Marek / Ochała, Andrzej / Wójcik, Jarosław / Lesiak, Maciej / Dudek, Dariusz / Legutko, Jacek. ·Przewodniczący AISN PTK; II Klinika Kardiologii, Uniwersytet Jagielloński, Collegium Medicum, Kraków, Polska. jacek.legutko@uj.edu.pl. ·Kardiol Pol · Pubmed #28819961.

ABSTRACT: Bioresorbable scaffold coated with antimitotic drug is the latest development in the coronary stents technology. The concept of temporary scaffolding and natural vessel healing after angioplasty is a very attractive alternative to conventional metal stents. The results of the first observational studies have confirmed their ultimate biodegradation. Newest results of randomised trials and registries in broader clinical and anatomical indications also revealed the limitations of the first generation of scaffolds. The relatively thick polymeric struts and compliance with specific implantation protocol may influence the results. In this document, the group of experts presents the current state of knowledge, with a particular focus on the advantages and limitations of the new technology; it presents practical guidelines for optimal implantation techniques and clarifies documented indications for patients and lesions selection.

2 Clinical Trial Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study. 2017

Escaned, Javier / Collet, Carlos / Ryan, Nicola / De Maria, Giovanni Luigi / Walsh, Simon / Sabate, Manel / Davies, Justin / Lesiak, Maciej / Moreno, Raul / Cruz-Gonzalez, Ignacio / Hoole, Stephan P / Ej West, Nick / Piek, J J / Zaman, Azfar / Fath-Ordoubadi, Farzin / Stables, Rodney H / Appleby, Clare / van Mieghem, Nicolas / van Geuns, Robert Jm / Uren, Neal / Zueco, Javier / Buszman, Pawel / Iñiguez, Andres / Goicolea, Javier / Hildick-Smith, David / Ochala, Andrzej / Dudek, Dariusz / Hanratty, Colm / Cavalcante, Rafael / Kappetein, Arie Pieter / Taggart, David P / van Es, Gerrit-Anne / Morel, Marie-Angèle / de Vries, Ton / Onuma, Yoshinobu / Farooq, Vasim / Serruys, Patrick W / Banning, Adrian P. ·Hospital Cliinico San Carlos IDISSC and Universidad Complutense de Madrid, Madrid, Spain; Calle Profesor Martín Lagos s/n, 28040 Madrid, Spain. · Department of Cardiology, Academic Medical Center of Amsterdam, Cardiology, Amsterdam, the Netherlands; Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, the Netherlands. · Department of Cardiology, John Radcliffe Hospital, Cardiology, Oxford, UK; Headley Way, Headington, Oxford OX3 9DU, UK. · Department of Cardiology Belfast Health & Social Care Trust, Belfast, UK; Knockbracken Healthcare Park, Saintfield Rd, Belfast BT8 8BH, UK. · Hospital Clinic I Provincial de Barcelona, Barcelona, Spain; Carrer de Villarroel, 170, 08036 Barcelona, Spain. · Department of Cardiology, Imperial College London, London, UK; Kensington, London SW7 2AZ, UK. · 1st Department of Cardiology, University of Medical Sciences, Poznan, Poland; Collegium Maius, Fredry 10, 61-701 Poznan, Poland. · Department of Cardiology, Hospital Universitario la Paz, Madrid, Spain; Paseo de la Castellana, 261, 28046 Madrid, Spain. · Department of Cardiology, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain; Paseo de San Vicente, 58, 37007 Salamanca, Spain. · Department of Cardiology, Papworth Hospital NHS Foundation Trust, Cambridge, UK; Papworth Everard, Cambridge CB23 3RE, UK. · Department of Cardiology, Freeman Hospital and Newcastle University, Newcastle-upon-Tyne, UK; High Heaton, Newcastle upon Tyne NE7 7DN, UK. · Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK; Oxford Rd, Manchester M13 9WL, UK. · Liverpool Heart and Chest Hospital, Liverpool, UK; Thomas Dr, Liverpool L14 3PE, UK. · Thoraxcenter, Erasmus MC, the Netherlands; 's-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands. · The Royal Infirmary of Edinburgh, Edinburgh, UK; 51 Little France Dr, Edinburgh EH16 4SA, UK. · Department of Cardiology, Hospital Universitario Valdecilla, Cantabria, Spain; Av. Valdecilla, 25, 39008 Santander, Cantabria, Spain. · American Heart of Poland (PAK), Ustrón, Poland; Sanatoryjna 1, 43-450 Ustrón, Poland. · Department of Cardiology, Hospital Meixoeiro, Pontevedra, Spain; Camiño Meixoeiro, s/n, 36214 Vigo, Pontevedra, Spain. · Brighton & Sussex University Hospitals NHS Trust, Brighton, UK; Barry Building, Eastern Rd, Brighton BN2 5BE, UK. · Gornoslaskie Centrum Medycnze, Poland; 45/47, 40-635 Katowice, Poland. · Department of Interventional Cardiology, Jagiellonian University, Krakow, Poland; Gol?bia 24, 31-007 Kraków, Poland. · Cardialysis BV, Rotterdam, the Netherlands; Westblaak 98, 3012 KM, Rotterdam, the Netherlands. · European Cardiovascular Research Institute, Westblaak 98, 3012 KM, Rotterdam, the Netherlands. ·Eur Heart J · Pubmed #29020367.

ABSTRACT: Aims: To investigate if recent technical and procedural developments in percutaneous coronary intervention (PCI) significantly influence outcomes in appropriately selected patients with three-vessel (3VD) coronary artery disease. Methods and results: The SYNTAX II study is a multicenter, all-comers, open-label, single arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in patients with 3VD in 22 centres from four European countries. The SYNTAX-II strategy includes: heart team decision-making utilizing the SYNTAX Score II (a clinical tool combining anatomical and clinical factors), coronary physiology guided revascularisation, implantation of thin strut bioresorbable-polymer drug-eluting stents, intravascular ultrasound (IVUS) guided stent implantation, contemporary chronic total occlusion revascularisation techniques and guideline-directed medical therapy. The rate of major adverse cardiac and cerebrovascular events (MACCE [composite of all-cause death, cerebrovascular event, any myocardial infarction and any revascularisation]) at one year was compared to a predefined PCI cohort from the original SYNTAX-I trial selected on the basis of equipoise 4-year mortality between CABG and PCI. As an exploratory endpoint, comparisons were made with the historical CABG cohort of the original SYNTAX-I trial. Overall 708 patients were screened and discussed within the heart team; 454 patients were deemed appropriate to undergo PCI. At one year, the SYNTAX-II strategy was superior to the equipoise-derived SYNTAX-I PCI cohort (MACCE SYNTAX-II 10.6% vs. SYNTAX-I 17.4%; HR 0.58, 95% CI 0.39-0.85, P = 0.006). This difference was driven by a significant reduction in the incidence of MI (HR 0.27, 95% CI 0.11-0.70, P = 0.007) and revascularisation (HR 0.57, 95% CI 0.37-0.9, P = 0.015). Rates of all-cause death (HR 0.69, 95% CI 0.27-1.73, P = 0.43) and stroke (HR 0.69, 95% CI 0.10-4.89, P = 0.71) were similar. The rate of definite stent thrombosis was significantly lower in SYNTAX-II (HR 0.26, 95% CI 0.07-0.97, P = 0.045). Conclusion: At one year, clinical outcomes with the SYNTAX-II strategy were associated with improved clinical results compared to the PCI performed in comparable patients from the original SYNTAX-I trial. Longer term follow-up is awaited and a randomized clinical trial with contemporary CABG is warranted. ClinicalTrials.gov Identifier: NCT02015832.

3 Clinical Trial Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study). 2016

Roleder, Tomasz / Pociask, Elżbieta / Wańha, Wojciech / Dobrolińska, Magdalena / Gąsior, Paweł / Smolka, Grzegorz / Walkowicz, Wojciech / Jadczyk, Tomasz / Bochenek, Tomasz / Dudek, Dariusz / Ochała, Andrzej / Mizia-Stec, Katarzyna / Gąsior, Zbigniew / Tendera, Michał / Ali, Ziad A / Wojakowski, Wojciech. ·Third Department of Cardiology, Medical University of Silesia. ·Circ J · Pubmed #27334029.

ABSTRACT: BACKGROUND: The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG. METHODS AND RESULTS: Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich tissue was identified in both de novo lesions and in ISR (75% vs. 50%, P=0.071) with a higher prevalence in BMS than in DES (23% vs. 7.5%; P=0.048). Calcific de novo lesions were detected in older grafts as compared with non-calcific atheromas (159±57 vs. 90±62 months after CABG, P=0.001). Heterogeneous neointima was found only in ISR (70% vs. 0, P<0.001) and was observed with similar frequency in both BMS and DES (24% vs. 30%, P=0.657). ISR was detected earlier in DES than BMS (median, 50 months; IQR, 18-96 months vs. 27 months; IQR, 13-29 months, P<0.001). CONCLUSIONS: OCT-based characteristics of de novo and ISR lesions in SVG were similar except for heterogeneous tissue, which was observed only in ISR. (Circ J 2016; 80: 1804-1811).

4 Article Clinical outcomes of state-of-the-art percutaneous coronary revascularisation in patients with three-vessel disease: two-year follow-up of the SYNTAX II study. 2019

Serruys, Patrick W / Kogame, Norihiro / Katagiri, Yuki / Modolo, Rodrigo / Buszman, Pawel E / Íñiguez-Romo, Andrés / Goicolea, Javier / Hildick-Smith, David / Ochala, Andrzej / Dudek, Dariusz / Piek, Jan J / Wykrzykowska, Joanna J / Escaned, Javier / Banning, Adrian P / Farooq, Vasim / Onuma, Yoshinobu. ·Imperial College London, London, United Kingdom. ·EuroIntervention · Pubmed #30636684.

ABSTRACT: AIMS: The purpose of the study was to investigate whether the favourable outcomes of state-of-the-art PCI in the SYNTAX II trial, demonstrated at one year, were maintained at two-year follow-up. METHODS AND RESULTS: The SYNTAX II study was a multicentre, single-arm study that investigated the impact of a contemporary PCI strategy on clinical outcomes in 454 patients with de novo three-vessel coronary artery disease, without left main disease. Clinical outcomes in SYNTAX II were compared to the predefined PCI (SYNTAX-I PCI) and coronary artery bypass graft (SYNTAX-I CABG) cohorts from the landmark SYNTAX trial (SYNTAX-I), selected on the basis of equipoise for long-term (four-year) mortality utilising the SYNTAX score II. At two years, major adverse cardiac and cerebrovascular events (MACCE: a composite of all-cause death, any stroke, myocardial infarction, or revascularisation) in SYNTAX II were significantly lower compared to SYNTAX-I PCI (13.2% vs. 21.9%, p=0.001). Furthermore, similar two-year outcomes for MACCE were evident between SYNTAX II PCI and SYNTAX-I CABG (13.2% vs. 15.1%, p=0.42). CONCLUSIONS: At two years, clinical outcomes with the SYNTAX II strategy remained superior to the predefined SYNTAX-I PCI cohort, and similar to the predefined SYNTAX-I CABG cohort.

5 Article Safety and efficacy of self-apposing Stentys drug-eluting stent in left main coronary artery PCI: Multicentre LM-STENTYS registry. 2019

Wańha, Wojciech / Mielczarek, Maksymilian / Smolka, Grzegorz / Roleder, Tomasz / Jaguszewski, Miłosz / Ciećwierz, Dariusz / Tomasiewicz, Brunon / Kubler, Piotr / Gorol, Jarosław / Chmielecki, Michał / Bartuś, Stanisław / Navarese, Eliano Pio / Kasprzak, Michał / Sukiennik, Adam / Kubica, Jacek / Lekston, Andrzej / Hawranek, Michał / Reczuch, Krzysztof / Gruchała, Marcin / Ochała, Andrzej / Wojakowski, Wojciech. ·Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. · First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland. · Military Hospital, Wroclaw, Poland. · Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland. · Third Department of Cardiology, Medical University of Katowice, Zabrze, Poland. · Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland. · INOVA Heart and Vascular Institute, Virginia. · Interventional Cardiology and Cardiovascular Medicine Research, Cardiovascular Research Center, Mater Dei Hospital, Bari, Italy. · SIRIO MEDICINE Research Network, Düsseldorf, Germany. · Department of Cardiology Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland. ·Catheter Cardiovasc Interv · Pubmed #30311397.

ABSTRACT: BACKGROUND: There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI) therapy with dedicated DES platforms. The LM-STENTYS is a multicenter registry aimed at evaluating clinical outcome after PCI of LM performed with a self-apposing Stentys DES implantation. METHODS: The registry consists of 175 consecutive patients treated with Stentys DES implanted to LM. The primary endpoint was the composite of major adverse cardiac and cerebral events (MACCE) defined as cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stroke assessed after 1 year. The secondary endpoint was stent thrombosis (ST) at 1 year. RESULTS: The median age was 69 years (IQR, 62-78 years). Acute coronary syndrome (ACS) was the presenting diagnosis in 117 (66.9%) patients [74 (63.2%) unstable angina, 31 (26.5%) NSTEMI, 12 (10.3%) STEMI] and stable angina (SA) was present in 58 (33.1%) patients. The median SYNTAX score was 23.0 (IQR, 18.7-32.2) in the SA group and 25.0 (IQR, 20.0-30.7) in the ACS group. During 1-year follow-up in the SA group two (3.4%) MACCE occurred, both of them were cardiac deaths. In ACS patients there were 19 (16.2%) MACCE [9 (7.7%) cardiac deaths, 11 (9.4%) MIs, 11(9.4%) TLR, 1(0.9%) stroke]. Altogether, three (1.7%) cases of acute ST were noted, all of them in ACS subset. CONCLUSION: LM PCI using self-apposing Stentys DES showed favorable clinical outcomes at 1-year in patients with SA. Events of ST in the ACS group warrant further research.

6 Article Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography. 2018

Kubiak, Grzegorz M / Dobrolińska, Magdalena / Pociask, Elżbieta / Wańha, Wojciech / Gąsior, Paweł / Smolka, Grzegorz / Ochała, Andrzej / Wojakowski, Wojciech / Roleder, Tomasz. ·Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze, Poland. · 3 Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland. · Krakow Cardiovascular Research Institute, Jagiellonian University Medical College, Krakow, Poland. · Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland. ·Postepy Kardiol Interwencyjnej · Pubmed #30603026.

ABSTRACT: Introduction: Coronary artery bypass grafting (CABG) is a method of choice in treatment of diffuse coronary artery disease (CAD), although it has some limitations such as late saphenous vein graft (SVG) patency loss, which occurs in one fifth of all conduits at 5 years. Since atherosclerosis in SVG has diffuse characteristics, it appears that significantly and non-significantly stenosed lesions may have an equal impact on worse prognosis. Aim: To assess non-significant lesions of SVG by the use of optical coherence tomography (OCT) and investigate the clinical and laboratory findings with the potential impact on plaque composition. Material and methods: Twenty-nine patients with 43 non-significant lesions were enrolled in the study. All variables were assessed using uni- and multivariable logistic regression analysis with each plaque morphology as a dependent variable. Odds ratio (OR) and 95% confidence interval (CI) were computed. Results: Plaque rupture (PRT) was independently associated with age (OR = 1.49, 95% CI: 1.09-2.04, Conclusions: Atherosclerosis of SVG is not restricted to significantly stenosed lesions. Plaque composition is independently associated with different types of clinical and laboratory findings, mostly recognized as risk factors of CAD.

7 Article Saphenous graft atherosclerosis as assessed by optical coherence tomography data for stenotic and non-stenotic lesions from the OCTOPUS registry. 2018

Kubiak, Grzegorz M / Pociask, Elżbieta / Wańha, Wojciech / Dobrolińska, Magdalena / Gąsior, Paweł / Smolka, Grzegorz / Ochała, Andrzej / Gąsior, Zbigniew / Wojakowski, Wojciech / Roleder, Tomasz. ·Department of Cardiac Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze, Poland. · Krakow Cardiovascular Research Institute, Jagiellonian University Medical College, Krakow, Poland. · 3 Division of Cardiology and Structural Heart Diseases, Department of Medical, University of Silesia, Katowice, Poland. · Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland. ·Postepy Kardiol Interwencyjnej · Pubmed #30008768.

ABSTRACT: Introduction: Coronary artery bypass grafting (CABG), although widely used for a long time in diffuse coronary artery disease (CAD), has serious limitations associated with graft aging and its degeneration. Aim: The relationship between saphenous vein graft (SVG) plaque morphology assessed by optical coherence tomography (OCT) and clinical findings has not been elucidated yet. Material and methods: We compared the morphology of SVG in stenotic vs. non-stenotic lesions using OCT imaging in 29 patients hospitalized in our center within the OCTOPUS registry. Results: Stenotic lesions were characterized by higher incidence of thin-cap fibroatheroma (TCFA) (33% vs. 0%, Conclusions: Presence of ITR was associated with advanced age, decreased LVEF and renal insufficiency. Decreased concentration of HDL was associated with higher occurrence of calcified and ruptured plaque.

8 Article Efficacy and Safety of the HeartMate Percutaneous Heart Pump During High-Risk Percutaneous Coronary Intervention (from the SHIELD I Trial). 2018

Dudek, Dariusz / Ebner, Adrian / Sobczyński, Robert / Trębacz, Jarosław / Vesga, Boris / Granada, Juan / Zembala, Marian / Witkowski, Adam / Van Mieghem, Nicolas M / Sood, Poornima / Ochała, Andrzej / Dziewierz, Artur / Żmudka, Krzysztof. ·Institue of Cardiology, Jagiellonian University, Krakow, Poland. Electronic address: mcdudek@cyfronet.pl. · Sanatorio Italiano, Asuncion, Paraguay. · Institue of Cardiology, Jagiellonian University, Krakow, Poland. · Universidad Industrial de Santander, Colombia. · Cardiovascular Research Foundation, New York, New York. · Silesian Center for Heart Diseases, Zabrze, Poland. · Institute of Cardiology, Warsaw, Poland. · Erasmus Medical Center Rotterdam, Netherlands. · St. Jude Medical, Burlington, Massachusetts. · Medical University of Silesia, Katowice, Poland. ·Am J Cardiol · Pubmed #29655880.

ABSTRACT: This study aimed to evaluate the use of the HeartMate percutaneous heart pump, a catheter-based axial flow pump designed to provide partial left ventricular support, in patients who underwent high-risk percutaneous coronary intervention (PCI). Patients who are hemodynamically unstable, or at risk of being hemodynamically unstable, while undergoing PCI may require mechanical circulatory support. Fifty high-risk patients were enrolled in a prospective, nonrandomized, multicenter, open-label trial. Primary end points were freedom from hemodynamic compromise during PCI and a composite measure of major adverse events. Patients were followed for 30 days. No patient met the primary performance end point. Six safety end points in 5 patients occurred, including 1 access site complication requiring intervention, 1 cerebrovascular accident, 2 major bleeding complications, and 2 cases of new or worsening aortic insufficiency. No cardiac deaths, myocardial infarctions, or surgical interventions occurred. In conclusion, initial results of the HeartMate percutaneous heart pump for mechanical circulatory support during high-risk PCI are encouraging. Hemodynamic stability was achieved in all patients with a low incidence of adverse events.

9 Article Concomitant coronary artery disease and its management in patients referred to transcatheter aortic valve implantation: Insights from the POL-TAVI Registry. 2018

Huczek, Zenon / Zbroński, Karol / Grodecki, Kajetan / Scisło, Piotr / Rymuza, Bartosz / Kochman, Janusz / Dąbrowski, Maciej / Witkowski, Adam / Wojakowski, Wojciech / Parma, Radosław / Ochała, Andrzej / Grygier, Marek / Olasińska-Wiśniewska, Anna / Araszkiewicz, Aleksander / Jagielak, Dariusz / Ciećwierz, Dariusz / Puchta, Dominika / Paczwa, Katarzyna / Filipiak, Krzysztof J / Wilimski, Radosław / Zembala, Marian / Opolski, Grzegorz. ·First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. · Institute of Cardiology, Warsaw-Anin, Poland. · Third Department of Cardiology, Medical University of Silesia, Katowice, Poland. · First Department of Cardiology, Medical University of Poznan, Poznan, Poland. · Department of Cardiac and Vascular Surgery, Medical University of Gdańsk, Gdańsk, Poland. · Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland. · Department of Cardiac Surgery, Medical University of Warsaw, Poland. · Department of Cardiac Surgery, Silesian Center for Heart Diseases, Zabrze, Poland. ·Catheter Cardiovasc Interv · Pubmed #28843025.

ABSTRACT: BACKGROUND: Coronary artery disease (CAD) and degenerative aortic stenosis often coexist. However, the impact of CAD and its management on the prognosis after transcatheter aortic valve implantation (TAVI) remains uncertain. We sought to evaluate the impact of obstructive CAD, SYNTAX score (Ss), and percutaneous coronary intervention (PCI) prior to TAVI on short-term outcome. METHODS: Overall, 896 patients who underwent TAVI after heart team decision was included. Pre-procedural angiograms were analysed to calculate baseline Ss (bSs) and residual Ss (rSs). Baseline, procedural and follow-up data up to 30 days was acquired from the national POL-TAVI registry. RESULTS: Patients with obstructive CAD at baseline (n = 462, 52%) had higher mortality as compared with the remaining (8.7 vs. 5.1%, log-rank P = 0.039). Also, after correction for confounding factors obstructive CAD was identified as independent predictor of mortality (hazard ratio [HR] 1.74, 95% confidence intervals [CIs] 1.03-2.94, P = 0.037). In obstructive CAD, neither bSs (AUC 0.47, CI 0.38-0.56, P = 0.47) nor rSs (AUC 0.47, CI 0.30-0.64, P = 0.72 for those undergoing PCI and AUC 0.48, CI 0.37-0.59, P = 0.75 for the remaining) was predictive of mortality. When revascularization status was considered, patients with PCI prior to TAVI had similar outcome as those without obstructive CAD at baseline (7.7 vs. 5.1%, log-rank P = 0.23) with no negative impact on mortality (HR 1.13, CI 0.62-2.09, P = 0.69). CONCLUSIONS: In conclusion, obstructive CAD at baseline evaluation for TAVI has independent negative impact on short-term prognosis. However, neither baseline nor residual Ss values have prognostic ability in patients undergoing TAVI. Revascularization prior to TAVI seems to improve survival to levels comparable with patients without obstructive CAD at baseline.

10 Article Poland: coronary and structural heart interventions from 2010 to 2015. 2017

Legutko, Jacek / Siudak, Zbigniew / Parma, Radosław / Ochała, Andrzej / Dudek, Dariusz. ·2nd Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland. ·EuroIntervention · Pubmed #28504231.

ABSTRACT: For the last five years, invasive cardiology in Poland has developed extensively. Currently, 98% of the 161 Polish cathlabs operate in 24/7 mode, 37 of them supported by cardiac surgery departments on-site. A certification curriculum for interventional cardiology operators is supported by dedicated workshops and scientific meetings during national conferences. The rise in the number of coronary angiographies and PCIs was paralleled by an increased use of drug-eluting stents, bioresorbable vascular scaffolds and physiologic assessment of coronary arteries. Radial artery access has become the default option for PCI. A rapid adoption of the EAPCI Stent for Life Initiative resulted in a significant increase in primary PCIs. Unlike coronary interventions, structural heart interventions have evolved unevenly, despite the solid network of Heart Teams set up in the 21 most experienced centres. Left atrial appendage closure is offered in an increasing number of cathlabs. MitraClip therapy remains largely underused (1 procedure/million population/year). Despite the slow growth of TAVI since 2008, the current annual number of 17.1 TAVI procedures per million population is incomparable with countries in Western Europe. A recently introduced EAPCI Valve for Life campaign was followed by a 42.6% annual increase in TAVI procedures and an improvement in patients' access to therapy in life-saving indications.

11 Article Second-generation drug-eluting stents in the elderly patients with acute coronary syndrome: the in-hospital and 12-month follow-up of the all-comer registry. 2017

Wańha, Wojciech / Kawecki, Damian / Roleder, Tomasz / Morawiec, Beata / Gładysz, Sylwia / Kowalówka, Adam / Jadczyk, Tomasz / Adamus, Barbara / Pawłowski, Tomasz / Smolka, Grzegorz / Kaźmierski, Maciej / Ochała, Andrzej / Nowalany-Kozielska, Ewa / Wojakowski, Wojciech. ·Third Division of Cardiology, Medical University of Silesia, Katowice, Poland. wojciech.wanha@gmail.com. · Second Division of Cardiology, Medical University of Silesia, Zabrze, Poland. · Third Division of Cardiology, Medical University of Silesia, Katowice, Poland. · Division of Cardiothoracic Surgery, Medical University of Silesia, Katowice, Poland. · Division of Cardiology, Specialist Hospital, Wilkowice, Poland. ·Aging Clin Exp Res · Pubmed #27832467.

ABSTRACT: BACKGROUND: Katowice-Zabrze registry provides data that can be used to evaluate clinical outcomes of percutaneous coronary interventions in elderly patients (≥70 y/o) treated with either first- (DES-I) or second-generation (DES-II) drug-eluting stents (DES). METHODS: The registry consisted of data from 1916 patients treated with coronary interventions using either DES-I or DES-II stents. For our study, we defined patients ≥70 years of age as elderly. We evaluated any major adverse cardiac and cerebral events (MACCE) at 12-month follow-up. RESULTS: Coronary angiography revealed a higher incidence of multivessel coronary artery disease in this elderly patient population. There were no differences in acute and subacute stent thrombosis (0.4 vs. 0.6%, p = 0.760; 0.4 vs. 0.4%; p = 0.712). Elderly patients experienced more in-hospital bleeding complications requiring blood transfusion (2.0 vs. 0.9%; p = 0.003). Resuscitated cardiac arrests (2.0 vs. 0.9%; p = 0.084) were observed more often in this elderly patients during hospitalization. The composite in-hospital MACCE rates did not differ statistically between both groups (1.4 vs. 1.1%; p = 0.567). Data from a twelve-month follow-up disclosed that mortality was higher (7.1 vs. 1.8%; p < 0.001) in the elderly, with no difference in TVR (7.2 vs. 9.9%, p = 0.075), MI (6.0 vs. 4.8%, p = 0.300), stroke (0.8 vs. 0.6%, p = 0.600) and composite MACCE (15.0 vs. 13.4%, p = 0.324). The age of 70 years or over was an independent predictor of death [HR = 2.55 (95% CI 1.49-4.37); p < 0.001]. The use of DES-II reduced the risk of MI [HR = 0.40 (95% CI 0.19-0.82); p = 0.012] in the elderly. CONCLUSION: This elderly patient population had an increased risk of in-hospital bleeding complications requiring blood transfusion and a higher risk of death at 12-month follow-up. The use of new-generation DES reduced the risk of MI in the elderly population.

12 Article A single-centre, randomised study on platelet reactivity after abrupt or gradual discontinuation of long-term clopidogrel therapy in patients after percutaneous coronary intervention. 2016

Nadrowski, Paweł / Syzdół, Marcin / Wańha, Wojciech / Nabiałek, Edyta / Skrzypek, Michał / Góral, Joanna / Siewniak, Maria / Kozakiewicz, Krystyna / Ochała, Andrzej / Tendera, Michał / Wojakowski, Wojciech. ·Third Department of Cardiology, Medical University of Silesia, Katowice. pawel24@gmail.com. ·Kardiol Pol · Pubmed #26779855.

ABSTRACT: BACKGROUND: Clinical studies have suggested increased risk of thrombotic events after planned cessation of clopidogrel therapy, due to increased platelet reactivity (platelet rebound); however, in many studies platelet function was not assessed before introducing clopidogrel. Patients who are scheduled to stop clopidogrel therapy, do it abruptly, so a gradual drug cessation might provide a beneficial treatment strategy. AIM: To determine whether a clopidogrel discontinuation results in platelet rebound hyperaggregability with increased activity compared to pre-treatment values and to assess whether abrupt or tapering clopidogrel cessation may affect platelet reactivity. METHODS: Patients with stable coronary artery disease (n = 49), on chronic acetylsalicylic acid treatment, who underwent coronary angiography, and were scheduled for elective percutaneous coronary intervention with stent implantation were en-rolled. Patients were randomised to either a tapering clopidogrel discontinuation during a two-week period (tapering group, n = 25) or abrupt drug cessation (abrupt group, n = 24). After 12 months of dual antiplatelet therapy with clopidogrel and acetylsalicylic acid, we performed three follow-up visits with blood sampling. Platelet aggregation was assessed using a mul-tiple electrode aggregometer at inclusion, at cessation day, and seven and 14 days after complete clopidogrel discontinuation. The primary endpoint was the level of adenosine-diphosphate (ADP)-induced platelet aggregation. We also analysed platelet function in the ASPI test and platelet count as secondary endpoints. RESULTS: In 36 patients included in the main analysis, we found significant differences between the two study groups in the levels of ADP-induced platelet aggregation at days seven and 14 after cessation of clopidogrel (p = 0.004 and p = 0.04, respectively). In the abrupt group, platelet aggregation returned to the values similar to baseline at day seven. There were no significant differences between baseline, seven, and 14 days after drug cessation (p = 0.92 and p = 0.37, respectively). However, in the tapering group, ADP values at seven and 14 days after drug cessation were significantly decreased, comparing to baseline (p < 0.0001 and p = 0.009, respectively). For the ASPI test and platelet count we did not find significant differ-ences between the groups. All values returned to levels similar to the baseline. During the follow-up there were no serious cardiovascular events or bleedings. CONCLUSIONS: Tapering vs. abrupt discontinuation of clopidogrel treatment results in significantly lower platelet aggregation values after 14 days from complete drug cessation. We found no evidence of a platelet rebound effect.

13 Article Outcomes of biodegradable polymer sirolimus-eluting PROLIM stent in patients with coronary artery disease. Results of 12-month follow-up of prospective registry. 2016

Roleder, Tomasz / Smolka, Grzegorz / Podolecka, Ewa / Chudek, Jolanta / Dworowy, Sebastian / Żelazowska, Katarzyna / Wojakowski, Wojciech / Ochała, Andrzej. ·3rd Department of Cardiology, Medical University of Silesia, Katowice, Poland. tomaszroleder@gmail.com. ·Kardiol Pol · Pubmed #26502940.

ABSTRACT: BACKGROUND: Data from clinical trials suggested that biodegradable-polymer-based drug-eluting stents (DES) might improve long-term clinical outcomes. PROLIM (Balton, Warsaw, Poland) DES is based on a stainless steel platform with a closed cell design releasing sirolimus from biodegradable copolymer (lactic and glycolic acid) in eight weeks. AIM: In the present study the safety and the efficacy of a PROLIM stent was assessed in patients with de novo coronary lesions in 12-month clinical follow-up. METHODS: It was a single-centre, observational, prospective registry to assess the safety and efficacy of a PROLIM stent implantation in all consecutive patients with de novo coronary artery lesions treated with percutaneous coronary intervention (PCI). The primary study endpoint was a composite safety (cardiac death, non-fatal myocardial infarction), and the second study endpoint was the efficacy of PROLIM implantation-clinically driven target vessel revascularisation (TVR) assessed at 12-month follow-up. RESULTS: One hundred patients were enrolled into the study and 118 PROLIM stents were implanted. Thirty-two (32%) patients had diabetes, 46 (46%) patients were prior PCI, and 17 (17%) patients had coronary artery bypass grafting. 67% of stented lesions were complex ones (B2/C) and 17% were bifurcations. During the 12-month follow-up primary study endpoints occurred in five (5%) patients. Two (2%) cardiac deaths were reported and three (3%) TVRs were performed, of which one was related to in-PROLIM stent restenosis. CONCLUSIONS: PCI with biodegradable-polymer PROLIM DES seems to be safe and effective in 12-month follow-up. A larger trial is warranted to assess clinical outcomes post PROLIM stent implantation.

14 Article Temporal trends and patterns in percutaneous treatment of coronary artery disease in Poland in the years 2005-2011. 2015

Siudak, Zbigniew / Ochała, Andrzej / Lesiak, Maciej / Witkowski, Adam / Gil, Robert J / Legutko, Jacek / Maciejewski, Paweł / Fijorek, Kamil / Dudek, Dariusz. ·Uniwersytet Jagiellonski Collegium Medicum. zbigniew.siudak@gmail.com. ·Kardiol Pol · Pubmed #25733178.

ABSTRACT: BACKGROUND: According to a recent survey, Poland is one of the leaders of interventional cardiology in Europe in terms of the number of primary percutaneous coronary intervention (PCI) procedures per million inhabitants. AIM: To present temporal trends in epidemiology, demographics, treatment, and periprocedural outcome of patients referred for percutaneous coronary angiography and angioplasty in Poland in 2005-2011, based on the Polish National PCI Registry. METHODS: Patients who underwent percutaneous coronary angiography (ANGIO group) and/or angioplasty (PCI group) were included in the Polish National PCI Registry - a prospective observational registry study in Poland. RESULTS: There were 935,429 patients in the ANGIO group and 501,117 in the PCI group in Poland in 2005-2011. The number of catheterisation labs increased from 75 to 137, angiography procedures rose from 99,195 to 180,935, and PCIs from 50,297 to 99,614. The procedural mortality and stroke rates for the ANGIO group have remained stable whereas for the PCI group procedural mortality has increased over the years. The use of drug eluting stents (DESs) rose from 32.8% to 55.3% in stable angina and the use of a radial approach from 26.8% to 39.1%. CONCLUSIONS: Use of modern attributes of interventional cardiology like DES stents, radial approach, and treatment of higher risk patients has increased in Poland in 2005-2011. The adoption of the "Stent for Life" initiative has resulted in an increasing number of percutaneous coronary procedures over the years.

15 Article Implantation of a bioabsorbable vascular scaffold into a coronary vein graft: a two-week angiography follow-up. 2014

Roleder, Tomasz / Ochała, Andrzej / Smolka, Grzegorz / Wańha, Wojciech / Wojakowski, Wojciech. ·2nd Department of Cardiology, Medical University of Silesia, Katowice, Poland. tomaszroleder@gmail.com. ·Kardiol Pol · Pubmed #24677079.

ABSTRACT: -- No abstract --

16 Article [Current status of drug-eluting stents and drug-eluting balloons in patients with stable coronary artery disease--an expert consensus document of the Association for Percutaneous Cardiovascular Interventions and Polish Cardiac Society]. 2011

Witkowski, Adam / Opolski, Maksymilian P / Dudek, Dariusz / Lesiak, Maciej / Legutko, Jacek / Wojakowski, Wojciech / Ochała, Andrzej / Maciejewski, Paweł / Deptuch, Tomasz / Araszkiewicz, Aleksander / Gil, Robert / Grajek, Stefan / Poloński, Lech / Anonymous4540711. ·Klinika Kardiologii i Angiologii Interwencyjnej, Instytut Kardiologii, ul. Alpejska 42, Warsaw. witkowski@hbz.pl ·Kardiol Pol · Pubmed #22125234.

ABSTRACT: Despite a dramatic reduction in restenosis and target vessel revascularisation rates by drug eluting stents (DES), conflicting concerns have been raised over the risk for late DES thrombosis when compared to bare metal stents. Certainly, the heterogeneity of DES results from the introduction of a great variety of new DES types with diverse efficacy and safety parameters. Furthermore, we observe a steady increase in DES availability without parallel and robust data from randomised clinical trials. Thus, the postulated class effect of DES should be regarded as non-obligatory. This article is based on 110 randomised DES trials performed on 72 305 patients. Current status of DES and guidelines for DES implantation in various clinical scenarios were discussed.