Adipokines and endothelial dysfunction in acute myocardial infarction and the risk of recurrent cardiovascular events.

AIMS: The aim of the study was to evaluate the prognostic role of adipokines (adiponectin, apelin, resistin, and visfatin) in patients with acute myocardial infarction (AMI) in relation to the extent of glucose metabolism impairment and intensity of systemic low-grade inflammation. METHODS: This case-control study covered 131 patients with coronary artery disease: 104 consecutive patients with AMI (74% men, mean age of 62 ±â€Š11 years) treated with primary percutaneous coronary intervention with stent implantation, and 27 patients with stable angina (70% men, mean age of 63 ±â€Š11 years), who were initially assessed in terms of adipokine levels, C-reactive protein and various echocardiographic and vascular parameters. Major adverse cardiovascular events were recorded in the AMI group during 3-year follow-up. RESULTS: Resistin and visfatin serum levels were significantly higher (P < 0.001), and adiponectin and apelin were lower (P < 0.001) in AMI patients as compared to patients with stable angina. In AMI patients, adipokine levels were not related to glucose metabolism disturbances, yet adiponectin (P = 0.03) and resistin (P = 0.001) concentrations were related to the number of affected coronary vessels. Serum adiponectin level correlated negatively (r = -0.608, P < 0.05), whereas resistin and visfatin correlated positively (r = 0.526, P < 0.05 and r = 0.352, P < 0.05, respectively) with C-reactive protein levels. All of the analyzed adipokines significantly accounted for the flow-mediated dilation variability (Radjusted 32%) in the AMI group. The Cox survival analysis indicated that resistin and visfatin were independent risk factors of recurrent AMI/unstable angina, with the diagnostic threshold above 12.2 ng/ml for resistin and above 11.8 ng/ml for visfatin concentrations. CONCLUSION: An abnormal profile in serum adipokines observed in AMI is related to systemic inflammation and the degree of atherosclerosis independently of glucose metabolism disturbances and heralds major adverse cardiovascular event occurrence in long-term observation.

B-cell lymphoma in a 70 year-old male patient with a cardiac tumour.

We present a case of a 70 year-old male with B-cell lymphoma of which the first clinical presentation was cardiac infiltration. The patient underwent full chemotherapy with complete tumour regression. Kardiol Pol 2011; 69, 10: 1063-1065.

[Sepsis--actual clinical problem]. / Posocznica--aktualny problem kliniczny.

An incidence of sepsis, septic shock, systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is still actual clinical problem. Inducing factors and clinical pictures are similar to recently reported data from comparable populations in North America, Europe and Australia. The most important complication of severe sepsis is organ dysfunction observed in over 30% of sepsis patients hospitalized in intensive care unit. Applied intensive therapy including new generations of antibiotics gives an increase in clinical recovery. However, a hospital mortality of sepsis patients is over 30%.