Self-Templating Copolymerization to Produce Robust Conductive Nanocoatings Based on Conjugated Polymer Brushes with Implementable Memristive Characteristics.

An effective synthesis of conductive polymer brushes, i.e., self-templating surface-initiated copolymerization (ST-SICP), is developed. It proceeds through copolymerization of pendant thiophene groups in the precursor multimonomer poly(3-methylthienyl methacrylate) (PMTM) brushes with free 3-methylthiophene (3MT) monomers leading to PMTM-co-P3MT brushes. This approach leads to improved conformational freedom of generated conjugated poly(thiophene)-based chains and their higher share in the brushes with respect to conjugation of pendant thiophene groups only. As a result, best performing conjugated PMTM-co-P3MT brushes demonstrate high ohmic conductivity in both out-of-plane and in-plane direction. Furthermore, thanks to the covalent anchoring as well as intra- and intermolecular connections, highly stable and mechanically robust nanocoatings are produced which can survive mechanical cleaning and long-term storage under ambient conditions. Grafting of ionic poly(sodium 4-styrenesulfonate) (PSSNa) in between PMTM-co-P3MT chains brings new properties to such binary mixed brushes that can operate as thin-film memristive coating with switchable conductance. It is worth mentioning that the crucial synthetic steps, i.e., grafting of precursor PMTM brushes by surface-initiated organocatalyzed atom transfer radical polymerization (SI-O-ATRP) and PSSNa chains by surface-initiated photoiniferter-mediated polymerization (SI-PIMP) are conducted under ambient conditions using only microliter volumes of reagents providing methodology that can be considered for use beyond the laboratory scale.

Ladder-like Polymer Brushes Containing Conjugated Poly(Propylenedioxythiophene) Chains.

The high stability and conductivity of 3,4-disubstituted polythiophenes such as poly(3,4-ethylenedioxythiophene) (PEDOT) make them attractive candidates for commercial applications. However, next-generation nanoelectronic devices require novel macromolecular strategies for the precise synthesis of advanced polymer structures as well as their arrangement. In this report, we present a synthetic route to make ladder-like polymer brushes with poly(3,4-propylenedioxythiophene) (PProDOT)-conjugated chains. The brushes were prepared via a self-templating surface-initiated technique (ST-SIP) that combines the surface-initiated atom transfer radical polymerization (SI-ATRP) of bifunctional ProDOT-based monomers and subsequent oxidative polymerization of the pendant ProDOT groups in the parent brushes. The brushes prepared in this way were characterized by grazing-angle FTIR, XPS spectroscopy, and AFM. Steady-state and time-resolved photoluminescence measurements were used to extract the information about the structure and effective conjugation length of PProDOT-based chains. Stability tests performed in ambient conditions and under exposure to standardized solar light revealed the remarkable stability of the obtained materials.

A New Protocol for Ash Wood Modification: Synthesis of Hydrophobic and Antibacterial Brushes from the Wood Surface.

The article presents the modification of ash wood via surface initiated activators regenerated by electron transfer atom transfer radical polymerization mediated by elemental silver (Ag0 SI-ARGET ATRP) at a diminished catalyst concentration. Ash wood is functionalized with poly(methyl methacrylate) (PMMA) and poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA) to yield wood grafted with PMMA-b-PDMAEMA-Br copolymers with hydrophobic and antibacterial properties. Fourier transform infrared (FT-IR) spectroscopy confirmed the covalent incorporation of functional ATRP initiation sites and polymer chains into the wood structure. The polymerization kinetics was followed by the analysis of the polymer grown in solution from the sacrificial initiator by proton nuclear magnetic resonance (1H NMR) and gel permeation chromatography (GPC). The polymer layer covalently attached to the wood surface was observed by scanning electron microscopy (SEM). The hydrophobic properties of hybrid materials were confirmed by water contact angle measurements. Water and sodium chloride salt aqueous solution uptake tests confirmed a significant improvement in resistance to the absorption of wood samples after modification with polymers. Antibacterial tests revealed that wood-QPDMAEMA-Br, as well as wood-PMMA-b-QPDMAEMA-Br, exhibited higher antibacterial activity against Gram-positive bacteria (Staphylococcus aureus) in comparison with Gram-negative bacteria (Escherichia coli). The paper presents an economic concept with ecological aspects of improving wood properties, which gives great opportunities to use the proposed approach in the production of functional hybrid materials for industry and high quality sports equipment, and in furniture production.

Exfoliated Ferrierite-Related Unilamellar Nanosheets in Solution and Their Use for Preparation of Mixed Zeolite Hierarchical Structures.

Direct exfoliation of layered zeolites into solutions of monolayers has remained unresolved since the 1990s. Recently, zeolite MCM-56 with the MWW topology (layers denoted mww) has been exfoliated directly in high yield by soft-chemical treatment with tetrabutylammonium hydroxide (TBAOH). This has enabled preparation of zeolite-based hierarchical materials and intimate composites with other active species that are unimaginable via the conventional solid-state routes. The extension to other frameworks, which provides broader benefits, diversified activity, and functionality, is not routine and requires finding suitable synthesis formulations, viz. compositions and conditions, of the layered zeolites themselves. This article reports exfoliation and characterization of layers with ferrierite-related structure, denoted bifer, having rectangular lattice constants like those of the FER and CDO zeolites, and thickness of approximately 2 nm, which is twice that of the so-called fer layer. Several techniques were combined to prove the exfoliation, supported by simulations: AFM; in-plane, in situ, and powder X-ray diffraction; TEM; and SAED. The results confirmed (i) the structure and crystallinity of the layers without unequivocal differentiation between the FER and CDO topologies and (ii) uniform thickness in solution (monodispersity), ruling out significant multilayered particles and other impurities. The bifer layers are zeolitic with Brønsted acid sites, demonstrated catalytic activity in the alkylation of mesitylene with benzyl alcohol, and intralayer pores visible in TEM. The practical benefits are demonstrated by the preparation of unprecedented intimately mixed zeolite composites with the mww, with activity greater than the sum of the components despite high content of inert silica as pillars.

Photoactive Surface-Grafted Polymer Brushes with Phthalocyanine Bridging Groups as an Advanced Architecture for Light-Harvesting.

Surface-grafted polymer brushes of novel ladder-like architecture were proposed for inducing ordering of chromophores embedded therein. The brushes with acetylene side groups were obtained by surface-initiated photoiniferter-mediated polymerization. The acetylene moieties reacted then through a "click" process with an axially azide-bifunctionalized silicon phthalocyanine bridging the neighboring chains that inherently adopt extended conformations in dense brushes. FTIR, quartz crystal microbalance, and atomic force microscopy were used to study formation and structure of the photoactive brushes varying in grafting densities. Importantly, photophysical properties of the chromophores were virtually unaffected upon embedding them into the brushes, as evidenced by UV/Vis absorption and emission spectroscopy. Owing to the unique ordering of the chromophores, the proposed method may open new opportunities for the fabrication of light-harvesting systems suitable for photovoltaic or sensing applications.

[Infective endocarditis in intensive cardiac care unit - clinical and biochemical differences of blood-culture negative infective endocarditis]. / Infekcyjne zapalenie wsierdzia w oddziale intensywnej terapii kardiologicznej ­ róznice kliniczne i biochemiczne w grupie z ujemnym posiewem krwi.

Diagnosis and treatment of infective endocarditis (IE) is still a challenge for physicians. Group of patients with the worst prognosis is treated in Intensive Cardiac Care Unit (ICCU). Etiologic agent can not be identified in a substantial number of patients. AIM: The aim of study is to find differences between patients with blood culture negative infective endocarditis (BCNIE) and blood culture positive infective endocarditis (BCPIE) treated in ICCU by comparing their clinical course and laboratory parameters. MATERIALS AND METHODS: Retrospective analysis of 30 patients with IE hospitalized in ICCU Swietokrzyskie Cardiac Centre between 2010 and 2016. This group consist of 26 men (86,67%) and 4 women (13,3%). Mean age was 58 years ±13. Most of the cases were new disease, recurrence of the disease was observed in 2 cases (6,7%). 8 patients (26,7%) required artificial ventilation, 11 (36,7%) received inotropes and 6 (20%) vasopresors. In 14 (46,7%) cases blood cultures was negative (BCNIE), the rest of patients (16, 53,3%) was blood cultures - positive infective endocarditis (BCIE). RESULTS: Both of the groups were clinically similar. There were no statistically significant differences in incidence of cardiac implants, localization of bacterial vegetations, administered catecholamines, antibiotic therapy, artificial ventilation, surgical treatment, complication and in-hospital mortality. Incidence of cardiac complications in all of BCNIE cases and in 81,3% cases of BCPIE draws attention, but it is not statistically significant difference (p=0,08). There was statistically significant difference in mean BNP blood concentration (3005,17 ng/ml ±2045,2 vs 1013,42 ng/ml ±1087,6; p=0,01), but there were no statistically significant differences in rest of laboratory parameters. CONCLUSIONS: BCNIE group has got higher mean BNP blood concentration than BCPIE group. There were no statistically significant differences between these groups in others laboratory parameters, clinical course and administered antibiotic therapy. In our endemic region major cause of BCNIE seems to be early antibiotic therapy prior to collection of blood samples, but further studies are necessary.

TDR Technique for Estimating the Intensity of Evapotranspiration of Turfgrasses.

The paper presents a method for precise estimation of evapotranspiration of selected turfgrass species. The evapotranspiration functions, whose domains are only two relatively easy to measure parameters, were developed separately for each of the grass species. Those parameters are the temperature and the volumetric moisture of soil at the depth of 2.5 cm. Evapotranspiration has the character of a modified logistic function with empirical parameters. It assumes the form ETR(θ (2.5 cm), T (2.5 cm)) = A/(1 + B · e (-C · (θ (2.5 cm) · T (2.5 cm)), where: ETR(θ (2.5 cm), T (2.5 cm)) is evapotranspiration [mm · h(-1)], θ (2.5 cm) is volumetric moisture of soil at the depth of 2.5 cm [m(3) · m(-3)], T (2.5 cm) is soil temperature at the depth of 2.5 cm [°C], and A, B, and C are empirical coefficients calculated individually for each of the grass species [mm · h(1)], and [-], [(m(3) · m(-3) · °C)(-1)]. The values of evapotranspiration calculated on the basis of the presented function can be used as input data for the design of systems for the automatic control of irrigation systems ensuring optimum moisture conditions in the active layer of lawn swards.

[Influenza infection in intensive cardiac care unit patients]. / Infekcja wirusem grypy u pacjentów oddzialu intensywnej terapii kardiologicznej.

Infection with influenza type A virus may cause serious cardiovascular complications, such as myocarditis, heart failure, acute myocardial infarction. Also infection with influenza type AH1N1 may contribute to aggravation of cardiac disorders, i.e. acute coronary syndrome, heart failure, cardiogenic shock, severe ventricular arrythmias. One of the most fatal complication of influenza is pneumonia leading to acute respiratory insufficiency requiring artifitial ventilation. Symptoms of respiratory tract infections durnig influenza epidemy should always be treated with a high index of suspicion. Early diagnosis and adequate antiviral treatment may prevent those complications. A series of four cases of patients hospitalised in intensive cardiac care unit due to suspected cardiac dyspnea and finally diagnosed as a cardiac disease complicated by influenza pneumonia is presented.

Development of functionalized poly(lactide) films with chitosan via SI-SARA ATRP as scaffolds for neuronal cell growth.

Polylactic acid (PLA), a polymer derived from renewable resources, is gaining increasing attention in the development of biomedical devices due to its cost-effectiveness, low immunogenicity, and biodegradability. However, its inherent hydrophobicity remains a problem, leading to poor cell adhesion features. On this basis, the aim of this work was to develop a method for functionalizing the surface of PLA films with a biopolymer, chitosan (CH), which was proved to be a material with intrinsic cell adhesive properties, but whose mechanical properties are insufficient to be used alone. The combination of the two polymers, PLA as a bulk scaffold and CH as a coating, could be a promising combination to develop a scaffold for cell growth. The modification of PLA films involved several steps: aminolysis followed by bromination to graft amino and then bromide groups, poly(glycidyl methacrylate) (PGMA) grafting by surface-initiated supplemental activator and reducing agent atom transfer radical polymerization (SI-SARA ATRP) and finally the CH grafting. To prove the effective adhesive properties, conjugated and non-conjugated films were tested in vitro as substrates for neuronal cell growth using differentiated neurons from human induced pluripotent stem cells. The results demonstrated enhanced cell growth in the presence of CH.

Does PM 2.5 and PM 10-associated heavy metals affect short-term and long-term survival after out-of-hospital cardiac arrest? Four-year study based on regional registry.

BACKGROUND: This study aims to investigate the effect of arsenic (As), cadmium (Cd), nickel (Ni) and lead (Pb) suspended on particulate matters (PM) 2.5 and PM 10 taking into account clinical factors on 30-day and one-year survival after out-of-hospital cardiac arrest (OHCA). METHODS: A retrospective 4-year study that involved patients hospitalized after OHCA. Patients' data were obtained from Emergency Medical Services dispatch cards and the National Health Fund. The concentration of air pollutants was measured by the Environmental Protection Inspectorate in Poland. RESULTS: Among the 948 patients after OHCA, only 225 (23.7%) survived for 30 days, and 153 (16.1%) survived for 1 year. Survivors were more commonly affected by OHCA in urban areas (85 [55.6%] vs. 355 [44.7%]; P=0.013) and had slightly higher one-year mean concentration of As (0.78 vs. 0.77; P=0.01), Cd (0.34 vs. 0.34; P=0.012), and Pb (11.13 vs. 10.20; P=0.015) with no differences in daily mean concentration. Significant differences in mean concentrations of heavy metals and PM 2.5 and PM 10 were observed among different quarters. However, survival analysis revealed no differences in long-term survival between quarters. Heavy metals, PM 2.5, and PM 10 did not affect short-term and long-term survival in multivariable logistic regression. CONCLUSIONS: The group of survivors showed slightly higher mean one-year concentrations of As, Cd and Pb, but they also experienced a higher incidence of OHCA in urban areas. There were no differences in long-term survival between patients who suffer OHCA in different quarters. Heavy metals did not independently affect survival.

Interplay between gender and pollution on the prognosis of resuscitated out-of-hospital cardiac arrest.

BACKGROUND: Differences between men and women in prognosis after sudden pre-hospital out-of-hospital cardiac arrest (OHCA) have been described in many studies, but the interplay between gender and pollution have not been characterized in detail. We aimed at appraising the interplay between gender and pollution on the prognosis of OHCA. METHODS: Details on patients with OHCA in whom return of spontaneous circulation was obtained and transferred to a large teaching hospital were obtained from the medical charts of the ambulance service and the Polish National Health Fund. Matching pollutant concentrations (PM 2.5, PM10, As, Ni, Cd, Pb) were obtained from the Polish National Environmental Protection Inspectorate. RESULTS: Details on 948 resuscitated OHCA, 325 (34.3%) of them in women, and occurring between 2018 and 2021, were retrieved. Notably, OHCA in women was associated with significantly higher daily concentrations of PM10 (23.37 [17.09, 37.04] vs. 21.92 [16.32, 29.98] µg/m3, P=0.023) and PM2.5 (16.83 [11.87, 28.24] vs. 15.27 [11.64, 22.72] µg/m3, P=0.026), as well as heightened concentrations of Cd, daily (0.32 [0.19, 0.44] vs. 0.27 [0.17, 0.40] ng/m3, P=0.027) and over 30 days (0.34 [0.20, 0.44] vs. 0.29 [0.18, 0.43] ng/m3, P=0.027). Concurrently, OHCA in females was associated with lower daily temperatures on the day of the incident (8.40 [0.20, 15.40] vs. 9.90 [1.40, 15.90] °C, P=0.042). Despite these differences, survival at 30 days and 12 months was similar in women and men (both P>0.05). CONCLUSIONS: OHCA events with successful resuscitation in women occurred in concomitance with higher daily contaminant levels, yet short-term and long-term prognosis was similar in men and women. The interplay between gender and air pollution on OHCA outcomes requires further population-based studies.

Management of Cardiovascular Complications in Antiphospholipid Syndrome: A Narrative Review with a Focus on Older Adults.

Antiphospholipid syndrome (APS), also known as Hughes syndrome, is an acquired autoimmune and procoagulant condition that predisposes individuals to recurrent thrombotic events and obstetric complications. Central is the role of three types of antiphospholipid antibodies that target phospholipid-binding proteins: lupus anticoagulant (LAC), anti-ß2-glycoprotein I (ß2-GPI-Ab), and anti-cardiolipin (aCL). Together with clinical data, these antibodies are the diagnostic standard. However, the diagnosis of APS in older adults may be challenging and, in the diagnostic workup of thromboembolic complications, it is an underestimated etiology. The therapeutic management of APS requires distinguishing two groups with differential risks of thromboembolic complications. The standard therapy is based on low-dose aspirin in the low-risk group and vitamin K antagonists in the high-risk group. The value of direct oral anticoagulants is currently controversial. The potential role of monoclonal antibodies is investigated. For example, rituximab is currently recommended in catastrophic antiphospholipid antibody syndrome. Research is ongoing on other monoclonal antibodies, such as daratumumab and obinutuzumab. This narrative review illustrates the pathophysiological mechanisms of APS, with a particular emphasis on cardiovascular complications and their impact in older adults. This article also highlights advancements in the diagnosis, risk stratification, and management of APS.

Risk factors of cardiac arrest during a percutaneous coronary intervention performed with rotational atherectomy - analysis based on a Large National Registry.

BACKGROUND: Rotational atherectomy (RA) is traditionally administered for patients with heavily calcified lesions and is thereby characterized by a high risk of the performed intervention. However, the prevalence characteristics of cardiac arrest are poorly studied in this group of patients. We aimed to evaluate the frequency and risk factors of cardiac arrest during percutaneous coronary interventions (PCI) performed with RA and preceding coronary angiography (CA). METHODS: Based on the data collected in the Polish Registry of Invasive Cardiology Procedures (ORPKI) from 2014 to 2021, we included 6522 patients who were treated with RA-assisted PCI. We scrutinized patient and procedural characteristics, as well as periprocedural complications, subsequently comparing groups in terms of cardiac arrest incidence with the use of univariable and multivariable analyses. RESULTS: Thirty-five (0.5%) patients suffered from cardiac arrest during RA-PCI or preceding CA. They were characterized by significantly higher rates of prior stroke, acute coronary syndromes (ACS) as indications and higher Killip class (P < 0.001) at the admission time. Among the confirmed independent predictors of in-procedure cardiac arrest, the following can be noted: factors related to patients' clinical characteristics (e.g., older age, female sex, and disease burden), periprocedural characteristics (e.g., PCI within left main coronary artery [LMCA]), and periprocedural complications (e.g., coronary artery perforation and no-reflow phenomenon). CONCLUSIONS: Severe clinical condition at baseline, expressed by ACS presence and Killip class IV, as well as RA-PCI performed within LMCA and other periprocedural complications, were the strongest predictors of cardiac arrest during RA-assisted PCI and CA.

Bonitation assessment of intensively used football turf depending on the date and area of observation.

This article aimed to evaluate the visual and functional characteristics of intensively used football turf over 10 years, depending on the different areas of the game. The research was conducted on the football turf of the AZS Environmental Club in Wroclaw (N: 51° 7' 31'' E:17° 4' 14''). High variability of the evaluated parameters was observed regarding seasonality, year of observation, and the area of play. It has been shown that the goal area and penalty box areas have the lowest functional value, which are vital areas of the game from the point of view of gaining an advantage in the game. Also, these places are more susceptible to creating sites without plants (requiring additional overseeding) due to the potential of hollowing and goalkeeper interventions ending with the body landing on the ground. The middle area was characterized by the highest overall aspect, color, and turf density values. In the vast majority of cases, there was a downward trend in the turfs' functional value with the turf's age, which is an essential finding in the context of the use of intensively used, athletic natural grass surfaces.

Polysaccharide-based nano-engineered multilayers for controlled cellular adhesion in label-free biosensors.

Controlling cellular adhesion is a critical step in the development of biomaterials, and in cell- based biosensing assays. Usually, the adhesivity of cells is tuned by an appropriate biocompatible layer. Here, synthetic poly(diallyldimethylammonium chloride) (PDADMAC), natural chitosan, and heparin (existing in an extracellular matrix) were selected to assembly PDADMAC/heparin and chitosan/heparin films. The physicochemical properties of macroion multilayers were determined by streaming potential measurements (SPM), quartz crystal microbalance (QCM-D), and optical waveguide lightmode spectroscopy (OWLS). The topography of the wet films was imaged using atomic force microscopy (AFM). The adhesion of preosteoblastic cell line MC3T3-E1 on those well-characterized polysaccharide-based multilayers was evaluated using a resonant waveguide grating (RWG) based optical biosensor and digital holographic microscopy. The latter method was engaged to investigate long-term cellular behavior on the fabricated multilayers. (PDADMAC/heparin) films were proved to be the most effective in inducing cellular adhesion. The cell attachment to chitosan/heparin-based multilayers was negligible. It was found that efficient adhesion of the cells occurs onto homogeneous and rigid multilayers (PDADMAC/heparin), whereas the macroion films forming "sponge-like" structures (chitosan/heparin) are less effective, and could be employed when reduced adhesion is needed. Polysaccharide-based multilayers can be considered versatile systems for medical applications. One can postulate that the presented results are relevant not only for modeling studies but also for applied research.

Surface engineering of mixed conjugated/polyelectrolyte brushes - Tailoring interface structure and electrical properties.

HYPOTHESIS: Mixed polymer brushes (MPBs) could be synthesized by surface dilution of homopolymer brushes and subsequent grafting of other type of chains in the formed voids. Nanophase separation and dynamics of surface-grafted chains could be tailored by modification of their molecular architecture. Mixed polyelectrolyte and conjugated chains contribute synergistically to tailor properties of the coating. EXPERIMENTS: A new synthetic strategy that allowed spatially controlled grafting of poly(sodium 4-styrenesulfonate) chains (PSSNa) in close neighborhood of poly(3-methylthienyl methacrylate) (PMTM) brushes (precursors of the conjugated chains) using surface-initiated polymerizations was developed. The final mixed conjugated/polyelectrolyte brushes were prepared by template polymerization of pendant thiophene groups in PMTM chains. Surface dynamics and nanophase separation of MPBs were studied by nanoscale resolution IR imaging, SIMS profiling and AFM mapping in selective solvents. FINDINGS: Unconjugated MPBs were shown to undergo vertical, and horizontal nanophase separation, while the size and shape of the nanodomains were dependent on molar ratio of the mixed chains and their relative lengths. Generation of the conjugated chains led to diminishing of nanophase separation thanks to stronger mutual interactions of conjugated PMTM and PSSNa (macromolecular mixing). The obtained systems demonstrated tunable interfacial structure and resistance switching phenomenon desired in construction of smart surfaces or memristive devices.

COVID-19 as an independent predictor of aspiration thrombectomy in STEMI. National data from the ORPKI register in the years 2020-2022.

Introduction: Coronavirus disease 2019 (COVID-19) exacerbates intravascular thrombosis that occurs in the coronary artery in ST-elevation myocardial infarction (STEMI). Aim: To analyze the impact of COVID-19 on the application and effect of thrombectomy in STEMI patients. Material and methods: 29915 STEMI patients were analyzed, of whom 3139 (10.5%) underwent thrombectomy. COVID-19 (+) was reported in 311 (10.8%). The clinical characteristics and management of STEMI in COVID-19 (+) and COVID-19 (-) patients were compared. A multivariable logistic regression analysis was performed in search of factors influencing thrombectomy. Results: COVID-19 (+) patients had higher Killip class (IV class; n = 33 (12.31%) vs. n = 138 (5.84%); p < 0.0001) and cardiac arrest at baseline was more frequent in this group (n = 25 (8.04%) vs. n = 137 (4.84%); p = 0.016). Thrombolysis in myocardial infarction (TIMI) 3 after percutaneous coronary intervention was less frequent (n = 248 (80.52%) vs. n = 2388 (87.19%); p = 0.001) in the COVID-19 (-) group. Periprocedural mortality was similar in both groups (n = 28 (0.99%) vs. n = 4 (1.29%); p = 0.622). In multivariable regression analysis COVID-19 increased the risk of thrombectomy (OR = 1.23; 97.5% CI: 1.05-1.43; p = 0.001). Conclusions: STEMI patients undergoing aspiration thrombectomy who were COVID-19 (+) were more likely to be in a severe clinical condition (higher Killip class, more frequent cardiac arrest before the procedure) than COVID-19 (-) patients. Despite more intensive antiplatelet and anticoagulant treatment, PCI procedures were less likely to result in an optimal TIMI 3 effect. COVID-19 is an independent strong predictor of patient qualification for aspiration thrombectomy in STEMI.

Risk factors for cardiovascular diseases: the focus on primary prevention.

Views on the etiopathogenesis of atherosclerosis are subject to evolution. In addition to the classic well-known risk factors, new ones related to mental state, social life and environment are being discovered. Both acute and chronic stress stimulate inflammatory processes. Due to the change in lifestyle and eating habits, the accumulation of risk factors in childhood is an increasing problem. Knowledge of risk factors allows for effective primary prevention of cardiovascular diseases. The effectiveness of prevention increases when the activities cover the largest possible part of the society, and access to a doctor is easy. Therefore, government programs are being implemented offering patients easier access to diagnostics of cardiovascular diseases at the level of primary health care, which enables faster identification of people at the greatest cardiovascular risk. Easier access to primary care and a good doctor-patient relationship improve patient compliance. In this situation, the importance of the family doctor as a key link in the diagnosis, prevention and treatment of cardiovascular diseases is increasing.

Factors affecting short- and long-term survival of patients with acute coronary syndrome treated invasively using intravascular ultrasound and fractional flow reserve: Analysis of data from the Polish Registry of Acute Coronary Syndromes 2017-2020.

BACKGROUND: Intravascular ultrasound (IVUS) and fractional flow reserve (FFR) are invasive procedures increasingly used in treating acute coronary syndrome (ACS). AIMS: This study aimed to evaluate the frequency of IVUS and FFR use in patients with ACS in Poland and to assess the safety of these procedures as well as their impact on short- and long-term survival. METHODS AND RESULTS: This retrospective study included 103849 patients enrolled in the Polish Registry of Acute Coronary Syndromes in 2017-2020. IVUS was performed in 1727 patients, FFR in 1537 patients, and both procedures in 37 patients. The frequency of performing FFR in ACS patients increased over the years from 1.3% to 1.8% (P <0.0001) and IVUS from 1.7% to 2.3% (P <0.0001). In the FFR and/or IVUS group, a similar incidence of stroke, reinfarction, target vessel revascularization, and major bleeding was observed while in-hospital mortality was lower (0% for IVUS + FFR vs. 0.9% for FFR vs. 2.3% for IVUS vs. 3.7 for no procedure; P <0.0001). FFR and IVUS did not affect the 30-day and one-year prognosis. CONCLUSION: In recent years, the number of FFR and IVUS procedures performed in patients with ACS in Poland has increased. There was lower in-hospital mortality in the FFR and/or IVUS group in ACS patients, and no differences in the incidence of stroke, reinfarction, target vessel revascularization, and major bleeding were observed. Performing FFR and IVUS in ACS patients does not significantly affect 30-day or one-year mortality.

The Effect of Daylight-Saving Time on Percutaneous Coronary Intervention Outcomes in Acute Coronary Syndrome Patients-Data from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI) in the Years 2014-2022.

INTRODUCTION: Many factors related to the switch to summer/winter time interfere with biological rhythms. OBJECTIVES: This study aimed to analyze the impact of time change on clinical outcomes of patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS: Electronic data of 874,031 patients with ACS who underwent invasive procedures were collected from the Polish National Register of Interventional Cardiology Procedures (ORPKI) between 2014 and 2021. We determined the number of patients undergoing PCI and periprocedural mortality during the day of spring or autumn time change and within the first 3 and 7 days after the time change. RESULTS: We demonstrated the impact of time changes on the periprocedural mortality of ACS patients within 1 day and the period of 3 and 7 days from the time change. We observed that the occurrence of all ACS and NSTEMI on the first day was lower for both time changes and higher in the case of UA and spring time change. The autumn time change significantly reduced the occurrence of all types of ACS. A significant decrease in the number of invasive procedures was found after autumn transition in the period from the first day to 7 days for ACS, NSTEMI, and UA. CONCLUSIONS: The occurrence of ACS and the number of invasive procedures were lower for both changes over time. Autumn time change is associated with increased periprocedural mortality in ACS and a less frequent occurrence of UA and NSTEMI within 7 days.