REVISITING THE VALUE OF HAEMATOLOGICAL AND BIOCHEMICAL MARKERS AND THE RATIOS IN PATIENTS WITH CORONARY ARTERY DISEASE.

OBJECTIVE: The aim: To investigate haematological and biochemical parameters and their potential for grading the severity of coronary artery lesions to predict the course atherosclerosis. PATIENTS AND METHODS: Materials and methods: The study is based on data obtained from a prospective analysis of 131 patients at the age of 51 to 82 years old from January to December 2019, whose complaints could indicate the coronary artery disease. All patients underwent a comprehensive clinical, laboratory and instrumental examination. RESULTS: Results: The ratios of haematological and biochemical parameters significantly correlated with Syntax Score I. Some indexes did not confirm significant correlations with the severity of coronary artery disease. NT-proBNP, as a biochemical parameter, was the highest in patients with multi-vessel coronary artery disease and it had a moderate positive correlation with Syntax Score I (r = 0.428, p = 0.0001). CONCLUSION: Conclusions: This study shows that ordinary indexes can be useful for assessment in daily practice for difficult patients. NTproBNP as an indicator requires further study as an additional marker for assessing the state of the cardiovascular system and can influence the choice of treatment.

Five-year Experience With Arterial Switch Operation in the First Hours of Life.

We assessed morbidity after 2 management strategies for arterial switch operation (ASO) in a single institution: first hours of life surgery and conventional approach. From September 2009 to September 2014, 346 consecutive patients who underwent ASO were enrolled. The study group included 92 patients who underwent ASO in the first 24 hours after birth (group I). The control group consisted of 254 patients who underwent ASO after 24 hours of life in the conventional way (group II). Three outcomes were analyzed: postoperative ventilation time (VT), post-extubation hospital length of stay (peLOS), and a composite morbidity index, defined as postoperative VT + peLOS + occurrence of selected major complications. Overall 30-day survival was 98% (2 [2%] group I vs 5 [2%] group II, P = 1.000). Fifty (13.3%) major complications were observed: 14 (15%) in group I and 36 (15%) in group II (P = 0.635). Although peLOS and morbidity index did not differ significantly between groups, postoperative VT (42 hours [24, 67] vs 27 hours [22, 47], P = 0.008) and total hospital stay were significantly longer in group II (18 days [10, 19] vs 14 days [12, 18]). A median volume of 80 mL (60-100 mL) of autologous umbilical cord blood was collected (80 mL, group 1 vs 60 mL, group II; P = 0.090). Homologous blood cell transfusion was avoided in 70 patients (78%) in group I and in 13 patients (6%) in group II (P < 0.001). Arterial switch operation during the initial 24 hours of life has similar outcomes in view of morbidity and mortality to the conventional approach.