Two polymorphisms of the FVII gene and their impact on the risk of myocardial infarction in poles under 45 years of age.

High levels of coagulation factor VII (FVII) in plasma have been associated with the increased risk of myocardial infarction (MI) in some studies. Both environmental and genetic factors are responsible for different levels of FVII in plasma. In the FVII gene there are two common polymorphisms (-323A1/A2 and IVS7)which are related to the level of FVII. The purpose of this study was to evaluate the influence of these polymorphisms on the risk of acute myocardial infarction in Poles under 45 years of age. We performed a case-control study of 266 patients with the history of MI. All patients had the first incidence of MI before 45 years of age. The control group consisted of 137 healthy individuals older than 45 years. Carriers of the A2 allele (-32341/A2 polymorphism) have a lower risk of MI than noncarriers (OR = 0.40, 95% CI = 0.20 to 0.80). The IVS7 polymorphism was shown not to be related to MI in this study. Our findings suggest that the -323A1/A2 polymorphism of the FVII gene is related to the risk of MI in Polish individuals. We pointed that plasma cholesterol (OR = 1.11, 95% CI = 1.03 to 1.18), arterial hypertension (OR = 3.84, 95% CI = 1.99 to 7.43) and family history (OR = 2.72, 95% CI = 1.57 to 4.73) are significant predictors of acute myocardial infarction.

[Recurrent vasovagal syncope and indications for pacemaker implantation--report of two cases]. / Nawracajace omdlenia wazowagalne a wskazania do implantacji rozrusznika serca--opis dwóch przypadków.

Recurrent syncope is a common clinical problem and a significant diagnosis and therapeutic challenge. Head-up tilt testing is commonly used in the evaluation of patients with vasovagal syncope. Analysis of the type of reaction leading to event is a base to the therapeutic method. Documented symptomatic bradycardia or asystole during head-up tilt testing is an indication to dual-chamber pacemaker implantation.

Value of Lesion Morphology and of Residual Stenosis in Predicting Late Clinical Outcomes and Restenosis Rate Post-PTCA in Single-Vessel Disease.

The study assessed an impact of stenosis morphology before coronary angioplasty (PTCA) and of residual diameter stenosis after the procedure on major adverse cardiac events and restenosis rate at 1 year after intervention in single-vessel disease. Visual analysis of stenoses, using the ABC lesion score system and on-line quantitative evaluation (ACA, DCI, Philips), was performed in 70 patients undergoing PTCA. Recurrence of angina at rest and/or positive treadmill exercise test (TET) >/=6 weeks after PTCA and/or major cardiac events were considered as evidence of restenosis. At 1 year follow-up 56 patients (80%) were event free, without angina at rest and without positive TET, with residual diameter (RD) after PTCA a mean of 2.00 +/- 0.48 mm. In the restenosis group (n = 14) RD was a mean of 1.58 +/- 0.43 mm (p < 0.01): there were three patients with angina at rest, five with Positive TET, and six with cardiac events. In this group, one-half of the stenoses was in class C of the lesion. Residual diameter stenosis, measured objectively after balloon angioplasty, and evaluation of lesion morphology before PTCA can predict late clinical outcomes after the procedure in single-vessel disease.

Effect of coronary stenosis diameter on variability of on-line quantitative and qualitative arteriography.

This study assessed the impact of stenosis diameter on the variability of on-line second generation quantitative coronary arteriography (QCA) and on visual coronary analysis (VCA). Lesions (140) were evaluated by two methods: quantitative, using an Automated Coronary Analysis package, and visual, by three independent observers, from whom the estimates were averaged. Lesions were divided into groups according to the magnitude of computerized measured diameter of stenosis. The study demonstrated that variability of QCA and VCA depends upon the severity of the stenosis. The greater the diameter of the coronary lesion, the greater the variability of both quantitative and qualitative assessment and the greater the variability between the two methods.