Implementation of Microcirculation Examination in Clinical Practice-Insights from the Nationwide POL-MKW Registry.

Background and Objectives: The assessment of coronary microcirculation may facilitate risk stratification and treatment adjustment. The aim of this study was to evaluate patients' clinical presentation and treatment following coronary microcirculation assessment, as well as factors associated with an abnormal coronary flow reserve (CFR) and index of microcirculatory resistance (IMR) values. Materials and Results: This retrospective analysis included 223 patients gathered from the national registry of invasive coronary microvascular testing collected between 2018 and 2023. Results: The frequency of coronary microcirculatory assessments in Poland has steadily increased since 2018. Patients with impaired IMR (≥25) were less burdened with comorbidities. Patients with normal IMR underwent revascularisation attempts more frequently (11.9% vs. 29.8%, p = 0.003). After microcirculation testing, calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitors were added more often for patients with IMR and CFR abnormalities, respectively, as compared to control groups. Moreover, patients with coronary microvascular dysfunction (CMD, defined as CFR and/or IMR abnormality), regardless of treatment choice following microcirculation assessment, were provided with trimetazidine (23.2%) and dihydropyridine CCBs (26.4%) more frequently than those without CMD who were treated conservatively (6.8%) and by revascularisation (4.2% with p = 0.002 and 0% with p < 0.001, respectively). Multivariable analysis revealed no association between angina symptoms and IMR or CFR impairment. Conclusions: The frequency of coronary microcirculatory assessments in Poland has steadily increased. Angina symptoms were not associated with either IMR or CFR impairment. After microcirculation assessment, patients with impaired microcirculation, expressed as either low CFR, high IMR or both, received additional pharmacotherapy treatment more often.

[Smoking among patients with obstructive sleep apnea syndrome--preliminary report]. / Palenie tytoniu u pacjentów z zespolem obturacyjnego bezdechu sródsennego--doniesienie wstepne.

UNLABELLED: Association of smoking with the occurrence and severity of the obstructive sleep apnea syndrome (OSAS) is poorly understood. THE AIM OF THE STUDY: The evaluation of smoking habits among the patients hospitalized with the suspicion and diagnosis of the OSAS. The possible relationship between smoking and severity of OSAS and the occurrence of concomitant diseases occurrence was also evaluated. MATERIAL AND METHODS: 82 patients has been included into the study: 11 without OSAS (apnea/hypopnea index-AHI < 5/hour) and 71 with OSAS of varying severity (AHI 7-74/hours). RESULTS: Forty six patients with OSAS were smokers or ex-smokers, and 5 persons from a group without OSAS were ex-smokers. Patients with OSAS who smoked at least 20 pack years had significant higher AHI (54.5/h) than non-smokers (38.5/h) and patients smoking less than 20 pack years (35.9/h). These groups of patients did not differ according to BMI (36.8 kg/m2, 38.8 kg/m2, 36.3 kg/ms). Smokers with OSAS more frequently had concomitant cardiovascular diseases than non-smokers with OSAS (86.1% and 23.1% respectively). CONCLUSION: Smoking influences the severity of OSAS independently of the degree of obesity.