The most common and dangerous operative complication after procedure hip joint replacement in ort... more The most common and dangerous operative complication after procedure hip joint replacement in orthopaedic surgery is plumonary embolysm. In our work we compare frequency of tromboembolic complications in group which was under suggested profilaxa and in other group with no such profilaxa. Importance of this work is not in a reducing of such complications but also in accepting of unique, wide excepted and scientific based protocol of postoperative tromboembolic profilaxa in ou country.
The role of exercise test in risk stratifying of asymptomatic patients with moderate and severe a... more The role of exercise test in risk stratifying of asymptomatic patients with moderate and severe aortic stenosis (AS) in recent literature is still controversial. The aim of this study was to evaluate the role of exercise test in stratifying the risk of patients with moderate to severe aortic stenosis. At the Internal Medicine Clinic, Department of Cardiology in Tuzla, in the period from January 2008 until January 2010 was followed 33 patients with clinical and echocardiographic parameters of moderate to severe asymptomatic aortic stenosis (mean effective orifice area EOA 0.9 +/- 0.34 cm2). In statistical analysis we used descriptive statistics, t-test, chi-square test and Kaplan-Meier life table for predictive values, sensitivity and specificity. A significance level of 0.05 was used. Two patients were excluded due to exclusion criteria, so 31 patient was followed up during 12 months period. Eighteen patients (58%) with EOA pounds sterling 0.8 cm2 had limiting symptoms during the te...
We started with Sarajevo Vascular Study (SVS) in 1994 with basic aim to evaluate arterial occlusi... more We started with Sarajevo Vascular Study (SVS) in 1994 with basic aim to evaluate arterial occlusive disease (AOD) of lower extremities and investigate possible effect of amelioration of risk factors to atherosclerosis regression. In 1996 we expanded SVS to polyvascular atherosclerotic disease, asymptomatic or symptomatic atherosclerotic disease on various vascular beds i.e. lower extremity arterial occlusive disease (AOD), cerebrovascular disease (CVD), coronary artery disease (CAD). We enrolled a total of 1680 pts. in the study but this number has changed depending on war migrations, comorbidity, or paramedical reasons. Follow-up of 10 yrs. had 645 pts, and follow-up of 8 yrs. had 1035 pts. We enrolled a total of 1680 pts, 954 pts with symptomatic disease, and 246 pts without atherosclerotic disease but with at least 3/8 multiple risk factors (MRF), and as controls 400 pts without vascular disease and less than 3 MRF. one center, prospective, consecutive, with evaluation of epidemi...
It is well known that atherosclerosis as systemic disease have a significant correlation with sco... more It is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF). Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate the presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease. We included 109 consecutive patients treated at our Institute in the period Dec 1999--Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD, we made three groups--group FII, clinical stage Fontaine II 63 pts, group FIII, clinical stage Fontaine III 32 pts, and group FIV, clinical stage Fontaine IV 14 pts. We evaluated clinical variables: age, gender, arterial hyperte...
The aim of the current study was to investigate the outcomes of coronary reperfusion therapies an... more The aim of the current study was to investigate the outcomes of coronary reperfusion therapies and ST-segment elevation myocardial infarction (STEMI) in patients of Eastern countries with economies in transition. Federation, and Serbia. The overall population consisted of 23,486 consecutive patients admitted to hospitals from January 1(st) to December 31(st) 2009. Registry data and statistics from the Organization for Economic Cooperation and Development (OECD) countries for the same period were used for comparison (2009-2010). In-hospital mortality was between 4% and 5% in the Western countries. In comparison mortality data were significantly larger in Serbia (10.8%) and Bosnia and Herzegovina (11.2%), intermediate in Russian Federation (7.2%) and similar in Hungary (5.0%). The rates of primary percutaneous coronary intervention (primary PCI) were very low in Bosnia and Herzegovina (18.3%), low in Russian Federation (20.6%) and Serbia (22%), and high in Hungary (70%). Major risk fa...
ABSTRACT Objectives: The aim of this article is to investigate the relationship between the degre... more ABSTRACT Objectives: The aim of this article is to investigate the relationship between the degree of the common carotid artery (CCA) atherosclerosis and the degree of complexity of the coronary artery disease (CAD) expressed with SYNTAX score. It is known that the existence of the CCA disease indicates with high probability the existence of CAD, but few studies have examined the relationship between CCA ultrasound findings and complexity, not just the presence of CAD. Patients and Methods: We included a total of 106 consecutive patients referred to the BH Heart Center for elective coronary angiography. In order to measure and calculate the mean intima-media thickness (IMT) we performed three measurements in predefined segments of CAA for both carotid arteries, the values are converged, and divided by the number of measurements. Plaque score (PS) was measured on the basis of maximum thickness of plaque in four clearly defined segments of both CCA. The final value of PS score is obtained by adding the thickness of plaques found in all segments of CCA. The complexity of coronary artery lesions is evaluated by using the SYNTAX score. The middle and high SYNTAX scores are associated with an increased risk of cardiac death and major cardiac events. Results: Data collection and statistical analysis is in progress and preliminary results indicate that IMT values and PS score significantly correlate with SYNTAX score >18 (r=.0,64, p<0,05), as well as SYNTAX score >27 (r=.0,79, p<0,01). It is expected that final results will show that there is a significant correlation between the degree of CCA atherosclerosis measured by two methods — IMT and PS, and the degree of complexity of coronary artery lesions. Conclusion: Preliminary results show that carotid ultrasound examination has sufficient sensitivity and specificity in the detection of patients with high risk of significant CAD and it is an argument for broader use of CCA ultrasound for the evaluation of patients who are considered for coronary angiography. Besides, we are going to improve algorithm of patients selection for coronary angiography, so, our limited material and human resources and efforts will be directed towards the treatment of patients i.e. net clinical benefit will be improved. KEYWORDS: common carotid arteries, intima-media thickness, plaque score, SYNTAX score. CITATION: Cardiol. Croat. 2013;8(9):285. Proπireni saæetak / Extended abstract Predictive value and relationship between intima-media thickness/carotid artery plaque score and severity of coronary artery disease
European journal of preventive cardiology, Jan 16, 2015
To determine whether the Joint European Societies guidelines on cardiovascular prevention are bei... more To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe. EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later. A total of 16,426 medical records were reviewed and 7998 patients (24.4% females) interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of those smoking at the time of the event were persistent smokers. Little or no physical activity was reported by 59.9%; 37.6% were obese (BMI ≥ 30 kg/m(2)) and 58.2% centrally obese (waist circumference ≥ 102 cm in men or ≥88 cm in women); 42.7...
To assess serum levels of tumor marker carbohydrate antigen 125 (CA125) in patients with heart fa... more To assess serum levels of tumor marker carbohydrate antigen 125 (CA125) in patients with heart failure (HF) and to investigate possible correlation with echocardiographic parameters and level of brain natriuretic peptide (BNP). We included 76 patients with different cardiac symptoms hospitalized at Clinic for heart disease and rheumatism. Control group (n = 26) was consisted of patients without signs and symptoms of HF, normal left ventricle ejection fraction (LVEF) and normal BNP level. Patients with diagnosis of HF (n = 50) were subdivided into 2 group depending on signs and symptoms of fluid overload: compensated (compHF, n = 10) and decompensated group (decompHF, n = 40). Serum CA125 and BNP were measured on admission and all patient underwent ECG recording and trans thoracic echocardiographic examination. The median CA125 level in HF group was significantly higher compared to control group (71.05 [30.70-141.47]U/ml vs 10.75 [8.05- 14.32] U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0005). Higher CA125 levels were found in decompHF group compared to compHF group (94.90 [49.75-196.75]U/ml vs 11.90 [10.25-15.80]U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0005). In decompHF group 13 of patients had pleural and/or pericardial effusion- their CA125 levels were significantly higher compared to patients without serosal effusion (n = 27) (205.10 [106.50-383.90]U/ml vs. 71.50 [47.30-109.55] U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.002). We found significant difference in CA125 levels between patients with atrial fibrillation and sinus rhythm (98.40 [48.20-242.70] U/ml vs. 47.30 [12.95-99.05] U/ml, p = 0.015). There was no significant difference in CA125 levels in group with enlarged left atrium compared to normal sized atrium (p = 0.282), as well as in group with moderate/severe mitral regurgitation compared to group with no/mild mitral regurgitation (p = 0.99). Finally, levels of serum CA125 positively correlated with serum level of BNP (r = 0.293, p = 0.039), but not with LVEF (p = 0.369) and left atrium diameter (p = 0.636). Serum CA125 is elevated in decompensated HF patients: more pronounced elevation was found in patients with pleural and/or pericard effusion compared to patients with no serosal effusion. CA125 level correlated with BNP, but not with left atrium diameter nor with LVEF. Tumor marker CA125 could be used as a marker of systemic congestion and volume overload in decompensated HF. We hypothesized that high CA125 level indicates that measured high BNP is actually wet BNP.
Cerebrovascular events (CVE) are the third most common cause of death in Western countries and ab... more Cerebrovascular events (CVE) are the third most common cause of death in Western countries and about 65-70% of CVE are due to atherosclerotic disease of carotid arteries. Color Doppler scanning is used to evaluate the presence, severity and type of atheromatous plaques as well as velocity parameters of carotid arteries. We performed this study to correlate data of morphological and velocity parameters with clinical variables in patients following CVE. We included total of 211 pts who had CVE, 118 females, 93 males, mean age 71.1 +/- SD 12.5 years. Out of total number of pts (n = 211) 93 pts had transient ischemic attacks (TIAs), 49 had recurrent TIAs (rTIAs), 44 had ischemic stroke (IS), and 25 had recurrent IS (rIS). As a control group we took 50 pts without CVE but with at least three multiple risk factor (MRF). Morphological parameters were; plaque composition and echogenecity. Velocity parameters were: peak-systolic velocity (PSV) and end-diastolic velocity (EDV). The following ...
We present a case of catheter induced pseudoaneurysm of femoral artery and postprocedural course.... more We present a case of catheter induced pseudoaneurysm of femoral artery and postprocedural course. This type of complications occurs in 2% to 8% patients after interventional procedures via trans femoral access and and has overall trend of increase due to significant number of this procedures in diagnostic and interventional cardiology. A 74-year-old female was admitted to Vascular department complaining of severe pain in her left groin. On physical examination, there was a femoral mass palpable but non-pulsatile in her left groin. Color Doppler documented the presence of femoral pseudoaneurysm as well as &amp;amp;quot;to-and-fro&amp;amp;quot; flow pattern on the pseudoaneurysm neck. CT arteriogram showed pseudoaneurysm with mostly thrombosed cavity, diameter of 85 x 27 mm. We concluded for further surgical repair.
The most common and dangerous operative complication after procedure hip joint replacement in ort... more The most common and dangerous operative complication after procedure hip joint replacement in orthopaedic surgery is plumonary embolysm. In our work we compare frequency of tromboembolic complications in group which was under suggested profilaxa and in other group with no such profilaxa. Importance of this work is not in a reducing of such complications but also in accepting of unique, wide excepted and scientific based protocol of postoperative tromboembolic profilaxa in ou country.
The role of exercise test in risk stratifying of asymptomatic patients with moderate and severe a... more The role of exercise test in risk stratifying of asymptomatic patients with moderate and severe aortic stenosis (AS) in recent literature is still controversial. The aim of this study was to evaluate the role of exercise test in stratifying the risk of patients with moderate to severe aortic stenosis. At the Internal Medicine Clinic, Department of Cardiology in Tuzla, in the period from January 2008 until January 2010 was followed 33 patients with clinical and echocardiographic parameters of moderate to severe asymptomatic aortic stenosis (mean effective orifice area EOA 0.9 +/- 0.34 cm2). In statistical analysis we used descriptive statistics, t-test, chi-square test and Kaplan-Meier life table for predictive values, sensitivity and specificity. A significance level of 0.05 was used. Two patients were excluded due to exclusion criteria, so 31 patient was followed up during 12 months period. Eighteen patients (58%) with EOA pounds sterling 0.8 cm2 had limiting symptoms during the te...
We started with Sarajevo Vascular Study (SVS) in 1994 with basic aim to evaluate arterial occlusi... more We started with Sarajevo Vascular Study (SVS) in 1994 with basic aim to evaluate arterial occlusive disease (AOD) of lower extremities and investigate possible effect of amelioration of risk factors to atherosclerosis regression. In 1996 we expanded SVS to polyvascular atherosclerotic disease, asymptomatic or symptomatic atherosclerotic disease on various vascular beds i.e. lower extremity arterial occlusive disease (AOD), cerebrovascular disease (CVD), coronary artery disease (CAD). We enrolled a total of 1680 pts. in the study but this number has changed depending on war migrations, comorbidity, or paramedical reasons. Follow-up of 10 yrs. had 645 pts, and follow-up of 8 yrs. had 1035 pts. We enrolled a total of 1680 pts, 954 pts with symptomatic disease, and 246 pts without atherosclerotic disease but with at least 3/8 multiple risk factors (MRF), and as controls 400 pts without vascular disease and less than 3 MRF. one center, prospective, consecutive, with evaluation of epidemi...
It is well known that atherosclerosis as systemic disease have a significant correlation with sco... more It is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF). Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate the presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease. We included 109 consecutive patients treated at our Institute in the period Dec 1999--Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD, we made three groups--group FII, clinical stage Fontaine II 63 pts, group FIII, clinical stage Fontaine III 32 pts, and group FIV, clinical stage Fontaine IV 14 pts. We evaluated clinical variables: age, gender, arterial hyperte...
The aim of the current study was to investigate the outcomes of coronary reperfusion therapies an... more The aim of the current study was to investigate the outcomes of coronary reperfusion therapies and ST-segment elevation myocardial infarction (STEMI) in patients of Eastern countries with economies in transition. Federation, and Serbia. The overall population consisted of 23,486 consecutive patients admitted to hospitals from January 1(st) to December 31(st) 2009. Registry data and statistics from the Organization for Economic Cooperation and Development (OECD) countries for the same period were used for comparison (2009-2010). In-hospital mortality was between 4% and 5% in the Western countries. In comparison mortality data were significantly larger in Serbia (10.8%) and Bosnia and Herzegovina (11.2%), intermediate in Russian Federation (7.2%) and similar in Hungary (5.0%). The rates of primary percutaneous coronary intervention (primary PCI) were very low in Bosnia and Herzegovina (18.3%), low in Russian Federation (20.6%) and Serbia (22%), and high in Hungary (70%). Major risk fa...
ABSTRACT Objectives: The aim of this article is to investigate the relationship between the degre... more ABSTRACT Objectives: The aim of this article is to investigate the relationship between the degree of the common carotid artery (CCA) atherosclerosis and the degree of complexity of the coronary artery disease (CAD) expressed with SYNTAX score. It is known that the existence of the CCA disease indicates with high probability the existence of CAD, but few studies have examined the relationship between CCA ultrasound findings and complexity, not just the presence of CAD. Patients and Methods: We included a total of 106 consecutive patients referred to the BH Heart Center for elective coronary angiography. In order to measure and calculate the mean intima-media thickness (IMT) we performed three measurements in predefined segments of CAA for both carotid arteries, the values are converged, and divided by the number of measurements. Plaque score (PS) was measured on the basis of maximum thickness of plaque in four clearly defined segments of both CCA. The final value of PS score is obtained by adding the thickness of plaques found in all segments of CCA. The complexity of coronary artery lesions is evaluated by using the SYNTAX score. The middle and high SYNTAX scores are associated with an increased risk of cardiac death and major cardiac events. Results: Data collection and statistical analysis is in progress and preliminary results indicate that IMT values and PS score significantly correlate with SYNTAX score &gt;18 (r=.0,64, p&lt;0,05), as well as SYNTAX score &gt;27 (r=.0,79, p&lt;0,01). It is expected that final results will show that there is a significant correlation between the degree of CCA atherosclerosis measured by two methods — IMT and PS, and the degree of complexity of coronary artery lesions. Conclusion: Preliminary results show that carotid ultrasound examination has sufficient sensitivity and specificity in the detection of patients with high risk of significant CAD and it is an argument for broader use of CCA ultrasound for the evaluation of patients who are considered for coronary angiography. Besides, we are going to improve algorithm of patients selection for coronary angiography, so, our limited material and human resources and efforts will be directed towards the treatment of patients i.e. net clinical benefit will be improved. KEYWORDS: common carotid arteries, intima-media thickness, plaque score, SYNTAX score. CITATION: Cardiol. Croat. 2013;8(9):285. Proπireni saæetak / Extended abstract Predictive value and relationship between intima-media thickness/carotid artery plaque score and severity of coronary artery disease
European journal of preventive cardiology, Jan 16, 2015
To determine whether the Joint European Societies guidelines on cardiovascular prevention are bei... more To determine whether the Joint European Societies guidelines on cardiovascular prevention are being followed in everyday clinical practice of secondary prevention and to describe the lifestyle, risk factor and therapeutic management of coronary patients across Europe. EUROASPIRE IV was a cross-sectional study undertaken at 78 centres from 24 European countries. Patients <80 years with coronary disease who had coronary artery bypass graft, percutaneous coronary intervention or an acute coronary syndrome were identified from hospital records and interviewed and examined ≥ 6 months later. A total of 16,426 medical records were reviewed and 7998 patients (24.4% females) interviewed. At interview, 16.0% of patients smoked cigarettes, and 48.6% of those smoking at the time of the event were persistent smokers. Little or no physical activity was reported by 59.9%; 37.6% were obese (BMI ≥ 30 kg/m(2)) and 58.2% centrally obese (waist circumference ≥ 102 cm in men or ≥88 cm in women); 42.7...
To assess serum levels of tumor marker carbohydrate antigen 125 (CA125) in patients with heart fa... more To assess serum levels of tumor marker carbohydrate antigen 125 (CA125) in patients with heart failure (HF) and to investigate possible correlation with echocardiographic parameters and level of brain natriuretic peptide (BNP). We included 76 patients with different cardiac symptoms hospitalized at Clinic for heart disease and rheumatism. Control group (n = 26) was consisted of patients without signs and symptoms of HF, normal left ventricle ejection fraction (LVEF) and normal BNP level. Patients with diagnosis of HF (n = 50) were subdivided into 2 group depending on signs and symptoms of fluid overload: compensated (compHF, n = 10) and decompensated group (decompHF, n = 40). Serum CA125 and BNP were measured on admission and all patient underwent ECG recording and trans thoracic echocardiographic examination. The median CA125 level in HF group was significantly higher compared to control group (71.05 [30.70-141.47]U/ml vs 10.75 [8.05- 14.32] U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0005). Higher CA125 levels were found in decompHF group compared to compHF group (94.90 [49.75-196.75]U/ml vs 11.90 [10.25-15.80]U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.0005). In decompHF group 13 of patients had pleural and/or pericardial effusion- their CA125 levels were significantly higher compared to patients without serosal effusion (n = 27) (205.10 [106.50-383.90]U/ml vs. 71.50 [47.30-109.55] U/ml, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.002). We found significant difference in CA125 levels between patients with atrial fibrillation and sinus rhythm (98.40 [48.20-242.70] U/ml vs. 47.30 [12.95-99.05] U/ml, p = 0.015). There was no significant difference in CA125 levels in group with enlarged left atrium compared to normal sized atrium (p = 0.282), as well as in group with moderate/severe mitral regurgitation compared to group with no/mild mitral regurgitation (p = 0.99). Finally, levels of serum CA125 positively correlated with serum level of BNP (r = 0.293, p = 0.039), but not with LVEF (p = 0.369) and left atrium diameter (p = 0.636). Serum CA125 is elevated in decompensated HF patients: more pronounced elevation was found in patients with pleural and/or pericard effusion compared to patients with no serosal effusion. CA125 level correlated with BNP, but not with left atrium diameter nor with LVEF. Tumor marker CA125 could be used as a marker of systemic congestion and volume overload in decompensated HF. We hypothesized that high CA125 level indicates that measured high BNP is actually wet BNP.
Cerebrovascular events (CVE) are the third most common cause of death in Western countries and ab... more Cerebrovascular events (CVE) are the third most common cause of death in Western countries and about 65-70% of CVE are due to atherosclerotic disease of carotid arteries. Color Doppler scanning is used to evaluate the presence, severity and type of atheromatous plaques as well as velocity parameters of carotid arteries. We performed this study to correlate data of morphological and velocity parameters with clinical variables in patients following CVE. We included total of 211 pts who had CVE, 118 females, 93 males, mean age 71.1 +/- SD 12.5 years. Out of total number of pts (n = 211) 93 pts had transient ischemic attacks (TIAs), 49 had recurrent TIAs (rTIAs), 44 had ischemic stroke (IS), and 25 had recurrent IS (rIS). As a control group we took 50 pts without CVE but with at least three multiple risk factor (MRF). Morphological parameters were; plaque composition and echogenecity. Velocity parameters were: peak-systolic velocity (PSV) and end-diastolic velocity (EDV). The following ...
We present a case of catheter induced pseudoaneurysm of femoral artery and postprocedural course.... more We present a case of catheter induced pseudoaneurysm of femoral artery and postprocedural course. This type of complications occurs in 2% to 8% patients after interventional procedures via trans femoral access and and has overall trend of increase due to significant number of this procedures in diagnostic and interventional cardiology. A 74-year-old female was admitted to Vascular department complaining of severe pain in her left groin. On physical examination, there was a femoral mass palpable but non-pulsatile in her left groin. Color Doppler documented the presence of femoral pseudoaneurysm as well as &amp;amp;quot;to-and-fro&amp;amp;quot; flow pattern on the pseudoaneurysm neck. CT arteriogram showed pseudoaneurysm with mostly thrombosed cavity, diameter of 85 x 27 mm. We concluded for further surgical repair.
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