1. The role of environmental PM2.5 in admission acute heart failure in ST-elevation myocardial infarction patients : an observational retrospective studyAndreja Sinkovič, Andrej Markota, Manja Kraševec, David Šuran, Martin Marinšek, 2021, izvirni znanstveni članek Opis: Background: Air pollution with increased concentrations of fine (< 2.5 μm) particulate matter (PM2.5) increases the risk of cardiovascular morbidity and mortality. Even short-term increase of PM2.5 may help trigger ST-elevation myocardial infarction (STEMI) and heart failure (HF) in susceptible individuals, even in areas with good air quality.
Purpose: To evaluate the role of PM2.5 levels ≥ 20 μg/m3 in admission acute HF in STEMI patients.
Materials and Methods: In 290 STEMI patients with the leading reperfusion strategy primary percutaneous coronary intervention (PPCI), we retrospectively studied independent predictors of admission acute HF and included admission demographic and clinical data as well as ambient PM2.5 levels ≥ 20 μg/m3. We defined admission acute HF in STEMI patients as classes II–IV by Killip Kimball classification.
Results: Acute admission HF was observed in 34.5% of STEMI patients. PPCI was performed in 87.1% of acute admission HF patients and in 94.7% non-HF patients (p= 0.037). Significant independent predictors of acute admission HF were prior diabetes (OR 2.440, 95% CI 1.100 to 5.400, p=0.028), admission LBBB (OR 10.190, 95% CI 1.160 to 89.360, p=0.036), prior resuscitation (OR 2.530, 95% CI 1.010 to 6.340, p=0.048), admission troponin I≥ 5μg/l (OR 3.390, 95% CI 1.740 to 6.620, p< 0.001), admission eGFR levels (0.61, 95% CI 0.52 to 0.72, p < 0.001), and levels of PM2.5 ≥ 20 μg/m3 (OR 2.140, 95% CI 1.005 to 4.560, p=0.049) one day before admission.
Conclusion: Temporary short-term increase in PM2.5 levels (≥ 20 μg/m3) one day prior to admission in an area with mainly good air quality was among significant independent predictors of acute admission HF in STEMI patients.
Ključne besede: admission acute heart failure, ST-elevation myocardial infarction, air pollution, PM2.5
Objavljeno v DKUM: 14.10.2024; Ogledov: 0; Prenosov: 1
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2. Factors of hospital mortality in men and women with ST-elevation myocardial infarction - an observational, retrospective, single centre studyMartin Marinšek, David Šuran, Andreja Sinkovič, 2023, izvirni znanstveni članek Opis: Purpose: There are well-known gender differences in mortality of patients with ST-elevation myocardial infarction (STEMI). Our purpose was to assess factors of hospital mortality separately for men and women with STEMI, which are less well known.
Patients and Methods: In 2018– 2019, 485 men and 214 women with STEMI underwent treatment with primary percutaneous coronary intervention (PCI). We retrospectively compared baseline characteristics, treatments and hospital complications between men and women, as well as between nonsurviving and surviving men and women with STEMI.
Results: Primary PCI was performed in 94% of men and 91.1% of women with STEMI, respectively. The in-hospital mortality was significantly higher in women than in men (14% vs 8%, p=0.019). Hospital mortality in both genders was associated significantly to older age, heart failure, prior resuscitation, acute kidney injury, to less likely performed and less successful primary PCI and additionally in men to hospital infection and in women to bleeding. In men and women ≥ 65 years, mortality was similar (13.3% vs 17.8%, p = 0.293).
Conclusion: Factors of hospital mortality were similar in men and women with STEMI, except bleeding was more likely observed in nonsurviving women and infection in nonsurviving men.
Ključne besede: ST-elevation myocardial infarction, female sex, male sex, sex differences, hospital mortality, 30-day survival, 6-month survival
Objavljeno v DKUM: 12.07.2024; Ogledov: 124; Prenosov: 18
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3. STEMI patients in the first and second waves of the COVID-19 pandemic in northeast Slovenia - a retrospective, single-center observational studyAndreja Sinkovič, Manja Kraševec, David Šuran, Martin Marinšek, 2022, izvirni znanstveni članek Opis: The COVID-19 pandemic has affected the outcomes of ST-elevation myocardial infarction (STEMI) patients in most countries. We aimed to retrospectively assess the admissions, treatments, complications, and mortality of STEMI patients in the northeast of Slovenia during the first (March–May 2020) and second waves (October–December 2020) of the COVID-19 pandemic and to compare them with data from 2019 (March–October). Comparing 2019 and both waves of the COVID-19 pandemic, we observed nonsignificant differences in the number of STEMI admissions, baseline characteristics, use of primary percutaneous coronary intervention (PCI) within the first 3 (40.5%* vs. 38.7% vs. 25%*, *p = 0.074) or 6 h, TIMI III flow after primary PCI, and hospital complications, as well as significant increases in hospital heart failure (23.3% vs. 42%, p = 0.015) and mitral regurgitation in the second wave (10% vs. 26.9%, p = 0.008) of the pandemic and a nonsignificant increase in hospital mortality (8.9% vs. 9.4% vs. 13.6%) during both waves of the pandemic. We conclude that, due to the increased severity of the COVID-19 pandemic in the second wave, there were longer delays to primary PCI in STEMI patients, resulting in significantly increased hospital heart failure and non-significantly increased hospital mortality.
Ključne besede: ST-elevation myocardial infarction, COVID-19, time delay, primary percutaneous coronary intervention, heart failure, mortality, pandemic
Objavljeno v DKUM: 04.07.2024; Ogledov: 134; Prenosov: 20
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4. Lipoprotein(a) as a risk factor in a cohort of hospitalised cardiovascular patients : A retrospective clinical routine data analysisDavid Šuran, Tadej Završnik, Peter Kokol, Marko Kokol, Andreja Sinkovič, Franjo Naji, Jernej Završnik, Helena Blažun Vošner, Vojko Kanič, 2023, izvirni znanstveni članek Opis: Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). Methods: A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. Results: In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60–75 years, p < 0.05). Conclusions: The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
Ključne besede: acute myocardial infarction, aortic valve stenosis, atherosclerosis, cardiovascular diseases, cardiovascular risk, ischemic heart disease, lipoprotein(a), postmenopausal women
Objavljeno v DKUM: 12.06.2024; Ogledov: 137; Prenosov: 11
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5. Alveolarna krvavitev kot zaplet po kombiniranem zdravljenju z antiagregacijskimi in antikoagulantnimi zdravili pri primarni koronarni intervenciji pri bolniku z akutnim koronarnim sindromom z elevacijo ST veznice - prikaz primeraSimona Kirbiš, Andreja Sinkovič, 2009, strokovni članek Opis: Platelet inhibitior with aspirin and systemic anticoagulation with unfractioned heparin to reduce the incidence of recurrent thrombosis after primary coronary intervention (PCI) has been the standard of care for patients with acute coronary syndrome (ACS) with ST elevation for some time. Eptifibatide is the platelet membrane glycoprotein IIb/IIIa inhibitor that is often used. Bleeding complications occur most often at sites of vascular access and are more common in elderly patients. Alveolar hemorrhage with hemoptysis is a rare complication. We describe the case of a 43-year old smoker with an ST elevation myocardial infarction admitted for PCI. He was treated with standard anticoagulation and dual antiplatelet therapy before admission. Hemoptysis began approximately five minutes after the intracoronary application of eptifibatide at the end of the procedure. Supportive care including endotracheal intubation, mechanical ventilation, transfusion of packed red blood cells and reversal of all anticoagulation. Alveolar hemorrhage is life-threatening but adequate intensive supportive measures can be life-saving.
Ključne besede: alveolarna krvavitev, hemoptize, eptifibatide, miokardni infarkt, primarna koronarna intervencija, antiagregacijsko zdravljenje
Objavljeno v DKUM: 19.04.2024; Ogledov: 169; Prenosov: 2
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6. First treatment with venovenous extracorporeal membrane oxygenation in MariborKristijan Skok, Andrej Markota, Franc Svenšek, Andreja Sinkovič, 2019, drugi znanstveni članki Ključne besede: zunajtelesni krvni obtok, VV ECMO, refraktarna hipoksemija, akutna dihalna odpoved, intenzivna medicina, enota za intenzivno terapijo
Objavljeno v DKUM: 05.04.2024; Ogledov: 177; Prenosov: 11
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8. Znanje, odnos in praksa medicinskih sester pri zdravljenju s kisikomTjaša Meolic, 2024, magistrsko delo Opis: Uvod: Kisik je zdravilo, ki rešuje življenja. Pomembno je, da terapevtsko dovajanje kisika pacientu izvajajo pristojni zdravstveni delavci, ki imajo za to ustrezne zahtevane kompetence, znanje in spretnosti. Namen raziskave je bil ugotoviti, kakšno je znanje, odnos in praksa medicinskih sester pri zdravljenju s kisikom ter, kateri so s tem povezani dejavniki.
Metode: Raziskava je bila izvedena v mesecu juniju/juliju 2023 v eni od javnih splošnih bolnišnic v severovzhodni Sloveniji. V raziskavi smo uporabili priložnostni vzorec, v katerem je sodelovalo 128 medicinskih sester (srednjih in diplomiranih). Med zaposlene smo razdelili anketne vprašalnike s štirimi sklopi zaprtih vprašanj, ki so bila vezana na znanje, odnos in prakso medicinskih sester glede terapije s kisikom. Pridobljene podatke iz anket smo analizirali s pomočjo dveh računalniških programov Microsoft Excel in SPSS za Windows 26.0. Raziskava je temeljila na kvantitativni metodologiji.
Rezultati: Od skupno 128 sodelujočih je v raziskavi sodelovalo 71,1 % (f = 91) žensk in 28,9 % (f = 37) moških, od tega je bilo 53, 1 % (f = 68) diplomiranih medicinskih sester in 46,9 % (f = 60) srednjih medicinskih sester. Raziskava je pokazala, da ima 74,2 % anketiranih dobro raven znanja, 85,2 % anketiranih pozitiven odnos in 63,3 % anketiranih dobro raven prakse terapije s kisikom.
Razprava in zaključek: Medicinske sestre imajo pri aplikaciji kisika zelo pomembno aktivno vlogo, zato morajo imeti pri svojem delu dobro znanje, pozitiven odnos do dela in spretnost. Priporočljivo je spodbujanje znanja in prakse z rednim usposabljanjem in z delavnicami ob delu.
Ključne besede: kisikova terapija, oksigenacija, kisik, znanje, odnos, praksa
Objavljeno v DKUM: 22.02.2024; Ogledov: 376; Prenosov: 61
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10. In-hospital bleeding occurring while treating ST-segment elevation myocardial infarction during the COVID-19 pandemic: STEMI during the COVID-19 pandemicMatej Kvartuh, Domen Lah, Martin Marinšek, David Šuran, Andreja Sinkovič, 2023, izvirni znanstveni članek Ključne besede: COVID-19 pandemic, ST-elevation myocardial infarction, bleeding, mortality, hospital complications
Objavljeno v DKUM: 21.12.2023; Ogledov: 289; Prenosov: 18
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