Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom

Tomulić, Vjekoslav

prikaz prve stranice dokumenta Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom

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doctoral thesis

Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom

Rijeka: University of Rijeka, Faculty of Medicine, 2017. urn:nbn:hr:184:892726

Tomulić, Vjekoslav

University of Rijeka
Faculty of Medicine
Department of Internal Medicine

Cite this document

APA 6th Edition

Tomulić, V. (2017). Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom (Doctoral thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:184:892726

MLA 8th Edition

Tomulić, Vjekoslav. "Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom." Doctoral thesis, University of Rijeka, Faculty of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:184:892726

Chicago 17th Edition

Harvard

Tomulić, V. (2017). 'Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom', Doctoral thesis, University of Rijeka, Faculty of Medicine, accessed 20 April 2024, https://urn.nsk.hr/urn:nbn:hr:184:892726

Vancouver

Tomulić V. Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom [Doctoral thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2017 [cited 2024 April 20] Available at: https://urn.nsk.hr/urn:nbn:hr:184:892726

IEEE

V. Tomulić, "Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom", Doctoral thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:184:892726

Cite this item: https://urn.nsk.hr/urn:nbn:hr:184:892726

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Metadata

Title	Solubilne adhezijske molekule u bolesnika s akutnim koronarnim sindromom liječenih balonom obloženim lijekom ili stentom
Title (english)	Soluble adhesion molecules in acute coronary syndrome patients treated with drug coated balloon or stent
Author	Vjekoslav Tomulić
Mentor	Luka Zaputović (mentor)
Committee member	Sandro Brusich (predsjednik povjerenstva)
Committee member	Vesna Barac-Latas (član povjerenstva)
Committee member	Luka Zaputović (član povjerenstva)
Granter	University of Rijeka Faculty of Medicine (Department of Internal Medicine) Rijeka
Defense date and country	2017, Croatia
Scientific / art field, discipline and subdiscipline	BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Universal decimal classification (UDC)	616 - Pathology. Clinical medicine
Thesaurus (MESH - Medical Subject Headings)
Abstract	Uvod: Kardiovaskularne bolesti (KVB) javljaju se u više oblika. Bolesnici koji razviju akutni koronarni sindrom (AKS) imaju najveći rizik nastanka nepovoljnih događaja ili smrti. Najučinkovitiji način liječenja bolesnika s AKS-om je perkutana koronarna intervencija (PCI). Balon obložen lijekom (DCB) nova je metoda u intervencijskoj kardiologiji kojom se izbjegava implantacija stenta. KVB i AKS nastaju kao posljedica aterosklerotske bolesti, u čijoj je podlozi upalna reakcija. Serumska razina adhezijskih molekula jedan je od pokazatelja razvoja upalnog procesa. Cilj istraživanja: Dokazati učinkovitost primjene DCB-a u odnosu na implantaciju stenta (BMS) u bolesnika s AKS-om praćenjem kliničkih, laboratorijskih i angiografskih parametara. Proučiti trendove serumskih razina adhezijskih molekula u bolesnika s AKS-om i pronaći njihovu ulogu u predikciji neželjenih događaja. Metode: Ovo je bilo prospektivno, randomizirano ispitivanje provedeno na 112 bolesnika s AKS-om, liječenih PCI-jem u Kliničkom bolničkom centru Rijeka od veljače 2014. do veljače 2015. godine. Bolesnici su praćeni šest mjeseci i bilježeni su veliki neželjeni događaji (MACE) i smrtnost. Svim je bolesnicima pri prijemu i nakon šest mjeseci određena serumska razina E- i P-selektina, intercelularne adhezijske molekule-1 (ICAM-1) i vaskularne adhezijske molekule-1 (VCAM-1). Rezultati: Bolesnici liječeni DCB-om u odnosu na BMS imali su značajno manji broj pozitivnih ergometrijskih nalaza (5,4% vs 17,9%; p=0,039), niži stupanj angine pektoris (Q1-Q2 1-1 vs 1-2; p=0,001), i učestalost MACE-a (8,9% vs 30,4%; p=0,004). Dvostruko je manji kasni gubitak lumena arterije u DCB skupini na kontrolnoj koronarografiji (-0,41 mm vs -0,86 mm; p=0,09). Sve analizirane adhezijske molekule povišene su do šestog mjeseca nakon AKS-a. Vrijednost VCAM-1 >862 ng/ml pokazuje dobru predikciju MACE-a u ispitivanom uzorku. Niti jedna molekula nije bila prediktivna za razvitak restenoze ciljne lezije. Zaključak: Liječenje bolesnika s AKS-om „DCB-only“ strategijom je sigurno i učinkovito. Povišeni VCAM-1 može predvidjeti neželjeni događaj šest mjeseci nakon AKS-
Abstract (english)	Introduction: Cardiovascular disease (CVD) occurs in several forms. Patients who develop acute coronary syndrome (ACS) have the highest risk of adverse events or death. The most effective treatment for patients with ACS is a percutaneous coronary intervention (PCI). The drug coated balloon (DCB) is a new method in interventional cardiology which avoids necessity of stent implantation. CVD and ACS are result of atherosclerotic disease, with underlying inflammatory reaction. Serum levels of adhesion molecules are indicators of the inflammatory process development. Aim: To demonstrate the effectiveness of the DCB application versus implantation of the bare metal stent (BMS) in patients with ACS analysing clinical, laboratory and angiographic parameters. To examine trends in serum levels of adhesion molecules in patients with ACS and finding their role in the prediction of adverse events. Methods: This was a prospective, randomized trial conducted on 112 patients with ACS treated with PCI in the Clinical Hospital Centre Rijeka, from February 2014 to February 2015. Patients were followed for six months and large adverse events (MACE) and mortality was observed. In all of the patients serum levels of E- and P-selectin, intercellular adhesion molecule-1 (ICAM-1) and vascular adhesion molecule-1 (VCAM-1) were obtained at admission and after six months. Results: Patients treated with DCB compared to BMS had a significantly lower number of positive ergometric findings (5,4% vs 17,9%; p=0,039), lower degree of angina (Q1-Q2 1-1 vs 1-2; p=0,001), and the number of MACE (8,9% vs 30,4%; p=0,004). There was less late lumen loss in the DCB group at control coronary angiography (-0,41 mm vs -0,86 mm; p = 0,09). All analysed adhesion molecules were elevated during sixth months after ACS. VCAM-1 levels above 862 ng/ml showed good prediction of MACE in our patients. None of the molecules was predictive for the development of target lesion restenosis. Conclusion: "DCB-only" strategy in the treatment of patients with ACS is safe and effective. Elevated VCAM-1 may predict adverse events up to six months after the ACS
Keywords
Keywords (english)
Language	croatian
URN:NBN	urn:nbn:hr:184:892726
Study programme	Title: Biomedicine Postgraduate (doctoral) study programme Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource	Text
File origin	Born digital
Access conditions	Access restricted to students and staff of home institution
Terms of use
Repository	Repository of the University of Rijeka, Faculty of Medicine
Created on	2017-12-29 09:08:54

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