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

Cite this document

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

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

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

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 16 November 2024, https://urn.nsk.hr/urn:nbn:hr:184:892726

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 November 16] Available at: https://urn.nsk.hr/urn:nbn:hr:184:892726

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

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Metadata
TitleSolubilne 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
AuthorVjekoslav Tomulić
MentorLuka Zaputović (mentor)
Committee memberSandro Brusich (predsjednik povjerenstva)
Committee memberVesna Barac-Latas (član povjerenstva)
Committee memberLuka Zaputović (član povjerenstva)
GranterUniversity of Rijeka
Faculty of Medicine
(Department of Internal Medicine)
Rijeka
Defense date and country2017, 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)
Languagecroatian
URN:NBNurn:nbn:hr:184:892726
Study programmeTitle: 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 resourceText
File originBorn digital
Access conditionsAccess restricted to students and staff of home institution
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Created on2017-12-29 09:08:54