Teresa Zielinska

Publications (3)7.02 Total impact

• Source

  Available from: Radoslaw Lenarczyk

  Article: The prognostic value of different glucose abnormalities in patients with acute myocardial infarction treated invasively.

  Michal Mazurek, Jacek Kowalczyk, Radoslaw Lenarczyk, Teresa Zielinska, Agnieszka Sedkowska, Patrycja Pruszkowska-Skrzep, Andrzej Swiatkowski, Beata Sredniawa, Oskar Kowalski, Lech Polonski, Krzysztof Strojek, Zbigniew Kalarus
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  ABSTRACT: BACKGROUND: Diabetes (DM) deteriorates the prognosis in patients with coronary heart disease. However, the prognostic value of different glucose abnormalities (GA) other than DM in subjects with acute myocardial infarction (AMI) treated invasively remains unclear. AIMS: To assess the incidence and impact of GA on clinical outcomes in AMI patients treated with percutaneous coronary intervention (PCI). METHODS: A single-center, prospective registry encompassed 2733 consecutive AMI subjects treated with PCI. In all in-hospital survivors (n = 2527, 92.5 %) without the history of DM diagnosed before or during index hospitalization standard oral glucose tolerance test (OGTT) was performed during stable condition before hospital discharge and interpreted according to WHO criteria. The mean follow-up period was 37.5 months. RESULTS: The incidence of GA was as follows: impaired fasting glycaemia - IFG (n = 376, 15 %); impaired glucose tolerance - IGT (n = 560, 22 %); DM (n = 425, 17 %); new onset DM (n = 384, 15 %); and normal glucose tolerance NGT (n = 782, 31 %). During the long-term follow-up, death rate events for previously known DM, new onset DM and IGT were significantly more frequent than those for IFG and NGT (12.3; 9.6 and 9.4 vs. 5.6 and 6.4 %, respectively, P < 0.05). The strongest and common independent predictors of death in GA patients were glomerular filtration rate < 60 ml/min/1,73 m^2 (HR 2.0 and 2.8) and left ventricle ejection fraction < 35 % (HR 2.5 and 1.8, all P < 0.05) respectively. CONCLUSIONS: Glucose abnormalities are very common in AMI patients. DM, new onset DM and IGT increase remote mortality. Impaired glucose tolerance bears similar long-term prognosis as diabetes.
  Cardiovascular Diabetology 06/2012; 11(1):78. · 3.35 Impact Factor
• Article: Prognosis in diabetic patients with acute myocardial infarction treated invasively is related to renal function.

  Jacek Kowalczyk, Radoslaw Lenarczyk, Krzysztof Strojek, Teresa Zielinska, Janusz Gumprecht, Agnieszka Sedkowska, Tomasz Kukulski, Marcin Swierad, Oskar Kowalski, Beata Sredniawa, Lech Polonski, Marian Zembala, Zbigniew Kalarus
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  ABSTRACT: The prevalence of diabetes mellitus (DM) and chronic kidney disease (CKD) is rapidly increasing. Both comorbidities are considered significant risk factors for cardiovascular complications. The aim of the study was to evaluate the impact of DM with and without CKD on prognosis in patients with acute myocardial infarction (AMI) treated invasively. This single-center prospective study encompassed 3334 AMI-patients without cardiogenic shock, who were divided into 2 major groups: 999 patients with type 2 DM diagnosed prior to or during index hospitalization, and 2335 non-diabetics. All diabetic patients were divided with respect to their renal status into: diabetics with CKD (DM-CKD; n=264) and without (DM-nCKD; n=735). Short- and long-term outcomes were compared between study groups. Independent predictors of death and composite end-point were selected with multivariate Cox-regression model. Mortality rates were significantly higher in DM group compared to nDM in all observation periods. DM-CKD was associated with excessive total mortality (35.6%) when compared to DM-nCKD (11.6%, P<0.001) and to nDM (9.8%, P<0.001). Mortality and major adverse cardiovascular event rates did not differ significantly between DM-nCKD and nDM groups. Diabetes coexisting with CKD was one of the strongest independent risk factors for death (hazard ratio 1.93; confidence interval 1.79-2.07; P<0.001). The prognosis in diabetics with AMI is significantly related to renal function. Diabetics without CKD had similar prognosis to non-diabetics. Multivariate analyses showed that unlike diabetes without renal dysfunction, DM-CKD was an independent risk factor for cardiovascular complications and total mortality.
  Medical science monitor: international medical journal of experimental and clinical research 02/2010; 16(2):CR67-74. · 1.70 Impact Factor
• Source

  Available from: Radoslaw Lenarczyk

  Article: Triple-site biventricular pacing in patients undergoing cardiac resynchronization therapy: a feasibility study.

  Radoslaw Lenarczyk, Oskar Kowalski, Tomasz Kukulski, Mariola Szulik, Patrycja Pruszkowska-Skrzep, Teresa Zielinska, Jacek Kowalczyk, Slawomir Pluta, Agata Duszanska, Beata Sredniawa, Agata Musialik-Lydka, Zbigniew Kalarus
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  ABSTRACT: To evaluate implantation safety and efficiency of triple-site (double left-single right) cardiac resynchronization therapy (CRT) and to assess the outcome of this procedure. Twenty-six patients with New York Heart Association (NYHA) class III-IV, left ventricular ejection fraction (EF) < or = 35%, and QRS > or = 120 ms underwent triple-site CRT. Procedural course and complications were analysed. NYHA class, QRS duration, echocardiographic parameters, peak oxygen consumption (VO(2)max), and 6 min walking distance (6MWD) were assessed at baseline and after 3 months. Responders were defined by survival, by no re-hospitalization for heart failure, and by >10% EF, VO(2)max, and 6MWD increase. Implantation was successful in 22 patients (84.6%). Procedure duration (199.1 min) and fluoroscopy time (38.7 min) were higher than in standard procedures. Two clinically silent coronary sinus dissections occurred intra-operatively; one phrenic nerve stimulation and one pocket infection were observed during follow-up. After 3 months of CRT, a significant reduction (P < 0.05) of NYHA class, increment of VO(2)max, 6MWD, EF, and improvement of indices of dyssynchrony were observed. Response rate in the studied group was 95.4%. Triple-site resynchronization appears to be a safe and efficient treatment method, with high response rate. Further studies are needed to evaluate the role of this pacing mode in CRT.
  Europace 10/2007; 9(9):762-7. · 1.98 Impact Factor