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Dive into the research topics where Jaroslaw Zalewski is active.

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Featured researches published by Jaroslaw Zalewski.


Arteriosclerosis, Thrombosis, and Vascular Biology | 2011

Reduced Thrombin Formation and Altered Fibrin Clot Properties Induced by Polyunsaturated Omega-3 Fatty Acids on Top of Dual Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention (OMEGA-PCI Clot)

Grzegorz Gajos; Jaroslaw Zalewski; Paweł Rostoff; Jadwiga Nessler; Wiesława Piwowarska; Anetta Undas

Objective—The goal of this study was to investigate whether omega-3 polyunsaturated fatty acids (n-3 PUFA) are able to alter plasma fibrin clot properties and reduce thrombin formation in stable coronary artery disease patients undergoing percutaneous coronary intervention (PCI). Methods and Results—In an investigator-initiated, prospective, double-blind, placebo-controlled, randomized study, patients undergoing PCI who received standard pharmacotherapy were assigned to the treatment with 1 g/day n-3 PUFA (n=30) or placebo (n=24) for 1 month. Plasma fibrin clot permeability (Ks); lysis time (t50%); prothrombin fragment 1.2; and peak thrombin generation from automated thrombogram, 8-isoprostaglandin F2&agr; (8-iso-PGF2&agr;, an oxidative stress marker), and C-reactive protein were determined at baseline, 3 to 5 days after randomization, and 30 days after randomization. At baseline, both treatment groups did not differ significantly. A 1-month treatment with n-3 PUFA compared with placebo was associated with 15.3% higher Ks, indicating larger pores in the fibrin network (P=0.0005); 14.3% shorter t50%, indicating increased susceptibility to fibrinolysis (P<0.0001); 33.8% lower prothrombin fragment 1.2 (P=0.0013); 13.4% lower peak thrombin generation (P=0.04); and 13.1% lower 8-iso-PGF2&agr; (P=0.009). Treatment with n-3 PUFA had no effect on fibrinogen and C-reactive protein. After 1 month of treatment, fibrinogen (r=−0.53, P<0.0001), treatment assignment (r=0.29, P=0.006) and 8-iso-PGF2&agr; (r=−0.27, P=0.015) were independently associated with clot permeability (P<0.0001, R2=0.66). Conclusion—Adding n-3 PUFA to standard therapy in stable patients undergoing PCI significantly decreases thrombin formation and oxidative stress and favorably alters fibrin clot properties. These findings indicate novel antithrombotic effects induced by n-3 PUFA in humans.


Arteriosclerosis, Thrombosis, and Vascular Biology | 2010

Altered Plasma Fibrin Clot Properties Are Associated With In-Stent Thrombosis

Anetta Undas; Jaroslaw Zalewski; Marek Krochin; Zbigniew Siudak; Marcin Sadowski; Jerzy Pręgowski; Dariusz Dudek; Marianna Janion; Adam Witkowski; Krzysztof Zmudka

Objectives—We sought to investigate whether patients with in-stent thrombosis (IST) display altered plasma fibrin clot properties. Methods and Results—We studied 47 definite IST patients, including 15 with acute, 26 subacute and 6 late IST, and 48 controls matched for demographics, cardiovascular risk factors, concomitant treatment and angiographic/stent parameters. Plasma clot permeability (Ks), which indicates a pore size, turbidity (lag phase, indicating the rate of fibrin clot formation, &Dgr;Absmax, maximum absorbance of a fibrin gel, reflecting the fiber thickness), lysis time (t50%) and maximum rate of d-dimer release from clots (D-Drate) were determined 2 to 73 (median 14.7) months after IST. Patients with IST had 21% lower Ks, 14% higher &Dgr;Absmax, 11% lower D-Drate, 30% longer t50% (all P<0.0001) and 5% shorter lag phase compared to controls (P=0.042). There were no correlations between clot variables and the time of IST or that from IST to blood sampling. Multiple regression analysis showed that Ks (odds ratio=0.36 per 0.1 &mgr;m2, P<0.001), D-Drate (odds ratio=0.16 per 0.01 mg/L/min, P<0.001) and stent length (odds ratio=1.1 per 1 mm, P=0.043) were independent predictors of IST (R2=0.58, P<0.001). Conclusions—IST patients tend to form dense fibrin clots resistant to lysis, and altered plasma fibrin clot features might contribute to the occurrence of IST.


International Journal of Cardiology | 2010

Transportation with very long transfer delays (> 90 min) for facilitated PCI with reduced-dose fibrinolysis in patients with ST-segment elevation myocardial infarction: The Krakow Network

Dariusz Dudek; Artur Dziewierz; Zbigniew Siudak; Tomasz Rakowski; Jaroslaw Zalewski; Jacek Legutko; Waldemar Mielecki; Marianna Janion; Stanislaw Bartus; Marcin Kuta; Lukasz Rzeszutko; Giuseppe De Luca; Krzysztof Zmudka; Jacek S. Dubiel

BACKGROUND The majority of ST-segment elevation myocardial infarction (STEMI) patients are admitted to centers without primary percutaneous coronary intervention (PCI) facilities. Purpose of the study was to determine safety and outcomes in STEMI patients with transfer delay to PCI>90 min receiving half-dose alteplase and abciximab before PCI (facilitated PCI with reduced-dose fibrinolysis). METHODS AND RESULTS Outcomes of 669 STEMI patients (<12 h chest pain, non shock, fibrinolysis eligible, <75 years) with transfer delay to PCI>90 min who received half-dose alteplase and full-dose abciximab and were immediately transferred for PCI were compared with primary PCI effects in 1311 patients with transfer delay <90 min. Mean time from symptom-onset to PCI was longer (357 ± 145 min vs. 201 ± 177; P<0.001) in facilitated PCI with reduced-dose fibrinolysis group. In-hospital and 12-month outcomes were similar in both groups, however bleeding events were more frequent in facilitated PCI group (hemorrhagic stroke 0.9% vs. 0%; P<0.001; severe+moderate 5.5% vs. 2.3%; P<0.001). CONCLUSIONS This is the first large report showing the safety and benefits of transportation with very long transfer delay (>90 min) for facilitated PCI with reduced-dose fibrinolysis in STEMI patients. In fact, pharmacological treatment (combotherapy) was effective in overcoming the deleterious effects of long time-delay on outcome, with similar survival as compared to short-time transportation, despite higher risk of major bleeding complication.


European Heart Journal | 2018

Nitric oxide for inhalation in ST-elevation myocardial infarction (NOMI): a multicentre, double-blind, randomized controlled trial

Stefan Janssens; Jan Bogaert; Jaroslaw Zalewski; A. Tóth; Tom Adriaenssens; Ann Belmans; Johan Bennett; Piet Claus; Walter Desmet; Christophe Dubois; Kaatje Goetschalckx; Peter Sinnaeve; Katleen Vandenberghe; Pieter Vermeersch; Árpád Lux; Zsolt Szelid; Monika Durak; Piotr Lech; Krzysztof Zmudka; Peter Pokreisz; Pascal Vranckx; Béla Merkely; Kenneth D. Bloch; Frans Van de Werf

Aims Inhalation of nitric oxide (iNO) during myocardial ischaemia and after reperfusion confers cardioprotection in preclinical studies via enhanced cyclic guanosine monophosphate (cGMP) signalling. We tested whether iNO reduces reperfusion injury in patients with ST-elevation myocardial infarction (STEMI; NCT01398384). Methods and results We randomized in a double-blind, placebo-controlled study 250 STEMI patients to inhale oxygen with (iNO) or without (CON) 80 parts-per-million NO for 4 h following percutaneous revascularization. Primary efficacy endpoint was infarct size as a fraction of left ventricular (LV) size (IS/LVmass), assessed by delayed enhancement contrast magnetic resonance imaging (MRI). Pre-specified subgroup analysis included thrombolysis-in-myocardial-infarction flow in the infarct-related artery, troponin T levels on admission, duration of symptoms, location of culprit lesion, and intra-arterial nitroglycerine (NTG) use. Secondary efficacy endpoints included IS relative to risk area (IS/AAR), myocardial salvage index, LV functional recovery, and clinical events at 4 and 12 months. In the overall population, IS/LVmass at 48-72 h was 18.0 ± 13.4% in iNO (n = 109) and 19.4 ± 15.4% in CON [n = 116, effect size -1.524%, 95% confidence interval (95% CI) -5.28, 2.24; P = 0.427]. Subgroup analysis indicated consistency across clinical confounders of IS but significant treatment interaction with NTG (P = 0.0093) resulting in smaller IS/LVmass after iNO in NTG-naïve patients (n = 140, P < 0.05). The secondary endpoint IS/AAR was 53 ± 26% with iNO vs. 60 ± 26% in CON (effect size -6.8%, 95% CI -14.8, 1.3, P = 0.09) corresponding to a myocardial salvage index of 47 ± 26% vs. 40 ± 26%, respectively, P = 0.09. Cine-MRI showed similar LV volumes at 48-72 h, with a tendency towards smaller increases in end-systolic and end-diastolic volumes at 4 months in iNO (P = 0.048 and P = 0.06, respectively, n = 197). Inhalation of nitric oxide was safe and significantly increased cGMP plasma levels during 4 h reperfusion. The Kaplan-Meier analysis for the composite of death, recurrent ischaemia, stroke, or rehospitalizations showed a tendency toward lower event rates with iNO at 4 months and 1 year (log-rank test P = 0.10 and P = 0.06, respectively). Conclusions Inhalation of NO at 80 ppm for 4 h in STEMI was safe but did not reduce infarct size relative to absolute LVmass at 48-72h. The observed functional recovery and clinical event rates at follow-up and possible interaction with nitroglycerine warrant further studies of iNO in STEMI.


American Heart Journal | 2007

Early abciximab administration before primary percutaneous coronary intervention improves infarct-related artery patency and left ventricular function in high-risk patients with anterior wall myocardial infarction: a randomized study.

Tomasz Rakowski; Jaroslaw Zalewski; Jacek Legutko; Stanislaw Bartus; Lukasz Rzeszutko; Artur Dziewierz; Danuta Sorysz; Leszek Bryniarski; Krzysztof Zmudka; Grzegorz L. Kaluza; Jacek S. Dubiel; Dariusz Dudek


Cardiovascular Drugs and Therapy | 2013

Omega-3 Polyunsaturated Fatty Acids Increase Plasma Adiponectin to Leptin Ratio in Stable Coronary Artery Disease

Magdalena Mostowik; Grzegorz Gajos; Jaroslaw Zalewski; Jadwiga Nessler; Anetta Undas


Journal of Thrombosis and Thrombolysis | 2013

Type 2 diabetes as a modifier of fibrin clot properties in patients with coronary artery disease

Maciej Bochenek; Jaroslaw Zalewski; Jerzy Sadowski; Anetta Undas


International Journal of Cardiology | 2008

Patency of infarct related artery after pharmacological reperfusion during transfer to primary percutaneous coronary intervention influences left ventricular function and one-year clinical outcome

Dariusz Dudek; Tomasz Rakowski; Nader El Massri; Danuta Sorysz; Jaroslaw Zalewski; Jacek Legutko; Artur Dziewierz; Lukasz Rzeszutko; Krzysztof Zmudka; Wieslawa Piwowarska; Giuseppe De Luca; Grzegorz L. Kaluza; Marianna Janion; Jacek S. Dubiel


Cardiovascular Diabetology | 2015

Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk

Grzegorz Gajos; Malgorzata Konieczynska; Jaroslaw Zalewski; Anetta Undas


Jacc-cardiovascular Imaging | 2017

Long-Term Incremental Prognostic Value of Cardiovascular Magnetic Resonance After ST-Segment Elevation Myocardial Infarction: A Study of the Collaborative Registry on CMR in STEMI

Rolf Symons; Gianluca Pontone; Juerg Schwitter; Marco Francone; Juan F. Iglesias; Andrea Barison; Jaroslaw Zalewski; Laura De Luca; Sophie Degrauwe; Piet Claus; Marco Guglielmo; Jadwiga Nessler; Iacopo Carbone; Giovanni Ferro; Monika Durak; Paolo Magistrelli; Alfonso Lo Presti; Giovanni Donato Aquaro; Eric Eeckhout; Christian Roguelov; Daniele Andreini; Pierre Vogt; Andrea Igoren Guaricci; Saima Mushtaq; Valentina Lorenzoni; Olivier Muller; Walter Desmet; Luciano Agati; Stefan Janssens; Jan Bogaert

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Anetta Undas

Jagiellonian University Medical College

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Krzysztof Zmudka

Jagiellonian University Medical College

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Dariusz Dudek

Jagiellonian University Medical College

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Grzegorz Gajos

Jagiellonian University Medical College

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Jadwiga Nessler

Jagiellonian University Medical College

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Artur Dziewierz

Jagiellonian University Medical College

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Jacek Legutko

Jagiellonian University Medical College

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Jacek S. Dubiel

Jagiellonian University Medical College

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Tomasz Rakowski

Jagiellonian University Medical College

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Lukasz Rzeszutko

Jagiellonian University Medical College

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