Jozica Šikić

Nutrition in primary and secondary prevention of cardiovascular risk in the continental and Mediterranean regions of Croatia

BackgroundThe aim of this observational study was to evaluate the effect of Mediterranean and continental nutrition on cardiovascular risk in patients with acute and chronic coronary heart disease in Croatia.MethodsThe study included 1284 patients who were hospitalized in a 28-month period due to acute or chronic ischaemic heart disease in hospitals across Croatia. An individual questionnaire was prepared which enabled recording of various cardiovascular risk factors.ResultsPatients with chronic coronary artery disease have a better index of healthy diet than patients with acute coronary disease. Women have a better index of diet than men in both Croatian regions. When the prevalence of risk factors (impaired glucose tolerance, diabetes mellitus types I and II, hypercholesterolaemia, hypertriglyceridaemia and hypertension) in patients with Mediterranean and continental nutrition is compared, a trend is seen for patients who have risk factors to consume healthier food.ConclusionThe Mediterranean diet is associated with reduced risk of developing cardiovascular disease. This effect is more evident in patients with known cardiovascular disease.

A Case Report of Drug-Eluting Balloon as a New Treatment Option for Cardiac Allograft Vasculopathy

Cardiac allograft vasculopathy (CAV) is the principal longterm cause of graft failure responsible for more than 30% of all deaths in heart transplanted patients. Driven mainly by immune factors, CAV is characterized by concentric thickening of the blood vessel wall. Previous studies about drugand bare-metal stents in the treatment of CAV showed no significant differences in treatment outcomes. Until now, heart retransplantation remains the only treatment option for severe CAV. To our knowledge, there are no reported studies about the use of drug-eluting balloons in CAV. There are several expected benefits from this kind of intervention: an optimized homogeneous drug dispersion stopping the immunological process, the lack of residual metal reducing local tissue reactions, and the need for short-term antiplatelet treatment providing fewer interactions with immunosuppressive therapy.

Differences in risk factors, presentation and angiographic findings in elderly patients with coronary artery disease

3. Vasiljevic-Pokrajcic Z, Mickovski N, Davidovic G, Asanin M, Stefanovic B, Krljanac G, et al. Sex and age differences and outcomes in acute coronary syndromes. Int J Cardiol. 2016 Aug;217 Suppl:S27-31. https://doi.org/10.1016/j.ijcard.2016.06.217 Introduction: Coronary artery disease (CAD) is common among elderly patients and may have certain characteristics that are different from those in younger age.1-3 The aim of this study is to determine the presented risk factors, clinical presentation and angiographic findings in elderly patients.

Pancreatitis and the broken heart

2018;13(1-2):28. Background: Broken heart syndrome or Takotsubo syndrome (TTS) is considered a type of acute and usually reversible heart failure episode, often indistinguishable from acute coronary syndromes, characterized by the lack of significant obstructive coronary artery disease. The most characteristic wall motion pattern is apical ballooning. Reversible LV dysfunction affects more than one coronary territory and timelines of recovery is variable. It is believed that enhanced sympathetic stimulation induces transient myocardial stunning through a variety of mechanisms associated with emotional or physical stress. To the best of our knowledge, there is only one published case report of TTS resulting from the exacerbation of chronic pancreatitis1. Case report: We report the case of a 69-year-old lady with fouryear history of chronic pancreatitis who came to our emergency room with acute epigastric pain and vomiting associated with STelevation in precordial leads (Figure 1) and elevated troponin (troponin I 1496 ng/L). Moreover, serum amylase (315 U/L) and lipase (249 U/L) were increased. Echocardiography revealed a dilated and hypokinetic apex with reduced left ventricle ejection fraction (LVEF 40%). The abdominal ultrasound showed inhomogeneous pancreas with calcifications. Obstructive lesions of coronary arteries were absent on the angiogram and apical ballooning was demonstrated on left ventriculography (Figure 2).The findings were consistent with TTS and acute exacerbation of chronic pancreatitis. The patient was managed with intravenous crystaloids, analgesics, anti-emetics, beta blockers, ACE inhibitors. Over the next 2-3 days she was able to tolerate an oral diet. The ECG typiPetra Grubić Rotkvić1*, Jozica Šikić1,2, Jasna Čerkez Habek1,3, Dean Strinić1, Zdravko Babić4, Marin Pavlov4

Mitral regurgitation and other valvular heart diseases

2. Zamorano JL, Manuel Monteagudo J, Mesa D, Gonzalez-Alujas T, Sitges M, Carrasco-Chinchilla F, et al. Frequency, Mechanism and Severity of Mitral Regurgitation: Are There any Differences Between Primary and Secondary Mitral Regurgitation? J Heart Valve Dis. 2016 Nov;25(6):724729. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/28290172 Ante Pašalić1*, Leon Adrović1, Tea Friščić1, Zrinka Planinić1, Marko Perčić1, Dario Gulin1, Dijana Bešić1, Jozica Šikić1,2

Additional file 1 of Nutrition in primary and secondary prevention of cardiovascular risk in the continental and Mediterranean regions of Croatia

*Questionnaire English version, *Study questionnaire containing main personal information, laboratory and physical findings and diet habits. (PDF 316 kb)

Percutaneous coronary interventions in cardiac allograft vasculopathy - a case report and review of the literature.

2016;11(3-4):108. VII. nacionalni sastanak o kardiovaskularnim intervencijama s međunarodnim sudjelovanjem VI. sastanak intervencijskih kardioloških medicinskih sestara i tehničara Introduction: Cardiac allograft vasculopathy (CAV) is a challenging long-term complication of cardiac transplantation and remains a leading long-term cause of graft failure, re-transplantation, and death.1-3 Not only pathological characteristics, but also asymptomatic presentation of CAV is significantly different from typical atherosclerotic coronary artery disease (CAD). Large multicenter studies of heart transplant recipients undergoing percutaneous coronary interventions are lacking.

Reversible peripartum cardiomyopathy in a triplet pregnancy

Peripartum cardiomyopathy (PPCM) is a rare form of dilated cardiomyopathy that occurs in previously healthy women in the last month of pregnancy and up to several months after delivery. The incidence of PPCM is low, but its morbidity and mortality rate are high, with a substantial risk of poor outcome of the pregnancy. Patients who have recovered from PPCM run a high risk of reoccurrence in subsequent pregnancies. In this case report we present a 32-year old female patient who developed acute heart failure (HF) associated with significantly reduced systolic function due to PPCM soon after a delivery of triplets. Treatment was immediately initiated in the intensive coronary unit with oxygen-therapy, loop diuretics, aldosterone blockers, beta blockers, angiotensin-converting enzyme (ACE) inhibitors and bromocriptine. During the follow up period, a year and a half after delivery, a complete recovery of systolic function was observed with no residual symptoms.

Thrombosis of bare metal and patent drug eluting stent in patient operated for colorectal carcinoma: The utility of new guidelines in patients with malignancy

Percutaneous coronary intervention with stent placement is widely used to achieve revascularization of the myocardium, especially in acute coronary syndrome. There is increasing number of reports published concerning stent thrombosis both in bare metal stents as in drug eluting stents. According to the newest ACC/AHA/SCAI 2007th guidelines, bare-metal stent or balloon angioplasty is recommended as an optimal solution if surgery is to be performed in 6-12 months time after stent placement. We present a case of a 56-year-old male with colon carcinoma who suffered from post-operational myocardial infarction due to bare metal stent thrombosis, while the drug eluting stent remained patent. Currently, in our opinion, high level evidence is lacking in the literature in support for recommendations published in current ACC, AHA and SCAI 2007th guidelines regarding the choice of stent, antiaggregation and anticoagulation therapy. This case, together with others previously published suggests a need for development of an applicable strategy for selection and treatment of patients with increased perioperative risk of in-stent thrombosis in order to ensure optimal medical treatment.