Maria Jastrzębska

Factors influencing multiplate whole blood impedance platelet aggregometry measurements, during aspirin treatment in acute ischemic stroke: a pilot study.

Among patients with stroke, the phenomenon of resistance to treatment with low-dose aspirin acetylsalicylic acid (ASA) is quite common. The study included 133 patients hospitalized with acute ischemic stroke. Impedance platelet aggregometry (IPA) and levels of vWF and thromboxane (TXB2) were assessed – with the efficacy of aspirin in daily clinical investigation. Responses to treatment with doses of 150 and 300 mg/day were measured. In addition, we analyzed the response of proinflammatory factors [fibrinogen, C-reactive protein (CRP), white blood corpuscles (WBC)], lipids and hemoglobin A1c, which may alter platelet aggregation response to treatment. After a week of treatment at 150 mg/day, ASA patients were classified as laboratory resistant (42%) or sensitive (58%). Values of IPA in the resistant group were significantly higher (472 ± 150 vs. 222 ± 59 AUC, P < 0.0001). In resistant patients were also found higher levels of fibrinogen (3.90 ± 0.89 vs. 3.46 ± 0.74 g/l, P = 0.0046), CRP (6.97 ± 5.66 vs. 4.17 ± 4.03 mg/l, P = 0.0011), WBC (9.2 ± 2.4 vs. 8.3 ± 2.2 × 109/l, P = 0.0207) and lower HDL cholesterol (46 ± 12 vs. 52 ± 15 mg/dl, P = 0.016). This research shows that aspirin resistance assessment by IPA well reflects the clinical status of patients and should be used routinely. Resistance generally fails to ‘break’ at higher doses, hence our suggestion that patients resistant to low doses of the drug immediately switch to a thienopyridine class antiplatelet agent, for example, clopidogrel.

Effect of Vitamin D Supplementation on Training Adaptation in Well-trained Soccer Players

Abstract Jastrzębska, M, Kaczmarczyk, M, and Jastrzębski, Z. Effect of vitamin D supplementation on training adaptation in well-trained soccer players. J Strength Cond Res 30(9): 2648–2655, 2016—There is growing body of evidence implying that vitamin D may be associated with athletic performance, however, studies examining the effects of vitamin D on athletic performance are inconsistent. Moreover, very little literature exists about the vitamin D and training efficiency or adaptation, especially in high-level, well-trained athletes. The purpose of the current study was to investigate the effect of vitamin D supplementation on training adaptation in well-trained football players. The subjects were divided into 2 groups: the placebo group (PG) and the experimental group (SG, supplemented with vitamin D, 5,000 IU per day). Both groups were subjected to High Intensity Interval Training Program. The selection to the groups was based on peak power results attained before the experiment and position on the field. Blood samples for vitamin D level were taken from the players. In addition, total work, 5, 10, 20, and 30 m running speed, squat jump, and countermovement jump height were determined. There were no significant differences between SG and PG groups for any power-related characteristics at baseline. All power-related variables, except the 30 m sprint running time, improved significantly in response to interval training. However, the mean change scores (the differences between posttraining and pretraining values) did not differ significantly between SG and PG groups. In conclusion, an 8-week vitamin D supplementation in highly trained football players was not beneficial in terms of response to High Intensity Interval Training. Given the current level of evidence, the recommendation to use vitamin D supplements in all athletes to improve performance or training gains would be premature. To avoid a seasonal decrease in 25(OH)D level or to obtain optimal vitamin D levels, the combination of higher dietary intake and vitamin D supplementation may be necessary.

Is there an effect of folic acid supplementation on the coagulation factors and C-reactive protein concentrations in subjects with atherosclerosis risk factors?

INTRODUCTION Folic acid (FA) may delay the formation of atherosclerotic lesions. Increased plasma levels of von Willebrand factor (VWF) are observed in cardiovascular disease, which leads to higher risk of thrombosis. Fibrinogen (Fb) is a well-documented risk factor of cardiovascular disease. The aim of this study was to analyze the effect of FA supplementation on the Fb, VWF and C-reactive protein (CRP) plasma concentrations in subjects with atherosclerosis risk factors. MATERIAL/METHODS The study enrolled 124 Caucasian individuals (60 M, 64 F) with atherosclerosis risk factors--family history of premature ischaemic stroke, arterial hypertension, dyslipidaemia, overweight and obesity, cigarette smoking and low physical activity. The participants were asked to take FA in the low dose of 0.4 mg/24 h for three months. RESULTS After FA supplementation a significant reduction of the VWF concentrations in females (76.6 vs 72.3%; p=0.028) and in males (75.5 vs 66.9%; p=0.001) was observed. Among women and men with dyslipidaemia concentrations of VWF decreased after FA supplementation (76.8% vs 69.6%; p=0.003 and 76.7% vs 67.8%; p=0.001 respectively). Among females and males with BMI ≥25 kg/m² concentrations of VWF decreased only in men (77.6% vs 66.5%; p=0.001). In female and male smokers supplementation of FA decreased VWF concentrations (82.5% vs 74.4%; p=0.012 and 76.6% vs 69.5%; p=0.036 respectively). DISCUSSION The results of our study suggest that there is an effect of FA supplementation on VWF concentrations in subjects with atherosclerosis risk factors.

The character of haemostatic disorders and level of protein S-100 in acute ischaemic stroke can affect survival in the first week of follow-up: a pilot study.

Disorders of haemostasis which result in ischaemic stroke usually appear as thromboembolism in peripheral veins and the pulmonary circulation, and to a lesser extent as coagulopathy. The S-100 protein, a marker of stroke, correlates positively with the neurological deficit National Institutes of Health Stroke Scale (NIHSS). We adopted the hypothesis that early death of patients with acute ischaemic stroke can be explained by changes in blood coagulation and fibrinolysis. The study included 84 patients hospitalized with acute ischaemic stroke. Three groups were created: I (death between 1 and 2 days), II (death between 5 and 7 days) and III (with no deaths in hospital). We measured levels of fibrinogen, antithrombin, D-dimers, plasmin–antiplasmin complexes, plasminogen and clotting times (prothrombin time and activated partial thromboplastin time), platelet number, euglobulin clot lysis time (ECLTindex) and S-100 protein, C-reactive protein and white blood cells (WBCs). Group I had lower concentrations of fibrinogen compared to groups II (3.13 vs. 4.18, P < 0.01) and III (3.13 vs. 3.77, P < 0.02) and higher levels of D-dimers (3643 vs. 2278, P < 0.05), higher concentrations of plasmin–antiplasmin complexes (1410 vs. 882, P = 0.03) and a lower ECLTindex (152 vs. 219, P < 0.02) when compared with group III. Group I also had higher concentrations of protein S-100 (2.09 vs. 0.61, P < 0.001), higher NIHSS (18.0 vs. 13.2, P = 0.073) and number of WBC (14.1 vs. 11.1, P < 0.02) than in group III. The observed abnormalities in haemostasis, either found systemically or locally as cerebral microvascular thrombosis, may be factors potentially associated with death of patients with the shortest survival time.

Tissue factor levels and the fibrinolytic system in thin and thick intraluminal thrombus and underlying walls of abdominal aortic aneurysms

Background: The hemostatic system cooperates with proteolytic degradation in processes allowing abdominal aortic aneurysm (AAA) formation. In previous studies, it has been suggested that aneurysm rupture depends on intraluminal thrombus (ILT) thickness, which varies across each individual aneurysm. We hypothesized that hemostatic components differentially accumulate in AAA tissue in relation to ILT thickness. Thick (A1) and thin (B1) segments of ILTs and aneurysm wall sections A (adjacent to A1) and B (adjacent to B1) from one aneurysm sac were taken from 35 patients undergoing elective repair. Methods: Factor levels were measured using enzyme‐linked immunosorbent assay of protein extract. Results: Tissue factor (TF) activities were significantly higher in thinner segments of AAA (B1 vs A1, P = .003; B vs A, P < .001; B vs A1, P < .001; B vs B1, P = .001). Significantly higher tissue plasminogen activator was found in thick thrombus‐covered wall segments (A) than in B, A1, and B1 (P = .015, P < .001, and P < .001, respectively). Plasminogen concentrations were highest in ILT. Concentrations of &agr;2‐antiplasmin in thin ILT adjacent walls (B) were higher compared with wall (A) adjacent to thick ILT (P = .021) and thick ILT (A1; P < .001). Significant correlations between levels of different factors were mostly found in thick ILT (A1). However, no correlations were found at B sites, except for a correlation between plasmin and TF activities (r = 0.55; P = .004). Conclusions: These results suggest that higher TF activities are present in thinner AAA regions. These parameters and local fibrinolysis may be part of the processes leading to destruction of the aneurysm wall. Clinical Relevance: Intraluminal thrombus (ILT) and abdominal aortic aneurysm wall thickness vary significantly across each individual aneurysm. The study suggests that intensified coagulation and probably local fibrinolysis in thin ILT segments may be part of a chain reaction leading to the destruction of the aneurysm wall and, as a result, its rupture. Considering the significant ability of coagulative and fibrinolytic systems to construct ILT as well as to regulate extracellular matrix proteolysis of the abdominal aortic aneurysm wall, the spatiotemporal distribution of components of these two systems represents data that may improve patient‐specific models of aneurysmal progression and rupture risk in the future.

Can Supplementation of Vitamin D Improve Aerobic Capacity in Well Trained Youth Soccer Players

Abstract There is no clear evidence that vitamin D effectively improves physical capacity in high-level athletes. The aim of this study was to confirm that vitamin D supplementation of soccer players during eight-week high-intensity training would have a significant effect on their aerobic capacity. The subjects were divided into two groups: the experimental one that was supplemented with vitamin D (SG, n = 20), and the placebo group (PG, n = 16), not supplemented with vitamin D. All the players were subjected to the same soccer training described as High-Intensity Interval Training (HIIT). The data of the vitamin D level, PWC170, lactate threshold (LT) were collected just before and after the intervention. A significant increase in vitamin D concentration (119%) was observed in the supplemented group, while the non-supplemented group showed a decrease of 8.4%. The studied subjects improved VO2max results by 20% in the SG, and by 13% in the PG. The improvement in velocity at the LT was similar in both groups. Results of this study show that vitamin D can have a positive, though moderate, effect on aerobic performance in players subjected to high-intensity training in the form of small-sided games for 8 weeks.

Iron, Hematological Parameters and Blood Plasma Lipid Profile in Vitamin D Supplemented and Non-Supplemented Young Soccer Players Subjected to High-Intensity Interval Training

Vitamin D deficiency has been associated with increased risk for cardiovascular disease and anemia. Vitamin D-related changes in lipid profile have been studied extensively but the relationship between vitamin D and lipid metabolism is not completely understood. As both vitamin D and intermittent training may potentially affect iron and lipid metabolism, the aim of the study was to evaluate whether a daily supplementation of vitamin D can modulate the response of hematological and lipid parameters to high-intensity interval training (HIIT) in soccer players. Thirty-six young elite junior soccer players were included in the placebo-controlled, double-blind study. Participants were non-randomly allocated into either a supplemented group (SG, n=20, HIIT and 5,000 IU of vitamin D daily) or placebo group (PG, n=16, HIIT and sunflower oil). Hematological parameters were ascertained before and after the 8-wk training. The change score (post- and pre-training difference) was calculated for each individual and the mean change score (MCS) was compared between SG and PG using the t test and analysis of covariance. There were no differences between SG and PG at baseline. The red and white cell count, hemoglobin, hematocrit, MCHC, ferritin, and HDL-cholesterol changed significantly over the 8-wk HIIT. However, no significant differences in MCS were observed between SG and PG for any variable. A daily vitamin D supplement did not have any impact on alteration in hematological or lipid parameters in young soccer players in the course of high-intensity interval training.

Does the progeny of premature ischemic stroke sufferers need intensive interest of physicians oriented toward primary prevention? A pilot study

Background Few studies focus on the progeny of stroke patients with respect to the occurrence of other potential risk factors. Methods The study group covered 60 males and 62 females whose parents had suffered premature ischemic stroke (PIS); the control group comprised of 41 males and 47 females whose parents had no history of premature vascular event (mean age: 28.4 and 27.1 years, respectively). Examination of both the groups consisted of evaluation of their diet, measurement of arterial blood pressure and body mass index (BMI). Moreover, blood test was carried out and concentration of biochemical stroke risk factors was determined. Results The adult progeny of parents with a history of PIS followed a deficient, unbalanced, and nonvaried diet. Their average blood pressure and BMI reached higher values, compared with the results obtained in the control group (125.7 ± 16.06 vs. 122.64 ± 10.83 mmHg; 24.27 ± 3.98 vs. 22.54 ± 2.69 kg/m2, respectively; P<0.05). The same applies to average concentrations of the triglycerides 1.22 ± 0.76 vs. 1.06 ± 0.54 mmol/l; total cholesterol (5.34 ± 1.16 vs. 4.82 ± 0.89 mmol/l), low-density lipoprotein-cholesterol (2.95 ± 0.97 vs. 2.52 ± 0.73 mmol/l), total homocysteine (11.22 ± 4.22 vs. 10.18 ± 2.45 μmol/l), and fibrinogen (2.91 ± 0.68 vs. 2.78 ± 0.6 g/l) (P<0.05). Conclusion Adult children of PIS sufferers show different stroke risk factor profiles than the control group. It may indicate a need for preventive activities for this group in the future. Family occurrence of stroke requires further detailed studies on a larger cohort of patients from risk group.