Wojciech Szot

The effects of cardiac rehabilitation on overall physical capacity and myocardial perfusion in women with microvascular angina

BACKGROUND Cardiac syndrome X (CSX) is linked with changes in microcirculation, without significant changes in main coronary vessels. According to European Society of Cardiology 2013 stable coronary artery disease (CAD) criteria, CSX was replaced by microvascular angina (MA). The main feature of MA should be regional myocardial ischaemia; however, there are several works on this subject which failed to demonstrate the presence of perfusion defects. AIM To determine the effect of non-pharmacological procedures (cardiac rehabilitation) in patients diagnosed with MA on changes in left ventricular perfusion as assessed by myocardial single photon emission computed tomography, along with potential related improvements in exercise capacity. METHODS Toward this goal we screened for the presence of CAD in a group of 528 women, of whom 55 were not only diagnosed with MA but also agreed to participate in our study, which involved myocardial perfusion imaging (MPI) studies, during which exercise tests and cardiac rehabilitation were performed. RESULTS Comparison of results obtained at the beginning of the study with data obtained after completion of a three month period of cardiac rehabilitation showed improvements in both exercise test parameters (length of test, metabolic equivalents, blood pressure control during extortion) and MPI parameters for the left ventricle (both at rest and stress, global and regional). CONCLUSIONS Cardiac rehabilitation is a very useful tool of choice in the treatment of patients with MA.

Antiplatelet and Anticoagulant Agents for Secondary Prevention of Thromboembolic Events in People With Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by the presence of antiphospholipid antibodies and subsequent arterial or venous thrombosis or pregnancy morbidity. Individuals with a definite APS diagnosis have an increased lifetime risk of recurrent thrombotic events. The aim of this systematic review was to assess the effects of antiplatelet or anticoagulant agents, or both, for the secondary prevention of recurrent thromboembolism, particularly ischemic stroke, in people diagnosed with APS. We searched several electronic databases up to February 2017 and supplemented them by searching several ongoing trials registers, checking the reference lists of included studies, systematic reviews, and practice guidelines, and contacting experts in the field. We included randomized controlled trials that evaluated any anticoagulant or antiplatelet agent, or both, in the secondary prevention of thromboembolism among patients with APS diagnosed according to the criteria valid when the …