Paljoskovska-jordanova, Savetka

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Paljoskovska-jordanova, Savetka

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Paljoskovska Jordanova Savetka

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Special Conditions in Venous Thrombembolism - Case Series
(Macedonian Academy of Sciences and Arts/Walter de Gruyter GmbH, 2019-10-01)
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Klincheva, Milka
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Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management, and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding, renal insufficiency, disseminated malignancy or pregnant patients) have been under-represented in randomized clinical trials. We still need information from real life data (as example RIETE). The paper presents case series with VTE in special conditions, including cancer associated thrombosis, malignant homeopathies, as well in high risk population.
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Uncommon Cases of Venous Thromboembolism
(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH, 2023-07-01)
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Vuchinikj, Aleksandra Gulevska
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Anguseva, Tanja
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There is a growing incidence of new cases of venous thromboembolismworldwide.Some of these patients do have a predisposition to the development of thrombosis, some of them do however have various risk factors associated with this event, but few of them have unrecognized etiology. This paper aimsto describe different scenarios of venous thromboembolism.
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Epidemiological aspects of carotid disease
(Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2021-03-22)
<jats:p>Carotid artery disease most commonly manifests as atherosclerotic carotid artery disease, which can lead to an ischemic stroke. Our aim was to present the epidemiological aspects of carotid disease and to demonstrate the association of risk factors with carotid disease. For that purpose, we prospectively followed 1031 patients at the University Clinic for Cardiology in Skopje, who were examined for carotid stenosis and its correlation with risk factors such as hypertension, smoking, hyperlipidemia, diabetes, obesity and peripheral arterial disease. Results: Carotid stenosis was correlated with arterial hypertension, hyperlipidemia, diabetes mellitus, smoking, and peripheral arterial disease. Conclusions: Our study found that conventional risk factors such as hypertension, diabetes, smoking, and dyslipidemia were independently associated with significant carotid artery disease and peripheral arterial disease.</jats:p>
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Gender Differences in High-risk CAS through Radial Access
(Scientific Foundation SPIROSKI, 2023-04-03)
Petkoska Spirova, Danica
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Vasilev, Ivan
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AIMS: Transradial (TR) carotid artery stenting (CAS) has been established as an acceptable alternative to carotid endarterectomy, especially in patients with a high risk for surgery. The purpose of this study was to evaluate the gender differences of radial access CAS in high-risk patients. MATERIALS AND METHODS: This was a prospective analysis which included 54 consecutive patients in the period from December 2020 to January 2022. According to the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy study for high-risk CAS, patients with at least one anatomic or comorbid factor associated with increased surgical risk were included in the study. Subjects were divided into two groups according to sex. Follow-up assessments included neurological exams, 12-lead electrocardiogram, and duplex ultrasound (DUS). The primary endpoint was 30-day composite rate of stroke, death, and myocardial infarction. Secondary endpoints included procedure success, access site complications according to Early Discharge after TR Stenting of Coronary Arteries (EASY) score classification, target lesion revascularization, and in-stent restenosis evaluated with DUS. RESULTS: The study population was predominantly male 37 (61.1%) and females were 17 (38.9%). Mean age in the women group was 64.4 ± 7.43 years, and in men, it was 69.1 ± 8.01 years (p = 0.0223). From risk factors for coronary artery disease, hypertension and smoking were more frequent in the male group and hyperlipidemia and diabetes in the female group. Most of the male patients were symptomatic compared to the female group (p = 0.0151). Procedural success was obtained in all cases. Transient vasospasm induced by the distal protection device was present in one male patient. No 30-day major adverse events were recorded between the two groups. Minor access site bleeding complications according to EASY score (Easy type 1) were recorded in 4 patients (3 males vs. 1 female). There were no cases of hand ischemia after procedure or follow-up. None of the patients had in-stent restenosis >70% on DUS during 1-year follow-up. CONCLUSION: Results from this study demonstrate no gender-related differences in radial access CAS for high-risk patients.
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Impact of anthropometric factors on outcomes in atrial fibrillation patients: analysis on 10 220 patients from the European Society of Cardiology (ESC)-European Heart Rhythm Association (EHRA) EurObservational Research Programme on Atrial Fibrillation (EORP-AF) general long-term registry
(Oxford University Press (OUP), 2022-06-07)
Boriani, Giuseppe
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Vitolo, Marco
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Malavasi, Vincenzo L
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Proietti, Marco
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Fantecchi, Elisa
Abstract Aim To investigate the association of anthropometric parameters [height, weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM)] with outcomes in atrial fibrillation (AF). Methods and results Ten-thousand two-hundred twenty patients were enrolled [40.3% females, median age 70 (62–77) years, followed for 728 (interquartile range 653–745) days]. Sex-specific tertiles were considered for the five anthropometric variables. At the end of follow-up, survival free from all-cause death was worse in the lowest tertiles for all the anthropometric variables analyzed. On multivariable Cox regression analysis, an independent association with all-cause death was found for the lowest vs. middle tertile when body weight (hazard ratio [HR] 1.66, 95%CI 1.23–2.23), BMI (HR 1.65, 95%CI 1.23–2.21), and BSA (HR 1.49, 95%CI 1.11–2.01) were analysed in female sex, as well as for body weight in male patients (HR 1.61, 95%CI 1.25–2.07). Conversely, the risk of MACE was lower for the highest tertile (vs. middle tertile) of BSA and LBM in males and for the highest tertile of weight and BSA in female patients. A higher occurrence of haemorrhagic events was found for female patients in the lowest tertile of height [odds ratio (OR) 1.90, 95%CI 1.23–2.94] and LBM (OR 2.13, 95%CI 1.40–3.26). Conclusions In AF patients height, weight, BMI, BSA, and LBM were associated with clinical outcomes, with all-cause death being higher for patients presenting lower values of these variables, i.e. in the lowest tertiles of distribution. The anthropometric variables independently associated with other outcomes were also different between male and female subjects.
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The Role of Carotid Stenosis in a Prediction of Prognosis of Coronary Artery Disease
(Македонска академија на науките и уметностите, Одделение за медицински науки = Macedonian Academy of Sciences and Arts, Section of Medical Sciences/Walter de Gruyter GmbH/Walter de Gruyter GmbH, 2021-04-01)
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Petkoska Spirova, Danica
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Stojanovska, Lily
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<jats:title>Abstract</jats:title> <jats:p> <jats:bold>Aims</jats:bold>: The aim of this paper is to indicate if carotid stenosis is predictive for the prognosis of coronary artery disease.</jats:p> <jats:p> <jats:bold>Method and materials</jats:bold>: Our study is a prospective cohort study. 1031 patients with proven coronary artery disease (CAD) were recruited consecutively. Carotid ultrasound was used to assess IMT, plaque, or stenosis. They were followed for 24 months for adverse cardiovascular events. Selected demographic date such as smoking history, dyslipidemia, hypertension, laboratory values, and clinical data (associated diseases and risk) were collected from each patient. Total cardiovascular events and mortality rate were followed up for the study population. The results were collected prospectively and retrospectively. The study was organized as a clinical, cross-sectional study and comparative study.</jats:p> <jats:p>From the data collected with the clinical research, a file was formed in the statistical program with the help of which the data were statistically analyzed.</jats:p> <jats:p>From the methods of descriptive statistics, absolute frequencies, percentages, arithmetic mean, median, measures of variability, minimum, maximum, standard deviation and logistic regression models were used.</jats:p> <jats:p> <jats:bold>Result</jats:bold>: Of the total number of patients 1026 had arterial hypertension (HTA). Data on hyperlipidemia (HLP) had been reported in 895 patients. 1.023 patients had peripheral artery disease (PAB). 1031 patients were presented with multivessel coronary artery disease (CAD). There were 1,029 patients with diabetes mellitus (DM), while 1,013 patients had coronary artery by-pass (CABG), and 1,012 had stroke (CVI). Elevated systolic blood pressure was reported in 966 patients. 184 patients had elevated triglycerides and 187 had elevated cholesterol. 1,008 patients have had a history of myocardial infarction. Carotid artery stenosis (CAS) has been found in 1,009 patients, increased body mass index (BMI) in 270 patients.</jats:p> <jats:p>1.031 patients were followed for 24 months. Cardiovascular events were reported in 54 patients (or 5.2%). Revascularization was performed in 28 (4.1%) patients, while 12 (1.8%) of patients died. Diabetes mellitus (OR 1.878 95% CI 0.491 7.184) and Carotid stenosis (OR 2.185 95% CI 0.731 6.53) were found to be predictive factors for future cardiovascular events.</jats:p> <jats:p> <jats:bold>Conclusion</jats:bold>: Due to our results carotid ultrasound may be a useful tool for risk stratification of coronary artery disease pts.</jats:p>
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Ipsilateral transulnar artery approach catheterizations after failure of the radial approach-Are two sheaths in the same arm safe?
(Wiley, 2021-05-28)
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Jovkovski, Aleksandar
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Vasilev, Ivan
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Taravari, Hajber
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Kitanoski, Darko
To assess the safety and feasibility of ipsilateral transulnar access (TUA) after failure of radial access (TRA), with two sheaths placed in the radial and ulnar arteries (RA and UA) in the same arm.
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Evaluation of echocardiographic parameters for right heart function and pulmonary hypertension in the progression of Chronic Obstructive Pulmonary Disease
(2022)
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Grueva Nastevska, Elena
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Risteski, Dejan
INTRODUCTION Chronic opstructive pulmonary disease (COPD) is one of the diseases with highest mortality rate, high morbidity and early mortality. Right ventricular hypertrophy with preserved systolic function is most common finding in patients with COPD.COPD patients not so rarely have increased pulmonary vascular resistance (PVR), moderate to severe form of pulmonary hypertension, ‘’cor pulmonale” and right heart failure. Our study investigated the echocardiographic parameters used to assess right ventricular function and pulmonary hypertension in patients with chronic obstructive pulmonary disease (COPD) according to their specificity and sensitivity and disease progression. MATERIAL AND METHODS We have analysed 94 patients with COPD (Gold class I-IV). The 13 echo-cardiography parameters important for assessment of right ventricular function and pulmonary hypertension due to their sensitivity and specificity and progression of the disease were evaluated: basal dimension of the right ventricle(DV bazal), right atrium(DA), right atrial area(DA area), S‘wave of the right ventricle of TDI, TAPSE, functional area change (FAC %), (SPAP), Vmax of tricuspid regurgitation , acceleration time of pulmonary artery (AT), pulmonary vascular resistance (PVR), myocardial performance index of the right venricle (MPI), global strain of the right ventricle(GL strain), collаpsibility of vena.cava inferior >/<50 %. RESULTS AND DISCUSSION Predictors of disease progression with high specifity ans sensitivity are the parameters: MPI DV TDI, Global strain of DV and collabsibility of v.cava inferior less then 50%. Predictors of disease progression with high specifity and low sensitivity are : DV bazal, DA, DA area, S TDI, TAPSE, FAC, SPAP, V max TR. Predictors of disease progression with low specifity and high sensistivity are parameters: shortened acceleration time of the pulse Dopler of the pulmonary valve and the development of pulmonary vascular resistаnce. CONCLUSION Echocardiography is a non invasive and useful method for evaluation and follow up the patients with COPD. All this indicates that the values of certain echocardiographic parameters can help us detect disease progression, with high sensitivity, high specificity or both.
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Carotid IMT in Patients with Documented Coronary Artery Disease- A Survey on Risk Factors
(Slovenian Society for Vascular Diseases, 2019-10)
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Special Conditions in Venous Thrombembolism – Case Series
(Macedonian Academy of Sciences and Arts, 2019-10-01)
;
;
;
Klincheva, Milka
;
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a preventable cause of in-hospital death, and one of the most prevalent vascular diseases. There is a lack of knowledge with regards to contemporary presentation, management, and outcomes of patients with VTE. Many clinically important subgroups (including the elderly, those with recent bleeding, renal insufficiency, disseminated malignancy or pregnant patients) have been under-represented in randomized clinical trials. We still need information from real life data (as example RIETE). The paper presents case series with VTE in special conditions, including cancer associated thrombosis, malignant homeopathies, as well in high risk population.

Paljoskovska-jordanova, Savetka

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