Cardiology Journal 2013, tom 20, nr 5

Platelet activation plays a pivotal role for the initiation of acute coronary syndromes. Platelet size has been shown to correlate with their function. Large platelets are considered metabolically and enzymatically more reactive than smaller ones [1]. Increased mean platelet volume (MPV) is associated with extent of slow coronary flow [2]. MPV has been reported as increased in unstable angina pectoris and myocardial infarction (MI) [3]...

Atrial fibrillation (AF) is a common arrhythmia [1] with significant morbidity and mortality [2]. Although management by rate or rhythm control are equally effective therapies in the management of AF [3–5] maintaining sinus rhythm may be beneficial in patients with symptoms or with other comorbidities [6]. Multiple antiarrhythmic drugs are available for use to prevent recurrent AF but are limited by modest efficacy and potentially serious side effects or toxicity [7, 8]. Amiodarone has relatively high efficacy [9] but also has significant risks of pulmonary, thyroid and hepatic toxicity [10–12]...

Dual antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel (CLO) is recommended after percutaneous coronary intervention (PCI) with stent implantation to reduce the risk of instent thrombosis [1, 2]. Despite dual antiplatelet therapy, some patients experience thrombotic cardiac events. Thus, agents that reduces the risk of thrombotic events without increasing the risk of bleeding merits further evaluation...

The restoration of coronary flow is necessary to reduce ischemic myocardial damage due to acute vessel occlusion. However, during the reperfusion period, an additional damage of cardiac tissue occurs resulting in an ischemia/reperfusion (I/R) injury [1]. I/R injury causes a necrosis and apoptosis of cardiomyocytes and in clinical settings it may manifests as a myocardial stunning observed after the global ischemia during the cardiac surgery [2] or as an impaired coronary flow (no-flow phenomenon) [3] due to microvessels dysfunction observed after the percutaneous coronary angioplasty...

Congenital short QT syndrome (SQTS) is a rare inherited channelopathy without structural heart disease. It is an autosomal dominant, primary electrical disorder with a low degree of penetrance. It has a characteristic clinical-electrocardiographic-electrophysiological phenotype consisting of irregular palpitations due to the frequent episodes of paroxysmal atrial fibrillation (AF), dizziness and/or sudden cardiac death (SCD). Affected individuals usually have a positive family history of syncope or SCD in first or second degree young relatives (younger than 40 years of age) with autopsy negative SCD...

Percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) represents an evolving field of interventional cardiology. Since complex techniques and high support are often required, large guiding catheters inserted by trans-femoral approach are usually adopted by CTO-dedicated operators [1]. As a consequence, the majority of interventionalists who perform CTO PCI consider trans-radial approach (TRA) unsuitable for such kind of interventions...