IntroductionType 2 diabetes mellitus (T2DM) is an important and common cardiovascular risk factor. The purpose of the study was to evaluate the frequency of use of oral antiplatelet drugs (OAPs) and oral anticoagulant drugs (OACs) among the elderly with T2DM in Poland.Material and methodsThe study was based on the data collected in the Polish national PolSenior study.ResultsAmong 4979 PolSenior participants aged 65 and over, 883 (17.8%) had previously diagnosed T2DM. Among them, 441 (49.9%) used at least one drug in pharmacological cardiovascular prevention, i.e. OAPs (mostly ASA) in 405 (45.9%) cases and OACs in 38 (4.3%). The use of these drugs significantly depended on the sex (p = 0.02) and personal income (p = 0.05). Age, place of residence and level of education did not affect the prevalence of pharmacological prevention. Previous stroke and myocardial infarction were mostly associated with OAPs, whereas a history of atrial fibrillation (AF) was related to OAC treatment. Among participants treated with OAPs, therapy was applied as secondary cardiovascular prevention in 211 (52.1%) subjects, and as primary prevention in 194 (47.9%) subjects. Among participants treated with OACs, 24 (64.9%) persons had a history of AF. Secondary cardiovascular pharmacological prevention should be considered in 45 untreated participants (12.5%), and primary cardiovascular pharmacological prevention (SCORE ≥ 10 and/or AF) in 154 participants (42.7%).ConclusionsCardiovascular pharmacological prevention in the elderly with T2DM in Poland seems to be unsatisfactory. Educational programmes concerning current recommendations for pharmacological cardiovascular prevention should be developed among general practitioners.

BackgroundUremic pruritus is a common complication in patients undergoing dialysis. The pathophysiological mechanisms of pruritus in patients with end-stage renal disease remain unknown. Neuropeptides, including substance P, are postulated to play an important role in the pathogenesis of pruritus. The aim of this study was to evaluate the role of substance P in uremic pruritus in patients on hemodialysis and peritoneal dialysis.Material/MethodsWe included 197 patients with end-stage renal disease: 54 on continuous ambulatory peritoneal dialysis and 143 on hemodialysis. Substance P, calcium, phosphorus, iron, ferritin, CRP, albumin, hemoglobin, Ca × P product, and iPTH level were determined in all participants. The correlation between these parameters and self-reported itching was evaluated in patients on hemodialysis in comparison with peritoneal dialysis patients.ResultsThe incidence of itching was similar in hemodialysis and peritoneal dialysis patients. No differences in substance P level between the 2 groups were found. There was no correlation between substance P level and the incidence or intensity of pruritus in dialyzed patients.ConclusionsThis study demonstrates that substance P does not play any important role in pruritus in hemodialysed and peritoneal dialyzed patients. However, further studies are necessary to assess the exact role of neuropeptides in uremic pruritus.

High on-treatment platelet reactivity in chronic kidney disease 667 platelet aggregation and causing vasoconstriction. 2 Up to 60% of patients on ASA exhibit high on-treatment platelet reactivity (HOPR), 3 formerly known as "aspirin resistance." The possible causes of this phenomenon might include drug interactions, alternative platelet activation pathways, non-platelet TXA2 production, genetic polymorphisms, increased platelet turnover, INTRODUCTION Due to its antiplatelet effect, acetylsalicylic acid (ASA) has been widely used in primary and secondary prevention of cardiovascular diseases (CVDs). 1 The mechanism of action of ASA is based on irreversible inhibition of platelet cyclooxygenase 1 (COX-1) and reduction of thromboxane A2 (TXA2) synthesis, which is a strong factor stimulating

The study was unique to determine the frequency of pharmacological stroke prevention among elderly people with AF in Poland. It occurred that oral anticoagulant drugs were applied too rarely in this group of patients. Educational programs should be developed among general practitioners concerning current recommendations for patients with AF.

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