Background Coronary artery fistula is defined as a connection between one or more coronary artery and a heart chamber. aims The aim of the study was to determine the overall incidence of coronary artery fistulas in Polish patients undergoing diagnostic coronary artery angiography as well as the frequency of particular origin and draining sites. methods The data were obtained from the Polish National Registry of Invasive Cardiology Procedures among patients hospitalized between January 1, 2014 and December 31, 2016 in invasive cardiology departments in Poland. results The study included 298 558 patients. A coronary artery fistula was present in 261 patients (0.087%). There were 131 women (50.19%) and 130 men (49.81%). The most frequent origin of a coronary artery fistula was the left anterior descending artery (167 cases, 59.22%). The pulmonary artery was the most frequent drainage site for fistulas originating from the left anterior descending artery and the right coronary artery (84 cases, 50.30% and 25 cases, 31.65%, respectively). Fistulas originating from the circumflex artery most frequently drained into another artery (10 cases, 27.78%). conclusions The left anterior descending coronary artery was the origin site for more than half of all detected coronary artery fistulas. The pulmonary artery was the most frequent origin and drainage site for coronary artery fistulas.

Aortic stenosis (AS) has been associated with impaired fibrinolysis and increased oxidative stress. This study aimed to investigate whether oxidative stress could alter fibrin clot properties in AS. We studied 173 non-diabetic patients, aged 51–79 years, with isolated AS. We measured plasma protein carbonylation (PC) and thiobarbituric acid reactive substances (TBARS), along with plasma clot permeability (Ks), thrombin generation, and fibrinolytic efficiency, which were evaluated by two assays: clot lysis time (CLT) and lysis time (Lys50). Coagulation factors and fibrinolytic proteins were also determined. Plasma PC showed an association with AS severity, reflected by the aortic valve area and the mean and maximum aortic gradients. Plasma PC was positively correlated with CLT, Lys50, plasminogen activator inhibitor-1 (PAI-1), and tissue factor (TF) antigens. TBARS were positively correlated with maximum aortic gradient, Lys50, and TF antigen. Regression analysis showed that PC predicted prolonged CLT (>104 min; odds ratio (OR) 6.41, 95% confidence interval (CI) 2.58–17.83, p < 0.001) and Lys50 (>565 s; OR 5.83, 95% CI 2.23–15.21, p < 0.001). Multivariate regression analysis showed that mean aortic gradient, PC, α2-antiplasmin, PAI-1, and triglycerides were predictors of prolonged CLT, while PC, α2-antiplasmin, and fibrinogen were predictors of Lys50. Our findings suggest that elevated oxidative stress contributes to impaired fibrinolysis in AS and is associated with AS severity.

BACKGROUND A myocardial bridge (MB) is defined as a congenital anomaly, in which a segment of an epicardial coronary artery takes an intramuscular course. AIMS The aim of the study was to evaluate the prevalence of MB in coronary arteries among patients who were diagnosed using coronary angiography. METHODS Data were obtained from the National Polish Percutaneous Interventions Registry for patients hospitalized between January 1, 2014, and December 31, 2016, in invasive cardiology departments in Poland and divided into groups with and without MB. RESULTS The study included 298 558 patients. The non-MB group comprised 296 133 patients (99.19%; women, 38.01%), while the MB group included 2425 patients (0.81%; women, 39.98%). The most frequent location of MB was the left anterior descending artery (n = 2355; 97.11% of patients). The MB group less often had diabetes (14.68% vs 21.63%), previous stroke (1.61% vs 2.96%), previous myocardial infarction (10.97% vs 21.97%), kidney disease (2.8% vs 5.04%), previous coronary artery bypass graft (1.03% vs 5.64%), previous percutaneous coronary intervention (13.20% vs 25.86%) than the non-MB group (P <0.0001). The incidence of acute coronary syndromes was lower in the MB group (P <0.0001), while smoking was more common (18.76% vs 16.87%, P <0.01). CONCLUSIONS Patients with MB were younger and had fewer comorbidities and risk factors for atherosclerosis than patients without MB. The condition was more common among patients with stable coronary artery disease. Smoking and female sex appeared to be associated with a more clinically symptomatic presentation of MB.

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