In this 1-year follow-up analysis of the EORP-AF pilot general registry, we provide data on the first contemporary registry focused on management practices among European cardiologists, conducted since the publication of the new ESC guidelines. Overall OAC use remains high, although persistence with therapy may be problematic. Nonetheless, continued OAC use was more common than in prior reports. Despite the high prescription of OAC, 1-year mortality and morbidity remain high in AF patients, particularly from heart failure and hospitalizations.

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Background In Europe, the mortality secundary to ischemic heart disease is an important cause of death among women. Rhythm disorders are frequently encountered in the context of this pathology. The aim of the study is to evaluate the profile of rhythm disorders in women with microvascular and obstructive coronary heart disease. Materials and methods We included in the study a number of 150 patients with ischemic heart disease documented by coronary angiography, with an average age of 63.24 ± 10.09 years, admited in the Cardiology Department of the Clinical Rehabilitation Hospital, Cluj-Napoca, Romania. The diagnosis of ischemic heart disease was established according to the recommendations of the 2019 ESC guideline. Results 66.6% of patients presented with microvascular angina, and 33.33% with obstructive coronary heart disease. Women with microvascular angina were younger (61.07 ± 9.68 vs. 67.60 ± 9.55 years). Atrial arrhythmias were the most frequent arrhythmias diagnosed - 64.66%. The percentage of rhythm disorders was similar in the two groups, without statistically significant differences: atrial fibrillation (21 vs. 22%), other supraventricular arrhythmias (39 vs. 52%), ventricular extrasystoles (42 vs. 44%), sustained/nonsustained ventricular tachycardia (4 vs. 4%). This finding shows us that not only obstructive coronary artery disease, but also microvascular angina presents an arrhythmogenic risk. At the same time, there were no significant differences regarding the administration of antiarrhythmics, namely amiodarone and betablockers in the two forms of ischemic heart disease. Conclusions Women with microvascular angina present significant arrhythmias, therefore they must be carefully evaluated and treated accordingly.

Introduction. The standard treatment for myocardial infarction is percutaneous revascularization. In patients with STEMI, is recommended an approach as early as possible, being established a period of less than 2 hours from the moment of diagnosis. Things are not as clear regarding myocardial infarction without ST segment elevation. The current guideline proposes to divide the patients with NSTEMI into 4 risk groups, and to perform coronarography in a range of less than 2 hours up to over 72 hours, depending on the risk group of which the patient is part. Several studies have been conducted to determine the benefit of an invasive approach to the detriment of current recommendations, but no consensus has been reached so far.Objective. The present study aims to analyze the short and medium term evolution, of a group of 125 patients, with NSTEMI, depending on the time of coronarography.Material and methods. We have analyzed all cases of NSTEMI, admitted in our hospital, between 1.01.2017-31.12 2017. The following parameters were noted: age, sex, presence of cardiovascular risk factors; personal pathological history, previous treatment, Killip class, GRACE score, left ventricular ejection fraction at admission, risk group, the moment of the coronarography.We have followed: complications, number of days of hospitalization, in-hospital and one year mortality.Results. Of the 125 patients with NSTEMI, 86 (68.8%) were men. They were divided into 4 risk groups as follows: very high risk (n =31; 16.8%), high risk (n =80; 43.5%), medium (n =58; 31.5%) and low risk (n =15; 8.2%). Coronarography was performed in the first 2 hours after presentation in 13 cases (10.40%), in 24 hours for 48 cases (38.40%), between 24-72 hours in 26 patients (20.80%) and late, after 72 hours in 38 patients (30.40%). Most commonly, coronarography was performed in the first 24 hours in patients in Killip I and II classes. Depending on the risk group, 11 of the 15 patients (73.34%) with very high risk received emergency angiography (within the first 24 hours). In contrast, high risk patients performed the procedure after 24 hours. During the hospitalization, 19 patients (15.20%) had complications. The multivariate analysis shows that the most powerful predictors for the onset of complications were age (p =0.02), Grace score (p =0.004) and the risk group in which the patient is classified. The timing of PCI did not influence the appearance of complications. The number of hospitalization days was 5.92±3.56 days in patients who had PCI under 2 hours, 7.47±5.41 days for those who received the procedure in 24 hours, 7.80±3.67 days between 24-72 hours, 10.28±3.79 for those who performed the procedure late. Applying multiple regression, the most powerful predictors for the number of hospitalization days were age, time of PCI and GRACE score. Intra-hospital mortality was 1.6%, and 11.20% at 1 year. Multiple regression showed that among the variables studied, the predictors for death at 1 year were the complications that occurred and the risk class of the patients.Conclusion. Performing early coronarography in patients with NSTEMI may represent a cost-effective strategy, by reducing the number of days of hospitalization, but it does not influence the rate of complications, nor the short and medium term mortality. In contrast, the age and the GRACE score are predictors of the cardio-vascular complications. Short- and medium-term mortality is correlated with the risk group and with the complications that occurred during the hospitalization.

SummaryIt is well known that the severity of coronary heart disease is associated with a poor prognosis. 70% of patients with NSTEMI have multivascular disease, the percentage being 40% for STEMI patients. Knowing the grade severity of the coronary artery disease has importance for the therapeutic management of the case and to establish the prognosis. However, until now, we have no possibilities to identify these patients before performing the coronarography.The objective of this study was to establish a correlation between cardiovascular risk factors, ECG changes, echocardiographic changes, GRACE score and the severity of coronary artery disease invasively detected by coronarography, in patients with myocardial infarction without ST-segment elevation.Material and methods. We performed a study on 125 patients diagnosed with NSTEMI, who performed coronarography. For each patient we noted age, sex, history of high blood pressure, dyslipidemia, chronic kidney disease, smoking habit, HS troponin T levels, LDL cholesterol, triglycerides, C-reactive protein, creatinine clearance, ejection fraction of left ventricle, number of lesions discovered on angiography, GRACE and SYNTAX score.Results. Of the 125 patients included, 86 (68.8%) were men, with a mean age of 63.66 ± 11.54. The average of the laboratory tests and the parameters studied: creatinine Cl 83.80 ± 33.862 ml / min, FEVS 46.37 ± 7.394%, troponin HS 3533.625 ± 7460.873 pg / ml, CRP 2.811 ± 5.262 mg / dl, LDL 113.618 ± 50.13 mg / dl, triglyceride ± 100.58mg / dl. The mean Syntax score in the studied group was 17, 58 ± 13.65, Grace score 118.80 ± 26.980, and the number of coronary lesions 2.19 ± 1.162 The number of coronary lesions and the SYNTAX score were significantly correlated statistics with age, Grace score, presence of diabetes and chronic kidney disease. With regard to laboratory tests, creatinine clearance proved to be the most important predictor for both the number of vessels affected (r =-0.322, p=0.000) and for the Syntax score (r = -0.323,p=0.000), the latter being influenced also by the level of triglycerides (r = -0.177, p = 0.048) and that of the high sensitive troponin (r = 0.322, p = 0.015).Conclusions. Independent predictors of multivascular disease in patients with NSTEMI are : age, diabetes, chronic kidney disease, creatinine clearance and Grace score. The severity of the coronary heart disease assessed by the Syntax score, is also correlated with age, history of diabetes and chronic kidney disease, creatinine clearance, Grace score, but also with the value of tiglycerides and high-sensitive T troponin.