Radovi

Učestalost poremećaja metabolizma glukoze i subkliničkog oštećenja renalne funkcije kod pacijenata sa ishemijskom bolešću srca
Autor: Svetlana Kostić
Preuzmite rad
S. Kostić1, I. Tasić 1,2, D. Djordjević 1,2
1. Institut za lečenje I rehabilitaciju” Niška Banja”, Niška Banja, 2. Medicinski fakultet, Niš, Srbija
05.05.2016. godine
Akutni kororonarni sindrom kod žena- liječenje i intrahospitalni mortalitet Autori D. Trninić, D. Vasić, V. Katić
Autor: Dijana Trninić
Preuzmite rad
Retrospektivna studija, koja je isptivala razlike u simptomatologiji, vremenu od pojave simptoma do ulaska u salu za kateterizaciju,koronarografskom nalazu, pojavi komplikacija i intrahospitalnom mortalitetu između pacijenata muškog i ženskog pola.
04.05.2016. godine
POTENTIALLY INAPPROPRIATE MEDICATIONS IN ELDERLY NURSING HOME RESIDENTS WITH CARDIOVASCULAR DISEASES
Autor: Danijela Mandić
Preuzmite rad
Rad o primjeni lijekova kod pacijenata s kardiovaskularnim oboljenjima smještenih u gerijatrijskim centrima U Republici Srpskoj
02.05.2016. godine
Postinfarction ventricular septal rupture, case report
Autor: Jelena Đoković
Preuzmite rad
prikaz slucaja rupture IVS - apstrakt na engleskom
29.04.2016. godine
Postinfarktna ruptura interventrikularnog septuma, prikaz slučaja
Autor: Jelena Đoković
Preuzmite rad
prikaz slucaja rupture IVS, kompletan rad
29.04.2016. godine
The Untreated adult with Tetralogy of Fallot. Case report
Autor: Ljiljana Kos
Preuzmite rad
apstrakt rada za kongres
29.04.2016. godine
Massive pulmonary embolism: Case report
Autor: Tamara Gnjatić Studen
Preuzmite rad
Prikaz slučaja pacijentkinje sa masivnom plućnom tromboembolijom.
27.04.2016. godine
Therapeutic challenge in patient with ventricular septal defect, atrial fibrillation and thyrotoxicosis: Case report
Autor: Tamara Knežević
Preuzmite rad
Prikaz slučaja pacijentice sa ventrikularnim septalnim defektom, atrijalnom fibrilacijom i tireotoksikozom
26.04.2016. godine
INFEKTIVNI ENDOKARDITIS TRIKUSPIDALNE I PLUĆNE VALVULE KOD TRUDNICE SA UROĐENOM SRČANOM MANOM - PRIKAZ SLUČAJA
Autor: Marina Majkić
Preuzmite rad
Prikaz slučaja infektivnog endokarditisa desnog srca kod trudnice sa urodjenom srčanom manom.
26.04.2016. godine
KARDIJALNA DEKOMPENZACIJA KOD PACIJENTA SA NEKOMPAKTNIM MIOKARDOM – PRIKAZ SLUČAJA
Autor: Marina Majkić
Preuzmite rad
Prikaz slučaja dvadesetogodišnjeg pacijenta sa non-compaction kardiomiopatijom.
26.04.2016. godine
Stenoza glavnog stabla lijeve koronarne arterije u Akutnom koronarnom sindromu-prikaz slučajaAu tori: D. Vasić, D. Trninić, M. Kozić
Autor: Dijana Trninić
Preuzmite rad
Rad je prikaz kliničkog slučaja pacijenta sa stenozom glavnog stabla koronarne arterije u akutnom koronarnom sindromu
24.04.2016. godine
Sekundarna prevecija koronarne bolesti kod dijabeticara
Autor: Sasa Milojevic
Preuzmite rad
Uporediti nalaz na koronarnim krvnim sudovima kod dobro i slabo regulisane šećerne bolesti
22.04.2016. godine
THE PROGNOSTIC VALUE OF CORONARY FLOW RESERVE IN PATIENTS WITH ANGIOGRAPHICALLY- ASSESSED INTERMEDIATE LEFT ANTERIOR DESCENDING ARTERY DIAMETER STENOSIS IN A COUNTRY WITH LOW GROSS DOMESTIC PRODUCT.
Autor: Bojan Stanetic
Preuzmite rad
Tamara Kovacevic-Preradovic* 1, Bojan Stanetic1, Ana Djordjevic-Dikic3, Miodrag Ostojic1


1Clinic for cardiovascular diseases, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina, 2Institute for Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia

Introduction: The coronary flow reserve (CFR) measured by transthoracic Doppler echocardiography has been proposed as an useful tool for functional lesion severity assessment.
Objectives: The aim of our study was to investigate the prognostic value of CFR in patients with angiographically- assessed intermediate LAD (50-70%) diameter stenosis.
Methods: We evaluated 61 patients (49 men; mean age 62.9±7.9) who underwent CFR assessment (intravenous adenosine at a dose of 140μg/kg/min) after elective coronary angiography in University hospital Banja Luka between January 2012 and October 2014. Patients were stratified according to the CFR value (≤2.0 vs. >2.0). The occurrence of cardiovascular events - a composite of target vessel revascularization (TVR), hospitalizations for cardiovascular reason (HOSP), non-fatal myocardial infarction (MI) and cardiac death - was ascertained from the hospital information system and/or telephone contacts.
Results: All patients were followed-up for a median of 830 ± 71 days. Among 24 patients with CFR ≤2.0 (mean CFR 1.61±0.27) 8 events occurred: 4 TVR, 3 HOSP, and 1 cardiac death. Thirty-seven patients had CFR >2.0 (mean CFR 2.57±0.48) who developed 6 events: 3 TVR, 2 HOSP and 1 non-fatal MI. Overall event rate in the entire cohort of 61 patients was 22.9%. Significantly higher event rate was shown in patients with CFR value ≤2.0 when compared with patients in whom CFR value was >2.0 (33.3% vs. 16.2%, respectively, log-rank P=0.028).
Conclusion: In patients with angiographically-assessed intermediate LAD stenosis, CFR provides reliable prognostic information and may act as a surrogate of invasive and more expensive stenosis assessment.
22.04.2016. godine
Appropriateness of Myocardial Revascularization Assessed by the SYNTAX Score II in a Centre Without On-Site Cardiac Surgery
Autor: Bojan Stanetic
Preuzmite rad
Bojan M. Stanetic, MD1 †; Miodrag C. Ostojic, MD, PhD1; Tamara Kovacevic-Preradovic, MD, PhD1; Sasa Loncar, MD1; Zeljko Zivanovic, MD1; Svetozar Srdic, MD1; Kurt Huber, MD, PhD2; Patrick W. Serruys, MD, PhD3

Author’s affiliations:

1 Department of Cardiology, University Hospital Clinical Centre Banja Luka, Banja Luka, Bosnia and Herzegovina
2 Wilhelminenspital, 3rd Medical Department – Cardiology, Vienna, Austria
3 International Centre of Circulatory Health, Imperial College London, London, United Kingdom

† Address for correspondence:
Bojan M. Stanetic, MD
12 beba bb, 78 000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina
Tel: +387 51 342 558; Fax: +387 51 342 553
E-mail: bojan.stanetic@gmail.com

All authors ave made substantial contribution to the intellectual content of the paper in: conceived and designed the research, performed statistical analysis, drafted the manuscript, made critical revision of the manuscript for key intellectual content.

All authors declare that the study complies with the Declaration of Helsinski. The relevant ethic committee approved the research protocol. Due to the retrospective nature of the study, written informed consent from the patients was waived, excluding those who refused participation in the study when contacted for follow-up.


Background: The recently published SYNTAX score II is a clinical tool that allows for objective, individualized decision-making on the most appropriate revascularisation strategy in patients with complex coronary artery disease. The SYNTAX Score II uses 4-year mortality predictions following percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) to aid the heart team in the decision-making process. The purpose of the present study was to investigate whether indications for PCI or CABG based on the clinical judgment of PCI-operators without on-site surgical facilities correlates to the objective decision-making undertaken with the SYNTAX Score II.
Methods: We retrospectively analysed 560 elective patients with 3-vessel (81.6%) or unprotected left main coronary artery (18.4%) disease treated by PCI or referred to other institutions for CABG by a centre without on-site cardiac surgery facilities (Banja Luka, Bosnia and Hercegovina) between January 2008 and May 2010. The actual treatment performed according to the clinical judgment was retrospectively compared with the SYNTAX Score II recommendation. Differences in outcomes were analysed using Kaplan-Meier estimates at 4-year follow-up.
Results: Out of 560 subjects, 362 (64.6%) underwent PCI and 198 (35.4%) were referred for CABG. Based on an assessment of the predicted 4-year mortality by the SYNTAX score II, CABG would have been the treatment of choice in 232/560 (41.4%) patients, PCI in 3/560 (0.6%) patients, and CABG or PCI in 325/560 (58.0%) patients. Out of 232 patients in whom CABG was recommended by the SYNTAX Score II, 99/232 (42.7%) were referred for CABG and 57.3% (133/232) underwent PCI. In 426/560 patients (76.1%) there was concordance between clinical judgment and SSII recommendations. In the remaining 134/560 patients (23.9%) there was discordance between the clinical judgment and SSII recommendation. Overall mortality in the entire cohort of 560 patients at 4-year follow-up was 8.4%. Discordance between the SSII recommendation and clinical decision was associated with a significantly higher 4-year mortality compared to when there was concordance between SSII recommendation and clinical decision (12.7% vs. 6.3%; log rank p value =0.028).
Conclusion: The present study demonstrated that the SYNTAX Score II provided more objective decision-making on the most appropriate revascularisation strategy in patients with complex coronary artery disease. Discordance between the SYNTAX Score II recommended revascularisation strategy and the clinical decision was met with a higher long-term 4 year mortality.

Keywords: decision making, SYNTAX score II, on-site cardiac surgery
21.04.2016. godine
Risk Stratification in 3-Vessel Coronary Artery Disease: Applying the SYNTAX Score II in the Heart Team Discussion of the SYNTAX II Trial
Autor: Bojan Stanetic
Preuzmite rad
Bojan M. Stanetic,1,3 Carlos M. Campos,1,2 MD, Vasim Farooq,4 MD, PhD, Simon Walsh,5 MD, Yuki Ishibashi,1 MD, PhD, Yoshinobu Onuma,1 MD, PhD, Hector M. Garcia-Garcia,1 MD, PhD, Javier Escaned,6 MD, PhD,
 Adrian Banning,7 MD, PhD, and Patrick W. Serruys,8* MD, PhD, on behalf of the SYNTAX II Study Group

1Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, The Netherlands
2Department of Interventonal Cardiology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
3Department of Interventional Cardiology, Heart Institute, Medical School, University of Sao Paulo, Sao Paulo, Brazil
4Department of Intervenional Cardiology, Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, Manchester, United Kingdom
5Belfast Health & Social Care Trust, Belfast, United Kingdom
6Cardiovascular Institute, Hospital Clinico San Carlos and Centro Nacional De Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain
7Department of Interventional Cardiology, Oxford University Hospitals, Oxford, United Kingdom 

8International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom

Bojan M. Stanetic and Carlos M. Campos contributed equally to this work.

*Correspondence to: Professor Patrick W Serruys MD, PhD, ‘s- Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. E-mail: p.w.j.c.serruys@erasmusmc.nl

Background: Heart Team (HT) and the SYNTAX Score II (SSII) have been integrated to the contemporary guidelines with the aim to provide a multidisciplinary decision-making process between coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI).
Aims: To prospectively assess the agreement between the HT decision and the SSII recommendation regarding the revascularization strategy in patients with 3-vessel coronary artery disease (CAD) of the SYNTAX II trial.
Methods: The SSII predicts the 4-year mortality of an individual patient both after PCI and after CABG. Patients were treated by PCI when the SSII predicted a mortality risk favoring PCI or when risk predictions were equipoise between PCI and CABG. However, the HT could overrule the SSII and recommend either CABG or PCI.
Results: A total of 202 patients have been screened and 24 did not fulfill inclusion criteria. The median age was 67.0 (IQR 59.0–73.3), and 167 (82.7%) were male. The HT endorsed SSII treatment recommendation, for CABG or PCI, in 152 patients (85.4%). Three patients had preference for PCI, irrespective of the HT decision. The main reason for the HT to overrule the SSII and recommend CABG was the prospect of a more complete revascularization (21 of 25 patients). Patients recommended for CABG by the HT had significantly higher anatomical SYNTAX score (P 5 0.03) and higher predicted mortality risk for PCI (P50.04) when compared with patients that were enrolled in the trial.
Conclusion: The SYNTAX score II showed to be a suitable tool for guiding treatment decisions of patients with 3-vessel coronary artery disease being endorsed by the HT in the vast majority of the patients that have been enrolled in the SYNTAX II trial.

Key words: risk stratification; stent; drug eluting; coronary artery disease
21.04.2016. godine
Comparison of Clinical Judgment and SYNTAX Score II Treatment Recommendation on Myocardial Revascularization in a Country With High Gross Domestic Product and an Institution With Cardiac Surgery Nearb
Autor: Bojan Stanetic
Preuzmite rad
Bojan M. Stanetic1 †, Kurt Huber2, Miodrag C. Ostojic1, Tamara Kovacevic-Preradovic1, Miklos Rohla2, Patrick W. Serruys3

Authors affiliations:
1 - University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
2 - Wilhelminenspital, 3rd Medical Department – Cardiology, Vienna, Austria
3 - International Centre of Circulatory Health, Imperial College London, London, United Kingdom

† Address for correspondence: Bojan M. Stanetic, MD, 12 beba bb, 78 000 Banja Luka, Republic of Srpska, Bosnia and Herzegovina. Tel: +387 65 614 340;
E-mail: bojan.stanetic@gmail.com

All authors declare that the study complies with the Declaration of Helsinski. The relevant ethic committee approved the research protocol.





Introduction: Every cardiologist being interventional and/or clinical has dilemmas if coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) was the right decision, especially in case of complications. Very often asked by the patients: “Doctor, what would you do if you were in my feet?”, cardiologists today are struggling to find out the best myocardial revascularization modality for their patients. We aimed to investigate whether indications for PCI or CABG based on the most educated intuitive judgment of PCI-operators with and without cardiac surgery on-site in routine clinical practice in the era before the SYNTAX Score II (SSII) approximate to the treatment recommendation of the recently published SSII. Methods: From the Wilhelminenspital, Vienna, Austria (WS) and University Clinical Centre, Banja Luka, Bosnia and Herzegovina (UCC) consecutive, hemodynamically stable patients with angiographically (≥50% diameter stenosis) proven 3-vessel coronary artery disease (CAD) and/or significant unprotected left main CAD, who were treated with PCI or referred to other institutions for CABG between January 1, 2008, and December 31, 2010 were retrospectively recruited. All-cause mortality was ascertained from Mortality Registries or by telephone contacts. The SSII was calculated for each patient using an electronic calculator available only to the investigators of the SYNTAX II Trial.
Results: After the post-hoc classification according to the SSII in WS, 85 patients had treatment recommendations in favour of CABG, of which 34/85 (40.0%) patients had actually CABG, with the remainder (51/85, 60.0%) who were treated with PCI. Three patients were classified for PCI, 2/3 patients (66.7%) underwent PCI and 1/3 patients (33.3%) underwent CABG. The remaining 302 patients were allocated by the SSII in a group favouring equally CABG and PCI of which 137/302 (45.4%) underwent CABG and 165/302 (54.6%) underwent PCI. Based on the post-hoc classification according to the SSII in UCC, CABG would have been the treatment of choice in 257/651 (39.5%) patients, PCI in 7/651 (1.1%) patients and CABG or PCI in 387/651 (59.4%) patients. Out of 257 patients in whom the treatment recommendations by the SSII was CABG, 113/257 (44.0%) patients had actually CABG, while the remaining 144/257 (56.0%) underwent PCI. Seven patients had SSII recommendations exclusively favouring PCI, 3/7 patients (42.9%) were treated with PCI and 4/7 patients (57.1%) were referred for CABG. Out of 387 patients with the SSII recommendations favouring equally CABG and PCI, 125/387 (32.3%) underwent CABG and 262/387 (67.7%) underwent PCI. Overall mortality in the CABG and PCI group in WS at 4-year follow-up was 11.6% and 9.7%, respectively (log rank P=0.18). A trend to have higher observed mortality was shown in the patient group in whom the post-hoc classification according to the SSII favoured CABG although treated with PCI compared with CABG/PCI and PCI recommended group treated with PCI (13.7% vs. 8.5% vs. 0.0%, respectively, log rank P=0.11). In UCC, 4-year mortality was 9.4% (CABG: 10.3% vs PCI: 8.8%, log rank P=0.29). The post-hoc classification according to the SSII showed that 144/257 patients with treatment recommendations in favour of CABG who were treated with PCI had significantly higher mortality at 4 years when compared with patients with treatment recommendation for PCI or equally favouring CABG and PCI (12.5% vs. 0.0% vs. 6.9%, respectively, log rank P=0.04).
Conclusion: The present study demonstrated that intuitive (most educated) decision-making for choosing optimal myocardial revascularisation method for individual patient, irrespective of presence of cardiac surgery on-site, differed from the SSII recommendation for CABG only. Discordance between the SSII recommended revascularisation strategy and the clinical decision was met with a higher 4-year mortality.
21.04.2016. godine
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