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  • 1
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 7 ( 2022-03-24), p. 1791-
    Abstract: Acute coronary syndrome (ACS) in patients with COVID-19 is triggered by various mechanisms and can significantly affect the patient’s further treatment and prognosis. The study aimed to investigate the characteristics, major complications, and predictors of mortality in COVID-19 patients with ACS. All consecutive patients hospitalized from 5 July 2020 to 5 May 2021 for ACS with confirmed SARS-Co-2 were prospectively enrolled and tracked for mortality until 5 June 2021. Data from the electronic records for age and diagnosis, matched non-COVID-19 and COVID-19 ACS group, were extracted and compared. Overall, 83 COVID-19 ACS patients, when compared to 166 non-COVID ACS patients, had significantly more prevalent comorbidities, unfavorable clinical characteristics on admission (acute heart failure 21.7% vs. 6.6%, p 〈 0.01) and higher rates of major complications, 33.7% vs. 16.8%, p 〈 0.01, and intrahospital 30-day mortality, 6.7% vs. 26.5%, p 〈 0.01. The strongest predictors of mortality were aortic regurgitation, HR 9.98, 95% CI 1.88; 52.98, p 〈 0.01, serum creatinine levels, HR 1.03, 95% CI 1.01; 1.04, p 〈 0.01, and respiratory failure therapy, HR 13.05, 95% CI 3.62; 47.01, p 〈 0.01. Concomitant ACS and COVID-19 is linked to underlying comorbidities, adverse presenting features, and poor outcomes. Urgent strategies are needed to improve the outcomes of these patients.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 2
    Online Resource
    Online Resource
    National Library of Serbia ; 2002
    In:  Military Medical and Pharmaceutical Journal of Serbia Vol. 59, No. 4 ( 2002), p. 405-410
    In: Military Medical and Pharmaceutical Journal of Serbia, National Library of Serbia, Vol. 59, No. 4 ( 2002), p. 405-410
    Type of Medium: Online Resource
    ISSN: 0042-8450 , 2406-0720
    Language: English
    Publisher: National Library of Serbia
    Publication Date: 2002
    detail.hit.zdb_id: 2169819-3
    SSG: 15,3
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  • 3
    In: Diagnostics, MDPI AG, Vol. 13, No. 1 ( 2022-12-31), p. 137-
    Abstract: Hypertension is one of the most important cardiovascular risk factors, associated with significant morbidity and mortality. Chronic high blood pressure leads to various structural and functional changes in the myocardium. Different sophisticated imaging methods are developed to properly estimate the severity of the disease and to prevent possible complications. Cardiac magnetic resonance can provide a comprehensive assessment of patients with hypertensive heart disease, including accurate and reproducible measurement of left and right ventricle volumes and function, tissue characterization, and scar quantification. It is important in the proper evaluation of different left ventricle hypertrophy patterns to estimate the presence and severity of myocardial fibrosis, as well as to give more information about the benefits of different therapeutic modalities. Hypertensive heart disease often manifests as a subclinical condition, giving exceptional value to cardiac magnetic resonance as an imaging modality capable to detect subtle changes. In this article, we are giving a comprehensive review of all the possibilities of cardiac magnetic resonance in patients with hypertensive heart disease.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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  • 4
    Online Resource
    Online Resource
    National Library of Serbia ; 2003
    In:  Military Medical and Pharmaceutical Journal of Serbia Vol. 60, No. 1 ( 2003), p. 19-27
    In: Military Medical and Pharmaceutical Journal of Serbia, National Library of Serbia, Vol. 60, No. 1 ( 2003), p. 19-27
    Abstract: Uvod. QT disperzija (QTd) predstavlja pokazatelj povecane heterogenosti miokarda komora. Cilj rada bio je da se ispita dinamika promena QTd tokom prvih 5 dana akutnog infarkta miokarda (AIM) u zavisnosti od neinvazivno procenjenog uspeha tromboliticke terapije. Metode. U rad je ukljuceno 36 bolesnika, sa AIM. Svi bolesnici su dobili alteplazu po ubrzanom protokolu. QTd (QTc max.-QTc min) je merena neposredno nakon prijema (0. min), nakon tromboliticke terapije (90. min) i od 2-5. dana. Reperfuzija je procenjivana na osnovu elektrokardiografskih i biohumoralnih pokazatelja. Rezultati. U grupi od 36 bolesnika, kod 3 bolesnika nisu bili u saglasnosti oba pokazatelja reperfuzije. Od ostalih 33, 23 bolesnika je imalo reperfuziju, a 10 nije. Bilo je 22 muskarca i 11 zena. Na prijemu u celoj grupi nije bilo znacajne razlike QTd izmedju grupe sa reperfuzijom (79?34 ms), i one bez reperfuzije (65?19 ms). Nakon primene alteplaze u grupi sa reperfuzijom prosecno trajanje QTd bilo je 67?31ms, sto nije bilo znacajno krace u odnosu na grupu bez reperfuzije (70?23ms). Drugog dana AIM ne registruje se znacajno kraca QTd kod bolesnika sa reperfuzijom u odnosu na one bez nje (54?17 prema 73?20ms), da bi od treceg dana razlika bila znacajna (46?16 prema 87?24 ms), cetvrtog dana (43?12 prema 78?21 ms) i petog dana (38?11 prema 62 ?23 ms). U grupi bolesnika sa anteriornim AIM prvog dana nije registrovana znacajna razlika QTd izmedju grupa sa i bez reperfuzije (0. min: 97?47 prema 72?16, 90. min: 68?47 prema 72?20), da bi od drugog dana ona bila statisticki znacajna (drugog dana 51?15 prema 74?20, treceg dana 51?20 prema 88?24, cetvrtog dana 46?10 prema 81?19 i petog dana 40?8 prema 69?22 ms). U grupi bolesnika sa inferolateralnim AIM samo je treceg dana registrovana znacajna razlika QTd izmedju grupe sa i bez reperfuzije (43?14 prema 69?29 ms), a u svim ostalim merenjima ona nije registrovana (0. min. 69?22 prema 42?9; 90. min 67?20 prema 67?41; drugi dan 55?19 prema 60?25 cetvrti dan 41?14 prema 51?6 i peti dan 51?12 prema 37?8 ms). Zakljucak. QT disperzija je znacajno kraceg trajanja kod bolesnika sa uspesnom reperfuzijom u odnosu na bolesnike bez reperfuzije. Kod bolesnika sa anteriornim AIM, QTd je znacajno razlicita kod bolesnika sa, u odnosu na one bez reperfuzije, za razliku od bolesnika sa inferolateralnim AIM.
    Type of Medium: Online Resource
    ISSN: 0042-8450 , 2406-0720
    Language: English
    Publisher: National Library of Serbia
    Publication Date: 2003
    detail.hit.zdb_id: 2169819-3
    SSG: 15,3
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  • 5
    In: Oxidative Medicine and Cellular Longevity, Hindawi Limited, Vol. 2021 ( 2021-4-20), p. 1-9
    Abstract: Introduction. Mortality among critically ill COVID-19 patients remains relatively high despite different potential therapeutic modalities being introduced recently. The treatment of critically ill patients is a challenging task, without identified credible predictors of mortality. Methods. We performed an analysis of 160 consecutive patients with confirmed COVID-19 infection admitted to the Respiratory Intensive Care Unit between June 23, 2020, and October 2, 2020, in University Hospital Center Bezanijska kosa, Belgrade, Serbia. Patients on invasive, noninvasive ventilation and high flow oxygen therapy with moderate to severe ARDS, according to the Berlin definition of ARDS, were selected for the study. Demographic data, past medical history, laboratory values, and CT severity score were analyzed to identify predictors of mortality. Univariate and multivariate logistic regression models were used to assess potential predictors of mortality in critically ill COVID-19 patients. Results. The mean patient age was 65.6 years (range, 29–92 years), predominantly men, 68.8%. 107 (66.9%) patients were on invasive mechanical ventilation, 31 (19.3%) on noninvasive, and 22 (13.8%) on high flow oxygen therapy machine. The median total number of ICU days was 10 (25th to 75th percentile: 6–18), while the median total number of hospital stay was 18 (25th to 75th percentile: 12–28). The mortality rate was 60% (96/160). Univariate logistic regression analysis confirmed the significance of age, CRP, and lymphocytes at admission to hospital, serum albumin, D-dimer, and IL-6 at admission to ICU, and CT score. Serum albumin, D-dimer, and IL-6 at admission to ICU were independently associated with mortality in the final multivariate analysis. Conclusion. In the present study of 160 consecutive critically ill COVID-19 patients with moderate to severe ARDS, IL-6, serum albumin, and D-dimer at admission to ICU, accompanied by chest CT severity score, were marked as independent predictors of mortality.
    Type of Medium: Online Resource
    ISSN: 1942-0994 , 1942-0900
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2455981-7
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  • 6
    In: Oxidative Medicine and Cellular Longevity, Hindawi Limited, Vol. 2021 ( 2021-06-30), p. 1-6
    Abstract: Introduction. Risk stratification is an important aspect of COVID-19 management, especially in patients admitted to ICU as it can provide more useful consumption of health resources, as well as prioritize critical care services in situations of overwhelming number of patients. Materials and Methods. A multivariable predictive model for mortality was developed using data solely from a derivation cohort of 160 COVID-19 patients with moderate to severe ARDS admitted to ICU. The regression coefficients from the final multivariate model of the derivation study were used to assign points for the risk model, consisted of all significant variables from the multivariate analysis and age as a known risk factor for COVID-19 patient mortality. The newly developed AIDA score was arrived at by assigning 5 points for serum albumin and 1 point for IL-6, D dimer, and age. The score was further validated on a cohort of 304 patients admitted to ICU due to the severe form of COVID-19. Results. The study population included 160 COVID-19 patients admitted to ICU in the derivation and 304 in the validation cohort. The mean patient age was 66.7 years (range, 20–93 years), with 68.1% men and 31.9% women. Most patients (76.8%) had comorbidities with hypertension (67.7%), diabetes (31.7), and coronary artery disease (19.3) as the most frequent. A total of 316 patients (68.3%) were treated with mechanical ventilation. Ninety-six (60.0%) in the derivation cohort and 221 (72.7%) patients in the validation cohort had a lethal outcome. The population was divided into the following risk categories for mortality based on the risk model score: low risk (score 0–1) and at-risk ( score 〉 1 ). In addition, patients were considered at high risk with a risk score 〉 2 . By applying the risk model to the validation cohort ( n = 304 ), the positive predictive value was 78.8% (95% CI 75.5% to 81.8%); the negative predictive value was 46.6% (95% CI 37.3% to 56.2%); the sensitivity was 82.4% (95% CI 76.7% to 87.1%), and the specificity was 41.0% (95% CI 30.3% to 52.3%). The C statistic was 0.863 (95% CI 0.805-0.921) and 0.665 (95% CI 0.598-0.732) in the derivation and validation cohorts, respectively, indicating a high discriminative value of the proposed score. Conclusion. In the present study, AIDA score showed a valuable significance in estimating the mortality risk in patients with the severe form of COVID-19 disease at admission to ICU. Further external validation on a larger group of patients is needed to provide more insights into the utility of this score in everyday practice.
    Type of Medium: Online Resource
    ISSN: 1942-0994 , 1942-0900
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2455981-7
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  • 7
    In: Frontiers in Pharmacology, Frontiers Media SA, Vol. 13 ( 2022-6-15)
    Abstract: Introduction: The present study aimed to establish the role of lipid abnormalities and inflammatory markers for developing cardiovascular risk, as well as to address the importance of obesity as a common comorbidity in patients with obstructive sleep apnea (OSA). Methods: The study was conducted as a prospective cohort study including 120 patients with newly diagnosed OSA between 2019 and 2020, at University Clinical Hospital Center “Bezanijska kosa”, Belgrade, Serbia. The diagnosis was established by polysomnography. In all patients, sociodemographic data, respiratory, lipid, and inflammatory parameters were collected and complete echocardiographic study and 24-h blood pressure monitoring were performed. Results: The mean patient age was 55.7 ± 13.8 years. Study population was mostly male (70.0%) and obese (56.7%). At least 30 apneas or hypopneas per hour were present in 39.0% of patients. A strong positive correlation was found between OSA severity and BMI (r = 0.562, p & lt; 0.001), both associated with lipid, inflammatory and respiratory parameters, and cardiovascular profile of patients with OSA ( p & lt; 0.05 for all). Echocardiographic study and 24-h blood pressure monitoring parameters were in turn correlated with lipid and inflammatory markers ( p & lt; 0.05 for all). Conclusion: The results of this study support the important role of dyslipidemia and inflammation, as well as coexistence of obesity in the pathogenesis of numerous conditions linked with an increased risk of cardiovascular morbidity and mortality in patients with OSA.
    Type of Medium: Online Resource
    ISSN: 1663-9812
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2587355-6
    SSG: 15,3
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