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Objective: Atrial fibrillation (AF) is the most important risk factor for ischemic stroke. Anticoagulation therapy can substantially decrease the risk of stroke in patients with AF. The aim of our study was to investigate the patient's comorbidities and management of patients with AF on the discharge. Methods: From 5382 consecutive patients admitted in our institution between January 2005 and March 2008, 525 (mean age 66.4±11.4 years, 53.3% male) had AF upon discharge, who were included in this retrospective study. Patients were divided in two groups according to prescription of anticoagulation therapy at discharge. Continuous data were compared between groups using a two-tailed unpaired Student t test. Discrete variables were compared using Chi-square test or Fisher's exact probability test as appropriate. Logistic regression analysis was used to identify the independent clinical and echocardiographic predictors of prescribing oral anticoagulation therapy. Results: Associated comorbidities of AF in our patients were: ischemic heart disease (21.4%), hypertensive heart disease (27.44%), valvular heart disease (17.4%), congestive heart failure (47%), chronic obstructive pulmonary disease (6.7%), and diabetes 14.3%). Of 525 patients 76% were discharged on beta-blockers, 67% on angiotensin converting enzyme inhibitors, 23% on digoxin, 16% on calcium antagonists, 67% on diuretics, 72% on aspirin, and 27% on oral anticoagulant (OAC) therapy, 11% were with both antithrombotics. Multivariate analysis showed that the underprescription of OAC therapy in patients with AF was independently associated with elder age (OR=0.916, 95%CI 0.891-0.942, p<0.001), non-enlarged left atrium (OR=1.148, 95%CI 1.100-1.198, p<0.001) and good left ventricular ejection fraction (OR=0.970, 95%CI 0.948-0.993, p=0.011). Conclusions: Patients with atrial fibrillation were mainly with ischemic, hypertensive heart disease and congestive heart failure. Our study, suggests underuse of anticoagulation therapy. The independent predictors of under prescription of anticoagulants in patients with atrial fibrillation were elder age, non-enlarged left atrium, and good left ventricular ejection fraction. Medical treatment with other groups of drugs for atrial fibrillation and comorbidities seems to be according to current guidelines. [ABSTRACT FROM AUTHOR]

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Objectives: This study sought to analyze the cost of percutaneous coronary interventions with use of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) in patients at high risk of restenosis. Background: Recent studies have shown different clinical efficacy with these drug-eluting stents. Whether this difference extends on cost estimates between the 2 stents is not known. Methods: We included 450 patients with diabetes mellitus and in-stent restenosis from 2 randomized studies comparing SES with PES. Assigned costs for the economic evaluation were the initial hospitalization and all subsequent cardiac-related inpatient/outpatient health resources during 9 to 12 months of clinical follow-up. The economic evaluation was performed from the health insurance system’s perspective. Results: There were no differences between the 2 study groups regarding mortality (p = 0.78) and myocardial infarction rates (p = 0.76). Target lesion revascularization was performed in 16 patients (7.1%) in the SES group and in 34 patients (15.1%) in the PES group (p = 0.01). Initial hospital costs were not significantly different between the 2 stents (p = 0.53). The follow-up costs were, however, different: 2,684 ± 2,072€ per patient treated with SES and 4,527 ± 6,466€ per patient treated with PES (p < 0.001). Total costs also differed at the end of the follow-up: 8,924 ± 3,077€ per patient treated with SES and 10,903 ± 7,205€ per patient treated with PES (p < 0.001). Conclusions: In patients at high risk of restenosis, use of SES is associated with lower costs compared with PES. The cost savings are mainly due to the reduced need of repeat revascularization procedures with SES. [Copyright &y& Elsevier]

Assesses the prevalence of diastolic dysfunction of the left ventricle in patients with non-insulin-dependent diabetes mellitus (NIDDM) and its relation to patient's age and duration of diabetes. Risks of patients with NIDDM in developing coronary artery disease; Methodology of the study; Discussion on the results of the study.

Background and Aim: Cardiovascular disease progresses after menopause. Conventional risk factors, particularly diabetes, for atherosclerosis are well-established predictors of phenotypic arterial disease. The aim of this study is to assess the predictors of subclinical atherosclerosis in asymptomatic non-diabetic postmenopausal women., Methods: This prospective study included 117 consecutive postmenopausal women (mean age 59 ± 7 years) referred from the outpatient Rheumatology Clinic of the University Clinical Centre of Kosovo, recruited between September 2021 and December 2022. Clinical, biochemical, carotid ultrasound and coronary CT angiography data were analysed. Subclinical atherosclerosis was diagnosed when plaque and/or carotid intima-media thickness >1.00 mm were present., Results: Women who had subclinical atherosclerosis had higher erythrocyte sedimentation (p = 0.022), higher total cholesterol (p = 0.013), higher CAC score (p = 0.017), and higher prevalence of CAC > 100 HU and CAC > 400 HU (p = 0.017 and p = 0.034, respectively) compared to those without subclinical atherosclerosis. Women who had mild coronary calcification (CAC score ≥10 HU) were older (p = 0.005), in longer menopause (p = 0.005), had thicker CIMT (p = 0.008) with higher prevalence (p = 0.03) compared to those with CAC score <10 HU. Women with moderate coronary calcification (CAC score ≥100 HU) had higher triglycerides, worse CIMT (p = 0.005) with higher prevalence (p = 0.039) compared to those with CAC score <100 HU. In multivariate analysis [odds ratio 95% confidence interval], age [1.101 (1.032-1.174), p = 0.037] and cholesterol [2.020 (1.225-3.331), p = 0.006] independently predicted the presence of subclinical atherosclerosis., Conclusions: In addition to the impact of age, hypercholesterolaemia is an important predictor of subclinical atherosclerosis in non-diabetic postmenopausal women., (© 2024 The Author(s). Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.)

The KOSovan Acute Coronary Syndrome (KOS-ACS) Registry is established as a prospective, continuous, nationwide, web-based registry that is operated online. The KOS-ACS registry is designed with the following objectives: (1) to obtain data on the demographic, clinical, and laboratory characteristics of ACS patients treated in Kosovo; (2) to create a national database with information on health care in ACS patients treated in Kosovo; (3) to identify the national features of associations between ACS characteristics and clinical outcomes, including mortality, complications, the length of hospital stay, and the quality of clinical care; and (4) to propose a practical guide for improving the quality and efficiency of ACS treatment in Kosovo. The Kosovo Society of Cardiology and University of Prishtina will be responsible for the development of the KOS-ACS registry and centralized data analysis at the national level. The KOS-ACS Registry will enroll all patients admitted, at any of the registered clinical centers, with the diagnosis of ACS and who will be clinically managed at any of the Kosovo hospitals. Data on patient demographics, clinical characteristics, previous and hospital drug treatment, and reperfusion therapy will be collected. The type of ACS (unstable angina, NSTEMI, or STEMI) will also be clearly defined. The time from first medical contact to balloon inflation (FMC-to-balloon) and door-to-ballon time will be registered. In-hospital death and complications will be registered. Data on the post-hospital primary outcome (MACE: cardiac death, all-cause mortality, hospitalization, stroke, need for coronary revascularization) of patients, at 30 days and 1 year, will be included in the registry.

Background: Myocardial infarction (MI), presented as ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI), is influenced by atherosclerosis risk factors., Aim: The aim of this study was to assess the patterns of presentation of patients with acute MI in Kosovo., Methods: This was a cross-sectional study conducted at the University Clinical Center of Kosovo, which included all patients hospitalized with acute MI over a period of 7 years., Results: Among the 7353 patients admitted with acute MI (age 63 ± 12 years, 29% female), 59.4% had STEMI and 40.6% had NSTEMI. The patients with NSTEMI patients less (48.3% vs. 54%, p < 0.001), but more of them had diabetes (37.8% vs. 33.6%, p < 0.001), hypertension (69.6% vs. 63%, p < 0.001), frequently had a family history of coronary artery disease (CAD) (40% vs. 38%, p = 0.009), and had more females compared to the patients with STEMI (32% vs. 27%, p < 0.001). The patients with NSTEMI underwent less primary percutaneous interventions compared with the patients with STEMI (43.6% vs. 55.2%, p < 0.001). Smoking [1.277 (1.117-1.459), p ˂ 0.001] and high triglycerides [0.791 (0.714-0.878), p = 0.02] were independent predictors of STEMI., Conclusions: In Kosovo, patients with STEMI are more common than those with NSTEMI, and they were mostly males and more likely to have diabetes, hypertension, and a family history of CAD compared to those with NSTEMI. Smoking and high triglycerides proved to be the strongest predictors of acute STEMI in Kosovo, thus highlighting the urgent need for optimum atherosclerosis risk control and education strategies.

Objective: The epidemiological data have shown that the goal blood pressure (BP) control is achieved in only a small percentage of the hypertensive patients. The aim of this study was to assess the quality of the management of arterial hypertension (AH) in patients hospitalized in Service of Cardiology, University Clinical Centre of Kosovo, in Prishtina, and to determine the predictors of uncontrolled AH., Methods: This retrospective study included 938 consecutive hypertensive patients (63.1+/- 11.3 years, 55.1% females), admitted to our institution between January 2003 and June 2006. Systolic and diastolic blood pressure, blood analyses, drug prescription and echocardiographic findings were analyzed in all study patients. Multiple regression analysis was used to identify the independent associates of poor BP control., Results: Overall, 83%f of patients were discharged on angiotensin-converting enzyme inhibitors (A), 71% - on beta-blockers (B), 26% - on calcium channel blockers (C) and 60% - on diuretics (D). The most frequent drug combination used was ABD (30.5%), followed by AB (18%) and AD (8%). The goal systolic and diastolic BP was achieved in 50% of patients. Multivariate analysis identified diabetes, (OR=0.479, 95% confidence interval [CI] 0.339-0.677, <0.001), creatinine level (OR=0.997, 95% CI 0.996-0.999, p=0.001], and ABCD combination therapy (OR=0.445, 95% CI 0.253-0.774, p=0.046)], as independent correlates of in-hospital poor BP control., Conclusions: Half of hypertensive patients hospitalized in the Service of Cardiology had achieved the goal blood pressure. The diabetes, level of creatinine and a combination of 4 antihypertensive drugs were independent predictors of poor hypertension control.

Background: Chronic heart failure is a major cardiovascular disorder., Objective: The aim of this study was to prospectively examine whether a 6-min walk test (6-MWT) result correlates with echocardiographic variables in patients with left ventricular systolic dysfunction and stable chronic heart failure., Methods: We prospectively studied 52 patients (65% male; mean age 60+/-11 years) who had chronic heart failure secondary to ischemic heart disease or idiopathic cardiomyopathy. All patients had left ventricular systolic dysfunction (ejection fraction

Background: Acute myocardial infarction is a rare complication of mitral stenosis. Acute myocardial infarction in the setting of severe unrecognized mitral stenosis has not been described., Case Report: A 47-year-old-woman was admitted to our department for chest pain typical of myocardial infarction. Electrocardiogram showed ST segment elevation in leads II, III, and aVF and atrial fibrillation. Creatine kinase level was elevated to 268 U/L. The diagnosis of acute myocardial infarction of the inferior wall was established. The patient reported breathlessness after physical exertion over the last 2 years; however, she had not sought medical help and was unaware of her heart disease. Transthoracic echocardiography showed severe mitral stenosis (surface mitral valve area <1 cm2) and inferior wall akinesia., Conclusions: We present a case of acute myocardial infarction in a patient with unrecognized severe mitral stenosis and atrial fibrillation. Our suggestion is that acute myocardial infarction in this patient with no risk factors for coronary atherosclerosis was of thromboembolic origin, from left atrial thrombi.