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Výzkumná databáze této práce se skládá ze zemí OECD (s výjimkou Turecka a Litvy). Primárním cílem studie je rozdělit země do skupin podle dvanácti proměnných – průměrná mzda, minimální mzda, HDP na obyvatele, míra nezaměstnanosti, směnná a inflační sazba, daň z příjmu, HDP za odpracovanou hodinu, indexy průmyslu, stavebnictví a zpracovatelského průmyslu, index produkce a maloobchodu, a určit, která z nich významně ovlivňuje průměrnou mzdu, a definuje typ a sílu takového vztahu. Průměrná mzda, minimální mzda a HDP na obyvatele se počítají po jejich převodu na paritu kupní síly, což umožňuje srovnání cenových hladin a PPP v různých zemích. Dalším důležitým cílem je vypracovat prognózy úrovně mezd pro země OECD do roku 2020. S ohledem na seskupení zemí podle výše uvedených kritérií je Česko vždy na úrovni ostatních postkomunistických zemí (kromě Slovinska). Jedinými vysvětlujícími proměnnými, které významně ovlivňují průměrnou mzdu, jsou HDP na obyvatele, daně z příjmu a indexy zpracovatelského průmyslu a maloobchodu, přičemž HDP má hlavní vliv. Jednoduchá regresní analýza závislosti mezi průměrnou mzdou a HDP na obyvatele naznačuje, že její průběh nejlépe zachycuje konkávní parabola s maximem 77 252 PPP USD. Vybraná polynomiální regrese druhého řádu vysvětluje cca 89% variability pozorovaných hodnot průměrné roční mzdy. Růst mezd do roku 2020 se očekává prakticky ve všech zemích OECD.

Aims: The current guidelines recommend reperfusion therapy in acute myocardial infarction (AMI) with ST-segment elevation or left bundle branch block (LBBB). Surprisingly, the right bundle branch block (RBBB) is not listed as an indication for reperfusion therapy. This study analysed patients with AMI presenting with RBBB [with or without left anterior hemiblock (LAH) or left posterior hemiblock (LPH)] and compared them with those presenting with LBBB or with other electrocardiographic (ECG) patterns. The aim was to describe angiographic patterns and primary angioplasty use in AMI patients with RBBB., Methods and Results: A cohort of 6742 patients with AMI admitted to eight participating hospitals was analysed. Baseline clinical characteristics, ECG patterns, coronary angiographic, and echocardiographic data were correlated with the reperfusion therapies used and with in-hospital outcomes. Right bundle branch block was present in 6.3% of AMI patients: 2.8% had RBBB alone, 3.2% had RBBB + LAH, and 0.3% had RBBB + LPH. TIMI flow 0 in the infarct-related artery was present in 51.7% of RBBB patients vs. 39.4% of LBBB patients (P = 0.023). Primary percutaneous coronary intervention (PCI) was performed in 80.1% of RBBB patients vs. 68.3% of LBBB patients (P< 0.001). In-hospital mortality of RBBB patients was similar to LBBB (14.3 vs. 13.1%, P = 0.661). Patients with new or presumably new blocks had the highest (LBBB 15.8% and RBBB 15.4%) incidence of cardiogenic shock from all ECG subgroups. Percutaneous coronary intervention was done more frequently (84.8%) in patients with new or presumably new RBBB when compared with other patients with blocks (old RBBB 66.0%, old LBBB 62.3%, new or presumably new LBBB 73.0%). In-hospital mortality was highest (18.8%) among patients presenting with new or presumably new RBBB, followed by new or presumably new LBBB (13.2%), old LBBB (10.1%), and old RBBB (6.4%). Among 35 patients with acute left main coronary artery occlusion, 26% presented with RBBB (mostly with LAH) on the admission ECG., Conclusion: Acute myocardial infarction with RBBB is frequently caused by the complete occlusion of the infarct-related artery and is more frequently treated with primary PCI when compared with AMI + LBBB. In-hospital mortality of patients with AMI and RBBB is highest from all ECG presentations of AMI. Restoration of coronary flow by primary PCI may lead to resolution of the conduction delay on the discharge ECG. Right bundle branch block should strongly be considered for listing in future guidelines as a standard indication for reperfusion therapy, in the same way as LBBB.

Aims: To compare two different clopidogrel regimens on the outcomes of patients undergoing elective coronary angiography (CAG)+/-ad hoc percutaneous coronary intervention (PCI)., Methods and Results: Open-trial randomized 1028 patients with stable angina to group A ('non-selective'-clopidogrel 600 mg > 6 h before CAG; n = 513) or group B ('selective'-clopidogrel 600 mg in the cath-lab after CAG, only in case of PCI; n = 515). Combined primary endpoint was death/periprocedural myocardial infarction (MI)/stroke/re-intervention within 7 days. Secondary endpoints were troponin elevation and bleeding complications. Primary endpoint occurred in 0.8% group A patients vs. 1% group B (P = 0.749; 90% CI for the percentage difference -1.2-0.8). Periprocedural troponin elevation (> 3 x ULN) was detected in 2.6% group A vs. 3.3% group B (P = 0.475; 90% CI -2.5-1.0). Bleeding complications occurred in 3.5% group A patients vs. 1.4% group B (P = 0.025). After adjustment for covariates and factors that may influence the bleeding risk, patients in group A were shown to have more likely bleeding complications when compared with group B (OR = 3.03; 95% CI 1.14-8.10; P = 0.027)., Conclusion: High (600 mg) loading dose of clopidogrel before elective CAG increased the risk of minor bleeding complications, while the benefit on periprocedural infarction was not significant. Clopidogrel can be given safely in the catheterization laboratory between CAG and PCI in chronic stable angina patients.

Background: Primary PCI (p-PCI) was shown to be the most effective reperfusion strategy for ST segment elevation myocardial infarction (STEMI). However, its success rates and clinical outcomes among the elderly patients are less well defined. The aim of this work was to access, whether primary PCI, as compared to thrombolysis, improves the outcomes of elderly patients with STEMI to the same extent as in the younger patient groups and whether this holds true also for the elderly patients presenting in cardiogenic shock or acute heart failure., Patients: A total of 2,073 patients were analysed: 1,050 were enrolled in the randomised trials PRAGUE-1 and -2 and 1,023 entered a p-PCI registry at our institution. The mean age was 64 years, 29% were females. Three hundred and ninety patients were in the elderly (> 75 years) age group, 605 patients were aged 65-74 years and 1,078 patients were <65 years old. Acute heart failure was more prevalent in the patients that entered in the registry as compared to the randomised patients: Killip class IV 10% vs 1% (p < 0.001), Killip II-III class 29% vs 18% (p < 0.001)., Results: An optimal PCI result was achieved in 81% of the elderly and 90% of the younger patients (p < 0.001). The absolute mortality reduction by p-PCI compared to thrombolysis was 5.7% in the elderly and 3.7% in the younger groups (n.s.). The in-hospital mortality of Killip IV patients was 69% (elderly group), 54% (group 65-74 years, p < 0.001) and 27% (group <65 years, p < 0.001). The in-hospital mortality of patients without cardiogenic shock was low in all age groups: 4% (elderly), 2.7% (65-74 years) and 0.8% (<65 years)., Conclusion: Primary PCI is the most effective reperfusion strategy for the elderly patients presenting with STEMI.

Using capillary gas chromatography, we determined total content of trans fatty acids (TFA) and C18:1 trans fatty acids in human milk and subcutaneous fat in 35 healthy Prague women. The average content of TFA in human milk fat was 4.22% (SD = 1.87%) of all fatty acids, and the value of trans C18:1 isomers was 3.63% (SD = 1.81%). The average concentration of total trans fatty acids in subcutaneous fat was 4.41% (SD = 0.79%) and the average content of C18:1 trans isomers was 2.81% (SD = 0.61%).