Cardiovascular safety of marathon running in recreational runners remains unclear. We set up this study to comprehensively evaluate the effects of a marathon run on the profile of cardiovascular stress biomarkers in connection with transthoracic echocardiography. Thirty-three healthy male amateur runners, aged ≥50 years (mean age 57 ± 7) were enrolled. Venous blood samples were obtained before the marathon, just after the race, 2–4 and seven days after the marathon. Using novel single molecule counting technology we measured: plasma concentrations of high-sensitivity cardiac troponin I (hs-cTnI) and endothelin-1. N-terminal pro B-type natriuretic peptide was measured using electrochemiluminescence. Each participant had transthoracic echocardiography before and immediately after the race. We observed a sharp rise in the levels of all biomarkers after the race (all p < 0.01), which subsequently normalized after 2–4 days and stayed within normal range after seven days. Runners with intensive training programmes (>169 km/month, a median for the studied group) had lower hs-cTnI leak after the race (median 15.11 ng/ml and 31.2 ng/ml, respectively; p < 0.05). Neither transthoracic echocardiography measures of ventricles nor strain rates changed after the run. We observed a decrease in the left atrial volume index and increase in the maximal right atrial volumes (all p < 0.05). Changes in Doppler indices of diastolic function suggestive of alteration in left ventricular relaxation were observed. Marathon run is associated with sharp and significant rises in the biomarkers of cardiovascular stress. The profile of these changes, however, along with echocardiographic parameters, does not suggest irreversible myocardial damage.

Background: To assess the influence of severe target lesion calcification (TLC) on outcomes of patients undergoing percutaneous coronary interventions (PCI) due to acute myocardial infarction (AMI). Aim: Contemporary data concerning coronary artery calcifications (CAC) are based on pooled analyses from randomized trials with short follow up. We still lack the knowledge on how CAC in target lesions affect long term prognosis of patients with AMI in everyday practice. Methods: We evaluated clinical and laboratory data of 206 consecutive patients who underwent coronary angiography and PCI due to AMI. Primary endpoints were all-cause death and recurrent hospitalizations due to acute coronary syndrome (ACS). Results: Severe TLC lesions were present in 17% of patients. These patients were older (71 vs. 65 years, p=0,02) and more often diagnosed with Non-ST Segment Elevation Myocardial Infarction (NSTEMI) (77% vs. 58%, p=0,03). Patients with severe TLC had lower rates of PCI success (80% vs. 97%, p < 0,0001) and less often achieved full revascularization during index procedure (14% vs. 41%, p=0,003). During 30 months follow-up patients with severe TLC more often suffered from another ACS (37% vs. 13%, p=0,0005) and had higher all-cause mortality (31% vs. 16%, p=0,04). Multivariate Cox regression model showed severe TLC to be an independent predictor of another ACS (HR 2,8; CI: 1,4-5,6; p=0,004). Conclusions: Severe TLC are not uncommon in patients with ACS. Presence of severe TLC is a prognostic factor of another ACS in AMI patients undergoing PCI. Background: To assess the influence of severe target lesion calcification (TLC) on outcomes of patients undergoing percutaneous coronary interventions (PCI) due to acute myocardial infarction (AMI). Aim: Contemporary data concerning coronary artery calcifications (CAC) are based on pooled analyses from randomized trials with short follow up. We still lack the knowledge on how CAC in target lesions affect long term prognosis of patients with AMI in everyday practice. Methods: We evaluated clinical and laboratory data of 206 consecutive patients who underwent coronary angiography and PCI due to AMI. Primary endpoints were all-cause death and recurrent hospitalizations due to acute coronary syndrome (ACS). Results: Severe TLC lesions were present in 17% of patients. These patients were older (71 vs. 65 years, p=0,02) and more often diagnosed with Non-ST Segment Elevation Myocardial Infarction (NSTEMI) (77% vs. 58%, p=0,03). Patients with severe TLC had lower rates of PCI success (80% vs. 97%, p < 0,0001) and less often achieved full revascularization during index procedure (14% vs. 41%, p=0,003). During 30 months follow-up patients with severe TLC more often suffered from another ACS (37% vs. 13%, p=0,0005) and had higher all-cause mortality (31% vs. 16%, p=0,04). Multivariate Cox regression model showed severe TLC to be an independent predictor of another ACS (HR 2,8; CI: 1,4-5,6; p=0,004). Conclusions: Severe TLC are not uncommon in patients with ACS. Presence of severe TLC is a prognostic factor of another ACS in AMI patients undergoing PCI.

Background: Nowadays, when the majority of patients with acute myocardial infarction (AMI) are treated with primary percutaneous coronary intervention and modern pharmacotherapy, risk stratification becomes a challenge. Simple and easily accessible parameters that would help in a better determination of prognosis are needed. The aim of the study was to estimate the prevalence of high mean corpuscular volume (MCV, defined as MCV > 92 fL) and to establish its prognostic value in non-anemic patients with AMI. Methods: We retrospectively analyzed the data of 248 consecutive non-anemic patients hospitalized due to AMI (median age: 65 [59–76] years, men: 63%, ST segment elevation myocardial infarction: 31%, and median left ventricular ejection fraction [LVEF]: 50%). Results: The prevalence of high MCV was 39 ± 6% (± 95% confidence interval) in the entire AMI population. High MCV was more prevalent in males, patients with low body mass index, non-diabetics and cigarette smokers (all p < 0.05). During the 180-day follow-up, there were 38 (15%) events, defined as another AMI or death. In a multivariable Cox proportional hazard model, female gender (p < 0.01), low LVEF (p < 0.001), previous AMI (p < 0.05), arterial hypertension (p < 0.05), and high MCV (p < 0.001) were prognosticators of pre-defined events. Conclusions: In non-anemic patients with AMI, high MCV is an independent prognostic factor of poor outcome defined as another AMI or death. Background: Nowadays, when the majority of patients with acute myocardial infarction (AMI) are treated with primary percutaneous coronary intervention and modern pharmacotherapy, risk stratification becomes a challenge. Simple and easily accessible parameters that would help in a better determination of prognosis are needed. The aim of the study was to estimate the prevalence of high mean corpuscular volume (MCV, defined as MCV > 92 fL) and to establish its prognostic value in non-anemic patients with AMI. Methods: We retrospectively analyzed the data of 248 consecutive non-anemic patients hospitalized due to AMI (median age: 65 [59–76] years, men: 63%, ST segment elevation myocardial infarction: 31%, and median left ventricular ejection fraction [LVEF]: 50%). Results: The prevalence of high MCV was 39 ± 6% (± 95% confidence interval) in the entire AMI population. High MCV was more prevalent in males, patients with low body mass index, non-diabetics and cigarette smokers (all p < 0.05). During the 180-day follow-up, there were 38 (15%) events, defined as another AMI or death. In a multivariable Cox proportional hazard model, female gender (p < 0.01), low LVEF (p < 0.001), previous AMI (p < 0.05), arterial hypertension (p < 0.05), and high MCV (p < 0.001) were prognosticators of pre-defined events. Conclusions: In non-anemic patients with AMI, high MCV is an independent prognostic factor of poor outcome defined as another AMI or death.

Long-distance running and, in particular, running marathons has become an increasingly popular activity among the elderly. The aim of the study was to examine the effects of a marathon effort on the psychomotor performance and catecholamine concentration in runners over 50 years of age. The participants were male runners (n = 28) who completed the 32nd Wrocław Marathon in Poland. The runners’ psychomotor performance was assessed on the basis of their choice reaction times (CRT), heart rate (HR) and running speed measurements. In addition, the adrenaline (A) and noradrenaline (NA) as well as lactate (LA) levels and anaerobic threshold (AT) were measured. The runners’ CRT after crossing the finish line was significantly longer by 50 ms (p < 0.05) in response to each emitted audiovisual stimulus, as compared with baseline. The mean running speed was reduced by 1 km/h between the first speed measurement (5th km of the run) and the last (42.195 km) (p < 0.05). The observed three-fold increase in adrenaline and noradrenaline levels indicates an intense activity of the sympathetic–adrenergic system. The cognitive function levels in the studied marathon runners returned to baseline after 30 min of recovery, and the function of the sympathetic–adrenergic system by seven days after completing the marathon race.

Background: Rotational atherectomy (RA) is indicated for fibrocalcified lesions when traditional percutaneous coronary intervention (PCI) could not be successfully performed. Some of the patients constitute a high-risk population and the procedure of RA is the last resort of successful revascularization. Such patients are among others those, in whom coronary artery bypass grafting (CABG) is not feasible. Aims: The aim of the study was to assess in-hospital and 1-year results of PCI with RA in high-risk patients without other revascularization options (RA-only group), in comparison to remaining lower risk RA patients. Methods: We evaluated data of 207 consecutive patients who underwent PCI with RA. Primary endpoints were 1-year all-cause mortality and 1-year major adverse cardiac events (MACE). Secondary endpoints were in-hospital outcome. Results: During the study 35% of patients fulfilled the inclusion criteria to high-risk group. Those patients had significantly lower left ventricle ejection fraction, more often prior CABG, higher admission glucose level, higher Euroscore II and Syntax Score. Procedural success was similar in both groups (85% vs. 91%, p=0.18). In-hospital outcomes were similar, except more frequent no/slow flow phenomenon in RA-only group. The MACE rate in 1-year follow-up and mortality were statistically not different in both groups (19% vs. 18%, p=0.82 and 11% vs. 9%, p=0.64). Conclusions: Despite high-risk characteristics of study subgroup no significant difference between in-hospital and 1-year outcomes in comparison to remaining RA lower risk patients has been found. Complex PCI including RA in patients without other revascularization options should be taken under consideration. Background: Rotational atherectomy (RA) is indicated for fibrocalcified lesions when traditional percutaneous coronary intervention (PCI) could not be successfully performed. Some of the patients constitute a high-risk population and the procedure of RA is the last resort of successful revascularization. Such patients are among others those, in whom coronary artery bypass grafting (CABG) is not feasible. Aims: The aim of the study was to assess in-hospital and 1-year results of PCI with RA in high-risk patients without other revascularization options (RA-only group), in comparison to remaining lower risk RA patients. Methods: We evaluated data of 207 consecutive patients who underwent PCI with RA. Primary endpoints were 1-year all-cause mortality and 1-year major adverse cardiac events (MACE). Secondary endpoints were in-hospital outcome. Results: During the study 35% of patients fulfilled the inclusion criteria to high-risk group. Those patients had significantly lower left ventricle ejection fraction, more often prior CABG, higher admission glucose level, higher Euroscore II and Syntax Score. Procedural success was similar in both groups (85% vs. 91%, p=0.18). In-hospital outcomes were similar, except more frequent no/slow flow phenomenon in RA-only group. The MACE rate in 1-year follow-up and mortality were statistically not different in both groups (19% vs. 18%, p=0.82 and 11% vs. 9%, p=0.64). Conclusions: Despite high-risk characteristics of study subgroup no significant difference between in-hospital and 1-year outcomes in comparison to remaining RA lower risk patients has been found. Complex PCI including RA in patients without other revascularization options should be taken under consideration.