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Antiplatelet therapy in elderly
Paluch, Zoltán ; Alušík, Štefan (advisor) ; Perlík, František (referee) ; Martínek, Arnošt (referee)
The aim of our study was to determine the efficacy of antiplatelet therapy in elderly and polymorbid patients. We were interested to know whether selected laboratory parameters, co-existing conditions, and concomitant therapy may affect the antiplatelet effect of low-dose acetylsalicylic acid. In our study groups, we demonstrated high urinary levels of 11-dehydrothromboxane B2 suggesting ineffective antiplatelet therapy. In our series, its prevalence was in excess of 46%. A comparison of groups of aspirin-sensitive and aspirin-resistant patients revealed statistically significant differences in CRP levels, smoking status, previous stroke, and atrial fibrillation. Patients with effective antiplatelet therapy were more often treated with statins, nitrates, and beta-blockers. Determination of the serum levels of salicylates showed a major role in the high prevalence of ineffective antiplatelet therapy was played by patient non-compliance.
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The influence of menopause on risk factors for atherosclerosis
Lejsková, Magdalena ; Alušík, Štefan (advisor) ; Žák, Aleš (referee) ; Kvapil, Milan (referee)
Introduction: While low in women of childbearing age, cardiovascular risk rises quickly after menopause. It is a well known fact that cholesterolemia increases in the absence of ovarian estrogen secretion, and a number of studies have demonstrated an increasing incidence of metabolic syndrome (MS) following menopause. Despite this, conclusive evidence for most of the MS components is unavailable, and an increase in insulin resistance due to menopause has likewise not been documented. The aim of our study was to determine the effect of menopause on selected cardiovascular risk factors in Czech women. Methods: A total of 909 women, as a random 5% sample of female residents of Prague 4 aged 45-55 years, were enrolled. Fasting blood samples were obtained, a thorough history was taken, necessary anthropometric measurements and ultrasound examinations of arteries were performed. Results: In multivariate regression analysis, postmenopausal status, not age, was the only predictor of combined markers, i.e., MS as defined by NCEP-ATPIII (p = 0.03) and atherogenic lipid indexes (total cholesterol/HDL-C, p = 0.002; LDL-C/HDL-C, p = 0.004; apolipoprotein B/apolipoprotein A-I, p = 0.004). While age was the strongest predictor of individual components of MS, menopausal status was only associated with waist circumference...
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