Kulecki M, Naskret D, Kubicki A
… +7 more, Lemanska A, Moska S, Haras P, Grzelka-Woźniak A, Uruska A, Araszkiewicz A, Zozulinska-Ziolkiewicz D
Pol Arch Intern Med
· 2026 Jun · PMID 42223380
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INTRODUCTION: Platelet morphology indices are indirectly related to platelet reactivity and may link glycemic exposure to cardiovascular risk. OBJECTIVES: We aimed to investigate associations between continuous glucose m...INTRODUCTION: Platelet morphology indices are indirectly related to platelet reactivity and may link glycemic exposure to cardiovascular risk. OBJECTIVES: We aimed to investigate associations between continuous glucose monitoring (CGM)-derived metrics and platelet morphology in adults with T1DM. PATIENTS AND METHODS: In this cross-sectional study, we enrolled adults with T1DM without established cardiovascular disease. Platelet morphology indices were measured from fasting blood samples using the Sysmex XN-1000 analyzer within 2 hours of blood collection. Glucose profiles were assessed using CGM over 7-, 14-, and 30-day windows and calculated with Glyculator 3.0. We used Spearman correlation and multivariable linear regression models adjusted for age, sex, BMI, diabetes duration, C-reactive protein, glomerular filtration rate, HbA1c, smoking, and platelet count. RESULTS: We included 301 adults with T1DM [median age 33.1 (24.1-41.0), 44.5% men, diabetes duration 13 (7-19) years]. Platelet large cell ratio (P-LCR), mean platelet volume (MPV), and platelet distribution width (PDW)correlated positively with mean glucose (R = 0.27-0.30), time above range (TAR) level 2 (P = 0.25-0.29), glycemic risk index (R = 0.28-0.30), and mean amplitude of glucose excursion (MAGE) (R = 0.20-0.22), and inversely with time in range (R = -0.25 to -0.30; all P < 0.001), but not with hypoglycemia indices. In multivariable models, hyperglycemia-related metrics remained independently associated with P-LCR (standardized β 1.37-1.59; ΔR² 0.014-0.024; P = 0.002); MAGE lost significance in the multivariable model after accounting for TAR level 2. CONCLUSION: In adults with T1DM, platelet morphology independently relates to cumulative hyperglycemic exposure rather than glycemic variability or hypoglycemia.
Maraj M, Prokop-Dorner A, Valli C
… +22 more, Žuljević MF, de Souza Serio Dos Santos DM, Wang Q, Ghosh NR, Gillespie-Friesen J, Reyes BC, Boyero CP, Warzecha S, Zajac J, Theodoro H, Lopes LPN, Thabane L, Majdak K, Zawisza K, Svendrovski A, Ge L, Poklepović-Peričić T, Cruz Lopes L, Alonso-Coello P, Guyatt GH, Johnston BC, Bała MM
Pol Arch Intern Med
· 2026 May · PMID 42138458
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INTRODUCTION: Patients are increasingly recognized as key interest holders in healthcare decision-making. Integrating patient's perspective is crucial to patient-centered, evidence-based nutrition guideline recommendatio...INTRODUCTION: Patients are increasingly recognized as key interest holders in healthcare decision-making. Integrating patient's perspective is crucial to patient-centered, evidence-based nutrition guideline recommendations. OBJECTIVES: To examine individuals' willingness to decrease consumption of foods high in saturated fatty acids (SFA) after being informed about the estimated absolute risk reduction (ARR) in myocardial infarction (MI) together with the certainty of the supporting evidence based on a Cochrane systematic review. METHODS: Based on regional samples from seven countries, respondents were presented with a conversation aid with the ARR of MI together with the certainty of evidence and asked about their willingness to reduce their intake of SFA-rich foods. Using a multivariable logistic regression model we explored 12 variables to identify factors underlying respondents' willingness to introduce dietary fat changes. RESULTS: We analyzed 3663 respondents from regions of Brazil, China, Croatia, Canada, Poland, Spain and USA. Overall, 50.2% were willing to reduce their SFA intake. Females (odds ratio, OR=1.51, 95% confidence interval [CI]: 1.29-1.77), non-omnivores (OR=1.73, 95%CI: 1.37-2.19), respondents from Spain, China and Brazil (OR=2.45, 95%CI: 1.83-3.27; OR=4.36, 95%CI: 3.49-5.45; OR=1.31, 95%CI: 1.08-1.58, respectively) showed greater willingness, whereas those from Croatia or holding a university degree showed lower willingness (OR=0.70, 95%CI: 0.51-0.95; OR=0.73, 95%CI: 0.61-0.87, respectively). CONCLUSIONS: The significant variation in people's willingness (e.g. gender, education levels, dietary pattern) to reduce their intake of SFA-rich foods underscores potential importance of incorporating patient preference when developing dietary guideline recommendations, and for promoting individualized evidence-based care using absolute effects and certainty of evidence.
Strach M, Brkic A, Kaczor M
… +7 more, Wójcik R, Kuszmiersz P, Birkenes T, Krzanowski M, Topór-Mądry R, Haugeberg G, Korkosz M
Pol Arch Intern Med
· 2026 May · PMID 42138457
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INTRODUCTION: The introduction of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has improved healthcare and health outcomes in patients with rheumatic inflammatory diseases but thei...INTRODUCTION: The introduction of biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has improved healthcare and health outcomes in patients with rheumatic inflammatory diseases but their cost is substantial. OBJECTIVE: Explore direct treatment costs of patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) using real-world data from a tertiary single-center. METHODS: A retrospective study integrating data from two databases: a clinical registry and a healthcare expenses database covering the period from January 2021 to September 2023 was performed. Direct medical costs were calculated from the public payer and the patient perspectives, encompassing fully reimbursed services and out-of-pocket expenses. RESULTS: The study comprised 593 patients with RA (50.6%), PsA (20.3%), and axSpA (29.1%). The annual average per patient direct medical costs were €4635 for PsA, €3891 for axSpA, and €3106 for RA. The highest healthcare costs were driven by b/tsDMARDs, which accounted for 94.7% of total costs in PsA, 91.8% in axSpA, and 90.9% in RA. Anti-TNF use was highest in axSpA with 61.3% (37.6% biosimilars), 58.3% with RA (41.7% biosimilars), and 34.2% with PsA (17.5% biosimilars). Anti-IL-17/IL-23 agents were used in 42.5% of PsA and 36.9% of axSpA patients, while anti-IL-6 in 48.7% of RA patients. CONCLUSIONS: The direct cost of b/tsDMARDs varies across diseases. Expenditures on PsA management were the highest and were mainly associated with the high prices of the drugs used and the lowest share of biosimilar anti-TNFs. Potential savings can be achieved by reducing the use of expensive agents.
Dabrowski EJ, Kralisz P, Dobrzycki S
… +8 more, Lipska PO, Kozłowska WU, Nowak K, Gugała K, Prokopczuk P, Mężyński G, Święczkowski M, Kożuch M
Pol Arch Intern Med
· 2026 Jun · PMID 42117782
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INTRODUCTION: Sex‑related differences in outcomes after left main coronary artery (LMCA) percutaneous coronary intervention (PCI) remain incompletely understood, particularly in real‑world settings. OBJECTIVES: This stud...INTRODUCTION: Sex‑related differences in outcomes after left main coronary artery (LMCA) percutaneous coronary intervention (PCI) remain incompletely understood, particularly in real‑world settings. OBJECTIVES: This study evaluated the impact of sex assigned at birth on long‑term clinical outcomes after LMCA PCI in the largest single‑center registry in Poland. PATIENTS AND METHODS: We retrospectively analyzed 998 patients who underwent LMCA PCI between 2007 and 2022. The end point was 5‑year all‑cause mortality. Survival analyses were performed in the overall cohort and after propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). RESULTS: The final cohort included 814 patients, of whom 228 (28%) were women. In the whole population, there was no difference in 5‑year mortality between men and women (hazard ratio [HR], 1.31; 95% CI, 0.99-1.73; P = 0.06). PSM resulted in 471 pairs, and IPTW generated a weighted cohort of 469 patients (131 women [28%]). After PSM, men showed higher mortality (HR, 1.64; 95% CI, 1.28-2.11; P <0.001), consistent with IPTW analysis (HR, 1.71; 95% CI, 1.04-2.83; P = 0.04). Exploratory subgroup analyses demonstrated higher mortality among men with heart failure (HR, 2.25; 95% CI, 1.66-3.04; P = 0.002), those undergoing rotational atherectomy (HR, 4.15; 95% CI, 2.25-7.65; P <0.001), and those treated for 2 or more lesions (HR, 2.02; 95% CI, 1.44-2.83; P <0.001). CONCLUSIONS: Men experienced worse long‑term survival than women after adjustment for clinical and procedural confounders. Mortality risk was higher among men with heart failure, multivessel disease, and those undergoing rotational atherectomy, highlighting the importance of considering sex‑based differences in LMCA management.
Burnier M, Prejbisz A, Vaclavik J
… +10 more, Gupta P, Azizi M, Dobrowolski P, Niro-Martin S, Cunha V, Versmissen J, Magne J, Desideri G, Persu A, Working Group on Lifestyle, Cardiovascular Pharmacotherapy, and Adherence of the European Society of Hypertension
Pol Arch Intern Med
· 2026 Jun · PMID 42117634
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INTRODUCTION: Few studies have assessed patient perception of the management of their hypertension in Europe. OBJECTIVES: We aimed to compare the attitudes, barriers, and expectations of patients receiving treatment for...INTRODUCTION: Few studies have assessed patient perception of the management of their hypertension in Europe. OBJECTIVES: We aimed to compare the attitudes, barriers, and expectations of patients receiving treatment for hypertension in 7 European countries. PATIENTS AND METHODS: Cross‑sectional data were obtained between January and April 2023, using a web‑based questionnaire translated into each country's official language and distributed in the Czech Republic, France, Germany, Italy, Poland, Spain, and the United Kingdom (UK). A total of 4001 treated hypertensive adults returned a valid questionnaire. Their mean (SD) age was 68.3 (9.2) years (median, 70 y), 59.7% were men, and 91% were treated for longer than 1 year. RESULTS: The participants from Poland and the Czech Republic had a more unfavorable cardiovascular risk profile than those from other countries (P <0.001). Differences across the countries were found for lifestyle, medical, and emotional risk scores (P <0.001). A total median number of pills per day was 4 (range, 3-5/d; P <0.001 between countries) and 2 for antihypertensive drugs. The frequency of follow‑up visits per year was the highest in France and lowest in the UK (P <0.001). In all countries, 10%-20% of the participants expressed a wish for more information mainly on treatment, drug side effects, and hypertension complications. Nonintentional interruption of medications was the main cause of nonadherence. CONCLUSIONS: According to patients, the management of hypertension is highly variable in different European countries. Our survey identified features that could be improved, such as increasing the amount of information provided to the patients, empowering the patients through adequate home blood pressure monitoring, and supporting medication adherence.