BACKGROUND: Strokes after left atrial appendage closure (LAAC) prophylaxis are generally less severe than those after warfarin prophylaxis-thought to be secondary to more hemorrhagic strokes with warfarin. Hemorrhagic strokes are similarly infrequent with direct oral anticoagulant (DOAC) prophylaxis, so the primary subtype after either LAAC or DOAC prophylaxis is ischemic stroke (IS). OBJECTIVES: The purpose of this study was to compare the severity of IS using the modified Rankin Scale in atrial fibrillation patients receiving prophylaxis with DOACs vs LAAC. METHODS: A retrospective analysis was performed of consecutive patients undergoing LAAC at 8 centers who developed an IS (ISLAAC) compared with contemporaneous consecutive patients who developed IS during treatment with DOACs (ISDOAC). The primary outcome was disabling/fatal stroke (modified Rankin Scale 3-5) at discharge and 3 months later. RESULTS: Compared with ISDOAC patients (n = 322), ISLAAC patients (n = 125) were older (age 77.2 ± 13.4 years vs 73.1 ± 11.9 years; P = 0.002), with higher HAS-BLED scores (3.0 vs 2.0; P = 0.004) and more frequent prior bleeding events (54.4% vs 23.6%; P < 0.001), but similar CHA2DS2-VASc scores (5.0 vs 5.0; P = 0.28). Strokes were less frequently disabling/fatal with ISLAAC than ISDOAC at both hospital discharge (38.3% vs 70.3%; P < 0.001) and 3 months later (33.3% vs 56.2%; P < 0.001). Differences in stroke severity persisted after propensity score matching. By multivariate regression analysis, ISLAAC was independently associated with fewer disabling/fatal strokes at discharge (OR: 0.22; 95% CI: 0.13-0.39; P < 0.001) and 3 months (OR: 0.25; 95% CI: 0.12-0.50; P < 0.001), and fewer deaths at 3 months (OR: 0.28; 95% CI: 0.12-0.64; P < 0.001). CONCLUSIONS: Ischemic strokes in patients with atrial fibrillation are less often disabling or fatal with LAAC than DOAC prophylaxis.

• MeSH
• antikoagulancia škodlivé účinky   MeSH
• cévní mozková příhoda * epidemiologie   etiologie   prevence a kontrola   MeSH
• fibrilace síní * komplikace   farmakoterapie   chirurgie   MeSH
• hemoragická cévní mozková příhoda * chemicky indukované   komplikace   farmakoterapie   MeSH
• ischemická cévní mozková příhoda * chemicky indukované   komplikace   farmakoterapie   MeSH
• krvácení chemicky indukované   MeSH
• lidé středního věku MeSH
• lidé MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• uzávěr ouška levé síně MeSH
• výsledek terapie MeSH
• warfarin škodlivé účinky   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND AND AIMS: Patients with long atrial high-rate episodes (AHREs) ≥24 h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never been compared with no anticoagulation in these patients. METHODS: This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation. RESULTS: Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE ≥24 h were present at baseline in 259/2389 patients (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9/132 patients with AHRE ≥24 h (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 h developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; P < .001). CONCLUSIONS: This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.

• MeSH
• antikoagulancia terapeutické užití   MeSH
• cévní mozková příhoda * etiologie   prevence a kontrola   diagnóza   MeSH
• fibrilace síní * komplikace   farmakoterapie   diagnóza   MeSH
• lidé MeSH
• pyridiny * MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční síně MeSH
• thiazoly * MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Úvod: U pacientů s fibrilací síní užívajících nová perorální antikoagulancia (NOAC) je nezbytné kontinuální užívání léků. Vyšší věk a polymorbidita mohou ovlivnit compliance související s antikoagulační léčbou. Metody: Observační kohortová studie (STROBE) hodnotila compliance pacientů s vybranými kardiovaskulárními diagnózami a dalšími komorbiditami, kteří dostávali NOAC a ambulantní péči na specializovaných klinikách v České republice, v dotazníkovém průzkumu v období od dubna do května 2023. Výsledky: Pacienti splňující kritéria studie byli osloveni ošetřujícím lékařem k zařazení do studie (4 kardiologické a 1 neurologická ambulance). Studie se zúčastnilo celkem 274 pacientů (146 žen, 128 mužů) s hlavní diagnózou fibrilace síní a alespoň jednou potvrzenou vedlejší diagnózou srdečního infarktu, mozkového infarktu, tranzitorní ischemické ataky (TIA), obezity, arteriální hypertenze nebo diabetes mellitus. Statistická analýza potvrdila, že pacienti s anamnézou cévní mozkové mozkové příhody nebo TIA měli vyšší počet pravidelných kontrolních návštěv (jednou za tři měsíce) (p = 0,002492). Analýza dat dále prokázala, že pacienti, kteří byli léčeni kratší dobu, měli tendenci k častějším pravidelným kontrolním návštěvám (délka léčby do 3 měsíců/průměrná kontrola 1,7krát; 3–5 měsíců/0,9krát; 6–12 měsíců/0,7krát). U jednoho pacienta (55 let) s paroxysmální fi brilací síní a diagnózou TIA, který deklaroval nepravidelnost užívání NOAC po dobu 3–5 měsíců léčby, byla zjištěna recidiva TIA. Závěr: Ve sledovaném souboru byla zjištěna vysoká zátěž dalšími komorbiditami spolu s nedostatečnou deklarací pravidelnosti užívání medikace NOAC a z toho plynoucích rizik. Vzhledem k narůstajícímu počtu předepsaných NOAC je nezbytná vhodná edukace pacientů, zejména u starších pacientů s vysokým rizikem cévní mozkové příhody.

Introduction: Continuous medication use is essential for patients with atrial fibrillation using new oral anticoagulants. Older age and polymorbidity may affect compliance related to the anticoagulation therapy. Methods: An observational cohort study (STROBE) assessed patients' compliance with selected cardiovascular diagnoses and other comorbidities who received NOAC and outpatient care in specialized clinics in the Czech Republic in the questionnaire survey between April and May 2023. Results: Patients meeting the study criteria were approached by the treating physician for inclusion (4 cardiology and 1 neurology clinic). A total of 274 patients (146 women, 128 men) with a primary diagnosis of atrial fibrillation and at least one confirmed secondary diagnosis of heart attack, cerebral infarction, transient cerebral ischemic attack (TIA), obesity, arterial hypertension, or diabetes mellitus participated. Statistical analysis confirmed that patients with a history of stroke or TIA had a higher number of regular follow-up visits (once every three months) (p = 0.002492). Furthermore, data analysis demonstrated that patients who had been on treatment for a shorter time tended to have more frequent regular follow-up visits (treatment duration up to 3 months/average check-ups 1.7 times; 3-5 months/0.9 times; 6-12 months/0.7 times). In one patient (55 years) with paroxysmal atrial fibrillation and a diagnosis of TIA, who declared irregularity of NOAC use for 3-5 months of treatment, a relapse of TIA was identified. Conclusion: A high burden of additional comorbidities was identified in the observed sample, along with the inadequate declaration of the regularity of NOAC medication use and the resulting risks. Appropriate patient education is essential, especially among older patients at a high risk of stroke, considering the in- creasing prescription rates.

• Klíčová slova
• studie STROBE,
• MeSH
• adherence pacienta MeSH
• antikoagulancia * klasifikace   terapeutické užití   MeSH
• fibrilace síní * diagnóza   farmakoterapie   MeSH
• kardiovaskulární nemoci farmakoterapie   prevence a kontrola   MeSH
• kohortové studie MeSH
• komorbidita MeSH
• lidé MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• pozorovací studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

AIMS: Data on the hybrid atrial fibrillation (AF) treatment are lacking in patients with structural heart disease undergoing concomitant CryoMaze procedures. The aim was to assess whether the timely pre-emptive catheter ablation would achieve higher freedom from AF or atrial tachycardia (AT) and be associated with better clinical outcomes than surgical ablation alone. METHODS AND RESULTS: The trial investigated patients with non-paroxysmal AF undergoing coronary artery bypass grafting and/or valve repair/replacement with mandatory concomitant CryoMaze procedure who were randomly assigned to undergo either radiofrequency catheter ablation [Hybrid Group (HG)] or no further treatment (Surgery Group). The primary efficacy endpoint was the first recurrence of AF/AT without class I or III antiarrhythmic drugs as assessed by implantable cardiac monitors. The primary clinical endpoint was a composite of hospitalization for arrhythmia recurrence, worsening of heart failure, cardioembolic event, or major bleeding. We analysed 113 and 116 patients in the Hybrid and Surgery Groups, respectively, with a median follow-up of 715 (IQR: 528-1072) days. The primary efficacy endpoint was significantly reduced in the HG [41.1% vs. 67.4%, hazard ratio (HR) = 0.38, 95% confidence interval (CI): 0.26-0.57, P < 0.001] as well as the primary clinical endpoint (19.9% vs. 40.1%, HR = 0.51, 95% CI: 0.29-0.86, P = 0.012). The trial groups did not differ in all-cause mortality (10.6% vs. 8.6%, HR = 1.17, 95%CI: 0.51-2.71, P = 0.71). The major complications of catheter ablation were infrequent (1.9%). CONCLUSION: Pre-emptively performed catheter ablation after the CryoMaze procedure was safe and associated with higher freedom from AF/AT and improved clinical outcomes.

• MeSH
• antiarytmika terapeutické užití   MeSH
• fibrilace síní * diagnóza   chirurgie   farmakoterapie   MeSH
• katetrizační ablace * škodlivé účinky   metody   MeSH
• krvácení MeSH
• lidé MeSH
• recidiva MeSH
• supraventrikulární tachykardie * chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• randomizované kontrolované studie MeSH

Atrial high-rate episodes (AHRE) are atrial tachyarrhythmias detected by continuous rhythm monitoring by pacemakers, defibrillators, or implantable cardiac monitors. Atrial high-rate episodes occur in 10-30% of elderly patients without atrial fibrillation. However, it remains unclear whether the presence of these arrhythmias has therapeutic consequences. The presence of AHRE increases the risk of stroke compared with patients without AHRE. Oral anticoagulation would have the potential to reduce the risk of stroke in patients with AHRE but is also associated with a rate of major bleeding of ∼2%/year. The stroke rate in patients with AHRE appears to be lower than the stroke rate in patients with atrial fibrillation. Wearables like smart-watches will increase the absolute number of patients in whom atrial arrhythmias are detected. It remains unclear whether anticoagulation is effective and, equally important, safe in patients with AHRE. Two randomized clinical trials, NOAH-AFNET6 and ARTESiA, are expected to report soon. They will provide much-needed information on the efficacy and safety of oral anticoagulation in patients with AHRE.

• MeSH
• antikoagulancia terapeutické užití   MeSH
• cévní mozková příhoda * diagnóza   etiologie   prevence a kontrola   MeSH
• fibrilace síní * komplikace   diagnóza   farmakoterapie   MeSH
• lidé MeSH
• rizikové faktory MeSH
• senioři MeSH
• srdeční síně MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Recent data have suggested that insulin-requiring diabetes mostly contributes to the overall increase of thromboembolic risk in patients with atrial fibrillation (AF) on warfarin. We evaluated the prognostic role of a different diabetes status on clinical outcome in a large cohort of AF patients treated with edoxaban. METHODS: We accessed individual patients' data from the prospective, multicenter, ETNA-AF Europe Registry. We compared the rates of ischemic stroke/transient ischemic attack (TIA)/systemic embolism, myocardial infarction (MI), major bleeding and all-cause death at 2 years according to diabetes status. RESULTS: Out of an overall population of 13,133 patients, 2885 had diabetes (22.0%), 605 of whom (21.0%) were on insulin. The yearly incidence of ischemic stroke/TIA/systemic embolism was 0.86% in patients without diabetes, 0.87% in diabetic patients not receiving insulin (p = 0.92 vs no diabetes) and 1.81% in those on insulin (p = 0.002 vs no diabetes; p = 0.014 vs diabetes not on insulin). The annual rates of MI and major bleeding were 0.40%, 0.43%, 1.04% and 0.90%, 1.10% and 1.71%, respectively. All-cause yearly mortality was 3.36%, 5.02% and 8.91%. At multivariate analysis, diabetes on insulin was associated with a higher rate of ischemic stroke/TIA/systemic embolism [adjusted HR 2.20, 95% CI 1.37-3.54, p = 0.0011 vs no diabetes + diabetes not on insulin] and all-cause death [aHR 2.13 (95% CI 1.68-2.68, p < 0.0001 vs no diabetes]. Diabetic patients not on insulin had a higher mortality [aHR 1.32 (1.11-1.57), p = 0.0015], but similar incidence of stroke/TIA/systemic embolism, MI and major bleeding, vs those without diabetes. CONCLUSIONS: In a real-world cohort of AF patients on edoxaban, diabetes requiring insulin therapy, rather than the presence of diabetes per se, appears to be an independent factor affecting the occurrence of thromboembolic events during follow-up. Regardless of the diabetes type, diabetic patients had a lower survival compared with those without diabetes.

• MeSH
• antikoagulancia terapeutické užití   MeSH
• cévní mozková příhoda * epidemiologie   etiologie   prevence a kontrola   MeSH
• diabetes mellitus * farmakoterapie   epidemiologie   MeSH
• embolie * MeSH
• fibrilace síní * komplikace   farmakoterapie   epidemiologie   MeSH
• infarkt myokardu * komplikace   MeSH
• inzuliny * MeSH
• ischemická cévní mozková příhoda * MeSH
• krvácení chemicky indukované   epidemiologie   MeSH
• lidé MeSH
• prospektivní studie MeSH
• registrace MeSH
• tranzitorní ischemická ataka * MeSH
• tromboembolie * epidemiologie   etiologie   prevence a kontrola   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH

INTRODUCTION: Observational studies have shown low bleeding rates in patients with atrial fibrillation (AF) treated by left atrial appendage closure (LAAC); however, data from randomized studies are lacking. This study compared bleeding events among patients with AF treated by LAAC and nonvitamin K anticoagulants (NOAC). METHODS: The Prague-17 trial was a prospective, multicenter, randomized trial that compared LAAC to NOAC in high-risk AF patients. The primary endpoint was a composite of a cardioembolic event, cardiovascular death, and major and clinically relevant nonmajor bleeding (CRNMB) defined according to the International Society on Thrombosis and Hemostasis (ISTH). RESULTS: The trial enrolled 402 patients (201 per arm), and the median follow-up was 3.5 (IQR 2.6-4.2) years. Bleeding occurred in 24 patients (29 events) and 32 patients (40 events) in the LAAC and NOAC groups, respectively. Six of the LAAC bleeding events were procedure/device-related. In the primary intention-to-treat analysis, LAAC was associated with similar rates of ISTH major or CRNMB (sHR 0.75, 95% CI 0.44-1.27, p = 0.28), but with a reduction in nonprocedural major or CRNMB (sHR 0.55, 95% CI 0.31-0.97, p = 0.039). This reduction for nonprocedural bleeding with LAAC was mainly driven by a reduced rate of CRNMB (sHR for major bleeding 0.69, 95% CI 0.34-1.39, p = .30; sHR for CRNMB 0.43, 95% CI 0.18-1.03, p = 0.059). History of bleeding was a predictor of bleeding during follow-up. Gastrointestinal bleeding was the most common bleeding site in both groups. CONCLUSION: During the 4-year follow-up, LAAC was associated with less nonprocedural bleeding. The reduction is mainly driven by a decrease in CRNMB.

• MeSH
• antikoagulancia škodlivé účinky   MeSH
• cévní mozková příhoda * diagnóza   etiologie   prevence a kontrola   MeSH
• fibrilace síní * komplikace   diagnóza   farmakoterapie   MeSH
• krvácení chemicky indukované   MeSH
• lidé MeSH
• prospektivní studie MeSH
• síňové ouško * chirurgie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Pulsed field ablation is a novel nonthermal cardiac ablation modality using ultra-rapid electrical pulses to cause cell death by a mechanism of irreversible electroporation. Unlike the traditional ablation energy sources, pulsed field ablation has demonstrated significant preferentiality to myocardial tissue ablation, and thus avoids certain thermally mediated complications. However, its safety and effectiveness remain unknown in usual clinical care. METHODS: MANIFEST-PF (Multi-National Survey on the Methods, Efficacy, and Safety on the Post-Approval Clinical Use of Pulsed Field Ablation) is a retrospective, multinational, patient-level registry wherein patients at each center were prospectively included in their respective center registries. The registry included all patients undergoing postapproval treatment with a multielectrode 5-spline pulsed field ablation catheter to treat atrial fibrillation (AF) between March 1, 2021, and May 30, 2022. The primary effectiveness outcome was freedom from clinical documented atrial arrhythmia (AF/atrial flutter/atrial tachycardia) of ≥30 seconds on the basis of electrocardiographic data after a 3-month blanking period (on or off antiarrhythmic drugs). Safety outcomes included the composite of acute (<7 days postprocedure) and latent (>7 days) major adverse events. RESULTS: At 24 European centers (77 operators) pulsed field ablation was performed in 1568 patients with AF: age 64.5±11.5 years, female 35%, paroxysmal/persistent AF 65%/32%, CHA2DS2-VASc 2.2±1.6, median left ventricular ejection fraction 60%, and left atrial diameter 42 mm. Pulmonary vein isolation was achieved in 99.2% of patients. After a median (interquartile range) follow-up of 367 (289-421) days, the 1-year Kaplan-Meier estimate for freedom from atrial arrhythmia was 78.1% (95% CI, 76.0%-80.0%); clinical effectiveness was more common in patients with paroxysmal AF versus persistent AF (81.6% versus 71.5%; P=0.001). Acute major adverse events occurred in 1.9% of patients. CONCLUSIONS: In this large observational registry of the postapproval clinical use of pulsed field technology to treat AF, catheter ablation using pulsed field energy was clinically effective in 78% of patients with AF.

• MeSH
• fibrilace síní * diagnóza   chirurgie   farmakoterapie   MeSH
• flutter síní * etiologie   MeSH
• funkce levé komory srdeční MeSH
• katetrizační ablace * škodlivé účinky   metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• recidiva MeSH
• registrace MeSH
• retrospektivní studie MeSH
• senioři MeSH
• tepový objem MeSH
• venae pulmonales * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Atrial fibrillation is common in patients with structural heart disease who are undergoing cardiac surgery. Surgical CryoMaze has been shown to be an effective treatment in several trials, but success rates have varied considerably, between 47-95%. The sequential hybrid approach, combining surgical CryoMaze followed by radiofrequency catheter ablation, can achieve high freedom from atrial arrhythmias. However, in patients with concomitant surgical atrial fibrillation treatment, data comparing the hybrid approach to CryoMaze alone are lacking. METHODS: The SurHyb study was designed as a prospective, open-label, multicentre randomized trial. Patients with non-paroxysmal atrial fibrillation who were scheduled for coronary artery bypass grafting or valve repair/replacement were randomized to either surgical CryoMaze alone or surgical CryoMaze followed by radiofrequency catheter ablation 3 months post-surgery. The primary outcome measure was arrhythmia-free survival without class I or III antiarrhythmic drugs, which has been evaluated using implantable cardiac monitors. CONCLUSIONS: This is the first randomized study that compares concomitant surgical CryoMaze alone with the staged hybrid surgical CryoMaze followed by catheter ablation, in patients with non-paroxysmal atrial fibrillation using rigorous rhythm monitoring. The results may contribute to the optimization of the treatment in patients undergoing concomitant CryoMaze for atrial fibrillation.

• MeSH
• antiarytmika terapeutické užití   MeSH
• fibrilace síní * chirurgie   farmakoterapie   MeSH
• kardiochirurgické výkony * metody   MeSH
• katetrizační ablace * metody   MeSH
• lidé MeSH
• multicentrické studie jako téma MeSH
• prospektivní studie MeSH
• randomizované kontrolované studie jako téma MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• protokol klinické studie MeSH

Překlad zkráceného dokumentu připravený Českou kardiologickou společnostíLyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, Moura B, Salinger SS, Stephens R, Suter TM, Szmit S, Tamargo J, Thavendiranathan P, Tocchetti CG, van der Meer P, van der Pal HJH; ESC Scientific Document Group.

Translation of the shortened document prepared by the Czech Society of Cardiology)Lyon AR, López-Fernández T, Couch LS, Asteggiano R, Aznar MC, Bergler-Klein J, Boriani G, Cardinale D, Cordoba R, Cosyns B, Cutter DJ, de Azambuja E, de Boer RA, Dent SF, Farmakis D, Gevaert SA, Gorog DA, Herrmann J, Lenihan D, Moslehi J, Moura B, Salinger SS, Stephens R, Suter TM, Szmit S, Tamargo J, Thavendiranathan P, Tocchetti CG, van der Meer P, van der Pal HJH; ESC Scientific Document Group.

• Klíčová slova
• kardioonkologie,
• MeSH
• antitumorózní látky škodlivé účinky   terapeutické užití   MeSH
• antracykliny škodlivé účinky   terapeutické užití   MeSH
• fibrilace síní chemicky indukované   farmakoterapie   prevence a kontrola   terapie   MeSH
• inhibitory kontrolních bodů škodlivé účinky   terapeutické užití   MeSH
• kardiovaskulární nemoci * chemicky indukované   farmakoterapie   prevence a kontrola   terapie   MeSH
• lidé MeSH
• mnohočetný myelom farmakoterapie   komplikace   terapie   MeSH
• nádory srdce diagnóza   klasifikace   terapie   MeSH
• nádory * farmakoterapie   komplikace   terapie   MeSH
• nemoci srdce chemicky indukované   farmakoterapie   prevence a kontrola   terapie   MeSH
• rizikové faktory kardiovaskulárních chorob MeSH
• směrnice pro lékařskou praxi jako téma MeSH
• srdeční arytmie chemicky indukované   farmakoterapie   klasifikace   prevence a kontrola   terapie   MeSH
• žilní tromboembolie chemicky indukované   farmakoterapie   prevence a kontrola   terapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH