Patients suffering acute coronary syndrome have a very high risk for a repeated syndrome. After stabilization of acute coronary syndrome and discharge of a patient it is important to educate the patient how to prevent it in the future (dietary and life style changes), but treatment of all cardiovascular risk factors/diseases, as hypertension, dyslipidemia, diabetes but stabilization of all cardiovascular diseases is also important. Important is also antithrombotic treatment (mostly double antiplatelet treatment when percutaneous coronary intervention was used with a coronary stents), RAAS blockers, betablockers and statins (strong as atorvastatin and rosuvastatin in the highest possible dose). There are also new risk factors, and vascular inflammation belongs here. We have nowadays also some successful clinical studies how to block inflammation and how to use this treatment. A good secondary cardiovascular prevention is able to improve enourmously prognosis of these patients.

• Klíčová slova
• acute coronary syndrome, cardiovascular risk factors, secondary cardiovascular prevention, vascular inflammation,
• MeSH
• akutní koronární syndrom * prevence a kontrola   MeSH
• atorvastatin MeSH
• dyslipidemie * MeSH
• koronární angioplastika * MeSH
• lidé MeSH
• sekundární prevence MeSH
• statiny * terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• atorvastatin MeSH
• statiny * MeSH

BACKGROUND AND OBJECTIVE: Recommendations for preventing cardiovascular (CV) disease are currently separated into primary and secondary prevention. We hypothesize that relative effects of interventions for CV prevention are not different across primary and secondary prevention cohorts. Our aim was to test for differences in relative effects on CV events in common preventive CV interventions across primary and secondary prevention cohorts. METHODS AND RESULTS: A systematic search was performed to identify individual patient data (IPD) meta-analyses that included both primary and secondary prevention populations. Eligibility assessment, data extraction, and risk of bias assessment were conducted independently and in duplicate. We extracted relative risks (RR) with 95% confidence intervals (95% CI) of the interventions over patient-important outcomes and estimated the ratio of RR for primary and secondary prevention populations. We identified five eligible IPDs representing 524,570 participants. Quality assessment resulted in overall low-to-moderate methodological quality. We found no subgroup effect across prevention categories in any of the outcomes assessed. CONCLUSION: In the absence of significant treatment-subgroup interactions between primary and secondary CV prevention cohorts for common preventive interventions, clinical practice guidelines could offer recommendations tailored to individual estimates of CV risk without regard to membership to primary and secondary prevention cohorts. This would require the development of reliable ASCVD risk estimators that apply across both cohorts.

• Klíčová slova
• Cardiovascular prevention, Prevention, Primary, Secondary prevention, Subgroup analysis, Systematic review,
• MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• primární prevence metody   normy   MeSH
• sekundární prevence metody   normy   MeSH
• směrnice pro lékařskou praxi jako téma * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• systematický přehled MeSH

AIMS: Prevention guidelines have identified the management of obese patients as an important priority to reduce the burden of incident and recurrent cardiovascular disease. Still, studies have demonstrated that over 80% of patients with coronary heart disease (CHD) fail to achieve their weight target. Here, we describe advice received and actions reported by overweight CHD patients since being discharged from hospital and how weight changes relate to their risk profile. METHODS AND RESULTS: Based on data from 10 507 CHD patients participating in the EUROASPIRE IV and V studies, we analysed weight changes from hospital admission to the time of a study visit ≥6 and <24 months later. At hospitalization, 34.9% were obese and another 46.0% were overweight. Obesity was more frequent in women and associated with more comorbidities. By the time of the study visit, 19.5% of obese patients had lost ≥5% of weight. However, in 16.4% weight had increased ≥5%. Weight gain in those overweight was associated with physical inactivity, non-adherence to dietary recommendations, smoking cessation, raised blood pressure, dyslipidaemia, dysglycaemia, and lower levels of quality of life. Less than half of obese patients was considering weight loss in the coming month. CONCLUSIONS: The management of obesity remains a challenge in the secondary prevention of CHD despite a beneficial effect of weight loss on risk factor prevalences and quality of life. Cardiac rehabilitation programmes should include weight loss interventions as a specific component and the incremental value of telehealth intervention as well as recently described pharmacological interventions need full consideration.

• Klíčová slova
• Coronary heart disease, Obesity, Secondary prevention,
• MeSH
• hmotnostní úbytek MeSH
• koronární nemoc * komplikace   epidemiologie   prevence a kontrola   MeSH
• kvalita života MeSH
• lidé MeSH
• nadváha * MeSH
• obezita komplikace   epidemiologie   terapie   MeSH
• sekundární prevence metody   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

The article discusses the effect of vitamin D on primary and secondary prevention of fractures and its effect on conditions after selected orthopaedic procedures. Fractures can be divided into traumatic, fatigue and pathological according to the cause. One of the complications of fracture is the formation of a nonunion. In addition to dealing with fractures, a total joint replacement is another common procedure in orthopaedic surgery. Because insufficient muscle strength can increase the risk of falls and thus result in a fracture, these topics are also mentioned in this article. Due to the impact of vitamin D deficiency on various musculoskeletal disorders, orthopaedic surgeons should pay more attention to the patients vitamin D status and be familiar with different strategies for preventing hypovitaminosis D, although clear evidence-based medical recommendations are still insufficient.

• Klíčová slova
• fracture, orthopaedics, osteoporosis, total joint replacement, vitamin, vitamin D,
• MeSH
• fraktury kostí * MeSH
• lidé MeSH
• nedostatek vitaminu D * prevence a kontrola   MeSH
• ortopedie * MeSH
• sekundární prevence MeSH
• vitamin D terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• vitamin D MeSH

BACKGROUND: The subcutaneous implantable defibrillator (S-ICD) provides an alternative to the transvenous ICD for the prevention of sudden cardiac death, but has not been well studied in the most commonly treated transvenous ICD patient population, namely, primary prevention (PP) patients with left ventricular dysfunction. OBJECTIVE: The analyses in the present study were designed to compare clinical outcomes for PP patients with and without a reduced ejection fraction (EF) and secondary prevention (SP) patients implanted with the S-ICD. METHODS: All patients 18 years and older from the S-ICD IDE study and the EFFORTLESS Registry with available data as of November 18, 2013, were included (n = 856; mean follow-up duration 644 days). Outcomes were evaluated in 2 analyses: (1) comparing all PP patients (n = 603, 70.4%) with all SP patients (n = 253, 29.6%) and (2) comparing all PP patients with an EF ≤35% (n = 379) with those with an EF >35% (n = 149, 17.4%). RESULTS: No differences were observed in mortality, complications, inappropriate therapy, or ability to convert ventricular tachyarrhythmias between SP and PP patients. However, SP patients had a higher incidence of appropriate therapy than did PP patients (11.9% vs 5.0%; P = .0004). In the PP subanalysis, the cohort with an EF ≤35% had significantly older patients with more comorbidities and higher mortality (3.0% annually vs 0.0%). Despite these differences, device-related complications, conversion efficacy, and incidence of inappropriate shock therapies were not significantly different between PP subgroups. CONCLUSION: The S-ICD performs well in protecting patients with either PP or SP implant indications from sudden cardiac death. Within PP patients, device performance was independent of EF.

• Klíčová slova
• Appropriate shock, Ejection fraction, Primary prevention, Secondary prevention, Subcutaneous ICD,
• MeSH
• defibrilátory implantabilní * MeSH
• dospělí MeSH
• dysfunkce levé srdeční komory * diagnóza   patofyziologie   MeSH
• elektrická defibrilace * škodlivé účinky   přístrojové vybavení   metody   MeSH
• Kaplanův-Meierův odhad MeSH
• komorová tachykardie * mortalita   terapie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhlá srdeční smrt prevence a kontrola   MeSH
• primární prevence metody   statistika a číselné údaje   MeSH
• protetické vybavení MeSH
• registrace MeSH
• sekundární prevence metody   statistika a číselné údaje   MeSH
• senioři MeSH
• tepový objem MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Lung cancer (LC) is one of the most frequently diagnosed cancers and one of the leading causes of cancer deaths in the Czech Republic, the prevalence of which is steadily increasing. There is scientific evidence that LC screening through low-dose computed tomography (LDCT) reduces the risk of death from LC. No systematic LC screening strategy has been currently in place in the Czech Republic. Since the beginning of 2022, the methodology of early detection of LC using LDCT has been piloted to test the feasibility of the screening program. The primary purpose of the project is an early and accurate diagnosis of the disease, which, in combination with follow-up treatment, will lead to a reduction in LC mortality. The pilot data will definitely serve as a basis for an expert discussion of the acceptability of the program to the Czech population and its impact on the healthcare system. It is clear that by introducing such a screening program, we will join the countries that, based on scientific data, enable the population to profit from an actively implemented LC prevention strategy. Public awareness of the benefits of early non-invasive LC detection can contribute to higher compliance of at-risk persons and their willingness to participate in the program. The key role in the entire process is played by general practitioners and/or outpatient pulmologists who address at-risk individuals and can positively influence their involvement in the program.

• Klíčová slova
• low-dose CT, lung cancer, mass screening, screening, secondary prevention,
• MeSH
• časná detekce nádoru metody   MeSH
• lidé MeSH
• nádory plic * diagnostické zobrazování   epidemiologie   MeSH
• plošný screening MeSH
• počítačová rentgenová tomografie MeSH
• sekundární prevence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika epidemiologie   MeSH

OBJECTIVES: It is evident that patients with atherosclerotic vascular disease (AVD) benefit from appropriate secondary prevention. In clinical reality, the secondary prevention in AVD patients other than those with coronary heart disease (CHD) is often overlooked. Therefore, we compared the adherence to secondary prevention principles between poststroke and CHD patients. STUDY DESIGN: Descriptive (cross-sectional) study with prospective mortality follow-up. METHODS: We examined 1729 chronic patients with AVD (mean age 65.9 (±SD 9.6) years), 964 with CHD, and 765 poststroke (pooled data of Czech samples of EUROASPIRE III, IV, and the ESH stroke survey). The interview was performed 6-36 months after the coronary event/revascularization or the first ischemic stroke, while the mortality follow-up 5 years after this interview. RESULTS: Poststroke patients had a significantly higher risk of persistent smoking, blood pressure ≥140/90 mmHg and LDL ≥2.5 mmol/L than CHD patients [odds ratios adjusted for age, gender and survey were 1.63 (95% CI: 1.13-2.33), 1.38 (95% CI: 1.13-1.69) and 2.26 (95% CI: 1.84-2.78), respectively]. In contrast, poststroke patients showed a lower risk of inappropriate glucose control and hypertriglyceridemia [0.66 (95%CI: 0.54-0.82) and 0.74 (95%CI: 0.61-0.91), respectively]. The prescription rates of antiplatelets/anticoagulants, antihypertensives and statins were also significantly lower in poststroke than in CHD patients (89.4 vs 93.7, 85.9 vs 97.5, and 57.7 vs 89.8, respectively). Mortality analysis was performed in a subsample of 815 subjects interviewed in 2006/07. The 5-year all-cause mortality rates were 25.8% and 13.3% in poststroke and coronary patients, respectively (P = 0.0023); the hazard ratio for stroke adjusted for major risk factors was 1.85 (95% CI: 1.31-2.63). CONCLUSIONS: Compared to CHD patients, poststroke patients are strongly handicapped in terms of poor adherence to secondary prevention target, prescription of basic pharmacotherapies and mortality risk.

• Klíčová slova
• Coronary heart disease, ESH stroke survey, EUROASPIRE, Ischemic stroke, Secondary prevention,
• MeSH
• adherence pacienta statistika a číselné údaje   MeSH
• antihypertenziva terapeutické užití   MeSH
• antikoagulancia terapeutické užití   MeSH
• cévní mozková příhoda prevence a kontrola   MeSH
• inhibitory agregace trombocytů terapeutické užití   MeSH
• koronární nemoc prevence a kontrola   MeSH
• krevní tlak MeSH
• lidé středního věku MeSH
• lidé MeSH
• proporcionální rizikové modely MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• sekundární prevence * MeSH
• senioři MeSH
• statiny terapeutické užití   MeSH
• zdravotnické přehledy MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Československo MeSH
• Názvy látek
• antihypertenziva MeSH
• antikoagulancia MeSH
• inhibitory agregace trombocytů MeSH
• statiny MeSH

INTRODUCTION: Hormone changes during pregnancy lead to increased plasma lipid levels. When there is added disorder of lipid metabolism, this otherwise physiological change can cause extremely high triglyceride levels with potentionally life-threatening complications, such as non-biliary acute pancreatitis. MATERIALS AND METHODS: We present a case report of a 27-year-old pregnant woman with familial hyperchylomicronemia and a history of 7 hypertriglyceridemia-induced acute pancreatitis attacks. Three attacks occured during her first pregnancy with the last one leading to its termination at 33 weeks owing to the death of the fetus. During her second pregnancy, standard treatment was not able to lower the triglyceride levels sufficiently and she suffered another acute pancreatitis attack. Therapeutic plasma exchange was therefore chosen as the treatment method. RESULTS AND CONCLUSION: Plasma exchange was succesful in the secondary prevention of acute pancreatitis attack and she delivered a healthy baby at 36 weeks of gestation. Treatment was very well tolerated by the mother and the fetus and this supports the use of apheresis as a safe and efficient method in tackling gestational hypertriglyceridemia.

• Klíčová slova
• acute pancreatitis, hypertriglyceridemia, pregnancy, therapeutic plasma exchange,
• MeSH
• dospělí MeSH
• hypertriglyceridemie krev   prevence a kontrola   terapie   MeSH
• komplikace těhotenství krev   terapie   MeSH
• lidé MeSH
• pankreatitida krev   prevence a kontrola   terapie   MeSH
• sekundární prevence MeSH
• těhotenství MeSH
• třetí trimestr těhotenství MeSH
• výměna plazmy * MeSH
• výsledek těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Although cardiovascular disease mortality rates seem to decline, especially among middle-aged people in developed countries, the prevalence of acute coronary syndrome (ACS) increases, representing the most common cause of morbidity in both developed and developing countries and generating large economic burden. It is estimated that one fifth of the ACS patients die suddenly and half of them belong to a fast growing popula- tion age-group, i.e., those between 70 and .80 years. A substantial number of these deaths has been attributed to various lifestyles, modifiable factors; therefore, it can be prevented. However, factors such as dietary habits and behaviours, physical activity, life stress and smoking habits, although thoroughly discussed, are not well understood and appreciated in the spectrum of secondary ACS prevention. The latter deserves further attention under the prism of socio-economic status that has changed dramatically in the last years in some populations. The aim of this review was to discuss the role of lifestyle factors on secondary ACS prevention under the prism of individual's socio-economic status. Based on the retrieved information it was revealed that there is vast evidence that secondary prevention of cardiovascular events cannot be accomplished simply through medical treatment, but it requires a multifaceted approach incorporating lifestyle modifications, too. Therefore, public health policy endeavours should be directed towards multifocal strategies, i.e., to motivate and support cardiac patients to consistently follow treatment regimens and to establish more effective and efficient community lifestyle interventions.

• MeSH
• akutní koronární syndrom prevence a kontrola   MeSH
• celosvětové zdraví MeSH
• cvičení MeSH
• dieta MeSH
• kouření MeSH
• lidé MeSH
• pití alkoholu MeSH
• rizikové faktory MeSH
• sekundární prevence metody   MeSH
• sociální determinanty zdraví * MeSH
• socioekonomické faktory MeSH
• zdravé chování MeSH
• životní styl * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: Despite individual recommendations on osteoporosis management in patients after hip fracture surgery, addressed by orthopedic surgeons to Czech general practitioners, the patients remained undiagnosed and untreated because of provider-level barriers to post-fracture secondary prevention. PURPOSE: The goal of the study was to assess whether an individual recommendation on osteoporosis treatment addressed to a hip fracture patient's GP would lead to better osteoporosis management. METHODS: Two groups of patients who suffered hip fractures and were treated at the Orthopedic Department were evaluated. In 111 patients, general recommendations on osteoporosis treatment and fracture prevention were provided in a discharge report addressed to the GP. In the second group, 96 patients were provided individually with a detailed written set of recommendations on osteoporosis examination, treatment, and fracture prevention, which was also provided in the discharge report. A questionnaire to assess the provided care was mailed to the patients 5.3 ± 1.2 months of discharge. Those patients who did not return the questionnaires were contacted by phone. RESULTS: The questionnaires were received from 44% and 49% of patients from the general and detailed recommendation groups, respectively. Along with the phone call, we were able to contact 78 (70.3%) and 68 (70.8%) patients from the general and detailed recommendation groups, respectively. GPs secured osteoporosis evaluation in 14.6% of the patients. Calcium supplementation and vitamin D supplementation were newly provided in 42.7 and 36.4% of the patients, respectively. Anti-resorptive therapy was newly provided in 8.3% of the patients. No significant differences between the groups were observed in osteoporosis evaluation, calcium and vitamin D supplementation, and anti-osteoporosis treatments. Out of 207 patients, further examination or treatment was requested by 45 patients (21.7%); 75 patients (36.2%) declared no interest in further care. CONCLUSION: Recommendations on osteoporosis management addressed to Czech GPs after surgical fracture management had little effect on treatment. As the anti-osteoporotic preparations can only be prescribed by specialists, the availability of necessary examinations and treatment is limited by the motivation of GPs. Consequently, the implementation of Fracture Liaison Services to help close the care gap may be limited in the absence of participation by Czech GPs.

• Klíčová slova
• Fracture Liaison Services, Hip fracture, Osteoporosis,
• MeSH
• fraktury kyčle prevence a kontrola   chirurgie   MeSH
• kooperační chování MeSH
• lidé středního věku MeSH
• lidé MeSH
• osteoporotické fraktury prevence a kontrola   MeSH
• osteoporóza komplikace   terapie   MeSH
• pooperační období MeSH
• potravní doplňky statistika a číselné údaje   MeSH
• praktické lékařství metody   MeSH
• průzkumy a dotazníky MeSH
• sekundární prevence metody   MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• Geografické názvy
• Česká republika MeSH