Filip Ađić

Introduction. Single-chamber and dual-chamber pacemakers are used for the treatment of bradycardia. Dual-chamber pacemakers more closely replicate physiological cardiac function by preserving atrioventricular synchrony, whereas single-chamber pacemakers are less complex, more cost-effective, and easier to implant. Clinical trials comparing these two pacing modalities have reported inconsistent results, largely depending on the studied population and study design. The AQUAREL questionnaire is a disease-specific instrument designed to assess life quality of life in patients with pacemakers. The aim of this study was to compare the quality of life of patients with single-chamber and dual-chamber pacemakers using the AQUAREL questionnaire. Material and Methods. After providing informed consent, 80 patients treated at the Institute for Cardiovascular Diseases of Vojvodina completed the AQUAREL questionnaire. Inclusion criteria were age ?60 years and implantation of either a single or dual-chamber pacemaker. These criteria were met by 69 patients, including 33 with single-chamber and 36 with dual-chamber pacemakers. Data were obtained from the Institute?s digital medical record. Statistical analysis was performed using standard methods. Results. The mean age of the patients was 76 years; 42 participants (63.77%) were male, and 92.75% had at least one comorbidity. Analysis of AQUAREL questionnaire scores revealed no statistically significant differences in overall quality of life between patients with single-chamber and dual-chamber pacemakers. Conclusion. Although patients with dual-chamber pacemakers reported fewer severe symptoms compared with those with single-chamber pacemakers, the difference was not statistically significant. Overall, no significant difference in quality of life was observed between patients according to pacemaker type.

In participants with stable chest pain referred for invasive coronary angiography, those with a coronary artery calcium score of 0 at CT had very low, while higher scores had increasing occurrence ... Background Coronary artery calcium (CAC) has prognostic value for major adverse cardiovascular events (MACE) in asymptomatic individuals, whereas its role in symptomatic patients is less clear. Pur...

Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019. Adult patients with stable chest pain and a CAD pretest probability of 10%-60% were randomly assigned to undergo initial CT or ICA. The primary end point was major adverse cardiovascular events (MACE), including cardiovascular death, nonfatal myocardial infarction, or stroke. The secondary end point was an expanded MACE composite, including transient ischemic attack, and major procedure-related complications. Competing risk analyses were performed using the Fine and Gray subdistribution Cox proportional hazard model to assess the impact of the relationship between BMI and initial management with CT or ICA on the study outcomes, whereas noncardiovascular death and unknown causes of death were considered competing risk events. Results Among the 3457 participants included, 831 (24.0%), 1358 (39.3%), and 1268 (36.7%) had a BMI of less than 25, between 25 and 30, and greater than 30 kg/m², respectively. No interaction was found between CT or ICA and BMI for MACE (P = .29), the expanded MACE composite (P = .38), or major procedure-related complications (P = .49). Across all BMI subgroups, expanded MACE composite events (CT, 10 of 409 [2.4%] to 23 of 697 [3.3%]; ICA, 26 of 661 [3.9%] to 21 of 422 [5.1%]) and major procedure-related complications during initial management (CT, one of 638 [0.2%] to five of 697 [0.7%]; ICA, nine of 630 [1.4%] to 12 of 422 [2.9%]) were less frequent in the CT versus ICA group. Participants with a BMI exceeding 30 kg/m² exhibited a higher nondiagnostic CT rate (7.1%, P = .044) compared to participants with lower BMI. Conclusion There was no evidence of a difference in outcomes between CT and ICA across the three BMI subgroups. Clinical trial registration no. NCT02400229 © RSNA, 2024 Supplemental material is available for this article.