1. Structured stillbirth management in Slovenia : outcomes and comparison with international guidelinesMaja Dolanc Merc, Tanja Premru-Sršen, 2026, drugi znanstveni članki Povzetek: Background: Stillbirth remains a major public health issue with long-lasting psychological impacts. Despite advancements in prenatal diagnostics, many stillbirths remain unexplained. Slovenia has implemented a structured, centralized algorithm for stillbirth investigation and care. Content: This mini-review analyzes a decade of clinical data (2013-2023) from the Department of Perinatology at University Medical Centre Ljubljana (UMC Ljubljana), assessing the outcomes of Slovenia's stillbirth management algorithm. The Slovenian approach is also compared with international guidelines from ACOG, RCOG, CNGOF, PSANZ, SOGC, and FOGSI. Slovenia reports one of the lowest stillbirth rates in Europe - 2 per 1,000 births at ≥24 weeks and 1.4 per 1,000 at ≥28 weeks. At UMC Ljubljana, fetal death rates remained stable between 0.4 % and 0.6 %. The structured algorithm includes maternal history, laboratory testing, placental and fetal pathology, and genetic evaluation. Active induction is preferred over expectant management, and routine TORCH screening and centralized committee oversight are emphasized. Summary: Slovenia's structured, algorithm-based system has led to notably low stillbirth rates, supported by uniform clinical care and systematic investigations. Although Slovenia's experience is encouraging, these results derive from a single-center national registry without comparative cohort analysis, limiting attribution of outcomes to specific elements of the algorithm. Outlook: Future progress will involve the expansion of WES access and full ICD-PM implementation by 2027, enhancing data comparability and facilitating broader international research.
Ključne besede: Slovenia, international guidelines, investigation algorithm, perinatal mortality, stillbirth, structured care
Objavljeno v DiRROS: 08.05.2026; Ogledov: 42; Prenosov: 16
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2. The impact of long-term adherence to guideline-directed medical therapy on outcomes in peripheral artery diseaseTjaša Furlan, Janez Bijec, Petra Došenović Bonča, Irena Ograjenšek, Borut Jug, 2026, drugi znanstveni članki Ključne besede: hospitals, health institutions, health care, mortality, health economics
Objavljeno v DiRROS: 04.05.2026; Ogledov: 77; Prenosov: 30
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3. Left bundle branch area pacing vs right ventricular pacing for atrioventricular block : the MELOS RELOADED studyMarek Jastrzębski, Grzegorz Kiełbasa, Oscar Cano, Karol Curila, Francesco Zanon, David Žižek, 2026, izvirni znanstveni članek Povzetek: Background and Aims: Left bundle branch area pacing (LBBAP) promotes physiological synchronous activation of the left ventricle and may be particularly beneficial in patients with atrioventricular block (AVB), but its mortality benefit remains unclear. This study aims to compare long-term survival in AVB patients receiving either LBBAP or right ventricular pacing (RVP) and to analyse predictors of mortality during LBBAP. Methods: MELOS RELOADED, a multicentre European collaboration, was a registry-based study of pacemaker patients with AVB, left ventricular ejection fraction (LVEF) >40% and ventricular pacing >20%. The primary outcome was all-cause mortality based on national registries. A 1:1 propensity score matching was performed between the RVP and LBBAP groups. Kaplan–Meier curves and multivariable Cox proportional hazards models were used to estimate survival. Results: In total, 3382 patients receiving LBBAP or RVP were matched. At 4-year follow-up, the Kaplan–Meier curve showed an absolute difference in survival of 11.8% in favour of LBBAP (P < .001). LBBAP was a robust predictor of reduced mortality with a hazard ratio (HR) of 0.53 (95% confidence interval 0.42–0.65, P < .001). Within the LBBAP group, the following independent predictors of increased mortality were identified: lack of confirmed left bundle branch capture (HR 1.85, P < .001), lower percentage of ventricular pacing (HR 1.12), and age. Conclusions: This is the first large study demonstrating the long-term survival benefit of LBBAP. This strengthens the use of LBBAP in AVB patients with preserved/mildly reduced LVEF while awaiting the results of randomized trials. Confirmation of left bundle branch capture seems advisable to achieve optimal results with LBBAP.
Ključne besede: conduction system pacing, left bundle branch area pacing, atrioventricular block, mortality, heart failure
Objavljeno v DiRROS: 10.04.2026; Ogledov: 230; Prenosov: 123
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4. 30-day morbidity and mortality after cholecystectomy for benign gallbladder disease (AMBROSE) : a prospective, international collaborative cohort studyGeoffrey Yuet Mun Wong, Himanshu Wadhawan, Victor Roth Cardoso, Laura Bravo Merodio, Yashasvi Rajeev, Ricardo David Maldonado, Alessandro Martinino, Vignesh Balasubaramaniam, Ashraf Aabid, Adeela Siddiqui, 2025, izvirni znanstveni članek Ključne besede: benign gallbladder disease, cholecystectomy, morbidity, mortality
Objavljeno v DiRROS: 09.04.2026; Ogledov: 133; Prenosov: 63
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6. Impact of smoking status on mortality in STEMI patients undergoing mechanical reperfusion for STEMI : insights from the ISACS–STEMI COVID-19 registryGiuseppe De Luca, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Čerček, 2022, izvirni znanstveni članek Povzetek: The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS–STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.
Ključne besede: myocardial infarction, smoking paradox, percutaneous coronary intervention, COVID-19, mortality
Objavljeno v DiRROS: 31.03.2026; Ogledov: 184; Prenosov: 76
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7. The burden of ageing : old age, poverty, and attitudes toward social issues in the 19th-century Austrian LittoralUrška Bratož, 2026, samostojni znanstveni sestavek ali poglavje v monografski publikaciji Povzetek: The paper examines attitudes toward ageing and the elderly in Istria and Trieste in the second half of the nineteenth century. It takes as its starting point the perceptions associated with old age, which in the nineteenth century inevitably included, on the one hand, the inability to work—often leading to the economic dependence of the elderly and to their being regarded as a burden on the family or the state—and, on the other hand, their physical frailty, whether biologically or socially conditioned, which could to some extent be both a cause and a symptom of their social deprivation. Elderly people can be traced among the residents of almshouses and recipients of poor relief, among patients in hospitals for infectious diseases, and among those who died of age related wasting. Medical imperatives directed at the elderly were tailored primarily to the bourgeoisie and stood in stark contrast to the actual experience of ageing among the lower classes, which could not be associated with rest and self care but rather with prolonged physical labour, bodily pain, and economic insecurity.
Ključne besede: diseases, old age, mortality, poverty, social measures, Trieste, Istria, 19th century
Objavljeno v DiRROS: 31.03.2026; Ogledov: 166; Prenosov: 142
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8. Renin-angiotensin system inhibitors and mortality among diabetic patients with STEMI undergoing mechanical reperfusion during the COVID-19 pandemicGiuseppe De Luca, Matteo Nardin, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, 2021, izvirni znanstveni članek Povzetek: Background: During the coronavirus disease 2019 (COVID-19) pandemic, concerns have been arisen on the use of renin-angiotensin system inhibitors (RASI) due to the potentially increased expression of Angiotensinconverting-enzyme (ACE)2 and patient’s susceptibility to SARS-CoV2 infection. Diabetes mellitus have been recognized favoring the coronavirus infection with consequent increase mortality in COVID-19. No data have been so far reported in diabetic patients suffering from ST-elevation myocardial infarction (STEMI), a very high-risk population deserving of RASI treatment. Methods: The ISACS-STEMI COVID-19 registry retrospectively assessed STEMI patients treated with primary percutaneous coronary intervention (PPCI) in March/June 2019 and 2020 in 109 European high-volume primary PCI centers. This subanalysis assessed the prognostic impact of chronic RASI therapy at admission on mortality and SARS-CoV2 infection among diabetic patients. Results: Our population is represented by 3812 diabetic STEMI patients undergoing mechanical reperfusion, 2038 in 2019 and 1774 in 2020. Among 3761 patients with available data on chronic RASI therapy, between those ones with and without treatment there were several differences in baseline characteristics, (similar in both periods) but no difference in the prevalence of SARS-CoV2 infection (1.6% vs 1.3%, respectively, p = 0.786). Considering in-hospital medication, RASI therapy was overall associated with a significantly lower in-hospital mortality (3.3% vs 15.8%, p < 0.0001), consistently both in 2019 and in 2010. Conclusions: This is first study to investigate the impact of RASI therapy on prognosis and SARS-CoV2 infection of diabetic patients experiencing STEMI and undergoing PPCI during the COVID-19 pandemic. Both preadmission chronic RASI therapy and in-hospital RASI did not negatively affected patients’ survival during the hospitalization, neither increased the risk of SARS-CoV2 infection.
Ključne besede: RAAS inhiibitors, mortality, diabetes, STEMI, COVID-19
Objavljeno v DiRROS: 24.03.2026; Ogledov: 244; Prenosov: 160
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9. Gender difference in the effects of COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI : results of the ISACS-STEMI COVID-19 registryGiuseppe De Luca, Stephane Manzo-Silberman, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Oliver Busljetik, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, 2023, izvirni znanstveni članek Povzetek: Background. Several reports have demonstrated the impact of the COVID-19 pandemic on the management and outcome of patients with ST-segment elevation myocardial infarction (STEMI). The aim of the current analysis is to investigate the potential gender difference in the effects of the COVID-19 pandemic on mechanical reperfusion and 30-day mortality for STEMI patients within the ISACS-STEMI COVID-19 Registry. Methods. This retrospective multicenter registry was performed in high-volume primary percutaneous coronary intervention (PPCI) centers on four continents and included STEMI patients undergoing PPCIs in March–June 2019 and 2020. Patients were divided according to gender. The main outcomes were the incidence and timing of the PPCI, (ischemia time ≥ 12 h and door-to-balloon ≥ 30 min) and in-hospital or 30-day mortality. Results. We included 16683 STEMI patients undergoing PPCIs in 109 centers. In 2020 during the pandemic, there was a significant reduction in PPCIs compared to 2019 (IRR 0.843 (95% CI: 0.825–0.861, p < 0.0001). We did not find a significant gender difference in the effects of the COVID-19 pandemic on the numbers of STEMI patients, which were similarly reduced from 2019 to 2020 in both groups, or in the mortality rates. Compared to prepandemia, 30-day mortality was significantly higher during the pandemic period among female (12.1% vs. 8.7%; adjusted HR [95% CI] = 1.66 [1.31–2.11], p < 0.001) but not male patients (5.8% vs. 6.7%; adjusted HR [95% CI] = 1.14 [0.96–1.34], p = 0.12). Conclusions. The COVID-19 pandemic had a significant impact on the treatment of patients with STEMI, with a 16% reduction in PPCI procedures similarly observed in both genders. Furthermore, we observed significantly increased in-hospital and 30-day mortality rates during the pandemic only among females.
Ključne besede: gender, COVID-19, mortality, STEMI
Objavljeno v DiRROS: 24.03.2026; Ogledov: 222; Prenosov: 121
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10. Presentation, care, and outcomes of patients with NSTEMI according to World Bank country income classification : the ACVC-EAPCI EORP NSTEMI Registry of the European Society of CardiologyRamesh Nadarajah, Peter Ludman, Cécile Laroche, Yolande Appelman, Salvatore Brugaletta, Andrzej J Budaj, Héctor Bueno, Kurt Huber, Vijay Kunadian, Sergio Leonardi, Maddalena Lettino, 2023, izvirni znanstveni članek Povzetek: Background The majority of NSTEMI burden resides outside high-income countries (HICs). We describe presentation, care, and outcomes of NSTEMI by country income classification. Methods and results Prospective cohort study including 2947 patients with NSTEMI from 287 centres in 59 countries, stratified by World Bank country income classification. Quality of care was evaluated based on 12 guideline-recommended care interventions. The all-or-none scoring composite performance measure was used to define receipt of optimal care. Outcomes included in-hospital acute heart failure, stroke/transient ischaemic attack, and death, and 30-day mortality. Patients admitted with NSTEMI in low to lower-middle-income countries (LLMICs), compared with patients in HICs, were younger, more commonly diabetic, and current smokers, but with a lower burden of other comorbidities, and 76.7% met very high risk criteria for an immediate invasive strategy. Invasive coronary angiography use increased with ascending income classification (LLMICs, 79.2%; upper middle income countries [UMICs], 83.7%; HICs, 91.0%), but overall care quality did not (≥80% of eligible interventions achieved: LLMICS, 64.8%; UMICs 69.6%; HICs 55.1%). Rates of acute heart failure (LLMICS, 21.3%; UMICs, 12.1%; HICs, 6.8%; P < 0.001), stroke/transient ischaemic attack (LLMICS: 2.5%; UMICs: 1.5%; HICs: 0.9%; P = 0.04), in-hospital mortality (LLMICS, 3.6%; UMICs: 2.8%; HICs: 1.0%; P < 0.001) and 30-day mortality (LLMICs, 4.9%; UMICs, 3.9%; HICs, 1.5%; P < 0.001) exhibited an inverse economic gradient. Conclusion Patients with NSTEMI in LLMICs present with fewer comorbidities but a more advanced stage of acute disease, and have worse outcomes compared with HICs. A cardiovascular health narrative is needed to address this inequity across economic boundaries.
Ključne besede: country income, mortality, NSTEMI, quality indicators, registry
Objavljeno v DiRROS: 23.03.2026; Ogledov: 245; Prenosov: 226
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