A new marker of coronary collateral flow in patients presenting with acute myocardial infarction.

OBJECTIVE: Multimerin-2 is an adhesion substrate between pericytes and basal membranes during angiogenesis. The present study aimed to assess the relationship between serum Multimerin-2 and coronary collateral flow grade. PATIENTS AND METHODS: Between April 2022 and August 2022, 88 patients with subacute ST-elevation myocardial infarction were included in this study. The main inclusion criteria were patients who present 12-48 hours after symptom onset and aged between 18 and 90 years. The patients were divided into two groups according to the Rentrop classification: poor collateral group (Rentrop grade 0-1) and good collateral group (Rentrop grade 2-3). Biochemical and hematological parameters were measured before coronary angiography. RESULTS: Serum Multimerin-2 levels were found to be significantly different between the two groups, and levels were higher in the Rentrop 2-3 group than in the Rentrop 0-1 group (3,527.9 ± 1,194.2 pg/ml and 946.7 ± 249.1 pg/ml; p < 0.00). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.918 (p = 0.001), and the best cut-off value of 849 pg/ml had a sensitivity of 90.1% and a specificity of 84.1% for predicting Rentrop grade 2-3 coronary flow. The number of patients with low left ventricular ejection fraction (LVEF) by echocardiography at 30 days was significantly higher in patients with poor collateralization. CONCLUSIONS: Multimerin-2 levels were found to be higher in patients with Rentrop grade 2-3 coronary flow than Rentrop grade 0-1 coronary flow after myocardial infarction. We detected a potential relationship between MMR-2 and good coronary collateral formation.

The serum copeptin levels in obstructive sleep apnea patients with prehypertensive.

OBJECTIVE: Copeptin is a precursor of AVP, an antidiuretic hormone, plays a pivotal role in the maintenance of cardiovascular homeostasis. Obstructive sleep apnea syndrome (OSAS) is related to cardiovascular disease. We sought to evaluate the serum copeptin levels in newly diagnosed prehypertensive patients with OSAS. PATIENTS AND METHODS: Eighty-four prehypertensive patients were evaluated using polysomnography and were divided into two groups, an OSAS (n = 41) group and a control (n = 43) group. Serum copeptin levels were measured using the ELISA method. RESULTS: Copeptin levels were significantly higher in the OSAS group compared to the control group (146 [93-739] pg/ml vs. 111 [33-253] pg/ml, respectively, p < 0.001). A regression analysis revealed that the apnea hypopnea index (AHI) and the lowest SpO2 were related to serum copeptin levels (unstandardized ß = 1.02 ± 0.40, p = 0.014 and unstandardized ß = -3.1 ± 0.9, p = 0.048 respectively). CONCLUSIONS: According to the results of our study, serum copeptin levels are higher in the prehypertensive patients with OSAS compared to those in the control group. Therefore, in assessing the severity of OSAS, serum copeptin levels can be a candidate for a biochemical marker in addition to polysomnographic findings.

Atherosclerosis, some serum inflammatory markers in psoriasis.

AIM: Psoriasis is an autoimmune inflammatory disease which is associated with increased inflammatory markers and atherosclerosis. We wanted to investigate whether there is a relationship between some inflammatory markers and subclinical atherosclerosis markers. METHODS: We studied 60 psoriasis patients and 50 healthy controls. Demographic, biochemical parameters, C3, C4, d-dimer, CRP, fibrinogen and YKL-40 (human cartilage glycoprotein-39) levels were measured. After measuring carotid intima-media thickness (cIMT) and aortic elasticity parameters such as aortic strain, (beta) stiffness index and compliance, statistical comparisons were done. RESULTS: Patients with psoriasis had significantly higher diastolic blood pressure, CRP, fibrinogen, C3, uric acid levels, ß-stiffness index, and cIMT values than the control group. cIMT was correlated with CRP, YKL-40 and psoriasis area and severity index (PASI) score (r=0.219, P=0.038; r=0.225, P=0.033 and r=0.275, P=0.034). Aortic strain (%), aortic compliance and aortic stiffness index were correlated with C3 (r=-0.349, r=-0.526 and r=0.235) and fibrinogen (r=-0.354, r=-0.275 and r=0.289), all P values <0.05, but not with PASI score. The presence of psoriasis was related to aortic strain (ß±SE: -2.055±0.861, P=0.019) and ß-stiffness index (ß±SE: 2.934±1.143, P=0.012). CONCLUSION: Serum C3, CRP, fibrinogen and YKL-40 levels are elevated as well as increased cIMT and impaired aortic elasticity in psoriasis. CRP, YKL-40 and PASI score are correlated with cIMT. Increased serum C3 and fibrinogen levels correlate negatively with aortic strain and aortic compliance, and correlate positively with the ß-stiffness index.

Cardioprotective effects of fish omega-3 fatty acids on doxorubicin-induced cardiotoxicity in rats.

The aim of this study was to investigate the protective effects of fish omega-3 (n-3) fatty acids on doxorubicin (DOX)-induced acute cardiotoxicity. A total of 24 rats were divided into three groups: control, DOX-treated, and DOX treated with fish n-3 fatty acids. Control group received 0.4 ml/kg/day of saline intragastrically. The rats in the fish n-3 fatty acid-pretreated group were given 400 mg/kg/day fish n-3 fatty acids for 30 days by intragastric intubation. To induce acute cardiotoxicity, DOX (30 mg/kg) was injected intraperitoneally by a single dose and the rats were killed after 48 h. DOX treatment caused severe damage in heart tissues. Disorganization of myocardial muscle fibers, myofibrillar loss, and cardiotoxic myocardial fibers with cytoplasmic vacuoles were seen. Fish n-3 fatty acid-treated rats showed an improved histological appearance in the DOX-treated group. Our data indicate a significant reduction in the activity of terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling in cardiomyocytes of the DOX-treated group with fish n-3 fatty acids therapy. The DOX-treated with fish n-3 fatty acids group showed a significant decrease in malondialdehyde levels, and an increase in superoxide dismutase and glutathione peroxidase activities in comparison with the DOX-treated group. This study showed that fish n-3 fatty acids may be a suitable cardioprotector against acute toxic effects of DOX.

Carotid intima-media thickness and serum paraoxonase-1 activity in patients with Helicobacter pylori.

AIM: To evaluate serum paraoxonase(PON)-1 activity and carotid intima-media thickness (CIMT) in patients with Cytotoxin-associated antigen(CagA)-positive and negative Helicobacter pylori strains. PATIENTS AND METHODS: The study group included a total of 134 individuals, of whom 103 were H. pylori positive, and 31 were H. pylori negative. Five biopsies were collected from each patient for histological examination: two from the antrum, two from the corpus, and one from the incisura angularis. The presence of H. pylori was determined using a modified Gram staining protocol. Peripheral blood was collected from each patient to determine levels of triglyceride, TC, HDL-cholesterol and LDL-cholesterol. IgG antibodies against CagA protein were analyzed by enzyme immunoassays. PON-1 activity was measured by colorimetric method. Carotid intima-media thickness and atherogenic plaques were measured using a grey scale color Doppler ultrasound. Data were analyzed by descriptive and inferential statistics. RESULTS: The right, the left and the mean CIMT were significantly higher in H. pylori (+) group versus H. pylori (-) group (p < 0.001 for all). However, the mean PON-1 concentration was significantly lower in H. pylori (+) group versus H. pylori (-) group (p < 0.001). The right, the left and the mean CIMT of CagA (+) group were significantly higher than that of CagA (-) group and controls, while PON-1 concentrations of CagA (+) group were significantly lower than that of CagA (-) group and controls (for all p = 0.0001). The right, the left and the mean CIMT of CagA (-) group were significantly higher than that of the control group, while the mean PON-1 concentration were significantly lower (for all p = 0.0001). CONCLUSIONS: Decreased PON-1 activity may be an etiopathogenetic factor in increased atherosclerosis in patients with H. pylori infection, especially in those infected with the CagA positive strain.

Evaluation of C-reactive protein, fibrinogen and antithrombin-III as risk factors for coronary artery disease.

BACKGROUND: Inflammation is an important feature of atherosclerotic lesions and increased production of the acute-phase reactant. The contribution of coagulation factor to the development of coronary artery disease has not yet been clearly established. OBJECTIVES: To test whether C-reactive protein, fibrinogen and antithrombin-III are associated with angiographic CAD, history of myocardial infarction and extensive atherosclerotic involvement. METHODS: Blood samples were tested for CRP, fibrinogen and AT-III levels from 219 individuals undergoing coronary angiography. RESULTS: CRP was higher in patients with CAD (0.95 +/- 1.31, n = 180, vs. 0.39 +/- 0.61 mg/dl, n = 39, P < 0.0001) and in those with a history of MI (1.07 +/- 1.64, n = 96, vs. 0.65 +/- 0.72 mg/dl, n = 84, P < 0.05) than in control subjects. The patients who developed unstable angina had higher CRP levels than the patients with stable CAD (2.07 +/- 2.38, n = 7, vs. 0.80 +/- 1.13 mg/dl, n = 173, P < 0.001). Fibrinogen was significantly higher in patients with CAD than in those without CAD (298 +/- 108 vs. 258 +/- 63 mg/dl, P < 0.01). In patients with CAD, mean AT-III value was less than in patients without CAD, but this difference was not statistically significant (P = 0.08). No difference was found in CRP, fibrinogen and AT-III values among the patients with single, double or triple vessel disease. CONCLUSIONS: CRP is elevated in patients with CAD and a history of MI. Elevated levels of CRP at the time of hospital admission is a predictive value for future ischemic events. There is an association between higher levels of fibrinogen and CAD. The association of AT-III levels with CAD needs testing in further studies.