The Association Between Atherogenic Index of Plasma and No-Reflow Phenomenon in Acute Coronary Syndrome.

BACKGROUND: The atherogenic index of plasma (AIP) is a biomarker of plasma atherogenicity. Elevated AIP is linked with adverse cardiac events. We sought to examine the association of admission AIP and no-reflow phenomenon (NRP) in acute coronary syndrome (ACS) patient population treated with percutaneous coronary intervention (PCI). METHODS: Eight hundred eight-four ACS patients were included to statistical tests retrospectively and classified according to the occurrence of NRP: NRP (-) (n = 662) and NRP (+) (n = 186). AIP levels were calculated through the formula log10 (triglyceride-to-high-density lipoprotein cholesterol ratio). RESULTS: AIP levels were higher in NRP (+) patients compared to NRP (-) group patients. The receiver operating characteristic (ROC) curve analysis for AIP to predict NRP yielded an area under the ROC curve value 0.643 [95% confidence interval (CI): 0.596-0.690, P <.001]. AIP was associated with NRP in univariate logistic regression analysis [Odds Ratio (OR): 2.46; P =.001; CI: 1.44 (lower limit)-4.21 (upper limit)]. However, AIP did not emerge as a significant prognostic factor of NRP in multiple logistic regression analysis [OR: 2.11; P =.422; CI: 0.34 (lower limit)-13.11 (upper limit)]. On the other hand, peak troponin T (log10) was an independent prognostic factor for NRP [OR: 0.13; P <.001; CI: 0.10 (lower limit)-0.37 (upper limit)] occurrence. CONCLUSION: The AIP level on admission is not a statistically significant prognostic factor of NRP. However, peak troponin T (log10) is an independent prognostic parameter of NRP.

Assessment of Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios in patients with acromegaly.

BACKGROUND: Cardiovascular complications, including ventricular arrhythmias associated with abnormalities of ventricular repolarization, are the leading cause of morbidity and mortality in patients with acromegaly. Herein, we aimed to investigate ventricular repolarization using Tp-e interval, Tp-e interval/QT, and Tp-e interval/QTc ratios in acromegalic patients compared to healthy subjects. METHODS: A total of 29 patients (aged 51.9 ± 11.2, 65.5% women) with acromegaly and 30 control subjects (aged 47.3 ± 14.4, 63.3% women) were enrolled in the study. Tp-e and QT interval, corrected QT (QTc), Tp-e/QT, and Tp-e/QTc ratios were calculated from the 12-lead electrocardiogram. RESULTS: Tp-e interval (89.28 ± 12.16 vs. 75.97 ± 9.92 ms; p < 0.001), Tp-e/QT ratio (0.237 ± 0.045 vs. 0.212 ± 0.029; p = 0.019), and Tp-e/ QTc ratio (0.218 ± 0.031 vs. 0.195 ± 0.026; p = 0.003) were significantly higher in patients with acromegaly compared to control group. A positive correlation was determined between left atrial volume index (LAVI) and Tp-e interval (r = 0.272, p = 0.039). DISCUSSION: The current study is the first to have shown significantly increased Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were increased in acromegalic patients. These results may be important for screening malignant arrhythmic events in acromegaly.

Mitral annular calcification and its severity predict high risk for cardio-embolic stroke in elderly patients with first diagnosed atrial fibrillation.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia worldwide and a large proportion of patients with AF are older than 75 years of age. Mitral annular calcification (MAC), which is usually observed in advanced age, is associated with increased risk of AF and cardio-embolic stroke in the general population. OBJECTIVES: This study was performed to assess whether presence of MAC and its severity predict cardio-embolic stroke in elderly patients with first diagnosed AF. METHODS: In this cross-sectional study, 72 elderly patients suffering from acute cardio-embolic stroke with first diagnosed AF and 79 elderly control group patients with first diagnosed AF and without stroke were investigated. A parasternal short-axis view at the level of the mitral annulus was used for MAC measurements. The severity of MAC was measured from the anterior to posterior edge at its greatest width. RESULTS: MAC thicknesses were significantly higher in the stroke group. ROC curve analysis showed that a cut point of 2.5 mm for the value of MAC thickness exhibited 68.1% sensitivity and 77.2% specificity for detecting cardio-embolic stroke in elderly patients with AF. In multivariate logistic regression analysis, MAC thickness (OR = 1.173, 95% CI 1.083-1.270; p < 0.001) was found to be independent predictor of cardio-embolic stroke in elderly patients with AF. CONCLUSION: MAC thickness may provide useful information for the relevant risk evaluation of elderly patients with AF. Pre-stroke MAC presence and its severity appear to have better clinical value for predicting cardio-embolic stroke in elderly patients with AF, independent from traditional risk factors for stroke.

Relationship between mild renal dysfunction and coronary artery disease in young patients with stable angina pectoris.

Aim: We investigated the relationship between mild renal dysfunction (MRD) and the presence of coronary artery disease (CAD) in people under 60 years of age. Materials & methods: A total of 634 (317 patients with vessel stenosis ≥50% and 317 with normal angiography) individuals diagnosed with stable angina pectoris and estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m2 were included in the present study. Results: The mean eGFR was lower (95.3 ± 23.7 vs 109.7 ± 22.3, respectively, p = 0.002) and the number of patients with MRD was higher in patients with CAD (137, 43.2%) than in the control group (52, 16.4%, p < 0.001). The multivariate analysis showed that lower eGFR is an independent risk factor for presence of CAD in people under 60 years of age with stable angina pectoris. Conclusion: According to our retrospective study, the risk of developing CAD appears to be slightly increased in individuals under 60 years of age with MRD.

CHA2DS2-Vasc score and saphenous vein graft disease in patients with coronary artery bypass graft surgery.

BACKGROUND: Saphenous vein grafts (SVGs) are still frequently used in coronary artery bypass graft surgery (CABG). However, the patency rate of SVGs is lower than arterial grafts. CHA2DS2-VASc score gives important information about the prognosis of various cardiovascular diseases. In this study, we aimed to investigate the association between CHA2DS2-VASc score and saphenous vein graft disease (SVGD) in patients with history of CABG surgery. METHODS: A total of 241 patients who had undergone CABG surgery and who underwent coronary angiography due to stable angina pectoris symptoms were reviewed retrospectively. SVGD was defined as ≥50% stenosis in at least one SVG. Patients were divided into two groups according to the presence or absence of SVGD. RESULTS: It was found that CHA2DS2-VASc scores were significantly higher in SVGD group. In multivariate logistic regression analysis, time interval after CABG [odds ratio (OR) = 1.077, 95% confidence interval (CI) 1.004-1.155; P = 0.037], and CHA2DS2-VASc score ≥ 4 (OR = 10.10, 95% CI 4.739-21.276; P < 0.001) were found to be independent predictors of SVGD. CONCLUSION: For the first time, our results have suggested that CHA2DS2-VASc score, which is commonly used in daily clinical practice and easy to calculate, can provide useful information for the risk assessment of patients with SVGs.

Risk factors for coronary artery disease in young patients with stable angina pectoris

Background/aim: We aimed to investigate the relationship between risk factors and the presence of coronary artery disease (CAD) in a young population with stable angina pectoris (SAP). Materials and methods: A total of571 individuals younger than 60 years old, admitted to the outpatient clinic with chest pain and referred for coronary angiography between January 2015 and December 2017, were included in the study. All clinical and biochemical parameters were documented in the hospital records. Coronary angiography of patients was monitored from records. The individuals were divided into two groups. The patient group consisted of 363 individuals with at least one-vessel stenosis of ≥70%, and the control group consisted of 208 individuals with normal coronary angiography. We compared the traditional and nontraditional risk factors of these two groups in terms of the presence of CAD. Results: Prevalence of male sex and smoking were higher in the patient group, and the prevalence of hypertension and diabetes were similar in the two groups. In the patient group, mean age, blood cholesterols, serum gamma-glutamyltransferase, hemoglobin, and white blood cell and lymphocyte levels were higher, while estimated glomerular filtration rate (eGFR), high-density lipoprotein cholesterol (HDL-C), platelets, and neutrophil/lymphocyte and platelet/lymphocyte ratios were lower. Low eGFR and HDL-C levels, older age, male sex, smoking, and high levels of low-density lipoprotein cholesterol and lymphocytes were independent risk factors for the presence of CAD in young patients. Conclusion: Contrary to studies performed in the elderly, traditional and nontraditional risk factors could not exactly predict the presence of CAD in a young population with SAP.

Electrocardiographic alterations in patients consuming synthetic cannabinoids.

INTRODUCTION: The aim of this study was to investigate the electrocardiographic parameters in patients consuming synthetic cannabinoids. METHODS: Thirty-five patients who were consuming synthetic cannabinoids were enrolled to the study, prospectively. The control group included 35 healthy age and sex-matched volunteers. The standard 12-lead surface electrocardiograms of the study population were recorded. P maximum (Pmax), P minimum (Pmin), P wave dispersion, interatrial duration, P wave area in D2 derivation, abnormal P terminal force in V1 derivation, heart rate, QT interval, corrected QT, QT dispersion, PR interval duration and macrovolt T-wave alternans were evaluated by two experienced cardiologists. The intra-observer and inter-observer variations for all measurements were non-significant. RESULTS: Pmax and Pmin duration was not different between the groups ( p=0.96, p=0.15, respectively). However, P wave dispersion was higher in the patient group compared to control group (34±9.4, 29.5±6.6, p=0.02, respectively). QT interval was significantly higher in the patient group than the control group (380.3±25, 365.6±22.8, p=0.01, respectively). Besides, corrected QT was higher in the patient group compared to control group (415±36.8, 392±15.5, p=0.001, respectively). QT dispersion was also higher in the patient group than the control group (39.8±10.0, 29.2±5.4, p<0.001, respectively). CONCLUSION: Altered electrocardiography parameters linked with atrial and ventricular arrhythmia development may be observed in patients consuming synthetic cannabinoids. These patients should be evaluated regularly for cardiovascular disease and arrhythmia development. The electrocardiogram, which is a cheap and easy test to apply, can be used to determine the pro-arrythmic risk in patients consuming synthetic cannabinoids.

The relationship between lymphocyte-to-monocyte ratio and saphenous vein graft patency in patients with coronary artery bypass graft.

AIM: A lower lymphocyte count and a high monocyte count give important clues about the prognosis of various cardiovascular diseases. We hypothesized that lymphocyte-to-monocyte ratio (LMR) was associated with the saphenous vein graft disease (SVGD) in patients with coronary artery bypass graft (CABG). PATIENTS & METHODS: A total of 218 patients with previous history of CABG surgery, who underwent coronary angiography due to stable angina symptoms, were investigated, retrospectively. RESULTS: LMR levels were significantly lower in the SVGD group. Multiple logistic regression analyses showed that LMR levels were independent predictors of SVGD (OR: 0.648; 95% CI: 0.469-0.894; p = 0.008). CONCLUSION: Our results suggested that LMR levels may provide useful information for the relevant risk evaluation of SVGD in CABG patients.

Percutaneous treatment of a superior mesenteric artery pseudoaneurysm and arteriovenous fistula with coil embolization: a case report.

Visceral artery pseudoaneurysm and arteriovenous fistula following penetrating abdominal injuries is a rarely observed complication. Presently described is the case of a 44-year-old male admitted to the hospital after having previously experienced penetrating abdominal trauma. The patient had developed a pseudoaneurysm in the superior mesenteric artery and an arteriovenous fistula between the superior mesenteric artery and vein following surgery. The patient underwent successful coil embolization procedure and he was discharged 1 day after intervention.