A rare cause of idiopathic right outflow tract premature ventricular contraction: Type-4 renal tubular acidosis.

The premature ventricular contractions (PVCs) have usually good prognosis in patients without structural heart disease. In case of left ventricular ejection fraction depression or symptoms, antiarrhythmic drugs or cardiac ablations could be an option for management. We present a case of a patient with high burden of PVC admitted for cardiac ablation. Preoperative assessment revealed hyperkalemia and metabolic acidosis which ended up with type-4 renal tubular acidosis (RTA). Its rare cause and management may draw attention to the possibility of type -4 RTA as the cause of the PVC, and hyperkalemia.

Evaluation of COVID-19 Patients According to the Survival Time.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was first detected as a form of atypical pneumonia. COVID-19 is a highly contagious virus, and some patients may experience acute respiratory distress syndrome (ARDS) and acute respiratory failure leading to death. We aim to evaluate the clinical, imaging, and laboratory parameters according to survival time to predict mortality in fatal COVID-19 patients. METHODS: Fatal 350 and survived 150 COVID-19 patients were included in the study. Fatal patients were divided into three groups according to the median value of the survival days. Demographic characteristics and in-hospital complications were obtained from medical databases. RESULTS: Of the non-survived patients, 30% (104) died within three days, 32% (110) died within 4-10 days, and 39% (136) died within over ten days. Pneumonia on computational tomography (CT), symptom duration before hospital admission (SDBHA), intensive care unit (ICU), hypertension (HT), C-reactive protein (CRP), D-dimer, multi-organ dysfunction syndrome (MODS), cardiac and acute kidney injury, left ventricular ejection fraction (LVEF), right ventricular fractional area change (RV-FAC), and Tocilizumab/Steroid therapy were independent predictors of mortality within three days compared to between 4-10 days and over ten days mortality.  A combined diagnosis model was evaluated for the age, CT score, SDBHA, hs-TnI, and D-dimer. The combined model had a higher area under the ROC curve (0.913). CONCLUSION: This study showed that age, pneumonia on CT, SDBHA, ICU, HT, CRP, d-dimer, cardiac injury, MODS, acute kidney injury, LVEF, and RV-FAC were independently associated with short-term mortality in non-surviving COVID-19 patients in the Turkish population. Moreover, Tocilizumab/Steroid therapy was a protective and independent predictor of mortality within three days.

Antithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarction.

BACKGROUND: Atrial fibrillation (AF) is a common complication of ST-segment elevation myocardial infarction (STEMI), and AF might require anticoagulant treatment in some conditions. STUDY QUESTION: There are no clear recommendations about vitamin K antagonist (VKA) use in patients with STEMI who complicated with new-onset transient AF. In this study, we examined the association of concomitant use of VKA and dual antiplatelet therapy (DAPT) with clinical outcomes of this patient population. STUDY DESIGN: A total of 4086 patients with STEMI who underwent primary percutaneous coronary intervention retrospectively investigated. Among these patients, a total of 286 patients who developed new-onset transient AF during hospitalization were enrolled. VKA group consisted of 116 patients treated with warfarin, aspirin, and clopidogrel, and DAPT group consisted of 170 patients treated with aspirin and clopidogrel. MEASURES AND OUTCOMES: One-year mortality, ischemic stroke, major, and minor bleeding were determined as clinical outcomes. RESULTS: Although VKA group had proportionally lower mortality (17.2% vs. 20.0%) and ischemic stroke (7.8% vs. 11.8%) compared with DAPT group, the differences did not reach to statistical significance, whereas the 1-year major bleeding had higher rates at VKA group and that had 3.5-times higher major bleeding than DAPT group. This relationship was persisted after multivariable analysis (hazard ratio = 3.37, 95% CI, 1.76-10.04, P = 0.012). CONCLUSIONS: There is not a widely accepted treatment algorithm in patients with STEMI who complicated with new-onset AF in clinical guidelines. The current study indicated that transient form of new-onset AF might not require long-term VKA. Besides, addition of VKA to DAPT therapy may increase the rates of major and minor bleeding.

The predictive role of modified TIMI risk index in patients with ST-segment elevation myocardial infarction.

BACKGROUND: The prognostic value of thrombolysis in myocardial infarction (TIMI) risk index (TRI) has been reported in patients with coronary artery disease. In this study, we evaluated the additional prognostic value of blood urea nitrogen (BUN) level to the TRI in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We evaluated the in-hospital and long-term (3-year) prognostic value of modified TRI (mTRI) in patients with STEMI. The mTRI is calculated using the following equation; mTRI = (TRI × BUN)/10. Patients were stratified into 5 groups according to 20-point increments of mTRI. RESULTS: The patients with higher mTRI had significantly higher in-hospital and long-term mortality. The risk for in-hospital and long-term mortality was highest for those within the Q5 (36.8 and 42.3%, respectively) and it was significantly higher than all the other groups (p < .001 for both). CONCLUSIONS: In this study, the prognostic value of TRI has been augmented by multiplication of TRI with BUN/10. Therefore, we present a pilot study of association of mTRI with overall STEMI patients.

Higher cancer antigen 125 level is associated with the presence of permanent atrial fibrillation in systolic heart failure patients.

INTRODUCTION: Atrial fibrillation (AF) is a common arrhythmia in heart failure (HF). Recent studies have shown that serum cancer antigen-125 (CA-125) levels are elevated in HF, and high levels of CA-125 in HF patients with sinus rhythm have been shown to be associated with the development of new onset AF. However, the relation between CA-125 levels and the presence of AF in HF is unknown. In this study we investigated whether plasma CA-125 levels in patients with systolic HF could predict the presence of AF. METHODS: The study was a retrospective cohort design including 205 stable systolic HF patients who were selected during outpatient clinic visits and who had CA-125 measurement and an electrocardiogram within the last one month before admittance to cardiology clinic. Patients were classified into two groups based on the presence of AF (n = 67) or sinus rhythm (n = 138). RESULTS: The mean age of the patients was 68 ± 11 years. CA-125 levels were significantly higher in patients with AF than patients with SR [33 (3-273) vs 102 (7-296) U/ml, P < 0.001]. CA-125 level, presence of right ventricular dilatation, pericardial effusion, moderate to severe TR and MR, and left atrial diameter were found to be associated with the presence of AF in univariate analysis. In a multivariate logistic regression model, only the CA-125 level remained associated. Also, according to the ROC curve analysis, the optimal cut-off level of CA-125 for predicting AF was ≥ 91 U/mL with a specificity of 84% and a sensitivity of 54%. CONCLUSION: We have shown that the CA-125 levels can be used to predict AF in patients with systolic HF.

Sublingual vs. Oral Captopril in Hypertensive Crisis.

BACKGROUND: There are confusing data in literature regarding oral and sublingual captopril effects over blood pressure (BP) decrease. OBJECTIVES: In our study we compared oral and sublingual captopril effectiveness over BP decrease in patients admitted to our Emergency Department with hypertensive urgency. METHODS: Our study was conducted from January 2012 to January 2013 in patients with hypertensive urgency. In this cross-sectional study after two initial BP measurements, patients were identified as eligible for the study. An initial electrocardiogram was obtained and blood samples were drawn. A total of 212 patients were accepted as eligible for the study, and 25 mg of captopril was randomly given orally or sublingually; BP was measured at 10, 30, and 60 min. We selected the patients to the groups consecutively. A 25% reduction of initial BP 1 h after initiation of the treatment was accepted as an accomplishment. A second 25 mg of captopril was given if the target of 25% reduction of BP was not reached after the first tablet. Intravenous drugs were administered to the patients resistant to the captopril and these patients were excluded from the study. RESULTS: The 10-min systolic BP (SBP), diastolic BP, and mean BP (MBP) decrease was more prominent in the sublingual captopril group (p < 0.001). This decrease was statistically significant in the SBP and MBP at 30 min (p < 0.001), and no statistical difference was recorded at 60 min (p > 0.05). CONCLUSIONS: In our study, sublingual captopril was found to decrease BP more efficiently in the first 30 min, but this difference equalized at 60 min.

MCP-1 and soluble TWEAK levels are independently associated with coronary artery disease severity in patients with chronic kidney disease.

PURPOSE: Patients diagnosed with chronic kidney disease (CKD) have a greater rate of cardiovascular mortality when compared with the general population. The soluble form of TNF-like weak inducer of apoptosis (TWEAK) and monocyte chemoattractan protein 1 (MCP-1) play important roles in cellular proliferation, migration and apoptosis. The current study aimed to analyze whether soluble TWEAK (sTWEAK) and MCP-1 levels are associated with the severity of coronary arterial disease (CAD) in CKD patients. METHODS: Ninety-seven patients diagnosed with CKD stages 2-3 according to their estimated glomerular filtration rate and the presence of kidney injury were included in the study. Plasma sTWEAK and MCP-1 concentrations were determined using commercially available ELISA kits. Coronary angiographies were performed through femoral artery access using the Judkins technique. RESULTS: Correlation analysis of sTWEAK and Gensini scores showed significant association (p < 0.01, r(2) = 0.287). Also significant correlation has been found in MCP-1 levels and Gensini scores (p < 0.01, r(2) = 0.414). When patients were divided into two groups with a limit of 17 according to their Gensini score, sTWEAK levels indicated a statistically significant difference (p < 0.01). CONCLUSIONS: Our findings support a relationship between sTWEAK and MCP-1 levels and CAD in CKD stages 2-3 patients.

A case of Mobitz type II atrioventricular block due to Nerium oleander poisoning successfully managed with digoxin-specific Fab antibody fragments.

Nerium oleander is a popular ornamental plant grown in many tropical and subtropical countries and in the Mediterranean region. It is dangerous because it has been shown to contain several types of cardiac glycosides, and hence can cause cardiac arrhythmias resembling digoxin in their toxicologic manifestations. We report a patient presenting to our hospital with Mobitz type II atrioventricular block after drinking herbal tea prepared from oleander leaves. Three hours after admission, a 200-mg empiric dose of digoxin-specific Fab antibody fragments was administered intravenously over 30 minutes. A 12-lead electrocardiogram (ECG) revealed sinus rhythm at the end of infusion. After 72 hours, the patient was discharged without any symptoms.

A case report of coronary artery aneurysm in a patient with Behçet's disease.

Behçet's disease (BD) is a multisystem vasculitis that may involve vessels of all sizes. Acute coronary syndrome (ACS) due to secondary involvement of BD is rare and its management less clear. In this case, a 29-year-old man admitted to the emergency room with ongoing chest pain was interned to the coronary care unit with a diagnosis of ACS. The patient had been diagnosed 1 year before with BD and had been without regular follow-up, despite the suggested use of cholchium. An immediate coronary angiography revealed a fresh thrombus image in the proximal segment of the right coronary artery (RCA), an aneurysm of the left anterior descending artery (LAD) at proximal segment, and a hemodynamically significant lesion following the aneurysm. Intervention was ended because of normal flow (TIMI III) of distal RCA. An intravenous infusion of glycoprotein IIb/IIIa receptor inhibitor (tirofiban) was administered, and a control angiography showed dissolution of a thrombus in RCA, but enlarged aneurysm of LAD and a new aneurysm in RCA.

Successful management of left main coronary artery thrombus with intracoronary thrombolysis.

The management of valvular heart diseases with mechanical valves has been performed for several years. Warfarin has been used in patients with mechanical heart valves to protect against thromboembolic complications; nevertheless, in these patients, thromboembolic event rates range from 0.5% to 1.7%. Acute occlusive embolism to the coronary arteries due to a mechanical valve is an uncommon occurrence. In this report, we present a case of a left coronary system occlusion due to thrombus embolization from a prosthetic aortic valve, which was successfully treated by thrombolytic therapy.

Comparison of Medical Treatments According to the Characteristics of Idiopathic Premature Ventricular Contractions: Beta-blockers or Calcium Channel Blockers?

Objective: Premature ventricular contractions (PVCs) are a common arrhythmic condition. The first approach in patients with symptomatic and frequent PVC is medical treatment, primarily beta-blockers (BB) or calcium channel blockers (CCB), but it is still unclear which of the two should be chosen. This study investigated which drug treatment would be beneficial according to patient and electrocardiography (ECG) characteristics in patients with idiopathic PVC. Methods: We retrospectively analyzed 156 patients with PVC who came to the cardiology outpatient clinic. Seventy-one patients were responsive to BB, and 85 were responsive to CCB. Their demographic and ECG characteristics were compared. Results: The male ratio was higher (p<0.001), and the left ventricular ejection fraction was lower in BB responders than in CCB responders (p<0.001). Although the mean heart rate was higher in BB responders (p<0.001), the initial PVC burden was lower in BB responders than in CCB responders (p<0.001). The PVC QRS duration was longer in BB responders than in CCB responders (p<0.001). Similarly, the coupling interval variability was higher in BB responders (p=0.006). Conclusions: The evaluation of clinical and ECG parameters in patients with frequent idiopathic PVCs may determine whether BBs or CCBs should be chosen as initial treatment. Further prospective studies are needed to verify our findings and establish their clinical applicability.

The successful management of type III coronary perforation.

The coronary artery perforation during percutaneous coronary intervention is a nightmare for interventional cardiologists and is always hard to manage timely and properly. We present a 60-year-old male with periprocedural coronary perforation during ST-segment elevation myocardial infarction. A coronary balloon was inflated in the proximal left anterior descending (LAD) artery just after perforation and the 600 cc of hemorrhagic fluid was drained with the pericardial drainage set. The covered stent was deployed in the LAD and he was discharged on the 7th day. At an 18-month follow-up, he is on dual-antiplatelet therapy and the exercise stress test shows no ischemic changes.

The Association of TWEAK with Coronary Artery Calcification in Patients with Chronic Kidney Disease. / A Associação de TWEAK com Calcificação da Artéria Coronária em Pacientes com Doença Renal Crônica.

BACKGROUND: The soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) is a member of the TNF superfamily that plays a critical role in proliferation and inflammation in the arterial circulation. OBJECTIVES: This prospective study aimed to show the relationship between the sTWEAK levels and coronary artery calcification (CAC) in patients with chronic kidney disease (CKD). METHODS: This prospective study included 139 consecutive patients undergoing computed coronary angiography for any reason except for acute coronary syndromes from August 2020 to February 2021. A total of 12 patients were excluded from the study due to exclusion criteria. Patients were divided into two groups with regard to having a CAC score of less than 400 (n=84) and 400 or more (n=43). Significance was assumed at a 2-sided p<0.05. RESULTS: As the CAC score increased, sTWEAK levels presented a statistically significant decrease, and a strong relationship between sTWEAK levels and the CAC score (r: -0.779, p<0.001) was observed. The ROC analysis revealed that the optimal cut-off level of sTWEAK for predicting the CAC score of 400 was 761 pg/mL with a sensitivity of 71% and a specificity of 73% (AUC: 0.78; 95% CI:0.70-0.85; p < 0.001). CONCLUSIONS: Even though the large-scale studies showed a positive correlation between eGFR and the sTWEAK levels, some studies found the increased sTWEAK levels to be associated with mortality and the severity of the coronary artery system in patients with CKD. Our results support our hypothesis that the sTWEAK level shows coronary calcification rather than other types of atherosclerotic plaques.

FUNDAMENTO: O receptor fraco indutor de apoptose semelhante a fator de necrose tumoral solúvel (sTWEAK) é um membro da superfamília de TNF que tem um papel crítico na proliferação e inflamação na circulação arterial. OBJETIVOS: Este estudo prospectivo tem o objetivo de mostrar a relação entre os níveis de sTWEAK e calcificação da artéria coronária (CAC) em pacientes com doença renal crônica (DRC). MÉTODOS: Este estudo prospectivo incluiu 139 pacientes consecutivos que passaram por angiografia coronariana por tomografia computadorizada, por qualquer motivo, para síndromes coronarianas agudas, de agosto de 2020 a fevereiro de 2021. Um total de 12 pacientes foi excluído do estudo devido aos critérios de exclusão. Os pacientes foram divididos em dois grupos com base em terem um escore CAC menor que 400 (n=84) ou um escore de 400 ou mais (n=43). A significância foi presumida em p-valor bilateral <0,05. RESULTADOS: À medida que o escore CAC aumentou, os níveis de sTWEAK diminuíram de forma estatisticamente significativa e detectou-se uma relação forte entre níveis de sTWEAK e escore CAC (r: -0,779, p<0,001). A análise ROC revelou que o nível de corte ideal de sTWEAK para prever o escore CAC de 400 era 761 pg/mL com uma sensibilidade de 71% e especificidade de 73% (AUC: 0,78; IC 95%: 0,70-0,85; p <0,001). CONCLUSÕES: Embora os estudos em larga escala tenham demonstrado uma correlação positiva entre os níveis de TFGe e sTWEAK, alguns estudos detectaram que o aumento nos níveis de sTWEAK estão associados a mortalidade e gravidade do sistema da artéria coronária em pacientes com DRC. Nossos resultados comprovam nossa hipótese de que os níveis de sTWEAK mostram calcificação coronária em vez de outros tipos de placas ateroscleróticas.

Reliability of normative tables in assessing elevated blood pressure in children.

Epidemiological studies indicate that elevated blood pressure (BP) is common among children. Early detection of elevated BP in children is important in the prevention of cardiovascular disease (CVD). Difficulties exist in the diagnosis of "elevated" BP in children of 8-12 years of age. Normative tables of sex, age, and height specific BP percentile levels are required. Reports provide normative tables of BP percentile levels in children. Elevated BP is defined as systolic and diastolic BP ≥ 90th age, sex, and height specific BP percentile. The study tests the internal consistency and reliability between the normative tables of BP in children. The main objective of the study is to assess the reliability of existing normative tables of BP in children by using ad hoc analysis of a prior survey. A cross-sectional survey was performed in elementary school children (8-12 years of age, n = 818) from Istanbul, Turkey. The survey was conducted in 2007-2008. Four different normative tables of BP were used to determine children with elevated BP. The reliability and internal consistency between the normative tables of BP in children were assessed. The prevalences of elevated systolic and diastolic BP in children differed significantly between the normative tables of BP. The internal consistency between the normative tables was poor (Cronbach α coefficient = 0.429). Kuder-Richardson 21 test indicated poor reliability between the local and international normative tables of BP. In conclusion, the study indicates that there are significant inconsistencies and poor reliability between the national and international normative tables of BP in children.

Catheter-based management of a catheterization related stroke.

Ischemic stroke is a rare and serious complication of coronary angiography and percutaneous coronary intervention, which has high morbidity and mortality. To our knowledge, there is no large-scale randomized controlled trial for the management of catheter-related ischemic stroke. In this case study, we presented a 46-year-old male with peri-procedural ischemic stroke during the coronary angiography (CAG). The CAG was terminated after the stroke and the left carotid artery was selectively cannulated, and digital subtraction angiography (DSA) revealed total occlusion (Modified Thrombolysis in Cerebral Infarction, mTICI, 0) of the M1 part of the left middle cerebral artery (MCA). A stent-assisted thrombectomy was performed and the DSA revealed restoration of flow to the left MCA with mTICI 3 flow in the distal branches. The next day, the neurological exam showed no sensory, motor deficits. The patient was discharged four days later. In the setting of catheter-related stroke, mechanical thrombectomy seems to be the least time-consuming and effective approach.

Atrial Fibrillation: A Novel Risk Factor for No-Reflow Following Primary Percutaneous Coronary Intervention.

There is a lack of evidence regarding the association of atrial fibrillation (AF) and no-reflow (NR) phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). A total of 2452 patients with STEMI who underwent pPCI were retrospectively investigated. After exclusions, 370 (14.6%) patients were in the AF group and 2095 (85.4%) were in the No-AF group. Patients with a thrombolysis in myocardial infarction flow rate <3 were defined as having NR. Patients in the AF group were older and had higher 3-vessel disease rates (24.1% vs 18.9%; P = .021) and lower left ventricular ejection fraction (45.4 [11.7] vs 48.7 [10.5%]; P < .001). No-reflow rates were higher in the AF group than in the No-AF group (29.1% vs 11.8%; P < .001). According to multivariable analysis, AF (odds ratio: 1.81, 95% confidence interval: 1.63-2.04, P < .001), age, Killip class, anterior myocardial infarction, diabetes mellitus, chronic kidney disease, stent length, and smoking were independent predictors of NR following pPCI. Atrial fibrillation is a quite common arrhythmia in patients with STEMI. Atrial fibrillation was found to be an independent predictor of NR in the current study. This effect of AF on coronary flow rate might be considered as an important risk factor in STEMI.

Effect of Dynamic Potassium Change on In-Hospital Mortality, Ventricular Arrhythmias, and Long-Term Mortality in STEMI.

We evaluated the effect of serum potassium (K) deviation on in-hospital and long-term clinical outcomes in patients with ST-segment elevation myocardial infarction who were normokalemic at admission. A total of 2773 patients with an admission serum K level of 3.5 to 4.5 mEq/L were retrospectively analyzed. The patients were categorized into 3 groups according to their K deviation: normokalemia-to-hypokalemia, normokalemia-to-normokalemia, and normokalemia-to-hyperkalemia. In-hospital mortality, long-term mortality, and ventricular arrhythmias rates were compared among the groups. In a hierarchical multivariable regression analysis, the in-hospital mortality risk was higher in normokalemia-to-hypokalemia (odds ratio [OR] 3.03; 95% confidence interval [CI], 1.72-6.82) and normokalemia-to-hyperkalemia groups (OR 2.81; 95% CI, 1.93-4.48) compared with the normokalemia-to-normokalemia group. In a Cox regression analysis, long-term mortality risk was also higher in normokalemia-to-hypokalemia (hazard ratio [HR] 3.78; 95% CI, 2.07-7.17) and normokalemia-to-hyperkalemia groups (HR, 2.97; 95% CI, 2.10-4.19) compared with the normokalemia-to-normokalemia group. Ventricular arrhythmia risk was also higher in normokalemia-to-hypokalemia group (OR 2.98; 95% CI, 1.41-5.75) compared with normokalemia-to-normokalemia group. The current study showed an increased in-hospital ventricular arrhythmia and mortality and long-term mortality rates with the deviation of serum K levels from normal ranges.

The Impact of Prognostic Nutritional Index on Coronary Flow Reserve in Patients with Inflammatory Bowel Disease.

OBJECTIVE: The recurring inflammation of mucosal layer of intestines is known as inflammatory bowel disease (IBD), which can be accompanied by nutritional deficiencies. The association between inflammation and coronary artery disease has been established. Coronary flow reserve (CFR), which is an established method to evaluate combined microvascular and epicardial flow of coronary arteries, can be assessed by using transthoracic echocardiography. The aim of this study was to evaluate the association of Prognostic Nutritional Index (PNI) with CFR in IBD patients. METHOD: This prospective study included 101 patients with IBD. These patients were compared to control group (n=32). PNI was calculated by using serum albumin level and lymphocyte count. CFR was assessed by using Doppler echocardiography. RESULTS: Multivariate regression analysis indicated that the presence of IBD, age (>40 years) and decreased PNI (<53.8) independently predict impairment of CFR. The area under the curve (AUC) was 75.1% (95% CI:0.664-0.838), and PNI levels were significant predictor of low CFR (p<0.001). CONCLUSION: This study showed that PNI, which is calculated using the serum level of albumin and lymphocyte count, is a strong predictor of decreased CFR in IBD patients in remission. Our findings support previous studies showing the relationship between PNI and coronary artery disease. This immunonutritional index has only two components and is easy to calculate, and inexpensive.

Successful percutaneous coronary intervention for chronic total occlusion via the radial artery.

Over the past decade, percutaneous coronary interventions (PCIs) performed via radial artery (RA) access have become popular among interventional cardiologists. Since the radial approach may limit the options in complex cases, most interventional cardiologists prefer femoral access to RA access for complex procedures, such as chronic total occlusions (CTOs) and bifurcation lesions. Presently described is a case of CTO of the right coronary artery that was successfully treated with PCI via the left RA. This study demonstrates that if there is an indication for revascularization and the CTO lesions are short and without poor prognostic factors, an intervention for CTO should still be considered, even if there is no femoral access.

Urban legend or real fact: Coronary artery size varies with demographics.

OBJECTIVE: This study aimed to determine the relationship between the diameter of coronary artery stents and age, gender, diabetes mellitus (DM), left ventricular ejection fraction (LVEF), renal dysfunction, and the clinical presentation of myocardial ischemia in the cohort of patients with implanted stents in coronary arteries with severe stenotic lesions. METHODS: This study included 2256 patients (mean age, 59.3±10.9 years; men, 62%) who underwent percutaneous coronary intervention (PCI). The clinical status of the patients at presentation was subcategorized as follows: ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, unstable angina pectoris, and stable angina pectoris. The diameters, without any type or brand differentiation, were divided into two groups as follows: Group I, which included 2.5- and 2.75-mm-diameter stents, and Group II, which included ≥3-mm-diameter stents. RESULTS: The type of procedure, including primary PCI, early invasive strategy, and elective stenting, was not found to be a significant factor affecting the diameter of coronary artery stents. Univariate and multivariate analyses revealed a relationship between the diameter of coronary artery stents and age, gender, DM, and LVEF. CONCLUSION: This study demonstrated that the diameter of coronary artery stents was independently associated with gender, age, a history of DM, and moderate-to-severe systolic left ventricular dysfunction.