RESUMEN
OBJECTIVE: The metabolic equivalent (MET) and Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score are two parameters with known cardiovascular prognostic significance. In this study, we aimed to investigate the direct relationship between MET and SYNTAX score in patients with chronic coronary syndrome (CCS). METHOD: This retrospective study included 200 patients over 18 years of age who underwent coronary angiography and had a positive exercise electrocardiography test result. Patients were divided into two groups: Group 1 with a low SYNTAX score and Group 2 with a medium-high SYNTAX score. MET values were then compared between these groups. RESULTS: Baseline demographic characteristics and laboratory values were similar between the groups. The mean MET values in the low and medium-high SYNTAX score groups were 9.36 ± 2.38 and 8.78 ± 2.43, respectively. No statistical difference was observed (P = 0.086). Additionally, there was no statistical difference between the two groups in terms of MET values being 10 ≤ or 10 > (P = 0.172). CONCLUSION: The main conclusion of our study is that there is no correlation between the SYNTAX score and functional MET value in CCS.
Asunto(s)
Enfermedad de la Arteria Coronaria , Intervención Coronaria Percutánea , Humanos , Adolescente , Adulto , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/cirugía , Pronóstico , Estudios Retrospectivos , Equivalente Metabólico , Medición de Riesgo , Resultado del Tratamiento , Angiografía Coronaria , Factores de RiesgoRESUMEN
The exercise electrocardiography test (EET) is still used before coronary angiography in the diagnosis of chronic coronary syndromes. This study aimed to demonstrate the value of the combination of a positive EET with the systemic inflammatory index (SII), the plasma atherogenic index (PAI), and the monocyte/HDL-C ratio (MHR) in the determination of obstructive coronary artery disease (CAD). This single-center, retrospective study included 540 patients who underwent coronary angiography after ETT. The patients were separated into Group 1, comprising 434 patients with normal coronary arteries and non-obstructive CAD, and Group 2, including 106 with obstructive CAD. In Group 2, the patients were separated into SYNTAX ≤ 22 or ≥23. Glucose, low-density lipoprotein, white blood cells, and MHR were determined to be significantly higher in Group 2 (p < 0.05). According to the multivariate logistic regression analysis, age, gender, diabetes mellitus, and low-density lipoprotein were determined to be independent predictors of CAD. In the ROC curve analysis, a cut-off value of 12 for the MHR in the determination of obstructive CAD had a sensitivity of 60.4% and a specificity of 53.0%. The main result of this study was that a high MHR is an indicator of obstructive CAD in patients with positive EET and suspected CAD.
RESUMEN
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is clinically defined as myocardial infarction in the absence of obstructive atherosclerosis on coronary angiography. Diagnosis may require multiple diagnostic tools in addition to standard coronary angiography, including cardiac imaging or provocative tests, according to clinical suspicion. We assessed the usefulness of the DETERMINE (Defibrillators to Reduce Risk by Magnetic Resonance Imaging Evaluation) score for distinguishing patients with MINOCA from those with non-ST segment elevation myocardial infarction with obstructive coronary artery disease (NSTEMI-CAD) in a single-center observational study. The patients were divided into two groups according to coronary angiography findings. The study included 277 patients: 227 with NSTEMI-CAD and 50 with MINOCA. The DETERMINE score (6.1 ± 3.7 vs 1.9 ± 2.1, P<.001) was significantly higher in the NSTEMI-CAD than MINOCA group. Logistic regression analysis revealed that the DETERMINE score (OR=0.591, P<0.001) was an independent predictor of MINOCA. The incidence of diabetes mellitus and glucose levels were significantly higher in the NSTEMI-CAD group; however, ejection fraction was significantly higher in the MINOCA group (P<0.05). Our findings suggest that the DETERMINE score constitutes a simple and inexpensive tool for the assessment of MINOCA.
Asunto(s)
Enfermedad de la Arteria Coronaria , Infarto del Miocardio , Infarto del Miocardio sin Elevación del ST , Humanos , MINOCA , Infarto del Miocardio sin Elevación del ST/diagnóstico por imagen , Infarto del Miocardio sin Elevación del ST/complicaciones , Infarto del Miocardio/etiología , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/complicaciones , Angiografía Coronaria/métodos , Vasos Coronarios/diagnóstico por imagen , Factores de RiesgoAsunto(s)
Válvula Aórtica , Estenosis Coronaria/diagnóstico , Prótesis Valvulares Cardíacas , Hipercolesterolemia Familiar Homocigótica , Angina Inestable/etiología , Puente de Arteria Coronaria , Estenosis Coronaria/complicaciones , Estenosis Coronaria/diagnóstico por imagen , Estenosis Coronaria/cirugía , Vasos Coronarios , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVES: This study aims to compare the diastolic functions between fibromyalgia (FM) patients and control subjects by using transthoracic echocardiography. PATIENTS AND METHODS: This case-control and cross-sectional study included 34 female FM patients (mean age 43.6±8.2 years; range 28 to 57 years), who were diagnosed by The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia and defined as the FM group. A control group was defined consisting of 30 healthy females (mean age 41.2±9.1 years; range 22 to 54 years). Echocardiography findings of the groups were compared. RESULTS: The body mass index and mean disease duration of the FM group were 25.37±2.71 kg/m2 and 12.24 months, respectively. The body mass index of the control group was 25.58±1.49 kg/m2. There was no significant difference between the groups in terms of age and body mass index. Isovolumetric relaxation time and mitral E-wave deceleration time values were significantly higher in the FM group than in the control group (p=0.047, p=0.003, respectively). CONCLUSION: Isovolumetric relaxation time and mitral valve deceleration time are significantly prolonged in FM patients compared with healthy subjects. Female patients with FM seem to be under risk of impaired relaxation and diastolic function of the left ventricle.
Asunto(s)
Fibrilación Atrial/prevención & control , Benzazepinas/uso terapéutico , Electrocardiografía , Metoprolol/uso terapéutico , Estenosis de la Válvula Mitral/tratamiento farmacológico , Adolescente , Adulto , Anciano , Antiarrítmicos/uso terapéutico , Fibrilación Atrial/etiología , Fibrilación Atrial/fisiopatología , Fármacos Cardiovasculares/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Ivabradina , Masculino , Persona de Mediana Edad , Estenosis de la Válvula Mitral/complicaciones , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenAsunto(s)
Fibrilación Atrial , Obesidad , Accidente Cerebrovascular , Anticoagulantes/uso terapéutico , Fibrilación Atrial/complicaciones , Fibrilación Atrial/epidemiología , Índice de Masa Corporal , Humanos , Metaanálisis como Asunto , Obesidad/diagnóstico , Obesidad/epidemiología , Vigilancia de la Población , Factores de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/prevención & controlAsunto(s)
Angioplastia Coronaria con Balón , Cateterismo Periférico , Enfermedad Coronaria , Vasos Coronarios , Stents Liberadores de Fármacos , Angioplastia Coronaria con Balón/instrumentación , Angioplastia Coronaria con Balón/métodos , Cateterismo Periférico/instrumentación , Cateterismo Periférico/métodos , Toma de Decisiones Clínicas , Angiografía Coronaria/métodos , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/cirugía , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/patología , Stents Liberadores de Fármacos/clasificación , Stents Liberadores de Fármacos/normas , Humanos , Diseño de Prótesis , Arteria Radial/cirugíaRESUMEN
N-terminal pro-brain natriuretic peptide (NT-proBNP) levels are associated with short- and long-term mortality in acute coronary syndrome (ACS). We investigated whether baseline NT-proBNP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore). We enrolled 509 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤ 22), intermediate SXScore (23-32), and high SXScore (≥ 33). The NT-proBNP levels demonstrated an increase from low SXScore tertile to high SXScore tertile. The NT-proBNP levels according to the SXScore tertiles are as follows: low and intermediate (median 635 vs 1635, P = .014), low and high (median 635 vs 4568, P < .001), and intermediate and high (median 1635 vs 4568, P < .001). In multivariate analysis, NT-proBNP remained an independent predictor of high SXScore (odds ratio: 2.688, 95% confidence interval: 1.315-5.494, P = .007) together with age (P = .002), neutrophil-lymphocyte ratio (P = .017), and presence of non-ST-segment elevation ACS (P = .002). The NT-proBNP was independently associated with burden of coronary atherosclerosis in patients with ACS.
Asunto(s)
Síndrome Coronario Agudo/sangre , Enfermedad de la Arteria Coronaria/sangre , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Índice de Severidad de la Enfermedad , Síndrome Coronario Agudo/mortalidad , Anciano , Anciano de 80 o más Años , Enfermedad de la Arteria Coronaria/mortalidad , Femenino , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana EdadRESUMEN
Prosthetic heart valve thrombosis (PVT) is a rare but serious complication with high morbidity and mortality. The optimal treatment of the PVT is controversial and depends on thrombus location and size, the patient's functional class, the risk of surgery or thrombolysis, and the clinician's experience. Although surgical therapy has been the traditional therapeutic approach, studies with low-dose and slow-infusion rates of thrombolytic agents have revealed excellent results. This article reviews the various treatment options in patient with PVT.
RESUMEN
High sensitive C-reactive protein (hs-CRP) levels are associated with short- and long-term mortality in patients with acute coronary syndrome (ACS). We investigated whether baseline hs-CRP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore).We enrolled 321 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤ 22), and intermediate-high SXScore (≥ 23).Subjects in the intermediate-high SXScore tertile had higher serum hs-CRP levels compare to low SXScore tertile patients (7.7 ± 3.4 mg/L versus 4.9 ± 2.5 mg/L, P < 0.001). The mean age of patients and prevalance of diabetes in the intermediate-high SXScore tertile were significantly higher than in the low SXScore tertile (63 ± 13 versus 58 ± 12 years P = 0.001 for age, P = 0.007 for diabetes). Multivariate logistic regression analysis showed that the strongest predictors of high SXScore were increased serum hs-CRP levels (OR: 1.14) together with multivessel disease (OR: 0.23), left ventricular ejection fraction (LVEF) (OR: 0.90), and troponin levels (OR: 1.12).Serum hs-CRP levels on admission in patients with ACS could predict the severity and complexity of coronary atherosclerosis together with multivessel disease, LVEF, and troponin levels. Thus, increased serum levels of hs-CRP were one of the strong predictors of high SXScore in ACS patients.
Asunto(s)
Síndrome Coronario Agudo , Proteína C-Reactiva/metabolismo , Enfermedad de la Arteria Coronaria , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/etiología , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Análisis de Regresión , Proyectos de Investigación , Medición de Riesgo/métodos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Troponina/sangre , TurquíaRESUMEN
Low serum albumin (SA) levels are associated with increased cardiovascular mortality. We investigated whether baseline SA levels are associated with no-reflow following primary percutaneous coronary intervention (pPCI). A total of 536 patients (aged 60 ± 13 years; 74% men) who underwent pPCI were enrolled. The patients were divided into 2 groups: no-reflow and normal-reflow. No-reflow was defined as thrombolysis in myocardial infarction ≤2 flow. Admission SA levels were significantly lower in the no-reflow group than in the normal-reflow group (3.55 ± 0.44 vs 4.01 ± 0.32 mg/dL, P < .001). Also, high-sensitivity C-reactive protein (hsCRP), creatinine, creatine kinase myocardial band isoenzyme, and troponin T were significantly higher while hemoglobin and left ventricular ejection fraction (LVEF) were significantly lower in the no-reflow group. In multivariate analysis, SA level remained an independent predictor of angiographic no-reflow (odds ratio 0.114, 95% confidence interval 0.032-0.405, P = .001) together with LVEF, hsCRP, and baseline culprit artery patency. Admission SA level was an independent predictor of no-reflow after pPCI.
Asunto(s)
Angiografía Coronaria , Infarto del Miocardio/terapia , Fenómeno de no Reflujo/etiología , Admisión del Paciente , Intervención Coronaria Percutánea/efectos adversos , Albúmina Sérica/análisis , Anciano , Biomarcadores/sangre , Proteína C-Reactiva/análisis , Distribución de Chi-Cuadrado , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Infarto del Miocardio/sangre , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/fisiopatología , Fenómeno de no Reflujo/sangre , Fenómeno de no Reflujo/diagnóstico por imagen , Fenómeno de no Reflujo/fisiopatología , Oportunidad Relativa , Valor Predictivo de las Pruebas , Factores de Riesgo , Albúmina Sérica Humana , Volumen Sistólico , Resultado del Tratamiento , Grado de Desobstrucción Vascular , Función Ventricular IzquierdaRESUMEN
Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in acute coronary syndrome (ACS). Mean platelet volume (MPV) and serum uric acid (SUA) are associated with cardiovascular events in ACS. We investigated the relationship between the presence of non-IRA-CTO with MPV and SUA levels in patients with ACS. Patients (n = 1024) who underwent urgent coronary angiography for ACS were included in this study. Blood samples were drawn on admission. Patients were categorized into 2 groups: non-IRA-CTO (-) and non-IRA-CTO (+). The MPV and SUA levels on admission were significantly higher in the non-IRA-CTO (+) group than in the non-IRA-CTO (-) group (P < .001). At multivariate analysis, MPV (odds ratio [OR]: 4.705, P < .001) and SUA (OR: 2.535, P < .001) were independent predictors of non-IRA-CTO together with age, hemoglobin, ejection fraction, and non-ST-segment elevation ACS. The MPV and SUA levels were significant and independent predictors for the presence of non-IRA-CTO in patients with ACS.
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Síndrome Coronario Agudo/diagnóstico , Oclusión Coronaria/diagnóstico , Volúmen Plaquetario Medio , Activación Plaquetaria , Ácido Úrico/sangre , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/mortalidad , Anciano , Biomarcadores/sangre , Distribución de Chi-Cuadrado , Enfermedad Crónica , Angiografía Coronaria , Oclusión Coronaria/sangre , Oclusión Coronaria/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Admisión del Paciente , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de RiesgoRESUMEN
Increased red cell distribution width (RDW) is closely related to the poor prognosis and adverse events of cardiovascular diseases. We aimed to investigate the association of serum RDW levels and in-stent restenosis (ISR) after coronary stenting with bare-metal stent in patients with stable coronary artery disease. A total of 251 patients (age 62 ± 11 years, 69% male) with a history of coronary stenting who underwent control coronary angiography (128 with ISR and 123 without ISR) were enrolled into the study. Laboratory parameters were measured before angiography. ISR was defined as luminal stenosis ≥50% within the stent or within 5 mm of its edges by the quantitative coronary analysis. The patients were divided into the two groups: ISR group and no-ISR group. Baseline characteristics of the patients were similar. The ISR group had significantly higher RDW levels compared with patients in no-ISR group (14.47 ± 1.37 vs. 13.59 ± 0.88, p < 0.001). Furthermore, the ISR group had significantly longer stent length and lower stent diameter when compared to no-ISR group (p = 0.001 and p = 0.004, respectively). In a multivariate analysis, RDW levels >13.75%, high-sensitivity C-reactive protein levels, stent diameter and stent length were independently associated with ISR [odds ratio (OR) = 2.12, 95% confidence interval (CI) = 1.71-3.15, OR = 2.80, 95% CI = (1.34-4.61), OR = -2.60, 95% CI = -(1.19-4.51), OR = 2.02, 95% CI = 1.99-3.76, p = 0.001, respectively]. We concluded that increased serum RDW levels were independently associated with bare-metal ISR in patients with stable coronary artery disease.