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.

Myocardial performance index increases at long-term follow-up in patients with mild to moderate COVID-19.

BACKGROUND: The long-term cardiovascular effects of Coronavirus disease-2019 (COVID-19) are not yet well known. Myocardial performance index (MPI) is a non-invasive, inexpensive and reproducible echocardiographic parameter that reflects systolic and diastolic cardiac functions. The aim of the study was to compare MPI with a healthy control group in patients with mild or moderate COVID-19 infection who subsequently had unexplained cardiac symptoms. METHODS: The study included 200 patients aged 18-70 years who were diagnosed with COVID-19 infection at least 2 months ago and defined cardiac symptoms in their follow-up. Patients with mild or moderate symptoms, no history of hospitalization, and no other pathology that could explain cardiac symptoms were included in the study. As the control group, 182 healthy volunteers without COVID-19 were evaluated. Echocardiographic examination was performed on the entire study group. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT), and ejection time (ET) were measured by tissue Doppler imaging. MPI was calculated with the IVCT+IVRT/ET formula. RESULTS: The mean age of the study group was 44.24 ± 13.49 years. In the patient group the MPI was significantly higher (.50 ± .11 vs .46 ± .07, p < .001), IVRT was longer (69.67 ± 15.43 vs 65.94 ± 12.03 ms, p = . 008), and ET was shorter (271.09 ± 36.61 vs 271.09 ± 36.61 ms, p = .028). IVCT was similar between groups (63.87 ± 13.66 vs. 63.21 ± 10.77 ms, p = .66). Mitral E and mitral A wave, E', A', and E/A were similar in both groups. CONCLUSIONS: Our study showed that conventional diastolic function parameters were not affected in patients who survived COVID-19 with mild symptoms but had symptoms in the long term. However, MPI measurements showed left ventricular dysfunction. To our knowledge, this is the first echocardiographic follow-up study to evaluate left ventricular systolic and diastolic functions with MPI in COVID-19 patients. We think that when cardiac involvement assessment is required in patients who have survived COVID-19, MPI should be measured alongside other echocardiographic measurements.