The Relationship between Resistant Hypertension and Advanced Glycation End-Product Levels Measured Using the Skin Autofluorescence Method: A Case-Control Study.

Resistant hypertension is hypertension that cannot be controlled despite the use of three antihypertensive drugs, one of which is a diuretic. Resistant hypertension often coexists with advanced age, obesity, smoking, and diabetes. Advanced glycation end products (AGEs) are substances that are generated as a result of the glycation of proteins, lipids, and nucleic acids due to conditions such as hyperlipidemia, oxidative stress, and hyperglycemia. There are studies showing the relationships between AGE levels and aortic stiffness, hypertension, and microvascular and macrovascular complications in diabetes. In our study, we examined the relationship between resistant hypertension and AGE levels. Our study was planned as a case-control study, and 88 patients with resistant hypertension were included in the focus group, while 88 patients with controlled hypertension were included in the control group. The AGE levels of the patients were measured using the skin autofluorescence method. AGE levels were found to be significantly higher in patients with resistant hypertension than those recorded in the control group. A significant increase in AGE levels was also observed in patients with resistant hypertension and without diabetes compared with the control group. The levels of AGEs, which can be measured cheaply, noninvasively, and quickly with the skin autofluorescence method, may provide benefits in identifying these patients with resistant hypertension.

The Role of Advanced Glycation End-Product Levels Measured by Skin Autofluorescence in the Development of Mitral Annular Calcification.

As a person ages, mitral annular calcification develops in the mitral annulus with increasing frequency. Lipid deposition, inflammation, and aging-related degeneration have been cited as potential causes of this pathophysiology, though there is currently no conclusive evidence to support this. AGEs accumulate in tissues due to the glycation of proteins and lipids, increasing the release of proinflammatory cytokines secondary to oxidative stress through the AGE receptor. The AGE levels increase in diabetic microvascular complications and degenerative aortic valve disease. Our study was planned prospectively as a case-control study involving 94 MAC-positive patients and 94 MAC-negative patients. The demographics, echocardiographic data and AGE levels of the patients were measured and recorded using the skin autofluorescence method. AGE levels were significantly higher in the MAC-positive patient group (3.2 vs. 2.7; p < 0.001). The AGE levels were observed as an independent predictor of MAC development in a regression analysis (OR: 8.05, 95% CI: 3.74-17.33, p < 0.001). In a ROC-curve analysis, the AUC was 0.79 (95% CI: 0.72-0.85). At a cut-off value of 2.7, 79.7% sensitivity and 69.1% specificity were observed. AGE levels can be used to cheaply, easily and non-invasively identify patients at risk of developing MAC.

Short-Term Prognostic Value of the Culprit-SYNTAX Score in Patients with Acute Myocardial Infarction.

BACKGROUND: The SYNergy between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery (SYNTAX) score is a scoring system that helps to decide on surgery or percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI), and studies are showing the prognostic value of this scoring system in both AMI and coronary artery disease patients undergoing PCI. In acute coronary syndrome (ACS) patients, the infarct-related artery and the complexity of the lesions are also important in terms of mortality and morbidity. Our study aimed to determine the prognostic value of the culprit vessel's SYNTAX score (cul-SS) in patients presenting with MI. METHODS: In our study, 1284 patients presenting with MI were analyzed retrospectively. The SYNTAX scores and cul-SS of the patients were calculated. In-hospital and 30-day deaths and major complications were accepted as primary outcomes. The SYNTAX scores and cul-SS were compared in terms of predicting primary outcomes. CONCLUSIONS: Major complications were observed in 36 (2.8%) patients, death in 42 (3.3%) patients, and stent thrombosis in 24 (1.9%) patients. The area under the curves for SYNTAX and cul-SS for predicting primary outcomes is 0.64 and 0.68 (p = 0.026), respectively. Cul-SS was as successful as the SYNTAX score in predicting stent thrombosis and was superior in predicting short-term death and major complications.

The effect of being married on heart rate variability, an indicator of autonomic dysfunction: A retrospective study.

Heart rate variability (HRV) is a noninvasive assessment that reflects the autonomic functions of the heart and is known to be impaired in many diseases. In our study, we aimed to investigate the relationship between HRV and being married. The study included 104 patients, between the aged 20 to 40 years were included in the study. The patients were divided into 2 groups as 53 healthy married (group 1) and 51 healthy unmarried (group 2). 24-hour rhythm Holter recordings were performed on all married and unmarried patients. Group 1 had a mean age of 32 ± 5 years and 47.2% men, and group 2 had a mean age of 30 ± 5 years and 54.9% men. Standard deviation of normal to normal (SDNN) was 150 ± 40 versus 128 ± 30 ( P = .003), SDNN index was 66 ± 20 versus 56 ± 12 ( P = .004), the square root of the mean of the squares of the differences of the adjacent root mean square of successive differences (RMSSD) was 37 ± 10 versus 30 ± 10 ( P < .001), percentage of successive R-R intervals that differ by more than 50 milliseconds (PNN50) was 13.5 ± 7 versus 8.5 ± 7 ( P = .001), HF was 450 ± 270 versus 225 ± 130 ( P < .001) found to be significantly less in the group 2. LF/HF ratio was 1.68 ± 0.65 versus 3.31 ± 1.56 ( P < .001) found to be significantly higher in the group 2. In our study, it is possible to say that the sympathetic system effect on the heart was more dominant and the HRV was lower in the unmarried group.

Real-World Evaluation of Anticoagulant Treatment Patterns in Patients with Atrial Fibrillation: Data from Multicenter ROTA Study.

OBJECTIVE: Oral anticoagulant therapy is the cornerstone of atrial fibrillation management to prevent stroke and systemic embolism. However, there is limited real-world information regarding stroke and systemic embolism prevention strategies in patients with atrial fibrillation. The aim of the ROTA study is to obtain the real-world data of anticoagulant treatment patterns in patients with atrial fibrillation. METHODS: The ROTA study is a prospective, multicenter, and observational study that included 2597 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January 2021 and May 2021. RESULTS: The median age of the study population was 72 years (range: 22-98 years) and 57.4% were female. The median CHA2DS2-VASc and HAS-BLED scores were 4 (range: 0-9) and 1 (range: 0-6), respectively. Vitamin K antagonists and direct oral anticoagulants were used in 15.9% and 79.4% of patients, respectively. The mean time in therapeutic range was 52.9% for patients receiving vitamin K antagonists, and 76% of those patients had an inadequate time in therapeutic range with <70%. The most common prescribed direct oral anticoagulants were rivaroxaban (38.1%), apixaban (25.5%), and edoxaban (11.2%). The rate of overuse of vitamin K antagonists and direct oral anticoagulants was high (76.1%) in patients with low stroke risk, and more than one-fourth of patients on direct oral anticoagulant therapy were receiving a reduced dose of direct oral anticoagulants. Among patients who were on direct oral anticoagulant treatment, patients with apixaban treatment were older, had higher CHA2DS2-VASc and HAS-BLED scores, and had lower creatinine clearance than the patients receiving other direct oral anticoagulants. CONCLUSIONS: The ROTA study provides important real-world information about anticoagulant treatment patterns in patients with atrial fibrillation.time in therapeutic range with <70%.

Interventional therapy of acute coronary syndromes in very old patient population and results of 2 years follow-up.

BACKGROUND: Research on cardiovascular treatment options and prognosis in very old age groups of patients is warranted. In our study, we evaluated and followed up on clinical conditions on admission and comorbidities of patients older than 80 years who were admitted to our hospital with acute myocardial infarction and shared our findings. RESULTS: A total of 144 patients were included in the study, with a mean age of 84.56 ± 5.01 years. No complications resulting in death or requiring surgery were observed in the patients. All-cause mortality was found to be related to heart failure, chronic pulmonary disease shock, and C-reactive protein levels. Cardiovascular mortality was correlated to heart failure, shock on admission, and C-reactive protein levels. No significant difference in mortality was observed between Non-ST elevated myocardial infarction and ST-elevation myocardial infarction. CONCLUSIONS: Percutaneous coronary intervention is a safe treatment option with low complication and mortality rates in very old patients with acute coronary syndromes.

PrevAleNce and Associated factors of inappropriaTe dosing of direct Oral anticoaguLants In pAtients with Atrial Fibrillation: the ANATOLIA-AF Study.

PURPOSE: Inappropriate dosing of direct oral anticoagulants is associated with an increased risk of stroke, systemic embolism, major bleeding, cardiovascular hospitalization, and death in patients with atrial fibrillation. The main goal of the study was to determine the prevalence and associated factors of inappropriate dosing of direct oral anticoagulants in real-life settings. METHODS: This study was a multicenter, cross-sectional, observational study that included 2004 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January and May 2021. The main criteria for inappropriate direct oral anticoagulant dosing were defined according to the recommendations of the European Heart Rhythm Association. RESULTS: The median age of the study population was 72 years and 58% were women. Nine-hundred and eighty-seven patients were prescribed rivaroxaban, 658 apixaban, 239 edoxaban, and 120 dabigatran. A total of 498 patients (24.9%) did not receive the appropriate dose of direct oral anticoagulants. In a logistic regression model, advanced age, presence of chronic kidney disease and permanent atrial fibrillation, prescription of reduced doses of direct oral anticoagulants or edoxaban treatment, concomitant use of amiodarone treatment, and non-use of statin treatment were significantly associated with potentially inappropriate dosing of direct oral anticoagulants. CONCLUSION: The study demonstrated that the prevalence of inappropriate direct oral anticoagulant dosing according to the European Heart Rhythm Association recommendations was 24.9% in patients with atrial fibrillation. Several demographic and clinical factors were associated with the inappropriate prescription of direct oral anticoagulants.

Comparison of SYNTAX and Gensini Scores in the Decision of Surgery or Percutaneous Revascularization in Patients With Multivessel Coronary Artery Disease.

INTRODUCTION:  Many scoring systems have been developed to determine the extent of coronary artery disease (CAD) in patients with multi-vessel disease. The most widely used of these are Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) and Gensini scoring. Gensini scoring system can successfully show coronary plaque burden. In our study, we aimed to test the predictive power of SYNTAX and Gensini scores for surgical or percutaneous intervention decisions made by the cardiac team in patients with three-vessel disease. METHODS: A total of 476 patients without ST-elevation myocardial infarction with the three-vessel disease were included in the study. SYNTAX and Gensini scores of the patients were calculated from their coronary angiographies. Receiver operating characteristic curve (ROC-curve) analysis was performed using both scores. RESULTS:  Both the SYNTAX score and Gensini score were able to predict heart team decisions (AUC: 0.759, 0.680; p<0.001). Diabetes and smoking were more common in patients who were decided to have surgery (p<0.001). CONCLUSION:  In the light of our study results, the decisions to be made with the SYNTAX score will be closer to the decisions of the heart team than the Gensini score.

The effect of empagliflozin on P wave peak time and other P wave parameters in patients with diabetes mellitus.

BACKGROUND: Empagliflozin is a selective SGLT2 inhibitor and provides a significant reduction in hospitalizations in heart failure patients and a reduction in combined cardiovascular deaths regardless of diabetes. The mechanisms of favorable effects remain unclear. Improvement in left ventricular diastolic function and a decrease in filling pressure are any mechanisms of positive effects. These effects may show themselves with some changes on the electrocardiography (ECG). So, we aimed to evaluate the effect of empagliflozin on P wave parameters in type 2 diabetes mellitus patients without HF. METHOD: Fifty-three patients were included in the study. The electrocardiographic and echocardiographic evaluations were examined at the baseline and end of the third month for all patients. RESULTS: The median age of all patients was 55 (45-64 IQR). After treatment, LA volume (p <.001) and diameter (p = .001) in both the parasternal long-axis (p = .001) and the apical four-chamber view decreased. E/e' and systolic pulmonary arterial pressure were significantly decreased after treatment. P wave duration max,min, PWDmin, and PWdis were significantly shorter after treatment. The P wave peak time (PWPT) in lead Dii and V1 were significantly shorter after treatment. CONCLUSION: We found shortening of PWPT, PWdis, and PWD as reflections of improvements in left atrial volume and LV diastolic function on ECG after empagliflozin treatment.

The prognostic value of the nutritional prognostic index (NPI) and controlling nutritional status (CONUT) scoring systems in non-ST elevated myocardial infarction patients over 65 years of age.

BACKGROUND: Nutritional status and metabolic responses to inflammation changes with age and comorbid conditions. AIMS: We aimed to compare the predictive values of the nutritional prognostic index (NPI) and controlling nutritional status (CONUT) Score systems with the GRACE score in elderly (non-ST elevated myocardial infarction) NSTEMI patients. METHODS: NSTEMI patients over 65 years of age have been included in this study. The factors affecting mortality were determined by regression analysis. ROC curve analysis were performed and predictiveness of the scores was tested. RESULTS: Mean age of patients was 74.49 ± 7.60 years, median GRACE and NPI scores were 118 (107-131.50 IQR) and 50.10 (45.30-54.27 IQR), respectively, and CONUT scores ≥ 3 were 24.4% of all patients. 32 (15.6%) patients died within 6 months. White blood cells and albumin levels maintain their significance in the multivariate regression analysis (OR: 1.386; 0.025, p < 0.001, respectively). ROC curve analysis of NPI, CONUT, Killip, and GRACE scores were performed (AUC: 0.757; 0.744; 0.725; 0.800, p < 0.001, respectively). DISCUSSIONS: The frequency of NSTEMI increases with the effect of increasing age and comorbid conditions. The NPI and CONUT scoring systems have been tested in many previous studies to predict the prognosis of both malignancy and cardiovascular diseases. What makes this scoring system valuable for our study is the thought that our study group will be more prone to malnutrition because they are old and present with an acute presentation. CONCLUSIONS: NPI and CONUT scoring systems have been successful at rates approaching the GRACE score system, which is used primarily to predict the prognosis of NSTEMI.

Long-term results of long segment coronary artery lesions overlapped with novolimus-eluting DESolve scaffold: Disappointment or futuristic?

OBJECTIVE: The data on using novolimus-eluting DESolve bioresorbable scaffolds (BVS) for long-segment coronary artery lesions remains insufficient. In this study, our main objective was to assess the long-term effects of the overlapping applications of both DESolve-DESolve and the drug-eluting stent (DES)-DESolve. METHODS: A single-centered study of 103 patients scheduled for DESolve placement for long-segment lesions (>28 mm) was conducted (October 2013 to November 2016). A DESolve-DESolve overlap was used on 43 patients and a DES-DESolve overlap on 60 patients. Acute procedural success and major adverse cardiac events (MACE) (stent thrombosis, targeted vessel revascularization, targeted lesion revascularization, and cardiac death) were evaluated. The patients were followed up for 48 months. RESULTS: Revascularization was performed on 4 (6.7%) patients in the DES-DESolve group and 5 (11.6%) patients in the DESolve-DESolve group for target lesion revascularization. Among the study population, 10 (9.7%) patients had MACE, including 5 (8.3%) patients in the DES-DESolve group and 5 (11.6%) patients in the DESolve-DESolve group. CONCLUSION: The positive results of our study concerning the use of DESolve for the treatment of long coronary lesions demonstrate that BVS will emerge with new platforms and become non-inferior to the DES.

Comparison of ventricular repolarization parameters of Covid-19 patients diagnosed with chest CT and RT-PCR.

BACKGROUND AND OBJECTIVES: The aim of the comparison is to evaluate the marker of ventricular repolarization parameters such as QT, QTc, cQT, Tp-e, Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios and the risk of ventricular arrhtythmias in patients with newly diagnosed Covid-19. METHODS: The study included 2 separate groups. The first one consisted of 96 positive reverse transcriptase polymerase chain reaction (RT-PCR) Covid-19 patients and the second one of 106 patients with negative PCR but positive chest computed tomography (CT) findings consistent with Covid-19. We measured QTmax, QTmin, QRS, JT and Tp-e intervals and estimated Tp-e/QT max, Tp- e/QTc max, Tp-e/JT and Tp-e/JTc rates and QTc max, QTc min, cQTd and JTc intervals. RESULTS: QT max, QT min, JT, cQTd, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc values were significantly higher in RT-PCR Covid-19 patient group. CONCLUSION: Positive RT-PCR Covid-19 patients should be followed more closely, in terms of high ventricular repolarization parameters and preventing ventricular arrhythmias that may develop due to this.

Impact of surgical weight loss on novel P-wave-related variables which are nominated as predictors of atrial arrhythmias.

BACKGROUND: Bariatric surgery has been associated with reduced cardiovascular mortality and morbidity in obese patients. In this study, we aimed to evaluate the alterations of novel P-wave related atrial arrhythmia predictors in patients who achieved effective weight loss with bariatric surgery. METHODS: The study included 58 patients who underwent bariatric surgery. We measured heart rate, PR, P wave (PW) max, PW min, Average P axis, P wave peak time (PWPT) in lead D2 and lead V1, terminal force in lead V1 (V1TF), and we estimated P wave dispersion (PWdis) interval both pre-operation and 6 months after operation. RESULTS: Heart rate, PR, PW max, PW min, PWdis, Average P axis, PWPTD2, PWPTV1 and V1TF values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months after the operation. The most prominent changes were observed in PW dis (51.15 ± 9.70 ms vs. 48.79 ± 9.50 ms, p = .010), PWPTD2 (55.75 ± 6.91 ms vs. 50.59 ± 7.67 ms, p < .001), PWPTV1 (54.10 ± 7.06 ms vs. 48.05 ± 7.64 ms, p < .001) and V1TF (25 [43.1%] vs. 12 [20.7%], p < .001). CONCLUSIONS: The results of our study indicated that bariatric surgery has positive effects on the regression of ECG parameters which are predictors of atrial arrhythmias, particularly atrial fibrillation (AF).

The effect of chronic DOAC treatment on clinical outcomes of hospitalized patients with COVID-19.

BACKGROUND: Recent findings indicate that thrombosis is one of the underlying pathophysiology and complication of COVID-19 infection. Therefore, the prognosis of the disease may be more favourable in people who were under oral anticoagulant treatment before the COVID-19 diagnosis. This study aims to evaluate the effects of chronic DOAC use on ICU admission and mortality in hospitalized patients due to COVID-19 infection. METHOD: Between 1 September and 30 November 2020, 2760 patients hospitalized in our hospital due to COVID-19 were screened. A total of 1710 patients who met the inclusion criteria were included in the study. The patients were divided into two groups as those who use DOAC due to any cardiovascular disease before the COVID-19 infection and those who do not. RESULTS: Seventy-nine patients were enrolled in the DOAC group and 1631 patients in the non-DOAC group. Median age of all study patient was 62 (52-71 IQR) and 860 (50.5%) of them were female. The need for intensive care, in-hospital stay, and mechanical ventilation were observed at higher rates in the DOAC group. Mortality was observed in 23 patients (29%) in the DOAC group, and it was statistically higher in the DOAC group (P = .002). In the multivariable analysis, age (OR: 1.047, CI: 1.02-1.06, P < .001), male gender (OR: 1.8, CI: 1.3-2.7, P = .02), lymphocyte count (OR: 0.45, CI: 0.30-0.69, P < .001), procalcitonin (OR: 1.12, CI: 1.02-1.23, P = .015), SaO2 (OR: 0.8, CI: 0.77-0.82, P < .001) and creatinine (OR: 2.59, CI: 1.3-5.1, P = .006) were found to be associated with in-hospital mortality. DOAC treatment was not found to be associated with lower in-hospital mortality in multivariable analysis (OR:1.17, CI: 0.20-6.60, P = .850). CONCLUSION: Our study showed that the use of DOAC prior to hospitalization had no protective effect on in-hospital mortality and intensive care need in hospitalized COVID-19 patients.

Evaluation of Changes in Ventricular Repolarization Parameters in Morbidly Obese Patients Undergoing Bariatric Surgery.

BACKGROUND: Weight loss after bariatric surgery has been associated with reduced cardiovascular mortality and overall mortality in obese patients. In this study, we aimed to analyze the changes between pre-operation and post-operation ventricular arrhythmia predictors in patients who underwent bariatric surgery. MATERIALS AND METHODS: The study included 58 patients who underwent bariatric surgery. We measured QT max, QT min, QRS, JT, and Tp-e intervals, and we estimated Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc rates, QTc max, QTc min, cQTd, and JTc intervals both pre-op and 6 months post-op. RESULTS: Heart rate, PR, QT max, QTc max, QTc min, cQTd, JTc, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, and Tp-e/JTc values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months post-op. CONCLUSION: The results of our study showed that bariatric surgery had positive effects on the regression of ventricular repolarization parameters and the possible development of ventricular arrhythmia.

Short- and long-term outcomes of percutaneous coronary interventions of high-risk vs. low-risk lesions performed at a hospital without an on-site cardiac surgery unit.

Aim    Widespread utilization of technology has led to the construction of a growing number of facilities with coronary angiography units and percutaneous coronary intervention (PCI) capability. Some of these centers do not have cardiovascular surgery (CVS) on site. Studies regarding the efficacy and safety of PCIs performed at these hospitals have been conducted. However, to date, high-risk procedures in this context have not been evaluated. The present study compares the outcomes of PCI procedures performed on high- and low-risk lesions groups in a center without CVS back-up.Material and methods    A total of 999 patients treated with PCI with diagnoses other than ST elevation myocardial infarction were included in this study. Patients with SYNTAX scores 22 or higher, bifurcation lesions, chronic total occlusions, left main coronary artery lesions and saphenous graft lesions were classified as a high-risk group. In contrast, patients with SYNTAX scores lower than 22 were included in the low-risk group. Coronary lesions were classified as Type-A, B, and C. The 30­day major adverse cardiac events (MACE) and 1­year target vessel revascularization (TVR) rates were compared.Results    There was no significant difference between the groups in terms of the rates of MACE (2 (0.9 %) vs 5 (0.6 %); p=0.64) and TVR (9 (4.2 %) vs 25 (3.2 %); p=0.52). Analysis regarding the lesion type also revealed no significant difference between the MACE and TVR rates (p=0.56 and p=0.43, respectively).Conclusions    The findings in this study demonstrated that, similar to low-risk procedures, complex and high-risk coronary interventions can safely and effectively be conducted in hospitals without a CVS unit.

High tenascin-C levels cause inadequate myocardial blush grade in patients with acute myocardial infarction.

AIM: Coronary artery disease (CAD) and its serious clinical form, ST segment elevated myocardial infarction (STEMI) has been the leader within the death causes around the world and in our country. In STEMI, the main objective is providing the myocardial reperfusion. In our study, it was aimed to investigate the predictive value of tenascin-C level for the degree of myocardial reperfusion in patients with STEMI. METHODS: In our study, 58 patients admitted to our hospital with acute anterior STEMI were included. All the patients had underwent primary percutaneous intervention for the single-vessel disease at left anterior descending coronary artery. After admission to coronary care unit tenascin-C levels were measured. Subjects were classified according to their myocardial blush grades (MBG); MBG 0, MBG 1 and MBG 2 were groupped as Group I, MBG 3 was groupped as Group II. The groups were compared according to their tenascin-C levels and other parameters. RESULTS: Between group I (n = 31, mean age 55 ± 12.5) and group II (n = 27, mean ages 49.3 ± 11.1); tenascin-C, troponin I and CK-MB levels were significantly higher in group I compared to the group-II (P < 0.001; P < 0.001 and P < 0.05; respectively). In group I, left ventricular ejection fraction (LVEF) was significantly lower (P < 0.001), left ventricular end-diastolic volume and left ventricular end-systolic volume were significantly higher (P = 0.03) as compared to group II. In group I, ST-segment resolution at ECG was worse (P = 0.003). In correlation analyzes, tenascin-C was significantly positively correlated with troponin-I (r = 0.596; P < 0.001) and CRP (r = 0.615, P < 0.001). Tenascin-C was significantly negatively correlated with MBG, LVEF and ST-segment resolution (r = -0.626, P < 0.001, r = -0.411, P = 0.002 and r = -0.631; P < 0.001, respectively). CONCLUSION: Based on our study, it can be estimated that in patients with high tenascin-C levels myocardial reperfusion was inadequate, even underwent successfull PCI. In this context, increased tenascin-C may help predict not only left ventricular remodelling and prognosis but also the effectiveness of primary PCI.