Renal artery occlusion in the late postoperative period managed with renal artery stenting after endovascular abdominal aortic aneurysm repair and renal function salvage.

Endovascular aneurysm repair (EVAR) of abdominal aorta is a valuable treatment option in selected patients with abdominal aortic aneurysm. Renal artery occlusion is a serious complication after EVAR and may progress to permanent renal injury requiring hemodialysis. In this report, case of unexpected renal artery occlusion after EVAR treated with renal artery stenting in the late postoperative period is described.

Rehabilitation of Eyelid Malpositions Secondary to Facial Palsy.

OBJECTIVES: To evaluate patient satisfaction and outcomes of surgical treatment of eyelid malpositions secondary to facial palsy. MATERIALS AND METHODS: Consecutive patients with facial palsy who underwent surgical treatment by the same surgeon at Izmir Katip Çelebi University Atatürk Training and Research Hospital between Jan 2007 and Dec 2012 were included in the study. Ophthalmic examination findings, surgical approaches, and their outcomes were evaluated. A successful result for upper eyelid position was defined as more than 50% reduction in lagophthalmos and induction of less than 2 mm of ptosis. A successful outcome for lower eyelid position was defined as the lower eyelid residing at or within 1 mm above or below the limbus. Linear visual analog scale 1 (VAS-1) (subjective complaints) and VAS-2 (cosmetic outcome), both ranging from 0 to 10, were used to compare preoperative findings with findings at last postoperative visit. RESULTS: The mean age of the 14 female and 21 male patients was 54.5±19.9 years. Gold weight implantation (n=31), lateral tarsal strip (n=22), tarsorrhaphy (n=15), suborbicularis oculi fat elevation (n=16), hard palate graft (n=14), and eyebrow ptosis repair (n=6) were performed. Average follow-up time was 17.9±16.9 months (range, 2-60). Surgical success rates were 90% for upper lids and 75% for lower lids. Mean lagophthalmos decreased from 7.1±2.7 mm to 1.6±1.6 mm postoperatively (p=0.000). The use of lubricating drops and gels was reduced from average preoperative daily values of 5.3±2.5 drops and 1.3±0.6 gel applications to 4.4±1.4 and 0.6±0.6, respectively (p=0.003, p=0.001). CONCLUSION: An individualized surgical approach tailored according to each patient's severity of facial palsy and associated malpositions resulted in both functional and aesthetic improvements in our patients.

Relationships among concha bullosa, nasal septal deviation, and sinusitis: Retrospective analysis of 296 cases.

We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients-132 men and 164 women, aged 17 to 76 years (median: 39)-who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.

Evaluation of arterial stiffness and subclinical atherosclerosis in patients with Behçet's disease without cardiovascular involvement.

OBJECTIVE: This study was conducted to evaluate arterial structure and function with assessment of pulse wave velocity (PWV) and carotid intima-media thickness (CIMT) in patients with Behçet's disease (BD). METHODS: Thirty patients (13 female, 17 male) with BD and 30 age, sex-matched healthy controls (12 female, 18 male) with no known cardiovascular disease were enrolled in this study. Carotid-femoral PWV and CIMT were measured. RESULTS: PWV was higher in BD patients compared with control group (6.35±1.05 vs. 5.75±0.83, respectively; p=0.017). There was no significant difference in maximum CIMT (0.751±0.077 mm vs. 0.735±0.079 mm, respectively; p=0.435), or mean CIMT (0.643±0.070 mm vs. 0.629±0.069, respectively; p=0.452). Maximum CIMT, mean CIMT, and PWV were positively correlated with duration of disease (r=0.410, p=0.025; r=0.404, p=0.027; and r=0.362, p=0.049, respectively). CONCLUSION: Findings suggest that endothelial function is impaired in cases of BD before visible structural changes to arterial wall. PWV is more useful measurement than CIMT in determination of vascular damage in BD, especially in early stage of disease duration.

[Congenitally corrected transposition of the great arteries in patient with atrial septal defect and acute inferior segment myocardial infarction]. / Ileri yasta akut inferiyor miyokart enfarktüsü ile basvuran ve atriyal septal defekt anomalisinin eslik ettigi dogumsal düzeltilmis büyük arter transpozisyonu.

Congenitally corrected transposition of the great arteries is a rare abnormality accounting for approximately 1% of clinically apparent congenital heart disease. Age at time of diagnosis and survival rate vary and depend on associated anomalies, including pulmonary stenosis, ventricular septal defect, atrial septal defect, atrioventricular block, and atrioventricular valve regurgitation. Reported cases of corrected transposition of the great arteries with single coronary ostium anomaly and atrial septal defect are very rare. Described in the present report is the case of a 55-year-old male who presented with acute inferior ST-segment elevation myocardial infarction and coincidental single coronary ostium arising from the right sinus of Valsalva, as observed on coronary angiography. Successful balloon angioplasty and stenting of the circumflex artery were performed. Echocardiography demonstrated the corrected transposition of the great arteries with negative contrast enhancement between the atrial chambers. The patient was discharged with medical therapy on the eighth postoperative day. To our knowledge, the present is the first report to describe corrected transposition of the great arteries, atrial septal defect, single coronary ostium, and acute myocardial infarction as comorbidities.

Red cell distribution width and neutrophil-to-lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction.

OBJECTIVES: Red cell distribution width (RDW) and neutrophil-to-lymphocyte ratio (NLR) are the two markers used to determine risk of mortality and adverse cardiovascular outcomes in patients with acute myocardial infarction. The relationship between RDW, NLR, and left ventricular (LV) systolic functions has not been reported. In this report, we aimed to investigate the relationship between RDW, NLR, and LV systolic function in anterior ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (PCI). METHODS: RDW and NLR were measured on admission in 106 STEMI patients treated with primary PCI. Patients were divided into two groups according to left ventricular ejection fraction (LVEF), as Group I (systolic dysfunction, LVEF <50%) and Group II (preserved global left ventricle systolic function, LVEF ⩾50%). The first group included 47 patients and the second group included 59 patients. RESULTS: Mean RDW and NLR were significantly higher in Group I compared to Group II [13.7 ± 0.9% vs. 13.4 ± 0.7%, p = 0.03 and 5.86 (range, 0.66-40.50) vs. 2.75 (range, 0.51-39.39), p = 0.013, respectively]. CONCLUSION: Increased RDW and NLR on admission, in anterior STEMI patients treated with primary PCI are associated with LV systolic dysfunction.

Early thrombus formation in patient with HeartWare left ventricular assist device presenting with acute heart failure.

Heart failure is one of the leading causes of mortality and morbidity in the world. Heart transplantation is still the gold standard therapy despite emerging treatment options. Due to the limited number of available donors, the use of ventricular assist devices has increased. However, increasing incidences of complications are observed with using these devices. In this article, surgical treatment of a huge mobile thrombus formation in an inflow cannula due to ineffective anticoagulation in a 59 year-old man who received a HeartWare ventricular assist device because of ischemic cardiomyopathy is presented.

Relation of neutrophil-to-lymphocyte ratio with GRACE risk score to in-hospital cardiac events in patients with ST-segment elevated myocardial infarction.

In this study, we aimed to investigate the association of the neutrophil-to-lymphocyte ratio (NLR) with Global Registry of Acute Coronary Events (GRACE) risk score in patients with ST-segment elevated myocardial infarction (STEMI). We analyzed 101 consecutive patients with STEMI. Patients were divided into 3 groups by use of GRACE risk score. The association between NLR and GRACE risk score was assessed. The NLR showed a proportional increase correlated with GRACE risk score (P < .001). The occurrence of in-hospital cardiac death, reinfarction, or new-onset heart failure was significantly related to NLR at admission (P < .001). Likewise, NLR and GRACE risk score showed a significant positive correlation (r = .803, P < .001). In multivariate analysis, NLR resulted as a predictor of worse in-hospital outcomes independent of GRACE risk score. Our study suggests that the NLR is significantly associated with adverse in-hospital outcomes, independent of GRACE risk score in patients with STEMI.

Evaluation of subclinical left ventricular systolic dysfunction using two-dimensional speckle-tracking echocardiography in patients with non-alcoholic cirrhosis.

INTRODUCTION: Cirrhosis is associated with certain abnormalities in left ventricular (LV) structure and function. Two-dimensional speckle-tracking echocardiography (2D-STE) enables a rapid and accurate analysis of regional LV systolic mechanics in the longitudinal, radial and circumferential directions. The aim of this study was to precisely assess the differences among the 3 directions in the early impairment of LV myocardial contraction in non-alcoholic cirrhotic patients with preserved LV pump function. METHODS: A total of 75 subjects, including 38 cirrhotic patients and 37 healthy individuals, were enrolled. Using 2D-STE, the strain (S) and systolic strain rate (SRS) values belonging to the radial (R), circumferential (C), and longitudinal (L) functions of the LV were measured. RESULTS: In the cirrhotic group, the LS (20.57 ± 2.1 vs. 28.7 ± 43.1, p<0.001) and LSR-S (1.1 ± 0.24 vs. 1.6 ± 0.3) values were found to be lower, whereas the CS (24.82 ± 2.57 vs. 19.16 ± 4.58, p<0.001) and CSRS (1.41 ± 0.3 vs. 1.2 ± 0.4, p<0.004) values were found to be higher than in the healthy control group. The RS and RSR-S values did not differ among the groups. A relationship was observed between the MELD score, which shows the severity of the disease, and the CS value (â: 0.211, p<0.01, 95%CI: 0.086-0.503). CONCLUSION: LV myocardial contraction was impaired in the longitudinal direction. However, LV pump function was augmented by the circumferential shortening during the ventricular systole. Using the 2D-STE method for the regional evaluation of the LV, the LV damage can be detected in the subclinical phase in cirrhotic patients.

Advanced oxidation protein product level in children with chronic otitis media with effusion.

OBJECTIVE: To determine the level of advanced oxidation protein products (AOPPs) in children with chronic otitis media with effusion (COME), in an effort to elucidate the multifactorial etiology of this disease. METHODS: This study involved 25 COME patients and 30 healthy children (control group) recruited from the Ear, Nose and Throat (ENT) and Pediatric Departments, respectively, of the Haseki Research and Training Hospital. In the COME group, blood samples were collected before a middle ear operation, and middle ear fluid was sampled during the operation. Blood samples were also obtained from the control subjects. AOPP levels in the plasma and effusion fluid were measured by the spectrophotometric method. RESULTS: In the COME group, the mean AOPP levels in plasma and effusion fluid were 168.08 µmol/l and 412.75 µmol/l, respectively. In the control group, the mean plasma AOPP level was 141.54 µmol/l. The plasma AOPP levels did not significantly differ between the COME and control groups (p>0.05). In the COME group, however, the effusion fluid AOPP level (412.75 ± 204.54 µmol/l) was significantly higher than the plasma AOPP level (168.08 ± 68.45 µmol/l; p<0.01). CONCLUSION: We found that AOPP levels were elevated in the effusion fluid, but not in the plasma, of COME patients. Thus, COME was associated with protein oxidation abnormalities. Oxidative stress may play a role in the etiopathogenesis of COME, and AOPPs may be used as markers of oxidative stress; however, further studies are required to confirm these findings.

[Relation between mean platelet volume and subclinical atherosclerosis in patients with metabolic syndrome]. / Metabolik sendromlu hastalarda ortalama trombosit hacminin subklinik ateroskleroz ile iliskisi.

OBJECTIVES: Metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. There is evidence of platelet activation in MetS. Mean platelet volume (MPV), a determinant of platelet activation, is a newly emerging risk factor for atherothrombosis. Therefore, we investigated the possible association between subclinical atherosclerosis, as evaluated by carotid intima-media thickness (CIMT) measurement and MPV, in MetS patients. STUDY DESIGN: Seventy-four patients with MetS were enrolled in the study. Patients were divided into two groups according to CIMT measurement: 35 patients with CIMT >=1.0 mm were in Group 1 and 39 patients with CIMT <1.0 mm were in Group 2. MPV was measured using an automated blood cell counter. RESULTS: The MPV level was significantly higher in patients with CIMT >=1.0 mm than in patients with CIMT <1.0 mm (8.2±0.7 vs. 7.8±0.6 fl; p=0.01). In our study, we observed that platelet count was lower in KIMK >=1.0 mm group and this finding was also found to be statistically significant. CONCLUSION: The risk of atherosclerosis could be shown by following the MPV values in MetS patients. Therefore, our results suggest that MPV is an important marker for early detection of atherosclerotic risk in patients with MetS.

Repair of symptomatic nasoseptal perforations using mucosal regeneration technique with interpositional grafts.

Over the past 60 years, many surgical techniques have been developed for the repair of nasoseptal perforations. This study describes a safe and practical technique involving the 5-layer repair of symptomatic nasoseptal perforations without mucosal flaps. The present study involved 23 patients (17 men and 6 women) who had symptomatic nasoseptal perforations in the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital. Patients were treated using the mucosal regeneration technique. Follow-up examinations were performed at 3 and 6 months postoperatively. The surgery was considered successful if total closure was achieved. Nasal mucosal physiology was also assessed preoperatively and at 3 and 6 months postoperatively by measuring the nasal mucociliary clearance time by means of the saccharin test. The most common etiological factor was former nasal surgery (56.5%), followed by nasal trauma (26%). In 4 patients (17.5%), the perforations were idiopathic. The average preoperative perforation size was 1.74 ± 0.87 cm. Total closure of the perforation was achieved in 21 patients (91.3%), and only 2 patients had subtotal healing. The mean preoperative mucociliary clearance time was 19.3 ± 4.15 minutes, which significantly improved to 12.4 ± 3.53 minutes and 10.1 ± 3.21 minutes at 3 and 6 postoperative months, respectively. Mucosal regeneration technique with interpositional grafts can be used to safely and reliably repair medium-to-large nasoseptal perforations.

Evaluation of increased subclinical atherosclerosis risk with carotid intima-media thickness and pulse wave velocity in inflamatory bowel disease.

BACKGROUND/AIMS: A significant increase in accelerated atherosclerosis risk have determined in chronic inflammatory diseases. Recent studies have suggested a pathophysiological link between inflamatory bowel disease (IBD) and atherosclerosis; for which carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) has been considered as an early marker. The aim of this study was to determine the presence of early atherosclerosis in IBD patients without clinically diagnosed cardiovascular disease and any coincident risk factors for atherosclerosis. MATERIALS AND METHODS: 40 IBD patients who are in remission and without known atherosclerosis and also without any risk factors for atherosclerosis (17 Crohn's disease and 23 ulcerative colitis ) and 40 healthy subjects for control group involved in the study. The measurement of bilateral CIMT and carotis-femoral PWV have done in patients and control groups. RESULTS: Significant differences existed between control subjects and patients with IBD in the values of PWV (5.97±0.54 vs. 7.17±0.92 m/sn; p<0.001), maximum CIMT (0.76±0.06 vs. 0.86±0.11 mm; p<0.001) and mean CIMT (0.66±0.06 vs 0.74±0.09 mm; p<0.001). In the correlation analysis, a positive correlation has determined between PWV and maximum CIMT and mean CIMT ( p<0.001, r=0.75 / p<0.001, r=0.74 respectively ). CONCLUSION: IBD patients have an increased risk of subclinical atherosclerosis than healty controls as showed by greater values of CIMT and PWV.

Use of bispectral index monitoring for determination of sedation depth in 50 patients undergoing cardioversion.

OBJECTIVES: To investigate the contribution of Bispectralindex monitoring on the amount of used anaesthetic substance and the quality of anaesthesia in patients with persistent atrial fibrillation who would undergo cardioversion. METHODS: The prospective, randomised, controlled clinical study was conducted at Akdeniz University, Antalya, Turkey from October 2010 to November 2011 Sedation was performed on 50 adult patients using midazolam and fentanyl. Patients were randomised to group 1 and 2. In group 1 cardioversion was performed when the BispectralIndex value was seen to have decreased to <80 and the Ramsay sedation score was 5-6. In Group 2, BispectralIndex monitor was blinded to the investigator, and cardioversion was performed when Ramsay sedation score was 5-6. In both groups, blood pressure, heart rate and Bispectral index values were recorded. Total anaesthetic amount, awareness and pain were also assessed. SPSS 13 was used for statistical analysis. RESULTS: Overall, 23(46%) patients were male and 27(54%) were female and there was no significant difference in the two groups in terms of age (p>0.05). No statistically significant difference was detected between the groups in terms of induction time, anaesthetic need and Bispectral Index values (p>0.05). In both groups, 2(8%) patients perceived pain and 2(8%) perceived the procedure. CONCLUSION: In the presence of anaesthetist in the team, Bispectral Index monitoring did not contribute to the determining of anaesthetic drug dosage and the depth and quality of anaesthesia in patients with persistent atrial fibrillation during cardioversion.

The effect of nebivolol on P wave duration and dispersion in patients with Behçet's disease; a prospective single-arm controlled study.

OBJECTIVE: Behçet's disease (BD) is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in BD. P wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. PD has been reported to be longer in patients with BD. Nebivolol, besides its selective beta1-blocking activity, causes an endothelium dependent vasodilatation through nitric oxide release. In this study, we searched for the effects of nebivolol on P wave duration and dispersion in patients with BD. METHODS: This study was designed as prospective single-arm controlled study. We prospectively studied 35 Behçet's patients who were diagnosed according to the International Study Group criteria. Patients received 5 mg nebivolol per day for 3 months. The patients were evaluated with 12-leads electrocardiography at baseline and after for 3-month therapy. The difference between maximum and minimum P wave durations was defined as PD. The paired samples t test, Wilcoxon test were used for statistical analysis. RESULTS: A significant decrease was observed in PD after therapy period (62.85±21.62 vs. 44.28±18.03 msec, p=0.001). No adverse effects were observed in treatment period. CONCLUSION: BD is associated with prolonged P wave duration and dispersion. We have shown for the first time that nebivolol causes a significant decrease in maximum P wave duration and PD in patients with BD. However, further comprehensive studies are needed to determine the long-term effects of nebivolol.

Evaluation of left atrial function using two-dimensional speckle tracking echocardiography in end-stage renal disease patients with preserved left ventricular ejection fraction.

BACKGROUND: Left atrial (LA) deformation analysis by two-dimensional speckle tracking echocardiography (2D-STE) has recently been proposed as an alternative approach for estimating left ventricular (LV) filling pressure and dysfunction. AIM: To assess the LA myocardial function using 2D-STE in end-stage renal disease (ESRD) patients with preserved LV ejection fraction (PLVEF) and to evaluate the relationship of the obtained results with echocardiographically estimated pulmonary capillary wedge pressure (ePCWP). METHODS: Eighty-five ESRD patients and 60 healthy individuals were enrolled in the study. Images of the LA were acquired from apical two- and four-chamber views. The LA volumes (LAV) were calculated using the biplane area-length method. The LA volume indices (LAVI) were calculated by dividing the LA volumes by the body surface area. The LA strain (%) (LAS) parameters (systolic [LA(S-S)], early diastolic [LA(S-E)], late diastolic [LA(S-A)] during atrial contraction) were assessed, and the ePCWP was calculated according to the following formula: ePCWP = 1.25(E/E') + 1.9. LA stiffness was calculated non-invasively and based on the ratio of E/E' to LAS-S. RESULTS: In patients with ESRD, the LA(S-S) (32.22 ± 7.64% vs. 57.93 ± 8.71%; p < 0.001), LA(S-E) (-15.86 ± 5.7% vs. -33.37 ± 7.71%; p < 0.001), and the LA(S-A) (-15.41 ± 4.16% vs. -24.57 ± 4.68%; p < 0.001) values were observed to be lower than the healthy group; while the LA stiffness (0.4 ± 0.19 vs. 0.17 ± 0.05; p < 0.001) value was higher. When the patients with ESRD were divided into two groups as those with a maximum LAVI value over 31.34 mL/m² and those with a maximum LAVI below this value, the LA(S-S) (30.36 ± 8.32% vs. 34.11 ± 6.43%; p = 0.023) and the LA(S-E) (-14.97 ± 5.88% vs. -16.76 ± 5.42%; p = 0.039) values were lower in the group with a LAVI value over 31.34 mL/m²; while the LA(S-A) (-16.06 ± 4.44% vs. -14.75 ± 3.8%; p < 0.001) and LA stiffness (0.4 ± 0.19 vs. 0.17 ± 0.05; p < 0.001) values were higher. An association was observed between the ePCWP and LA(S-S) (p < 0.001), LAS-E (p = 0.01), LA(S-A) (p < 0.001), and LA stiffness (p < 0.001) values. CONCLUSIONS: The results of our study have demonstrated that LA myocardial function assessed using the 2D-STE method is associated with the ePCWP, which is an echocardiographically calculated marker of LV dysfunction. The LA deformation parameters may be used as echocardiographic findings to predict the LV dysfunction in ESRD patients with PLVEF. Further studies are needed to determine the independent prognostic power of the atrial strain measurement as a predictor of future cardiovascular events in ESRD patients.

Normal range of peak nasal inspiratory flow and its role in nasal septal surgery.

Nasal obstruction can be evaluated by objective and subjective methods. We sought to determine normative peak nasal inspiratory flow meter (PNIF) measurements of a healthy population in Turkey and to investigate the importance of PNIF in surgery for nasal septal deviation as well as to investigate the correlation of PNIF with subjective methods. In a total of 269 patients, 50 patients underwent septoplasty and 219 control subjects were enrolled in the study. Data on preoperative and postoperative PNIF measurements, nasal septal indices, and subjective measurements (visual analogue scale, VAS) were recorded. Mean PNIF value was 137.8 L/min in control subjects. Postoperative PNIF, VAS, and nasal septal index data were statistically significantly higher in the study group as compared with those of preoperative data. We found PNIF, VAS, and nasal septal indices of the control group to be consistent with postoperative data and to be higher than preoperative data of the study group. We identified a normal PNIF range for the healthy Turkish population and we saw that the data were compatible with VAS scores. PNIF seems to be a very effective method in the evaluation of nasal obstruction and in deciding operation.

Association between mean platelet volume and severity of disease in patients with obstructive sleep apnea syndrome without risk factors for cardiovascular disease.

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. Platelet activation and aggregation are central processes in the pathophysiology of atherothrombosis. Mean platelet volume (MPV), a determinant of platelet activation, is a newly-emerging risk factor for atherothrombosis. Therefore, we have investigated the possible association between OSAS and MPV. STUDY DESIGN: We selected 30 mild, 32 moderate, and 31 severe OSAS patients and 31 healthy control subjects matched for age, sex, and body mass index. MPV was measured using an automated blood cell counter. RESULTS: The MPV levels were significantly higher in the severe OSA group than in the control group (8.6±1.1 vs. 7.8±0.7 fl, p=0.03). There were no significant differences in respect to MPV between controls and patients with mild and moderate OSA (7.8±0.7 vs. 8.3±1.2 fl, p=0.2; 7.8±0.7 vs. 8.4±1.3 fl, p=0.08) and between patients with mild, moderate, and severe OSA (8.3±1.2 vs. 8.4±1.3 vs. 8.6±1.1 fl, p=0.9). Significant correlations were seen between MPV and apnea-hypopnea index (r=0.347, p?0.001), minimal oxygen saturation (r=-0.224, p=0.03), and the percentage of recording time spent at a oxygen saturation less than 90% (r=0.240, p=0.02). CONCLUSION: Our results suggest that OSAS patients tend to have relatively increased platelet activation andatherothrombotic risk.