Evaluation of Patients with COVID-19 Followed Up in Intensive Care Units in the Second Year of the Pandemic: A Multicenter Point Prevalence Study.

OBJECTIVE: A 1-day point prevalence study was planned to obtain country data by determining the clinical characteristics, follow-up and treatment methods of coronavirus disease 2019 (COVID-19) cases that required intensive care unit (ICU) treatment in the second year of the pandemic. MATERIAL AND METHODS: All patients who were hospitalized in the ICUs due to COVID-19 between March 11, 2022, 08.00 am, and March 12, 2022, 08.00 am, were included in the study. Demographic characteristics, intensive care and laboratory data, radiological characteristics, and follow-up results of the patients were recorded. RESULTS: A total of 811 patients from 59 centers were included in the study, 59% of the cases were male, and the mean age was 74 ± 14 years. At least one comorbid disease was present in 94% of the cases, and hypertension was the most common. When ICU weight scores were examined, Acute Physiology and Chronic Health Evaluation-II: 19 (15-27) and Sequential Organ Failure Assessment: 7 (4-10) were seen. Sepsis was present in 37% (n = 298) of cases. PaO2/FiO2 ratios of the patients were 190 the highest and 150 the lowest and 51% of the cases were followed via invasive mechanical ventilation. On the study day, 73% bilateral involvement was seen on chest x-ray, and ground-glass opacities (52%) were the most common on chest tomography. There was growth in culture in 40% (n = 318) of the cases, and the most common growth was in the tracheal aspirate (42%). CONCLUSION: The clinical course of COVID-19 is variable, and ICU follow-up was required due to advanced age, comorbidity, presence of respiratory symptoms, and widespread radiological involvement. The need for respiratory support and the presence of secondary infection are important issues to be considered in the follow-up. Despite the end of the second year of the pandemic and vaccination, the high severity of the disease as well as the need for follow-up in ICUs has shown that COVID-19 is an important health problem.

Predictive Factors of BK Virus Development in Kidney Transplant Recipients and the Effect of Low-Dose Tacrolimus Plus Everolimus on Clinical Outcomes.

OBJECTIVES: This study aimed to determine the predictive factors of BK virus viremia/nephropathy in kidney transplant recipients and to evaluate the effects of low-dose tacrolimus plus everolimus. MATERIALS AND METHODS: This study included 3654 kidney transplant recipients. The patients were divided into 2 groups: group 1 were BK virus negative (n = 3525, 96.5%) and group 2 were BK virus positive (n = 129, viremia 3.5%, nephropathy 1%). Predictive factors were determined by receiver operating characteristic curve analysis and logistic regression models.We also divided and analyzed patients with BK virus viremia/nephropathy into 2 groups according to immunosuppressive changes. Group 2a had been switched to low-dose tacrolimus plus everolimus (n = 54, 41.9%), and group 2b had been switched to other immunosuppressive protocols (n = 75, 58.1%). RESULTS: We found that use of anti-T-cell lymphocyte globulin and tacrolimus, deceased donor transplant, and rejection were predictive factors for BK virus viremia/nephropathy. In addition, patients who had low-dose calcineurin inhibitor plus mammalian target of rapamycin inhibitor regimens showed a low rate of BK virus development(only 6.2% of all cases). In Group 2a, both the BK polyomavirus-associated nephropathy rate (n = 23 [42.6%] vs n = 12 [16%] in group 2b; P = .001) and viral load (DNA > 104 copies/mL) (n = 49 [90.7%] vs n = 27 [36%] in group 2b; P = .001) were increased versus group 2b. Graft function, graft survival, viral clearance, and rejection rate were similar between the groups after protocol change. CONCLUSIONS: BK virus viremia/nephropathy rate was lower in patients who received low-dose calcineurin inhibitor plus mammalian target of rapamycin inhibitor protocols; the low-dose tacrolimus plus everolimus switch protocol after BK virus was more effective and safe than other protocols.

Evaluation of the effect and predictive role of vitamin D and vitamin D receptor expression in CD4 + , CD8 + , CD14 + , CD56 + cells on the development of chronic rejection and graft functions in kidney transplant patients.

PURPOSE: It is known that vitamin D has positive effects on graft functions (reduce fibrosis, suppress excessive inflammatory response, improve graft functions). In our study, it was aimed to evaluate the effects and predictive roles of vitamin D, the expression of vitamin D receptor (VDR) in lymphocytes, monocytes, natural killer cells on chronic rejection and graft functions in kidney transplant patients. METHODS: Seventy one people were included in the study and analyses were made by dividing them into 3 groups. Group 1: Healthy control (n = 29), Group 2: Kidney transplant patients with stable kidney function (n = 17), and Group 3: Kidney transplant patients with chronic rejection diagnosis (n = 25). Serum 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels and VDR percentages in CD4 + , CD8 + , CD14 + , CD56 + cells were measured in 3 groups. ROC analyses and logistic regression models were performed to predict rejection and long-term graft functions. RESULTS: The percentage of VDR expression in CD4 + lymphocytes (p < 0.001) and CD14( +) monocytes (p < 0.001), 25-hydroxycholecalciferol and 1.25 dihydroxycholecalciferol levels were lower in group 3 was detected. In ROC analyses and logistic regression models, VDR expression in CD4( +)T lymphocytes was shown to have a statistically significant value in the development of chronic rejection (Odds ratio 0.86: 0.76-0.92; p = 0.001/AUC = 0.941, p < 0.001) and prediction of 5th-year graft functions (Odds ratio 0.93: 0.88-0.98; p = 0.017/AUC = 0.745, p = 0.007). CONCLUSION: In our study, it was shown that low vitamin D and VDR expression is associated with poor outcome and VDR expression in CD4( +)T lymphocytes is predictive in terms of graft function and rejection.

Comparison of tomographic kidney volumes measured by semiautomatic segmentation method with scintigraphic split renal function in predicting posttransplant kidney functions.

INTRODUCTION: In this study, it was aimed to compare scintigraphic split renal function (SRF) and computed tomographic (CT) kidney volumes by semiautomatic segmentation method in predicting graft functions after kidney transplantation. METHODS: One hundred and twelve patients (77 males, 35 females) who had a living-donor kidney transplant between 2015 and 2017 in our centre were included in the study. While SRF was calculated with technetium-99m-diethylenetriaminepentaacetic acid (99m Tc-DTPA) scintigraphy, CT angiography was used for volumetric calculations. RESULTS: CT-volumetric measurements, especially renal cortical volume (RCV: 103.8 ± 20 ml) and ratio to body mass index (RCV/BMI: 4.45 ± 1.3) were found to be more significant than 99m Tc-DTPA-SRF in predicting graft functions. The correlations between SRF and RCV with 6th-month estimated glomerular filtration rate (eGFR) (rSRF: 0.052, rRCV: 0.317, p = 0.041) and 1st-year eGFR (rSRF: 0.104, rRCV: 0.374, p = 0.033) were found to be more significant in favour of RCV. The correlation between SRF/BMI and RCV/BMI with 1st-, 6th- and 12th-month eGFR (respectively, p = 0.02/0.048/0.024) were found to be more significant in favour of RCV/BMI. Although univariate analysis showed a significant relationship between most volumetric measurements and 1st-year graft functions, in multivariate analysis only RCV [odds ratio (OR): 1.04 (1.01-1.07), p = 0.023] and RCV/BMI [OR: 2.5 (1.27-5.39), p = 0.013] showed a significant relationship between graft functions. CONCLUSION: In our study, it was shown that CT-based renal volumetric measurements, especially RCV and RCV/BMI, predicted graft functions more strongly than scintigraphic 99m Tc-DTPA-SRF.

High-Resolution Computed Tomography Scores in Cases of Bronchopulmonary Dysplasia.

BACKGROUND: Bronchopulmonary dysplasia (BPD) carries a risk of long-term pulmonary sequelae. High-resolution computed tomography (HRCT) is a method of detecting such structural changes. This study is aimed at characterizing structural abnormalities associated with BPD and at evaluating the clinical findings in the newborn period associated with HRCT scores. METHODS: 28 patients born with a mean gestation age of 30 ± 2.9 weeks and diagnosed as BPD in their neonatal period were reevaluated when they were between the postnatal ages of 6 and 12 months. HRCT was performed in 20 patients with a history of moderate and severe BPD. Scans were interpreted by one radiologist using a scoring system. RESULTS: Patients were 9.8 ± 2.3 months at the time of reevaluation. The average HRCT score of patients was, respectively, 7.20 ± 4.05 with moderate and 7.40 ± 2.84 with severe BPD. The difference between them was not significant (p = 0.620). When moderate and severe groups were collected as a whole on the basis of physical findings and drug treatment, 6 had normal physical examination findings, no oxygen and no drug requirement; 14 had at least one finding at the time of reevaluation. No significant difference was detected in terms of HRCT score between the two groups (6.50 ± 3.83 versus 7.64 ± 3.30). CONCLUSIONS: More studies are needed in terms of the role of HRCT in the assessment of BPD prognosis. A contemporary definition of BPD that correlates with respiratory morbidity in childhood is needed. Also, a new lung ultrasound technique for predicting the respiratory outcome in patients with BPD can be used instead of HRCT.

The relationship between COVID-19 and HLA in kidney transplant recipients, an evaluation of predictive and prognostic factors.

INTRODUCTION: The purpose of this study was to determine the predictive and prognostic factors for COVID-19 infection and its relationship with human leukocyte antigen (HLA) in kidney transplant recipients. MATERIAL AND METHOD: Three hundred fifty kidney transplant recipients were included in the study. Recipients were divided into two groups: COVID-19(+) (n = 100) and control (n = 250). The relationships between HLA frequencies, COVID-19 infection, and prognostic factors (age, donor type, immunosuppression protocol, etc.) were then evaluated. Logistic regression analysis, heatmap, and decision tree methods were used to determine predictive and prognostic factors. The study was performed retrospectively. RESULTS: Advanced age and deceased transplantation emerged as predictive of SARS-CoV-2 infection, while the presence of HLA-A*11, the HLA match ratio, and high-dose tacrolimus were identified as prognostic factors in kidney transplant recipients. HLA-A10, HLA-B*13, HLA-B22, and HLA-B*55 were shown to be associated with SARS-CoV-2 infection at univariate analysis, and HLA-B*57, HLA-DRB1*11, and HLA-DRB1*13 at logistic regression analysis. CONCLUSION: HLA-A10, HLA-B*13, HLA-B*55, HLA-B*57, HLA-DRB1*11, and HLA-DRB1*13 were identified for the first time in the literature associated with SARS-CoV-2 infection in kidney transplant recipients.

A novel measurement to evaluate supraspinatus tendinopathies with strain elastography.

BACKGROUND: In addition to the traditional strain ratio (STR), a novel measurement termed hard percent of the whole tendon, provided by the device's software and resembling shear-wave elastography, was included in the study. PURPOSE: To evaluate the correlation between magnetic resonance imaging (MRI) and strain elastography findings in cases with rotator cuff tendinopathy, including tears. MATERIAL AND METHODS: As a prospective study, cases suggestive of rotator cuff tendinopathy were included. After MRI evaluation by two observers, grading of the elastography examination was performed by a third radiologist. For the first measurement, the region of interest (ROI) was chosen from the gray-scale evaluation corresponding to the area showing a MRI pathological signal. Stiffness was assessed with the STR. For the second measurement, the whole visible tendon was measured as the ROI. The hard percent (unaffected areas as a percent) was measured. Correlation coefficients between MRI grade and the two strain value measurements were calculated. RESULTS: There were 93 cases (31 men, 62 women) with 112 involved tendons. The correlation coefficient between MRI grade and age was calculated as 0.56, between MRI grade and STR it was -0.51, and with the novel measurement the correlation coefficient was -0.53. CONCLUSION: This study showed a good association of findings of tendon stiffness with those of tendinopathy on MRI. Using the hard ratio as a novel measurement, its correlation with MRI grade was as reliable as the STR. We also experienced that the benefit of elastography is a challenging issue for defining small ruptures.

A new technique in the evaluation of strangulated and incarcerated hernias: Near-infrared spectroscopy.

BACKGROUND: The present study aims to investigate the usefulness of NIRS in identifying decreased blood flow in intestinal tissue inside the hernial sac in incarcerated hernias. METHODS: Forty patients with manually irreducible inguinal hernias and with ileus determined by clinical findings and imaging were included in this study. Patients' intestinal oxygenations were measured by placing NIRS probes over the areas of inguinal hernia and over non-herniated areas immediately lateral to these. Differences in oxygenation between normal and herniated areas were evaluated. RESULTS: Forty patients, 14 women (35.0%) and 26 (65.0%) men, with a mean age of 65±14, were enrolled in this study. Intestinal oxygenation was lower in areas of irreducible hernia compared to normal regions (p<0.001). Incarceration and/or strangulation were detected when hernial sacs with low intestinal oxygenation were operated on. Low NIRS measurements were able to identify incarceration and/or strangulation in the intestine but were unable to distinguish between them. CONCLUSION: In conclusion, in the light of the findings of this study, although not capable of differentiating incarceration from strangulation, NIRS appears to be a good method for showing impaired intestinal oxygenation. NIRS can be used to support ultrasonography findings in irreducible hernias. Therefore, this technique could be used in the future to evaluate and monitor intestinal oxygenation in the Emergency Department.

Daily Practice of Mechanical Ventilation and Weaning in Turkish PICUs: A Multicenter Prospective Survey.

OBJECTIVES: To investigate conventional mechanical ventilation weaning characteristics of patients requiring conventional mechanical ventilation support for greater than 48 hours within the PICU. DESIGN: The prospective observational multicenter cohort study was conducted at 15 hospitals. Data were being collected from November 2013 to June 2014, with two designated researchers from each center responsible for follow-up and data entry. SETTING: Fifteen tertiary PICUs in Turkey. PATIENTS: Patients between 1 month and 18 years old requiring conventional mechanical ventilation for greater than 48 hours were included. A single-center was not permitted to surpass 20% of the total sample size. Patients with no plans for conventional mechanical ventilation weaning were excluded. INTERVENTIONS: Conventional mechanical ventilation MEASUREMENTS AND MAIN RESULTS:: Pertinent variables included PICU and patient demographics, including clinical data, chronic diseases, comorbid conditions, and reasons for intubation. Conventional mechanical ventilation mode and weaning data were characterized by daily ventilator parameters and blood gases. Patients were monitored until hospital discharge. Of the 410 recruited patients, 320 were included for analyses. A diagnosis of sepsis requiring intubation and high initial peak inspiratory pressures correlated with a longer weaning period (mean, 3.65 vs 1.05-2.17 d; p < 0.001). Conversely, age, admission Pediatric Risk of Mortality III scores, days of conventional mechanical ventilation before weaning, ventilator mode, and chronic disease were not related to weaning duration. CONCLUSIONS: Pediatric patients requiring conventional mechanical ventilation with a diagnosis of sepsis and high initial peak inspiratory pressures may require longer conventional mechanical ventilation weaning prior to extubation. Causative factors and optimal weaning for this cohort needs further consideration.

Results of Allogenic Hematopoietic Stem Cell Transplantation in Fanconi Anemia Caused by Bone Marrow Failure: Single-Regimen, Single-Center Experience of 14 Years.

Hematopoietic stem cell transplantation (HSCT) is the only curative treatment for bone marrow failure (BMF) in patients with Fanconi anemia (FA). We retrospectively analyzed the records of patients with FA who underwent HSCT with a radiation-free, reduced-intensity conditioning regimen (fludarabine, cyclophosphamide, and antithymocyte globulin) along with an unmanipulated graft infusion between 2004 and 2018. A total of 44 patients underwent HSCT during the study period. Median age at transplantation was 121 months. Regarding the donor source, 22 transplants (50%) were collected from matched related donors (MRDs), and 22 transplants (50%) were collected from alternative donors (ADs). The median infused CD34+ cell dose was 4.7 × 106/kg (range, 0.8 to 23) in bone marrow or peripheral blood stem cell recipients and 1.2 × 105/kg (range, 1.1 to 3.6) in umbilical cord blood recipients. All but 2 patients achieved primary neutrophil engraftment (95%). In a median follow-up of 36 months (range, 1 to 159), 3-year overall survival was 70.5% in the entire group and 91% in the MRD recipients. Primary causes of death were infections (n = 5), acute grade 3 to 4 graft-versus-host disease (n = 4), and hemorrhagic cystitis (n = 3). All surviving patients have full (n = 29) and acceptable mixed (n = 2) donor chimerism and good clinical status. Our results showed an excellent outcome with unmanipulated grafts using a fludarabine-based, radiation-free preparative regimen for MRD recipients. Even though primary neutrophil engraftment rates were good in AD recipients, intervening complications increased mortality in these patients. In clinics where T cell depletion is not feasible, more effort is warranted to improve outcomes for AD recipients.

A clinical compilation of lymph node pathologies comparing the diagnostic performance of biopsy methods.

PURPOSE: It is critical to obtain sufficient tissue, both in quality and quantity, in biopsy applications for histopathological review. Our aim was to compare fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) techniques in terms of their diagnostic performance in lymph node biopsies. This was a clinical compilation, and histopathological results from biopsies were also evaluated. METHODS: A total of 242 patients and 246 lymph nodes were prospectively evaluated. All histopathologic specimens were obtained through ultrasonography-guided biopsies performed at our institute between April 2015 and October 2017. Histopathological results were grouped according to diagnostic performance, and the mean performance scores of the two methods were compared. RESULTS: For FNAC, the mean diagnostic score was calculated to be 1.63, whereas for CNB, the mean diagnostic score was calculated to be 1.89. The difference between diagnostic scores of the two techniques was statistically significant (p < 0.01). CONCLUSION: We recommend that interventional radiologists perform vacuum-assisted biopsies if there are no financial hindrances or evidence of psychological issues in patients. We recommend this not only for lymph nodes of malignant appearance but also for those that appear benign.

Prealbumin and Retinol Binding Proteins Are Not Usable for Nutrition Follow-Up in Pediatric Intensive Care Units.

PURPOSE: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. METHODS: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. RESULTS: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. CONCLUSION: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

Evaluation of diagnostic value of conventional and color Doppler ultrasound with elastography strain ratios in differentiation between benign and malignant lymph nodes.

INTRODUCTION: The aim of this study was to evaluate the diagnostic value of conventional ultrasonography (USG) and color Doppler ultrasonography (CDU) with elastography strain ratios (ESR) in discrimination between benign and malignant lymphatic nodes. MATERIAL AND METHODS: Two hundred and forty-seven patients (252 lymph nodes) were included in this study. USG and CDU with ESR were performed. Materials were obtained by using fine-needle or vacuum-assisted aspiration methods depending on the site and condition of lymph nodes. The χ2 test and Student's t-test were used for comparisons. RESULTS: Ninety-two of 252 (36.5%) lymph nodes were malignant, and 160 (63.5%) were benign. Short axis, S/L ratio, presence or absence of the fatty hilum and extra-hilar vascularity were valuable, statistically significant indicators of malignancy. In contrast, long axis and ESR were not significant indicators of malignancy. The short axis cut-off value was calculated to be 12 mm and the S/L ratio cut-off value was calculated to be 1. CONCLUSIONS: Long axis of lymph nodes and strain ratios cannot be used as malignancy criteria, and their use is controversial despite the fact that some studies have found them valuable. On the other hand, our results support common knowledge that the short axis, S/L ratio, absence of the fatty hilum, and extrahilar vascularity are significant indicators.

Evaluating the role of strain ratio elastography in determining malignancy potential and calculating objective BIRADS US scores using ultrasonography and elastography features.

PURPOSE: The aims of this study were, firstly, to evaluate solid breast masses based on their malignancy potential and to determine whether the strain elastography ratio (SER) can contribute to classical grey-scale ultrasonography findings, and secondly, to define objective BIRADS US scores using ultrasound (US) and SER findings. MATERIAL AND METHODS: A total of 280 patients and 297 solid breast masses were evaluated using sonographic and elastographic data. The SER was measured for each lesion. RESULTS: The positive predictive values (PPV) for each criterion was calculated to be between 35% and 83.3%. The lowest PPV was obtained from hypoechogenicity (35%) and the highest PPV was obtained for anti-parallel features (83.3%). The difference between the mean SER of benign and malignant lesions was statistically significant. After ROC analysis, the SER cut-off value was calculated to be 3.1 for determining if the mass was benign or malignant. Mass scores were calculated for each solid breast mass based on positive predictive values, and BIRADS US score was defined as the sum of mass scores. CONCLUSIONS: SER findings can be used as malignancy criteria in evaluating solid breast masses. BIRADS US score can be objectively determined based on US and elastography features instead of doing subjective scoring. As an additional result, all solid breast masses have the possibility to be malignant, even though US and elastography findings indicate the opposite.

Evaluating Qualitative and Quantitative Computerized Tomography Indicators of Chronic Obstructive Pulmonary Disease and Their Correlation with Pulmonary Function Tests.

BACKGROUND: With increasingly aging populations, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death today. Emphysematous changes, an important component of the disease, must be determined on HRCT, either qualitatively or quantitatively. The purpose of this study was to evaluate features that help determine emphysematous changes and correlate them with respiratory function tests (RFTs). MATERIAL/METHODS: A total of thirty COPD patients and a control group of the same size, matched for age, were included in the study. The mean lung parenchyma density values on inspiration and expiration, visual HRCT scores, and pulmonary function tests were obtained. IBM SPSS statistical software (version 22) was used to perform correlation analysis (Pearson's coefficient) and the Mann-Whitney U test. RESULTS: The most valuable RFTs for determining emphysematous changes were DLCO, FEV1, and FEV1/FVC, in that order. Quantitative measures of the mean lung density had the highest correlation with coefficient on expiration. CONCLUSIONS: As regards the comparison between objective and subjective density values, the HRCT-based visual density values are satisfactory. On the other hand, the best assessment can be performed with the use of mean density values on expiration. DLCO, FEV1, and FEV1/FVC were found to be valuable parameters in determining parenchymal changes.

Effectiveness of Computed Tomography Guided Percutaneous Radiofrequency Ablation Therapy for Osteoid Osteoma: Initial Results and Review of the Literature.

BACKGROUND: The aim of this retrospective study is to determine our experience of technique success rate, complications and clinical results in long term follow up for computed tomography (CT)-guided radiofrequency ablation [RA] therapy for osteoid osteoma (OO). MATERIAL/METHODS: We performed RA therapy to 18 patients with OO referred to interventional radiology from other clinics primarily from orthopedics; between January 2011 to May 2014. Daytime and nighttime pain intensity of 18 patients was noted according to visual analog scale (VAS). After procedure pain intensity was compared with before one. We also discussed other factors can affect it. RESULTS: All procedures were completed technically successful for all patients [100%]. We did not experience any major complication or mortality. However we had 3 minor complications. Pain came back in 1 patient after 5 months from procedure and it was considered as recurrence. Dramatic pain intensity fall was seen in patients after procedure, both daytime and nighttime. However we did not find and statistically significant change in comparison of pain intensity reduce and time needed to return back to routine life when using patients demographic data and lesion size. CONCLUSIONS: CT guided RA therapy of OO is minimally invasive, effective and secure procedure.

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.