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1.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
2.
Angiology ; : 3319719868360, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31416325

RESUMO

The SYNTAX score (SS) and SS II, which include additional clinical parameters, are widely used today for deciding revascularization following coronary angiography. We investigated the association between the presence and severity of carotid artery disease (CrAD) using the SS and SS II in 287 patients who underwent coronary artery bypass grafting. We based this investigation on the known association between coronary artery disease and CrAD. A significant association was observed between the groups with and without CrAD in terms of SS II values (28.4 ± 9.6 vs 21.4 ± 7.7, respectively; P < .001). A significant difference was also observed when stenosis was classified according to severity as <50%, 50% to 70%, and >70% (P < .001). The results indicated a positive correlation between the presence and severity of CrAD as SS II increased (r = 0.187, P = .005). According to the results of multivariate logistic regression analysis, the SS II was an independent predictor of CrAD.

3.
Int J Impot Res ; 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31243351

RESUMO

The objective of this study was to compare the Atherogenic Index of Plasma (AIP) values as indicators of subclinical atherosclerosis among 124 patients with erectile dysfunction, which was thought to be vasculogenic and 126 control subjects who had no erectile dysfunction, and to compare cardiac performance values between both the groups using exercise stress tests (EST). Erectile function was assessed using the International Index of Erectile Function (IIEF-5) questionnaire form. AIP values were studied and compared between patients with ED (IIEF < 22) and those without ED (IIEF > 22) using the log10 TG/HDL-C formula. In addition, the correlation between the severity of ED and AIP was investigated according to IIEF-5 scoring. Metabolic equivalent (MET) values, maximal heart rates (max HR), and heart rate recovery (HRR) were evaluated with effort tests. AIP values were significantly higher in the ED group than in the control group (0.45 ± 0.27, and 0.37 ± 0.27; p = 0.015). According to IIEF-5 scoring, AIP values increased as ED scores decreased. In the EST, MET score and max HR values were significantly lower in the ED group (METs: 11.1 ± 2.2, and 11.6 ± 2.2; p = 0.045; Max HR: 162.8 ± 6.1, and 165 ± 8.7; p = 0.019). Although not statistically significant, HRR values were lower in the ED group. Higher AIP values were found in the ED group, and a positive correlation was established between AIP and the severity of ED. In addition, lower performance during the EST and lower HRR values, again in the ED group, confirms cardiac interaction with ED. These results indicate the importance of referral of patients with ED from urology clinics to cardiology units for risk determination and cardiac assessment, even if they areasymptomatic.

4.
Angiology ; 70(9): 860-866, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31170823

RESUMO

New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACSs). The objective of this study was to investigate the relationship between the development of NOAF and severity of coronary artery disease using the SYNTAX score (SS) and SYNTAX score II (SSII) in patients with non-ST-segment elevation ACS (NSTE-ACS) who were treated with percutaneous coronary intervention (PCI). A total of 662 patients with NSTE-ACS were consecutively enrolled. The incidence of NOAF was 11.4% among the patients with NSTE-ACS. Mean age was significantly higher in NOAF group (P = .011). White blood cell count, peak troponin I, high sensitivity C-reactive protein, uric acid, left atrial volume index, and ratio between early mitral inflow velocity and mitral annular early diastolic velocity were significantly higher in NOAF group (respectively, P = .024, P = .017, P = .002, P = .009, P = .025, P < .001, and P < .001). The hemoglobin, ejection fraction, and post PCI thrombolysis in myocardial infarction grade <3 were significantly lower in NOAF group (P = 001, P = .010, P = .038). The SS and SSII were significantly higher in NOAF group (all P < .001). According to the results of multivariate logistic regression analysis, the SSII was correlated with NOAF (P < .001) in the study groups. We demonstrated that high SSII is significantly associated with NOAF.


Assuntos
Síndrome Coronariana Aguda/etiologia , Fibrilação Atrial/etiologia , Doença da Artéria Coronariana/etiologia , Infarto do Miocárdio/etiologia , Síndrome Coronariana Aguda/complicações , Adulto , Fatores Etários , Idoso , Fibrilação Atrial/terapia , Proteína C-Reativa/metabolismo , Doença da Artéria Coronariana/complicações , Feminino , Humanos , Contagem de Leucócitos/métodos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Intervenção Coronária Percutânea/métodos
5.
Aging Clin Exp Res ; 2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30707356

RESUMO

BACKGROUND: Hypertension is an important risk factor for cardiovascular diseases and cognitive function. Blood pressure (BP) variability has been associated with cognitive dysfunction, but data are sparse regarding the relationship between BP variability and cognitive function in geriatric patients with well-controlled BP. AIM: The aim of this study was to demonstrate the relationship between blood pressure variability and cognitive functions in geriatric hypertensive patients with well-controlled BP. METHOD: We analyzed 435 hypertensive patients (167 male, 74.9 ± 8.3; 268 female, 76.1 ± 8.6) treated at least with one antihypertensive drug. All patients underwent ambulatory BP monitoring and the standardized mini mental test (sMMT). RESULTS: We divided the weighted standard deviation (SD) of systolic BP (SBP) as a measure of BP variability into quartiles. The top quartile group (≥ 18.5 mmHg) had a significantly lower total sMMT score (23.3 ± 3.2, p < 0.001). According to the results of multivariate logistic regression analysis for sMMT, the SD of 24-h SBP was related to sMMT (p = 0.007, 95% confidence interval - 0.301 [- 0.370 to - 0.049]). DISCUSSION: Although there are some inconsistencies among the studies investigating the relationship between blood pressure variability and cognitive functions in elderly patients, we demonstrated the relationship between increased 24-h blood pressure variability and cognitive functions assessed with sMMT in geriatric population with well-controlled BP. CONCLUSION: The increased blood pressure variability was associated with poorer cognitive functions in geriatric hypertensive patients with well-controlled blood pressure.

6.
Int J Angiol ; 27(4): 223-226, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30410294

RESUMO

Simultaneous multivessel epicardial coronary artery thrombosis is an uncommon finding in acute ST-segment elevation myocardial infarction (STEMI). It generally leads to cardiogenic shock and sudden cardiac death in the hospital. We report a 42-year-old male patient presenting with acute anterior STEMI with triple coronary artery thrombosis. An emergency coronary angiogram showed total occlusion of the left anterior descending artery (LAD) with thrombus formation. At the same time, thrombus formations were also seen in the circumflex artery (CXA), the second obtuse marginal (OM2) branch, and the distal right coronary artery (RCA). We unsuccessfully attempted thrombus aspiration of the LAD. Subsequently, we decided to stent the LAD, and a successful percutaneous coronary intervention (PCI) was performed for the LAD. In a second procedure, RCA thrombosis regressed with 24-hour tirofiban (glycoprotein IIb/IIIa receptor inhibitor) perfusion, although CXA thrombosis and OM thrombosis did not regress. Therefore, we performed stenting of the CXA and OM with a newer provisional technique called the flower petal technique. Thrombolysis in myocardial infarction (TIMI) flow grade III was seen after stenting. The patient was discharged from the hospital 5 days after PCI without any symptoms.

7.
Turk Kardiyol Dern Ars ; 46(5): 366-374, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30024393

RESUMO

OBJECTIVE: The aim of this study was to investigate the oscillometric measurements of the elastic properties of the aorta in patients with isolated coronary artery ectasia (CAE). METHODS: This study included 137 patients (92 men and 45 women; mean age: 60.8±11.7 years) who underwent coronary angiography to investigate ischemic heart disease. The patients were divided into 3 groups; the first group consisted of 51 patients with CAE, the second group comprised 36 patients with coronary artery disease (CAD), and the third group was made up of 50 patients with normal coronary arteries. Aortic stiffness (AS) measurements, including pulse wave velocity (PWV) and augmentation index (AIx), were measured using the oscillometric method. RESULTS: The mean PWV was significantly higher in the CAE group compared with the CAD and control groups (9.1±2.3 vs. 8.2±1.3 and 8.0±1.6; p=0.008), whereas the median AIx was significantly lower in the CAE group compared with the CAD and control groups (10.0% [-3.0-63.0] vs. 15.5% [-2.0-57.0] and 21.5% [-1.0-45.0]; p=0.010). Multinomial logistic regression analysis demonstrated that gender, hypertension, highdensity lipoprotein cholesterol level, PWV, and AIx were independently associated with CAE. CONCLUSION: The oscillometric elastic properties of the aorta, including PWV and AIx, are impaired in patients with CAE.


Assuntos
Aorta/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/fisiopatologia , Aorta/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Estudos de Casos e Controles , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Dilatação Patológica/diagnóstico por imagem , Dilatação Patológica/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fluxo Pulsátil , Rigidez Vascular
8.
Intractable Rare Dis Res ; 7(1): 58-60, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29552449

RESUMO

Right coronary artery (RCA) originating from the left coronary system is a subtype of single coronary artery (SCA) anomaly, and the origin of RCA as a branch from the left anterior descending artery (LAD) is a very rare variant. A 55-year-old male who had a percutaneous coronary intervention (PCI) history was hospitalized due to acute coronary syndrome. Coronary angiography revealed an aberrant RCA originating from the mid-LAD as well as stent thrombosis. A successful PCI was performed and he was discharged from the hospital three days after the PCI. It is known that there is an increased incidence of atherosclerosis and stent thrombosis in coronary anomaly patients. Therefore, interventional cardiologists should consider the most suitable PCI strategy before stenting and avoid complex techniques.

9.
Kardiol Pol ; 75(11): 1199-1207, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28715070

RESUMO

BACKGROUND: Despite advances in cardiovascular medicine, acute coronary syndrome (ACS) is still a major cause of morbidity and mortality worldwide. Synergy between percutaneous coronary intervention with TAXUS™ and Cardiac Surgery (SYNTAX) score is used to determine the extent and complexity of coronary artery disease (CAD). Renal resistive index (RRI), a renal Doppler ultrasound parameter, is used to detect renal haemodynamics. Although some risk factors for CAD, including hypertension and diabetes mellitus, were demonstrated to have an association with RRI; a direct relationship between the presence, extent, and complexity of CAD and RRI has not been investigated yet. AIM: In this study, we evaluated the relationship between RRI and SYNTAX score in patients with ACS. METHODS: This cross-sectional study enrolled 235 patients who were diagnosed with ACS and underwent coronary angiography at our tertiary clinic between February 2016 and August 2016. Regarding clinical presentation, 112 patients were diagnosed with non-ST-segment elevation ACS (NSTE-ACS) and 123 patients were diagnosed with ST-segment elevation ACS (STE-ACS). The patients' demographic, clinical, laboratory, echocardiographic data, SYNTAX scores and measurements of renal Doppler ultrasound parameters, including RRI, renal pulsatility index (RPI) and acceleration time (AT) were recorded. RESULTS: Among 235 patients, 112 (47.7%) were diagnosed with NSTE-ACS and 123 (52.3%) were diagnosed with STE-ACS. Mean SYNTAX score and RRI of patients with NSTE-ACS and STE-ACS were 15.4 and 0.69, 21.1 and 0.67, respectively. The SYNTAX score was associated with gender, height, plasma uric acid level, left atrial diameter, left ventricular (LV) end-systolic and end-diastolic diameter, RPI, and RRI in patients with NSTE-ACS, as well as with low-density lipoprotein-cholesterol, total cholesterol, ejection fraction, and LV end-systolic diameter in patients with STE-ACS (p < 0.05 for each variable). RRI was significantly associated with age, haemoglobin level, left atrial diameter, SYNTAX score, AT, and RPI in patients with NSTE-ACS, as well as with weight, body mass index, interventricular septum thickness at diastole, LV posterior wall thickness at diastole, LV ejection fraction, and RRI in patients with STE-ACS. Multivariate logistic regression analysis demonstrated that LV end-systolic diameter (ß = 0.385, 95% CI 1.065-2.029, p = 0.019), RRI (ß = 32.230, 95% CI 5343.15-2.E+24, p = 0.008), and RPI (ß = -7.439, 95% CI 0.000-0.231, p = 0.015) were independent predictors of moderate to high SYNTAX score in patients with NSTE-ACS. CONCLUSIONS: Non-invasively detected RRI is closely associated with the extent and complexity of CAD in patients with NSTE-ACS. However, there is a need for randomised, controlled studies involving wider populations.


Assuntos
Síndrome Coronariana Aguda/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Hemodinâmica , Rim/irrigação sanguínea , Síndrome Coronariana Aguda/sangue , Adulto , Idoso , Colesterol/sangue , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Rim/diagnóstico por imagem , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Ultrassonografia Doppler
10.
Kardiol Pol ; 75(8): 763-769, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28553874

RESUMO

BACKGROUND: Due to ischaemic time delays from the chest pain occurrence in acute ST elevation myocardial infarction (STEMI), prompt recruitment collaterals (PRCCs) to infarct-related artery (IRA) are the major protective structures during this period. AIM: We aimed to investigate the clinical significance and determinants of PRCCs in acute STEMI patients. METHODS: A total of 1375 consecutive acute STEMI patients were prospectively enrolled in the study. The patients were divided into two groups, according to PRCCs to IRA; Rentrop ≤ 1 were defined as inadequate collateral development (ICD) group and Rentrop ≥ 2 defined as adequate collateral development (ACD) group. RESULTS: Patients in the ICD group had higher incidence of baseline risk characteristics, including older age, hypertension, and diabetes mellitus; however, pre-infarct angina incidence was lower than in the ACD group (p < 0.05 for all). In addition, the ICD group had worse haemodynamic status on admission and 30-day mortality. Compared to the ACD group, the non-IRA chronic total occlusion (CTO), peak troponin-T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and high sensitivity C-reactive protein (hs-CRP) levels were higher in the ICD group. On multivariate logistic regression analysis, non-IRA CTO (b = 3.114, 95% CI 1.382-7.017, p < 0.006) with pre-infarction angina together with higher values of peak troponin-T, NT-proBNP, and hs-CRP were associated with PRCCs in acute STEMI. CONCLUSIONS: Taking into account that the main message of the study is that if patients have higher cardiac biomarkers and adverse clinical findings (which, of note, may show the extent of myocardial infarction) and have non-IRA CTO, there is a higher chance that they will have inadequate collateralisation.


Assuntos
Circulação Coronária , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia , Idoso , Proteína C-Reativa/análise , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Resultado do Tratamento , Troponina T/sangue
11.
Am J Emerg Med ; 34(12): 2315-2319, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27614370

RESUMO

OBJECTIVE: The aim of this study was to evaluate the role of thiol/disulfide homeostasis in acute pulmonary embolism (APE) and investigate its compliance to show hospital mortality of patients with APE. MATERIAL AND METHODS: A total of 173 participants including 113 patients with APE, and 60 healthy individuals were included in the study. APE group was categorized into two subgroups according to Pulmonary Embolism Severity Index (PESI) clinic risk score (PESI low group [n=71, class 1-3] and PESI high group [n=42, class 4-5]). RESULTS: Mean level of native thiol was lower and disulfide level and disulfide/total thiol ratio were higher in APE group than control group. In APE group, 14 patients died during hospitalization. Native thiol and disulfide level, presence of shock, heart rate, oxygen saturation, right ventricular dysfunction, N-terminal pro-brain natriuretic peptide, and creatinine levels were found to have prognostic significance in univariate analysis. On multilvariable logistic regression analysis, native thiol and disulfide level (odds ratio [OR], 1.16(0.87-1.36); P=.010 and OR, 1.49; P=.015, respectively), presence of shock (OR, 1.04; P=.012) and N-terminal pro-brain natriuretic peptide (OR, 1.67; P=.002) were strong predictors for APE-related hospital mortality after the adjustment of other potential confounders. CONCLUSION: We have shown that thiol/disulfide homeostasis can be altered during APE and associated with worse hemodynamic parameters, and may be used as a prognostic marker for hospital mortality.


Assuntos
Dissulfetos/sangue , Mortalidade Hospitalar , Embolia Pulmonar/sangue , Compostos de Sulfidrila/sangue , Disfunção Ventricular Direita/fisiopatologia , Doença Aguda , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Homeostase , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Prognóstico , Estudos Prospectivos , Embolia Pulmonar/complicações , Índice de Gravidade de Doença , Choque/complicações , Disfunção Ventricular Direita/complicações
12.
Coron Artery Dis ; 27(3): 207-12, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26863599

RESUMO

BACKGROUND: The influence of coexisting collateral circulation between chronic total occlusion (CTO) and infarct-related artery (IRA) in patients with acute ST segment elevation myocardial infarction (STEMI) remains unclear. We aimed to investigate the impact of coexisting collateral circulation between CTO and IRA on early clinical outcomes in patients with acute STEMI. METHODS: A total of 1488 consecutive acute STEMI patients who underwent primary percutaneous coronary intervention were prospectively included in the study. After restoration of antegrade flow, the patients who had coexisting CTO and collateral supply from IRA were defined as the CTO-IRA-related (CIR) group (n=56). Patients with coexisting CTO but with no collateral supply from IRA were defined as the CTO-IRA-unrelated (CIUR) group (n=104). Patients without coexisting CTO were defined as the non-CTO group (n=1328). RESULTS: Compared with the CIUR and non-CTO groups, the CIR group was significantly associated with higher Killip class of at least 2 (P<0.001) at presentation, a lower rate of postprocedural thrombolysis in myocardial infarction 2/3 flow (P<0.001), and myocardial perfusion grade 3 (P<0.001). Moreover, the CIR group had significantly higher in-hospital (P<0.001) and 30-day mortality (P<0.001). On multivariate regression analysis, the CIR group (odds ratio=15.96, 95% confidence interval=4.94-51.54; P<0.001) as well as age, post-PCI TIMI, Killip and NT-proBNP levels were independently associated with 30-day mortality. However, the CIUR group was not an independent predictor of early clinical outcomes. CONCLUSION: After restoration of antegrade flow, coexisting CTO supplied by IRA collaterals has unfavourable effects on procedural success, enzymatic infarct size and postprocedural haemodynamic conditions. These collaterals are also independent predictors of 30-day mortality in acute STEMI patients.


Assuntos
Circulação Colateral , Circulação Coronária , Oclusão Coronária/terapia , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Idoso , Distribuição de Qui-Quadrado , Doença Crônica , Angiografia Coronária , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/mortalidade , Oclusão Coronária/fisiopatologia , Feminino , Hemodinâmica , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/mortalidade , Estudos Prospectivos , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico por imagem , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
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