Abdi Sagcan

Primary spontaneous coronary artery dissections in atherosclerotic patients. Report of nine cases with review of the pertinent literature

Primary spontaneous coronary artery dissection is one of the rare causes of acute myocardial infarction. Previous studies reports that it is mostly seen in middle aged women in the last trimester of pregnancy and early postpartum period. Clinical presentation of the disease is variable in pattern and severity related to extent and development rate of dissection. In the last 2 years, nine non-pregnant primary spontaneous coronary artery dissection cases were found in coronary angiography among 3750 patients prediagnosed as coronary artery disease. The cases were presented and discussed with review of the pertinent literature.

Right atrial and ventricular thrombi in Behçet's disease : a case report and review of literature

Behçets disease is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Cardiac involvement is an extremely rare manifestation of this disorder. We report an unusual case of Behçets disease characterized by a mural cardiac thrombi in the right atrium and right ventricle along with transient protein C and S deficiency.

No association of interleukin-6 gene polymorphism (-174 G/C) with premature coronary artery disease in a Turkish cohort.

ObjectivesInterleukin-6 (IL-6) may contribute to the inflammatory response by activating endothelial cells and stimulating the synthesis of fibrinogen. It might thus be important in the pathogenesis of inflammation associated with coronary artery disease (CAD). Several studies suggested that the -174 C allele was associated with an increased prevalence of coronary heart disease. The aim of this study was to investigate further the association of the IL-6 -174 G/C allele status with premature CAD. MethodsA total of 120 patients and 105 controls were included in the study. The IL-6 -174 G/C polymorphism was genotyped using PCR–restriction fragment length polymorphism. ResultsThe genotype distribution of the -174 G/C polymorphism was not different in premature CAD patients (GG: 53%; GC: 42.6%; CC: 4.3%) and controls (GG: 54.3%; GC: 39%; CC: 6.7%) (P=0.72). The prevalence of the C allele was 25.6% in patients and 26.1% in controls. By multiple regression analysis, family history, smoking, diabetes, and hypertension were independent risk factors of premature CAD, but not IL-6 genotype. ConclusionsWe conclude that the IL-6 -174 G/C polymorphism is not associated with the risk of premature CAD, and does not contribute to cardiovascular risk stratification.

Effects of coronary artery bypass surgery on diastolic and systolic parameters of left ventricle in Type II diabetic patients

Diabetes mellitus itself can cause systolic and diastolic dysfunctions of the left ventricle in the absence of atherosclerotic coronary artery disease. Effects of coronary bypass surgery on the left ventricular functions of Type II diabetic patients having atherosclerotic coronary artery disease were investigated. Forty-eight Type II diabetic and 63 nondiabetic multivessel coronary artery disease patients who had no differences in age, sex, drugs used, number of revascularized arteries and aortic cross-clamp time were included in the study. Doppler echocardiographic examinations before and 6 months after operations were made, and early diastolic flow (E), atrial contraction (A), deceleration (DT) and isovolumetric relaxation time (IVRT), E/A ratio and systolic parameters like end-diastolic volume, end-systolic volume, stroke volume and left ventricular ejection fraction (LVEF) were measured in sequence. Preoperative and postoperative echocardiographic measurements were compared in the same group and between groups by paired t and Students t tests, respectively. P<.05 was accepted as statistically significant. E, A, E/A, DT, IVRT and LVEF were significantly improved after coronary bypass surgery in Groups I (P<.001, P<.01, P<.001, P<.01, P<.0001, P<.01) and II (P<.05, P<.05, P<.001, P<.001, P<.001, P<.001). Statistical comparison of values between groups showed better recovery in diastolic and systolic functions of diabetic and nondiabetic patients, respectively. It was concluded that Type II diabetic coronary patients by time could gain as much as the same benefit from coronary bypass surgery that nondiabetic patients had.

The effect of type II diabetes mellitus on platelet aggregation in patients who underwent percutaneous transluminal coronary angioplasty.

BackgroundIn noninsulin-dependent type II diabetic (tIIDM) patients it was reported that ADP-induced platelet aggregation response was increased with decreased level of platelet guanylate cyclase. This study was therefore designed to examine the effects of tIIDM on collagen-induced, in-vitro platelet aggregation in percutaneous transluminal coronary angioplasty (PTCA) patients. MethodsTwenty patients with tIIDM and 30 nondiabetic patients who had successful PTCA were included in the study. Platelet-rich plasma samples from the patients before and after PTCA were treated with in-vitro collagen and platelet aggregation waves were calculated via the turbidometric method of Born. The maximum amplitude (%) and the ratio of changes after PTCA in the study participants were measured by these waves and data were compared by students t tests and nonparametric methods. The maximum amplitude of collagen-induced platelet aggregation before and after the procedure was also compared using variant analysis. ResultsThe change in collagen-induced maximum amplitude of platelet aggregation in both wave 1 and wave 2 was significantly more (P  < 0.001–P  < 0.001) in the tIIDM group. The ratio of restenosis seen in the control coronary angiography made 6 months after intervention was found to be significantly more in the tIIDM group (P  < 0.05). ConclusionsCollagen-induced platelet aggregation response was greater in patients with tIIDM than in nondiabetic patients. This makes us think that tIIDM patients could need more potent antiplatelet therapy before PTCA after the blood glucose levels have been regulated.