Adil Baydas

Deficiency of a new protein associated with cardiac syndrome X; called adropin.

The pathophysiology of cardiac syndrome X (CSX) is still unclear, but most patients with CSX have endothelial dysfunction. It has been shown that adropin uniquely effects the regulation of endothelial function. The purpose of the study was to evaluate the role of adropin in CSX. Eighty-six consecutive cardiac syndrome X-diagnosed patients and 86 age-sex matched healthy subjects were enrolled into the study. Serum adropin levels, nitrite/nitrate levels were measured in each subject. The adropin levels were significantly lower in patients with CSX than healthy subjects (1.7 ± 0.8 ng/mL and 3.4 ± 1.8 ng/mL, respectively; P < 0.001). The BMI values of patients with CSX were significantly higher than control subjects (28.1 ± 2.4 kg/m(2) and 26.0 ± 3.7 kg/m(2) , respectively; P < 0.001). Plasma nitrite/nitrate levels were lower in patients with CSX than control subjects (15.9 ± 1.6 μmol/L vs. 25.4 ± 2.8 μmol/L, respectively; P < 0.001), and they have a significantly positive correlation with plasma adropin levels (r = 0.463, P < 0.001). In the multiple linear regression analysis, nitrite/nitrate levels, BMI, and adropin were found to be independent risk factors for CSX. A ROC curve is used to identify the ability of adropin levels to predict the cardiac syndrome X. The area under the ROC curve was 0.854 for adropin levels (P = 0.0001). The sensitivity and specificity values of adropin levels were 90.7 and 70.9%, respectively (cut-off value 2.73). In conclusion, lower serum adropin levels were associated with CSX. Adropin is an independent risk factor for CSX.

Decreased saliva/serum irisin concentrations in the acute myocardial infarction promising for being a new candidate biomarker for diagnosis of this pathology.

Irisin is a muscle-secreted protein. Cardiac muscle produces more irisin than skeletal muscle in response to acute exercise, and is associated with myocardial infarction (MI) in an experimental model induced by isoproterenol in rats. The timing and significance of its release in patients with acute myocardial infarction (AMI) needs further investigation. We have studied the relationship between serum/saliva irisin concentration and AMI in humans. Serum and saliva samples were taken within 3 days of admission in 11 patients with AMI and in 14 matched controls. Salivary gland irisin was detected immunohistochemically, and serum and saliva levels were measured by ELISA. The three major paired salivary glands (submandibular, sublingual and parotid) produce and release irisin into saliva. Troponin-I, CK, CK-MB concentrations in the AMI group gradually increased from up to 12h, while saliva and serum irisin gradually decreased from up to 48 h, compared with the control group (P<0.05). After 12h, troponin-I, CK, CK-MB started to decrease, while saliva and serum irisin started to increase at 72 h. Serum irisin levels correlated with age, while troponin I, CK-MB, and CK were correlated and with saliva irisin in AMI patients. Besides cardiac troponin and CK-MB, irisin adds new diagnostic information in AMI patients, and the gradual decrease of saliva/serum irisin over 48 h could be a useful biomarker.

The Investigation of Serum Vaspin Level in Atherosclerotic Coronary Artery Disease

Background It was speculated that fatty tissue originated adipocytokines may play role in pathogenesis of atherosclerosis. These adipocytokines may alter vascular homeostasis by effecting endothelial cells, arterial smooth muscle cells and macrophages. Vaspin is a newly described member of adipocytokines family. We aimed to investigate whether plasma vaspin level has any predictive value in coronary artery disease (CAD). Methods Forty patients who have at least single vessel ≥ 70 % stenosis demostrated angiographically and 40 subjects with normal coronary anatomy were included to the study. The vaspin levels were measured from serum that is obtained by centrifigation of blood and stored at -20 oC by ELISA method. The length, weight and body mass index of patients were measured. Biochemical parameters including total cholesterol, low density lipoprotein, high density lipoprotein, creatinine, sodium, potassium, hemoglobine, uric acid and fasting glucose were also measured. Results Biochemical markers levels were similar in both groups. Serum vaspin levels were significantly lower in CAD patients than control group (respectively; 256 ± 219 pg/ml vs. 472 ( 564 pg/ml, P < 0.02). Beside this serum vaspin level was lower in control group with high systolic blood pressure. Conclusion Serum vaspin levels were found significantly lower in patients with CAD than age-matched subjects with normal coronary anatomy. Vaspin may be used as a predictor of CAD. Keywords Coronary artery disease; Vaspin; Adipokine

The level of hs-CRP in coronary artery ectasia and its response to statin and angiotensin-converting enzyme inhibitor treatment.

Background/Aim. Coronary artery ectasia (CAE) was thought of as a variant of atherosclerosis. C-reactive protein (CRP) which is among the most sensitive markers of systemic inflammation, and elevation of systemic and local levels of this inflammatory marker which has been associated with an increased risk for cardiovascular disease in the obstructive coronary artery disease (O-CAD) are well known, but little was known in CAE. The anti-inflammatory effects of statins and the effect of angiotensin-converting enzyme (ACE) inhibitors on endothelial dysfunction are well established in atherosclerosis. The aim of the present study was to investigate CRP level and its response to statin and ACE inhibitor treatment in CAE. Materials and method. We measured serum hs-CRP level in 40 CAE (26 males, mean age: 56.32 ± 9 years) and 41 O-CAD (34 males, mean age: 57.19 ± 10 years) patients referred for elective coronary angiography at baseline and after 3-month statin and ACE inhibitor treatment. Results. Plasma hs-CRP levels were significantly higher in CAE group than O-CAD group at baseline (2.68 ± 66 mg/L versus 1, 64 ± 64, resp., P < .0001). Plasma hs-CRP levels significantly decreased from baseline 3 months later in the CE (from 2.68±0.66 mg/L to 1.2±0.53 mg/L, P < .0001) as well as in the O-CAD group (from 1.64±0.64 mg/L to 1.01±0.56 mg/L, P < .001). Conclusion. We think that hs-CRP measurement may be a good prognostic value in CAE patients as in stenotic ones. Further placebo-controlled studies are needed to evaluate the clinical significance of this decrease in hs-CRP.

Circulating Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Levels Are Associated With Erectile Dysfunction in Patients Without Known Coronary Artery Disease

AIM Endothelial dysfunction and microvascular damage are involved in the pathogenesis of erectile dysfunction (ED). Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) is identified endothelial receptor for oxidized low-density lipoprotein (ox-LDL) that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between sLOX-1 and ED in patients without known coronary artery disease (CAD). MAIN OUTCOME MEASURES Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of sLOX-1 were measured in serum by enzyme-linked immunosorbent assay. METHODS One hundred thirty-eight subjects with ED patients without known CAD (ED group) and 75 age-matched subjects without ED and known CAD (Non-ED Group) were included in this study. RESULTS Plasma levels of sLOX-1 were significantly higher in ED than in Non-ED group (95±87 and 49±30 pg/mL, respectively, P<0.001). The levels of sLOX-1 highly negative correlated with score of ED (r=-0.618, P<0.001). The sLOX-1 levels>75 pg/mL predicts ED with 26.8% sensitivity and 96.0% specificity on receiver operator characteristic analysis. CONCLUSIONS Our study demonstrated that serum sLOX-1 levels were associated with endothelial dysfunction that predicts ED. Moreover, the current study revealed that there was strong negative correlation between the levels of circulating sLOX-1 and score of ED. This study suggested sLOX-1 may be involved in the pathogenesis of ED in patients without known CAD.

Efficacy of Clopidrogel on Reperfusion and High-Sensitivity C-Reactive Protein in Patients with Acute Myocardial Infarction

We investigated the effects of clopidogrel on reperfusion and inflammatory process in STEMI. A total of 175 STEMI patients with similar clinical characteristics were included to this study. One was the standard pharmacological reperfusion therapy group (group 1, n : 90), who received 300 mg aspirin, 70 U/kg bolus, and 12 U/kg/hr continuous infusion of unfractioned heparin and accelerated t-PA. Clopidogrel 450 mg loading and 75 mg/d thereafter was added to standard reperfusion therapy in the other group (group 2, n : 85). The ST-segment resolution, CK-MB, and high-sensitive CRP (hs-CRP) parameters were measured. Complete ST resolution was observed in 32 patients (36.8%) in group 1 and 53 patients (63.8%) in group 2 (P < .001). Also in the first 24 hours, the CK-MB levels of patients in group 1 were significantly higher than those of group 2 (P = .001). The hs-CRP values were greater in group 1 than group 2 at 48th hour (gruop 1: 9.4 ± 0.1 mg/L, group 2: 3.7 ± 1.4 mg/L; P = .000). We concluded that adding clopidogrel to standard treatment in STEMI patients provided early reperfusion and suppression of inflammatory response.

The relationship between platelet collagen receptor glycoprotein VI and no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction.

Objectives The purpose of this study was to determine whether admission soluble glycoprotein VI (sGP-VI) level is associated with no-reflow phenomenon (NRP) after primary percutaneous coronary intervention (P-PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 178 consecutive patients admitted to our hospital for a first STEMI and undergoing P-PCI within 12 hours of onset of symptoms were enrolled. The patients were divided into 2 groups (NRP group and reflow group). Admission sGP-VI plasma levels were measured by enzyme-linked immunosorbent assay. Results Of the 178 patients who underwent P-PCI, 41 patients (23%) developed NRP. The patients in the reflow group had higher levels of sGP-VI compared with the patients in the NRP group (38.5 ± 21.0 vs 21.9 ± 11.9 ng/mL, P < 0.001). The sensitivity and specificity values of the sGP-VI levels were 90% and 49%, respectively (cutoff value was ⩽25). In the multivariate logistic regression analyses, sGP-VI levels of 25 ng/mL or lower, higher peak troponin T levels and body mass index value, amount of opaque of greater than 250 mL, and lesion length of greater than 13.5 mm were independent predictors of angiographic NRP. Conclusions Lower admission sGP-VI levels are associated with NRP in patients with STEMI undergoing P-PCI. This outcome may open new therapeutic facility in the setting of P-PCI.

Pregnancy Followed by Delivery May Affect Circulating Soluble Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Levels in Women of Reproductive Age

Background/Objective. It is known that menopause or lack of endogenous estrogen is a risk factor for endothelial dysfunction and CAD. Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is involved inmultiple phases of vascular dysfunction.The purpose of the current study was to determine the association between soluble LOX-1 (sLOX-1) and pregnancy followed by delivery in women of reproductive age. Materials/Methods. Sixty-eight subjects with pregnancy followed by delivery (group 1) and 57 subjects with nongravidity (group 2) were included in this study. Levels of sLOX-1 were measured in serum by EL SA. Results. Plasma levels of sLOX-1 were significantly lower in Group 1 than Group 2 in women of reproductive age (0.52 ± 0.18 ng/mL and 0.78 ± 0.13, resp., P < 0.001). There were strong correlations between sLOX-1 levels and the number of gravida (r = −0.645, P < 0.001). The levels of sLOX-1 highly correlated with the number of parous (r = −0.683, P < 0.001). Conclusion. Our study demonstrated that serum sLOX-1 levels were associated with pregnancy followed by delivery that might predict endothelial dysfunction. We conclude that pregnancy followed by delivery may delay the beginning and progress of arteriosclerosis and its clinical manifestations in women of reproductive age.

PP-042 THE EVALUATION OF STREPTOKINAZ REZISTANCE, A FIBRINOLYTIC AGENT IN HIGH RISK PROFILE FOR CORONARY ARTERY DISEASE LIVING UPPER FIRAT REGION

His daughter and his brother’s children also homocysteine levels, factor V Leiden mutation was detected in the heterozygous mutant. Folic acid, and warfarin started to the Patients and their relatives. Homocysteine levels were normal during 7 years follow up to watch it. Conclusions: At the end of 7 years progress or either regress on coronary angiography lesions in the patient and his relatives were unchaged. Ischemic heart disease symptoms and signs were not detected. Based on this experience, we were studied and reviewed with the literature.