Osman Akın Serdar

Statin Therapy May not Effect NLR and MPV Levels in Patients With Hypercholesterolemia A Retrospective Study

Statins may exert pleiotropic effects in coronary artery disease (CAD), diabetes mellitus, and familial hypercholesterolemia. We evaluated the effects of statins on the neutrophil–lymphocyte ratio (NLR) and mean platelet volume (MPV) in 261 consecutive patients with hypercholesterolemia having CAD or at high cardiovascular (CV) risk and 50 healthy participants who were retrospectively included in this study. Patients were treated with 10 to 80 mg atorvastatin or 10 to 40 mg rosuvastatin for 24 weeks according to baseline levels of cholesterol, triglycerides, and CV risk. Baseline NLR and MPV were significantly higher in patients with CAD or at high risk compared to the control group (1.89 [0.37-6.78]) vs 1.44 [0.75-2.41], P < .001 and 8.8 [6.27-18.6] vs 8.45 [6-11] fL, P = .038, respectively). The NLR, MPV, and lipid parameters were also compared in the patient group after statin treatment for 24 weeks. Lipid levels decreased but the NLR and MPV did not change significantly after the statin therapy. Further studies are needed to clarify the effect of statin therapy on NLR and MPV in patients with CAD or at high CV risk.

Ascaris-induced eosinophilic myocarditis presenting as acute St elevation myocardial infarction and cardiogenic shock in a young woman

To the EditorEosinophilic myocarditis is a relatively rare condition and usually results from myocardial damage as a result of drugs or parasites. It is generally associated with increased peripheral eosinophil count.1 The clinical presentation of patients with myocarditis is variable, ranging from

Successful treatment of saphenous venous graft thrombus by tirofiban infusion

A 60-year old man with a history of coronary-artery bypass grafting presented with symptoms of acute coronary syndrome. Coronary angiography revealed a huge intraluminal thrombus in the saphenous vein graft to the second obtuse marginal branch of the left circumflex artery. A glycoprotein IIb/IIIa inhibitor (tirofiban) was administered intravenously. Two days later, thrombus dissolution and Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow were evident on repeat coronary angiography. Glycoprotein IIb/IIIa inhibitors may be useful in a thrombus-laden saphenous-vein graft.

Assessment of the Association Between serum Uric Acid level and the Predicted Risk Score of Sudden Cardiac Death at Five Years in Patients with Hypertrophic Cardiomyopathy

OBJECTIVE The aim of this study was to determine the relationship between serum uric acid (UA) level and the predicted risk score for sudden cardiac death in 5 years (the HCM Risk-SCD), galectin-3 level, and positive fragmented QRS (fQRS) on electrocardiography (ECG) in patients with hypertrophic cardiomyopathy (HCM). METHODS This was a prospective, observational study. In all, 115 consecutive patients (age >17 years) with HCM and 80 healthy participants were included in the study. The HCM Risk-SCD score (%), galectin-3 level, and fQRS on ECG were evaluated in all patients. RESULTS The serum UA, galectin-3 level, UA/Creatinine ratio, incidence of ventricular tachycardia (VT) and syncope, and some echocardiographic parameters were significantly higher in the patient group than in the control group (all p<0.05). The UA value was significantly higher in patients with a high score on the HCM Risk-SCD, a positive fQRS, a high galectin-3 level, VT incidence, and need for implantable cardioverter defibrillator (ICD) implantation or cardiopulmonary resuscitation (CPR) than in those without (HCM Risk-SCD >6%. Namely, HCM Risk-SCD >6%, UA: 6.71±1.29 mg/dL, HCM Risk-SCD ≤5.9%, UA: 5.84±1.39 mg/dL, p=0.001; fQRS(+), UA: 6.56±1.20 mg/dL, fQRS(-), UA: 5.63±1.49 mg/dL, p<0.001; galectin-3 >6.320 pg/mL, UA: 6.56±1.27 mg/dL, galectin-3 ≤6.310 pg/mL, p=0.016; left atrium anterior-posterior dimension (LAAPD) >36 mm, UA: 6.31±1.33 mg/dL, LAAPD <36 mm, UA: 5.20±1.60 mg/dL, p=0.005; VT(+), UA: 6.83±1.19 mg/dL, VT(-), UA: 5.97±1.42 mg/dL, p=0.008; ICD(+), UA: 7.08±0.88 mg/dL, ICD(-), UA: 6.06±1.42 mg/dL, p=0.022; CPR(+), UA: 7.03±0.96 mg/dL, CPR(-), UA: 6.04±1.42 mg/dL, p=0.018. A statistically significant correlation was observed between UA and HCM Risk-SCD, galectin-3 level, LAAPD, and left ventricular (LV) mass (LVM) (r and p values, respectively: 0.355, <0.001; 0.297, 0.002; 0.309, 0.001; 0.276, 0.003. CONCLUSION The serum UA level was significantly higher in patients with HCM compared with the control group. A high UA level was associated with a higher HCM Risk-SCD score, positive fQRS, higher galectin-3 level, greater LAAPD, VT incidence, and the need for ICD implantation and CPR in patients with HCM.

The value of coronary artery calcium score in the early diagnosis of coronary artery disease in patients with stable chronic obstructive pulmonary disease.

Objective: Our aim was to assess the value of coronary artery calcium score (CACS) in the early diagnosis of coronary artery disease in Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II chronic obstructive pulmonary disease (COPD) patients and to identify high-risk patients. Methods: Forty-two patients with GOLD stage II COPD and 31 healthy control subjects were enrolled in the study. This study was designed as a prospective observational cross-sectional study. Pearson’s correlation coefficient was used for comparisons between groups. Criteria for stage II COPD diagnosis were forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) of <70% and 50%≤FEV1<80%. Excluded from the study were individuals who had a previous diagnosis of coronary artery disease, GOLD stage I-III-IV COPD, or left ventricular systolic dysfunction. Results: As compared with the control group, CACS values were significantly higher in the patient group (p=0.030 and 0.001, respectively). CACS was significantly higher in male patients with a positive family history, physical inactivity, long duration of disease, and low FEV1 (0.027, 0.008; 0.001 and 0.001; 0.001, respectively). Logistical regression analysis of sex, age, diabetes mellitus, hypertension, cigarette smoking, family history, physical inactivity, and FEV1 values showed that physical inactivity was independently correlated with high CACS [odds ratio (OR): 7; confidence interval (CI): 3–20; p=0.001]. Conclusion: The value of CACS is high in stage II COPD patients. Male stage II COPD patients with a disease duration of 10 years, physical inactivity, and/or a positive family history should be monitored for early stage coronary artery disease and coronary events, regardless of risk factors such as diabetes, hypertension, and hyperlipidemia.

Acute Haemodialysis-induced Changes in Tissue Doppler Echocardiography Parameters.

BACKGROUND Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium. AIMS To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD). STUDY DESIGN Cross sectional study. METHODS Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD. Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes. RESULTS Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged. CONCLUSION A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients.