Search

Amaç: Stent içi restenoz (SR), perkütan koroner girişimin (PKG) önemli komplikasyonlarından biridir. Eozinofil ile SR arasındaki ilişkiyi ortaya çıkaran çok sayıda çalışma olmasına rağmen, literatürde eozinofil-lenfosit oranı (ELO)’nın SR gelişimi ile ilişkisi hakkında veri bulunmamaktadır. Bu çalışmada, hastaların başvuru ELO değerlerinin SR ile ilişkisini araştırmayı amaçladık. Yöntemler: Çalışmaya, daha önce koroner stent takılmış olup hastanemize stabil angina nedeniyle başvuran ve tekrar koroner anjiyografisi yapılan 314 hasta dahil edildi. Hastaların verileri retrospektif olarak incelendi. Anjiyografik olarak SR tespit edilen 197 kişi hasta grubuna alındı, stentleri açık olan 117 hasta ise kontrol grubuna dahil edildi. Bulgular: Yaş, cinsiyet, hipertansiyon, diabetes mellitus, LDL-kolesterol, HDL-kolesterol, platelet sayısı, platelet-lenfosit oranı (PLO), hemoglobin düzeyleri ve sol ventrikül ejeksiyon fraksiyonu (LVEF) ölçümleri bakımından gruplar arasında anlamlı bir fark yoktu. Başvuruda bakılmış olan kan beyaz küre sayısı (WBC), nötrofil, eozinofil, C-reaktif protein (CRP), ELO ve nötrofil-lenfosit oranı (NLO) değerleri SR grubunda kontrol grubuna göre istatistiksel olarak anlamlı şekilde daha yüksek lenfosit değerleri daha düşüktü. Tüm hastalar ELO düzeylerine göre iki gruba ayrıldığında, yüksek-ELO grubunda düşük-ELO grubuna kıyasla daha sık SR görüldü. Başvuru ELO değerinin ≥0,745 olması durumunda, SR’u %64 sensitivite ve %61 spesifite ile öngördürebildiği saptandı. Sonuç: Bu çalışmada ELO değerleri kontrol grubuna kıyasla SR grubunda anlamlı olarak daha yüksek bulundu. Çalışmadan elde ettiğimiz bulgular ışığında kolay ve ucuz bir yöntem olan ELO, SR açısından yüksek riskli hastaların belirlenmesine yardımcı olabilir ve yüksek ELO, SR için bir öngördürücü olarak kullanılabilir., Objective: Stent restenosis (SR) is an important compli­cation of percutaneous coronary intervention. There are many studies explored the relation of eosinophils with SR, however, there is no data about relationship between eo­sinophil-lymphocyte ratio (ELR) and SR. In this study we aimed to investigate the relationship between the value of ELR on admission and SR. Methods: The study was included 314 patients who had been applied a coronary stent implantation and they were admitted to cardiology clinic with stabile angina and un­derwent repeat coronary angiography. The data obtained from patients were analyzed retrospectively. The patient group was consisted of 197 patients who were diagnosed as SR, and the control group was consisted of 117 pa­tients whose stents were patent angiographically. Results: The groups were similar in terms of age, gender, hypertension, diabetes mellitus, LDL-C, HDL-C, platelet count, platelet-lymphocyte ratio (PLR), hemoglobin and left ventricle ejection fraction (LVEF). White blood cell (WBC), neutrophil, eosinophil, C-reactive protein (CRP), ELR and neutrophil-lymphocyte ratio (NLR) on admission were higher in the SR group compared to the controls. All patients were categorized into two groups according to ELR values and SR was more frequent in the high ELR group compared to low ELR group. An ELR value of ≥0.745 predicted SR with 64% sensitivity and 61% specif­ity. Conclusion: In this study ELR was found statistically higher in SR patients compared to the controls. Accord­ing to our data ELR as an inexpensive and easy method, may contribute to determination of high risk patients and increased ELR can be used as a predictor of SR.

Giriş:Bu çalışmada, hematolojik parametrelerin ölçümleriile preeklamptik kadınlarda hipertansiyon şiddetini tahmin etmenin mümkün olupolmadığını araştırdık.Hastalarve Yöntem: İki yüz altmış birpreeklamptik ve 51 normal gebe kadın çalışmaya alındı. Preeklampsi olgularıhafif ve ağır preeklampsi olarak sınıflandırıldı.Bulgular:Doğum sonrası sonuçlar karşılaştırıldığında,preeklamptik kadınların trombosit sayıları düşük, ortalama trombosit hacimlerive nötrofil lenfosit oranları yüksekti (sırasıyla; p< 0.001, p< 0.001 vep< 0.001). Çoklu lineer regresyon analizinde, ortalama trombosit hacmi venötrofil lenfosit oranı hipertansiyon şiddeti ile bağımsız bir şekildekorelasyon gösterdi (sırasıyla; β= 0.25, p< 0.001 ve β= 0.31, p< 0.001).Sonuç: Hemortalama trombosit hacmi hemde nötrofil lenfosit oranı preeklamptikgebelerde hipertansiyonun şiddetini öngörmede bağımsız birer belirleyici olarakkullanılabilir., Introduction:This study was undertaken to examine the role ofhematological parameters in predicting the severity of hypertension inpre-eclamptic women.Patientsand Methods: Two hundred sixty-one pre-eclamptic women andfifty-one women with normal pregnancy were included in the study. The severityof preeclampsia was classified as mild or severe. Results:Compared to post-delivery period, pre-eclampticfemales had lower platelet count, raised mean platelet volume and raisedneutrophil lymphocyte ratio (p< 0.001, p< 0.001, p< 0.001,respectively). Multiple linear regression analysis showed an independentcorrelation between the severity of hypertension and mean platelet volume aswell as the neutrophil lymphocyte ratio (β= 0.25, p< 0.001; β= 0.31, p

Objectives: Our aim was to evaluate whether more than one observer or fractional flow reserve has the same re­sults in assessing coronary lesion severity in intermediate lesions. Methods: Our hospital\'s database was searched for frac­tional flow reserve procedures and then these patient\'s lesions were assessed visually by three experienced in­terventional cardiologist. Results: 8 of 46 patients were (17.4%) female and 38 of 46 were (82,6%) male. Average age was 61±11 years (Male: 60±11 / Female: 70±7 years). One observer could only detect 66.7% of severe lesions and 76.2% of non-severe lesions. When two observers agreed about lesion sever­ity, true detection of severe lesions was (max) 76.7%, and true detection of non-severe lesions was (max) 66.7%, so a decrease in true detection of non-severe lesions was observed. When one of the observers called a lesion “se­vere” and the lesion was assumed as “severe”, detection of a severe lesion was 83.3% (p=0.017); if all of the ob­servers agreed that the lesion was “non-severe” then true detection of a non-severe lesion was 90.5% (p, Amaç: Koroner arter hastalığında orta dereceli lezyonla­rın ciddiyetinin değerlendirilmesinde, çok gözlemci ile ya­pılan değerlendirmenin fraksiyonel akım rezervi ile benzer sonuçlar elde edip edemeyeceği belirlenmek istenmiştir. Yöntemler: Hastanemizin veritabanı fraksiyonel akım re­zervi işlemleri açısından tarandı ve hastalara ait lezyonlar üç deneyimli girişimsel kardiyolog tarafından görsel ola­rak değerlendirildi. Bulgular: 46 olgunun 8\'i (%17,4) kadın ve 38\'i (%82,6) erkekti. Yaş ortalaması 61±11 yıl idi. (Erkek: 60±11 / Ka­dın: 70±7 yıl). Tek gözlemcinin ciddi lezyonların ancak %66,7\'sini saptayabildiği, ciddi olmayan lezyonların ise en fazla %76,2\'sini saptayabildiği gözlendi. İki gözlemci­nin ortak kararına bakıldığında ise ciddi lezyonları sap­tama olasılığının maksimum %76,7, ciddi olmayan lez­yonları saptama olasılığının ise maksimum %66,7 olduğu saptandı, yani iki gözlemcinin ortak kararı ile ciddi olma­yan lezyonların değerlendirilmesinde yanlışlık olasılığının arttığı görüldü. Üç gözlemciden biri lezyona ciddi dediğin­de ciddi çıkma ihtimalinin %83,3 e yükseldiği (p=0,017), üç gözlemcinin de ciddi değil olarak değerlendirdiği lez­yonların ciddi çıkmama olasılığının %90,5\'e yükseldiği (p

Objective: Myocardial bridge (MB) is a congenital anomaly characterized by systolic narrowing of the epicardial coronary arterial segment while traveling in the myocardium. It is a benign entity but previous studies showed that the proximal portion is prone to an enhanced atherosclerosis. Neutrophil/lymphocyte ratio (NLR) is a sensitive marker of systemic inflammation used as a predictor for adverse cardiovascular outcomes in atherosclerotic heart disease. So in this study, we sought to evaluate the association between NLR and myocardial bridging. Methods: A total of 172 patients (mean age: 50.8 ± 11.5 years, 77.3% men) with either angiographically proven MB or normal coronary arteries were included in the study. For the entire study population, hematologic parameters were measured using an automatic blood counter. Results: The study population consisted of 71 patients with MB (mean age: 51.4 ± 11.9 years, 80.3% male) and 101 patients with normal coronary arteries (mean age: 50.5 ± 11.3 years, 75.2% male). There were no significant differences between groups regarding hemoglobin level, platelet count, glucose and creatinine. Compared to the control group, NLR was significantly higher in patients with MB (2.45 ± 1.19 vs. 1.72 ± 0.48; p< 0.001). In ROC analysis, NLR > 1.82 predicted myocardial bridge presence with 70% sensitivity and 71% specificity (ROC area under curve: 0.733, 95% CI: 0.654-0.811, p < 0.001). Conclusion: Our study findings demonstrated that MB is associated with elevated NLR, which is used to assess inflammatory status of the body. J Clin Exp Invest 2014; 5 (1): 24-28, Amaç: Miyokardiyal kas bandı miyokart içinde seyreden epikardiyal koroner arterlerin sistolde daralması ile seyreden konjenital bir anomalidir. İyi huylu olmasına rağmen önceki çalışmalarda proksimal kesimlerin artmış ateroskleroza eğilimli olduğu gösterilmiştir. Nötrofil/lenfosit oranı (NLO) aterosklerotik kalp hastalıklarında kötü prognozu öngören sistemik enflamasyonun duyarlı bir belirtecidir. Biz bu çalışmada NLO ile miyokardiyal kas bandı arasında bir ilişki var olup olmadığını araştırmayı amaçladık. Metodlar: Anjiyografik olarak tespit edilmiş miyokardiyal kas bandı veya normal koroner arterleri olan 172 hasta (ortalama yaş: 50.8 ± 11.5 yıl, %77.3 erkek) çalışmaya dahil edildi. Otomatik kan sayacı kullanılarak tüm hastaların hematolojik parametreleri ölçüldü. Bulgular: Çalışma 71 miyokardiyal kas bandı (ortalama yaş: 51,4 ± 11,9 yıl, %80,3 erkek) ve 101 normal koroner arterleri (ortalama yaş: 50,5 ± 11,3 yıl, %75.2 erkek) olan hastadan oluşmaktaydı. Hemoglobin, trombosit sayısı, glukoz ve kreatinin açısından gruplar arasında fark saptanmadı. Kontrol grubuna göre miyokardiyal kas bandı grubunda NLO anlamlı olarak daha yüksekti (2,45 ± 1,19 vs. 1,72 ± 0,48; p< 0,001). ROC analizinde, NLO > 1,82 miyokardiyal kas bandı varlığını %70 duyarlılık ve %71 özgüllükle öngörmüştür (ROC eğri altında kalan alan: 0.733, 95% güvenlik aralığı: 0.654-0.811, p < 0.001). Sonuç: Çalışmamız miyokardiyal kas bandının vücutta enflamatuar düzeyi gösteren yüksek NLO seviyeleri ile ilişkili olduğunu göstermiştir.

Objective: We aimed to investigate short term effects of oral and infusion dosages of amiodarone on thyroid function. Methods: A hundred and fifty-five prospectively consecutive patients with a diagnosis of atrial or ventricular arrhythmias admitted to our clinic whom amiodarone were applied enrolled to our study. 134 patients received 16 mg/kg amiodarone iv infusion for 24 hours and oral 500±100 mg/day amiodarone as the maintenance dose for one month. 21 patients received only oral 500±100 mg/day amiodarone dose for one month. Follow up visit was performed in the first month of amiodarone therapy. Results: In this study 68% of patients were male and the average age of the patients was 62.8±13.5. The indications for amiodarone treatment were atrial fibrillation (41%), ventricular tachycardia (41%), and preoperative (5%), supraventricular tachycardia (5%), atrial flutter (5%), and ventricular fibrillation (3%). At the first month of follow up 83% of patients were in euthyroid state, 17% of the patients had amiodarone induced thyroid dysfunction (TD), 5% of patients had subclinical hyperthyroidism, 5% of patients had manifest hypothyroidism, 7% of patients had subclinical hyperthyroidism, and 1% of the patients developed overt hyperthyroidism. Conclusion: In this study we showed that amiodarone can cause adverse effects on thyroid function in a short time of period. For this reason patients should be followed in the first, third, sixth and twelfth months of amiodarone therapy and thyroid function should be evaluated. J Clin Exp Invest 2014; 5 (2): 280-285, Amaç: Bu yazıda amiodaronun tiroid fonksiyonları üzerindeki kısa dönem etkilerini, oral ve infüzyon dozlarınının tiroid fonksiyonları üzerindeki etkisini araştırmak amaçlanmıştır. Yöntemler: Kliniğimize atrial ve ventriküler aritmilerle başvurup amiodaron başlama endikasyonu olan ardışık 155 ötroid hasta çalışmaya alındı. Hastaların 134\'üne 16 mg/kg dozunda 24 saat IV amiodaron infüzyonu takiben bir ay boyunca oral 500±100 mg/gün, geriye kalan 21 hastaya ise sadece oral 500±100 mg/gün amiodaron başlandı. Hastalar tedavinin birinci ayında kontrole çağrıldı. Bulgular: Çalışmaya alınan hastaların %68\'i erkek olup hastaların ortalama yaşı. 62,8±13,5 idi. Amiodaron başlama endikayonu olan hastaların %41\'i atrial fibrilasyon, % 41\'i ventriküler taşikardi, %5\'i preoperatif, %5\'i supraventriküler taşikardi, %5\'i atriyal flutter, %3\'ü ventriküler fibrilasyondu. Birinci ay kontrolünde %83 hastada ötiroid durum, % 17 hastada ise amiodarona bağlı tiroid disfonksiyonu (TD) saptandı. TD saptanan hastaların %5\'i subklinik hipotiroidi, %5\'i aşikar hipotiroidi, %7\'si subklinik hipertiroidi, %1\'inde de aşikar hipertiroidi gelişmişti. Sonuçlar: Bu çalışmada amiodaronun kısa dönemde de tiroid fonksiyonları üzerinde olumsuz etki yapabileceğini gösterdik. Bu nedenle amiodaron tedavisi başlanan hastalar birinci ay, üçüncü ay, altıncı ay ve onikinci ay kontrole çağrılmalıdır. Böylece amiodaron tedavisi alması zorunlu hastalarda gelişecek olan TD erkenden tespit edilebilecek ve uygun tedavi başlanabilecektir.

A 40 years old male with history of unexplained recurrent presyncope and palpitation episodes referred to cardiology department. Patient had no past medical history. Subsequently, electrophysiology study was performed to detect any underlying atrioventricular nodal disease or inducible tachyarrhythmias. During this period, 1.0 mg of atropine was injected intravenously to performed stimulation and patient suddenly developed polymorphic ventricular tachycardia that could not be terminated with overdrive pacing. Ventricular tachycardia was terminated spontaneously, two minutes later. J Clin Exp Invest 2014; 5 (3): 449-451, Tekrarlayan çarpıntı ve presenkop şikayetleri ile 40 yaşında erkek hasta kardiyoloji kliniğine başvurdu. Hastanın öz geçmişinde herhangi bir özellik yoktu. Atriyoventriküler nod hastalığı veya taşiaritmi indüklemek için elektrofizyolojik çalışma yapıldı. Atropin 1.0 mg yapıldıktan sonra testin tekrarlanması planlandı. Bu esnada polimorfik ventriküler taşikardi gelişti. Overdrive pacing ile taşikardi sonlanmadı yaklaşık 2 dakika sonra spontan olarak sonlandı.

BSTRACT Objective: the neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: the study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. the χ2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. the sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI. (

Yuksel, Murat/0000-0003-2636-5211 WOS: 000364114800011 Aim: To investigate the predisposing factors, demographic and clinical characteristics, echocardiographic and prognostic features, and Outcomes of patients with native valve infective endocarditis (IE) in Turkey in a multicenter based study. Materials and methods: The study population consisted Of 15,8 consecutive patients with native valve IE (NVE). Data on demographics, medical history, medications, clinical procedures, predisposing factors, clinical examination, microbiology, antibiotic therapy, echocardiography, surgery, complications, and outcome were collected and compared. Results: The mean age of the patients was 47 19 (range 13-87). Seventy seven patients (49%) Were female. Of the 158. NVE patients, 49 died during hospitalization. Mortality rate was 31%. Twenty eight patients experienced a stroke. The patients who died during hospitalization were significantly older than the survivors and had higher mean heart rate, white blood cell, C reactive protein, creatinine, poor NYHA functional etas's, multiple vegetations and large vegetations. Culture negative endocarditis was seen in 54 eases (34%). Staphylococci were the most common causative organisms (28%). Eighty patients had undergone surgical treatment (51%). Hemoglobin, presence of multiple vegetation, vegetation size. (>10 mm), septic shock and poor NYHA Class on admission were independent risks for in hospital mortality and stroke Beside these variables C. reactive Protein was also an independent risk for in hospital mortality Conclusion: Native valve IE in Turkey was associated with high in hospital mortality. Rheumatic heart disease continues to be the most common underlying heart condition and echocardiographie findings on admission were the most important independent predictors of mortality or stroke.

Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF) with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

akil, mehmet ata/0000-0001-6004-1822; KAYA, HASAN/0000-0003-3923-4026 WOS: 000319517900003 PubMed: 23661513 OBJECTIVE: This study aimed at the assessment of the clinical approach to atrial fibrillation (AF) in the older population and the consistency with the guidelines based on the records of the multicenter, prospective AFTER (Atrial Fibrillation in Turkey: Epidemiologic Registry) study. PATIENTS AND METHODS: 2242 consecutive patients admitted to the Cardiology Outpatient Clinics of 17 different tertiary Health Care Centers with at least one AF attack determined on electrocardiographic examination, were included in the study. Among the patients included in the study, 631 individuals aged 75 years and older were analyzed. RESULTS: The mean age of the patients was determined as 80.3 +/- 4.2 years. The most frequent type of AF in geriatric population was the persistent-permanent type with a percentage of 88%. 60% of the patients with AF were female. Hypertension was the most common co-morbidity in patients with AF (76%). While in 16% of patients a history of stroke, transient ischemic attack or systemic thromboembolism was present, a history of bleeding was present in 14% of the patients. 37% of the patients were on warfarin treatment and 60% of the patients were on aspirin treatment. In 38% of the patients who were on oral anticoagulant treatment, INR level was in the effective range. CONCLUSIONS: The rate of anticoagulant use in the elderly with AF was 37% and considering the reason of this situation was the medication not being prescribed by the physician, one should pay more attention particularly in the field of treatment.

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEY Kaya, Hasan/0000-0003-3923-4026; WOS: 000329858400146 … Turkish Soc Cardiol

Ayhan, Erkan (Balikesir Author), Amaç: Adiponektin, insülin duyarlılığını düzenleyen ve adipositden sekrete edilen bir proteindir ve dolaşımdaki seviyesinin azalması insülin direnci ile ilişkilidir. Biz, stabil anjina pektorisli hastalarda serum adiponektin ve kan gli- koz seviyeleri ile koroner arter hastalığı şiddeti arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve yöntem: Bu çalışmaya stabil anjina pektorisli 160 hasta (82 erkek) dahil edildi. Hastalar başvuru es- nasındaki kan glikoz seviyerine göre 3 gruba ayrıldı; 24 hasta normal kan glikoz grubu,53 hasta bozulmuş glikoz tolerans grubu ve 53 hasta diabetes mellitus (DM) grubu. Koroner lezyonların şiddeti Gensini skoru kullanarak de- ğerlendirildi. Tüm gruplarda serum adiponektin seviyeleri de ölçüldü. Bulgular: Hipertansiyon, hiperlipidemi, obesite ve insü- lin direnci DM grupta anlamlı olarak daha yüksekdi. DM’li hastalarda serum adiponektin seviyeleri anlamlı olarak daha düşük saptandı (13.55±7.16, p=0.002). Ortalama Gensini skoru DM grupta 40.84 ±37.25 olarak saptandı (p=0.006). Sonuç: Stabil anjina pektorisi olan hastalarda serum adi- ponektin düzeyleri koroner arter hastalığı yaygınlığı için bir ipucu olabilir., Objectives: Adiponectin is an adipocyte-secreted protein that modulates insulin sensitivity and whose low circulat- ing concentration is associated with insulin resistance. We evaluated the association between serum adiponec- tin and blood glucose levels with coronary artery disease severity on the angiogram in patients with stable angina pectoris. Materials and methods: The study included 160 patients (82 males) with stable angina pectoris. The patients were divided into three groups according to the blood glucose levels on admission; thus, 24 had normal glucose group, 53 had impaired glucose tolerance group, and 53 had diabetes mellitus (DM) group. The severity of coronary lesions was assessed using the Gensini score. Serum adiponectin levels were measured in the all group. Results: The hypertension, hyperlipidemia, obesity, and insulin resistance were significantly higher in the DM group. Patients with DM significantly lower serum levels of adiponectin (13.55±7.16, p=0.002). The mean Gensini score was 40.84± 37.25 in the DM group (p=0.006). Conclusion: Serum adiponectin levels may be a clue for severity coronary artery disease in patients with stable angina pectoris.

WEB SITE FEATURE

Atherosclerosis is the name given to the buildup of cholesterol and fatty deposits or plaques in the coronary artery walls. The coronary arteries become narrow and hardened, their elasticity disappears and it becomes difficult for blood to flow through. The fatty plaques can also rupture, causing blood to clot around the rupture. Plaque ruptures are a common cause of unstable angina pectoris 1 . Coronary artery reperfusion is commonly achieved by intravenous administration of thrombolytic agents and mechanical recanalization 2 . An 85-year-old man was admitted to the coronary care unit with non-ST elevation myocardial infarction. The patient underwent coronary angiography showed totally occluded LAD left anterior descendent coronary artery before the first diagonal branch and right coronary artery RCA . There was severe stenosis in ostial and proximal part of circumflex artery Cx Fig.1 A-B . Retrograde TIMI grade-3 coronary collateral flow between the conus branch of right coronary artery and proximal LAD Fig.1 C-D , and retrograde TIMI grade-1 coronary collateral flow between RCA and distal part of Cx. was demonstrated Fig. 1B . The patient was referred to operation but he refused

WOS:000614539900006 PMID: 33371718 The present study aimed to examine the association of C-reactive protein to albumin ratio (CAR) with short-term major adverse cardiac events (MACEs) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). We included 539 STEMI patient treated with pPCI in this study. Patients were divided into 2 groups according to MACE development. Patients with MACE had higher CAR than those without (1.18 [0.29-1.99] vs 0.21 [0.09-0.49], P < .001). Multivariate analysis showed that The Global Record for Acute Coronary Events score, Percutaneous Coronary Intervention with TAXus and cardiac surgery (SYNTAX) score, glucose and CAR (odds ratio:1.326, 95% CI: 1.212-1452, P < .001) were independent predictors of MACE. The CAR may be proven useful for risk stratification in STEMI patients undergoing pPCI

Amaç: Periferik arter hastalıkları (PAH), dünya genelinde kardiyovasküler morbidite ve mortalitenin önemli nedenlerinden biri olup sıklığı giderek artmaktadır. Altta yatan temel patoloji ateroskleroz olduğundan iskemik kalp hastalıkları ve serebrovasküler hastalıklar ile birlikteliği sıktır. Birçok çalışma, sistemik inflamasyonun aterosklerozun başlamasında, ilerlemesinde ve izleminde önemli bir yere sahip olduğunu göstemiştir. Nötrofiller, lenfositler, plateletler ve eozinofiller inflamasyonda kilit rol oynayan hücreler olup özellikle nötrofiller salgıladıkları araşidonik asit metabolitleri, kemoatraktanlar ve süperoksid radikalleri ile inflamasyonun ilerlemesinde katkıda bulunurlar. Bunun yanında kanda ölçülen yüksek eritrosit dağılım aralığı (RDW), platelet dağılım aralığı (PDW), ortalama platelet hacmi (MPV) değerleri inflamatuar reaksiyonlar ile ilişkili bulunmuş ve aterosklerotik periferik arter hastalıklarında morbidite veya mortalite öngördürücüsü olarak kullanılabileceği fikri oluşmuştur. Bu çalışmada amacımız bu parametreler ve bunlardan elde edilen indeksler [nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO), eozinofil/lenfosit oranı (ELO) ] ile TASC-II (Trans-Atlantic Inter-Society Consensus) sınıflamasına göre periferik arter hastalığı ciddiyetini değerlendirmektir.Gereç ve Yöntem: Çalışmaya Eylül 2014 ve Ağustos 2017 tarihleri arasında Dicle Üniversitesi Kalp Hastanesi'nde PAH tanısıyla periferik anjiyografi yapılan 170 hasta dahil edildi. Hastaların laboratuar değerleri retrospektif olarak incelendi. TASC-II sınıflamasına göre hastaların lezyonları belirlendi ve hastalar, lezyonların anjiyografik olarak belirlenen ciddiyetine göre TASC-II AB (n:77) veya TASC-II CD (n:93) şeklinde iki gruba ayrıldı. Hastaların demografik özellikleri (yaş, cinsiyet, sigara içiciliği, hipertansiyon, diyabet, kronik böbrek hastalığı, hiperlipidemi) sorgulandı ve her iki grupta da rapor edildi.Bulgular: Gruplar arasında hipertansiyon dışında demografik özellikler bakımından anlamlı fark yoktu. Periferik anjiyografi yapılan 170 hastanın 106'sına perkutan girişim yapılmış olup bunların 60'ına stent takıldı. En fazla müdahale edilen arter süperfisyal femoral arter oldu (48 hasta). Yüksek NLO, PLO, ELO, RDW ve PDW değerleri ile TASC-II sınıflamasına göre PAH ciddiyeti arasında istatistiksel olarak anlamlı ilişki saptandı. MPV değerleri ile PAH ciddiyeti arasında ise istatistiksel olarak anlamlı ilişki saptanmadı. Korelasyon analizi yapıldığında TASC-II sınıflaması ile RDW arasında yüksek; NLO, PLO, PDW ile orta; ELO ile düşük düzeyde korelasyon saptandı.Sonuç: Plazma NLO, PLO, ELO, RDW ve PDW değerleri ile TASC-II sınıflamasına göre PAH ciddiyeti arasında istatistiksel olarak anlamlı ilişki mevcuttur. Basit bir tam kan sayımı ile ölçülebilecek olan bu belirteçler, PAH ciddiyeti ve yaygınlığı konusunda tahmin sağlayabilir. Ancak bu alanda literatürde yapılan çalışma sayısı çok az olduğundan başka çalışmalar ile bu ilişkinin doğrulanması gerekmektedir. MPV değerleri ile PAH ciddiyeti arasında ise anlamlı ilişki saptanamamıştır. Literatürde yapılan çalışmaların sayısı çok az olduğundan ve olan çalışmalar da çelişkili bilgiler içerdiğinden bu alanda daha fazla çalışmaya ihtiyaç vardır. Aim: Peripheral arterial diseases (PAD) are one of the major causes of cardiovascular morbidity and mortality worldwide and their frequency is increasing. It is often associated with ischemic heart diseases and cerebrovascular diseases because of underlying pathology is atherosclerosis. Several studies have shown that systemic inflammation has an important place in the onset, progression and prognosis of atherosclerosis. Neutrophils, lymphocytes, platelets, and eosinophils are cells that play a key role in inflammation, especially neutrophils contribute to the progression of inflammation via secreting arachidonic acid metabolites, chemoattractants and superoxide radicals. Besides blood measured by high red cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV) values have been associated with the inflammatory reaction and the idea can be used as predictors of morbidity or mortality in atherosclerotic PAD. In this study, we aimed to evaluate these parameters and the indices [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), eosinophil to lymphocyte ratio (ELR)] obtained from them and PAD severity according to TASC-II classification.Methods: 170 PAD patients with peripherally angiographically diagnosed between September 2014 and August 2017 at Dicle University Heart Hospital were included in the study. Laboratory values of the patients were analyzed retrospectively. According to TASC-II classification, lesions of patients were determined and patients were divided into two groups as TASC-II AB (n:77) or TASC-CD (n:93) according to the angiographic severity of the lesions. The demographic characteristics of the patients (age, sex, smoking, hypertension, diabetes, chronic kidney disease, hyperlipidemia) were questioned and reported in both groups.Results: There was no significant difference between groups in terms of demographic features except hypertension. Percutaneous intervention was performed in 106 of 170 patients who underwent peripheral angiography and 60 of them were stented. Most intervened artery was superficial femoral artery (48 patients). Statistically significant relation was found between the high values of NLR, PLR, ELR, RDW and PDW and the severity of peripheral arterial disease according to TASC-II classification. There was no statistically significant relationship between MPV values and PAD severity. When correlation analysis was performed, high correlation with RDW; moderate correlation with NLR, PLR, PDW; low correlation with ELR was detected between TASC-II classification.Conclusion: There is a statistically significant relationship between plasma NLR, PLR, ELR, RDW and PDW values and PAD severity according to TASC-II classification. These markers, which can be measured with a simple whole blood count, can provide prediction the severity and prevalence of PAD. However, because of there are only a small number of studies done in the literature in this area, it is necessary to confirm this relationship with any other studies. There was no significant relationship between MPV values and the severity of PAD. Since the number of studies done in the literature is very small and studies involve conflicting information, more work is needed in this area. 86

Lisansüstü tezlerin elektronik ortamda toplanması, düzenlenmesi ve erişime açılması konusuna ilişkin yök'ün 18.06.2018 tarihli yönergesine istinaden artık bu tarihten sonra gizlilik şartı aranmayan bütün tezler erişime açılacaktır. Amaç: Periferik arter hastalıkları (PAH), dünya genelinde kardiyovasküler morbidite ve mortalitenin önemli nedenlerinden biri olup sıklığı giderek artmaktadır. Altta yatan temel patoloji ateroskleroz olduğundan iskemik kalp hastalıkları ve serebrovasküler hastalıklar ile birlikteliği sıktır. Birçok çalışma, sistemik inflamasyonun aterosklerozun başlamasında, ilerlemesinde ve izleminde önemli bir yere sahip olduğunu göstemiştir. Nötrofiller, lenfositler, plateletler ve eozinofiller inflamasyonda kilit rol oynayan hücreler olup özellikle nötrofiller salgıladıkları araşidonik asit metabolitleri, kemoatraktanlar ve süperoksid radikalleri ile inflamasyonun ilerlemesinde katkıda bulunurlar. Bunun yanında kanda ölçülen yüksek eritrosit dağılım aralığı (RDW), platelet dağılım aralığı (PDW), ortalama platelet hacmi (MPV) değerleri inflamatuar reaksiyonlar ile ilişkili bulunmuş ve aterosklerotik periferik arter hastalıklarında morbidite veya mortalite öngördürücüsü olarak kullanılabileceği fikri oluşmuştur. Bu çalışmada amacımız bu parametreler ve bunlardan elde edilen indeksler [nötrofil/lenfosit oranı (NLO), platelet/lenfosit oranı (PLO), eozinofil/lenfosit oranı (ELO) ] ile TASC-II (Trans-Atlantic Inter-Society Consensus) sınıflamasına göre periferik arter hastalığı ciddiyetini değerlendirmektir. Gereç ve Yöntem: Çalışmaya Eylül 2014 ve Ağustos 2017 tarihleri arasında Dicle Üniversitesi Kalp Hastanesi'nde PAH tanısıyla periferik anjiyografi yapılan 170 hasta dahil edildi. Hastaların laboratuar değerleri retrospektif olarak incelendi. TASC-II sınıflamasına göre hastaların lezyonları belirlendi ve hastalar, lezyonların anjiyografik olarak belirlenen ciddiyetine göre TASC-II AB (n:77) veya TASC-II CD (n:93) şeklinde iki gruba ayrıldı. Hastaların demografik özellikleri (yaş, cinsiyet, sigara içiciliği, hipertansiyon, diyabet, kronik böbrek hastalığı, hiperlipidemi) sorgulandı ve her iki grupta da rapor edildi. Bulgular: Gruplar arasında hipertansiyon dışında demografik özellikler bakımından anlamlı fark yoktu. Periferik anjiyografi yapılan 170 hastanın 106'sına perkutan girişim yapılmış olup bunların 60'ına stent takıldı. En fazla müdahale edilen arter süperfisyal femoral arter oldu (48 hasta). Yüksek NLO, PLO, ELO, RDW ve PDW değerleri ile TASC-II sınıflamasına göre PAH ciddiyeti arasında istatistiksel olarak anlamlı ilişki saptandı. MPV değerleri ile PAH ciddiyeti arasında ise istatistiksel olarak anlamlı ilişki saptanmadı. Korelasyon analizi yapıldığında TASC-II sınıflaması ile RDW arasında yüksek; NLO, PLO, PDW ile orta; ELO ile düşük düzeyde korelasyon saptandı. Sonuç: Plazma NLO, PLO, ELO, RDW ve PDW değerleri ile TASC-II sınıflamasına göre PAH ciddiyeti arasında istatistiksel olarak anlamlı ilişki mevcuttur. Basit bir tam kan sayımı ile ölçülebilecek olan bu belirteçler, PAH ciddiyeti ve yaygınlığı konusunda tahmin sağlayabilir. Ancak bu alanda literatürde yapılan çalışma sayısı çok az olduğundan başka çalışmalar ile bu ilişkinin doğrulanması gerekmektedir. MPV değerleri ile PAH ciddiyeti arasında ise anlamlı ilişki saptanamamıştır. Literatürde yapılan çalışmaların sayısı çok az olduğundan ve olan çalışmalar da çelişkili bilgiler içerdiğinden bu alanda daha fazla çalışmaya ihtiyaç vardır. Aim: Peripheral arterial diseases (PAD) are one of the major causes of cardiovascular morbidity and mortality worldwide and their frequency is increasing. It is often associated with ischemic heart diseases and cerebrovascular diseases because of underlying pathology is atherosclerosis. Several studies have shown that systemic inflammation has an important place in the onset, progression and prognosis of atherosclerosis. Neutrophils, lymphocytes, platelets, and eosinophils are cells that play a key role in inflammation, especially neutrophils contribute to the progression of inflammation via secreting arachidonic acid metabolites, chemoattractants and superoxide radicals. Besides blood measured by high red cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV) values have been associated with the inflammatory reaction and the idea can be used as predictors of morbidity or mortality in atherosclerotic PAD. In this study, we aimed to evaluate these parameters and the indices [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), eosinophil to lymphocyte ratio (ELR)] obtained from them and PAD severity according to TASC-II classification. Methods: 170 PAD patients with peripherally angiographically diagnosed between September 2014 and August 2017 at Dicle University Heart Hospital were included in the study. Laboratory values of the patients were analyzed retrospectively. According to TASC-II classification, lesions of patients were determined and patients were divided into two groups as TASC-II AB (n:77) or TASC-CD (n:93) according to the angiographic severity of the lesions. The demographic characteristics of the patients (age, sex, smoking, hypertension, diabetes, chronic kidney disease, hyperlipidemia) were questioned and reported in both groups. Results: There was no significant difference between groups in terms of demographic features except hypertension. Percutaneous intervention was performed in 106 of 170 patients who underwent peripheral angiography and 60 of them were stented. Most intervened artery was superficial femoral artery (48 patients). Statistically significant relation was found between the high values of NLR, PLR, ELR, RDW and PDW and the severity of peripheral arterial disease according to TASC-II classification. There was no statistically significant relationship between MPV values and PAD severity. When correlation analysis was performed, high correlation with RDW; moderate correlation with NLR, PLR, PDW; low correlation with ELR was detected between TASC-II classification. Conclusion: There is a statistically significant relationship between plasma NLR, PLR, ELR, RDW and PDW values and PAD severity according to TASC-II classification. These markers, which can be measured with a simple whole blood count, can provide prediction the severity and prevalence of PAD. However, because of there are only a small number of studies done in the literature in this area, it is necessary to confirm this relationship with any other studies. There was no significant relationship between MPV values and the severity of PAD. Since the number of studies done in the literature is very small and studies involve conflicting information, more work is needed in this area.

PMID: 25550173 Objective: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). Methods: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. Results: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p

Objective: We aimed to assess relationship between the severity of coronary atherosclerosis assessed by SYNTAX score (SS) and neutrophil to lymphocyte ratio (NLR) in patients with ST elevation myocardial infarction (STEMI. Methods: After accounting for exclusion criteria, a total of 291 patient with STEMI in whom primary percutaneous coronary intervention was performed were retrospectively included (216 male, 75 female; mean age 61.6+14.0 years). Total and differential leukocyte counts and other biochemical markers were measured at admission. Patients were categorized into tertiles on the basis of SS. Monitoring for major adverse cardiac events (MACEs) was performed during the in hospital follow-up period. Results: The SS high group leukocyte (p=0.009), neutrophil (p=0.008), NLR (p=0.048), peak troponin (p, Amaç: Biz bu çalışmada STEMİ hastalarında nötrofil lenfosit oranı (NLO) ve Syntax skoru (SS) ile değerlendirilen koroner aterosklerozun şiddeti arasındaki ilişkiyi ST yükselmeli miyokard infarktüsü (STEMİ)\'ünde değerlendirmeyi amaçladık. Yöntemler: Dışlama kriterleri sonrası primer perkütan koroner girişim uygulanan geriye dönük olarak toplamda 291 STEMI hastası çalışmaya alındı. (216 erkek,75 kadın, ortalama yaş 61,6±14,0 yıl). Toplam ve diferensiyel lökosit sayımı ve diğer biyokimyasal belirteçler hasta kabulünde alındı. Hastalar SS göre üç tertile ayrıldı. Majör istenmeyen kardiyak olaylar (MİKO) için izleme hastanede yatış döneminde yapıldı Bulgular: SSyüksek grup, lökosit (p=0,009), nötrofil (p=0,008), NLO (p=0,048), zirve troponin (p

WOS: 000421963600007, PubMed: 25782122, Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials. gov number, NCT02354456.).

Objective: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. Methods: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ2 and independentsamples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. Results: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. Conclusion: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in riskstratifying STEMI. (Anatol J Cardiol 2015; 15: 648-56)

PMID: 25537998 Abstract: Objective: The aim of this study was to evaluate the relationship between atrial electromechanical delay (EMD) measured with tissue Doppler imaging (TDI) and left atrial (LA) mechanical functions in patients with ischemic stroke and compare them with healthy controls. Methods: Thirty patients with ischemic stroke were enrolled into this cross-sectional, observational study. The control group consisted of 35 age- and gender-matched apparently healthy individuals patients. Acute cerebral infarcts of probable embolic origin were diagnosed via imaging and were confirmed by a neurologist. Echocardiographically, time intervals from the beginning of P wave to beginning of A wave from the lateral and septal mitral and right ventricular tricuspid annuli in TDI were recorded. The differences between these intervals gave the mechanical delays (inter- and intra-atrial). Left atrial (LA) volumes were measured using the biplane area-length method, and LA mechanical function parameters were calculated. Statistical analysis was performed using student s t-test, chi-squared test, and Pearson s test. Results: The laboratory and clinical characteristics were similar in the two groups. Increased left atrial EMD (21.36±10.38 ms versus 11.74±6.06 ms, p

Giriş ve Amaç: Koroner arter hastalığı dünyada en yaygın ölüm nedenidir. Biz çalışmamızda STEMI’li hastalarda başvuru kan şekeri yüksekliği ile no-reflow arasındaki ilişkiyi araştırdık. Daha önceki çalışmalarda hiperglisemi ile STEMI sonrasında artmış kalp yetmezliği, kardiyojenik şok ve ölüm riski arasındaki ilişki gösterilmiş ancak altta yatan mekanizması açıklanamamıştır. Materyal ve Metod: Dicle Üniversitesi Kalp Hastanesi Yoğun Bakımı’na yatırılan STEMI’li 900 hasta geriye dönük olarak değerlendirildi. Tüm hastaların yoğun bakım ünitesine kabullerinde serum kan şekeri ile birlikte diğer laboratuar parametreleri ölçüldü. Önceki çalışmalara uygun olarak, TIMI akım derecesi ≤2 olanlar no-reflow fenomeni olarak değerlendirildi. Hastalar reflow ve no-reflow şeklinde gruplandırıldı. Tüm bilgiler dökümante edildi. Bulgular: Çalışmamızda 372 hasta analiz edildi. Çalışmaya dahil edilen hastalar primer PCI sonrası TIMI akımına göre sınıflandırıldığında; 70 hasta (%19) no-reflow grubuna dahil edilirken 302 hasta (%81) reflow grubuna dahil edildi. Yaş ortalaması reflow grubunda 60.9±13.7, no-reflow grubunda 66.1±13.4 idi (p=0.005). Başvuru anındaki kan şekeri ortalaması no-reflow grubunda 199.7±106.9 mg/dl, reflow grubunda 163.8±71.1 mg/dl izlendi (p=0.001). Stepwise forward çok değişkenli lojistik regresyon analiziyle yaş (p=0.001), Killip sınıfı (p=0.010), kan şekeri (p=0.038), MPV (p=0.039) ve nötrofil sayısının (p=0.030) no-reflowun bağımsız öngördürücüleri olduğu gösterildi. Sonuçlar: STEMI ile gelen hastalarda başvuru kan şekeri düzeyi yüksekliği ile no-reflow fenomeni arasında anlamlı bir ilişki tespit edildi. Başvuru kan şekeri düzeyi, no-reflow gelişmesi açısından bağımsız bir öngördürücü olarak kabul edilebilir. STEMI ile gelen hastalarda başvuru kan şekerinin düşürülmesi ile no-reflow fenomeninin azalabileceğini gösteren çalışmalar yapılabilir. Anahtar Kelimeler: STEMI, Başvuru kan şekeri düzeyi, No-reflow fenomeni. Introduction and purpose: Coronary artery disease is the most common cause of death in the world. We investigated the association between hyperglycemia and the no-reflow phenomenon in patients with Acute ST-Elevation Myocardial Infarction (STEMI). Hyperglycemia is associated with increased risks of heart failure, cardiogenic shock, and death after STEMI, but its underlying mechanism remains unknown. Materials and methods: We analyzed 900 retrospective consecutive patients admitted for STEMI to the Coronary Care Unit of Dicle Universiy Heart Hospital. All patients in the intensive care unit admission, serum blood glucose levels with other laboratory parameters were measured. We defined angiographic no-reflow phenomenon as a coronary TIMI flow grade ≤2 after vessel re-canalized. Patients were grouped into reflow and no-reflow. All data were documented. Results: A total of 372 patients who underwent p-PCI were enrolled in the study. 70 patients (19%) was included in the no-reflow group, 302 patients (81%) were included in the reflow group. The mean age was 60.9 ± 13.7 in the reflow group, the no-reflow group was 66.1 ± 13.4 years (p=0.005). Admission mean blood glucose level in no-reflow group was 199.7 ± 106.9 mg/dl, in the reflow group was 163.8 ± 71.1 mg/dl (p=0.001). By stepwise forward multivariate logistic regression analysis; age (p=0.001), Killip class (p=0.010), admission blood glucose levels (p=0.038), MPV (p=0.039) and neutrophil counts (p=0.030) were shown to be independent predictors noreflow. Conclusions: In patients presenting with STEMI application was a significant association between a high level of blood sugar on admission with no-reflow phenomenon. High blood glucose level on admission, can be considered as an independent predictor of no-reflow phenomenon. Application in patients presenting with STEMI done studies showing no-reflow phenomenon can be reduced by lowering blood glucose level. Key Words: STEMI, Blood glucose level on admission, No-reflow phenomenon.

Background/aim: The thrombolysis in myocardial infarction (TIMI) risk score (TRS), and the TIMI risk index (TRI) have been reported in coronary artery disease patients. We investigated whether admission TRI is associated with no-reflow (NRF) in patients undergoing primary percutaneous coronary intervention (p-PCI). Materials and methods: ST-segment elevation myocardial infarction (STEMI) patients treated with p-PCI were included in the study. TRI was calculated on admission using specified variables. We defined the angiographic NRF phenomenon as a coronary TIMI flow grade of ≤2 after the vessel was recanalized or a TIMI flow grade of 3 together with a final myocardial blush grade (MBG) of