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Objectives: Various vascular grafts are used in coronary artery bypass graft (CABG) surgeries, however, the most commonly used one is the saphenous vein graft (SVG). Various studies conducted on this topic have found a relationship between uric acid to HDL-C (UHR) and cardiovascular diseases. In this current study, we aimed to investigate the predictive importance of UHR value in predicting long-term SVG disease in patients who underwent CABG surgery. Methods: Patients who had a history of CABG surgery at least one year prior, had stable angina pectoris, and underwent coronary angiography between January 01, 2016 and January 01, 2020, were included in the study retrospectively. Patients with open saphenous veins were defined as Group 1, and patients who had 50% or more stenosis in at least one SVG after coronary angiography, were defined as Group 2. Results: The median age of the 204 patients included in Group 1 and 292 patients in Group 2 were 65 (38-77) years and 66 (45-79) years, respectively (p = 0.251). The two groups were similar in terms of gender, hypertension, chronic obstructive pulmonary disease rates, history of cerebrovascular events, ejection fraction, body mass index, and current medical treatments. In univariate analysis, SVG disease was found to significantly correlate with diabeter mellitus (odds ratio [OR]: 1.644, 95% confidence interval [CI]: 1.190-1.985, p = 0.008), current smoking (OR: 0.875, 95% CI: 0.669-0.940, p = 0.030), number of patients with target artery diameter < 1.5 mm (OR: 1.945, 95% CI: 1.221-2.398, p < 0.001), age of SVG (OR: 2.960, 95% CI: 1.980-4.168, p < 0.001), uric acid (OR: 1.241, 95% CI: 1.078-1.592, p = 0.004), triglyceride (OR: 0.780, 95% CI: 0.569-0.935, p = 0.044) and UHR (OR: 1.894, 95% CI: 1.384-2.896, p < 0.001). Conclusions: In this study, we showed that we can predict saphenous vein graft occlusion with serum UHR value.

Objectives: Atrial fibrillation (AF) may cause thromboembolism and cardiac morbidity and mortality. Patients with cardiovascular diseases are at risk for developing AF. In this study, the relationship between inflammation markers and AF was examined. Methods: Among 689 people followed up in the cardiology outpatient clinic for reasons such as hypertension, coronary artery disease, and rheumatic valve disease, 88 patients with AF and 601 patients without AF were compared. The blood parameters of the AF group were examined during the period when AF developed in the patients. Hemogram and biochemistry parameters of AF and non-AF groups were compared. Results: C-reactive protein to albumin ratio (CAR), neutrophil count to albumin ratio, neutrophil count to lymphocyte count ratio, and monocyte count to lymphocyte count ratio were significantly higher in the AF group than in the non-AF group (p < 0.001, p < 0.001, p = 0.001, and p < 0.001; respectively). According to the Receiver Operating Characteristics analysis, it was found that the CAR value of cut-off: 0.0533 could diagnose AF with 74% sensitivity (AUC: 0.789, CI 95%: 0.726-0.853, p < 0.001). Albumin value of cut-off: 3.75 was found to be able to diagnose AF with 82% specificity (AUC: 0.772, CI 95%: 0.707-0.836, p < 0.001). Conclusions: AF is an arrhythmia that should be recognized early due to the complications it causes, and the CAR value can be used in the diagnosis of AF in individuals with cardiac disease.

Objectives: Platelet-lymphocyte ratio (PLR) combines the predictive risk of platelet and lymphocyte counts into a single risk index. PLR has been studied as a predictive marker in a variety of cardiovascular diseases. However, our understanding of the link between PLR and coronary artery disease (CAD) remains limited. The present study aimed to evaluate the relationship between PLR and intensity of coronary atherosclerosis in patients with suspected CAD. Methods: In this retrospective study, we included 221 patients undergoing dual-source 64-slice coronary computed tomography angiography (CCTA). Total and different types of leukocyte counts were measured with an automatic blood counter. Based on a modified version of the American Heart Association's categorisation, the coronary artery tree was divided into 16 segments. To assess the extent of coronary atherosclerosis, the number of affected coronary segments was counted. Coronary artery plaques were classified into three categories: (1) calcified plaque, (2) non-calcified plaque, and (3) mixed plaque. Results: After multivariable backward stepwise regression analysis, PLR remained as an independent predictor for both the presence and extent of coronary atherosclerosis (OR=2.38, 95% CI: 1.27-4.47 and OR=1.66, 95% CI: 1.10-2.51, respectively). There was no significant relationship between PLR and plaque morphology. Conclusions: Higher PLR was associated with the intensity of coronary atherosclerosis detected by CCTA. Further research is necessary to determine the optimal approach to using PLR in medical practice.

Cardiovascular diseases are among the leading causes of death worldwide. Atherosclerotic cardiovascular diseases consist of a broad spectrum of diseases such as coronary artery disease, carotid artery disease, peripheral artery diseases, cerebral vascular diseases and visceral artery diseases. Although atherosclerosis occurs over time due to age; hypertension, hyperlipidemia, smoking, and diabetes mellitus are important factors that play a role in the emergence of atherosclerosis. Diabetes mellitus has an active role in the development of atherosclerotic cardiovascular disease. It is expected that there will be a significant increase in the incidence of diabetes-related cardiovascular diseases in the future. In this review, it is aimed to review the coexistence of diabetes with different cardiovascular diseases and its menanisms.

Objectives: We planned our survey study to evaluate the opinion of cardiologists about the class II recommendations on levels of evidence in the current European Society of Cardiology Guidelines (ESC). Our aim is to determine which diagnosis or treatment option most prefer by cardiologist when guidelines do not make clear recommendations. Methods: The survey was conducted on September 2020 with the participation of cardiologists (n = 102). Our survey covers ESC's guidelines published in 2018-2020 on diagnosis and treatment strategies in coronary artery disease, diabetes, heart valve disease, arrhythmia, dyslipidemia and heart failure. Our survey consisting of 40 questions was shared with the cardiologists via e-mail. Results: Participants answered all of the survey questions. The majority of the participants (79.41%) did not consider the addition of a second long-term antithrombotic medication in addition to aspirin for secondary prevention in diabetes mellitus (DM) and coronary artery disease (CAD) patients who are not at high risk of bleeding. The lowest low density lipoprotein (LDL) value achieved by the participant physicians with treatment in their practices was < 40 mg/dl in 32 (31.37%) participants . One of the striking results of the survey was that 51.96% of the participants stated that it was not possible to measure the lipoprotein a (Lp(a)) level in the center where they were carrying out their practices, and 34.31% did not consider the Lp(a) level in the treatment of dyslipidemia in terms of directing the treatment. As for patients with asymptomatic Wolff-Parkinson-White (WPW) syndrome, 58.82% of the participants considered catheter ablation therapy. Conclusions: Although there were different opinions on some recommendations, the participants were mostly in agreement. We think that these survey results, which were mostly based on expert opinions, may contribute to the guidelines to be published in the future with the increase of survey studies on these issues.

Objectives: The aim of this study was to assess the safety and efficacy of single Judkins left (JL) catheter to view right and left coronary artery in right transradial coronary angiography. Methods: A total of 266 patients underwent coronary angiography from the right radial artery were studied prospectively. Patients with ad-hoc percutaneous coronary intervention (PCI), peripheral angiography, ventriculography or aortography procedures (67 patients) were excluded from the study. Coronary angiography was performed with the JL catheter as single catheter group in 171 of the remaining 199 patients, and with the Judkins right and left catheters as the control group in the other 28 patients. Complications, procedure success, procedure time and fluoroscopy time were evaluated between the two groups. Results: Procedure success were 93% (159/171) in patients with a single catheter group and 96.4% (27/28) in patients with two catheter (Judkins right and left) group (control group) (p = 0.49). Complications (spasm) are the same between the two groups (8 of 171 [4.7%] patients in study group and 1 of 28 [3.6%] patients in control group, p = 0.79). Fluroscopy time in single JL catheter group was significantly higher (6.20 ± 4.97 min vs 3.76 ± 2.78 min, p = 0.01). Conclusions: Single JL catheter using to view right and left coronary artery in right transradial coronary angiography was safe and effective. In our study, the success rate of getting left and right coronary artery images with a single JL catheter as high as 93%. However, insisting on imaging with a single catheter extends the duration of fluoroscopy time.

Objectives: Total circulatory arrest (TCA) technique is a method used in cardiac surgery accompanied by cardiopulmonary bypass (CPB). It has been shown that Tulbaghia violacea extract increases antioxidant capacity, regulates blood pressure, decreases lipid peroxide, and reduces atherosclerosis. In this experimental study, we aimed to investigate the effect of T. violacea extract administration on serum oxidative stress parameters (Total antioxidant status [TAS], total oxidant status [TOS] and oxidative stress index [OSI] and deoxyribonucleic acid [DNA] damage level with 8-Hydroxy-2-Deoxyguanosine [8-OHdG]) and histopathological changes in the heart and other organs in rats with deep circulatory arrest model.Methods: In this study, 48 Wistar Albino adult rats, 24 female and 24 male, obtained from Harran University Experimental Animals Research Center were used. The average weight of female rats was 250-300 g, and the average weight of male rats was 450-500 g. These rats were randomly divided into four groups. 6 male and 6 female rats were used in each group (Group 1 = Sham, Group 2 = Injury, Group 3 = Treatment and Injury, Group 4 = Treatment).Results: As a result of this experimental study, the changes in the biochemical 8-OHdG, TOS, OSI and TAS levels of the groups were found to be statistically significant (p < 0.001). In the subgroup analyzes of the data, 8-OHdG level, which is an oxidative DNA damage marker in Group 2 was higher than the Group 1, Group 3 and Group 4 and there was a statistically significant difference (p < 0.001, p = 0.027 and p < 0.001; respectively). The TOS level of the injury group was higher than Group 1, Group 3 and Group 4 and there was a statistically significant difference (p < 0.001, p = 0.003 and p < 0.001; respectively).Conclusions: As a result of our study, we revealed that T. violacea extract has a protective effect on organ and tissue damage in the TCA model.

In most adult cardiac surgery operations, the heart must be completely immobile and isolated from the blood. Therefore, the heart is stopped in diastole and a still operative site is obtained. Cardiac arrest results in ischemia-reperfusion injury. For these reasons, myocardial protection and the prevention of damages are required. Various cardioplegia solutions are used for this purpose. It can be said that cardioplegia is the gold standard method of myocardial protection in cardiac arrest. Nowadays, "Single-dose cardioplegia" applications are increasingly used, especially in minimally invasive cardiac surgery and basic coronary bypass procedures due to the advantages they provide, which include reduction of aortic cross-clamp time, prevention of frequent interruption of the procedure due to cardioplegia, and reduced postoperative myocardial dysfunction incidence. The two main solutions used in single dose cardioplegia applications are the Bretschneider solution and the del Nido extracellular cardioplegia solution. The del Nido cardioplegia solution (dNCS), which was originally developed for use in pediatric cardiac surgery, has recently increased its use in adult cardiac surgery due to straightforward application and long-term effectiveness. The del Nido cardioplegia reduces the aortic cross clamp duration, cardiopulmonary bypass time and required cardioplegia solution volume, and is a safer and superior cardioplegia solution and technique in terms of myocardial protection with regards to many organs and cardiac-biochemical parameters.

Objectives: Chronic limb-threatening ischemia (CLTI) is the end-stage form of lower extremity artery disease (LEAD) whose main reason is atherosclerosis. Plasma osmolality (PO) and plasma lipid levels affect the development and progression of atherosclerosis directly. The purpose of this study was to investigate the predictive effect of PO and atherogenic index of plasma (AIP) for the development of CLTI. Methods: A total of 324 patients who were diagnosed with LEAD were analyzed retrospectively. The clinical stage of the disease was evaluated according to the Rutherford classification, and patients without CLTI were defined as “Group 1” and patients with CLTI as “Group 2”. Results: There were 248 patients (mean age 64.44 ± 9.05 years and 73.4% male) in Group 1, and 76 patients (mean age 66.62 ± 8.22 years and 76.3% male) in Group 2. In the multivariate regression analysis, CAD, PO, CRP and AIP were defined as independent predictive factors for the development of CLTI (p = 0.015, p < 0.001, p = 0.007, p < 0.001; respectively). ROC curve analysis showed that, PO cut-off value for CLTI development was 293.28 mOsm/kg (AUC: 0.821, p < 0.001) with 75% sensitivity and 74.2% specificity, and AIP cut-off value was 0.23 (AUC: 0.740, p < 0.001) with 67.1% sensitivity and 68.5% specificity. Conclusions: The PO and AIP values in LEAD patients may be used as the new biomarkers of atherosclerosis progression, and therefore as predictive factors for the development of CLTI.

Objectives: Cardiovascular diseases and risk factors are associated with adverse cardiac events following kidney transplant. Therefore, pre-transplant evaluation of cardiovascular diseases and risk factors is important for determining the cardiac risk. The objective of this study is to determine the prevalence of cardiovascular diseases and risk factors in kidney transplant candidates. Methods: This is a single-center and observational study which includes 174 end-stage renal disease patients (male: 55.2% and mean age: 49 ± 13 years) who underwent kidney transplant. Preoperative clinical characteristics, cardiovascular diseases and risk factors of the patients were examined retrospectively. Results: The study population had multiple cardiovascular risk factors such as hypertension (66.7%), diabetes (28.2%), dyslipidemia (29.9%) and smoking (30.5%) in the evaluation conducted prior to kidney transplant. The most common cardiovascular diseases were detected as congestive heart failure (10.9%) and coronary artery disease (8.6%). The rate of the patients who underwent myocardial revascularization (percutaneous coronary intervention or coronary artery bypass grafting) before kidney transplant was 6.9%. The patients’ mean left ventricular mass index was 114 ± 32 g/m2, and 55.5% of the study population had left ventricular hypertrophy. Conclusions: In our study, the prevalence of cardiovascular diseases and risk factors in the patients who underwent kidney transplant was found to be high.

Objectives: The aim of this study was to evaluate the relationship between carotid intima-media thickness and the presence of fragmented QRS in end-stage renal disease patients. Methods: The study included 100 end-stage renal disease patients who received hemodialysis treatment. Two groups were formed according to the presence of electrocardiography and fragmented QRS: the fragmented QRS (+) (Group I) and the fragmented QRS (-) (Group II). Echocardiographic measurements of the cardiac dimensions and carotid intima-media thickness were examined. Results: The study population included 41 end-stage renal disease patients with fragmented QRS (48.8% male) and a control group of 59 end-stage renal disease patients without fragmented QRS (35.6% male) on electrocardiography. Left ventricular end systolic diameters (p = 0.012),left ventricular end diastolic diameters (p < 0.001), left atrial diameter (p = 0.001), interventricular septal thickness (p < 0.001), posterior wall thickness (p < 0.001) and left ventricular hypertrophy (p < 0.001), blood urea nitrogen (p = 0.011), creatinine (p = 0.014), uric acid (p < 0.05) and parathyroid hormone (p < 0.05) values were found to be significantly increased in the fragmented QRS (+) group. The right and left carotid intima-media thickness values were significantly higher in fragmented QRS (+) patients than fragmented QRS (-) patients (right:[0.81 ± 0.19] vs [0.62 ± 0.14] mm, p < 0.001) and left: [0.83 ± 0.19 vs 64 ± 0.14], p < 0.001; respectively). Conclusions: In end-stage renal disease patients, the presence of fragmented QRS, left ventricular hypertrophy and increased carotid intima-media thickness are important markers in the evaluation of the inflammatory process of atherosclerosis.

Objectives: Central venous catheterization is an important procedure for infants undergoing heart surgery. Ultrasound-guided methods have been shown to decrease failure and complications. The goal of the present study was investigate the effect of anatomical landmark technique during internal jugular vein access in low-weight infants undergoing congenital heart surgery. Methods: A total 98 infants (median age was 16.5 days, median weight was 3275 g) who underwent internal jugular vein catheterization between January 2017 and October 2019 were retrospectively analyzed. All catherizations were performed by a pediatric heart surgeon. Data including demographic characteristics of the infants, success rate, and catheter-related adverse events were recorded. Results: Success rate was 94.9% (n = 93). There were three arterial puncture (3.1%) and hematoma occurred in five patients (5.1%). Central venous catheterization of 78 (79.6%) patients were successful at the first attempt. Conclusions: Our study suggest that landmark technique still seems useful by experienced operators and is safe and effective in infants weighing less than 5 kg undergoing congenital heart surgery.

Objectives: The coronary endarterectomy combined with coronary artery bypass grafting (CABG) is an useful but still controversial surgical technique in diffuse coronary artery disease. The aim of this study was to analyze the operative and early postoperative outcomes of the patients who underwent CABG with and without coronary endarterectomy. Methods: This retrospective study included a total of 312 consequtive patients undergoing on-pump CABG from December 2018 to December 2020 in the Department of Cardiovascular Surgery, Bursa Yüksek İhtisas Training and Research Hospital. Patients were divided into 2 groups as those who underwent coronary endarterectomy combined with on-pump CABG (Group 1, n = 48) and those who underwent isolated on-pump CABG (Group 2, n = 264). Peroperative variables were obtained from our hospital's computerized database and retrospectively analyzed. Results: Previous percutaneus coronary intervention rate and the number of patients with diabetes mellitus was significantly higher in the endarterectomy group. The demographics and characteristics of the patients were similar between the two groups. The median number of distal anastomoses was 4 (2-5) in Group 1 and 2 (1-5) in Group 2. Median cross-clamp duration and perfusion times in Group 1 were longer than Group 2 (82 min vs. 63 min; p < 0.001 and 120 min vs. 95 min; p = 0.003, respectively). A total of 54 coronary endarterectomy practices were performed on 48 patients, and the LAD artery (73%) was the most endarterectomized vessel. In Group 1, postoperative 24 hours high-sensitive troponin I levels were significantly higher than in Group 2 (p < 0.001). There was no significant difference between the groups in terms of operative mortality, low cardiac output rates and perioperative myocardial infarction rates. Postoperative atrial fibrillation was significantly higher in Group 1 (p = 0.023). Conclusions: Although coronary endarterectomy is a complex procedure, in patients with diffuse coronary artery disease, it is an essential and sometimes mandotary method in order to achieve complete revacularization and can be performed safely with acceptable operative and early postoperative outcomes.

Objectives: We evaluated the efficacy and safety of single high-dose versus double high-dose intracoronary bolus tirofiban in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: A total of 80 patients, who were admitted to our clinic and underwent primary PCI, were included in this observational cohort study. The patients were divided into the single high-dose group (n = 40) and the double high-dose group (n = 40) according to the intracoronary bolus tirofiban regime. The primary endpoint was assumed as the incidence of major adverse cardiac event (s) (MACE) defined as all-cause mortality and repeat coronary revascularization (target vessel revascularization [TVR]) at 30 days. MACE and bleeding events were evaluated at 7 and 30 days. Results: The primary endpoint was not significantly different between the single and the double high-dose groups (40.0% vs. 17.5%, p = 0.994). However, a significantly lower 30-day TVR rate was observed in the double high-dose group (27.5% vs. 7.5%, p = 0.019). No significant difference was observed in terms of 30-day all-cause mortality between the two groups (12.5% vs. 10.0%, p = 0.712). Major bleeding events were not observed in any group. Multivariate logistic regression analysis demonstrated that CRUSADE score (Hazard ratio [HR]: 5.721; 95% CI: 2.036 to 16.073, p = 0.001) and platelet count (HR: 1.009; 95% CI: 1.000 to 1.018, p = 0.048) were the independent predictors of bleeding at 7 days. Conclusions: Double high-dose intracoronary bolus tirofiban in STEMI patients undergoing primary PCI was associated with significantly lower 30-day TVR rates without an increase in bleeding events. However, it did not significantly affect MACE and all-cause mortality rates.

Objectives: The aim of this study was to determine the total antioxidant capacity, total oxidant capacity, oxidative stress index and antimicrobial activity of a poisonous mushroom Agaricus xanthodermus. The effects of mushrooms on atherosclerosis are due to their antioxidant effects. Methods: Mushroom samples collected from study field were extracted with methanol (MeOH) and dichloromethane (DCM) using soxhlet apparatus. Total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) were measured using Rel Assay trade kits. Antimicrobial activities were tested on 9 microorganisms (Staphylococcus aureus, S. aureus MRSA, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, Candida albicans, C.krusei and C. glabrata) using the modified agar dilution method. Results: In this study A. xanthodermus has shown high antioxidant and antimicrobial activities. In addition, the highest activities of MeOH and DCM extracts of the mushrooms were demonstrated against E. coli, P. aeruginosa, and A. baumannii. Conclusions: In conclusion, A. xanthodermus is considered to be a poisonous mushroom and can be used as a pharmacological natural agent due to its high antioxidant and antimicrobial activities.

Objectives: The speckle-tracking technique calculates the regional rate, the strain and the strain rate from two-dimensional gray-scale visualizations. The aim of this study was to evaluate with speckle-tracking echocardiography the effects of the first, second and third trimesters of pregnancy on cardiac functions. Methods: One hundred five voluntary pregnant and 35 healthy women of reproductive age were included in the study. For echocardiographic evaluations, the 111 highest-quality visualizations were chosen: 24 cases in the first trimester, 31 cases in the second trimester, 32 cases in the third trimester and 24 healthy women as a control group. Global longitudinal, radial, and circumferential strain, and left ventricular (LV) rotation and twist were evaluated by two-dimensional speckle tracking echocardiography. Results: During pregnancy, the diameter, and volume of the left atrium, LV stroke volume, and the heart rate significantly increased beginning in the first trimester (p < 0.0125). The parameters of pulse-Doppler E velocity and tissue Doppler Em velocity significantly increased in the first trimester (p < 0.0125), whereas in the second and third trimester they decreased to control levels. Global longitudinal strain was significantly decreased in the third trimester of the pregnancy (p < 0.0125). Basal and apical LV rotation and twist were significantly increased in the third trimester of pregnancy (p < 0.0125). LV apical and basal reverse rotation rate were significantly increased in the first trimester of pregnancy (p < 0.0125). Conclusions: In the third trimester global longitudinal strain decreased whereas LV rotation and twist increased. Speckle-tracking echocardiography may be used to evaluate the effects of pregnancy and that provide further data on cardiac functions.

Objectives: Atherosclerosis is a chronic disease that causes various cardiovascular complications. The onset and progression of atherosclerosis depends primarily on genetic factors and life style, but the underlying cellular and molecular mechanisms are still unclear. In recent studies, circulating cytokines have been shown to play an important role in inflammatory events. Interleukin-6 (IL-6) plays an important role in the regulation of proinflammation. In this study, a single nucleotide polymorphism of IL-6 gene at position -174 was studied. Our aim was to investigate the relationship between IL-6 -174G/C polymorphism and atherosclerosis.Methods: In this prospective randomized study, 104 patients were included in both groups. We used Polymerase Chain Reaction-Restriction Fragment Lenght Polymorphism (PCR-RFLP) method to amplify the polymorphism region.Results: Allele frequency distributions of IL-6 -174G/C polymorphism in the study and control groups were evaluated. There were no statistically significant diversity between A and B allele frequencies.Conclusions: The allele frequency and genotype distribution between the groups was not statistically different, which indicates another mechanisms on regulation of these cytokines. Single gene polymorphisms are generally not reproducible. Therefore, broad-based studies should be carried out considering suitable conditions and multi-factor features.

Objectives: The aim of the study to evaluate the safety and efficacy of the transthoracic echocardiography (TTE) guided secundum atrial septal defect (ASD) closure without balloon sizing, sedation or general anesthesia in adults. Methods: We retrospectively evaluated 200 secundum ASD closure patients in the tertiary cardiology center. Transesophageal echocardiography (TEE) was performed to all the patients at least one day before the intervention by the procedure operators. The patients who were closed with a cribriform device, using more than one device, with insufficient rim (

Peripheral artery disease (PAD) is a common disease among women and is expected to increase in the coming years. Diagnostic and therapeutic management of PAD in women is difficult due to their gender-related differences, comorbid factors, atypical symptoms, more functional disorders, the presence of advanced disease, being older age of the disease onset, smaller vessel diameter, and psychosocial factors. Especially due to the high prevalence of asymptomatic disease, late admission status and further disease on admission affect the success of the treatment negatively. By focusing more on PAD in women and more clinical studies, gender-specific differences can be identified. Hereby, there is a need to develop appropriate strategies to improve women's overall quality of life. In this review, we aimed to draw attention to the female gender with PAD, which is increasingly occurring.

Objectives: Atherosclerosis represents an active inflammation that leukocytes play a major role. Neutrophil-lymphocyte ratio (NLR) has been shown as an indicator of systemic inflammation. Our aim was to evaluate inflammatory markers in obstructive coronary artery disease (CAD) and cardiac syndrome X (CSX) and to evaluate NLR in predicting CAD in patients with typical chest pain and coronary risk factors. Methods: Eighty patients with CSX, 80 patients with obstructive CAD with unstable angina pectoris and a control group of 80 subjects were recruited into the study. Hematologic and biochemical parameters were investigated. Results: High-sensitive C-reactive protein (hs-CRP) was increased in CAD group and CSX group compared to the control group (p < 0.001); however it was comparable between CAD and CSX groups (p = 0.065). Mean NLR was higher in CAD group than CSX group and control group that the lowest value was in the control group. In CAD group, hs-CRP was positively correlated with NLR (r = 0.43, p < 0.001), and Gensini score (r = 0.54, p < 0.001). NLR was also linearly correlated with Gensini score (r = 0.49, p < 0.001). In ROC curve analysis, for the NLR of 2.26, NLR values attained 85.5% sensitivity and 43.9% specificity (p < 0.001). When cut-off value was taken as 3.05 mg/dL for CRP, CRP values attained 78.7% sensitivity and 43.6% specificity (p < 0.001). When cut-off value was taken as 9.5 (×109 /L) for white blood cell (WBC), WBC values attained 58.8% sensitivity and 34.3% specificity (p < 0.001). Conclusions: NLR seems to be usefull in prediction of obstructive CAD and can be implemented in planning for diagnostic procedures in patients with typical chest pain. Increased CRP, WBC and NLR may give insight about main pathology of CSX. Despite absence of obstructive narrowing in epicardial coronaries, it appears be salutary to treat CSX due to the similar underlying pathophysiology with obstructive CAD.

Objectives: B-type natriuretic peptide (BNP) has been extensively studied as a biomarker in heart failure. There is clear benefit of BNP in diagnosis and risk stratification of several cardiac diseases including acute coronary syndromes. Our aim was to evaluate diagnostic role of changes in BNP levels with exercise in coronary artery disease (CAD). Methods: Fifty-one patients underwent exercise stress testing (EST) for suspected CAD and consequently underwent coronary angiography (CA) were prospectively enrolled. Patients with and without at least one significant diameter stenosis in major epicardial arteries (CA+ and CA-) versus patients with and without evidence of myocardial ischemia during exercise stress testing (EST+ and EST-) were classified into 4 groups, respectively (Group 1, CA+/EST+; group 2, CA+/EST-; group 3, CA-/EST+; and group 4, CA-/EST-). All patients underwent EST. Blood was drawn from patients for determination of BNP levels 10 minutes prior to, 10 minutes after and 4 hours after EST. Results: EST parameters other than the parameters signifying myocardial ischemia didn’t differ significantly among groups (p > 0.05). Pre-exercise, post-exercise and 4h-post exercise BNP values were significantly higher in group 1 and group 2 compared to group 3 and group 4 (p < 0.05 for all comparisons between the groups for pre-exercise, post-exercise and 4h-post exercise BNP). Exercise-induced increases in BNP were higher in group 1 and group 2. Patients with significant CAD involving LAD demonstrated higher basal and exercise-induced BNP as well as BNP increases, irrespective of the EST result. Conclusions: Basal, maximal-exercise and post exercise BNP values predicted CAD, as well as CAD involving LAD irrespective of ischemic changes in EST. Our results point out potential role of BNP as an adjunct to EST in diagnosis and management of CAD.

Objectives: Factor VII has a crucial role in the extrinsic coagulation pathway and initiates the thrombus formation. Some studies showed that high plasma factor VII level was related to increased acute myocardial infarction (AMI) risk. But, some studies were reported opposite findings. Some polymorphisms can change the factor VII level. There is limited information about factor VII polymorphisms in southern Turkey population. Our aim was to determine the frequencies of Factor VII-401 and -402 polymorphisms and their relation to AMI in southern Turkey area. Methods: We enrolled 83 patients with AMI and 71 healthy subjects. Routine laboratory tests and factor VII-401 and -402 polymorphisms were determined from blood samples. Factor VII -401 and -402 polymorphisms were analyzed by LightCycler device using Real-Time PCR technique. Results: Family history of coronary artery disease and smoking frequencies were higher in patients group (p < 0.001 and p = 0.013, respectively). Patients had higher LDL cholesterol (p = 0.011) level, and lower HDL cholesterol (p = 0.025) level compared to healthy subjects. Factor VII-401 and -402 polymorphism genotypes were not significantly different in both groups. Also allele frequencies were similar in both groups. Conclusion: Factor VII-401 and -402 polymorphisms do not seem to increase AMI risk in southern Turkey.

Objectives: Kidney transplantation recipients (KTRs) have higher cardiovascular complications risk compared to the general population. Cardiovascular risk factors (CVRF, Traditional and non-traditional) are widely studied to understand the causes of increased cardiovascular disease (CVD) risk in KTRs. Fetuin-A prevents from vascular calcification (VC) by inhibiting production and collapsing of apatite crystals to the vascular wall. The relationship between fetuin-A levels and CVRF in KTRs was investigated in this study. Methods: Sixty-two KTRs with no prior CVD history participated. Anthropometrical, laboratory (fetuin-A, inflammation markers, antioxidants, lipid peroxidation products) and cardiological (echocardiographic, pulse wave velocity) measurements were performed. Participants were divided into two groups according to normal (≥ 0.5 g/L, n = 32, NFA) and low (< 0.5 g/L, n = 30, LFA) fetuin-A levels according to manufacturer’s reference range, and the results were compared. Results: No significant difference was observed in demographic features, body mass index, systolic and diastolic blood pressures, left ventricle mass index, waist and hip circumferences, left ventricle hypertrophy and waist-hip ratios between the two groups (p > 0.05). The ratios of drug usage such as immunosuppressives, anti-hypertensives and statin were comparable between two groups. Parathormone levels were significantly higher in the NFA group (p = 0.015) and glomerular filtration rate was calculated significantly higher in LFA group (p = 007). The comparison of other CVRF reveals no significant difference (p > 0.05). Conclusions: Although many CVRF improved in KTRs, subclinical inflammation markers were still higher than the healthy population. Identification and early recognition of CVRF in high-risk individuals may contribute to the reduction of cardiovascular mortality. In our study, we observed no significant relationship between fetuin-A levels and CVRFs. We evaluated the relationship between serum fetuin-A levels on cardiovascular risk factors by its role in pathophysiology.

Objective. This study aimed to assess the effects of low-dose dopamine on patients with depression in the intensive coronary unit. Methods: Relatives of 43 ICU patients enrolled in the study. Sociodemographic characteristics of patients and their families recorded. Patients evaluated basal echocardiographic and biochemical values measured in the patient group. The Beck Anxiety and Depression Scale was used to assess anxiety and depression. The assessment performed by Beck scale at the 1stand 24th hour. Results: The final study population consisted of 42 patients hospitalized with heart failure. Mean patient age was 67.5 ± 12.6 years. Average EF was 23.5% ± 8.7% and mean ProBNP was 6343.76 pg/mL in our study population. Changes of before and after dopamine treatment in depression score of heart failure patients was showed significantly (before value: 18.95 ± 9.89; after value: 17.29 ± 10.30, p < 0.001) however systolic and diastolic pressure difference was not significant. Conclusion: Depression increased mortality and hospitalization in patients with heart failure. Therefore, it is an essential trial because of low-dose dopamine improve depression score in intensive care patients. However, prospective studies were needed to assess the long-term efficacy of dopamine.

There are various problems associated with cardiopulmonary bypass in cardiac operations of patients with cancer. Our patient was a 73-year-old male patient diagnosed with pancreatic ductal adenocarcinoma. Coronary angiography of the patient who was planned to undergo tumor surgery revealed severe anomalies extending to the proximal of the diagonal 1 at the left anterior descending artery osteal and diagonal 1 distinction. Minimally invasive off-pump direct coronary artery bypass was performed in the patient. The patient was discharged on the 4th postoperative day and he was operated with the cause of pancreatic cancer at the third week. We think that minimally invasive coronary bypass without cardiopulmonary bypass can be performed with delayed prevention of cancer treatment and faster healing in patients with cancer of various systems.