Search

Aim: Isolated coronary artery ectasia (CAE) is an abnormal dilatation of the coronary artery which cause ischemia. RDW has been investigated in several cardiovascular disorders and has also been recently proposed as a predictive biomarker of adverse outcomes in patients with these conditions. We hypothesized that increased RDW would be associated with isolated CAE because both are associated with inflammation. Material and Methods: We studied 140 subjects, including 69 patients with isolated CAE, 71 patients with angiographically normal controls. Baseline clinical characteristics and laboratory findings, including RDW, were compared among two groups. Results: The level of RDW was significantly higher in isolated CAE than normal controls (14,36±1,61vs 13,59±1.57, p=0.005). In addition, the levels of glomerular filtration rate and creatinin, high density lipoprotein and low density lipoprotein were significantly lower in isolated CAE than normal controls (76,43±19,64 vs 100,36±18,3 and 0,9±0,28 vs 0,74±0,25, 43,39±10,09 vs 48,4±13,67, 121,36±32,05 vs 143,70±55,33 p=0,001, p=0,001, p=0,01, p=0,004 respectively). In a ROC curve analysis, a RDW value of 13,5 was identified as an effective cut off point for the discrimination of the presence or absence of isolated CAE (Area Under curve [AUC]: 0.71, CI 95%, 0.62-0.80, p

Background In this study, we aimed to compare the management and clinical outcomes of patients with acute coronary syndrome (ACS) before and during pandemic. Methods A total of 239 patients with ACS were enrolled into the study. Patients who were admitted during pandemic were compared with pre-pandemic patients according to their demographic, biochemical, angiographic features, revascularisation strategies and clinical outcomes. Results During the pandemic period, we observed an increase in total number of patient with ST elevation myocardial infarction patients compared to the pre-pandemic period. Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients (1953 pg/ml versus 259 pg/ml for troponin I and 14 ng/ml versus 6 ng/ml for CK-MB p 0.05). Conclusion Although clinical, laboratory, and angiographic features were worse in ACS patients during pandemic, the mortality rate of ACS was similar in both pre-pandemic and pandemic era. It is important to keep coronary intensive care units and catheter labs open and fully-functioning during the pandemic.

Background: The AnTicoagulation and Risk factors in Atrial fibrillation (ATRIA) and CHA2DS2VASc risk scores used to detect the thromboembolic and hemorrhagic risk in atrial fibrillation (AF) patients has been shown recently to predict poor clinical outcomes varies clinical settings, regardless of having AF. We aimed to examine the potential utility of admission CHA2DS2VASc and ATRIA scores for predicting in-hospital mortality in patients with coronavirus disease 2019 (COVID-19). Methods: In this retrospective study hospitalized 134 COVID-19 patients who diagnosed with a positive polymerase chain reaction test, were included. Patients were divided into two groups who were died and survivors, both the groups were compared according to clinical, laboratory, and demographic features, including the CHA2DS2VASc and ATRIA risk score. Predictors of mortality were determined by logistic regression analysis. Results: ATRIA and CHA2DS2VASc risk scores were predicting mortality in COVID-19 patients. Logistic regression analysis showed that ATRIA risk score, AF and chronic obstructive pulmonary disease were an independent predictor of mortality. For an ATRIA score cut off value of 3, the sensitivity was 77.78%, specificity 57.94%, positive predictive value 31.80, and negative predictive value 91.20. For a CHA2DS2VASc score cut-off value of 4, the sensitivity was 44.44%, specificity 83.18%, positive predictive value 40, and negative predictive value 85.60. Conclusion: CHA2DS2-VASc and ATRIA scores can be used as a novel, simple tool for predicting mortality in COVID-19 patients.

IntroductionAlthough most ischaemic strokes are due to cardioembolism, about 25–40% of strokes are cryptogenic. Patent foramen ovale has been associated with cryptogenic stroke; however, the precise mechanism of this association has not been demonstrated. The aim of this study was to evaluate the association between inflammatory markers and cryptogenic stroke in patients with patent foramen ovale.Material and methodsWe included 206 patients with patent foramen ovale. Ninety-four (45.63%) out of 206 patients had had stroke, and 112 (54.37%) had not had stroke. The ratio of the total neutrophil count to the total lymphocyte count was defined as the neutrophil to lymphocyte ratio, and the ratio of the absolute platelet count to the absolute lymphocyte count was determined as the platelet to lymphocyte count.ResultsThe neutrophil to lymphocyte ratio was significantly higher in patients who had stroke than in those who did not (2.41 ±1.69 vs. 2.19 ±1.74, p = 0.047). Although the platelet to lymphocyte count was also higher in patients who had had stroke than in those who had not, it was not statistically significant (120.94 ±55.45 vs. 118.01 ±52.21, p = 0.729). 1.62 was the cut-off value for neutrophil to lymphocyte ratio to be associated with stroke with 73.4% sensitivity and 45.05% specificity (p = 0.042).ConclusionsThis study demonstrated that elevated neutrophil to lymphocyte ratio and platelet to lymphocyte count could be associated with cryptogenic stroke in patients with patent foramen ovale.

Resumo Fundamento Foi demonstrado que as subunidades de interleucina-35 (IL-35) estão fortemente expressas nas placas ateroscleróticas em humanos. Assim, considera-se que elas têm um papel na aterosclerose. Objetivos Neste estudo, os níveis de IL-35 foram comparados com o grupo controle em pacientes com doença arterial coronariana (DAC) estável, e a associação entre os níveis de IL-35 e o tipo, gravidade e extensão da lesão foram investigadas com o escore Gensini (GS) e o escore Syntax (SS) no grupo de pacientes Métodos Sessenta pacientes (18 mulheres e 42 homens) com DAC, diagnosticados por meio da angiografia coronária, que apresentaram dor no peito típica e teste de esforço não invasivo positivo, e 46 pacientes (18 mulheres e 28 homens) com luminograma normal, foram incluídos no estudo. Tanto o GS quanto o SS foram calculados para o grupo de pacientes, e esses valores foram comparados com os níveis de IL-35. Variáveis com distribuição não normal foram avaliadas com o teste U de Mann-Whitney, enquanto os parâmetros com distribuição normal foram analisados com o teste t de Student. A diferença entre as variáveis categóricas foi avaliada pelo teste de qui-quadrado ou de Fisher. Os valores de p

Background: The first reports on coronaviruse disease 2019 (COVID-19) revealed an exaggerated mortality rate in hypertensive patients. In this regard, concerns about angiotensin-converting enzyme (ACE) inhibitors’ and angiotensin-receptor blockers’ (ARBs) have been aroused. Our aim in this study was to evaluate the potential bad outcome effect of hypertension and anti-hypertensive therapy on COVID-19. Methods: 183 patients with polymerase-chain-reaction (PCR)-proven COVID-19, who were admitted to our hospital and consulted to cardiology department between 15th of March and 15th of April 2020 were included. Data were recruited from hospital records. Results: Thirty-two out of 183 patients with COVID-19 died in hospital. Hypertension incidence was not statistically different between patients who survived and died (76 [50.3%] vs 19 [59.4%, p = 0.352]). Although the usage rate of ACEI were similar among groups, ARB usage rate was significantly higher in patients who died than survived (11 [34.4%] vs 23 [15.2%], p = 0.011). Binary regression analysis showed an association between ARBs and mortality (OR: 0.032, 95% CI 1.045–2.623, p = 0.032). Conclusion: Our study confirmed previous concerns regarding a potential harmful effects of ARBs on COVID-19 related mortality. Kontext: První zprávy o onemocnění koronavirem v roce 2019 (coronavirus disease 2019, COVID-19) ukazovaly na zvýšenou mortalitu jedinců s hypertenzí, což vyvolalo obavy ohledně užívání inhibitorů angiotenzin konvertujícího enzymu (ACEI) a blokátorů receptoru AT1 pro angiotenzin II (ARB). Cílem naší studie bylo posoudit možnost nepříznivého vlivu onemocnění covid-19 na závažnost hypertenze a účinnost antihypertenzní léčby. Metody: Do studie bylo zařazeno 183 pacientů s onemocněním covid-19 prokázaným PCR testem, kteří byli v období od 15. března do 15. dubna 2020 přijati do naší nemocnice a následně odesláni na kardiologickou kliniku. Údaje byly získány z nemocničních záznamů. Výsledky: Celkem 32 ze 183 pacientů s onemocněním covid-19 zemřelo v nemocnici. Incidence hypertenze se mezi pacienty, kteří přežili a zemřeli, statisticky významně nelišila (76 [50,3 %] vs. 19 [59,4 %]; p = 0,352). I když podíly pacientů užívajících inhibitory ACE byly v obou skupinách podobné, léčiva ze skupiny ARB užívalo statisticky významně více pacientů, kteří zemřeli, než těch, kteří přežili (11 [34,4 %] vs. 23 [15,2 %]; p = 0,011). Binární regresní analýza prokázala souvislost mezi užíváním ARB a mortalitou (OR: 0,032; 95% CI 1,045–2,623; p = 0,032). Závěr: Naše studie potvrdila původní obavy týkající se možných škodlivých účinků lékové skupiny ARB na mortalitu v souvislosti v onemocněním covid-19.

Purpose: This study aims to assess the association between CHA2DS2-VASc score and erectile dysfunction in patients who were admitted to cardiology outpatient clinics. Materials and methods: One hundred and two male patients who were admitted to the cardiology outpatient clinic were included to the study. Erectile dysfunction was evaluated in the urology outpatient clinic in the same hospital and scored using Turkish Version of The International Index of Erectile Function. CHA2DS2-VASc score was calculated for every patient using the current associated guidelines. Results: There was a negative correlation between The International Index of Erectile Function score and CHA2DS2-VASc score, age, hypertension, heart failure, diabetes mellitus, stroke respectively. Smoking and dislipidemia were not correlated with The International Index of Erectile Function score (p>0.05). Conclusion: CHA2DS2-VASc score can be used to detect Erectile dysfunction in patients who are admitted to the cardiology outpatient clinics.

Introduction: The aim of this study was to evaluate the correlation between the epicardial fat tissue thickness (EFTT) and serum omentin levels in patients with cardiac syndrome X (CSX). Patients and Methods: A total of 51 patients with CSX admitted to our clinic were included in the patient group, and 46 healthy subjects were included in the control group. Demographics, routine laboratory tests, and high sensitive C-reactive protein (hsCRP) levels of all patients were recorded. The EFTT was measured with transthoracic echocardiography (TTE). Serum omentin levels were measured with the enzyme-linked immunosorbent assay. Results: The EFTT was significantly higher in the CSX group (p< 0.001). Serum omentin levels were significantly lower in patients with CSX in comparison with the control group (p< 0.001). The median age was significantly higher in the CSX group (p< 0.001). The white blood count and hsCRP levels showed no significant difference between the CSX and the control group (p= 0.46 and p= 0.49, respectively). Conclusion: In our study, we found increased epicardial fat tissue (EFT) thickness and decreased serum omentin levels in patients with CSX, a finding similar with the literature. Thus, increased EFT thickness may play a role in the pathophysiology of CSX by causing a decrease in the serum omentin level.

Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.

It has been shown that interleukin-35 (IL-35) subunits are strongly expressed in atherosclerotic plaques in humans. Therefore, it is considered to play a role in atherosclerosis.In this study, IL-35 levels were compared with the control group in patients with stable coronary artery disease (CAD), and the association between IL-35 levels and the lesion type, lesion severity and extension was investigated with the Gensini score (GS) and the Syntax score (SS) in the patient group.Sixty patients (18 female and 42 male) with CAD diagnosed by coronary angiography, who presented with typical chest pain and positive noninvasive cardiac stress test, and 46 patients (18 female and 28 male) with normal coronary lumenogram, were included in this study. Gensini and Syntax scores were calculated in the patient group, and these values were compared with IL-35 levels. Non-normally distributed variables were analyzed by the Mann-Whitney U test, whereas normally distributed parameters were assessed by Student's t-test. The difference between categorical variables were evaluated by the Chi-square or Fisher test. P-values0.05 were considered as statistically significant.No significant differences were observed between patients and the control group in terms of demographic characteristics and laboratory findings. Compared to the control group, IL-35 levels of the CAD group were considerably lower (36.9±63.9 ng/ml vs. 33.2±13.2 ng/ml, p0.008). Although not statistically significant, IL-35 levels were higher in patients with low SS than among those with high SS (33.2±13.7 vs. 31.8±8.9, p=0.51). The IL-35 values of the patients with high GS were significantly lower than in patients with low GS (35±17.4 vs. 30.7±8.6, p=0.043).It has been shown that IL-35 levels can be a new biomarker for stable CAD, and IL-35 is associated with the extension of CAD.Foi demonstrado que as subunidades de interleucina-35 (IL-35) estão fortemente expressas nas placas ateroscleróticas em humanos. Assim, considera-se que elas têm um papel na aterosclerose.Neste estudo, os níveis de IL-35 foram comparados com o grupo controle em pacientes com doença arterial coronariana (DAC) estável, e a associação entre os níveis de IL-35 e o tipo, gravidade e extensão da lesão foram investigadas com o escore Gensini (GS) e o escore Syntax (SS) no grupo de pacientes.Sessenta pacientes (18 mulheres e 42 homens) com DAC, diagnosticados por meio da angiografia coronária, que apresentaram dor no peito típica e teste de esforço não invasivo positivo, e 46 pacientes (18 mulheres e 28 homens) com luminograma normal, foram incluídos no estudo. Tanto o GS quanto o SS foram calculados para o grupo de pacientes, e esses valores foram comparados com os níveis de IL-35. Variáveis com distribuição não normal foram avaliadas com o teste U de Mann-Whitney, enquanto os parâmetros com distribuição normal foram analisados com o teste t de Student. A diferença entre as variáveis categóricas foi avaliada pelo teste de qui-quadrado ou de Fisher. Os valores de p0,05 foram considerados como estatisticamente sinificativos.Não foram observadas diferenças significativas entre pacientes e o grupo controle em termos de características demográficas e achados laboratoriais. Em comparação ao grupo controle, os níveis de IL-35 no grupo com DAC foram consideravalmente menores (36,9±63,9 ng/ml vs. 33,2±13,2 ng/ml, p0,008). Embora não tenha sido estatisticamente significativo, os níveis de IL-35 foram maiores em pacientes com SS mais baixo do que nos com SS mais alto (33,2±13,7 vs. 31,8±8,9, p=0,51). Os valores de IL-35 em pacientes com GS alto foram significativamente mais baixos do que em pacientes com GS baixo (35±17,4 vs. 30,7±8,6, p=0,043).Demonstrou-se que os níveis de IL-35 podem ser um novo biomarcador para a DAC estável, e que a IL-35 está associada à extensão da DAC.

Objective COVID-19 is a disease with high mortality, and risk factors for worse clinical outcome have not been well-defined yet. The aim of this study is to delineate the prognostic importance of presence of concomitant cardiac injury on admission in patients with COVID-19. Methods For this multi-center retrospective study, data of consecutive patients who were treated for COVID-19 between 20 March and 20 April 2020 were collected. Clinical characteristics, laboratory findings and outcomes data were obtained from electronic medical records. In-hospital clinical outcome was compared between patients with and without cardiac injury. Results A total of 607 hospitalized patients with COVID-19 were included in the study; the median age was 62.5 ± 14.3 years, and 334 (55%) were male. Cardiac injury was detected in 150 (24.7%) of patients included in the study. Mortality rate was higher in patients with cardiac injury (42% vs. 8%; P < 0.01). The frequency of patients who required ICU (72% vs. 19%), who developed acute kidney injury (14% vs. 1%) and acute respiratory distress syndrome (71%vs. 18%) were also higher in patients with cardiac injury. In multivariate analysis, age, coronary artery disease (CAD), elevated CRP levels, and presence of cardiac injury [odds ratio (OR) 10.58, 95% confidence interval (CI) 2.42–46.27; P < 0.001) were found to be independent predictors of mortality. In subgroup analysis, including patients free of history of CAD, presence of cardiac injury on admission also predicted mortality (OR 2.52, 95% CI 1.17–5.45; P = 0.018). Conclusion Cardiac injury on admission is associated with worse clinical outcome and higher mortality risk in COVID-19 patients including patients free of previous CAD diagnosis.

Objective We aimed to investigate whether soluble CD40 ligand (CD40L) levels are higher in patients with isolated coronary artery ectasia (CAE) compared to patients with angiographically normal coronary arteries and those with stable coronary artery disease (CAD). Materials and methods In all, 55 patients with isolated CAE without stenosis, 55 with stable CAD, and 55 control participants with angiographically normal coronary arteries were included. The CAE severity was determined according to the Markis classification. Plasma levels of soluble CD40 ligand were measured by enzyme-linked immunosorbent assay. Results The baseline characteristics of the 3 groups were similar. Plasma levels of soluble CD40 ligand were significantly higher in patients with CAE and CAD than in controls (2.6 ± 3.1 ng/mL and 2.0 ± 3.1 ng/mL vs 1.8 ± 2.1 ng/mL, P = .004). No difference was found between the CAE and CAD groups. Soluble CD40 ligand level was significantly higher in the type 1 Markis subgroup than that in the type 3 or type 4 subgroups ( P = .01). A receiver operating characteristic curve analysis revealed that soluble CD40 ligand level >1.2 ng/mL identified patients with isolated CAE. Conclusion Significantly higher levels of soluble CD40 ligand were detected in patients with CAE than that in control participants with normal coronary arteries, suggesting that soluble CD40 ligand may be involved in the pathogenesis of CAE. The CD40-CD40 ligand system likely plays a role in the pathogenesis of CAE.

The risk for cardiovascular diseases and type 2 diabetes mellitus significantly increases in the patient population with metabolic syndrome (MeS). The present study aimed to investigate the association between the epicardial adipose tissue thickness (EATT) and the oxidative stress parameters in MeS patients. The study included 181 patients as a patient group of 92 consecutive patients with MeS and a control group of 89 consecutive patients with similar age and gender. EATT was evaluated by transthoracic echocardiography. Serum levels of total oxidant status (TOS), total antioxidative capacity (TAS), paraoxonase-1 (PON-1), and arylesterase activities were measured. EATT was higher in the MeS group compared to the control group (6.0 ± 2.0 mm and4.0 ± 1.0 mm, resp.;P<0.001). The level of TOS was higher in the MeS group compared to the control group (P<0.001). Additionally, the TAS level was higher in the MeS group compared to the control group (P<0.001). Furthermore, the serum levels of PON-1 and arylesterase were lower in the MeS group compared to the control group (P<0.001). EAT may cause an increased risk of cardiovascular diseases by leading to increased oxidative stress in patients with MeS.