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Background: Atrial fibrillation (AF) is associated with increased morbidity in myocardial infarction (MI), especially thromboembolic risk increases. The PRECISE-DAPT (The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy) score was created to predict the bleeding risk of dual antiplatelet therapy. The purpose of this study was to evaluate the association between new-onset AF and the PRECISE-DAPT score in ST-segment-elevation myocardial infarction (STEMI). Methods: This retrospective study enrolled patients who developed STEMI within 12 hours of the onset of symptoms and underwent primary percutaneous coronary intervention. The study population was divided into 2 groups of PRECISE-DAPT scores of 25 or greater and PRECISE-DAPT scores of below 25 and their baseline characteristics, as well as laboratory and echocardiography results, were compared. In-hospital new AF and related events were compared between the 2 PRECISE-DAPT score groups. Results: From February 2015 to December 2017, this study enrolled 2234 patients with STEMI at a mean age of 54.4 years. The new-onset AF incidence rate was higher in the higher PRECISE-DAPT group than in the lower PRECISE-DAPT group (62 [28.7 %] vs 58 [2.9%]; P

We aimed to investigate association between mean platelet volume (MVP), platelet distribution width (PDW) and red cell distribution width (RDW) and mortality in patients with COVID-19 and find out in which patients the use of acetylsalicylic acid (ASA) affects the prognosis due to the effect of MPV on thromboxan A2. A total of 5142 patients were divided into those followed in the intensive care unit (ICU) and those followed in the ward. Patient medical records were examined retrospectively. ROC analysis showed that the area under curve (AUC) values were 0.714, 0.750, 0.843 for MPV, RDW and D-Dimer, the cutoff value was 10.45fl, 43.65fl, 500.2 ng/mL respectively. (all P 10.45 f/l and D-Dimer >500.2 ng/mL, treatment with ASA had lower in-hospital and 180-day mortality than patients without ASA in ICU patients (HR = 0.773; 95% CI = 0.595-0.992; P = .048, HR = 0.763; 95% CI = 0.590-0.987; P = .036). Administration of low-dose ASA in addition to anti-coagulant according to MPV and D-dimer levels reduces mortality.

Amaç: Hastaların nütrisyonel durumu ve mitral anüler kalsifikasyon (MAK) arasında ilişki daha önce herhangi bir şekilde ortaya konulamamıştır. Daha önceki çalışmalarda prognostik nütrisyonel indeksinin (PNİ) kolorektal kanserli hastalardaoperasyon sonrası septik komplikasyonlar ve ST yükselmeli miyokart enfarktüsü gibi birçok hastalıkta prognostik öneme sahip olduğu gösterilmiştir. Bu çalışmanın amacı PNİ ile MAK varlığı arasındaki ilişkiyi ortaya koymaktır.Gereç ve Yöntemler: Bu retrospektif çalışmaya ekokardiyografi laboratuvarına başvuran 398 hasta dahil edildi. MAK saptanan 310 hasta ile çalışma grubu,MAK saptanmayan 88 kişi ile kontrol grubu oluşturuldu. Kontrol grubuna; yaş,cinsiyet,hipertansiyon ve diyabetesmellitus varlığı gibi demografik özellikler açısından, MAK (+) grupla benzer özellikler taşıyan hastalar dahil edildi. Laboratuvar parametreleri kaydedildi ve PNİ değerleri hesaplandı.Bulgular: Gruplar arasında ortalama yaş, hipertansiyon ve diyabet varlığı açısından fark mevcut değildi. Serum albümin düzeyleri MAK (+) grupta kontrol grubuna göre istatistiki olarak anlamlı olacak şekilde daha düşük seviyelerde saptandı (3,76±0,57; 4,12 ±0,31,p

Levothyroxine suppression therapy (LST) can cause some unfavorable effects on the cardiovascular system in patients with differentiated thyroid cancer (DTC). The aim of this study was to evaluate ventricular arrhythmia predictors based on electrocardiography (ECG) in patients with DTC with LST. The ECG parameters including QT, corrected QT (QTc), Tp-e intervals, Tp-e/QT, and Tp-e/QTC ratios of 265 patients with DTC who met the inclusion criteria were compared with 100 controls. No difference was observed in the number of patients with DTC and controls with prolonged and borderline QTc interval ( P = .273). Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients ( P = .002, P = .02, P = .003; respectively). Linear regression analysis suggested that male gender was a predictor of higher Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios (β = 4.322, R 2 = 0.024, P = .042; β = 0.016, R 2 = 0.048, P = .005; β = 0.015, R 2 = 0.044, P = .006, respectively). A higher serum fT4 level was found to be associated with a higher Tp-e/QT ratio (β = 0.018, R 2 = 0.089, P = .007). Ventricular arrhythmia indicators were found to be higher in patients with DTC with LST. Defining ventricular arrhythmia predictors through ECG, an easily accessible cardiac diagnostic tool, can be potentially useful in raising awareness of the possible cardiac harm of LST.

Aim: An increased risk of arrhythmia has been shown in patients with psoriatic arthritis (PsA). Tp-e interval and Tp-e/QT ratio are considered useful markers for the assessment of myocardial repolarization heterogeneity. In present study we aim to investigate the characteristics of ventricular repolarization on the basis of QTc interval and Tp-e/QTc ratio in patients PsA.Methods: This cross-sectional observational study included patients with psoriatic arthritis who were over 18 years of age. A control group was created with healthy volunteers. The diagnosis of psoriatic arthritis were done according to the CASPAR criteria. QT interval, corrected QT (QTc), Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were measured from the 12-lead electrocardiograms(ECG) of the PsA patients and control group. Results: The study population consisted of 82 patients with PsA and 82 healthy volunteers. According to electrocardiographic parameters the heart rate was similar in both groups, but QT, QTc, Tp-e intervals; Tp-e /QT and Tp-e/ QTc ratios were significantly higher in the PsA group. The median Tp-e/QTc ratio of the patients with PsA was significantly higher than the median Tp-e/QTc ratio of the control group (0.21 (0.20-0.25) vs. 0.18 (0.17-0.19, P, Amaç: Psoriatik artritli (PsA) hastalarda aritmi riski artışı olduğu gösterilmiştir. Tp-e aralığı ve Tp-e/QT oranı, miyokardiyal repolarizasyon heterojenitesinin değerlendirilmesinde yararlı belirteçler olarak kabul edilmektedir. Bu çalışmada PsA hastalarında QTc aralığı ve Tp-e/QTc oranı temelinde ventriküler repolarizasyonun özelliklerini incelemeyi amaçladık.Yöntemler: Bu kesitsel gözlemsel çalışmaya 18 yaşın üzerinde psoriatik artritli hastalar dahil edildi. Sağlıklı gönüllülerden bir kontrol grubu oluşturuldu. Psoriatik artrit tanısı CASPAR kriterlerine göre yapıldı. PsA hastalarının ve kontrol grubunun 12 kanallı elektrokardiyogramlarından (EKG) QT aralığı, düzeltilmiş QT (QTc), Tp-e aralığı, Tp-e/QT oranı ve Tp-e/QTc oranı ölçüldü.Bulgular: Çalışma popülasyonu 82 PsA hastası ve 82 sağlıklı gönüllüden oluşuyordu. Elektrokardiyografik parametrelere göre kalp hızı her iki grupta da benzerdi, ancak QT, QTc, Tp-e aralıkları; Tp-e/QT ve Tp-e/QTc oranları PsA grubunda anlamlı olarak yüksekti. PsA'lı hastaların medyan Tp-e/QTc oranı, kontrol grubunun medyan Tp-e/QTc oranından (0,21 (0,20-0,25) ve 0,18 (0,17-0,19, P

Introduction: Lower-extremity peripheral artery disease (PAD) can lead to a wide spectrum of symptoms that can progress from claudication to amputation. The prognostic nutritional index (PNI), which is calculated using the levels of albumin and lymphocyte, is an accepted indicator of immunological and nutritional status. In this study, the association between nutritional status determined using the PNI, and extremity amputation in patients with lower-extremity PAD was investigated. Methods: Lower-extremity PAD patients who had been admitted to the cardiology clinic of the Dışkapı Yıldırım Beyazıt Training & Research Hospital with stage 2b or higher claudication, and who were technically unsuitable for revascularization or underwent unsuccessful revascularization procedure were enrolled in this retrospective study. Patients were grouped according to whether or not limb amputation had been performed previously. Potential factors were tested to detect independent predictors for amputation with logistic regression analysis. Results: A study group was formed with 266 peripheral artery patients. The amputated group (39 patients) had a higher number of hypertensive (76.9% vs 57.7%; P = 0.032) and diabetic (92.3% vs 54.2%; P

Aim: Mitral annulus calcification (MAC) is characterized by degenerative calcification of the mitral valve annulus, MAC and atherosclerosis are similar in regard to risk factors and pathogenesis. Monocyte count to high density lipoprotein (HDL) cholesterol ratio (MHR) is an inflammatory marker that is associated with several atherosclerotic diseases. We aimed to show the association of MHR levels with the presence of MAC.Methods: This retrospective cohort study was conducted with MAC (+) patients who admitted to our echocardiography laboratory which constituted the study group (n=200) and MAC (-) patients which constituted the control group. Demographic features like age and sex, presence of hypertension and diabetes mellitus were similar between groups. Laboratory and echocardiographic parameters were recorded and evaluated for statistical analysis.Results: When groups were compared according to echocardiographic parameters; left atrial diameter, pulmonary artery systolic pressure (PASP) were found to be positively correlated with the presence of MAC (r=0.271, p

The heterogeneity in myocardial repolarization increases the risk of ventricular arrhythmias and sudden death in patients with diabetes mellitus (DM). The Tp-e interval and Tp-e/QTc ratio are found to be useful in the prediction of ventricular arrhythmias. In this study, we aimed to investigate the Tp-e interval and Tp-e/QTc ratio in diabetic patients with and without microvascular complications.This cross-sectional observational study included patients with type 2 DM who presented to the endocrinology outpatient clinic. Diabetic microvascular complications were evaluated. The Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio were also calculated.A total of 240 patients with type 2 DM (148 patients had microvascular complications) were included in the study. Diabetic neuropathy rate was 30.4%, diabetic nephropathy rate was 38.4%, and diabetic retinopathy rate was 21.7%. Upon comparing patients according to Tp-e/QTc ratio, the median Tp-e/QTc interval of the group of patients with complications was 0.21 (0.19-0.23) and the median Tp-e/QTc ratio of the group of patients without complications was 0.19 (0.18-0.20) (p 0.001). When patients were grouped according to the presence and severity of retinopathy, the Tp-e/QTc ratio was more prolonged in the proliferative retinopathy group [0.27 (0.23-0.30)] than the non-proliferative retinopathy group [0.20 (0.19-0.22), p 0.001]. When patients were grouped according to the presence and severity of nephropathy, the Tp-e/QTc ratio was more prolonged in the macroalbuminuria and microalbuminuria group than the normoalbuminuric group [0.25 (0.21-0.30), 0.23 (0.19-0.24), and 0.19 (0.20-0.22), respectively, p = 0.002].Our study is the first to demonstrate the association of the Tp-e interval and Tp-e/QTc ratio with the presence and severity of microvascular complications in patients with type 2 DM.

Background Fragmented QRS (fQRS) complex, with various morphology, has been recently described as a diagnostic criterion of several cardiac diseases. However, there are little data regarding the prognostic role of fQRS in peripartum cardiomyopathy (PPCM) patients. We aimed to investigate the effect of fQRS on predicting left ventricular (LV) nonrecovery in patients with peripartum cardiomyopathy (PPCM). Methods Ninety patients (mean age: 34.7 ± 6.5 years) with the diagnosis of PPCM were analyzed retrospectively. The median follow‐up period of was 67.0 (12.0–192.0) months. Fragmented QRS was defined as the presence of various RSR’ patterns (QRS duration 45%. Results Of the patients, 54 (60%) did not recover LV function at the last follow‐up visit (nonrecovery group), while 36 of the patients (40%) exhibited LV recovery (recovery group). LV ejection fraction (EF) and fQRS were identified as independent predictors of LV nonrecovery in patients with PPCM (odds ratio OR: 5.546, 95% confidence interval CI: 0.792–0.979, p = .019 and OR: 5.986, 95% CI: 1.313–11.787, p = .014, respectively). Conclusion Our data firstly indicated that presence of fQRS was a significant predictor of LV nonrecovery in patients with PPCM. The fQRS might assist in identifying high‐risk patients.

Introduction: Pulmonary embolism is an acute emergency with high mortality and morbidity rates. The monocyte/high-density lipoprotein (HDL) ratio was suggested as a new marker of inflammation and oxidative stress. In addition, the monocyte/HDL ratio has been shown to be closely related with the presence and prognosis of some cardiovascular diseases. Inflammation and oxidative stress play an important role in the pathophysiology of pulmonary embolism. The aim of the present study was to determine the prognostic value of the monocyte/HDL ratio in determining the short-term mortality for patients with acute pulmonary embolism. Patients and Methods: Ninety-nine patients who were admitted to the emergency department and diagnosed with acute pulmonary embolism, which was confirmed by multidetector computed tomography, were included in this retrospective study. Results: Of the 99 patients, 26 (25.2%) died within 1 month after the diagnosis was made. Patients were divided into two groups as survivors (group 1) and (group 2) within 1 month after diagnosis. Age; malignancy; coronary artery disease; right ventricular dysfunction; white blood cell, neutrophil, lymphocyte, platelet and monocyte counts; systolic pulmonary artery pressure, diastolic blood pressure, neutrophil/lymphocyte ratio, monocyte/HDL ratio and simplified pulmonary embolism severity index were significantly higher in group 1 (patients died within 1 month after diagnosis) than those in group 2. The monocyte/HDL ratio, neutrophil/lymphocyte ratio, right ventricle dysfunction and simplified pulmonary embolism severity index were independent predictors of mortality in patients with acute pulmonary embolism. Conclusion: The monocyte/HDL ratio, neutrophil/lymphocyte ratio, right ventricle dysfunction and simplified pulmonary embolism severity index were independent predictors of mortality in patients with acute pulmonary embolism.

Introduction: Calcific aortic valve disease, a chronic progressive disorder, is the leading cause of valve replacement among elderly patients. The lymphocyte/monocyte ratio has been recently put forward as an inflammatory marker of relevance in several cancers as well as in cardiovascular disease. This study aims to assess the correlation between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio. Methods: The study retrospectively included 178 patients with a diagnosis of calcific aortic stenosis and 139 age- and gender-matched controls. The patients were divided into two groups according to the severity of aortic stenosis: mild-to-moderate and severe. Results: An inverse correlation was discerned between the severity of the aortic stenosis process (mean gradient) and the lymphocyte/monocyte ratio (r=-0.232, p=0.002). The lymphocyte/monocyte ratio was observed to decrease as the severity of aortic stenosis increased (p

In the present study, we aimed to investigate whether copeptin values on admission are related to left ventricle (LV) systolic function and its improvement at 6 months in ST-segment elevation myocardial infarction (STEMI) patients. In this single-center, prospective observational study, we included 122 STEMI patients from January 2016 to November 2016. LV systolic functions in the form of global longitudinal strain (GLS) in addition to conventional echocardiography parameters were evaluated on admission and at 6-month. Serum copeptin levels were determined using an ultrasensitive immunofluorescence assay. The study population was divided into 2 groups according to median values of copeptin. GLS was significantly lower in patients with high copeptin levels compared to those with low copeptin levels at early stage and 6-month (−16% (16–16.5) vs −15% (15–15.5), P

WOS: 000469269200010 Objectives: This study aims to evaluate the right ventricular (RV) and left ventricular (LV) systolic and diastolic functions with speckle tracking echocardiography in addition to routine echocardiographic measurements in adult familial Mediterranean fever (FMF) patients in order to detect cardiac functions. Patients and methods: Sixty FMF patients (23 males, 37 females; median age 35 years; interquartile range, 26 to 38 years) and 20 healthy subjects (10 males, 10 females; median age 31 years; interquartile range, 25 to 35 years) were included in the study. The diagnosis was established according to the Tel-Hashomer criteria. All patients were using regular colchicine and they were in the attack-free period. Laboratory examinations included complete blood count, creatinine, and inflammatory markers. In addition to routine echocardiographic examination, RV and LV global longitudinal strains were measured and compared. Results: Erythrocyte sedimentation rate and C-reactive protein values were higher in FMF group. LV global longitudinal strain was similar among the groups. FMF patients had slightly lower early diastolic trans-mitral flow (E) values than controls. As similar as the mitral E flow, tricuspid E flow was slightly lower in FMF groups than controls. RV ejection fraction was similar and in normal ranges among the groups. RV global longitudinal strain was lower in FMF group than controls. RV Myocardial Performance Index (or Tei index) was higher in FMF group. Conclusion: The present study indicates low values of mean RV global longitudinal strain and higher Tei index in FMF patients. These results suggest that FMF may cause subclinical RV deterioration.

The clinical significance of poor nutritional status in patients with peripartum cardiomyopathy (PPCM) is not clearly understood. Prognostic nutritional index (PNI) is a simple nutritional assessment tool, which was first demonstrated to be valuable in patients with colorectal surgeries. We aimed to investigate the predictive value of PNI in patients with PPCM. A total of 92 patients diagnosed with PPCM were enrolled in this study. PNI was calculated using the following formula: 10 × serum albumin value (g/dL) + 0.005 × total lymphocyte count. The primary endpoint was defined as composite adverse cardiac events that included cardiac death or hospitalization due to worsening heart failure (HF). Cardiac death, hospitalization due to worsening HF, and persistent left ventricular (LV) systolic dysfunction were evaluated, respectively, as secondary endpoints. Primary composite endpoint was higher in the lower PNI group. After adjusting for other risk factors, PNI was found to be as an independent predictor of primary composite endpoint (odds ratio 0.805; 95% confidence interval 0.729–0.888; P

Objective Parkinson's disease (PD) is a neurological disorder, and ergot dopamine agonists (DAs) are no longer usually preferred in the treatment due to the increased risk of valvular heart disease. Some recent studies have shown that commonly used non-ergot DA also increases the risk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was to investigate the cardiac effects of non-ergot DAs in patients with PD using echocardiography. Methods Conventional echocardiography and two-dimensional (2D) speckle tracking strain echocardiography were performed to determine the possible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD were included in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients were divided into groups according to their medication. Patients using levodopa were classified as Group 1 (36), levodopa+pramipexole as Group 2 (27), and levodopa+ropinirole as Group 3 (28). Results Left ventricle dysfunction with non-ergot DA use in patients with PD was not established with conventional echocardiographic evaluation. For 2D strain analysis, global longitudinal strain values were obtained as -18.5%, -18.5%, and -18.9% in the groups, respectively. Strain and strain rate values of the left ventricle were not different between the groups (p=0.816 and p=0.881, respectively). Conclusion There was no significant relationship between left ventricular dysfunction and use of non-ergot DA in patients with PD. Similar results were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DA in the point of heart failure risk. To our knowledge, this is the first study to evaluate the effect of this group of drugs on subclinical left ventricular systolic function.

Background There is much evidence linking inflammation to the initiation and continuation of atrial fibrillation (AF). Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease (CD), are chronic systemic inflammatory disorders. Atrial electromechanical delay (EMD) has been known as an early marker of AF. The objectives of this study were to evaluate the atrial electromechanical properties in patients with IBD. Methods Fifty-two patients with IBD and 26 healthy controls were recruited in the study. Twenty-five of patients with IBD were on active period, and the remaining 27 were on remission period. Atrial electromechanical properties were measured by using transthoracic echocardiography and tissue Doppler imaging and simultaneous surface ECG recording. Interatrial EMD, left intraatrial EMD, and right intraatrial EMD were calculated. Results Patients on activation with IBD had significantly prolonged left and right intraatrial EMDs and interatrial EMD compared to patients on remission (P = 0.048, P = 0.036, P < 0.001, respectively) and healthy controls (P < 0.001, for all comparisons). Left and right intraatrial EMDs and interatrial EMD were also found to be higher when patients on remission with IBD compared with healthy controls. No statistical difference was observed between UC and CD in terms of inter- and intraatrial EMDs. Conclusions Atrial electromechanical conduction is prolonged in IBD, and exposure to chronic inflammation may lead to structural and electrophysiological changes in the atrial tissue that causes slow conduction. Measurement of atrial EMD parameters might be used to predict the risk for the development of AF in patients with IBD.

Lale Dinc Asarcikli, Ahmet Akyel, Tolga Cimen, Hamza Sunman, Hilal Erken Pamukcu, Tolgahan Efe, Murat Bilgin, Mehmet Dogan, Ekrem Yeter. Department of Cardiology, Ministry of Health Diskapi Research and Educational Hospital. Background: Percutaneous interventions for safenous vein grafts (SVGs) carry higher risk of no-reflow. The emboli protection devices may be used in this setting. However, these devices are not utilisied in many cases of ST-elevation myocardial infarction (STEMI). We report that 64-year old man history of coronary bypass surgery presented with inferior STEMI. Coronary angiography (CAG) revealed proximal total occlusion of SVG. Method: 0.014-inch floppy guidewire was passed through the total occlusion of SVG. Thrombus aspiration was performed to attenuate thrombus burden, and better characterize SVG anatomy by avoiding unnecessary balloon angioplasty. Despite successful retrieval of macroscopic thrombus, no-reflow occurred. Intracoronary tirofiban bolus was started. We decided to use higher-dose adenosine for relieving microvascular obstruction by using manual thrombus aspiration catheter. Because of the short half life of adenosine, we firstly positioned thrombus aspiration catheter distal coronary artery to give adenosine efficiently into the microvascular bed. After higher-dose adenosine with the total dose of 5 mg, blood aspirations via aspiration catheter were employed from distal to the proximal part of SVG. CAG revealed resolution of no-reflow. Finally, 2.5x20 mm sized drug eluting stent was deployed to stenosis at the distal anastomosis. Discussion: Thrombus aspiration is a popular technique to remove thrombus, and is recommended in STEMI. However, it is not wellknown whether coronary thrombus aspiration is associated with improved outcomes for SVG interventions. After thrombus aspiration, we performed different technique to overcome no-reflow, and higher thrombus burden by giving tirofiban and higher dose adenosine into microvascular circulation via distal positioned thrombus aspiration catheter. Although some evidence has suggested that a number of therapies might have a role in the no-reflow treatment, we believe that many open questions remain, including the optimal patient selection and the delivery method of therapies into SVG. Conclusion: The combination of different techniques and medical therapies is required to overcome no-reflow for SVGs, as in our case. TERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY ARDIOVASCULAR SURGERY ABSTRACTS / Poster S109