A decline in kidney function after contrast exposure is associated with a high risk of morbidity and mortality during hospitalization and over long-term periods. Several retrospective and recent prospective clinical trials have shown that statin therapy might prevent contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. In this study, we aimed to assess the effects of statin therapies on renal function parameters in patients undergoing elective coronary angiography. One hundred and sixty patients undergoing elective coronary angiography were randomized equally into two groups: atorvastatin 40 mg/day group (statin started 3 days before coronary angiography) and an untreated control group. An additional 80 patients were included as a chronic statin therapy group. Serum creatinine, serum cystatin C, and glomerular filtration rate (GFR) were measured before and 48 h after coronary angiography. Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations were used to determine GFR. After coronary angiography, serum creatinine and GFR determined by MDRD were significantly better in patients using atorvastatin than those in controls (P = 0.002 and P = 0.004, respectively). Postprocedure serum creatinine, cystatin C, and GFR determined by MDRD were also significantly better in chronic statin therapy group than those in controls (P = 0.006, P = 0.003, and P = 0.004, respectively). There were no differences in renal function parameters between the short-term atorvastatin group and the chronic statin therapy group. Our data demonstrate that the use of short-term atorvastatin and chronic statin therapy may have a role in protecting renal function after elective coronary angiography.

SUMMARYDiastolic heart failure affects approximately 40%-50% of patients presenting with signs and symptoms of heart failure. The aim of this study was to investigate the relationship between brain natriuretic peptide (BNP) levels and functional capacity in patients admitted with dyspnea and diagnosed with isolated diastolic dysfunction.Fifty-four patients (mean age, 57.4 ± 8.5 years) with class-2 dyspnea with isolated diastolic dysfunction were enrolled. Serum levels of BNP were measured, and peak oxygen consumption (peak VO 2 ), anaerobic threshold (AT), and metabolic equivalent (MET) values were determined with a cardiopulmonary exercise test (CPET).There was a negative correlation between BNP levels and exercise duration (P < 0.05, r = -0.304), AT (P < 0.05, r = -0.380), and number of MET (P < 0.05, r = -0.322) determined by CPET. When patients were divided into 2 groups according to BNP levels; BNP ≤ 50 pg/mL (n = 40) versus BNP > 50 pg/mL (n = 14) and analyzed, those with BNP levels > 50 pg/mL had lower peak VO 2 (P = 0.05) and anaerobic threshold (P = 0.01) compared with patients with BNP ≤ 50 pg/mL.The results suggest that BNP levels provide an indication about the functional capacity determined by CPET in patients admitted with dyspnea and isolated diastolic dysfunction. (Int Heart J 2007; 48: 97-106) Key words: Diastolic dysfunction, Brain natriuretic peptide, Cardiopulmonary exercise test HEART failure (HF) is an important cause of mortality and morbidity worldwide.1) Its prevalence increases as the age of the population increases. Approximately 40%-50% of HF patients have diastolic HF with preserved left ventricular systolic function. 2)Dyspnea is one of the most common symptoms of patients admitted to emergency, cardiology, and pulmonary facilities. It is sometimes difficult for a physiFrom the

We describe a patient with an intracardiac intravenous catheter fragment in the right heart that was found during fluoroscopy. The catheter fragment had broken off from an intravenous catheter inserted 25 years previously when the patient was admitted after a road accident. There were no complications during these years. The fragment was removed during coronary bypass surgery. Other cases of intracardiac foreign bodies have been described, some causing complications even after many years. Uninfected, these can be removed easily with local interventional techniques. Removal of an infected foreign body per cardiotomy has a much higher mortality risk.

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Persistent platelet reactivity was not associated with increased risk of CK-MB, cTnI elevations in low-to-intermediate risk PCI patients.