No abstract

We investigated the association of mean platelet volume (MPV) with culprit lesion severity and major cardiac outcomes (MCOs) in patients with acute coronary syndrome (ACS) with non-ST elevation (NSTE). This study included 344 patients with NSTE-ACS who had significant coronary stenosis at least 50%. They were divided into high MPV group (n = 109, upper tertile >9.9 fl) and low MPV group (n = 235, lower and mid tertile ≤ 9.9 fl) according to MPV values on admission. They were followed up for MCOs during 12 months. MCO consisted of the composite end-point of cardiac death, myocardial infarction (MI), recurrent angina or hospitalization. High MPV was independently associated with NSTE-MI [odds ratio (OR) 4.24, 95% confidence interval (CI) 2.52-7.15, P = 0.001] and severe culprit stenosis (≥ 80%) (OR 4.05, 95% CI 2.39-6.83, P = 0.001). MPV of 9.9 fl was predictive of severe culprit stenosis with a sensitivity of 73% and specificity of 77% (P < 0.001). At 12 months, MCO rate was higher in high MPV group than low MPV group (39 vs. 26%; P = 0.016). This difference resulted from death (6.4 vs. 2.1; P = 0.06) and recurrent angina (16.5 vs. 8.9%; P = 0.045). The MCO-free survival was worse in patients with high MPV than those with low MPV (61 vs. 74%; P = 0.01). In Cox regression analysis, high MPV remained an independent predictor of MCO (hazard ratio 1.52, 95% CI 1.01-2.29, P = 0.04) after adjusting for baseline characteristics. Elevated MPV was independently associated with NSTE-MI presentation and severity of culprit stenosis in NSTE-ACS patients. Moreover, MPV greater than 9.9 fl was predictive of a 12-month MCO.

No abstract

We have shown that MPV was significantly elevated in patients with AS compared to control participant.

N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation after electrical cardioversion: a prospective randomized study N-3 çoklu doymamış yağ asitlerinin kullanımı elektriksel kardiyoversiyon sonrası inflamasyon ve atriyal fibrilasyon nüks oranlarını azaltmaz: Prospektif randomize bir çalışma ÖZETAmaç: Bu prospektif randomize çalışmanın amacı, n-3 çoklu doymamış yağ asitlerinin elektriksel kardiyoversiyon sonrası atriyal fibrilasyon (AF) nüksü üzerine olan etkilerini araştırmaktır.Yöntemler: Gerekli hasta sayısı, sinüs ritmi idamesinin amiyodaron grubunda %20, yağ asidi grubunda %65 olacağı tahmin edilerek hesaplandı. Alfa değeri 0.05 ve güç %80 olacak şekilde anlamlı sonuç elde etmek için her bir grupta 22 hastanın gerekli olduğu bulundu. Toplam 47 hasta elektriksel kardiyoversiyon öncesi amiyodaron (n=24) ve amiyodaron+n-3 çoklu doymamış yağ asidi (n=23) gruplarına randomize edildiler. Sonlanım noktası 12 aylık takipte AF nüksü olarak belirlendi. N-3 çoklu doymamış yağ asitlerinin inflamasyon üzerine olan etkisi C-reaktif protein düzeylerinin ölçülmesi ile değerlendirildi. İstatistiksel analiz eşleştirilmemiş Student t-testi, Mann-Whitney U testi Ki-kare testi ile yapıldı. Atriyal fibrilasyon nüksü, potansiyel etkili faktörleri kontrol ederek Cox oransal regresyon modeli ile değerlendirildi. Bulgular: Amiyodaron grubundaki 9 hastada (%37.5) ve amiyodaron+n-3 çoklu doymamış yağ asidi grubundaki 9 hastada (%39.1) nüks gözlendi (p=1). Cox regresyon analizinde, nüks için risk faktörleri önceden elektriksel kardiyoversiyon yapılmış olması (izafi risk 10.33; %95 GA 1.74-61.10; ABSTRACTObjective: The purpose of the present prospective randomized study was to evaluate the effects of n-3 polyunsaturated fatty acids on recurrence rates of atrial fibrillation (AF) and inflammation after electrical cardioversion. Methods: Calculation of the number of patients needed was based on the assumption of 20% and 65% chance of maintaining sinus rhythm with amiodarone and with polyunsaturated fatty acids, respectively. To observe a significant difference with an alpha level of 0.05 and a power of 0.80 it was necessary to include 22 patients in each group. A total of 47 patients were randomized to amiodarone (n=24) and amiodarone plus n-3 polyunsaturated fatty acids (n=23) groups before scheduled electrical cardioversion. The end-point was the recurrence of AF during 12-month follow-up. Effect of n-3 polyunsaturated fatty acids on inflammation was evaluated with high sensitivity C-reactive protein level measurements. Statistical analysis was performed using unpaired Student' t, Mann Whitney U and Chi-square tests. We analyzed the recurrence of AF using the Cox proportional hazards regression model to control for potentially confounding factors. Results: Nine patients in the amiodarone group (37.5%), and 9 patients in the amiodarone plus n-3 polyunsaturated fatty acids group (39.1%) had recurrence of AF during follow-up (p=1). With the Cox proportional model, risk f...

Although the majority of cases of acute myocardial infarction are caused by atherosclerotic coronary artery disease (CAD), it can also occur in people with normal coronary arteries. One of the possible mechanisms causing myocardial infarction with normal coronary arteries (MINC) is transient occlusion of the infarct-related artery owing to platelet hyperactivity and thrombosis. Mean platelet volume (MPV), an indicator of platelet activation, has been shown to be elevated in patients with unstable angina and myocardial infarction in the setting of obstructive CAD. However, the value of MPV in patients with MINC is not known. The aim of this study was to assess the MPV in patients with MINC. We retrospectively studied 47 patients with MINC, 63 patients with myocardial infarction resulting from single coronary artery disease (MISC) and 55 control subjects. MPV values were recorded in all study patients and control subjects. The MPV values of patients with MINC and MISC were significantly higher than those of the control group (9.1+/-1.8 and 9.4+/-1.0 versus 8.3+/-1.4 fl; p<0.05 and p<0.001, respectively). There were no significant differences in MPV values between the MINC and MISC groups. We show for the first time that MPV is significantly higher in patients with MINC compared with control subjects. Concurring with previous studies, we also show that MPV is significantly higher in patients with MISC compared to control subjects.

Objectives: The aim of this study was to assess the mean platelet volume (MPV), an indicator of platelet activation in patients with infective endocarditis. Subjects and Methods: Twenty-nine patients with infective endocarditis and 29 healthy subjects were studied. Plasma MPV values in patients and control subjects were measured on admission and after 2 weeks of specific treatment of infective endocarditis. Results: The MPV was significantly higher among patients with infective endocarditis when compared with the control group (9.86 ± 1.1 vs. 8.0 ± 1.0 fl, respectively; p < 0.01). The MPV values of patients with infective endocarditis decreased significantly after treatment from 9.86 ± 1.1 to 7.86 ± 1.0 fl (p < 0.01). Total platelet counts increased significantly after treatment from 193.4 ± 96.5 × 10⁹ to 243.7 ± 92.4 × 10⁹ (p = 0.04). Conclusion: MPV values were higher in patients with infective endocarditis and decreased significantly after treatment. Elevated MPV values indicate that patients with infective endocarditis have increased platelet activation and infective endocarditis treatment decreases this platelet activation by decreasing MPV.

Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevation myocardial infarction (STEMI). Oxidative stress and inflammation may cause structural and electrical remodeling in the atria making these critical processes in the pathology of AF. In this study, we aimed to evaluate the association between total oxidative status (TOS), total antioxidative capacity (TAC) and high-sensitivity C-reactive protein (hs-CRP) in the development of AF in patients presenting with STEMI. This prospective cohort study consisted of 346 patients with STEMI. Serum TAC and TOS were assessed by Erel's method. Patients were divided into two groups: those with and those without AF. Predictors of AF were determined by multivariate regression analysis. In the present study, 9.5% of patients developed AF. In the patients with AF, plasma TOS and oxidative stress index (OSI) values were significantly higher and plasma TAC levels were significantly lower compared to those without AF (p = .003, p = .002, p < .0001, respectively). Multivariate regression analysis results showed that, female gender (Odds ratio [OR] = 3.07; 95% Confidence Interval [CI] = 1.26-7.47; p = .01), left atrial diameter (OR =1.28; 95% CI =1.12-1.47; p < .0001), hs-CRP (OR =1.02; 95% CI =1.00-1.03; p = .001) and OSI (OR =1.10; 95% CI =1.04-1.18; p = .001) were associated with the development of AF in patients presenting with STEMI. The main finding of this study is that oxidative stress and inflammation parameters were associated with the development of AF in patients presenting with STEMI. Other independent predictors of AF were female gender, left atrial diameter and hs-CRP.