The platelet to lymphocyte ratio (PLR) has been investigated as a new predictor for cardiovascular risk. The aim of the present study was to investigate the prognostic role admission PLRat admission in predicting in-hospital and early mortality in patients presenting with ST segment elevation myocardial infarction (STEMI). A total of 639 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PCI) were included. The study population was divided into tertiles on the basis of PLR values at the admission. A high PLR (N = 213) was defined as a value in the upper third tertile (PLR >174.9) and a low PLR (N = 426) was defined as any value in the lower two tertiles (PLR ≤ 174.9). The patients were followed for clinical outcomes for up to 6 months after discharge. In Kaplan-Meier survival analysis, the rate of 6-month all-cause deaths was 7% in the high PLR group versus 3% in the low PLR group (P = 0.03). In multivariate analyses, a significant association was noted between high PLR levels and the adjusted risk of 6-month all-cause deaths (odds ratio = 2.51, 95% confidence interval = 1.058-5.95; P = 0.03). PLR is a readily available clinical laboratory value associated with 6-month all-cause death in patients with STEMI who undergo primary PCI.

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WMSI was significantly related with the presence of the fQRS, which reflects the linking between impairment of regional left ventricular systolic function and the presence of severe myocardial injury in STEMI.

Objective: Patients with resistant hypertension are at increased risk for cardiovascular events. Mean platelet volume (MPV) is an accepted biomarker of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV levels are higher in resistant hypertensive (RHTN) patients than in controlled hypertensive (CHTN) patients and healthy normotensive controls. Materials and Methods Results:The mean platelet volume levels were significantly higher in RHTN group than in the CHTN and normotensive groups (p<0.001). In correlation analysis office systolic and diastolic blood pressure was positively correlated with MPV. Conclusion:Our study demonstrated that MPV, as an important indicator of platelet activation, was statistically higher in RHTN patients than in CHTN and in normotensive subjects. Elevated MPV levels may help to determine a high risk group for atherosclerosis in RHTN patients. Bulgular: Dirençli hipertansif grupta ortalama trombosit hacmi kontrollü hipertansif ve normotansif gruba göre istatistiksel olarak anlamlı olarak yüksek saptanmıştır (p<0,001). Korelasyon analizinde ofis sistolik ve diastoliktansiyonları ortalama trombosit hacmiyle pozitif korelasyon göstermekteydi. KeywordsSonuç: Çalışmamızda trombosit aktivasyonunun önemli belirteci olan ortalama trombosit hacmi dirençli hipertansif hastalarda diğer gruplara gore anlamlı olarak yüksek saptanmıştır. Artmış ortalama trombosit hacminin dirençli hipertansif hastalarda atheroskleroz açısından yük-sek riskli olanları değerlendirmede kullanılabileceği düşünülmektedir.Anahtar Kelimeler: Dirençli hipertansion, ortalama trombosit hacmi, kontrollü hipertansiyon

In this first study comparing the findings of EPS and electrocardiography, the impact of the Lotus valve on AV conduction systems was greater than that of the Sapien XT. However, the need for PPM was higher in the Lotus valve than in the Sapien XT. PPM requirement is related to valve design; it may decrease with reduced frame height and metal burden in novel valve systems.

IntroductionMany studies have reported the diagnostic and prognostic value of haemoglobin A1c (HbA1c) levels in patients with acute coronary syndrome. However, the short- and long-term prognostic value of HbA1c level in patients with ST elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is controversial.AimTo investigate whether admission HbA1c level has a prognostic value for in-hospital, short-, and long-term cardiovascular (CV) mortality and major adverse cardiovascular events in patients with STEMI undergoing primary PCI.Material and methodsThis prospective study included 443 consecutive patients with STEMI who underwent primary PCI between September 2010 and July 2012. The patients were divided into three groups based on admission HbA1c levels: group I (HbA1c ≤ 5.6%), group II (HbA1c 5.7–6.4%), and group III (HbA1c ≥ 6.5%). The in-hospital, 1-month, and 1-year CV events of all 3 patient groups were followed up.ResultsA significant association was found between HbA1c level and 1-year primary clinical outcomes, including CV mortality, non-fatal reinfarction, and stroke (p = 0.037). In addition, age, Killip class > 1, and left ventricular ejection fraction were found to be independent predictors of long-term CV mortality in multivariate analysis (hazard ratios (95% confidence interval) 1.081 (1.020–1.146), 4.182 (1.171–14.935), and 0.832 (0.752–0.920); p = 0.009, p = 0.028, and p < 0.001, respectively).ConclusionsIn this study, we demonstrated that increased admission HbA1c levels were associated with higher rates of major adverse CV events, including mortality, non-fatal reinfarction, and stroke, in patients with STEMI who underwent primary PCI.

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Objective: This study aims to identify possible determinants of coronary collaterals in patients with severe coronary artery disease. Methods: The current study has a retrospective cohort design. Seventy four patients with ≥90% stenosis or total occlusion of the left anterior descending artery (LAD) were enrolled; coronary collateral grades, high-sensitive C-reactive protein (hs-CRP), fibrinogen, protein C and S, lipids, uric acid levels and medications applied before coronary angiography were noted and compared. Multiple logistic regression analysis was used for the multivariate analyses of independent variables associated with the development of adequate coronary collateral vessels. Results: The presence of coronary collaterals was significantly higher in males (p=0.018), with higher hs-CRP (p=0.023), prior statin use (p=0.022), and higher Gensini scores (p<0.001). In multiple logistic regression analysis, hs-CRP levels (OR=0.94, 95.0% CI=0.883-1.000, p=0.048), male gender (OR=4.73, 95.0% CI=1.441-15.539, p=0.010) and prior statin usage (OR=4.70, 95.0% CI=1.264-17.452, p=0.021) were identified as independent predictors of coronary collateral development. Conclusion: Male gender, prior statin usage, and higher hs-CRP levels are determinants of coronary collaterals in patients with coronary artery disease. (Anadolu Kardiyol Derg 2013; 13: 146-51) Key words: Coronary collateral circulation, coronary artery disease, high-sensitivity C-reactive protein, regression analysis Original Investigation Özgün Araşt›rma 146ÖZET Amaç: Bu çalışmada ciddi koroner arter hastalığı olanlarda koroner kollateral gelişimini sağlayan muhtemel nedenler araştırılmıştır. Yöntemler: Bu çalışma retrospektif kohort dizayna sahiptir. Sol ön inen arterde (SÖİA)-%90 ve daha fazla darlığı olan ya da (SÖİA) arteri tamamen tıkalı olan 74 hasta çalışmaya alınmıştır. Hastaların yüksek duyarlıklı C-reaktif protein (hs-CRP), fibrinojen, protein C ve S, lipid değerleri, ürik asit düzeyleri ile kullandığı ilaçlar tespit edilmiş ve koroner kollateral gelişimine göre karşılaştırılmıştır. Yeterli koroner kollateral gelişimi ile ilişkili bağımsız değişkenlerin belirlenmesinde çoklu lojistik regresyon analizi kullanılmıştır. Bulgular: Koroner kollateral gelişimi, erkek cinsiyette (p=0.018), önceden statin kullananlarda (p=0.022), yüksek hs-CRP düzeyi olanlarda (p=0.023) ve yüksek Gensini skoruna (p<0.001) sahip olan kişilerde daha fazla tespit edildi. Çoklu lojistik regresyon analizinde; hs-CRP düzeyleri (OR=0.94, %95.0 CI=0.883-1.000, p=0.048), erkek cinsiyet (OR=4.73, %95.0 CI=1.441-15.539, p=0.010) ve önceden statin kullanımı (OR=4.70, %95.0 CI=1.264-17.452, p=0.021) koroner kollateral gelişiminin bağımsız belirleyicileri olarak tespit edildi. Sonuç: Koroner arter hastalığı olanlarda erkek cinsiyet, statin kullanımı ve yüksek hs-CRP düzeyleri koroner kollateral gelişiminin belirleyicileridir.