Increased RDW and NLR on admission, in anterior STEMI patients treated with primary PCI are associated with LV systolic dysfunction.

Nondipping pattern in hypertensive patients had a worse cardiac remodeling, and impaired mechanical LA function compared with dipping pattern. The PWD and PTF findings support these changes.

Statin nonadherence or discontinuation is associated with increased cardiovascular events. Many factors related to the physicians or the patients are influential in this. We aimed to compare the compliance with statin therapy between the patients who first presented with ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA) based on the target achievement according to the current dyslipidemia guidelines.We retrospectively acquired all the information about demographic characteristics, in-hospital revascularization procedures, prescribed treatments, and index and up to 6-month follow-up laboratory results of the first acute coronary syndrome patients. Acute coronary syndrome patients were divided into 3 groups as STEMI, NSTEMI, and UA.The STEMI group consisted of 260 patients, NSTEMI group consisted of 560 patients, and UA group consisted of 206 patients. Seventy-six percent of patients underwent percutaneous coronary interventions, 18.3% were managed medically, and 5.7% were referred for coronary artery bypass grafting. There was a significant decrease in low-density lipoprotein-cholesterol (LDL-C) values with the statin treatment at the follow-up in all 3 groups (for all P < .001). In the STEMI group, the percentage of those achieving the target LDL-C level was significantly higher than those who did not achieve the target according to both The American College of Cardiology/American Heart Association (ACC/AHA) and European Society of Cardiology dyslipidemia guidelines. The LDL-C target achievement rates were also higher in the STEMI group than in the NSTEMI and UA groups.Our study concluded that statin treatment goals were more attained in STEMI patients than NSTEMI and UA. All physicians should encourage lifelong intensive statin treatment in UA and NSTEMI patients such as STEMI patients.

The aim of the present study is to investigate if the melatonin has any protective effect on diabetic cardiomyopathy and antioxidant enzymes via phosphorylation of vascular endothelial growth factor-A (VEGF-A). A total of 40 male Wistar rats were enrolled in the study. Rats were divided into four groups: group 1 (control, n=10), group 2 (DM, n=10), group 3 (melatonin, n=10), and group 4 (melatonin+DM, n=10). Melatonin was injected intraperitoneally at a dose of 50 mg/kg/day for 56 days to group 3 and group 4. We investigated expression and phosphorylation of the VEGF-A in coronary vessels of all groups. Staining intensities, biochemical, immunohistochemistry analysis, and transthoracic echocardiography were performed. In comparison to the group 1, DM induced a decrease in p-VEGF-A in coronary vessels of group 2. The lower constitutive phosphorylation of VEGF-A in the group 2 was also increased in coronary vessels after melatonin treatment (p<0.05). Diabetic rats developed myocardial hypertrophy with preserved cardiac function (p<0.05). Cardio-protective effect of melatonin may reduce the damages of diabetes mellitus on the heart muscle fibers and coronary vessels via the phosphorylation of VEGF-A. Melatonin-dependent phosphorylation of VEGF-A in coronary angiogenesis may be associated with the physiological as well as with the pathological cardiac hypertrophy.

The aim of this study is to assess the left atrium (LA) deformation parameters by using 2D speckle tracking echocardiography (2D-STE) in ankylosing spondylitis (AS) patients and to evaluate the relationship between these parameters and AS clinical indexes. 30 patients with AS (22 males, 8 females) and 30 healthy individuals (19 males, 11 females) were enrolled in this study. Transthoracic echocardiography was performed to both groups. Besides the conventional echocardiographic parameters, the LA strain parameters; including systolic-reservoir (LA S-S), early diastolic-conduit (LA S-E), late diastolic-contraction (LA S-A) were measured. No significant difference was found between two groups in terms of conventional echocardiographic parameters except mean deceleration time (DT). Mean DT was prolonged in the AS patients compare with the control group (173.5 ± 22.5 vs. 155.3 ± 36.7, p = 0.025). In the AS patients, LA S-S (48.3 ± 9.4 vs. 56.9 ± 10.1, p = 0.001), LA S-E (26.4 ± 6.4 vs. 31.6 ± 7.3, p = 0.005) and LA S-A (21.9 ± 4.7 vs. 25.4 ± 5.7, p = 0.013) values were statistically lower than the control group. Also a negative correlation was observed between the Bath Ankylosing Spondylitis Metrology Index (BASMI) and LA S-S (r = - 0.509, p = 0.004), LA S-E (r = - 0.501, p = 0.005). Our study demonstrated that 2D-STE is a useful method to determine the left atrial involvement in AS patients without the clinical evident of cardiovascular disease.

Endovascular aneurysm repair (EVAR) of abdominal aorta is a valuable treatment option in selected patients with abdominal aortic aneurysm. Renal artery occlusion is a serious complication after EVAR and may progress to permanent renal injury requiring hemodialysis. In this report, case of unexpected renal artery occlusion after EVAR treated with renal artery stenting in the late postoperative period is described.

C oronary artery anomalies occur in approximately 1% of the population, often without other congenital cardiac malformations and generally, they are found incidentally during conventional coronary angiography. The most common anomaly is an aberrant origin of the right coronary artery (RCA) from the wrong sinus of Valsalva.[1] Anomalous high origin of RCA above the sinotubular junction and continuing between the aorta and pulmonary artery is a very rare congenital anomaly. The expansion of the roots of the aorta and pulmonary trunk on exertion can lead to compression of the coronary artery and result in myocardial ischemia. Case ReportA 59-year-old man was admitted to our clinic with prolonged chest pain particularly during exercise. The patient's history included surgery for large cell lung cancer in 1994 and a dual-chamber (DDD) pacemaker implantation for a complete atrioventricular block in 2010. His physical examination was normal, and myocardial enzyme levels were not elevated. Electrocardiography showed paced rhythm (atrial sense, ventricular paced, 90 beats/min). There were no any pathological findings on transthoracic echocardiography, except mild valve insufficiencies. Coronary angiography by the femoral approach demonstrated non-critical plaques in LMCA, LAD, and Cx arteries. RCA could not be viewed using standard JR catheters. After ascending aortography with a 6-Fr pigtail catheter, RCA could be viewed with 6-Fr Amplatz Left 2 guiding catheter. RCA originated from the left side of ascending aorta above the sinotubular junction (not from the sinus of Valsalva) ( Fig. 1 and 2). There was a 40% stenosis of the proximal RCA. He underwent multi-detector computed tomography coronary angiography (MCTCA) to exclude obstructive coronary artery Abnormal origin of the right coronary artery (RCA) from the left side of ascending aorta and continuing between the aorta and the truncus pulmonalis is a very rare congenital anomaly. Systolic expansion of the aorta and pulmonary trunk may lead to compression of the coronary artery and result in myocardial ischemia, particularly with exertion. A 59-yearold man admitted to cardiology department with prolonged chest pain during exercise. Abnormal origin of RCA with an interarterial course between the aorta and pulmonary artery was observed on coronary angiography and multi-detector computed tomography coronary angiography (MCTCA). In addition, RCA output compression was reported on MCTCA.

Sinus of valsalva aneurysm (SVA) is a rare cardiac disease. The most common complication of SVA is rupture into the right atrium or right ventricle. Rupture into the left chambers is very rare. Patients with ruptured SVA are likely to die of heart failure or endocarditis. We present a 29-year-old man who was hospitalized for hepatic transplantation with rupture of SVA. Transthoracic echocardiography and transesophageal echocardiography showed rupture of a noncoronary SVA into the left atrium. Mitral valve infective endocarditis developed and surgery was planned for the patient, but the patient died due to multiple organ dysfunction syndrome.