OBJECTIVE: This study aims to examine the predictive role of systemic immune-inflammation index on postoperative new-onset atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting. METHODS: A total of 722 patients undergoing elective off-pump coronary artery bypass grafting between January 2017 and September 2021 were included in this study and divided into two groups as the atrial fibrillation group (n=172) and the non-atrial fibrillation group (n=550). Both groups were compared in terms of patients' baseline clinical features, operative and postoperative variables, and preoperative hematological indices derived from the complete blood count analysis. Multivariate logistic regression and receiver-operating characteristic curve analyses were performed to detect the independent predictors of postoperative new-onset atrial fibrillation. RESULTS: The median age and length of hospital stay in the atrial fibrillation group were significantly higher than those in the non-atrial fibrillation group. The median values of white blood cell, platelet, neutrophil, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immuneinflammation in the atrial fibrillation group were significantly greater than in those in the non-atrial fibrillation group. Logistic regression analysis demonstrated that age, platelet, platelet/lymphocyte ratio, and systemic immune-inflammation were independent predictors of postoperative newonset atrial fibrillation. receiver-operating characteristic curve analysis revealed that systemic immune-inflammation of 706.7×10 3 /mm 3 constituted cut-off value to predict the occurrence of new-onset atrial fibrillation with 86.6% sensitivity and 29.3% specificity. CONCLUSION: Our study revealed for the first time that systemic immune-inflammation predicted new-onset atrial fibrillation after off-pump coronary artery bypass grafting.
INTRODUCTIONVitamin D is a fat-soluble vitamin that is synthesized non-enzymatically in the skin and metabolized in the liver and kidneys. It arranges the immune response of the body, acts as a steroid hormone and plays a crucial role in mineral homeostasis and skeletal health. 1 Serum vitamin D levels in the range 30-60 ng/ml (75-150 nmol/l) are considered normal.Deficiency of vitamin D is associated with a variety of bone disorders (rickets, osteoporosis or osteomalacia), skin diseases and autoimmune disorders. 1,2 It also causes increased risk of cardiovascular diseases such as myocardial infarction (MI), heart failure and coronary artery disease. 2-5 Furthermore, deficiency of vitamin D has been reported in arterial diseases, including aortic aneurysm, peripheral arterial disease, arterial calcification and hypertension. [6][7][8][9] Deep vein thrombosis (DVT) is characterized by thrombus formation, usually in the lower-extremity deep venous system, which causes obstruction or occlusion of blood flow in veins. It is considered to be the third most common cardiovascular disease, after ischemic heart diseases and cerebrovascular events. 10 Although the medical and interventional treatment options for deep vein thrombosis have improved nowadays, it continues to pose a serious problem, especially in cases with inadequate treatment. It can lead to pulmonary thromboembolism, venous gangrene, chronic venous insufficiency and post-thrombotic syndrome. 11 The most well-known factors in the etiology of lower-extremity deep vein thrombosis are genetic predisposition, malignancy, history of surgical operation, immobilization, trauma, bone fractures, long journeys and oral contraceptive use. 12 Nevertheless, there may also be other factors that play a role in the etiopathogenesis of deep vein thrombosis.
OBJECTIVE: This study aimed to investigate the effect of preoperative pulmonary hypertension (PHT) on postoperative early mortality and morbidity in patients undergoing off-pump coronary artery bypass grafting (CABG). METHODS: A total of 1107 patients undergoing elective first-time off-pump CABG between January 2011 and April 2022 were included in this retrospective observational cohort study. The patients were categorized into two groups according to their preoperative systolic pulmonary artery pressure (SPAP) values. The PHT group (n=104) consisted of patients with a SPAP value >30 mmHg, while the non-PHT group (n=1003) consisted of patients with a SPAP value ≤30 mmHg. Patients' preoperative demographics and clinical features, operative data, and postoperative outcomes were recorded and then compared between the groups. RESULTS: In the PHT group, the median age was significantly higher (66 vs. 63 years, p=0.001) and the median left ventricular ejection fraction level was significantly lower (45 vs. 50%, p=0.045) as compared to the non-PHT group. Additionally, the PHT group included a significantly greater percentage of patients with chronic obstructive pulmonary disease (22.1 vs. 7.4%, p=0.019). As perioperative early-term outcomes, complications, and mortality were considered, the groups were statistically similar, and there were no significant differences between the groups, except for the development of atrial fibrillation. CONCLUSION: For the first time in the literature, this study revealed that mild PHT (mean SPAP=38.9±8.7 mmHg) did not significantly affect earlyterm outcomes of off-pump CABG.
Abstract:Background: Congenital heart diseases affect a large number of newborns and account for a high proportion of infant mortality worldwide. There are regional differences in the prevalence and distribution pattern of congenital heart diseases. We aimed to evaluate the relative frequencies, risk factors and diagnostic clues of congenital heart disease in newborns at our neonatal intensive care unit. Materials and methods: Among 326 cases admitted to the Abant Izzet Baysal University Neonatal Intensive Care Unit between February 2013 -September 2014, thirty-five newborns with congenital heart disease were evaluated, retrospectively. Data was collected on a predesigned proforma containing information regarding gender, gestational age and weight at birth, family history, and associated malformations. Results: The prevalence of congenital heart disease was 10.7%. The most common cause for cardiology consultation was cardiac murmur (85.5%). The relative percentage of acyanotic and cyanotic heart defects were 91.6% and 8.4%, respectively. The most frequent acyanotic defect was ventricular septal defect with a prevalence of 22.8%. Maternal diabetes mellitus and Down syndrome were observed in 17.1% and 2.8% of cases, respectively. Conclusion: The prevalence of congenital heart disease in newborns at the neonatal intensive care unit was higher than that in all live births and most common defect was muscular VSD. The most frequent diagnostic clue was cardiac murmur.
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