We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of thrombus burden in patients with acute myocardial infarction. Patients (n = 229; male 72.9%; mean age 63 ± 13.4 years) who were admitted with ST-segment elevation myocardial infarction (STEMI) were enrolled. Patients were divided into 2 groups. Group 1 was defined as low thrombus burden and group 2 was defined as high thrombus burden. Patients with high thrombus burden had higher total bilirubin levels (14.4 [4.3-22.9] vs 7.7 [2.4-20.3] µmol/L, P ≤ .001), (0.84 [0.25-1.34] vs 0.45 [0.14-1.19] mg/dL P ≤ .001) and direct bilirubin levels (3.1 [2.1-8.4] vs 1.7 [0.5-6.5] µmol/L, P ≤ .001), (0.18 [0.03-0.49] vs 0.10 [0.03-0.38] mg/dL, P ≤ .001). At multivariate analysis, total bilirubin (odds ratio: 1.05, 95% confidence interval: 1.03-1.08, P ≤ .001) was the independent predictor of high thrombus burden. In conclusion, total bilirubin level is independently associated with high thrombus burden in patients with STEMI.
Chronic total occlusion (CTO) is a common finding in 40% of the patients with peripheral arterial disease (PAD). The aim of this study was to investigate the determinants of CTO in patients with PAD. The study included a total of 211 nonanemic patients with PAD. All patients were categorized according to the Fontaine classification. In lower extremity angiography cohorts, CTO patients were designated as group 1 and CTO patients were designated as group 2. Patients with CTO had significantly higher red cell distribution width (RDW), neutrophil-lymphocyte ratio, uric acid, and high-sensitivity C-reactive protein compared to patients without CTO ( P ≤ .001, P = .036, P ≤ .001, and P = .015, respectively). Albumin, total bilirubin, and direct bilirubin were significantly lower in the patients with CTO compared to patients without CTO ( P = .023, P ≤ .001, and P = .049, respectively). Multivariate logistic regression analysis showed that RDW, uric acid, and total bilirubin were independent predictors of CTO in patients with PAD. We demonstrated that increased RDW and uric acid levels and lower total bilirubin values were independently associated with CTO in patients with PAD.
The aim of the present study was to investigate whether YKL-40 levels and epicardial adipose tissue (EAT) thickness were associated with non-dipping pattern in essential hypertension (HT). Age- and sex-matched 40 dipper hypertensive patients and 40 non-dipper hypertensive patients were included in the study. Non-dippers had significantly increased EAT thickness and higher YKL-40 and high-sensitivity C-reactive protein levels than dippers. Multivariate logistic regression analysis showed that the EAT thickness and serum levels of YKL-40 and high-sensitivity C-reactive protein were independent predictors of non-dipping pattern in essential HT. In essential HT, presence of non-dipping pattern is associated with increased inflammatory response.
Introduction: Coronary artery ectasia (CAE) is characterised by an abnormal dilatation of the coronary arteries. Platelet volume indices, including the mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and platelet count, are indicators of platelet activation. In this study, we investigated platelet volume indices in patients with CAE. Patients and Methods:The study group included 51 patients (38 men; mean age: 52 ± 9.9 years) with isolated CAE and 50 individuals with normal coronary arteries (39 men; mean age: 54 ± 11.3 years). Admission platelet volume indices were measured as part of the automated complete blood count.Results: Platelet count, MPV, PCT and PDW were higher in CAE than in the control group (p< 0.05). Multivariate analysis revealed PDW (odds ratio: 0.22, 95% confidence interval: 0.06-0.73, p= 0.013) and PCT (odds ratio: 3.41, 95% confidence interval: 1.66-6.98, p≤ 0.001) as independent predictors of CAE. Conclusion:This study demonstrates that PCT and PDW are independent predictors of CAE.Key Words: Coronary artery ectasia; coronary artery disease; mean platelet volume; platelet distribution width Plateletkrit ve Trombosit Dağılım Genişliği Koroner Arter Ektazisinin Bağımsız Öngördürücüsüdür ÖZETGiriş: Koroner arter ektazisi (KAE), koroner arterlerin anormal genişlemesi ile karakterize edilir. Ortalama trombosit hacmi (OTH), trombosit dağılım genişliği (TDG), plateletkrit (PKT) dahil olmak üzere trombosit hacmi endeksleri ve trombosit sayısı trombosit aktivasyonunun göstergeleridir. Bu çalışmada KAE'li hastalarda trombosit hacmi endeksleri incelendi. Hastalar ve Yöntem: Çalışmaya, izole KAE'si olan 51 (38 erkek; ortalama yaş: 52 + 9.9 yıl) hasta ve koroner arterleri normal olan 50 (39 erkek; ortalama yaş: 54 + 11.3 yıl) sağlıklı birey dahil edildi. Başvuruda trombosit hacmi endeksleri otomatik tam kan sayımı parçası olarak ölçüldü. Sonuç: Bu çalışma, PKT ve TDG'nin KAE'nin bağımsız belirleyicileri olduğunu göstermektedir.
After acute coronary syndromes (ACS), cardiac remodelling affecting not only ventricles but also both atria is an important problem associated with an increased risk for adverse cardiovascular outcomes. However, it is usually underestimated to evaluate atrial size and functions. The aim of the present study is to compare left and right atrial size and functions in ACS patients with healthy controls during transthoracic echocardiography by means of diameter, area and volume measurements, and pulsed-wave tissue Doppler imaging (TDI). 150 ACS patients (128 male, 22 female) and 25 healthy controls (19 male, 6 female) were enrolled into the study. Of the ACS patients, 75 had ST-segment elevation myocardial infarction (STEMI) and 75 had non-STEMI. Biatrial diameters, areas, and volumes were measured from different echocardiographic views. Atrial total emptying fraction and expansion index values were calculated from volume measurements. By the pulsed-wave TDI of the atrial walls; peak systolic (S'), peak early diastolic (E'), and peak late diastolic (A') velocities were measured. Almost all left atrial parameters for diameter, area, and volume measurements were higher in ACS patients. Similarly, they had higher values for the same right atrial parameters. Left and right atrial total emptying fraction and expansion index values were lower in ACS patients than controls. All left and right atrial walls had lower S' and E' velocities in ACS patients. ACS cause important alterations in the biatrial size and functions evaluated by echocardiographic diameter, area and volume measurements, and pulsed-wave TDI.
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