Relationship between coronary tortuosity and plateletcrit coronary tortuosity and plateletcrit

Rahman

The Egyptian Heart Journal

et al. 2018

BackgroundCoronary tortuosity (CT) had different definitions and scores in literature with unclear pathophysiological impact.ObjectivesTo study degree of CT and it's relation to ischemic changes in patients with angina but normal coronary angiography (CA).MethodsWe conducted a prospective study at University hospitals between May 2016 and January 2017. We included 200 consecutive patients who underwent CA due to chest pain assumed to be of cardiac origin, and their CA was normal (no diameter stenosis >30%, nor myocardial bridging). Patients were prospectively divided into 2 groups based on the presence (n = 113) or absence (n = 87) of ischemic changes during stress study and compared for clinical, echocardiographic and CA characteristics. A newly proposed Tortuosity Severity Index (TSI) was developed into significant (mild/moderate CT with more than 4 curvatures in total, or severe/extreme CT with any number of curvatures) or not significant TSI (mild CT with curvatures less than or equal to 4 curvatures in total).ResultsPatients with ischemic changes had the highest rate of CT (76.5 vs 18%, p = 0.004) compared to those without. CT mostly affects the left anterior descending (LAD) coronary artery in mid and distal segments. Females, elderly, and hypertensives with left ventricular hypertrophy were strongly related to CT. Multivariate logistic regression analysis identified CT with significant TSI as the only predictor of ischemic changes in these patients (OR = 6.2, CI = 2.5–15.3, P = <0.001).ConclusionsCoronary tortuosity is a strong predictor of anginal pain among patients with normal CA, despite positive stress study. This finding is more pronounced among elderly, hypertensive female patients.

Section: Discussionsupporting

confidence: 89%

Validity of tortuosity severity index in chest pain patients with abnormal exercise test and normal coronary angiography

Rahman

The Egyptian Heart Journal

et al. 2018

“…Platelet distribution width (PDW), another marker of platelet activation, indicates variation in platelet dimensions (14,15). Plateletcrit (PCT) provides more comprehensive information about the total thrombocyte mass (16). It is similar to the red cell haematocrit and indicates the percentage of the blood produced by the platelets (17,18).…”

mentioning

confidence: 99%

An Evaluation of Platelet Parameters and Neutrophil/Lymphocyte Ratios in Children with Acute Rheumatic Fever

Asik¹,

Duru²,

Elevli³

2019

jpr

Acute rheumatic fever (ARF) is an inflammatory disease resulting from an autoimmune response to group A beta haemolytic streptococcal infection in sensitive individuals. It is particularly important due to being capable of leading to rheumatic heart disease associated with high morbidity and mortality (1-4). Cytokines produced by lymphocytes and macrophages that are differentiated following an antigenic stimulus play an important role in the triggering of immunological and inflammatory reactions and therefore in the pathogenesis of ARF (5-7).

“…High P-LCR levels were found statistically significant in a study that investigated the relationship between the P-LCR levels and coronary tortuosity; the finding showing the presence of myocardial ischemia even if coronary artery disease was not present. 13 The most important point of this study is the exclusion of aspirintreated patients, unlike other ACS studies.…”

Section: Discussionmentioning

confidence: 99%

Platelet large cell ratio (P-LCR) in predicting acute coronary syndromes before aspirin use

et al. 2020

Introduction Chest pain is one of the most common causes of all emergency department applications. 1 In the United States, approximately 8 million patients are admitted to the emergency department because of chest pain each year, from whom only 15%-25% are diagnosed with acute coronary syndrome (ACS). 2 Considering the fact that ACS is fatal but it is largely possible to provide full healing when diagnosed early, rapid and accurate management of patients with chest pain becomes even more important. In ACS, as a multifactorial disease, endogenous and exogenous risk factors are involved in pathogenesis. Platelet activation leads to an increase in platelet consumption in the area of atherosclerotic plaque rupture. This leads to the release of large-sized platelets from the bone marrow during an acute coronary event. 3 Large platelets are relatively younger and contain more intracellular granules, meaning that platelets have more thrombogenic potential. 4 Hemogram is an easy and inexpensive test that can be performed easily in all health systems, including primary care centers. Platelet large cell ratio (P-LCR) test is one of the test parameters that is routinely calculated and given in the hemogram test, and expressed as the ratio of platelets with platelet volume greater than 12 femtolitres (fL). The ratio of normal P-LCR, i.e. large-volume platelets to all platelets, should be less than 30%. 5 Larger platelets which are reflected by high P-LCR levels indicate higher circulating cholesterol and triglyceride levels in serum. 6 There are many studies in the literature that explore the relationship between platelet parameters in the hemogram and the ACS. Although the mean platelet volume was studied frequently in these studies, the P-LCR test was studied in a small number of the studies. 6,7 In one of these studies, Dehghani et al investigated the relationship between platelet parameters between unstable angina (UA), ST elevation MI (STEMI), and non-ACS chest pain. 8 In this study, a significant correlation between P-LCR value elevations and ACS was