The relationship between serum asymmetric dimethylarginine levels and radial artery spasm

Objective: The use of the radial approach in coronary angiography or percutaneous coronary intervention has increased owing to its advantages over the femoral approach such as rapid patient mobilization and improved patient comfort. However, radial artery spasm (RAS) that occurs during the procedure is a crucial factor in transradial approach failure and access site switch. Asymmetric dimethylarginine (ADMA) is a naturally occurring, modified amino acid that inhibits nitric oxide (NO) production. High ADMA levels may reduce arterial elasticity especially in small arteries like the radial artery. This study aimed to evaluate the relationship between ADMA levels and RAS in radial artery access. Methods: This study included 155 patients (89 males and 66 females) who underwent transradial coronary angiography between January 2016 and June 2016. The ADMA level in the plasma was determined using a quantitative sandwich enzyme immunoassay technique. Results: RAS was observed in 16 of the 155 patients (10.1%). The RAS was found to be more frequent in female patients (17.9% for women vs. 4.4% for men, p=0.019). The plasma concentration of ADMA in the RAS group was significantly higher than that in the control group [22.1 ng/mL (12.1–37.8) vs. 9.2 ng/mL (5.9–14.8), p<0.001]. Moreover, the plasma concentration of ADMA was significantly higher in patients with RAS among female patients [20.4 ng/mL (12.1–44.9) vs. 9.9 ng/mL (6.2–16.6); p=0.002] and among male patients [25.2 ng/mL (13.7–35.4) vs. 8.2 ng/mL (5.9–12.8); p=0.007]. Binary logistic regression analysis of all patients showed that ADMA concentration was the only predictor for RAS (odds ratio=1.142; 95% confidence interval=1.061–1.228; p<0.001). Conclusion: It was found that the ADMA concentration of the patients in the RAS group was elevated compared to that of controls. The findings indicated that elevated ADMA concentrations could predict RAS that may occur. (Anatol J Cardiol 2020; 23: 228-32

Badanie służące ocenie występowania choroby wieńcowej w młodym wieku

Introduction. An increasing number of younger patients are being hospitalized with acute coronary syndromes. Earlier risk assessment is essential to prevent or delay coronary artery disease (CAD). This study aimed to assess the rate, risk factor profile, presentation, management and prognosis in young patients with CAD and compared with the same age group without CAD. Material and methods. In this retrospective study, 4325 patients who had undergone coronary angiography from 2011 to 2014 were identified. A total of 627 patients were ≤ 45 years age; 412 of them had CAD, and 215 had normal coronary arteries (control group). Results. The mean age of the patients was 41.7 ± 4.1 years in the CAD group and 41.5 ± 4.5 years in the control group. The prevalences of dyslipidemia, smoking, family history of CAD, hypertension, diabetes, and overweight were higher in the CAD than in the control group. However, the obesity rate was not significantly different between the two groups. Patients with ACS often presented with ST elevation myocardial infarction (STEMI) (49.3%), and single-vessel involvement (55.3%) predominated. Percutaneous coronary intervention (PCI) was the main myocardial reperfusion therapy (68.4%). Conclusıons. Among the young patients studied, CAD had a higher incidence in males. Smoking was the most important modifiable risk factor. Also, patients showed high prevalences of dyslipidemia, overweight, diabetes, and family history of CAD. This study re-emphasizes the relationship between traditional cardiovascular risks and CAD in young.Wstęp. Coraz więcej młodych osób jest hospitalizowanych z powodu ostrych zespołów wieńcowych (ACS). Wczesna ocena ryzyka ma podstawowe znaczenie w zapobieganiu chorobie wieńcowej (CAD) lub opóźnieniu jej wystąpienia. Badanie przeprowadzono w celu oceny częstości występowania CAD, jej czynników ryzyka, objawów, leczenia oraz rokowania u młodych pacjentów z CAD i porównanie tych danych z odpowiednimi danymi dotyczącymi osób niechorujących na CAD. Materiał i metody. Na potrzeby tego retrospektywnego badaniu zidentyfikowano 4325 chorych poddanych koronarografii w latach 2011–2014. W grupie badanych było 627 chorych w wieku nie więcej niż 45 lat; u 412 osób z tej grupy stwierdzono CAD, a u 215 obraz tętnic wieńcowych był prawidłowy (grupa kontrolna). Wyniki. Średni wiek chorych wynosił 41,7 ± 4,1 roku w grupie CAD i 41,5 ± 4,5 roku w grupie kontrolnej. W grupie CAD stwierdzono częstsze występowanie dyslipidemii, palenia tytoniu, dodatniego wywiadu rodzinnego odnośnie do CAD, nadciśnienia tętniczego, cukrzycy i otyłości niż w grupie kontrolnej. Jednak różnica w zakresie częstości występowania otyłości nie była istotna statystycznie. U chorych z ACS często stwierdzano zawał serca z uniesieniem odcinka ST (49,3%), a dominującym typem zmian w koronarografii była choroba jednonaczyniowa (55,3%). Najczęściej stosowanym leczeniem reperfuzyjnym (68,4%) była przezskórna interwencja wieńcowa. Wnioski. W badanej grupie młodych pacjentów stwierdzono większą zapadalność na CAD wśród mężczyzn. Najważniejszym poddającym się modyfikacji czynnikiem ryzyka było palenie tytoniu. U dużej części chorych stwierdzono również dyslipidemię, otyłość, cukrzycę i występowanie CAD w rodzinie. Badanie ponownie zwróciło uwagę na zależność między tradycyjnymi czynnikami ryzyka sercowo-naczyniowego a występowaniem CAD w młodym wieku

Percutaneous endovascular therapy for symptomatic chronic total occlusion of the left subclavian artery

CONCLUSION Balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery is safe and effective, with good acute success rate and mid-term patency. Prospective randomised studies on larger patient populations would provide more precise results

RELATIONSHIP BETWEEN CAROTID ARTERY DOPPLER FLOW VELOCITY AND EXTENT OF CORONARY ARTERY DISEASE

Conclusion: To Patients with carotid artery disease have a high incidence of concomitant coronary artery disease, which is not different between the patients treated conservatively and stenting. In addition, the extension of coronary artery disease (not the presence) were associated with these two Doppler parameters

Clinical and laboratory findings in mad honey poisoning: A single center experience

Objective: This study is aimed at analyzing the demographic and clinical characteristics, as well as the hematological-biochemical parameters of patients who admitted to the hospital with the diagnosis of mad honey poisoning. Materials and Methods: A total of 16 patients who were admitted with mad honey intoxication symptoms and treated in Emergency Department of Sakarya Education and Research Hospital between January 2009 and December 2012 were included in the study. Demographic and clinical characteristics of the patients and hematological, biochemical parameters were obtained from hospital records. Heart rate, systolic and diastolic blood pressure on admission and at discharge were obtained retrospectively. Results: Sixteen patients (10 males and 6 females, mean age 58.5 +/- 10 years, range between 41 and 79) were included in our study. Heart rate was 42 +/- 6 beats/min, systolic blood pressure was 73 +/- 19 mmHg, and diastolic blood pressure was 45 +/- 17 mmHg on admission. In the evaluation of the patients' heart rhythms on admission to the emergency room, nine (56.3%) patients had sinus bradycardia, three (18.8%) patients had nodal rhythm, two (12.5%) patients had first degree atrioventricular block, and two (12.5%) patients had atrial fibrillation. Atropine 1.1 +/- 0.4 mg and saline 1125 +/- 465 ml were used to treat patients. Patients were discharged with a stable condition after an average 27.7 +/- 7.2 h of follow-up. Heart rate was 75 +/- 8 beats/min, systolic blood pressure was 132 +/- 7 mmHg, and diastolic blood pressure was 82 +/- 6 mmHg at discharge. Mortality was not observed. Hematological and biochemical parameters measured at the time of admission were within normal ranges. Conclusion: Mad honey poisoning should be considered in previously healthy patients with unexplained symptoms of bradycardia, hypotension, and cardiac dysrhythmias. Therefore, diet history should carefully be obtained from the patients admitted with bradycardia and hypotension, and mad honey intoxication should also be considered in the differential diagnosis, as well as primary cardiac, neurologic, and metabolic disorders. Mad honey poisoning may be presented with life-threatening symptoms without any hematological and biochemical disorder