Can Vitamin D Deficiency Predict Coronary Artery Disease?

Aim:On the basis of emerging data about the association of vitamin D and coronary artery disease (CAD), we investigated whether a relationship exists among vitamin D, inflammation represented by C-reactive protein (CRP), and serum lipid profile in CAD.Materials and Methods:Patients with newly diagnosed CAD (n = 115) and 62 healthy subjects were enrolled in the study. Blood lipids, CRP, and vitamin D levels were measured, and the patient and control groups’ values were compared.Results:The low-density lipoprotein cholesterol (LDL-C), triglyceride, and CRP levels were higher, and vitamin D and high-density lipoprotein cholesterol (HDL-C) levels were lower in the patient group. A positive correlation was found between the vitamin D and HDL-C levels (r=0.328; p<0.001) and a negative correlation was seen between vitamin D and CRP (r= -0.484; p<0.001). In the multivariate logistic regression analysis, smoking (p=0.001, OR = 5.301; 95% CI = 2.215 – 12.687), the presence of hypertension (p=0.040, OR = 2.355; 95% CI=1.039 – 5.336), LDL-C level (p=0.048, OR =1.021, 95% CI=1.000 – 1.042) and vitamin D level (p=0.001, OR = 0.937, 95% CI = 0.902 – 0.973) were found to be predictors of CAD.Conclusion:Decreased level of vitamin D is associated with presence and CAD. Decreased vitamin D levels are associated with low HDL-C and high CRP levels in CAD. Smoking, hypertension, LDL-C and vitamin D are predictors of CAD

Serum fetuin-A levels are associated with carotid intima–media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima–media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1–10] vs. 3 [1–12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 ± 19.8 ng/mL, 72.9 ± 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50–0.98] vs. 0.62 [0.44–0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = –0.320, p = 0.032). Age (b ± SE: 0.002 ± 0.001, p = 0.008) and fetuin-A (b ± SE: –0.002 ± 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

Serum fetuin-A levels are associated with carotid intima-media thickness in patients with normotensive chronic obstructive pulmonary disease

Background: There are contradictory reports about the relationship between fetuin-A and atherosclerotic process. Coronary artery disease is the most important cause of mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to investigate the association of serum fetuin-A level with mean carotid intima-media thickness (cIMT) and ankle-brachial index (ABI) in COPD. Methods: We evaluated the association of serum fetuin-A level, mean cIMT and ABI in normotensive subjects with COPD (n = 65) and with non-COPD (n = 50). Results: Fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and C-reactive protein level higher (4 [1-10] vs. 3 [1-12] mg/dL, p = 0.034) in COPD patients than the control group. Compared to controls, fetuin-A level was significantly lower (63.5 +/- 19.8 ng/mL, 72.9 +/- 16.2 ng/mL, p = 0.035) and mean cIMT higher (0.69 [0.50-0.98] vs. 0.62 [0.44-0.98] mm, p = 0.034, respectively) in the COPD group. There was a significant negative correlation between mean cIMT and fetuin-A levels (r = -0.320, p = 0.032). Age (beta +/- SE: 0.002 +/- 0.001, p = 0.008) and fetuin-A (beta +/- SE: -0.002 +/- 0.001, p = 0.035) were decisive for the mean cIMT. Conclusions: There are increased cIMT values, decreased fetuin-A levels, but unchanged ABI values in patients with normotensive COPD. Age and fetuin-A were predictors for cIMT, while fetuin-A was negatively correlated with cIMT

Fatal Deep Inguinal Infection after Diagnostic Coronary Angiography

Herein we would like to share our case complicated with inguinal infection secondary to femoral haematoma after coronary angiography. A-79 years-old female underwent diagnostic coronary angiography suffered from a large haematoma in the right inguinal region where femoral artery puncture was performed at another hospital. She was treated at same hospital 16 days and discharged. She presented to our department with a deep ulcerative and ruptured wound in the femoral artery puncture site. The wound-site culture revealed E. coli. After appropriate antibiotic treatment and wound care, the deep inguinal infection began healed. Purulan material and swallowing decreased and patient discharged. After 8 days, she came back with shock presentation and hospitalised to intensive care unit, but she died within 3 hours. We emphasised that the importance of prevention and management of access site haematoma during percutaneous procedures is vital and should not be neglected in routine practice

The relationship between copper, homocysteine and early vascular disease in lean women with polycystic ovary syndrome

This study investigates copper (Cu) levels and vascular dysfunction in lean women with polycystic ovary syndrome (PCOS). 44 subjects with PCOS, diagnosed according to Rotterdam criteria, and 42 healthy subjects matched for body mass index and age. Comparison of serum Cu, homocysteine, carotid intima-media thickness (CIMT), brachial artery flow mediated dilation (FMD) was carried out between PCOS patients and the control group. Clinical study was done in Namik Kemal University School of Medicine. The CIMT and concentration of Cu in PCOS patients was significantly higher than the healthy controls. FMD levels in PCOS patients were significantly lower than those in controls. In PCOS patients, CIMT was correlated with estrogen and Cu levels. However, FMD was correlated with age and Cu levels. Among these contributing factors, Cu levels were correlated with a change in CIMT and FMD. CIMT and FMD in PCOS patients were related to Cu levels as well as several cardiovascular risk factors. Thus, increased Cu levels may be responsible for the increased risk of early vascular disease in women with PCOS

The effects of onion (Allium cepa) extract on doxorubicin-induced apoptosis in aortic endothelial cells

The aim of this study was to investigate the effects of onion (Allium cepa) extracts (ACE) on doxorubicin (DOX)-induced apoptosis in aortic endothelial cells. The rats in the ACE-pretreated group were given a daily dose of 1ml ACE for 14days. To induce aortic endothelial cell apoptosis, DOX (30mgkg1 body weight) was injected intraperitoneally by a single dose and the rats were sacrificed after 48h. To date, no such studies have been performed on antiapoptotic potential of ACE on DOX-induced apoptosis in aortic endothelial cells. Our data indicate a significant reduction in the activity of in situ identification of apoptosis using terminal dUTP nick end-labeling in aortic endothelial cells of the DOX-treated group with ACE therapy. DOX-treated with ACE groups showed a significant decrease in malondialdehyde levels and increased levels of glutathione in comparison with the DOX-treated group. Data from our study show that prevention of endothelial cell apoptosis by ACE may contribute to the restoration of aortic endothelial dysfunction that is associated with DOX treatment. Copyright (c) 2011 John Wiley & Sons, Ltd

Antioxidant and anti-apoptotic effects of onion (Allium cepa) extract on doxorubicin-induced cardiotoxicity in rats

The aim of this study was to investigate the antioxidant and anti-apoptotic effects of onion (Allium cepa) extracts (ACE) on doxorubicin (DOX)-induced cardiotoxicity. The rats in the ACE-pretreated group were given a daily dose of 1 ml ACE for 14 days. To induce cardiotoxicity, DOX (30 mg kg-1 body weight) was injected intraperitoneally by a single dose and the rats were sacrificed after 48 h. To date, no such studies have been performed on the cardioprotective and anti-apoptotic potential of ACE on DOX-induced cardiotoxicity. Our data indicate a significant reduction in the activity of in situ identification of apoptosis using terminal dUTP nick end-labeling in cardiomyocytes of the DOX-treated group with ACE therapy. The DOX-treated with ACE groups showed a significant decrease in malondialdehyde levels, and increased activities of superoxide dismutase, glutathione and glutathione peroxidase in comparison with the DOX-treated group. Creatine kinase, creatine kinase MB, lactate dehydrogenase activities and cardiac troponin I levels were significantly decreased in the DOX + ACE group in comparison with the DOX group. These biochemical and histological disturbances were effectively attenuated on pretreatment with ACE. The present study showed that ACE may be a suitable cardioprotector against toxic effects of DOX. Copyright (C) 2011 John Wiley & Sons, Ltd

Endothelial dysfunction in children with low birth weight, born at term

The aim of our study was to assess whether endothelial function of the brachial artery is normal or impaired in children born at term with low birth weight (LBW) compared with their normal birth weight (NBW) peers, because there are still few data on this subject in children born at term with LBW. We compared brachial artery flow mediated dilatation (FMD) in children with LBW (n= 55, 30 male) and NBW (n= 45, 24 male) who were born at term. Age, gender, weight, height, waist and hip circumference, body mass index, body mass Z score, fasting glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol, high density lipoprotein- cholesterol, calcium, C-reactive protein, hemoglobin, serum insulin concentration, homeostatic model assessment index, creatinine values, brachial artery baseline diameter and brachial artery post dilatation diameter were similar in both groups (all p values >0.05). Compared with the NBW group, the LBW group had lower FMD (%) (6.68 +/- 2.1 vs. 7.8 +/- 1.9, p = 0.004). Brachial artery FMD was negatively correlated with waist circumferences (r = - 0.521, p < 0.001). A general linear analysis model, FMD as the dependent variable revealed significant effect of waist circumference (ss +/- SE:- 0.07 +/- 0.02, p<0.001) and LBW controlling for age (ss +/- SE: -0.028 +/- 0.01, p = 0.004). LBW closely affects to FMD. Therefore, the children with LBW born at term may be potentially at risk for early atherosclerosis compared with their peers

Novel imaging modalities in detection of cardiovascular involvement in ankylosing spondylitis

Objectives: The diagnosis of cardiovascular involvement in ankylosing spondylitis (AS) is usually delayed since conventional echocardiography relies mainly on the morphological alterations. The aim of this study was to evaluate the role of echocardiographic methods such as tissue Doppler and strain imaging of left ventricle (LV) and proximal aorta; and concentrations of biomarkers of cardiac fibrosis such as galectin-3 (Gal-3) and soluble suppression-of-tumorogenicity-2 (sST2) in determining early cardiovascular impairment in AS. Design: In this prospective study of 75 AS and 30 healthy subjects (mean age 41.7 +/- 10.1 years; 37.3% female), we determined layer-specific strain and strain rates in longitudinal, circumferential and radial axes for LV as well as transverse and longitudinal strains of proximal aorta; central pulse wave velocity(cPWV); plasma high sensitivity C-reactive protein(hsCRP), Gal-3 and sST2 levels. Results: Patients with AS had increased levels of hsCRP and sST2 when compared to healthy controls. cPWV, E and e' velocities; longitudinal strain and strain rates at all myocardial layers; and transverse strains of both anterior and posterior aortic walls were reduced in AS patients. Gal-3 levels with strain and strain rates at circumferential and radial axes were similar between the groups. Among all echocardiographic and clinical parameters, AS was independently associated with LV dysfunction (expressed by longitudinal strain of LV) and aortic impairment (expressed by transverse strain of anterior wall). Conclusions: This study demonstrates that functional impairment in AS occurs early in the disease course and strain imaging is an effective tool in discriminating involvement. sST2 may represent the link between inflammation and fibrosis in AS