The Impact of Hospitalization Time on Major Cardiovascular Event Frequency in Patients with ST-Elevation Myocardial Infarction Over a 6-Month Follow-up

MakaleWOS:000964102000002Aim: The mortality rates related to acute myocardial infarction have significantly decreased recently due to early-period cardiovascular interventions. Some studies have shown that there is no difference in cardiovascular outcomes between the early discharge and the late one. In this study, we planned to investigate the effects of early and late discharge on the frequency of major events in patients treated for acute ST-segment elevation myocardial infarction (STEMI) in our clinic. Methods: Angiography records, demographic characteristics, and laboratory parameters of the patients who were diagnosed with acute STEMI in our clinic between February 2020 and December 2021 were examined. Patients were classified as being in Group 1 (discharge within 48 h) or Group 2 (discharge after 48 h), and rates of recurrent hospitalization, heart failure attacks, cardiovascular events, and death were compared between the two groups. Results: A total of 321 patients were included in our study. There were 129 patients in Group 1 and 192 patients in Group 2. There was no difference between the two Groups in terms of gender, age, or affected coronary vessels. The ejection fraction was lower in the late discharge group (p=0.004). The postoperative ventricular arrhythmia rate was found to be statistically significantly higher in the late discharge group (p=0.046). There was no difference in cardiovascular events between the first and sixth months in either group (p-values of 0.096 and 0.649, respectively). Conclusion: Considering the positive economic and psychosocial effects of early discharge for the patient and physician, when planning the discharge of patients with STEMI, patients with low comorbidity, unaffected ejection fractions, no malignant arrhythmia in their follow-up, and appropriate laboratory parameters can be evaluated for early discharge

Relationship between serum vitamin D levels and angiographic severity and extent of coronary artery disease

Amaç: İçinde bulunduğumuz yüzyılda kalp damar hastalıkları dünya genelinde halen önemli bir mortalite ve morbitide sebebidir. Her geçen gün giderek artan hasta sayısı sebebiyle hastalığın tanı, tedavi ve prognozuna etki eden yeni yöntemler geliştirilmektedir. D vitamini son 2 dekadda bu konu içerisinde kendisine önemli bir yer bulmuştur. Yöntem: Çalışmamıza Gazi Üniversitesi Tıp Fakültesi Kardiyoloji AnabilimDalı'nda Ağustos 2012 ve Temmuz 2013 tarihleri arasında hemodinami laboratuvarında koroner anjiyografi endikasyonu konulan ve koroner anjiyografi yapılan toplam 746 (300 kadın, 460 erkek; min. 19, maks. yaş 87 ort. yaş: 60.44) hasta alındı. Hastalar; D vitamini düzeyine göre 20 ng/ml altında (n=602) grup 1 ve üstünde (n=144) grup 2 olmak üzere iki ayrı gruba ayrıldı. Aynı zamanda paratiroid hormon düzeyleri ölçüldü. Gruplar arasında, D vitamini ile koroner arter hastalığı yaygınlığı ve ciddiyeti arasındaki ilişki gensini skorlama sistemi ile değerlendirildi. Bulgular: Hastaların bazal karakteristikleri ve demografik özellikleri açısından gruplar arasında anlamlı fark yoktu. Hastaların lipid profilleri arasında her iki grupta da anlamlı bir fark izlenmedi. LDL düzeyi birinci grupta 121,61±41,5 mg/dl, ikinci grupta 118,29±40,6 mg/dl olarak değerlendirildi (p=0,668). Sistolik ve diyastolik kan basınçları arasında önemli bir farklılık izlenmedi. Gruplar arasında koroner arter hastalığı için risk faktörleri olan diyabetes mellitus, hipertansiyon ve sigara kullanımı açısından fark saptanmadı. Çalışmaya alınan hastaların serum D vitamin düzeyi ortalamalası 15,54±7,46 ng/ml olarak bulundu. Serum D vitamini düzeyi grup 1'de 12.6±3.3 ng/ml, grup 2'de 27.5±7.8 ng/ml olarak saptandı. Kadın hastalarda ortalama D vitamini düzeyi 15.28±7.95 ng/ml, erkek hastalara ait ortalama D vitamini düzeyi 16.43±8.09 ng/ml olarak saptandı (p=0.097). Serum parathormon düzeyi ortalaması 43.5±28.82 ng/ml olarak bulundu. Parathormon düzeyi grup 1'de 43.7±29.4 pg/ml, grup 2'de 43.1±26.2 pg/ml olarak saptandı ve gruplar arasında istatiksel olarak anlamlı bir fark yoktu ( p= 0.826). Tüm çalışma grubunda gensini skoru ortalaması 26.25±34.32 olarak bulundu. D vitamini 20 ng/ml olan grupta 25.5±27.5 olarak tespit edildi. Gruplar arasında istatiksel olarak anlamlı farklılık saptanmadı (p= 0.097). %50'nin üzerinde darlığı sahip tıkayıcı koroner arter hastalığı olan hastalar arasında istatiksel olarak anlamlı bir farklılık izlenmedi (p=0.110). Akut koroner olay hikayesi olan hastalarda, akut koroner sendrom tipi ile D vitamini arasında istatiksel olarak anlamlı bir farklılık izlenmedi (p=0.534). Sonuç: D vitamini düzeyi ile koroner arter hastalığı ciddiyeti ve yaygınlığı arasında anlamlı bir ilişki saptanmamıştır. Aynı şekilde parathormon düzeyleri ile koroner arter hastalığı ile ciddiyeti arasında anlamlı bir ilişki olmadığı gösterilmiştir. D vitamininin kardiyovasküler hastalıklar üzerinde etkinliğinin değerlendirilmesi için çevresel ve bireysel özelliklerin benzer olduğu homojen gruplar arasında daha geniş çaplı çalışmalara ihtiyaç vardır.Purpose: Cardiovascular disorders are still among the most significant cause of mortality and morbidity. Rapidly increased rate of effected population stimulates novel approaches on diagnosis and management. In the last two decades vitamin D has been the focus of interest as a causative factor for cardiovascular diseases. Methods: A total of 746 patients (300 women, 460 men, mean age 60.44; 19-87) in whom coronary angiography had been performed at Gazi University Cardiology Department between August 2012 and July 2013 were enrolled in this study. Serum vitamin D levels were measured and patients were grouped according their serum vitamin D levels (vitamin D 20ng/dl (n=144) group 2). Baseline characteristics and demographic features were comparable between groups. Serum parathyroid hormone was also measured. Gensini scoring system was used to evaluate the association between serum vitamin D levels and severity and extent of coronary artery disease.89 Results: There was no significant difference between lipid profiles; serum low density lipoprotein levels were 121,61±41,5 mg/dl in the first group; whereas it was 118,29±40,6 mg/dl in the other (p=0,668). Systolic and diastolic blood pressures, as well as coronary artery risk factors including diabetes mellitus, hypertension and smoking were also compatable. Mean serum vitamin D levels of all patient cohort was 15,54±7,46 ng/ml. Group 1 and Group 2 had an avarage serum vitamin D levels of 12.6±3.3 ng/ml and 27.5±7.8 ng/m, respectively. Mean vitamin D levels of men and women were 16.43±8.09 ng/ml and 15.28±7.95 ng/ml; respectively (p=0.074). Mean serum parathormon levels of all patient cohort was 43.5±28.82 pg/ml; it was 43.7±29.4 pg/ml for group 1, whereas it was 43.1±26.2 pg/ml in group 2 and serum parathormon levels showed no statisticaly significant difference ( p= 0.826). Gensini score for all patients was 26.25±34.32 ( 0-170.5). Patients with serum vitamin D levels 20 ng/dl (p= 0.097). There was no significant difference between patients with obstructive coronary artery disease (more than 50% decrease in diameter)(p=0.110). In patients with acute coronary syndrome, there was no significant difference between type of acute coronary syndrome and serum vitamin D levels (p=0.534). 90 Conclusion: This study failed to demonstrate significant relationship between serum vitamin D levels, serum parathormon levels and the severity and extent of coronary artery disease. Further studies with more participation and homogenous groups with comparable individual and environmental features are needed to evaluate the association of serum vitamin D levels and cardiovascular disease

A google trends analysis: Change in internet searches related to cardiovascular disease during covid-19 outbreak

Aim: A rapidly grown up information about coronavirus (COVID-19) has been regularly broadcast on internet websites or social media. We investigated the Google research trends in searches regarding cardiovascular system diseases or symptoms such as chest pain, hypertension, hyperlipidemia, heart attack during the COVID-19 pandemic in two countries, Turkey and Italy, which are most affected by this disease. Methods : The Google TrendsTM (GTTM) was used to retrieve data on Internet user search activities and patterns of Google search queries. We searched most known keywords related to cardiovascular disease and symptoms such as chest pain, heart attack, heart diseases, hypertension, high cholesterol in GTTM between January 1, 2020 and May 5, 2020 in Turkish and Italian. Results: Search interest about coronavirus in Turkey and Italy appeared to have an increasing pattern and it has gradually tended to fall after a short time. Searching trends were higher both of countries about chest pain, hypertension, ACE inhibitor and death between January and May 2020. Searching rates about heart attack was not different for all year, but a signifi cant decrease was remarkable for cholesterol. It was also revealed that as the duration of the pandemic increases in both countries, these research rates decrease. Conclusion: Internet could be used to determine behaviours of people for searching cardiovascular disease and their symptoms during the outbreak. These data illustrate that internet users in both countries conducted an intense research on cardiac symptoms or diseases during the COVID-19 pandemic

The right coronary artery originating from the left anterior descending artery: A variant of single coronary artery anomaly

Although coronary artery anomalies have been accepted as benign conditions, clinical presentations have a large spectrum including chest pain, dyspnea, palpitations, malign arrhythmias, myocardial infarction,  syncope and sudden death. An atypical anomalous form of single coronary artery in which the right coronary artery originates from the left anterior descending coronary artery is an extremely rare situaiton. In this report,  we presented a case of 63 years old woman who was taken to the coronary angiography due to recurrent chest pain and acute coronary syndrome. Coronary angiography revealed an atypical form of single coronary artery anomaly that the right coronary artery originates from the left anterior descending coronary artery. The treatment strategy was discussed with heart team and patient.  Percutaneous coronary intervention (PCI) was performed because of her recurrent chest pain and isolated LAD lesion and preference of the patient.  In conclusion, this case is important for demonstrating the feasibility of PCI in patients with single coronary artery anomaly

Favorable electrocardiographic changes after substantial weight loss in patients with morbid obesity Results of a prospective study

*Gül, Murat ( Aksaray, Yazar ) *İnci, Sinan ( Aksaray, Yazar ) *Özkan, Namık ( Aksaray, Yazar )Background Obese patients have an increased risk of arrhythmias and sudden death, even in the absence of structural heart disease and cardiac dysfunction. This study aimed to determine whether weight loss by bariatric surgery has an effect on arrhythmia-related electrocardiographic (ECG) variables in morbidly obese patients. Methods In this prospective study, the data of 48 patients were analyzed. All ECG variables that have the potential to predict ventricular arrhythmia were evaluated before surgery, and were compared with the 1-month and 6-month follow-up results. Results The mean body mass index was 45.74 +/- 5.60 kg/m(2) before surgery. There was a statistically significant decline in body mass index in the first and sixth month after surgery (39.26 +/- 5.00 kg/m(2) and 31.71 +/- 4.49 kg/m(2), respectively; p < 0.001). Furthermore, notable reduction was found in terms of heart rate measurements-QTc-d, JTc, JTc-d, Tp-e, TP-e/QT, TP-e/QTc-in the first month and sixth month compared with baseline (p < 0.001 for all comparisons). Several ECG variables, such as heart rate (r = 0.369, p = 0.001), QTc-d (r = 0.449, p = 0.001), JTc-d (r = 0.324, p = 0.002), Tp-e (r = 0.592, p = 0.001), Tp-e/QTc (r = 0.543, p = 0.001), Tp-e/JTc (r = 0.515, p = 0.001), exhibited a positive and significant correlation with weigh loss. Moreover, a negative and weakly significant correlation was found between the index of cardiac electrophysiological balance (r = -0.239, p = 0.004) and body mass index. Conclusion Substantial weight loss following laparoscopic sleeve gastrectomy in obese patients is accompanied by a significant improvement in ventricular repolarization. Therefore, this effect may lead to a decrease in the incidence of lethal ventricular arrhythmia and sudden cardiac death

Role of calcium–albumin ratio in severity of coronary artery disease assessed by angiographic SYNTAX score

Aim: Numerous studies have reported a relationship between serum calcium or albumin levels and acute coronary syndromes and coronary artery disease. The present study investigated the relation between serum albumin, calcium or albumin-corrected calcium levels or calcium/albumin ratio (CAR) and extensiveness and severity of atherosclerosis. Methods: This prospective study included patients with non-ST elevation myocardial infarction (NSTEMI, n=120) and a control group (n=109). We used the SYNTAX score to evaluate the association between CAR and severity and extent of coronary artery disease. Results: There were higher, but statistically nonsignificant, levels of calcium in patients with NSTEMI (p=0.058). However, serum albumin-corrected calcium levels were significantly higher in NSTEMI group (p=0.001). Yet, albumin levels did not differ between the groups (p=0.093). CAR and corrected calcium–albumin ratio (cCAR) were significantly higher in NSTEMI group (p=0.001). A positive correlation existed between CAR (r=0.235, p=0.010), cCAR (r=0.259, p=0.004), and SYNTAX score, whereas albumin and SYNTAX score (r=−0.259, p=0.004) showed a negative correlation. Conclusion: Calcium/albumin ratio has been found to be associated with an increased coronary atherosclerotic burden as calculated by SYNTAX score. Further large-scale studies are warranted to confirm our findings

Woven Coronary Artery Disease Successfully Managed with Percutaneous Coronary Intervention: A New Case Report.

Woven coronary artery is relatively rare and can be complicated in both acute and chronic phases. A few case reports have been published until now. Herein we report a case with right woven coronary artery managed with drug-eluted stent implantation without complication

Short- and mid-term effects of sleeve gastrectomy on Left Ventricular Functions with Two-Dimensional Speckle Tracking Echocardiography in obese patients

Gül, Murat ( Aksaray, Yazar ) İnci, Sinan ( Aksaray, Yazar )Aim: This study aimed to investigate left ventricular functions of obese patients with no known heart disease who underwent laparoscopic sleeve gastrectomy by speckle tracking echocardiography in their early and medium-term postoperative follow-up. Patients and Method: Thirty-seven obese patients (10 M, 27 F) without coronary artery disease or heart failure who had undergone LSG were included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions preoperatively, at the postoperative Month 1 and at the postoperative Month 6 (QLAB 6.0), using current software. Results: No difference was found between standard echocardiography and Doppler parameters in terms of the 1-month versus 6-month follow-up values compared to baseline. Left ventricular STE longitudinal measurements demonstrated significantly higher longitudinal strain and strain velocity parameters in the follow-up values at Month 6 compared to the values at Month 1 and at baseline. Global longitudinal strain (GLS) was −17.48 ± 1.09% in 6-month follow-up, −16.16 ± 1.26% in 1-month follow-up, and −16.06 ± 1.25% at baseline (P <.001). A significant correlation was found between delta GLS, which represents patients’ GLS change in 6 months, and delta weight, which represents patients’ body weight change in 6 months. Conclusion: Obese patients who had undergone LSG were observed to have improved left ventricular function in the mid-term...