The Prognostic Value of the Systemic Immune-inflammation Index in ST-segment Elevation Myocardial Infarction Patients and Its Correlation with Syntax II Score and TIMI Risk Score

Background and Aim:The systemic immune-inflammation index (SII) has been identified as a novel prognostic marker in various illnesses. We investigated the relationship between SII and mortality in patients undergoing primary percutaneous coronary intervention (pPCI). In addition, we planned to examine how SII correlated with SYNTAX II and thrombolysis in myocardial infarction (TIMI) risk scores in this population.Materials and Methods:This retrospective observational study included patients with ST-segment elevation myocardial infarction who underwent pPCI. The endpoint was 1 year all-cause mortality. SII [(neutrophil x platelet)/lymphocyte] was calculated from admission blood samples. Besides clinical and laboratory findings, SII, Syntax II and TIMI risk scores were compared between survivors and non-survivors. The correlation between SII and Syntax II and TIMI risk scores was also evaluated.Results:The study included 334 patients (82.3% male). In the 1 year follow-up, 18 patients (5.4%) died. The SII, Syntax II, and TIMI risk scores were significantly higher in non-survivors than in survivors [mean (standard deviation: SD), 2423 (2005) vs 1686 (998), P = 0.005; median (interquartile range) 43 (35-53) vs 30 (25-37), P < 0.001; and 4 (2-5) vs 2 (1-3), P = 0.005, respectively]. Furthermore, the Syntax II score, TIMI risk score, and SII was independent predictors of 1 year all-cause mortality. SII showed a significant correlation with Syntax II and TIMI risk scores (R2 = 0.28, P = 0.001 and R2 = 0.37, P < 0.001, respectively).Conclusion:SII might provide additional prognostic data alongside Syntax II and TIMI risk scores in patients undergoing pPCI

Comparison of SYNTAX score II efficacy with SYNTAX score and TIMI risk score for predicting in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction

WOS: 000439342900001PubMed ID: 29541904SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion. The patients were divided into three groups according to increased SS-II value: low (n:562; SS-II = 34.4). In-hospital and long term mortality rate from all causes (0 vs. 0.5 vs. 10.6% and 1.8 vs. 3.2 vs. 18.1% respectively, p <= 0.001) were significantly increased with SS-II tertiles and SS-II was found to be independent predictor of in-hospital and long term mortality (HR: 1.076 95% CI 1.060-1.092, p <0.001) and (HR: 1.070 95% CI 1.050-1.090, p <0.0001). The predictive power of SS-II, SS, and TRS were compared by ROC curve and decision curve analysis. SS-II surpassed SS and TRS in long-term and in-hospital mortality prediction. SS-II is a powerful tool to predict in-hospital and long-term mortality from all causes in STEMI patients treated with p-PCI

Düzenli ve Yoğun Egzersiz Yaptırılan Ratlarda Takviye Olarak Tüketilen Dallı Zincirli Amino Asitlerin Miyokard ve Koroner Damarlar Üzerine Etkisi

This study was conducted to investigate the effects of branched chain amino acids (BCAAs) consumption on myocardium and coronary arteries, in rats subjected to regular and intense exercise. Eight-week old, 30 male rats were randomly divided into experimental-and control-groups. For a total of 8 weeks, every other day, both groups were subjected to a ladder-climbing exercise on a 1.5 m long ladder, with 2.5 cm steps interval, at 70 degrees angle. The experimental group, besides the standard diet, was additionally fed BCAA-supplement at a dose of 1.5 mg/g/day. This study showed that, the experimental group had more frequent atherosclerotic lesions compared to the control group (61.5% vs. 21.4%; p=0.034). Although creatine kinase was similar between the groups, creatine kinase - myocardial band isoform (CK-MB) was significantly higher in the experimental group compared both to control and baseline levels. This is the first study that examines the effects of consuming BCAA supplements on myocardium and coronary arteries in rats subjected to prolonged exercise. We demonstrated that continuous and long-term consumption of BCAA supplement in endurance exercises was associated with coronary atherosclerotic process and myocardial injury

Impact of Supplementation with Branched Chain Amino Acids on Myocardium and Coronary in Regularly and Intensively Exercising Rats

This study was conducted to investigate the effects of branched chain amino acids (BCAAs) consumption on myocardium and coronary arteries, in rats subjected to regular and intense exercise. Eight-week old, 30 male rats were randomly divided into experimental-and control-groups. For a total of 8 weeks, every other day, both groups were subjected to a ladder-climbing exercise on a 1.5 m long ladder, with 2.5 cm steps interval, at 70 degrees angle. The experimental group, besides the standard diet, was additionally fed BCAA-supplement at a dose of 1.5 mg/g/day. This study showed that, the experimental group had more frequent atherosclerotic lesions compared to the control group (61.5% vs. 21.4%; p=0.034). Although creatine kinase was similar between the groups, creatine kinase - myocardial band isoform (CK-MB) was significantly higher in the experimental group compared both to control and baseline levels. This is the first study that examines the effects of consuming BCAA supplements on myocardium and coronary arteries in rats subjected to prolonged exercise. We demonstrated that continuous and long-term consumption of BCAA supplement in endurance exercises was associated with coronary atherosclerotic process and myocardial injury

Association between BNP levels and new-onset atrial fibrillation: A propensity score approach

WOS: 000444701600011PubMed ID: 28707026New-onset atrial fibrillation (NOAF), a common complication of acute ST-segment elevation myocardial infarction (STEMI), is associated with a poor prognosis. Several clinical and laboratory parameters are reported to be associated with NOAF in patients with STEMI. The aim of the present study was to evaluate the predictive value of plasma BaEurotype natriuretic peptide (BNP) levels for NOAF development and long-term prognosis in STEMI patients undergoing primary percutaneous coronary intervention (pPCI). We retrospectively enrolled 1,928 patients with STEMI who underwent pPCI. After applying exclusion criteria, 1,057 patients were retained in the final study population. Patients with NOAF were compared with patients without NOAF in the entire study population and in a matched group. Patients with NOAF had a significantly higher average plasma BNP level (161 pg/ml, range: 72.3-432) than patients without NOAF in the study population (70.7 pg/ml, range: 70-129; p <0.001) and in the matched group (104.6 pg/ml, range: 47.2-234.5; p = 0.014). Furthermore, the plasma BNP level was found to be an independent predictor of NOAF development (odds ratio [OR]: 1.003; 95% confidence interval [CI]: 1.000-1.005; p = 0.034) and mortality in the long-term follow-up (OR: 1.004; 95% CI: 1.002-1.006; p <0.001). The present study found that a high plasma BNP level was significantly associated with NOAF development in STEMI patients, and was an independent predictor of NOAF development and all-cause mortality during long-term follow-up, regardless of other NOAF risk factors

Pertuzumab, trastuzumab and taxane-based treatment for visceral organ metastatic, trastuzumab-naive breast cancer: Real-life practice outcomes

WOS: 000458407200014PubMed ID: 30377778PurposeIn this study, we aimed to describe the real-life practice outcomes of pertuzumab-trastuzumab-taxane (PTT) combination in visceral organ metastatic, trastuzumab-naive breast cancer (BC) patients.MethodsThis study was conducted by Turkish Oncology Group and included 317 patients' data from 36 centers.ResultsMedian age was 51 (22-82). Median PFS was 28.5months, while median OS was 40.3months. Patients with brain metastases (n: 13, 4.1%) had worse PFS (16.8m vs. 28.5m; p=0.002) and OS (26.7m vs. 40.3m; p=0.009). Patients older than 65years of age (n: 42, 13.2%) had significantly lower OS results (19.8m vs. 40.3m; p=0.01). Two hundred sixty-eight patients (86.7%) received docetaxel while 37 patients (11.7%) received paclitaxel. PFS and OS were similar between taxane groups. In eight patients (2.5%), 5-40% ejection fraction decrement from baseline was detected without any clinical sign of heart failure.ConclusionsOur RLP trial included only visceral metastatic, trastuzumab-naive BC patients including cases with brain involvement who received PTT combination in the first-line treatment. Regardless of negative prognostic characteristics, our results are in parallel with pivotal trial. Further strategies for brain metastasis should be developed to improve outcomes despite encouraging results with PTT treatment. Taxane selection can be personalized and endocrine maintenance may further improve outcomes after taxanes were discontinued. To our knowledge, this is the largest scale real-life clinical practice study of pertuzumab-trastuzumab-taxane therapy to date