Association between inflammation and cigarette smoking in cardiac remodeling after acute myocardial infarction

Objective: In this study, we aimed to investigate the relationship between smoking and adverse cardiac remodeling after ST-elevation MI (STEMI), and the association between smoking and inflammatory markers, including cytokine levels. Methods: Forty-three patients admitted to the emergency department between June 2015 and June 2020 who were diagnosed with STEMI for the first time and underwent successful primary percutaneous coronary intervention were included in the study. Inflammatory markers (interferon (IFN)-α, -γ, -β, interleukin (IL)-6R-α, and soluble tumor necrosis factor receptor (sTNFR)-1,-2) were measured on the first day and two weeks post-MI. Left ventricular volume and functions were evaluated using cardiac magnetic resonance imaging at two weeks and six months post-STEMI. Adverse remodeling (AR) was defined as an increase in left ventricular (LV) end-diastolic volume >12%. Results: The AR ratio (65% vs. 30.4%; p= 0.024) and the levels of each inflammatory marker on the first-day post-STEMI were higher in the smokers' group than in the non-smokers' group. Smoking (OR= 4.46; p= 0.032) and IFN-β (OR= 1.07; p=0.023) levels on the first-day post-MI were independent predictors of AR. Also, smoking (β(SE)= 8.96(2.74); p=0.002), increased neutrophil levels (β±SE= 1.72(0.66); p= 0.013) and increased LDL levels (β(SE) = 0.07(0.03); p=0.031) were independent predictors of elevated IFN-β levels. Conclusion: Baseline inflammatory marker levels and incidence of AR post-STEMI were higher in smokers. Smoking can contribute to the development of AR by increasing the severity of inflammation at the onset of acute STEMI

Treatment of Iatrogenic Aortocoronary Arteriovenous Fistula with Coronary Covered Stent

An 83-year-old man, who underwent coronary artery bypass operation of left internal mammary artery (LIMA) to left anterior descending (LAD) artery, with sequential saphenous vein to the first and second obtuse marginal (OM) branches of circumflex artery 5 years ago and coronary artery stent implantation to right coronary artery 2 months ago, was admitted to the hospital with syncope and chest pain. Aortosaphenous graft selective angiography revealed that first sequential side to side ligation was inadvertently anastomosed to left posterolateral coronary vein with resultant flow into the coronary sinus and distal end to side sequential anastomosis to OM 2 coronary artery which was filling very weakly. In order to close this iatrogenic coronary arteriovenous fistula and to supply saphenous vein flow to OM artery, we decided to implant a graft covered stent into the saphenous vein at the same session

A Practical Method for No-Reflow Treatment

No-reflow is an undesirable result of percutaneous coronary interventions. Vasoactive drug administration at the distal part of the coronary artery is suggested as a therapeutic option for no-reflow treatment. Here, we represent two cases of successful no-reflow management with previously used monorail balloon at the same procedure as a hand-made distal infusion catheter

Association between parathyroid hormone levels and the extensiveness of coronary artery disease

Objective: Previous studies have suggested that there is a relationship between coronary artery disease (CAD) and parathyroid hormone (PTH) levels. Here, we aimed to evaluate the association between PTH levels and severity of CAD. Methods: Patients were divided into two groups based on their serum PTH values. Patients with PTH levels = 72 pg/mL were accepted as Group 1 (n=568) and >72 pg/mL as Group 2 (n=87). Gensini score system and > 50\% stenosis in any coronary artery with conventional coronary angiography were used to determine the extensiveness of CAD. This study was designed as a prospective and cross-sectional study. Results: Baseline characteristics except for age, gender, and blood pressure were similar between groups. Mean serum PTH levels of the entire cohort was 43.4 +/- 29.5 pg/mL. Median Gensini score was 19.5 in Group 1 and 14.5 in Group 2 (p=0.75). On the other hand, PTH levels were weakly correlated with Gensini score (Spearman's Rho=0.11, p=0.003). Additionally, we did not observe a statistically significant difference between PTH levels and the number of stenotic vessels (p=0.14). This study was designed as a prospective and cross-sectional study. Conclusion: There is no association between serum PTH levels and extensiveness of CAD