The relationship of preinfarct angina and serum sphingosine 1 phosphate levels

Amaç: Sfingozin 1 Fosfat molekülünün iskemik ön koşullanmadan sorumlu bir molekül olabileceği birçok hayvan deneyinde ileri sürülmüştür. Günlük hayatta iskemik ön koşullanmanın en canlı örneği preenfarkt anginadır. Çalışmanın amacı preenfarkt angina ile serum S1P değerleri arasındaki ilişkinin değerlendirilmesidir. Yöntem: Mayıs 2011 ile Ocak 2012 arasında GÜTF Koroner Yoğun Bakımda takip edilen 86 NSTEMI ve STEMI hastası çalışmaya alındı. Hastaların hepsi preenfark angina açısından sorgulanarak, preenfarkt anginası olan ve olmayanlar şeklinde iki gruba ayrıldı. Hastaların hastaneye geliş ve hastaneden çıkış S1P değerleri, CKMB, troponin düzeyleri ölçüldü. Kollateral koroner dolaşımı olanlar inceleme dışına çıkarıldı. Bulgular: 40 hastanın preenfarkt anginası varken 46 hastanın preenfarkt anginası yoktu. Gruplar bazal karakteristikler ve demografik özellikler açısından benzer dağılmışlardı. Preenfarkt anginası olan hastalarda geliş S1P değeri 0,78 ʯM, çıkış S1P değeri 0,91 ʯM, troponin değeri ise 2,23 ng/ml idi. Preenfarkt anginası olmayanlarda bu değerler sırası ile 0,45/0,49 ʯM ve 4,37 ng/ml idi(sırası ile p=0,014-0,010-0,034). Preenfarkt anginası olan ve olmayanlar arasında CKMB düzeyi ve sol ventrikül EF arasında ise anlamlı bir ilişki yoktu. Sonuç: Preenfarkt anginası olan hastalarda serum S1P değeri preenfarkt anginası olmayanlara göre anlamlı şekilde yüksektir. Ayrıca preenfarkt anginası olan hastalarda miyokard nekrozunun göstergesi olan troponin düzeyleri preenfarkt anginası olmayanlara göre belirgin olarak düşüktür.Purpose: It has been suggested that sphingosine 1 phosphate may be responsible for ischemic preconditioning according to numerous animal studies. And in dialy life it seem like preinfarct angina is the most viable example of ischemic preconditioning. Our aim is to evaluate the relationship between preinfarct angina and serum S1P levels. Method: Between May 2011 and January 2012, 86 STEMI and NSTEMI patients enrolled the study who were followed in Gazi University Faculty of Medicine Coronary Care Unit. All the patients questioned for preinfarct angina and they divided into two groups of preinfarct angina positive and preinfarct angina negative. The serum levels of S1P at the admittance and at discharge are measured and maximum CKMB and troponin levels are recorded. Findings: 40 patients had preinfarct angina and 46 had no preinfarct angina. The groups were similar according to the bazal characteristics. The admittance serum level of S1p was 0,78 ʯM, discharge serum level S1P was 0,91 ʯM and maximum troponin level was 2,23 ng/ml in preinfarct angina positive group. The admittance serum level of S1p was 0,45 ʯM, discharge serum level S1P was 0,49 ʯM and maximum troponin level was 4,37 ng/ml in preinfarct angina negative group(p values espectively 0,014, 0,010, 0,034). There were no statistical significance for CKMB levels and left ventricular ejection fraction between the two groups. Conclusion: Patients with preinfarct angina have higher serum S1P levels than patients without preinfarct angina, significantly. In addition, troponin levels as an indicator of infarct size are significantly lower in patients with preinfarct angina

Zależność między stężeniem albuminy modyfikowanej niedokrwieniem a dobrze rozwiniętym krążeniem obocznym

Background: It is important to determine the grade of the coronary collateral circulation (CCC) in patients with stable coronary artery disease. Aim: In this study, we aimed to investigate the relationship between the ischaemia-modified albumin (IMA) level and good CCC. Methods: A total of 95 patients with coronary angiography and at least one epicardial coronary artery obstruction were included in the study. The Rentrop classification was used with CCC grading, where 0 and 1 were defined as poor collateral, and 2 and 3 were defined as good collateral. The IMA level of the patients was measured using an enzyme-linked immunosorbent assay (ELISA). The receiver–operating characteristic curve was used to show the sensitivity and specificity of IMA levels and the optimal cut-off value for predicting good CCC. Results: The multiple logistic regression analysis revealed that the IMA level in the good CCC group was higher (p &lt; 0.045). Conversely, the high-sensitivity C-reactive protein level was lower in the good CCC group (p &lt; 0.023). We found an IMA cut-off value (4.7 ng/mL) that indicated good CCC level, and this shows good CCC with 70.2% sensitivity and 60.3% specificity. Conclusions: The IMA level could serve as a simple and useful predictor of well-developed CCC.Wstęp: U chorych ze stabilną chorobą wieńcową (CAD) istotne jest ustalenie stopnia rozwoju wieńcowego krążenia obocznego (CCC). Cel: Badanie przeprowadzono w celu oceny zależności między stężeniem albuminy modyfikowanej niedokrwieniem (IMA) a dobrze rozwiniętym CCC. Metody: Do badania włączono 95 chorych z dostępnym wynikiem koronarografii, u których stwierdzono co najmniej jedno zwężenie nasierdziowej tętnicy wieńcowej. Do określenia stopnia CCC używano klasyfikacji Rentropa, w której oceny 0 i 1 oznaczały słabe krążenie oboczne, natomiast 2 i 3 — dobre krążenie oboczne. Stężenie IMA mierzono za pomocą metody immunoenzymatycznej (ELISA). Wyznaczono krzywe ROC w celu określenia czułości i swoistości oznaczania stężeń IMA oraz optymalnej wartości granicznej pozwalającej na predykcję dobrze rozwiniętego CCC. Wyniki: W analizie wielokrotnej regresji logistycznej wykazano, że stężenie IMA było wyższe w grupie z dobrym CCC (p < 0,045). Z kolei stężenie białka C-reaktywnego oznaczane metodą wysokoczułą było niższe u osób z dobrym CCC (p < 0,023). Autorzy określili wartość graniczną stężenia IMA (4,7 ng/ml), która wskazywała na obecność dobrze rozwiniętego CCC z czułością wynoszącą 70,2% i swoistością równą 60,3%. Wnioski: Stężenie IMA może służyć jako łatwy w zastosowaniu i użyteczny predyktor dobrze rozwiniętego CCC

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

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

Predictive value of supraventricular short runs for new-onset atrial fibrillation in patients with ischemic stroke

Background: The clinical importance of supraventricular run (SVR) is uncertain in the management of patients with previous cerebrovascular events. We aim to evaluate the role of SVRs in the development of future atrial fibrillation (AF) in patients diagnosed with ischemic stroke. Methods: We retrospectively evaluated patients who underwent 24-h Holter monitoring for the evaluation of possible AF after ischemic cerebrovascular events. The presence and duration of SVR were noted. Subsequent diagnosis of AF was searched in patients with sinus rhythm. Results: A total of 694 patients were included in the analysis. SVR was detected in 104 (14.9%) patients in the study group. Seventy-one (10.2%) patients were diagnosed with AF in the follow-up. SVRs were more prevalent among patients with AF (P < 0.001). The median atrial run duration was 5.96 (2.02–17.84) s in the AF absent group vs. 8.76 (3.78–17.62) s in the AF present group (P < 0.001). The best predictive cut-off duration of an atrial run was 8 s (sensitivity = 61.5% and specificity = 74.4%, Area Under Curve (AUC) = 0.708). Cox regression analysis showed that age (odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.00–1.060, P = 0.020), presence of short supraventricular run (OR: 2.53, 95% CI 1.40–4.57, P = 0.002), and left atrial diameter (OR: 1.13 95% CI: 1.07–1.19, P < 0.001) were the independent predictors of AF development in the follow-up. Conclusion: Age, left atrial diameter, and the presence of SVRs are associated with an increased risk of future AF after ischemic stroke. SVR duration may be an important parameter in risk stratification