Prognostic value of mean platelet volume in patients undergoing elective percutaneous coronary intervention

Objective: We sought to determine the role of mean platelet volume (MPV) for predicting long-term outcomes of elective percutaneous coronary intervention (PCI). Methods: On the basis of retrospective cohort study, we collected characteristics of 680 patients undergoing elective PCI from October 2005 to August 2010. The patients who had preoperative MPV were assessed for developing major adverse cardiac events (MACE) during 1-year follow- up. They were categorized into two groups including MPV <9.6 fL (n=89) and MPV �9.6 fL (n=92). Data were analyzed using t-test, chi-square test, Pearson correlation, receiver operating characteristic (ROC) curve and logistic regression. Results: One-hundred eighty one patients (26.6) met inclusion criteria. The MACE was observed in 29 patients (16); and its rate in low- and high-MPV groups was 11.2 and 20.7, respectively (p=0.084). MPV was significantly higher in the patients with left ventricular ejection fraction (LVEF) <40 compared with that of �40 (p<0.001). There were a significant and negative correlation between MPV and platelet count (r=-0.305, p<0.001), and significant and positive correlations between MPV and platelet distribution width (PDW) and platelet large cell ratio (P-LCR) (r=0.615, p<0.001 and r=0.913, p<0.001; respectively). The best MPV cut-off point was 9.25 fL; the sensitivity and specificity were 79 and 38, respectively. Elevated MPV was the best predictor of MACE at 1-year follow-up (OR=11.359, 95 CI 2.481-51.994, p=0.002). Conclusion: The results indicate that preoperative MPV is an independent predictor of the MACE at 1-year follow-up in the patients undergoing elective PCI. Moreover, it may be useful for risk stratification in such cases. © 2015 by Turkish Society of Cardiology

Clinical and radiological characteristics of pediatric patients with COVID-19: focus on imaging findings

Purpose: CT imaging has been a detrimental tool in the diagnosis of COVID-19, but it has not been studied thoroughly in pediatric patients and its role in diagnosing COVID-19. Methods: 27 pediatric patients with COVID-19 pneumonia were included. CT examination and molecular assay tests were performed from all participants. A standard checklist was utilized to extract information, and two radiologists separately reviewed the CT images. Results: The mean age of patients was 4.7 ± 4.16 (mean ± SD) years. Seventeen patients were female, and ten were male. The most common imaging finding was ground-glass opacities followed by consolidations. Seven patients had a single area of involvement, five patients had multiple areas of involvement, and four patients had diffuse involvement. The sensitivity of CT imaging in diagnosing infections was 66.67. Also, some uncommon imaging findings were seen, such as a tree-in-bud and lung collapse. Conclusion: CT imaging shows less involvement in pediatric compared to adult patients, due to pediatric patients having a milder form of the disease. CT imaging also has a lower sensitivity in detecting abnormal lungs compared to adult patients. The most common imaging findings are ground-glass opacities and consolidations, but other non-common imaging findings also exist. © 2020, Japan Radiological Society

The association of serum vitamin D concentration and ventricular dysfunction among patients with acute coronary syndrome

Kamal Khademvatani,1 Mirhosein Seyed Mohammadzad,1 Zahra Yekta,2 Omid Hadizadeh1 1Department of Cardiology, Shohada Hospital, 2Department of Community and Preventive Medicine, Urmia University of Medical Sciences, Urmia, Iran Objective: To determine if vitamin D deficiency was associated with higher odds of left ventricular dysfunction among patients with acute coronary syndrome (ACS) and, if so, to determine whether this association was mediated by increased inflammation as measured by C-reactive protein (CRP) and white blood cell count (WBC). Methods: This was a cross-sectional study of 170 participants with ACS. Multiple logistic regression was used to examine the association between the outcome of ventricular performance and serum vitamin D concentrations. We also determined whether CRP and WBC meet standard criteria as the mediators between left ventricular ejection fraction and vitamin&nbsp;D deficiency. Results: Participants with vitamin D deficiency were more likely to have ventricular dysfunction (OR: 2.12, 95% CI: 1.2&ndash;5.23). WBC counts did not meet one of the criteria for mediation. However, the WBC was an effect modifier such that the association of vitamin&nbsp;D deficiency and ventricular dysfunction was only present among participants with WBC more than 11,000. Conclusion: This study found that vitamin D deficiency was associated with higher odds of ventricular dysfunction. Further longitudinal and experimental studies are necessary to confirm this finding and to determine if there is a role for vitamin D supplementation therapy in preventing ventricular dysfunction in select patient populations. Keywords: ventricular dysfunction, vitamin D deficiency, acute coronary syndrome, ejection fractio

The relationship between vitamin D status and idiopathic lower-extremity deep vein thrombosis

Kamal Khademvatani,1 Mir Hossein Seyyed-Mohammadzad,1 Mohammad Akbari,1 Yousef Rezaei,2 Ramin Eskandari,3 Alireza Rostamzadeh1 1Department of Cardiology, Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran; 2Seyyed-al-Shohada Heart Center, Urmia University of Medical Sciences, Urmia, Iran; 3Department of Cardiology, Firoozgar Hospital, Iran University of Medial Sciences, Tehran, Iran Background: Vitamin D has been shown to have an anticoagulant effect. A decrease in 25-hydroxyvitamin D [25(OH)D] concentration has also been associated with an increased risk of venous thromboembolism. Hence, we sought to determine the relationship between 25(OH)D levels and idiopathic lower-extremity deep vein thrombosis (DVT). Methods: In a case control study, a total of 82 participants with idiopathic lower-extremity DVT were enrolled along with 85 sex- and age-matched healthy participants as controls. The plasma 25(OH)D levels were measured in all the studied samples. Results: The participants&#39; mean age was 47.1&plusmn;12.3 years. Baseline characteristics were not significantly different between the groups. The concentration of 25(OH)D was significantly lower in the DVT group compared to that of the control group (17.9&plusmn;10.3 versus 23.1&plusmn;12.5 ng/mL, P=0.004). The prevalence of participants with deficient 25(OH)D levels was significantly higher in the both DVT and control groups than those with sufficient 25(OH)D levels (68.3% versus 13.4%, and 49.4% versus 28.2%, respectively, P=0.027). In a multivariate analysis, 25(OH)D levels and sex were found to be the only independent predictors of DVT (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02&ndash;1.08, P=0.001 and OR 0.51, 95% CI 0.26&ndash;1.00, P=0.049, respectively). Conclusion: Low levels of 25(OH)D are associated with idiopathic lower-extremity DVT. Further investigation is needed to establish determinants and probable causative role of 25(OH)D. Keywords: vitamin D, venous thromboembolism, idiopathic deep vein thrombosi

Acute pulmonary embolism caused by enlarged uterine leiomyoma: A rare presentation

Objective: Management of emergency care. Background: Deep venous thrombosis (DVT) and subsequent pulmonary embolism (PE) caused by pelvic vein compression are rare and life-threatening complications of leiomyoma of the uterus. Case Report: We report a 42-year-old virgin woman with a history of leiomyoma who presented to the emergency department with complaints of dyspnea and pleuritic chest pain with transient spotting. On physical examination, she had a non-tender abdomen with a 20-week size uterus. Imaging investigations revealed an acute DVT in her left leg and a huge uterine-derived mass compressing the common iliac veins. Transesophageal echocardiography (TEE) demonstrated an echogenic mass in her right pulmonary artery consistent with thrombosis. The patient was completely cured using thrombolytic therapy and myomectomy, and was well at 1 year after thrombolysis. Conclusions: PE caused by pelvic vein compression is a rare complication of leiomyoma, which should be considered. Thrombolytic therapy associated with myomectomy can be implemented for treating such cases, and TEE can be used for diagnosing suspected high-risk PE. © Am J Case Rep, 2014