Primer Perkütan Koroner Girişim Yapılan Hastalarda Akut Stent Trombozunu Öngörmek İçin R2CHA2DS2-VASc Skoru ile CHA2DS2-VASc Skorlarının Karşılaştırılması

Aim: Acute stent thrombosis (AST) is an important complication resulting fromsudden vascular occlusion after stent implantation, especially in patients with STsegment elevation myocardial infarction (STEMI). It occurs in about 1% of thepatients after primary percutaneous coronary intervention. The CHA2DS2-VAScscore is easily applied in daily practice and the components of this score are similarto common risk factors of the AST. Chronic renal disease has a hypercoagulablestate and this condition is associated with an increased risk of AST in STEMI. Sincethe CHA2DS2-VASc score is insufficient to assess the risk of AST in patients withrenal dysfunction, we aimed to investigate the prognostic significance of the modifiedscore, R2CHA2DS2-VASc score in patients with AST.Methods:This cross-sectional study retrospectively included 56 patients withASTand 1493 patients without AST after STEMI. The CHA2DS2-VASc and R2CHA2DS2-VASc scores were compared between the two groups.Results:The median CHA2DS2-VASc and R2CHA2DS2-VASc scores weresignificantly higher in the AST group (P <0.001, P <0.001, respectively). TheR2CHA2DS2-VASc score ?2 was used as a predictor of the AST with a sensitivity of65% and specificity of 89%.Conclusions: The R2CHA2DS2-VASc score is a simple, cheap, and easilyaccessible score that can predict AST.Amaç: Akut stent trombozu (AST), özellikle ST segment yükselmesi olan miyokard infarktüsü (STYMI) hastalarında stent yerleştirildikten sonra ani damar tıkanıklığı sonucu oluşan önemli bir komplikasyondur. Primer perkütan koroner girişim sonrası hastaların yaklaşık% 1'inde ortaya çıkar. CHA2DS2-VASc skoru günlük pratikte kolayca uygulanır ve bu skorun bileşenleri AST'nin risk faktörlerine benzer. Kronik böbrek hastalığında pıhtılaşmaya meyilli bir duruma yol açabilir ve bu durum STYMI' da artmış AST riski ile ilişkilidir. CHA2DS2-VASc skoru renal disfonksiyonlu hastalarda yetersiz olduğundan AST'li hastalarda modifiye skor olan R2CHA2DS2- VASc skorunun prognostik önemini araştırmayı amaçladık. Yöntem: STYMI sonrası 56 AST' li hasta ve AST'siz 1493 hasta retrospektif olarak bu kesitsel çalışmaya dahil edildi. CHA2DS2-VASc skoru ve R2CHA2DS2-VASc skoru iki grup arasında karşılaştırıldı. Bulgular: Medyan CHA2DS2-VASc skoru ve medyan R2CHA2DS2-VASc skoru AST grubunda anlamlı olarak daha yüksekti (P <0.001, P <0.001). R2CHA2DS2- VASc skoru ?2 iken %65 duyarlılık ve % 89 özgüllük ile AST' nin bir prediktörü olarak kullanılabilir. Sonuç: R2CHA2DS2-VASc skoru, AST' yi tahmin edebilen basit, ucuz ve kolay erişilebilir bir skorlamadır

Association Between Insulin Resistance Estimated by Triglyceride Glucose Index and In-Stent Restenosis in Non-Diabetic Patients

Objectives: The triglyceride glucose index (TGI) is associated with poor prognosis in cardiovascular disease. The usefulness of TGI to predict coronary in-stent restenosis (ISR) has not been determined. This study aimed to investigate the relationship between TGI and ISR in patients with stable coronary artery disease (CAD) undergoing angiography. Materials and Methods: This retrospective study analyzed the data of 224 non-diabetic patients with coronary drugeluting stents and undergoing angiography. The patients were divided into two groups based on the angiogram results: the non-ISR group (n=114) and the ISR group (n=100). TGI was compared between the two groups. The clinical characteristics and laboratory data were considered for univariate and multivariate analyses. Results: No significant differences in age, sex, hypertension, and smoking history were found between the ISR and nonISR groups. TGI was higher in the ISR group than in the non-ISR group (p=0.011). According to the multiple logistic regression analysis, Gensini score and SYNTAX score, TGI and white blood cell count were independent predictors of ISR. Conclusion: Patients with ISR were found to have higher TGI than those without ISR, suggesting that TGI might be a valuable predictor of ISR in patients with stable CAD

Tip 2 Diabetes Mellitus’ lu hastalarda serum ve ı?drar galektin-3 düzeyi ile mikroalbuminüri arasındaki ı?lişkinin deg?erlendirilmesi

Amaç: Bu çalıs?manın amacı Tip 2 diyabetes mellitusu olan hastalarda mikroalbuminürigelis?imi ile serum ve idrar galektin-3 düzeyleri arasındaki ilis?kiyi deg?erlendirmektir.Yöntem: Tip 2 diyabet tanısı olan mikroalbüminüri gelis?mis? 30 hasta ve tip 2 diyabettanısı olan normoalbüminürik 30 hasta çalıs?maya dahil edildi. Tüm hastalarda açlık kans?ekeri, hemoglobin A1c, kan üre nitrojeni, kreatinin, düs?ük dansiteli lipoproteinkolesterol, total kolesterol, tam idrar tetkiki, spot idrarda albümin, spot idrarda kreatinin,serum galektin-3 ve idrar galektin-3 çalıs?ıldı. Serum galektin-3, idrar galektin-3,hemoglobin A1c, düs?ük dansiteli lipoprotein kolesterol, total kolesterolmikroalbüminürik ve normoalbüminürik gruplar arasında kars?ılas?tırıldı. Bulgular:Çalıs?mamızda mikroalbüminürik grupta, normoalbüminürik gruba göre hem serumgalektin-3 düzeyi (20.1±14.9 ng/ml ve 4.8±5.6 ng/ml, p <0.001) hem de idrar galektin-3düzeyi (19.6±18.7 ng/ml ve 10.5±10.2 ng/ml, p = 0.027) yüksek tespit edildi.Mikroalbüminüri düzeyi ile serum ve idrar galektin-3 düzeyi arasında pozitif korelasyontespit edildi (r=0.614, p<0.01 ve r=0.268, p<0.05, sırasıyla). Serum galektin-3 düzeyinin,mikroalbüminüriyi öngörmede bag?ımsız bir etken oldug?u görüldü (Odds oranı:1.26,güven aralığı:1.07-1.46, p=0.004). Sonuç: Tip 2 diyabetes mellitusu olan hastalardamikroalbüminürisi olan hastalarda normoalbüminürisi olanlara göre hem serum hem deidrar galektin-3 düzeylerinde artıs? saptandı. Çalıs?mamızın bulguları diyabetiknefropatide galektin-3’ün bir biyobelirteç olarak kullanılabileceg?i görüs?ünüdesteklemis?tir

Apolipoprotein E and adiponectin levels in coronary artery disease patients with low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol discordance

Objectives: The aim of this study was to investigate whether serum apolipoprotein E (ApoE) and adiponectin were as sociated with discordance of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) levels in coronary artery disease (CAD) patients. Methods: A total of 243 patients with significant CAD were studied. The fasting levels of serum lipids, plasma ApoE, and adiponectin were measured. The median LDL-C and non-HDL-C values were determined to assess and analyze discordance. Discordance was defined as an LDL-C? the median and non-HDL-C< the median, or an LDL-C< the median and a non-HDL-C? the median. ApoE and adiponectin were compared between discordant and concordant groups. Results: Discordance between the LDL-C and the non-HDL-C was observed in 14% of the patients. Although the me dian adiponectin was lowest in the group with an LDL-C< median and a non-HDL-C? the median, and the median ApoE was lowest in the group with an LDL-C? median and a non-HDL-C< the median, no statistically significant differences in the ApoE and adiponectin were recorded between the groups (p=0.186 and p=0.161, respectively). Adiponectin was negatively correlated with triglyceride and remnant cholesterol (p<0.001 and p<0.001, respectively). Conclusion: While discordance between the LDL-C and the non-HDL-C in CAD patients (14%) was observed, the plas ma ApoE and adiponectin levels were not significantly different between the discordant and concordant groups