Could plasma asymmetric dimethylarginine level be a novel predictor beyond the classic predictors of stent restenosis?

Objective: The aim of this study was to investigate the factors associated with coronary stent restenosis and if there is an association between plasma asymmetric dimethylarginine (ADMA) levels and stent restenosis. Methods: Ninety-one patients, who had a history of coronary bare metal stent implantation due to any cause in the last one year period, were admitted to this observational cross-sectional study. Coronary angiography was performed to all patients and quantitative angiography was used to determine the presence of stent restenosis. Laboratory parameters and angiographic features that contribute to stent restenosis were evaluated. Plasma ADMA levels were measured by using high performance liquid chromatography. Logistic regression analysis was used to determine the independent factors of stent restenosis. Results: Angiographic restenosis was found in 35 patients (38.5%). Stent diameter (p=0.038) and left ventricular ejection fraction (p=0.023) were lower and stent implantation history due to acute coronary syndrome (p=0.029), plasma ADMA level (5.0 +/- 1.8x10(-4) mmol/L vs. 3.9 +/- 1.0x10(-4) mmol/L, p=0.001), C-reactive protein concentration (p=0.016), white blood cell count (p=0.044) and stent length (p=0.005) were higher in patients with restenosis. Plasma ADMA level (beta=0.536; OR: 1.710; CI: 1.022-2.861; p=0.041), C-reactive protein concentration (beta=0.062; OR: 1.064; CI: 1.003-1.129; p=0.041), stent diameter (beta=-3.047; OR: 0.048; CI: 0.007-0.313; p=0.002) and length (beta=0.165; OR: 1.179; CI: 1.036-1.343; p=0.013) were found to be the independent predictors of stent restenosis in logistic regression analysis. Conclusion: We conclude that plasma ADMA levels may be used as a novel marker for stent restenosis beyond the classic stent restenosis markers

Relationship between renal volume and atherosclerosis in nondiabetic hypertensive patients with normal glomerular filtration rate

Background: The association between cystatin C (CysC) and atherosclerosis has been shown in numerous studies in hypertensive patients and in various patient groups with high cardiovascular risk. The study examining the association between renal volume and atherosclerosis is very limited. This study aimed to investigate whether there is an association between the presence of atherosclerosis with CysC and renal volume in hypertensive patients. Methods: 133 hypertensive patients and 80 healthy volunteers were evaluated. CysC level was studied in the blood sample taken from all participants. Carotid intima media thickness (CIMT) and renal volume were measured with ultrasound always by the same radiologist. Laboratory findings, CysC, CIMT, and renal volume measurements of the groups were compared statistically. Results: There was no significant difference in mean renal volume values between hypertension and control groups. There was no significant correlation between renal volume with albuminuria and proteinuria. CIMT was significantly higher in hypertension group than in control group (p = .003). There was a significant correlation between renal volume and CIMT, which is an indicator of subclinical atherosclerosis (r = 0.213, p = .001). Renal volume was found to be an independent predictor of CIMT when corrected with variables such as age, BMI, serum LDL-cholesterol level, creatinine, CysC, and albumin-to-creatinine ratio. Conclusion: Ultrasonographic renal volume measurement, which is easy to perform and does not take a long time, can be a useful method for predicting the presence of atherosclerosis in hypertensive patients with GFR >60 ml/min

Türkiye’de nonvalvüler atriyum fibrilasyonlu hastalarda vitamin K antagonisti ve yeni oral antikoagülan kullanımı uygulamalarını değerlendirmek için epidemiyolojik çalışma - AFTER*-2 çalışması dizaynı

Amaç: Atriyum fibrilasyonu (AF) önlenebilir iskemik inmenin en sık nedenlerinden biri olup artmış kardiyovasküler morbidite ve mortaliteyle ilişkilidir. Ülkemizde yeni oral antikoagülan kullanım sıklığı, vitamin K antagonisti kullanan hastalarda Uluslararası Düzeltme Oranı’nın (INR) etkin düzeyde kalma oranı ve AF tedavi yönetimi ile ilgili büyük bir çalışma mevcut değildir. Bu çok merkezli çalışmada amacımız nonvalvüler AF hastalarında epidemiyolojik verilerin analizi, takibi ve değerlendirilmesidir. Çalışma planı: Kırk iki merkezden elektrokardiyografisinde en az bir defa AF atağı tespit edilmiş ardışık 4100 erişkin hasta çalışmaya alınacaktır. Romatizmal mitral darlığı ve protez kapak hastalığı olan AF hastaları çalışmaya alınmayacaktır. Hastalar birinci yılın sonunda majör kardiyak sonlanım noktaları (ölüm, geçici iskemik atak, inme, sistemik tromboembolizm, majör kanama ve hastane yatışı) açısından değerlendirilecektir. Bulgular: İlk sonuçlar Haziran 2015 yılında bekleniyor. Majör kardiyak sonlanım noktaları açısından veriler Ocak 2016’da elde edilecektir. Sonuç: AFTER-2 çalışması ile ülkemizdeki non-valvüler AF hastalarının oral antikoagülan tedavi kullanım sıklığı ve çeşidi, varfarin alan hastalarda etkin INR düzeylerinde kalma oranı ve benimsenen tedavi yönetimi belirlenecektir. Ayrıca, ülkemizde AF’li hastalarda majör istenmeyen olay sıklığı ve bu olayların bağımsız belirteçleri de ortaya çıkarılacaktır (AFTER-2 Study ClinicalTrials.gov number, NCT02354456). Anahtar Kelimeler: Antikoagülan ilaç; atriyum fibrilasyonu/epidemiyoloji; ilaç kullanımı; elektrokardiyografi; uluslararası düzeltme oranı; varfarin.Objectives: Atrial fibrillation (AF) is one of the most common causes opreventable ischemic stroke and is related to increased cardiovasculamorbidity and mortality. There is a lack of data in Turkey on the use onew oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modalityIn this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. Study design: Four thousand one hundred consecutive adulpatients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, strokesystemic thromboembolism, major bleeding and hospitalization). Results: First results are expected in June 2015. Data about majocardiovascular end-points will be available in January 2016. Conclusion: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 studyIn addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.)

An epidemiological study to evaluate the use of vitamin K antagonists and new oral anticoagulants among non-valvular atrial fibrillation patients in Turkey- AFTER-2 study design

Objectives: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients

SARS-CoV-2 and Stroke Characteristics: A Report from the Multinational COVID-19 Stroke Study Group

cited By 0BACKGROUND AND PURPOSE: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. METHODS: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2-infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries' health expenditure on outcomes. RESULTS: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were CONCLUSIONS: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.Peer reviewe