Badanie służące ocenie występowania choroby wieńcowej w młodym wieku

Introduction. An increasing number of younger patients are being hospitalized with acute coronary syndromes. Earlier risk assessment is essential to prevent or delay coronary artery disease (CAD). This study aimed to assess the rate, risk factor profile, presentation, management and prognosis in young patients with CAD and compared with the same age group without CAD. Material and methods. In this retrospective study, 4325 patients who had undergone coronary angiography from 2011 to 2014 were identified. A total of 627 patients were ≤ 45 years age; 412 of them had CAD, and 215 had normal coronary arteries (control group). Results. The mean age of the patients was 41.7 ± 4.1 years in the CAD group and 41.5 ± 4.5 years in the control group. The prevalences of dyslipidemia, smoking, family history of CAD, hypertension, diabetes, and overweight were higher in the CAD than in the control group. However, the obesity rate was not significantly different between the two groups. Patients with ACS often presented with ST elevation myocardial infarction (STEMI) (49.3%), and single-vessel involvement (55.3%) predominated. Percutaneous coronary intervention (PCI) was the main myocardial reperfusion therapy (68.4%). Conclusıons. Among the young patients studied, CAD had a higher incidence in males. Smoking was the most important modifiable risk factor. Also, patients showed high prevalences of dyslipidemia, overweight, diabetes, and family history of CAD. This study re-emphasizes the relationship between traditional cardiovascular risks and CAD in young.Wstęp. Coraz więcej młodych osób jest hospitalizowanych z powodu ostrych zespołów wieńcowych (ACS). Wczesna ocena ryzyka ma podstawowe znaczenie w zapobieganiu chorobie wieńcowej (CAD) lub opóźnieniu jej wystąpienia. Badanie przeprowadzono w celu oceny częstości występowania CAD, jej czynników ryzyka, objawów, leczenia oraz rokowania u młodych pacjentów z CAD i porównanie tych danych z odpowiednimi danymi dotyczącymi osób niechorujących na CAD. Materiał i metody. Na potrzeby tego retrospektywnego badaniu zidentyfikowano 4325 chorych poddanych koronarografii w latach 2011–2014. W grupie badanych było 627 chorych w wieku nie więcej niż 45 lat; u 412 osób z tej grupy stwierdzono CAD, a u 215 obraz tętnic wieńcowych był prawidłowy (grupa kontrolna). Wyniki. Średni wiek chorych wynosił 41,7 ± 4,1 roku w grupie CAD i 41,5 ± 4,5 roku w grupie kontrolnej. W grupie CAD stwierdzono częstsze występowanie dyslipidemii, palenia tytoniu, dodatniego wywiadu rodzinnego odnośnie do CAD, nadciśnienia tętniczego, cukrzycy i otyłości niż w grupie kontrolnej. Jednak różnica w zakresie częstości występowania otyłości nie była istotna statystycznie. U chorych z ACS często stwierdzano zawał serca z uniesieniem odcinka ST (49,3%), a dominującym typem zmian w koronarografii była choroba jednonaczyniowa (55,3%). Najczęściej stosowanym leczeniem reperfuzyjnym (68,4%) była przezskórna interwencja wieńcowa. Wnioski. W badanej grupie młodych pacjentów stwierdzono większą zapadalność na CAD wśród mężczyzn. Najważniejszym poddającym się modyfikacji czynnikiem ryzyka było palenie tytoniu. U dużej części chorych stwierdzono również dyslipidemię, otyłość, cukrzycę i występowanie CAD w rodzinie. Badanie ponownie zwróciło uwagę na zależność między tradycyjnymi czynnikami ryzyka sercowo-naczyniowego a występowaniem CAD w młodym wieku

Neutrophil to lymphocyte ratio might help prediction of acute myocardial infarction in patients with elevated serum creatinine

Conclusions: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending

Usefulness of the platelet-to-lymphocyte ratio in predicting the severity of carotid artery stenosis in patients undergoing carotid angiography

Carotid artery stenosis (CAS) is primarily caused by atherosclerotic plaque. Progressive inflammation may contribute to the rupture of an atherosclerotic plaque. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study, we aimed to investigate the use of the PLR to determine the severity of CAS. One hundred forty patients were chosen from among patients who underwent carotid angiography in our institution. Symptomatic patients with stenosis >50% in the carotid arteries and asymptomatic patients with stenosis >80% were diagnosed via carotid angiography as having critical stenosis. Patients were classified into two groups. Group 1 included patients who had critical CAS, whereas Group 2 included patients with noncritical CAS, as determined by carotid angiography. Correlations between the PLR and the severity of CAS were analyzed. There were no significant differences in sex and age between the two groups. The PLR was 162.5 +/- 84.7 in the noncritical CAS group patients and 94.9 +/- 60.3 in the critical CAS group patients (p < 0.0001). The PLR value of 117.1 had 89% sensitivity and 68% specificity for CAS [95% confidence interval, 0.043-0.159; area under the curve, 0.101 +/- 0.03)]. In this study, we have shown that PLR values may be associated with critical stenosis in at least one of the carotid arteries. Furthermore, PLR values may be used to predict critical stenosis in the carotid arteries. Copyright (C) 2016, Kaohsiung Medical University. Published by Elsevier Taiwan LLC

Echocardiographic Evaluation of Biventricular Function in Patients with Euthyroid Hashimoto's Thyroiditis

Objective: The aim of this study was to evaluate the left (LV) and right (RV) ventricular function in euthyroid Hashimoto's thyroiditis (eHT) patients. Subjects and Methods: Forty-five patients diagnosed with eHT and 45 age-and gendermatched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities (E, A, E', A'), isovolumic relaxation (IVRT) and contraction (IVCT) times, ejection time (ET), deceleration time (DT), Tei index, pulmonary acceleration time (PAcT) and tricuspid annular plane systolic excursion (TAPSE) of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signedrank test. Results: Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index (0.6 +/- 0.2 vs. 0.4 +/- 0.1, p < 0.001), higher DT (p < 0.001) and IVRT (p < 0.001) values, and higher E/E' ratios (p = 0.04). In contrast, the peak E wave velocity (p = 0.02), E/A ratio (p = 0.01) and ET (p = 0.02) were significantly lower in the eHT group than amongst the controls. The RV, Tei index (0.40 +/- 0.11 vs. 0.28 +/- 0.07, p < 0.001), TAPSE (2.0 +/- 0.3 vs. 2.2 +/- 0.2 mm, p < 0.001), PAcT (124.3 +/- 22.6 vs. 149.4 +/- 18.3 ms, p < 0.001), A' (p = 0.007) and IVCT (p = 0.001) were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio (p = 0.01), E' (p = 0.03) and E'/A' ratio (p = 0.001) were significantly lower in the eHT patients than the control group. Conclusions: This study demonstrated that both RV and LV functions were impaired in patients with eHT. (C) 2015 S. Karger AG, Base