Use of neutrophil-lymphocyte ratio for risk stratification and relationship with time in therapeutic range in patients with nonvalvular atrial fibrillation: A pilot study

ConclusionsTo our knowledge, this is the first study showing correlation of NLR with both CHA(2)DS(2)-VASc and HAS-BLED risk scores. NLR might represent a useful marker to identify patients with high risks of stroke and bleeding and may have predictive value in identifying patients within the therapeutic INR range

Atherosclerosis in geriatric patients known to be healthy

Background: The aim of the present study is to determine the presence of atherosclerosis in geriatric patients who are known to be healthy and examine sociodemographic and laboratory parameters affecting the presence of atherosclerosis.Method: 90 healthy volunteers including 66(73.3%) non-geriatric ones and 24(26.7%) geriatric ones were included in the study. It was analyzed whether there was a correlation between the two groups in terms of the parameters of gender, age average, alcohol consumption, smoking, carotid intima-media thickness (CA-IMT), and pulse wave velocity (PWV). Sociodemographic and laboratory parameters of the volunteers with and without atherosclerosis in the geriatric group were examined. Results: Among geriatric volunteers (Group 1), 13(54.2%) were male; whereas, among non-geriatric volunteers (Group 2), 41(62.1%) were male. CA-IMT was determined to be higher in Group 1 (averagely 0.80±0.12 mm) than Group 2 (averagely 0.62±0.14 mm) (p:<0.001). PWV was significantly higher in Group 1 (averagely 10.32±1.44 m/s) than Group 2 (6.26±1.09 m/s) (p:<0.001). After PWV or CA-IMT examination, atherosclerosis findings were determined in 12 healthy geriatric volunteers (50%) in Group 1.Conclusion: It should be remembered that even though atherosclerosis can be frequently observed in geriatric individuals who are known to be healthy, it may also go unnoticed. Determination of atherosclerosis with noninvasive methods will be helpful in preventing complications that might be caused by atherosclerosis.

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

RELATIONSHIP BETWEEN CAROTID ARTERY DOPPLER FLOW VELOCITY AND EXTENT OF CORONARY ARTERY DISEASE

Conclusion: To Patients with carotid artery disease have a high incidence of concomitant coronary artery disease, which is not different between the patients treated conservatively and stenting. In addition, the extension of coronary artery disease (not the presence) were associated with these two Doppler parameters

Concurrent acute interstitial pneumonia and pulmonary embolism during treatment with peginterferon alpha-2a and ribavirin in a patient with hepatitis C

The case presented is the first patient with concurrent acute interstitial pneumonia and pulmonary embolism associated with combined treatment of peginterferon and ribavirin for hepatitis C

Association Between Nonalcoholic Fatty Liver Disease and Coronary Artery Disease Complexity in Patients With Acute Coronary Syndrome: A Pilot Study

Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in patients with acute coronary syndrome (ACS). We assessed the association between NAFLD and SYNTAX Score (SS) in patients with ACS. Eighty consecutive patients with ACS were enrolled. Patients were evaluated using ultrasound to detect NAFLD and hepatosteatosis stage. The prevalence of NAFLD was 81.2%; median SS was 15. The SS was significantly higher in patients with NAFLD (18 +/- 8 vs. 11 +/- 5, P = .001). Univariate analysis showed that the stage of NAFLD correlated with SS (r = .6, P < .001). In multivariate binary logistic analysis, increased age (odds ratio [OR], 1.05; 95% confidence interval [CI],1.00-1.10) and presence of NAFLD (OR, 13.20; 95% CI, 2.52-69.15) were independent factors associated with supramedian SS. In conclusion, among patients with ACS, those with NAFLD have more complex CAD as assessed by SS

COMPLETE PERCUTANEOUS REVASCULARIZATION OF A SINGLE CORONARY OSTIUM IN A 84 YEAR-OLD WOMAN

Coronary arteries originating from a single coronary ostium is a rare condition. The incidence is 0.03% of patient undergoing diagnostic coronary angiography. Approximately 20 possible variations of single coronary artery have been described. Of these, single coronary artery arising from the right sinus of valsalva are extremely rare. Some of the patients are clinically silent, except for cases in which a coronary artery passes between the pulmonary artery and aorta, which can present with sudden death expecially in the athletes. Yet, most of the patient can present with recurrent ischemia or heart failure at younger age. Treatment is still controversial and no guidelines for treatment of this condition exist. We report the case of an octogenarean patient with acute inferior myocardial infarction who was managed by primary percutaneous coronary intervention (PCI) to the single coronary ostium

Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary angioplasty with stenting, and 26 were treated with thrombolytic agents. Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event. The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction. The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008). In conclusion, this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence, and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction. Asian Journal of Andrology (2012) 14, 784-787; doi:10.1038/aja.2012.41; published online 16 July 201