The effect of ticagrelor and clopidogrel on angiographic parameters according to diabetic status in patients with ST elevation myocardial infarction

Aim. We aimed to compare post-interventional angiographic outcomes of ticagrelor versus clopidogrel according to glycosylated hemoglobin (HbA1c) levels in patients with ST-elevation myocardial infarction.Material and methods. The study included a total of 532 patients, with 334 receiving ticagrelor (62,8%) and 198 clopidogrel (37,2%). Diabetic status of the patients was assessed with HbA1c. TIMI flow grade and TIMI frame count were calculated and compared between two groups.Results. TIMI flow grade 3 was higher and TFC was lower after percutaneous coronary intervention of the infarct-related artery in patients treated with ticagrelor compared to clopidogrel (89,2% vs. 73,7%; p< 0,001, 20 vs. 24; p< 0,001). There was a positive correlation between the increases in HbA1c and TFC levels in the whole group (r=0,225; p=0,004). In subgroup analysis, higher HbA1c levels did not affect TFC in patients using ticagrelor (r=-0,060; p=0,326 for patients with noreflow, r=-0,133; p=0,321 for patients with TIMI-3 flow). While level of HbA1c did not affect TFC in patients with TIMI-3 flow, the presence of post-procedural no-reflow caused worsening of TFC in patients using clopidogrel as HbA1c levels increased (r=0,374; p=0,005).Conclusion. Ticagrelor was found to be better in terms of angiographic parameters regardless of diabetes

QT araliği ile antropometrik ve otonomik faktörler arasindaki ilişkiler

Objectives: We investigated the effect of anthropometric and autonomous factors on the QT interval in both sexes. Study design: The study included 237 individuals (114 males, 123 females) who were asymptomatic and had no abnormal laboratory or physical findings. The mean age was 47 years (range 20 to 79 years) for men, and 39 years (range 20 to 71 years) for women. All the participants were subjected to a careful history taking, physical examination, routine biochemical examinations, electrocardiographic recording, 24-hour Holter monitoring, and when necessary, color Doppler echocardiography and treadmill exercise test. Serum estrogen levels, serum free and total testosterone levels were also measured in males. Results: The minimum QT interval was significantly lower in males (p=0.043). The mean QT (p=0.022) and QTc (p<0.001) intervals in females, and QT dispersion in males (p=0.025) were significantly higher. In male participants, the maximum QT interval (p=0.049) and QT dispersion (p=0.043) were significantly different between age groups of 20-44 years and 45-69 years. Parasympathetic activity played a determinant role in the mean and maximum QT intervals. Anthropometric features were not correlated with the QT interval in females, whereas in males, waist-hip ratio was positively correlated with the mean QT and minimum QTc intervals (r=0.188, p=0.049 and r=0.236, p=0.013, respectively). Serum sex hormone levels were significantly effective on the QT interval in males. Conclusion: Concerning anthropometric and autonomic factors, the QT interval is significantly influenced by gender-related features

Arteryel kan basincindaki ortostatik değişikliklerin otonomik tonus ile ilişkisi: Cinsiyetle ilgili farkliliklar

Objectives: The differences in orthostatic blood pressure result from dynamic changes in the sympathovagal balance. We studied sex-related variations in autonomic tone regulation. Study design: The study included 237 individuals (114 males, 123 females) who were asymptomatic and had no abnormal laboratory or physical findings. The mean age was 47 years (range 20 to 79 years) for men, and 39 years (range 20 to 71 years) for women. All the participants were subjected to a careful history taking, physical examination, routine biochemical examinations, electrocardiographic recording, 24-hour Holter monitoring, and orthostatic tests. Results: In heart rate variability analysis, parasympathetic tone parameters, in particular the high frequency (HF) component was significantly high in females, whereas sympathetic tone parameters, in particular the low frequency (LF)/HF ratio was significantly high in males (p<0.001). The normalized LF component in males showed positive correlations with systolic (r=0.308, p=0.001) and diastolic (r=0.301, p=0.002) blood pressures during the rapid stand test; this correlation was not seen in females. Blood pressures obtained in the second minute of the rapid supine test following the stand test were in positive correlation with the LF/HF ratio in both sexes. In males, variations in systolic and diastolic blood pressures during rest, stand, and supine positions were primarily influenced by the LF component and HF component, respectively. In females, variations in systolic blood pressure during the three positions were not correlated with autonomic tone components, but variations in diastolic blood pressure were primarily affected by the LF/HF ratio. Conclusion: Autonomic system works through varying priorities in both sexes and this causes sex-related differences in orthostatic tolerance

On haftalik gebede Staphylococcus aureus'un etken olduğu koryoamniyonit

Infections are the most important causes of chorioamnionitis. Causative bacteria are usually genital mycobacteria, anaerobes, enteric Gram-negative bacilli and group B streptococci. Staphylococcus aureus can also rarely be the causative agent. In this study a case of chorioamnionitis caused by Staphylococcus aureus was reported. A ten weeks pregnant was admitted to our hospital with fever, physical examination revealed lower quadrant tenderness. Therapeutic abortion was planned for the patient whose fetal heart sounds were not heard by ultrasound. The meropenem treatment was administered to the patient with the pre-diagnosis of chorioamnionitis after obtainined cultures. Then Staphylococcus aureus was growed in the blood cultures and in the cultures of amniotic membranes obtained during operation. The histopathologic examination of the amniotic membranes was reported as acute funisit and acute chorioamnionitis. The therapy was continued with cefazoline and completed in 14 days. As a result Staphylococcus aureus should also be considered as a causative agent in chorioamnionitis cases and the empirical therapy should be administered accordingly. © 2018, Refik Saydam National Public Health Agency (RSNPHA)

Madde bağimliliği olan hastada görülen miyokardiyal infarktüs

Amongst the illicit drugs, heroin, cocaine and cannabis have been studied and documented well to cause sudden death by different mechanisms. Cocaine-related myocardial infarction is well-known phenomenon. Heroin-induced myocardial infarction has been seldom reported. In this article we presented a case of drug abuse such as heroin, cocaine, bonsai and arrest after heroin injection with literature. A 28-year-old young male was brought to the emergency with sudden cardiac arrest after eroin injection intravenously. Myocardial infarction with left ventricular failure was diagnosed. Coronary angiography showed 100% occlusion of left ascending coronary artery. On day 7, cardiac arrest occured after recurrent attacks of ventricular fibrillation and resuscitation was unsuccessful

Madde bağimliliği ve miyokardiyal infarktüs

Amongst the illicit drugs, heroin, cocaine and cannabis have been studied and documented well to cause sudden death by different mechanisms. Cocaine-related myocardial infarction is a well-known phenomenon. Heroin-induced myocardial infarction has seldom beenreported. In this article we presented a case of drug abuse such as heroin, cocaine, bonsai and arrest after heroin injection with literature. A 28-year-old young male was brought to the emergency with sudden cardiac arrest after eroin injection intravenously. Myocardial infarction with left ventricular failure was diagnosed. Coronary angiography showed 100% occlusion of left ascending coronary artery. On day 7, cardiac arrest was occured after recurrent attacks of ventricular fibrillation and ressussitation was unsuccessful

Serum orexin-a level and the severity of coronary artery disease: Original article

In this study, we aimed to investigate the correlations of serum Orexin-A level (SOAL) and the severity of coronary artery disease (CAD). A total of 80 participants (mean age: 55.7±12.7 years) were enrolled into the study. SOAL, electrocardiography and transthoracic echocardiography and 24 Hour Holter monitoring (24HHM) and coronary angiography were performed in all participants. Autonomic functions were assessed using the data of Heart Rate Variability measurements. Patients were categorized into three groups according to their Gensini scores as: Group 1: The patients with normal coronary angiogram, Group 2: The patients with mild CAD (Gensini <20) and Group 3: The patients with severe CAD (Gensini ?20). A total of 28 patients were Group 1 (mean age 51.8±12.0 years), 25 patients were Group 2 (mean age 57.7±11.6 years) and 27 patients were Group 3 (mean age 57.6±13.6 years). There were statistically significant differences in SOAL (p=0.004) among the groups. We found that SOAL had statistically significant associations with Gensini score and LF/HF (Sympathetic activity) values. (F= 15.299; p=0.004 and F= 15.470; p=0.004, respectively). Serum Orexin-A levels are positively correlated with severity of CAD and sympathetic activity

The effects of statin therapy on pulse wave velocity measurements

Several studies have shown that positive effects of statins on pulse wave velocity parameters. However, there is few study about the comparison of the effectivity of statins on pulse wave velocity parameters. In the present study, we aimed to show the difference about the effects of long term atorvastatin and rosuvastatin therapy on aortic stiffness in patients with hyperlipidemia. A total of 104 hyperlipidemic patients were enrolled into the study. There were 50 patients in Group 1 (The patients treated with Atorvastatin 20 mg/day) (23 male and 27 female, mean age: 55.8 ± 10.3 years;, mean age: 52.7 ± 9.4 years) and 54 patients in Group 2 (The patients treated with Rosuvastatin 10 mg/day) (23 male and 31 female, mean age: 52.7 ± 9.4 years). All patients followed up to 12 months about their lipid profile and pulse wave analysis data. After 12 months, we found that rosuvastatin was of higher positive effects on arterial stiffness and reflection index parameters (Student T test, p=0.049 and =0.041, respectively ) We considered that, rosuvastatin was of greater ameliorative effect on vascular stiffness than that of atorvastatin in the patients with hyperlipidemia