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Tumer C, Saler T, Aslan MZ, Koc AS, Koc M, Erel O, Neselioglu S, Gulumsek E, Avci BS, Avci A, Sumbul HE. Aumento da Espessura Médio-intimal Aórtica e sua Relação com Estresse Oxidativo Elevado em Pacientes com Talassemia Menor. Arq Bras Cardiol 2022; 119:426-435. [PMID: 35703665 PMCID: PMC9438530 DOI: 10.36660/abc.20210666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/26/2022] [Indexed: 11/23/2022] Open
Abstract
Fundamento A espessura médio-intimal (EMI) da artéria aorta abdominal (EMI-A) pode ser um marcador precoce de aterosclerose subclínica e um indicador objetivo de estresse oxidativo em pacientes com talassemia menor. Objetivo Avaliar se as EMIs da artéria aorta e da artéria carótida (EMI-C) se alteram com estresse oxidativo, e examinar a relação entre esses parâmetros em pacientes com talassemia menor. Métodos O estudo incluiu 80 pacientes diagnosticados com talassemia menor, e 50 indivíduos sadios com idade e sexo similares. Após procedimentos de rotina, as amostras de sangue foram coletadas dos grupos de estudo para a medida da homeostase tiol/dissulfeto e da albumina modificada pela isquemia (AMI). As medidas da EMI-C foram realizadas a partir de quatro regiões diferentes (artéria carótida externa direita e esquerda e artéria carótida interna direita e esquerda) por ultrassonografia, e a medida da EMI-A foi realizada por ultrassonografia abdominal. Um valor de p<0,05 foi definido como estatisticamente significativo. Resultados Nos pacientes com talassemia menor, os níveis de tiol nativo e tiol total, e a razão tiol nativo/tiol total foram mais baixos, e os valores de AMI, razão dissulfeto/tiol nativo, e razão dissulfeto/tiol total foram mais altos que no grupo controle. A EMI-A foi significativamente maior no grupo de pacientes com talassemia menor que nos controles (1,46±0,37 vs 1,23±0,22 e p<0,001). Quando os parâmetros associados com EMI-A na análise univariada foram avaliados por regressão linear multivariada, EMI-A apresentou uma relação positiva, e os níveis de tiol nativo e tiol total apresentaram uma forte relação negativa com AMI (p<0,01). Conclusão Nós demonstramos, pela primeira vez, um aumento no estresse oxidativo com a elevação da EMI-A, e valores inalterados da EMI-C em pacientes com talassemia menor.
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Cirakoglu OF, Karadeniz AG, Akyüz AR, Aydın C, Şahin S, Erkan H. Abdominal Aortic Intima-Media Thickness Predicts Coronary Artery Disease Severity in Patients With Stable Angina Pectoris: A Prospective Study. Angiology 2021; 72:754-761. [PMID: 33663258 DOI: 10.1177/0003319721998853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Accurately identifying coronary artery disease (CAD) is the key element in guiding the work-up of patients with suspected angina. Thickening of the arterial wall is a hallmark of atherosclerosis. Therefore, the main purpose of this study was to determine whether abdominal aortic intima-media thickness (AAIMT), which is the earliest zone of atherosclerotic manifestations, has a predictive value in CAD severity. A total of 255 consecutive patients who were referred for invasive coronary angiography due to suspected stable angina pectoris were prospectively included in the study. B-mode ultrasonography was used to determine AAIMT before coronary angiography. Coronary artery disease severity was assessed with the SYNTAX score (SS). A history of hypertension, age, dyslipidemia, and higher AAIMT (odds ratio: 2.570; 95%CI 1.831-3.608; P < .001) were independent predictors of intermediate or high SS. An AAIMT <1.3 mm had a negative predictive value of 98% for the presence of intermediate or high SS and 83% for obstructive CAD. In conclusion, AAIMT showed a significant and independent predictive value for intermediate or high SS. Therefore, AAIMT may be a noninvasive and useful tool for decision-making by cardiologists (eg, to use a more invasive approach).
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Affiliation(s)
- Omer Faruk Cirakoglu
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ayşe Gül Karadeniz
- Department of Radiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Ali Riza Akyüz
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Cihan Aydın
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Sinan Şahin
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
| | - Hakan Erkan
- Department of Cardiology, Trabzon Ahi Evren Training and Research Hospital, University of Health Science, Trabzon, Turkey
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Kucukosmanoglu M, İçen YK, Sumbul HE, Koca H, Koc M. Residual SYNTAX Score Is Associated With Contrast-Induced Nephropathy in Patients With Non-ST Segment Elevation Myocardial Infarction With Preserved LVEF. Angiology 2020; 71:799-803. [PMID: 32462903 DOI: 10.1177/0003319720928673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to investigate the relation between residual SYNTAX score (rSS) and contrast-induced nephropathy (CIN) development in patients with non-ST segment elevation myocardial infarction (NSTEMI) with normal or near-to-normal left ventricular ejection fraction (LVEF) who underwent percutaneous coronary intervention (PCI). A total of 306 patients who underwent PCI with NSTEMI were included in our study. SYNTAX scores were calculated for the periods before and after PCI. Patients were divided into 2 groups as developed CIN following PCI (CIN +) and patients did not (CIN -). Fifty-four (17.6%) of patients who were included in the study developed CIN. Age (P = .001) and rSS (P = .002) were significantly higher and LVEF was lower (P = .034) in the CIN (+) group. Age (P = .031, odds ratio [OR]: 1.031, 95% CI, 1.003-1.059) and rSS (P = .04, OR: 1.036, 95% CI, 1.002-1.071) were independent predictors for CIN. In receiver operating characteristic analyses, when the cutoff value of rSS was taken as 3.5, it determined CIN with 79% sensitivity and 65% specificity. Contrast-induced nephropathy may develop more frequently in patients with increased rSS value. The rSS may be useful to follow-up these patients for CIN development.
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Affiliation(s)
- Mehmet Kucukosmanoglu
- Department of Cardiology, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey
| | - Yahya Kemal İçen
- Department of Cardiology, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey
| | - Hilmi Erdem Sumbul
- Department of Internal Medicine, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey
| | - Hasan Koca
- Department of Cardiology, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey
| | - Mevlut Koc
- Department of Cardiology, University of Health Sciences-Adana Health Practice and Research Center, Adana, Turkey
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Bulut A, Avci B. Carotid intima-media thickness values are significantly higher in patients with prediabetes compared to normal glucose metabolism. Medicine (Baltimore) 2019; 98:e17805. [PMID: 31689862 PMCID: PMC6946422 DOI: 10.1097/md.0000000000017805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/13/2019] [Accepted: 10/07/2019] [Indexed: 12/22/2022] Open
Abstract
Carotid intima-media thickness (C-IMT) increases in patients with adult type-2 diabetes mellitus (DM) and is used for early detection of macrovascular complications. We aimed to investigate the change of C-IMT in prediabetes and type-2 DM patients compared to subjects with normal glucose metabolism (NGM).A total of 180 individuals (60 subjects with NGM, 60 patients with prediabetes and 60 patients with type-2 DM) were included in this study. Routine laboratory and micro-macrovascular involvement were investigated. Urine albumin-creatinine ratio (ACR) was measured for urinary albuminuria detection. In addition to routine laboratory examination, right-left common and internal C-IMT (CC-IMT and IC-IMT) were measured.Systolic and diastolic blood pressure values were found to be higher in prediabetes and type-2 DM groups than NGM group. The prevalence of nephropathy and presence of CAD were higher in type-2 DM groups than prediabetes. Glucose, glycated hemoglobin (HbA1c), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, blood urea nitrogen, creatinine, high sensitive C reactive protein (hs-CRP) levels and urinary ACR were significantly higher in patients within prediabetes and type-2 DM groups than NGM group. Glucose, HbA1c and hs-CRP levels were found to be higher in type-2 DM groups than prediabetes. Estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol level was found to be lower in patients within prediabetes and type-2 DM groups than NGM group. Right-left-mean CC-IMT and IC-IMT values were found to be higher in prediabetes and type-2 DM groups than NGM group. Left IC-IMT, left CC-IMT, and mean IC-IMT values were found to be higher in type-2 DM patients compared to prediabetes. LDL and HDL cholesterols, HbA1c, and hs-CRP levels were independently associated with IC-IMT and CC-IMT.C-IMT values were significantly higher in impaired glucose metabolism compared to NGM. C-IMT measurement may be used as part of routine screening of macrovascular complication in patients with prediabetes and newly diagnosed type-2 DM.
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Affiliation(s)
| | - Begum Avci
- Department of Internal Medicine, University of Health Sciences - Adana Health Practice and Research Center, Adana, Turkey
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Gavrili S. Prognostic Implications and Future Associations of Coronary Intimal Thickening in Fetuses/Neonates. Angiology 2019; 71:291. [PMID: 31370676 DOI: 10.1177/0003319719866317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Stavroula Gavrili
- Neonatal Intensive Care Unit, "Alexandra" University and State Maternity Hospital, Athens, Greece
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Aortic intima-media thickness can be used to determine target organ damage in adult patients with coronary artery disease risk factors. ACTA ACUST UNITED AC 2019; 4:e183-e190. [PMID: 31538122 PMCID: PMC6747883 DOI: 10.5114/amsad.2019.87002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/01/2019] [Indexed: 11/17/2022]
Abstract
Introduction We aimed to evaluate the relationship between abdominal aortic intima-media thickness (AA-IMT) and thoracic aortic intima-media thickness (TA-IMT) values and to investigate their relationship with common carotid intima-media thickness (CC-IMT) in patients with coronary artery disease (CAD) risk factors. Material and methods This study included 100 patients who underwent transesophageal echocardiography (TEE) examination for different reasons with at least one CAD risk factor. CC-IMT, AA-IMT, and TA-IMT values were measured. Patients with CC-IMT > 0.9 mm were considered as having increased CC-IMT. Patients were divided into two groups with and without increased CC-IMT. Results Mean AA-IMT and TA-IMT values of all patients were 1.55 ±0.27 mm and 1.39 ±0.25 mm, respectively. In patients with increased CC-IMT, blood pressure, hyperlipidemia and hypertension frequency, creatinine, total and low-density lipoprotein (LDL) cholesterol, triglyceride, high-sensitivity C-reactive protein (hs-CRP) and uric acid levels, AA-IMT and TA-IMT values were higher, while the high-density lipoprotein (HDL) cholesterol level was lower than the normal CC-IMT group. AA-IMT, systolic blood pressure (SBP), total and HDL cholesterol levels independently determined the patients with CC-IMT > 0.9 mm. Each 0.1 mm increase in AA-IMT value was found to increase the probability of having CC-IMT > 0.9 mm. In addition, linear regression analysis showed that CC-IMT was closely and independently related to AA-IMT (p < 0.001 and β = 0.599). When the cut-off value for AA-IMT was taken as 1.5 mm, it determined the patients with CC-IMT > 0.9 mm with 86% sensitivity and 82% specificity. Conclusions The AA-IMT value was found to be higher than TA-IMT in the same patient. Also it was found that AA-IMT was more closely related to CC-IMT.
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Demirtaş AO, Bulut A. Increased renal cortical stiffness is associated with coronary artery disease severity in patients with acute coronary syndrome. Medicine (Baltimore) 2019; 98:e16464. [PMID: 31305479 PMCID: PMC6641659 DOI: 10.1097/md.0000000000016464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Atherosclerosis is the primary etiological factor associated with acute coronary syndrome (ACS). Kidneys have a highly arterial vascular structure and are therefore commonly affected by atherosclerosis, including those affecting the coronary arteries. Renal shear wave elastography (SWE) is an ultrasonographic method, which provides reliable information regarding the condition of the renal parenchyma.We investigated the relationship between SWE findings and the severity of coronary atherosclerosis.We calculated the following: the renal cortical stiffness (rCS) evaluated via SWE, the renal resistive index, the renal pulsatility index, the acceleration time, and the mean Syntax score (SS). Patients with a mean SS <12 were categorized into a low-risk (LR) and those with a mean SS ≥12 were categorized into the high-risk (HR) group.Our study included 132 patients-76 in the LR and 56 in the HR group. Creatinine, high-sensitivity C-reactive protein (hs-CRP), and rCS were significantly higher, but the glomerular filtration rate (GFR) was significantly lower in the HR group. The Hs-CRP (odds ratio [OR] 1.220), GFR (OR 0.967), and rCS (OR 1.316) were observed to be independent predictors for the HR group. The cutoff value of rCS using receiver-operating characteristic curve analysis was 4.43 for the prediction of HR patients and showed 60.7% sensitivity and 57.9% specificity (area under the curve 0.642).SWE which shows renal parenchymal injury and atherosclerosis in renal vessels may give an idea about the severity of coronary atherosclerosis.
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Icen YK, Koc AS, Sumbul HE. Reply to the Letter to the Editor Entitled "Association of SYNTAX Score With Abdominal Aortic Intima-Media Thickness in Non-ST Elevation Myocardial Infarction". Angiology 2018; 70:571. [PMID: 30394794 DOI: 10.1177/0003319718811653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yahya Kemal Icen
- 1 Department of Cardiology, Adana Health Practices and Research Center, Health Sciences University, Adana, Turkey
| | - Ayse Selcan Koc
- 2 Department of Radiology, Adana Health Practice and Research Center, Health Sciences University, Adana, Turkey
| | - Hilmi Erdem Sumbul
- 3 Department of Internal Medicine, Adana Health Practice and Research Center, Health Sciences University, Adana, Turkey
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İçen YK, Koc AS, Sumbul HE. Reply to the Letter to the Editor Entitled ''Coronary Artery Disease Severity Is Associated With Abdominal Aortic Intima-Media Thickness in Patients With Non-ST-Segment Elevation Myocardial Infarction''. Angiology 2018; 70:568. [PMID: 30354183 DOI: 10.1177/0003319718808391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Yahya Kemal İçen
- 1 Health Sciences University Adana Health Practices and Research Center Cardiology Department, Adana, Turkey
| | - Ayse Selcan Koc
- 2 Health Sciences University Adana Health Practice and Research Center Radiology Department, Adana, Turkey
| | - Hilmi Erdem Sumbul
- 3 Health Sciences University Adana Health Practice and Research Center Internal Medicine Department, Adana, Turkey
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Kaya A, Keskin M, Tatlisu MA, Cinar T. Association of SYNTAX Score With Abdominal Aortic Intima–Media Thickness in Non-ST Elevation Myocardial Infarction. Angiology 2018; 70:569-570. [DOI: 10.1177/0003319718804418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Adnan Kaya
- Department of Cardiology, Duzce University School of Medicine, Konuralp, Duzce, Turkey
| | - Muhammed Keskin
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Adem Tatlisu
- Department of Cardiology, Medeniyet University School of Medicine, Istanbul, Turkey
| | - Tufan Cinar
- Department of Cardiology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Yayla Ç, Yayla KG, Ertem AG, Unal S, Karanfil M, Demirtas K. SYNTAX Score and Severity of Atherosclerosis. Angiology 2018; 70:567. [PMID: 30231618 DOI: 10.1177/0003319718802051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Çağri Yayla
- 1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- 2 Diskapi Yildirim Beyazit Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Goktug Ertem
- 1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sefa Unal
- 1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mustafa Karanfil
- 1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Koray Demirtas
- 1 Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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