Are you Sani Namik Murat?

Claim your profile

Publications (43)80.73 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In-stent restenosis (ISR) is a common clinical problem in patients with coronary artery disease treated with percutaneous coronary intervention. Inflammatory process plays a pivotal role in the development of ISR. Both lymphocytes and monocytes are associated with inflammatory status. Recently, it has been shown that the lymphocyte-to-monocyte ratio (LMR) is a novel inflammatory marker. We aimed to investigate the association of serum LMR levels and ISR in patients undergoing bare-metal stent (BMS) implantation. The study included 273 patients (aged 61 ± 11 years, 66.5% men) with a history of BMS implantation and a further control coronary angiography due to stable angina pectoris. Patients were divided into 2 groups: patients with and without ISR. The LMR levels were significantly lower in patients with ISR than in those without ISR (2.50 ± 0.95 vs 3.87 ± 1.51, respectively, P < .001). On multivariate logistic regression analysis, the LMR was independently associated with ISR (odds ratio [OR]: 0.310, 95% confidence interval: 0.166-0.579, P < .001) together with high-sensitivity C-reactive protein (OR: 1.244, P = .008), reason for stent implantation (OR: 6.566, P = .003), stent diameter (OR: 0.015, P < .001), and stent length (OR: 1.137, P = .007). In conclusion, LMR levels are inversely related to ISR in patients treated with BMS implantation.
    No preview · Article · Jan 2016 · Clinical and Applied Thrombosis/Hemostasis
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: High Syntax score (SXscore) is associated with more serious disease and worse prognosis in patients with acute coronary syndrome (ACS). Plasma fibrinogen levels are associated with poor cardiovascular outcomes. Aim: We sought to investigate the relation of admission fibrinogen levels with intermediate-high SXscore in patients with ACS. Methods: A total of 752 patients (61.6±12.8 years, 67.3% men) with ACS who underwent urgent coronary angiography (CA) were enrolled. Laboratory data including fibrinogen and high sensitivity C-reactive protein were obtained before CA. SXscore of all patients were calculated from baseline CA. The patients were divided into two groups as low SXscore (≤22) and intermediate-high SXscore (≥23). Results: Admission fibrinogen levels were significantly higher in the SXscore ≥23 group when compared with the SXscore ≤22 group (median 492 mg/dL, interquartile range 428-581 mg/dL vs median 370 mg/dL, interquartile range 309-428 mg/dL, respectively; P<0.001). In multivariate analysis, the independent predictors of intermediate-high SXscore were fibrinogen (OR: 1.008, 95% CI: 1.005-1.010, P<0.001), left ventricular ejection fraction (OR: 0.935, P<0.001), and age (OR: 1.029, P=0.041). A level of fibrinogen >417 mg/dL had an 80.0% sensitivity and 71.3% specificity in predicting intermediate-high SXscore. Conclusions: Increased fibrinogen levels are independently associated with the intermediate-high SXscore in patients with ACS.
    No preview · Article · Sep 2015 · Kardiologia polska
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recently, it has been shown that the lymphocyte-to-monocyte ratio (LMR) is a novel inflammatory marker. A decreased LMR is associated significantly with a high risk for vascular endpoints in patients with peripheral arterial disease. We aimed to investigate whether LMR on admission is associated with no-reflow after a primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). A total of 857 patients (mean age 58.9±13.1 years, 75.6% men), who were admitted to our hospital for STEMI and undergoing primary PCI within 12 h of onset of symptoms, were recruited. LMR was calculated by dividing the lymphocyte count by the monocyte count. The patients were divided into two groups according to the postprocedural thrombolysis in myocardial infarction (TIMI) flows: no-reflow and normal-reflow. No-reflow was defined as a final TIMI flow of 2 or less or final TIMI flow of 3 with a myocardial blush grade of less than 2. Admission LMR levels were significantly lower in patients with no-reflow than in patients with normal-reflow (1.85±1.01 vs. 3.64±1.74, P<0.001). A receiver-operating characteristic analysis indicated that an LMR value of less than 2.292 and had a 76.3% sensitivity and a 72.5% specificity in predicting no-reflow. Multivariate analysis showed that LMR less than 2.292 [odds ratio (OR) 2.657, P=0.030], Killip class at least 2 at admission (OR 3.442, P=0.039), baseline infarct artery patency (OR 0.260, P=0.004), neutrophil count (OR 1.213, P=0.002), and total stent length (OR 1.059, P=0.001) were independent factors for predicting no-reflow. Our results suggested that LMR could be a simple and useful marker to predict high risk of patients for no-reflow in patients with STEMI who underwent primary PCI.
    No preview · Article · Sep 2015 · Coronary artery disease
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiac syndrome X (CSX) is a condition characterized by exercise-induced chest pain that occurs considering a normal coronary angiogram. We aimed to investigate the total serum antioxidant capacity (TAC) and biventricular global functions using echocardiography in patients with CSX. The study population included 55 patients with typical anginal symptoms and a positive exercise stress test, or ischemia in myocardial perfusion scintigraphy and normal coronary arteries detected angiographically, and 49 healthy volunteers with atypical chest pain and a negative stress test. TAC was assessed from blood samples. Transthoracic echocardiography was performed for the entire study population. The Tei index was calculated using the formula IVCT+IVRT/ET. TAC was found to be significantly lower in the CSX group compared with the control group (0.70±0.37 vs. 1.5±0.30, respectively, P<0.001). The Tei index was significantly higher in patients with CSX than the control group (0.60±0.18 vs. 0.42±0.12, respectively, P<0.001).There was a significant and inverse relationship between TAC and the Tei index (r=-0.41, P<0.001). When we divided the study population according to the normal range of TAC into the decreased TAC group (<1.30 mmol/l), the normal TAC group (1.30-1.77 mmol/l), and the increased TAC group (>1.77 mmol/l), it was found that the Tei index was higher in the decreased TAC group compared with the other groups (0.66±0.18 vs. 0.49±0.10 and 0.46±0.13 mmol/l, P<0.001, respectively). Our study suggested that TAC was significantly decreased in CSX patients and decreased antioxidant levels were related to impaired Tei index in echocardiography in patients with microvascular angina.
    No preview · Article · Aug 2015 · Coronary artery disease
  • [Show abstract] [Hide abstract]
    ABSTRACT: In-stent restenosis (ISR) remains a significant clinical problem in patients with coronary artery disease treated with percutaneous coronary intervention. Decreased serum albumin (SA) level is related to an increased risk of cardiovascular events. The aim of the present study was to assess whether SA levels at admission are an independent predictor of ISR in patients undergoing bare-metal stent (BMS) implantation. A total of 341 patients (aged 61 ± 11, 65.4% men) with a history of BMS implantation and a further control coronary angiography due to stable angina pectoris (SAP) were included. The study population was classified into 2 groups: patients with and without ISR. The ISR was observed in 140 (41.1%) patients. We found significantly lower SA levels in patients who developed ISR than in those who did not (3.69 ± 0.41 vs 4.07 ± 0.35 mg/dL, P < .001). Multivariate analysis revealed that SA level (odds ratio 0.109, 95% confidence interval 0.017-0.700, P = .020), stent diameter, reason for stent implantation, and body mass index were independent risk factors for the development of ISR. The SA level at admission is inversely associated with ISR in patients with SAP. © The Author(s) 2015.
    No preview · Article · Aug 2015 · Angiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: High SYNTAX score is a predictor of adverse cardiovascular events, including mortality, in acute coronary syndromes (ACSs). Decreased serum albumin (SA) concentration is associated with an increased risk of cardiovascular events. We aimed to investigate whether SA levels at admission are associated with high SYNTAX score and in-hospital mortality in patients with ACS. The study included 1303 patients with ACS who underwent coronary angiography (CA). The patients were divided into 2 groups as high SYNTAX score (≥33) and lower SYNTAX score (≤32). Baseline SA levels were significantly lower in patients with high SYNTAX score than with lower SYNTAX score (3.46 ± 0.42 mg/dL vs 3.97±0.37 mg/dL, respectively; P < .001). On multivariate logistic regression, SA (<3.65 mg/dL) was an independent predictor of high SYNTAX score (odds ratio 4.329, 95% confidence interval 2.028-8.264; P < .001) together with admission glucose, estimated glomerular filtration rate, and left ventricular ejection fraction. In Cox regression analyses, systolic blood pressure, high SYNTAX score, and SA (<3.65 mg/dL) were found as independent predictors of in-hospital all-cause mortality. In conclusion, SA concentration on admission is inversely associated with high SYNTAX score and in-hospital mortality in ACS. © The Author(s) 2015.
    No preview · Article · Mar 2015 · Angiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Contrast-induced acute kidney injury (CI-AKI) is a major issue after percutaneous coronary intervention (PCI), especially in the setting of acute coronary syndrome (ACS). Contrast-induced acute kidney injury is associated with increased mortality and morbidity. Inflammation plays an important role in the pathophysiology of CI-AKI. Procalcitonin (PCT) is introduced as a new marker of inflammation. We sought to examine whether admission PCT levels predict the development of CI-AKI. Patients (n = 814) were divided into 2 groups, namely, CI-AKI (-) and CI-AKI (+). An increase in serum creatinine of ≥0.5 mg/dL from baseline within 48 to 72 hours of contrast exposure was defined as CI-AKI. Contrast-induced acute kidney injury occurred in 96 (11.8%) patients. The PCT levels were significantly higher in patients with CI-AKI than in those without, 0.11 (0.056-0.495) vs 0.04 (0.02-0.078) µg/L; P < .001. After multivariable analysis, PCT remained a significant independent predictor of CI-AKI (odds ratio 2.544; 95% CI [1.207-5.347]; P = .014) as well as age, women, white blood cell, hemoglobin, glomerular filtration rate, creatine kinase myocarial band, and SYNTAX score. In conclusion, serum PCT levels are independently associated with a risk of CI-AKI in patients with ACS who underwent urgent PCI. © The Author(s) 2015.
    No preview · Article · Feb 2015 · Angiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Acute ST-segment elevation myocardial infarction patients presenting persistent no-flow after wire insertion have a lower survival rate despite successful mechanical intervention. The neutrophil-to-lymphocyte ratio has been associated with increased mortality and worse clinical outcomes in ST-segment elevation myocardial infarction. We hypothesized that an elevated neutrophil-to-lymphocyte ratio would also be associated with a persistent Thrombolysis In Myocardial Infarction flow grade of 0 after wire insertion in patients undergoing primary percutaneous coronary intervention. A total of 644 patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention within 12 hours of symptom onset were included in our study. Blood samples were drawn immediately upon hospital admission. The patients were divided into 3 groups according to their Thrombolysis In Myocardial Infarction flow grade: Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion, Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. The neutrophil-to-lymphocyte ratio was significantly higher in the group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion compared with the group with Thrombolysis In Myocardial Infarction flow grade 1-3 after wire insertion and the group with Thrombolysis In Myocardial Infarction flow grade 1-3 at baseline. The group with Thrombolysis In Myocardial Infarction flow grade 0 after wire insertion also had a significantly higher in-hospital mortality rate. Persistent coronary no-flow after wire insertion was independently associated with the neutrophil-to-lymphocyte ratio. An increased neutrophil-to-lymphocyte ratio on admission is significantly associated with persistent coronary no-flow after wire insertion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
    Full-text · Article · Feb 2015 · Clinics (São Paulo, Brazil)
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in acute coronary syndrome (ACS). Mean platelet volume (MPV) and serum uric acid (SUA) are associated with cardiovascular events in ACS. We investigated the relationship between the presence of non-IRA-CTO with MPV and SUA levels in patients with ACS. Patients (n = 1024) who underwent urgent coronary angiography for ACS were included in this study. Blood samples were drawn on admission. Patients were categorized into 2 groups: non-IRA-CTO (-) and non-IRA-CTO (+). The MPV and SUA levels on admission were significantly higher in the non-IRA-CTO (+) group than in the non-IRA-CTO (-) group (P < .001). At multivariate analysis, MPV (odds ratio [OR]: 4.705, P < .001) and SUA (OR: 2.535, P < .001) were independent predictors of non-IRA-CTO together with age, hemoglobin, ejection fraction, and non-ST-segment elevation ACS. The MPV and SUA levels were significant and independent predictors for the presence of non-IRA-CTO in patients with ACS.
    Full-text · Article · Jan 2015 · Angiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: . RED CELL DISTRIBUTION WIDTH PREDICTS CONTRAST-INDUCED NEPHROPATHY IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION FOR ACUTE CORONARY SYNDROME. Angiology. 2015 May;66(5):433-40.
    Full-text · Article · Jan 2015 · Angiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The Syntax score (SXscore) is an anatomic scoring system based on the coronary angiography (CA), which not only quantifies lesion severity and complexity, but also predicts poor cardiovascular outcomes including mortality in patients with acute coronary sydromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. We sought to investigate the association of PLR with severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS undergoing urgent CA. Methods: A total of 1016 patients with ACS undergoing urgent CA were included into the study between August 2012 and March 2014. Admission PLR values were calculated before CA. The SXscore was determined from baseline CA. The patients were divided into two groups as low SXscore (≤22) and intermediate-high SXscore (≥23). Results: The PLR was significantly higher in patient with intermediate-high SXscore compared with low SXscore (P<0.001). In-hospital mortality was significantly higher in high PLR and intermediate-high SXscore groups. In multivariate analysis, the independent predictors of intermediate-high SXscore were PLR (OR:1.018, 95% CI:1.013-1.023, P < 0.001) together with left ventricular ejection fraction (OR:0.935, 95% CI:0.910-0.960, P<0.001), and age (OR: 1.029, 95% CI:1.029-1.054, P=0.02). An PLR ≥116 had a 71% sensitivity and 66% specificity in predicting intermediate-high SXscore. Conclusion: The PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SXscore in patients with ACS underwent urgent CA
    Full-text · Conference Paper · Oct 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: We investigated the relationship between red cell distribution width (RDW) and contrast- induced nephropathy (CIN) in patients (aged 61±12, 69% men) with acute coronary syndrome (ACS). Patients and Methods: Consecutive patients diagnosed with ACS (n=662) who underwent percutaneous coronary intervention (PCI) were included in the study. Patients were divided into 2 groups: CIN and no-CIN. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or ≥25% above baseline within 72 h after PCI. Results: CIN occurred in 81 patients (12.2%). RDW, creatinine, and high sensitivity C-reactive protein levels were significantly higher in the CIN group than no-CIN group. Multivariate regression analysis revealed that baseline RDW level (OR 1.379, 95% CI 1.084 to 1.753, P=0.009), age (P=0.025), creatinine (P=0.004), and LVEF (P=0.011) were independent risk factors for the development of CIN. Conclusions: In conclusion, increased RDW levels are independently associated with a greater risk of CIN in patients undergoing PCI for ACS
    No preview · Conference Paper · Oct 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: We investigated the relationship between red cell distribution width (RDW) and contrastinduced nephropathy (CIN) in patients (aged 61±12, 69% men) with acute coronary syndrome (ACS). Patients and Methods: Consecutive patients diagnosed with ACS (n=662) who underwent percutaneous coronary intervention (PCI) were included in the study. Patients were divided into 2 groups: CIN and no-CIN. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or ≥25% above baseline within 72 h after PCI. Results: CIN occurred in 81 patients (12.2%). RDW, creatinine, and high sensitivity C-reactive protein levels were significantly higher in the CIN group than no-CIN group. Multivariate regression analysis revealed that baseline RDW level (OR 1.379, 95% CI 1.084 to 1.753, P=0.009), age (P=0.025), creatinine (P=0.004), and LVEF (P=0.011) were independent risk factors for the development of CIN. Conclusions: In conclusion, increased RDW levels are independently associated with a greater risk of CIN in patients undergoing PCI for ACS.
    No preview · Conference Paper · Oct 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: We investigated the relationship between red cell distribution width (RDW) and contrast- induced nephropathy (CIN) in patients (aged 61±12, 69% men) with acute coronary syndrome (ACS). Patients and Methods: Consecutive patients diagnosed with ACS (n=662) who underwent percutaneous coronary intervention (PCI) were included in the study. Patients were divided into 2 groups: CIN and no-CIN. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dl or ≥25% above baseline within 72 h after PCI. Results: CIN occurred in 81 patients (12.2%). RDW, creatinine, and high sensitivity C-reactive protein levels were significantly higher in the CIN group than no-CIN group. Multivariate regression analysis revealed that baseline RDW level (OR 1.379, 95% CI 1.084 to 1.753, P=0.009), age (P=0.025), creatinine (P=0.004), and LVEF (P=0.011) were independent risk factors for the development of CIN. Conclusions: In conclusion, increased RDW levels are independently associated with a greater risk of CIN in patients undergoing PCI for ACS.
    No preview · Conference Paper · Oct 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The Syntax score (SXscore) is an anatomic scoring system based on the coronary angiography (CA), which not only quantifies lesion severity and complexity, but also predicts poor cardiovascular out- comes including mortality in patients with acute coronary sydromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. We sought to investigate the association of PLR with severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS undergoing urgent CA. Methods: A total of 1016 patients with ACS undergoing urgent CA were included into the study between Au- gust 2012 and March 2014. Admission PLR values were calculated before CA. The SXscore was determined from baseline CA. The patients were divided into two groups as low SXscore (≤22) and intermediate-high SXscore (≥23). Results: The PLR was significantly higher in patient with intermediate-high SXscore compared with low SXscore (P<0.001). In-hospital mortality was significantly higher in high PLR and intermediate-high SX- score groups. In multivariate analysis, the independent predictors of intermediate-high SXscore were PLR (OR:1.018, 95% CI:1.013-1.023, P < 0.001) together with left ventricular ejection fraction (OR:0.935, 95% CI:0.910-0.960, P<0.001), and age (OR: 1.029, 95% CI:1.029-1.054, P=0.02). An PLR ≥116 had a 71% sensitivity and 66% specificity in predicting intermediate-high SXscore. Conclusion:The PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SXscore in pa- tients with ACS underwent urgent CA
    No preview · Conference Paper · Oct 2014
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Syntax score (SXscore) is an anatomic scoring system based on the coronary angiography (CA), which not only quantifies lesion severity and complexity, but also predicts poor cardiovascular outcomes including mortality in patients with acute coronary sydromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. We sought to investigate the association of PLR with severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS undergoing urgent CA. A total of 1016 patients with ACS undergoing urgent CA were included into the study between August 2012 and March 2014. Admission PLR values were calculated before CA. The SXscore was determined from baseline CA. The patients were divided into two groups as low SXscore (≤22) and intermediate-high SXscore (≥23). The PLR was significantly higher in patient with intermediate-high SXscore compared with low SXscore (P<0.001). In-hospital mortality was significantly higher in high PLR and intermediate-high SXscore groups. In multivariate analysis, the independent predictors of intermediate-high SXscore were PLR (OR:1.018, 95% CI:1.013-1.023, P < 0.001) together with left ventricular ejection fraction (OR:0.935, 95% CI:0.910-0.960, P<0.001), and age (OR: 1.029, 95% CI:1.029-1.054, P=0.02). A PLR ≥116 had a 71% sensitivity and 66% specificity in predicting intermediate-high SXscore. In conclusion, the PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SXscore in patients with ACS underwent urgent CA.
    No preview · Article · Oct 2014 · The American Journal of Cardiology
  • Sani Namik Murat · Alparslan Kurtul · Mikail Yarlioglues
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI) are at high risk of contrast-induced acute kidney injury (CI-AKI), a complication associated with poor clinical outcomes. Serum albumin (SA) levels are associated with cardiovascular mortality. We assessed the association between SA levels and the risk of CI-AKI in patients with ACS (n = 890) treated with PCI. Patients were divided into 2 groups: patients with and without CI-AKI. Contrast-induced acute kidney injury was defined as an increase in serum creatinine (≥25% or ≥0.5 mg/dL) from baseline occurring 72 hours after PCI. The SA levels were significantly lower in patients with CI-AKI than in those without CI-AKI (3.52 ± 0.40 vs 3.94 ± 0.39 mg/dL, P < .001). On multivariate analysis, SA was an independent predictor of CI-AKI (odds ratio 0.177, 95% confidence interval 0.080-0.392, P < .001) together with age, female gender, creatine kinase-myocardial band, and glomerular filtration rate. Baseline SA levels are inversely associated with CI-AKI after PCI for ACS.
    No preview · Article · Sep 2014 · Angiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated whether admission estimated glomerular filtration rate (eGFR) values are associated with no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Patients (n = 673; 59 ± 13 years; 77.1% men) were stratified into 3 groups according to eGFR at admission: normal renal function (eGFR ≥ 90 mL/min/1.73 m(2)), mild renal impairment (eGFR 60-89 mL/min/1.73 m(2)), and moderate renal impairment (eGFR 30-59 mL/min/1.73 m(2)). No-reflow phenomenon was defined as thrombolysis in myocardial infarction flow grade <3 after pPCI. The rate of no-reflow gradually increased from the normal renal function group to the moderate impaired renal function group (P < .001). Multivariate analysis showed that eGFR (odds ratio [OR] 0.942, P < .001), Killip ≥2 class (OR 3.968, P = .008), left ventricular ejection fraction (OR 0.959, P = .034), and early patency of infarct vessel (OR 0.186, P < .001) were independent predictors of no-reflow phenomenon. Mild to moderate renal impairment at admission is independently associated with no-reflow phenomenon after pPCI.
    No preview · Article · Aug 2014 · Angiology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Contrast-induced nephropathy (CIN) is associated with significantly increased morbidity and mortality after percutaneous coronary intervention (PCI). Patients with acute coronary syndrome (ACS) are at higher risk for CIN. N-terminal pro-brain natriuretic peptide (NT-proBNP) is closely linked to the prognosis as a strong predictor of both short- and long-term mortality in patients with ACS.HypothesisWe hypothesized that NT-proBNP levels on admission can predict the development of CIN after PCI for ACS.MethodsA total of 436 patients (age 62.27 ± 13.01 years; 64.2% male) with ACS undergoing PCI enrolled in this study. Admission NT-proBNP levels were measured before PCI. Serum creatinine values were measured before and within 72 hours after the administration of contrast agents. Patients were divided into 2 groups: CIN group and no-CIN group. CIN was defined as an increase in serum creatinine level of ≥0.5 mg/dL or ≥25% above baseline within 72 hours after contrast administration.ResultsCIN developed in 63 patients (14.4%). Baseline NT-proBNP levels were significantly higher in patients who developed CIN compared to those who did not develop CIN (median 774 pg/mL, interquartile range 177.4–2184 vs median 5159 pg/mL, interquartile range 2282–9677, respectively; P < 0.001). Multivariate analysis found that NT-proBNP (odds ratio [OR]: 3.448, 95% confidence interval [CI]: 1.394-8.474, P = 0.007) and baseline creatinine (OR: 6.052, 95% CI: 1.860-19.686, P = 0.003) were independent predictors of CIN.Conclusions Admission NT-proBNP level is an independent predictor of the development of CIN after PCI in ACS.
    Full-text · Article · Aug 2014 · Clinical Cardiology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Chronic total occlusion (CTO) in a noninfarct-related artery (non-IRA) is an independent predictor of mortality in acute coronary syndrome (ACS). Mean platelet volume (MPV) and serum uric acid (SUA) are associated with cardiovascular events in ACS. We investigated the relationship between the presence of non-IRA-CTO with MPV and SUA levels in patients with ACS. Patients (n = 1024) who underwent urgent coronary angiography for ACS were included in this study. Blood samples were drawn on admission. Patients were categorized into 2 groups: non-IRA-CTO (-) and non-IRA-CTO (+). The MPV and SUA levels on admission were significantly higher in the non-IRA-CTO (+) group than in the non-IRA-CTO (-) group (P < .001). At multivariate analysis, MPV (odds ratio [OR]: 4.705, P < .001) and SUA (OR: 2.535, P < .001) were independent predictors of non-IRA-CTO together with age, hemoglobin, ejection fraction, and non-ST-segment elevation ACS. The MPV and SUA levels were significant and independent predictors for the presence of non-IRA-CTO in patients with ACS.
    No preview · Article · Jul 2014 · Angiology