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Amaç: Çalışmamızın amacı, elektrokardiyogramdan ölçülen RS zamanının kronik obstrüktif akciğer hastalığı (KOAH) şiddeti ile ilişkili olup olmadığını belirlemekti.Gereç ve Yöntem: Çalışma popülasyonu, ortalama yaşı 63 ± 10 yıl olan (% 86 erkekti) 100 KOAH hastasından oluştu. Kronik Obstrüktif Akciğer Hastalığına Karşı Küresel Girişim (GOLD) aşamalarına göre bu hastalar hafif ve orta derecede KOAH (GOLD 1–2) grubu (s = 45) ve şiddetli ve çok şiddetli KOAH (GOLD 3–4) grubuna (s = 55) ayrıldı. Bu gruplar birbirleriyle karşılaştırıldı.Bulgular: Şiddetli ve çok şiddetli KOAH'lı hastalarda kalp hızı, P dalga aksı, QRS ekseni, RS zamanı ve sağ dal bloğu insidansı anlamlı olarak daha yüksekti. Çok değişkenli analizde, kalp hızı, P dalga aksı ve RS zamanı (olasılık oranı = 1.081) şiddetli ve çok şiddetli KOAH'ın bağımsız belirleyicileriydi. Alıcı işletim karakteristik eğrisi analizi, şiddetli ve çok şiddetli KOAH tahmini için en iyi RS zaman kesme değerinin, % 69,1 duyarlılık ve % 66,7 özgüllük ile 60 ms olduğunu gösterdi.Sonuç: Bir elektrokardiyogramda basitçe ölçülen RS zamanı, şiddetli ve çok şiddetli KOAH'lı hastaların hızlı tahmini için yararlı bir tarama testi olabilir., Purpose: The aim of our study was to determine whether the RS time measured on an electrocardiogram is associated with the severity of chronic obstructive pulmonary disease (COPD).Materials and Methods: The study population was made up of 100 COPD patients with a mean age of 63 ± 10 years (86% were males). These patients were divided into the mild and moderate COPD (GOLD 1–2) group (n = 45) and the severe and very severe COPD (GOLD 3–4) group (n = 55) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages. These groups were compared with each other.Results: Heart rate, P wave axis, QRS axis, RS time, and incidence of right bundle branch block were significantly higher in patients with severe and very severe COPD. In the multivariable analysis, heart rate, P wave axis, and RS time (odds ratio = 1.081) were the independent predictors of severe and very severe COPD. The receiver operating characteristic curve analysis showed that the best RS time cutoff value for the prediction of severe and very severe COPD was 60 ms, with a sensitivity of 69.1% and a specificity of 66.7%.Conclusion: RS time simply measured on an electrocardiogram may be a useful screening test for the quick estimation of patients with severe and very severe COPD.

Giriş: Daha öncedenyapılan çalışmalar, inflamatuvar belirteçlerin koroner arter hastalığı olanhastalarda yeni başlayan atriyal fibrilasyon (AF)’un gelişimi ile ilişkiliolduğunu göstermiştir. Bununla birlikte, ST yükselmeli miyokart infarktüslü(STEMİ) hastalarda AF gelişimi için serum C-reaktif protein (CRP)’in serumalbumin oranı (CAR)’na göre prediktif değeri henüz araştırılmamıştır. Bunedenle, bu çalışmada, primer perkütan koroner girişim (pPKG) yapılan STEMİhastalarında AF’ı öngörmedeki değerini değerlendirmeyi amaçladık. Hastalar ve Yöntem:Bu çalışma, pPKG uygulanan 1153 STEMİ hastasına ilişkin verilerin geriyeyönelik analiz edilmesi ile yapıldı. CRP düzeyleri immünoturbidimetrik yöntemegöre ölçüldü ve serum albumin düzeyleri bromkresol yeşili yöntemiyle analizedildi. CAR, CRP değerlerinin serum albumin oranı olarak tanımlandı. Bulgular: Hastanedekalış sırasında AF insidansı %5.2 (n= 62 hasta) idi. AF olan hastalar, AFolmayanlara kıyasla yüksek CAR değerlerine sahipti. Çok değişkenli lojistik regresyonanalizleri, yüksek CAR değerinin AF’ın bağımsız bir belirleyicisi olduğunuortaya koydu (OR: 3.280, %95 CI: 1.564-6.878; p= 0.002). Ayrıca, ROC curveeğrilerinin karşılaştırıldığında, CAR’ın öngörücü performansının sırasıyla CRPve albuminden daha yüksek olduğunu göstermiştir. Sonuç: Bu çalışmadapPKG ile tedavi edilen STEMİ hastalarında yüksek CAR değerlerinin AF gelişimiile bağımsız olarak ilişkili olduğunu gözlemledik., Introduction:Previous studies reported that inflammatory markers are associated with thedevelopment of new-onset atrial fibrillation (NOAF) in patients with coronaryartery disease. However, the predictive value of serum C-reactive protein (CRP)to serum albumin ratio (CAR) for the development of NOAF in patients with STelevation myocardial infarction (STEMI) has not been investigated yet. Hence,the aim of the present study was to evaluate the potential utility of the CARin predicting NOAF in patients with STEMI who underwent primary percutaneouscoronary intervention (pPCI). Patients and Methods:The present study was a retrospective analysis of the data related to 1153patients with STEMI who underwent pPCI. CRP levels were measured according tothe immunoturbidimetric method, and serum albumin levels were analyzed by thebromocresol green method. The CAR was defined as the serum CRP level divided bythe serum albumin level. Results: Theincidence of NOAF during in-hospital stay was 5.2% (n= 62 patients). Patientswith NOAF had higher CAR values than those without NOAF. Multivariate logisticregression analyses revealed that elevated CAR value was an independentpredictor of NOAF (odds ratio 3.280, 95% confidence interval 1.564-6.878; p=0.002). Furthermore, comparison of receiver operating characteristic curvesyielded that the predictive performance of CAR was higher than CRP and albuminalone, respectively. Conclusion: In thepresent study, we observed that elevated CAR values were independentlyassociated with NOAF development in patients with STEMI treated with pPCI.

WOS: 000442902500007, Background: Smoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI. Objective: To assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial (RA) versus femoral approach (FA). Methods: Our population is represented by 138 STEMI patients undergoing pPCI by FA or RA. The smoking cessation rates and QOL scores were evaluated. Results: Patients at RA group (46 patients, 57 +/- 9 years, 87% male) had a higher European Quality of Life-5 Dimensions (EQ-5D) index score at post-PCI first week compared to FA group (92 patients, 57 +/- 8 years, 75% male) [FA: median 0.81 (0.22) vs. RA: 1 (0.22), p = 0.042], although it was similar at baseline [FA: median 1 (0) vs. RA: 1 (0), p = 0.992]. Total hospital length of stay [RA: median 3 (1) day vs. FA: 4 (1), p < 0.001] was significantly reduced in the RA group. Whereas the smoking cessation rates at 1-year post-discharge were 41% in RA group, it was 67% in FA group (p = 0.003). Female sex, pain-to-door time and RA during p-PCI were independent predictors of continued smoking after STEMI. Conclusion: This study shows that the smoking cessation was lower in RA group compared to FA group. The more comfortable conditions of STEMI management related to RA may cause a lower awareness of the disease severity and lower motivation to quit smoking. Therefore, it is important to inquire about smoking status at each clinical encounter, particularly in patients undergoing pPCI by the radial approach. (c) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.

WOS: 000439342900001 PubMed ID: 29541904 SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion. The patients were divided into three groups according to increased SS-II value: low (n:562; SS-II = 34.4). In-hospital and long term mortality rate from all causes (0 vs. 0.5 vs. 10.6% and 1.8 vs. 3.2 vs. 18.1% respectively, p