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Objective Serum procalcitonin levels are associated with congestive heart failure, but are not established biomarkers of the disease. We evaluated the predictive value of serum procalcitonin levels for diagnosing heart failure and assessing its severity. Methods and results This retrospective, case-control study involved 59 subjects (mean age 59.7 +/- 10.1 years; 38 males), including 21 outpatients and 19 inpatients with heart failure and left ventricular ejection fractions 45%, and 19 healthy controls. Serum procalcitonin levels were measured and compared among the 3 groups. Procalcitonin levels were significantly higher among inpatients (median [interquartile range], 1.45 [0.25-5.80] ng/mL) than among the outpatients (0.35 [0.001-1.70] ng/mL; P 0.001) or controls (0.05 [0.02-0.08] ng/mL; P 0.001). Using a procalcitonin cut-off level of 0.09 ng/mL, 35(87.5%) of the 40 inpatients and outpatients were procalcitonin-positive; all control individuals were procalcitonin-negative. Serum procalcitonin levels differentiated between heart failure patients and healthy controls (sensitivity, 88.9% [95% confidence interval, 75.9-96.2%]; specificity, 100% [82.2-100.0%]; positive predictive value, 100% [91.1-100.0%]; negative predictive value, 79.2% [57.8-92.8%]). Procalcitonin levels were > 0.53 ng/mL in 4/21 (19%) outpatients and in 16/19(84.2%) inpatients.The sensitivity and specificity of serum procalcitonin levels for differentiating between inpatients and outpatients were 84.2% and 81.0%, respectively (positive predictive value 80% [95% confidence interval, 67.6-92.4%] and 85.0% [73.9-96.1%], respectively). Conclusion Serum procalcitonin levels, showing high sensitivity and specificity for diagnosing and assessing the severity of heart failure in this small study, might be considered potential heart failure biomarkers.

Objective Serum procalcitonin levels are associated with congestive heart failure, but are not established biomarkers of the disease. We evaluated the predictive value of serum procalcitonin levels for diagnosing heart failure and assessing its severity. Methods and results This retrospective, case-control study involved 59 subjects (mean age 59.7 +/- 10.1 years; 38 males), including 21 outpatients and 19 inpatients with heart failure and left ventricular ejection fractions 45%, and 19 healthy controls. Serum procalcitonin levels were measured and compared among the 3 groups. Procalcitonin levels were significantly higher among inpatients (median [interquartile range], 1.45 [0.25-5.80] ng/mL) than among the outpatients (0.35 [0.001-1.70] ng/mL; P 0.001) or controls (0.05 [0.02-0.08] ng/mL; P 0.001). Using a procalcitonin cut-off level of 0.09 ng/mL, 35(87.5%) of the 40 inpatients and outpatients were procalcitonin-positive; all control individuals were procalcitonin-negative. Serum procalcitonin levels differentiated between heart failure patients and healthy controls (sensitivity, 88.9% [95% confidence interval, 75.9-96.2%]; specificity, 100% [82.2-100.0%]; positive predictive value, 100% [91.1-100.0%]; negative predictive value, 79.2% [57.8-92.8%]). Procalcitonin levels were > 0.53 ng/mL in 4/21 (19%) outpatients and in 16/19(84.2%) inpatients.The sensitivity and specificity of serum procalcitonin levels for differentiating between inpatients and outpatients were 84.2% and 81.0%, respectively (positive predictive value 80% [95% confidence interval, 67.6-92.4%] and 85.0% [73.9-96.1%], respectively). Conclusion Serum procalcitonin levels, showing high sensitivity and specificity for diagnosing and assessing the severity of heart failure in this small study, might be considered potential heart failure biomarkers.

Objectives: There is substantial evidence that the majority of cases of lower extremity peripheral artery disease are undetected. As a result, there is great interest in the detection of lower extremity peripheral artery disease through routine screening. However, routine screening of lower extremity peripheral artery disease is still debated. Methods: In our cross-sectional study, we included 200 consecutive patients with symptoms suggestive of angina who were undergoing coronary angiography. Irrespective of intermittent claudication, we subsequently performed peripheral angiography to detect lower extremity peripheral artery disease. The predictors of lower extremity peripheral artery disease were analyzed, and the diagnostic utility of these predictors and their combinations were determined. Additionally, the determinants of the amount of radio-opaque material used and peripheral fluoroscopy time were investigated. Results: The overall prevalence of lower extremity peripheral disease was 16%. Being older than 65 years, having coronary artery disease and smoking history remained significant predictors after adjusting for other well-known parameters. Having the combination of age ?65 and smoking was associated with a positive predictive value of 50% (likelihood ratio 5.06), and having all of the predictors was associated with a positive predictive value of 100% (likelihood ratio >1000). Conclusions: Routine screening for lower extremity peripheral disease patients undergoing coronary angiography may be useful in selected patients.

Background: Left ventricular aneurysm (LVA) is an important complication of acute myocardial infarction. In this study, we investigated the role of N-Terminal pro B type natriuretic peptide level to predict the LVA development after acute STsegment elevation myocardial infarction (STEMI). Methods: We prospectively enrolled 1519 consecutive patients with STEMI. Patients were divided into two groups according to LVA development within the six months after index myocardial infarction. Patients with or without LVAs were examined to determine if a significant relationship existed between the baseline N-Terminal pro B type natriuretic peptide values and clinical characteristics. A p-value 0.05 was considered statistically significant. Results: LVA was detected in 157 patients (10.3%). The baseline N-Terminal pro-B type natriuretic peptide level was significantly higher in patients who developed LVA after acute MI (523.5 +/- 231.1 pg/mL vs. 192.3 +/- 176.6 pg/mL, respectively, p 0.001). Independent predictors of LVA formation after acute myocardial infarction was age > 65 y, smoking, Killip class > 2, previous coronary artery bypass graft, post-myocardial infarction heart failure, left ventricular ejection fraction 50%, failure of reperfusion, no-reflow phenomenon, peak troponin I and CK-MB and NT-pro BNP > 400 pg/mL at admission. Conclusions: Our findings indicate that plasma N-Terminal pro B type natriuretic peptide level at admission among other variables provides valuable predictive information regarding the development of LVA after acute STEMI.

Objectives: There is substantial evidence that the majority of cases of lower extremity peripheral artery disease are undetected. As a result, there is great interest in the detection of lower extremity peripheral artery disease through routine screening. However, routine screening of lower extremity peripheral artery disease is still debated. Methods: In our cross-sectional study, we included 200 consecutive patients with symptoms suggestive of angina who were undergoing coronary angiography. Irrespective of intermittent claudication, we subsequently performed peripheral angiography to detect lower extremity peripheral artery disease. The predictors of lower extremity peripheral artery disease were analyzed, and the diagnostic utility of these predictors and their combinations were determined. Additionally, the determinants of the amount of radio-opaque material used and peripheral fluoroscopy time were investigated. Results: The overall prevalence of lower extremity peripheral disease was 16%. Being older than 65 years, having coronary artery disease and smoking history remained significant predictors after adjusting for other well-known parameters. Having the combination of age ?65 and smoking was associated with a positive predictive value of 50% (likelihood ratio 5.06), and having all of the predictors was associated with a positive predictive value of 100% (likelihood ratio >1000). Conclusions: Routine screening for lower extremity peripheral disease patients undergoing coronary angiography may be useful in selected patients.

[No abstract available]

Background: Left ventricular aneurysm (LVA) is an important complication of acute myocardial infarction. In this study, we investigated the role of N-Terminal pro B type natriuretic peptide level to predict the LVA development after acute STsegment elevation myocardial infarction (STEMI). Methods: We prospectively enrolled 1519 consecutive patients with STEMI. Patients were divided into two groups according to LVA development within the six months after index myocardial infarction. Patients with or without LVAs were examined to determine if a significant relationship existed between the baseline N-Terminal pro B type natriuretic peptide values and clinical characteristics. A p-value 0.05 was considered statistically significant. Results: LVA was detected in 157 patients (10.3%). The baseline N-Terminal pro-B type natriuretic peptide level was significantly higher in patients who developed LVA after acute MI (523.5 +/- 231.1 pg/mL vs. 192.3 +/- 176.6 pg/mL, respectively, p 0.001). Independent predictors of LVA formation after acute myocardial infarction was age > 65 y, smoking, Killip class > 2, previous coronary artery bypass graft, post-myocardial infarction heart failure, left ventricular ejection fraction 50%, failure of reperfusion, no-reflow phenomenon, peak troponin I and CK-MB and NT-pro BNP > 400 pg/mL at admission. Conclusions: Our findings indicate that plasma N-Terminal pro B type natriuretic peptide level at admission among other variables provides valuable predictive information regarding the development of LVA after acute STEMI.

Amaç:Atriyal fibrilasyon klinik pratikte en sık rastlanılan ritim bozukluğudur ve kardiyak ritim bozuklukları nedeniyle hastaneye yatışla-rın üçte birinden sorumludur. Atriyal fibrilasyon tedavisinde ana basamak kalp hızı kontrolünün sağlanması veya sinüs ritminin sağlana-rak devam ettirilmesidir. Atriyal fibrilasyonlu olgularda, sinüs ritmi sağlanmasını takiben atriyal fibrilasyon nüksünü önlemek için antia-ritmik ilaç tedavisi başlanmaktadır. Bu amaçla uygulanan antiaritmik ilaçlardan en etkin olanı amiodarondur. Ancak yan etkileri nede-niyle kullanımı kısıtlıdır. Biz bu çalışmada kardiyoversiyonla sinüs ritmi sağlanan persistan atriyal fibrilasyonlu hastalarda uzun ve kısadönem amiodaron tedavilerinin etkinliklerini karşılaştırdık. Gereç ve Yöntem :Çalışmaya persistan atriyal fibrilasyon tanısıyla elektriksel kardiyoversiyon planlanan 137 hasta alındı. Kardiyo -versiyonla sinüs ritmi sağlanan hastalara amiodaron başlandı ve hastalar iki gruba ayrıldı. Birinci grupta tedavi 2 ayın sonunda kesilir-ken ikinci grupta 12 ay süresince devam edildi. Bulgular :On iki ay sonunda, 8 hafta oral amiodaron tedavisi kullanan hastalardan 28’inde (%45,2) ve 12 ay oral amiodaron tedavisikul lanan hastaların 30’unda (%45,5) atriyal fibrilasyon nüksü saptandı. Her iki grup arasında atriyal fibrilasyon nüks oranı benzerdi (p=0,56). Sonuç:Sonuç olarak bu çalışmada, persistan atrial fibrilasyonlu olgularda, elektriksel kardiyoversiyon sonrası amiodaronun 2 ay sürey-le uygulanmasının, 12 ay uygulanması ile karşılaştırmasında sinüs ritminin idamesinde benzer etkinlikte iken, yan etkiler açısından da-ha güvenilir olduğu tespit edilmiştir., Objective: Atrial fibrillation is the most common arrhythmia in clinical practice and responsible for the 1/3 of the atrial fibrillation rela-ted hospitalizations. It has been estimated that approximately 2.2 million people have paroxysmal or persistent atrial fibrillation in USA.The initial management decision involves primarily a rate control or rhythm-control strategy. Antiarrhythmic therapy is started after res-torating sinusal rhythm to prevent the recurrence of atrial fibrillation in patients with persistent atrial fibrillation. Amiodarone is themost effective therapeutic option which is administrated for this proposes. However, side effects of this agent limit its use. In this studywe compared the effectiveness of long and short term amiodarone therapies in patients with persistent atrial fibrillation after restora-ting sinusal rhythm. Material and Method: Patients, undergoing cardioversion with the diagnosis of persistent atrial fibrillation included. Patients in whomsinusal rhythm was restorated separated into two groups. In the first group, amiodarone therapy stopped after 2 months, in the secondgroup therapy is continued for 12 months. Results:12 months after the cardioversion, recurrence of atrial fibrillation occurred in 28 patients (45.2%) in the group 1 and in 30 pa-tients (45.5%) in the group 2 (p=0.56). Conclusion: In this study, we determined that amiodarone therapy for 2 months had similar effectiveness and fewer side effects afterrestorating sinusal rhythm in patients with atrial fibrillation compared with long lasting amiodarone therapy.

Background. Platelet to lymphocyte ratio (PLR) has been demonstrated as a risk and prognostic marker in many of cardiovascular diseases. A relationship between PLR and severity of carotid stenosis has been shown. The aim of our study was to investigate the relationship between PLR and all cause mortality in patients with carotid arterial disease. Methods. This retrospective study included 146 patients who had been performed selective carotid angiography. Carotid stenosis were graded by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Platelet to lymphocyte ratio was calculated as the ratio of platelets to lymphocytes. The end point of the study was all-cause mortality. Results. During median follow-up of 16 months (0-65 months) 15 (10.3%) patients suffered all-cause mortality. 50 patients (34.2%) underwent carotid endarterectomy and 69 patients (47.3%) had non-carotid cardiac surgery. 38 patients (26.02%) had cerebrovascular events (stroke/transient ischemic attack) at admission. NASCET grades were not different between survivors and non-survivors. Non-survivors had significantly lower hemoglobin (Hb) levels (12.7 +/- 1.6 g/dL vs. 13.7 +/- 1.7 g/dL, p = 0.031) and they were older than survivors (74.2 +/- 8.4 years vs. 68.6 +/- 8.5 years, p = 0.029). Non-survivors had significantly higher PLR values compared with survivors (190.3 +/- 85.6 and 126.8 +/- 53.8, p = 0.017). In multivariate analysis, only PLR predicted all-cause mortality in patients with carotid artery stenosis. Conclusion. In our study, higher PLR was associated with increased all-cause mortality.

Amaç: Vitamin D (vit D) eksikliği, koroner kalp hastalığı, hipertansiyon ve sol ventrikül hipertrofisi ile ilişkili bulunmuştur. Ancak kardiyak iletim sistemi ve atriyal fibrilasyon (AF) yatkınlığına etkisi henüz araştırılmamıştır. Bu çalışmada, VitD'nin invaziv elektrofizyolojik parametreler ve AF indüklenebilirliği üzerindeki etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu retrospektif kesitsel çalışma 135 hastayı içermektedir. Çalışma popülasyonu, temel vitD düzeylerine göre VitD yeterli, VitD yetersiz ve VitD eksikliği olmak üzere üç gruba ayrıldı. Hastaların invaziv elektrofizyolojik parametreleri ve uyarılan AF epizodları kaydedildi. Bulgular: Düzeltilmiş sinüs nodu iyileşme zamanı, bazal döngü uzunluğu, atriyal-His aralığı, His-ventriküler aralık ve Wenckebach siklus uzunluğu, vitD eksikliği olan grupta uzamış, ancak istatistiksel olarak anlamlı bulunmamıştır. AF indüklenebilirlik oranı, VitD eksikliği olan grupta, yeterli gruba göre iki kat daha fazlaydı., ancak istatistiksel olarak anlamlı değildi. Sonuç: Bazal VitD seviyeleri kardiyak elektrofizyolojik parametreler ve AF indüklenebilirliği ile ilişkili değildi. VitD'nin kardiyak iletim sistemindeki rolünü ve AF'nin indüklenebilirliğini tam olarak göstermek için VitD replasmanını da içeren daha ileri çalışmalar gereklidir., Deficiencies of Vitamin D (VitD) has been associated with coronary heart disease, hypertension and left ventricular hypertropy. However its effects on cardiac conduction system and atrial fibrillation (AF) predisposition have not been studied yet. In this study we aim to evaluate the effects of VitD on invasive electrophysiologic parameters and AF inducibility. Materials and Methods: This retrospective crosssectional study included 135 patients. Study population was divided into three group as VitD sufficient, VitD insufficient and VitD deficient according to baseline vitD levels. Patients’ invasive electrophysiologic parameters and induced AF episodes were recorded. Results: Corrected sinus node recovery time, baseline cycle length, atrial-His interval, His-ventricular interval and Wenckebach cycle length were lengthened in vitD deficient group but they didn’t reach statistical significance. The rate of AF inducibility was twice as likely in VitD deficient group than sufficient group, however, it also didn’t reach statistical significance. Conclusion: Baseline VitD levels were not associated with cardiac electrophysiologic parameters and AF inducibility. To demonstrate the role of VitD in cardiac conduction system and AF inducibility thoroughly, further studies such as addressing VitD replacement are warranted.

Amaç:Atriyal fibrilasyon klinik pratikte en sık rastlanılan ritim bozukluğudur ve kardiyak ritim bozuklukları nedeniyle hastaneye yatışla-rın üçte birinden sorumludur. Atriyal fibrilasyon tedavisinde ana basamak kalp hızı kontrolünün sağlanması veya sinüs ritminin sağlana-rak devam ettirilmesidir. Atriyal fibrilasyonlu olgularda, sinüs ritmi sağlanmasını takiben atriyal fibrilasyon nüksünü önlemek için antia-ritmik ilaç tedavisi başlanmaktadır. Bu amaçla uygulanan antiaritmik ilaçlardan en etkin olanı amiodarondur. Ancak yan etkileri nede-niyle kullanımı kısıtlıdır. Biz bu çalışmada kardiyoversiyonla sinüs ritmi sağlanan persistan atriyal fibrilasyonlu hastalarda uzun ve kısadönem amiodaron tedavilerinin etkinliklerini karşılaştırdık. Gereç ve Yöntem :Çalışmaya persistan atriyal fibrilasyon tanısıyla elektriksel kardiyoversiyon planlanan 137 hasta alındı. Kardiyo -versiyonla sinüs ritmi sağlanan hastalara amiodaron başlandı ve hastalar iki gruba ayrıldı. Birinci grupta tedavi 2 ayın sonunda kesilir-ken ikinci grupta 12 ay süresince devam edildi. Bulgular :On iki ay sonunda, 8 hafta oral amiodaron tedavisi kullanan hastalardan 28’inde (%45,2) ve 12 ay oral amiodaron tedavisikul lanan hastaların 30’unda (%45,5) atriyal fibrilasyon nüksü saptandı. Her iki grup arasında atriyal fibrilasyon nüks oranı benzerdi (p=0,56). Sonuç:Sonuç olarak bu çalışmada, persistan atrial fibrilasyonlu olgularda, elektriksel kardiyoversiyon sonrası amiodaronun 2 ay sürey-le uygulanmasının, 12 ay uygulanması ile karşılaştırmasında sinüs ritminin idamesinde benzer etkinlikte iken, yan etkiler açısından da-ha güvenilir olduğu tespit edilmiştir., Objective: Atrial fibrillation is the most common arrhythmia in clinical practice and responsible for the 1/3 of the atrial fibrillation rela-ted hospitalizations. It has been estimated that approximately 2.2 million people have paroxysmal or persistent atrial fibrillation in USA.The initial management decision involves primarily a rate control or rhythm-control strategy. Antiarrhythmic therapy is started after res-torating sinusal rhythm to prevent the recurrence of atrial fibrillation in patients with persistent atrial fibrillation. Amiodarone is themost effective therapeutic option which is administrated for this proposes. However, side effects of this agent limit its use. In this studywe compared the effectiveness of long and short term amiodarone therapies in patients with persistent atrial fibrillation after restora-ting sinusal rhythm. Material and Method: Patients, undergoing cardioversion with the diagnosis of persistent atrial fibrillation included. Patients in whomsinusal rhythm was restorated separated into two groups. In the first group, amiodarone therapy stopped after 2 months, in the secondgroup therapy is continued for 12 months. Results:12 months after the cardioversion, recurrence of atrial fibrillation occurred in 28 patients (45.2%) in the group 1 and in 30 pa-tients (45.5%) in the group 2 (p=0.56). Conclusion: In this study, we determined that amiodarone therapy for 2 months had similar effectiveness and fewer side effects afterrestorating sinusal rhythm in patients with atrial fibrillation compared with long lasting amiodarone therapy.

Background. Platelet to lymphocyte ratio (PLR) has been demonstrated as a risk and prognostic marker in many of cardiovascular diseases. A relationship between PLR and severity of carotid stenosis has been shown. The aim of our study was to investigate the relationship between PLR and all cause mortality in patients with carotid arterial disease. Methods. This retrospective study included 146 patients who had been performed selective carotid angiography. Carotid stenosis were graded by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria. Platelet to lymphocyte ratio was calculated as the ratio of platelets to lymphocytes. The end point of the study was all-cause mortality. Results. During median follow-up of 16 months (0-65 months) 15 (10.3%) patients suffered all-cause mortality. 50 patients (34.2%) underwent carotid endarterectomy and 69 patients (47.3%) had non-carotid cardiac surgery. 38 patients (26.02%) had cerebrovascular events (stroke/transient ischemic attack) at admission. NASCET grades were not different between survivors and non-survivors. Non-survivors had significantly lower hemoglobin (Hb) levels (12.7 +/- 1.6 g/dL vs. 13.7 +/- 1.7 g/dL, p = 0.031) and they were older than survivors (74.2 +/- 8.4 years vs. 68.6 +/- 8.5 years, p = 0.029). Non-survivors had significantly higher PLR values compared with survivors (190.3 +/- 85.6 and 126.8 +/- 53.8, p = 0.017). In multivariate analysis, only PLR predicted all-cause mortality in patients with carotid artery stenosis. Conclusion. In our study, higher PLR was associated with increased all-cause mortality.

Amaç: Vitamin D (vit D) eksikliği, koroner kalp hastalığı, hipertansiyon ve sol ventrikül hipertrofisi ile ilişkili bulunmuştur. Ancak kardiyak iletim sistemi ve atriyal fibrilasyon (AF) yatkınlığına etkisi henüz araştırılmamıştır. Bu çalışmada, VitD'nin invaziv elektrofizyolojik parametreler ve AF indüklenebilirliği üzerindeki etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu retrospektif kesitsel çalışma 135 hastayı içermektedir. Çalışma popülasyonu, temel vitD düzeylerine göre VitD yeterli, VitD yetersiz ve VitD eksikliği olmak üzere üç gruba ayrıldı. Hastaların invaziv elektrofizyolojik parametreleri ve uyarılan AF epizodları kaydedildi. Bulgular: Düzeltilmiş sinüs nodu iyileşme zamanı, bazal döngü uzunluğu, atriyal-His aralığı, His-ventriküler aralık ve Wenckebach siklus uzunluğu, vitD eksikliği olan grupta uzamış, ancak istatistiksel olarak anlamlı bulunmamıştır. AF indüklenebilirlik oranı, VitD eksikliği olan grupta, yeterli gruba göre iki kat daha fazlaydı., ancak istatistiksel olarak anlamlı değildi. Sonuç: Bazal VitD seviyeleri kardiyak elektrofizyolojik parametreler ve AF indüklenebilirliği ile ilişkili değildi. VitD'nin kardiyak iletim sistemindeki rolünü ve AF'nin indüklenebilirliğini tam olarak göstermek için VitD replasmanını da içeren daha ileri çalışmalar gereklidir., Deficiencies of Vitamin D (VitD) has been associated with coronary heart disease, hypertension and left ventricular hypertropy. However its effects on cardiac conduction system and atrial fibrillation (AF) predisposition have not been studied yet. In this study we aim to evaluate the effects of VitD on invasive electrophysiologic parameters and AF inducibility. Materials and Methods: This retrospective crosssectional study included 135 patients. Study population was divided into three group as VitD sufficient, VitD insufficient and VitD deficient according to baseline vitD levels. Patients’ invasive electrophysiologic parameters and induced AF episodes were recorded. Results: Corrected sinus node recovery time, baseline cycle length, atrial-His interval, His-ventricular interval and Wenckebach cycle length were lengthened in vitD deficient group but they didn’t reach statistical significance. The rate of AF inducibility was twice as likely in VitD deficient group than sufficient group, however, it also didn’t reach statistical significance. Conclusion: Baseline VitD levels were not associated with cardiac electrophysiologic parameters and AF inducibility. To demonstrate the role of VitD in cardiac conduction system and AF inducibility thoroughly, further studies such as addressing VitD replacement are warranted.