Serum Irisin Level Can Predict the Severity of Coronary Artery Disease in Patients with Stable Angina

BACKGROUND AND OBJECTIVES: The recently discovered myokine irisin has a proposed role in adipose tissue metabolism. The aim of this study was to evaluate the relationship between serum irisin level and the coronary artery severity in patients with stable coronary artery disease (CAD). SUBJECTS AND METHODS: Sixty-three patients who underwent coronary angiography (CA) diagnosed with stable CAD and twenty-six patients with normal coronary artery (NCA) were enrolled in the study. Stable CAD patients were divided into two groups as high synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score (≥23) and lower SYNTAX score (<23). Serum irisin level measurement was carried out using human irisin colorimetric enzyme-linked immunosorbent assay (ELISA) commercial kit (AG-45A-0046EK-KI01, Adipogen, San Diego, CA, USA) as recommended by the manufacturer's protocol. RESULTS: The patients with stable CAD with a higher SYNTAX score (score ≥23) had significantly lower serum irisin levels (127.91±55.38 ng/mL), as compared the patients with a low SYNTAX score (score <23) (224.69±92.99 ng/mL) and control group (299.54±123.20 ng/mL). Irisin levels showed significant differences between all groups (p<0.001). CONCLUSION: Serum irisin level is an independent predictor of coronary artery severity in patients with stable CAD.

Neutrophil Lymphocyte Ratio as a Predictor of Left Ventricular Apical Thrombus in Patients with Myocardial Infarction

BACKGROUND AND OBJECTIVES: In this study, we examined the role of inflammatory parameters in an apical mural thrombus with a reduced ejection fraction due to large anterior myocardial infarction (MI). SUBJECTS AND METHODS: A total of 103 patients who had suffered from heart failure, 45 of whom had left ventricular apical thrombus (AT) after a large anterior MI, were enrolled in the study. A detailed clinical history was taken of each participant, biochemical inflammatory markers, which were obtained during admission, were analyzed and an echocardiographical and angiographical evaluation of specific parameters were performed. RESULTS: There were no statistically significant differences in terms of age, gender, and history of hypertension, diabetes mellitus, and atrial fibrillation between both groups (p>0.05). Similarly there were no statistically significant differences in terms of biochemical and echocardiographic parameters (p>0.05). However, there were significant differences in terms of neutrophil lymphocyte ratio (p=0.032). After a multivariate regression analysis, neutrophil lymphocyte ratio (NLR) was an independent predictor of thrombus formation (β: 0.296, p=0.024). The NLR >2.74 had a 78% sensivity and 61% specifity in predicting thrombus in patients with a low left ventricular ejection fraction. CONCLUSION: In this study, neutrophil lymphocyte ratios were significantly higher in patients with apical thrombus.

Serum uric acid levels are elevated in patients with diastolic dysfunction and preserved ejection fraction

Elevated uric acid levels are associated with diastolic dysfunction in chronic heart failure patients. Uric acid is a marker of impaired oxidative metabolism and is correlated with endothelial function. In this study, we investigated whether uric acid levels correlate with the degree of left ventricular diastolic dysfunction [LVDD] in patients with normal ejection fraction. Prospective case-control study Uric acid levels were measured in 201 patients with normal ejection fraction. The study population was divided into two groups as controls and patients with LVVD. Patients with LVDD were divided into two groups according to dysfunction grade. [Normal, n = 64, Grade 1 LVDD, n = 74, Grade 2 LVDD, n = 63]. Interventions: For uric acid analysis, 5 ml of venous-blood was drawn from each patient after at least 8 hours of fasting. Serum uric acid levels were measured and LVDD was assessed by transthoracic echocardiography normal diastolic function group than grade 1 LVDD and grade 2 LVDD groups respectively [4.28 +/- 1.20 mg/dl, 8.17 +/- 2.12 mg/dl, 9.52 +/- 2.30 mg/dl, p < 0.001]. Although Grade 2 LVDD patients had higher uric acid levels, there is no. Our study demonstrated that uric acid dysfunction. Further studies are needed to assess whether inhibition of xanthine oxidase [XO] with allopurinol results in an improvement in diastolic dysfunction