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.

Usefulness of the macruz index for predicting successful percutaneous mitral balloon valvuloplasty in patients with mitral stenosis

Objective: The aim of this study was to determine whether the Macruz index [P/P-R segment] could predict the severity of valvular involvement and the success of percutaneous mitral balloon valvuloplasty [PMBV] in patients with mitral stenosis [MS]

Subjects and Methods:Sixty-one patients with MS eligible for PMBV and 72 healthy subjects [61 females and 11 males] with sinus rhythm were enrolled into this study. PMBV was performed in all patients using a percutaneous transseptal antegrade approach and a multitrack balloon technique. The P/P-R segment ratio and echocardiographic variables were measured before and 48-72 h after the procedure. The optimal cutoff point for differences in the Macruz index to determine clinical success was evaluated by receiver operating characteristic analysis by calculating the area under the curve as giving the maximum sum of sensitivity and specificity for the significant test

Results:In the patient group [mean age 42.9 +/- 11.1 years], the preprocedural Macruz index was significantly higher than in the control group [2.79 +/- 1.03 vs. 1.29 +/- 0.11; p < 0.001]. In the successful-procedure group [n = 53], the mean postindex value was significantly lower [2.12 +/- 0.71 vs. 2.81 +/- 1.0, p = 0.020], and the decrease in the Macruz index was significantly higher than in the unsuccessful-procedure group [p = 0.007]. An index decrease of 0.105 was the best cutoff value to distinguish the successful-PMBV group from the unsuccessful- PMBV group [area under the curve = 0.888, 95% confidence interval 0.788-0.988, p < 0.001]

Conclusion:The Macruz index was significantly higher in patients with MS compared to healthy subjects. A greater decrease in the Macruz index was associated with a successful PMBV

Red cell distribution width can predict the significance of angiographically intermediate coronary lesions

Objective: In the present study, the association between red cell distribution width [RDW] with functional significance of intermediate coronary artery lesions was investigated

Materials and Methods: Two hundred and forty-six consecutive patients, 168 males and 78 females, who underwent fractional flow reserve [FFR] measurement for angiographically intermediate coronary stenosis [40-70% in quantitative coronary analysis] in the left anterior descending coronary artery were enrolled into the study. The functional significance of intermediate coronary artery lesions was determined by FFR measurement. An FFR value <0.75 was defined as functionally significant. Venous blood samples were taken within 48 h before the FFR measurement, and RDW levels were determined by a Coulter LH Series hematology analyzer. Logistic regression analysis was used to examine the association between functional significance in FFR measurement and other variables

Results: Of the 246 patients, 62 [25.2%] exhibited significant functional stenosis [FFR <0.75] in the FFR measurement. The mean RDW level was significantly higher in patients with significant stenosis [14.19 +/- 0.73 vs. 13.69 +/- 0.77, p < 0.001]. In stepwise multivariate logistic regression analysis, RDW [OR = 2.489, 95% CI = 1.631-3.799, p < 0.001] and male gender [OR = 2.826, 95% CI = 1.347-5.928, p = 0.006] were independent predictors of significant functional stenosis

Conclusion: Increased RDW levels were associated with functional significance of angiographically intermediate coronary artery stenoses

The Association between Platelet/Lymphocyte Ratio and Coronary Artery Disease Severity in Asymptomatic Low Ejection Fraction Patients

BACKGROUND AND OBJECTIVES: Coronary angiography (CAG) is generally needed in the setting of systolic heart failure (HF) with an unidentified etiology as a part of diagnostic strategy. On the other hand, the clinical value of this invasive strategy is largely unknown. Platelet-lymphocyte ratio (PLR) has recently emerged as a novel inflammatory index that may serve as an important predictor of inflammatory state and overall mortality. The present study aimed to search the predictive value of PLR in determining the extent of coronary atherosclerosis in asymptomatic low ejection fraction (EF) patients. SUBJECTS AND METHODS: 156 asymptomatic heart failure (HF) subjects (without angina or HF symptoms, mean age: 58 years; to male: 71.2%) were enrolled, and thereafter a CAG was performed. Gensini Score was used to determine the severity of coronary artery disease (CAD) on CAG. According to this scoring system, the overall study group was categorized into three distinct subgroups: control group with the score 0, mild atherosclerosis group with the score 0 to 20 and severe atherosclerosis group with the score of >20. Thereafter, a comparison was made among groups with regard to mean values of PLR. RESULTS: The severe atherosclerosis group had a substantially higher level of mean PLR in comparison to other groups (p<0.001). Pre-CAG PLR levels as well as a variety of clinical variables including age, low density lipoprotein (LDL)-cholesterol demonstrated an independent correlation with Gensini score through a multivariate analysis. CONCLUSION: These findings suggest the potential association of high PLR levels with severe atherosclerosis in the setting of asymptomatic systolic HF. A simple measurement of PLR helps to identify the severity of coronary atherosclerosis prior to conducting coronary angiography.