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SUMMARY OBJECTIVE: Cardiovascular disease risk prediction in scleroderma is important. In this study of scleroderma patients, the aim was to investigate the relationship between cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide and cardiovascular disease risk with the Systematic COronary Risk Evaluation 2 model of the European Society of Cardiology. METHODS: Systematic COronary Risk Evaluation 2 risk groups of 38 healthy controls and 52 women with scleroderma were evaluated. Cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide levels were analyzed with commercial ELISA kits. RESULTS: In scleroderma patients, cardiac myosin-binding protein-C and trimethylamine N-oxide levels were higher than healthy controls but sensitive troponin T was not (p<0.001, p<0.001, and p=0.274, respectively). Out of 52 patients, 36 (69.2%) were at low risk, and the other 16 (30.8%) patients were at high-moderate risk with the Systematic COronary Risk Evaluation 2 model. At the optimal cutoff values, trimethylamine N-oxide could discriminate high-moderate risk with sensitivity 76%, specificity 86% and cardiac myosin-binding protein-C with sensitivity 75%, specificity 83%. Patients with high trimethylamine N-oxide levels (≥10.28 ng/mL) could predict high-moderate- Systematic COronary Risk Evaluation 2 risk 15 times higher than those with low trimethylamine N-oxide (<10.28 ng/mL) levels (odds ratio [OR]: 15.00, 95%CI 3.585-62.765, p<0.001). Similarly, high cardiac myosin-binding protein-C (≥8.29 ng/mL) levels could predict significantly higher Systematic COronary Risk Evaluation 2 risk than low cardiac myosin-binding protein-C (<8.29 ng/mL) levels (OR: 11.00, 95%CI 2.786-43.430). CONCLUSION: Noninvasive cardiovascular disease risk prediction indicators in scleroderma, cardiac myosin-binding protein-C, and trimethylamine N-oxide could be recommended to distinguish between high-moderate risk and low risk with the Systematic COronary Risk Evaluation 2 model.
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SUMMARY OBJECTIVE: In this article, we investigated the association of chromogranin A with coronary artery disease. METHODS: Biochemical parameters and chromogranin A levels obtained from peripheral blood samples during coronary angiography were analyzed in 90 patients. Patients were classified into two groups, namely, SYNergy between PCI with TAXUS and Cardiac Surgery score ≥1 (n=45) and SYNergy between PCI with TAXUS and Cardiac Surgery score=0 (n=45). This is a cross-sectional, prospective study. RESULTS: Serum chromogranin A levels were significantly higher in the group with SYNergy between PCI with TAXUS and Cardiac Surgery score ≥1 compared to the group with SYNergy between PCI with TAXUS and Cardiac Surgery score=0 (1381.5±418.9 ng/mL and 1121.2±290.7 ng/mL, respectively; p=0.002). Serum chromogranin A levels were correlated with SYNergy between PCI with TAXUS and Cardiac Surgery score (r=0.556, p<0.04). ROC analysis showed that the area under the curve for serum chromogranin A levels was 0.687 (p=0.007), and the best cutoff value of 1,131 ng/mL had a sensitivity of 67% and a specificity of 65% for the prediction of coronary artery disease. CONCLUSION: Serum chromogranin A levels were increased in coronary artery disease patients with SYNergy between PCI with TAXUS and Cardiac Surgery score ≥1. Increasing serum chromogranin A levels are proportional to the SYNergy between PCI with TAXUS and Cardiac Surgery score.
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Resumo Fundamento O índice imunoinflamatório sistêmico (IIS), derivado das contagens de neutrófilos, plaquetas e linfócitos, representa o equilíbrio homeostático entre os estados inflamatório, imune e trombótico. O IIS é superior a índices como a relação neutrófilos-linfócitos no prognóstico de várias malignidades, além de ser um melhor preditor de futuros eventos cardíacos que os fatores de risco tradicionais após a intervenção coronariana. Objetivos Este estudo objetivou avaliar a relação do IIS com a carga aterosclerótica e complicações hospitalares em pacientes com síndrome coronariana aguda. Métodos Desfechos clínicos, como extensão do dano miocárdico, carga aterosclerótica, sangramento, insuficiência renal aguda, duração da internação e mortalidade hospitalar, foram avaliados em uma coorte retrospectiva de 309 pacientes consecutivos com síndrome coronariana aguda. O IIS foi calculado como (plaqueta x neutrófilos)/contagem de linfócitos na admissão. A população estudada foi categorizada em tercis de IIS. Valores de p<0,05 foram considerados estatisticamente significativos. Resultados Os maiores valores de IIS foram encontrados em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (641,4 com angina pectoris instável, 843,0 com infarto do miocárdio sem supradesnivelamento do segmento ST e 996,0 com infarto do miocárdio com supradesnivelamento do segmento ST; p=0,004). Concentração máxima de troponina (0,94 versus 1,26 versus 3; p<0,001), número de vasos doentes (1 versus 2 versus 2; p<0,001), escore SYNTAX ( The SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery — sinergia entre intervenção coronária percutânea com taxus e cirurgia cardíaca) (9 versus 14 versus 17,5; p<0,001) e duração da internação (2 versus 2 versus 3; p<0,001) também aumentaram de acordo com o tercil de IIS (tercil 1 versus tercil 2 versus tercil 3). O IIS foi um preditor independente de escore SYNTAX (ß: 0,232 [0,001 a 0,003]; p<0,001), extensão do dano miocárdico (ß: 0,152 [0 a 0,001]; p=0,005) e duração da internação (ß: 0,168 [0,0 a 0,001]; p=0,003). Conclusões Este estudo demonstrou que o IIS, um índice hematológico simples, é um marcador melhor de carga aterosclerótica e internação mais longa do que fatores de risco bem conhecidos em pacientes com síndrome coronariana aguda de alto risco.
Abstract Background Systemic immune-inflammatory index (SII), which is derived from neutrophil, platelet and lymphocyte counts, represents the homeostatic balance among inflammatory, immune and thrombotic status. The systemic immune-inflammatory index is superior to indices such as neutrophil-lymphocyte ratio in predicting prognosis in various malignancies, while it is shown to predict future cardiac events better than traditional risk factors after coronary intervention. Objectives Herein, we aimed to evaluate the relationship of the systemic immune-inflammatory index with atherosclerotic burden and in-hospital complications in acute coronary syndrome patients. Methods The clinical outcomes, such as extent of myocardial damage, atherosclerotic burden, bleeding, acute kidney injury, duration of hospital stay and in-hospital mortality, were evaluated in a retrospective cohort of 309 consecutive acute coronary syndrome patients. The systemic immune-inflammatory index was calculated as (Platelet X Neutrophil)/Lymphocyte count on admission. Study population was categorized into tertiles with regard to systemic immune-inflammatory index. A p value of <0.05 was considered statistically significant. Results The highest systemic immune-inflammatory index values were within ST elevation myocardial infarction patients (641.4 in unstable angina pectoris, 843.0 in non-ST elevation myocardial infarction patients and 996.0 in ST elevation myocardial infarction patients; p=0.004). Maximal troponin concentration (0.94 vs. 1.26 vs. 3; p<0.001), number of diseased vessels (1 vs. 2 vs. 2; p<0.001), the SYNTAX (synergy between percutaneous coronary intervention with taxus and coronary artery bypass grafting) score (9 vs. 14 vs. 17.5; p<0.001) and duration of hospital stay (2 vs. 2 vs. 3; p<0.001) also increased with increasing SIItertile(tertile1 vs. tertile 2 vs. tertile 3). Systemic immune-inflammatory index was an independent predictor of SYNTAX score (ß: 0.232 [0.001 to 0.003]; p<0.001), extent of myocardial damage (ß: 0.152 [0 to 0.001]; p=0.005) and duration of hospital stay (ß: 0.168 [0.0 to 0.001]; p=0.003). Conclusions This study has demonstrated that the systemic immune-inflammatory index, a simple hematological index, is a marker of atherosclerotic burden and longer hospital stay on well-known risk factors in high risk acute coronary syndrome patients.
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SUMMARY OBJECTIVE: This study aimed to investigate the seropositivity of CoronaVac-SinoVac vaccination in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) risk factors and comorbidities. METHODS: Immunoglobulin (IgG) antibody responses were examined on the 21st day after the second dose of CoronaVac-SinoVac 6 μg vaccine on the 28th day. SARS-CoV-2 IgG antibody levels were measured by using the enzyme-linked immunosorbent assay method in vaccinated health care workers (n=134) (Group I), vaccinated polymerase chain reaction (PCR) (+) who had coronavirus-19 (COVID-19) disease (n=21) (Group II), and unvaccinated PCR (+) (n=28) (Group III) participants. Subgroups were formed in Group I according to the presence of COVID-19 risk factors and comorbidities (diabetes mellitus, cardiovascular disease, and asthma/allergy) and demographic data. RESULTS: Seropositivity rates were 95.5, 100, and 89.3% for Groups I, II, and III, respectively. IgG antibody levels were found significantly higher in the group between the ages of 20-30 in group I compared to those aged 31-50 and over 50 (both p<0.01). It was found significantly higher in normal-weight individuals than in the overweight and obese group (both p<0.01). IgG antibody levels were found significantly lower in people with cardiovascular disease and diabetes mellitus compared with those who did not (p<0.05 and p<0.001, respectively). There was a negative correlation between IgG antibody response values and body mass index and age in Group I (r= −0.336, p<0.001 and r= −0.307, p<0.001, respectively). CONCLUSION: IgG antibody values decrease with age and with increasing body mass index. The presence of comorbidities (i.e., diabetes mellitus and cardiovascular disease) decreased COVID-19 IgG antibody values.