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SUMMARY OBJECTIVE: This study aimed to evaluate the effects of statin response on cardiovascular outcomes in patients with ST-segment elevation myocardial infarction. METHODS: A total of 1029 ST-segment elevation myocardial infarction patients were enrolled in the study. The patients who failed to achieve >40% reduction in baseline low-density lipoprotein cholesterol levels within 30 days to 12 months after statin initiation were defined as suboptimal statin responders. The adjusted hazard ratios for cardiovascular outcomes for low-density lipoprotein cholesterol response to statins were estimated via the Cox proportional regression model. The relationship between the statin response and cardiovascular outcomes was also evaluated in a subgroup of on-treatment low-density lipoprotein cholesterol levels below 55 mg/dL. RESULTS: Among the study population, 573 (55.6%) patients demonstrated suboptimal low-density lipoprotein cholesterol response to statin therapy. These patients showed a significantly higher incidence of the composite of major adverse cardiovascular events, including cardiovascular death, reinfarction, recurrent myocardial infarction, and target vessel revascularization during the follow-up compared with optimal responders (adjusted hazard ratios 3.99; 95%CI 2.66-6.01; p<0.001). In a subgroup of patients with on-treatment low-density lipoprotein cholesterol levels below 55 mg/dL, suboptimal statin responders also showed unfavorable cardiovascular outcomes (adjusted hazard ratios 8.73; 95%CI 2.81-27.1; p<0.001). CONCLUSIONS: The present study showed that over half of the patients with ST-segment elevation myocardial infarction did not exhibit optimal low-density lipoprotein cholesterol response to statin. These patients have an increased risk of future major adverse cardiovascular events.
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Background: The aim of the present study is to determine the presence of atherosclerosis in geriatric patients who are known to be healthy and examine sociodemographic and laboratory parameters affecting the presence of atherosclerosis.Method: 90 healthy volunteers including 66(73.3%) non-geriatric ones and 24(26.7%) geriatric ones were included in the study. It was analyzed whether there was a correlation between the two groups in terms of the parameters of gender, age average, alcohol consumption, smoking, carotid intima-media thickness (CA-IMT), and pulse wave velocity (PWV). Sociodemographic and laboratory parameters of the volunteers with and without atherosclerosis in the geriatric group were examined. Results: Among geriatric volunteers (Group 1), 13(54.2%) were male; whereas, among non-geriatric volunteers (Group 2), 41(62.1%) were male. CA-IMT was determined to be higher in Group 1 (averagely 0.80±0.12 mm) than Group 2 (averagely 0.62±0.14 mm) (p:<0.001). PWV was significantly higher in Group 1 (averagely 10.32±1.44 m/s) than Group 2 (6.26±1.09 m/s) (p:<0.001). After PWV or CA-IMT examination, atherosclerosis findings were determined in 12 healthy geriatric volunteers (50%) in Group 1.Conclusion: It should be remembered that even though atherosclerosis can be frequently observed in geriatric individuals who are known to be healthy, it may also go unnoticed. Determination of atherosclerosis with noninvasive methods will be helpful in preventing complications that might be caused by atherosclerosis.
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Background: The pathogenesis of irritable bowel syndrome (IBS) has not been fully elucidated. The gastrointestinal tract have a well-differentiated intrinsic nervous system and also this system is connected with nervous system. The symptoms of IBS are related with autonomic nervous system (ANS). It was also possible to see cardiovascular symptoms due to this link. This link can influence QT dispersion (QTd). The aim of this case control study is to show the cardiac effects of IBS by changes in QTd.Methods: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in this study. IBS was diagnosed using the new Roma IV Criterias. Standard 12-lead electrocardiogram (ECG) were taken in both two groups. QTd and corrected QTd (QTcd), QT max, QT min, QT avarage, Corrected QT (QTc) min, QTc max, QTc avarage values were calculated with Bazzet Formula from rest ECGs.Results: There were 56 newly diagnosed patients with IBS and 60 control subjects were included in the study (p:0.94). The mean age of the patients and control patients were 51.75±10.41 years and 48.41±9.72 (p: 0.53) years, respectively. QTd and corrected QTd (QTcd), QT max, QT min, QT mean, Corrected QT (QTc) min, QTc max, QTc mean values were calculated. QTd and QTcd values were found to be significantly higher in the patients with IBS (40.2±7.18; 34.1±6.18 / 52±9.8; 50.6±7.61 Msec, respectively). It is concluded that, QTd (p: 0.022) and QTcd (p: 0.032) were significantly incresased in the IBS.Conclusions: Activation of ANS in the patients with IBS can affect QT period in ECG.