Investigation of possible effects of microRNAs involved in regulation of lipid metabolism in the pathogenesis of atherosclerosis.

Due to being stable in the circulatory system plasma miRNAs have been detected in various diseases including coronary artery disease (CAD) which is the major cause of mortality and morbidity worldwide. Atherosclerosis is the major cause of CAD. The first and most important event in the progression of atherosclerosis is endothelial dysfunction and accumulation of the lipids in the arterial wall. Recent studies have shown that different expression levels of lipid metabolism-related miRNAs associated with the pathogenesis of atherosclerosis. Therefore, in this current study, we aimed to investigate the possible effects of lipid metabolism-related miRNAs in plasma of patients with CAD. miRNA analysis was performed by high throughput quantitative PCR method using RNA samples isolated from 46 patients with CAD and 43 non-CAD or control. Data were analyzed using SPSS software version 17 and GeneGlobe Data Analysis Center by Qiagen. Among 40 miRNAs, 4 miRNAs were markedly up-regulated while 4 miRNAs were down-regulated in patients with CAD compared to the control group. The results have shown that, hsa-mir-144-3p, hsa-miR-222-5p and hsa-miR-133a-5p were statistically different in the patient with CAD compared to the control (p = 0.040, 0.030 and 0.005 respectively). Increased expression of hsa-mir-144-3p, hsa-miR-222-5p and hsa-miR-133a-5p would have associated with presence of the CAD. Furthermore, we suggested that these miRNAs might have been useful markers for early detection of the CAD.

Neutrophil to lymphocyte ratio: a novel marker for predicting hospital mortality of patients with acute type A aortic dissection.

INTRODUCTION: The inflammatory process has been reported to be associated with aortic dissection (AD) from the development to the prognosis. The aim of the study was to investigate a relationship between the neutrophil to lymphocyte ratio (NLR) and in-hospital outcomes in patients with acute aortic dissection (AAD) who underwent surgical repair. METHODS: One hundred and eighty-four patients who were admitted with the diagnosis of type A AAD who underwent surgical repair at two large tertiary hospitals. According to their NLR, 91 patients had high NLR (>6.0) and 93 patients had low NLR (⩽6.0). RESULTS: The frequency of major bleeding, hospital-related infection, multi-organ dysfunction and mortality in hospital were higher in the high NLR group compared to the low NLR group. NLR, WBC count and operation duration were found to be independent predictors for in-hospital mortality. CONCLUSIONS: The novel inflammatory marker NLR may be used to predict worse outcomes and hospital mortality in patients with AAD treated by surgical repair.

Usefulness of admission hematologic parameters as diagnostic tools in acute pulmonary embolism.

The purpose of this study was to determine the role of red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) in the diagnostic phase of acute pulmonary embolism (PE). We screened 248 consecutive patients who were admitted to the emergency service with PE foremost in the differential diagnosis. Based on spiral computed chest tomography, the patients were divided into two groups. There were 112 confirmed cases of acute PE and 138 patients without PE. Blood samples were obtained within 2 hours of presentation and before starting any medication. There were no significant differences between the PE and the non-PE groups with respect to sex, age, frequency of disease, serum creatinine, sodium, and potassium (p > 0.05 for all). NLR, RDW, and PLR were higher in patients with PE than those without PE. High-sensitivity C-reactive protein, D-dimer, and troponin levels were also higher in patients with PE. RDW values were positively correlated with troponin levels (r = 0.147, p = 0.021). There were no correlations between RDW and NLR, PLR, or D-dimer. NLR had a highly positive correlation with PLR (r = 0.488, p < 0.001). In multivariate logistic regression analysis, troponin I, D-dimer, high-sensitivity C-reactive protein, and RDW were found to be independent predictors of PE [odds ratio (95% confidence interval) respectively: 5.208 (2.534-10.704), 1.242 (1.094-1.409), 1.005 (1.000-1.010), 1.175 (1.052-1.312)]. In receiver operating characteristic analysis of the patients in the study, RDW >18.9 predicted acute PE with a sensitivity of 20.7% and a specificity of 93.4%. In conclusion, RDW can be considered useful as a diagnostic measure for patients with suspected acute PE.

[Ventriculer fibrillation due to Prinzmetal angina in a pregnant patient]. / Hamile bir hastada ventrikül fibrilasyonuna neden olan Prinzmetal anjina.

Variant angina, which is also referred to as prinzmetal or coronary vasospastic angina, is a clinical entity characterized by episodes of angina pectoris, usually at rest and often between midnight and early morning, in association with ST-segment elevation on the electrocardiogram. Angina is usually caused by focal spasm of a major coronary artery resulting in a high-grade obstruction, and myocardial infarction may develop in some cases. We report a prinzmetal angina which caused ventricular fibrillation and cardiac arrest in an 18-week pregnant woman.

[The relationship between epicardial adipose tissue and endothelial dysfunction in patients with type 2 diabetes mellitus]. / Tip 2 diyabetli hastalarda epikart yag yastikçigi ile endotel fonksiyon bozuklugunun iliskisi.

OBJECTIVES: Epicardial adipose tissue (EAT) has been shown to be related to cardiovascular risk. The aim of the present study was to investigate the relationship between EAT and endothelial function in patients with type 2 diabetes mellitus (DM). STUDY DESIGN: Type 2 DM patients were divided into two groups according to their brachial flow-mediated dilatation (FMD) values. The endothelial dysfunction (ED) group consisted of 46 patients with FMD change of <7%, while 46 patients with FMD change of >7% were accepted as the non-ED group. EAT thickness was measured on the right ventricular free wall from the transthoracic echocardiographic parasternal long- and short-axis views. The patients' demographic, anthropometric and laboratory findings were recorded. RESULTS: The mean diameter of EAT was 8.0±1.8 cm in the ED group and 6.6±1.2 cm in the non-ED group (p<0.001). The HbA1c levels were significantly higher in the ED group than non-ED group (8.55 [7.30-9.80], 7.45 [6.50-9.30], respectively; p=0.042). There were a negative correlation between FMD values and EAT (r=-0.437, p<0.001). The FMD values were weakly and negatively correlated with DM duration and HbA1c levels (r=-0.216, p=0.038; r=-0.266, p=0.010, respectively). EAT thickness was strongly correlated with body mass index (BMI) and waist length (r=0.405, p<0.001; r=0.515, p<0.001, respectively). The neutrophil count was significantly higher in the ED group than in the non-ED group. In multivariate logistic regression analysis, HbA1c and EAT diameters were found as predictors of ED in type 2 DM (odds ratio (OR): 1.887, 95% confidence interval (CI): 1.298-2.743, p=0.001; OR: 1.485, 95% CI: 1.054-2.093). CONCLUSION: EAT thickness predicts ED in patients with type 2 DM.