Evaluation of the relationship between aspartate aminotransferase/alanine aminotransferase ratio and coronary slow-flow phenomenon.

Aim: To assess the correlation between the ratio of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and slow coronary flow (SCF). Methods: A total of 119 patients with SCF and 121 age- and sex-matched patients with normal coronary flow were included in this retrospective cross-sectional study. Thrombolysis in myocardial infarction frame count of angiography images was marked by two interventionalists. In addition to AST and ALT levels, complete blood count; kidney, liver and thyroid function tests; age; sex; medication and medical history were recorded. Results: Significant spikes in AST/ALT ratio were discovered in the SCF group compared with the normal coronary flow group (p < 0.001). Thrombolysis in myocardial infarction frame count values were significantly higher in all coronaries for the SCF group compared with the normal coronary flow group (p < 0.001). Thrombolysis in myocardial infarction frame count values of the left anterior descending artery (r = 0.258; p < 0.001), left circumflex artery (r = 0.297; p < 0.001) and right coronary artery (r = 0.195; p = 0.002) were positively correlated with AST/ALT ratio. Conclusion: AST/ALT ratio is significantly correlated with SCF; therefore, this ratio may have predictive value.

Sarcopenia and Its Prognostic Role on Hospitalization and In-Hospital Mortality in Coronavirus Disease 2019 Patients with At Least One Cardiovascular Risk Factor.

BACKGROUND: The coronavirus disease 2019 infection is a global pandemic that has affected the whole world population. We aimed to evaluate the prognostic role of cross-sectional area, muscle index, and muscle attenuation values in computed tomography-based skeletal groups [erector spinae muscle, pectoralis muscle, and total skeletal muscle] of patients hospitalized for coronavirus disease 2019 and with at least 1 cardiovascular risk factor. METHODS: A total of 232 patients with coronavirus disease 2019 and at least 1 cardiovascular risk factor were enrolled in the study, retrospectively. The cross-sectional area, muscle index, and attenuation of erector spine muscle, pectoralis muscle, and total skeletal muscle were automatically measured on computed tomography images. The study population was assigned into tertiles on the basis of the total SMcsa index. The relationship between the values obtained and the length of hospital stay, admission to intensive care unit, the need for invasive mechani cal ventilation, and mortality was investigated. RESULTS: Admission to intensive care unit, need for invasive mechanical ventilation, and mor tality were higher at tertile 3 groups than in the other groups (all P values <.001). Statistically, all muscle measurements were significantly lower in tertile 3 (P <.001). Diabetes mellitus, hypertension, and total SMcsa index were predictors of in-hospital mortality in patients with coronavirus disease 2019 on the basis of Cox regression analysis. In the Kaplan-Meier analysis for the proportion of survivors relative to the total SMcsa index, tertile 3 had the highest mortal ity (survival rates 57%, P < .001). CONCLUSIONS: Sarcopenia and attendant cardiovascular comorbidities can effectively assess dis ease severity and predict outcome in patients with coronavirus disease 2019.

Prognostic Nutritional Index as a New Prediction Tool for Coronary Collateral Development.

BACKGROUND: Nutritional status is a predictor of the prognosis of cardiovascular diseases. The association between the Prognostic Nutritional Index (PNI), which is an immunonutritional parameter, and cardiovascular diseases has been extensively studied in the literature. OBJECTIVES: The aim of this study was to investigate whether PNI is associated with coronary collateral development. METHODS: This retrospective study included 172 patients with chronic total occlusion. The patients were diagnosed with stable coronary artery disease, and all patients underwent coronary angiography. PNI was calculated using serum albumin level and lymphocyte count. Collateral circulation was classified according to Rentrop grade. RESULTS: There was a positive correlation between PNI and Rentrop grade (r = 0.168, p = 0.026) and a negative correlation between C-reactive protein and PNI (r = -0.353, p < 0.001). Multivariate logistic regression analysis showed that uric acid and PNI were independent predictors of Rentrop grade (p = 0.008 and p = 0.037, respectively). CONCLUSIONS: This study showed that PNI, which can easily be calculated using serum albumin level and lymphocyte count, was a predictor of coronary collateral development in terms of Rentrop grade.

Relationship Between C-Reactive Protein to Albumin Ratio and Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction.

The C-reactive protein to albumin ratio (CAR) is a predictive marker of systemic inflammatory state in atherosclerotic coronary disease when compared with the predictive value of these 2 markers separately. We investigated the relationship between CAR and infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). The study population (n = 1047) was divided into 2 groups according to IRA patency which was assessed by the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Nonpatent flow was defined as TIMI grade 0 (no-reflow), 1, and 2 flows, and normal flow was defined as TIMI 3 flow. There was a significant positive correlation between CAR and SYNTAX score (r = 0.312, P < .001) and a negative correlation between CAR and TIMI grade flow (r = -0.210, P < .001). At a cutoff level of 0.693, the CAR predicted TIMI no-reflow with a sensitivity of 65.4% and a specificity of 65.5% (area under the curve: 0.670, 95% CI: 0.62-0.71, P < .001). Multivariate logistic regression analyses showed that CAR was an independent predictor of IRA patency (0.003 [0.001-0.029]; P < .001). A higher CAR is a significant and independent predictor of IRA patency in patients with STEMI.

Tp-e/QTc ratio, SYNTAX, and GRACE score in patients who underwent coronary angiography owing to acute coronary syndrome.

OBJECTIVE: Ventricular arrhythmias following acute coronary syndrome (ACS) range from benign to life-threatening fatal arrhythmias. Tpeak-end (Tp-e) interval has been shown to be an important parameter in the assessment of repolarization dispersion. We aimed to evaluate the relationship between SYNTAX and Global Registry of Acute Coronary Events (GRACE) risk score calculated on admission and Tp-e interval and Tp-e/QTc ratio. METHODS: A total of 421 patients were included in the study. The patients were divided into 2 groups as low SYNTAX score (≤22) and moderate and high risk SYNTAX score (>22). According to the GRACE risk score, the patients were divided into 2 groups; high-risk patients ≥140 and <140 low-risk patients. RESULTS: In the group with SYNTAX score >22, the Tp-e interval (p<0.001) and Tp-e/QTc ratio (p<0.001) was found to be significantly higher than in the group with a SYNTAX score ≤22. Tp-e interval (p<0.001) and Tp-e/QTc ratio (p=0.002) was higher in patients with GRACE risk score ≥140 compared with patients with a GRACE risk score <140. The correlation between Tp-e interval and Tp-e/QTc ratio and SYNTAX score (r=0.489; p<0.001) and GRACE risk score (r=0.274; p<0.001) were found to be significant. A significant and independent correlation was found between the SYNTAX score and Tp-e/QTc ratio (ß=0.385; p<0.001). CONCLUSION: Tp-e interval and Tp-e/QT ratio increased in patients with severe coronary artery disease assessed with SYNTAX score. Tp-e interval and Tp-e/QT ratio increased in patients with a high GRACE risk score.

The assessment of Tp-e interval and Tp-e/QT ratio in patients with hyperthyroidism before and after thyroid surgery.

BACKGROUND: Ventricular repolarisation is assessed using the Tp-e interval and QT interval corrected by the heart rate (QTc) via an electrocardiogram (ECG). Prolonged Tp-e/QTc is related with an increased risk of arrhythmias and cardiac mortality. OBJECTIVE: This study was conducted at a single centre in collaboration with general surgery and cardiology clinics. We aimed to appraise the assessment of Tp-e interval and Tp-e/QT ratio in patients with hyperthyroidism before and after thyroid surgery. METHODS: Totally 65 patients with hyperthyroidism before and after thyroid surgery were enrolled in our study. In presurgical hospitalisation and six months after the thyroid surgery, we measured the electrocardiographic parameters again on same patients. All subjects who were investigated in this study were in sinus rhythm. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were measured from the 12-lead electrocardiogram. RESULTS: Heart rate (P = .073), QT interval (P = .432) and QTc interval (P = .179) were similar before and after thyroid surgery. Tp-e interval (84.6 ± 13.1 vs 77.2 ± 10.9; P = .031), Tp-e/QT ratio (0.23 ± 0.04 vs 0.21 ± 0.04; P < .001), Tp-e/QTc ratio (0.21 ± 0.04 vs 0.19 ± 0.03; P < .001) and QTc dispersion (52.4 ± 7.2 vs 48.4 ± 7.4; P < .001) were significantly different before and after thyroid surgery. In correlation analysis, there was a significant correlation between preprocedural Tp-e/QTc ratio and preprocedural fT4 in patients with hyperthyroidism (r = 0.275, P = .026). CONCLUSION: Our study demonstrated that Tp-e interval, Tp-e/QT and Tp-e/QTc ratios were shortened in patients with hyperthyroidism after thyroid surgery than before procedure. This study is considerable to display that hyperthyroidism may have a negative effect on cardiac conduction system, which potentially may induce formation of ventricular arrhythmias.

Whole blood viscosity in patients with aortic stenosis.

Whole blood viscosity (WBV) may promote endothelial shear stress, inflammation, and can accelerate the atherosclerotic process. We aimed to evaluate the relationship between WBV and aortic stenosis. The study included 209 participants of whom 49 patients had severe aortic stenosis, 98 patients had mild-to-moderate aortic stenosis and 62 patients served as control. WBV values were significantly higher for high shear rate (HSR) (P = 0.001) and for low shear rate (LSR) (P = 0.002) in severe aortic stenosis group. HSR and LSR were correlated with mean systolic transaortic gradient (P < 0.001 and P < 0.001, respectively). WBV for both LSR and HSR were found to be independent predictors for the aortic stenosis severity (P = 0.034 and P = 0.049, respectively). We found a significant relationship between WBV and aortic stenosis.

Relationship between c-reactive protein to albumin ratio and coronary artery calcium score and CAD-RADS scores with coronary computed tomography angiography.

BACKGROUND: : C-reactive protein (CRP) to albumin ratio (CAR) is predictive marker of systemic inflammatory state in atherosclerotic coronary diseases when compared to predictive value of these two markers separately. We aimed to evaluate the relationship between CAR and the coronary artery calcium (CAC) score, Coronary Artery Disease-Reporting and Data System (CAD-RADS) score in patients' unknown diagnosis of coronary artery disease (CAD) underwent coronary CTA (Computed Tomography Angiography) and were classified by CAD-RADS scores. METHODS: A total of 187 patients consecutively referred for the evaluation of their chest pain underwent coronary CTA were included retrospectively. RESULTS: CRP, CAR, and CAD-RADS scores were higher in patients with CAC score > 400 than the other groups (p < 0.001). We found positive correlation between CAR and CAC score (r= 0.384, p < 0.001), and also there was a positive correlation between CAR and CAD-RADS score (r= 0.462, p < 0.001). Multivariate logistic regression analyses showed that low density lipoprotein cholesterol (LDL-C), CAD-RADS score, and CAR were independent predictors of CAC score (p < 0.05). DISCUSSION: Higher CAR can be a predictive marker of atherosclerosis and CAD. CAR may be useful in the management of patients before invasive coronary angiography. Further studies are needed to clarify the pathophysiologic role of CAR in patients with atherosclerotic coronary heart diease.

The association of aortic elasticity properties with novel inflammatory marker CRP /albumin ratio.

OBJECTIVE: Hypertension (HT) is the most important preventable cause of cardiovascular disease and mortality. Aortic elasticity parameters are affected in HT, and inflammation plays a central role in the development of HT. C-reactive protein (CRP) to albumin ratio (CAR) is a novel inflammatory marker. We aimed to evaluate the association of aortic elasticity properties with CAR. METHODS: A total of newly diagnosed untreated 101 hypertensive patients and 98 control participants were included to study. Clinical, demographic parameters, and blood sample parameters were recorded. Aortic strain, aortic stiffness index (ASI), and aortic distensibility (AoD) as aortic elasticity parameters were obtained from transthoracic echocardiography. RESULTS: CRP, CAR, ASI were significantly higher in hypertensive patients. (6.32 ± 2.48 vs 8.41 ± 3.35, p:<0.001; 0.158 ± 0.065 vs. 0.204 ± 0.083, p: <0.001; 6.73 ± 1.00 vs. 10.93 ± 1.81, p: <0.001, respectively) Aortic strain and AoD levels were significantly lower in hypertensive patients. (6.75 ± 2.17 vs 7.98 ± 2.27; p: <0.001 vs. 3.05 ± 0.97 vs 5.16 ± 1.01; p: <0.001, respectively). CONCLUSION: CAR a novel inflammatory marker, which can be obtained from blood samples without additional time and cost, can be useful to predict aortic elasticity properties of hypertensive patients in daily clinical practice.

C-Reactive Protein to Albumin Ratio in Patients With Saphenous Vein Graft Disease.

Atherosclerosis plays an important role in saphenous vein graft disease (SVGD). Previous studies showed that inflammatory blood cells play an active role in this process. C-reactive protein to albumin ratio (CAR) is considered as a novel predictor for cardiovascular risk and an indicator of inflammation. We aimed to assess the relationship between SVGD and CAR. A total of 711 participants with saphenous vein graft (SVG) were included; 348 patients had SVGD and 363 patients had patent (no stenosis) SVG. C-reactive protein to albumin ratio was higher in patients with SVGD (P < .001). There was a significant positive correlation between CAR and the age of SVG (r = 0.123; P = .001) and SYNTAX score (r = 0.568; P < .001). Multivariate logistic regression analyses showed that lymphocyte count, CAR, and SYNTAX score were independent predictors of SVGD (P < .05). C-reactive protein to albumin ratio may be a useful marker after bypass surgery to predict SVGD.