Increased Cardio-ankle Vascular Index Values in Migraine Patients With Aura.

Patients with migraine with aura are at an increased risk of cardiovascular disease. There are limited data on arterial stiffness in migraine patients with aura. The present study evaluated arterial stiffness in these patients using the cardio-ankle vascular index (CAVI). This prospective study included 50 patients with migraine with aura (43 female, mean age 38.9 ± 9.9 years). The patient group was matched for age and gender with 50 healthy individuals with no history of migraine (43 female, mean age 39.3 ± 10.3 years). All patients and control subjects underwent a comprehensive clinical evaluation by an experienced neurologist and were interviewed about their headache histories. There was no significant difference in baseline demographic characteristics and echocardiographic parameters between migraine with aura patients and the control group. Both right and left CAVI values were significantly higher in the patients with migraine with aura (6.5 ± 1.2 vs 6.1 ± 0.7, P = .043 and 6.6 ± 1.2 vs 6.1 ± 0.7, P = .009, respectively). Arterial stiffness is an important mediator of cardiovascular diseases. We found that CAVI, a novel marker of the arterial stiffness, is increased in patients with migraine with aura.

Doppler ultrasonographic evaluation of radial and ulnar artery diameters and blood flow, before and after percutaneous coronary interventions.

AIM: Although the transforearm approach is considered a safe and effective option for percutaneous coronary intervention, the different characteristics of the radial and ulnar arteries deserve attention. This study aimed to evaluate radial (RA) and ulnar artery (UA) diameter and blood flow parameters changes after catheterization. MATERIAL AND METHOD: A total of 328 patients were enrolled. Their artery (171 RA and 157 UA) diameter and flow parameters [peak systolic velocity (PSV), end-diastolic volume (EDV) and pulsatility index (PI)] were evaluated before and after catheterisation. RESULTS: After RA catheterization, the diameters and PSV decreased in the RA (from 2.71±0.66 to 2.47±0.51, p=0.007; from 44.7±8.3 to 33.9±9.5, p=0.021) and increased in the UA (from 2.49±0.83 to 2.59±0.58, p=0.033; from 48.3±11.9 to 59.6±11.0, p.

The Ulnar Artery as a Favorable Primary or Alternative Access Site for Coronary Angiography and Interventions.

The transulnar approach (TUA) has been considered both as primary access and as a secondary access site after transradial access (TRA) failure for coronary invasive procedures. However, there is little evidence supporting the use of the TUA as the first approach to diagnostic coronary angiography (CAG) or interventions. Patients (n = 587) who underwent CAG and/or angioplasty (292 patients via TRA, 295 patients via TUA) were included. The primary end points of the study were major adverse cardiac events and major vascular events (hematoma, vascular occlusion, vasospasm), and secondary end points included angiographic success, crossover rate, and angiographic procedural times. The mean age was 60 ± 21 years. The composite primary end points occurred in 34 (11.6%) patients in the TRA and 22 (7.4%) patients in the TUA arm (P < .001). More arterial occlusion and more arterial spasm than in the TUA and similar urgent target vessel revascularization were observed in the TRA group in 48 hours. Based on previous studies and our clinical experience, we speculated that the TUA performed by an experienced operator has equal status with the TRA for coronary catheterization, especially in patients with a palpable ulnar pulse.

Association between Cardio-ankle Vascular Index and Contrast-induced Nephropathy.

OBJECTIVE: To investigate the relationship between cardio-ankle vascular index (CAVI), which is a marker of arteriosclerosis and the development of contrast-induced nephropathy (CIN). STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Department of Cardiology, Sakarya University Medical Faculty, from May to December 2019. METHODOLOGY: Between May and December 2019, demographic characteristics, CAVI measurements, and in-hospital clinical outcomes were compared among 66 patients, who developed CIN after coronary angiography (CAG) and an acute coronary syndrome (ACS) diagnosis, and 60 ACS patients without CIN. RESULTS: The frequency of CIN development in the study was 5.5%. In the CIN group, EF was lower (44.5 ± 10.6% vs. 49.3 ± 9.8%, p = 0.011) and GFR (mL/min/1.73 m2) at admission, was lower (60.3 ± 23.3 vs. 87.0 ± 21.5, p <0.001) than in the non-CIN group. CAVI values indicative of arterial stiffness (AS) were significantly higher in the CIN group. Mortality was not significantly higher in the CIN group (p = 0.099). CONCLUSION: AS is more common in ACS patients, who developed CIN after CAG. Older patients with low EF and low GFR, in whom AS is more common, should be intravenously hydrated and more closely monitored to prevent CIN development. Key Words: Contrast-induced nephropathy, Acute coronary syndrome, Cardio-ankle vascular index, Arterial stiffness.