Cardiac risk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion.
Objective:Vitamin D deficiency is an independent risk factor for cardiovascular mortality. The relationship between vitamin D level and left ventricle (LV) myocardial performance index (MPI=Tei index), which incorporates both LV systolic function and diastolic function, was not investigated in previous studies. We hypothesized that vitamin D level may be associated with LV function and geometry. We aimed to investigate the association between serum 25-hydroxyvitamin D (25 [OH] D) levels and MPI and LV hypertrophy in hypertensive patients with newly diagnosed and preserved ejection fraction.Methods:We studied 151 sequential newly diagnosed hypertensive subjects who lived in the Çukurova region without known cardiovascular risk factors or overt heart disease (mean age: 62.8±10.4 years). Serum 25 (OH) D was measured using a direct competitive chemiluminescent immunoassay. The patients were divided into two groups according to serum 25 (OH) D level: vitamin D-non-deficient group (vitamin D> 20.00 ng/mL, n=53) and vitamin D-deficient group (vitamin D< 20.00 ng/mL, n=98). MPI was defined as the sum of isovolumic contraction and relaxation times divided by the ejection time. LV mass index (LVMI) was calculated by using the Devereux formula and body surface area.Results:MPI and LVMI values were lower and low-density lipoprotein (LDL) levels were higher in patients who were vitamin D-non-deficient than patients who were vitamin D-deficient (p<0.05 for all). Multivariate linear regression analysis showed that serum 25 (OH) D was indepen-dently associated with MPI (β=-0.426, p<0.001), LVMI (β=-0.345, p=<0.001), and LDL (β=0.140, p<0.026).Conclusion:Lower serum 25 (OH) D levels are significantly associated with impaired myocardial performance and LVMI.
In the pathogenesis of atherosclerosis, oxidative stress plays a major role in plaque instability, rupture, and erosion, which subsequently leads to thrombus formation and causes total infarct-related artery (IRA) occlusion. We investigated the relationship between spontaneous reperfusion (SR) of IRA and oxidative stress in patients with anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. A total of 341 consecutive patients with anterior STEMI were prospectively included in the present study. Patients were divided into 2 groups according to their thrombolysis in myocardial infarction (TIMI) flow grade: SR group (66 patients, TIMI flow 3) and non-SR group (275 patients, TIMI flow 0-2). On multivariate logistic regression analysis, oxidative stress index (β = 0.868, 95% confidence interval [CI] = 0.806-0.934, P < .001), neutrophil to lymphocyte ratio, uric acid, mean platelet volume, Killip 2 to 4 class, and initial SYNTAX score were independently associated with SR. Oxidative stress as well as inflammation may play a pivotal role in the pathogenesis of SR in patients with STEMI.
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