NLR has been found to be correlated with clinical and angiographic risk scores. Low NLR might be a good predictor for low in-hospital mortality and simple coronary anatomy in NSTE-ACS patients.

Objective:Although an early repolarization (ER) pattern was considered to be a benign electrocardiographic variant, several studies have shown that it is associated with an increased risk of idiopathic ventricular fibrillation and death. The aim of the present study was to determine whether there is any abnormality in myocardial deformation parameters (strain, strain rate, rotation, and twist) of the left ventricle obtained by speckle-tracking echocardiography (STE) in subjects with ER pattern.Methods:There were two groups in this prospective case-control study. The first group consisted of subjects with ER pattern (n=35). The other group was control without ER pattern (n=25). Subjects with poor echocardiographic image quality and history of cardiovascular, pulmonary, systemic, or metabolic disease were excluded from the study. For STE of the left ventricle, two-dimensional images from apical long-axis, two-chamber, and four-chamber views and from parasternal short-axis views were obtained.Results:We did not observe significant differences between the groups for left ventricular (LV) longitudinal deformation parameters, rotation, and twist. When LV circumferential deformation parameters were analyzed, early diastolic strain rate value at the level of apex was higher in subjects with ER pattern (2.3±0.7 s–1 vs. 1.9±0.4 s–1, p=0.01). Among LV radial deformation parameters, only peak strain (42.5±16.1% in the ER group vs. 56.9±21.1% in controls, p=0.004) and early diastolic strain rate (–2.0±0.7 s–1 in the ER group vs. –2.3±0.7 s–1 in controls, p=0.03) values at the level of papillary muscle were different.Conclusion:In subjects with ER pattern, LV myocardial deformation evaluated by STE is normal with a few regional exceptions. STE does not provide much information about risk stratification of these subjects.

Objective: Inflammatory mechanisms are known to play an important role in coronary artery disease. The present study aimed to investigate the importance of the neutrophil-to-lymphocyte ratio (NLR) in terms of in-hospital mortality and its association with currently used risk scores in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods: Three hundred and seventeen patients with NSTE-ACS were included. The patients were divided into tertiles according to their NLR values (NLR <2.6, NLR=2.6---4.5, and NLR >4.5). Clinical and angiographic risk was evaluated by the SYNTAX and GRACE risk scores. Results: The GRACE risk score was significantly higher in the group with high NLR values compared to those with moderate or low NLR (161.5±40.3, 130.5±32.3, and 123.9±34.3, respectively, p<0.001). Similarly, the SYNTAX score was significantly higher in the group with high NLR values (20.4±10.1, 15.5±10.5, and 13.4±7.8, respectively, p=0.003). Moreover, both GRACE (r=0.457, p<0.001) and SYNTAX scores (r=0.253, p=0.001) showed a significant positive correlation with NLR. Conclusion: NLR has been found to be correlated with clinical and angiographic risk scores. Low NLR might be a good predictor for low in-hospital mortality and simple coronary anatomy in NSTE-ACS patients.Síndrome coronária aguda sem elevação do segmento ST; Rácio neutrófilo/linfócito; Score SYNTAX; Score GRACE Rácio neutrófilo-linfócito prevê a complexidade da lesão arterial coronária e a mortalidade após o enfarte do miocárdio sem elevação do segmento ST ResumoObjetivos: Sabe-se que os mecanismos inflamatórios têm um papel importante na doença arterial coronária. O presente estudo visa investigar a importância do rácio neutrófilo/linfócito (RNL) relativamente à mortalidade hospitalar e à sua associação com os scores de risco atuais em doentes com síndromes coronárias agudas sem elevação do segmento-ST (SCA-NSTE). Métodos: Foram incluídos 317 doentes com SCA-NSTE. Os doentes foram divididos em tercis de acordo com os seus valores de RNL (RNL < 2,6, RNL = 2,6-4,5 e RNL > 4,5). Os scores de risco clínicos e angiográficos foram avaliados pelos métodos de risco SYNTAX e GRACE. Resultados: O score de risco GRACE foi significativamente mais elevado no grupo com valores RNL elevados comparado com os grupos com RNL moderado ou baixo (161,5 ± 40,3, 130,5 ± 32,3 e 123,9 ± 34,3, respetivamente, p<0,001). Do mesmo modo, o score SYNTAX foi significativamente superior no grupo com valores RNL elevados (20,4 ± 10,1, 15,5 ± 10,5 e 13,4 ± 7,8, respetivamente, p=0,003). Por outro lado, tanto o score de risco GRACE (r=0,457, p<0,001) como o score SYNTAX (r=0,253, p=0,001) mostraram uma correlação positiva significativa com RNL. Conclusão: Verificou-se que o RNL está correlacionado com os scores de risco clínicos e angiográficos. Um RNL baixo pode ser um bom fator preditor de mortalidade intra-hospitalar e de anatomia coronária simples em doentes com enfarte do miocárdio sem elevação do segmento ST.

Anahtar Kelimelerİmaj Plak Alanı İn-Stent esteno Abstract Aim: n this study we have used uantitative coronary angiography ( CA) and the mage program in order to investigate the in uence of pla ue area, as identified prior to stent implantation, on the development of stent restenosis. Material and Method: 5180 coronary angiography procedures were performed between March 2008 and uly 2011. f these, 227 presented with in-stent restenosis. A er application of the exclusion criteria, 164 intracoronary stents implanted in 121 patients were retrospectively investigated. These stents were divided into two groups depending upon the clinical status of the patient: (a) those who developed in-stent restenosis (n: 77, 47 ), and (b) those who failed to develop in-stent restenosis (n: 87, 53 ). Narrowing by 50 or more, as identified during coronary angiography performed at least six months a er the stent implantation, was considered as positive for development of in-stent restenosis. Pla ue area measurement in the patients was performed using uantitative coronary angiography ( CA) and the mage program. esults: Pla ue area measurement when performed uantitatively revealed no statistically significant di erence between the groups (p 0.05). owever, significant di erence in area was observed when mage was used (p 0.05). Statistically significant di erences were observed between groups in terms of history of hypertension and hyperlipidemia, use of statins, D values, and lesion type (p 0.05) the di erence in terms of presence of diabetes or smoking status (p 0.05) was not significant. There was a relationship among the development of restenosis and hypertension, non-usage of statin therapy, D level, poor lesion type, and pla ue area as measured with mage . Discussion: ypertension, non-usage statin therapy, low levels of D , poor lesion type, and larger pla ue areas as measured with the mage program were identified as important indicators for development of in-stent restenosis.