Inflammation and genetics play a key role in the pathogenesis of atherosclerosis and its clinical result myocardial infarction (MI). Proinflammatory cytokines, IL-1 and IL-6, have been shown to play essential roles in developmental stages of coronary artery plaque formation. The aim of this study was to determine the association between IL-1 [IL-1RN, IL-1β (-511, +3953)], IL-6 [-174, -572, -597] gene polymorphisms and MI in Turkish population. A total of 402 people were participated; 235 healthy control subjects and 167 MI patients (MI<40, n: 72; MI>40, n: 95). Polymerase chain reaction (PCR) was used to determine the genotype of IL-1RN, whereas the genotypes of IL-1β (-511, +3953) and IL-6 (-174, -572, -597) were determined using PCR followed with restriction digestion analysis. There was no significant difference between MI and controls for IL-1RN, IL-1β-511, +3953 (P: 0.875, 0.608, 0.442) and IL-6 -174, -572, -597 (P: 0.977, 0.632, 0.584) gene polymorphisms. Lack of association was observed between MI at younger age (MI<40) and either IL-1RN VNTR, IL-1β-511, +3953 (P: 0.878, 0.732, 0.978) or IL-6 -174, -572, -597 (P: 0.313, 0.654, 0.552) gene polymorphisms. This study demonstrated that there was not any association between IL-1, IL-6 gene variants and MI in Turkish population. In addition, IL-1 and IL-6 gene polymorphisms did not affect MI at younger age (MI<40) or older age (MI>40). Thus, IL-1 and IL-6 single nucleotide polymorphisms may not be a risk factor for susceptibility to MI in Turkish population.

The use of coronary artery bypass grafting (CABG) in primary treatment of acute myocardial infarction is still debated. We evaluated the predictors of mortality in patients undergoing primary CABG for ST-elevated myocardial infarction (STEMI). Between January 2003 and January 2008, all patients referred to our institution with STEMI who did not qualify for primary angioplasty and required CABG were included in this study. Survivors and nonsurvivors were compared retrospectively in terms of demo-graphics, preoperative, intraoperative, and postoperative characteristics. Preoperatively confirmed cases of STEMI (n = 150) were included in the analysis. There were 114 survivors and 36 nonsurvivors. In-hospital mortality rate was 22%. In Cox regression analysis age, cardiogenic shock (Killip ≥3), preoperative cardiac troponin levels, preoperative use of intra-aortic balloon counterpulsation (IABP), previous myocardial infarction, and percutaneous coronary intervention were independent predictors of in-hospital mortality. After multivariate analysis, factors predicting in-hospital mortality were age, preoperative cardiac troponin levels, and preoperative IABP. Age, preoperative cardiac troponin levels, and preoperative IABP use were predictive factors of in-hospital mortality in patients undergoing primary CABG for STEMI.

The newly developed three dimensional speckle-tracking echocardiography (3D-STE) technology provides quick and comprehensive quantitative assessment of biventricular myocardial dynamics. The impact of coronary slow flow phenomenon (CSFP) on biventricular functions has not been comprehensively evaluated using this new technology. Therefore, the aim of this study was to evaluate the effects of CSFP on biventricular systolic functions using 3D-STE. Forty patients with CSFP and otherwise normal coronary arteries (NCAs) and 40 age- and sex-matched controls with normal coronary angiograms (CAGs) were prospectively enrolled. Biventricular systolic function was evaluated by 3D-STE. Left ventricular (LV) global longitudinal, circumferential and radial strains, ejection fraction (EF) were significantly lower and LV end-systolic volume (ESV) was significantly higher in the CSFP group compared to the control group. There were no significant differences in LV mass, LV end-diastolic volume (EDV) or LV stroke volume (SV). Additionally, Right ventricular (RV) free wall, septal wall and global longitudinal strains, and RV EF were significantly lower in the CSFP group, but there were no significant differences in RV EDV, ESV and RV SV. The present study demonstrated that CSFP has a notable negative effect on not only 3D strain parameters but also biventricular EF. There was a strong correlation between the strain parameters of the affected vessel's myocardial area and the TIMI frame count of same vessel.

Platelet volume is a marker of platelet function and activation. An elevated mean platelet volume (MPV) is associated with acute coronary syndromes (ACS). Recurrent cardiovascular events were found to be higher in patients with aspirin resistance. In this study, we investigated the effect of MPV on prognosis of patients with and without aspirin resistance by PFA-100 in settings of non-ST-segment elevated ACS. Two hundred and twenty patients with ACS were followed for an average of 14.86 +/- 5.93 months for the occurrence of death, myocardial infarction (MI) and revascularization. Aspirin effect on platelet function was assessed by PFA-100. According to MPV value and aspirin resistance status, patients were divided into four groups. Group 4 (with an elevated MPV and aspirin resistance) was significantly associated with worse prognosis for composite endpoint (death, MI and revascularization), death and MI (for all, log-rank P < 0.0001). Multivariate analysis showed that presence of an elevated MPV and aspirin resistance was an independent predictor of composite endpoint [hazard ratio 8.21, 95% confidence interval (CI) 3.48-19.35, P < 0.0001], death (hazard ratio 5.48, 95% CI 1.62-18.53, P = 0.006) and MI (hazard ratio 4.44, 95% CI 1.57-12.58, P = 0.005). Presence of an elevated MPV and aspirin resistance was significantly associated with death, MI and the composite endpoint, due to the lack of beneficial effect of aspirin on activated platelets. Patients with ACS, especially in the presence of an elevated MPV may benefit from the evaluation of aspirin resistance for risk stratification.

AERP dispersion is a suitable electrophysiologic indicator for atrial vulnerability. The presence of increased preoperative AERP dispersion and PA interval may indicate patients at high risk for development of AF in the early postoperative period after coronary artery bypass grafting.