High SYNTAX score is a predictor of adverse cardiovascular events, including mortality, in acute coronary syndromes (ACSs). Decreased serum albumin (SA) concentration is associated with an increased risk of cardiovascular events. We aimed to investigate whether SA levels at admission are associated with high SYNTAX score and in-hospital mortality in patients with ACS. The study included 1303 patients with ACS who underwent coronary angiography (CA). The patients were divided into 2 groups as high SYNTAX score (!33) and lower SYNTAX score ( 32). Baseline SA levels were significantly lower in patients with high SYNTAX score than with lower SYNTAX score (3.46 + 0.42 mg/dL vs 3.97+0.37 mg/dL, respectively; P < .001). On multivariate logistic regression, SA (<3.65 mg/dL) was an independent predictor of high SYNTAX score (odds ratio 4.329, 95% confidence interval 2.028-8.264; P < .001) together with admission glucose, estimated glomerular filtration rate, and left ventricular ejection fraction. In Cox regression analyses, systolic blood pressure, high SYNTAX score, and SA (<3.65 mg/dL) were found as independent predictors of in-hospital all-cause mortality. In conclusion, SA concentration on admission is inversely associated with high SYNTAX score and in-hospital mortality in ACS.

A b s t r a c tBackground: High Syntax score (SXscore) is associated with more serious disease and worse prognosis in patients with acute coronary syndrome (ACS). Plasma fibrinogen levels are associated with poor cardiovascular outcomes. Aim:To investigate the relation of admission fibrinogen levels with intermediate-high SXscore in patients with ACS. Methods:A total of 752 patients (61.6 ± 12.8 years, 67.3% men) with ACS, who underwent urgent coronary angiography (CAG) were enrolled. Laboratory data including fibrinogen and high sensitivity C-reactive protein were obtained before CAG. Syntax scores of all patients were calculated from baseline CAG. The patients were divided into two groups: low SXscore (≤ 22) and intermediate-high SXscore (≥ 23).Results: Admission fibrinogen levels were significantly higher in the SXscore ≥ 23 group when compared with the SXscore ≤ 22 group (median 492 mg/dL, interquartile range 428-581 mg/dL vs. median 370 mg/dL, interquartile range 309-428 mg/dL, respectively; p < 0.001). In multivariate analysis, the independent predictors of intermediate-high SXscore were fibrinogen (OR 1.008, 95% CI 1.005-1.010, p < 0.001), left ventricular ejection fraction (OR 0.935, p < 0.001), and age (OR 1.029, p = 0.041). A level of fibrinogen > 417 mg/dL had an 80.0% sensitivity and 71.3% specificity in predicting intermediate-high SXscore. Conclusions:Increased fibrinogen levels are independently associated with intermediate-high SXscore in patients with ACS.

In this study, we aimed to investigate the blood pressure (BP) profile in children with a unilateral functioning solitary kidney (UFSK). A group of 49 patients between the ages of 5 and 18 years, and 30 healthy controls between the ages of 6 and 16 years were investigated. Gender, weight, height and body mass index (BMI) of patients and controls were recorded. BP profile was determined by ambulatory BP monitoring (ABPM). We have observed a higher risk of hypertension compared with healthy children. Also, masked hypertension is more frequently in the patients group and white-coat hypertension was observed in the control group. The mean night-time systolic BP (SBP) load (p = 0.01) and 24-h diastolic BP (DBP) load (p = 0.008) of children with multicystic dysplastic kidney (MCDK) was significantly higher than the healthy group. The mean night-time SBP load (p = 0.001) of children with unilateral renal agenesis (URA) and 24-h DBP load (p = 0.003) of children with unilateral atrophic or hypoplastic kidney were significantly higher than healthy group. We showed that the children with a solitary kidney had increased risk of hypertension. ABPM reflects the BP profile more precisely than casual BP measurement and it can be used to evaluate white-coat and masked hypertension in children with a solitary kidney.

Background. Fecal calprotectin is an important inflammatory marker in intestinal diseases and is not routinely used in the upper gastrointestinal system disorders. The aim of this study was to show whether there is a relationship between fecal calprotectin levels and Helicobacter pylori (H pylori) gastritis in children and to determine the association of fecal calprotectin levels with gastric biopsy results in terms of chronic inflammation and neutrophil activity. Methods. Patients with the complaints of the upper gastrointestinal system (epigastric pain, heartburn, nausea and vomiting) who were planned to undergo endoscopy were enrolled prospectively. The presence of H pylori was defined according to the gastric antrum biopsy results. Fecal calprotectin level was tested in the stool sample of the patients. The fecal calprotectin levels, upper gastrointestinal endoscopy and gastric biopsy results of 89 patients were evaluated. Results. H pylori was found to be positive in the gastric biopsies of 51 (57.3%) patients. In the H pylori positive group mean fecal calprotectin level was 74.8 &#xb1; 67 &#x3bc;g/g, and in the H pylori negative group mean fecal calprotectin level was 52.7 &#xb1; 46 &#x3bc;g/g and the difference was significant (p= 0.039). We also found a significant relationship between fecal calprotectin levels and gastric neutrophil activity grades (p= 0.034). Conclusions. Mean fecal calprotectin levels were found to be higher in H pylori positive subjects in our study. Fecal calprotectin levels were correlated with gastric neutrophil activity grades. Fecal calprotectin represents gastric neutrophilic inflammation. When interpreting a high fecal calprotectin level, H pylori infection should be kept in mind.

In-stent restenosis (ISR) remains a significant clinical problem in patients with coronary artery disease treated with percutaneous coronary intervention. Decreased serum albumin (SA) level is related to an increased risk of cardiovascular events. The aim of the present study was to assess whether SA levels at admission are an independent predictor of ISR in patients undergoing bare-metal stent (BMS) implantation. A total of 341 patients (aged 61 ± 11, 65.4% men) with a history of BMS implantation and a further control coronary angiography due to stable angina pectoris (SAP) were included. The study population was classified into 2 groups: patients with and without ISR. The ISR was observed in 140 (41.1%) patients. We found significantly lower SA levels in patients who developed ISR than in those who did not (3.69 ± 0.41 vs 4.07 ± 0.35 mg/dL,P< .001). Multivariate analysis revealed that SA level (odds ratio 0.109, 95% confidence interval 0.017-0.700,P= .020), stent diameter, reason for stent implantation, and body mass index were independent risk factors for the development of ISR. The SA level at admission is inversely associated with ISR in patients with SAP.