Pulmoner emboli yüksek mortalite ve morbidite oranları ile giden akut acil bir durumdur. Monosit/ yüksek yoğunluklu lipoprotein (HDL) oranının, inflamasyon ve oksidatif stresin yeni bir belirteci olabileceği, ayrıca bazı kardiyovasküler hastalıkların varlığı ve prognozu ile de yakından ilişkili olduğu gösterilmiştir. Pulmoner emboli fizyopatolojisinde inflamasyon ve oksitadif stres önemli bir rol oynamaktadır. Çalışmanın amacı akut pulmoner emboliden monosit/HDL oranının kısa dönemde prognostik değerini belirlemektir. Hastalar ve Yöntem: Acil servise başvuran ve akut pulmoner emboli tanısı çok kesitli bilgisayarlı tomografi ile teyit edilen 99 hasta çalışmaya retrospektif olarak dahil edildi. Bulgular: Pulmoner emboli tanısı alan 99 hastanın, tanı aldıktan sonra 26 (%25.2)'sı bir ay içinde eksitus oldu. Hastalar, tanı sonrası bir ay içinde ölenler (1. grup) ve hayatta kalanlar (2. grup) olmak üzere iki gruba ayrıldı. Yaş, malignite, koroner arter hastalığı, sağ ventrikül fonksiyon bozukluğu, beyaz kan hücresi, nötrofil, lenfosit, trombosit ve monosit sayımları, sistolik pulmoner arter basıncı, diyastolik kan basıncı, nötrofil/ lenfosit oranı, monosit/HDL oranı, basitleştirilmiş pulmoner emboli ciddiyet indeksi 1. grupta 2. gruba göre anlamlı derecede yüksek bulundu. Monosit/HDL oranı, nötrofil/lenfosit oranı ve basitleştirilmiş pulmoner emboli ciddiyet indeksi akut pulmoner emboli tanısı almış hastalarda mortalitenin bağımsız bir belirleyicisi olduğu görüldü. Sonuç: Monosit /HDL oranı, pulmoner emboli sonrası erken dönemde mortalite gelişen hastalarda, mortalite gelişmeyenlere göre daha yüksekti. Bu nedenle, monosit/HDL oranı gibi ucuz ve pratik bir parametre akut pulmoner embolide mortalite risk tahmininde kullanılabilir.

Objective The importance of nutritional status in non-ST segment elevated acute coronary syndrome (NSTE-ACS) is not clear. In this study, the importance of prognostic nutritional index (PNI) in terms of in-hospital mortality in patients with NSTE-ACS and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods A total of 498 consecutive NSTE-ACS patients were recorded retrospectively. PNI for nutritional status assessment of patients with NSTE-ACS. PNI was calculated as 10 × serum albumin (g / dL) + 0.005 × total lymphocyte count (per mm3). The association between PNI and GRACE risk score was assessed.Results Patients were classified as low-risk group (≤108 points, n=222), medium-risk group (109–140 points, n=161) and high-risk group (>140 points, n=115) according to the GRACE score. The mean PNI value was found to be the lowest in the high-risk group compared to other risk groups. There was a significant negative correlation between GRACE risk score and PNI (p<0.001). In multivariate analysis, PNI resulted as a predictor of in-hospital mortality independent of GRACE risk score (OR=0.909; 95 % CI: 0.842–0.981; p=0.01). PNI value in the high risk group for in-hospital mortality was determined to have significant predictive ability (AUC=0.710; 95 % CI: 0.61–0.80; p<0001).Conclusions PNI evaluation is a useful and easy method to evaluate the nutritional status of patients with NSTE-ACS. Our study suggests that the PNI is significantly associated with in-hospital mortality, and GRACE risk score in patients with NSTE-ACS. This study is the basis for new studies to investigate whether PNI contributes additional prognostic to the GRACE risk score.

Goal In this study, it was investigated whether the age, creatinine, and ejection fraction (ACEF) score [age (years) / ejection fraction (%) +1 (if creatinine >2 mg / dL)] could predict in-hospital mortality in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and its relationship with the Global Record of Acute Coronary Events (GRACE) risk score were investigated.Material and methods The study enrolled 658 NSTE-ACS patients from January 2016 to August 2020. The patients were divided into two groups according to the ACEF score with an optimum cut-off value of 1.283 who were divided into two groups according to the ACEF score: low ACEF (≤1.283, n:382) and high ACEF (>1.283, n: 276). The primary outcome of the study was in-hospital all-cause mortality. The primary outcome of the study was in-hospital all-cause mortality. Statistically accuracy was defined with area under the curve by receiver-operating characteristic curve analysis.Results In total, 13 (4.71 %) patients had in-hospital mortality. The ACEF score was significantly higher in the group with higher mortality than in the group with low mortality (2.1±0.53 vs. 1.34±0.56 p=0.001). The ACEF score was positively correlated with GRACE risk score (r=0.188 p<0.0001). In ROC curve analysis, the AUC of the ACEF score for predicting in-hospital mortality was 0.849 (95 % CI, 0.820 to 0.876; p<0.0001); sensitivity, 92.3 %; specificity, 59.2 %, and the optimum cut-off value was >1.283.Conclusion The ACEF score presented excellent discrimination in predicting in-hospital mortality. We obtained an easier and more useful result by dividing the ACEF score into two groups instead of three in NSTE-ACS patients. As a simple, useful, and easily applicable risk stratification in the evaluation of an emergency event such as the ACEF score, it can significantly contribute to the identification of patients at high risk.

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In the present study, we aimed to investigate whether copeptin values on admission are related to left ventricle (LV) systolic function and its improvement at 6 months in ST-segment elevation myocardial infarction (STEMI) patients. In this single-center, prospective observational study, we included 122 STEMI patients from January 2016 to November 2016. LV systolic functions in the form of global longitudinal strain (GLS) in addition to conventional echocardiography parameters were evaluated on admission and at 6-month. Serum copeptin levels were determined using an ultrasensitive immunofluorescence assay. The study population was divided into 2 groups according to median values of copeptin. GLS was significantly lower in patients with high copeptin levels compared to those with low copeptin levels at early stage and 6-month (−16% (16–16.5) vs −15% (15–15.5), P < .001 and −18% (18–19) vs −16% (16–16.25), P < .001, respectively). Copeptin values were negatively correlated with an early and 6-month GLS ( r = –0.459 at early stage and r = –0.662 at 6-month). In addition, we observed that copeptin values were negatively correlated with the improvement of GLS at 6-month follow-up ( r = −0.458, P < .001 and r = −0.357, P = .005, respectively). Serum copeptin levels in STEMI patients at the time of admission may predict early and 6-month LV systolic function assessed by two-dimensional GLS. To the best of our knowledge, this study is the first to specifically address the relationship between copeptin values and GLS in STEMI patients.