Background: Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are new systemic inflammation markers and predictor of adverse cardiovascular outcomes. Approximately 10% of patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) have chronic total occlusion (CTO) of the non-infarct-related artery. The presence of concurrent CTO is associated with short- and long-term morbidity and mortality. Here, we aimed to investi-gate the relationship of NLR and PLO with coexistent CTO in STEMI patients.Materials and Methods: Ninety consecutive STEMI patients with concurrent CTO were included in the study group and 100 STEMI patients without CTO were included in the control group retrospectively. The relationship between inflammatory markers and concurrent CTO in STEMI was analyzed.Results: STEMI patients with concurrent CTO had increased NLR, PLR, C-reaktive protein and troponin while decreased glomerular filtration rate, left ventricular ejection fraction (LVEF) in comparison with patients without CTO. In multivariate analysis, NLR (p=0.002), PLR (p=0.042), CRP (p=0.002), hypertension (p<0.001), Hyperlipidemia (p=0.002) and LVEF (p=0.012) were found to be the independent predictors for the presence of concurrent CTO. In the ROC (Receiver Operating Characteristic) curve analysis, ≥ 5.6 and ≥ 164 cut-off values were determined for NLR and PLR in detecting concurrent CTO in STEMI.Conclusions: PLR and NLR, simple and easily calculated laboratory parameters, may permit prediction of concurrent CTO in patients with STEMI.Key Words:

The presence of mechanical heart valves in both aortic and mitral positions is a significant limitation for traditional left ventricular (LV) access, including retrograde transaortic and/or antegrade interatrial transseptal routes. We present a case of successful catheter ablation for ventricular tachycardia via a traditional transfemoral venous approach, which involves direct puncture of the inferior and medial aspect of the right atrium adjacent to the posteroseptal process of LV (PSPLV). Percutaneous trans‐right atrial access to the left ventricle appears to be a safe and feasible method for catheter ablation of ventricular tachycardia in patients with mechanical aortic and mitral valves.