Background: Coronary artery anomalies are found in 0.2% to 1.3% of patients undergoing coronary angiography and 0.3% of an autopsy series. We aimed to estimate the frequency of coronary artery anomalies in our patient population. Methods: The data were collected retrospectively by analyzing the angiographic data of 12 457 consecutive adult patients undergoing coronary angiography between September 2002 and October 2007. Results: Coronary artery anomalies were found in 112 patients (0.9% incidence), 100 patients (89.3%) had origin and distribution anomalies, and 12 patients (10.7%) had coronary artery fistulae. Their mean age was 52±8 years (range, 22-79 y). Separate origins of left anterior descending and left circumflex coronary artery from the left sinus of Valsalva was the most common anomaly (63.4%). The right coronary artery rising from the left coronary sinus of Valsalva was found in 10 (8.9%) patients. Anomalous origin of the left circumflex coronary artery from the right sinus of Valsalva was seen in 10 (8.9%) patients. The left main coronary artery from the right coronary sinus of Valsalva was found in 1 (0.89%) patient while an isolated single coronary artery was seen in 2 (1.78%) patients. Conclusion:The incidence and the pattern of coronary artery anomalies in our patient population were almost identical with previous studies. Cardiologists should be aware of the coronary anomalies which may be associated with potentially serious cardiac events, because recognition of these coronary anomalies is mandatory in order to prescribe appropriate therapy. IntroductionCongenital coronary artery anomalies are present at birth, but relatively few are symptomatic. Most anomalies are encountered as incidental findings during coronary angiography or at autopsy. 1 About 20% of coronary artery anomalies produce life threatening symptoms including arrhythmias, syncope, myocardial infarction, or sudden death while 80% are benign. 2,3 Coronary artery anomalies are the second most common cause of sudden cardiac death (SCD) in young athletes. 4 Prevalence of coronary artery anomalies was reported as 0.6% to 1.3% in angiographic series and 0.3% in autopsy series. 1,2,5 -7 There are several classifications for coronary artery anomalies. We preferred to use the classification of coronary artery anomalies that was modified to be used in clinical practice in 2 groups; anomalies of origin, distribution, intercoronary communications, and coronary artery fistulae.

Leukocytes are reported as crucial not only for plaque activation but also in thrombus formation in acute coronary syndromes (ACSs). Among the markers of inflammation, in coronary artery disease neutrophil-lymphocyte ratio (NLR) has been reported to have the greatest predictive power of poor outcomes. Our aim was to evaluate the association of NLR with coronary thrombus in patients with non-ST-segment elevated ACSs (NST-ACSs). A total of 251 patients were hospitalized with a diagnosis of NST-ACS including non-ST-segment elevated myocardial infarction and unstable angina pectoris. Coronary angiographies were performed. In 167 patients, coronary thrombus was detected. Between the patient groups with and without coronary thrombus, neutrophil count, platelet count, and NLR are significantly increased, and lymphocyte count is significantly decreased in the group with coronary thrombus as compared to patient group without coronary thrombus. Leukocyte count and NLR may give an indication about the presence of coronary thrombus. In NST-ACS, blood parameters may give valuable information about the status of the coronary arteries.

Presence of fQRS on a 12-lead ECG on admission is associated with increased long-term mortality in patients with NSTEMI.

ObjectiveThe prognostic value of a high platelet-lymphocyte ratio (PLR) has been reported in patients with non-ST elevated myocardial infarction (NSTEMI) and different oncologic disorders. We aimed to evaluate the predictive value of the PLR for left ventricular systolic dysfunction (LVSD) in patients with non-ST elevated acute coronary syndrome (NST-ACS).MethodsA total of 220 patients with NST-ACS were included in the study. The study population was divided into tertiles based on admission PLR values. High (n=73) and low PLR (n=147) groups were defined as patients having values in the third tertile (>135.6) and lower 2 tertiles (≤135.6), respectively. Left ventricular dysfunction was defined as ejection fraction ≤40%, and related variables were evaluated by backward conditional binary logistic regression analysis.ResultsThe patients in the high PLR group were older (p<0.001) and had a higher rate of previous myocardial infarction and NSTEMI (p=0.046, p=0.013, respectively). There were significantly more coronary arteries narrowed (p=0.001) and lower left ventricular ejection fraction (p<0.001) in the high PLR group. Baseline platelet levels were significantly higher (p<0.001) and triglyceride and lymphocyte levels were significantly lower (p=0.009 and p<0.001, respectively) in the high PLR group. PLR >135.6 was found to be an independent predictor of systolic dysfunction in the multivariate analyses (ß: 0.306, 95% confidence interval: 0.151-0.619; p=0.001).ConclusionA high PLR is a strong and independent predictor for LVSD in patients with NST-ACS.