We investigated whether serum bilirubin level (a marker of heme oxygenase activity) is a predictor of high levels of SYNTAX score (SXscore) in patients with acute myocardial infarction. Patients (n = 281; male 77%; mean age 60 ± 12) who were admitted with ST-elevation myocardial infarctions (STEMIs) were enrolled. Patients were divided into 2 groups. Group 1 was defined as SXscore <22 and group 2 was defined as SXscore ≥22. Total bilirubin levels were significantly higher in the high-SXscore group than in the low-SXscore group (0.86 ± 0.42 vs 1.02 ± 0.51, P = .005). A significant correlation was detected between total bilirubin and SXscore ( r = .42; P = .001). At multivariate analysis, total bilirubin (odds ratio: 1.86, 95% confidence interval 1.04-3.35; P = .038) was an independent risk factor for high SXscore in patients with STEMI. In conclusion, serum bilirubin level is independently associated with SXscore in patients with STEMI.

Objective:Coronary artery disease (CAD) is a common, complex, and progressive disorder characterized by the accumulation of lipids and fibrous elements in the arteries. It is one of the leading causes of death in industrialized nations. Oxidative modification of low-density lipoprotein (LDL) in the arterial wall plays an important role in the initiation and progression of atherosclerosis. Paraoxonase1 (PON1) is involved in lipid metabolism and is believed to protect LDL oxidation. In our study, we aimed to clarify the relationship between PON1 gene L55M polymorphism and the extent and severity of CAD.Methods:In total, 114 patients (54 males, mean age: 56.7±12.0 years; 60 females, mean age: 55.7±13.2 years) with stable angina or angina equivalent symptoms were enrolled in this prospective study. Cardiological evaluation was performed with electrocardiogram and transthoracic echocardiogram. The presence of hypertension, dyslipidemia, diabetes, and smoking status were ascertained. The patients were grouped according to their Gensini scores and gender. Genetic analysis of the PON1 gene L55M polymorphism was performed by polymerase chain reaction-restriction fragment length polymorphism.Results:We determined that the LL genotype was more prevalent in patients with Gensini score higher than or equal to 20 (p=0.026) and that this correlated with severe atherosclerotic coronary artery lesions in both gender groups, reaching a statistical significance in the female subjects (p=0.038).Conclusion:It was thought that the PON1 gene L55M polymorphism plays a significant role in CAD progression, especially in females.

Objective: In this prospective study, we aimed to investigate acute effect of nasal continuous positive airway pressure (CPAP) therapy on the endothelial function of patients with obstructive sleep apnea syndrome (OSA) by using brachial artery flow mediated dilatation (FMD) method. Methods: Newly diagnosed thirty OSA patients with ages between 29 and 72 years were included in this study. FMD and high sensitivity C-reactive protein (hsCRP) values of patients obtained before and after CPAP dose titration test were compared with paired samples t test or Wilcoxon signed ranks test. Results: With CPAP therapy apnea hypopnea indices were reduced (60.6±24.9/h vs. 9.6±7.9/h; p<0.001) and oxygen desaturation indices recovered (50±27/h vs. 6±7/h; p<0.001). Heart rates of patients decreased after CPAP therapy (80±10/min vs. 73±8/min; p=0.003). Original Investigation Özgün Araşt›rma 560ÖZET Amaç: Bu prospektif çalışmamızda obstrüktif uyku apneli (OUA) hastalarda endotel fonksiyonuna nazal sürekli pozitif hava yolu basıncı (SPHB) tedavisinin akut etkisini brakiyal arterde akıma bağlı genişleme (ABG) yöntemini kullanarak değerlendirmeyi amaçladık. Yöntemler: Yeni tanı almış 29 ve 72 yaş arasında otuz OUA hastası çalışmaya dahil edildi. Hastaların SPHB doz titrasyonu öncesi ve sonrasında bakılan ABG ve yüksek duyarlıklı C-reaktif protein (ydCRP) değerleri eşleştirilmiş örneklem t-testi ya da Wilcoxon işaret rank testi ile karşılaştırıldı. Bulgular: SPHB tedavisi ile apne hipopne indeksleri azaldı (60.6±24.9/st vs. 9.6±7.9/st; p<0.001), oksijen desatürasyon indeksleri düzeldi (50±27/st vs. 6±7/st; p<0.001). Hastaların SPHB tedavisi sonrası kalp hızları azaldı (80±10/dk vs. 73±8/dk; p=0.003). ABG değerleri SPHB sonrası belirgin olarak arttı (%8.55±5.82 vs. %12.08±7.17; p=0.003). ydCRP değeri SPHB sonrası bazal değerlerden farklı değildi. Sonuç: Bir gecelik SPHB tedavisi ile akıma bağlı dilatasyonun düzelmesi OUA hastalarında endotel disfonksiyonunun akut patofizyolojik mekanizmalar sonucu geliştiğini düşündürmektedir. Orta ve ağır OUA hastalarında SPHB tedavisi endotel disfonksiyonu ile ilişkili hastalıkların akut tedavisinde düşünülebilir. (Anadolu Kardiyol Derg 2012; 12: 560-5) Anahtar kelimeler: Endotel disfonksiyonu, obstrüktif uyku apnesi, sürekli pozitif havayolu basıncı, C-reaktif protein, akıma bağlı genişleme

White coat hypertension is an intermediate group between SH and NT in terms of atrial electromechanical abnormalities which may be associated with the risk of atrial fibrillation.

We report a patient who experienced an anaphylactic reaction during coronary artery stenting. Immediately after a polymer-based paclitaxel-eluting stent (Taxus, Boston-Scientific) is deployed, the patient developed profound hypotension and an erythematous rash. The case complicated with coronary spasm and a new thrombus formation making a second stent implantation necessary. The reaction was successfully reversed with epinephrine, steroid, antihistaminic, a 9-hr infusion of dopamine, and intraaortic balloon counterpulsation.