1.The Relationship between Vitamin D and Coronary Artery Ectasia in Subjects with a Normal C-Reactive Protein Level.
Goksel CAGIRCI ; Selcuk KUCUKSEYMEN ; Isa Oner YUKSEL ; Nermin BAYAR ; Erkan KOKLU ; Ramazan GUVEN ; Sakir ARSLAN
Korean Circulation Journal 2017;47(2):231-237
BACKGROUND AND OBJECTIVES: Vitamin D is generally known to be closely related to inflammation. The effects of vitamin D on coronary artery disease (CAD) are not fully explained. Nowadays, coronary artery ectasia (CAE) cases are common and are regarded as being a kind of CAD. We aimed to investigate, in a case-control study, the relationship between vitamin D and CAE without an associated inflammatory process. SUBJECTS AND METHODS: This study population included 201 patients (CAE group, 121 males; mean age, 61.2±6.4 years) with isolated CAE; and 197 healthy individuals (control group, 119 males; mean age, 62.4±5.8 years), comprising the control group, who had normal coronary arteries. These participants concurrently underwent routine biochemical tests, tests for inflammatory markers, and tests for 25-OH vitamin D in whole-blood draws. These parameters were compared. RESULTS: There are no statistical significance differences among the groups for basic clinical characteristics (p>0.05). Inflammatory markers were recorded and compared to exclude any inflammatory process. All of them were similar, and no statistical significance difference was found. The average parathyroid hormone (PTH) level of patients was higher than the average PTH level in controls (41.8±15.1 pg/mL vs. 19.1±5.81 pg/mL; p<0.001). Also, the average 25-OH vitamin D level of patients was lower than the average 25-OH vitamin D level of controls (14.5±6.3 ng/mL vs. 24.6±9.3 ng/mL; p<0.001). In receiver operating characteristic curve analysis, the observed cut-off value for vitamin D between the control group and patients was 10.8 and 85.6% sensitivity and 75.2% specificity (area under the curve: 0.854, 95% confidence interval: 0.678-0.863). CONCLUSION: We found that there is an association between vitamin D and CAE in patients who had no inflammatory processes. Our study may provide evidence for the role of vitamin D as a non-inflammatory factor in the pathophysiology of CAE.
C-Reactive Protein*
;
Case-Control Studies
;
Coronary Artery Disease
;
Coronary Vessels*
;
Dilatation, Pathologic*
;
Humans
;
Inflammation
;
Male
;
Parathyroid Hormone
;
ROC Curve
;
Sensitivity and Specificity
;
Vitamin D Deficiency
;
Vitamin D*
;
Vitamins*
2.Association of Neutrophil/Lymphocyte Ratio with Plaque Morphology in Patients with Asymptomatic Intermediate Carotid Artery Stenosis.
Isa Oner YÜKSEL ; Erkan KÖKLÜ ; Sakir ARSLAN ; Göksel ÇAĞIRCI ; Eylem Ozaydın GÖKSU ; Pınar KOÇ ; Serkan ÇAY ; Filiz KIZILIRMAK
Korean Circulation Journal 2016;46(5):699-705
BACKGROUND AND OBJECTIVES: Non-calcified carotid plaques are more unstable than calcified plaques, and they are associated with a higher risk of rupture, thromboembolism, and consequently, stroke. The purpose of the present study is to compare calcified and non-calcified plaques that cause intermediate carotid artery stenosis with respect to neutrophil/lymphocyte ratio (NLR). SUBJECTS AND METHODS: A total number of 139 asymptomatic patients with 50-70% stenosis of the carotid artery were included in this study. Carotid Doppler ultrasound imaging and computed tomography angiography were performed to divide the carotid artery plaques into two groups as calcified and non-calcified. Patients included in the calcified (n=73) and non-calcified (n=66) plaque groups were compared with respect to total neutrophil count, lymphocyte count and NLR. RESULTS: Total lymphocyte count was statistically significantly lower in the non-calcified plaque group compared to the calcified plaque group (total lymphocyte count in non-calcified/calcified plaque groups [103/mm3]: 2.1/2.3, respectively) (p=0.002). NLR was statistically significantly higher in the non-calcified plaque group compared to the calcified plaque group (NLR in non-calcified/calcified plaque groups: 2.6/2.1, respectively) (p<0.001). The cut-off value for NLR was found to be >2.54. Multivariate regression analysis showed that NLR was independently associated with non-calcified carotid artery plaques (odds ratio 5.686, 95% CI 2.498-12.944, p<0.001). CONCLUSIONS: NLR is increased in the presence of non-calcified carotid artery plaques that cause asymptomatic intermediate stenosis. Increased NLR can be used as a marker to assess the risk of rupture of non-calcified carotid artery plaques.
Angiography
;
Atherosclerosis
;
Carotid Arteries*
;
Carotid Stenosis*
;
Constriction, Pathologic
;
Humans
;
Lymphocyte Count
;
Neutrophils
;
Plaque, Atherosclerotic
;
Rupture
;
Stroke
;
Thromboembolism
;
Ultrasonography, Doppler
3.The Relationship between Spontaneous Multi-Vessel Coronary Artery Dissection and Celiac Disease.
Nermin BAYAR ; Goksel CAGICI ; Cagin Mustafa UREYEN ; Gorkem KUS ; Selcuk KUCUKSEYMEN ; Sakir ARSLAN
Korean Circulation Journal 2015;45(3):242-244
Celiac disease (CD) is an immune-mediated enteropathy involving the small intestines. Genetic and environmental risk factors as well as autoimmunity have been linked to its etiology. Studies have shown that coronary artery disease, autoimmune myocarditis, arrhythmias and premature atherosclerosis are more prevalent in individuals with CD compared to individuals without the disease. In this case report a young male patient with CD presented with acute myocardial infarction with spontaneous coronary artery dissections of two vessels. To the best of our knowledge, this is the first case report of spontaneous multi-vessel coronary artery dissection in a patient with CD.
Arrhythmias, Cardiac
;
Atherosclerosis
;
Autoimmunity
;
Celiac Disease*
;
Coronary Artery Disease
;
Coronary Vessels*
;
Homocysteine
;
Humans
;
Intestine, Small
;
Male
;
Myocardial Infarction
;
Myocarditis
;
Risk Factors
4.An Unusual Pattern of All Three Coronary Arteries Originating from a Single Coronary Artery Arising from the Right Sinus of Valsalva.
Isa Oner YUKSEL ; Sakir ARSLAN ; Nermin BAYAR ; Selcuk KUCUKSEYMEN ; Erkan KOKLU ; Bekir EROL
Korean Circulation Journal 2014;44(2):125-127
Anomalous origin of coronary arteries is generally asymptomatic and a rare disease. However, some cases can cause severe life-threatening events such as myocardial ischemia, arrhythmia, and acute myocardial infarction. We describe a case of a single coronary artery arising from the right sinus of Valsalva in a 48-year-old female patient with a complaint of stable angina pectoris and palpitations. Coronary angiography revealed that all three coronary arteries arose from the right sinus. Coronary CT angiography confirmed that there was an anomalous origin of the left coronary artery arising from the right sinus of Valsalva. The patient was managed with conservative treatment.
Angina, Stable
;
Angiography
;
Arrhythmias, Cardiac
;
Coronary Angiography
;
Coronary Vessel Anomalies
;
Coronary Vessels*
;
Female
;
Humans
;
Middle Aged
;
Myocardial Infarction
;
Myocardial Ischemia
;
Rare Diseases
;
Sinus of Valsalva*