Purpose: The aim of this study was to investigate the diagnostic value of ischemia modified albumin (IMA) in early non-ST elevation myocardial infarction (NSTEMI) patients diagnosed with high-sensitive cardiac troponin (hs-cTn)assays. Materials and Methods: In the first three hours of symptom onset, one hundred sixty-two patients without cardiovascular disease history admitted to our hospital with NSTEMI were enrolled between March 2018 and August 2019. The patients' IMA levels were compared with IMA levels of randomly selected, age and the sexmatched control group comprised of 61 subjects with normal coronary angiography results. Results: IMA levels of NSTEMI patients were higher than the control group. In receiver operating characteristic (ROC) curve analysis, a value equal or greater than 0.3855 ABSU has an 82% sensitivity and a 99.4% specificity for diagnosing NSTEMI (AUC: 0.962, 95% CI: 0.937 – 0.986,). In addition, ROC curve analysis revealed moderate predictive power for distinguishing three-vessel disease (cut-off value: 0.4290 ABSU, sensitivity 78.4% and specificity 56.3%, AUC: 0.696, 95% CI: 0.616 – 0.776,). IMA levels were positively correlated with Gensini scores of the patient group. Conclusion: Ischemia-modified albumin, when used alone, was very useful in distinguishing NSTEMI from non-ischemic controls. Besides, IMA levels were positively correlated with CAD severity.
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AbstractAim: We aimed to investigate the relationship between oxidative parameters- total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI)- and EFT in patients with CSX. Without clinically significant coronary artery disease, cardiac syndrome X (CSX) is characterized by cardiac ischemia, and chest pain. However, there is some evidence about increased oxidative stress in CSX patients; the relationship between oxidative stress parameters and epicardial fat thickness (EFT) is not well established in this population.Material and Methods: : One hundred and twenty-two patients with normal coronary arteries (73 female, 49 males, mean age 56.71 ± 10.69 years) were enrolled in the study. The study population was divided into two groups according to their OSI. Oxidative stress index below the median was defined as the OSI low group and equal or higher than the median was defined as the OSI high group.Results: EFT was higher in the high OSI group than the low OSI group (6 (3.9 – 8.9) vs. 5.4 (0.56 – 7.2), p= 0.032). In bivariate correlation analysis EFT was positively correlated with OSI and TOS (r=0.242, p=0.036 and r=0.234, p=0.025 respectively). In binary logistic regression analysis, EFT was found to be an independent predictor of OSI.Conclusion: : In our study, EFT was independently associated with OSI in CSX patients. This finding suggests that EFT may be a marker of increased oxidative stress in CSX.
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Aim: Postoperative atrial fibrillation is common after cardiac surgery and is associated with higher rates of complications and mortality. Despite the importance of postoperative atrial fibrillation, the most effective management strategy for this common surgical complication remains uncertain. The aim of this study was to evaluate the effectiveness of amiodarone and early direct current cardioversion to restore sinus rhythm in new onset postoperative atrial fibrillation.Material and Methods: This was a prospective, open-labeled randomized- controlled trial. A total of 50 patients who had new onset postoperative atrial fibrillation longer than 30 minutes were enrolled in the study; 26 patients were randomized to control group and 24 to amiodarone group. Patients in whom sinus rhythm did not return within 24 hours, then external electrical direct current cardioversion was performed for both groups. The primary endpoint of the study was a restoration of sinus rhythm at the 24th hour. Secondary endpoints needed for direct current cardioversion, success rate, sinus rhythm at discharge, sinus rhythm at 30th days and crossover rates.Results: There was a significantly higher number of patients with sinus rhythm at the 24th hour in the amiodarone group than the control group (79.2% vs. 46.2%, p=0.022). Need for direct current cardioversion (p=0.022) and crossover ratio (p=0.021) were significantly higher in control group than amiodarone group. Direct current cardioversion success rate, normal sinus rhythm at discharge and 1st month did not differ significantly between groups. Conclusion: Amiodarone therapy seems effective in restoring sinus rhythm within 24 hours and decreases the need for direct current cardioversion.
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