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  • Küçük Resim
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    The prognostic value of serum albumin levels on admission in patients with acute ST-segment elevation myocardial infarction undergoing a primary percutaneous coronary intervention
    (Lippincott Williams & Wilkins, 2013) Oduncu, Vecih; Erkol, Ayhan; Karabay, Can Y.; Kurt, Mustafa; Akgun, Taylan; Bulut, Mustafa; Pala, Selcuk
    Objectives Hypoalbuminemia is associated with a poor prognosis in patients with end-stage renal disease, chronic ischemic heart disease, heart failure (HF), and stroke. We aimed to investigate its prognostic value in patients with acute ST-segment elevation myocardial infarction (STEMI) treated by a primary percutaneous coronary intervention (p-PCI). Materials and methods We retrospectively enrolled 1706 patients with STEMI treated by p-PCI. We prospectively followed up the patients for a median duration of 40 months. Results On admission, hypoalbuminemia (< 3.5 g/dl) was present in 519 (30.4%) patients. The incidence of final TIMI grade 3 flow (84 vs. 91.4%, P < 0.001) was lower in the patients with hypoalbuminemia. In-hospital mortality (9.4 vs. 2%), HF (20.2 vs. 8.6%), and major bleeding (6 vs. 2.5%) rates were significantly higher in patients with hypoalbuminemia. However, in-hospital stroke and reinfarction rates were similar in both groups. At long-term follow-up (median duration: 42 months), all-cause mortality (23.3 vs. 8.4%, P < 0.001), reinfarction (11.6 vs. 7.7%, P= 0.013), stroke (2.6 vs. 1.1%, P = 0.031), and advanced HF (13.3 vs. 6.1%, P < 0.001) rates were significantly higher in patients with hypoalbuminemia. In the Cox proportional hazard model, hypoalbuminemia was determined as an independent predictor of long-term mortality [hazard ratio 2.98, 95% confidence interval 1.35-6.58, P = 0.007) and development of advanced HF (hazard ratio 2.96, 95% confidence interval 1.44-6.08, P = 0.003). Conclusion Hypoalbuminemia on admission is a strong independent predictor for long-term mortality and development of advanced HF in patients with STEMI undergoing p-PCI. Coron Artery Dis 24: 88-94 (C) 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.
  • Küçük Resim
    Öğe
    Relationship between human platelet antigen-1 gene polymorphism and clopidogrel resistance in patients with coronary artery disease
    (Turkish Soc Cardiology, 2013) Tanboga, Ibrahim Halil; Can, Mehmet Mustafa; Ozkan, Alper; Tokgoz, Hacer Ceren; Akgun, Taylan; Koca, Fatih; Kurt, Mustafa
    Objectives: It has been proposed that human platelet antigen-1 (HPA-1) gene polymorphism is associated with coronary artery disease (CAD) and affects platelet function. We aimed to investigate the distribution of HPA gene polymorphism between angiographic CAD and a control group and the relation between HPA gene polymorphism and platelet aggregation. Study design: The study population consisted of 94 patients with angiographic CAD and 115 patients without angiographic CAD. Platelet aggregation was measured with impedance aggregometry on the fifth day of percutaneous coronary intervention (PCI). Platelet aggregation >480 AU/min was defined as the clopidogrel resistance. Blood samples were obtained from all participants at discharge for the analysis of HPA-1 gene polymorphism. Results: There was no significant difference in the distribution of HPA-1 gene polymorphism between the control and CAD groups (78.7% vs. 78.1% for A allele and 21.3% vs. 21.9% for B allele, p=NS). The analysis between groups with and without clopidogrel resistance revealed no significant difference in the distribution of HPA-1A and HPA-1B alleles between the groups (A allele 78.7% vs. 78.9% and B allele 21.3% vs. 21.1%, p=NS). In the CAD group, there were no significant differences in platelet aggregation between HPA-1A and HPA-1B alleles (294 +/- 240 vs. 259 +/- 261 AU/min, p=NS). Conclusion: Distribution of HPA-1 gene polymorphism was not different in CAD patients compared to the control group. HPA-1 gene polymorphism was not associated with platelet aggregation or clopidogrel resistance assessed by impedance aggregometry in the CAD group.