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    Authors' response to the comments on automated platelet analyses by Dr Beyan
    (Elsevier Ireland Ltd, 2014) Akpinar, Ibrahim; Sayin, Muhammet Rasit; Gursoy, Yusuf Cemil; Aktop, Ziyaeddin; Karabag, Turgut; Kucuk, Emrah; Aydin, Mustafa
    [Abstract Not Available]
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    Evaluation of biochemical, hematological, and thyroid function parameters in nondipper and dipper hypertensive patients
    (Springer Wien, 2012) Akpinar, Ibrahim; Basar, Nurcan; Sen, Nihat; Kisacik, Halil Lutfu
    In this study we investigated the effects of biochemical, hematologic, and thyroid function parameters on the circadian rhythm of hypertensive patients whose 24-h ambulatory blood pressure was being followed. We studied the fasting glucose, urea, creatinine, uric acid, aspartate transaminase, alanine aminotransferase, gamma-glutamyl transferase, total protein, albumin, lipid profiles, sodium, potassium, hemoglobin, white blood cell count, platelet count, mean platelet volume, thyroid stimulating hormone, free thyroid hormone values obtained simultaneously with 24-h ambulatory blood pressure results, as documented in the case records of 470 patients. Of the patients, 398 were in the nondipper hypertensive group and 72 in the dipper hypertensive group. Differences in serum biochemical, hematologic, and thyroid function parameters were compared between the groups. No statistically meaningful difference was detected between the age, gender, biochemical and hematologic parameters of the two groups. When the two were compared with respect to thyroid function tests, thyroid stimulating hormone levels in the nondipper hypertensive group were significantly higher, while free triiodothyronine and thyroxine levels were significantly lower. Thyroid function disorders are associated with hypertension. However, there are not enough data on the effects of thyroid hormones particularly on the nighttime blood pressure decrease in hypertensive patients. Although the exact mechanism between low thyroid hormone levels and nondipping hypertension development is not known, relatively low thyroid hormone levels in the nondipper group may be related to the decrease in vein wall compliance, considering the vascular effect of overt hypothyroidism.
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    Plateletcrit and red cell-distribution width are independent predictors of the slow coronary flow phenomenon
    (Elsevier, 2014) Akpinar, Ibrahim; Sayin, Muhammet Rasit; Gursoy, Yusuf Cemil; Aktop, Ziyaeddin; Karabag, Turgut; Kucuk, Emrah; Sen, Nihat
    Background and purpose: Endothelial dysfunction may play a role in the pathogenesis of the slow coronary flow (SCF) phenomenon. A detailed examination of blood cellular components has not been performed for this condition. We investigated the relationship between SCF and whole blood cell counts. Method: Records of 17,315 patients who underwent coronary angiography between January 2006 and December 2012 were evaluated retrospectively. A total of 146 patients with SCF were compared with 148 patients with normal coronary arteries according to demographic data, complete blood count, and biochemical parameters. Results: The following parameters were significantly higher in SCF patients than in patients with normal coronary arteries: percentage of smokers (36.3% vs. 25%, p = 0.036), body mass index (26.69 +/- 2.84 vs. 26.07 +/- 3.15, p = 0.049), white blood cells (WBCs) (7.52 +/- 1.43 x 10(3) mm(-3) vs. 7.01 +/- 1.42 x 10(3) mm(-3), p = 0.002), red cell distribution width (RDW) (13.68 +/- 1.42% vs. 13.15 +/- 1.13%, p < 0.001), platelets (250.29 +/- 50.96 x 10(3) mm(-3) vs. 226.10 +/- 38.02 x 10(3) mm(-3), p < 0.001), plateletcrit (PCT) (0.214 +/- 0.40% vs. 0.184 +/- 0.29%, p < 0.001), mean platelet volume (8.63 +/- 1.10 fL vs. 8.22 +/- 0.83 fL, p < 0.001), platelet distribution width (PDW) (16.58 +/- 0.76% vs. 16.45 +/- 0.57%, p = 0.028), and neutrophils (4.44 +/- 1.25 x 10(3) mm(-3) vs. 4.12 +/- 1.24 x 10(3) mm(-3), p = 0.029). Positive PCT values [odds ratio (OR), 4.165; 95% confidence interval (CI), 2.493-6.959; p < 0.001) and RDW (OR, 1.304; 95% Cl, 1.034-1.645; p = 0.025) were independent predictors of SCF. Conclusion: Although within the normal range, the increased numbers of WBCs and neutrophils in patients with SCF suggest that SCF may be a subclinical inflammatory condition. Furthermore, increased RDW and PDW in SCF patients may cause microvascular blood flow resistance due to impaired cell deformability. The PCT provides reliable data regarding total platelet mass and may be a useful predictor of SCF. (C) 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
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    Usefulness of Monocyte Chemoattractant Protein-1 to Predict No-Reflow and Three-Year Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
    (Excerpta Medica Inc-Elsevier Science Inc, 2013) Buyukkaya, Eyup; Poyraz, Fatih; Karakas, Mehmet F.; Kurt, Mustafa; Akcay, Adnan B.; Akpinar, Ibrahim; Motor, Sedat
    Although monocyte chemoattractant protein-1 (MCP-1) levels are increased in patients with ST-segment elevation myocardial infarction, the prognostic value of MCP-1 in primary percutaneous coronary intervention (pPCI) is not clear. The goal of the present study was to investigate the association of MCP-1 levels with myocardial perfusion and prognosis in patients with ST-segment elevation myocardial infarction undergoing pPCI. Consecutive pPCI patients (n = 192) were assigned to tertiles according to their admission serum MCP-1 levels. Angiographic no-reflow, Thrombolysis In Myocardial Infarction flow grade, myocardial blush grade, and ST-segment resolution were assessed. Mortality and major adverse cardiac events were evaluated during hospitalization and at the 3-year clinical follow-up visit. Failure of ST resolution was associated with greater admission MCP-1 levels. The risk of no-reflow (Thrombolysis In Myocardial Infarction flow <= 2 or Thrombolysis In Myocardial Infarction flow 3 with final myocardial blush grade <= 2 after pPCI and ST resolution <30%) increased as the admission MCP-1 increased. The 3-year mortality increased as the MCP-1 level increased (8% vs 22% vs 28% for the 3 tertiles, p <0.01). Multivariate logistic regression analysis demonstrated that MCP-1 levels at admission are a significant independent correlate of 3-year mortality in patients with no-reflow as detected by myocardial blush grade. A receiver operating characteristics analysis identified an optimum cut point of >= 254 pg/ml, which was associated with a negative predictive value of 95% in association with 1-year mortality. In conclusion, the plasma MCP-1 levels at admission are independently associated with the development of no-reflow and 3-year mortality in patients with ST-segment elevation myocardial infarction undergoing pPCI. Crown Copyright (C) 2013 Published by Elsevier Inc. All rights reserved.