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  • Küçük Resim
    Öğe
    Coronary vasospasm and acute myocardial infarction induced by a topical capsaicin patch
    (2009) Akçay, Adnan Burak; Özcan, Türkay; Seyis, Sabri; Acele, Armağan
    Capsaicin is the active component of chili peppers, which has been shown to possess several beneficial effects. Currently, the best-known medical use of capsaicin is as a topical painkiller. Drug-induced myocardial infarction is not a common phenomenon and the underlying mechanism has been related with coronary spasm in the majority of cases. We present a 29-year-old man who experienced coronary vasospasm and acute myocardial infarction (AMI) which were possibly induced by the use of a topical capsaicin patch to relieve lumbago. He presented with chest pain of one hour onset. The electrocardiogram showed ST-segment elevation in the leads II, III, and aVF, consistent with inferior wall AMI. Echocardiography confirmed inferior hypokinesia. Urgent coronary angiography showed normal right and left coronary arteries. Since he had no cardiac risk factors for coronary artery disease, nor a history of recent emotional or physical stress, or ingestion of any illicit substance, the vasospasm and subsequent AMI was attributed to the use of the capsaicin patch for six days. Upon institution of appropriate treatment and removal of the patch, no new anginal attacks or ischemic episodes were seen within a follow-up of one month. This is the first case report of AMI induced by the use of a topical capsaicin patch.
  • Küçük Resim
    Öğe
    The relationship between paraoxonase-1 activity and coronary artery disease in patients with metabolic syndrome
    (Turkish Soc Cardiology, 2011) Akcay, Adnan Burak; Camsari, Ahmet; Ozcan, Turkay; Cicek, Dilek; Akkus, Necdet; Seyis, Sabri; Cimen, Burak
    Objectives: We investigated the correlation of serum paraoxonase-1 (PON-1) activity with coronary artery disease (CAD) in patients with metabolic syndrome (MetS). Study design: The study included 21 patients (mean age 55 +/- 9 years) with MetS, stable angina pectoris, and angiographically shown CAD, 24 patients (mean age 51 +/- 10 years) with MetS and angiographically normal coroner arteries, and 28 healthy controls (mean age 49 +/- 12 years). Demographic and clinical characteristics, insulin levels, homeostasis model assessment of insulin resistance index, and PON- 1 activity were assessed in all the groups. Severity of CAD was assessed using the Gensini score. Results: Paraoxonase-1 activity was significantly lower in patients with MetS compared to the control group (p= 0.02). The two MetS groups with and without CAD exhibited similar characteristics in all the parameters including PON-1 activity (p>0.05). Univariate correlation analysis performed in MetS-CAD patients showed a significant negative correlation between the Gensini score and PON-1 activity (r=-0.48, p=0.02). The overall PON- 1 activity of all the subjects showed no correlation with the parameters examined. Conclusion: Decreased PON-1 activity in patients with MetS compared to the control group suggests increased oxidative stress in MetS. Detection of similar PON-1 activity levels in MetS groups with and without CAD suggests that disturbance of oxidative- antioxidative balance occurs before the development of CAD. The negative correlation between the Gensini score and PON-1 activity implies that decreased PON-1 activity may be one of the etiologic causes of atherosclerotic progress in MetS.