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    Serum Uric Acid, Inflammation, and Nondipping Circadian Pattern in Essential Hypertension
    (Wiley, 2013) Turak, Osman; Ozcan, Firat; Tok, Derya; Isleyen, Ahmet; Sokmen, Erdogan; Tasoglu, Irfan; Aydogdu, Sinan
    Uric acid (UA) is independently associated with the emergence of hypertension. Nocturnal nondipping pattern of hypertension is associated with a greater risk of cardiovascular, renal, and cerebrovascular complications than dippers. The aim of the present study was to evaluate the relationship between the circadian blood pressure rhythm and UA level in patients with newly diagnosed essential hypertension. The study included 112 essential hypertensive patients and 50 healthy controls. The hypertensive patients were divided into two groups according to the results of 24-hour ambulatory blood pressure monitoring, including 60 dippers (35 men, 25 women; mean age, 52.6 +/- 15.8 years) and 52 nondippers (29 men, 23 women; mean age, 55.9 +/- 13.2 years). Nondippers had significantly higher serum UA levels than the dippers and controls (5.8 +/- 0.8, 5.1 +/- 0.9 and 4.2 +/- 0.9 mg/dL, respectively; P<.001). Serum high-sensitivity C-reactive protein levels were also significantly higher in the nondipper group than the other groups (P<.001) and significantly correlated with serum UA (r=0.358, P<.001). Multivariate logistic regression analysis revealed an independent positive association between serum UA levels and nondipper pattern (odds ratio, 2.28; 95% confidence interval, 1.333.94; P=.003). Serum UA is strongly and independently associated with the nondipper circadian pattern in essential hypertension.
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    Usefulness of the Neutrophil-to-Lymphocyte Ratio to Predict Bare-Metal Stent Restenosis
    (Excerpta Medica Inc-Elsevier Science Inc, 2012) Turak, Osman; Ozcan, Firat; Isleyen, Ahmet; Tok, Derya; Sokmen, Erdogan; Buyukkaya, Eyup; Aydogdu, Sinan
    Inflammation plays a crucial role in the pathogenesis of in-stent restenosis (ISR). Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and prognosis in patients with coronary artery disease. The aim of the present study was to investigate the predictive value of preprocedural NLR on development of ISR in patients undergoing coronary stent implantation. We retrospectively analyzed clinical, hematologic, and angiographic data of 624 patients (mean age 60.5 +/- 10.2 years, 71.8% men) who had undergone coronary stent implantation and a further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural NLR. Restenosis occurred in 21 patients (10.1%) in the lowest tertile, in 62 (29.8%) in the middle tertile, and in 107 (51.4%) in the highest NLR tertile (p <0.001). Serum C-reactive protein levels were also significantly higher in patients in tertile 3 than in those in tertiles 1 and 2 (p <0.001). Using multiple logistic regression analysis, smoking, diabetes mellitus, stent length, preprocedural NLR, and C-reactive protein levels emerged as independent predictors of ISR. In receiver operating characteristics curve analysis, NLR >2.73 had 80% sensitivity and 75% specificity in predicting ISR. In conclusion, high preprocedural NLR is a powerful and independent predictor of bare-metal stent restenosis in patients with stable and unstable angina pectoris. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved. (Am J Cardiol 2012;110:1405-1410)