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OP-036 Effect of Hematologic Parameters on Reperfusion in ST Elevation Myocardial Infarction
MARCH 26e29, 2015
O R A L
Table
QT dispersion
T peak to end (Tpe)
A B S T R A C T S
Tpe/QT
Table PAI_ 4G/4G 5G/5G 4G/5G
p
59,32, 8503, 2482,0 82,719 92,618 8820 0,2040,052 0,2290,046 0,2190,047
:0,153
:0,161
:0,20
FactorXIII Val/Val Val/Leu Leu/Leu
p
52,72,5 50,32, 7451,1 87,218 87,02:17 9519
0:783
0,2140,049 0,2170,046 0,2620,057
0:690
STR<70% STR>70%
P
MBG;0-1 MBG;2-3
P
WBC count, (109/L) 14,23,6 11,54 0,000 14,44 12,13,6 0,000 Neutrophil count (109/L) 11,63,6 8,8 3,3 0,000 11,83,7 9,5 3,4 0,000 Lymphocyte count, (109/L) 2,31,1 1,91,09 :0,004 2,431,9 1,961,05 :0,002 Platelet count (109/L) 268,468 253,774 :0,147 265,965 26075 :0,603 Hemoglobin(g/dL) 13,9 1,3 13,41,2 :0,01 14 1,2 13,51,4 0,02 Mean platelet volume (fL) 9,81,6 9,11,3 :0,004 9,861,3 9,331,6 :0,012 N/ L ratio 7,26,8 6,95,6 :0,690 6,94,6 7,37 0,733 P/N ratio 25,410,6 32,416 :0,000 24,18,6 31,216 0,000
0:157
WBC: white blood cell, N: Neutrophil, L: Lymphocyte, P: Platelet STR:ST resolution MBG:myocardial blush grade.
Val: valine Leu:leusin. XIIIgene polymorphism was as follows: Val/Val genotype (normal) in 67 patients, Val/Leu genotype (heterozygous) in 37 patients and Leu/ Leu genotype (homozygous) in 4 patients. The forty one of those pa_ genotypes nor patients had Leu carrier. Neither patients with PAI-1 tients with factor XIII genotypes was found a significiant association between QT dispersion, Tpe interval and Tpe/QT ratio in the table. Moreover, no significant difference was found in patiens with the 4G allele carriers compared to without the 4G allele carriers according to QT dispersion, Tpe interval and Tpe/QT ratio (51,9 0,23ms vs 500,32ms p:0,767; 86,2917,7ms vs 92,6317,9ms p:0,161; 0,2150,049 vs 2290,046 p: 0,248, respectively).In addition, no significant difference was found in patiens with the Leu allele carriers compared to without the Leu allele carriers according to QT dispersion, Tpe interval and Tpe/QT ratio (49,8 0,26ms vs 520,25ms p:0,562; 87,8017,8 ms vs 87,1617,9ms p:0,857; 0,2220,048 vs 2150,049 p: 0,423, respectively). Conclusion: The present study, for the first time, has shown that the plasminogen activator inhibitör 1 (PAI-1) and factor XIII gene polymorphism was not influence admission repolarization parameters.
- OP-036 Effect of Hematologic Parameters on Reperfusion in ST Elevation Myocardial Infarction. Zülküf Karahan, Barıs¸ Yaylak, Ilyas Kaya, Murat Ugurlu, Özlem Aydınalp, Berzal Uçaman, Kemal Çevik, Ali Veysel Ulug, Bernas Altıntas¸, Önder Öztürk. Department of Cardiology, Gazi Yas¸argil Education and Research Hospital, Diyarbakır, Turkey. Objectives: Hematologic parameters play an important role in reperfusion injury. Nonetheless, the relationship between hematologic parameters and microvasculare reperfusion is not well known. Our aim in present study was to evaluate the relationship between admission hematologic parameters and microvasculare reperfusion in patients with ST elevation myocardial infarction (STEMI) with treated primary percutaneous coronary intervention (primary PCI). Methods: Two hundred thirteen patients( mean ag:57,5þ/-11 years) with STEMI were included in present study. Blood samples were obtained all patients before primary PCI. Electrocardiograph for ST segment resolution(STR) were withdrawn before and after primary PCI. Angiographic assessment in infarcted related artery was defined as myocardial blush grade (MBG). Patiens were divided into two groups according to impaired microvasculare reperfuion ( STR<70% and MBG:0-1) and normal microvasculare reperfusion (STR>70% and MBG:2-3). Results: Of the 213 patients, STR<70% and MBG 0-1 were present in 139 and 105 patients, respectively. The patients with STR< 70% and MBG 0-1 were found to have a higher WBC count, neutrophil count, lymphocyte count, platelet/neutrophil (P/N)ratio and MPV in table. The
neutrophil/lymphocyte (N/L) ratio and platelet count were not a significiant different between both groups(Table). Correlation analysis showed a negative correlation between lymphocyte count and STR (r:-0,195, p:0,004 ), lymphocyte count and MBG (r:-0,211, p:0,002), respectively. Conclusion: In present study, admission higher WBC count and MPV were found as independent predictors of impaired microvascular perfusion in patients with STEMI. Moreover, negative correlation was found between lymphocyte count and impaired microvascular perfusion. Elevated lymphocyte count was found in impaired microvasculare reperfusion in patients with STEMI.
- OP-037 PDW Can Predict Long Term Adverse Cardiac Events in Patients with Acute Coronary Syndrome. S¸eref Ulucan1, Ahmet Keser1, Zeynettin Kaya1, Hüseyin Katlandur1, Hüseyin Özdil1, Mustafa Bilgi2, Mehmet Sıddık Ülgen1. 1 Department of Cardiology, Mevlana University, Konya, Turkey; 2Department of Internal Medicine, Mevlana University, Konya, Turkey. Background: Inflammation is a very important factor that augments the entire process of atherosclerosis. Platelets have a major role in the pathogenesis of Acute Coronary Syndrome (ACS), where plaque rupture is followed by platelet activation and thrombus formation leading to coronary artery occlusion. Platelets vary in size and activity. When platelets are activated they become larger in size, which can be measured by both larger mean platelet volume (MPV) and platelet distribution width (PDW). Larger platelets are more adhesive and tend to aggregate more than smaller ones. This increase in platelet volume will increase the tendency for coronary thrombus formation in ACS patients. Platelet distribution width (PDW), a direct measure of the variability of platelet size. Therefore, the PDW can be an indicator of platelet activation. We aimed to investigate the association between the pre procedural PDW and outcomes of patients with ACS underwent primary PCI via transradial approach(TRA). Methods: A total of 679 consecutive patients with ACS (320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) underwent primary PCI via TRA were enrolled in retrospective study. According to levels of PDW, patients were divided into tertiles. Coronary angiographic evaluation and/or primary PCI and transthoracic echocardiography were performed for each patient. Blood samples were obtained in the emergency room on admission. Results: The mean follow-up period was 21 months (1-44 months). In-hospital and long-term major adverse cardiac events (MACE) were evaluated. In-hospital period; there were no statistical different between tertiles in terms of non-fatal myocardial infarction and mortality (p¼0.617, p¼0.628 respectively) while in-stent thrombosis was
S16 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral
O R A L
Table
QT dispersion
T peak to end (Tpe)
A B S T R A C T S
Tpe/QT
Table PAI_ 4G/4G 5G/5G 4G/5G
p
59,32, 8503, 2482,0 82,719 92,618 8820 0,2040,052 0,2290,046 0,2190,047
:0,153
:0,161
:0,20
FactorXIII Val/Val Val/Leu Leu/Leu
p
52,72,5 50,32, 7451,1 87,218 87,02:17 9519
0:783
0,2140,049 0,2170,046 0,2620,057
0:690
STR<70% STR>70%
P
MBG;0-1 MBG;2-3
P
WBC count, (109/L) 14,23,6 11,54 0,000 14,44 12,13,6 0,000 Neutrophil count (109/L) 11,63,6 8,8 3,3 0,000 11,83,7 9,5 3,4 0,000 Lymphocyte count, (109/L) 2,31,1 1,91,09 :0,004 2,431,9 1,961,05 :0,002 Platelet count (109/L) 268,468 253,774 :0,147 265,965 26075 :0,603 Hemoglobin(g/dL) 13,9 1,3 13,41,2 :0,01 14 1,2 13,51,4 0,02 Mean platelet volume (fL) 9,81,6 9,11,3 :0,004 9,861,3 9,331,6 :0,012 N/ L ratio 7,26,8 6,95,6 :0,690 6,94,6 7,37 0,733 P/N ratio 25,410,6 32,416 :0,000 24,18,6 31,216 0,000
0:157
WBC: white blood cell, N: Neutrophil, L: Lymphocyte, P: Platelet STR:ST resolution MBG:myocardial blush grade.
Val: valine Leu:leusin. XIIIgene polymorphism was as follows: Val/Val genotype (normal) in 67 patients, Val/Leu genotype (heterozygous) in 37 patients and Leu/ Leu genotype (homozygous) in 4 patients. The forty one of those pa_ genotypes nor patients had Leu carrier. Neither patients with PAI-1 tients with factor XIII genotypes was found a significiant association between QT dispersion, Tpe interval and Tpe/QT ratio in the table. Moreover, no significant difference was found in patiens with the 4G allele carriers compared to without the 4G allele carriers according to QT dispersion, Tpe interval and Tpe/QT ratio (51,9 0,23ms vs 500,32ms p:0,767; 86,2917,7ms vs 92,6317,9ms p:0,161; 0,2150,049 vs 2290,046 p: 0,248, respectively).In addition, no significant difference was found in patiens with the Leu allele carriers compared to without the Leu allele carriers according to QT dispersion, Tpe interval and Tpe/QT ratio (49,8 0,26ms vs 520,25ms p:0,562; 87,8017,8 ms vs 87,1617,9ms p:0,857; 0,2220,048 vs 2150,049 p: 0,423, respectively). Conclusion: The present study, for the first time, has shown that the plasminogen activator inhibitör 1 (PAI-1) and factor XIII gene polymorphism was not influence admission repolarization parameters.
- OP-036 Effect of Hematologic Parameters on Reperfusion in ST Elevation Myocardial Infarction. Zülküf Karahan, Barıs¸ Yaylak, Ilyas Kaya, Murat Ugurlu, Özlem Aydınalp, Berzal Uçaman, Kemal Çevik, Ali Veysel Ulug, Bernas Altıntas¸, Önder Öztürk. Department of Cardiology, Gazi Yas¸argil Education and Research Hospital, Diyarbakır, Turkey. Objectives: Hematologic parameters play an important role in reperfusion injury. Nonetheless, the relationship between hematologic parameters and microvasculare reperfusion is not well known. Our aim in present study was to evaluate the relationship between admission hematologic parameters and microvasculare reperfusion in patients with ST elevation myocardial infarction (STEMI) with treated primary percutaneous coronary intervention (primary PCI). Methods: Two hundred thirteen patients( mean ag:57,5þ/-11 years) with STEMI were included in present study. Blood samples were obtained all patients before primary PCI. Electrocardiograph for ST segment resolution(STR) were withdrawn before and after primary PCI. Angiographic assessment in infarcted related artery was defined as myocardial blush grade (MBG). Patiens were divided into two groups according to impaired microvasculare reperfuion ( STR<70% and MBG:0-1) and normal microvasculare reperfusion (STR>70% and MBG:2-3). Results: Of the 213 patients, STR<70% and MBG 0-1 were present in 139 and 105 patients, respectively. The patients with STR< 70% and MBG 0-1 were found to have a higher WBC count, neutrophil count, lymphocyte count, platelet/neutrophil (P/N)ratio and MPV in table. The
neutrophil/lymphocyte (N/L) ratio and platelet count were not a significiant different between both groups(Table). Correlation analysis showed a negative correlation between lymphocyte count and STR (r:-0,195, p:0,004 ), lymphocyte count and MBG (r:-0,211, p:0,002), respectively. Conclusion: In present study, admission higher WBC count and MPV were found as independent predictors of impaired microvascular perfusion in patients with STEMI. Moreover, negative correlation was found between lymphocyte count and impaired microvascular perfusion. Elevated lymphocyte count was found in impaired microvasculare reperfusion in patients with STEMI.
- OP-037 PDW Can Predict Long Term Adverse Cardiac Events in Patients with Acute Coronary Syndrome. S¸eref Ulucan1, Ahmet Keser1, Zeynettin Kaya1, Hüseyin Katlandur1, Hüseyin Özdil1, Mustafa Bilgi2, Mehmet Sıddık Ülgen1. 1 Department of Cardiology, Mevlana University, Konya, Turkey; 2Department of Internal Medicine, Mevlana University, Konya, Turkey. Background: Inflammation is a very important factor that augments the entire process of atherosclerosis. Platelets have a major role in the pathogenesis of Acute Coronary Syndrome (ACS), where plaque rupture is followed by platelet activation and thrombus formation leading to coronary artery occlusion. Platelets vary in size and activity. When platelets are activated they become larger in size, which can be measured by both larger mean platelet volume (MPV) and platelet distribution width (PDW). Larger platelets are more adhesive and tend to aggregate more than smaller ones. This increase in platelet volume will increase the tendency for coronary thrombus formation in ACS patients. Platelet distribution width (PDW), a direct measure of the variability of platelet size. Therefore, the PDW can be an indicator of platelet activation. We aimed to investigate the association between the pre procedural PDW and outcomes of patients with ACS underwent primary PCI via transradial approach(TRA). Methods: A total of 679 consecutive patients with ACS (320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) underwent primary PCI via TRA were enrolled in retrospective study. According to levels of PDW, patients were divided into tertiles. Coronary angiographic evaluation and/or primary PCI and transthoracic echocardiography were performed for each patient. Blood samples were obtained in the emergency room on admission. Results: The mean follow-up period was 21 months (1-44 months). In-hospital and long-term major adverse cardiac events (MACE) were evaluated. In-hospital period; there were no statistical different between tertiles in terms of non-fatal myocardial infarction and mortality (p¼0.617, p¼0.628 respectively) while in-stent thrombosis was
S16 The American Journal of Cardiologyâ MARCH 26e29, 2015 11th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Oral