Duman, Hakan; Çinier, Goksel; Bakirci, Eftal Murat; Duman, Handan; Simsek, Ziya; Hamur, Hikmet; Degirmenci, Huesnue; Emlek, Nadir

Increased coronary thrombus burden is known to be a strong predictor of adverse cardiovascular (CV) outcomes. C-reactive protein to albumin ratio (CAR) can be used as a surrogate marker of pro-inflammation which is closely related to prothrombotic state. We aimed to evaluate the association between CAR and coronary thrombus burden in patients who presented with acute coronary syndrome (ACS). Patients who presented with ACS and treated with primary percutaneous coronary intervention were included in the study. Patients were divided into 2 groups as high thrombus burden and low thrombus burden. The study population included 347 patients with non-ST-segment elevation myocardial infarction (169 [48.7%]) and ST-segment elevation myocardial infarction (178 [51.3%]). The CAR was significantly higher in patients with higher thrombus burden (24.4 [1.2-30.2] vs 31.9 [2.2-31.3], P < .001). Independent predictors for increased thrombus burden were higher CRP level (odds ratio [OR]: 0.047; 95% confidence interval [CI]: 0.004-0.486; P = .010), lower serum albumin level (OR: 0.057; 95% CI: 0.033-0.990; P = .049), higher CAR (OR: 1.13; 95% CI: 1.03-1.23; P = .008), higher neutrophil-lymphocyte ratio (OR: 1.18; 95% CI: 1.05-1.31; P = .004), and baseline troponin I level (OR: 1.06; 95% CI: 1.01-1.13; P = .017). Novel CAR can be used as a reliable marker for increased coronary thrombus burden that is associated with adverse CV outcomes.

Bakirci, Eftal Murat; Degirmenci, Husnu; Duman, Hakan; Inci, Sinan; Hamur, Hikmet; Buyuklu, Mutlu; Ceyhun, Gokhan; Topal, Ergun

We aimed to evaluate the relation among epicardial adipose tissue (EAT) thickness, angiographic presence of thrombus, and the no-reflow in the patients with non-ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The study population consisted of 229 patients. The EAT thickness and neutrophil to lymphocyte ratio (NLR) were significantly higher in the patients with coronary thrombus than in those without coronary thrombus (6.1 ± 1.1 vs 5.1 ± 1.3 mm, P <.001 and 3.4 ± 0.9 vs 2.5 ± 0.7, P <.001, respectively) and in the patients with no-reflow compared to patients with reflow. The EAT thickness was found to be correlated positively with the degree of the thrombus burden, NLR, and waist circumference and negatively with high-density lipoprotein cholesterol. Multivariate logistic regression analysis demonstrated that EAT thickness and NLR independently predicted coronary thrombus formation and no-reflow. We have suggested that EAT can play an important role in the pathophysiology of coronary thrombus formation and the no-reflow.

Sevimli, Serdar; Karakoyun, Suleyman; Bakirci, Eftal Murat; Topcu, Selim; Kalkan, Kamuran; Borekci, Abdurrezzak; Vançelik, Serhat

We aimed to investigate the association of aspirin and/or clopidogrel low response with-455G/A polymorphism of β-fibrinogen in patients with acute coronary syndrome (ACS). We enrolled 114 consecutive patients (mean age 61 ± 7, 31 female [27.2%], 83 male [72.8%]) with a first ACS. The diagnostic criteria for ACS were based on current guidelines. The-455 G/A β-fibrinogen polymorphism genotype distribution in the patient group was determined as the following: 54.4% GG homozygote, 39.5% GA, and 6.1% AA homozygote. Clopidogrel low response was present in 25 (21.9%) patients, aspirin low response in 21 (18.4%) patients, and dual antiplatelet low response in 9 (7.9%) patients. In our study, no difference was observed in terms of the distribution of-455 G/A β-fibrinogen polymorphism between the groups with and without aspirin and/or clopidogrel or dual antiplatelet low response in the patient group who underwent aspirin and clopidogrel treatment for ACS (P >.05).