Relationship between mean platelet volume and morning blood pressure surge in newly diagnosed hypertensive patients

OBJECTIVE

Morning blood pressure surge (MBPS) is an independent predictor of atherothrombotic cardiovascular events in hypertensive patients. There is evidence from studies supporting the validity of mean platelet volume (MPV) as a marker of vascular risk and predictor of thrombotic complications. The aim of this study is to investigate the relationship between MPV and MBPS in hypertensive patients.

METHODS

Measurements were obtained from 298 patients with newly diagnosed essential hypertension (Mean age: 51.9 ± 11.7 years). The patients were divided into two groups (MPV(low) group; <10.8 fL, MPV(high) group; ≥ 10.8 fL). The MBPS was calculated as mean systolic BP during the 2 hours after awaking minus the mean systolic BP during the 1 hour that included the lowest sleep BP.

RESULTS

MPV was independently associated with MBPS (β=0.554, p<0.001) and hs-CRP level (β=0.286, p<0.001).

CONCLUSION

Finally, higher MPV values related to enhanced MBPS which are associated with atherothrombotic cardiovascular events.

Gamma Glutamyl Transferase Activity is Associated With Both Paraoxonase Activity and Aortic Stiffness in Hypertensive Patients

BACKGROUND

We aimed to investigate relationship between gamma glutamyl transferase (GGT) activity with paraoxonase 1 (PON1) activity and aortic stiffness (AS) parameters such as pulse wave velocity (PWV) and augmentation index (AIx).

METHODS

Measurements were obtained from 324 patients with newly diagnosed essential hypertension (mean age: 55.0 ± 8.2 years). The patients were divided into two groups according to their median GGT values. PWV and AIx were calculated using the single-point method via the Mobil-O-Graph® ARCsolver algorithm.

RESULTS

PWV, Aix, and high-sensitive C-reactive protein (hs-CRP) values were higher and PON1 activity values were lower in GGThigh group compared with GGTlow group (P < 0.05, for all). Multiple linear regression analysis showed that GGT activity was independently associated with PWV (β = 0.496, P < 0.001) and PON1 activity (β = -0.343, P < 0.001) as well as hs-CRP (β = 0.334, P < 0.001).

CONCLUSION

These results may support that increased GGT activity would be associated with both impaired antioxidant system and increased AS in hypertensive patients.

Serum 25-Hydroxyvitamin D Level and Aortic Intima-Media Thickness in Patients Without Clinical Manifestation of Atherosclerotic Cardiovascular Disease

OBJECTIVES

Existing evidence suggests that impaired vitamin D metabolism contribute to the development of atherosclerosis. Aortic intima-media thickness (IMT) is an earlier marker than carotid IMT of preclinical atherosclerosis. However, there is a lack of researches on direct investigation of relevance between serum 25-hydroxyvitamin D (25(OH)D) and thoracic aortic IMT. In this study, we aimed to assess the relationship between thoracic aortic IMT and 25(OH)D.

METHODS

We studied 117 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Serum 25(OH)D was measured using a direct competitive chemiluminescent immunoassay. The patients were divided into three groups according to the their serum 25(OH)D levels (VitDdeficiency , VitDinsufficient and VitDnormal groups). TEE was performed in all subjects. High sensitive C-reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer.

RESULTS

Only 24.8% (29 patients) of patients had normal levels of 25(OH)D. The highest aortic IMT values were observed in VitDdeficiency group compared with VitDinsufficient and VitDnormal groups (P < 0.05, for all). Also aortic IMT values of VitDinsufficient group were higher than VitDnormal group (P < 0.05). 25(OH)D was independently associated with hs-CRP (β = -0.442, P < 0.001) and aortic IMT (β = -0.499, P < 0.001).

CONCLUSIONS

The lower 25(OH)D level was independently associated with higher aortic IMT values. Therefore, hypovitaminosis D may have a role on pathogenesis of subclinical thoracic atherosclerosis.

Rheumatoid pleural effusion with nodular pleuritis. A rare presentation of rheumatoid arthritis

Rheumatoid pleural effusion and lung nodules are unusual complications of rheumatoid disease that typically present subsequently to other more common manifestations of rheumatoid illness. However, these complications may occasionally occur before or concurrently with the development of joint manifestations of disease. We report the case of a 41-year-old female patient with rheumatoid pleural effusion and lung nodule arising simultaneously with the onset of joint symptoms. The patient underwent thoracentesis followed by video-assisted thoracoscopic biopsy to result in a diagnosis of rheumatoid pleuritis and nodular disease. A high index of suspicion and coexistence of the cytologic and histopathologic effusion picture characteristic of rheumatoid pleuritis are of clinical importance in making a diagnosis.

Evaluation of the effects of recipient/donor gender on early/late postoperative renal graft functions by renal scintigraphy

OBJECTIVES

We discuss the effects of recipient/donor gender on renal allograft functions using scintigraphic parameters obtained 3 days after renal transplant and 1 year after transplant.

MATERIALS AND METHODS

This retrospective study included 76 renal allograft recipients (group one, 38 males; group two, 38 females). Patients underwent scintigraphic imaging with Tc-99m DTPA on postoperative day 3 and 1 year after transplant. We used the Hilson perfusion index, maximum renal activity/background activity, ratio of renal activity at 20 minutes to renal activity at 3 minutes, time-to-peak activity, and glomerular filtration rate to measure quantitative parameters.

RESULTS

On postoperative day 3, the Hilson perfusion index, maximum renal activity/background activity, the ratio of renal activity at 20 minutes to renal activity at 3 minutes, time-to-peak activity, and glomerular filtration rate values for male/female recipients were similar (P = .65, P = .77, P = .38, P = .10, P = .99). The gender of donors was compared with the above-mentioned scintigraphic parameters of the recipients, and no statistically significant differences were found (P = .24, P = .25, P = .44, P = .29, P = .13). At 1-year follow-up, values obtained from group 1 and group 2 recipients were similar. After 1 year, chronic rejection developed in 15.7% of group 1 recipients and in 10.5% of group 2 recipients; acute rejection developed in 21% of group 1 recipients and in 23.6% of group 2 recipients. There were no statistically significant differences between the occurrence of acute rejection and the gender of recipients or donors (P = 1.00, P = .45).

CONCLUSIONS

We observed no statistically significant differences between renal graft functions and gender of the recipients/donors during the early/late posttransplant period.

Oxidative Stress and Paraoxonase 1 Activity Predict Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Reactive oxygen species have been implicated in the pathogenesis of contrast-induced nephropathy (CIN). We investigated the relationship between CIN with paraoxonase 1 (PON-1) activity and oxidative stress markers (total antioxidant status [TAS], total oxidant status [TOS], and oxidative stress index [OSI]) in patients with anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention; 289 consecutive patients with STEMI were prospectively included. The patients were divided into 2 groups: CIN (n = 69) and non-CIN (n = 220). Activity of PON-1 and TAS levels were significantly lower and OSI and TOS levels were significantly higher in patients with CIN compared to the non-CIN group ( P < .05, for all). On multivariate logistic regression analysis, PON-1 activity and OSI as well as the amount of contrast medium and diabetes were independent predictors for CIN in patients with anterior STEMI. Activity of PON-1 and oxidative stress may play a role in the pathogenesis of CIN.

Increased Aortic Stiffness Predicts Contrast-Induced Nephropathy in Patients With Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Increased aortic stiffness (AS) has been shown to be an independent risk factor for cardiovascular disease in renal failure and was also found to be associated with even mild renal insufficiency. We investigated the relationship between contrast-induced nephropathy (CIN) and AS parameters such as pulse wave velocity (PWV) and augmentation index (AIx). Patients (n = 440) with stable coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) were included prospectively (mean age: 60.3 ± 10.3 years). The PWV and AIx were calculated using the single-point method. The PWV, age, diabetes, SYNTAX score, and contrast media dose were independent predictors for CIN ( P < .05, for all). The cutoff value for PWV obtained by the receiver–operator characteristic curve analysis was 10.35 m/s for the prediction of CIN (95% confidence interval: 0.838-0.916, sensitivity: 82.1%, specificity: 77.9%, and P < .001). In conclusion, a greater AS pre-PCI may predict CIN development in patients with stable CAD.