Background    Elevation of blood urea nitrogen (BUN) indicates renal dysfunction and is associated with increased mortality in cardiovascular diseases. We investigated the relationship between the BUN concentration measured at hospital admission and the long-term all-cause mortality in patients with stable angina pectoris (SAP).Methods    The mortality rate of 344 patients who underwent coronary angiography (CAG) in our clinic due to SAP was analyzed during a mean follow-up period of 8 yrs.Results    Age (p<0.001), male gender (p=0.020), waist circumference (p=0.007), body-mass index (p=0.002), fasting glucose (p=0.004), BUN (p<0.001), serum creatinine (Cr) (p<0.001), hemoglobin (p=0.015), triglyceride concentrations (p=0.033), and the Gensini score (p<0.001) were related to all-cause mortality as shown by univariate Cox regression analysis. Age (OR 1.056, 95 % CI 1.015-1.100, p=0.008), fasting glucose (OR 1.006, 95 % CI 1.001-1.011, p=0.018), BUN, (OR 1.077, 95 % CI 1.026-1.130, p=0.003), and the Gensini score (OR 2.269, 95 % CI 1.233-4.174, p=0.008) were significantly related with mortality as shown by multivariate Cox regression analysis. According to receiver operating characteristic analysis ofthe sensitivity and specificity of BUN and Cr for predicting mortality, the area under the curve values of BUN and Cr were 0.789 (p<0.001) and 0.652 (p=0.001), respectively. BUN had a stronger relationship with mortality than Cr. A concentration of BUN above 16.1 mg / dl had 90.1 % sensitivity and 60 % specificity for predicting mortality (OR=2.23).Conclusion    In patients who underwent CAG due to SAP, the BUN concentration was associated with all-cause mortality during a mean follow-up period of 8 yrs.

INTRODUCTION/OBJECTIVES Thiols are crucial anti-oxidant agents that contain a sulfhydryl group; they play an important role in defence against reactive oxygen species. We aimed to determine the thiol/disulphide homeostasis in rheumatoid arthritis (RA) patients in conjunction with its association with disease activity, preclinical atherosclerosis, and other disease-related indices. METHODS We enrolled 64 RA patients without known cardiovascular (CV) disease or risk factors and 46 healthy controls. Disease activity was evaluated using the Disease Activity Score 28-erythrocyte sedimentation rate (DAS28-ESR). Thiol/disulphide homeostasis was evaluated using a novel automated method, and serum native thiol (NT), total thiol (TT), and disulphide(SS) levels were recorded. The carotid intima media thickness (CIMT) was measured using carotid ultrasound to evaluate preclinical atherosclerosis. RESULTS The NT and TT levels were significantly lower in RA patients than in controls (231.7 ± 52.3 vs. 293.6 ± 74.8 µmol/L, p < 0.001; 271.6 ± 52.1 vs. 331.3 ± 68.2 µmol/L, p < 0.001, respectively). There was no difference in SS levels between both groups. The CIMT was significantly higher in RA patients than in controls (0.80 vs. 0.56 mm, p ˂ 0.001). NT levels showed a significant negative correlation withCIMT in patients with RA (r = - 0.253, p = 0.040). In RA patients, NT and TT levels were significantly correlated with ESR (r = - 0.394, r = -0.399), high-sensitivity C-reactive protein (r = -0.413, r = - 0.342), DAS28-ESR (r = - 0.279, r = - 0.312), fibrinogen level (r = - 0.302, r = - 0.346), and anti-cyclic citrullinated peptide titres (r = - 0.305, r = 0.322) (, respectively). The association of thiol levels with CIMT did not arrive at a statistically significant level in multivariable linear regression analysis. CONCLUSIONS RA patients without known CV disease or risk factors exhibited increased CIMT values and decreased thiol levels; moreover, thiol levels were found to be correlated with disease activity. Further studies are needed to detect the value of thiol/disulphide homeostasis for CV risk stratification and risk prediction in RA patients.

Objective: Oxidative stress is one of the essential factors in the development of Hypertension (HT). Hair whitening is a visual sign of oxidative stress. We hypothesized that the intensity of premature hair whitening might predict HT development, and we aimed to test it. Materials and Methods: A total of 172 healthy males with different stages of hair whitening were included in the study and evaluated after an average of 86 months. During the follow-up, we compared the data of patients diagnosed with HT to those who remained healthy. Results: Fifty-five (32%) of 172 patients were diagnosed with HT during follow-up period. In terms of demographic characteristics, age (41.48 ± 6.39 vs 44.36 ± 5.25 years; p=0.013), waist circumference (97.52 ± 10.87 vs 104.80 ± 11.94 cm; p=0.004), and body-mass index (27.61 ± 3.56 vs 30.20 ± 3.55 kg/m2; p lt;0,001) were higher in the HT group, whereas smoking history (p=0.211) was similar between the groups. In univariate analysis carotid intima-media thickness (CIMT)(p=0.013), gamma-glutamyl transferase (GGT)(p=0.021), and uric acid (p lt;0.001) levels were higher in the HT group; on the contrary, estimated glomerular filtration rate (eGFR)(p=0.039) and high-density lipoprotein (HDL) levels (p=0.026) were lower in this group. There was no difference between groups in terms of hair whitening stage and intensity. In multivariate analysis age (OR=0.143, 95%CI (1.002-1.328), p=0.046), eGFR (OR= -0.058, 95%CI (0.895-0.995), p=0.032), uric acid (OR=0.567, 95%CI (1.032-3.015), p=0.038), GGT (OR=0.030, 95%CI (1.001-1.060), p=0.041), and HDL (OR=-0.129, 95%CI (0.783- 0.986), p=0.028) were independently associated with de nova HT. Body-mass index, CIMT, and the leukocyte count were similar between the groups. Conclusion: Premature hair whitening is not predictive in determining the development of HT in young and middle-aged healthy men.

Left atrial function has an important role in determining optimal performance of the heart. Increase of left atrial dysfunction and volume are poor prognostic factors. In this study, we investigated independent determinants of left atrial function in non-diabetic patients with de novo hypertension. The study included 124 consecutive non-diabetic patients with de novo hypertension. Brachial artery flow-mediated dilatation, carotid intima-media thickness, transthoracic echocardiography, 24-h rhythm holter, and aortic stiffness measurements were recorded. In echocardiography, left atrial maximum (LAMaV) and minimum (LAMiV) volumes were calculated. Left atrium total emptying fraction (LATEF) and total emptying volume (LATEV) were divided into two groups according to the mean levels. Multivariate analysis was performed after correlation analysis for LATEV and LATEF mean levels. By logistic regression analysis, systolic blood pressure (OR 0.882, 95% CI 0.784–0.992, p = 0.036), percent of flow-mediated dilation (OR 0.747, 95% CI 0.595–0.938, p = 0.012), and presence of carotid plaque (OR 0.014, 95% CI 0.001–0.188, p = 0.001) were found as independent variables that determine LATEF. Age (OR  0.879, 95% CI 0.795–0.972, p = 0.012), smoking (OR  23.739, 95% CI 2.699–208.810, p = 0.004), left ventricular mass index (OR  1.052, 95% CI 1.012–1.094, p = 0.011), mitrale E-wave velocity (OR 1.108, 95% CI 1.031–1.191, p = 0.005) and LDL (low-density lipoprotein) cholesterol (OR 0.942, 95% CI 0.911–0.974, p = 0.001) were independent predictors of LATEV. In non-diabetic patients with de novo hypertension endothelial dysfunction, subclinical atherosclerosis and LDL cholesterol levels independently affect left atrial function.

Background: Long-term mortality rate following coronary artery bypass grafting (CABG) procedure is still considered to be high despite advances in surgical techniques and perioperative management. Identifying high-risk patients by using cost-effective and clinically useful parameters is needed. Methods: Patients who were admitted to our cardiology clinic with the diagnosis of coronary artery disease and underwent CABG between January 2008 and August 2010 were included. Study patients were followed-up for 112.6 ± 17.8 months for major adverse cardiac events (MACE) which were defined as all-cause mortality and new-onset decompensated heart failure (HF). Results: Patients in MACE (þ) group were older ( p < 0.001), had higher additive Euroscore ( p < 0.001), and lower left ventricular ejection fraction ( p < 0.001). Multivariate Cox regression analysis showed that additive Euroscore [odds ratio (OR) ¼ 1.601; 95% confidence interval (CI) ¼ 1.374e1.864; p < 0.001)] and blood urea nitrogen-to-left ventricular ejection fraction ratio (BUNEFr; OR ¼ 1.028; 95% CI ¼ 1.006e1.050; p ¼ 0.011) independently predicted MACE. Receiver operating characteristic curve analysis demonstrated that BUNEFr had an area under curve of 0.794 and BUNEFr >33 had a sensitivity and specificity of 74% and 64%, respectively. Conclusion: BUNEFr is a clinically useful and cost-effective parameter for the prediction of long-term mortality and new-onset decompensated HF in patients undergoing CABG.

Background Arterial hypertension is associated with cardiovascular morbidity and mortality. It was previously shown that left atrium volume increase associated with mortality and atherosclerotic heart disease. The aim of the present study was to demonstrate the value of endothelial dysfunction in predicting left atrium volume increase in newly diagnosed hypertension patients. Methods This study included 96 consecutive newly diagnosed hypertensive patients. Left atrium volume and left ventricular ejection fraction were calculated. Pulse wave velocity and brachial artery flow-mediated dilation measurements were obtained from each patient. Results Left Ventricle Mass Index (114 ± 29 g/m2, 91 ± 17 g/m2, P < 001), left ventricular septum (P < 0.001) and posterior wall thickness (P = 0.001), left ventricular end diastolic diameter (P = 0.016) were significantly higher in patients with higher left atrial volume index. FMD% was lower in patients with higher left atrial volume index those without (9.7 ± 3.5 vs. 13.31 ± 6.01, P = 0.004). Lateral wall E wave velocity was significantly lower (8.68 ± 2.8, 10.2 ± 2.8; P = 0.009), while isovolumetric relaxation time (101.9 ± 19.9 ms, 85.7 ± 15.2 ms; P < 0.001), and ejection time was longer (101.9 ± 19.9 ms, 85.7 ± 15.2 ms; P = 0.077) and Mitral E/ lateral wall E ratio (E/E relation) was significantly higher (P = 0.031) in patients with higher left atrial volume index. Conclusion The rate of isovolumetric relaxation time, FMD% and E/E′ ratio independently predicted left atrial volume index increase in newly diagnosed hypertension patients

Objective. Aortic valve sclerosis (AVS) is closely related to endothelial dysfunction. The association of AVS with contrast-induced nephropathy (CIN) is unknown. We planned to investigate the relationship of AVS besides known parameters with CIN. Design. Baseline characteristics, biochemical values, and AVS of 292 consecutive patients with acute coronary syndrome (ACS) that underwent percutaneous coronary intervention (PCI) were analyzed. Results. Fifty-three patients (18.2%) had CIN. Patients with CIN were older, less likely to be smokers, and had more prevalent prior bypass surgery, higher Mehran score, creatinine, and uric acid concentrations than those without CIN. AVS was more prevalent in patients with CIN. Logistic regression analysis including all related parameters identified Mehran score (OR = 1.036, p = .033), uric acid concentration (OR = 1.244, p = .023), and AVS (OR: 2.223, p = .027) as independent predictors of CIN. Conclusion. AVS is independently associated with CIN in patients with acute coronary syndrome undergoing percutaneous coronary intervention. AVS may help to identify high-risk patients for CIN, who would benefit from preventive measures.

AIM:The relationship between arrhythmia induction and ablation with palpitation characteristics has been demonstrated in electrophysiological study (EPS) patients. However, there is insufficient data on palpitation characteristics and their sensitivity and specificity. We aimed to identify the relationship between scoring composed of palpitation characteristics with the supraventricular tachycardia (SVT) induction and the success rate of the procedure. METHOD:A total of 119 patients, diagnosed as paroxysmal supraventricular tachycardia (PSVT) by electrocardiography, rhythm Holter or symptoms, and underwent EPS, were enrolled in the study. A psychiatrist administered the Hospital Anxiety and Depression Score (HADS) questionnaire. RESULTS:In SVT induced group, palpitation duration (p = 0.048), palpitation spread to neck (p 0.004), responsiveness to medication (p = 0.008), induction with stress (p = 0.007), admission to emergency (p = 0.021) and documented PSVT (p = 0.017) were more common. Atropine administration (p = 0.001) was higher, and the Wenckebach cycle length (p < 0.001) was longer in the non-induced arrhythmia group. The presence of dual AV pathways was higher in SVT induced group (p = 0.002). There were no differences between groups in terms of anxiety score (p = 0.192), depression score (p = 0.730), and total psychiatric results (p = 0.280) in the HADS questionnaire. In scoring designed by the palpitation characteristics, the score of four and over predicted SVT induction with 63.6% sensitivity and 92.5% specificity. Radio-frequency ablation (RFA) was performed succesfully in 82.1% of patients with a score of ≥4. CONCLUSION:Supraventricular tachycardia induction score obtained from the palpitations characteristics and arrhythmia documentation can be useful in predicting the induction of SVT and the success of RFA.

Aim: Preeclampsia is one of the major causes of perinatal, fetal, and maternal mortality and morbidity. The aim of this study was to investigate the association of serum interleukin 37 (IL 37) with preeclampsia. Methods: 39 women with preeclampsia were included as the study group. 38 healthy, and normotensive pregnant women, at similar gestational week with similar gravidity volunteered as the control group. Clinical findings, biochemical parameters, maternal and perinatal outcomes, and the serum concentrations of IL37 were compared between the groups. The relationship of IL 37 concentrations with clinical findings and blood pressure outcomes were also investigated. Results: Maternal serum IL 37 concentrations were significantly higher in patients with preeclampsia compared to the healthy pregnant women in the control group (p = .005). IL 37 positively correlated systolic blood pressure (BP) (r = 0.344, p = .002), and diastolic BP (r = 0.332, p = .003). IL 37 was identified as an independent predictor of preeclampsia. Conclusions: Serum IL 37 concentrations were higher in preeclamptic patients compared to healthy pregnant women. Furthermore, IL 37 concentrations achieved success in identifying preeclampsia with hypertension. Increased IL 37 activity may have a role in the pathophysiology of preeclampsia.

Aim: We investigated the association of intermediate QRS prolongation with the long-term all-cause mortality in coronary artery bypass grafting (CABG) surgery patients with a narrow QRS complex in the preoperative electrocardiography (ECG). Material and methods: A total of 221 consecutive patients with narrow QRS (< 120 ms) sinus rhythm who underwent CABG surgery were included in the study. The patients were followed up for 9.2 years postoperatively in terms of mortality outcomes. Results: Follow-up data were obtained from 211 (173 men, 38 women) of 221 patients. Death occurred in 57 of them. We examined patients in the two groups according to survival outcomes. In multivariate COX regression analysis EuroSCORE (OR = 1.342, 95% CI: 1.167-1.544, p < 0.001), extent of coronary artery disease (OR = 1.768, 95% CI: 1.034-3.020, p = 0.037), QRS duration (OR = 1.029, 95% CI: 1.002-1.058, p = 0.035) and fasting glucose levels (OR = 0.992, 95% CI: 0.984-0.999, p = 0.029) were independent predictors of all-cause mortality. QRS duration > 89.5 ms determined all-cause mortality with a sensitivity of 73.7% and a specificity of 52% (OR = 2.07) due to ROC analysis. All-cause mortality was significantly higher in patients with preop QRS duration > 90 ms from the first year (chi(2) = 6.724, p = 0.010). Conclusions: In CABG patients with a narrow QRS complex, preoperative intermediate prolonged QRS is an independent predictor of all-cause mortality in long-term follow-up.

It is important to identify patients that are at high risk following primary percutaneous coronary intervention (P-PCI) for the treatment of ST-segment elevation myocardial infarction (STEMI). Left ventricular ejection fraction (LVEF) is the most important parameter obtained from transthoracic echocardiography (TTE) for risk stratification. The authors evaluated the value of pulmonary artery pressure (PAP) and left atrial volume index (LAVI) for the prediction of major adverse cardiovascular events (MACE) in patients with STEMI that underwent P‑PCI. A total of 92 patients that underwent P‑PCI for STEMI were included in the study. All patients underwent TTE examination before discharge. The composite primary outcome of the study was all-cause mortality and new onset heart failure (HF) during an 8-year follow-up period. The mean age of patients was 61.6 ± 12.4 years and 15 were female (16.3%). Major adverse cardiovascular events (MACE) defined as all-cause mortality and new onset HF occurred in 30 (41%) patients during a mean of 6 ± 2.7 years of follow-up. In the backward multivariate Cox regression analysis LVEF (odds ratio [OR] = 0.933, 95% confidence interval [CI]: 0.876–0.994, p = 0.031), LAVI (OR = 1.069, 95%CI: 1.017–1.124, p = 0.009), PAP (OR = 1.137, 95% CI: 1.057–1.223, p = 0.001) and creatinine level (OR = 1.730, 95% CI: 1.350–1.223, p = 0.029) were found to independently predict MACE during long-term follow-up. Receiver operating characteristic (ROC) curve analysis was performed, revealing that sPAP >24.5 mm Hg had a sensitivity and specificity of 72 and 66%, respectively; LAVI >31 ml/m2 had a sensitivity and specificity of 72.2 and 83.3%, respectively. In patients that underwent P‑PCI for the treatment for STEMI, LVEF, LAVI, PAP and creatinine level independently predicted all-cause mortality and new onset HF during long-term follow-up.

Postdilation is frequently used during coronary interventions to prevent stent malapposition. Currently there are contradictory findings regarding the benefits of postdilation for both intraprocedural and long-term outcomes. We evaluated the impact of postdilation among patients who presented with acute coronary syndromes (ACS) and underwent percutaneous coronary interventions (PCI). A total of 258 consecutive patients who presented with ACS and underwent PCI were included in the study. The patients were followed up for 25±1.7 months for the occurrence of major adverse cardiovascular events (MACE). During follow-up, 65 patients (25.2%) had MACE. Among patients without MACE, intracoronary nitrate infusion was less frequently used (P=0.005), myocardial blush grade was higher (P<0.001), and a drug-eluting stent was more frequently used (P=0.005). No significant differences were noted between groups regarding the predilation, recurrent dilation, postdilation, and other angiographic characteristics. In multivariate analysis, female sex (P=0.047), myocardial blush grade (P=0.038), previous coronary artery disease (P=0.030), and peak troponin level (P=0.002) were found to be predictors of MACE. In patients who were treated with PCI for ACS, performing postdilation did not predict final Thrombolysis in Myocardial Infarction (TIMI) flow grade, corrected TIMI frame count, myocardial blush grade, or MACE.

We aimed to investigate the predictive value of the fibrinogen-to-albumin ratio (FAR) regarding the development of major cardiovascular events (MACE) in patients treated with percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). This was a prospective, observational cohort study that included 261 consecutive patients who were treated with PCI. The patients were grouped according to the occurrence of MACE during the follow-up period. During follow-up, MACE occurred in 68 (26%) patients. The FAR was independently predictive of MACE (HR: 1.017, 95% CI: 1.010–1.024, p < 0.001). In addition, left ventricular ejection fraction (LVEF) and a diagnosis of ST-segment elevation myocardial infarction (STEMI) were independent predictors of MACE. The area under the curve (AUC) of the multivariable model, including LVEF and diagnosis of STEMI, was 0.707 (95% CI: 0.631–0.782, p < 0.001). When the FAR was added to the multivariable model, the AUC was 0.770 (95% CI: 0.702–0.838, z = 2.820, difference p = 0.0048). The FAR could be used for the prediction of MACE in patients with ACS who have undergone PCI.

AIM: We intended to investigate the association of bilirubin with total mortality in patients with chronic total coronary occlusion (CTO). METHODS: We included 172 patients who underwent coronary angiography due to stable angina pectoris and had CTO. We checked the viability of patients after 9 years of follow-up. RESULTS: Direct bilirubin levels were significantly lower in the non-viable group. We revealed age (OR = 1.045, 95% C.I: 1.009.1.083; p = 0.015) and direct bilirubin concentrations (OR = 0.029, 95% C.I: 0.002.0.435; p = 0.029) as independent predictors of mortality. Direct bilirubin value of > 0.2 mg/dL was associated with decreased mortality with a sensitivity of 85 %, and a specificity of 46 %. CONCLUSION: Serum direct bilirubin concentrations independently predict total mortality in patients with chronic total occlusion over 9 years of follow-up (Tab. 1, Fig. 2, Ref. 23).

Background: Despite the presence of several clinical studies evaluating the association of atherosclerosis and MAC, no data is present regarding the value of MAC in predicting CV adverse events in patients with acute coronary syndrome (ACS). Methods: Prospective, observational cohort study including 314 patients presented with ACS and underwent percutaneous coronary intervention (PCI). MAC was defined by increased echodensity located at the junction of the atrioventricular groove and posterior mitral leaflet on the parasternal long-axis, short-axis, or apical four-chamber view. Patients were followed for a median 25.1 (23.1-26.5) months for any occurrence of major adverse cardiovascular events (MACE). Results: Among 316 patients 46 (14%) had MAC. Seventy (22.1%) patients had MACE during the follow-up. Patients with MACE had higher creatinine, white blood cell count (WBC), C-reactive protein (CRP), peak troponin I, glucose level at admission compared to those without MACE. Age (HR = 1.026, 95% CI = 1.004-1.049; p = .023), myocardial blush grade (HR = 0.637, 95% CI = 0.480-0.846; p = .008), MAC (HR = 2.429, 95% CI = 1.126-5.239; p = .026), and WBC at admission (HR = 1.079, 95% CI = 1.007-1.157; p = .031) were independent predictors for MACE. Conclusion: In patients presented with ACS and underwent PCI, MAC detected by TTE was an independent predictor for MACE during the long-term follow-up.

Background: YKL-40 (human cartilage glycoprotein 39, chitinase-3-like protein 1) is an inflammatory marker secreted mainly by macrophages and has distinctive roles on extracellular matrix remodeling, macrophage maturation, adhesion, and migration. Despite the presence of robust data suggesting the association of YKL-40 with variety of cardiovascular diseases (CV), there is no study up to date evaluating the role of YKL-40 on the long-term prognosis in patients with hypertension (HT). Methods: A single center, prospective, observational cohort study that included 327 consecutive hypertensive patients which were presented to a cardiology outpatient clinic. Patients were followed up for 7.89 ± 0.12 years. Primary outcome of the study was the occurrence of major cardiovascular outcomes (MACE) defined as all-cause mortality, new onset heart failure (HF), and coronary artery disease (CAD) requiring revascularization. Results: A total of 135 patients constituted the final study population [mean age: 52.4 ± 10.2, female: 63 (46%)]. A total of 28 (20.7%) patients had MACE during the follow up. Cox regression analysis revealed that age (HR: 1.046, 1.016–1.093 CI 95%, p = .026), diabetes (HR: 2.278, 1.026–5.057 CI 95%, p = .043), and YKL-40 level (HR: 1.019, 1.013–1.026 CI 95%, p = .005) significantly predicted MACE. We found that sensitivity and specificity of YKL-40 > 93.5 for predicting MACE was 71.4% and 65%, respectively with an area under curve (AUC) 0.723 (0.617–0.828 CI 95%, p < .001) Conclusion: Elevated serum YKL-40 level predicted MACE in hypertensive patients during a long-term follow up.

Objective: We planned to investigate the effect of mean platelet volume (MPV) on in-hospital mortality and coronary risk factors in geriatric patients with ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Methods: We enrolled 194 consecutive STEMI patients. The study population was divided into two groups on the basis of admission MPVs. The high-MPV group ( n =49) included patients in the highest tertile (>8.9 fL), and the low-MPV group ( n =145) included patients with a value in the lower two tertiles (≤8.9 fL). Clinical characteristics, in-hospital mortality, cardiovascular risk factors, and outcomes of primary PCI were analyzed. Results: The patients in the high-MPV group were older, more of them had three-vessel disease, and they had higher in-hospital mortality. Patients with in-hospital death were older, had higher Gensini score, creatinine concentration, and MPV, and had lower HDL cholesterol concentration. MPV, age, HDL cholesterol concentration, creatinine concentration, and Gensini score were found to be independent predictors of in-hospital death. Conclusion: These results suggest that high admission MPV levels are associated with increased in-hospital mortality in geriatric patients with STEMI undergoing primary PCI.

Abstract Background Long-term mortality rate following coronary artery bypass grafting (CABG) procedure is still considered to be high despite advances in surgical techniques and perioperative management. Identifying high-risk patients by using cost-effective and clinically useful parameters is needed. Methods Patients that were admitted to our cardiology clinic with the diagnosis of coronary artery disease (CAD) and underwent CABG between January 2008 and August 2010 were included. Study patients were followed-up for 112.6±17.8 months for major adverse cardiac events (MACE) which were defined as all-cause mortality and new-onset decompensated heart failure (HF). Results Patients in MACE (+) group were older (p 33 had a sensitivity and specificity of 74% and 64% respectively. Conclusion BUNEFr is a clinically useful and cost-effective parameter for the prediction of long-term mortality and new-onset decompensated HF in patients following CABG.

Background:Visceral obesity is strongly associated with atherosclerosis. Even though waist circumference (WC) is the most common assessment method of total visceral adipose tissue and cardiometabolic risk, this method lacks direct measurement of adipose tissue and has better correlation to subcutaneous fat rather than visceral fat. We intended to investigate whether epicardial adipose tissue (EAT) is clinically superior to body mass index (BMI) and WC in predicting Framingham risk score (FRS) and carotid intima-media thickness (CIMT).Methods:Our study included 331 patients who were admitted to our outpatient clinic for risk factor assessment. We calculated BMI, FRS, and WC, and the patients underwent echocardiographic and carotid examinations to measure EAT and CIMT. The metabolic syndrome (MS) score was calculated by summing the MS risk factor scores.Results:The area under the curve values of EAT were similar to FRS and higher than those of weight, BMI, and WC for both increased CIMT and the presence of carotid plaque. Male gender, age, low-density lipoprotein-cholesterol level, and EAT thickness were independent predictors of CIMT, whereas male gender, age, WC, uric acid concentration, and EAT significantly predicted the presence of carotid plaque.Conclusions:This study demonstrated that epicardial adipose tissue (EAT) has a stronger correlation with CIMT than BMI and WC, and it was a significant predictor of increased CIMT and the presence of carotid plaque. Additional data are required to clarify the diagnostic and therapeutic role of EAT in managing obese patients, and to decrease their cardiometabolic risk.

Objective: Venous thromboembolism (VTE) is a disease that includes both deep venous thrombosis (DVT) and pulmonary embolism (PE). Bilirubin is an endogenous anti-inflammatory marker associated with atherothrombosis. The purpose of our study was to investigate the association of serum bilirubin levels with the presence of VTE. Methods: A total of 103 patients with VTE (distal DVT, n = 34; proximal DVT, n = 30; PE, n = 39) and 50 control patients were cross-sectionally enrolled. Peripheral venous duplex ultrasound and computed tomography were used for the diagnosis of VTE. Fasting blood samples were drawn for biochemical analyses. Results: Baseline characteristics were not different between groups. The VTE group had lower bilirubin level (9.0 +/- 2.6 mu mol/L vs 7.3 +/- 3 mu mol/L; P = .001) and higher high-sensitivity C-reactive protein (hs-CRP) concentration (0.8 [0.3-2] mg/L vs 1.1 [0.2-3] mg/L; P = .008) and white blood cell count (7.4 +/- 1.5 x 10(9)/L vs 8.2 +/- 2.7 x 10(9)/L; P = .02) compared with control patients. In the analysis of variance, the levels of total direct bilirubin and hs-CRP were clearly different between the control group and VTE subgroups (distal and proximal DVT and PE). The receiver operating characteristic curve analysis showed a cutoff value of 8.9 mu mol/L for total bilirubin (sensitivity, 74%; specificity, 55%) and an area under the curve of 0.659 (P < .001). Conclusions: Bilirubin level, hs-CRP concentration, and white blood cell count were independently associated with VTE.