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    The predictive value of triglyceride to high density lipoprotein cholesterol ratio in patients with isolated coronary artery ectasia
    (2020) Gurdal, Ahmet; Keskin, Kudret; Sigirci, Serhat; Cetin, Sukru; Orta Kilickesmez, Kadriye
    Aim: The pathophysiology of coronary artery ectasia (CAE) has not been clear. Dyslipidemia is a serious cause for increasing the risk of coronary artery disease. The relationship between isolated CAE and dyslipidemia is unknown. We evaluated the triglyceride to high-density lipoprotein cholesterol ratio (Tg to HDLc) and dyslipidemia in patients with isolated CAE. Material and Methods: We included 60 patients and 70 controls with normal coronary arteries with similar baseline risk factors. Total cholesterol (Tc), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglycerides (Tg) levels were measured and Tg to HDLc ratio was calculated. Factors predicting CAE were analyzed. Results: When compared with the controls serum Tg level and Tg to HDLc ratio were significantly higher, HDLc level was significantly lower in the patients (p=0.001; p=0.004; p=0.001, an respectively). The multivariate logistic regression analysis revealed that Tg to HDLc ratio (OR:1.476, 95% CI 0.1199-1.817, p=0.001) was independent factor predicting isolated CAE. In the ROC curve analysis, Tg to HDLC ratio was found to be statistically significant with a cut-off point value of 4.2 was determined to predict isolated CAE [AUC=0.829, (95% CI, 0.752-0.906), p=0.001]. Conclusion: Tg to HDLc ratio, HDLc and triglycerides were found to be independent factors predicting isolated CAE. These lipid parameters and Tg to HDLc ratio may be a valuable, easily accessible, non-invasive way of predicting the presence of isolated CAE.
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    Severity of coronary artery disease is associated with contrast induced nephropathy in patients with impaired renal function
    (2020) Gurdal, Ahmet; Sigirci, Serhat; Orta Kilickesmez, Kadriye
    Aim: Patients with acute coronary syndrome who underwent percutaneous coronary intervention (PCI) constitute the group with the highest risk of contrast-induced nephropathy development. Contrast media exposure might increase in patients who have lesions with >70% stenosis in the major epicardial arteries. Also, the impaired kidney function is associated with severity of coronary artery disease. We evaluated the relationship with severity of coronary artery disease (CAD) calculated by Gensini score and contrast induced nephropathy (CIN) in patients with mild renal insufficiency in acute coronary syndrome (ACS). Material and Methods: We enrolled 227 patients with ACS who underwent percutaneous coronary intervention. Patients were divided into groups according to CIN development. Severity of CAD was evaluated by Gensini score. Logistic regression analysis (univariate and multivariate) was performed to evaluate the predictors of CIN using variables that are clinically related to CIN. The 95% confidence interval (CI) and odds ratios (OR) were presented. Receiver–operating characteristic (ROC) curve was performed to demonstrate the sensitivity and specificity of the Gensini score.Results: A total of 69 (30.1%) patients with ACS had CIN. Compared to CIN (-) patients, CIN (+) patients had higher Gensini score, incidence of diabetes mellitus and amount of contrast media. Multivariate logistic regression analyses demonstrated that Gensini score, DM and amount of contrast media were independent risk factors for CIN development (p 0.05 for all parameters).Conclusion: Gensini score, which simply shows severity of CAD, may be helpful in the determination of CIN risk in patients with ACS.