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      Epicardial Fat Thickness and Cardio-Ankle Vascular Index without Other Inflammatory Markers May Not Provide Information to Clinicians about the Systemic Inflammation

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          Evaluation of the mean platelet volume in patients with cardiac syndrome X

          OBJECTIVE: Cardiac syndrome X is characterized by angina-like chest pain, a positive stress test, and normal coronary arteries. A patient's mean platelet volume, which potentially reflects platelet function and activity, is associated with coronary atherosclerosis and endothelial dysfunction. The aim of the present study was to evaluate the mean platelet volumes of patients with cardiac syndrome X, those with coronary artery disease and normal subjects. METHODS: Two hundred thirty-six subjects (76 patients with cardiac syndrome X, 78 patients with coronary artery disease, and 82 controls) were enrolled in the study. All of the subjects were evaluated with a detailed medical history, physical examination, and biochemical analyses. The mean platelet volumes were compared between the three groups. RESULTS: The mean platelet volumes in the patients with cardiac syndrome X and with coronary artery disease were significantly higher than those that were observed in the control group. There were no significant differences in the mean platelet volumes between the cardiac syndrome X and the coronary artery disease groups. CONCLUSION: We have established that patients with cardiac syndrome X and coronary artery disease exhibit higher mean platelet volumes compared to controls. Patients with cardiac syndrome X exhibited higher mean platelet volumes compared to the controls, reflecting the presence of subclinical atherosclerosis. These findings suggest that, in addition to endothelial dysfunction, the presence of atherosclerosis may also contribute to the etiopathogenesis of cardiac syndrome X.
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            Epicardial adipose tissue relating to anthropometrics, metabolic derangements and fatty liver disease independently contributes to serum high-sensitivity C-reactive protein beyond body fat composition: a study validated with computed tomography.

            Epicardial adipose tissue (EAT) measured by echocardiography has been proposed to be associated with metabolic syndrome and increased cardiovascular risks. However, its independent association with fatty liver disease and systemic inflammation beyond clinical variables and body fat remains less well known. The relationships between EAT and various factors of metabolic derangement were retrospectively examined in consecutive 359 asymptomatic subjects (mean age, 51.6 years; 31% women) who participated in a cardiovascular health survey. Echocardiography-derived regional EAT thickness from parasternal long-axis and short-axis views was quantified. A subset of data from 178 randomly chosen participants were validated using 16-slice multidetector computed tomography. Body fat composition was evaluated using bioelectrical impedance from foot-to-foot measurements. Increased EAT was associated with increased waist circumference, body weight, and body mass index (all P values for trend = .005). Graded increases in serum fasting glucose, insulin resistance, and alanine transaminase levels were observed across higher EAT tertiles as well as a graded decrease of high-density lipoprotein (all P values for trend <.05). The areas under the receiver operating characteristic curves for identifying metabolic syndrome and fatty liver disease were 0.8 and 0.77, with odds ratio estimated at 3.65 and 2.63, respectively. In a multivariate model, EAT remained independently associated with higher high-sensitivity C-reactive protein and fatty liver disease. These data suggested that echocardiography-based epicardial fat measurement can be clinically feasible and was related to several metabolic abnormalities and independently associated fatty liver disease. In addition, EAT amount may contribute to systemic inflammation beyond traditional cardiovascular risks and body fat composition. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
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              Association of Ankle-Brachial Index with Severity of Angiographic Coronary Artery Disease in Patients with Peripheral Arterial Disease and Coronary Artery Disease

              The ankle-brachial index (ABI) was correlated with the severity of coronary artery disease (CAD) in 273 patients, mean age 71 years, with peripheral arterial disease and angiographically obstructive CAD (>50% occlusion). Of 155 patients with an ABI <0.40, 130 (84%) had 3- or 4-vessel CAD, 17 (11%) had 2-vessel CAD and 8 (5%) had 1-vessel CAD. Of 80 patients with an ABI of 0.40–0.69, 37 (46%) had 3- or 4-vessel CAD, 33 (41%) had 2-vessel CAD and 10 (13%) had 1-vessel CAD. Of 38 patients with an ABI of 0.70–0.89, 10 (26%) had 3- or 4-vessel CAD, 16 (42%) had 2-vessel CAD and 12 (32%) had 1-vessel CAD. The lower the ABI, the higher the prevalence of 3- or 4-vessel CAD and the lower the prevalence of 1-vessel CAD.
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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2013
                May 2013
                19 April 2013
                : 125
                : 1
                : 13-14
                Affiliations
                aDepartment of Cardiology, Gulhane Medical Academy, and bDepartment of Internal Medicine, Beytepe Hospital, Ankara, Turkey
                Author notes
                *Dr. Sevket Balta, Department of Cardiology, Gulhane School of Medicine, Tevfik Saglam Street, TR-06018 Etlik-Ankara (Turkey), E-Mail drsevketb@gmail.com
                Article
                348339 Cardiology 2013;125:13-14
                10.1159/000348339
                23615076
                © 2012 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Pages: 2
                Categories
                Letter to the Editor

                General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

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