Objective: White blood cell (WBC) count to mean platelet volume (MPV) ratio (WMR) is associated with major adverse cardiovascular events in patients with non-ST elevation myocardial infarction (NSTEMI). We aimed to compare WMR between NSTEMI patients and matched-controls and to evaluate its predictive value on SYNTAX score. Methods: Total 175 patients with NSTEMI and 160 age and co-morbidity matched subjects were recruited in our study. WMR was compared between the patient and control groups. The patient group was further subdivided into 3 tertiles according to SYNTAX scores as follows: low SYNTAX score tertile (score ≤22, 141 patients); intermediate SYNTAX score tertile (score between 23 and 32, 20 patients); and, high SYNTAX score tertile (score ≥33, 14 patients). WMR was further assessed among the tertiles. Results: WMR was significantly greater in the patient group compared to the control group (p<0,001). WMR among low, intermediate and high score tertiles were calculated to be 890±26, 1090±042 and 1500±65, respectively (p 960 predicted a SYNTAX score ≥23 with 80.6% sensitivity and 67.6% specificity (AUC: 0.756; 95% CI: 0.685 - 0.818; p 1360 predicted a SYNTAX score ≥33 with 71.4% sensitivity and 93% specificity (AUC: 0.840; 95% CI: 0.777 - 0.892; p <0.0001). Conclusions: WMR value was significantly elevated in NSTEMI patients, compared to controls. Higher WMR was associated with greater SYNTAX score in patients with NSTEMI. WMR may be used to predict severity of the CAD and to implement risk stratification in patients with NSTEMI. doi: https://doi.org/10.12669/pjms.35.3.1017 How to cite this:Sivri S, Sokmen E, Celik M, Ozbek SC, Yildirim A, Boduroglu Y. Usefulness of white blood cell count to mean platelet volume ratio in the prediction of SYNTAX score in patients with non-ST elevation myocardial infarction. Pak J Med Sci. 2019;35(3):824-829. doi: https://doi.org/10.12669/pjms.35.3.1017 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Endothelial dysfunction plays role in the generation of both essential hypertension (EH) and aortic stiffness. We evaluated the relationship between serum endocan level and aortic elastic properties (AEPs) assessed with the aortic strain, aortic distensibility, and aortic stiffness index by echocardiography. Newly diagnosed EH patients (n = 67) and controls (n = 70) were included in the study. The EH group was subdivided into stage 1 and 2 EH groups. A higher endocan level was found in the EH group, compared to the controls (34.2 ± 13.0 vs 24.1 ± 7.3 ng/mL, respectively, P < .001). All the AEP parameters were worse in the EH group, compared to the controls. Further, endocan levels correlated with aortic distensibility (r = −0.305, P < .001) and aortic strain (r = −0.181, P = .038), but not with aortic stiffness index (r = 0.162, P = .064) in the whole study population. Aortic elastic properties deteriorate and serum endocan level increases in patients with EH. Moreover, serum endocan level shows a correlation with deteriorated AEPs, and hence may a surrogate marker of escalating aortic stiffness in patients with newly diagnosed EH.

Background: Cardiovascular diseases are still one of the leading causes of death in industrialized countries, and oxidative stress plays an important role in the pathogenesis of acute coronary syndromes (ACS). The dynamic thiol/disulfide homeostasis has an important role in maintaining the oxidant-antioxidant balance. Aim: We aimed to demonstrate the relationship between dynamic thiol/disulfide homeostasis parameters and non-ST elevation ACS (NSTE-ACS). Methods: The patients with NSTE-ACS (n:210) and a control group (n:185) were included in the study. The GRACE risk score and the development of major adverse cardiovascular event (MACE) were used to evaluate the prognosis. Results: Native thiol, total thiol, disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol levels were found to be lower in the NSTE-ACS group (p <0.001). There was statistically significant difference between native and total thiol levels in GRACE risk score subgroups (p <0.001). The correlation between MACE and native thiol levels (p=0.04) was showed. Conclusions: Consequently, the dynamic thiol/disulfide homeostasis parameters were significantly different in the NSTE-ACS group and may be used to predict prognosis in this patient group. Background: Cardiovascular diseases are still one of the leading causes of death in industrialized countries, and oxidative stress plays an important role in the pathogenesis of acute coronary syndromes (ACS). The dynamic thiol/disulfide homeostasis has an important role in maintaining the oxidant-antioxidant balance. Aim: We aimed to demonstrate the relationship between dynamic thiol/disulfide homeostasis parameters and non-ST elevation ACS (NSTE-ACS). Methods: The patients with NSTE-ACS (n:210) and a control group (n:185) were included in the study. The GRACE risk score and the development of major adverse cardiovascular event (MACE) were used to evaluate the prognosis. Results: Native thiol, total thiol, disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol levels were found to be lower in the NSTE-ACS group (p <0.001). There was statistically significant difference between native and total thiol levels in GRACE risk score subgroups (p <0.001). The correlation between MACE and native thiol levels (p=0.04) was showed. Conclusions: Consequently, the dynamic thiol/disulfide homeostasis parameters were significantly different in the NSTE-ACS group and may be used to predict prognosis in this patient group.

Objectives: Cupping therapy (CT) is an ancient medical treatment since antiquity and is used for the treatment of such various disease states as contagious diseases, chronic or acute inflammatory disease, and autoimmune disorders. Ventricular repolarization is represented by QT and corrected-QT (QTc) intervals from surface ECG. As novel repolarization parameters, Tpeak-toTend (Tp-Te) interval, and Tp-Te/QT and Tp-Te/QTc ratios are suggested to correlate better with ventricular arrhythmia risk in various clinical conditions than sole QT and QTc intervals. In this study, we aimed to determine whether these parameters changed significantly after cupping therapy in healthy individuals. Methods: One hundred and twenty subjects (57 women and 63 men; mean age 49.0 ± 13.0 years) participated in this study. ECGs strips were recorded 1 hour before and 1 hour after cupping therapy from each participant, and relevant ECG parameters were compared. Results: No statistically significant change was observed in mean heart rate, QT and QTc intervals, QT/QRS and cQT/QRS, and frontal QRS/T angle after the procedure compared with the same parameters before the procedure (p >0.05). However, Tp-Te interval [69.51 ± 11.54 msec vs 63.15 ± 10.89 msec, p= 0.001], Tp-Te/QT ratio [0.191 ± 0.030 vs 0.174 ± 0.031, p=0.002] and Tp-Te/QTc ratio [0.175 ± 0.030 vs 0.159 ± 0.026, p=0.001] were found to be significantly decreased 1 hour following the procedure compared with the pre-procedure values. Conclusions: According to the results of our study, it is plausible to conclude that CT may exert cardioprotective effect. However, larger-scale prospective studies are needed to support our findings.

Aim: Numerous studies have reported a relationship between serum calcium or albumin levels and acute coronary syndromes and coronary artery disease. The present study investigated the relation between serum albumin, calcium or albumin-corrected calcium levels or calcium/albumin ratio (CAR) and extensiveness and severity of atherosclerosis. Methods: This prospective study included patients with non-ST elevation myocardial infarction (NSTEMI, n=120) and a control group (n=109). We used the SYNTAX score to evaluate the association between CAR and severity and extent of coronary artery disease. Results: There were higher, but statistically nonsignificant, levels of calcium in patients with NSTEMI (p=0.058). However, serum albumin-corrected calcium levels were significantly higher in NSTEMI group (p=0.001). Yet, albumin levels did not differ between the groups (p=0.093). CAR and corrected calcium–albumin ratio (cCAR) were significantly higher in NSTEMI group (p=0.001). A positive correlation existed between CAR (r=0.235, p=0.010), cCAR (r=0.259, p=0.004), and SYNTAX score, whereas albumin and SYNTAX score (r=−0.259, p=0.004) showed a negative correlation. Conclusion: Calcium/albumin ratio has been found to be associated with an increased coronary atherosclerotic burden as calculated by SYNTAX score. Further large-scale studies are warranted to confirm our findings.