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    Association Between Plasma Levels of Fibrinogen and the Presence and Severity of Coronary Artery Ectasia
    (2020) Ozde, Cem; Kayapınar, Osman; Afşin, Hamdi
    Objective The aim of this study was to investigate the plasma fibrinogen levels in patients with isolated coronary artery ectasia (CAE).Materialsand MethodsThe study population included 154 patients, of whom 52 had isolated CAE, 52 had stable coronary artery disease (CAD) and 50 had normal coronary arteries (NCA). Theseverity of isolated CAE was determined using the Markis classification. All the subjects underwent complete physical examinations, including a detailed medical history,complete blood count and biochemical parameters. Plasma fibrinogen levels also were measured in all subjects.Results The baseline characteristics of the three groups were similar. Plasma fibrinogen levels were significantly higher in the CAE group and CAD group than in the NCA group(383.3 ± 53.0 mg/dl and 400.8 ± 50.6 mg/dl vs 324.0 ± 56.4 respectively, p < 0.001). No difference was found between the CAE and CAD groups. The fibrinogen level wassignificantly higher in the type 1 Markis subgroup than in the type 2 and type 3 subgroups (P <0.001). In multivariate logistic regression analyses, fibrinogen level wasindependently and significantly associated with isolated CAE. Receiver operating characteristic curve analysis revealed that fibrinogen levels > 325 mg/dl identified patientswith isolated CAE.Conclusions Plasma fibrinogen is an easily measurable systemic inflammatory biomarker that is independently associated with CAE presence and severity. This suggests that fibrinogenmay be involved in the pathophysiology of CAE.
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    The Relationship Between Coronary Slow Flow and Myocardial Ischaemia Evaluated with Timi Frame Count and Myocardial Perfusion Scintigraphy
    (Ordu University, 2023) Yılmaztekin, Mehmet Zeki; Kayapinar, Osman; Aktüre, Gülşah; Coşkun, Gökhan; Aşık, Muhammet; Afşin, Hamdi
    Objective: Coronary slow flow (CSF) is known as a form or early stage of common atherosclerotic disease. Myocardial perfusion scintigraphy (MPS) is a valuable technique in the diagnosis of coronary artery disease and prediction of prognosis. The aim of this study was to investigate the relationship between the myocardial defect score and ischaemia in patients with CSF. Methods: A total of 168 patients who applied with the complaint of angina pectoris and underwent SPECT as a non-invasive test followed by coronary angiography were included in this retrospective study. 9 patient was excluded from the study for various reasons. The study population comprised determined with CSF and no obstructive stricture in the coronary arteries and with normal flow. The mean age of the patients was 56±12 years. The scores obtained from Quantitative Perfusion SPECT (QPS) and Quantitative Gated SPECT (QGS) software were used in the myocardial perfusion evaluation. The TIMI frame counts were compared with the myocardial defect and ischaemia scores. The TIMI frame count method was used in the determination of CSF. Results: In patients with slow flow in the circumflex (Cx) coronary artery, the stress total perfusion defect Cx (sTPD-Cx) was found to be 0.1 (range, 0.0-1.3), and in those with normal flow, it was 0.0 (range, 0.0-0.28) (p=0.002). The stress score Cx (sscore-Cx) was found to be 1.0 (range, 0.0-3.0) in patients with slow flow and 0.0 (range, 0.0-2.0) in those with normal flow (p=0.031). A linear correlation was determined between the Cx TIMI frame count and the sTPD-Cx and sscore-Cx values (r=0.207, p=0.009; r=0.159, p=0.045). No relationship was found between slow flow and the defect and ischemia scores in other myocardial regions. Conclusion: In patients with slow flow in the Cx coronary artery, the sTPD-Cx and the sscore-Cx values were found to be significantly high. Although at a weak level, a linear correlation was found between the Cx TIMI frame count and the sTPD-Cx and the sscore-Cx values