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    Eosinophil percentage as a new prognostic marker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
    (Akademiai Kiado Zrt, 2019) Güner, Ahmet; Zehir, Regayip; Kalçık, Macit; Uslu, Abdulkadir; Ösken, Altuğ; Kalkan, Ali Kemal; Gültekin Güner, Ezgi
    Background: In addition to proinflammatory properties, eosinophils can stimulate platelet activation and enhance prothrombotic pathways. In this study, we aimed to investigate the association between the eosinophil percentage (EOS%) and major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: This study enrolled a total of 1,909 patients who were diagnosed with STEMI. Ventricular arrhythmia, reinfarction, the need for cardiopulmonary resuscitation, target vessel revascularization, congestive heart failure, and cardiovascular mortality during index hospitalization were defined as MACE. Results: Three hundred and eighty patients (19.7%) reached the combined endpoint with MACE. The rates of inhospital mortality and MACE were significantly higher in low EOS% group as compared to high EOS% group (4% vs. 1.1%, p < 0.01 and 32.8% vs. 11.3%, p < 0.01, respectively). On multivariate logistic regression analyses, EOS% (OR = 0.44, p < 0.01) was found to be one of the independent predictors of MACE. The EOS% lower than 0.60 on admission predicted inhospital MACE with a sensitivity of 68% and a specificity of 72% (AUC: 0.684, p < 0.01). Conclusions: Low EOS% on admission may be associated with high inhospital MACE in STEMI patients. EOS% may be used as a novel biomarker for risk stratification of these patients.
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    Noninvasive diagnostic tools available for discrimination pannus from thrombus in patients with prosthetic valve dysfunction
    (Blackwell Publishing Inc., 2019) Güner, Ahmet; Kalçık, Macit; Gündüz, Sabahattin; Yesin, Mahmut; Bayam, Emrah; Kalkan, Ali Kemal; Kalkan, Semih; Özkan, Mehmet
    We have recently read with great interest the article by Barroso Freitas?Ferraz et al1 entitled “Prosthetic aortic valve thrombosis: To fibrinolyse or not to fibrinolyse? That is the question!”. The authors reported a case of aortic prosthetic valve dysfunction (PVD), which was successfully treated surgically. We congratulate the authors for achieving a successful outcome in such a high?risk patient. However, we would like to discuss the importance of noninvasive diagnostic tools for differentiation of prosthetic valve thrombus and pannus, which are the major causes of PVD, before surgical treatment.