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    Reference interval of pregnancy-associated plasma protein-A in healthy men and non-pregnant women
    (ELSEVIER, 2013-01-01) Coskun, Abdurrahman; Serteser, Mustafa; Duran, Sadik; Inal, Tamer C.; Erdogan, Birsen E.; Ozpinar, Aysel; Can, Ozge; Unsal, Ibrahim
    Objective: The serum pregnancy-associated plasma protein-A (PAPP-A) concentration is a predictor of ischemic cardiac events and renal impairment. However, the reference interval of PAPP-A has not been determined. This study determined the reference interval of PAPP-A in men and non-pregnant women. Methods: The study enrolled 126 apparently healthy individuals (52 males and 74 females). The mean age of the men and women was 34.7 (range 20-66) years and 34.6 (range 18-65) years, respectively. Serum PAPP-A concentrations were determined using an ultrasensitive enzyme-linked immunoassay kit. Reference intervals were calculated using the bootstrap method. Results: The results for three subjects were outliers, so the reference interval of PAPP-A was calculated using the data for 123 subjects. PAPP-A was undetectable in 26 subjects. The reference interval of PAPP-A for men and women (with the 90\% confidence interval) was <22.9 ng/mL (19.7-23.3) and <33.6 ng/mL (25.2-36.7), respectively. In male subjects, serum PAPP-A levels of smokers {[}3.10 (UD, 7.30) ng/mL] were significantly lower than that of non-smokers {[}11.00 (UD, 24.4) ng/mL] (p < 0.001) and there was a positive correlation between serum PAPP-A levels and subjects' age (r=0.439
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    Prognostic value of aVR lead and the well-known risk factors in acute ST-segment elevated myocardial infarction
    (MEDCOM LTD, 2011-01-01) Eren, S. H.; Aktas, C.; Korkmaz, I.; Karcioglu, O.; Coskun, A.; Guven, F. M. Kukul
    Objective: The present study was designed to analyse the effect of ST segment changes in aVR lead and the well-known risk factors in ST-segment elevated myocardial infarction (STEMI) patients. Materials and Methods: A total of 250 patients who were admitted between 2009 and 2010 with STEMI and mm ST-segment elevation in aVR lead were enrolled in the study. The patients were followed for life-threatening events like acute pulmonary oedema, atrial fibrillation, AV block, ventricular tachycardia, length of stay in hospital and death. Results: Among the enrolled patients, 222 were discharged and 28 died. Pulmonary oedema and mortality rates were significantly higher in patients with ST-segment elevation in aVR lead (both p=0.001). Conclusions: There is a correlation of ST-segment elevation in aVR lead with poor outcome in STEMI. Therefore aVR lead must be analysed as well as the other leads and well-known risk factors while it estimates the prognosis. (Hong Kong j.emerg.med. 2011
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    Cigarette Smoking Increases Pregnancy-associated Plasma Protein-A in Men
    (UNIV WEST INDIES FACULTY MEDICAL SCIENCES, 2017-01-01) Coskun, A.; Bulut, I.; Serteser, M.; Eren, A.; Ozseker, Z. F.; Cuhadaroglu, C.; Aksungar, F. B.; Ozpinar, A.; Can, O.; Yakar I, H.; Unsal, I.
    Objective: Elevation of pregnancy-associated plasma protein-A (PAPP-A), a pro-atherosclerotic molecule, has been shown to be an independent risk factor for acute coronary syndrome. Smoking is also an important risk factor for acute coronary syndrome (ACS). However, the molecular mechanism of this relationship is not clear. In the present study, we aimed to determine the association between smoking and serum PAPP-A levels in men and non-pregnant women. Method: The study population consisted of 112 smokers and 58 age-matched non-smoking healthy subjects as a control group. Blood samples were drawn from the antecubital vein of all subjects and serum PAPP-A levels were measured using an ELISA kit (ultrasensitive ELISA). Results: The serum PAPP-A level was significantly high in male smokers (smokers: 9.11 ng/mL (3.10 ng/mL, 18.55 ng/mL))
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    Treatment strategies in the left main coronary artery disease associated with acute coronary syndromes
    (ELSEVIER SCIENCE BV, 2015-01-01) Karabulut, Ahmet; Cakmak, Mahmut
    Significant left main coronary artery (LMCA) stenosis is not rare and reported 3 to 10\% of patients undergoing coronary angiography. Unprotected LMCA intervention is a still clinical challenge and surgery is still going to be a traditional management method in many cardiac centers. With a presentation of drug eluting stent (DES), extensive use of IVUS and skilled operators, number of such interventions increased rapidly which lead to change in recommendation in the guidelines regarding LMCA procedures in the stable angina (Class 2a recommendation for ostial and shaft lesion and class 2b recommendation for distal bifurcation lesion). However, there was not clear consensus about the management of unprotected LMCA lesion associated with acute myocardial infarction (MI) with a LMCA culprit lesion itself or distinct culprit lesion of other major coronary arteries. Surgery could be preferred as an obligatory management strategy even in the high risk patients. With this review, we aimed to demonstrate treatment strategies of LMCA disease associated with acute coronary syndrome, particularly acute myocardial infarction (MI). In addition, we presented a short case series with LMCA lesion and ST elevated acute MI in which culprit lesion placed either in the left anterior descending artery or circumflex artery. We reviewed the current medical literature and propose simple algorithm for management. (C) 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.