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- 저자 : Haybar (검색결과 3 건)
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Ahmadreza Assareh,Habib Haybar,Hojjat Yoosefi,Mohammadreza Bozorgmanesh 대한심장학회 2013 Korean Circulation Journal Vol.43 No.4
Background and Objectives: We investigated if a combination of plasma or salivary interleukin-2 (IL-2), interleukin-6 (IL-6), tumor necro-sis factor-alpha (TNF-α), transforming growth factor-beta (TGF-β), and troponin can improve estimation of the pretest probability of the left ventricular systolic dysfunction (LVSD). Subjects and Methods: Eighty patients with newly-diagnosed myocardial infarction (MI) were echocardiographically examined for LVSD (ejection fraction ≤40%). Measurements included traditional MI risk factors, plasma and salivary concentrations of troponin, IL-2, IL-6,TNF-α, and TGF-β. With the LVSD as the outcome variable, we developed logistic regression models, starting with a basic model incorpo-rating traditional risk factors and consecutively adding salivary and plasma biomarkers. Models were compared using several criteria, in-cluding (but not limited to) C statistic (discrimination) and net reclassification improvement index (NRI). Results: Apart from troponin, plasma, and salivary values of the biomarkers were correlated: spearman’s ρ was 0.19 (p=0.088) for troponin,0.36 (p=0.001) for IL-2, 0.74 (p<0.001) for IL-6, 0.61 (p<0.001) for TNF-α, and 0.65 (p<0.001) for TGF-β. The predictive performances of the basic model for estimating the pretest probability of the presence of LVSD considerably improved when cytokines were added (salivary added: C-statistic from 0.77 to 0.82 and NRI 77%; plasma added: C-statistic to 0.80 and NRI 134%). Conclusion: Multiple biomarkers added diagnostic value to the standard risk factors for predicting the presence of post-MI LVSD.
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Isa Khaheshi,Mohammad Parsa Mahjoob,Shooka Esmaeeli,Vahid Eslami,Habib Haybar 대한심장학회 2015 Korean Circulation Journal Vol.45 No.2
This case report underscores that crystal methamphetamine abuse is an important cause of multivessel coronary thrombosis and raisesdoubts about the therapeutic options. The patient was a 34-year-old smoker and crystal methamphetamine abuser with no significantmedical history, who presented with retrosternal chest pain associated with cold sweats. Twelve-lead electrocardiogram revealed diffuseST-segment elevation in I, II, AVL, AVF, and V 2–6 leads. He underwent urgent coronary angiography and it showed Thrombolysis in MyocardialInfarction (TIMI) grade 3 flow in coronary arteries and presence of a thrombus in the left anterior descending artery (LAD) and the rightcoronary artery (RCA). The patient underwent medical therapy with antiplatelet agents and anticoagulants. Repeat coronary angiographyafter three months of dual therapy with warfarin and aspirin did not show any thrombus or any significant lesion in the RCA and the LADhaving TIMI grade 3 flow.
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Mohammad Hasan Namazi,Habibollah Saadat,Morteza Saf,Hossein Vakili,Saeed Alipourparsa,Mohammadreza Bozorgmanesh,Habib Haybar 대한심장학회 2014 Korean Circulation Journal Vol.44 No.4
Background and Objectives: The aim of this study was to examine the hypothesis that pentraxin 3 (PTX3) can have a diagnostic value for predicting anatomical complexity of coronary artery stenosis as measured by the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score. Subjects and Methods: We investigated the association of systemic arterial PTX3 with SYNTAX score among 500 patients with ischemic heart disease assigned to medical treatment (251), percutaneous coronary intervention (PCI) (197), or coronary artery bypass graft (CABG) (52). Results: The clinical judgment of the cardiologists was near-perfectly concordant with the SYNTAX score. Mean {99% confidence intervals (CIs)} SYNTAX scores were 5.8 (5.1–6.6), 18.4 (17.1–19.8), and 33.2 (32.8–33.6) in patients assigned to medical therapy, PCI, and CABG, respectively. The AROC (95% CIs) for discriminating between patients with and without a high SYNTAX score (>23) was 0.920 (0.895–0.946) for systemic arterial levels of PTX3. As the systemic arterial level of PTX3 increased, the SYNTAX scores also increased almost in a curvilinear fashion, with the value corresponding to the SYNTAX score of 23 being 0.29 ng · dL-1. This cutpoint achieved a sensitivity of 0.66 (0.57– 0.74), a specificity of 0.94 (0.91–0.96), a positive predictive value of 0.79 (0.70–0.87), and a negative predictive value of 0.89 (0.85–0.92). Conclusion: We observed that systemic arterial levels of PTX3 were associated with the SYNTAX score in a curvilinear fashion. The discriminatory power of systemic arterial levels of PTX3 for a high SYNTAX score was excellent. The interesting finding of this study was the near perfect concordance between the decisions made by the cardiologists based on their clinical judgment and the SYNTAX score. The systemic arterial PTX3 level of 0.29 ng · dL-1 was highly specific for diagnosing complex coronary artery stenosis.
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