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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 6, November/December 2017

384

AFRICA

45. Ulasi II, Ijoma CK, Onodugo OD, Arodiwe EB, Ifebunandu NA,

Okoye JU. Towards prevention of chronic kidney disease in Nigeria: a

community-based study in Southeast Nigeria.

Kidney Int Suppl

2013;

3

(2): 195–201. doi: 10.1038/kisup.2013.13.

46. Odenigbo C, Oguejiofor O, Onwubuya E, Onwukwe C. The prevalence

of chronic kidney disease in apparently healthy retired subjects in asaba,

Nigeria.

Ann Med Health Sci Res

2014;

4

(Suppl 2): S128–S132. doi:

10.4103/2141-9248.138031.

47. Oladapo OO, Salako L, Sodiq O, Shoyinka K, Adedapo K, Falase

AO. A prevalence of cardiometabolic risk factors among a rural

Yoruba south-western Nigerian population: a population-based survey.

Cardiovasc J Afr

2010;

21

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http://www.ncbi.nlm.nih.gov/

pubmed/20224842

\nhttp://www.pubmedcentral.nih.gov/articlerender.

fcgi?artid=PMC3721297.

48. Stamler J, Elliott P, Appel L,

et al

. Higher blood pressure in middle-aged

American adults with less education-role of multiple dietary factors:

the INTERMAP study.

J Hum Hypertens

2003;

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49. Craig SR, Amin RV, Russell DW, Paradise NF. Blood cholesterol screen-

ing: Influence of fasting state on cholesterol results and management

decisions.

J Gen Intern Med

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1497.2000.03509.x.

50. Mora S, Rifai N, Buring JE, Ridker PM. Fasting compared with

non-fasting lipids and apolipoproteins for predicting incident cardio-

vascular events.

Circulation

2008;

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CIRCULATIONAHA.108.777334.

Dear Sir

We read the article titled ‘Relationship between coronary

tortuosity and plateletcrit coronary tortuosity and plateletcrit’

by Cerit

et al

., published online in the

Cardiovascular Journal of

Africa

on 25 April 2017, with great interest (see page 385 in this

issue). However, we have some comments regarding this study.

Although it is a relatively common finding in coronary

angiography, little is known about the importance of coronary

tortuosity (CorT). As mentioned in the article, clinical

studies have demonstrated that CorT may be related to aging,

hypertension, atherosclerosis and diabetes mellitus.

1,2

In this study, there was a significant difference between the

groups regarding hypertension, diabetes mellitus and aging.

For this reason, it was to be expected that CorT would be

higher in the group with these risk factors. High blood pressure

itself initiates a chain of events in vessel walls in the form of

oxidative stress, inflammation and endothelial dysfunction.

3

Similarly, in diabetes, Herder

et al

. found an increased level

of inflammatory reactions and their components, including

inflammatory parameters.

4

In previous studies, PCT, MPV, NLR

and PLR were found to be markers of inflammatory status.

In conclusion, we would have expected higher PCT, MPV,

NLR and PLR values in the CorT group. It would have been

preferable if there were no differences between the two groups

in terms of hypertension, diabetes mellitus and aging. Then

PCT, MPV, NLR and PLR would have provided more accurate

information about the ability of CorT to predict disease. Future

studies should be directed towards larger randomised trials with

more emphasis on long-term clinical endpoints.

References

1.

Han HC. Twisted blood vessels: symptoms, etiology and biomechanical

mechanisms.

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: 185–197.

2.

Li Y, Shen C, Ji Y, Feng Y, Ma G, Liu N. Clinical implication of coro-

nary tortuosity in patients with coronary artery disease.

PLoS One

2011;

6

: 24232. doi: 10.1371/journal.pone.0024232.

3.

Mittal BV, Singh AK. Hypertension in the developing world: challenges

and opportunities.

Am J Kidney Dis

2010;

55

(3): 590–598. doi: 10.1053/j.

ajkd.2009.06.044.

4.

Herder C, Carstensen M, Ouwens DM. Anti-inflammatory cytokines

and risk of type 2 diabetes.

Diabetes Obes Metab

2013;

15

: 39–50.

Training and Research Hospital, Sakarya University,

Sakarya, Turkey

Kahraman Cosansu, MD,

kahraman141@gmail.com

Mustafa Gokhan Vural, MD

Mehmet Akif Cakar, MD

Letter to the Editor