1
|
Yılmaz AS, Kahraman F, Ersoy İ, Taylan G, Kaya EE, Aydın E, Karakayalı M, Öğütveren MM, Taşdelen AG, Kümet Ö, Gül M, Nurkoç SG, Atan Ş, Özgeyik M, Kılıç O, Toprak AM, Özbek M, Kertmen Ö, Şafak Ö, Mert GÖ, Demir M, Yavuz YE, Keleşoğlu Ş, Uçar M, Işık İB, Öncel CR, Cengil ME, Küçük U, Dindaş F, Altınsoy M, Akkaya F. Baseline Characteristics of a Patient Cohort and Predictors of In-hospital MORtality in CORonary Care Units (MORCOR-TURK) Trial in Türkiye. Turk Kardiyol Dern Ars 2024; 52:175-181. [PMID: 38573092 DOI: 10.5543/tkda.2023.67505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions.
Collapse
Affiliation(s)
- Ahmet Seyda Yılmaz
- Recep Tayyip Erdogan University, Faculty of Medicine, Department of Cardiology, Rize, Turkiye
| | - Fatih Kahraman
- Kütahya Evliya Çelebi Training and Research Hospital, Department of Cardiology, Kütahya, Turkiye
| | - İbrahim Ersoy
- Afyonkarahisar Science of Health University, Department of Cardiology, Afyon, Turkiye
| | - Gökay Taylan
- Trakya University, Department of Cardiology, Tekirdağ, Turkiye
| | - Emin Erdem Kaya
- Ersin Arslan Training and Research Hospital, Department of Cardiology, Gaziantep, Turkiye
| | - Ertan Aydın
- Giresun University, Department of Cardiology, Giresun, Turkiye
| | - Muammer Karakayalı
- Kafkas University Training and Research Hospital, Department of Cardiology, Kars, Turkiye
| | | | | | - Ömer Kümet
- Van Training and Research Hospital, Department of Cardiology, Van, Turkiye
| | - Murat Gül
- Aksaray University, Department of Cardiology, Aksaray, Turkiye
| | | | - Şeyhmus Atan
- Ankara University, Faculty of Medicine, Department of Cardiology, Ankara, Turkiye
| | - Mehmet Özgeyik
- Eskişehir City Hospital, Department of Cardiology, Eskişehir, Turkiye
| | - Oğuz Kılıç
- Karaman Training and Research Hospital, Department of Cardiology, Karaman, Turkiye
| | - Aslıhan Merve Toprak
- Selçuk University, Faculty of Medicine, Department of Cardiology, Konya, Turkiye
| | - Mehmet Özbek
- Dicle University, Faculty of Medicine, Department of Cardiology, Diyarbakır, Turkiye
| | - Ömer Kertmen
- Amasya Training and Research Hospital, Department of Cardiology, Amasya, Turkiye
| | - Özgen Şafak
- Balıkesir University, Faculty of Medicine, Department of Cardiology, Balıkesir, Turkiye
| | - Gurbet Özge Mert
- Osmangazi University, Faculty of Medicine, Department of Cardiology, Eskişehir, Turkiye
| | - Mevlüt Demir
- Kütahya Evliya Çelebi Training and Research Hospital, Department of Cardiology, Kütahya, Turkiye
| | - Yunus Emre Yavuz
- Siirt Training and Research Hospital, Department of Cardiology, Siirt, Turkiye
| | - Şaban Keleşoğlu
- Erciyes University, Faculty of Medicine, Department of Cardiology, Kayseri, Turkiye
| | - Melisa Uçar
- Samsun Training and Research Hospital, Department of Cardiology, Samsun, Turkiye
| | | | - Can Ramazan Öncel
- Alanya Alaaddin Keykubat University, Department of Cardiology, Antalya, Turkiye
| | | | - Uğur Küçük
- Çanakkale 18 Mart University, Department of Cardiology, Çanakkale, Turkiye
| | - Ferhat Dindaş
- Uşak Training and Research Hospital, Department of Cardiology, Uşak, Turkiye
| | - Meltem Altınsoy
- Ankara Etlik City Hospital, Department of Cardiology, Ankara, Turkiye
| | - Fatih Akkaya
- Ordu University, Faculty of Medicine, Department of Cardiology, Ordu, Turkiye
| |
Collapse
|
2
|
Elif Akgün D, Avcı E, Yaman A, Şafak Ö, Lütfi Kısacık H, Argan O, Elçim Yıldırım S, Yıldırım T, Naser A, Gençbay M, Kırış T. The Relationship Between Endocan and Serum Inflammatory Markers in Patients with Senile Calcific Aortic Stenosis. Anatol J Cardiol 2024; 28:102-108. [PMID: 38168010 PMCID: PMC10837674 DOI: 10.14744/anatoljcardiol.2023.3695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Endocan is an indicator of many pathologies accompanied by inflammation, endothelial cell activation, and dysfunction. In this study, we examined the relationship between degenerative aortic sclerosis, which progresses in a similar pathophysiologic mechanism as atherosclerosis, and serum inflammatory markers and endocan levels. METHODS A total of 155 patients without known coronary artery disease, aged between 65 and 80 years, were consecutively included in the prospective cross-sectional study. The study population was analyzed in 4 different groups. The control group consisted of patients with normal aortic valve structure, while patients with aortic stenosis were classified as mild aortic stenosis (2-2.9 m/s), moderate aortic stenosis (3-3.9 m/s), and severe aortic stenosis (≥ 4 m/s) according to their aortic velocity. While there were 39 patients in the control group, there were 58, 24, and 34 patients in the mild, moderate, and severe aortic stenosis groups, respectively. RESULTS There was no statistically significant difference between the groups in terms of patient distribution and characteristics. History of dyspnea and angina was correlated with the severity of aortic stenosis (P <.001). In this study, no statistically significant correlation was found between serum endocan levels and the severity of aortic stenosis (control group: 17.3 ± 6.3 ng/mL, mild aortic stenosis: 17.6 ± 8.7 ng/mL, moderate aortic stenosis: 16.3 ± 3.8 ng/mL, severe aortic stenosis: 15.2 ± 5.9 ng/mL, P =.396). However, it was figured out that there was a positive correlation between endocan levels and hemoglobin (Hg) (r = 0.308, P =.001), platelet (PLT) (r = 0.320, P <.001), and albumin (Alb) (r = 0.206, P =.026). CONCLUSION In this study, no significant correlation was found between serum endocan levels and the severity of aortic stenosis. On the other hand, there was a positive correlation between endocan levels and Hg, PLT, and Alb.
Collapse
Affiliation(s)
- Didar Elif Akgün
- Department of Cardiology, Kırklareli Training and Research Hospital, Kırklareli, Türkiye
| | - Eyüp Avcı
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Ali Yaman
- Department of Biochemistry, Marmara University, Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Özgen Şafak
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Halil Lütfi Kısacık
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Onur Argan
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Seda Elçim Yıldırım
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Tarık Yıldırım
- Department of Cardiology, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Abdulrahman Naser
- Department of Cardiology, Kırklareli Training and Research Hospital, Kırklareli, Türkiye
| | - Murat Gençbay
- Department of Cardiology, Kırklareli Training and Research Hospital, Kırklareli, Türkiye
| | - Tuncay Kırış
- Department of Cardiology, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
| |
Collapse
|
3
|
Akyıldız Akçay F, Yaşar Sinan Ü, Çağlar Gürbüz D, Şafak Ö, Kaya H, Yüksek Ü, Zoghi M. Gender-Related Differences in Patients with Acute Heart Failure: Observation from the Journey Heart Failure-Turkish Population Study. Anatol J Cardiol 2023; 27:639-649. [PMID: 37466026 PMCID: PMC10621605 DOI: 10.14744/anatoljcardiol.2023.2971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/06/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Gender-related clinical variations in patients with acute heart failure have been described in previous studies. However, there is still a lack of research on gender differences in patients hospitalized for acute heart failure in Türkiye. The aim of this study is to compare the clinical features, in-hospital approaches, and outcomes of male and female patients hospitalized for acute heart failure. METHODS Differences in clinical characteristics, medication prescription, hospital management, and outcomes between males and females with acute heart failure were investigated from the Journey Heart Failure-Turkish Population study. RESULTS Nine hundred eighteen patients (57.2%) were men and 688 (42.8%) were women. Women were older than men (70.48 ± 13.20 years vs. 65.87 ± 12.82 years; P <.001). The frequency of comorbidities such as hypertension (72.7% vs. 62.4%, P <.001), diabetes (46.5% vs. 38.5%, P = .001), atrial fibrillation (46.5% vs. 33.4%, P <.001), New York Heart Association class III-IV symptoms (80.6% vs. 71.2%, P =.001), and dyspnea in the rest (73.8% vs. 68.3%, P =.044) were more common in women on admission. Male patients were more frequently hospitalized with reduced left ventricular ejection fraction (51.0% vs. 72.4%, P <.001). In-hospital mortality was higher among female patients (9.3% vs. 6.4%, P =.022). Higher New York Heart Association class, lower estimated glomerular filtration rate, higher N-terminal pro-B type natriuretic peptide on admission, and mechanical ventilation usage were the independent parameters of in-hospital mortality, whereas the female gender was not. CONCLUSION Our study clearly demonstrated the diversity in presentation, management, and in-hospital outcomes of acute heart failure between male and female patients. Although left ventricular systolic functions were better in female patients, in-hospital mortality was higher. Recognizing these differences in the management of heart failure in different sexes will serve better results in clinical practice.
Collapse
Affiliation(s)
- Filiz Akyıldız Akçay
- Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Ümit Yaşar Sinan
- Department of Cardiology, Faculty of Medicine, İstanbul University Cerrahpaşa Institute of Cardiology, İstanbul, Türkiye
| | - Doğaç Çağlar Gürbüz
- Department of Cardiology, Faculty of Medicine, Koç University, İstanbul, Türkiye
| | - Özgen Şafak
- Department of Cardiology, Faculty of Medicine, Balıkesir University, Balıkesir, Türkiye
| | - Hakkı Kaya
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Ümit Yüksek
- Department of Cardiology, Ödemiş State Hospital, İzmir, Türkiye
| | - Mehdi Zoghi
- Department of Cardiology, Faculty of Medicine, Ege University, İzmir, Türkiye
| |
Collapse
|
4
|
Şafak Ö, Gürsoy O, Emren V, Demir E, Yıldırım T, Argan O, Şimşek EÇ, Aytemiz F, Özdemir E, Bayar N, Erkal Z, Çelik O, Akhan O, Dönmez C, Kemaloğlu Öz T, Akyel S, Oktay Ergene A, Özkan M. Echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population: ECHO-DOP-TR Trial. Echocardiography 2020; 37:1374-1381. [PMID: 32815581 DOI: 10.1111/echo.14827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 11/26/2022] Open
Abstract
AIM Doppler echocardiography has become the standard imaging modality for diastolic function and provides pathophysiological insight into systolic and diastolic heart failure. In this study, we aimed to obtain normal echocardiographic Doppler parameters of healthy Turkish population. METHODS Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination and The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used for echocardiographic Doppler measurements. RESULTS A total of 967 healthy participants were enrolled in this study after applying exclusion criteria. Echocardiographic examination was obtained from all subjects following predefined protocols. Mitral E wave velocity and E/A ratio were higher in females and decreased progressively in advancing ages. E wave deceleration time and A wave velocity were increased with aging. Assessment of tissue Doppler velocities showed that left ventricular lateral e', septal e', and septal s' were higher in younger subjects and in females. E/e' ratio was increased progressively with advancing decades. Right ventricular e' and s' were decreased but a' was increased with increasing age. Septal e' lower than 8 cm/s was 1.9% in the fifth decade and 13.7% in ages older than 50 years. The E/e' ratio greater than 15 (and also 13) was not found. CONCLUSION This study, for the first time, provides echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population which will be useful in routine clinical practice as well as in future clinical trials.
Collapse
Affiliation(s)
- Özgen Şafak
- Department of Cardiology, Faculty of Medicine, Balıkesir University Hospital, Balıkesir, Turkey
| | - Ozan Gürsoy
- Department of Cardiology, Faculty of Medicine, İzmir Katip Çelebi University Hospital, İzmir, Turkey
| | - Volkan Emren
- Department of Cardiology, Faculty of Medicine, İzmir Katip Çelebi University Hospital, İzmir, Turkey
| | - Emre Demir
- Department of Cardiology, Faculty of Medicine, Ege University Hospital, İzmir, Turkey
| | - Tarık Yıldırım
- Department of Cardiology, Faculty of Medicine, Balıkesir University Hospital, Balıkesir, Turkey
| | - Onur Argan
- Department of Cardiology, Faculty of Medicine, Balıkesir University Hospital, Balıkesir, Turkey
| | | | - Fatih Aytemiz
- Department of Cardiology, Manisa State Hospital, Manisa, Turkey
| | - Emre Özdemir
- Department of Cardiology, Faculty of Medicine, İzmir Katip Çelebi University Hospital, İzmir, Turkey
| | - Nermin Bayar
- Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Zehra Erkal
- Department of Cardiology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Oğuzhan Çelik
- Department of Cardiology, Faculty of Medicine, Hitit University Hospital, Çorum, Turkey
| | - Onur Akhan
- Department of Cardiology, Bilecik State Hospital, Bilecik, Turkey
| | - Cevdet Dönmez
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | | | - Serdar Akyel
- Department of Cardiology, Faculty of Medicine, Kastamonu University Hospital, Kastamonu, Turkey
| | - Asim Oktay Ergene
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University Hospital, İzmir, Turkey
| | - Mehmet Özkan
- Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
5
|
Özlek E, Çekiç EG, Özlek B, Çil C, Çelik O, Doğan V, Başaran Ö, Tanık VO, Özdemir Hİ, Çelik Y, Kaçmaz C, Şimşek Z, Güneş HM, Şafak Ö, Özkan B, Tasar O, Önal Ç, Bekar L, Biteker M. Rationale, design, and methodology of the EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study. Turk Kardiyol Dern Ars 2019; 47:391-398. [PMID: 31311898 DOI: 10.5543/tkda.2019.27724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The aim of this study is to assess the prevalence of polypharmacy, inappropriate drug use, and drug-drug interactions (DDIs) in elderly patients presenting at outpatient cardiology clinics in Turkey. METHODS The EPIC (Epidemiology of Polypharmacy and Potential Drug-Drug Interactions in Elderly Cardiac Outpatients) study will be an observational, real-world, multicenter study conducted to evaluate DDIs and polypharmacy in elderly cardiac outpatients. All consecutive patients (aged ≥65 years) admitted to outpatient cardiology clinics between July 30, 2018 and July 30, 2019 who provide written, informed consent will be enrolled. A total of approximately 5000 patients are to be enrolled in this non-interventional study. All of the data will be collected at one point in time and current clinical practice will be evaluated (ClinicalTrials.gov NCT03370523). RESULTS Patient demographics, comorbid disease characteristics, laboratory test results, and details of medication use will be collected using self-reports and medical records. The severity of comorbid disease will be recorded and scored according to Charlson Comorbidity Index (CCI) and patients will be divided into 3 groups: mild, those with a CCI score of 1-2; moderate, those with a CCI score of 3-4; and severe, those with a CCI score of ≥5. Polypharmacy will be defined as the use of 5 or more medications at one time. DDIs will be determined using the Lexicomp Online drug interaction screening tool and potentially inappropriate medications will be defined based on the 2015 update of the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Severe drug interactions will be defined as those in category D or X. CONCLUSION EPIC will be the first large-scale study in Turkey to evaluate polypharmacy, potentially inappropriate medications, and DDIs in elderly cardiac outpatients in a real-world clinical setting.
Collapse
Affiliation(s)
- Eda Özlek
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Edip Güvenç Çekiç
- Department of Pharmacology, Muğla Sıtkı Koçman University, Faculty of Medicine, Muğla, Turkey
| | - Bülent Özlek
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Cem Çil
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Oğuzhan Çelik
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Volkan Doğan
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Özcan Başaran
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| | - Veysel Ozan Tanık
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | | | - Yunus Çelik
- Department of Cardiology, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Turkey
| | - Caner Kaçmaz
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Zeki Şimşek
- Department of Cardiology, Tuzla State Hospital, İstanbul, Turkey
| | - Hacı Murat Güneş
- Department of Cardiology, Medipol University Faculty of Medicine, İstanbul, Turkey
| | - Özgen Şafak
- Department of Cardiology, Burdur State Hospital, Burdur, Turkey
| | - Buğra Özkan
- Department of Cardiology, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Onur Tasar
- Department of Cardiology, Elazığ Training and Research Hospital, Elazığ, Turkey
| | - Çağatay Önal
- Department of Cardiology, Bulanık State Hospital, Muş, Turkey
| | - Lütfü Bekar
- Department of Cardiology, Hitit University Çorum Erol Olcok Training and Research Hospital, Çorum, Turkey
| | - Murat Biteker
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey
| |
Collapse
|
6
|
Yakar Tülüce S, Tülüce K, Şimşek EÇ, Şafak Ö, Ökten MŞ, Yapan Emren Z, Emren SV, Kocabaş U, Bayata S, Nazlı C. Assessment of bicuspid aortic valve phenotypes and associated pathologies: A transesophageal echocardiographic study. Turk Kardiyol Dern Ars 2018; 45:690-701. [PMID: 29226889 DOI: 10.5543/tkda.2017.03152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We investigated the frequency of different bicuspid aortic valve disease (BAV) phenotypes,the associated valvular pathologies, and the aortopathy phenotypes, using 2-dimensional (2D) transthoracic, 2D transesophageal echocardiography (TEE) and 3-dimensional (3D) TEE. METHODS A total of 154 patients with BAV were included. Five BAV phenotypes were detected. To better define valvular pathologies, binary classifications of BAV were used: BAV with antero-posterior commisural line (BAV-AP) and right-left commissural line (BAV-RL). Aortopathy phenotype was classified according to the involved tract(s). RESULTS Of the patients, 53.2% had type 1, 16.2% type 2, 15.6% type 3, 1.3% type 4, and 13.6% had type 5 BAV. The prevalence of BAV-AP and BAV-RL was 68.2% and 31.8%, respectively. No difference was detected with respect to aortic regurgitation between BAV-AP and BAV-RL (p=0.9), but the BAVRL group had an increased propensity to have a stenotic aortic valve (p=0.003). The indexed aortic diameter was larger in BAV-AP cases than BAV-RL at the sinus of Valsalva (p=0.008). In patients with dilatation of the root and tubular portion, a predominance of BAV-AP versus BAV-RL was observed (85% vs 15%). A markedly low prevalence of the root phenotype (3.2%) was observed. In 90.1% of the patients, 2D TEE was sufficient to classify BAV phenotypes; further 3D imaging was needed in 9.9% of the cases. CONCLUSION There may be racial differences in the frequency of valvular and aortopathy phenotypes in patients with BAV. BAV phenotypes differ with respect to aortic stenosis and aortopathy phenotypes. TEE may have good diagnostic utility in differentiating BAV phenotypes.
Collapse
Affiliation(s)
- Selcen Yakar Tülüce
- Department of Cardiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Şafak Ö, Karaca I, Özgüler M. Is it a new late complication of transcatheter aortic valve implantation? Int J Cardiovasc Acad 2018. [DOI: 10.4103/ijca.ijca_9_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Mert KU, Mert GÖ, Başaran Ö, Beton O, Dogan V, Tekinalp M, Aykan AÇ, Kalaycıoğlu E, Bolat I, Taşar O, Şafak Ö, Kalçık M, Yaman M, Kırma C, Biteker M. Real-world stroke prevention strategies in nonvalvular atrial fibrillation in patients with renal impairment. Eur J Clin Invest 2017; 47:428-438. [PMID: 28407216 DOI: 10.1111/eci.12758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 04/10/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The data regarding stroke prevention strategies in nonvalvular atrial fibrillation (NVAF) are limited especially in patients with renal impairment (RI). We sought to evaluate management dilemmas in patients with concurrent NVAF and RI in RAMSES (ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies inTurkey) study. METHODS We conducted a prospective, multicenter, nation-wide registry in NVAF patients in outpatient cardiology clinics. All consecutive patients with NVAF were enrolled in RAMSES study (ClinicalTrials.gov identifier NCT02344901). The baseline data were collected. Glomerular filtration rate (GFR) was estimated by Cockcroft-Gault equation. RESULTS A total number of 6273 patients from 29 provinces of Turkey with the contribution of 83 investigators were enrolled to the study. Of the study population, 1964(33%) patients had RI which was defined as GFR < 60 mL/min. Patients with RI had significantly higher CHA2 DS2 VASc and HAS-BLED scores compared to those without RI (3·9 ± 1·5 vs. 2·9 ± 1·5, and 2·0 ± 1 vs. 1·4 ± 1; P < 0·001). Prior history of major bleeding (6·9% vs. 4·1%, P < 0·001) and stroke (16·2% vs. 11·8%, P < 0·001) was significantly higher among individuals with concomitant RI and NVAF. Although RI patients had a higher risk for thromboembolism, number of the patients who did not receive any anticoagulant therapy was higher in patients with RI than without RI (30·1 vs. 26·4%, P = 0·003). CONCLUSION RAMSES study showed that one-third of the patients with NVAF had RI in the real-world setting. Although it is mandatory in most of the patients with concomitant NVAF and RI, nearly one-third of these patients did not receive any anticoagulant therapy.
Collapse
Affiliation(s)
- Kadir U Mert
- Department of Cardiology, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Gurbet Ö Mert
- Department of Cardiology, Eskisehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Özcan Başaran
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Muğla, Turkey
| | - Osman Beton
- Department of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Volkan Dogan
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Muğla, Turkey
| | - Mehmet Tekinalp
- Department of Cardiology, Kahramanmaraş Necip Fazıl State Hospital, Kahramanmaraş, Turkey
| | - Ahmet Ç Aykan
- Department of Cardiology, Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Ezgi Kalaycıoğlu
- Department of Cardiology, Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Ismail Bolat
- Department of Cardiology, Fethiye State Hospital, Muğla, Turkey
| | - Onur Taşar
- Department of Cardiology, Elazığ Education and Research Hospital, Elazığ, Turkey
| | - Özgen Şafak
- Department of Cardiology, Burdur State Hospital, Burdur, Turkey
| | - Macit Kalçık
- Department of Cardiology, Iskilip Atıf Hoca State Hospital, Çorum, Turkey
| | - Mehmet Yaman
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Cevat Kırma
- Kartal Kosuyolu Heart Education and Research Hospital, İstanbul, Turkey
| | - Murat Biteker
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Muğla, Turkey
| | | |
Collapse
|
9
|
Başaran Ö, Dogan V, Beton O, Tekinalp M, Aykan AÇ, Kalaycıoğlu E, Bolat I, Taşar O, Şafak Ö, Kalçık M, Yaman M, İnci S, Altıntaş B, Kalkan S, Kırma C, Biteker M. Impact of valvular heart disease on oral anticoagulant therapy in non-valvular atrial fibrillation: results from the RAMSES study. J Thromb Thrombolysis 2017; 43:157-165. [PMID: 27848065 DOI: 10.1007/s11239-016-1445-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The definition of non-valvular atrial fibrillation (NVAF) is controversial. We aimed to assess the impact of valvular heart disease on stroke prevention strategies in NVAF patients. The RAMSES study was a multicenter and cross-sectional study conducted on NVAF patients (ClinicalTrials.gov identifier NCT02344901). The study population was divided into patients with significant valvular disease (SVD) and non-significant valvular disease (NSVD), whether they had at least one moderate valvular disease or not. Patients with a mechanical prosthetic valve and mitral stenosis were excluded. Baseline characteristics and oral anticoagulant (OAC) therapies were compared. In 5987 patients with NVAF, there were 3929 (66%) NSVD and 2058 (34%) SVD patients. The predominant valvular disease was mitral regurgitation (58.1%), followed by aortic regurgitation (24.1%) and aortic stenosis (17.8%). Patients with SVD had higher CHA2DS2VASc [3.0 (2.0; 4.0) vs. 4.0 (2.0; 5.0), p < 0.001] and HAS-BLED [2.0 (1.0; 2.0) vs. 2.0 (1.0; 2.0), p = 0.004] scores compared to patients with NSVD. Overall, 2763 (71.2%) of NSVD and 1515 (73.8%) of SVD patients were on OAC therapy (p = 0.035). When the patients with SVD were analyzed separately, the mean CHA2DS2VASc and HAS-BLED scores were higher in patients with mitral regurgitation compared to patients with aortic regurgitation and aortic stenosis [4.0 (3.0; 5.0), 3.0 (2.0; 4.0), 3.0 (2.0; 4.0) p < 0.001 and 2.0 (1.0; 3.0), 1.0 (1.0; 2.0), 1.0 (0.0; 2.0) p < 0.001, respectively]. In patients with SVD, 65.7% of mitral regurgitation, 82.6% of aortic regurgitation and 88.0% of aortic stenosis patients were on OAC therapy. One out of three NVAF patients had at least one moderate valvular heart disease with the predominance of mitral regurgitation. Patients with SVD were at greater risk of stroke and bleeding compared to patients with NSVD. Although patients with mitral regurgitation should be given more aggressive anticoagulant therapy due to their higher risk of stroke, they are undertreated compared to patients with aortic valve diseases.
Collapse
Affiliation(s)
- Özcan Başaran
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman Universitesi Tip Fakultesi, Orhaniye Mah. Haluk Özsoy Cad., 48000, Muğla, Turkey
| | - Volkan Dogan
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman Universitesi Tip Fakultesi, Orhaniye Mah. Haluk Özsoy Cad., 48000, Muğla, Turkey
| | - Osman Beton
- Department of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Mehmet Tekinalp
- Department of Cardiology, Kahramanmaraş Necip Fazıl State Hospital, Kahramanmaraş, Turkey
| | - Ahmet Çağrı Aykan
- Department of Cardiology, Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Ezgi Kalaycıoğlu
- Department of Cardiology, Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon, Turkey
| | - Ismail Bolat
- Department of Cardiology, Fethiye State Hospital, Muğla, Turkey
| | - Onur Taşar
- Department of Cardiology, Elazığ Education and Research Hospital, Elazig, Turkey
| | - Özgen Şafak
- Department of Cardiology, Burdur State Hospital, Burdur, Turkey
| | - Macit Kalçık
- Department of Cardiology, İskilip Atıf Hoca State Hospital, Iskilip, Turkey
| | - Mehmet Yaman
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Sinan İnci
- Department of Cardiology, Aksaray State Hospital, Aksaray, Turkey
| | - Bernas Altıntaş
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey
| | - Sedat Kalkan
- Department of Cardiology, Gönen State Hospital, Gönen, Turkey
| | - Cevat Kırma
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Murat Biteker
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman Universitesi Tip Fakultesi, Orhaniye Mah. Haluk Özsoy Cad., 48000, Muğla, Turkey
| | | |
Collapse
|
10
|
Emren SV, Şenöz O, Bilgin M, Beton O, Aslan A, Taşkin U, Açiksari G, Asarcikli LD, Çakir H, Bekar L, Bolat İ, Yayla Ç, Çelebi B, Dalgiç O, Çelik O, Şafak Ö, Akyel S, Güngör H, Düzel B, Zoghi M. Drug Adherence in Patients With Nonvalvular Atrial Fibrillation Taking Non-Vitamin K Antagonist Oral Anticoagulants in Turkey: NOAC-TR. Clin Appl Thromb Hemost 2017; 24:525-531. [PMID: 28301907 DOI: 10.1177/1076029617693940] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016. To measure the adherence level, an 8-item Morisky Medication Adherence Scale was used. The mean age of the patients was 70 ± 10 years. Of the 2738 patients, 44% were receiving dabigatran, 38% rivaroxaban, and 18% apixaban. A total of 630 (23%) patients had high medication adherence, 712 (26%) moderate adherence, and 1396 (51%) low adherence. Nonadherence had related to stroke (5.6% vs 2.5%, P < .001) and minor (21.2% vs 11.1%, P < .001) and major (6.1% vs 3.7%, P = .004) bleeding rates. The adherence to NOAC was found to be quite low in Turkey. Nonadherence is associated with bleeding and thromboembolic cardiovascular events. Age, taking NOAC twice a day, and the additional noncardiac diseases, depression, and dementia were the independent factors affecting poor medication adherence.
Collapse
Affiliation(s)
- Sadık Volkan Emren
- 1 Department of Cardiology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Oktay Şenöz
- 2 Department of Cardiology, Artvin State Hospital, Artvin, Turkey
| | - Murat Bilgin
- 3 Department of Cardiology, Ankara Dışkapı Research and Education Hospital, Ankara, Turkey
| | - Osman Beton
- 4 Department of Cardiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Abdullah Aslan
- 5 Department of Cardiology, Dokuz Eylül University, Izmir, Turkey
| | - Uğur Taşkin
- 6 Department of Cardiology, Akşehir State Hospital, Konya, Turkey
| | - Gönül Açiksari
- 7 Department of Cardiology, Istanbul İstinye State Hospital, Istanbul, Turkey
| | - Lale Dinç Asarcikli
- 3 Department of Cardiology, Ankara Dışkapı Research and Education Hospital, Ankara, Turkey
| | - Hakan Çakir
- 8 Department of Cardiology, Darıca Farabi State Hospital, Kocaeli, Turkey
| | - Lütfü Bekar
- 9 Department of Cardiology, Hitit University, Çorum, Turkey
| | - İsmail Bolat
- 10 Department of Cardiology, Fethiye State Hospital, Muğla, Turkey
| | - Çağrı Yayla
- 11 Department of Cardiology, Ankara Yüksek İhtisas Research and Education Hospital, Ankara, Turkey
| | - Barış Çelebi
- 12 Department of Cardiology, Silifke State Hospital, Mersin, Turkey
| | - Onur Dalgiç
- 13 Department of Cardiology, Karşıyaka State Hospital, İzmir, Turkey
| | - Oğuzhan Çelik
- 14 Department of Cardiology, School of Medicine, Hitit University, Çorum, Turkey
| | - Özgen Şafak
- 15 Department of Cardiology, Burdur State Hospital, Burdur, Turkey
| | - Serdar Akyel
- 16 Department of Cardiology, Münif İslamoğlu State Hospital, Kastamonu, Turkey
| | - Hasan Güngör
- 17 Department of Cardiology, Aydın University School of Medicine, Aydın, Turkey
| | - Barış Düzel
- 18 Department of Cardiology, Mersin State Hospital, Mersin, Turkey
| | - Mehdi Zoghi
- 19 Department of Cardiology, Ege University, Izmir, Turkey
| |
Collapse
|
11
|
Doğan V, Başaran Ö, Beton O, Tekinalp M, Aykan AÇ, Kalaycıoğlu E, Bolat İ, Taşar O, Şafak Ö, Kalçık M, Kırma C, Biteker M. Gender-related differences in presentation and treatment of patients with non-valvular atrial fibrillation: results from RAMSES study. Turk Kardiyol Dern Ars 2017; 45:16-25. [PMID: 28106016 DOI: 10.5543/tkda.2016.89894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey. METHODS As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55.9% women) from Turkey. RESULTS Compared with men, women with NVAF were older (71 years [range: 65-78 years] vs. 70 years [range: 62-77 years]; p<0.001), had lower frequency of coronary artery disease (22.0% vs. 38.3%; p<0.001) and congestive heart failure (18.2% vs. 27.2%; p<0.001). Women had higher median CHA2DS2-VASc score (4 [range: 3-5] vs. 3 [range: 2-4]; p<0.001), but similar HAS-BLED score (2 [range: 1-2] vs. 2 [range: 1-2]; p=0.141) when compared with men. Anticoagulant therapy use was higher in women (74.5% vs. 69.9%; p<0.001). Analysis of anticoagulation therapy use revealed that 68.5% of men and 61.6% of women (p=0.204) who had low risk for stroke (CHA2DS2-VASc score: 0 [male], 1 [female]) received anticoagulation therapy, and 30.5% of the men. Meanwhile, 25.3% of the women (p<0.001) with high risk for stroke (CHA2DS2-VASc score: ≥1 [male], ≥2 [female]) had not received any anticogulant therapy. CONCLUSION Although women with NVAF receive better treatment than men, anticoagulation therapy is suboptimal in large proportion of men and women, with underuse in high-risk patients and overuse in low-risk patients. There is an urgent need to improve optimization of anticoagulation in patients with NVAF.
Collapse
Affiliation(s)
- Volkan Doğan
- Department of Cardiology, Muğla Sıtkı Koçman University Faculty of Medicine, Muğla, Turkey.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Biteker M, Başaran Ö, Dogan V, Beton O, Tekinalp M, Çağrı Aykan A, Kalaycıoğlu E, Bolat I, TaŞar O, Şafak Ö, Kalçık M, Yaman M, Kırma C. Real-life use of digoxin in patients with non-valvular atrial fibrillation: data from the RAMSES study. J Clin Pharm Ther 2016; 41:711-717. [PMID: 27671101 DOI: 10.1111/jcpt.12460] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 09/04/2016] [Indexed: 02/05/2023]
Affiliation(s)
- M. Biteker
- Department of Cardiology; Faculty of Medicine; Mugla Sitki Kocman University; Muğla Turkey
| | - Ö. Başaran
- Department of Cardiology; Faculty of Medicine; Mugla Sitki Kocman University; Muğla Turkey
| | - V. Dogan
- Department of Cardiology; Faculty of Medicine; Mugla Sitki Kocman University; Muğla Turkey
| | - O. Beton
- Department of Cardiology; Faculty of Medicine; Sivas Cumhuriyet University; Sivas Turkey
| | - M. Tekinalp
- Department of Cardiology; Kahramanmaraş Necip Fazıl State Hospital; Kahramanmaraş Turkey
| | - A. Çağrı Aykan
- Department of Cardiology; Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital; Trabzon Turkey
| | - E. Kalaycıoğlu
- Department of Cardiology; Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital; Trabzon Turkey
| | - I. Bolat
- Department of Cardiology; Fethiye State Hospital; Muğla Turkey
| | - O. TaŞar
- Department of Cardiology; Elazığ Education and Research Hospital; Elazig Turkey
| | - Ö. Şafak
- Department of Cardiology; Burdur State Hospital; Burdur Turkey
| | - M. Kalçık
- Department of Cardiology; İskilip Atıf Hoca State Hospital; İskilip Turkey
| | - M. Yaman
- Department of Cardiology; Samsun Education and Research Hospital; Samsun Turkey
| | - C. Kırma
- Kartal Kosuyolu Heart Education and Research Hospital; Istanbul Turkey
| |
Collapse
|
13
|
Başaran Ö, Dogan V, Beton O, Tekinalp M, Aykan AC, Kalaycioğlu E, Bolat I, Taşar O, Şafak Ö, Kalcik M, Yaman M, İnci S, Altintaş B, Kalkan S, Kirma C, Biteker M. Suboptimal use of non-vitamin K antagonist oral anticoagulants: Results from the RAMSES study. Medicine (Baltimore) 2016; 95:e4672. [PMID: 27583892 PMCID: PMC5008576 DOI: 10.1097/md.0000000000004672] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/19/2016] [Accepted: 07/31/2016] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study).RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.Of the 2086 eligible patients, 1247 (59.8%) received adequate treatment. However, off-label use was detected in 839 (40.2%) patients; 634 (30.4%) patients received UT and 205 (9.8%) received OT. Independent predictors of UT included >65 years of age, creatinine clearance ≥50 mL/min, urban living, existing dabigatran treatment, and HAS-BLED score of <3, whereas that of OT were creatinine clearance <50 mL/min, ongoing rivaroxaban treatment, and HAS-BLED score of ≥3.The suboptimal use of NOACs is common because of physicians' poor compliance to the guideline recommendations in patients with nonvalvular atrial fibrillation (NVAF). Older patients who were on dabigatran treatment with good renal functions and low risk of bleeding were at risk of UT, whereas patients who were on rivaroxaban treatment with renal impairment and high risk of bleeding were at risk of OT. Therefore, a greater emphasis should be given to prescribe the recommended dose for the specified patients.
Collapse
Affiliation(s)
- Özcan Başaran
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla
| | - Volkan Dogan
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla
| | - Osman Beton
- Department of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas
| | - Mehmet Tekinalp
- Department of Cardiology, Kahramanmaraş Necip Fazıl State Hospital, Kahramanmaraş
| | - Ahmet Cağri Aykan
- Department of Cardiology,Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon
| | - Ezgi Kalaycioğlu
- Department of Cardiology,Trabzon Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Trabzon
| | - Ismail Bolat
- Department of Cardiology,Fethiye State Hospital, Fethiye
| | - Onur Taşar
- Department of Cardiology, Elazığ Education and Research Hospital, Elazığ
| | - Özgen Şafak
- Department of Cardiology, Burdur State Hospital, Burdur
| | - Macit Kalcik
- Department of Cardiology, İskilip Atıf Hoca State Hospital, Corum
| | - Mehmet Yaman
- Department of Cardiology, Samsun Education and Research Hospital, Samsun
| | - Sinan İnci
- Department of Cardiology, Aksaray State Hospital, Aksaray
| | - Bernas Altintaş
- Department of Cardiology, Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır
| | - Sedat Kalkan
- Department of Cardiology, Gönen State Hospital, Gönen
| | - Cevat Kirma
- Kartal Kosuyolu Heart Education and Research Hospital, Kartal, Istanbul, Turkey
| | - Murat Biteker
- Department of Cardiology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla
| |
Collapse
|
14
|
Berilğen R, Eren NK, Ertaş F, Acet H, Kırdök AH, Gürsul E, Akdemir SN, Şafak Ö. Comparison between fractional flow reserve and visual assessment by multiple observers in patients with moderate coronary artery lesions. J Clin Exp Invest 2013. [DOI: 10.5799/ahinjs.01.2013.02.0262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|