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Toprak K, Kaplangöray M, Omar MB, Dursun A, Toprak İH, Acar O, Demirbağ R. Non-O Blood Group is Associated with High Thrombus Burden and Poor short- and long-term Prognosis in STEMI Patients. Med Princ Pract 2024:000538777. [PMID: 38615658 DOI: 10.1159/000538777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION This study investigates how non-O blood groups relate to thrombus burden (TB) and prognosis in STEMI patients, aiming to shed light on their association with thrombotic complications in cardiovascular diseases. METHODS Retrospectively, 1180 STEMI patients undergoing primary percutaneous coronary intervention were included. The study population was divided into groups according to TB status and the groups were compared in terms of basic clinical characteristics, laboratory parameters and ABO blood group types. In addition, short- (30 days) and long-term (12 months) clinical outcomes were assessed to evaluate the prognostic implications. RESULTS The analysis revealed a significant association between non-O blood groups and increased thrombus burden in STEMI patients (p = 0.001). Non-O blood group was independently associated with high thrombus burden (OR: 1.726, 95% CI: 1.279-2.330, p < 0.001). Additionally, patients with non-O blood groups had higher short and long-term mortality rates (HR: 2.480, 95% CI: 1.361-4.520, p = 0.003; HR: 2.347, 95% CI: 1.433-3.844, p = 0.001; respectively). CONCLUSIONS This study emphasizes the significance of the ABO blood group system in STEMI outcomes, associating non-O blood groups with higher thrombus burden and poorer clinical outcomes. While proposing personalized treatment strategies based on blood group status to improve reperfusion interventions and outcomes, additional trials are needed to comprehensively evaluate their impact.
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Toprak K, Toprak İH, Acar O, Ermiş MF. The predictive value of the HALP score for no-reflow phenomenon and short-term mortality in patients with ST-elevation myocardial infarction. Postgrad Med 2024; 136:169-179. [PMID: 38356155 DOI: 10.1080/00325481.2024.2319567] [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: 11/16/2023] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE ST-elevation myocardial infarction (STEMI) is a medical emergency demanding immediate intervention, and primary percutaneous coronary intervention (pPCI) is the standard of care for this condition. While PCI has proven highly effective, a subset of patients experience the devastating no-reflow phenomenon, and some face increased short-term mortality. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score, a novel biomarker-based tool, has recently surfaced as an innovative predictor of these adverse outcomes. This study aims to investigate the groundbreaking findings that designate a low HALP score as a robust risk factor for no-reflow and short-term mortality in STEMI patients. METHODS 1817 consecutive STEMI patients who underwent pPCI were included in this retrospective study, and the patients were divided into two groups according to whether no-reflow developed or not, and the HALP scores of the groups were compared. In addition, short-term mortality was compared between the study groups according to their HALP score values. The predictive ability of the HALP score for no-reflow was evaluated using a receiver operating characteristic curve. RESULTS No-reflow developed in 198 (10.1%) of the patients included in the study. HALP score value was found to be significantly lower in the no-reflow group (27 ± 13 vs 47 ± 24, p < 0.001). After multivariable adjustment, the HALP score was an independent predictor of no-reflow (OR, 0.923, 95% CI, 0.910-0.935, p < 0.001). Furthermore, the HALP score showed good discrimination for no-reflow (AUC, 0.771, 95% CI, 0.737-0.805, p < 0.001). In addition, HALP score was determined to be an independent predictor for short-term mortality (HR, 0.955, 95% CI, 0.945-0.966, p < 0.001). CONCLUSIONS HALP score can independently predict the development of no-reflow and short-term mortality in STEMI patients undergoing pPCI.
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Affiliation(s)
- Kenan Toprak
- Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | | | - Osman Acar
- Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Mehmet Fatih Ermiş
- Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
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Toprak K, Kaplangoray M, Memioğlu T, İnanır M, Omar B, Ermiş MF, Toprak İH, Acar O, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. The HbA1c/C-Peptide Ratio is Associated With the No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction. Angiology 2023:33197231213166. [PMID: 37920902 DOI: 10.1177/00033197231213166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Currently, the gold standard treatment for ST-elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI), but even after successful pPCI, a perfusion disorder in the epicardial coronary arteries, termed no-reflow phenomenon (NR), can develop, resulting in short- and long-term adverse events. The present study assessed the relationship between NR and HbA1c/C-peptide ratio (HCR) in 1834 consecutive patients who underwent pPCI due to STEMI. Participants were divided into two groups according to NR status and the demographic, clinical and periprocedural characteristics of the groups were compared. NR developed in 352 (19.1%) of the patients in the study. While C-peptide levels were significantly lower in the NR group, HbA1c and HCR were significantly higher (P < .001, for all). In multivariable analysis, C-peptide, HbA1c, and HCR, were determined as independent predictors for NR (P < .05, for all). In Receiver Operating Characteristic (ROC) analysis, HCR predicted the NR with 80% specificity and 77% sensitivity. In STEMI patients, combining HbA1c and C-peptide in a single fraction has a predictive value for NR independent of diabetes. This ratio may contribute to risk stratification of STEMI patients.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medical, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Bahadır Omar
- Department of Cardiology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Fatih Ermiş
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - İbrahim Halil Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Osman Acar
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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Toprak K, Kaplangoray M, Memioğlu T, İnanır M, Ermiş MF, Toprak İH, Acar O, Taşcanov MB, Biçer A, Demirbağ R. Comparative Evaluation of Intermountain Risk Score With Mehran Risk Score for Risk Estimation of Contrast-Induced Nephropathy and Short-Term Mortality in ST-Segment Elevation Myocardial Infarction Patients. Angiology 2023:33197231201931. [PMID: 37672723 DOI: 10.1177/00033197231201931] [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] [Indexed: 09/08/2023]
Abstract
Contrast-induced nephropathy (CIN) has become one of the most important causes of in-hospital acute renal failure with the increasing use of contrast-mediated imaging tools. This significantly increases the morbidity and mortality of the affected subjects and causes a financial burden on the health system. In this context, prediction of CIN is important and some risk scores have been developed to predict CIN. The most frequently used and popular among these is the Mehran Score (MS), which is based on a number of hemodynamic and metabolic parameters. The Intermountain Risk Score (IMRS) is a recently developed risk score that highly predicts short-term mortality based on common laboratory parameters, and many parameters of this risk score have been found to be closely associated with CIN. In this context, we aimed to compare MS and IMRS in terms of CIN and short-term mortality estimation. The study included 931 patients who underwent percutaneous coronary intervention. CIN developed in 21.5% of patients. Both MS and IMRS independently predicted CIN. In receiver operating characteristic analysis, IMRS was found to be non-inferior to MS in predicting CIN and IMRS was superior to MS in predicting short-term mortality. IMRS and MS were independently associated with short-term mortality.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Cardiology Department, Medical Faculty, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Cardiology Department, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Cardiology Department, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet Fatih Ermiş
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - İbrahim Halil Toprak
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Osman Acar
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | | | - Asuman Biçer
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
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Toprak K, Kaplangoray M, Palice A, İnanır M, Memioğlu T, Kök Z, Altıparmak İH, Toprak İH, Biçer A, Demirbağ R. Increased whole blood viscosity is associated with primary idiopathic complete atrioventricular block and poor clinical outcomes in these patients. Clin Hemorheol Microcirc 2023; 84:141-151. [PMID: 36683503 DOI: 10.3233/ch-221596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Indexed: 01/22/2023]
Abstract
BACKGROUND Complete atrioventricular block is most commonly caused by age-related degeneration and fibrosis in the cardiac conduction system and is called primary idiopathic complete atrioventricular (iCAVB). Although many factors affect this situation, which increases with age in the cardiac conduction system, the relationship between whole blood viscosity (WBV) and iCAVB has not been clarified until now. In this study, we aim to reveal the relationship between iCAVB and WBV. METHODS AND RESULTS 141 patients with dual-chamber permanent pacemaker implanted for iCAVB and 140 age- and sex-matched subjects were included in this study. The WBV values of the study groups were compared in both high shear rate (HSR) and low shear rate (LSR). Both WBV at HSR and WBV at LSR were significantly higher in the iCAVB group compared to the control group (16.11 [15.14-16.89] vs 14.40 [13.62-15.58]; 39.82 [17.43-55.23] vs 1.38 [-13.14-26.73]; p < 0.001, respectively). The patient population was followed up for an median of 38 months for all-cause mortality. Higher mortality rates were found in higher WBV at HSR and WBV at LSR (p < 0.001,for both). CONCLUSIONS In this study, WBV was found to be an independent predictor for iCAVB, and in these patients WBV was associated with poor clinical outcomes.
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Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | - Ali Palice
- Mehmet Akif İnan Training and Research Hospital, Sanlıurfa, Turkey
| | - Mehmet İnanır
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Tolga Memioğlu
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Zafer Kök
- Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | | | - İbrahim Halil Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
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