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Skorupa D, Akyel A, Fields M, Gerlach R. Facultative and anaerobic consortia of haloalkaliphilic ureolytic micro‐organisms capable of precipitating calcium carbonate. J Appl Microbiol 2019; 127:1479-1489. [DOI: 10.1111/jam.14384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/12/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Affiliation(s)
- D.J. Skorupa
- Department of Chemical and Biological Engineering Montana State University Bozeman MT USA
- Center for Biofilm Engineering Montana State University Bozeman MT USA
| | - A. Akyel
- Department of Chemical and Biological Engineering Montana State University Bozeman MT USA
- Center for Biofilm Engineering Montana State University Bozeman MT USA
| | - M.W. Fields
- Center for Biofilm Engineering Montana State University Bozeman MT USA
- Department of Microbiology and Immunology Montana State University Bozeman MT USA
| | - R. Gerlach
- Department of Chemical and Biological Engineering Montana State University Bozeman MT USA
- Center for Biofilm Engineering Montana State University Bozeman MT USA
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Yayla C, Akyel A, Canpolat U, Gayretli Yayla K, Eyiol A, Akboga M, Turkoglu S, Tavil Y, Boyaci B, Cengel A. P1471Comparison of three different diuretic treatment strategies in acute decompensated heart failure patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1471] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Çimen T, Sunman H, Efe TH, Akyel A, Yayla K, Şahan HF, Bilgin M, Asarcıklı LD, Nallbani A, Doğan M, Açıkel S, Yeter E. Early changes in atrial conduction times in hypertensive patients with elevated pulse pressure. Rev Port Cardiol 2017; 36:453-459. [DOI: 10.1016/j.repc.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/09/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
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Çimen T, Sunman H, Efe TH, Erat M, Şahan HF, Algül E, Guliyev İ, Akyel A, Doğan M, Açıkel S, Yeter E. The relationship between 24-hour ambulatory blood pressure load and neutrophil-to-lymphocyte ratio. Rev Port Cardiol 2017; 36:97-105. [PMID: 28159426 DOI: 10.1016/j.repc.2016.07.009] [Citation(s) in RCA: 7] [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] [Received: 05/11/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE The neutrophil-to-lymphocyte ratio (NLR) is established as a reliable marker of systemic inflammation. Low-grade inflammation has a key role in the pathogenesis and progression of hypertension (HTN). Blood pressure (BP) load, defined as the percentage of abnormally elevated BP readings, is a good marker of HTN severity. We aimed to evaluate the relationship between HTN severity and NLR using averaged ambulatory BP readings and BP load. METHODS A total of 300 patients with untreated essential HTN were included in this cross-sectional study. Patients were divided into quartiles according to NLR values (first: <1.55; second: 1.55-1.92; third: 1.92-2.48; and fourth: >2.48). Averaged ambulatory BP values and BP load were assessed for each quartile. RESULTS In the interquartile evaluation there were no differences between quartiles in terms of baseline demographic, clinical and echocardiographic characteristics (p>0.05). Daytime systolic BP (SBP), 24-hour diastolic BP (DBP), daytime DBP, daytime SBP load, 24-hour DBP load and daytime DBP load were found to be significantly higher in the upper two quartiles (p<0.05 for all). In correlation analysis, log NLR values were found to be positively correlated with 24-hour SBP, DBP, SBP load and DBP load (Pearson coefficients of 0.194, 0.197, 0.157 and 0.181, respectively; p<0.01 for all). In multivariate analysis, log NLR had an independent association with 24-hour SBP and DBP and 24-hour SBP and DBP load. CONCLUSION This study showed for the first time that increased NLR is independently associated with HTN severity in untreated essential HTN patients.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Mehmet Erat
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Haluk Furkan Şahan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Engin Algül
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - İlkin Guliyev
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sadık Açıkel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Sunman H, Erat M, Gayretli Yayla K, Algül E, Aytürk M, Dinç Asarcıklı L, Bilgin M, Çimen T, Akyel A, Açıkel S, Doğan M, Yeter E. Comparison of coronary artery dimensions in patients with chronic aortic regurgitation or stenosis. Turk Kardiyol Dern Ars 2017; 44:656-662. [PMID: 28045411 DOI: 10.5543/tkda.2016.25852] [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: 11/04/2022] Open
Abstract
OBJECTIVE Effects of various conditions on coronary artery dimensions is an important research topic, and data regarding effect of aortic valvular diseases are limited. Aim of the present study was to investigate effects of aortic regurgitation (AR) and aortic stenosis (AS) on coronary artery dimensions. METHODS Coronary dimensions of 95 patients (35 with isolated AR, 30 with isolated AS, and 30 without any valvular disease) were calculated. Patients with severe coronary artery disease and concurrent moderate to severe additional valvular disease were excluded. Mean diameter of major coronary arteries was determined using quantitative coronary angiography. RESULTS The 3 study groups were similar in terms of baseline characteristics. Diameter of left main coronary artery was found to be greater in AR group than AS group (2.66±0.57 mm/m2 vs 2.36±0.49 mm/m2; p=0.015). Mean diameter of left anterior descending and left circumflex arteries were found to be similar in AR and AS groups, and greater than control group. Mean diameter of right coronary artery was found to be greater in AR group compared with controls; however, no significant difference was found in same measurement between AS group and controls. CONCLUSION Present study findings indicate that coronary dimensions in AR group tend to be greater than AS group. Further studies investigating factors that affect coronary dimensions would be beneficial in order to demonstrate mechanisms and differences in AR and AS groups.
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Affiliation(s)
- Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Çimen T, Bilgin M, Akyel A, Felekoğlu MA, Nallbani A, Özdemir Ş, Erden G, Öztürk A, Doğan M, Yeter E. Endocan and Non-Dipping Circadian Pattern in Newly Diagnosed Essential Hypertension. Korean Circ J 2016; 46:827-833. [PMID: 27826342 PMCID: PMC5099339 DOI: 10.4070/kcj.2016.46.6.827] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 01/27/2016] [Accepted: 04/05/2016] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension. Subjects and Methods Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded. Results Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern. Conclusion Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Ali Felekoğlu
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ali Nallbani
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Şeyda Özdemir
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gönül Erden
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Alpaslan Öztürk
- Department of Clinical Biochemistry, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Çimen T, Akyel A, Efe TH. Reply to the Letter to the Editor Entitled "Role of Endothelial Dysfunction and Endocan in Atherosclerosis: Point of Origin or End Point?". Angiology 2016; 71:478. [PMID: 27535947 DOI: 10.1177/0003319716664285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Çimen T, Efe TH, Akyel A, Sunman H, Algül E, Şahan HF, Erden G, Özdemir Ş, Alay EF, Doğan M, Yeter E. Human Endothelial Cell-Specific Molecule-1 (Endocan) and Coronary Artery Disease and Microvascular Angina. Angiology 2016; 67:846-53. [DOI: 10.1177/0003319715625827] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endothelial cell-specific molecule-1 (endocan) is an immunoinflammatory marker linked to endothelial activation and dysfunction. We investigated the relationship between obstructive coronary artery disease (CAD), microvascular angina (MVA), and plasma levels of endocan. We included 53 healthy individuals as controls, 40 MVA patients, and 120 patients with obstructive CAD. The severity of CAD was assessed by the Gensini and SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery (SYNTAX) scores. Endocan levels were 382.7 (313.8-470.2) pg/mL in patients with obstructive CAD; 324.3 (277.1-460.7) pg/mL in MVA group, and 268.0 (226.4-336.5) pg/mL ( P < .001) in controls. Endocan levels in obstructive CAD and MVA groups were similar but both were significantly higher than for the control group ( P < .001 and P = .002, respectively). In subgroup analysis, similar to the hypertensive subgroup results, endocan was still an independent predictor of presence of obstructive CAD in normotensives (odds ratio = 1.005, 95% confidence interval = 1.001-1.010, P = .024). There was also an independent positive correlation between endocan levels and SYNTAX score both in the hypertensives (β = 0.414, t = 3.21, P = .002) and in the normotensives (β = .301, t = 2.23, P = .031). In conclusion, endocan could be a common predictor of the endothelium-dependent inflammatory processes, rather than related with specific risk factors.
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Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Engin Algül
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Haluk Furkan Şahan
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Gönül Erden
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Şeyda Özdemir
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Emine Figen Alay
- Department of Clinical Biochemistry, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Yayla Ç, Canpolat U, Akyel A, Yayla KG, Yilmaz S, Açikgöz SK, Özcan F, Turak O, Doğan M, Yeter E, Aydoğdu S. Association Between Platelet to Lymphocyte Ratio and Saphenous Vein Graft Disease. Angiology 2016; 67:133-138. [PMID: 25818104 DOI: 10.1177/0003319715578258] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 09/12/2023]
Abstract
Atherosclerosis plays an important role in saphenous vein graft disease (SVGD). Previous trials showed that inflammatory blood cells play a role in this process. The platelet to lymphocyte ratio (PLR) has been proposed as a novel predictor for cardiovascular risk and indicator of atherosclerosis. The aim of this study was to assess the relationship between SVGD and PLR. A total of 220 patients with SVG were enrolled (n = 87 with SVGD and n = 133 with patent SVG). A ≥ 50% stenosis within the SVG was defined as clinically significant. Median PLR (P < .001) and mean platelet volume (MPV; P = .043) were significantly higher in patients with SVGD. Also, PLR showed significantly positive correlation with age of SVG (P < .05). Median age of SVGs was also higher in the SVGD group (P = .025). In multivariate logistic regression analyses, the PLR and MPV were independent predictors of SVGD. Using a cutoff level of 106.3, the PLR predicted SVGD with a sensitivity of 87.4% and a specificity of 80.3%. To the best of our knowledge, this study showed, for the first time, that PLR was independently associated with SVGD. Both PLR and MPV might predict SVGD.
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Affiliation(s)
- Çağrı Yayla
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Uğur Canpolat
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Samet Yilmaz
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sadık Kadri Açikgöz
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Fırat Özcan
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Osman Turak
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Cardiology Clinic, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sinan Aydoğdu
- Cardiology Clinic, Türkiye Yüksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Çimen T, Doğan M, Kızıltepe U, Akyel A, Sunman H, Yeter E. Mitral-aortic intervalvular fibrosa pseudoaneurysm with rupture into the left atrium: a three-dimensional trans-esophageal echocardiographic approach. Anatol J Cardiol 2015; 15:1030-1. [PMID: 26663226 PMCID: PMC5368457 DOI: 10.5152/anatoljcardiol.2015.6663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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Abstract
Objective: Cigarette smoking increases the risk of cardiovascular events. The heart rate recovery index (HRRI) is an indicator of autonomous nervous system function and is an independent prognostic risk factor for cardiovascular diseases. In this study, we aimed to evaluate HRRI in heavy smokers. Methods: A total of 179 apparently healthy subjects (67 non-smokers as the control group and 112 heavy smokers) were enrolled into this prospective cross-sectional study. The presence of hypertension, diabetes mellitus, and known cardiac or non-cardiac diseases was specified as the exclusion criteria. Heavy cigarette smoking was defined as the consumption of more than one packet of cigarette per day. All subjects underwent the maximal Bruce treadmill test. HRRIs of the heavy cigarette smoker group at 1, 2, 3, and 5 min after maximal exercise were calculated and compared to those of the control group. Student t-test, chi-square test, and analysis of covariance were used for statistical analysis. Results: The baseline characteristics of the two groups were similar, except for body mass index and high-density lipoprotein level. HRRIs at 1, 2, 3, and 5 min after maximal exercise were found to be significantly lower in the heavy smoker group (HRRI1: 26.78±8.81 vs. 32.82±10.34, p<0.001; HRRI2: 44.37±12.11 vs. 51.72±12.87, p<0.001; HRRI3: 52.73±11.54 vs. 57.22±13.51, p=0.018; and HRRI5: 58.31±10.90 vs. 62.33±13.02, p=0.029). Conclusions: In the present study, we found that HRRI was impaired in heavy smokers. Our results suggest that beside previously known untoward effects on vascular biology, heavy smoking also has deleterious effects on the neuro–cardiovascular system.
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Affiliation(s)
- Mehmet Erat
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Mehmet Doğan
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Hamza Sunman
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey.
| | - Lale Dinç Asarcıklı
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Tolga Han Efe
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Murat Bilgin
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Tolga Çimen
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Ahmet Akyel
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
| | - Ekrem Yeter
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Ankara-Turkey
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Yayla Ç, Akboğa MK, Canpolat U, Akyel A, Yayla KG, Doğan M, Yeter E, Aydoğdu S. Platelet to Lymphocyte Ratio Can be a Predictor of Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction. Angiology 2015; 66:831-836. [PMID: 25712290 DOI: 10.1177/0003319715573658] [Citation(s) in RCA: 35] [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: 09/12/2023]
Abstract
Patency of infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI) before primary percutaneous coronary intervention (pPCI) is associated with lower mortality and better clinical outcome. However, there were little data regarding the predictors of IRA patency before pPCI in the setting of STEMI. We aimed to assess the association of platelet to lymphocyte ratio (PLR) with IRA patency in STEMI. A total of 452 patients were enrolled and categorized as occluded or patent IRA. Patency IRA was assessed by the thrombolysis in myocardial infarction (TIMI) flow grade. Blood samples were obtained on admission to calculate PLR. Of all patients, 92 (20.4%) patients revealed pre-pPCI TIMI 3 flow in IRA. The PLR was significantly higher in occluded IRA group (138.4 ± 51.4 vs 95.4 ± 43.5, P < .001). Glucose, troponin I, and neutrophil to lymphocyte ratio (NLR) levels were also higher in occluded IRA group (P < .05). Multivariate regression analysis demonstrated the PLR (odds ratio [OR]: 0.987; 95% confidence interval [CI]: 0.978-0.995, P = .002) and NLR (OR: 0.758; 95% CI: 0.584-0.985, P = .038) on admission as independent predictors of IRA patency. In conclusion, a higher PLR is a powerful and independent predictor of IRA patency in patients with STEMI before pPCI.
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Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Doğan
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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Alsancak Y, Cengel A, Akyel A, Ozkan S, Sezenoz B, Unlu S, Kiziltunc E, Akboga MK, Alsancak AD, Elbeg S, Sahinarslan A, Yalcın MR. Relationship between serum vitamin D levels and angiographic severity and extent of coronary artery disease. Eur J Clin Invest 2015; 45:940-8. [PMID: 26248116 DOI: 10.1111/eci.12490] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 03/23/2015] [Accepted: 07/01/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Vitamin D is known for its effect in calcium and bone homeostasis. There is an increasing evidence for health benefits accomplished by activated vitamin D that go beyond these classical functions. Previous studies have suggested that lower vitamin D levels are associated with increased cardiovascular disease risk. Therefore, we aimed to evaluate relationship between vitamin D levels and extent and severity of coronary artery disease. MATERIALS AND METHODS A total of 746 patients in whom coronary angiography was performed between August 2012 and July 2013 were enrolled in this study. Serum vitamin D levels were measured, and patients were grouped according to their serum vitamin D levels (vitamin D <20 ng/mL (n = 602) Group 1 versus >20 ng/dL (n = 144) Group 2). Gensini score system was used to evaluate the association between serum vitamin D levels and severity and extent of coronary artery disease. RESULTS There was no significant difference between the groups in terms of baseline characteristics and demographic characteristics. Mean serum vitamin D levels of all patient cohort was 15.54 ± 7.46 ng/mL. Group 1 and Group 2 had an average serum vitamin D levels of 12.6 ± 3.3 ng/mL and 27.5 ± 7.8 ng/mL, respectively. Gensini score for all cohort was 26.25 ± 34.32. Group 1 had an average Gensini score of 26.4 ± 35.7; on the other hand, Gensini score was 25.5 ± 27.5 in Group 2 (P = 0.097). CONCLUSIONS This study failed to demonstrate significant relationship between serum vitamin D levels and the severity and extent of coronary artery disease. Further studies with more participation and homogenous groups with comparable individual and environmental features are needed to evaluate the association of serum vitamin D levels and cardiovascular diseases.
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Affiliation(s)
- Yakup Alsancak
- Department of Cardiology, Ataturk Education and Research Hospital, Ankara, Türkiye
| | - Atiye Cengel
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
| | - Ahmet Akyel
- Department of Cardiology, Dıskapı Education and Research Hospital, Ankara, Türkiye
| | - Selcuk Ozkan
- Department of Cardiology, 29 Mayıs State Hospital, Ankara, Türkiye
| | - Burak Sezenoz
- Department of Cardiology, Gazi Mustafa Kemal State Hospital, Ankara, Türkiye
| | - Serkan Unlu
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
| | - Emrullah Kiziltunc
- Department of Cardiology, Numune Education and Research Hospital, Ankara, Türkiye
| | - Mehmet Kadri Akboga
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Aybuke Demir Alsancak
- Department of Family Medicine, Numune Education and Research Hospital, Ankara, Türkiye
| | - Sehri Elbeg
- Department of Biochemistry, Gazi University Medical Faculty, Ankara, Türkiye
| | - Asife Sahinarslan
- Department of Cardiology, Gazi University Medical Faculty, Ankara, Türkiye
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14
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Yayla Ç, Bilgin M, Akboğa MK, Gayretli Yayla K, Canpolat U, Dinç Asarcikli L, Doğan M, Turak O, Çay S, Özeke Ö, Akyel A, Yeter E, Aydoğdu S. Evaluation of Tp-E Interval and Tp-E/QT Ratio in Patients with Aortic Stenosis. Ann Noninvasive Electrocardiol 2015; 21:287-93. [PMID: 26246339 DOI: 10.1111/anec.12298] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 01/19/2023] Open
Abstract
BACKGROUND The risk of syncope and sudden cardiac death due to ventricular arrhythmias increased in patients with aortic stenosis (AS). Recently, it was shown that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio can be novel indicators for prediction of ventricular arrhythmias and mortality. We aimed to investigate the association between AS and ventricular repolarization using Tp-e interval and Tp-e/QT ratio. METHODS Totally, 105 patients with AS and 60 control subjects were enrolled to this study. The severity of AS was defined by transthoracic echocardiographic examination. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured from the 12-lead electrocardiogram. RESULTS Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were significantly increased in parallel to the severity of AS (P < 0.001, P = 0.001, and P = 0.001, respectively). Also, it was shown that Tp-e/QTc ratio had significant positive correlation with mean aortic gradient (r = 0.192, P = 0.049). In multivariate logistic regression analysis, Tp-e/QTc ratio and left ventricular mass were found to be independent predictors of severe AS (P = 0.03 and P = 0.04, respectively). CONCLUSIONS Our study showed that Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with severe AS. Tp-e/QTc ratio and left ventricular mass were found as independent predictors of severe AS.
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Affiliation(s)
- Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Murat Bilgin
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Kadri Akboğa
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Lale Dinç Asarcikli
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Doğan
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Osman Turak
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Serkan Çay
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Özcan Özeke
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Ekrem Yeter
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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15
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Celik IE, Akyel A, Colgecen M, Ozeke O. A rare cause of 2:1 atrioventricular block: carbamazepine. Am J Emerg Med 2015; 33:1541.e3-4. [PMID: 26306438 DOI: 10.1016/j.ajem.2015.07.055] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/25/2015] [Indexed: 10/23/2022] Open
Abstract
We report a case of carbamazepine-induced 2:1 atrioventricular (AV) block. A 56-year-old man was admitted to our emergency department for recurrent attacks of dizziness and syncope. His serum carbamazepine level was within therapeutic range, and his electrocardiogram revealed 2:1 AV block. After withdrawal of carbamazepine therapy, the arrhythmia completely resolved. This report suggests that carbamazepine-induced AV block can occur even in therapeutic serum concentrations and that it can be reversible.
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Affiliation(s)
- Ibrahim Etem Celik
- Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey.
| | - Ahmet Akyel
- Dışkapı Yıldırım Beyazıt Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | | | - Ozcan Ozeke
- Türkiye Yüksek İhtisas Education and Research Hospital, Department of Cardiology, Ankara, Turkey
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16
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Karadeniz M, Duran M, Akyel A, Yarlıoğlueş M, Öcek AH, Çelik İE, Kılıç A, Yalcin AA, Ergün G, Murat SN. High Sensitive CRP Level Is Associated With Intermediate and High Syntax Score in Patients With Acute Coronary Syndrome. Int Heart J 2015; 56:377-80. [PMID: 26118590 DOI: 10.1536/ihj.14-299] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
High sensitive C-reactive protein (hs-CRP) levels are associated with short- and long-term mortality in patients with acute coronary syndrome (ACS). We investigated whether baseline hs-CRP levels are associated with burden of coronary atherosclerosis assessed by SYNTAX score (SXScore).We enrolled 321 patients with ACS who underwent coronary angiography. The patients were divided into tertiles according to the SXScore: low SXScore (≤ 22), and intermediate-high SXScore (≥ 23).Subjects in the intermediate-high SXScore tertile had higher serum hs-CRP levels compare to low SXScore tertile patients (7.7 ± 3.4 mg/L versus 4.9 ± 2.5 mg/L, P < 0.001). The mean age of patients and prevalance of diabetes in the intermediate-high SXScore tertile were significantly higher than in the low SXScore tertile (63 ± 13 versus 58 ± 12 years P = 0.001 for age, P = 0.007 for diabetes). Multivariate logistic regression analysis showed that the strongest predictors of high SXScore were increased serum hs-CRP levels (OR: 1.14) together with multivessel disease (OR: 0.23), left ventricular ejection fraction (LVEF) (OR: 0.90), and troponin levels (OR: 1.12).Serum hs-CRP levels on admission in patients with ACS could predict the severity and complexity of coronary atherosclerosis together with multivessel disease, LVEF, and troponin levels. Thus, increased serum levels of hs-CRP were one of the strong predictors of high SXScore in ACS patients.
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Bilgin M, Akyel A, Doğan M, Sunman H, Yeter E. Acute coronary syndrome secondary to clarithromycin: the first case and review of the literature. Turk Kardiyol Dern Ars 2015; 42:461-3. [PMID: 25080953 DOI: 10.5543/tkda.2014.92891] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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
Kounis syndrome (KS) is characterized by concurrent acute coronary syndrome and allergic reaction, in which acute inflammatory mediators cause spasm and/or erosion and rupture of coronary atheromatous plaque. In this report, we remind clinicians to consider KS in patients who are subjected to allergenic substances and demonstrate acute chest pain. A 36-year-old woman had chest pain, severe dyspnea, hypotension, and symmetrical negative T waves on the anterior leads during electrocardiography approximately two hours after the use of clarithromycin. KS was considered as a possible diagnosis based on the presentation. Laboratory tests revealed an elevated level of troponin I, suggesting myocardial infarction, and an elevated level of serum tryptase level, suggesting an allergic reaction. The patient promptly underwent coronary angiography, which revealed only plaques in all main coronary arteries without any obstructive lesion. To the best of our knowledge, we report herein the first case in the literature describing an association between clarithromycin and KS.
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Affiliation(s)
- Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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18
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Çimen T, Durmaz HA, Akyel A, Yeter E, Karapınar K, Felekoğlu MA. Hypotension, tachycardia, and tachypnea in a patient with coronary artery disease. Anatol J Cardiol 2015; 15:430, 440. [PMID: 25993720 PMCID: PMC5779186 DOI: 10.5152/akd.2015.6151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tolga Çimen
- Clinic of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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19
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Tacoy G, Akboga MK, Yayla C, Akyel A, Turkoglu S, Ozdemir M, Yalcin R. The effect of statin treatment on P-wave characteristics and atrial conduction time. Kardiol Pol 2015; 73:747-452. [PMID: 25985732 DOI: 10.5603/kp.a2015.0090] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Revised: 04/08/2015] [Accepted: 03/31/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIM The aim of this study was to evaluate the effect of statin treatment on P-wave morphology, dispersion, and tissue Doppler imaging-derived atrial conduction time (PA-TDI), which are known to be predictors of atrial fibrillation (AF). METHODS A total of 132 patients with guideline-directed statin indications but no clinical atrial tachyarrhythmias were studied. P-wave duration, P-wave dispersion, and P-wave amplitude on surface 12-lead electrocardiogram and PA-TDI were evaluated before and after three months of statin (either atrovastatin 10-40 mg/d or rosuvastatin 10-20 mg/d) treatment. RESULTS Total and low-density lipoprotein cholesterol were significantly reduced after statin therapy. P-wave dispersion significantly decreased from 39.6 ± 9.4 to 36.9 ± 9.6 ms. Statin treatment significantly decreased both the maximum (from 1.5 ± 0.36 to 1.45 ± 0.33 mV, p = 0.001) and the minimum (from 1.07 ± 0.28 to 1.04 ± 0.27 mV, p = 0.01) P-wave amplitude. The PA-TDI value was found to be significantly shorter after statin treatment (121.7 ± 18.7 vs. 118.7 ± 15.8 ms, p = 0.016) CONCLUSIONS: Short-term statin therapy was shown to significantly affect P-wave amplitude, P-wave dispersion, and atrial conduction time in a broad range of patients without any clinical atrial tachyarrhythmia.
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Affiliation(s)
| | - Mehmet Kadri Akboga
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
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20
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Akyel A, Yayla Ç, Erat M, Çimen T, Doğan M, Açıkel S, Aydoğdu S, Yeter E. Neutrophil-to-lymphocyte ratio predicts hemodynamic significance of coronary artery stenosis. Anatol J Cardiol 2015; 15:1002-7. [PMID: 25880055 PMCID: PMC5368453 DOI: 10.5152/akd.2015.5909] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: Coronary artery disease is closely linked with inflammation, and the neutrophil-to-lymphocyte ratio (NLR) has emerged as a new inflammatory marker. Fractional flow reserve (FFR) is a well-established method for determining hemodynamic significance of coronary artery stenosis. In this study, we aimed to investigate the relationship between NLR and hemodynamic significance of coronary artery lesion as assessed by FFR. Methods: A total of 134 patients with FFR measurement between January 2012 and December 2013 were enrolled in this retrospective study. Patients with single intermediate-grade coronary artery stenosis were enrolled, and those with second intermediate or severe coronary artery stenosis were excluded from study. Patients’ NLR were calculated. An FFR value of <0.80 was accepted for hemodynamic significance. Statistical analysis was performed by the chi-square test, Student’s t-test, Mann–Whitney U test, logistic regression analysis, and ROC curve analysis. Results: Patients with hemodynamically significant lesions had higher NLR values (3.3±1.2 vs. 2.0±0.9, p<0.001). White blood cell count, male gender, high-density lipoprotein levels, platelet-to-lymphocyte ratio, and NLR were found to be possible confounding factors predicting hemodynamically significant coronary artery stenosis. In multiple logistic regression analysis, NLR remained as the only independent predictor for hemodynamically significant coronary artery stenosis. An NLR value of 2.4 had 87.5% sensitivity and 78.4% specificity for prediction of hemodynamically significant coronary artery stenosis. Conclusion: In present study, we showed that NLR was significantly higher in patients with hemodynamically significant coronary artery stenosis. We also found NLR to be an independent predictor of hemodynamically significant coronary artery stenosis as measured by FFR. Further studies are needed to find a causal relationship.
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Affiliation(s)
- Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara-Turkey.
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21
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Akyel A, Yayla KG, Erat M, Sunman H, Doğan M, Çimen T, Aytürk M, Yeter E. Relationship between Epicardial Adipose Tissue Thickness and Atrial Electromechanical Delay in Hypertensive Patients. Echocardiography 2015; 32:1498-503. [DOI: 10.1111/echo.12917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Ahmet Akyel
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Kadriye G. Yayla
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Erat
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Hamza Sunman
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Doğan
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Tolga Çimen
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
| | - Mehmet Aytürk
- Department of Cardiology; Keçiören Education and Research Hospital; Ankara Turkey
| | - Ekrem Yeter
- Department of Cardiology; Dışkapı Yıldırım Beyazıt Education and Research Hospital; Ankara Turkey
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22
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Acikel S, Asarcikli LD, Akyel A, Cimen T, Sunman H, Pamukcu HE, Efe T, Bilgin M, Dogan M, Yeter E. PP-030 Manual Thrombus Aspiration and High-dose Adenosine via Thrombus Aspiration Catheter in the Treatment of No-reflow for Saphenous Vein Graft Intervention in ST-elevation Myocardial Infarction. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.386] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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23
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Yayla Ç, Canpolat U, Yayla KG, Akboğa MK, Akyel A, Açıkgöz SK, Özcan F, Turak O, Aydoğdu S, Kanbay M. OP-031 The Relationship Between Monocyte/HDL Cholesterol Ratio and Aortic Elasticity in Newly-Diagnosed Hypertensive Patients. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.077] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Yayla Ç, Canpolat U, Akyel A, Yayla KG, Yılmaz S, Açıkgöz SK, Özcan F, Turak O, Doğan M, Yeter E, Aydoğdu S. OP-066 Association Between Platelet to Lymphocyte Ratio and Saphenous Vein Graft Disease. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.112] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Akboğa MK, Akyel A, Şahinarslan A, Yayla Ç, Alsancak Y, Gökalp G, Nurkoç S, Abacı A. OP-073 Neutrophil to Lymphocyte Ratio is Increased in Patients with Rheumatic Mitral Valve Disease. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.119] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Acikel S, Asarcikli LD, Akyel A, Cimen T, Efe T, Pamukcu HE, Bilgin M, Dogan M, Yeter E. PP-134 The Successful Percutaneous Revascularization of Subclavian Artery Stenosis Causing Coronary Subclavian and Vertebral Artery Steal Syndrome. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.491] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Erat M, Doğan M, Sunman H, Algül E, Felekoğlu MA, Yayla KG, Asarcıklı LD, Efe TH, Bilgin M, Çimen T, Akyel A, Yeter E. OP-198 Evaluate the Heart Rate Recovery Index in Patients with Heavy Cigarette Smoking. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Asarcikli LD, Erat M, Acikel S, Dicle CB, Yuceege M, Efe TH, Bilgin M, Akyel A, Dogan M, Firat H, Yeter E. PP-156 Neutrophil to Lymphocyte Ratio is Associated with Severe Obstructive Sleep Apnea Syndrome and Increased Inflammation. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.513] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Akboğa MK, Canpolat U, Balcı KG, Akyel A, Şen F, Yayla Ç, Çay S, Aras D, Aydoğdu S. OP-065 Increased Platelet-to-Lymphocyte Ratio is Related to Slow Coronary Flow. Am J Cardiol 2015. [DOI: 10.1016/j.amjcard.2015.01.111] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Akboga MK, Canpolat U, Balci KG, Akyel A, Sen F, Yayla C, Cay S, Aras D, Aydogdu S. Increased Platelet to Lymphocyte Ratio is Related to Slow Coronary Flow. Angiology 2015; 67:21-6. [PMID: 25725035 DOI: 10.1177/0003319715574625] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [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: 11/16/2022]
Abstract
Previous studies showed that both inflammation and platelets have a role in development of slow coronary flow (SCF). Platelet to lymphocyte ratio (PLR) as an emerging inflammatory indicator was significantly associated with adverse cardiovascular events. Therefore, we aimed to assess the relationship between PLR and SCF. Patients who had angiographically normal coronary arteries were enrolled in this retrospective study (n = 221 as SCF group and n = 293 as control group). Patients who had thrombolysis in myocardial infarction frame counts (TFC) above the normal cutoffs were considered to have SCF. Both PLR and C-reactive protein (CRP) were significantly higher in the SCF group. In correlation analysis, PLR has a significantly positive correlation with the left anterior descending artery TFC (P = .001), circumflex artery TFC (P < .001), right coronary artery TFC (P < .001), and serum CRP level (P < .001). In multiple logistic regression analysis, PLR was independently associated with presence of SCF (odds ratio: 1.014, P < .001). In conclusion, higher PLR levels were significantly and independently related to the presence of SCF. Besides, PLR was positively correlated with serum CRP level as a conventional marker for systemic inflammation.
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Affiliation(s)
- Mehmet Kadri Akboga
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ugur Canpolat
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Kevser Gulcihan Balci
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Fatih Sen
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Cagri Yayla
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
| | - Sinan Aydogdu
- Department of Cardiology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
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Ataş N, Erten Y, Okyay GU, Inal S, Topal S, Öneç K, Akyel A, Çelik B, Tavil Y, Bali M, Arınsoy T. Left ventricular hypertrophy and blood pressure control in automated and continuous ambulatory peritoneal dialysis patients. Ther Apher Dial 2015; 18:297-304. [PMID: 24965296 DOI: 10.1111/1744-9987.12104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Hypertension, non-dipper blood pressure (BP) pattern and decrease in daily urine output have been associated with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. However, there is lack of data regarding the impact of different PD regimens on these factors. We aimed to investigate the impact of circadian rhythm of BP on LVH in end-stage renal disease patients using automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD) modalities. Twenty APD (7 men, 13 women) and 28 CAPD (16 men, 12 women) patients were included into the study. 24-h ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography besides routine blood examinations were performed. Two groups were compared with each other for ABPM measurements, BP loads, dipping patterns, left ventricular mass index (LVMI) and daily urine output. Mean systolic and diastolic BP measurements, BP loads, LVMI, residual renal function (RRF) and percentage of non-dippers were found to be similar for the two groups. There were positive correlations of LVMI with BP measurements and BP loads. LVMI was found to be significantly higher in diastolic non-dippers compared to dippers (140.4 ± 35.3 vs 114.5 ± 29.7, respectively, P = 0.02). RRF and BP were found to be independent predictors of LVMI. Non-dipping BP pattern was a frequent finding among all PD patients without an inter-group difference. Additionally, higher BP measurements, decrease in daily urine output and non-dipper diastolic BP pattern were associated with LVMI. In order to avoid LVH, besides correction of anemia and volume control, circadian BP variability and diastolic dipping should also be taken into consideration in PD patients.
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Affiliation(s)
- Nuh Ataş
- Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
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Kurtul A, Murat SN, Yarlioglues M, Duran M, Ergun G, Acikgoz SK, Demircelik MB, Cetin M, Akyel A, Kasapkara HA, Ornek E. Association of platelet-to-lymphocyte ratio with severity and complexity of coronary artery disease in patients with acute coronary syndromes. Am J Cardiol 2014; 114:972-8. [PMID: 25118117 DOI: 10.1016/j.amjcard.2014.07.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 07/02/2014] [Accepted: 07/02/2014] [Indexed: 11/19/2022]
Abstract
The SYNTAX score (SXscore) is an anatomic scoring system based on coronary angiography (CA) that not only quantifies lesion severity and complexity but also predicts poor cardiovascular outcomes, including mortality, in patients with acute coronary syndromes (ACS). Recent studies have shown that platelet-to-lymphocyte ratio (PLR) is associated with worse outcomes in many cardiovascular diseases. The aim of this study was to investigate the association of PLR with the severity and complexity of coronary atherosclerosis as assessed by the SXscore in patients with ACS who underwent urgent CA. A total of 1,016 patients with ACS who underwent urgent CA were included in the study from August 2012 to March 2014. Admission PLR values were calculated before CA was performed. The SXscore was determined from baseline CA. The patients were divided into 2 groups, those with low SXscores (≤22) and those with intermediate to high SXscores (≥23). PLRs were significantly higher in patients with intermediate to high SXscores compared with those with low SXscores (p<0.001). In-hospital mortality was significantly higher in the groups with high PLR and intermediate to high SXscores. In multivariate analysis, the independent predictors of intermediate to high SXscore were PLR (odds ratio 1.018, 95% confidence interval 1.013 to 1.023, p<0.001) together with the left ventricular ejection fraction (odds ratio 0.935, 95% confidence interval 0.910 to 0.960, p<0.001), and age (odds ratio 1.029, 95% confidence interval 1.029 to 1.054, p=0.02). A PLR≥116 had 71% sensitivity and 66% specificity in predicting intermediate to high SXscore. In conclusion, the PLR at admission is significantly associated with the severity and complexity of coronary atherosclerosis in patients with ACS. Increased PLR is an independent predictor of higher SXscore in patients with ACS who undergo urgent CA.
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Affiliation(s)
- Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
| | - Sani Namik Murat
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mikail Yarlioglues
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mustafa Duran
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Gokhan Ergun
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Sadik Kadri Acikgoz
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | | | - Mustafa Cetin
- Department of Cardiology, Numune Education and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Diskapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Haci Ahmet Kasapkara
- Department of Cardiology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey
| | - Ender Ornek
- Department of Cardiology, Numune Education and Research Hospital, Ankara, Turkey
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Akboga MK, Akyel A, Sahinarslan A, Demirtas CY, Yayla C, Boyaci B, Yalcin R. Relationship between plasma apelin level and coronary collateral circulation. Atherosclerosis 2014; 235:289-94. [DOI: 10.1016/j.atherosclerosis.2014.04.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/17/2014] [Accepted: 04/23/2014] [Indexed: 11/17/2022]
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Doğan M, Sunman H, Akyel A, Çimen T, Bilgin M, Efe T, Erat M, Aralov B, Gayretli Yayla K, Aytürk M, Açıkel S, Yeter E. [Prevalence and clinical features of microfistulas between the coronary artery and left ventricle: single-center experience]. Turk Kardiyol Dern Ars 2014; 42:332-8. [PMID: 24899476 DOI: 10.5543/tkda.2014.25936] [Citation(s) in RCA: 2] [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
OBJECTIVES Coronary artery fistula is an infrequent malformation, and the prevalence was reported as approximately 0.1-0.4% in previous studies. However, the number of studies about microfistulas from coronary arteries to the left ventricle is inadequate, especially in the Turkish population. The purpose of this study was to evaluate the prevalence and clinical features of microfistulas in subjects undergoing coronary angiography for the assessment of coronary artery disease. STUDY DESIGN In this retrospective study, we researched the cardiac catheterization laboratory database between January 2008 and July 2013. The presence of microfistulas was established according to the following criteria: 1) direct filling of the heart cavity during selective coronary injection without interposing "capillary" phase or venous filling, and 2) visualization of small vessels interposed between the epicardial coronary vessels and the heart cavity and emptying into the heart. RESULTS Microfistulas were found in 12 (0.11%) of the 11403 coronary angiographies. There were 7 (58.3%) female patients (mean age, 70.2±10.8 years), and contemporary severe coronary artery stenosis was noted in 2 (16.7%) patients. Chest pain was the most frequently encountered complaint, followed by dyspnea. Microfistulas originated from the left anterior descending artery (100%), circumflex artery (66.7%), and right coronary artery (58.3%). In addition, multiple microfistulas were seen in 6 (50%) patients, bilateral microfistulas in 3 (25%) patients and unilateral microfistula in 3 (25%) patients, and all of them terminated in the left ventricle. CONCLUSION Our study found an overall incidence of microfistulas of 0.11%. Microfistula is a rare cardiac anomaly that sometimes causes cardiac symptoms; otherwise, it is detected during routine coronary angiography.
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Affiliation(s)
- Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Tolgahan Efe
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Erat
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Bahtiyar Aralov
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Mehmet Aytürk
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Sadık Açıkel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Kurtul A, Murat SN, Yarlioglues M, Duran M, Karadeniz M, Ergun G, Akyel A, Mendi MA, Oksuz F. The association of red cell distribution width with in-stent restenosis in patients with stable coronary artery disease. Platelets 2014; 26:48-52. [PMID: 24831828 DOI: 10.3109/09537104.2014.881990] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 02/05/2023]
Abstract
Increased red cell distribution width (RDW) is closely related to the poor prognosis and adverse events of cardiovascular diseases. We aimed to investigate the association of serum RDW levels and in-stent restenosis (ISR) after coronary stenting with bare-metal stent in patients with stable coronary artery disease. A total of 251 patients (age 62 ± 11 years, 69% male) with a history of coronary stenting who underwent control coronary angiography (128 with ISR and 123 without ISR) were enrolled into the study. Laboratory parameters were measured before angiography. ISR was defined as luminal stenosis ≥50% within the stent or within 5 mm of its edges by the quantitative coronary analysis. The patients were divided into the two groups: ISR group and no-ISR group. Baseline characteristics of the patients were similar. The ISR group had significantly higher RDW levels compared with patients in no-ISR group (14.47 ± 1.37 vs. 13.59 ± 0.88, p < 0.001). Furthermore, the ISR group had significantly longer stent length and lower stent diameter when compared to no-ISR group (p = 0.001 and p = 0.004, respectively). In a multivariate analysis, RDW levels >13.75%, high-sensitivity C-reactive protein levels, stent diameter and stent length were independently associated with ISR [odds ratio (OR) = 2.12, 95% confidence interval (CI) = 1.71-3.15, OR = 2.80, 95% CI = (1.34-4.61), OR = -2.60, 95% CI = -(1.19-4.51), OR = 2.02, 95% CI = 1.99-3.76, p = 0.001, respectively]. We concluded that increased serum RDW levels were independently associated with bare-metal ISR in patients with stable coronary artery disease.
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Affiliation(s)
- Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital , Ankara , Turkey
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Akboğa MK, Akyel A, Şahinarslan A, Yayla Ç, Alsancak Y, Gökalp G, Nurkoç S, Abacı A. Neutrophil-to-lymphocyte ratio is increased in patients with rheumatic mitral valve stenosis? Anatol J Cardiol 2014; 15:380-4. [PMID: 25430404 PMCID: PMC5779174 DOI: 10.5152/akd.2014.5399] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The role of systemic and chronic inflammatory processes in the pathophysiology of rheumatic heart valve disease is well known. The neutrophil-to-lymphocyte ratio (NLR) was shown to be an indicator of systemic inflammation. In this study, we aimed to investigate relationship between NLR as a marker of systemic inflammation and rheumatic mitral valve stenosis (RMVS). METHODS This is a retrospective study. Among patients who underwent transthoracic echocardiography between January 2008-March 2013, 314 patients with RMVS were included retrospectively in the study. The control group included 57 healthy persons who underwent transthoracic echocardiography during the study period. Basal characteristics and NLR were compared between the two groups. Independent predictors of RMVS were determined by logistic regression analysis. RESULTS Basal characteristics were similar among the groups (age, 50.2 ± 14.2 vs. 49.2 ± 13.0, p=0.60). The NLR was significantly higher in patients with RMVS [2.9 (0.6-13.0) vs. 2.1 (0.7-5.8), p<0.001]. Besides, C-reactive protein (CRP) was also higher in the RMVS group [5.99 (0.3-23.7) vs. 2.98 (0.6-6.3), p=0.001]. In the regression analysis, NLR (OR: 2.24, p=0.04), CRP (OR: 1.34, p=0.03), and left atrial diameter (OR: 1.21, p=0.001) were independent predictors of RMVS. In the correlation analysis, there was a significant positive correlation between NLR and CRP (r=0.43, p<0.001). CONCLUSION We found that NLR was significantly increased in RMVS. Furthermore, NLR was an independent predictor of the presence of RMVS in our study population. According to these findings, NLR can be used as a predictor of RMVS. Since it is an easily available and cheap method, it can easily be used in daily clinical practice. Increased NLR can also be a sign of ongoing chronic inflammation in patients with RMVS.
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Affiliation(s)
- Mehmet Kadri Akboğa
- Department of Cardiology, Ministry of Health Etimesgut State Hospital; Ankara-Turkey.
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Akyel A, Öksüz F, Karadeniz M, Yarlıoğlueş M, Ergün G, Cankurt T, Yozgat A, Arıel M, Aral Y, Sunman H, Murat S. PP-232 Atrial Electromechanical Delay in Type 2 Diabetes Mellitus. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.253] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Akyel A, Çengel A, Tavil Y, Şahinarslan A, Topal S, Yayla Ç, Elbeğ Ş, Boyaci B, Arslan M. Relationship between plasma asymmetric dimethylarginine level and autonomic dysfunction in diabetic patients. Turk Kardiyol Dern Ars 2014; 40:148-54. [PMID: 22710585 DOI: 10.5543/tkda.2012.01826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
OBJECTIVES We aimed to investigate the relationship between plasma asymmetric dimethylarginine (ADMA) levels and heart rate variability (HRV) in diabetic patients. STUDY DESIGN The study included 100 patients (44 men, 56 women) with type 2 diabetes mellitus. The patients were divided into two groups based on the use of oral antidiabetics (n=67; mean age 54.6±7.8 years) or insulin (n=33; mean age 51.6±8.8 years). Plasma ADMA levels were measured and HRV parameters were calculated from 24-hour Holter EKG recordings. The findings were compared with those of a control group consisting of 42 nondiabetic individuals (mean age 52.8±6.2 years). RESULTS Compared to the control group, plasma ADMA levels were significantly higher (p=0.007) and all HRV parameters were significantly reduced in both diabetic groups. However, ADMA levels and HRV parameters were similar in the two diabetic groups (p>0.05). Correlation analysis showed no significant relationship between plasma ADMA levels and HRV parameters. CONCLUSION Our findings show that plasma ADMA levels are increased and HRV is reduced in diabetic patients, indicating that these patients have both endothelial dysfunction and autonomic dysfunction, but plasma ADMA levels cannot be used to evaluate autonomic dysfunction.
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Affiliation(s)
- Ahmet Akyel
- Department of Cardiology, Medicine Faculty of Gazi University, Ankara, Turkey.
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Akyel A, Öksüz F, Karadeniz M, Yarlıoğlueş M, Ergün G, Cankurt T, Yozgat A, Keskin Arıel M, Aral Y, Murat SN. Atrial electromechanical delay in type 2 diabetes mellitus. Wien Klin Wochenschr 2014; 126:101-5. [DOI: 10.1007/s00508-013-0477-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 11/19/2013] [Indexed: 12/22/2022]
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Doğan M, Turak O, Akyel A, Grboviç E, Mendi MA, Oksüz F, Doğan A, Cimen T, Bilgin M, Sunman H, Yeter E, Aydoğdu S. Increased epicardial adipose tissue thickness is linked to aortic stiffness in patients with primary hypertension. Blood Press 2013; 23:222-7. [PMID: 24328851 DOI: 10.3109/08037051.2013.863991] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
AIMS In patients with hypertension (HT), increased aortic stiffness is related to higher cardiovascular morbidity and mortality. Recent investigations have shown that epicardial adipose tissue (EAT) is a new potential cardiometabolic risk factor. The aim of our study was to examine the relation between echocardiographically measured EAT thickness and aortic stiffness in patients with primary HT. METHODS The study included 144 newly diagnosed and untreated essential hypertensive outpatients. Transthoracic echocardiographic EAT thickness and aortic stiffness measurements were performed for all study participants. Afterwards patients were divided in two groups according to their median EAT thickness values. The patients with EAT thickness of < 7 mm were included in group 1 and patients with EAT thickness of ≥ 7 mm were included in group 2. RESULTS Aortic strain and distensibility parameters of group 2 were lower than in group 1. The aortic stiffness index of group 2 was found to be higher than group 1. Multivariate regression analysis revealed that EAT thickness was the only independent variable for all three parameters of aortic stiffness index, aortic strain and aortic distensibility. CONCLUSION In patients with newly diagnosed primary HT, increased EAT thickness was significantly linked to impaired aortic elastic properties independently of other conventional adiposity measurements.
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Affiliation(s)
- Mehmet Doğan
- Ministry of Health Dışkapı Yıldırım Beyazıt Research and Educational Hospital, Department of Cardiology , Ankara , Turkey
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Doğan M, Akyel A, Bilgin M, Erat M, Çimen T, Sunman H, Efe TH, Açıkel S, Yeter E. Can Admission Neutrophil to Lymphocyte Ratio Predict Infarct-Related Artery Patency in ST-Segment Elevation Myocardial Infarction. Clin Appl Thromb Hemost 2013; 21:172-6. [DOI: 10.1177/1076029613515071] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: In this study, we aimed to investigate the relationship between neutrophil to lymphocyte ratio (NLR) and infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 349 patients with STEMI were recruited to this retrospective study. Baseline characteristics were reviewed. Patency of IRA was evaluated by thrombolysis in myocardial infarction flow grade. Results: Of all patients, 293 patients formed the occluded IRA group and 56 patients formed the patent IRA group. The NLR was significantly higher in occluded IRA group (4.4 ± 4.1 vs 1.9 ± 1.1, P < .001). Glucose levels were also higher in occluded IRA group (171.3 ± 78.0 vs 144.7 ± 49.7, P = .022). Regression analysis demonstrated admission NLR and plasma glucose levels as independent predictors of IRA patency. Conclusion: In this study, we found that admission NLR and glucose levels were higher in patients with occluded IRA than in patients with STEMI. We also found that NLR and glucose levels were independent predictors of IRA patency. Because hemogram is a cheap, fast, and widely available test, it can be used in daily practice as a predictor of IRA patency.
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Affiliation(s)
- Mehmet Doğan
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Mehmet Erat
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Tolga Çimen
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Tolga Han Efe
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Sadık Açıkel
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Ministry of Health Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
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Aktas Yılmaz B, Akyel A, Kan E, Ercin U, Tavil Y, Bilgihan A, Cakır N, Arslan M, Balos Toruner F. Cardiac structure and functions in patients with asymptomatic primary hyperparathyroidism. J Endocrinol Invest 2013; 36:848-52. [PMID: 23666470 DOI: 10.3275/8961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND The data about cardiovascular (CV) changes in patients with asymptomatic primary hyperparathyroidism (PHPT) are scarce. AIM The aim of this study is to compare cardiac structure and functions in patients with asymptomatic PHPT and controls by using tissue Doppler echocardiography. SUBJECTS AND METHODS Thirty-eight patients with asymptomatic PHPT and 31 sex- and age-matched controls with similar cardiac risk factors were evaluated. RESULTS There was no significant difference in ejection fraction (EF) between the patients and the controls [64±5.95 vs 62±3.25% (p=0.094)]. Left ventricular mass index (LVMI) was significantly higher in patients than controls [105.96 (66.45-167.24) vs 93.79 (64.25- 139.25) g/m2, p=0.014]. There was a significant correlation between LVMI and serum calcium (Ca) (r=0.240, p<0.005). Myocardial performance index (MPI) was significantly higher in patients than controls [0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.001]. There was positive correlation between theMPI and serumCa levels (r=0.505, p<0.001), parathyroid hormone (PTH) levels (r=0.464, p<0.001) and LVMI (r=0.270, p<0.005). When the normotensive patients and controls were evaluated, the difference between the groups remained statistically significant considering LVMI and MPI [109 (66.45-167.24) g/m2 vs 94.17 (64.25-75.10) g/m2, p=0.03; and 0.49 (0.35-0.60) vs 0.39 (0.33-0.62), p<0.01, respectively]. There were significant correlations between MPI and Ca (r=0.566, p<0.001), and PTH (r=0.472, p<0.001). CONCLUSIONS Our study results showed that cardiacmorphology and diastolic functions are altered in the patients with asymptomatic PHPT. High serum PTH and Ca levels may have an impact on these CV changes. Whether these subtle CV changes would affect cardiac systolic functions and mortality in patients with asymptomatic PHPT should be investigated in further prospective studies.
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Affiliation(s)
- B Aktas Yılmaz
- Department of Endocrinology and Metabolism, Gazi University School of Medicine, Ankara, Turkey.
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Doğan M, Turak O, Akyel A, Grboviç E, Mendi MA, Öksüz F, Doğan A, Çimen T, Bilgin M, Sunman H, Yeter E, Aydoğdu S. Increased Epicardial Adipose Tissue Thickness is Linked with Aortic Stiffness in Patients with Essential Hypertension. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.277] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sunman H, Yayla K, Erat M, Şahan F, Nallbani A, Aytürk M, Efe TH, Bilgin M, Akyel A, Çimen T, Açıkel S, Doğan M, Yeter E. Influence of Chronic Aortic Insufficiency on the Coronary Artery Diameter. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.556] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Cay S, Celik E, Akyel A. Treatment of acute inferior wall myocardial infarction and ruptured abdominal aortic aneurysm: a hybrid approach. Int J Cardiol 2013; 168:613-4. [PMID: 23465223 DOI: 10.1016/j.ijcard.2013.01.212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 01/18/2013] [Indexed: 10/27/2022]
Affiliation(s)
- Serkan Cay
- Department of Cardiology, Yuksek Ihtisas Heart-Education and Research Hospital, Ankara, Turkey.
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Doğan M, Akyel A, Çimen T, Bilgin M, Sunman H, Kasapkara HA, Arslantaş U, Yayla KG, Açıkel S, Yeter E. Relationship Between Neutrophil to Lymphocyte Ratio and Slow Coronary Flow. Clin Appl Thromb Hemost 2013; 21:251-4. [DOI: 10.1177/1076029613498814] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: We evaluated the relationship between neutrophil to lymphocyte ratio (NLR) and slow coronary flow (SCF). Methods: A total of 180 participants were recruited to the present study. Of all the participants, 82 patients were with SCF and 98 participants were with normal coronary arteries. Basal characteristics were recorded. Coronary flow was quantified by thrombolysis in myocardial infarction frame count. Results: Basal characteristics were similar between the 2 groups. The NLR was significantly higher in the SCF group when compared to the control group (2.3 ± 0.8 and 1.5 ± 0.4 respectively, P < .001). In multiple logistic regression analysis, NLR remained as the independent predictor of SCF ( P < 0.001). Conclusions: Our findings showed that NLR was significantly higher in the SCF group when compared to the control group with normal coronary arteries. We also showed that NLR was related to the presence of SCF rather than the extent of SCF. Besides these findings, we also showed the NLR as an independent predictor of SCF.
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Affiliation(s)
- Mehmet Doğan
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Tolga Çimen
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Murat Bilgin
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Haci Ahmet Kasapkara
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Uğur Arslantaş
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Kadriye Gayretli Yayla
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Sadık Açıkel
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Education and Research Hospital, Ankara, Turkey
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Dogan M, Sari M, Acikel S, Akyel A, Albayrak M, Yeter E. Dense spontaneous echo contrast in the right heart chambers of a patient with autoimmune hemolytic anemia. Herz 2013; 39:767-9. [PMID: 23989765 DOI: 10.1007/s00059-013-3889-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 05/21/2013] [Accepted: 06/17/2013] [Indexed: 11/24/2022]
Affiliation(s)
- M Dogan
- Department of Cardiology, Ministry of Health Diskapi Yildirim Beyazit Research and Educational Hospital, 06110, Ankara, Turkey,
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Sahinarslan A, Erbas G, Kocaman SA, Bas D, Akyel A, Karaer D, Ergun MA, Arac M, Boyaci B. Comparison of radiation-induced damage between CT angiography and conventional coronary angiography. Acta Cardiol 2013; 68:291-7. [PMID: 23882875 DOI: 10.1080/ac.68.3.2983424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Both computed tomography (CTA) and conventional angiography (CCA) can provide direct visualization of the coronary arteries. The aim of the present study was to compare the radiation exposure between CTA and CCA and to search whether this amount of radiation causes significant DNA damage. METHOD Seventy-two patients who underwent CTA or CCA were enrolled prospectively. We recorded the radiation dosage that was used during the procedures and calculated the effective dose (ED). We determined the sister chromatid exchange (SCE) level from the blood samples which were drawn from the patients before and after the procedures. The change in SCE is used as the measure of DNA damage induced by the radiation. RESULTS The patients in the CTA (n = 36) and CCA groups (n= 36) had similar baseline characteristics. The ED was higher in CTA examinations compared to CCA examinations (14.2 +/- 2.7 vs 6.4 +/- 3.1, P <0.001). The SCE level increased significantly after both angiography methods (P <0.001). When the change in SCE after angiography was compared, we did not find a significant difference among the groups (2.73 +/- 1.6 vs 2.54 +/- 1.22, P= NS). CONCLUSION Although the patients who underwent CTA were exposed to a greater amount of radiation, the radiation-induced genetic damage was similar with both types of the procedures.
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Affiliation(s)
- Asife Sahinarslan
- Dept. of Cardiology, Gazi University, School of Medicine, Ankara, Turkey
| | - Gonca Erbas
- Dept. of Radiology, Gazi University, School of Medicine, Ankara, Turkey
| | | | - Duygu Bas
- Dept. of Cardiology, Gazi University, School of Medicine, Ankara, Turkey
| | - Ahmet Akyel
- Dept. of Cardiology, Gazi University, School of Medicine, Ankara, Turkey
| | - Derya Karaer
- Dept. of Medical Genetics, Gazi University, School of Medicine, Ankara, Turkey
| | - Mehmet Ali Ergun
- Dept. of Medical Genetics, Gazi University, School of Medicine, Ankara, Turkey
| | - Mehmet Arac
- Dept. of Radiology, Gazi University, School of Medicine, Ankara, Turkey
| | - Bulent Boyaci
- Dept. of Cardiology, Gazi University, School of Medicine, Ankara, Turkey
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Doğan M, Akyel A, Çimen T, Öksüz F, Çelik İE, Aytürk M, Murat SN, Yeter E. Relationship Between Neutrophil-to-Lymphocyte Ratio and Saphenous Vein Graft Disease in Patients With Coronary Bypass. Clin Appl Thromb Hemost 2013; 21:25-9. [DOI: 10.1177/1076029613488935] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: In this study, we aimed to investigate the relationship between saphenous vein graft disease (SVGD) and neutrophil-to-lympocyte ratio (NLR) with other possible confounding factors. Methods: A total of 120 patients were enrolled into the present study. Of all participants, 40 patients were with SVGD and 80 of them were with patent SVG. Results: The NLR, white blood cell (WBC) count, age of SVG, red cell distribution width (RDW), and mean platelet volume were significantly higher in the SVGD group. In regression analysis, NLR, WBC, RDW, and age of SVG remained as independent predictors of SVGD. Conclusion: To our knowledge, we showed for the first time that NLR is independently associated with SVGD. It can be easily used in this era, because it is easily available, widely used, and relatively cheap. Besides NLR, WBC count, SVG age, and RDW can also be used to predict SVGD.
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Affiliation(s)
- Mehmet Doğan
- Department of Cardiology, Diskapi Yildirim Bayezit Educational and Research Hospital, Ankara, Turkey
| | - Ahmet Akyel
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Tolga Çimen
- Department of Cardiology, Diskapi Yildirim Bayezit Educational and Research Hospital, Ankara, Turkey
| | - Fatih Öksüz
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - İbrahim Etem Çelik
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mehmet Aytürk
- Department of Cardiology, Diskapi Yildirim Bayezit Educational and Research Hospital, Ankara, Turkey
| | - Sani Namık Murat
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Ekrem Yeter
- Department of Cardiology, Diskapi Yildirim Bayezit Educational and Research Hospital, Ankara, Turkey
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Karadeniz M, Akyel A, Çelik İE, Cankurt T, Barış VÖ, Murat SN. An unusual etiology of Kounis syndrome; warble fly. Indian Heart J 2013; 65:358-9. [DOI: 10.1016/j.ihj.2013.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 04/03/2013] [Indexed: 11/24/2022] Open
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