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Correction to: Prevalence and Associated Factors of Inappropriate Dosing of Direct Oral Anticoagulants In Patients With Atrial Fibrillation: The ANATOLIA-AF Study. Cardiovasc Drugs Ther 2024; 38:601-603. [PMID: 36656413 DOI: 10.1007/s10557-023-07427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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PrevAleNce and Associated factors of inappropriaTe dosing of direct Oral anticoaguLants In pAtients with Atrial Fibrillation: the ANATOLIA-AF Study. Cardiovasc Drugs Ther 2024; 38:581-599. [PMID: 36527566 DOI: 10.1007/s10557-022-07409-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Inappropriate dosing of direct oral anticoagulants is associated with an increased risk of stroke, systemic embolism, major bleeding, cardiovascular hospitalization, and death in patients with atrial fibrillation. The main goal of the study was to determine the prevalence and associated factors of inappropriate dosing of direct oral anticoagulants in real-life settings. METHODS This study was a multicenter, cross-sectional, observational study that included 2004 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January and May 2021. The main criteria for inappropriate direct oral anticoagulant dosing were defined according to the recommendations of the European Heart Rhythm Association. RESULTS The median age of the study population was 72 years and 58% were women. Nine-hundred and eighty-seven patients were prescribed rivaroxaban, 658 apixaban, 239 edoxaban, and 120 dabigatran. A total of 498 patients (24.9%) did not receive the appropriate dose of direct oral anticoagulants. In a logistic regression model, advanced age, presence of chronic kidney disease and permanent atrial fibrillation, prescription of reduced doses of direct oral anticoagulants or edoxaban treatment, concomitant use of amiodarone treatment, and non-use of statin treatment were significantly associated with potentially inappropriate dosing of direct oral anticoagulants. CONCLUSION The study demonstrated that the prevalence of inappropriate direct oral anticoagulant dosing according to the European Heart Rhythm Association recommendations was 24.9% in patients with atrial fibrillation. Several demographic and clinical factors were associated with the inappropriate prescription of direct oral anticoagulants.
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Re: "Factors associated with favorable outcomes in cardiac arrest and target temperature management" by Kimura et al. Ther Hypothermia Temp Manag 2024. [PMID: 38634803 DOI: 10.1089/ther.2024.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
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Letter to the Editor; Comment on "Association between Premorbid Renin-Angiotensin-Aldosteron System Blockade and the Risk of Acute Kidney Injury in Critically Ill Patients". ACTA CARDIOLOGICA SINICA 2024; 40:258-259. [PMID: 38532810 PMCID: PMC10961631 DOI: 10.6515/acs.202403_40(2).20231206a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/06/2023] [Indexed: 03/28/2024]
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Sexual Dimorphism in the Heart Failure Population. Anatol J Cardiol 2024:173-174. [PMID: 38284567 PMCID: PMC10918282 DOI: 10.14744/anatoljcardiol.2023.4040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
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Academic Advancement in Türkiye. Turk Kardiyol Dern Ars 2023; 51:592-593. [PMID: 38164783 DOI: 10.5543/tkda.2023.89288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
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Real-World Evaluation of Anticoagulant Treatment Patterns in Patients with Atrial Fibrillation: Data from Multicenter ROTA Study. Turk Kardiyol Dern Ars 2023; 51:88-96. [PMID: 36916815 DOI: 10.5543/tkda.2022.98455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
OBJECTIVE Oral anticoagulant therapy is the cornerstone of atrial fibrillation management to prevent stroke and systemic embolism. However, there is limited real-world information regarding stroke and systemic embolism prevention strategies in patients with atrial fibrillation. The aim of the ROTA study is to obtain the real-world data of anticoagulant treatment patterns in patients with atrial fibrillation. METHODS The ROTA study is a prospective, multicenter, and observational study that included 2597 patients with atrial fibrillation. The study population was recruited from 41 cardiology outpatient clinics between January 2021 and May 2021. RESULTS The median age of the study population was 72 years (range: 22-98 years) and 57.4% were female. The median CHA2DS2-VASc and HAS-BLED scores were 4 (range: 0-9) and 1 (range: 0-6), respectively. Vitamin K antagonists and direct oral anticoagulants were used in 15.9% and 79.4% of patients, respectively. The mean time in therapeutic range was 52.9% for patients receiving vitamin K antagonists, and 76% of those patients had an inadequate time in therapeutic range with <70%. The most common prescribed direct oral anticoagulants were rivaroxaban (38.1%), apixaban (25.5%), and edoxaban (11.2%). The rate of overuse of vitamin K antagonists and direct oral anticoagulants was high (76.1%) in patients with low stroke risk, and more than one-fourth of patients on direct oral anticoagulant therapy were receiving a reduced dose of direct oral anticoagulants. Among patients who were on direct oral anticoagulant treatment, patients with apixaban treatment were older, had higher CHA2DS2-VASc and HAS-BLED scores, and had lower creatinine clearance than the patients receiving other direct oral anticoagulants. CONCLUSIONS The ROTA study provides important real-world information about anticoagulant treatment patterns in patients with atrial fibrillation.time in therapeutic range with <70%.
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Long-Term Prognosis of Patients with Heart Failure: Follow-Up Results of Journey HF-TR Study Population. Anatol J Cardiol 2023; 27:26-33. [PMID: 36680444 PMCID: PMC9893707 DOI: 10.14744/anatoljcardiol.2022.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/21/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite advances in therapeutic management of patients with heart failure, there is still an increasing morbidity and mortality all over the world. In this study, we aimed to present the 3-year follow-up outcomes of patients included in the Journey HF-TR study in 2016 that has evaluated the clinical characteristics and management of patients with acute heart failure admitted to the hospital and present a national registry data. METHODS The study was designed retrospectively between November 2016 and December 2019. Patient data included in the previously published Journey HF-TR study were used. Among 1606 patients, 1484 patients were included due to dropout of 122 patients due to inhospital death and due to exclusion of 173 due to incomplete data. The study included 1311 patients. Age, gender, concomitant chronic conditions, precipitating factors, New York Heart Association, and left ventricular ejection fraction factors were adjusted in the Cox regression analysis. RESULTS During the 3-year follow-up period, the ratio of hospitalization and mortality was 70.5% and 52.1%, respectively. Common causes of mortality were acute decompensation of heart failure and acute coronary syndrome. Angiotensin receptor blockers, betablockers, statin, and sacubitril/valsartan were found to reduce mortality. Hospitalization due to acute decompensated heart failure, acute coronary syndrome, lung diseases, oncological diseases, and cerebrovascular diseases was associated with the increased risk of mortality. Implantation of cardiac devices also reduced the mortality. CONCLUSIONS Despite advances in therapeutic management of patients with heart failure, our study demonstrated that the long-term mortality still is high. Much more efforts are needed to improve the inhospital and long-term survival of patients with chronic heart failure.
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The Safety and Tolerability of Nebivolol in Hypertensive Patients with Coronary Artery Disease and Left Ventricular Ejection Fraction ≥ 40%: A Population-Based Cohort Study (Nebivolol-TR Study). Turk Kardiyol Dern Ars 2022; 50:568-575. [PMID: 36317659 DOI: 10.5543/tkda.2022.21237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to assess the safety and tolerability of nebivolol in hypertensive patients with coronary artery disease and left ventricular ejection fraction ≥ 40% in a Turkish cohort. METHODS A total of 1015 hypertensive patients and coronary artery disease with left ventricular ejection fraction ≥ 40% were analyzed from 29 different centers in Turkey. Primary outcomes were the mean change in blood pressure and heart rate. Secondary outcomes were to assess the rate of reaching targeted blood pressure (<130/80 mmHg) and heart rate (<60 bpm) and the changes in the clinical symptoms (angina and dyspnea). Adverse clinical events and clinical outcomes including cardiovascular mortality, cardiovascular hospital admissions, or acute cardiac event were recorded. RESULTS The mean age of the study population was 60.3 ± 11.5 years (male: 54.2%). During a mean follow-up of 6 months, the mean change in blood pressure was -11.2 ± 23.5/-5.1 ± 13.5 mmHg, and the resting heart rate was -12.1 ± 3.5 bpm. Target blood pressure and heart rate were achieved in 76.5% and 37.7% of patients. Angina and functional classifications were improved by at least 1 or more categories in 31% and 23.2% of patients. No serious adverse events related to nebivolol were reported. The most common cardiovascular side effect was symptomatic hypotension (4.2%). The discontinuation rate was 1.7%. Cardiovascular hospital admission rate was 5% and hospitalization due to heart failure was 1.9% during 6 months' follow-up. Cardiovascular mortality rate was 0.1%. CONCLUSION Nebivolol was well tolerated and safe for achieving blood pressure and heart rate control in hypertensive patients with coronary artery disease and heart failure with preserved or mildly reduced ejection fraction.
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Association of the Atherogenic Index of Plasma with C-Reactive Protein and Urinary Albumin Excretion in a Normotensive Nondiabetic Population. Metab Syndr Relat Disord 2022; 20:421-427. [PMID: 35549355 DOI: 10.1089/met.2021.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The atherogenic index of plasma (AIP) is an indicator of atherogenic dyslipidemia and is significantly associated with the development of atherosclerotic cardiovascular disease. Previous studies showing the association of AIP with C-reactive protein (CRP) and microalbuminuria included hypertensive and diabetic patients. We aimed to determine the association of AIP with CRP and albuminuria in a normotensive and nondiabetic population. Methods: The study was conducted retrospectively. Two hundred thirty-three individuals without hypertension, diabetes, cardiovascular disease, malignancy, systemic inflammatory disease, nephrological disease, and active infection were determined and included in the study. Urinary albumin excretion was calculated from the albumin-creatinine ratio in fresh spot urine [urinary albumin-creatinine ratio (UACR)]. AIP risk groups were compared in terms of clinical and laboratory findings, and the correlation between AIP and CRP and UACR was evaluated. Results: A total of 233 people, with a mean age of 45.4 years and 139 (69.7%) of whom were male, were included in the study. One hundred thirty-eight (59.2%) individuals were found to be in the low-risk group, 29 (12.5%) in the medium-risk group, and 66 (28.3%) in the high-risk group, according to the AIP value. CRP and UACR were not different between the AIP risk groups (P: 0.141 and 0.441, respectively). A mild correlation was found between AIP and CRP (r: 0.192; P: 0.003), but no correlation was found between AIP and UACR (r: 0.086; P: 0.193). The stepwise linear regression analysis with model adjusted for possible confounders and AIP revealed that only body mass index was a significant predictor of CRP (β: 0.308; P < 0.001), while only systolic blood pressure was a significant predictor of UACR (β: 0.19; P: 0.004), but AIP was not. Conclusions: AIP was not associated with CRP and UACR in normotensive and nondiabetic individuals. This finding suggests that the relationship found in previous studies is related to the presence of hypertension or diabetes rather than the AIP.
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New Oral AntiCoagulant Use in REnal Disease and AF (NOACURE-AF) Where do we stand? An expert consensus view using the Delphi method. TURK KARDIYOLOJI DERNEGI ARSIVI : TURK KARDIYOLOJI DERNEGININ YAYIN ORGANIDIR 2021; 49:596-597. [PMID: 34623306 DOI: 10.5543/tkda.2021.21180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pheochromocytoma: An overlooked reversible cause of heart failure with reduced ejection fraction. TURK KARDIYOLOJI DERNEGI ARSIVI : TURK KARDIYOLOJI DERNEGININ YAYIN ORGANIDIR 2021; 49:501-505. [PMID: 34523598 DOI: 10.5543/tkda.2021.86087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Pheochromocytoma is a rare, benign tumor of adrenal medulla, and its clinical symptoms are related to catecholamine production. Clinical presentation may vary in a broad spectrum. Dilated or hypertrophied cardiomyopathies are the possible clinical outcomes of pheochromocytoma. Pheochromocytoma should be kept in mind in the differential diagnosis where resistant hypertension, palpitations, headache, and sweating accompany cardiomyopathy. Excessive adrenergic stimulation causing catecholamine discharge can trigger hypertension crisis, pulmonary edema, and myocardial necrosis. Here in this report, we aimed to present the case of a patient with pheochromocytoma related cardiomyopathy who was totally recovered after surgical excision of the tumor.
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Heart rate variability and heart rate turbulence in patients with vasovagal syncope. ACTA ACUST UNITED AC 2021; 61:54-59. [PMID: 34549694 DOI: 10.18087/cardio.2021.8.n1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/18/2022]
Abstract
Aim The autonomic nervous system plays an important role in the pathogenesis of vasovagal syncope, but studies on the effect of basal autonomic tone have found confusing results. The aim of this study was to investigate the effect of basal autonomic functions, as assessed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with vasovagal syncope.Material and methods Patients who underwent head-up tilt test (HUTT) due to unexplained syncope and who had a 24 hr Holter ECG recording in the same period were retrospectively analyzed. Patients with diabetes, a history of myocardial infarction, heart failure, orthostatic hypotension, atrial fibrillation, or use of vasoactive drugs, such as beta blockers, were excluded from the study. 161 patients who met these criteria were included in the study. Time domain HRV parameters from Holter ECG recordings and HRT parameters from patients with sufficient number of ventricular premature contractions were measured.Results The age of the patients varied from 16 to 75 yrs (mean: 44.8±18.5 yrs). HUTT results of 60 (37.2 %) patients were evaluated as positive. There were no significant differences in the basal demographic, clinical, or laboratory findings of the tilt-positive and tilt-negative patient groups. Likewise, there were no significant differences between the time domain HRV parameters and HRT parameters of both groups.Conclusion HRV and HRT parameters reflecting basal autonomic function were not different between HUTT positive and HUTT negative patient groups. These findings suggest that basal autonomic functions have no effect on vasovagal syncope pathogenesis.
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Aortic arch calcification: a novel parameter for prediction of masked hypertension. Blood Press Monit 2021; 26:257-262. [PMID: 33734125 DOI: 10.1097/mbp.0000000000000529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Masked hypertension is directly related to increased cardiovascular morbidity and mortality but remains underdiagnosed in clinical practice. The aim of the study was to search the role of aortic arch calcification (AAC) in the diagnosis of masked hypertension. METHODS AND RESULTS Among the patients who underwent ambulatory blood pressure monitoring (ABPM) in our clinic, those with office blood pressure (OBP) <140/90 mmHg were included in the study population. According to OBP, they were divided into two groups as normal (<130/85 mmHg) and high normal (130-139/85-89 mmHg) OBP groups. Subjects were also investigated for the presence of masked hypertension with ABPM and searched in masked hypertension and control groups. Masked hypertension was defined as in the latest 2017 ACC/AHA Hypertension guideline and was diagnosed as the daytime BP ≥ 135/85 mmHg and nighttime BP ≥ 120/70 mmHg. AAC was evaluated on direct X-ray telecardiography. Diagnosis of masked hypertension was searched depending on the presence of AAC and OBP measurements as well. A total of 216 volunteers were involved in the study [mean age 45.2 ± 12.2 years; female gender 120 (55.5%)]. One hundred ten volunteers (50.9%) had masked hypertension according to the ABPM. AAC was significantly more common in the masked hypertension group (44.5% vs. 26.4%) (P = 0.005). AAC had a positive predictive value of 79% in those with high normal OBP in the diagnosis of masked hypertension, and also AAC had a negative predictive value of 74% in those with normal OBP. CONCLUSION AAC can be used as a reliable diagnostic tool to exclude and predict masked hypertension during office examination.
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Determinants of reverse dipping blood pressure in normotensive, non-diabetic population with an office measurement below 130/85mmHg. Clin Exp Hypertens 2021; 43:647-652. [PMID: 34151642 DOI: 10.1080/10641963.2021.1925685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The role of dipping blood pressure pattern in normotensives is unclear. The study aims to search the circadian blood pressure rhythm and the clinical determinants related to reverse dipping pattern in a strictly selected, normotensive population.Methods: The study population was divided into three groups depending on the nocturnal dipping pattern as dipping, non-dipping, and reverse dipping. Basal clinical characteristics, anthropometric measurements, and spot urine samples from the first-morning void were collected. Clinical determinants related to the presence of reverse dipping pattern were tested by the Multiple Binary Logistic Regression analysis.Results: A total of 233 participants were involved in the study population (median age 45 years [40-50]). Dipping pattern was detected in 55.4%, non-dipping pattern in 33.0%, and reverse dipping pattern in 11.6% of the study population. There was no difference between the groups in terms of basal clinical features. Albumin-to-creatinine ratio (ACR) (p < .001) and hs-CRP levels (p = .006) were also statistically significant across the groups. ACR (HR: 1.195, 95% CI: 1.067-1.338, p = .002) and hs-CRP (HR: 2.438, 95% CI: 1.023-5.808, p = .044) were found to be related to the presence of reverse dipping blood pressure pattern.Conclusions: The absence of nocturnal physiological dipping is seen at a remarkable rate in the normotensive Turkish population. ACR and hs-CRP are the clinical determinants related to the presence of reverse dipping blood pressure pattern.
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Which is responsible for target organ damage in masked hypertension? Is it an increase in blood pressure or a disruption of the circadian rhythm? Clin Exp Hypertens 2021; 43:579-585. [PMID: 33870802 DOI: 10.1080/10641963.2021.1916946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern. METHODS Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP ≥135/85 mmHg and night BP ≥120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage. RESULTS 289 patients [mean age 46.6 ± 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives (p < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI (p < .05, for both). CONCLUSION Target organ damage seen in MH may be due to the deterioration of the dipping pattern.
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Comparison of clinical features and conventional echocardiographic characteristics of patients with heart failure with mid-range ejection fraction with and without interatrial block. Turk Kardiyol Dern Ars 2021; 49:247-248. [PMID: 33847277 DOI: 10.5543/tkda.2021.28782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Admission Tpe interval predicts reperfusion success in STEMI patients treated with fibrinolytic agents. Turk Kardiyol Dern Ars 2020; 48:49-57. [PMID: 31974326 DOI: 10.5543/tkda.2019.84789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Myocardial infarction is a leading cause of morbidity and mortality. Fibrinolytic administration is still a life-saving choice in ST-segment elevated myocardial infarction (STEMI), but the rate of successful reperfusion can be inconsistent. Failed reperfusion adds additional clinical risks to rescue percutaneous coronary intervention for STEMI patients. The interval between the peak of the T wave and the end of the T wave (Tpe) and the ratio of Tpe and a corrected measurement of the time from the start of the Q wave to the end of the T wave (Tpe/QTc ratio) are relatively new electrocardiogram (ECG) indices and have not yet been tested in STEMI patients treated with fibrinolytic agents. METHODS A total of 177 STEMI patients (mean age: 60.5±11.1 years; 138 men and 39 women) were enrolled in this retrospective study to evaluate ECG parameters. The Tpe interval and the Tpe/QTc ratio at baseline and at the 90th minute following the administration of fibrinolytic therapy were analyzed. The clinical and ECG findings of successful and failed reperfusion groups were compared. RESULTS Successful reperfusion was achieved in 119 patients (67.2%). The average Tpe interval on the admission ECG was shorter (91.7 vs. 100.9 milliseconds [ms]) (p<0.001) and shortened more in the successful reperfusion group (9.3 vs. 4.5 ms) (p<0.001). A cut-off value of 89.0 ms for the Tpe interval on the admission ECG was found to be related to reperfusion success with a sensitivity of 90.9%. CONCLUSION The Tpe interval was a predictor for reperfusion success in STEMI patients treated with fibrinolytic agents.
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Concomitant usage of thrombolytic therapy and therapeutic hypothermia in a case of sudden cardiac arrest due to massive pulmonary embolism. Turk Kardiyol Dern Ars 2019; 47:512-515. [PMID: 31483312 DOI: 10.5543/tkda.2018.65708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Massive pulmonary embolism is a well-known cause of sudden cardiac arrest in the adult population. Systemic fibrinolysis can be a life-saving option. Therapeutic hypothermia is highly recommended for nontraumatic sudden cardiac arrest victims to minimize neurological complications. However, there are limited data about the use of therapeutic hypothermia for sudden cardiac arrest victims also treated with systemic fibrinolysis. Concerns about hypothermia-related coagulopathy and a possible tendency to bleeding have limited the use of cooling therapy in such cases. Presently described is a case of sudden cardiac arrest due to a massive pulmonary embolism that was successfully treated with the concomitant usage of systemic fibrinolysis and therapeutic hypothermia.
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Evaluation of hs-CRP and sLOX-1 Levels in Moderate-to-High Risk Acute Coronary Syndromes. Endocr Metab Immune Disord Drug Targets 2019; 20:96-103. [PMID: 30961517 DOI: 10.2174/1871530319666190408145905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/02/2019] [Accepted: 03/05/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Risk stratification and prompt treatment are essential for the management of acute coronary syndromes (ACS) and prediction of future prognosis. Subclinical vascular inflammation and novel biomarkers play an important role in the clinical evaluation of ACS patients. METHODS We enrolled patients who were admitted to emergency service with unstable angina or non- ST segment elevated ACS (NSTE-ACS) in the study population. Coronary artery disease (CAD) complexity was determined via evaluation of angiographical views and peripheral venous blood samples were collected to measure highly sensitive C-reactive protein (hs-CRP) and soluble form of Lectin-like OxLDL receptor-1 (sLOX-1) levels. RESULTS A total of 40 patients were enrolled in the study population, mean age was 65.1±13.8 years and male gender percentage was 52.5%. Twenty-nine of patients had NSTE-ACS and 11 patients had unstable angina presentation. The modified Gensini scores were higher for patients with elevated hs- CRP and sLOX-1 levels. CONCLUSION Vascular inflammation displays the onset of ACS and it is related to more complex CAD in these patients. An increase in sLOX-1 expression is closely related to anatomical complexity of CAD in ACS.
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Mid-term clinical outcomes of new generation drug-eluting stents for treatment of diffuse coronary artery disease. TURK KARDIYOLOJI DERNEGI ARSIVI : TURK KARDIYOLOJI DERNEGININ YAYIN ORGANIDIR 2019; 46:659-666. [PMID: 30516523 DOI: 10.5543/tkda.2018.10.5543/tkda.2018.62678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Diffuse coronary artery disease (CAD) is a challenging issue in clinical cardiology practice. There are limited data about percutaneous revascularization in these patients. METHODS This study was an observational clinical evaluation. The records of patients with diffuse CAD revascularized with new-generation drug-eluting stents (DES) were researched retrospectively. Patients treated with multiple, overlapping new-generation DES (at least 60mm in length per vessel) were included. The incidence of major adverse cardiac events (MACE), defined as cardiac death, stent thrombosis, non-fatal myocardial infarction, and target lesion revascularization (TLR), at the end of the first year following the index procedure was recorded. RESULTS A total of 71 patients (with 75 coronary vessels) treated with new-generation DES for diffuse CAD were enrolled in the study. Zotarolimus-eluting stents were used in 48 vessels and biolimus A9-eluting stents were used in 27 vessels. The median total stent length per vessel was 75.0 mm (60.0-106.0) and the median number of stents implanted was 3 (2-4) for each vessel. The cumulative incidence of MACE at the end of the first year was 11.2% (8 patients). The presence of diabetes mellitus (DM) and ST-segment elevated myocardial infarction (STEMI) were defined as independent clinical risk factors related to MACE development. CONCLUSION Coronary artery revascularization with new-generation drug-eluting stents can be a good choice in the treatment of selected patients with diffuse CAD. DM and STEMI were found to be related to poorer clinical outcomes with this treatment option in our study.
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Kaplı Stent Trombozu Sonrası Perikardiyal Kanama: İki Ucu Keskin Bıçak. ACTA MEDICA ALANYA 2018. [DOI: 10.30565/medalanya.421746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Akut Miyokart Enfarktüsü Seyrinde Yeni Tanı Konulan Rektum Kanseri Yönetimi. ACTA MEDICA ALANYA 2018. [DOI: 10.30565/medalanya.383365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Successful treatment of massive pulmonary embolism with reteplase. Turk Kardiyol Dern Ars 2018; 46:143-146. [PMID: 29512616 DOI: 10.5543/tkda.2017.33568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Unexpected and unexplained out-of-hospital cardiac arrests have a poor prognosis. Difficulties encountered during the differential diagnosis phase may delay the administration of specific treatment for treatable and reversible causes of cardiac arrest. Massive pulmonary embolism is a reversible cause of cardiac arrest, but without proper management it has a high mortality rate. Presently described is the case of a 53-year-old female patient with a massive pulmonary embolism.
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Mid-term clinical outcomes of new generation drug eluting stents for treatment of diffuse coronary artery disease. Turk Kardiyol Dern Ars 2018. [DOI: 10.5543/tkda.2018.62678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Predictors of neurologically favorable survival among patients with out-of-hospital cardiac arrest: A tertiary referral hospital experience. Turk Kardiyol Dern Ars 2017; 45:489. [PMID: 28694409 DOI: 10.5543/tkda.2017.64609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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OP-125 [AJC » Cardiac imaging - Cardiac CT] Successful Treatment of Massive Pulmonary Embolism With Reteplase. Am J Cardiol 2017. [DOI: 10.1016/j.amjcard.2017.03.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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OP-121 [AJC » Diseases of aorta] Acquired Aneurysm of Sinus of Valsalva. Am J Cardiol 2017. [DOI: 10.1016/j.amjcard.2017.03.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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OP-194 [AJC » Chronic stable angına pectoris] Are Oxidative Stress Markers Helpful for Diagnosing the Disease and Determining its Complexity or Extent in Patients with Stable Coronary Artery Disease? Am J Cardiol 2017. [DOI: 10.1016/j.amjcard.2017.03.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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A rare coexistence: Type 1 congenital intrahepatic portosystemic shunt in a patient with non-compaction cardiomyopathy. INTERNATIONAL JOURNAL OF THE CARDIOVASCULAR ACADEMY 2016. [DOI: 10.1016/j.ijcac.2016.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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OP-054 The Relation Between Epicardial Adipose Tissue Thickness and Chadsvasc Score. Am J Cardiol 2016. [DOI: 10.1016/j.amjcard.2016.04.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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[A rare complication of percutaneous coronary intervention: aortic pseudoaneurysm]. Turk Kardiyol Dern Ars 2016; 44:90. [PMID: 26875141 DOI: 10.5543/tkda.2015.65748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Which is responsible for cardiac autonomic dysfunction in non-diabetic patients with metabolic syndrome: Prediabetes or the syndrome itself? Diabetes Metab Syndr 2016; 10:S13-S20. [PMID: 26610403 DOI: 10.1016/j.dsx.2015.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 09/27/2015] [Indexed: 01/28/2023]
Abstract
AIMS Cardiac autonomic dysfunction (CAD) is associated with both prediabetes and metabolic syndrome (MS). Heart rate variability (HRV) and heart rate turbulence (HRT) are reliable 24-h Holter-ECG findings of cardiac autonomic function. This study aimed to investigate the relation between MS and its components and CAD using HRV and HRT. MATERIALS AND METHODS The study included 80 non-diabetic patients with MS and 70 control subjects. All study population and the patients with MS were further analyzed for each diagnostic component of MS to investigate which criteria impaired HRV and HRT. RESULTS HRV and HRT parameters were disturbed in patients in the MS group. While impairment in HRV and HRT was significantly related to the presence of the fasting plasma glucose (FPG) criterion, there were no differences between groups in terms of the other 4 MS criteria. Moreover, FPG level was significantly correlated with SDNN (r=-0.352, p<0.001), SDNN index (r=-0.423, p<0.001), SDANN (r=-0.301, p<0.001), RMSSD (r=-0.237, p<0.001), pNN50 (r=-0.237, p<0.001), turbulence onset (TO) (r=0.365, p<0.001) and turbulence slope (TS) (r=-0.365, p<0.001). Among the MS diagnostic criteria, only FPG level was an independent determinant of all HRV and HRT parameters. CONCLUSIONS This study confirms the relation between MS and CAD. Increased FPG alone appears to be responsible for the mentioned findings among the 5 diagnostic criteria. Accordingly, CAD may be the result of prediabetes, not MS in patients with MS.
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Chronic aortic dissection and recoarctation as a late complication of aortic coarctation surgery. Turk Kardiyol Dern Ars 2015; 43:752. [PMID: 26717344 DOI: 10.5543/tkda.2015.57088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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OP-027 Aortic Distensibility in Postmenopausal Grandmultiparous Women with Metabolic Syndrome: A Comparison Between Revised NCEP ATP III and IDF Definitions in Diagnosing Metabolic Syndrome. Am J Cardiol 2014. [DOI: 10.1016/j.amjcard.2014.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Parathyroid Hormone Levels is Increased in Ischemic Cerebrovascular Events and Related with Decreased Aortic Distensibility. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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A giant left ventricular pseudoaneurysm presenting with severe mitral regurgitation. Hellenic J Cardiol 2013; 54:316-317. [PMID: 23912923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
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Case Images: Pulsus paradoxus due to left ventricular collapse with localized pericardial effusion. Turk Kardiyol Dern Ars 2013; 41:91. [PMID: 23518951 DOI: 10.5543/tkda.2013.24294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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OP-006 A GIANT LEFT VENTRICULAR PSEUDOANEURYSM PRESENTING WITH SEVERE MITRAL REGURGITATION. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70007-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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OP-060 RED CELL DISTRIBUTION WIDTH, MEAN PLATELET VOLUME AND NEUTROPHIL/LYMPHOCYTE RATIO ARE NOT USEFUL IN EVALUATION OF INTERMEDIATE CORONARY LESIONS. Int J Cardiol 2013. [DOI: 10.1016/s0167-5273(13)70061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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OP-249 MANAGEMENT OF MYOCARDIAL INFARCTION RELATED TO IN-SITU THROMBOSIS. Int J Cardiol 2012. [DOI: 10.1016/s0167-5273(12)70164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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