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Uysal OK, Turkoglu C, Duran M, Kaya MG, Sahin DY, Gur M, Cayli M. Predictive value of newly defined CHA2DS2-VASc-HSF score for severity of coronary artery disease in ST segment elevation myocardial infarction. Kardiol Pol 2016; 74:954-60. [DOI: 10.5603/kp.a2016.0054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 02/17/2016] [Accepted: 03/22/2016] [Indexed: 11/25/2022]
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Lee VWY, Tsai RBC, Chow IHI, Yan BPY, Kaya MG, Park JW, Lam YY. Cost-effectiveness analysis of left atrial appendage occlusion compared with pharmacological strategies for stroke prevention in atrial fibrillation. BMC Cardiovasc Disord 2016; 16:167. [PMID: 27581874 PMCID: PMC5007846 DOI: 10.1186/s12872-016-0351-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 08/19/2016] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Transcatheter left atrial appendage occlusion (LAAO) is a promising therapy for stroke prophylaxis in non-valvular atrial fibrillation (NVAF) but its cost-effectiveness remains understudied. This study evaluated the cost-effectiveness of LAAO for stroke prophylaxis in NVAF. METHODS A Markov decision analytic model was used to compare the cost-effectiveness of LAAO with 7 pharmacological strategies: aspirin alone, clopidogrel plus aspirin, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban. Outcome measures included quality-adjusted life years (QALYs), lifetime costs and incremental cost-effectiveness ratios (ICERs). Base-case data were derived from ACTIVE, RE-LY, ARISTOTLE, ROCKET-AF, PROTECT-AF and PREVAIL trials. One-way sensitivity analysis varied by CHADS2 score, HAS-BLED score, time horizons, and LAAO costs; and probabilistic sensitivity analysis using 10,000 Monte Carlo simulations was conducted to assess parameter uncertainty. RESULTS LAAO was considered cost-effective compared with aspirin, clopidogrel plus aspirin, and warfarin, with ICER of US$5,115, $2,447, and $6,298 per QALY gained, respectively. LAAO was dominant (i.e. less costly but more effective) compared to other strategies. Sensitivity analysis demonstrated favorable ICERs of LAAO against other strategies in varied CHADS2 score, HAS-BLED score, time horizons (5 to 15 years) and LAAO costs. LAAO was cost-effective in 86.24 % of 10,000 simulations using a threshold of US$50,000/QALY. CONCLUSIONS Transcatheter LAAO is cost-effective for prevention of stroke in NVAF compared with 7 pharmacological strategies. The transcatheter left atrial appendage occlusion (LAAO) is considered cost-effective against the standard 7 oral pharmacological strategies including acetylsalicylic acid (ASA) alone, clopidogrel plus ASA, warfarin, dabigatran 110 mg, dabigatran 150 mg, apixaban, and rivaroxaban for stroke prophylaxis in non-valvular atrial fibrillation management.
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Affiliation(s)
- Vivian Wing-Yan Lee
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, Hong Kong
| | - Ronald Bing-Ching Tsai
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, Hong Kong
| | - Ines Hang-Iao Chow
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, Hong Kong
| | - Bryan Ping-Yen Yan
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Mehmet Gungor Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Jai-Wun Park
- Charité University Medicine Berlin, Klinikum Coburg, Coburg, Germany
| | - Yat-Yin Lam
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Celik T, Balta S, Ozturk C, Kaya MG, Aparci M, Yildirim OA, Demir M, Unlu M, Demirkol S, Kilic S, Iyisoy A. Predictors of No-Reflow Phenomenon in Young Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology 2016; 67:683-689. [DOI: 10.1177/0003319715605977] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
No-reflow is of prognostic value in ST-segment elevation myocardial infarction (STEMI) but has not been extensively investigated in young patients. Young patients with STEMI admitted within 12 hours from symptom onset and treated by primary percutaneous coronary intervention (pPCI) were recruited. Patients were classified into 2 groups based on postintervention thrombolysis in myocardial infarction (TIMI) flow grade; no-reflow: TIMI flow grade 0, 1 or 2 (group 1; n = 27; 21 men, mean age: 42 ± 4 years); and angiographic success: TIMI flow grade 3 (group 2; n = 118; 110 men, mean age: 43 ± 4 years). Adjusted odds ratios were 13.79 for female gender ( P < .001; confidence interval [CI] = 1.88-101.26), 2.09 for pain to balloon time ( P < .017; CI = 1.14-3.812), 12.29 for high TIMI thrombus grade ( P = .012; CI = 1.74-86.94), 0.04 for tirofiban use ( P < .001; CI = 0.01-0.22), 5.19 for mean platelet volume (MPV; P < .001; CI = 2.44-11.01), and 1.008 for platelet–lymphocyte ratio (PLR; P = .034; CI = 1.001-1.016). In conclusion, female gender, pain to balloon time, high TIMI thrombus grade, tirofiban, MPV, and PLR were independent predictors of no-reflow in young patients with STEMI after pPCI.
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Affiliation(s)
- Turgay Celik
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Cengiz Ozturk
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Mustafa Aparci
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Osman A. Yildirim
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Mustafa Demir
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Murat Unlu
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Sait Demirkol
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Selim Kilic
- Department of Epidemiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
| | - Atila Iyisoy
- Department of Cardiology, School of Medicine, Gulhane Military Medical Academy, Etlik, Ankara, Turkey
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Dogdu O, Yarlioglues M, Kaya MG, Ardic I, Kilinc Y, Elcik D, Kelesoglu S, Akpek M, Sahin O, Cosgun S, Oguzhan N, Oguzhan A. Assessment of Atrial Conduction Time in Patients With Systemic Lupus Erythematosus. J Investig Med 2015. [DOI: 10.2310/jim.0b013e318207050a] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Senel S, Cobankara V, Taskoylu O, Karasu U, Karapinar H, Erdis E, Evrengul H, Kaya MG. The Safety and Efficacy of Etanercept on Cardiac Functions and Lipid Profile in Patients With Active Rheumatoid Arthritis. J Investig Med 2015; 60:62-5. [DOI: 10.2310/jim.0b013e31823a00f4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Buyukoglan H, Kaya MG, Ardic I, Yarlioglues M, Dogdu O, Bol C, Sahin O, Kanbay A, Koç F, Ozdogru I. Assessment of Atrial Conduction Time in Patients With Sarcoidosis. J Investig Med 2015. [DOI: 10.2310/jim.0b013e3182001680] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Senel S, Cobankara V, Taskoylu O, Guclu A, Evrengul H, Kaya MG. Effect of Infliximab Treatment on QT Intervals in Patients With Ankylosing Spondylitis: TABLE 1. J Investig Med 2015. [DOI: 10.2310/jim.0b013e3182330720] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Celık T, Balta S, Demır M, Yıldırım AO, Kaya MG, Ozturk C, Demırkol S, Unlu M, Kılıc S, Aydın İ, Iyısoy A. Predictive value of admission red cell distribution width-platelet ratio for no-reflow phenomenon in acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Cardiol J 2015; 23:84-92. [PMID: 26503078 DOI: 10.5603/cj.a2015.0070] [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] [Received: 06/05/2015] [Revised: 08/16/2015] [Accepted: 09/16/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The red cell distribution width-platelet ratio (RPR), a novel inflammatory marker is currently used to predict inflammation in chronic diseases. It may be associated with adverse outcomes among artery disease but its prognostic value in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) has not been fully investigated. There is no data regarding the association between RPR and in-hospital major adverse cardiovascular events (MACEs). This study evaluated the relations between pre-procedural RPR and the in-hospital and long-term outcomes in STEMI patients undergoing primary PCI. METHODS This study included 580 STEMI patients (77% men, mean age: 59 ± 12 years). The patients were divided into two groups according to thrombolysis in myocardial infarction (TIMI) flow grades after primary PCI. No-reflow was defined as a post-PCI TIMI flow grade of 0, 1 or 2 (group 1). Angiographic success was defined as TIMI flow grade 3 (group 2). RESULTS Whole blood cell count, neutrophil and lymphocyte percentages, red cell distribution width, platecrit, neutrophil-lymphocyte ratio (NLR) and RPR values were higher among patients with no-reflow. On multivariate analysis, pain to balloon time, multivessel disease, TIMI thrombus grade, tirofiban, aspirin, previous coronary artery disease, NLR, platecrit and RPR remained independent predictors of no-reflow after primary PCI. Patients in no-reflow group tended to be higher percent in-hospital MACE, including nonfatal myocardial infarction and cardiovascular mortality compared to the reflow patients. CONCLUSIONS Admission NLR, platecrit and RPR are independent correlates of no-reflow and in-hospital MACEs among patients with STEMI undergoing primary PCI.
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Affiliation(s)
| | - Sevket Balta
- Gulhane Medical Faculty, Dept. of Cardiology, Ankara, Turkey.
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Kaya MG, Yildirim S, Calapkorur B, Akpek M, Unluhizarci K, Kelestimur F. Metformin improves endothelial function and carotid intima media thickness in patients with PCOS. Gynecol Endocrinol 2015; 31:401-5. [PMID: 25791462 DOI: 10.3109/09513590.2015.1006188] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Oral contraceptive pills (OCP) are widely used for treating women with polycystic ovary syndrome (PCOS). Metformin has beneficial effects on insulin resistance and endothelial functions. The aim of this study was to investigate the effects of treatment with drospirenone/ethinyl estradiol (EE) alone or in combination with metformin on the flow-mediated vasodilatation (FMD) and carotid intima media thickness (CIMT) in women with PCOS. METHODS Fifty women with PCOS (mean age 23 ± 5) were randomized to oral treatment of OCP alone (n = 25) or an OCP combination with metformin (n = 25) for 6 months. FMD from the brachial artery and CIMT were calculated. The hormonal profile, HOMA-IR score, basal insulin and glucose levels were studied in both groups. Before and after 6 months' treatment, echocardiographic measurements and laboratory tests were also obtained. RESULTS After 6 months' treatment we observed a small decrease in FMD in the OCP group (14.9 ± 9.4 versus 14.4 ± 9.9, p = 0.801) and a slight increase in the combination group (14.5 ± 9.1 versus 15.0 ± 8.0, p = 0.715) but neither of them reached significance. CIMT increased in the OCP group (0.048 ± 0.011 to 0.050 ± 0.010 cm, p = 0.433) and decreased slightly in the combination group (0.049 ± 0.012, 0.048 ± 0.011 cm, p = 0.833). CONCLUSION We demonstrated that adding metformin to OCP treatment may have beneficial effect on FMD and CIMT that represent vascular function in patients with PCOS. These results suggest that adding metformin to OCP treatment for PCOS could preserve the cardiovascular system and improve it.
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Kaya MG, Karadavut S. Percutaneous treatment of aortic coarctation with new generation self expandable stent system and the images of 320-slice tomographic angiography. Int J Cardiol 2015; 184:483. [PMID: 25756570 DOI: 10.1016/j.ijcard.2015.02.110] [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: 01/17/2015] [Accepted: 02/27/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Mehmet Gungor Kaya
- Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey
| | - Serhat Karadavut
- Erciyes University School of Medicine, Department of Cardiology, Kayseri, Turkey.
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Oz F, Cizgici AY, Kaya MG, Kurt M, Basibuyuk M, Tufan F, Oflaz H. Low bilirubin levels are associated with coronary slow flow phenomenon. Kardiol Pol 2015; 73:40-5. [DOI: 10.5603/kp.a2014.0117] [Citation(s) in RCA: 6] [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: 12/04/2013] [Revised: 03/01/2014] [Accepted: 04/22/2014] [Indexed: 11/25/2022]
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Sahin O, Akpek M, Sarli B, Baktir AO, Savas G, Karadavut S, Elcik D, Saglam H, Kaya MG, Arinc H. Association of red blood cell distribution width levels with severity of coronary artery disease in patients with non-ST elevation myocardial infarction. Med Princ Pract 2015; 24:178-83. [PMID: 25531370 PMCID: PMC5588291 DOI: 10.1159/000369396] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 10/28/2014] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the association of the levels of red blood cell distribution width (RDW) with the severity of atherosclerosis and to determine whether or not the RDW level on admission is an independent predictor of all-cause mortality in patients with non-ST elevation myocardial infarction (NSTEMI). MATERIALS AND METHODS A total of 335 consecutive patients with NSTEMI were enrolled in this study. The patients were divided into high (n = 105) and low (n = 230) SYNTAX groups. The high SYNTAX group was defined as patients with a value in the third tertile (SYNTAX score, SXscore ≥12), while the low SYNTAX group was defined as those with a value in the lower 2 tertiles (SXscore <12). The high RDW group (n = 152) was defined as patients with RDW >14.25% and the low RDW group (n = 183) as those with RDW ≤14.25%. All-cause mortality was followed up to 38 months. RESULTS The mean follow-up period was 18 ± 11 months. The RDW levels of patients were significantly higher in the high SYNTAX group than in the low SYNTAX group (15.2 ± 1.8 vs. 14.2 ± 1.2, p < 0.001). Pearson's coefficients were used to determine the degree of association between RDW levels and SXscore and also between RDW levels and high-sensitivity C-reactive protein. There was a significant correlation between RDW levels and SXscore (r = 0.460, p < 0.001). Also, there was a significant correlation between RDW levels and high-sensitivity C-reactive protein (r = 0.180, p = 0.001). All-cause mortality rate was not significantly different between the high and low RDW groups (log-rank, p = 0.621). CONCLUSION RDW levels were independently associated with high SXscore but were not associated with long-term mortality in NSTEMI patients.
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Affiliation(s)
- Omer Sahin
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
- * Omer Sahin, MD, Department of Cardiology, Kayseri Education and Research Hospital, TR-38039 Kayseri (Turkey) E-Mail
| | - Mahmut Akpek
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Bahadir Sarli
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Ahmet Oguz Baktir
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Goktug Savas
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Serhat Karadavut
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Deniz Elcik
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hayrettin Saglam
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Huseyin Arinc
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
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Elitok A, Ikitimur B, Onur I, Oz F, Emet S, Karaayvaz EB, Serbest NG, Sarikaya R, Kasali K, Bilge AK, Kaya MG, Mercanoglu F, Oflaz H. The relationship between T-wave peak-to end interval and ST segment recovery on intracoronary ECG during primary PCI. Eur Rev Med Pharmacol Sci 2015; 19:1086-1091. [PMID: 25855936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE T-wave peak to end interval (TPE) is a measure of repolarization dispersion, which has been reported as a major arrhythmogenic factor post acute myocardial infarction. The aim of our study was to investigate the changes in TPE in this patient population with regard to peri-procedural intracoronary ECG findings. PATIENTS AND METHODS Forty-four patients (34 male and mean age of 54.9 ± 10.9 years) with acute STEMI were included. Intracoronary ECG was performed during primary PCI. TPE indices were calculated before and after the procedure. Measurement of the intracoronary ST-segment was carried out before and just after coronary blood flow was established in the infarct related artery. Intracoronary ST-segment resolution (IC-STR) was defined as ≥ 1 mm compared to baseline. RESULTS There was no difference with respect to baseline characteristics when patients with IC-STR were compared with patients without IC-STR. TPE values decreased significantly after primary PCI in patients with IC-STR (80.9 ± 22.8 ms vs. 65.8 ± 14.4 ms; p < 0.001) whereas they did not change significantly after PCI in patients without IC-STR (79.2 ± 20.9 ms vs. 68.5 ± 16.3 ms; p = 0.18). CONCLUSIONS TPE measured from surface ECG recordings is significantly reduced in STEMI patients with successful reperfusion after primary PCI, as determined by IC-ECG recordings.
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Affiliation(s)
- A Elitok
- Department of Cardiology, Istanbul University, School of Medicine, Istanbul, Turkey.
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Calapkorur B, Kelesoglu S, Sarli B, Turasan A, Arinc H, Kaya MG. Atrial electromechanical delay is impaired in patients with psoriasis. Med Princ Pract 2015; 24:30-5. [PMID: 25138738 PMCID: PMC5588181 DOI: 10.1159/000365760] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 07/07/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE In this study, we aimed to investigate atrial electromechanical delay (EMD) in patients with psoriasis. SUBJECTS AND METHODS A total of 43 patients with psoriasis (26 mild-moderate, 17 severe) and 17 healthy control subjects were enrolled. Patients with psoriasis were divided into two groups: the mild-moderate group and the severe group according to their psoriasis area severity index (PASI) scores. Atrial EMD was measured from the lateral mitral annulus and called 'PA lateral', from the septal mitral annulus, called 'PA septal', and from the right ventricle tricuspid annulus, called 'PA tricuspid'. Atrial EMD was defined as the time interval from the onset of atrial electrical activity (P wave on surface ECG) to the beginning of mechanical atrial contraction (late diastolic A wave). All three groups were compared with each other, and correlation analysis was performed to investigate the relationship between the PASI score and interatrial EMD. RESULTS PA lateral was significantly higher in both the mild-moderate psoriasis group and the severe psoriasis group compared to controls (69 ± 12 and 78 ± 13 vs. 60 ± 6 ms; p = 0.001). Also, PA septal (63 ± 11 vs. 53 ± 6 ms; p = 0.005, post hoc analysis) and PA tricuspid (49 ± 7 vs. 41 ± 5 ms; p = 0.009, post hoc analysis) were significantly higher in the severe psoriasis group than in the control group. Correlation analysis revealed that the PASI score was well correlated with PA lateral (r = 0.520, p < 0.001), PA septum (r = 0.460, p = 0.002), interatrial EMD (r = 0.371, p = 0.014) and intra-atrial EMD (r = 0.393, p = 0.009). CONCLUSION Atrial EMD was prolonged in patients with psoriasis. The measurement of atrial EMD might be used to determine the risk of development of AF in patients with psoriasis.
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Affiliation(s)
- Bekir Calapkorur
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Saban Kelesoglu
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Bahadir Sarli
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
- *Bahadir Sarli, MD, Department of Cardiology, Kayseri Education and Research Hospital, TR–38010 Kayseri (Turkey), E-Mail
| | - Abdullah Turasan
- Department of Dermatology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Huseyin Arinc
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Department of Cardiology, Erciyes University, School of Medicine, Kayseri, Turkey
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Simsek Y, Kaya MG, Tanriverdi F, Çalapkorur B, Diri H, Karaca Z, Unluhizarci K, Kelestimur F. Evaluation of long-term pituitary functions in patients with severe ventricular arrhythmia: a pilot study. J Endocrinol Invest 2014; 37:1057-64. [PMID: 25107344 DOI: 10.1007/s40618-014-0142-1] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 07/24/2014] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), stroke and cerebrovascular disease (CVD) are identified as risk factors for hypopituitarism. Pituitary dysfunction after TBI, SAH, and CVD may present in the acute phase or later in the course of the event. Chronic hypopituitarism, particularly growth hormone (GH) deficiency is related to the increased cardiovascular morbidity and mortality. In patients with serious ventricular arrhythmias, who need cardiopulmonary resuscitation, brain tissue is exposed to short-term severe ischemia and hypoxia. However, there are no data in the literature regarding pituitary dysfunction after ventricular arrhythmias. PATIENTS AND METHODS Forty-four patients with ventricular arrhythmias [ventricular tachycardia (VT), ventricular fibrillation (VF)] (mean age, 55.6 ± 1.8 years; 37 men, 7 women) were included in the study. The patients were evaluated after mean period of 21.2 ± 0.8 months from VT-VF. Basal hormone levels, including serum free triiodothyronine (fT3), free thyroxine (fT4), TSH, ACTH, prolactin, FSH, LH, total testosterone, estradiol, IGF-1, and cortisol levels were measured in all patients. To assess (GH)-insulin like growth factor-1 (IGF-1) axis, glucagon stimulation test was performed and 1 µg ACTH stimulation test was used for assessing hypothalamic-pituitary-adrenal (HPA) axis. RESULTS The frequencies of GH, gonadotropin and TSH deficiency were 27.2, 9.0, 2.2%, respectively. Mean IGF-1 levels were lower in GH deficiency group, but it was not statistically significant. CONCLUSION The present preliminary study showed that ventricular arrhythmias may result in hypopituitarism, particularly in growth hormone deficiency. Unrecognized hypopituitarism may be responsible for some of the cardiovascular problems at least in some patients.
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Affiliation(s)
- Y Simsek
- Department of Endocrinology, Erciyes University Medical School, 38039, Kayseri, Turkey
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Kaya MG, Akpek M, Celebi A, Saritas T, Meric M, Soylu K, Karapinar H, Lam YY. A multicentre, comparative study of Cera septal occluder versus AMPLATZER Septal Occluder in transcatheter closure of secundum atrial septal defects. EUROINTERVENTION 2014; 10:626-31. [DOI: 10.4244/eijy14m07_04] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kucukdurmaz Z, Karavelioglu Y, Karapinar H, Gul I, Yilmaz A, Yarlioglues M, Akpek M, Kaya MG. Hypertensive response to exercise in dipper and non-dipper normotensive diabetics. Clin Exp Hypertens 2014; 36:275-9. [DOI: 10.3109/10641963.2013.789050] [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] [Indexed: 11/13/2022]
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Kaya MG, Simsek Z, Sarli B, Buyukoglan H. Myocardial performance index for detection of subclinical abnormalities in patients with sarcoidosis. J Thorac Dis 2014; 6:429-37. [PMID: 24822099 DOI: 10.3978/j.issn.2072-1439.2014.03.19] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 03/10/2014] [Indexed: 01/12/2023]
Abstract
AIM The aim of this study was to evaluate ventricular functions in patients with sarcoidosis without an obvious heart disease by using tissue Doppler-derived left and right ventricular myocardial performance index (MPI). METHODS The study population included 45 patient with sarcoidosis (29 men, 16 women; mean age, 44±10 years, mean disease duration, 4.2±2.7 years) and 45 healthy control subjects (31 men, 14 women; mean age, 41±8 years). Cardiac functions were determined using echocardiography, consisting of standard two-dimensional and conventional Doppler and tissue Doppler imaging (TDI). Myocardial tissue Doppler velocities [peak systolic (Sa), early diastolic (Ea), and late diastolic velocities (Aa)] were recorded using spectral pulsed Doppler from the LV free wall, septum, and RV free wall from the apical four chamber view. MPI was also calculated by TDI. RESULTS The conventional echocardiographic parameters and tissue Doppler measurements were similar between the patients and controls. Left ventricular MPI (0.490±0.092 vs. 0.396±0.088, P=0.010) and right ventricular MPI (0.482±0.132 vs. 0.368±0.090, P=0.006) were significantly higher in patients with sarcoidosis than the control subjects. There was a correlation between the disease duration and right and left ventricular MPI (r=0.418, P=0.005; r=0.366, P=0.013, respectively). There was also a correlation between the systolic pulmonary arterial pressure and right ventricular MPI but not left ventricular MPI (r=0.370, P=0.012; r=0.248, P=0.109, respectively). In receiver operating characteristics curve analysis, the cutoff value of left ventricular MPI >0.46 had 92% sensitivity and 64% specificity in predicting left ventricular diastolic dysfunction. CONCLUSIONS We have demonstrated that tissue Doppler-derived myocardial left and right ventricular MPI were impaired in sarcoidosis patients, although systolic function parameters were comparable in the patients and controls, showed a subclinic impaired ventricular functions in patients with sarcoidosis.
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Affiliation(s)
- Mehmet Gungor Kaya
- 1 Department of Cardiology, 2 Department of Respiratory Disease, Erciyes University School of Medicine, Kayseri, Turkey
| | - Zuhal Simsek
- 1 Department of Cardiology, 2 Department of Respiratory Disease, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bahadir Sarli
- 1 Department of Cardiology, 2 Department of Respiratory Disease, Erciyes University School of Medicine, Kayseri, Turkey
| | - Hakan Buyukoglan
- 1 Department of Cardiology, 2 Department of Respiratory Disease, Erciyes University School of Medicine, Kayseri, Turkey
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Koc F, Ozdemir K, Altunkas F, Celik A, Dogdu O, Karayakali M, Gul EE, Erkorkmaz U, Kadi H, Akpek M, Kaya MG. Sodium bicarbonate versus isotonic saline for the prevention of contrast-induced nephropathy in patients with diabetes mellitus undergoing coronary angiography and/or intervention: a multicenter prospective randomized study. J Investig Med 2014; 61:872-7. [PMID: 23552179 DOI: 10.2310/jim.0b013e31828e9cab] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Contrast-induced nephropathy (CIN) is a leading cause of acute renal failure and affects mortality and morbidity. Although the incidence of CIN is quite low in the general population, CIN incidence is significantly increased in patients with diabetes mellitus (DM). OBJECTIVES We compared the efficacy of prophylactic use consisting of a saline infusion or a sodium bicarbonate infusion for the prevention of CIN in patients with DM. MATERIALS AND METHODS A total of 195 DM patients who had unselected renal function were randomized into 2 groups: 101 patients were assigned to saline infusion, and 94 patients were assigned to bicarbonate infusion. The primary end point was the maximum increase in the serum creatinine (SCr) level, whereas the secondary end point was the development of CIN after the procedure. RESULTS The maximum increase in SCr levels was significantly lower in the saline group than in the bicarbonate group: -0.03 mg/dL (IQR, -0.09 to 0.10 mg/dL) versus 0.02 mg/dL (IQR, -0.09 to 0.13 mg/dL) (P = 0.014). The rate of CIN was significantly lower in the saline group than in the bicarbonate group (5.9% vs 16%, P = 0.024). In the subset of study participants with a baseline creatinine clearance of less than 60 mL/min, the maximum increase in SCr levels was significantly lower, -0.08 mg/dL (IQR, -0.13 to -0.04 mg/dL), in the saline group than in the bicarbonate group, 0.03 mg/dL (IQR, -0.13 to 0.12 mg/dL) (P = 0.004). CONCLUSIONS The use of prophylactic hydration with isotonic saline before coronary procedures may decrease SCr levels and reduce the incidence of CIN in patients with DM with unselected renal functions to a greater extent than sodium bicarbonate can.
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Affiliation(s)
- Fatih Koc
- Medical Faculty, Cardiology Department, Gaziosmanpasa University, Tokat/Turkey
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Orscelik O, Kocyigit I, Akpek M, Dogdu O, Kaya C, Unal A, Sipahioglu M, Tokgoz B, Zengin H, Oymak O, Kaya MG. Mean platelet volume and its relation with arterial stiffness in patients with normotensive polycystic kidney disease. J Investig Med 2014; 61:597-603. [PMID: 23360844 DOI: 10.2310/jim.0b013e31828218e7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Autosomal-dominant polycystic kidney disease (ADPKD) demonstrates cardiovascular manifestations, such as hypertension, myocardial infarction, and increased carotid intimae-media thickness. These complications are the main cause of morbidity and mortality in patients with ADPKD. Platelet activation and arterial stiffness are important manifestations that independently predict cardiovascular events. In the present study, we aimed to investigate the relation between arterial stiffness, mean platelet volume (MPV), and highly sensitive C-reactive protein (hs-CRP) in patients with normotensive polycystic kidney disease. METHODS We included 30 normotensive subjects with ADPKD with an estimated glomerular filtration rate (eGFR) of 60 mL or more per minute per 1.73 m, 30 normotensive subjects with ADPKD with eGFR from 30 to 60 mL/min per 1.73 m, and 30 healthy controls in our study. Pulse wave velocity (PWV), eGFR, spot urine protein-creatinine ratio, MPV, and hs-CRP levels were measured in all participants. In addition, transthoracic echocardiography and ambulatory blood pressure monitoring were performed. RESULTS Age, sex, biochemical markers, eGFR, hemoglobin level, and platelet count were similar in the ADPKD subjects and the controls. There were significant differences in MPV (9.8 ± 0.7, 8.7 ± 0.8, and 8.0 ± 0.5 femtolitre; P < 0.001) and hs-CRP (6.8 ± 3.0, 5.3 ± 2.7, and 2.6 ± 0.52 mg/L; P < 0.001) in the groups. Additionally, PWV values were increased from healthy subjects to ADPKD patients who have decreased eGFR (5.5 ± 1.1, 8.8 ± 1.6, and 10.8 ± 1.2 m/s; P for trend <0.001). There were significant positive correlations between PWV and MPV (r = 0.401; P = 0.002) and hs-CRP (r = 0.343; P = 0.007) in the patients with ADPKD. Additionally, PWV was independently predicted by MPV (β = 0.286; P = 0.007), proteinuria (β = 0.255; P = 0.001), eGFR (β = -0.479; P < 0.001), and hs-CRP (β = 0.379; P < 0.001) in the patients with ADPKD. In addition, eGFR, as a sign of severity of disease, was independently predicted by MPV (β = -0.325; P = 0.003), PWV (β = -0.471; P < 0.001), and hs-CRP (β = -0.269; P = 0.008). CONCLUSIONS Our findings suggest that MPV and hs-CRP levels are associated with increased arterial stiffness in patients with early-stage ADPKD and those with late-stage ADPKD. Also, MPV and hs-CRP were independently associated with the severity of ADPKD.
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Affiliation(s)
- Ozcan Orscelik
- Department of Cardiology, Erciyes University Medical Faculty, Kayseri, Turkey
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Kaya MG, Elcik D, Akpek M, Kelesoglu S, Sahin O, Sarli B, Lam YY. Mean platelet volume levels predict pulmonary artery hypertension in patients with atrial septal defect. Acta Cardiol 2014; 69:161-6. [PMID: 24783467 DOI: 10.1080/ac.69.2.3017297] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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
INTRODUCTION Some reports have shown increased platelet aggregation and activation in patients with pulmonary artery hypertension (PAH). Mean platelet volume (MPV) is a simple and easy method of assessing platelet function. We aimed to investigate the mean platelet volume levels in patients with atrial septal defect (ASD) and the association between MPV levels and pulmonary artery hypertension. METHOD One hundred and forty consecutive patients (42 males and mean age 35 +/- 9 y) and forty healthy controls (15 males and mean age 35 +/- 4 y) were enrolled in the study between December 2008 and February 2011. RESULTS The ASD group demonstrated a significantly higher right ventricular size and pulmonary artery pressure than the control group (42 +/- 4 mm vs. 36 +/- 3 mm and 43 +/- 12 mmHg vs. 32 +/- 11 mmHg; P < 0.001 and P < 0.001, respectively). MPV levels were higher in the ASD group than the control group (9.3 +/- 1.2 fl vs. 8.6 +/- 0.8 fl, P < 0.001). There was a significant, positive correlation between MPV and systolic pulmonary artery pressure (PAP) (r = 0.542 and P < 0.001) in the ASD group. MPV was also significantly correlated with right ventricular size but not ASD diameter in the ASD group (r = 0.441, P < 0.001 and r = 0.126, P = 0.268, respectively). In receiver operating characteristics curve analysis, the cut-off value of MPV levels was > 8.7 fl and had 82% sensitivity and 63% specificity in predicting pulmonary artery hypertension. CONCLUSION In the present study, we found that MPV levels, an indicator of platelet activation, were significantly higher in patients with ASD and correlated with systolic pulmonary artery pressure and right ventricular diameter.
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Affiliation(s)
- Mehmet Gungor Kaya
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Deniz Elcik
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Mahmut Akpek
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Saban Kelesoglu
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Omer Sahin
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Bahadir Sarli
- Erciyes University School of Medicine, Dept. of Cardiology, Kayseri, Turkey
| | - Yat-Yin Lam
- Division of Cardiology, Dept. of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR
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Onur I, Ikitimur B, Oz F, Ekmekci A, Elitok A, Cagatay AA, Adalet K, Bilge AK, Kaya MG. Evaluation of Human Immunodeficiency Virus Infection-Related Left Ventricular Systolic Dysfunction by Tissue Doppler Strain Echocardiography. Echocardiography 2014; 31:1199-204. [DOI: 10.1111/echo.12569] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Imran Onur
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Baris Ikitimur
- Department of Cardiology; Cerrahpasa School of Medicine; Istanbul University; Istanbul Turkey
| | - Fahrettin Oz
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ahmet Ekmekci
- Department of Internal Medicine; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ali Elitok
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Arif Atahan Cagatay
- Department of Infectious Diseases and Clinical Microbiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Kamil Adalet
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology; Erciyes University School of Medicine Kayseri; Istanbul Turkey
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Sakalar C, Gurbuz E, Kalay N, Kaya MG. Higher frequency of rs4977574 (the G Allele) on chromosome 9p21.3 in patients with myocardial infarction as revealed by PCR-RFLP analysis. TOHOKU J EXP MED 2014; 230:171-6. [PMID: 23856978 DOI: 10.1620/tjem.230.171] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Single Nucleotide Polymorphisms (SNPs) can genetically predispose individuals for certain diseases and therefore are of clinical significance. Myocardial infarction (MI) was investigated in large genetic association studies revealing novel SNPs associated with MI. rs4977574 is a non-protein coding SNP (A>G) that is located in proximity of cyclin-dependent kinase inhibitor 2A and B genes on chromosome 9p21.3. rs4977574 has been recently found to be associated with the early-onset of MI, and rs4977574 is characterized by a guanine nucleotide (G) instead of an adenine nucleotide (A). rs4977574 has been reported to increase the risk for MI by 28%. In this study, we developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for detecting rs4977574 in Turkish population that consisted of 28 controls without previous MI record and 44 patients with MI. An intergenic genomic region containing the target SNP was amplified by PCR using patient's genomic DNA. Amplified DNA fragments were digested with a restriction enzyme, HhaI that cuts the amplified sequence if only the sequence has GCGC that carries rs4977574. After digestion with HhaI, DNA fragments were visualized in order to detect genotypes. PCR-RFLP revealed that the frequency of rs4977574, the MI-associated allele (G), was 56.8% (25/44) in patients with MI and 33.9% (9.5/28) in controls; the frequency of rs4977574 in patients with MI was significantly higher compared to controls (P = 0.027). Importantly, for the first time in this study, we have developed a novel PCR-RFLP method to detect the presence of rs4977574.
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Affiliation(s)
- Cagri Sakalar
- Department of Medical Biology, School of Medicine, Erciyes University, Kayseri, Turkey
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Kaya MG, Sahin O, Akpek M. Reply to the Letter to the Editor Entitled “The Prognostic Role of Serum Total Bilirubin in Non-ST-Segment Elevation Myocardial Infarction. Angiology 2013; 65:251. [DOI: 10.1177/0003319713513830] [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: 11/17/2022]
Affiliation(s)
- Mehmet Gungor Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Omer Sahin
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mahmut Akpek
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
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Sahin O, Akpek M, Kaya MG. Reply to Letter to the Editor Entitled “Conditions That may Affect Serum Bilirubin Levels Should be Kept in Mind in Patients With STEMI” by Dr Bugan. Angiology 2013; 64:643. [DOI: 10.1177/0003319713488933] [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)
- Omer Sahin
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mahmut Akpek
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
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Affiliation(s)
- Onur Kadir Uysal
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mustafa Duran
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Durmus Yildiray Sahin
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Zafer Elbasan
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Mustafa Gur
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Murat Cayli
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
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Kaya MG, Sarli B, Akpek M, Kaya EG, Yarlioglues M, Topsakal R, Lam YY. Evaluation of beta-blockers on left ventricular dyssynchrony and reverse remodeling in idiopathic dilated cardiomyopathy: A randomized trial of carvedilol and metoprolol. Cardiol J 2013; 21:434-41. [PMID: 24142686 DOI: 10.5603/cj.a2013.0149] [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: 07/03/2013] [Revised: 07/29/2013] [Accepted: 09/16/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The effect of b-blockage on cardiac dyssynchrony in idiopathic dilated cardio-myopathy (IDC) is unknown. This study evaluated the impact of carvedilol and metoprolol succinate on left ventricular (LV) dyssynchrony and reverse remodeling in IDC. METHODS In this small, prospective, double-blind study, we randomly assigned 81 IDC patients to receive carvedilol or metoprolol succinate. Echocardiographic measurements (dyssynchrony, LV volumes and ejection fraction [EF]) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were obtained at baseline and at first and sixth month of therapy. RESULTS A total of 74 (91%) patients completed all investigations at sixth month (38 and 36 taking carvedilol and metoprolol succinate, respectively). In the carvedilol group, reduction in LV end diastolic volume (D LVEDV at 6 months, 50 ± 15 mL to 40 ± 17 mL, p = 0.03) and increase in LVEF (D LVEF, 7 ± 2% to 5 ± 3%, p = 0.02) was higher compared to the metoprolol group. Also improvement in inter-ventricular dyssynchrony achieved with carvedilol was higher than metoprolol (D interventricular delay at 6 months, 11 ± 8 ms to 6 ± 7 ms, p = 0.03). However, improvement in intraventricular dyssynchrony was similar in the two groups (D intraventricular delay, 9 ± 7 ms to 9 ± 6 ms, p = 0.91). Improvements in LV mechanical dyssynchrony and reverse remodeling achieved with both drugs were accompanied by reduction in NT-proBNP levels in both carvedilol and metoprolol groups (1614 ± 685 pg/mL to 654 ± ± 488 pg/mL and 1686 ± 730 pg/mL to 583 ± 396 pg/mL, respectively, p < 0.001 for both). CONCLUSIONS Although reduction in LVEDV and increase in LVEF was higher with carvedilol, improvement in intraventricular dyssynchrony was similar in carvedilol and metoprolol groups.
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Affiliation(s)
| | | | | | | | | | | | - Yat-Yin Lam
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong.
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Kaya MG, Sahin O, Akpek M, Duran M, Uysal OK, Karadavut S, Cosgun MS, Savas G, Baktir AO, Sarli B, Lam YY. Relation between serum total bilirubin levels and severity of coronary artery disease in patients with non-ST-segment elevation myocardial infarction. Angiology 2013; 65:245-9. [PMID: 24101706 DOI: 10.1177/0003319713504820] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [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: 01/14/2023]
Abstract
We studied 403 consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI). This population was divided into tertiles according to the SYNTAX score (SXscore). The high SXscore group was defined as an SXscore ≥13, and the low SXscore group as an SXscore <13. The total bilirubin (sTB) and direct bilirubin levels of patients were significantly higher in the high SXscore group (P = .001 and P = .007, respectively). There was a correlation between sTB and SXscore (r = .495; P = .005). On multivariate linear regression analyses, age (β = .100; P = .041), sTB levels (β = .171; P = .005), low-density lipoprotein cholesterol (β = .121; P = .014), and troponin-I (β = .124; P = .011) remained independent correlates of high SXscore. The mean follow-up period was 18.2 months. All-cause mortality rate was higher in the high SXscore group but did not reach significance (P = .058). In conclusion, high sTB level is independently associated with severity of coronary artery disease in patients with NSTEMI. However, no association was found with long-term mortality.
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Affiliation(s)
- Mehmet Gungor Kaya
- 1Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
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Sarli B, Celik T, Kaya MG. Letter to editor: Late gadolinium enhancement on cardiac magnetic resonance images predicts reverse remodeling in patients with nonischemic cardiomyopathy treated with carvedilol. Int J Cardiol 2013; 168:3134-5. [DOI: 10.1016/j.ijcard.2013.04.033] [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] [Received: 03/10/2013] [Accepted: 04/06/2013] [Indexed: 10/26/2022]
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Uysal OK, Turkoglu C, Sahin DY, Duran M, Yıldırım A, Elbasan Z, Ozkan B, Tekin K, Kunak AU, Yilmaz Y, Kaya MG, Gur M, Cayli M. The Relationship Between Neutrophil-to-Lymphocyte Ratio and Coronary Collateral Circulation. Clin Appl Thromb Hemost 2013; 21:329-33. [DOI: 10.1177/1076029613503399] [Citation(s) in RCA: 10] [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: 01/01/2023] Open
Abstract
Neutrophil/lymphocyte ratio (NLR) has been proposed as a prognostic marker to determine systemic inflammatory response and atherosclerosis. Our aim was to determine the relationship between NLR and development of coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD). A total of 521 consecutive patients with stable CAD who underwent coronary angiography and documented total occlusion in one of those major coronary arteries were included in this study. Levels of fasting blood glucose, white blood cell, and NLR were significantly higher in patients with poor collateral than in those with good collateral. After multivariate analysis, high level of NLR was an independent predictor of CCC together with levels of fasting blood glucose. The receiver–operating characteristic analysis provided a cutoff value of 2.75 for NLR to predict poor CCC with 65% sensitivity and 68% specificity. We demonstrated an independent association between levels of NLR and development of CCC in patients with stable CAD.
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Affiliation(s)
- Onur Kadir Uysal
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Caner Turkoglu
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Durmus Yildiray Sahin
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Mustafa Duran
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Arafat Yıldırım
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Zafer Elbasan
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Bugra Ozkan
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Kamuran Tekin
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Aysegul Ulgen Kunak
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Yucel Yilmaz
- Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mustafa Gur
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | - Murat Cayli
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
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Uysal OK, Sahin DY, Duran M, Turkoglu C, Yildirim A, Elbasan Z, Ozkan B, Tekin K, Kunak AU, Yilmaz Y, Kaya MG, Gur M, Cayli M. Association between uric acid and coronary collateral circulation in patients with stable coronary artery disease. Angiology 2013; 65:227-31. [PMID: 23966572 DOI: 10.1177/0003319713500706] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Serum uric acid (SUA) levels have been proposed as a biomarker of coronary artery disease (CAD) and coronary collateral circulation (CCC). We investigated the association between SUA levels and development of CCC in patients with stable CAD. Consecutive patients (n = 480) with stable CAD who underwent coronary angiography and documented total occlusion in 1 of the major coronary arteries were included in this study. Levels of fasting blood glucose, white blood cell (WBC), creatinine, platelet count, and SUA were significantly higher in patients with poor CCC than in those with good CCC. After multivariate analysis, high levels of SUA were an independent predictor of CCC together with levels of fasting blood glucose and WBC. The receiver-operating characteristic analysis provided a cutoff value of 5.65 mg/dL for SUA to predict poor CCC with 60% sensitivity and 66% specificity. High levels of SUA may be associated with poor CCC in patients with stable CAD.
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Affiliation(s)
- Onur Kadir Uysal
- 1Department of Cardiology, Kayseri Education and Research Hospital, Kayseri, Turkey
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Sahin O, Akpek M, Kaya MG. Procedural complications may affect serum bilirubin levels in patients with ST-elevation myocardial infarction. Am J Cardiol 2013; 112:307. [PMID: 23830304 DOI: 10.1016/j.amjcard.2013.05.001] [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] [Received: 04/25/2013] [Revised: 05/05/2013] [Accepted: 05/05/2013] [Indexed: 10/26/2022]
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Kaya MG. Hyperuricemia and cardiovascular disease: is this relationship independent of the etiology of hyperuricemia? Cardiology 2013; 125:201-3. [PMID: 23796915 DOI: 10.1159/000351697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 04/24/2013] [Indexed: 11/19/2022]
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Yarlioglues M, Kaya MG, Ardic I, Dogdu O, Yarlioglues H, Zencir C, Ozdogru M, Akpek M, Kasapkara HA, Sarli B, Duran M, Dogan A, Ozdogru I, Oguzhan A. Dose-dependent acute effects of passive smoking on left ventricular cardiac functions in healthy volunteers. J Investig Med 2013; 60:517-22. [PMID: 22222229 DOI: 10.2310/jim.0b013e31823e9fb1] [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: 11/18/2022]
Abstract
OBJECTIVE We have previously shown that acute passive smoking impaired left ventricular diastolic function in healthy volunteers. The aim of this study was to determine whether length of exposure and/or ambient smoke concentration is the key determinant of this outcome. METHODS We measured blood carboxyhemoglobin (COHb)and lactate level to investigate the acute effects of passive smoking on tissue oxygenation. A total of 90 healthy nonsmoker volunteers were prospectively enrolled into the study. Each of 30 subjects were exposed to carbon monoxide (CO) less than 5.0 ppm smoke in group A for 30 minutes, to CO 5 to 10 ppm smoke in group B for 30 minutes, and to CO less than 5.0 ppm smoke in group C for 60 minutes. Hemodynamic parameters were obtained, blood samples for measuring COHb and lactate levels were taken and echocardiographic examinations were performed at baseline and after exposure to passive smoking. RESULTS Mean ± SD CO levels in groups A, B, and C were 4.2 ± 0.5 ppm, 9.2 ± 0.3 ppm, and 4.1 ± 0.8 ppm, respectively. There was no change in left ventricular systolic functions in all groups. Left ventricular diastolic functions were impaired in groups B and C, whereas no change was observed in group A. Carboxyhemoglobin and lactate levels increased after passive smoking in groups B and C. However, group B had significantly higher COHb and lactate levels compared to group C (P < 0.001). CONCLUSIONS Our results suggested that passive smoking at a certain dose in relation with length of exposure and ambient smoke concentration seems to cause relative left ventricular diastolic dysfunction.
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Duran M, Uysal OK, Gunebakmaz O, Yilmaz Y, Vatankulu MA, Turfan M, Duran AO, Ornek E, Cetin M, Murat SN, Kaya MG. Renal impairment and coronary collaterals in patients with acute coronary syndrome. Herz 2013; 39:379-83. [PMID: 23649321 DOI: 10.1007/s00059-013-3823-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/02/2013] [Accepted: 03/24/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We aimed to elucidate the relationship between mild-to-moderate renal impairment and the development of coronary collateral vessels (CCV) in patients with acute coronary syndrome (ACS). METHODS We enrolled 461 patients with ACS who underwent coronary angiography for the first time. The development of CCV was assessed with the Rentrop score. Kidney function was classified according to the estimated glomerular filtration rate (eGFR). The Gensini score was used to show the extent of atherosclerosis. RESULTS The mean eGFR value was 89.9 ± 24.3 U/l for patients with no development of collaterals and 82.7 ± 20.5 for patients who had CCV. The mean age was 59 ± 11 years and 349 patients (75.7 %) were male. Rentrop classifications 1-2-3 (presence of CCV) were determined in 222 (48.1 %) patients. The presence of CCV was significantly associated with low levels of eGFR (p = 0.001), increased serum creatinine levels (p = 0.034), high levels of serum albumin (0.036), and the Gensini score (p < 0.001). Multivariate analysis showed that the Gensini score was an independent predictor of the presence of CCV (OR = 1.090, 95 % CI: 1.032-1.151, p = 0.002). CONCLUSION We suggest that the association between mild-to-moderate renal impairment and the presence of CCV may be explained by increased myocardial ischemia and severe CAD.
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Affiliation(s)
- M Duran
- Department of Cardiology, Ankara Research and Education Hospital, Ankara, Turkey,
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Duran M, Uysal OK, Gunebakmaz O, Baran O, Turfan M, Ornek E, Cetin M, Murat SN, Yarlioglues M, Karadeniz M, Kurtul A, Kaya MG. Glomerular filtration rate is associated with burden of coronary atherosclerosis in patients with acute coronary syndrome. Angiology 2013; 65:350-6. [PMID: 23636853 DOI: 10.1177/0003319713486536] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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
We aimed to elucidate the relationship between mild to moderate renal impairements and burden of atherosclerosis in patients with acute coronary syndrome (ACS). A total of 380 patients with ACS were included in the study. Gensini and SYNTAX scores were also calculated. Kidney function was classified based on estimated glomerular filtration rate (eGFR) into stage 1: eGFR >90, stage 2: 60 to 89, and stage 3: 30 to 60 mL/min per 1.73 m(2). Gensini and SYNTAX scores were higher in stages 2 and 3 than in stage 1. Also, the number of diseased vessels, number of critical lesions (>50 and 70%), left main disease, and number of total occlusion vessels were higher in stages 2 and 3 than in stage 1. Multivariate linear regression analysis demonstrated that a decreased eGFR was an independent risk factor for SYNTAX and Gensini scores together with age and male gender.
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Affiliation(s)
- Mustafa Duran
- 1Ankara Research and Education Hospital, Ankara, Turkey
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Saritas T, Kaya MG, Yin Lam Y, Erdem A, Akdeniz C, Demir F, Erol N, Demir H, Celebi A. A comparative study of Cardi-O-Fix septal occluder versus Amplatzer septal occluder in percutaneous closure of secundum atrial septal defects. Catheter Cardiovasc Interv 2013; 82:116-21. [DOI: 10.1002/ccd.23301] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 06/27/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Turkay Saritas
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology; Erciyes University School of Medicine; Kayseri; Turkey
| | - Yat Yin Lam
- Division of Cardiology; SH Ho Cardiovascular and Stroke Centre; Department of Medicine and Therapeutics; Prince of Wales Hospital; The Chinese University of Hong Kong; Hong Kong; SAR
| | - Abdullah Erdem
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Celal Akdeniz
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Fadli Demir
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Nurdan Erol
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Halil Demir
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
| | - Ahmet Celebi
- Department of Pediatric Cardiology; Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center; Istanbul; Turkey
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Gunebakmaz O, Duran M, Kaya Z, Kaya MG. Contrast agent: a scapegoat for serum creatinine increase in patients with acute myocardial infarction undergoing coronary angiography. Angiology 2013; 64:400. [PMID: 23515412 DOI: 10.1177/0003319713481490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Duran M, Gunebakmaz O, Uysal OK, Ocak A, Yilmaz Y, Arinc H, Eryol NK, Ergin A, Kaya MG. Relation between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes. J Cardiol 2013; 61:295-8. [PMID: 23473769 DOI: 10.1016/j.jjcc.2012.12.011] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 11/23/2012] [Accepted: 12/04/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Elevated mean platelet volume (MPV) has been proposed as a risk factor for coronary artery disease (CAD) and is associated with poor clinical outcome in acute coronary syndrome (ACS). We aimed to evaluate the association of MPV with presence of coronary collateral vessel (CCV) in patients with ACS. METHODS A total of 417 patients with ACS were included in the study. All patients underwent coronary angiography on the first day after admission and patients with a greater than or equal to 80% obstruction in at least one epicardial coronary artery were included in the study. The CCVs are graded according to the Rentrop scoring system and a Rentrop grade 0 was accepted as no CCV development (group 1), Rentrop grade 1-2-3 were accepted as presence of CCV development (group 2). RESULTS The median of MPV was 9.1±1.4fl. Mean age was 60±12 year. Group 1 consisted of 233 (55.9%) patients and Group 2 consisted of 184 (44.1%) patients. Presence of CCV was significantly associated with high levels of MPV (p=0.005). Presence of CCV was also associated with presence of diabetes and systolic blood pressure. CONCLUSION High MPV on admission was associated with presence of CCV in patients with ACS.
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Affiliation(s)
- Mustafa Duran
- Kayseri Research and Education Hospital, Kayseri, Turkey.
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Kucukoglu S, Kaymaz C, Sagin Saylam G, Kula S, Alehan D, Akcevin A, Celiker A, Cicek S, Kaya MG, Tokgozoglu L. THE QUANTIFICATION OF FUNCTIONAL CLASS AND THE SIX-MINUTE WALKING DISTANCE IN PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL SHUNTS: CLINICAL AND HEMODYNAMIC CORRELATES. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61269-3] [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: 10/27/2022]
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Dogan A, Dogdu O, Ozdogru I, Yarlioglues M, Kalay N, Inanc MT, Ardic I, Celik A, Kaynar L, Kurnaz F, Eryol NK, Kaya MG. Cardiac effects of chronic graft-versus-host disease after stem cell transplantation. Tex Heart Inst J 2013; 40:428-434. [PMID: 24082373 PMCID: PMC3783135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Chronic graft-versus-host disease (GVHD) develops as a result of the immunologic response that donor T-lymphocytes generate against host tissue after allogeneic stem cell transplantation. We tried to elucidate the contribution of cardiac dysfunction to the high morbidity and mortality rates observed after GVHD. Forty patients who had undergone bone marrow transplantation were enrolled in this prospective study: 14 patients who had been diagnosed with chronic GVHD (manifestations beyond day 100 after hemopoietic cell transplantation) and 26 patients who had not. All patients had undergone baseline echocardiography before bone marrow transplantation and were monitored. After the expected period of time had elapsed for GVHD after transplantation, these patients were divided into 2 groups in accordance with whether or not they developed chronic GVHD. No significant differences were observed before bone marrow transplantation in the 2 groups' broad attributes or in their laboratory and echocardiographic findings (P >0.05). After transplantation, high-sensitivity C-reactive protein levels and erythrocyte sedimentation rates were significantly higher in the chronic GVHD group (P < 0.001 and P=0.01, respectively). Mean left ventricular mass was 227 ± 32.3 g in the GVHD group and 149.3 ± 27.4 g in the non-GVHD group (P < 0.001). The E/A flow rate was significantly higher in the non-GVHD group. This study shows that chronic GVHD increases left ventricular mass and impairs left ventricular diastolic function in patients who have developed chronic GVHD. In addition, it shows that inflammatory markers increase to higher levels in these patients. Comprehensive studies with larger samples are needed to more fully elucidate the cardiac effects of this disease.
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Affiliation(s)
- Ali Dogan
- Departments of Cardiology (Drs. Ardic, Celik, Dogan, Dogdu, Eryol, Inanc, Kalay, Kaya, Ozdogru, and Yarlioglues) and Hematology (Drs. Kaynar and Kurnaz), Erciyes University School of Medicine, 38100 Kayseri, Turkey
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Kalay N, Elcik D, Canatan H, Kaya MG, Yarlioglues M, Oguzhan A, Dweik RA, Aytekin M. Elevated Plasma Hyaluronan Levels in Pulmonary Hypertension. TOHOKU J EXP MED 2013; 230:7-11. [DOI: 10.1620/tjem.230.7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Nihat Kalay
- Department of Cardiology, Erciyes University, Faculty of Medicine
| | - Deniz Elcik
- Department of Cardiology, Erciyes University, Faculty of Medicine
| | - Halit Canatan
- Department of Medical Biology, Erciyes University, Faculty of Medicine
- Genome and Stem Cell Center, Erciyes University
| | | | | | | | - Raed A. Dweik
- Pulmonary and Critical Care Medicine/Respiratory Institute, Cleveland Clinic
| | - Metin Aytekin
- Department of Medical Biology, Erciyes University, Faculty of Medicine
- Genome and Stem Cell Center, Erciyes University
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Uysal OK, Duran M, Ozkan B, Sahin DY, Tekin K, Elbasan Z, Akin F, Balli M, Gunebakmaz O, Arinc H, Kaya MG, Cayli M. Red cell distribution width is associated with acute myocardial infarction in young patients. Cardiol J 2012; 19:597-602. [DOI: 10.5603/cj.2012.0111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Akpek M, Kaya MG, Lam YY, Sahin O, Elcik D, Celik T, Ergin A, Gibson CM. Relation of neutrophil/lymphocyte ratio to coronary flow to in-hospital major adverse cardiac events in patients with ST-elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol 2012; 110:621-7. [PMID: 22608360 DOI: 10.1016/j.amjcard.2012.04.041] [Citation(s) in RCA: 161] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 04/26/2012] [Accepted: 04/26/2012] [Indexed: 11/25/2022]
Abstract
With the growing understanding of the role of inflammation in patients with atherosclerotic disease, studies have focused on high-sensitivity C-reactive protein (hs-CRP) and other inflammatory markers in their association with outcomes in ST-segment elevation myocardial infarction. The goal of this study was to investigate the association of the neutrophil/lymphocyte (N/L) ratio and in-hospital major adverse cardiac events (MACEs) in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). The association of hs-CRP and N/L ratio on admission with Thrombolysis In Myocardial Infarction (TIMI) flow grade after PCI was assessed in 418 consecutive primary patients with PCI. The N/L ratio was significantly higher in the no-reflow group (TIMI grade 0/1/2 flow, n = 158) compared to that of the normal-flow group (TIMI grade 3 flow, n = 260, 4.6 ± 1.7 vs 3.1 ± 1.9, p <0.001). In-hospital MACEs were significantly higher in patients with no reflow (23% vs 7%, p <0.001). There was a significant and positive correlation between hs-CRP and N/L ratio (r = 0.657, p <0.001). In receiver operating characteristic analysis, N/L ratio >3.3 predicted no reflow with 74% sensitivity and 83% specificity. In a multivariate regression model, N/L ratio remained an independent correlate of no reflow (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.34 to 1.76, p <0.001) and in-hospital MACEs (OR 1.14, 95% CI 0.98 to 1.32, p = 0.043). The N/L ratio, an inexpensive and easily measurable laboratory variable, is independently associated with the development of no reflow and in-hospital MACEs in patients with ST-segment elevation myocardial infarction undergoing primary PCI.
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Karavelioglu Y, Karapinar H, Gul İ, Kucukdurmaz Z, Yilmaz A, Akpek M, Kaya MG. Blood pressure response to exercise is exaggerated in normotensive diabetic patients. Blood Press 2012; 22:21-6. [PMID: 22784362 DOI: 10.3109/08037051.2012.701045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the blood pressure (BP) response to exercise in normotensive patients with type II diabetes mellitus (DM). MATERIALS AND METHODS A cross-sectional study was carried out on 75 normotensive subjects with type 2 DM (group 1), and 70 age-gender matched normotensive healthy volunteers (group 2). Treadmill exercise test, 24-h ambulatory BP monitoring (ABPM) were performed for each patients and healthy volunteers. RESULTS There were 67 patients (mean age 52 ± 9 years and 42% male) in group 1 and 68 healthy volunteers (mean age 51 ± 7 years and 43% male) in group 2. Eight patients from group 1 and 2 subjects from group 2 were excluded because of high BP on ABPM. Groups were similar for systolic BP (SBP) and diastolic BP (DBP) on office measurements and on ABPM. Groups were similar for rest SBP, DBP, heart rate, exercise duration on exercise test. Peak SBP was significantly higher in group 1 than in group 2, but peak DBP was not (196.9 ± 18 vs 165.9 ± 18.6 mmHg, p<0.001; 88.1 ± 11.6 vs 86.2 ± 8.7 mmHg, p = 0.283, respectively). Hypertensive response to exercise (HRE) was more frequent in group 1 than in group 2 [39 (58%) vs 6 (9%), p<0.001]. Independent predictors of peak SBP were DM, office SBP and male gender, while independent predictors of HRE were DM, office SBP and age in multivariate analysis. CONCLUSIONS SBP response to exercise is exaggerated in normotensive diabetic patients compared with non-diabetic subjects. DM, office SBP and male gender are independent predictors of peak SBP. DM, office SBP and age are independent predictors of HRE.
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Duran M, Unal A, Inanc MT, Kaya MG, Kalay N, Ocak A, Uysal OK, Oguzhan A. Changes in carotid intima-media thickness over two years in patients on haemodialysis. J PAK MED ASSOC 2012; 62:575-579. [PMID: 22755343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To evaluate the progression of carotid intima-media thickness (CIMT) and to search for possible associations between these changes and other risk factors of atherosclerosis for 2 years in stable patients with chronic renal failure (CRF) on haemodialysis (HD). METHODS Study population consisted of 22 patients with newly diagnosed CRF. All patients underwent B-mode ultrasonography of common carotid artery for estimating CIMT and the presence of plaques before and after the first HD session (mean 24.22 +/- 2.14 months). The differences in CIMT before and after long-term HD treatment were compared. Acute phase proteins, calcium-phosphate balance and lipid profile were assessed and anthropometric parameters were measured. RESULTS Mean age was 55 +/- 13 years and 10 (45%) of the patients were female. After long-term HD treatment, (mean 24.22 +/- 2.14 months) the mean value for CIMT (0.57 +/- 0.08 mm) was significantly lower than that at baseline (0.68 +/- 0.12 mm) (p = 0.02). Only male gender and smoking were correlated with baseline CIMT. After long-term HD treatment, age, total cholesterol, LDL cholesterol, and triglyceride were related with CIMT. Diabetes and smoking were correlated with CIMT. Presence of plaque before HD only correlated with creatinine level and after long-term HD treatment only correlated with total cholesterol level. CONCLUSION We found that CIMT was significantly decreased 2 years after starting HD. An association between CIMT and other atherosclerotic risk factors (such as age, cholesterol, triglyceride etc.) could not be determined due to a small sample size.
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Affiliation(s)
- Mustafa Duran
- Department of Cardiology, Kayseri Education and Research Hospital, Turkey.
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Dogdu O, Yarlioglues M, Gungor Kaya M, Ardic I, Akpek M, Senarslan O, Elcik D, Sahin O, Tulumen E, Calapkorur B, Kalay N. Relationship between psychosocial status, diabetes mellitus, and left ventricular systolic function in patients with stable multivessel coronary artery disease. Cardiol J 2012; 19:249-55. [DOI: 10.5603/cj.2012.0046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Orscelik O, Kocyigit I, Baran O, Kaya C, Dogdu O, Zengin H, Karadavut S, Gedikli O, Kut E, Duran M, Calapkorur B, Tokgoz B, Kaya MG. Impairment of heart rate recovery index in autosomal-dominant polycystic kidney disease patients without hypertension. Blood Press 2012; 21:300-5. [DOI: 10.3109/08037051.2012.680691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Senel S, Cobankara V, Taskoylu O, Guclu A, Evrengul H, Kaya MG. Effect of infliximab treatment on QT intervals in patients with ankylosing spondylitis. J Investig Med 2012; 59:1273-5. [PMID: 21955979 DOI: 10.2130/jim.0b013e3182330720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cardiovascular complications are one of the most common and the most serious extraskeletal manifestations of ankylosing spondylitis (AS). Infliximab, a monoclonal antibody against tumor necrosis factor, is widely used in the treatment of AS. QT dispersion (QTd), which relates to left ventricular function and is used as an index of cardiac dysrhythmia, may be useful as a prognostic guide. Early detection of possible cardiac involvement may not be clinically evident, whereas it may be detected by electrocardiography. OBJECTIVES The aim of this prospective study was to assess the effect of infliximab treatment on QT intervals in patients with AS. METHODS Twenty-one patients (17 females and 4 males) with AS who were in the active phase of disease (Bath Ankylosing Spondylitis Disease Activity Index score >4) were enrolled in the study. Infliximab was administered intravenously at a dosage of 5 mg/kg at weeks 0, 2, and 6 and every 6 weeks thereafter. QT intervals were recorded before and after 6 months of treatment. RESULTS QT corrected (QTc) for heart rate was significantly reduced in the patients with AS after 6 months of infliximab therapy (406 ± 5.5 vs 388 ± 6.6 milliseconds; P = 0.029). There was no difference in the QTc dispersion (34.3 ± 11.1 vs 34.1 ± 8.6; P = 0.171). Body mass index and lipid profile were slightly increased after the treatment, but the difference was statistically insignificant. CONCLUSION Inflammation can affect the ventricles with an unknown mechanism, and QTc may be slightly prolonged as a result in the active phase of AS. In our study, QTc was shortened under infliximab therapy by suppressing inflammation. Therefore, this effect may protect patients with AS from fatal arrhythmias and sudden cardiac death.
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Affiliation(s)
- Soner Senel
- Division of Rheumatology, Department of Internal Medicine, Cumhuriyet University School of Medicine, Sivas, Turkey.
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