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Çetinarslan Ö, Yenerçağ M, Zoghi M, Ergene AO. Antiplatelet Treatment Preferences of a Group of Cardiologists from Türkiye: A Survey Research Study. Turk Kardiyol Dern Ars 2024; 52:116-124. [PMID: 38465531 DOI: 10.5543/tkda.2023.54778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE Deciding on the optimal duration of dual antiplatelet treatment (DAPT) remains a complex decision. This survey aims to explore the preferences for antiplatelet therapy and the daily routine regarding DAPT duration in coronary artery disease among a group of cardiologists in Türkiye. METHOD Using an online questionnaire with 38 questions, the preferences of 314 cardiologists were collected. Qualitative descriptive characteristics of the answers received from the participants were examined. RESULTS Participating cardiologists mostly worked in training and research hospitals (51.59%) and university hospitals (21.66%). Participants primarily favored ticagrelor in patients undergoing PCI with a diagnosis of STEMI and NSTE-ACS (69.75% and 55.73% respectively). Clopidogrel was the most preferred P2Y12 treatment in patients with chronic coronary syndrome (CCS) after PCI (94.90%). Pre-treatment with a loading dose of a P2Y12 receptor inhibitor was administered to 57.01% of patients with NSTE-ACS, irrespective of the planned treatment strategy. In NSTE-ACS patients with low bleeding risk treated with PCI, 83.12% of participants recommended DAPT for 12 months and 14.65% for >12 months. In high-bleeding-risk NSTE-ACS patients treated with PCI, DAPT durations of six months (74.52%), three months (19.75%), and one month (5.73%) were chosen. Among CCS patients treated with PCI without an increased risk of bleeding, 12 months of DAPT was preferred by 68.15% of participants. Most participants (70.70%) were switching to a more potent P2Y12 receptor inhibitor therapy in emergency department clopidogrel-loaded patients with ACS. CONCLUSION The aim of this survey to capture a snapshot of the preferences of a group of cardiologists in Türkiye regarding DAPT treatment and duration. The responses were both in accordance and in conflict with the current guidelines.
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Affiliation(s)
- Özge Çetinarslan
- Department of Cardiology, Liv Hospital, Vadi İstanbul, İstanbul, Türkiye
| | - Mustafa Yenerçağ
- Department of Cardiology, Ordu University Faculty of Medicine, Türkiye
| | - Mehdi Zoghi
- Department of Cardiology, Ege University, Faculty of Medicine, Türkiye
| | - Asım Oktay Ergene
- Department of Cardiology, Dokuz Eylül University, Faculty of Medicine, Türkiye
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Ekin T, Kış M, Güngören F, Akhan O, Atıcı A, Kunak AÜ, Mutlu D, Katkat F, Demir M, Saraç İ, Soydan E, Karabulut D, Karaduman M, Alp Ç, Bekar L, Böyük F, Adıyaman MŞ, Kaplan M, Zengin İ, Çalışkan S, Kıvrak T, Öz A, Eren H, Bayrak M, Karabulut U, Öztaş S, Düz R, Uluuysal Ö, Balun A, Sağır GN, Kudat H, Pamukçu HE, Abacıoğlu ÖÖ, Göldağ ÖG, Özmen Ç, Günay Ş, Zoghi M, Ergene AO. Awareness and Knowledge of Pneumococcal Vaccination in Cardiology Outpatient Clinics and the Impact of Physicians’ Recommendations on Vaccination Rates. Vaccines (Basel) 2023; 11:vaccines11040772. [PMID: 37112684 PMCID: PMC10142867 DOI: 10.3390/vaccines11040772] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 04/03/2023] Open
Abstract
Aim: We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physicians’ recommendations on vaccination rates. Methods: This was a multicenter, observational, prospective cohort study. Patients over the age of 18 from 40 hospitals in different regions of Turkey who applied to the cardiology outpatient clinic between September 2022 and August 2021 participated. The vaccination rates were calculated within three months of follow-up from the admitting of the patient to cardiology clinics. Results: The 403 (18.2%) patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n = 1808) was 61.9 ± 12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor, and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The main differences between vaccinated and unvaccinated patients were related to education level and ejection fraction. The physicians’ recommendations were positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant correlation between vaccination and female sex [OR = 1.55 (95% CI = 1.25–1.92), p < 0.001], higher education level [OR = 1.49 (95% CI = 1.15–1.92), p = 0.002] patients’ knowledge [OR = 1.93 (95% CI = 1.56–2.40), p < 0.001], and their physician’s recommendation [OR = 5.12 (95% CI = 1.92–13.68), p = 0.001]. Conclusion: To increase adult immunization rates, especially among those with or at risk of cardiovascular disease (CVD), it is essential to understand each of these factors. Even if during COVID-19 pandemic, there is an increased awareness about vaccination, the vaccine acceptance level is not enough, still. Further studies and interventions are needed to improve public vaccination rates.
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Affiliation(s)
- Tuba Ekin
- Clinic of Cardiology, Sorgun State Hospital, 66700 Yozgat, Turkey
- Correspondence:
| | - Mehmet Kış
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, 35340 İzmir, Turkey
| | - Fatih Güngören
- Department of Cardiology, Faculty of Medicine, Harran University, 63000 Şanlıurfa, Turkey
| | - Onur Akhan
- Cardiology Department, Bilecik Training and Research Hospital, 11130 Bilecik, Turkey
| | - Adem Atıcı
- Cardiology Department, Faculty of Medicine, Istanbul Medeniyet University, 34722 Istanbul, Turkey
| | - Ayşegül Ülgen Kunak
- Antalya Private Medstar Topçular Hospital Cardiology Clinic, 07200 Antalya, Turkey
| | - Deniz Mutlu
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, 34452 Istanbul, Turkey
| | - Fahrettin Katkat
- Cardiology Department, Bagcilar Training and Research Hospital, University of Health Sciences, 34165 Istanbul, Turkey
| | - Mevlüt Demir
- Department of Cardiology, Faculty of Medicine, Kütahya Health Sciences University, 43270 Kütahya, Turkey
| | - İbrahim Saraç
- Department of Cardiology, University of Health Sciences, Education and Research Hospital, 25240 Erzurum, Turkey
| | - Elton Soydan
- Department of Cardiology, Faculty of Medicine, Ege University, 35100 İzmir, Turkey
| | - Dilay Karabulut
- Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, 34450 Istanbul, Turkey
| | - Medeni Karaduman
- Cardiyology Department, Van Yüzüncü Yıl Universty, 65080 Van, Turkey
| | - Çağlar Alp
- Department of Cardiology, Faculty of Medicine, Kırıkkale University, 71450 Kırıkkale, Turkey
| | - Lütfü Bekar
- Department of Cardiology, Hitit University Corum Erol Olcok Training and Research Hospital, 19040 Corum, Turkey
| | - Ferit Böyük
- Department of Cardiology, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, 34020 Istanbul, Turkey
| | - Mehmet Şahin Adıyaman
- Department of Cardiology, Gazi Yaşargil Training and Research Hospital, 21010 Diyarbakır, Turkey
| | - Mehmet Kaplan
- Department of Cardiology, Gaziantep University School of Medicine, 27310 Gaziantep, Turkey
| | - İsmet Zengin
- Department of Cardiology, Bursa City Hospital, 16110 Bursa, Turkey
| | - Serhat Çalışkan
- Department of Cardiology, Bahçelievler State Hospital, 34476 İstanbul, Turkey
| | - Tarık Kıvrak
- Department of Cardiology, Faculty of Medicine, Elazığ Fırat University, 23119 Elazığ, Turkey
| | - Ahmet Öz
- Department of Cardiology, İstanbul Training and Research Hospital, University of Health Sciences, 34098 İstanbul, Turkey
| | - Hayati Eren
- Department of Cardiology, Elbistan State Hospital, 46300 Kahramanmaraş, Turkey
| | - Murat Bayrak
- Antalya Kepez State Hospital Cardiology Clinic, 07320 Kepez, Turkey
| | - Umut Karabulut
- Department of Cardiology, İstanbul Acıbadem International Hospital, 34149 İstanbul, Turkey
| | - Selvi Öztaş
- Department of Cardiology, Bursa City Hospital, 16110 Bursa, Turkey
| | - Ramazan Düz
- Cardiyology Department, Van Yüzüncü Yıl Universty, 65080 Van, Turkey
| | - Ömer Uluuysal
- Department of Cardiology, Uludağ University, 16059 Bursa, Turkey
| | - Ahmet Balun
- Department of Cardiology, Bandırma Onyedi Eylul University, 10200 Balıkesir, Turkey
| | - Gurur Nar Sağır
- Cardiology Department, Bagcilar Training and Research Hospital, University of Health Sciences, 34165 Istanbul, Turkey
| | - Hasan Kudat
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, 34452 Istanbul, Turkey
| | - Hilal Erken Pamukçu
- Department of Cardiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, 06110 Ankara, Turkey
| | - Özge Özcan Abacıoğlu
- Department of Cardiology, Adana City Training and Research Hospital, 01120 Adana, Turkey
| | - Ömer Görkem Göldağ
- Department of Cardiology, Training and Research Hospital, 07400 Alanya, Turkey
| | - Çağlar Özmen
- Department of Cardiology, Faculty of Medicine, Cukurova University, 01330 Adana, Turkey
| | - Şeyda Günay
- Department of Cardiology, Uludağ University, 16059 Bursa, Turkey
| | - Mehdi Zoghi
- Department of Cardiology, Faculty of Medicine, Ege University, 35100 İzmir, Turkey
| | - Asım Oktay Ergene
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, 35340 İzmir, Turkey
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Kahya Eren N, Karaca E, Şirin FB, Levent F, Gündüz C, Özdemir E, Nazlı C, Cogulu O, Ergene AO, Ergene AO. Does MicroRNA Profile Differ in Early Onset Coronary Artery Disease? Turk Kardiyol Dern Ars 2022; 50:407-414. [PMID: 36068979 DOI: 10.5543/tkda.2022.22408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE MicroRNAs have been explored as potential biomarkers for many pathological processes including coronary artery disease. In this study, we aimed to compare the circulating levels of selected atherosclerosis-associated miRNAs in patients with a history of early-onset coronary artery disease with that of age- and sex-matched healthy controls and older patients with late-onset coronary artery disease. METHODS Study population consisted of 30 patients with early onset coronary artery disease, 31 age- and sex-matched healthy controls, and 30 patients with late-onset coronary artery disease. Plasma levels of 13 microRNAs (endothelial cell-related miR-126, -92a/b; vascular smooth muscle cell-related miR-145; inflammation-related miR-16, -21, -125b, -146a/b, -147b, -150, -155; lipometabolism-related miR-27b, -122, -370) were evaluated by using real-time polymerase chain reaction. RESULTS In patients with early onset coronary artery disease, plasma expressions of the lipometabolism-related miR-27b, miR-122; inflammation-related miR-125b, miR-146a/b, miR-147b, miR-150, miR-155; and VSMC-related miR-145 were significantly downregulated and endothelial cell-related miR-126 was significantly upregulated compared to age- and sexmatched healthy controls. Circulating microRNA profile of patients with early onset coronary artery disease was also different from that of older patients with late-onset coronary artery disease. Plasma levels of miR-21, miR-27b, miR-122, miR-125b, miR-146b, miR-147b, and miR-155 were lower and plasma levels of miR-16 and miR-92a were higher in patients with early onset coronary artery disease compared to older patients with late-onset coronary artery disease. CONCLUSION MicroRNAs are promising biomarkers for early onset coronary artery disease.
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Affiliation(s)
- Nihan Kahya Eren
- Department of Cardiology, Faculty of Medicine, Katip Çelebi University, İzmir, Turkey
| | - Emin Karaca
- Department of Medical Biology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Fevziye Burcu Şirin
- Department of Biochemistry, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Fatih Levent
- Department of Cardiology, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Cumhur Gündüz
- Department of Medical Biology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Emre Özdemir
- Department of Cardiology, Faculty of Medicine, Katip Çelebi University, İzmir, Turkey
| | - Cem Nazlı
- Department of Cardiology, Faculty of Medicine, Katip Çelebi University, İzmir, Turkey
| | - Ozgur Cogulu
- Department of Medical Biology, Faculty of Medicine, Ege University, İzmir, Turkey
| | - Asım Oktay Ergene
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Turan OE, Yilancioglu RY, Alak C, Baskurt AA, Hunuk B, Dugral E, Yilmaz MB, Ergene AO, Ozcan EE. Telemedicine-based early rule out and followup ECG algorithm for COVID-19 patients. Europace 2021. [PMCID: PMC8194838 DOI: 10.1093/europace/euab116.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Background Drugs with the potential to prolong QT are used in the treatment of coronavirus 19 (COVID-19) pneumonia. We have developed a telemedicine-based corrected QT (QTc) follow-up algorithm that allows early rule out for follow up. Aims In this study, we investigated the availability and safety of the algorithm. Study design Retrospective cohort Methods Consecutive patients; administered hydroxychloroquine (HCQ) for COVID-19 pneumonia were enrolled into digital ECG recording program which includes QTc follow-up algorithm. Results Patients were classified into three groups as those, excluded promptly from the QTc follow-up based on two consecutive ECG findings (early rule out, n = 92) and those, for whom the follow-up was continued (n = 12) and usual care group (n = 68). Of note, 237 ECG tracings were performed in our algorithm population contrary to standard practice of daily recommended ECG monitoring which could have yielded 975 ECG tracings along with accompanied risks of exposure. This way; we ended in 738 (75.7%) fewer ECG tracings. Sustained ventricular arrhythmia or sudden cardiac death was not observed in the entire patient population. Conclusions It is safe to rely on telemedicine-based early rule out algorithm in COVID-19 patients, receiving hydroxychloroquine treatment. This algorithm abolished the need for further ECG in majority of patients without increased risk during follow up. These algorithms can significantly reduce the healthcare worker exposures by eliminating the need for ECG follow-up promptly.
Abstract Figure. Covid-19 Follow up Algorithm ![]()
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Affiliation(s)
- OE Turan
- Dokuz Eylul University, Izmir, Turkey
| | - RY Yilancioglu
- Bornova Turkan Ozilhan State hospital, Cardiology, Izmir, Turkey
| | - C Alak
- Dokuz Eylul University, Izmir, Turkey
| | | | - B Hunuk
- Yeditepe University Hospital, Cardiology, Istanbul, Turkey
| | - E Dugral
- Dokuz Eylul University, Izmir, Turkey
| | - MB Yilmaz
- Dokuz Eylul University, Izmir, Turkey
| | - AO Ergene
- Dokuz Eylul University, Izmir, Turkey
| | - EE Ozcan
- Dokuz Eylul University, Izmir, Turkey
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Kayayurt K, Akoglu H, Limon O, Ergene AO, Yavasi O, Bayata S, Berk NV, Unluer EE. Comparison of existing syncope rules and newly proposed anatolian syncope rule to predict short-term serious outcomes after syncope in the Turkish population. Int J Emerg Med 2012; 5:17. [PMID: 22520447 PMCID: PMC3352305 DOI: 10.1186/1865-1380-5-17] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 04/20/2012] [Indexed: 11/25/2022] Open
Abstract
Background We wished to compare the San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in Syncope Study (EGSYS) and the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk scores and to assess their efficacy in recognising patients with syncope at high risk for short-term adverse events (death, the need for major therapeutic procedures, and early readmission to the hospital). We also wanted to test those variables to designate a local risk score, the Anatolian Syncope Rule (ASR). Methods This prospective, cohort study was conducted at the emergency department of a tertiary care centre. Between December 1 2009 and December 31 2010, we prospectively collected data on patients of ages 18 and over who presented to the emergency department with syncope. Results We enrolled 231 patients to the study. A univariate analysis found 23 variables that predicted syncope with adverse events. Dyspnoea, orthostatic hypotension, precipitating cause of syncope, age over 58 years, congestive heart failure, and electrocardiogram abnormality (termed DO-PACE) were found to predict short-term serious outcomes by logistic regression analysis and these were used to compose the ASR. The sensitivity of ASR, OESIL, EGSYS and SFSR for mortality were 100% (0.66 to 1.00); 90% (0.54 to 0.99), 80% (0.44 to 0.97) and 100% (0.66 to 1.00), respectively. The specificity of ASR, OESIL, EGSYS and SFSR for mortality were 78% (0.72 to 0.83); 76% (0.70 to 0.82); 80% (0.74 to 0.85) and 70% (0.63 to 0.76). The sensitivity of ASR, OESIL, EGSYS and SFSR for any adverse event were 97% (0.85 to 1.00); 70% (0.52 to 0.82); 56% (0.40 to 0.72) and 87% (0.72 to 0.95). The specificity of ASR, OESIL, EGSYS and SFSR for any adverse event were 72% (0.64 to 0.78); 82% (0.76 to 0.87); 84% (0.78 to 0.89); 78% (0.71 to 0.83), respectively. Conclusion The newly proposed ASR appears to be highly sensitive for identifying patients at risk for short-term serious outcomes, with scores at least as good as those provided by existing diagnostic rules, and it is easier to perform at the bedside within the Turkish population. If prospectively validated, it may offer a tool to aid physicians' decision-making.
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Affiliation(s)
- Kamil Kayayurt
- Department of Emergency Medicine, İzmir Atatürk Training and Research Hospital, Izmir, Turkey.
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