1
|
Özkan M, Güner A, Gündüz S, Yıldız G, Yıldırım Aİ, Kalçık M, Yesin M, Bayam E, Kalkan S, Gürsoy MO, Kılıçgedik A, Bayram Z, Sarı M, Aytürk M, Karakoyun S, Astarcıoğlu MA, Gündoğdu EC, Biçer A, Gürcü E, Koçak T, Demirbağ R. Combination Anticoagulation Strategy in Pregnancy With Mechanical Valves: The KYBELE Study. Am Heart J 2024:S0002-8703(24)00075-9. [PMID: 38570020 DOI: 10.1016/j.ahj.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Optimal first-trimester anticoagulation is still challenging in pregnant women with mechanical heart valves (MHVs) requiring high-dose warfarin.This multicenter prospective study aims to determine the optimal anticoagulation regimens for pregnant patients with MHVs. METHODS All women were allocated to one of three treatment options during first trimester including lone low-molecular-weight heparin (LMWH), combination of LMWH+2.5 mg warfarin, and LMWH+4 mg warfarin. Primary maternal outcome included a combination of death, thromboembolism, severe bleeding, and need for treatment of mechanical valve thrombosis (MVT).Any fetal loss was determined as primary fetal outcome. RESULTS The study included 78 pregnancies in 65 women with MHVs.Primary maternal outcome rate was 44%, 12.5%, 3.5%, respectively.The rates of primary maternal outcome (44 vs 3.5%, p<0.001), obstructive MVT (16 vs 0%, p=0.04), MVT requiring treatment (28 vs 0%, p=0.003), and cerebral embolism (24 vs 3.4%, p=0.041) were found to be significantly higher in lone LMWH group compared to LMWH+4 mg warfarin group. Moreover, the rates of primary maternal outcome (12.5 vs 44%, p=0.015) and treatment for MHV thrombus (4.2 vs 28%, p=0.049) were significantly lower in LMWH+2.5 mg warfarin group compared to lone LMWH group.The incidences of fetal loss were 8 (32%) in the lone LMWH group, 8 (33.3%) in LMWH+2.5 mg warfarin group, and 11 (37.9%) in LMWH+4 mg warfarin group (p=0.890 for 3-group).Warfarin related-embryopathy was not observed in any case. CONCLUSIONS The combined anticoagulation strategy of LMWH plus low-dose warfarin during the first trimester of pregnancy may result in less maternal complications with comparable fetal outcomes in patients with MHVs. CONDENSED ABSTRACT Low-molecular-weight heparin (LMWH) is thought to be safer for the fetus, however it is suspected to be less protective for the mother. To solve this dilemma, the authors suggested a novel anticoagulation strategy in pregnant women with prosthetic valves. Seventy-eight pregnancies of 65 women [median age 32 (27-35) years] were included in the study. A combination of LMWH and a reduced dose warfarin were associated with low rates of thrombus-related complications in pregnant patients with mechanical heart valves.
Collapse
Affiliation(s)
- Mehmet Özkan
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.; Ardahan University, Faculty of Health Sciences, Ardahan, Turkey
| | - Ahmet Güner
- Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey..
| | - Sabahattin Gündüz
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Gazi Yıldız
- Kartal Dr. Lutfi Kirdar Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Ayşe İnci Yıldırım
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Pediatric Cardiology, Istanbul, Turkey
| | - Macit Kalçık
- Hitit University, Faculty of Medicine, Department of Cardiology, Corum, Turkey
| | - Mahmut Yesin
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Emrah Bayam
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Semih Kalkan
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mustafa Ozan Gürsoy
- İzmir Katip Çelebi University, Atatürk Training and Reseach Hospital, Department of Cardiology, Izmir, Turkey
| | - Alev Kılıçgedik
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Zübeyde Bayram
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Münevver Sarı
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mehmet Aytürk
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Süleyman Karakoyun
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mehmet Ali Astarcıoğlu
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Elif Cansu Gündoğdu
- Kartal Dr. Lutfi Kirdar Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Asuman Biçer
- Harran University, Faculty of Medicine, Department of Cardiology, Şanlıurfa, Turkey
| | - Emre Gürcü
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Anesthesia and Reanimation, Istanbul, Turkey
| | - Tuncer Koçak
- Koşuyolu Kartal Heart Training and Research Hospital, Department of Anesthesia and Reanimation, Istanbul, Turkey
| | - Recep Demirbağ
- Harran University, Faculty of Medicine, Department of Cardiology, Şanlıurfa, Turkey
| |
Collapse
|
2
|
Toprak K, Kaplangoray M, Akyol S, İnanır M, Memioğlu T, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. The non-HDL-C/HDL-C ratio is a strong and independent predictor of the no-reflow phenomenon in patients with ST-elevation myocardial infarction. Acta Cardiol 2024; 79:194-205. [PMID: 38174719 DOI: 10.1080/00015385.2023.2299102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 12/15/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND No-reflow (NR) is the inability to achieve adequate myocardial perfusion despite successful restoration of attegrade blood flow in the infarct-related artery after primary percutaneous coronary intervention. The non-HDL-C/HDL-C ratio has been shown to be superior to conventional lipid markers in predicting most cardiovascular diseases. In this study, we wanted to reveal the predictive value of the NR by comparing the Non-HDL-C/HDL-C ratio with traditional and non-traditional lipid markers in patients who underwent primary percutaneous coronary intervention (pPCI) due to ST-elevation myocardial infarction (STEMI). METHODS A total of 1284 consecutive patients who underwent pPCI for STEMI were included in this study. Traditional lipid profiles were detected and non-traditional lipid indices were calculated. Patients were classified as groups with and without NR and compared in terms of lipid profiles. RESULTS No-reflow was seen in 18.8% of the patients. SYNTAX score, maximal stent length, high thrombus burden, atherogenic index of plasma and non-HDL-C/HDL-C ratio were determined as independent predictors for NR (p < 0.05, for all). The non-HDL-C/HDL-C ratio predicts the development of NR in STEMI patients with 71% sensitivity and 67% specificity at the best cut-off value. In ROC curve analysis, the non-HDL-C/HDL-C ratio was superior to traditional and non-traditional lipid markers in predicting NR (p < 0.05, for all). CONCLUSION The non-HDL-C/HDL-C ratio can be a strong and independent predictor of NR in STEMI patients and and therefore non-HDL-C/HDL-C ratio may be a useful lipid-based biomarker that can be used in clinical practice to improve the accuracy of risk assessment in patients with STEMI.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Harran University, Sanliurfa, Turkey
| | | | - Selahattin Akyol
- Department of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Mehmet İnanır
- Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Tolga Memioğlu
- Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Harran University, Sanliurfa, Turkey
| |
Collapse
|
3
|
Toprak K, Kaplangoray M, Inanır M, Dursun A, Tascanov MB, Altıparmak IH, Biçer A, Demirbag R. Reply to Letter: HbA1c/C-Peptide Ratio is a Potential Biomarker Used to Predict No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction. Angiology 2024:33197241238513. [PMID: 38445572 DOI: 10.1177/00033197241238513] [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: 03/07/2024]
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Cardiology Department, Medical Faculty, Şeyh Edebali University, Bilecik, Turkey
| | - Mehmet Inanır
- Cardiology Department, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Ayten Dursun
- Nursing Department, Şanlıurfa Provincial Health Directorate, Sanliurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbag
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
4
|
Toprak K, Kaplangoray M, Özen K, Koyuncu İ, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. Disruption of the endothelial glycocalyx layer is associated with idiopathic complete atrioventricular block in the elderly population: An observational pilot study. J Investig Med 2024; 72:233-241. [PMID: 38102740 DOI: 10.1177/10815589231222239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Idiopathic atrioventricular block (iCAVB) is the most common reason for the need for a permanent pacemaker in the elderly population. The fibrotic process that occurs in the conduction system of the heart with aging is the main pathogenesis in the development of iCAVB. However, the processes that trigger the development of iCAVB in the elderly population have not been fully elucidated. In this study, we aimed to reveal the possible relationship between the endothelial glycocalyx (EG) layer and idiopathic complete atrioventricular block. A group of 68 consecutive patients who developed iCAVB and a group of 68 healthy subjects matched for age, sex, and cardiovascular risk factors were included in the study. The groups were compared for clinical, laboratory, and levels of Syndecan-1 (SDC1), an EG layer marker. In the study, SDC1 levels were found to be significantly higher in the iCAVB group compared to the control group (23.7 ± 7.5 vs 16.7 ± 5.2; p = 0.009). In multivariable regression analysis, SDC1 was determined as an independent potential predictor for iCAVB (OR: 1.200; 95% CI: 1.119-1.287; p < 0.001). In the receiver operating characteristic curve analysis, SDC1 predicted iCAVB with 74% sensitivity and 72% specificity at the best cut-off value of 18.5 ng/mL (area under the curve: 0.777; confidence interval: 0.698-0.856; p < 0.001). Disruption of the endothelial glycolic layer may be one of the main triggering factors for the process leading to iCAVB.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medicine, Şeyh Edebali University, Bilecik, Turkey
| | - Kaya Özen
- Department of Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | - İsmail Koyuncu
- Department of Clinical Biochemistry, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
5
|
Toprak K, Özen K, Memioğlu T, İnanır M, Kaplangöray M, Akyol S, Tascanov MB, Biçer A, Demirbağ R. Comparison of the effect of uric acid/albumin ratio on coronary slow flow with other inflammation-based markers. Biomark Med 2024; 18:25-37. [PMID: 38323551 DOI: 10.2217/bmm-2023-0386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Background: Many inflammation-based markers (IBMs) have been shown to be closely related to coronary slow flow (CSF), but the effect of the uric acid/albumin ratio (UAR) on CSF and its relationship with other IBMs are not clearly known. In this study, we aimed to compare the effects of UAR and other IBMs on CSF. Methods: After the exclusion criteria, 126 patients with CSF detected on coronary angiography and 126 subjects with normal coronary flow as the control group were included in the study. Results: UAR was determined as an independent predictor for CSF. In addition, the UAR was superior to other IBMs in detecting CSF (p < 0.05 for all). Conclusion: This study is the first to investigate the effect of UAR on CSF in comparison with other IBMs.
Collapse
Affiliation(s)
- Kenan Toprak
- Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, 63050, Turkey
| | - Kaya Özen
- Gazi Yaşargil Training & Research Hospital, Department of Cardiology, Diyarbakır, 21010, Turkey
| | - Tolga Memioğlu
- Abant Izzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, 14300, Turkey
| | - Mehmet İnanır
- Abant Izzet Baysal University, Medical Faculty, Department of Cardiology, Bolu, 14300, Turkey
| | - Mustafa Kaplangöray
- Şeyh Edebali University, Medical Faculty, Department of Cardiology, Bilecik, 11230, Turkey
| | - Selahattin Akyol
- Kartal Kosuyolu High Specialization Training & Research Hospital, Department of Cardiology, İstanbul, 34865, Turkey
| | - Mustafa B Tascanov
- Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, 63050, Turkey
| | - Asuman Biçer
- Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, 63050, Turkey
| | - Recep Demirbağ
- Harran University, Faculty of Medicine, Department of Cardiology, Sanliurfa, 63050, Turkey
| |
Collapse
|
6
|
Toprak K, Kaplangoray M, Memioğlu T, İnanır M, Omar B, Ermiş MF, Toprak İH, Acar O, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. The HbA1c/C-Peptide Ratio is Associated With the No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction. Angiology 2023:33197231213166. [PMID: 37920902 DOI: 10.1177/00033197231213166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Currently, the gold standard treatment for ST-elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI), but even after successful pPCI, a perfusion disorder in the epicardial coronary arteries, termed no-reflow phenomenon (NR), can develop, resulting in short- and long-term adverse events. The present study assessed the relationship between NR and HbA1c/C-peptide ratio (HCR) in 1834 consecutive patients who underwent pPCI due to STEMI. Participants were divided into two groups according to NR status and the demographic, clinical and periprocedural characteristics of the groups were compared. NR developed in 352 (19.1%) of the patients in the study. While C-peptide levels were significantly lower in the NR group, HbA1c and HCR were significantly higher (P < .001, for all). In multivariable analysis, C-peptide, HbA1c, and HCR, were determined as independent predictors for NR (P < .05, for all). In Receiver Operating Characteristic (ROC) analysis, HCR predicted the NR with 80% specificity and 77% sensitivity. In STEMI patients, combining HbA1c and C-peptide in a single fraction has a predictive value for NR independent of diabetes. This ratio may contribute to risk stratification of STEMI patients.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Department of Cardiology, Faculty of Medical, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Department of Cardiology, Faculty of Medical, Abant Izzet Baysal University, Bolu, Turkey
| | - Bahadır Omar
- Department of Cardiology, Umraniye Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Fatih Ermiş
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - İbrahim Halil Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Osman Acar
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
7
|
Toprak K, Yıldız Z, Akdemir S, Esen K, Kada R, Can Güleç N, Omar B, Biçer A, Demirbağ R. Low pregnancy-specific beta-1-glycoprotein is associated with nondipper hypertension and increased risk of preeclampsia in pregnant women with newly diagnosed chronic hypertension. Scand J Clin Lab Invest 2023; 83:479-488. [PMID: 37887078 DOI: 10.1080/00365513.2023.2275083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Abstract
Chronic hypertension is one of the major risk factors for preeclampsia. Pregnancy-specific beta-1-glycoprotein (PSG-1) is a protein that plays a critical role in fetomaternal immune modulation and has been shown to be closely associated with pregnancy adverse events such as preeclampsia. It is also known that PSG-1 and its source placenta are associated with many molecular pathways associated with blood pressure regulation. In addition, the nondipping pattern (NDP) of chronic hypertension has been shown to be an independent risk factor for preeclampsia. Dipper individuals experience a notable nighttime drop in blood pressure, typically around 10% or more compared to daytime levels, while nondipper individuals show a smaller nighttime blood pressure decrease, indicating potential circadian blood pressure regulation disruption. In this context, we aimed to reveal the relationship between PSG-1, NDP and preeclampsia in this study. A total of 304 pregnant women who were newly diagnosed in the first trimester and started on antihypertensive medication were included in this study. All subjects performed 24-h ambulatory blood pressure monitoring twice throughout pregnancy, the first in the 1. trimester to confirm the diagnosis of hypertension and the second between 20+0 and 21+1 gestational weeks to determine the dipper-nondipper status of hypertension. Subjects were grouped as dipper and nondipper according to blood pressure, and groups were compared in terms of PSG-1 levels. In this study, low PSG-1 levels and NDP were independently associated with preeclampsia. Findings from this study suggest that PSG-1 may play an important role in the causal relationship between NDP and preeclampsia.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Zafer Yıldız
- Department of Obstetrics and Gynecology, Siverek State Hospital, Sanliurfa, Turkey
| | - Selim Akdemir
- Department of Obstetrics and Gynecology, Siverek State Hospital, Sanliurfa, Turkey
| | - Kamil Esen
- Department of Obstetrics and Gynecology, Siverek State Hospital, Sanliurfa, Turkey
| | - Rahime Kada
- Department of Obstetrics and Gynecology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Nuran Can Güleç
- Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, Istanbul, Türkiye
| | - Bahadır Omar
- Department of Cardiology, Umraniye Training and Research Hospital, Istanbul, Türkiye
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
8
|
Toprak K, Kaplangoray M, Memioğlu T, İnanır M, Ermiş MF, Toprak İH, Acar O, Taşcanov MB, Biçer A, Demirbağ R. Comparative Evaluation of Intermountain Risk Score With Mehran Risk Score for Risk Estimation of Contrast-Induced Nephropathy and Short-Term Mortality in ST-Segment Elevation Myocardial Infarction Patients. Angiology 2023:33197231201931. [PMID: 37672723 DOI: 10.1177/00033197231201931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
Contrast-induced nephropathy (CIN) has become one of the most important causes of in-hospital acute renal failure with the increasing use of contrast-mediated imaging tools. This significantly increases the morbidity and mortality of the affected subjects and causes a financial burden on the health system. In this context, prediction of CIN is important and some risk scores have been developed to predict CIN. The most frequently used and popular among these is the Mehran Score (MS), which is based on a number of hemodynamic and metabolic parameters. The Intermountain Risk Score (IMRS) is a recently developed risk score that highly predicts short-term mortality based on common laboratory parameters, and many parameters of this risk score have been found to be closely associated with CIN. In this context, we aimed to compare MS and IMRS in terms of CIN and short-term mortality estimation. The study included 931 patients who underwent percutaneous coronary intervention. CIN developed in 21.5% of patients. Both MS and IMRS independently predicted CIN. In receiver operating characteristic analysis, IMRS was found to be non-inferior to MS in predicting CIN and IMRS was superior to MS in predicting short-term mortality. IMRS and MS were independently associated with short-term mortality.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Mustafa Kaplangoray
- Cardiology Department, Medical Faculty, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Cardiology Department, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Cardiology Department, Medical Faculty, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet Fatih Ermiş
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - İbrahim Halil Toprak
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Osman Acar
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | | | - Asuman Biçer
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Harran University, Faculty of Medicine, Sanliurfa, Turkey
| |
Collapse
|
9
|
Toprak K, Yılmaz R, Kaplangoray M, Memioğlu T, İnanır M, Akyol S, Özen K, Biçer A, Demirbağ R. Comparison of the effect of uric acid/albumin ratio on coronary colleteral circulation with other inflammation-based markers in stable coronary artery disease patients. Perfusion 2023:2676591231202105. [PMID: 37674333 DOI: 10.1177/02676591231202105] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND The Uric acid/Albumin ratio (UAR) has recently been identified as a prominent marker in cardiovascular diseases. In this study, we aimed to reveal the effect of UAR on coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD) patients by comparing it with conventional inflammation-based markers. METHODS In this study, 415 consecutive patients who underwent coronary angiography for stable angina pectoris and were found to have chronic total occlusion in at least one coronary artery were retrospectively included. The study population was divided into two groups as good CCC (Rentrop 2-3) and poor CCC (Rentrop 0-1) according to the Rentrop classification, and the groups were compared in terms of UAR and other traditional inflammation-based markers. RESULTS In the poor CCC group, C-reactive protein/albumin ratio (CAR), monocyte/high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and UAR were found to be significantly high (p < .05, for all). UAR negatively correlated with rentrop classification (r = -0.383, p < .001). In multivariate regression analysis, MHR, NLR, SII and UAR were determined as independent predictors for poor CCC (p < .05, for all). The ability of UAR to predict poor CCC was superior to uric acid and albumin alone (p < .0001, for both). In addition, UAR was found to be superior to other inflammation-based markers in predicting poor CCC (p < .005, for all). CONCLUSION UAR was identified as a strong and independent predictor of CCC. In this context, UAR may be a useful biomarker in the risk prediction of patients with stable CAD.
Collapse
Affiliation(s)
- Kenan Toprak
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Rüstem Yılmaz
- Faculty of Medicine, Department of Cardiology, Samsun University, Samsun, Turkey
| | - Mustafa Kaplangoray
- Medical Faculty, Department of Cardiology, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioğlu
- Medical Faculty, Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Mehmet İnanır
- Medical Faculty, Department of Cardiology, Abant Izzet Baysal University, Bolu, Turkey
| | - Selahattin Akyol
- Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, İstanbul, Turkey
| | - Kaya Özen
- Department of Cardiology, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
| | - Asuman Biçer
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Faculty of Medicine, Department of Cardiology, Harran University, Sanliurfa, Turkey
| |
Collapse
|
10
|
Toprak K, Kaplangöray M, Memioğlu T, İnanir M, Omar B, Taşcanov MB, Biçer A, Demirbağ R. HbA1c/C-peptide ratio is associated with angiographic thrombus burden and short-term mortality in patients presenting with ST-elevation myocardial infarction. Blood Coagul Fibrinolysis 2023; 34:385-395. [PMID: 37577863 DOI: 10.1097/mbc.0000000000001240] [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: 08/15/2023]
Abstract
OBJECTIVES Angiographic high thrombus burden (HTB) is associated with increased adverse cardiovascular events in patients with ST-elevation myocardial infarction (STEMI). HbA1c and C-peptide are two interrelated bioactive markers that affect many cardiovascular pathways. HbA1c exhibits prothrombogenic properties, while C-peptide, in contrast, exhibits antithrombogenic effects. In this study, we aimed to demonstrate the value of combining these two biomarkers in a single fraction in predicting HTB and short-term mortality in patients with STEMI. METHODS 1202 patients who underwent primary percutaneous coronary intervention (pPCI) for STEMI were retrospectively included in this study. The study population was divided into thrombus burden (TB) groups and compared in terms of basic clinical demographics, laboratory parameters and HbA1c/C-peptide ratios (HCR). In addition, short-term mortality of the study population was compared according to HCR and TB categories. RESULTS HCR values were significantly higher in the HTB group than in the LTB group (3.5 ± 1.2 vs. 2.0 ± 1.1; P < 0.001; respectively). In the multivariable regression analysis, HCR was determined as an independent predictor of HTB both as a continuous variable [odds ratio (OR): 2.377; confidence interval (CI): 2.090-2.704; P < 0.001] and as a categorical variable (OR: 5.492; CI: 4.115-7.331; P < 0.001). In the receiver operating characteristic (ROC) analysis, HCR predicted HTB with 73% sensitivity and 72% specificity, and furthermore, HCR's predictive value for HTB was superior to HbA1c and C-peptide. The Kaplan-Meier cumulative survival curve showed that short-term mortality increased at HTB. In addition, HCR strongly predicted short-term mortality in Cox regression analysis. CONCLUSIONS In conclusion, HCR is closely associated with HTB and short-term mortality in STEMI patients.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa
| | | | - Tolga Memioğlu
- Bolu Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu
| | - Mehmet İnanir
- Bolu Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu
| | - Bahadir Omar
- Umraniye training and research hospital, Cardiology Department, Istanbul, Turkey
| | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa
| |
Collapse
|
11
|
Toprak K, Kaplangöray M, Memioglu T, İnanır M, Biçer A, Demirbağ R, Erdoğdu H. The Relationship Between Nitrate-Induced Headache and -Blood Viscosity: An Observational Prospective Study. J Cardiovasc Pharmacol 2023; 82:162-168. [PMID: 37314267 DOI: 10.1097/fjc.0000000000001443] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/27/2023] [Indexed: 06/15/2023]
Abstract
ABSTRACT Nitrates are one of the most prescribed medications in the treatment of angina pectoris today. Headache is the most common side effect of nitrates, and there is limited prospective data on the determinants of this effect. Our aim in this study is to open a foresight window for clinicians in clinical practice by explaining the possible relationship between nitrate-induced headache and whole-blood viscosity (WBV). After coronary revascularization treatment, 869 patients with angina who were prescribed nitrate preparations were divided into groups according to the development of headache or not and categorized according to the 4-grade scale level. Those who had no headache during nitrate use were graded as grade 0, those who felt mild headache were grade 1, those who felt moderate headache were grade 2, and those who described severe headache were graded as grade 3. The groups were compared according to WBV values. A total of 869 participants were included in the study. Most patients (82.1%) experienced some level of headache. Headache severity correlated with both WBV at high shear rate (r = 0.657; P < 0.001) and WBV at low shear rate (r = 0.687; P < 0.001). In multivariate analysis, WBV was determined as an independent predictor of headache experience. WBV predicted nitrate-induced headache with 75% sensitivity and 75% specificity at high shear rate and 77% sensitivity and 77% specificity at low shear rate. WBV seems to be one of the major determinants for nitrate-induced headache. WBV may be a guide for initiating alternative antianginal drugs without prescribing nitrates to the patient to increase patient compliance.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Mustafa Kaplangöray
- Cardiology Department, Faculty of Medicine, Şeyh Edebali University, Bilecik, Turkey
| | - Tolga Memioglu
- Cardiology Department, Medical Faculty, Bolu Abant Izzet Baysal University, Bolu, Turkey; and
| | - Mehmet İnanır
- Cardiology Department, Medical Faculty, Bolu Abant Izzet Baysal University, Bolu, Turkey; and
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Hamza Erdoğdu
- Department of Biostatistics, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
12
|
Toprak K, Kaplangoray M, Altiparmak İH, Taşcanov MB, Güngören F, Fedai H, İnanir M, Biçer A, Demirbağ R. Can increased intestinal permeability and low-grade endotoxemia be the triggering pathogenesis in isolated coronary artery ectasia? Coron Artery Dis 2023; 34:102-110. [PMID: 36720018 DOI: 10.1097/mca.0000000000001209] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Isolated coronary artery ectasia (ICAE) is a rare coronary artery disease (CAD) encountered during coronary angiography. Although many mechanisms have been suggested today that may be associated with ICAE, the underlying pathogenesis has not been fully understood. In this study, we aimed to reveal the possible relationship between intestinal permeability and ICAE. METHODS Of the 12 850 patients who underwent coronary angiography, 138 consecutive patients with ICAE and 140 age- and sex-matched subjects with normal coronary arteries as the control group and 140 subjects with stenotic CAD were included in the study. RESULTS Serum zonulin and lipopolysaccharide levels were significantly higher in patients with ICAE than in the control group and CAD group. Additionally, zonulin and lipopolysaccharide levels were significantly higher in the CAD group than in the ICAE group. In the correlation analysis, serum zonulin levels were correlated with the mean diameter and length of the ecstatic segment. In multivariate analysis, zonulin and lipopolysaccharide were identified as independent predictors for ICAE. CONCLUSION These results suggest that there may be a pathophysiological relationship between increased intestinal permeability and ICAE.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University
| | - Mustafa Kaplangoray
- Department of Cardiology, Mehmet Akif İnan Training and Research Hospital, Sanliurfa
| | | | | | - Fatih Güngören
- Department of Cardiology, Istanbul Aydin University VM Medical Park Florya Hospital, Istanbul
| | - Halil Fedai
- Department of Cardiology, Şanliurfa Training and Research Hospital, Sanliurfa
| | - Mehmet İnanir
- Department of Cardiology, Bolu Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University
| |
Collapse
|
13
|
Altıparmak IH, Tanrıverdi Z, Taşcanov MB, Güngören F, Biçer A, Fedai H, Toprak K, Elmas AN, Demirbağ R. C-Reactive Protein/Albumin Ratio as a Novel Predictor of Contrast Induced Nephropathy in Patients With Stable Angina Pectoris. Angiology 2023; 74:189-196. [PMID: 35589620 DOI: 10.1177/00033197221103635] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of CAR in patients with stable angina pectoris (SAP) has not been clarified. We hypothesized that CAR might predict the development of CIN in patients with SAP undergoing coronary angiography (CAG). Patients (n = 554) with SAP who underwent CAG were included in the study. CIN was defined as a ≥25% increase in serum creatinine compared with baseline value within 72 h of CAG. Participants were divided into two groups: CIN (n = 87) and non-CIN (n = 467). Age, CRP, CAR, mean corpuscular volume (MCV), urea, uric acid, contrast medium volume, the percent of percutaneous coronary intervention were significantly greater, whereas albumin and high-density lipoprotein were significantly lower in the CIN group than non-CIN group (p < .05, for all). Multivariate analysis showed that CAR was the only independent predictor for CIN (odds ratio = 7.065, 95% confidence interval (CI); 3.279-15.221, p < .001). Receiver operating characteristic ROC analysis showed that a CAR ≥ 0.1164 could predict CIN (sensitivity of 71% and specificity of 72%; area under curve = 0.736; 95% CI: 0.677-0.795, p < .001). CAR was significantly greater in patients who developed CIN and this independently predicted CIN.
Collapse
Affiliation(s)
| | - Zülkif Tanrıverdi
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Mustafa Begenç Taşcanov
- Department of Cardiology, 218511Şanlıurfa Education and Research Hospital, Şanlıurfa, Turkey
| | - Fatih Güngören
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Asuman Biçer
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Halil Fedai
- Department of Cardiology, 218511Şanlıurfa Education and Research Hospital, Şanlıurfa, Turkey
| | - Kenan Toprak
- Cardiology Clinic, Siverek State Hospital, Şanlıurfa, Turkey
| | - Ali Nizami Elmas
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, 111374Harran University, Faculty of Medicine, Şanlıurfa, Turkey
| |
Collapse
|
14
|
Toprak K, Kaplangoray M, Palice A, İnanır M, Memioğlu T, Kök Z, Altıparmak İH, Toprak İH, Biçer A, Demirbağ R. Increased whole blood viscosity is associated with primary idiopathic complete atrioventricular block and poor clinical outcomes in these patients. Clin Hemorheol Microcirc 2023; 84:141-151. [PMID: 36683503 DOI: 10.3233/ch-221596] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Complete atrioventricular block is most commonly caused by age-related degeneration and fibrosis in the cardiac conduction system and is called primary idiopathic complete atrioventricular (iCAVB). Although many factors affect this situation, which increases with age in the cardiac conduction system, the relationship between whole blood viscosity (WBV) and iCAVB has not been clarified until now. In this study, we aim to reveal the relationship between iCAVB and WBV. METHODS AND RESULTS 141 patients with dual-chamber permanent pacemaker implanted for iCAVB and 140 age- and sex-matched subjects were included in this study. The WBV values of the study groups were compared in both high shear rate (HSR) and low shear rate (LSR). Both WBV at HSR and WBV at LSR were significantly higher in the iCAVB group compared to the control group (16.11 [15.14-16.89] vs 14.40 [13.62-15.58]; 39.82 [17.43-55.23] vs 1.38 [-13.14-26.73]; p < 0.001, respectively). The patient population was followed up for an median of 38 months for all-cause mortality. Higher mortality rates were found in higher WBV at HSR and WBV at LSR (p < 0.001,for both). CONCLUSIONS In this study, WBV was found to be an independent predictor for iCAVB, and in these patients WBV was associated with poor clinical outcomes.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | - Ali Palice
- Mehmet Akif İnan Training and Research Hospital, Sanlıurfa, Turkey
| | - Mehmet İnanır
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Tolga Memioğlu
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Zafer Kök
- Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | | | - İbrahim Halil Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
15
|
Toprak K, Kaplangoray M, Palice A, Taşcanov MB, İnanır M, Memioğlu T, Kök Z, Biçer A, Demirbağ R. SCUBE1 is associated with thrombotic complications, disease severity, and in-hospital mortality in COVID-19 patients. Thromb Res 2022; 220:100-106. [PMID: 36334396 PMCID: PMC9597517 DOI: 10.1016/j.thromres.2022.10.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/15/2022] [Accepted: 10/22/2022] [Indexed: 11/17/2022]
Abstract
Introduction COVID-19 disease, which has recently become an important cause of mortality and morbidity all over the world, is remarkably associated with thrombotic complications. Although many factors are responsible for these increased thrombotic complications in COVID-19 disease, its relationship with a marker that increases the risk of thrombosis such as Signal peptide-CUB-EGF domain-containing protein 1 (SCUBE1) has not yet been clarified. This is the first study to examine the potential diagnostic and prognostic value of SCUBE1 levels in patients with COVID-19. In this study, we aimed to clarify the relationship between the increased risk of thrombosis and SCUBE1 in the course of COVID-19 disease. Materials and methods 553 patients with COVID-19 and 553 healthy controls were compared in terms of SCUBE1 levels. Additionally, patients with COVID-19 were divided into two groups according to their SCUBE1 levels and compared in terms of severity of disease, thrombotic complications and ın-hospital mortality. Results SCUBE1 levels were significantly higher in patients with COVID-19 compared to the control group (p < 0.001). Plasma SCUBE1 levels were significantly higher in patients with severe disease and thrombotic complications, those with mild to moderate disease, and those without thrombotic complications (p < 0.001, for both). In addition, SCUBE1 was found to be an independent predictor of in-hospital mortality (p < 0.001). Conclusions SCUBE1 may be one of the major determinants of thrombotic complications, which is an increased cause of mortality and morbidity in COVID-19 patients so inhibition of this peptide may be among the therapeutic targets in patients with COVID-19.
Collapse
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey,Corresponding author
| | | | - Ali Palice
- Mehmet Akif İnan Training and Research Hospital, Sanlıurfa, Turkey
| | | | - Mehmet İnanır
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Tolga Memioğlu
- Abant Izzet Baysal University, Medical Faculty, Cardiology Department, Bolu, Turkey
| | - Zafer Kök
- Izzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
16
|
Toprak K, Kaplangoray M, Palice A, Taşcanov MB, Altıparmak İH, Biçer A, Demirbağ R. Ectodysplasin A is associated with the presence and severity of coronary artery disease and poor long-term clinical outcome in patients presenting with ST-elevation myocardial infarction. Acta Clin Belg 2022:1-10. [DOI: 10.1080/17843286.2022.2140246] [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: 11/07/2022]
Affiliation(s)
- Kenan Toprak
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | | | - Ali Palice
- Mehmet Akif Inan Training and Research Hospital, Sanlıurfa, Turkey
| | | | | | - Asuman Biçer
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| | - Recep Demirbağ
- Department of Cardiology, Faculty of Medicine, Harran University, Sanliurfa, Turkey
| |
Collapse
|
17
|
Biçer A, Altıparmak İH. [How to diagnose Libman-Sacks endocarditis with echocardiography?]. Turk Kardiyol Dern Ars 2021; 49:80-84. [PMID: 33390582 DOI: 10.5543/tkda.2020.95074] [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: 11/04/2022] Open
Affiliation(s)
- Asuman Biçer
- Department Of Cardiology, Harran University, Sanliurfa, Turkey
| | | |
Collapse
|
18
|
Gallastegui E, Biçer A, Orlando S, Besson A, Pujol MJ, Bachs O. p27 Kip1 represses the Pitx2-mediated expression of p21 Cip1 and regulates DNA replication during cell cycle progression. Oncogene 2017; 36:350-361. [PMID: 27270438 DOI: 10.1038/onc.2016.200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 01/08/2015] [Revised: 04/04/2016] [Accepted: 05/02/2016] [Indexed: 02/06/2023]
Abstract
The tumor suppressor p21 regulates cell cycle progression and peaks at mid/late G1. However, the mechanisms regulating its expression during cell cycle are poorly understood. We found that embryonic fibroblasts from p27 null mice at early passages progress slowly through the cell cycle. These cells present an elevated basal expression of p21 suggesting that p27 participates to its repression. Mechanistically, we found that p27 represses the expression of Pitx2 (an activator of p21 expression) by associating with the ASE-regulatory region of this gene together with an E2F4 repressive complex. Furthermore, we found that Pitx2 binds to the p21 promoter and induces its transcription. Finally, silencing Pitx2 or p21 in proliferating cells accelerates DNA replication and cell cycle progression. Collectively, these results demonstrate an unprecedented connection between p27, Pitx2 and p21 relevant for the regulation of cell cycle progression and cancer and for understanding human pathologies associated with p27 germline mutations.
Collapse
Affiliation(s)
- E Gallastegui
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| | - A Biçer
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| | - S Orlando
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| | - A Besson
- INSERM UMR1037, Cancer Research Center of Toulouse, Toulouse, France
- Université de Toulouse, Toulouse, France
- CNRS ERL5294, Toulouse, France
| | - M J Pujol
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| | - O Bachs
- Department of Cell Biology, Immunology and Neurosciences, University of Barcelona - IDIBAPS, Barcelona, Spain
| |
Collapse
|
19
|
Çoğul K, Biçer A, Balcı S, Akbayır S, Tamer L. AB0159 The Investigation of Blood Micro-Rna Levels in Ankylosing Spondylitis and the Relationship between Disease Activity and Functional Capacity. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3529] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
20
|
Biçer A, Karakurt Ö, Akdemir R, Erden G, Yildiz A, Özcan Ö, Sezen Y, Açikel S, Kiliç H, DemirbaG R. Thymosin beta 4 is associated with collateral development in coronary artery disease. Scandinavian Journal of Clinical and Laboratory Investigation 2011; 71:625-30. [DOI: 10.3109/00365513.2011.599417] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
21
|
Sari A, Eroglu R, Biçer A, Karaipekli A. Synthesis and Thermal Energy Storage Properties of Erythritol Tetrastearate and Erythritol Tetrapalmitate. Chem Eng Technol 2010. [DOI: 10.1002/ceat.201000306] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|