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Karakoyun S, Cagdas M, Celik AI, Bezgin T, Tanboga IH, Karagoz A, Cınar T, Dogan R, Saygi M, Oduncu V. Predictive Value of the Naples Prognostic Score for Acute Kidney Injury in ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention. Angiology 2024; 75:576-584. [PMID: 36888971 DOI: 10.1177/00033197231161922] [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: 03/10/2023]
Abstract
The purpose of this investigation was to investigate whether there was an association between the Naples prognostic score and the development of acute kidney injury (AKI) in ST-elevation myocardial infarction (STEMI) patients following primary percutaneous coronary intervention (pPCI). The study comprised 2901 consecutive STEMI patients who had pPCI. For each patient, the Naples prognostic score was determined. To evaluate the predictive performance of the Naples score (which included either continuous and categorical variables), we developed a Nested model and a nested model combined with the Naples score. The Naples prognostic score was the most significant predictor of AKI occurrence after admission creatinine, age, and contrast volume. The continuous Naples prognostic score model provided the best prediction performance and discriminative ability. The C-index of the Nested and full models with continuous Naples prognostic score were significantly higher than that of the Nested model. The decision curve analysis found that the overall model had a higher full range of probability of clinical net benefit than the baseline model, with a 10% AKI likelihood. The present study found that the Naples prognostic score may be useful to predict the risk of AKI in STEMI patients undergoing pPCI.
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Affiliation(s)
| | - Metin Cagdas
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
| | - Aziz Inan Celik
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
| | - Tahir Bezgin
- Department of Cardiology, Gebze Fatih State Hospital, Heart Center, Kocaeli, Turkey
| | - Ibrahim H Tanboga
- Department of Cardiology, School of Medicine, Nisantasi University, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kartal Kosuyolu Education and Research Hospital, Istanbul, Turkey
| | - Tufan Cınar
- Department of Cardiology, Health Sciences University Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Remziye Dogan
- Department of Cardiology, Duzce State Hospital, Duzce, Turkey
| | - Mehmet Saygi
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Vecih Oduncu
- Department of Cardiology, Bahcesehir University, School of Medicine, Istanbul, Turkey
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Keskin B, Karagoz A, Hakgor A, Kultursay B, Tanyeri S, Tokgoz HC, Kulahcioglu S, Tosun A, Bulus C, Sekban A, Tanboga IH, Ozdemir N, Kaymaz C. A novel method for the evaluation of right ventricular dysfunction in acute pulmonary embolism: Myocardial work indices. J Clin Ultrasound 2024. [PMID: 38760961 DOI: 10.1002/jcu.23716] [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] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 04/16/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE The presence of right ventricular dysfunction indicates a higher risk status in patients with pulmonary embolism (PE). The RV strain evaluated by speckle-tracking echocardiography seems to be more reliable method in the evaluation of RV dysfunction as compared to standard echocardiographic measures. In this study, we aimed to determine the value of myocardial-work indices in evaluating serial changes of RV function in acute PE. METHODS Our study comprised 83 consecutive acute PE patients who admitted to our tertiary cardiovascular hospital. Echocardiography was performed within the first 24-hours of hospitalization, and RV and LV myocardial-work parameters were obtained along with standard echocardiographic parameters. The change in the RV/LVr detected on tomography was selected as the primary outcome measure, and its' predictors were analyzed with classical linear regression and a generalized additive model (GAM). RESULTS Among the LV-RV strain and myocardial work parameters, the RV global longitudinal strain (GLS) has borderline statistical significance in predicting the RV/LVr change whereas the RV global work efficiency (RV-GWE) strongly predicted RV/LVr change (p: 0.049 and <0.001, respectively). CONCLUSION In this study, classical linear regression and GAM analyses showed that RV-GWE seems to offer a better prediction of RV/LVr change in patients with acute PE.
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Affiliation(s)
- Berhan Keskin
- Department of Cardiology, Kocaeli City Hospital, Kocaeli, Turkey
| | - Ali Karagoz
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | | | - Barkın Kultursay
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Seda Tanyeri
- Department of Cardiology, Kocaeli City Hospital, Kocaeli, Turkey
| | - Hacer Ceren Tokgoz
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Seyhmus Kulahcioglu
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ayhan Tosun
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Cagdas Bulus
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ahmet Sekban
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim H Tanboga
- Department of Cardiology, Nisantası University, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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Sarikaya S, Altas O, Ozgur MM, Hancer H, Yilmaz F, Karagoz A, Ozer T, Aksut M, Ozen Y, Kirali K. Treatment of Nutcracker Syndrome with Left Renal Vein Transposition and Endovascular Stenting. Ann Vasc Surg 2024; 102:110-120. [PMID: 38296038 DOI: 10.1016/j.avsg.2023.11.036] [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] [Received: 09/12/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 02/26/2024]
Abstract
BACKGROUND Nutcracker syndrome is a rare condition that occurs as a result of the entrapment of the left renal vein (LRV) between the aorta and the superior mesenteric artery. It is typically associated with symptoms such as left flank pain, hematuria, proteinuria, and pelvic congestion. The current treatment approach may be conservative in the presence of tolerable symptoms, and surgical or hybrid and stenting procedures in the order of priority in the presence of intolerable symptoms. The aim of this study is to review our experiences to evaluate the results of both methods in this series in which we have a greater tendency toward surgery instead of stenting. METHODS The clinical data of consecutive patients with nutcracker syndrome who underwent LRV transposition and LRV stenting between July 2019 and October 2023 were retrospectively reviewed. The patients were divided into 2 groups based on the methods of treatment: surgical and stenting. For procedure selection, LRV transposition was primarily recommended, with stenting offered to those who declined. Primary end points were morbidity and mortality. Secondary end points included late complications, patency, freedom from reintervention, and resolution of symptoms. Standard basic statistics and survival analysis methods were employed. RESULTS Nineteen patients with nutcracker syndrome (female: 100%) were treated with LRV stentings (n = 5) and LRV transposition (n = 14). The mean age was 24 (20-27, interquartile range [IQR]) years. The mean follow-up was 23 (9-32, IQR) months. There were no major complications and mortality after both procedures. The most frequent sign and symptom associated with LRV entrapment were left flank pain 100% (n = 19), proteinuria 88% (n = 15), and hematuria 47% (n = 9). The mean peak velocity ratio on Doppler ultrasound was 6.13 (6-6.44, IQR). Aortomesenteric angle, beak angle (beak sign), and mean diameter ratio on computed tomography were 26° (22.6-28.5, IQR), 25° (23.9-28, IQR), and 5.3 (5-6, IQR), respectively. Venous pressure measurements were only used to confirm the diagnosis in 5 patients in the stenting group. The measured renocaval gradient was 4 (3.9-4.4, IQR) mm Hg. After both procedures, the classical symptoms, including left flank pain, proteinuria, and hematuria, resolved in 89.5% (n = 17), 57.8% (n = 11), and 82.3% (n = 15) of the cases, respectively. A total of 4 patients required reintervention, 3 patients after LRV transposition (occlusion, n = 2; stenosis, n = 1), and 1 patient after stenting (occlusion, n = 1). The 1-year and 3-year primary patency for the 19 patients was 87% and 80%, respectively. Three-year primary-assisted patency was 100%. Similarly, the 1-year and 3-year freedom from reintervention rate was 83% and 72%, respectively. Additionally, the 1-year and 3-year primary patency for the surgical group was 91% and 81%, respectively, and the 1-year and 3-year primary patency for the stenting group was 75%. CONCLUSIONS Nutcracker syndrome should be kept in mind in cases where flank pain and hematuria cannot be associated with kidney diseases. Radiographic evidence must be accompanied by serious symptoms to initiate the treatment of nutcracker syndrome with LRV transposition and endovascular stenting procedures. Both procedures, along with their respective advantages and disadvantages, can be preferred as primary treatments for nutcracker syndrome. Our study demonstrates that both procedures can be safely and effectively performed, yielding good outcomes.
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Affiliation(s)
- Sabit Sarikaya
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
| | - Ozge Altas
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Mert Ozgur
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Hakan Hancer
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Fatih Yilmaz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Tanıl Ozer
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Aksut
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Yucel Ozen
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Kaan Kirali
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
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Sarikaya S, Altas O, Deniz G, Ozer T, Aksut M, Hancer H, Ozgur MM, Karagoz A, Kirali K. Long-Term Results of Thoracofemoral Bypass in the Initial Treatment of Juxtarenal Total Aortic Occlusion. Ann Vasc Surg 2024; 99:400-413. [PMID: 37918658 DOI: 10.1016/j.avsg.2023.09.069] [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] [Received: 07/14/2023] [Revised: 08/28/2023] [Accepted: 09/02/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Thoracofemoral bypass has been applied mostly secondary to previous procedures in the treatment of aortoiliac occlusive disease. However, its application as an initial treatment is less common, and long-term outcomes remain uncertain. The aim of this analysis was to review the 16-year experience and long-term outcomes of 31 consecutive patients who underwent thoracofemoral bypass as the primary procedure. METHODS All patients who underwent thoracofemoral bypass for severe aortoiliac occlusive disease between 2005 and 2021 were retrospectively analyzed. The occlusion and calcified plaques of the abdominal aorta at the renal level were common characteristics of all patients. The patients were divided into 2 groups: severe claudication group (Rutherford III group) and chronic limb-threatening ischemia group (Rutherford IV-V). Chi-square test or Fisher's exact test was used to compare categorical variables between the groups, and t-test or Mann-Whitney U-tests were used to compare continuous variables according to their distributions. The Kaplan-Meier curve was used to depict the time-to-event data. RESULTS Thirty-one patients [age: 62 (56-67.5); male: 87%] underwent thoracofemoral bypass. Among the 31 patients, 21 (67.7%) belonged to the severe claudication group (Rutherford III), while 10 (32.3%) were in the chronic limb-threatening ischemia (Rutherford IV-V). Twenty-two patients (83.8%) remained asymptomatic after thoracofemoral bypass. The mean follow-up duration was 79 ± 32 months. The 30-day mortality rate was 3.2% (n = 1). Major complications were observed in 9.6% of patients (n = 3; respiratory: 6.4%, retroperitoneal hematoma: 3.2%). No significant difference was found between the claudication and chronic limb-threatening ischemia groups regarding major complications (3.2% vs. 6.4%, P = NS). Minor complications occurred in 41.9% of patients, including pleural effusion 9.6% (n = 3), acute kidney injury 9.6% (n = 3), gastrointestinal bleeding 3.2% (n = 1), paralytic ileus 6.4% (n = 2), and superficial skin infection 12.9% (n = 4). The rate of postoperative superficial skin infection was higher in the chronic limb-threatening ischemia group compared to the claudication group (4 [40%] vs. 0 [0%], P: 0.007). The univariable Cox regression analysis revealed that hypertension and diabetes mellitus were not related to primary patency of the thoracofemoral bypass graft. The 5-year Kaplan-Meier estimated primary patency for the entire study was 96% ± 7% (95% confidence interval [CI]: 88.6-100), and the secondary patency was 96.3% ± 6% (95% CI: 89.4-100). The 5-year Kaplan-Meier estimated survival rate after thoracofemoral bypass was 93.4% ± 3 (95% CI: 91-100). CONCLUSIONS We demonstrated in this study that thoracofemoral bypass can yield good outcomes when preferred as the initial treatment in selected patients with juxtarenal total aortic occlusion. Despite being a complex surgical technique, thoracofemoral bypass has shown to have safe, acceptable mortality and morbidity rates, as well as excellent long-term follow-up results in selected patients.
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Affiliation(s)
- Sabit Sarikaya
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey.
| | - Ozge Altas
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Gunay Deniz
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Tanil Ozer
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Aksut
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Hakan Hancer
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mustafa Mert Ozgur
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Kaan Kirali
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
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Saygi M, Tanalp AC, Tezen O, Pay L, Dogan R, Uzman O, Karabay CY, Tanboga IH, Kacar FO, Karagoz A. The prognostic importance of the Naples prognostic score for in-hospital mortality in patients with ST-segment elevation myocardial infarction. Coron Artery Dis 2024; 35:31-37. [PMID: 37990558 DOI: 10.1097/mca.0000000000001285] [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: 11/23/2023]
Abstract
BACKGROUND The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. However, the prognostic significance of NPS is unknown in ST-segment elevation myocardial infarction (STEMI). We aimed to analyze the prognostic value of the NPS in-hospital mortality in patients with STEMI. METHODS The study consisted of 3828 patients diagnosed with STEMI who underwent primer percutaneous coronary intervention. As the primary outcome, in-hospital mortality was defined as all-cause deaths during hospitalization. The included patients were categorized into three groups based on NPS (group 1:NPS = 0,1,2; group 2:NPS = 3; group 3:NPS = 4). RESULTS Increased NPS was associated with higher in-hospital mortality rates( P < 0.001). In the multivariable logistic regression analysis, the relationship between NPS and in-hospital mortality continued after adjustment for age, male sex, diabetes, hypertension, Killip score, SBP, heart rate, left ventricular ejection fraction, myocardial infarction type and postprocedural no-reflow. A strong positive association was found between in-hospital mortality and NPS by multivariable logistic regression analysis [NPS 0-1-2 as a reference, OR = 1.73 (95% CI, 1.04-2.90) for NPS 3, OR = 2.83 (95% CI, 1.76-4.54) for NPS 4]. CONCLUSION The present study demonstrates that the NPS could independently predict in-hospital mortality in STEMI. Prospective studies will be necessary to confirm the performance, clinical applicability and practicality of the NPS for in-hospital mortality in STEMI.
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Affiliation(s)
- Mehmet Saygi
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul
| | | | - Ozan Tezen
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Levent Pay
- Department of Cardiology, Ardahan Public Hospital, Ardahan
| | - Remziye Dogan
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul
| | - Osman Uzman
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Can Yucel Karabay
- Department of Cardiology, Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Education Research Hospital, Istanbul
| | - Ibrahim Halil Tanboga
- Department of Biostatistics and Cardiology, Nisantasi University Medical School, Istanbul
| | - Flora Ozkalayci Kacar
- Department of Biostatistics and Cardiology, Nisantasi University Medical School, Istanbul
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Education Research Hospital, Istanbul, Turkey
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Ozkan E, Erdogan A, Karagoz A, Tanboğa IH. Comparison of Systemic Immune-Inflammation Index and Naples Prognostic Score for Prediction Coronary Artery Severity Patients Undergoing Coronary Computed Tomographic Angiography. Angiology 2024; 75:62-71. [PMID: 37060352 DOI: 10.1177/00033197231170979] [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: 04/16/2023]
Abstract
This study compared the predictive power of the systemic immune-inflammation index (SII) and Naples prognostic score (NPS) in determining the severity of coronary artery disease (CAD). The study included 1138 patients who underwent coronary computed tomographic angiography (CCTA). The primary outcome was the evaluation of CAD severity, determined by the Coronary Artery Disease-Reporting and Data System (CAD-RADS) obtained from the CCTA scans. A basic statistical model including age, gender, chest pain, diabetes mellitus, hypertension, hyperlipidemia, and smoking was built, and categorical variables, NPS (Naples 3,4 vs 0,1,2) and SII, were added to the basic statistical model. The net benefits of the predictive parameters were determined by a decision curve analysis, and the association between CAD-RADS and NPS, SII was quantified by odds ratios (OR) and 95% confidence intervals (CI). The decision curve analysis showed that adding SII to the statistical model had a better full range of probability of clinical net benefit compared with the baseline model (OR: 5.77, 95% CI 4.15-8.02, P < .001). However, adding the NPS (P = .11) to the model did not outperform the basic statistical model. In conclusion, the SII may have a net predictive effect on top of traditional risk factors.
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Affiliation(s)
- Eyup Ozkan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Aslan Erdogan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Clinic of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Erdogan A, Genc O, Ozkan E, Goksu MM, Ibisoglu E, Bilen MN, Guler A, Karagoz A. Impact of Naples Prognostic Score at Admission on In-Hospital and Follow-Up Outcomes Among Patients with ST-Segment Elevation Myocardial Infarction. Angiology 2023; 74:970-980. [PMID: 36625023 DOI: 10.1177/00033197231151559] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 01/11/2023]
Abstract
The Naples prognostic score (NPS) consists of cholesterol level, albumin concentration, lymphocyte-to-monocyte and neutrophil-to-lymphocyte ratios and reflects systemic inflammation, malnutrition, and survival for various conditions. We investigated the relationship of NPS at admission with in-hospital and follow-up outcomes among ST-segment elevation myocardial infarction (STEMI) patients. This retrospective study included 1887 consecutive patients diagnosed with STEMI and who underwent primary percutaneous coronary intervention between March 2020 and May 2022. The study population was divided by NPS into 2; low (0-1-2) and high (3-4). In-hospital adverse events and all-cause mortality rates during follow-up were extracted from the registry. The Median follow-up time was 15 months. The overall mortality rate was 14.6%. The proportions of in-hospital events that included acute respiratory failure, acute kidney injury, malignant arrhythmia, and mortality were significantly higher in the high NPS group than in the low NPS group. Compared with the baseline model, in the full model of Cox regression analysis; NPS was an independent predictor of all-cause mortality (adjusted hazard ratio (aHR): 2.49, 95%CI, 1.75-3.50, P < .001), with a significant improvement in model performance (likelihood ratio χ2, P < .001) and better calibration. In conclusion, we found an association between NPS and in-hospital and follow-up outcomes in STEMI patients.
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Affiliation(s)
- Aslan Erdogan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Omer Genc
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Eyüp Ozkan
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Muhammed M Goksu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ersin Ibisoglu
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Mehmet N Bilen
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Guler
- Clinic of Cardiology, Cam and Sakura City Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Clinic of Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Inan D, Erdogan A, Pay L, Genc D, Demırtola AI, Yıldız U, Guler A, Tekkesin AI, Karagoz A. The prognostic impact of inflammation in patients with decompensated acute heart failure, as assessed using the pan-immune inflammation value (PIV). Scand J Clin Lab Invest 2023; 83:371-378. [PMID: 37432669 DOI: 10.1080/00365513.2023.2233890] [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: 02/27/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/12/2023]
Abstract
There is increasing evidence that composite scores based on blood counts, which are reflectors of uncontrolled inflammation in the development and progression of heart failure, can be used as prognostic biomarkers in heart failure patients. The prognostic effects of pan-immune inflammation (PIV) as an independent predictor of in-hospital mortality in patients with acute heart failure (AHF) were evaluated based on this evidence. The data of 640 consecutive patients hospitalized for New York Heart Association (NYHA) class 2-3-4 AHF with reduced ejection fraction were analyzed and 565 patients were included after exclusion. The primary outcome was in hospital all-cause death. Secondary outcomes were defined as the following in-hospital events: Acute kidney injury (AKI), malignant arrhythmias, acute renal failure (ARF) and stroke. The PIV was computed using hemogram parameters such as lymphocytes, neutrophils, monocytes and platelets. Patients were categorized as low or high PIV group according to the median value, which was 382.8. A total of 81 (14.3%) in-hospital deaths, 31 (5.4%) AKI, 34 (6%) malignant arrhythmias, 60 (10.6%) ARF and 11 (2%) strokes were reported. Patients with high PIV had a higher in-hospital mortality rate than patients with low PIV (OR: 1.51, 95% CI, 1.26-1.80, p < 0.001). Incorporating PIV into the full model significantly improved model performance (odds ratio X2, p < 0.001) compared to the baseline model constructed with other inflammatory markers. PIV is a potent predictor of prognosis with better performance than other well-known inflammatory markers for patients with AHF.
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Affiliation(s)
- Duygu Inan
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Aslan Erdogan
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Levent Pay
- Department of Cardiology, Ardahan State Hospital, Ardahan, Turkey
| | - Duygu Genc
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ayse Irem Demırtola
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ufuk Yıldız
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Guler
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ahmet Ilker Tekkesin
- Department of Cardiology, Basaksehir Cam & Sakura City Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Istanbul Kosuyolu High Specialization Education and Research Hospital, Istanbul, Turkey
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Cakir Guney B, Ceneli D, Karagoz A, Serindag Z, Dogantekin B, Cinar T, Atis O, Tukel N, Asal S, Sinlik E, Kaplan M. Prognostic role of intermountain risk score (IMRS) in intensive care unit patients with a diagnosis of COVID-19. Eur Rev Med Pharmacol Sci 2023; 27:6437-6444. [PMID: 37458667 DOI: 10.26355/eurrev_202307_33005] [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: 07/20/2023]
Abstract
OBJECTIVE In this study, we aimed to assess the predictive value of Intermountain Risk Score (IMRS) in intensive care unit (ICU) patients with COVID-19. PATIENTS AND METHODS Our retrospective study included the data of 194 patients who were admitted to the COVID-19 ICU of a tertiary care center. COVID-19 diagnoses were made by a positive result from a real-time reverse-transcriptase (RT) polymerase chain reaction (PCR) assay of nasal and pharyngeal swab specimens. Patients who had negative RT-PCR results or who were not admitted to ICU and patients under 18 years old were excluded from the study. Complete blood count, biochemistry panel, and blood gas analysis results were gathered and compiled. RESULTS 194 ICU patients with COVID-19 (PCR positive) were included in the study. The patients were divided into two groups according to IMRS (if IMRS was <15 in women and <17 in men, patients were included in the non-high-risk group, while patients with IMRS ≥15 in women and ≥17 in men were defined as a high-risk group). Multivariate regression analysis was performed to predict in-hospital mortality. The IMRS [OR: 1.17 (1.08-1.27) p<0.001)] was found to predict in-hospital mortality. CONCLUSIONS In this study, we showed that the IMRS score at admission can predict in-hospital mortality in intensive care unit patients with a diagnosis of COVID-19.
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Affiliation(s)
- B Cakir Guney
- Department of Internal Medicine, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
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Küp A, Celik M, Kepez A, Demir S, Gulsen K, Ozgeyik M, Kanar BG, Karagoz A, Yildirim C, Tanircan MR, Akgun T, Uslu A. [Evaluation of the operator learning curve for radiofrequency ablation for atrioventricular nodal reentrant tachycardia]. Kardiologiia 2023; 63:47-52. [PMID: 37307208 DOI: 10.18087/cardio.2023.5.n2167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/16/2022] [Indexed: 06/14/2023]
Abstract
Aim The aim of this study was to determine the average minimum number of slow pathway ablation procedures required to reach a steady success rate among inexperienced operators.Material and Methods We analyzed the consecutive AVNRT ablation procedures of three inexperienced operators for the rate of operational success and complications.Results Operators performed a total of 156 AVNRT ablation procedures. There was no statistical significance between the three operators regarding the rate of success (p=0.69) and complications. There were significant differences between the operators in terms of procedure time, fluoroscopy time, and cumulative air kerma. The variability of procedure time and cumulative air kerma, both among three operators and within each operator, decreased significantly after the 25th case. Each operator was analyzed individually for the probability of success as related to the cumulative number of ablations. All trainee operators reached a success rate of 90 % at the 27th procedure.Conclusion An average of 27 slow pathway ablation procedures should be performed by a beginner operator to achieve proficiency.
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Affiliation(s)
- Ayhan Küp
- Kartal Kosuyolu Heart and Research Hospital
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11
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Erdogan A, Genc O, Inan D, Yildiz U, Balaban I, Guler Y, Genc D, Ozkan E, Demirtola AI, Erdinc B, Algul E, Kilicgedik A, Karagoz A. Impact of Naples Prognostic Score on midterm all-cause mortality in patients with decompensated heart failure. Biomark Med 2023; 17:219-230. [PMID: 37129507 DOI: 10.2217/bmm-2022-0689] [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: 05/03/2023] Open
Abstract
Aim: This work was designed to investigate the relationship between cardiac outcomes and Naples Prognostic Score (NPS) among heart failure (HF) patients. Materials & methods: This retrospective observational study enrolled 298 consecutive individuals hospitalized for New York Heart Association class 3-4 HF. The primary outcome was all-cause mortality. Secondary outcomes were rehospitalization and in-hospital death. Results: The high NPS group had a statistically greater rate of all-cause mortality (p < 0.001). In Cox regression analysis, integrating NPS considerably improved the performance of the full model over the baseline model (adjusted hazard ratio = 2.28; p = 0.004). Based on time-dependent receiver operating characteristic curve analysis, the NPS model outperformed the baseline and CONUT score models in discriminatory power in predicting the probability of survival. Conclusion: NPS was associated with short- and midterm mortality as well as rehospitalization.
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Affiliation(s)
- Aslan Erdogan
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Omer Genc
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Duygu Inan
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Ufuk Yildiz
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Ismail Balaban
- Clinic of Cardiology, Kartal Kosuyolu Training & Research Hospital, 34865, Istanbul, Turkey
| | - Yeliz Guler
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Duygu Genc
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Eyup Ozkan
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Ayse I Demirtola
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Berk Erdinc
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Engin Algul
- Clinic of Cardiology, Dıskapı Yıldırım Beyazıt Training & Research Hospital, 06110, Ankara, Turkey
| | - Alev Kilicgedik
- Clinic of Cardiology, Cam & Sakura City Hospital, 34480, Istanbul, Turkey
| | - Ali Karagoz
- Clinic of Cardiology, Kartal Kosuyolu Training & Research Hospital, 34865, Istanbul, Turkey
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12
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Saygi M, Uzman O, Birdal O, Karagoz A, Yumurtas AC, Tezen O, Tanboga IH, Karabay CY. The Relation of Body Mass Index with In-Hospital Mortality in Patients with ST-Segment Elevation Myocardial Infarction. Metab Syndr Relat Disord 2023; 21:94-100. [PMID: 36459115 DOI: 10.1089/met.2022.0070] [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: 12/05/2022] Open
Abstract
Objectives: In this study, we aimed to determine whether body mass index (BMI) is an independent predictor of in-hospital mortality in ST-segment elevation myocardial infarction (STEMI) patients and to assess the relationship between BMI and mortality. Methods: One thousand three hundred fifty-seven patients with STEMI were included to the study. Primary outcome was in-hospital mortality. The multivariable logistic regression was used to assess the relationship between BMI and in-hospital mortality using age, gender, diabetes mellitus, systolic blood pressure, heart rate, smoking status, serum creatinine and hemoglobin, type of STEMI, and Killip class as adjustment variables. Results: The frequency of in-hospital mortality was 14.7%. The mean BMI was found to be 28.2 ± 4.8 kg/m2. Considering the in-hospital mortality frequencies between the groups, mortality was observed in 61.7% of the BMI <20 kg/m2 group, 15.5% of the 20-25 kg/m2 group, 8.5% of the 25-30 kg/m2 group, and 9.5% of the >30 kg/m2 group (chi-square P value <0.001). In the multivariable logistic regression analysis, a change in BMI from 20 to 30 kg/m2 was associated with a reduced risk of in-hospital mortality (odds ratio: 0.39, 95% confidence interval: 0.23-0.67, P < 0.001). Conclusion: Our study results revealed that there was inverse significant association between BMI and in-hospital mortality in STEMI patients.
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Affiliation(s)
- Mehmet Saygi
- Department of Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Osman Uzman
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Istanbul, Turkey
| | - Oguzhan Birdal
- Department of Cardiology, Ataturk University Medical School, Erzurum, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Education Research Hospital, Istanbul, Turkey
| | - Ahmet Cagdas Yumurtas
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Istanbul, Turkey
| | - Ozan Tezen
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Istanbul, Turkey
| | - Ibrahim Halil Tanboga
- Department of Biostatistics and Cardiology, Nisantasi University Medical School, Istanbul, Turkey
| | - Can Yucel Karabay
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Istanbul, Turkey
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13
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Tanyeri S, Tokgoz HC, Karagoz A, Akbal OY, Keskin B, Kultursay B, Hakgor A, Kulahcioglu Ş, Ceneli D, Tosun A, Efe SC, Bayram Z, Tanboga IH, Ozdemir N, Kaymaz C. Reappraisal of echocardiographic algorithm in predicting the pulmonary hypertension redefined by updated pulmonary artery mean pressure treshold. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1877] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Although an adopted echocardiography algorithm based on tricuspid regurgitation jet peak velocity (TRVmax) and suggestive findings (SF) for pulmonary hypertension (PH) has been utilized in the non-invasive prediction of PH probability, reliability of this approach for updated hemodynamic definition of PH remains to be determined.
Aims
In this study, first time, we aimed to evaluate the TRVmax and SF in predicting the probability of PH as defined by mean pulmonary arterial pressure (mPAP) >20 mm Hg and mPAP >25 mm Hg, respectively.
Methods
Our study group comprised of the retrospectively evaluated 1300 patients (age 53.1±18.8 years, female 62.1%) who underwent right heart catheterisation (RHC) with different indications between 2006 and 2018. All echocardigraphic and RHC assessments were performed in accordance with European Society of Cardiology (ESC)/European Respiratory Society (ERS) 2015 PH Guidelines.
Results
Although TRVmax showed a significant relation with mPAP in both definitions, SF offered significant contribution for only in predicting mPAP >25 mm Hg, but not for mPAP >20 mm Hg. In predicting the mPAP >20 mm Hg TR Vmax and SF showed odds ratio (OR) of 2.57 (1.59–4.14, p<0.001) and OR of 1.25 (0.86–1.82, p=0.16), respectively (Table 1). In predicting the mPAP >25 mm Hg, TR Vmax and SF showed OR of 2.33 (1.80–3.04, p<0.001) and OR of 1.54 (1.15–2.08, p<0.001), respectively (Table 1). The TRVmax >2.8 m/sec and TRVmax >3.4 m/sec were associated with 70% and 84% probability of mPAP >20 mm Hg, and 60% and 76% probability of mPAP >25 mm Hg, respectively (Figure 1).
Conclusions
In contrast to those in predicting the mPAP >25 mm Hg, SF did not provide a significant contribution to probability of mPAP >20 mm Hg predicted by TRVmax solely. The impact of the novel mPAP treshold on echocardiographic prediction of PH remains to be clarifed by future studies.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Tanyeri
- Kocaeli Derince Hospital, Cardiology , Kocaeli , Turkey
| | - H C Tokgoz
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - A Karagoz
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - O Y Akbal
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - B Keskin
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - B Kultursay
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - A Hakgor
- Istanbul Medipol University , Istanbul , Turkey
| | - Ş Kulahcioglu
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - D Ceneli
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - A Tosun
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - S C Efe
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - Z Bayram
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - I H Tanboga
- Hisar Intercontinental Hospital, Cardiology , Istanbul , Turkey
| | - N Ozdemir
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
| | - C Kaymaz
- Kartal Kosuyolu Heart and Research Hospital, Cardiology , Istanbul , Turkey
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14
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Kalkan S, Karagoz A, Efe SC, Sungur MA, Simsek B, Yilmaz MF, Batgerel U, Yilmaz F, Tanboga IH, Oduncu V, Karabay CY, Kirma C. Metformin and CI-AKI Risk in STEMI: Evaluation Using Propensity Score Weighting Method. Turk Kardiyol Dern Ars 2022; 50:422-430. [DOI: 10.5543/tkda.2022.22430] [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] Open
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15
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Kaymaz C, Akbal OY, Keskin B, Tokgoz HC, Hakgor A, Karagoz A, Tanyeri S, Kultursay B, Kulahcioglu S, Dogan C, Bayram Z, Efe SÇ, Erkılınç A, Tanboga IH, Akbulut M, Ozdemir N, Tapson V, Konstantinides S. An Eight-year, Single-center Experience on Ultrasound Assisted Thrombolysis with Moderate-dose, Slow-infusion Regimen in Pulmonary Embolism. Curr Vasc Pharmacol 2022; 20:370-378. [PMID: 36324223 DOI: 10.2174/1570161120666220428095705] [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] [Received: 11/15/2021] [Revised: 02/19/2022] [Accepted: 03/10/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND There is limited data on moderate-dose with slow-infusion thrombolytic regimen by ultrasound-asssisted-thrombolysis (USAT) in patients with acute pulmonary embolism (PE). AIMS In this study, our eight-year experience on USAT with moderate-dose, slow-infusion tissue-type plasminogen activator (t-PA) regimen in patients with PE at intermediate-high- and high-risk was presented, and short-, and long-term effectiveness and safety outcomes were evaluated. METHODS Our study is based on the retrospective evaluation of 225 patients with PE having multiple comorbidities who underwent USAT. RESULTS High- and intermediate-high-risk were noted in 14.7% and in 85.3% of patients, respectively. Mean t-PA dosage was 35.4±13.3 mg, and the infusion duration was 26.6±7.7 h. Measures of pulmonary artery (PA) obstruction and right ventricle (RV) dysfunction were improved within days (p<0.0001 for all). During the hospital stay, major and minor bleeding and mortality rates were 6.2%, 12.4%, and 6.2%, respectively. Bleeding and unresolved PE accounted for 50% and 42.8% of in-hospital mortality, respectively. Age, rate, and duration of t-PA were not associated with in-hospital major bleeding and mortality. Oxygen saturation exceeded 90% in 91.2% of patients at discharge. During follow-up of median 962 (610-1894) days, high-risk status related to 30-day mortality, whereas age >65 years was associated with long-term mortality. CONCLUSION Our real-life experience with USAT with moderate-dose, slow-infusion t-PA regimen in patients with PE at high-and intermediate-high risk demonstrated clinically relevant improvements in PA obstructive burden and RV dysfunction. Age, rate or infusion duration of t-PA was not related to major bleeding or mortality risk, whereas unresolved obstruction remained as a lethal issue.
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Affiliation(s)
- Cihangir Kaymaz
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ozgur Yasar Akbal
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Berhan Keskin
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Hacer Ceren Tokgoz
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Aykun Hakgor
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Seda Tanyeri
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Barkın Kultursay
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Seyhmus Kulahcioglu
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cem Dogan
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zubeyde Bayram
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Süleyman Çağan Efe
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Atakan Erkılınç
- Department of Anesthesiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Mehmet Akbulut
- Faculty of Medicine, Department of Cardiology, Fırat University, Elâzığ, Turkey
| | - Nihal Ozdemir
- Department of Cardiology, Kosuyolu Heart Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Victor Tapson
- Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Stavros Konstantinides
- Department of Cardiology, Democritus University Medical School, Thrace, Greece.,Centre for Thrombosis and Haemostasis, University Medical Centre Mainz, Johannes Gutenberg-University, Mainz, Germany
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16
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Bayram Z, Dogan C, Efe SC, Guvendi B, Karagoz A, Acar RD, Uysal S, Akbas RB, Yilmaz F, Akbal OY, Tokgoz HC, Kirali MK, Kaymaz C, Ozdemir N. Ischaemic versus non-ischaemic: how does heart failure aetiology affect pulmonary arterial capacitance and pulmonary artery pulsatility index in end-stage heart failure? Acta Cardiol 2022; 77:204-210. [PMID: 34923932 DOI: 10.1080/00015385.2021.1951999] [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: 10/19/2022]
Abstract
BACKGROUND The aetiology of heart failure may have different effects on right ventricular (RV) function, pulmonary pressures and RV afterload. Pulmonary arterial capacitance (PAC) and pulmonary artery pulsatility index (PAPi) are novel haemodynamic indices used in determining RV afterload and RV function, respectively. We aimed to investigate whether there was a difference in PAC and PAPi between ischaemic cardiomyopathy (ICMP) and non-ischaemic cardiomyopathy (NICMP) in patients with end-stage heart failure. METHODS AND RESULTS A total of 215 subjects undergoing evaluation for heart transplantation or left ventricular (LV) assist device were classified into two groups: ICMP (n = 101) and NICMP (n = 114). The patients with LV ejection fraction ≤ 25% were included in the study. ICMP group had lower PAC and higher PAPi values compared to NICMP group [1.25 (0.82-1.86) vs. 1.58 (1.02-2.21), p = 0.002 and 3.4 (2.2-5.0) vs. 2.5 (1.7-4.0); p = 0.007]. Pulmonary vascular resistance, pulmonary artery systolic and mean pressure were higher in ICMP group compared to NICMP group [3.5 ± 1.8 vs. 2.9 ± 2.3, p = 0.004; 59.0 (42.0-73.0) vs. 46.0 (37.0-59.0), p < 0.001, 35.0 (27.0-46.0) vs. 31.0 (23.0-39.0), p = 0.002]. The patients with ICMP had higher tricuspid annular plane systolic excursion and less RV dilatation. ICMP was an independent risk factor for pulmonary hypertension (OR: 4.02, 95% CI: 1.13-14.24, p = 0.031). CONCLUSION ICMP was associated with lower PAC and higher PAPi. These results indicated that an ischaemic aetiology is associated with higher RV afterload and better RV function in the end-stage heart failure.
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Affiliation(s)
- Zubeyde Bayram
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Cem Dogan
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Suleyman C. Efe
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Busra Guvendi
- Department of Cardiology, Istanbul Maltepe State Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Rezzan Deniz Acar
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Samet Uysal
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ravza Betul Akbas
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Fatih Yilmaz
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Y. Akbal
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Hacer Ceren Tokgoz
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Kaan Kirali
- Cardiovascular Surgery Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Cardiology Department, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
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17
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Turkyilmaz E, Ozkalayci F, Birdal O, Karagoz A, Tanboga IH, Tanalp AC, Oduncu V. Serum Albumin to Creatinine Ratio and Short-Term Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction. Angiology 2022; 73:809-817. [PMID: 35451336 DOI: 10.1177/00033197221089423] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/29/2022]
Abstract
There is a lack of evidence regarding the short-term predictive value of serum albumin to creatinine ratio (sACR) in patients with ST-segment elevation myocardial infarction (STEMI). This study aims to investigate the relationship between sACR and short-term outcomes in these patients. We retrospectively enrolled 3057 patients with STEMI who underwent primary percutaneous coronary interventions (PCI) (median age was 58 years, and 74.3% were male). In-hospital mortality occurred in 114 (3.7%) patients. Contrast-induced nephropathy (CIN) was reported in 381 (12.4%) patients. During a 30-day follow-up, stent thrombosis (ST) occurred in 28 (.9%) patients and 30-day death in 147 (4.8%) patients. Multivariable logistic regression analysis reported that sACR was inversely associated with 30-day mortality (adjusted odds ratio (aOR): .51, 95% confidence interval (CI) .31-.82, P < .001). The sACR was also inversely associated with in-hospital mortality (aOR: .71, 95% CI .56-.90, P = .009), CIN (aOR: .60, 95% CI .52-.68, P < .001), congestive heart failure (CHF) (aOR: .64, 95% CI .47-.87, P = .007), and ST (aOR .61, 95% CI .41-.92, P = .001) at 30 days. Our findings suggest that sACR is inversely associated with short-term clinical outcomes in patients with STEMI after PCI.
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Affiliation(s)
| | - Flora Ozkalayci
- 599103Cardiology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Oğuzhan Birdal
- Medical School, Cardiology, Ataturk University, Erzurum, Turkey
| | - Ali Karagoz
- Cardiology, Kosuyolu Heart, Research and Training Hospital, Istanbul, Turkey
| | - Ibrahim H Tanboga
- 385796Medical School, Cardiology and Biostatistics, Nisantasi University, Istanbul, Turkey
| | | | - Vecih Oduncu
- 472597Medical School, Cardiology, Bahcesehir University, Istanbul, Turkey
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18
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Celik M, Emiroglu MY, Bayram Z, Izci S, Karagoz A, Akbal OY, Kahyaoglu M, Kup A, Yilmaz Y, Kirali MK, Ozdemir N. Electrophysiologic Changes and Their Effects on Ventricular Arrhythmias in Patients with Continuous-Flow Left Ventricular Assist Devices. ASAIO J 2022; 68:341-348. [PMID: 35213883 DOI: 10.1097/mat.0000000000001472] [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: 11/26/2022] Open
Abstract
Ventricular arrhythmias (VAs) continue even after left ventricular assist device (LVAD) implantation. The effect of LVAD on VAs is controversial. We investigated electrophysiologic changes after LVAD and its effects on VAs development. A total of 107 implantable cardioverter-defibrillator (ICD) patients, with LVAD, were included in this study. Electrocardiographic parameters including QRS duration (between the beginning of the QRS complex and the end of the S wave), QT duration (between the first deflection of the QRS complex and the end of the T wave) corrected QT (QTc), QTc dispersion, fragmented QRS (F-QRS), and ICD recordings before, and post-LVAD first year were analyzed. All sustained VAs were classified as polymorphic ventricular tachycardia (PVT) or monomorphic VT (MVT). The QRS, QT, QTc durations, and QTc dispersion had decreased significantly after LVAD implantation (p < 0.001 for all). Also MVT increased significantly from 28.9% to 49.5% (p = 0.019) whereas PVT decreased from 27.1% to 4.67% (p = 0.04) compared to pre-LVAD period. A strong correlation was found between QT shortening and the decrease in PVT occurrence. Besides, the increase in the F-QRS after LVAD was associated with post-LVAD de nova MVT development. Finally, F-QRS before LVAD was found as an independent predictor of post-LVAD late VAs in multivariate analysis. Pre-existing or newly developed F-QRS was associated with post-LVAD late VAs, and it may be used to determine the risk of VAs after LVAD implantation.
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Affiliation(s)
- Mehmet Celik
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Mehmet Yunus Emiroglu
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Zubeyde Bayram
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Servet Izci
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ozgur Yasar Akbal
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Muzaffer Kahyaoglu
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ayhan Kup
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Yusuf Yilmaz
- Department of Cardiology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet Kaan Kirali
- Department of Cardiovascular Surgery, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- From the Department of Cardiology, KartalKosuyolu Heart and Research Hospital, Istanbul, Turkey
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19
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Bayram Z, Efe SC, Karagoz A, Dogan C, Guvendi B, Uysal S, Akbal OY, Yilmaz F, Tokgoz HC, Acar RD, Kirali MK, Kaymaz C, Ozdemir N. Prognostic impact of nutritional indices in candidates for heart transplantation. Turk Kardiyol Dern Ars 2022; 50:92-100. [DOI: 10.5543/tkda.2022.21126] [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] Open
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20
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Dogan C, Cinaral F, Karagoz A, Bayram Z, Onal SC, Candan O, Acar RD, Cap M, Erdogan E, Hakgor A, Akbal OY, Uslu A, Kaymaz C, Ozdemir N. Comparison of automated quantification and semiquantitative visual analysis findings of IQ SPECT MPI with conventional coronary angiography in patients with stable angina. Turk Kardiyol Dern Ars 2022. [DOI: 10.5543/tkda.2018.03367] [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] Open
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21
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Bayram Z, Dogan C, Efe SC, Karagoz A, Guvendi B, Uysal S, Akbas RB, Acar RD, Akbal OY, Yilmaz F, Tokgoz HC, Kirali MK, Kaymaz C, Ozdemir N. Prognostic Importance of Pulmonary Artery Pulsatility Index and Right Ventricular Stroke Work Index in End-Stage Heart Failure Patients. Cardiology 2022; 147:143-153. [PMID: 34979515 DOI: 10.1159/000521205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/13/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Right ventricular (RV) failure is an important cause of morbidity and mortality in patients with left ventricular (LV) end-stage heart failure (ESHF). Pulmonary artery pulsatility index (PAPi) and right ventricular stroke work index (RVSWI) are invasive parameters related to RV function. This study aimed to investigate the prognostic impact of PAPi and RVSWI in these patients. METHODS AND RESULTS In this study, 416 patients with ESHF were included. The adverse cardiac event (ACE) was defined as left ventricular assist device (LVAD) implantation, urgent heart transplantation, or cardiac mortality. There were 218 ACE cases and 198 non-ACE cases over a median follow-up of 503.50 days. Patients with ACE had lower PAPi and similar RVSWI compared to those without ACE (3.1±1.9 vs. 3.7±2.3, P=0.003 and 7.3±4.9 vs. 6.9±4.4, P=0.422, respectively). According to the results of multivariate analysis, while PAPi (from 2 to 5.65) was associated with ACE, RVSWI (from 3.62 to 9.75) was not associated with ACE (HR: 0.75, 95% CI (0.55-0.95), P=0.031; HR: 0.79, 95% CI: (0.58-1.09), P=0.081, , respectively). Survival analysis revealed that PAPi ≤2.56 was associated with a higher ACE risk compared to PAPi >2.56 (HR: 1.46, 95% CI: 1.11-1.92, P=0.006). PAPi ≤2.56 could predict ACE with 56.7% sensitivity and 51.3% specificity at one year. Furthermore, the association between RVSWI and ACE was nonlinear (J-curve pattern). Low and high values seem to be associated with higher ACE risk compared to intermediate values. CONCLUSION The low PAPi was an independent risk for ACE and it had a linear association with it. However, RVSWI seems to be have a nonlinear association with ACE (J-curve pattern).
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Affiliation(s)
- Zubeyde Bayram
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Cem Dogan
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Suleyman Cagan Efe
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Busra Guvendi
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Samet Uysal
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ravza Betul Akbas
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Rezzan Deniz Acar
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Yasar Akbal
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Fatih Yilmaz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Hacer Ceren Tokgoz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Kaan Kirali
- Department of Cardiovascular Surgery, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Department of Cardiology, Kosuyolu Heart Training and Research Hospital, Istanbul, Turkey
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22
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Isik AC, Karagoz A, Ocal A, Akin S, Boyuk B, Keskin O. The Relationship between Nutritional Status and Early-and Mid-term Mortality of Geriatric Patients Admitted to the Emergency Internal Medicine Unit. Haseki 2022. [DOI: 10.4274/haseki.galenos.2021.7876] [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: 12/01/2022] Open
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23
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Dogan C, Bayram Z, Efe SC, Acar RD, Tanboga IH, Karagoz A, Havan N, Ozer T, Uslu A, Kırali MK, Kaymaz C, Ozdemir N. Prognostic value of main pulmonary artery diameter to ascending aorta diameter ratio in patients with advanced heart failure. Acta Cardiol 2021; 76:1108-1116. [PMID: 33501898 DOI: 10.1080/00015385.2021.1872186] [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: 10/22/2022]
Abstract
OBJECTIVES AND BACKGROUND In this study we assessed the prognostic value of main pulmonary artery diameter and its ratio to ascending aorta diameter (P/Ao ratio) in advanced heart failure patients. METHODS Patients with advanced heart failure who were candidates for heart transplantation were retrospectively evaluated. The clinical information, cardiac catheterisation results, and computed tomography images were gathered from institutional database system. The observed and predicted probabilities for survival were analysed in a nomogram. RESULTS The P/Ao ratio was found to be a strong predictor for MACE both in traditional multivariable Cox proportional hazard regression modelling (increase in P/Ao ratio per 2 SD, HR:2.72, 95% CI 1.14-6.48, p = 0.024) and ridge regression analysis (increase in P/Ao ratio per 2SD, HR:3.45, 95% CI 1.53-7.74, p = 0.003). Prediction model showed statistically significant correlation between the observed and predicted probabilities for 1-year survival. CONCLUSION In patients with advanced heart failure, computed tomography derived P/Ao ratio might be a prognostic predictor during follow up.
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Affiliation(s)
- Cem Dogan
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Zubeyde Bayram
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Süleyman Cagan Efe
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Rezzan Deniz Acar
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim Halil Tanboga
- Department of Cardiology, Atatürk University Department of Biostatistics, Erzurum and Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Nuri Havan
- Department of Radiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Tanıl Ozer
- Department of Cardiovascular Surgery, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Abdulkair Uslu
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Kaan Kırali
- Department of Cardiovascular Surgery, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Department of Cardiology, University of Health Sciences, Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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24
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Yontar OC, Erdogan G, Yenercag M, Gul S, Arslan U, Karagoz A. Relationship between Selvester ECG Score and Cardiovascular Outcomes in Patients with Non-ST Elevation Myocardial Infarction. Acta Cardiol Sin 2021; 37:580-590. [PMID: 34812231 PMCID: PMC8593486 DOI: 10.6515/acs.202111_37(6).20210602a] [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] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/02/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Early risk stratification plays a crucial role in the treatment of non-ST-elevation myocardial infarction (NSTEMI). Selvester score is an electrocardiography (ECG)-based method for estimating infarcted myocardial mass, however it has not been studied in NSTEMI before. In this study, we aimed to investigate the relationship between Selvester score and cardiovascular outcomes in a 1-year follow-up period in NSTEMI patients. METHODS One hundred and forty-three consecutive patients with NSTEMI were analyzed. TIMI and GRACE risk scores were calculated accordingly. Selvester score was calculated on surface ECG as reported in prior studies. Syntax score was calculated using an online calculator. The study population was divided into two groups based on a cut-off value from receiver operating characteristic curve analysis for the discriminative ability of Selvester score for mortality: low score (≤ 4), and high score (> 4) groups. RESULTS Age was higher, left ventricle ejection fraction and high-density lipoprotein-cholesterol levels were significantly lower, and TIMI, GRACE and SYNTAX scores were significantly higher in the high Selvester score group. In multivariate Cox regression analysis, ejection fraction [hazard ratio (HR): 0.926, 95% confidence interval (CI): 0.883-0.971, p = 0.002] and Selvester score > 4 (HR: 3.335, 95% CI: 1.306-8.503, p = 0.012) were found to be independent predictors of adverse events after 1 year of follow-up. CONCLUSIONS Selvester score is a fast and feasible method that has prognostic value for mortality and other major adverse outcomes in low and intermediate risk NSTEMI patients treated with urgent percutaneous coronary intervention for 12 months.
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Affiliation(s)
- Osman Can Yontar
- University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun
| | - Guney Erdogan
- University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun
| | - Mustafa Yenercag
- University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun
| | - Sefa Gul
- University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun
| | - Ugur Arslan
- University of Health Sciences Turkey, Samsun Training and Research Hospital, Cardiology Clinic, Samsun
| | - Ali Karagoz
- Cardiology Clinic, Kosuyolu Postdoctorate Hospital, Istanbul, Turkey
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25
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Bayram Z, Dogan C, Efe SC, Karagoz A, Guvendi B, Uysal S, Aktas RB, Akbal OY, Yilmaz F, Tokgoz HC, Kirali MK, Kaymaz C, Ozdemir N. Effect of Group 2 Pulmonary Hypertension Subgroups on Outcomes: Impact of the Updated Definition of Pulmonary Hypertension. Heart Lung Circ 2021; 31:508-519. [PMID: 34756531 DOI: 10.1016/j.hlc.2021.10.002] [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] [Received: 04/10/2021] [Revised: 08/24/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is a common complication of end-stage heart failure (ESHF) and associated with increased mortality. The definition of PH has recently been changed from a mean pulmonary arterial pressure (PAPm) ≥25 mmHg to a PAPm >20 mmHg. Since this change, there are no data evaluating group 2 PH subgroups on outcomes. The purpose of this study was to determine the impact of updated group 2 PH subgroups on outcomes, as well as to evaluate the clinical, echocardiographic, and haemodynamic characteristics of subgroups, and determine predictors of PH in patients with ESHF. METHOD A total of 416 patients with ESHF with left ventricle ejection fraction (LVEF) ≤25% were divided into three groups. Pulmonary hypertension was defined as PAPm >20 mmHg. Primary outcome was defined as left ventricular assist device (LVAD) implantation, urgent heart transplantation (HT), or death. Secondary outcome was defined as LVAD implantation and HT. RESULTS Over a median follow-up of 503.5 days, combined pre- and postcapillary PH (Cpc-PH) displayed greater risk of primary outcome than those with isolated postcapillary (Ipc-PH) (hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.29-1.91; p<0.001) and those with no PH (HR, 2.47; 95% CI, 1.68-3.63; p<0.001). Patients with Ipc-PH demonstrated greater risk than those with no PH (HR, 1.57; 95% CI, 1.57-1.90; p<0.001). Likelihood ratios of updated PH criteria and old PH criteria (PAPm ≥25 mmHg) in identifying primary outcome were 75.6 (R2=0.179) and 72.09 (R2=0.164). Patients with PAPm 21-24 mmHg had a higher primary outcome than those with PAPm ≤20 mmHg. Severe mitral regurgitation, LVEF, grade 3 diastolic dysfunction, diabetes, and cardiac output were predictors of PH. CONCLUSIONS Pulmonary hypertension increases the risk of LVAD, urgent HT, or death, and Cpc-PH further increases risk in patients with ESHF. Compared to the previous definition, a new PH definition better discriminates death, going to urgent HT, or LVAD implantation for PH subgroups.
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Affiliation(s)
- Zubeyde Bayram
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul.
| | - Cem Dogan
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | | | - Ali Karagoz
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Busra Guvendi
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Samet Uysal
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Ravza Betul Aktas
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Ozgur Yasar Akbal
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Fatih Yilmaz
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | | | | | - Cihangir Kaymaz
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
| | - Nihal Ozdemir
- Kartal Koşuyolu Yüksek Eğitim ve Araştırma Hastanesi, Kartal, Istanbul
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26
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Ozkalayci F, Türkyılmaz E, Karagoz A, Karabay CY, Tanboga İH, Oduncu V. A Clinical Score to Predict "Corrected Thrombolysis in Myocardial Infarction Frame Count" in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Angiology 2021; 73:365-373. [PMID: 34625005 DOI: 10.1177/00033197211045021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Corrected thrombolysis in myocardial infarction frame count (cTFC) is an objective, simple, and reproducible method to assess coronary blood flow which is a surrogate for cardiovascular outcomes. It is important to learn which factors are associated with cTFC. The goal of this study was to determine predictive models for epicardial blood flow assessed by cTFC and develop a diagnostic predictive model that indicates the individualized assessment of epicardial blood flow prior to primary percutaneous coronary intervention. This is a retrospective study including 3205 patients with ST-segment elevation myocardial infarction who underwent pPCI. The primary outcome was cTFC. Multivariable linear regression analysis was performed. Subsequently, a nomogram was developed to predict cTFC according to the candidate predictors. Median age was 58; the number of male patients was 2381 (74.3%). Median value of cTFC was 22 and interquartile range (IQR): 16.5-28.0). Age, diabetes mellitus (DM), total ischemic time, systolic blood pressure (SBP), heart rate (HR), and history of statin use remained in both full and reduced models. Our model may potentially allow clinicians to identify patients at high risk for impaired epicardial perfusion.
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Affiliation(s)
- Flora Ozkalayci
- Department of Cardiology, Hisar Intercontinental Hospital, İstanbul, Turkey
| | - Erdem Türkyılmaz
- Department of Cardiology, Uşak Training and Research Hospital, Uşak, Turkey
| | - Ali Karagoz
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Can Yucel Karabay
- Department of Cardiology, 111319Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - İbrahim Halil Tanboga
- Department of Cardiology, Hisar Intercontinental Hospital, İstanbul, Turkey.,Department of Biostatistics, School of Medicine, Nişantaşı University, İstanbul, Turkey
| | - Vecih Oduncu
- Department of Cardiology, Bahçesehir University Hospital, İstanbul, Turkey
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27
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Sari M, Yazar H, Kocayigit I, Karagoz A, Ayturk M, Fidan S, Arslantas U, Cakmak EO, Alici G, Ozkan B. Alteration of serum biomarkers in patients with hypertrophic cardiomyopathy with and without atrial fibrillation. Biomark Med 2021; 15:1131-1142. [PMID: 34402630 DOI: 10.2217/bmm-2021-0022] [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: 11/21/2022] Open
Abstract
Aim: We sought to determine the relationship between presence of atrial fibrillation (AF) and serum biomarkers, including native thiol (antioxidant), disulphide/native thiol ratio, Hs-CRP and high-sensitivity Troponin-I (Hs-TnI) in hypertrophic cardiomyopathy (HCM). Materials & methods: We enrolled consecutive 121 HCM outpatients without AF and 40 HCM outpatients with AF. A 12-lead electrocardiogram, transthoracic echocardiography and 24/48-h ambulatory rhythm monitoring were performed for all patients. Fasting venous blood samples were taken from all study patients to measure serum thiol-disulphide homeostasis, Hs-CRP and Hs-TnI. Results: Serum-native thiol was lower and disulphide/native thiol ratio was more oxidized in HCM patients with AF (p < 0.001). Also, HCM patients with AF had higher Hs-TnI and Hs-CRP than no-AF HCM patients. Disulphide/native thiol ratio, serum-native thiol, age, NYHA functional class≥III, and advanced diastolic dysfunction were independently associated with the presence of AF in HCM. Conclusion: In addition to clinical and echocardiographic findings, oxidative stress is also associated with AF in HCM patients.
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Affiliation(s)
- Munevver Sari
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Hayrullah Yazar
- Department of Biochemistry, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ibrahim Kocayigit
- Department of Cardiology, Sakarya University Education & Research Hospital, Sakarya, Turkey
| | - Ali Karagoz
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Mehmet Ayturk
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Serdar Fidan
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Ugur Arslantas
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Ender O Cakmak
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Gokhan Alici
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
| | - Birol Ozkan
- Department of Cardiology, University of Health Sciences Turkey, Kartal Kosuyolu High Specialization Health Application and Research Center, Istanbul, Turkey
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28
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Ozkalayci F, Turkyilmaz E, Altıntaş B, Akbal OY, Karagoz A, Karabay CY, Tanboga İH, Oduncu V. Prognostic impact of bundle branch blocks in patients with ST-segment elevation myocardial infarction. Acta Cardiol 2021; 76:581-586. [PMID: 32284031 DOI: 10.1080/00015385.2020.1747179] [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: 10/24/2022]
Abstract
BACKGROUND In this study we aim to determine and compare short term outcomes of all type bundle branch blocks (BBB) according to their onset time among those patients presented with ST-Segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI). METHOD Three thousand fifty-seven ST-segment elevation myocardial infarction patients who underwent pPCI were retrospectively evaluated. Those patients with BBB in their ECG on admission were re-evaluated for their prior ECG records. A composite of death, recurrent myocardial infarction (re-MI) and stroke in one moth follow up were defined as major adverse cardiovascular events (MACE). RESULTS Three thousand fifty-seven STEMI patients underwent pPCI were enrolled to the study. Among these patients 134 (4.4%) had LBBB, and 120 (3.9%) had RBBB. Bundle brunch block was classified according to the timing of their onset as follows; New or Presumably New BBB, Old BBB, Indeterminate Onset BBB. At one month, 4.8% of the patients died, 2.6% had re-MI/stent thrombosis, 0.5% had stroke. MACE occurred in 7.6% of patients. Left ventricle ejection fraction, BBB, estimated glomerular filtration rate (eGFR), shock and age were ranked as the strongest predictors of MACE. Compared to non-BBB, all BBBs except for old RBBB was found to be associated with increased MACE. New onset LBBB was the strongest predictor (OR:13.1, 95%CI:3.98-43.4, p < .001) at one month MACE. CONCLUSION Compared to non-BBB, all BBBs except for old RBBB was found to be associated with increased MACE. New onset LBBB was the strongest predictor for MACE at one month.
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Affiliation(s)
| | | | - Bernas Altıntaş
- Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| | | | - Ali Karagoz
- Kartal Kosuyolu Medical and Research Hospital, İstanbul, Turkey
| | | | - İbrahim Halil Tanboga
- Hisar Intercontinental Hospital, Istanbul, Turkey
- School of Health Science, Nisantasi University, Istanbul, Turkey
- Department of Biostatistics, Ataturk University, Erzurum, Turkey
| | - Vecih Oduncu
- Bahçesehir University Hospital, İstanbul, Turkey
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29
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Celik M, Yilmaz Y, Kup A, Karagoz A, Kahyaoglu M, Cakmak EO, Celik FB, Sengor BG, Guner A, Izci S, Kilicgedik A, Candan O, Kahveci G, Gecmen C, Kaymaz C. Crochetage sign may predict late atrial arrhythmias in patients with secundum atrial septal defect undergoing transcatheter closure. J Electrocardiol 2021; 67:158-165. [PMID: 34246066 DOI: 10.1016/j.jelectrocard.2021.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Atrial arrhythmias are well-known complications of atrial septal defect (ASD), and associated with substantial morbidity. After ASD closure, right atrial and ventricular enlargement regresses, however, the risk of atrial arrhythmia development continues. In this study, we aimed to investigate the relationship between the Crochetage sign, which is a possible reflection of heterogeneous ventricular depolarization due to long-term hemodynamic overload, and the development of late atrial arrhythmia after ASD closure. METHODS This retrospective study included a total of 314 patients (mean age: 39.5 (30-50) years; male: 115) who underwent percutaneous device closure for secundum ASD. The study population was divided into two groups according to the presence or absence of the Crochetage sign. The Crochetage sign was defined as an M-shaped or bifid pattern notch on the R wave in one or more inferior limb leads. Cox-regression analysis was performed to determine independent predictors of late atrial arrhythmia development. RESULT Fifty-seven patients (18.1%) presented with late atrial arrhythmia. Of these 57 patients, 30 developed new-onset atrial fibrillation/atrial flutter (AF/AFL), and 27 patients with pre-procedure paroxysmal AF/AFL had a recurrence of AF/AFL during follow-up. History of paroxysmal AF/AFL before the procedure (HR: 4.78; 95% CI 2,52-9.05; p < 0.001), the presence of Crochetage sign (HR: 3.90; 95% CI 2.05-7.76; p < 0.001), and older age at the time of ASD closure (HR: 1.03; 95% CI 1.01-1.06; p = 0.002) were found as independent predictors for late atrial arrhythmia. CONCLUSION The presence of Crochetage sign may be used to predict the risk of late atrial arrhythmia development after transcatheter ASD closure.
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Affiliation(s)
- Mehmet Celik
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
| | - Yusuf Yilmaz
- Department of Cardiology, Istanbul Medeniyet Universty, Istanbul, Turkey
| | - Ayhan Kup
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Muzaffer Kahyaoglu
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ender Ozgun Cakmak
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Fatma Betul Celik
- Department of Cardiology, Istanbul Medeniyet Universty, Istanbul, Turkey
| | - Busra Guvendi Sengor
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ahmet Guner
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training & Research Hospital, Istanbul, Turkey
| | - Servet Izci
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Alev Kilicgedik
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Ozkan Candan
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Gokhan Kahveci
- Department of Cardiology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Cetin Gecmen
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- Department of Cardiology, Kartal Kosuyolu Heart and Research Hospital, Istanbul, Turkey
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30
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Celik M, Yilmaz Y, Karagoz A, Kahyaoglu M, Cakmak EO, Kup A, Celik FB, Karaduman A, Kulahcioglu S, Izci S, Gecmen C, Caliskan M. Anxiety Disorder Associated with the COVID-19 Pandemic Causes Deterioration of Blood Pressure Control in Primary Hypertensive Patients. Medeni Med J 2021; 36:83-90. [PMID: 34239759 PMCID: PMC8226403 DOI: 10.5222/mmj.2021.08364] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 03/08/2021] [Accepted: 05/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objective The new coronavirus disease (COVID-19) has spread rapidly all over the world and caused anxiety disorders. Recent studies have also shown that the prevalence of depression and anxiety increased during the COVID-19 outbreak. We aimed to evaluate the anxiety and depression levels during the pandemic and identify the effect of pandemic-related stress on blood pressure (BP) control in primary hypertensive patients. Method A total of 142 patients with primary hypertension (HT) who continued to use the same antihypertensive drugs before and during the pandemic were included in the study. Twenty-four -hour Ambulatory Blood Pressure Monitoring (ABPM) and the Hospital Anxiety and Depression Scale (HADS) questionnaire were applied to patients. We retrospectively reviewed 24-h ABPM records of the same patients for the year before the pandemic. Results Daytime, nighttime and 24 -hour-systolic blood pressure (SBP) levels as well as daytime, nighttime, and 24- hour-diastolic blood pressure (DBP) levels , were significantly elevated during the COVID-19 outbreak compared to the pre-pandemic period (p<0.001). Higher HADS-A scores (HADS-A ≥7) were significantly associated with much greater increase in BP compared to the patients with lower HADS-A scores. Conclusion Psychological stress due to the COVID-19 outbreak led to worsening of the regulation of BP in controlled hypertensive patients whose antihypertensive treatments did not change.
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Affiliation(s)
- Mehmet Celik
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Yusuf Yilmaz
- Istanbul Medeniyet University, Department of Cardiology, Istanbul, Turkey
| | - Ali Karagoz
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Muzaffer Kahyaoglu
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ender Ozgun Cakmak
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ayhan Kup
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Fatma Betül Celik
- Istanbul Medeniyet University, Department of Cardiology, Istanbul, Turkey
| | - Ahmet Karaduman
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Seyhmus Kulahcioglu
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Servet Izci
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Cetin Gecmen
- Kartal Kosuyolu Education and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mustafa Caliskan
- Istanbul Medeniyet University, Department of Cardiology, Istanbul, Turkey
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Demir S, Timucin Atayoglu A, Galeotti F, Garzarella EU, Zaccaria V, Volpi N, Karagoz A, Sahin F. Antiviral activity of different extracts of standardized propolis preparations against HSV. Antivir Ther 2021; 25:353-363. [DOI: 10.3851/imp3383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
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Efe SÇ, Karagoz A, Dogan C, Bayram Z, Kalkan S, Altıntas MS, Yuksel Y, Karabag T, Ayca B, Ozdemir N. Relative Fat Mass Index can be solution for obesity paradox in coronary artery disease severity prediction calculated by SYNTAX Score. Postgrad Med J 2020; 97:434-441. [PMID: 33310896 DOI: 10.1136/postgradmedj-2020-138926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/24/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The relation between body mass index (BMI) and coronary artery disease (CAD) extension remains controversial. A new score was developed to estimate body fat percentage (BFP) known as Relative Fat Mass (RFM) Index. This study aimed to evaluate the value of RFM Index in predicting the severity of the CAD, compared with other anthropometric measurements. METHODS A total of 325 patients with chronic CAD were investigated. RFM, BFP, BMI and other anthropometric characteristics of patients were measured before angiography. CAD severity was determined by SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery trial (SYNTAX) Score. The association between SYNTAX Score and variables was evaluated using linear regression models. In order to compare the model performance, R-squared (R2), Akaike's information criterion, Bayesian information criterion and root mean square error were used. RESULTS Univariate linear regression outcome variable, SYNTAX was used to determine whether there was any relationship between variables. Independent variables were included in the multivariable linear logistic regression models. The analysis showed that in model 1, RFM (β coefficient: 2.31 (0.90 to 3.71), p=0.001)), diabetes mellitus (β coefficient: 3.72 (1.67 to 3.76), p=0.004)), haemoglobin (β coefficient: -2.12 (-3.70 to -0.53), p=0.03) and age (β coefficient: 1.83 (0.29 to 3.37), p=0.02)) were statistically significant. The adjusted R2 values in model 1 were higher than model 2 (BFP) and model 3 (BMI) (0.155, 0.137 and 0.130, respectively), and χ2 values of RFM were higher than BFP and BMI (10.5, 3.4 and 1.0, respectively). CONCLUSION RFM Index is a more reliable and compatible marker of obesity in showing the severity of CAD compared to BMI.
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Affiliation(s)
- Süleyman Çağan Efe
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Cem Dogan
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Zubeyde Bayram
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | - Sedat Kalkan
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
| | | | - Yasin Yuksel
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Turgut Karabag
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Burak Ayca
- Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- Cardiology, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
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Keskin B, Tokgoz H, Akbal O, Hakgor A, Tanyeri S, Karagoz A, Turkday S, Kulahcioglu S, Tanboga I, Dogan C, Bayram Z, Ozdemir N, Kaymaz C. Syncope in relation to pulmonary arterial obstructive burden, hemodynamic status and short- and long-term outcome in patients with acute pulmonary embolism. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2278] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and aims
Although syncope (S) has been reported as one of the presenting findings in patients (pts) with acute pulmonary embolism (APE), its clinical and haemodynamic correlates and impacts on the long-term outcome in this setting remains to be determined. In this single-centre study we evaluated the clinical and haemodynamic significance of S in APE in initial asessment, and during short- and long-term follow-up period.
Methods
Our study was based on the retrospective and prospective analysis of the overall 641 pts (age 65 (51–74 IQR) yrs, 56.2% female) with diagnosis of documented APE who underwent anticoagulant (n=207), thrombolytic (n=164), utrasound-facilitated thrombolysis (UFT) (n=218) or rheolytic thrombectomy (RT) (n=52). The systematic work- up including multidetector computed tomography (MDCT), Echo, biomarkers, and PE severity indexes were performed in all pts, and Qanadli score (QS) was used as the measure of the thrombotic burden in the pulmonary arteries (PA).
Results
The S as the presenting symptom In 30.2% of pts with APE. At baseline assessment, S(+) vs S(−) APE subgroups had a significantly shorter symptom-diagnosis interval, a higher risk status according to the significant elevations in troponin T, D-dimer, the higher PE severity indexes, a more deteriorated right ventricle/left ventricle ratio (RV/LV r), right atrial/left atrial ratio (LA/RAr) and RV longitudinal function indexes including tricuspid annular planary excursion (TAPSE) and tissue velocity (St), a significantly higher PA obstructive burden as assessed by QS and PA pressures. Thrombolytic therapy (36.2% vs 21%, p<0.001) and RT (11.9% vs 6.47%, p=0.037) were more frequently utilized S(+) as compared to S(−) group. However, all these differences between two subgroups were found to disappear after evidence-based APE treatments. In-hospital mortality (IHM) (12.95% vs 6%, p=0.007) and minor bleeding (10.36% vs 2.9%, p<0.001) were significantly higher in S(+) pts as compared to those in S(−) subgroup. Binominal logistic regression analysis revealed that PESI score and RV/LVr independently associated with S while IHM was only predicted by age and heart rate. The COX proportional hazard method showed that RV/LVr at discharge and malignancy were independently associated with cumulative mortality during follow-up duration of 620 (200–1170 IQ) days.
Conclusions
The presence of S in pts with APE was found to be asociated with a higher PA obstructive burden, a more deteriorated RV function and haemodynamics and higher risk status which may need more agressive reperfusion treatments. However, in the presence of the optimal treatments, S did not predict neither in-hospital outcome, nor long-term mortality.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- B Keskin
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - H.C Tokgoz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - O.Y Akbal
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - A Hakgor
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - S Tanyeri
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - A Karagoz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - S Turkday
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - S Kulahcioglu
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - I.H Tanboga
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - C Dogan
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Z Bayram
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - N Ozdemir
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - C Kaymaz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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Tanyeri S, Tokgoz H, Keskin B, Akbal O, Karagoz A, Hakgor A, Bayram Z, Dogan C, Acar R, Kultursay B, Guner Z, Tanboga I, Ozdemir N, Kaymaz C. The reveal, reveal 2.0, compera and fphn risk scores in predciting the pah mortality: a single-centre study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2308] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
Several risk prediction models have been developed for risk assessment at the time of diagnosis and during follow-up in patients (pts) with pulmonary arterial hypertension (PAH). In this single-centre study we aimed to compare baseline REVEAL, REVEAL 2.0, COMPERA and FPHN risk scores in predicting the mortality in pts with PAH.
Methods
Study group comprised of 504 pts (age 54.4±18.9 years, female 64.4%) with PAH out of the overall 852 pts with pulmonary hypertension enrolled fourteen year period. Subgroups of PAH were as follows; IPAH (39%), CHD-PAH (51%), CTD-PAH (7.7%) and other PAH (3.3%). Functional-class (FC), six-minute-walking-distance (6MWD), pericardial effusion (PE), right atrial area (RAA), tricuspid-annular-planary-systolic-excursion (TAPSE) and systolic annular velocity (St), Echo and Catheter pulmonary artery mean presures (PAMP) and N-terminal-pro brain natriuretic-peptide (NT-proBNP) measures were evaluated at baseline and periodical control examinations with 6-months apart. Baseline assessments for REVEAL, REVEAL 2.0, COMPERA and FPHN risk scores were performed in all pts.
Results
In baseline assessment mean FC and 6MWD were 3 (3–4 IQR), and 230±100 m, repectively. Mean PAMP was 51.5±26 mm Hg, and pulmonary vascular resistance was 8.8±6.5 Wood units. Mono, dual and triple combination therapies were noted in 42%, 40%, and 18% of pts. Median follow-up time was (1470 (275–4840 IQR)) and overall all-cause mortality was 32.1%. Using the Cox proportional hazard model, likelihood ratio (LR) of scores and p values were as follows; REVEAL: 95.09 (p<0.001), REVEAL-2: 122.16 (p<0.001), COMPERA: 22.73 (p<0.001) and FPHN: 1.63 (p=0.210). Adding the TAPSE on REVEAL 2.0 score did not increase the LR of REVEAL 2.0.
When comparing the different combinations including REVEAL 2.0, with likelihood ratio test, the LR of REVEAL 2.0 plus TAPSE vs REVEAL 2.0 was 7.32 (p=0.12),
Conclusions
In this single-centre study, REVEAL 2.0 as compared to REVEAL, COMPERA and FPHN models provided the highest prediction for mortality, and adding the TAPSE on the REVEAL 2.0 scoring offered no additional benefit for risk assessment.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Tanyeri
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - H.C Tokgoz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - B Keskin
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - O.Y Akbal
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - A Karagoz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - A Hakgor
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Z Bayram
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - C Dogan
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - R.D Acar
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - B Kultursay
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Z.E Guner
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - I.H Tanboga
- Hisar Intercontinental Hospital, Cardiology, Istanbul, Turkey
| | - N Ozdemir
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - C Kaymaz
- Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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Hayıroğlu Mİ, Çinier G, Keser N, Uzun M, Karagoz A, Fak AS, Okuyan E, Altundaş C, Tekkesin I. Evaluation of websites reached using Google in the modern digital era related to approach to cholesterol. Turk Kardiyol Dern Ars 2020; 48:576-584. [PMID: 32955028 DOI: 10.5543/tkda.2020.40306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The Google search engine is widely used as a source of medical information; however, legal and medical governance of the accuracy of the content retrieved is lacking. The aim of this study was to assess the most read Turkish-language texts related to cholesterol during a specific period according to the validity of the content. METHODS Google Trends was queried on January 5, 2019 for the search term 'cholesterol' and the 9 other most popular search phrases used in Turkey that included the word cholesterol. In all, 100 links were obtained for each phrase, generating a total of 1000 links. Once duplicates were eliminated, a total of 604 links was used for the study. Since there is currently no validation scoring system for this purpose in the literature, the authors created a checklist according to well-accepted recent guidelines focused on cholesterol. The content of the texts acquired was classified as misleading, insufficient but favorable, or sufficient and favorable. RESULTS The source of the online texts studied was universities (n=8, 1.3%), hospitals (n=6, 0.9%), personal blogs (n=200, 33.1%), health websites (n=183, 30.2%), and medical journals (n=207, 34.2%). In all, 235 texts (38.9%) were classified as sufficient and favorable and 35 (5.7%) were categorized as misleading. A medical practitioner was named in 378 texts (62.5%). All of the results from universities and hospitals were ranked in the favorable group. A statistical difference in the word count was seen in a comparison of the misleading and favorable texts. CONCLUSION Google can connect users to a significant quantity of material related to cholesterol that includes a wide range from misleading information to sufficient and favorable texts. The variation in the quality of the content on websites accessible via Google necessitates that cholesterol resource material should be selected with great care.
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Affiliation(s)
- Mert İlker Hayıroğlu
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Göksel Çinier
- Department of Cardiology, Rize Kaçkar State Hospital, Rize, Turkey
| | - Nurgül Keser
- Department of Cardiology, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Mehmet Uzun
- Department of Cardiology, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, İstanbul Kartal Koşuyolu Training and Research Hospital, İstanbul, Turkey
| | - Ali Serdar Fak
- Department of Cardiology, Marmara University Faculty of Medicine, İstanbul, Turkey
| | - Ertugrul Okuyan
- Department of Cardiology, İstanbul Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - Can Altundaş
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
| | - Ilker Tekkesin
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
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Tanyeri S, Akbal OY, Keskin B, Hakgor A, Karagoz A, Tokgoz HC, Dogan C, Bayram Z, Kulahcioglu S, Erdogan E, Balaban I, Ceneli D, Acar RD, Tanboga IH, Ozdemir N, Kaymaz C. Impact of the updated hemodynamic definitions on diagnosis rates of pulmonary hypertension. Pulm Circ 2020; 10:2045894020931299. [PMID: 32922744 PMCID: PMC7457658 DOI: 10.1177/2045894020931299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 05/05/2020] [Indexed: 11/15/2022] Open
Abstract
We evaluated whether updated pulmonary hypertension definitive criteria proposed in sixth World Symposium on Pulmonary Hypertension had an impact on diagnosis of overall pulmonary hypertension and pre-capillary and combined pre- and post-capillary phenotypes as compared to those in European Society of Cardiology/European Respiratory Society 2015 pulmonary hypertension Guidelines. Study group comprised the retrospectively evaluated 1300 patients (age 53.1 ± 18.8 years, female 807, 62.1%) who underwent right heart catheterization with different indications between 2006 and 2018. Mean pulmonary arterial pressure ≥25 mmHg (European Society of Cardiology) and PAMP (mean pulmonary arterial pressure) >20 mmHg (World Symposium on Pulmonary Hypertension) right heart catheterization definitions criteria were used, respectively. For pre-capillary pulmonary hypertension, pulmonary artery wedge pressure ≤15 mmHg and pulmonary vascular resistance ≥3 Wood units criteria were included in the both definitions. Normal mean pulmonary arterial pressure (<21 mmHg), borderline mean pulmonary arterial pressure elevation (21–24 mmHg), and overt pulmonary hypertension (≥25 mmHg) were documented in 21.1, 9.8, and 69.1% of the patients, respectively. The pre-capillary and combined pre- and post-capillary pulmonary hypertension were noted in 2.9 and 1.1%, 8.7 and 2.5%, and 34.6 and 36.6% of the patients with normal mean pulmonary arterial pressure, borderline, and overt pulmonary hypertension subgroups, respectively. The World Symposium on Pulmonary Hypertension versus European Society of Cardiology/European Respiratory Society definitions resulted in a net 9.8% increase in the diagnosis of overall pulmonary hypertension whereas increases in the pre-capillary pulmonary hypertension and combined pre- and post-capillary pulmonary hypertension diagnosis were only 0.8 and 0.3%, respectively. The re-definition of mean pulmonary arterial pressure threshold seems to increase the frequency of the overall pulmonary hypertension diagnosis. However, this increase was mainly originated from those in post-capillary pulmonary hypertension subgroup whereas its impact on pre-capillary and combined pre- and post-capillary pulmonary hypertension was negligible. Moreover, criteria of pre-capillary pulmonary vascular disease and combined pre- and post-capillary phenotypes were still detectable even in the presence of normal mean pulmonary arterial pressure. The obligatory criteria of pulmonary vascular resistance ≥3 Wood units seems to keep specificity for discrimination between pre-capillary versus post-C pulmonary hypertension after lowering the definitive mean pulmonary arterial pressure threshold to 20 mmHg.
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Affiliation(s)
- Seda Tanyeri
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ozgur Y Akbal
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Berhan Keskin
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Aykun Hakgor
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ali Karagoz
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Hacer Ceren Tokgoz
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Cem Dogan
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Zubeyde Bayram
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Seyhmus Kulahcioglu
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Emrah Erdogan
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ismail Balaban
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Dogancan Ceneli
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Rezzan Deniz Acar
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Ibrahim H Tanboga
- Department of Biostatistics, Medical School, Ataturk University, Erzurum, Turkey.,Department of Cardiology, Nisantası University, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Nihal Ozdemir
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
| | - Cihangir Kaymaz
- University of Health Sciences, Kartal Kosuyolu Heart Education and Research Hospital, Istanbul, Turkey
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Uslu A, Kup A, Demir S, Balaban I, Gulsen K, Karagoz A, Kepez A, Akgun T. P1507Experience in chronical lead extraction with ablation catheter and snare via femoral route. Europace 2020. [DOI: 10.1093/europace/euaa162.311] [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: 11/13/2022] Open
Abstract
Abstract
Background
Transvenous lead extraction may become a complicated process and special sheath systems used for extraction may not be available in the laboratory. Transvenous lead extraction from femoral vein by using ablation catheter and snare may be an alternative and cost-effective method to transvenous lead extraction with specialized lead extraction sheaths. The aim of the present study is to evaluate the factors that may be associated with the use of transfemoral technique during extraction of chronically implanted leads.
Methods
We retrospectively analyzed consecutive patients who underwent transvenous extraction of pacemaker, cardiac resynchronization therapy (CRT) and intracardiac defibrillator (ICD) leads in our institution in between 01.01.2016 and 01.01.2019. The indications for lead extraction were based on the European Heart Rhythm Association recommendations. Manual traction was applied to all leads at the beginning of each case. If manual traction was not successful, a subclavian approach by using locking stylet (Liberator Universal Locking Stylet, Cook Medical) or femoral approach was used. Femoral approach was performed using the flexible 13F long sheath and a second sheath for ablation catheter. Ablation catheter was wrapped around the lead and the tip of the ablation catheter was caught with gooseneck snare. Downward traction was applied on the body of the lead by using ablation catheter and gooseneck snare complex to release either end of the lead.
Results
A total of 160 leads in 94 patients were extracted during the time interval between 01.01.2016 and 01.01.2019. The indications for extraction were cardiac device related pocket erosion and infection in 71 (75.6%) and lead failure in the 23 (24.4%) cases. Extracted system was ICD in 48 (51.1%), CRT in 9 (9.6%) and pacemaker in 37 (39.3%) cases. The median time from the preceding procedure was 62.5 (IQR:32.3- 95.3) months. Lead extraction was performed by manual traction in 35 (37.2%) patients, by locking stylet method in 7 (7.4%) and by femoral approach in 52 (55.3%) patients. Clinical success was achieved in 93 (98.9%) cases and all of the patients discharged uneventfully without a major complication as death, cardiac avulsion or tear requiring pericardiocentesis or emergent surgery. Procedural success with femoral approach was achieved in 51/52 (98%) patients (99 leads). Ordinal regression revealed the time from the preceding procedure as the only parameter that was significantly associated with the usage of femoral approach (OR:1.065 ( 95% CI 1.039-1.100) p < 0.001).
Conclusion
Based on our experience, transfemoral approach by using ablation catheter and gooseneck snare seems to be an effective and safe method for chronically implanted lead extraction. It may be particularly be useful when manual traction is unsuccessful and special toolkids are not available for extraction.
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Affiliation(s)
- A Uslu
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - A Kup
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - S Demir
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - I Balaban
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - K Gulsen
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - A Karagoz
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
| | - A Kepez
- Marmara University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
| | - T Akgun
- Kartal Kosuyolu Training and Research Hospital, Cardiology , Istanbul, Turkey
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Kocabay G, Yilmaz F, Karagoz A. A simple and inexpensive option in nonsurgical splenic artery aneurysm treatment by coronary bare metal stents. Int J Cardiovasc Acad 2020. [DOI: 10.4103/ijca.ijca_35_20] [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] Open
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Tasar O, Kocabay G, Karagoz A, Kalayci Karabay A, Karabay CY, Kalkan S, Kirma C. Evaluation of Left Atrial Functions by 2-dimensional Speckle-Tracking Echocardiography During Healthy Pregnancy. J Ultrasound Med 2019; 38:2981-2988. [PMID: 30927311 DOI: 10.1002/jum.15004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 03/04/2019] [Accepted: 03/07/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES We aimed to determine the effects of normal pregnancy on left atrial (LA) mechanics using 2-dimensional speckle-tracking echocardiography. METHODS A total of 47 healthy women with singleton pregnancies were prospectively enrolled in this study. A total of 4 visits, including each trimester and postpartum at 6 months, were planned. Echocardiographic studies were performed with a Vivid 7 device equipped with a 2.5-MHz transducer (GE Vingmed Ultrasound AS, Horten, Norway). RESULTS Although the LA reservoir phase strain showed a gradual decrease from the first trimester to the third trimester during pregnancy, the measurements in the postpartum period were found to return to initial levels (mean ± SD: first trimester, 40.3% ± 11.7%; second trimester, 37.5% ± 12.9%; third trimester, 33.5% ± 9.0%; postpartum, 42.1% ± 11.1%; P < .001). The LA pump function strain was also parallel to the LA reservoir strain and gradually decreased from the first trimester to the third trimester during pregnancy, and it was observed that rose to the initial level in the postpartum period (first trimester, 16.7% ± 7.4%; second trimester, 14.8% ± 5.5%; third trimester, 12.7% ± 4.3%; postpartum, 15.8% ± 5.5%; P < .001). CONCLUSIONS We prospectively determined normal reference values for LA deformation parameters using speckle-tracking echocardiography in each trimester and the postpartum period in healthy pregnancy. These reference values may help identify subclinical LA dysfunction in several cardiovascular or systemic conditions. According to this study, these parameters decreased toward the third trimester during pregnancy and recovered in the postpartum period.
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Affiliation(s)
- Onur Tasar
- Department of Cardiology, Elazig Research and Training Hospital, Elazig, Turkey
| | - Gonenc Kocabay
- Department of Cardiology, Istanbul University-Cerrahpasa, Faculty of Health Science, Istanbul, Turkey
| | - Ali Karagoz
- Department of Cardiology, Istanbul Kartal Kosuyolu Heart Center, Istanbul, Turkey
| | - Arzu Kalayci Karabay
- Department of Cardiology, Istanbul Kartal Kosuyolu Heart Center, Istanbul, Turkey
| | - Can Yucel Karabay
- Department of Cardiology, Doktor Siyami Ersek Heart Center, Istanbul, Turkey
| | - Sedat Kalkan
- Department of Cardiology, Istanbul Kartal Kosuyolu Heart Center, Istanbul, Turkey
| | - Cevat Kirma
- Department of Cardiology, Istanbul Kartal Kosuyolu Heart Center, Istanbul, Turkey
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Tanyeri S, Akbal OY, Keskin B, Hakgor A, Karagoz A, Tokgoz HC, Kulahcioglu S, Erdogan E, Tanboga IH, Dogan C, Acar RD, Ozdemir N, Kaymaz C. P6469Predictive value of currently available echocardiographic work-up algorithm for previous and updated pulmonary hypertension definitions. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1061] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aim
In this study we evaluated the predictive value of currently available European Society of Cardiology 2015 Pulmonary Hypertension (PH) Guidelines two-step echocardiographic (Echo) work-up algorithm for two PH definitions as invasively evaluated pulmonary arterial mean pressures (PAMP) ≥25 mmHg and >20 mmHg.
Methods
Study group comprised the retrospectively evaluated 1299 patients (pts) (53.1±18.8 years, female 807, 62.1%) who underwent right heart catheterisation (RHC) with different indications between 2006 and 2018. Echo data obtained from same day and pre-RHC evaluation were available in all pts. Chemla method was used for Doppler estimation of PAMP from tricuspid regurgitant jet. For two PH definitions as PAMP ≥25 mmHg (definition-A) and PAMP >20 mmHg (definition-B) predictive value of the ESC Echo algorithm was tested with two logistic regression models based on only PAMP-Echo (Model-1) and PAMP-Echo and Echo findings supportive for PH (Model-2).
Results
RHC revealed that criteria for PH definitions A and B were met in 891 (68.6%) and 1051 (80.9%) of overall pts. Pre-RHC Echo findings supportive for PH were noted in 529 (40.7%) of pts. Because pulmonary regurgitant velocity data were imprecise, other 6 supportive Echo findings were utilised. The % of the supportive Echo measures were as follows; 1 (11%), 2 (10%),3 (8.1%), 4 (7.2%), 5 (2.5%) and 6 (1.8%). In Model-1, for definitions A and B, odds ratio (OR) of PAMP-Echo were (1.07; 0.99–1.19, p=0.058, LRX2:139, c: 0.72) and (1.05; 0.98–1.12, p=0.102, LRX2:129, c: 0.71), respectively.
In Model-2, for definition-A, OR of PAMP-Echo and number of supportive findings were (1.05; 0.98–1.12, p=0.162) and (1.58; 1.42–1.75, p<0.001) (LRX2:217, c: 0.77), respectively. Using the same model for definition-B, OR of PAMP-Echo and number of supportive findings were (1.04; 0.97–1.11, p=0.264) and (1.56; 1.40–1.73, p<0.001),(LRX2:203, c: 0.76), respectively. Receiver operating curve (ROC) analysis yielded that PAMP-Echo >39.8 mmHg had a sensitivity of 80% and a specificity of 54% for definition-A, and a sensitivity of 81% and a specificity of 52% for definition-B, respectively. Regardless of the definition tresholds for PH on RHC, number of supportive Echo findings were responsible for nearly 70% of the overall variance in the PH diagnosis.
Conclusions
Irrespective of the RHC definition criteria as PAMP ≥25 mmHg or >20 mmHg, number of supportive Echo findings but not PAMP-Echo only approach seems to be reliable in the diagnostic work-up for PH.
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Affiliation(s)
- S Tanyeri
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - O Y Akbal
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - B Keskin
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - A Hakgor
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - A Karagoz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - H C Tokgoz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - S Kulahcioglu
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - E Erdogan
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - I H Tanboga
- Nisantasi University, Cardiology, Istanbul, Turkey
| | - C Dogan
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - R D Acar
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - N Ozdemir
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - C Kaymaz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
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Tanyeri S, Keskin B, Akbal OY, Hakgor A, Karagoz A, Tokgoz HC, Dogan C, Acar RD, Bayram Z, Kulahcioglu S, Erdogan E, Tanboga IH, Ozdemir N, Kaymaz C. P4689How is the impact of updated hemodynamic definitions on frequencies of overall pulmonary hypertension and pre-capillary pulmonary hypertension as compared to those with previous criteria. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1070] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and aim
In this study we evaluated the impact of the updated pulmonary hypertension (PH) definitive criteria proposed in 6th World PH Symposium (WSPH) on numbers and frequencies of and pre- versus post-capillary PH as compared to those in European Society of Cardiology (ESC) 2015 PH Guidelines.
Methods
Study group comprised the retrospectively evaluated 1299 patients (pts) (age 53.1±18.8 years, female 807, 62.1%) who underwent right heart catheterisation (RHC) with different indications between 2006 and 2018. For ESC and WSPH PH definitions, pulmonary arterial mean pressure (PAMP) ≥25 mmHg (definition-A) and PAMP >20 mmHg (definition-B) RHC criteria were used, respectively. For pre-capillary PH definitions, pulmonary artery wedge pressure (PAWP) ≤15 mmHg and pulmonary vascular resistance (PVR) ≥3 Wood units criteria were included in the both definitions.
Results
In RHC assessments, PAMP ≥25 mmHg and >20 mmHg were noted in 891 (68.6%) and 1051 (80.9%) of overall pts, respectively. Moreover, pre-capillary PH was diagnosed in 284 (21.8%) and 298 (22.9%) with definition-A and B, respectively. Although updated WSPH definition was associated with a net 12.3% and a relative 18% increase in the overall PH diagnosis, net and relative changes in the frequency of the pre-capillary PH were only 1% and 4.9%. Increase in the overall PH with updated WSPH criterias compared to previous ESC definitions was associated with increase in the number of pre-capillary PH (n=298, 22.9%) but not in the overall frequency of post-capillary PH (688, 52.9%). Because PVR was the product of the transpulmonary gradient (PAMP minus PAWP) divided by cardiac output, this measure was found to keep specificity for distinction between pre- versus post-capillary PH even after lowering thetreshold diagnostic for PAMP from 25 to 20 mmHg.
Conclusions
Although updated WSPH definition was associated with net 12.3% and relative 18% increase in the overall PH diagnosis, its impact on frequencies of pre- versus post-capillary PH within overall PH population was negligible.These seem to be due to critical role of PVR ensuring specificity in pre-capillary PH diagnosis even after lowering the definitive PAMP treshold to 20 mmHg.
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Affiliation(s)
- S Tanyeri
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - B Keskin
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - O Y Akbal
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - A Hakgor
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - A Karagoz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - H C Tokgoz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - C Dogan
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - R D Acar
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - Z Bayram
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - S Kulahcioglu
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - E Erdogan
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - I H Tanboga
- Nisantasi University, Cardiology, Istanbul, Turkey
| | - N Ozdemir
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
| | - C Kaymaz
- Kartal Kosuyolu Heart and Research Hospital, cardiology, Istanbul, Turkey
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Coner A, Saracoglu E, Akdeniz A, Ozkan H, Tuluce K, Gul M, Coskun FY, Kurt D, Karagoz A, Karaarslan O, Gok G, Ozdogan O, Ozpelit E, Ozer SF, Zoghi M. P3622Demographic and clinical characteristics of atrial fibrillation patients suffering from an ACS without prior revascularization history. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0480] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of atrial fibrillation in acute coronary syndromes (ACS) ranges from 3% to 25%. The purpose of the current study was to investigate the demographic and baseline clinical characteristics, cardiovascular risk factors and comorbid conditions between patients (pts) with concomitant atrial fibrillation (AF) to those without AF in patients suffering from ACS without previous coronary artery bypass graft (CABG) and/or percutaneous coronary intervention.
Methods
The MINOCA-TR study has a cross-sectional, multicenter, observational design and was conducted with 32 interventional cardiology centers in our country. Heart rhythm at emergency admission, demographical, clinical and angiographic data was recorded for each patient. Patients with stable coronary artery disease, unstable angina pectoris and with type 4/5 myocardial infarction were excluded from study population.
Results
A total of 1626 patients (male: 70.7%, mean age: 61.4±12.5 years) were classified according to the presence of AF. The rate of AF was 3.1% in study population. This group was older (73.4 vs. 61.0 years, p<0.001) and AF was more common among females (43.1% vs. 28.7%, p=0.027). The frequency of AF was slightly higher (7.8%) in MINOCA group (p=ns).
STEMI presentation was more common in patients without AF (31.3% vs. 46.9%, p=0.028). LVEF was significantly lower in ACS patients with AF (44.1% vs. 49.4%, p=0.039). The frequency of AF was significantly higher (3.7%) in MINOCA group.
AF vs. non-AF ACS pts w/o prior revasc Parameter ACS with AF ACS without AF p value Age (years) 73.4 (±9.4) 61.0 (±12.4) <0.001 Female (%) 43.1 28.7 0.027 cTnT levels (pg/dL) median (IQR) 15.2 (96) 15.3 (428) 0.421 STEMI (%) 31.3 46.9 0.028 LVEF (%) 44.1 (±12.2) 49.4 (±10.4) 0.039 MINOCA (%) 7.8 6.6 0.743 STEMI: ST-segment elevation MI; NSTEMI: Non-ST-segment elevation myocardial infarction; LVEF: left ventricular ejection fraction; MINOCA: Myocardial Infarction with Non-Obstructive Coronary Arteries.
Conclusions
The frequency of AF was relatively lower in patients suffering from an ACS without prior revascularization history. They were older than patients without AF and were common in females. Non-ST-segment elevation myocardial infarction was significantly higher in the AF. The presence of MINOCA was similar between 2 groups.
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Affiliation(s)
- A Coner
- Baskent University Hospital Alanya Application and Research Center, Cardiology, Antalya, Turkey
| | - E Saracoglu
- Doctor Ersin Arslan Research and Training Hospital, Cardiology, Gaziantep, Turkey
| | - A Akdeniz
- Bursa Yuksek Ihtisas Research and Training Hospital, Cardiology, Bursa, Turkey
| | - H Ozkan
- Medical Park Hospital, Cardiology, Bursa, Turkey
| | - K Tuluce
- Cigli Research and Training Hospital, Cardiology, Izmir, Turkey
| | - M Gul
- Aksaray University, Cardiology, Aksaray, Turkey
| | - F Y Coskun
- Gaziantep University, Cardiology, Gaziantep, Turkey
| | - D Kurt
- Giresun University, Cardiology, Giresun, Turkey
| | - A Karagoz
- Giresun University, Cardiology, Giresun, Turkey
| | - O Karaarslan
- Hitit University Erol Olcok Research and Training Center, Cardiology, Corum, Turkey
| | - G Gok
- Mardin State Hospital, Cardiology, Mardin, Turkey
| | - O Ozdogan
- Tepecik Training and Research Hospital, Cardiology, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | - S F Ozer
- Necmettin Erbakan University, Cardiology, Konya, Turkey
| | - M Zoghi
- Ege University, Cardiology, Izmir, Turkey
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Dogan C, Bayram Z, Karagoz A, Bakal RB, Erdogan E, Yilmaz F, Akbal OY, Acar RD, Aktemur T, Guvendi B, Karaduman A, Hakgor A, Kaymaz C, Ozdemir N. Is elevated triglyceride high density lipoprotein cholesterol ratio a risk factor that causes acute coronary syndrome to appear earlier? ACTA ACUST UNITED AC 2019; 119:770-775. [PMID: 30686016 DOI: 10.4149/bll_2018_140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to assess the relationship between the triglyceride/high density lipoprotein cholesterol ratio and the risk of acute myocardial infarction in young adults. PATIENTS AND METHODS A total of 621 patients, who underwent coronary angiography (CAG) due to Myocardial Infarction (MI) at our hospital were included in this study. Demographic characteristics, risk factor profile, laboratory test results, electrocardiographic and CAG findings were assessed in the selected groups. RESULTS Total cholesterol, triglyceride/high density lipoprotein cholesterol (Tg/HDL) ratio, Tg levels, were higher in younger patients with MI, while glucose and high-density lipoprotein levels were lower. Using propensity score matching in the matched population comparing young patients to the older ones, serum triglyceride levels [179 (145-231) vs 148 (101-197)] and triglyceride to high density lipoprotein cholesterol ratio [5.8 (4.1-9.1) vs 3.0 (1.8-4.6)] were significantly higher, whereas high density lipoprotein levels were observed dramatically lower (32.6 ± 8.2 vs 41.7 ± 8.8). CONCLUSION This study demonstrated that Tg/HDL ratio may be an important predictor for an acute coronary syndrome in the young adult population. Tg/HDL ratio can be used to prevent MI in young adults (Tab. 3, Fig. 1, Ref. 32.).
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Kaymaz C, Akbal OY, Hakgor A, Tokgoz HC, Karagoz A, Tanboga IH, Tanyeri S, Keskin B, Turkday S, Demir D, Dogan C, Bayram Z, Acar RD, Guvendi B, Ozdemir N, Tapson VF, Konstantinides S. A five-year, single-centre experience on ultrasound-assisted, catheter-directed thrombolysis in patients with pulmonary embolism at high risk and intermediate to high risk. EUROINTERVENTION 2018; 14:1136-1143. [DOI: 10.4244/eij-d-18-00371] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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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Abstract
Objective The aim of this study was to investigate the accuracy of bedside lung ultrasound (BUS) in the diagnosis of community-acquired pneumonia (CAP) in patients with dyspnoea presenting to the emergency department (ED) and to analyse the characteristic sonographic findings of CAP. Methods After a six-hour training program, BUS procedures were performed between October 2011 and February 2012 to prospectively evaluate patients presenting to the ED with dyspnoea. Chest X-ray (CXR) or computerised tomography (CT) were ordered, depending on the presence of consolidation signs on CXR. The outcome was determined by consolidation findings on CXR or CT. BUS results were compared using Chi-squared testing. Results Of the 112 enrolled patients with dyspnoea, 40 patients were excluded and 72 were included in the study. Thirty-four patients were BUS positive. Of these, CXR or CT findings agreed with the BUS findings in 27 patients. In 38 cases, BUS was negative, and one patient was diagnosed with pneumonia based on the CT report. The sensitivity, specificity, PPV, NPV, and the positive and negative likelihood ratios for BUS were 96.4%, 84.1%, 79.4%, 97.4%, 6.1 and 0.042, respectively. The diagnostic accuracy of BUS was 89%. The presence of consolidation signs, either shred or hepatisation, were the most frequent sonographic findings in our study. Conclusions Acute alveolar consolidation can be diagnosed easily by performing BUS with high degree of accuracy in EDs.
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Affiliation(s)
| | | | | | | | - KH Olow
- Benadir University, Faculty of Medicine and Surgery, Mogadishu/Somalia
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Bezgin T, Elveran A, Karagoz A, Canga Y, Dogan C. Parathyroid hormone is associated with heart failure with preserved ejection fraction. ACTA ACUST UNITED AC 2017; 117:442-7. [PMID: 27546695 DOI: 10.4149/bll_2016_086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in patients who suffered heart failure with preserved ejection fraction (HFpEF). OBJECTIVE We aimed to investigate the association of serum PTH levels and measures of disease severity (NYHA functional class, NT-proBNP, CRP, EF, Troponin I) in patients with HFpEF. METHODS A total of consecutive 58 outpatients with HFpEF and 30 controls were prospectively studied. All patients underwent laboratory tests, including NT-proBNP and PTH analyses. RESULTS PTH, NT-proBNP, troponin I, and CRP levels were significantly higher in patients with HFpEF when compared with control group (54.61 ± 31.02 vs 40.40 ± 14.22 pg/ml, p < 0.05; 126.05 ± 162.94 vs 44.57 ± 14.95 pg/ml, p < 0.01; 0.011 ± 0.013 vs 0.004 ± 0.001 ug/L, p < 0.01; 4.65 ± 4.24 vs 1.63 ± 0.97 mg/L, p < 0.01, respectively). Left atrium was found to be more enlarged in HFpEF patients (LAVI = 36 ± 18 vs 28 ± 11 ml/m², p < 0.01). Most indices of left ventricular diastolic function were more severely impaired compared to controls (p < 0.05). There was no correlation between PTH and CRP, troponin I, LVMI, LV volumes, LV diameters, E/E', age, and BMI in both groups (p = NS). There was strong positive correlation between PTH and NT-proBNP levels in all study participants (r = 0.359; p < 0.01). CONCLUSION PTH together with other markers of heart failure may provide valuable information both in the diagnosis and staging of heart failure syndromes (Tab. 4, Fig. 1, Ref. 40).
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Ozcan G, Dagdeviren Ozsoylemez O, Akman G, Khalilia W, Tezel Yetiz B, Karagoz A, Melikoglu G, Anil S, Kultur S, Sutlupinar N. Screening for antitumor activity of various plant extracts on HeLa and C 4-I cell lines. J BUON 2016; 21:1552-1560. [PMID: 28039722] [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: 06/06/2023]
Abstract
PURPOSE Cancer is a long process that leads the organism to death and is associated with the normal cells acquiring the ability to divide permanently. Nowadays, the use of natural products in cancer therapy has a great importance. In addition, working with plants that are endemic to Turkey and determining the biological activities of these plant extracts, is extremely important due to the potential for new drug development. There is no comparative study available in the literature on the antitumor effects of Colchicum sanguicolle, a new found species of the genus Colchicum in Turkey, Crateagus microphylla, of the genus Crateagus and Centaurea antiochia of the genus Centaurea. In this study, we tried to demonstrate the antitumor effect of these plant extracts on HeLa and C 4-1 cells. METHODS Five different doses (0.001, 0.01, 0.05, 0.25 and 0.5 mg/ml) of the three plant types were prepared and applied for 24, 48 and 72 hrs on the cervical cancer derived cell lines. Subsequently, the growth rate was evaluated with the mitochondrial dehydrogenase enzyme method. RESULTS Colchicum sanguicolle extracts showed the most effective antitumor activity. For the Colchicum sanguicolle extract, the IC50 dose for HeLa cells was 0.01 mg/ml at 48 hrs, while for the C-4 I cells it was 0.001 mg/ml at 48 hrs. These results showed that C-4 I cells were more sensitive to the Colchicum sanguicolle extracts. Conclus?on: The results of from this study regarding the antitumor effect of plant extracts of endemic varieties of Turkey may have an important place in design and development of anticancer drugs and would make contributions to other studies to be conducted in this area.
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Affiliation(s)
- Gul Ozcan
- Department of Biology, Istanbul University, Faculty of Science, Istanbul, Turkey
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Tas E, Genc H, Nacir B, Karagoz A. AB1000 Evaluation of The Presence and Frequency of Neuropathic Pain Component in Myofascial Pain Syndrome. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5990] [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]
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49
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Tugba Artun F, Karagoz A, Ozcan G, Melikoglu G, Anil S, Kultur S, Sutlupinar N. In vitro anticancer and cytotoxic activities of some plant extracts on HeLa and Vero cell lines. J BUON 2016; 21:720-725. [PMID: 27569095] [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: 06/06/2023]
Abstract
PURPOSE The aim of our study was to evaluate the effect of in vitro anticancer and cytotoxic activity of the methanolic extracts of 14 medicinal plants, 8 of which are endemic species in Anatolia, against the human HeLa cervical cancer cell line and to compare to the normal African green monkey kidney epithelial cell line (Vero) using the MTT colorimetric assay. METHODS Values for cytotoxicity measured by MTT assay were expressed as the concentration that causes 50% decrease in cell viability (IC50, μg/mL). The degree of selectivity of the compounds can be expressed by its selectivity index (SI) value. High SI value (>2) of a compound gives the selective toxicity against cancer cells (SI = IC50 normal cell/IC50 cancer cell). RESULTS Dose-dependent studies revealed IC50 of 293 mg/mL and >1000 mg/mL for Cotinus coggygria Scop., IC50 of 265 μg/mL and >1000 mg/mL for Rosa damascena Miller, IC50 of 2 μg/mL and 454 mg/mL for Colchicum sanguicolle K.M. Perss, IC50 of 427 μg/mL and >1000 μg/mL for Centaurea antiochia Boiss. var. praealta (Boiss & Bal) Wagenitz on the HeLa cells and the Vero cells, respectively. Four plants showed significant SI values which were 227 for Colchicum sanguicolle K.M. Perss (endemic species), >3.8 for Rosa damascena Miller, >3.4 for Cotinus coggygria Scop. and >2.3 for Centaurea antiochia Boiss. var. praealta (Boiss & Bal)Wagenitz (endemic species). CONCLUSION According to our study, 4 methanolic extracts of 14 tested plants exhibit greater activity on the HeLa cell line and little activity on the Vero cell line, meaning that these plants can be evaluated for potential promising anticancer activity.
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50
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Turkmen K, Karagoz A, Kucuk A. Sirtuins as novel players in the pathogenesis of diabetes mellitus. World J Diabetes 2014; 5:894-900. [PMID: 25512793 PMCID: PMC4265877 DOI: 10.4239/wjd.v5.i6.894] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/04/2014] [Accepted: 10/10/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus (DM) is a systemic and complex disease with micro and macrovascular complications that result from impaired metabolic pathways and genetic susceptibilities. DM has been accepted as an epidemic worldwide during the last two decades. A substantial gap in our knowledge exists regarding the pathophysiology of this metabolic disorder despite the improved diagnostic tools and therapeutic approaches. Sirtuins are a group of NAD+ dependent enzymes that are involved in cellular homeostasis due to their deacetylating activity. In the present review, we aimed to discuss the role of associated sirtuins in the pathogenesis and treatment of diabetes mellitus.
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